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Module 2 Anatomy > Oro-facial lymphatics > Flashcards

Oro-facial lymphatics Flashcards

1
Q

The lymphatic system consists of 4 components. What are these components?

A
  1. organs (bone marrow, spleen and thymus)
  2. lymphatic vessels (e.g. thoracic duct)
  3. lymph nodes
  4. mucosa-associated lymphoid tissue (MALT eg “tonsils”)
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2
Q

What are the 3 functions of the lymphatic system?

A
  1. Removes excess fluid (interstitial/tissue fluid) from the tissues of the body and returns it (as lymph) to the venous system.
  2. Carries fats from the GI tract to the venous system.
  3. Produces immune cells (lymphocytes, plasma cells & monocytes) in the defence against infection and cancer.
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3
Q

What is the difference between tissue fluid and lymph?

A

Tissue fluid and lymph are essentially the same thing; however lymph is the name of tissue fluid when taken up into a lymphatic vessel.

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4
Q

In the lymphatic system, where does the arterial blood head?

A

Towards the capillary bed

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5
Q

In the lymphatic system, what happens to the deoxygenated blood?

A

It is taken away from the capillary bed

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6
Q

What do lymph nodes contain?

A

Lymphocytes and macrophages.

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7
Q

What is the major lymphatic vessel in the body responsible for?

A

It’s responsible for returning lymph to large veins in the neck.

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8
Q

Where does the thoracic duct drain into?

A

The left venous angle

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9
Q

What makes up the venous angle?

A

Internal jugular vein and subclavian vein

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10
Q

Approximately how much tissue fluid is reabsorbed (taken back into capillary) daily?

A

16 - 18 litres

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11
Q

Approximately, how much lymph is produced daily and returned to blood at venous angles?

A

2 - 4 litres

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12
Q

Approximately how much lymph is produced daily in the head and neck?

A

400ml

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13
Q

What is Elephantiasis?

A

Elephantiasis is the accumulation of a fluid called lymph in the affected areas.

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14
Q

What is Elephantiasis caused by?

A

Elephantiasis is caused by obstruction of the lymphatic system.

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15
Q

What is Oedema?

A

Excess / abnormal collection of fluid in tissues.

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16
Q

What happens to all of the lymph as it is passed through the lymph nodes?

A

It is filtered.

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17
Q

What is lymph screened for?

A

Lymph is screened for infectious agents and cancer cells by the lymphocytes and macrophages in the lymph nodes

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18
Q

What happens to the lymph node as a result of it attempting to fight against an infection in the lymph?

A

It produces germinal centres, enlarges and becomes painful due to its capsule stretching

19
Q

A secondary tumour may grow in the node. What is the name of the development of this tumour?

A

Metastasis.

20
Q

Which group of nodes are the first to receive lymph from any given structure/area?

A

Regional lymph nodes (eg. tip of tongue)

21
Q

The lymph nodes of the head and neck are described in 2 groups; name these two groups.

A
  1. The superficial ring

2. The deep cervical nodes.

22
Q

Where is the superficial ring group located?

A

The superficial ring group of nodes are located superficially- you can palpate these lymph nodes.

23
Q

Where are the deep cervical nodes located?

A

The deep cervical nodes are located deep to sternocleidomastoid muscle- these nodes are not directly palpable.

24
Q

How would you describe the orientation of the Superficial Ring of Regional Lymph Nodes?

A

They are arranged in a scarf- like orientation.

25
Q

What structures are drained in the lymphatic drainage of superficial structures of the head & neck?

A

Scalp, face, superficial upper neck

26
Q

What 7 nodes are associated with the superficial ring of regional lymph nodes?

A
  1. occipital nodes
  2. mastoid nodes
  3. superficial cervical nodes
  4. parotid nodes
  5. buccal nodes
  6. submental nodes
  7. submandibular nodes
27
Q

What do the superficial cervical nodes accompany?

Where is this situated?

A

They accompany the external jugular vein, and are situated on top of sternocleidomastoid.

28
Q

What do the deep cervical lymph nodes accompany?

Where is this situated?

A

Deep cervical lymph nodes accompany internal jugular vein and are located deep to the sternocleidomastoid-opposite to superficial cervical lymph nodes

29
Q

What nodes are associated with the deep cervical nodes?

A
  1. retro-pharyngeal nodes
  2. submental nodes
  3. submandibular

note: submental and submandibular nodes cross both superficial and deep.

30
Q

What are the 5 kinds of tonsils and where are they found?

A
  1. palatine tonsil “tonsil”: found in oropharynx
  2. “palate associated lymphoid tissue”
  3. pharyngeal tonsil “adenoid”: found in nasopharynx
  4. tubal tonsil: found in nasopharynx
  5. lingual tonsil: found in oropharynx
31
Q

As tonsils are the first site of encounter with inhaled and ingested micro-organisms, what are they considered as?

A

They are considered as the first line of defence against exogenous aggressors.

32
Q

The generation of __________ in the germinal centres of the tonsil is one of the most essential tonsillar functions.

A

B cells.

33
Q

What is the ring of tonsil/lymphoid tissue known as?

A

Waldeyer’s ring

34
Q

Lymph from the palatine tonsil drains to one specific deep cervical lymph node.

What is the name of this node?

A

The jugulo-digastric node.

35
Q

What happens to this node in response to infection? (eg. tonsilitis)

A

It enlarges.

36
Q

Where is the jugulo-digastric node located?

A

Located in posterior belly of digastric muscle.

37
Q

When looking at the lymphatic drainage of the tongue,
where does the middle anterior section of the tongue drain to?

Is this drainage bilateral or unilateral?

A

The middle anterior section of the tongue drains to
the inferior deep cervical nodes.

This drainage is bilateral.

38
Q

Where do the sides of the anterior section of the tongue drain to?

Is this drainage bilateral or unilateral?

A

The sides drain UNI-laterally to submandibular nodes.

Note: unilateral means the right side will only drain to right submandibular nodes and the left side would only drain to left submandibular nodes.

39
Q

Where does the tip of the anterior section of the tongue drain to?

Is this drainage bilateral or unilateral?

A

The tip of the tongue drains BI-laterally to submental nodes.

40
Q

Where does the posterior 1/3rd of the tongue drain to?

Is this drainage bilateral or unilateral?

A

The posterior 1/3rd of the tongue drains BI-laterally to superior deep cervical nodes.

41
Q

If a patient suffers from an infection (eg. dental abscess), what symptoms might they experience in their lymph nodes?

What could be prescribed to treat the infection?

A
  • swollen
  • painful
  • soft
  • smooth
  • not fixed (stuck to) adjacent structures

Antibiotics can be prescribed as treatment.

42
Q

If a patient suffers from a cancer (eg. of tongue or gingivae), what symptoms might they experience in their lymph nodes?

A
  • swollen
  • not painful
  • hard
  • irregular
  • fixed
  • do not improve
43
Q

What should the full examination of the dental patient include?

A

The full examination of the dental patient should include an assessment of the submental, submandibular and deep cervical lymph nodes.

44
Q

What groups of lymph nodes can be examined?

A 
submental
submandibular
parotid
mastoid
occipital
deep cervical (including jugulo-digastric)
superficial cervical  nodes

Module 2 Anatomy (6 decks)

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