Introduction to the Lymphatic System

Question 1

the lymphatic system drains ___ from the body’s ___ & returns it to the ___

Answer 1

excess fluid
tissues
bloodstream

Question 2

the lymphatic system consists of tissues & organs which provide ___ responses

these tissues & organs include:

• ___ gland
• ___
• aggregates of ___ tissue in the ___ & ___ tracts
• ___

Answer 2

immunological

• thymus
• spleen
• lymphatic, respiratory, digestive
• lymph nodes

Question 3

the lymphatic system is of vital importance to medical personnel since it may be the channel for the ___ & a conduit for the ___

Answer 3

spread of infection

spread of malignant disease

Question 4

origin of interstitial fluid & lymph:

at the arterial end of a capillary bed, where the ___ pressure of the blood exceeds its ___ pressure, fluid passes ___ into the tissues

at the venous end of a capillary bed, the ___ pressure of blood exceeds its ___ pressure & the greater part of the fluid ___

the remainder of the fluid, including some high molecular weight proteins, is removed from the ___ spaces by drainage into minute lymphatic vessels called ___

Answer 4

hydrostatic
osmotic
out of vessels

osmotic
hydrostatic
returns to the blood

interstitial
lymphatic capillaries

Question 5

origin of interstitial fluid & lymph:

the lymphatic capillaries begin blindly in the tissue’s ___

the interstitial fluid drained into lymphatic capillaries is called ___, & the larger lymphatic vessels that conduct lymph away from a tissue are called ___

Answer 5

intercellular spaces

lymph
lymphatics

Question 6

origin of interstitial fluid & lymph:

the lymph collected from a tissue or organ passes through at least one cluster of ___ before finally being emptied into the ___

Answer 6

lymph nodes

bloodstream

Question 7

origin of interstitial fluid & lymph:

lymphatics conducting lymph into a cluster of lymph nodes are called ___

lymphatics draining lymph from the lymph nodes are called ___

Answer 7

afferent lymphatics

efferent lymphatics

Question 8

origin of interstitial fluid & lymph:

the lymph reaches the bloodstream at the junctions of the ___ & ___ by way of the ___ & the ___

Answer 8

internal jugular
subclavian veins
right lymphatic duct
thoracic duct

Question 9

origin of interstitial fluid & lymph:

in general terms, the right lymphatic duct drains:

• the right side of the ___ & ___
• the right ___
• the right side of the ___, including the right ___

all the rest of the body including both lower limbs is drained by the ___

Answer 9

• head & neck
• upper limb
• thorax, lung

thoracic duct

Question 10

the thoracic duct:

begins in the ___ as a dilated sac called the ___

it lies behind the right side of the ___ on the bodies of ___ & ___ vertebrae

it ascends through the ___ & passes upward on the right side of the ___ b/n the ___ & the ___

Answer 10

abdomen
cysterna chili

aorta
L1 & L2

aortic hiatus
aorta
aorta
azygous vein

Question 11

the thoracic duct:

at about the level of ___, it begins crossing toward the ___ & reaches the left border of the ___ at the level of the ___

it runs upward into the root of the ___ & empties into the ___ system at the junction of the ___ & ___

Answer 11

T5
left
esophagus
sternal angle

neck
venous
left subclavian
left internal jugular veins

Question 12

the right lymphatic duct:

empties into the ___ system at the junction of the ___ & ___

Answer 12

venous
right internal jugular
right subclavian veins

Question 13

the body wall & limbs:

lymphatic vessels from upper limbs converge on the ___

lymphatic vessels from the lower limbs converge on the ___

Answer 13

axillary nodes

inguinal nodes

Question 14

the body wall & limbs:

lymphatic vessels from the wall of the thorax & abdomen, for the most part, drain into the ___ & ___

some vessels pierce the body wall to run to deeper nodes, particularly in the ___ wall of the ___

Answer 14

axillary & inguinal nodes

anterior
thorax

Question 15

the body wall & limbs:

the watershed b/n the axillary & inguinal drainage areas is a line around the ___ at the level of the ___

the main vessels carrying lymph from the axilla are the ___, which pass proximally alongside the subclavian artery & vein

the efferent vessels from the inguinal nodes pass into the abdomen & drain into the ___

Answer 15

trunk
umbilicus

subclavian trunks

external iliac nodes

Question 16

the inguinal lymph nodes:
main groups (2)

Answer 16

superficial inguinal nodes

deep inguinal nodes

Question 17

superficial inguinal nodes:

lie in the ___ just below the ___

receive lymph from:

• anterior & posterior surfaces of the ___ below the ___
• the ___ including the lower half of the ___, the ___, & all of the external ___ of both sexes (except the ___)
• the ___ vessels of the ___ limb

Answer 17

superficial fascia
inguinal ligament

• trunk, umbilicus
• perineum, anal canal, vagina, genitalia, testes
• superficial lymph, lower

Question 18

deep inguinal nodes:

lie along the ___ side of the ___ vein deep to the ___

receive all of the lymph from the ___ & from the ___ structures of the ___ limb

the efferent vessels from these nodes ascend through the ___ & drain into the ___

Answer 18

medial
femoral
fascia lata

superficial
deep
lower

femoral canal
external iliac nodes

Question 19

the head & neck:

the final nodes draining the head & neck lie alongside the ___ & are known as the ___

the main vessels draining from these nodes on each side is the ___

like the axillary & inguinal nodes, the ___ drain skin & superficial fascia & also deeper structures

Answer 19

carotid sheath
deep cervical nodes

jugular trunk

deep cervical nodes

Question 20

the deep thorax:

lymph from the lungs & pleura, the bronchi, the trachea, & the heart converge on the ___ lymph nodes

the efferents from these nodes unite w/ each other to from the ___

Answer 20

bronchomediastinal

bronchomediastinal trunks

Question 21

the deep thorax:

the left jugular, subclavian, & bronchomediastinal trunks empty into the ___

the right jugular, subclavian, & bronchomediastinal trunks join the ___

individual trunks on either side may drain directly into the ___ system at the junction of the ___ & ___

Answer 21

thoracic duct

right lymphatic duct

venous
internal jugular
subclavian veins

Question 22

the abdomen:

the major lymph node groups in the abdomen are arranged along the ___

these groups include the ___ nodes & the ___nodes

Answer 22

blood vessels

pre-aortic
para-aortic (lumbar)

Question 23

the abdomen:
the pre-aortic nodes:

lie along the ___ of the ___ & are divided into three groups:

• ___ nodes drain the ___
• ___ nodes drain the ___
• ___ nodes drain the ___

efferents from these nodes form the ___, which contributes to the formation of the ___

Answer 23

front, aorta

• celiac, foregut
• superoir mesenteric, midgut
• inferior mesenteric, hindgut

intestinal trunk
cysterna chili

Question 24

the abdomen:
the para-aortic (lumbar) nodes:

lie along the ___ borders of the ___

drain the ___, ___, & ___

Answer 24

lateral
aorta

kidneys
suprarenal glands
gonads

Question 25

the abdomen:
the para-aortic (lumbar) nodes:

receive efferents from the ___

the upper nodes in this group give rise to the ___ which contribute to the formation of the ___

Answer 25

common iliac nodes

lumbar trunks
cysterna chili

Question 26

the pelvis:

nodes (3)

Answer 26

internal iliac
external iliac
common iliac

Question 27

the pelvis:
internal iliac nodes:

drain the organs of the ___ supplied by the ___ arteries

exceptions: the ___, ___, & ___ & ___ of the ___ drain directly into the para-aortic (lumbar) nodes

Answer 27

pelvis
internal iliac

gonads
uterine tube
fundus & upper body of the uterus

Question 28

the pelvis:
external iliac nodes:

receives the efferents form the ___ & drain into the ___

Answer 28

inguinal nodes

common iliac nodes

Question 29

the pelvis:
common iliac nodes:

drain into the ___

Answer 29

para-aortic (lumbar) nodes

Question 30

the axillary nodes:

lymph nodes of the axilla receive & filter the lymph from the ___ & from the anterior & posterior aspects of the ___ as far distal as the ___ & the ___

they may number fewer than ___ or up to about ___ nodes

the nodes are usually subdivided by both the ___ they drain & their ___

Answer 30

upper limb
trunk
umbilicus
iliac crest

a dozen
three dozen

territories
location

Question 31

the axillary nodes:

groups of axillary lymph nodes (5)

Answer 31

brachial (lateral) group
subscapular (posterior) group
pectoral (anterior) group
central group
apical (subclavian) group

Question 32

brachial (lateral) group of axillary lymph nodes:

lie along the ___ side of the ___

receive most of the lymph from the ___

Answer 32

medial
axillary vein

upper limb

Question 33

subscapular (posterior) group of axillary lymph nodes:

lie in front of the ___

receive lymph from the ___ & the ___

Answer 33

subscapularis muscle

scapular region
back

Question 34

pectoral (anterior) group of axillary lymph nodes:

lie along the ___ border of the ___ behind the ___

receive lymph from the ___ & ___

Answer 34

lower
pectoralis minor muscle
pectoralis major

thoracic wall
anterior abdominal wall

Question 35

central group of axillary lymph nodes:

lie in the ___ of the axilla in the ___

receive lymph from three groups of axillary lymph nodes: ___, ___, & ___

Answer 35

center
axillary fat

brachial (lateral)
subscapular (posterior)
pectoral (anterior)

Question 36

apical (subclavian) group of axillary lymph nodes:

lie in the ___ of the axilla at the ___ border of the ___ rib

receive efferent vessels from ___

efferents from the apical group from the ___

Answer 36

center
lateral
first

all of the other axillary nodes

subclavian lymph trunk

Question 37

drainage of the breast:

about ___% of the lymph in the breast courses laterally & upward to ___, ___, & ___ nodes

most of the remaining lymph passes medially to ___ nodes along the ___ vessels

some lymph drains downward to upper ___ nodes & some goes to the ___

Answer 37

75
axillary (mostly pectoral)
supraclavicular
infraclavicular

parasternal (internal thoracic)
internal thoracic

abdominal
opposite breast

Question 38

drainage of the uterus:
fundus & body:

few - to ___ nodes

most - unite w/ lymphatics from the ___ & ___ passing to the ___ nodes

Answer 38

superficial inguinal

uterine tube
ovary
lumbar (para-aortic)

Question 39

drainage of the uterus:
lower body & cervix:

most frequent site of ___

four nodes: ___, ___, ___, & ___

Answer 39

carcinoma

internal
external
common iliac
sacral

Question 40

drainage of the vagina:

upper three-fourths - ___ nodes

lower one-fourth - ___ nodes

Answer 40

internal iliac

superficial inguinal

Question 41

testes & ovaries:

to ___ nodes

Answer 41

para-aortic (lumbar)