Week 5- Lymphedema Flashcards
General Lymphatic Anatomy:
- The lymphatic vessels begin as ____-________ capillaries, which feed into larger and larger lymphatic vessels, and eventually empty into the bloodstream by a series of _______.
- Lymph travels through lymph nodes, which are commonly found near what areas?
- Humans have about _____-______ lymph nodes throughout the body.
- open-ended, ducts
- groin, armpits, neck, chest, and abdomen
- 500-600
_____________, called terminal lymphatics, are vessels where interstitial fluid enters the lymphatic system to become lymph fluid.
Lymphatic capillaries
- Lymph is 95% _______, the remaining 5% is proteins, lipids, carbs, ions, and some cells.
- Lymph in the GI system is called _____, and is rich in fats.
- The average adult produces __-__ liters of lymph fluid each day.
- water
- chyle
- 3-4L
When interstitial pressure is _____, endothelial flaps close to prevent “backflow”. As interstitial pressure _________, the spaces between the cells open up and filaments anchoring the capillaries , pull on the cell flaps, opening them up even further, allowing fluid to enter.
- low
- increases
Lymphatic capillaries empty into larger lymphatic ________.
vessels
Lymph vessels have ___-____ valves fairly close to one another, making a bulge in the vessel, giving the vessels a beaded appearance.
one-way
Superficial and deep lymphatics eventually merge to form larger lymphatic vessels, called lymphatic ______.
trunks
- Lymph fluid drains into the right subclavian vein via the ________ lymphatic duct. What areas of the body does it receive lymph from?
- Lymph fluid drains into the left subclavian vein via the __________ duct. What areas of the body does it receive lymph from?
- right lymphatic duct, R side of body (excluding R lower quadrant/leg)
- thoracic duct, L side of body and R lower quadrant/leg
The thoracic duct begins just beneath the diaphragm in the ________ ________, a sac-like chamber that receives lymph from lower half of the body via the right and left lumbar trunks and the intestinal trunk.
cisterna chyli
- _______ nodes drain arm/chest/upper back.
- ________ nodes drain leg/buttock/lower abdomen/genitals.
- axillary
- inguinal
Other Lymphatic Organs:
- ______ _______- where T-lymphocyte cells mature.
- _______ _______- where T-cells develop and mature.
- _________- produce antibodies to fight infection and trap germs entering nose/mouth.
- _______- are important in helping kid’s bodies recognize, destroy and develop immunity to common environmental pathogens, for later protection.
- _________- called “filter of the blood” because its extensive vascularization and it removes blood debris, including dying red blood cells.
- bone marrow
- thymus gland
- adenoids
- tonsils
- spleen
What are the 4 functions of the lymphatic system?
- Fluid Balance
- Nutritional Function
- Importance for Self-Tolerance
- Immune Response
How does the lymphatic system help with fluid balance?
By draining the capillary ultrafiltrates and escaped plasma proteins and returning them to the blood circulation. Once interstitial fluid is picked up by lymph capillaries, it is then called lymph fluid.
How does the lymphatic system help with nutritional function?
Intestinal lymphatics are responsible for fat absorption.
How does the lymphatic system help with self-tolerance?
Suppresses the immune response to cleared peripheral tissue antigens. Failure can result in autoimmune disease.
How does the lymphatic system help with immune response?
Immune Surveillance Program
- Main route for transport of antigen and immune cells from tissues.
- Important in adaptive immunity (immune response SPECIFIC for each pathogen)
Lymph Nodes- Major Staging Areas For Immune Response
- Remove debris (filters of the lymph)
- Make and store WBC
- Recruit inflammatory cells in response to pathogens.
What are the (3) reasons for lymph motility?
- Automatic contraction (valves prevent backflow)
- Negative pressure gradient (lymph moves from high pressure to low pressure)
- Being in close proximity to muscles
Lymphedema:
- What is lymphedema? What causes it?
- It is a ________ and ___________ condition.
- Its associated with increased risk of _______ and ________ swollen tissue, as well as thickened skin.
- Does it have a cure?
- Swelling of a body part (usually in extremity and adjacent trunk quadrant) that is caused by the abnormal accumulation of protein rich interstitial fluid.
- chronic and progressive
- infection and fibrotic swollen tissue
- No
Chronic lymphedema is often associated with tissue ______ and accumulation of ___ and adipose tissues.
- fibrosis
- fat
What are bioimpedence and lymphoscintigraphy?
2 ways of detecting/diagnosing lymphedema
What are some common issues with lymphedema?
- Heaviness/decreased motion of limb
- Cosmetic issues (clothes/shoes don’t fit)
- Altered lifestyle to prevent exacerbation
- Psychological impacts (anxiety, depression, loss of body image, fear, withdrawal, etc…)
Lymphedema can be either _________ or _________.
primary or secondary
Primary Lymphedema:
- Cause?
- Shows up clinically/visibly at birth (_________), in teens (___________), or after midlife (________).
- Could be ________ (no lymph capillaries), _______ (too few or too narrow lymph vessels), ___________ (too wide lymph vessels, causing ineffective valves and back flow), or inguinal node _________ (hardening of groin lymph nodes).
- Does a family history of primary lymphedema increase your risk of primary lymphedema? What triggers it?
- Has no cause, it’s a congenital defect of the lymphatic system.
- Birth (congenital), Teens (praecox), After Midlife (tarda).
- aplasia (no lymph capillaries), hypoplasia (too few/narrow lymph vessels), hyperplasia (wide lymph vessels, causing backflow), inguinal node fibrosis (hardening of groin lymph nodes).
- Yes, triggered by increased blood flow
Secondary Lymphedema
- Worldwide, the most common cause is from a _______ that blocks inguinal/groin lymph nodes causing LE lymphedema.
- In the US, the most common causes are what?
- parasite
- surgery, radiation, infections, cancer, injuries, lymph node removal
- Damage to the armpit/axilla causes swelling where?
- Damage to the neck or throat causes swelling where?
- Damage to the groin/inguinal causes swelling where?
- Armpit/Axilla = hand, forearm, upper arm, chest, armpit, and/or upper back ON THAT SIDE.
- Neck/Throat = face, head, and or neck.
- Groin/Inguinal = foot, lower leg, thigh, genitalia, buttocks, and/or lower abdomen ON THAT SIDE.
