Lecture 26: Venous, Portal, and Lymphatic Systems

Question 1

organs and tissues of lymphatic system

Answer 1

thymus, lymph nodes, spleen, tonsils, lymphoid follicles

Question 2

functions of lymphatic system organs/tissues

Answer 2

immunity, defense

Question 3

lymph system vessels, in increasing diameter

Answer 3

capillaries, vessels, trunks, ducts (thoracic, right lymphatic), sac (cisterna chyli)

Question 4

functions of lymphatic vessels

Answer 4

drain and transport lymph (including transport of fat absorbed by small intestine)

Question 5

what is lymph

Answer 5

fluid, formed in extracellular spaces of tissues and organs

Question 6

where is lymph

Answer 6

flows in lymphatic vessels, adds to venous blood circulation

Question 7

what does lymph contain

Answer 7

plasma proteins, antigens, antibodies, fat, lymphocytes

Question 8

2 classifications of lymphatic vessels

Answer 8

deep, superficial

Question 9

deep lymphatic vessels location

Answer 9

beneath deep fascia, accompany main arteries

Question 10

deep lymphatic vessels function

Answer 10

drain lymph from skeletal muscle, internal organs

Question 11

superficial lymphatic vessels location

Answer 11

superficial fascia of skin - camper’s fascia

Question 12

superficial lymphatic vessels function

Answer 12

drain lymph from skin and its associated structures

Question 13

lymph nodes’ location

Answer 13

along the course of lymphatic vessels

Question 14

size/shape of lymph node

Answer 14

a kidney bean or green pea

Question 15

what do all lymphatic vessels have?

Answer 15

valves

Question 16

where does thoracic duct pass

Answer 16

through aortic hiatus of diaphragm; along vertebral column; through thoracic cavity; to upper part of thorax

Question 17

lacteals

Answer 17

lymphatic capillaries of the small intestine

Question 18

chyle

Answer 18

milky lymph, result of chylomicrons released into lacteals that form chyle

Question 19

where are lacteals

Answer 19

the center of the villi of lymphatic capillaries

Question 20

where does intestinal lymphatic trunk drain lymph

Answer 20

into cisterna chyli

Question 21

which organs’ lymph drains into cisterna chylia, via intestinal lymphatic trunk?

Answer 21

stomach, pancreas, spleen, liver

Question 22

where does SVC return venous blood?

Answer 22

from all structures SUPERIOR to the DIAPHRAGM

Question 23

where does IVC receive blood from?

Answer 23

all structures INFERIOR to the DIAPHRAGM, except the: stomach, small intestine, large intestine, pancreas, spleen, gall bladder

Question 24

do portal veins/its tributaries have valves?

Answer 24

NO

Question 25

does lymph enter the venous or arterial system?

Answer 25

ONLY VENOUS

Question 26

where is lymph transported to

Answer 26

lymphatic capillaries > lymphoid cells

Question 27

where do lymphoid cells drain into

Answer 27

afferent lymph vessel

Question 28

what does lymph exit lymph node through?

Answer 28

efferent lymphatic vessel

Question 29

what are the largest lymphatic vessels

Answer 29

cisterna chyli, thoracic duct

Question 30

vertebral level of cisternal chyli

Answer 30

L1-L2

Question 31

L side lymphatic duct

Answer 31

thoracic duct

Question 32

R side lymphatic duct

Answer 32

R lymphatic duct

Question 33

where is chyle transported from

Answer 33

small intestine > thoracic duct

Question 34

where does fat go for absorption

Answer 34

jejunum

Question 35

what do chlyomicrons do

Answer 35

process fat absorbed by jejunal cells; then release it into lymphatic system to produce chyle

Question 36

what drains into cisterna chyli from below

Answer 36

intestinal lymph trunk, lumbar lymph trunk

Question 37

what drains into cisterna chyli from above

Answer 37

descending thoracic lymph trunk

Question 38

where does thoracic duct empty lymph into venous circulation?

Answer 38

venous angle: where internal jugular vein - subclavian vein meet

Question 39

where does thoracic duct receive lymph from, in thorax region?

Answer 39

L jugular trunk, L subclavian trunk, broncho-mediastinal trunk

Question 40

where does right lymphatic duct receive lymph from?

Answer 40

R jugular trunk, R subclavian trunk, broncho-mediastinal trunk

Question 41

what body area drains to the right lymphatic duct?

Answer 41

right upper quadrant (R side head, neck, thorax, R lung, R side of heart, R upper limb)

Question 42

what body area drains to thoracic duct?

Answer 42

L side of head, beck, thorax, L lung, L side heart, trachea, esophagus, L upper limb

Question 43

where do scrotum/labium majus drain lymph to?

Answer 43

superficial inguinal lymph nodes

Question 44

where does testis drain lymph to?

Answer 44

lateral aortic (lumbar) lymph node, preaortic lymph node, then to cysterna chyli and thoracic duct

Question 45

where does 75% of breast lymph drain to?

Answer 45

axillary lymph node

Question 46

where does remaining 25% of breast lymph drain to?

Answer 46

clavicular lymph node, parasternal lymph nodes, abdominal lymph nodes

Question 47

where is the SVC

Answer 47

superior mediastinum

Question 48

SVC function?

Answer 48

returns venous blood from all structures superior to diaphragm to the heart

Question 49

where do L and R common iliac veins join, what do they form?

Answer 49

form the IVC at L4 vertebral level

Question 50

how many lumbar veins?

Answer 50

5

Question 51

where do lumbar veins drain?

Answer 51

IVC

Question 52

where does testicular vein drain?

Answer 52

L2-L3 level of IVC

Question 53

where do L testicular and orvarian veins drain?

Answer 53

L Renal vein

Question 54

comparison of L to R Renal vein?

Answer 54

left is 2x longer than right

Question 55

location of right suprarenal v?

Answer 55

vertebral level L1-L2

Question 56

where does L suprarenal vein go?

Answer 56

L Renal V

Question 57

where is the R inferior phrenic vein, what does it do?

Answer 57

drains diaphragm, to IVC | T12-L1

Question 58

which structures inferior to the diaphragm DO NOT drain into the IVC?

Answer 58

stomach, small intestine, large intestine, pancreas, spleen, gall bladder

Question 59

how does venous blood from stomach, small intestine, large intestine, pancreas, spleen, gall bladder get to the IVC?

Answer 59

via portal vein, liver, hepatic veins

Question 60

azygos vein system function?

Answer 60

form collateral pathway between IVC and SVC

Question 61

on R side, azygos vein system?

Answer 61

azygos vein

Question 62

on L side, azygos vein system parts?

Answer 62

hemiazygos vein, accessory hemiazygos vein

Question 63

where are lumbar veins

Answer 63

posterior abdominal wall

Question 64

what does ascending lumbar vein connect?

Answer 64

L5, 4, 3, 2, 1

Question 65

azygos system of veins drain (3)

Answer 65

posterior abdominal and thoracic walls, esophagus, lungs

Question 66

posterior abdominal wall vein?

Answer 66

lumbar veins

Question 67

thoracic wall vein?

Answer 67

posterior intercostal veins

Question 68

esophagus vein?

Answer 68

esophageal veins

Question 69

lung vein?

Answer 69

bronchial veins

Question 70

definition of hepatic portal circulation

Answer 70

vein between 2 capillaries artery > capillaries > portal vein > liver capillaries (sinusoids) > hepatic veins > heart

Question 71

where are 2 sets of capillaries of hepatic portal system

Answer 71

first in abdominal viscera, second in liver

Question 72

what kind of blood does hepatic portal system carry

Answer 72

venous blood, low in oxygen, rich in nutrients

Question 73

portosystemic anastomoses

Answer 73

1. left gastric v (portal) - esophageal branch (systemic) 2. superior rectal v - middle rectal v (lower part of rectum) 3. superficial epigastric v - paraumbilical v (in camper's fascia)

Question 74

do portal vein/ its tributaries have valves?

Answer 74

no!

Question 75

fibrotic nodules

Answer 75

develop on cirrhotic liver sinusoids inside liver compromised/blocked; blood can't flow to liver; blood goes through anastomosis of porto-hepatic system, esophageal branch of L gastric v - azygos v