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)