C11: Lymphatics

Question 1

What is the lymphatic system

Answer 1

Drainage system that returns extra cellular fluid into the blood stream

Question 2

What are the 3 types of extra cellular fluid

Answer 2

Plasma
Interstitial
Lymph

Question 3

Describe plasma. Where is it found

Answer 3

• colourless fluid found in blood

- seeps through capillary walls into tissue…

Question 4

Describe interstitial fluid. Where is it found

Answer 4

-plasma that has seeped through the capillary walls into body tissue

Question 5

Describe lymph. Where is it found

Answer 5

-fluid that was once in the body tissue but has now entered the lymphatic ducts

Question 6

How is the lymphatic system different from circulatory system

Answer 6

• no pump
• flow is only in 1 direction
• contains lymph nodes

Question 7

The lymphatic system courses along which other body system

Answer 7

Circulatory

Question 8

The lymphatic sys consists of which structures

Answer 8

• capillaries
• vessels
• ducts
• nodes

Question 9

Describe lymphatic capillaries… where are they found

Answer 9

• Blind ended structures found in interstitial spaces… there walls are 1 endothelial later thick
• capillaries join together to form larger vessels

Question 10

Do lymph vessels have valves?

Answer 10

Yes

Question 11

Describe the flow of lymph from the superficial vessels to the bloodstream

Answer 11

• superficial vessels at the subcutaneous level drain into the deep lymphatic vessels…
• the lymph in the deep vessels pass through the lymph nodes and travel towards the chest
• once at the chest the lymph re-enters the bloodstream

Question 12

Lymph nodes are part of which larger body system

Answer 12

RE system

Question 13

Where are lymph nodes located

How large are they normally

Answer 13

In clusters around the lymph vessels throughout the body

• measures 1 mm to 1-2 cm

Question 14

Do lymph nodes have a capsule?

Answer 14

Yes

Made out of connective tissue

Question 15

Describe the anatomy of a lymph node

Answer 15

• contains afferent vessels and efferent vessels
• has a capsule
• contains a sinus and germinal centres w/in the sinus

Question 16

Describe the afferent lymph node vessels

Answer 16

-drain lymph into the node and carry it through the sinuses which are lined with phagocytic cells

Question 17

What’s the function of the phagocytic cells found in the sinus of the lymph node

Answer 17

Filter out and destroy bacterial and cancer cells

Question 18

What’s the function of the germinal cells found in the node

Answer 18

-produce lymphocytes which it empties into the lymph before it leaves the node

Question 19

Do the afferent vessels have multiple entry points into the node?
What about the efferent vessels

Answer 19

Afferent: multiple entry sites

Efferent: exit only at the hilum and carry lymph out of the node

Question 20

Are lymph nodes often the site of primary disease?

Answer 20

No

Question 21

When is secondary disease sometimes seen in lymph node

Answer 21

W/ systemic infection and many neoplasms

Question 22

Where are the 2 major lymph bearing areas in the retroperitoneum

Answer 22

• iliac and hypogastric areas/pelvis

- para-aortic/upper retroperitoneum

Question 23

List 3 other areas that contain lymphatic tissue

Answer 23

• tonsils
• thymus (produces antibodies b4 puberty and produces lymphocytes)
• spleen

Question 24

Does the lymphatic system have both deep and superficial channels of drainage

Answer 24

Yes

Question 25

List the groups of nodes found at key locations

Answer 25

- axillary - cervical - inguinal - intestinal

Question 26

What name refers to the intestinal lymph nodes

Answer 26

Peyer’s patch

Question 27

The R lymphatic duct drains which area(s) of the body

Answer 27

RUQ

Question 28

The L lymphatic duct drains which area(s) of the body Another name for the L lymphatic duct

Answer 28

3/4 of the body -thoracic duct

Question 29

Where does the lymph drain back into the blood stream

Answer 29

@ the junction of the subclavian vein and IJV

Question 30

Does lymph have a higher of lower albumin ratio that blood plasma? What type of blood cells does it contain? Which does it not? Does it contain digestive enzymes?

Answer 30

- higher ratio - has small amount of WBCs but no RBCs - yes to digestive enzymes

Question 31

Describe lymph flow.... what does it depend on

Answer 31

- slow when resting | - depends on contraction of muscles.... valves in larger vessels to prevent back flow

Question 32

List the functions of the lymphatic system

Answer 32

- phagocytosis - immunity - tissue drainage - excretion

Question 33

How does the lymphatic system carry out excretion

Answer 33

Through absorption and circulation of end products of fat digestion

Question 34

Are lymph notes typically seen in the abdo What’s the AP diameter of abdo lymph nodes and what is there echoexture

Answer 34

No AP: <1 cm Homogenous (w/ low level echos)

Question 35

What are some pitfalls when scanning lymph nodes

Answer 35

- enlarged para-AO nodes can mimic an aneurysm - bowel gas - enlarged nodes can make it hard to assess vessels - fluid filled areas can hide enlarged lymph nodes

Question 36

What’s it called when enlarged lymph nodes in the para-AO area push the AO anteriorly

Answer 36

Floating AO

Question 37

when assessing at the pelvic level, we should be assessing along which muscles?

Answer 37

Psoas and iliacus

Question 38

What is the function of albumin

Answer 38

Helps maintain osmotic press and fluid balance

Question 39

Enlarged nodes Around the renal hilum can lead to......?

Answer 39

Hydronephrosis