thoracic regional anatomy

Question 1

purpose of lymphatic system

Answer 1

more fluid leaves blood capillaries than returns to them - uncompensated fluid movement from blood to the extracellular fluid would result in oedema and loss of blood volume - lymphatic vessels drain excess extracellular fluid back into the blood - ensure foreign particles come into contact with immune system

Question 2

what is the lymphatic system

Answer 2

network of tissues and organs consisting of lymph vessels, lymph nodes and lymph; includes tonsils, adenoids, spleen and thymus; 600-700 lymph nodes in humans; filter the lymph before it returns to the circulatory system

Question 3

lymph trunks

Answer 3

carry fluid

Question 4

lymph nodes

Answer 4

enlargements among channels; filter fluid; associated with brain

Question 5

thoracic duct

Answer 5

drains most of body

Question 6

drainage

Answer 6

return to neck; upper right quadrant drained separately to thoracic duct to same place but right side of neck; rest of body drained by thoracic duct to left side of neck

Question 7

lymphatic drainage

Answer 7

cell debris and products go into lymphatic capillaries, into lymph vessels (valves), filtered in node (lymphocytes and macrophages), into blood and vena cavae to heart

Question 8

anatomy of lymph node

Answer 8

lentil (unless infected it becomes larger), found along lymph vessels, contain lymphocytes and macrophages, act upon foreign bodies, drainage detectable in enlarged lymph nodes (armpit, groin, neck)

Question 9

enlarged lymph nodes

Answer 9

common infection, less common is cancers

Question 10

lymph fluid

Answer 10

clear and odourless in most vessels, opaque and milky from small intestine due to absorbed fats; contains white blood cells, pathogens, hormones, cell debris, fats, particulate matter, fluid from tissues

Question 11

movement

Answer 11

no pump so sporadic due to maintaned by action of adjacent structures (skeletal muscle and pulses in arteries); unidirectional as valves

Question 12

lymphatic cancer in breast

Answer 12

removal of lymph nodes, then breast

Question 13

lymphatics of thoracic wall

Answer 13

drained into nodes associated with internal thoracic arteries (parasternal), ribs (intercostal), diaphram (diaphragmatic) up to neck

Question 14

parasternal drainage

Answer 14

bronchomediastinal trunks

Question 15

upper intercostal drainage

Answer 15

bronchomediastinal trunks

Question 16

lower intercostal drainage

Answer 16

thoracic duct

Question 17

diaphragmatic drainage

Answer 17

brachiocephalic, aortic/lumbar

Question 18

superficial drainage

Answer 18

axillary or parasternal

Question 19

thoracic duct

Answer 19

back of chest wall; main channel draining most of body (abdomen, pelvis, perineum, lower limbs); begins at cisterna chyli; begins at L2 vertebral level; enters behind oesophagus through diaphragm; ascends on right of midline between aorta and azygous vein (superior mediastinum); crosses over onto left at T5 (between T7 and T4); empties into junction of left internal jugular vein and subclavian vein to form left braciocephalic vein

Question 20

lymphatics of lungs

Answer 20

tracheobroncial, bronchomediastinal

Question 21

tracheobroncial

Answer 21

around bronchi and trachea, from within lung through hilum, unite with vessels from parasternal and brachiocephalic nodes anterior to brachiocephalic veins, forming bronchomediastinal

Question 22

nodes in lungs

Answer 22

large congregation can change appearance of trachea - enlargement causes change in angle

Question 23

lymphatics of heart

Answer 23

follow coronary arteries, frain into brachiocephalic and tracheobroncial

Question 24

lymphatics of posterior mediastinum

Answer 24

nodes on aorta receive lymph from oesophagus, diaphragm, liver and pericardium; drain into thoracic duct and posterior mediastinal - spread across body

Question 25

lymphatic flow

Answer 25

flow is up to neck; majority via thoracic duct into junction of left internal jugular vein and left subclavian vein; right upper is junction of right internal jugular vein and right subclavian vein

Question 26

characteristics of lymph vessels

Answer 26

blind ended, thin walled, lined by endothelial cells, permeable to fluid, proteins, particles, cells, pass through lymph nodes at intervals, larger possess valves

Question 27

superficial lymphatics

Answer 27

follow superficial veins to lymph nodes in axillar, inguinal or cervical areas to drain into deep lymphatics

Question 28

deep lymphatics

Answer 28

follow main arteries, drain into venous system near formation of braciocephalic veins

Question 29

superficial lymphatic drainage

Answer 29

according to quadrants to axillar or inguinal nodes; head to cervical nodes below mandible, all drain into deep lymph nodes through deep fascia

Question 30

deep lymphatic drainage

Answer 30

from inguinal nodes: along path of iliac arteries to para-aortic; from intestines: to pre-aortic nodes anterior to aorta; all to collecting vessel via cisterna chyli to thoracic duct; drains into left brachioceophalic vein - only lymph from upper right quadrant straight to right brachiocephalic, not thoracic