Lymph

Question 1

what is lymph

Answer 1

clear watery, slightly yellow fluid lost from the capillary beds that collects in the surrounding tissues

Question 2

describe the course of lymph

Answer 2

fluid lost from capillary beds is taken up by lymphatic plexuses (network of lymphatic capillaries)

Question 3

lymph is drained from the lymphatic capillaries to

Answer 3

lymphatic vessels (lymphatics)

Question 4

lymphatics have abundant ____

Answer 4

valves

Question 5

multiple lymphatic vessels join to form

Answer 5

lymphatic trunks

Question 6

do lymphatics occur in the brain

Answer 6

no - excess tissue fluid of the CNS drains into the CSF

Question 7

how is lymph filtered

Answer 7

lymph nodes occur along the course of lymphatic vessels

Question 8

what are the circulating cells of the immune system

Answer 8

lymphocytes

Question 9

superficial lymphatic vessels follow

Answer 9

venous drainage

Question 10

deep lymphatic vessels follow

Answer 10

arteries

Question 11

describe the course of lymph from the superficial lymphatic vessels

Answer 11

follow venous drainage then eventually drain into deep lymphatic vessels which follow arteries and also receive drainage from internal organs

Question 12

superficial and deep lymphatic vessels become ____ as they merge with vessels draining adjacent regions

Answer 12

larger

Question 13

large lymphatic vessels enter

Answer 13

lymphatic trunks

Question 14

lymphatic trunks unite to form

Answer 14

either the right lymphatic duct or thoracic duct

Question 15

where does the right lymphatic duct drain

Answer 15

body’s right upper quadrant - right side of head, neck, and thorax and right upper limb

Question 16

where does the right lymphatic duct join the venous system

Answer 16

junction of right internal jugular vein and right subclavian vein - right venous angle

Question 17

where does the thoracic duct drain

Answer 17

rest of the body - lower limbs, abdomen, left side of thorax head and neck and left upper limb

Question 18

the lymphatic trunks draining the lower half of the body merge in the abdomen sometimes forming a dilated collecting sac called the

Answer 18

cisterna chyli

Question 19

where does the thoracic duct join the venous system

Answer 19

left venous angle at the junction of the left internal jugular and left subclavian veins

Question 20

what is chyle

Answer 20

milky lymph containing lipids and lipid soluble vitamins absorbed from the small intestine

Question 21

lymphatic vessels have a similar structure to

Answer 21

very small veins

Question 22

what is contained in the lymph nodes

Answer 22

lymphocytes and macrophages

Question 23

where are lymphocytes formed

Answer 23

in bone marrow

Question 24

after forming in the bone marrow where do lymphocytes mature

Answer 24

either in bone marrow (B cells) or thymus (T cells)

Question 25

what are 2 primary lymphoid organs

Answer 25

bone marrow and thymus

Question 26

name some other concentrations of lymphoid tissue in the body (secondary lymphoid organs - seeded from primary)

Answer 26

``` spleen tonsils lymph nodes Peyer's Patches GALT, BALT, MALT ```

Question 27

what do GALT, BALT and MALT stand for

Answer 27

Gut Bronchiolar Mucosa Associated Lymphoid Tissue

Question 28

what are Peyer's patches

Answer 28

small groups of lymphoid tissues in the walls of the small intestines (GALT)

Question 29

how do plasma proteins, bacteria, cellular debris and whole cells e.g. lymphocytes readily enter lymphatic capillaries

Answer 29

highly attenuated endothelium which lacks a basement membrane and have a surplus of tissue fluid

Question 30

lymph node swelling indicates

Answer 30

a problem

Question 31

slow lymph flow through a node can lead to what

Answer 31

cancer cells forming secondary tumours within nodes

Question 32

describe healthy nodes

Answer 32

small, soft, bean shaped | difficult to see in dissection and difficult to palpate

Question 33

what are 2 ways lymph can be visualised

Answer 33

lymphogram - older method | surgery

Question 34

what is the sentinel node

Answer 34

first node that the structure drains to

Question 35

lymph from lower limbs and pelvis drain to the _____ trunks

Answer 35

lumbar trunks

Question 36

where does the thoracic duct pass

Answer 36

posterior mediastinum of thorax between the aorta and azygous vein

Question 37

is the right lymphatic duct always present

Answer 37

no

Question 38

what 3 trunks drain to the junction of the RSCV and RJV

Answer 38

right jugular trunk right subclavian trunk right bronchomediastinal trunk

Question 39

the right jugular trunk drains

Answer 39

the right side of the face and neck

Question 40

right subclavian trunk drains

Answer 40

right upper limb and superficial structures of the upper part of the thorax and abdominal walls on RHS

Question 41

the right bronchomediastinal trunk drains

Answer 41

deep thoracic structures on the right

Question 42

what is an anatomical variant seen in the trunks draining

Answer 42

in most individuals the 3 trunks drain independently into RSC and RJ junction - 20% population, the jugular and subclavian trunks unite to form right lymphatic duct that drains to junction instead - bronchomedistinal trunk usually drains independently

Question 43

are there the equivalent 3 trunks on the left

Answer 43

yes

Question 44

the foregut drains where

Answer 44

coeliac nodes

Question 45

the midgut drains where

Answer 45

superior mesenteric nodes

Question 46

the hindgut drains where

Answer 46

inferior mesenteric nodes

Question 47

the coeliac, SM and IM nodes are also known as

Answer 47

pre-aortic nodes (anterior surface)

Question 48

renal nodes are

Answer 48

para-aortic

Question 49

the cisterna chyli is seen very close to the _____ on dissection

Answer 49

diaphragm

Question 50

where are the axillary nodes found

Answer 50

in axilla in fat surrounding the brachial plexus and axillary vessels

Question 51

axillary nodes drain what

Answer 51

upper limb | lateral sides of breast and thoracic wall

Question 52

there are also small nodes where in the arm

Answer 52

cubital fossa

Question 53

testes and ovaries drain where

Answer 53

para-aortic nodes

Question 54

what are some nodes of the pelvis

Answer 54

superficial and deep inguinal | common, external and internal iliac

Question 55

describe the lymph drainage of the lower limb

Answer 55

popliteal and femoral to inguinal to iliac

Question 56

name the lymph nodes in the head and neck

Answer 56

parotid, sublingual, submental, auricular, jugular, cervical