Week 3- Lymphatic System

Question 1

Which of the following is NOT a primary function of the lymphatic system?
 A) Transport of oxygenated blood to tissues
 B) Immune surveillance and defence
 C) Maintenance of fluid balance in tissues
 D) Absorption of fats from the digestive tra

Answer 1

Transport of oxygenated blood to tissues

Question 2

List primary functions of lymphatic system

Answer 2

Maintaining fluid balance
Absorption of dietary fats
Immune function
Removal of cellular waste
Transport of WBC

Question 3

Where is lymph initially formed?

Answer 3

Interstitial fluid spaces

Question 4

What structure is responsible for filtering lymph and trapping patching ends

Answer 4

Lymph nodes

Question 5

What is the arrest lymphatic vessel in the body

Answer 5

Thoracic duct
Starts in abdomen and extends to chest and neck

Question 6

Function of thoracic duct

Answer 6

Begining in abdomen, it extends upward through chest to the neck.

It drains lymp0h from the lower half of the body (both legs and abdomen) left side of chest, left arm and left side of head and neck and empties into the subclavian vain.

Question 7

What is the most common cause of lymphoedema

Answer 7

Blockage of lymphatic vessels

Question 8

Explain how the lymphatic system contrinbutes to immune function

Answer 8

Transporting and filtering lymph fluid. The lymph nodes trap pathogens and foreign particles preventing them from spreading through the body. In the lymph nodes immune cells recognise these invaders and start an immune response

Lymph nodes house lymphocytes and macrophages. Once an immune cell is activated an immune respionse occurs leading to increased immune activity

Lymphoid organs like bone marrow (produces immature lymphocytes) thymus (t-cell mature and enter blood stream for immune certain acne) and spleen (filter blood) are crucial.

Immune surveillance
Absorption and transport of antyiugens
Tissue drainage and infection control

Question 9

Function of T cells, b cell and macrophages

Answer 9

T cells are involved in identifying and destroying infected or abnormal cells.
B cells produce antibodies that target specific pathogens.
Macrophages engulf and digest pathogens, debris, and dead cells via a process called phagocytosis.

Question 10

Describe the pathophysiology of lymphoedema and how it impacts normal lymphatic function

Answer 10

Lymphoedema is accumulatin of lymphatic fluid in tissues due to impaired lymphatic draining. Resulting in chronic swelling.

Normally, lymph system collects excess interstitial fluid and proteins from tissues, filtering through lymph nodes and returning to blood stream.
This condition there is a failure in drainage preventing return of the fluid to the circulatory system.

This leads to an accumulation of fluid. Interstitial fluid increases pressure and tissue swelling edema.

The lymphatic system normally returns proteins to the circulation, but in lymphedema, these proteins also accumulate in the tissues, further exacerbating fluid retention and attracting more fluid into the tissue spaces through osmotic forces.

The protein rich lymph in tissues triggers an inflammatory repointed

Question 11

What is the significance of the thoracic duct in the lymphatic system

Answer 11

Drains lymph into the blood stream

Question 12

Where are excillary lymph nodes located

Answer 12

Arm pits

Question 13

List primary lymphoid organs

Answer 13

Thymus gland
Bone marrow

Question 14

Where do T cells and b cells mature

Answer 14

T- thymus
B- bone marrow

Question 15

List secondary lymphoid organs

Answer 15

Lymph nodes
Tonsils
spleen
MALT/GALT/SALT

Question 16

What does MALT/GALT/SALT stand for

Answer 16

Skin associated lymphoid tissue
Gastro associated lymphoid tissue
Mucosa associated lymphatic tissue

Question 17

Function of the thymus

Answer 17

• Production of T Lymphocytes
• receives immunologically incompetent stem cells from bone marrow
• In the thymus these cells divide and mature into T-
lymphocytes
• Functions at peaks levels only during childhood
• Secretes hormone thymosin which support the
activity of T-lymphocytes throughout the body

Removal of the thymus
results in decreased T-
cell production
increasing susceptibility
to infection

Question 18

Functions of the tonsils

Answer 18

• Small masses of
lymphoid tissue around
the pharynx

• Trap and remove bacteria
and other foreign
materials

• Tonsillitis is caused by
congestion with bacteria

Question 19

What is peyers patches

Answer 19

Tonsils of the intestine

Found in wall of s intesntine
Capture and destroy bacteria in the intestine

Question 20

Function of mucosa associated lymphatic tissue

Answer 20

Lymphatic tissue that exists in the walls of alimentary, respiratory and genitourinary
tracts. It includes:
• Peyer’s patches
• Tonsils
• Other small accumulations of lymphoid tissue
It is subdivided into:
 Bronchus associated lymphoid tissues (BALT)
 Gut associated lymphoid tissues (GALT)
 Skin associated lymphoid tis

Question 21

Malt functions

Answer 21

 Protects the body against foreign
materials
 Transport clean fluids back to the
blood
 Drains excess fluids from tissues
 Removes debris from cells of body
 Transports dietary fats
 Production of immune cells (such as
lymphocytes, m

Question 22

Where are lymph capillaries absent

Answer 22

 Epidermis
 Hair
 Nails
 Cornea
 Articular cartilage
 Brain & spinal cord
 Splenic pulp

Question 23

What are lymph capialries

Answer 23

Form vast network of intracellular spaces of most of tissues

The wall is made by a single layer of epithelial cells

Question 24

Buletpoint lymphatic system

Answer 24

One way system towards heart

No pump

Milking action of skeletal muscle

Rhythmic contraction of smooth muscle in vessel walls

Gravity effects movement

Question 25

Briefly describe lymphatic vessels valves

Answer 25

Lymph leaks through mini valves into lymph capillaries

Higher pressure on the inside closes mini valve

Question 26

Where can lymph empty

Answer 26

The thoracic duct (left)
Receive lymph from lower body and pooper left quadrant

Right lymphatic duct
Receive lymph from upper right quadrant

Lymph from these ducts enter blood stream via eft and right subclavian veins

Question 27

Function and location of lymph nodes

Answer 27

Filters lymph before its
returned to the blood.

• Medulla houses
macrophages
• B-cells are concentrated
in the follicle or the
germinal centre
• T-lymphocytes are
concentrates in the
paracotex

Question 28

From the outside to the inside label a lymph node

Answer 28

Capsule

Subcapsular sinus

Germinal centre

Lymphoid nodule

Trabeculae

Question 29

What occurs in a lymph node

Answer 29

…
 As lymph passes through a node bacteria and other foreign material are trapped
by reticular fibres within the node.
 Bacteria are then phagocytosed by macrophages.
 Plasma cells produce antibodies to antigens in the lymph.
 Antibodies, lymphocytes and monocytes are eventually returned to the blood via
subclavian ve

Question 30

Describe proces of lymph fluid system

Answer 30

 Lymph is formed when high arterial pressure forces
fluid out of the capillaries and into tissues.
 It contains more WBC than plasma
 Enters nodes through afferent lymphatic vessels.
 Flows through node in one direction, through sinuses
in lymph node cortex and then into the medulla
 Exits the lymph node through efferent lymphatic
vessels
 Must be returned to the blood stream to maintain
bloody volume and pressure
 About 30 litres of fluid passes from arterial end of
capillaries into intracellular space every day

Question 31

What is elephantiasis or lymphodema

Answer 31

Blockage
Obstruction may lead to scar tissue that develops when lymph vessels or nodes are damaged or removed during surgery radiation infirm or infection

Question 32

What is lymphangitis

Answer 32

Inflamed or infected lymph nodes by organisms that spread throughout the lymphatic system from original site of infection

Red painful subcutaneous streaks
Lymohadentitis
Can result in cellulitis, bacteraemia or death

Question 33

What is lymphadenitis

Answer 33

Acute or chronic
Swollen and painful nodes
Pus

Question 34

What is Hemophagocytic Lymphohistiocytosis

Answer 34

• Aka macrophage activation syndrome
• Systemic activation of macrophages & CD8+ cytotoxic T cells on itself
• body self destructs.
• Acute febrile illness associated with splenomegaly and hepatomegaly
• Tx with immunosuppressives, chemotherapy and antibody therapy
50% mortality rate

Question 35

What is chronic lymphocitic leukemia

Answer 35

Chronic lymphocytic leukaemia
Most common in over 60
Bone marrow produces roo many naive lymphocytes
Fatigue, swollen lymph nodes in neck, armpit, groin. Unusual bruising or bleeding

Question 36

What is acute lymphocytic leukemia

Answer 36

Most common type of cancer in children
Affects blood and bone marrow

Bleeding from gums or nose, bone pain, fever, frequent infections, swollen lymph nodes, pale skin, shortness of breath, fatigue, weakness, pupura (skin rashes) abdominal pain, swollen spleen or liver

Question 37

What is Hodgkin’s lymphoma

Answer 37

A cancer which affects the lymphatic system
Affects people 15-40 and over 55.
Abnormal b-cell proliferation
Enlarged non-tender lymph nodes
Night sweats, itchy skin, fever, fatigue, weight loss, persistent cough, pain in lymph nodes after consuming alcohol
Painless enlarged lymph node is a red flag

Idiopathic but gender (men>) age, family history of the disease and Epstein Barr virus injection may increase the risk.

Question 38

What is non-hodgkins lymphoma

Answer 38

Most common than Hodgkin’s lymphoma
Abnormal b-cell proliferation
Tumours can grow into other organs
Disseminates widely and unpredictably early in their course.
Associuatred with Epstein Barr virus, hiv, pylori infection, previous radiotherapy or chemotherapy
Can occur at any age but 30% cases is over 75
Abdominal pain/ swelling, cough (pressing on vagus nerve) fatigue, sweats, chest pain, difficulty breathing, weight loss

Question 39

Where are preauricular lymph nodes found

Answer 39

Anterior to the ear

Question 40

Where are parotid lymph nodes found

Answer 40

Anterior to ear lobe

Question 41

Where are retropharyngeal lymph nodes found

Answer 41

Inferior to mandible

Question 42

Where are postauricular lymph nodes found

Answer 42

Posterior to ear

Question 43

Where are anterior lymph nodes found

Answer 43

Inferior to submandibular lymph nodes.
Anterior lateral neck along SCM

Question 44

Where are supraclavicular lymph nodes found

Answer 44

Palpable a superior to clavicle

Question 45

Where are posterior cervical lymph nodes found

Answer 45

Posterior cervical. Posterior to SCM

Question 46

Where are occipital lymoph nodes found

Answer 46

Posterior to postauricular

Question 47

What is the significance of the thoracic duct in the lymphatic system

Answer 47

The largest most significant lymphatic vessel in rhe body.
The thoracic duct drains lymph from 3/4 of the body in both lower limbs, left upper limb, left head and neck. This is then transported to the left subclavian view where it enters the blood stream. Curcial for fluid balance and without would cause edema.

Transport of fluid also transports fats and vitamins absorbed from digestive system which is transferred into bloodstream for distribution, crucial for body function.

Immune cells in lymph is also in blood stream so can maintain immune surveillance.

Primer to thoracic duct, lympoh nodes filter out harmful microorganism, foreign particles and cancer clues. Thoracic duct ensures lymph is efficiently returned to blood stream

Question 48

Compare and contrast roles of the thymus and the spleen ion lymphatic system

Answer 48

Both are integral components of lymph system and immune system function.

Thymus is located in upper chets, S is upper left abdomen

T is small and decreased with age, S is larger

T function id Tcell development and maturation S is blood filtrationa dn immune surveillance.

T cell types involve T cells, S is B cells, Tcells, macrophages

T role in immunity is it establishes T cell and tolerance and S mounts immune response against blood borne pathogens

T T cells mature and enter circulation and s b cells can become long lived memory cells

Question 49

A patient presents with swollen lymph nodes in the neck and fever. What might this indicate and what is the role of the lymphatic system in response

Answer 49

Infection.
Swollen lymoph nodes indicate lymph system is actively engaged in filtering lympoh fluid and reponding to infection. Antigens from pathogens are presented to B and T cells activating an adaptive umune response.

Lympoh nodes produce and activate T and B cells which are crucial for fighting infections.

Lymph system transports activated immune cells from lymph into circulation allowing them to reach site of infection or inflammation

Fever caused by hypothalamus can enhance activity of immune cells whilst denaturing growth of pathogens and is seen in immune response