Session 3: Lymphatic Drainage Of The Head And Neck

Question 1

What happens to fluid if hydrostatic pressure is greater than oncotic pressure?

Answer 1

Fluid moves from the capillary to the interstitium

Question 2

T/F: net filtration of fluid is equal to net reabsorption of fluid at the capillaries

Answer 2

False

Question 3

What is the significance of lymphatic vessels having more porous walls than blood capillaries?

Answer 3

It’s easier for proteins to pass into lymphatics than it is for them to pass back into blood

Question 4

How much lymph is produced by the body a day?

Answer 4

3-4Litres

Question 5

What is the importance of lymphatic vessels?

Answer 5

They remove remaining tissue fluid from the interstitium and deliver it back to blood circulation

Question 6

Why does fluid move from the lymphatics to the venous system?

Answer 6

Venous blood has a lower pressure than the lymph (fluid moves down a concentration gradient)

Question 7

Why will the flow of lymph slow at the nodes?

Answer 7

Allows for filtration

Question 8

What are the two lymphatic ducts called?

Answer 8

Thoracic (left) and right

Question 9

How is unidirectional flow maintained in the lymphatic system?

Answer 9

Valves

Passive and intrinsic constriction

Question 10

What major vessels do the lymphatic ducts drain into?

Answer 10

Subclavian veins

Question 11

What causes lymphoedema?

Answer 11

The abnormal collection of protein rich fluid in the interstitium

Question 12

How can you differentiate lymphoedema from other oedema?

Answer 12

It will pit and is usually unilateral and very large

Question 13

Describe the structure of a lymph node in regards to CT structures

Answer 13

Tough fibrous outer capsule with reticular connective tissue inside

Question 14

Give three ways in which lymph nodes provide defence against infection

Answer 14

Physical filter
Phagocytise foreign material
Contain lymphocytes - activated on exposure to foreign antigens

Question 15

For what two reasons may a lymph node be enlarged?

Answer 15

During an infection

Malignancy

Question 16

What will an enlarged lymph node in infection feel like?

Answer 16

Tender and mobile

Question 17

What are the two classifications of lymph nodes?

Answer 17

Regional

Terminal

Question 18

Give three regions where you can normally palpate lymph nodes

Answer 18

Neck
Armpit
Groin

Question 19

What separates the regional and terminal lymph nodes in the neck?

Answer 19

The investing layer

Question 20

Which lymph node drains parts of the eye?

Answer 20

Pre auricular

Question 21

Where are the terminal lymph nodes of the neck found?

Answer 21

Within the carotid sheath

Question 22

Name the five superficial lymph nodes of the head

Answer 22

Sub-mental
Sub-mandibular
Pre-auricular
Mastoid (or post-auricular)
Occipital

Question 23

Name three deep cervical lymph nodes

Answer 23

Jugulo-digastric
Jugulo-omohyoid
Supraclavicular

Question 24

What region do the supraclavicular lymph nodes drain?

Answer 24

The abdominal cavity

Question 25

Which two superficial lymph nodes are closely associated with the EJV?

Answer 25

Superficial cervical and posterior cervical

Question 26

What name is given to the left of the supraclavicular lymph nodes?

Answer 26

Virchow’s node

Question 27

Where does the right supraclavicular lymph node drain?

Answer 27

The mid section of the chest, oesophagus and lungs

Question 28

What regions does the jugulo-digastric node drain?

Answer 28

The palatine tonsil, oral cavity and tounge

Question 29

What is Troiser’s sign?

Answer 29

An enlarged and hard left supraclavicular lymph node - secondary to metastatic abdominal malignancy

Question 30

Where does the jugulo-omohyoid node drain?

Answer 30

The tounge, oral cavity, trachea and thyroid gland

Question 31

Name the four tonsils of Waldeyer’s ring

Answer 31

Palatine
Tubal
Pharyngeal
Lingual

Question 32

Which tonsils are readily visible on examination of the oropharynx?

Answer 32

Palatine tonsils

Lingual tonsils

Question 33

What is the purpose of Waldeyer’s ring?

Answer 33

To act as a line of defence against microbes entering through the nasal or oral cavities

Question 34

Where is the lingual tonsil located?

Answer 34

The posterior third of the tounge