Lecture 7

Question 1

What are the three functions of lymph vessels?

Answer 1

1. Collection of tissue fluid and its return to the systemic circulation
2. Transport of lymphocytes and other cells
3. Uptake and transport of long chain fatty acids absorbed in the intestine

Question 2

Where is majority of lymph is returned to venous system?

Answer 2

Junction of subclavian and internal jugular veins

Question 3

What is name of blood supply to larger lymph vessels?

Answer 3

Vasa vasorum

Question 4

Where are lymph vessels not found?

Answer 4

CNS, bone marrow, avascular tissue

Question 5

What are the proliferative structures found within lymph nodes?

Answer 5

Lymph nodules

Question 6

What is a sentinel lymph node?

Answer 6

The first node or group of nodes into which lymph from a particular organ drains

Question 7

The thoracic duct is considered to run on which side of the body?

Answer 7

Left

Question 8

The thoracic duct is formed by the confluence of what 5 tributaries?

Answer 8

2 x lumbar
1 x gastrointestinal
2x descending intercostal trunks

Question 9

At what level is the origin of the thoracic duct and what dilation is it associated with?

Answer 9

L2; cisterna chyli (present in 20% of individuals)

Question 10

At what level does the thoracic duct pass through the diaphragm?

Answer 10

Aortic hiatus - T12

Question 11

Describe the route of the thoracic duct from the aortic hiatus

Answer 11

Pass through posterior mediastinum from right to left. Passes posterior to L IVC, brachiocephalic vein and internal jugular to enter jugulosubclavian junction

Question 12

Where does thoracic duct in thorax recieve lymph from?

Answer 12

mediastinal trunks

5-6 upper intercostal trunks

Question 13

What tributaries does the thoracic trunk form in the neck?

Answer 13

L subclavian trunk
L jugular trunk
L bronchomediastinal trunk

Question 14

What tributaries is the right lymphatic duct formed from?

Answer 14

R subclavian trunk
R jugular trunk
R bronchomediastinal trunk

Question 15

Where does R lymphatic duct drain into?

Answer 15

Right jugulosubclavian junction

Question 16

What % of people have R lymphatic duct?

Answer 16

20

Question 17

If R lymphatic duct is not present, then where does the lymph drain into?

Answer 17

subclavian vein
internal jugular vein
IVC

Question 18

What lymph nodes are located along the thoracic duct and R lymphatic duct?

Answer 18

None

Question 19

Lymph drainage of the skin is defined by which imaginary lines?

Answer 19

1/2 way through clavicle
through umbilicus
vertically through midline

Question 20

Where does lymph from skin above clavicle drain into?

Answer 20

Deep cervical group of lymph nodes on same side

Question 21

Where does lymph from skin between clavicle and umbilicus drain into?

Answer 21

Axillary group of lymph nodes on same side

Question 22

Where does lymph from skin beneath level of umbilicus drain into?

Answer 22

Inguinal group of lymph nodes on the same side

Question 23

What consists a resting breast?

Answer 23

Mainly fibrous and adipose tissue

Few ducts and alveoli

Question 24

What happens to breast composition in pregnancy and lactation?

Answer 24

Ducts and alveoli proliferate and secrete

fibrous and adipose decrease

Question 25

What happens to breast composition post lactation?

Answer 25

Glandular tissue involutes and is replaces with fibrous tissue and fat

Question 26

Where does lymph drain from breasts?

Answer 26

75% to axillary group of nodes | Remaining to infraclavicular and parasternal groups

Question 27

What are the three groups of the axillary group?

Answer 27

lateral, anterior and posterior groups

Question 28

What are the divisions of the inguinal nodes?

Answer 28

Superficial - proximal and distal | Deep

Question 29

Where do superficial proximal nodes receive vessels from?

Answer 29

external genitalia (not testis), anal region, skin below level of umbilicus

Question 30

Where do superficial proximal lymph vessels travel with?

Answer 30

round ligament

Question 31

Where do superficial distal nodes receive vessels from?

Answer 31

lower limb

Question 32

Where do superficial distal lymph vessels travel with?

Answer 32

great saphenous vein

Question 33

Where do the efferent vessels from superficial and deep inguinal nodes drain into?

Answer 33

external and common iliac nodes | aortic nodes

Question 34

What do lymph vessels of the intestinal lymph trunk follow?

Answer 34

Major anterior branches (3) of the abdominal aorta

Question 35

What do lymph vessels of the intestinal lymph trunk drain?

Answer 35

Most abdominal organs, especially alimentary system

Question 36

What is the name of the nodes associated with the lymph vessels of the intestinal lymph trunk?

Answer 36

preaortic nodes

Question 37

What do lymph vessels of the lumbar lymph trunk drain?

Answer 37

urogenital organs, posterior body wall and lower limbs

Question 38

What do lymph vessels of the lumbar lymph trunk follow?

Answer 38

iliac vessels and sides of aorta

Question 39

What is the name of the nodes associated with the lymph vessels of the lumbar lymph trunk?

Answer 39

lateral aortic or lumbar nodes

Question 40

Where do lower thoracic lymph vessels drain into?

Answer 40

descending thoracic lymph trunks that contribute to formation of cisterna chyli

Question 41

Where do upper thoracic lymph vessels drain into?

Answer 41

bronchomediastinal lymph trunks and then into jugulosubclavian junction

Question 42

What are divisions of lung lymph vessels?

Answer 42

Deep plexus and superficial subpleural plexus

Question 43

Where do deep plexus and superficial subpleural plexus of lung drain into?

Answer 43

bronchomediastinal lymph trunks

Question 44

What is the highest point reached by thoracic duct before arching behind internal jugular?

Answer 44

C7

Question 45

What veins do the jugular trunk, subclavian trunk and bronchomediastinal trunk run against respectively? What happens if the R lymphatic trunk is not present?

Answer 45

internal jugular vein, subclavian vein and brachiocephalic vein; These trunks drain into the corresponding veins

Question 46

If normal lymph channels from breast are blocked, then where does the lymph drain?

Answer 46

inferior deep cervical nodes or contralateral breast

Question 47

What is the deep cervical group of lymph nodes split into?

Answer 47

superior and inferior