The Lymphatic System

Question 1

tissues that don’t have lymphatic vessels, but use direct diffusion

Answer 1

epidermis, endomysium, cartilage, BM

Question 2

embryology

Answer 2

begins 5th week, significantly present 20th week

Question 3

spleen

Answer 3

largest single mass of lymphoid tissue, pressure sensitive (diaphragm drives fluid movement)
destroys damaged RBC, make Ig’s, clear bact

Question 4

liver

Answer 4

pressure sensitive (diaphragm), gate keeper of shared hepato-biliary-pancreatic lymph drainage
half of body's lymph formed here

Question 5

thymus

Answer 5

anterior mediastinum
replaced by fat
t cell mat

Question 6

tonsils

Answer 6

palatine, lingual, pharyngeal

nonessential to adults

Question 7

appendix

Answer 7

prox end of the cecum
lymphoid pulp
GALT

Question 8

thoracic duct

Answer 8

drains L head/neck. LUE, L thorax/abdomen, everything below unbilicus
origin: cisterna chyli @ L1-2
empties into left subclavian v./IJV at the lymphovenous junvtion
right lymphatic duct drains rest into the right subclavian v./IJ venous junction

Question 9

virchow’s node

Answer 9

L supra-clavicular, indicative of intrathoracic or

abdominal cancer

Question 10

epitrochlear nodes

Answer 10

secondary syphilis

Question 11

chlyomicrons

Answer 11

lacteals–>larger lymph vessels–>thoracic duct–>venous system

Question 12

normal lymph flow

Answer 12

lymph capillaries plexus–>larger paired lymphatic vessels–>either thoracic duct or R lymph duct–>venous

Question 13

interstitial fluid pressure

Answer 13

normally -6.3 mmHg

Question 14

thoracic diaphragm

Answer 14

with each breath, contraction increases negative pressure, pulls fluid centrally
also direct force on cisterna chyli

Question 15

pelvic diaphragm

Answer 15

4 muslces

helps move fluids from lower extremities and pelvis to thoracic duct

Question 16

sympathetic effects

Answer 16

increase symph tone=tighter valves=lower lymph flow into venous
smooth muscles within larger vessles: increase symph tone=lower peristalsis=lymphatic conjestion

Question 17

consequence of poorly functioning lymph system

Answer 17

EDEMA

Question 18

absolute contraindications for lymphatic OMM

Answer 18

anuria, necrotizing facistis, patient refuse

Question 19

sequence for lymphatic treatment

Answer 19

thoracic inlet
zone 1 thoracic
zone 2 abdomen
zone 3 upper extremity
zone 4 lower extremity
zone 5 head and neck
thoracic inlet

Question 20

swollen, fixed, hard, painful LN indicative of

Answer 20

malignancy

Question 21

swollen, soft, painful LN indicative of

Answer 21

bacterial infection