The Lymphatic System Flashcards

1
Q

What are the 3 anatomic components of the lymphatic system?

A
  1. lymph fluid
  2. lymphatic vessels
  3. organized lymphatic tissue
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2
Q

What is the physiologic function of the lymphatic system?

A

Homeostatic mechanisms: immune, digestive, fluid balance, waste

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3
Q

Describe the embryological timeline of the lymphatics system

A

formed in the 5th week and is significantly present by the 20th week

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4
Q

The _______ contributes to the lymphatic vessels, lymph nodes, spleen, and myeloid tissue

A

mesoderm

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5
Q

the ______ contributes to the thymus and parts of the tonsils

A

endoderm

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6
Q

Describe the timeline of the lymphoid tissue throughout the life

A

Immature at birth
Increases at 6-9 years
At puberty, the system matures but regresses until 15-16
remains stable throughout the rest of the life

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7
Q

Describe fluid balance

A

30 L of fluid moves from the capillaries to the interstitial space everyday

90% to capillaries and 10% to lymphatic system

The lymph system will help with fluid overload

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8
Q

What is the function of the lymph fluid?

A

Bathes the organs and cleanses the extracellular space of toxins

fluid travels from vessel to node and acts as a purifier

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9
Q

How is the lymphatic system able to contribute to the defense of the body?

A

lymph fluid delivers everything to the lymph nodes which have high concentrations of immune cells

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10
Q

How does the lymph system contribute too digestion?

A

Helps to absorb the fats via chylomicrons because they are too big to cross the intercellular junctions

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11
Q

Describe the components of lymph fluid. How do they get there?

A

substances that leak out of the arteries into the interstitium that are taken up by the lymph

contains…
immune cells, antigens, bacteria and viruses, clotting factors, and chylomicrons

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12
Q

What are tissues that do NOT have lymphatic vessels?

A

Epidermis
Endomysium of muscle
Cartilage
Bone marrow

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13
Q

Describe the flow of the lymphatics

A
terminal lymphatics 
collecting vessels 
afferent lymph vessels 
lymph nodes 
efferent lymph nodes 
lymphatic trunks 
thoracic duct or right lymphatic duct 
venous system
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14
Q

Describe terminal lymphatics

A

lymph formation begins in the interstitial space of tissues

lined by leaky endothelium and anchored by small filaments

they gather into the collecting vessels

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15
Q

_________ are chains of muscular units that possess two-leaflet bicuspid valves referred to as “lymphatic hearts”

A

Lymphangions

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16
Q

What is the function of lymph nodes?

A

Filtration of lymph fluid
Maturation of lymphocytes
Phagocytosis of bacteria and cellular debris

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17
Q

What is the path of the lymph fluid in the lymph node (basic)

A
  1. Afferent lymph
  2. sub capsular space
  3. outer cortex
  4. deep cortex
  5. medullary sinus
  6. Efferent lymphatics
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18
Q

What are the lymphatic regions?

A
  1. lumbar
  2. intestinal
  3. bronchmediastinal
  4. subclavian
  5. jugular
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19
Q

The ______ ______ is located at the level of L1-L2 and drains the lymphatic trunks of the lower body, giving rise to the thoracic duct

A

cisterna chyli

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20
Q

What is the function of the thoracic duct?

A

Drains the Left head and neck, Left UE, L thorax and abdomen, Everything inferior to the umbilicus, receives the lumbar lymphatics

21
Q

The _____ ________ ______ drains the right head and neck, R UE, R thorax, heart, and lungs

A

Right lymphatic duct

22
Q

Describe the course of the right lymphatic duct

A

Originates at the junction of the R jugular and subclavian trunks and ends at the junction of the right IJ and the right subclavian vein

23
Q

What should you look for when assessing the lymph nodes?

A
Size 
Shape 
Consistency 
Tenderness 
Mobility 
Color  
Warmth
24
Q

_____ _____ is the left supraclavicular node and is sometimes swollen in abdominal cancer

A

Virchow’s node

25
Q

The _____ is located beneath the 9-11th ribs underneath the diaphragm

A

spleen

26
Q

What are the functions of the spleen?

A

Destroys damaged RBCs
synthesize Igs
clears bacteria

27
Q

What are the pressure sensitive organs in the body?

A

The liver and the spleen

28
Q

What is the function of the liver?

A

Forms half of the body’s lymph
clears the bacteria
“gate keeper” of the shared hepatic-biliary-pancreatic venous and lymphatic drainage

29
Q

The _______ is the maturation site for the T cells and has little or no function in adults

A

Thymus

30
Q

Describe where all 3 of the tonsils are

A

Palatine tonsils are in the lateral pharynx

Lingual tonsils are on the posterior 1/3 of the tongue

Pharyngeal tonsils are at the nasopharyngeal border

31
Q

What is the function of the tonsils?

A

Provide cells to influence and build immunity in early life

nonessential to adult immune function

32
Q

What is the function of the appendix?

A

Part of the gut associated lymphoid tissue

33
Q

What is the effect of the sympathetic nervous system on the lymph valves and smooth muscle?

A
  1. causes the valves to tighten and decreases the lymph flow into the venous system
  2. decreases peristalsis
34
Q

______ is a consequence of a poorly functioning lymphatic system

A

EDEMA

35
Q

Define edema

A

build up of interstitial fluid from poor lymphatic flow with an imbalance in the starling forces

36
Q

What are the causes of edema?

A

Increased arterial pressure
Increased venous pressure
Decreased plasma osmotic pressure
Increased capillary permeability

37
Q

What effects does edema have on the body?

A

Compression of local structures
Decreased waste removal
Decreased pathogen clearance and immunity
Chronic states

38
Q

______ _____ is a diverse group of techniques that is designed to remove impediments to the lymphatic circulation and promote and augment the flow of interstitial fluid and lymph

A

Lymphatic OMT

39
Q

What are some of the indications for lymphatic OMT?

A
Lymphatic congestion 
Mild CHF 
Upper or lower respiratory infections 
Asthma 
COPD 
Ligamentous sprains or muscular strains 
Acute SD
40
Q

What are the ABSOLUTE contraindications for lymphatic OMT

A
  1. Anuria- need kidneys functioning to process the extra fluid return
  2. Necrotizing fasciitis
41
Q

What are some of the relative contraindications for lymphatic OMT?

A
Inability to tolerate excessive preload 
COPD 
Acute asthma exacerbation 
Unstable cardiac conditions 
cancer 
fractures 
pregnancy
42
Q

The _____ ______ ______ _______ is the clinical judgment that must be used in employing lymphatic techniques, with particular attention to the patients diagnosis, clinical conditions, and medical therapy. There factors influence choice of the appropriate technique, dose, duration and frequency of treatment

A

Risk to benefit ratio

43
Q

What are the 5 steps to diagnose the lymphatic system SD in OMM?

A
  1. evaluate the risk-benefit ratio
  2. evaluate the fascial patterns of Zink (where is the fascia restricted bc this might cause restrictions of the lymph)
  3. Evaluate diaphragms/fascia
  4. Evaluate SD
  5. Tissue congestion
44
Q

The L/R/L/R is the ______ ______ ______ in 80% of healthy people

A

Common compensatory pattern

45
Q

The R/L/R/L is the ______ _______ ______ in 20% of healthy people

A

Uncommon Compensatory Pattern

46
Q

What is the cause of an un-compensated pattern?

A

Symptomatic and sometimes has trauma involved

47
Q

What are the transverse restrictors that are present in the body?

A

Tentorium cerebelli
Thoracic Inlet
Thoracolumbar diaphragm
Pelvic diaphragm

48
Q

What are the transition zones of the spine?

A

OA, C1, C2

C7, T1

T12, L1

L5, sacrum

49
Q

What is the sequence of treatment of a lymphatic issue?

A
  1. open the pathways to remove restriction flow
  2. maximize diaphragmatic functions
  3. increase pressure differentials or transmit motion
  4. mobilize targeting tissue fluids