4. Lymphatic System

Question 1

3 anatomic components of lymphatic system

Answer 1

• lymph fluid
• lymphatic vessels
• oganized lymphatic tissues/organs
  
  • spleen, liver, thymus, tonsils, appendix, visceral lymphoid tissue, lymph nodes

Question 2

physiologic function of lymphatic system

Answer 2

immune

digestive

fluid balance

waste

Question 3

When does lymphatic development begin?

Answer 3

5th week of gestation

(significant presence by 20 weeks)

Question 4

What aspects of lymphatic system come from mesoderm?

Answer 4

lymphatic vessels

lymph nodes

spleen

myeloid tissue

Question 5

What aspects of lymphatic system come from endoderm?

Answer 5

thymus and parts of tonsils

Question 6

When do lymphoid tissues start to regress?

Answer 6

15-16 y/o

Question 7

How many L of fluid move from capillaries to interstitial space each day?

Answer 7

30 L of fluid

(90% to capillaries, 10% to lymphatic system)

(1/2 diffused plasma proteins re-enter system via lymph)

Question 8

When fluid overload occurs, lymphatic systems helpes prevent damage by clearing the excess.

Answer 8

“second/third spacing”

Question 9

purification and cleansing via lymph fluid

Answer 9

bathes organs

cleanses extracellular spaces of particulate matter, toxins, bacteria, cell waste products, and post-injury biochemical by-products

fluid travels from vessel to node

Question 10

defense via lymph fluid

Answer 10

brings toxins, bacteria, and viruses into contact w/ organized lymph tissue

contain high concentration of immune cells and APCs

maturation of immune cells = immunity

Question 11

What is the role of OMT in treating lymphatics?

Answer 11

free flow of lymph necessary for appropriate immune function

OMT used to establish better free flow of lymph

Question 12

fat absorption occurs via ___

Answer 12

chylomicrons (packaged form of fats)

Question 13

How do chylomicrons get to the venous system?

Answer 13

travel via lacteals > larger lymph vessels > thoracic duct > venous system

Question 14

substances that leak out of arterial capillries into interstitium

eventually taken up by lymphatic capillaries

Answer 14

lymph fluid

Question 15

components of lymph fluid

Answer 15

fluids, proteins, electrolytes, and cells

immune cells

foreign Ag

bacteria and viruses

clotting factors

chylomicrons (post-prandial)

Question 16

Which tissues do not have lymphatic vessels?

Answer 16

epidermis

endomysium of muscle

cartilage

bone marrow

Question 17

Trace the route of lymph through lymphatic vessels.

Answer 17

terminal lymphatics > collecting vessels > afferent lymph vessels > lymph node(s) > efferent lymph vessels > lymphatic trunks > thoracic duct or right lymphatic duct > venous system

Question 18

Where does lymph formation begin?

Answer 18

interstitial spsace of tissues with initial lymphatics/terminal lympatics/lymph capillaries

anchored by leaky endothelium (anchored to ECM by smll filaments)

terminal lymphatics coalesce into collecting vessels

Question 19

Describe the leaky endothelium of terminal lymphatics.

Answer 19

anchored to ECM by small filaments

endothelial cells overlap creating 1-way valves

lack smooth muscle walls

Question 20

Collecting vessels consist of ____.

Answer 20

lymphangions

Question 21

possess 2-leaflet bicuspid valves, called “lymphatic hearts”, which contract regularly throughout lymphatic system and moving lymph in peristaltic waves

Answer 21

lymphangions

Question 22

contain lymphangion

contain smooth muscle

extensive autonomic innervation

Answer 22

collecting vessels

Question 23

collecting vessels prior to lymph node

Answer 23

afferent or prenodal vessels

Question 24

collecting vessels draining lymph node

Answer 24

efferent or postnodal vessels

Question 25

most highly organized lymphoid tissue disperesed along course of lymph vessels can be superficial or deep

Answer 25

lymphoid organs

Question 26

functions of lymph nodes

Answer 26

filtration of lymp fluid maturation of lymphochytes phagocytosis of bacteria and cellular debris

Question 27

path of lymph flow through a lymph node

Answer 27

afferent lymphatics \> subscapular space \> outer cortex \> deep cortex \> medullary sinus \> efferent lymphatics

Question 28

Where do lymphatic vessels drain into?

Answer 28

lymphatic trunk

Question 29

drain lymph from lower limbs and pelvic organs

Answer 29

lumbar

Question 30

drains abdominal viscera

Answer 30

intestinal

Question 31

drains portions of thorax

Answer 31

bronchomediastinal

Question 32

drains upper limbs

Answer 32

subclavian

Question 33

drains portions of neck and head

Answer 33

jugular

Question 34

located at level of L1-2 drains lymphatic trunks of lower body gives rise to thoracic duct

Answer 34

cisterna chyli

Question 35

origin of thoracic duct

Answer 35

cisterna chyli (dilation at L1-L2)

Question 36

termination of thoracic duct

Answer 36

pierces Sibson's fascia at superior inlet U-turns to empty into L subclavian and L internal jugular veins

Question 37

function of thoracic duct

Answer 37

master lymph vessel and drains: * L head/neck * LE * L thorax/abdomen * everything inferior to umbilicus * receives from lumbar lymphatics

Question 38

origin of right lymphatic duct

Answer 38

from junction of right angular and subclavian trunks (and occasionally bronchomediastinal trunk)

Question 39

termination of right lymphatic duct

Answer 39

empties at right subclavian and right internal jugular venous junction

Question 40

function of right lymphatic duct

Answer 40

drains: * right head/neck * RUE * right thorax * heart * lungs (except LUL)

Question 41

short course that originates at junction of R jugular and subclavian trunks (and occasionally the bronchomediastinal trunk) and ends where it empties at the junction of the right IJ and right subclavian vein

Answer 41

right lymphatic duct

Question 42

acute signs of infectious lymph nodes

Answer 42

swollen, soft, painful

Question 43

chronic signs of lymph node malignancy

Answer 43

swollen, indurated (hard), non-painful, fixed

Question 44

left-supra clavicular node

Answer 44

Virchow's Node

Question 45

secondary syphilis node

Answer 45

epitrochlear node

Question 46

spleen

Answer 46

Question 47

liver

Answer 47

Question 48

thymus

Answer 48

Question 49

tonsils

Answer 49

Question 50

appendix

Answer 50

Question 51

visceral lymphoid tissue (GALT)

Answer 51