The Lymphatic System Flashcards
Lymphatic system functions
Drains excess interstitial fluid
Transports dietary lipids from GI tract to blood
Immune responses
What type of nutrient is transported from the GI tract to the blood by lymph
Lipids
What role does lymph have in cancer
Spreads malignancy
Are hydrostatic and osmotic pressure in the arteriolar end of the capillary bed high or low
High hydrostatic pressure
Low osmotic pressure
Are hydrostatic and osmotic pressure in the venous end of the capillary bed high or low
Low hydrostatic pressure
High osmotic pressure
What generates the high hydrostatic pressure in the arteriolar end of capillary beds
Pressure in arterioles system
What generates the high osmotic pressure in the venous end of capillary beds
Protein remains in blood but H2O has been forced out
Where does lymphatic fluid come from
Excess interstitial fluid
How much excess interstitial fluid is drained by the lymphatic system a day
3 litres
Are lymph vessels 1 or 2 directional
1
How is 2 way flow of lymph prevented
Valves
What is the sequence of lymph vessels from lymphatic capillary to lymphatic duct
Lymphatic Capillary -> lymphatic collecting vessels -> lymph nodes -> lymph trunk -> lymphatic duct
Lymphatic filariasis
Roundworm infection of lymph nodes blocking lymphatic drainage so interstitial fluid builds up in tissues
Lymph node
Small mass of lymphoid tissue located along the length of the lymphatic vessels which lymph is filtered through
Why do lymph nodes swell during infection
Increased numbers of lymphocytes
Which vessels does lymph enter and leave the lymph nodes through
Enters through afferent lymphatic vessels
Leaves through efferent lymphatic vessels
What separates different regions within lymph nodes
Trabeculae
What parts of the body have lymph drained to the right lymphatic trunk
Right arm and right side of head + neck
What parts of the body does lymph drain to the thoracic duct
Lower limbs, abdomen, left arm, left head +neck
Where is the venous angle
Where internal jugular vein meets the subclavian vein
Inflammation of which node may suggest stomach cancer
Virchow node
What layer of tissue are superficial lymphatic vessels found in
Subcutaneous
What do superficial lymphatic vessels drain into
Deep lymphatics
Where are the 3 sites of superficial lymph nodes
Cervical
Axillary
Inguinal
Which vessels do the superficial cervical lymph nodes run along
External jugular vein
Which vessel do the deep cervical nodes run along
Internal jugular vein
Where do efferent vessels from the deep cervical nodes run to
Right jugular trunk
Superficial cervical nodes
Occipital
Retroauricular
Parotid
Buccal
Submental
Submandibular
What structures are drained by the superficial cervical nodes
Tongue
Tonsils
Pinna
Scalp
Neck
Thorax
Which structures are drained by the deep cervical nodes
Tongue
Tonsils
Pinna
Parotid
Oropharynx
Nose
Paranasal sinuses
Palate
Larynx
Trachea
Oesophagus
Middle ear
When are lymph nodes readily palpable
Fighting infections
What is the difference between lymph nodes during infection and malignancy
Infection - firm, tender, enlarged, warm
Malignancy - firm, non tender, matted, fixed, size incr over time
What can cause lymph nodes to become fixed and matted
Malignancy
What is the most important factor in the spread of head and neck squamous cell carcinoma from primary sites
Metastatic neck disease
What structures are removed in a radical neck dissection
Sternocleidomastoid
Internal jugular vein
Spinal accessory nerve
Cervical lymph nodes
What procedure involves removal of 3 or fewer of the SCM, IJV, spinal accessory nerve, and cervical lymph nodes
Modified radical neck dissection
What procedure involves removal of 2 of the SCM, IJV, and spinal accessory nerve
Selective neck dissection
Which lymph nodes does 75% of the lymph from the breast drain to
Axillary
Nodes in axillary lymph nodes group
Humeral
Pectoral
Subscapular
Central
Apical
Supraclavicular
What structures are removed in a radical mastectomy
All breast tissue
Nipple
Axillary lymph nodes
Portion of pec major
What tissues/structures are removed in a modified radical mastectomy
Breast
Nipple
Most axillary nodes
What is the difference between a radical mastectomy and a modified radical mastectomy
Radical removes all axillary lymph nodes and some of pec major, modified doesnt
What is sentinel lymph node identification used for
Identify which lymph nodes need to be removed due to cancer
What happens in sentinel lymph node identification
Radioactive subastance/dye injected into tumour -> stained nodes removed
Where are inguinal lymph nodes located
Femoral triangle
What are the 2 groups of inguinal lymph nodes
Vertical
Horizontal
What vessel do the vertical inguinal lymph nodes run along
Great saphenous vein
Where do the horizontal inguinal lymph nodes run
Superficial to inguinal ligament
Where are the deep inguinal nodes
Femoral canal
Where do the superficial lymphatics from the anterior abdominal wall, perineum, and external genitalia ex testes drain to
Horizontal inguinal lymph nodes
Where do internal organs drain lymph to
Deep nodes
Pre aortic lymph nodes
Celiac
Superior mesenteric
Inferior mesenteric
What is the beginning of the thoracic duct
Cisterna chyli
Where does lymph from the common iliac nodes drain to
Lumbar nodes
Where does lymph from the GI tract drain to
Pre aortic lymph nodes
Where do the intestinal, right lumbar, and left lumbar trunks drain to
Cisterna chyli
What nodes drain the thorax
Bronchomediastinal trunks
Superior tracheobronchial nodes
Bronchopulmonary nodes
Inter pulmonary nodes
Interlobar lymph vessels
Sub pleural plexus
Inferior trachea bronchial nodes
What lymph nodes drain the heart
Inferior trachea bronchial nodes
How does the thoracic duct cross the diapragm
Aortic hiatus
Which part of the mediastinum is the thoracic duct in
Posterior
What is the largest lymphoid organ
Spleen
Which abdominal region is the spleen in, and which ribs is it under
Left hypochondrium
9-11th
Roles of the spleen
Lymphocyte proliferation
RBC filtration
RBC destruction
RBC storage
What happens to the thymus after puberty
Progressive atrophy and replacement by fat
Which part of the mediastinum is the thymus in
Superior
Waldeyers ring
Ring of tonsils at the back of the mouth that acts as a barrier for pathogens
4 tonsils
Palatine
Lingual
Pharyngeal
Tubal
Where are the tubal tonsils
Opening of Eustachian tube
What are the pharyngeal tonsils termed when enlarged
Adenoids
