Lymph System

Question 1

What does liver damage do to levels of albumin in blood?

How does this affect oncotic pressure?

Answer 1

Decreases the levels of albumin in blood

It decreases oncotic pressure

Question 2

What is oncotic pressure?

Answer 2

force pulling fluid back into capillaries d/t proteins

Question 3

2 main functions of Lymphatic system

Answer 3

1. ) Fluid Balance- lacteals (in capillary beds) take-up fluid from interstitium, fluid is returned to systemic circulation.
2. ) Immune Surveilance- filter fluid scanning for bacteria and other pathogens

Question 4

Which is higher in the blood compared to the lymph?

Electrolytes
Total Protein
IgG
Cholesterol

Answer 4

electrolytes are same in both lymph and serum

total protein greater in serum

IgG higher in serum

Cholesterol higher in serum

Question 5

What are the Starling forces that cause interchange between intervascular and interstitial space?

Answer 5

Net hydrostatic pressure (pressure on the capillary d/t capillary hydrostatic pressure and intersitial hydrostatic pressure)

Net oncotic pressure [pressure exerted by proteins in blood plasma (capillary oncotic pressure) vs intersitium (interstitial oncotic pressure)]

Capillary filtration- how permeable the capillaries are

Question 6

Factors effecting capillary permeability

Answer 6

fever, sepsis, infection, inflammation, burns, etc.

Question 7

What is the net effect of increased intravascular hydrostatic pressure? (downstream obstruction)

Answer 7

increase in capillary hydrostatic pressure resulting in flitration into the interstitium. Lacteals of lymph cannot return all of excess fluid into circulation so edema/ascites results.

causes: Heart failure, cirrhotic liver disease

Question 8

What is the net effect of fluid in decreased intravascular oncotic pressure (decreased protein in blood)?

Answer 8

decrease in capillary oncotic pressure resulting in decreased re-absorption of fluid into serum, this leads to increased fluid in interstitium leading to edema/ascites.

Causes:
hypalbuminemia from;
-Malnutrition (low protein intake)
-Liver failure (not enough protein produced)
-Nephrotic syndrome (too much protein lost in urine)

Question 9

When does increased capillary filtration occur?

Answer 9

Burns, inflamm, toxic damage: sepsis, pancreatitis, inhalation injuries

Question 10

What is the net effect of fluid in lymphatic obstruction?

Answer 10

Lymphatic obstruction is the inability to absorb fluid from the interstitium leading to edema.

Causes:
Lymphoma
Metastatic Cancers
Surgical removal of lymph nodes

Question 11

Primary lymphoid organs are?

Answer 11

bone marrow

thymus

Question 12

secondary lymphoid organs are?

Answer 12

• Spleen,
• Lymph nodes
• MALT (mucosal associated lymphoid tissue, ex- tonsil, peyers patches)

Question 13

What types of cells are formed in the bone marrow?

Answer 13

Granulocytes (neutrophils, eosinophils, basophils)

Agranulocytes; Lymphocytes (T and B), Monocytes (Mf in tissue)

Question 14

Cells formed in the lymph tissue?

Answer 14

Lymphocytes from precursor cells that originate in marrow)

Question 15

WBC found in the blood

Answer 15

• PMN neutrophils
• PMN eosinophils
• PMN basophils
• Monocytes
• Lymphocytes
• Plasma cells occasionally

Question 16

Lymphocytes are store ____.

Lifetime is how long?

Answer 16

lymph organs

weeks to months

Question 17

WBC get into tissues by___

WBC move around once inside the tissues by_____

WBC are attracted to inflamed tissue areas by____

Answer 17

1. ) diapedesis
2. ) amoeboid motion
3. ) chemotaxis

Question 18

3 factors determining whether or not phagocytosis occurs

Answer 18

How smooth is it? (rough surface increases phagocytosis)

2. ) protective protein coat (without coat more easily phagocytosed)
3. )Opsonization (yummy, tags cells for phagocytoses)

Question 19

Most important function of Mf and neutrophils?

Answer 19

PHAGOCYTOSIS!!!

Question 20

What cells make up the Reticuloendothelial System?

What tissues are part of this system?

How long do these cells remain in the tissues?

Answer 20

Monocytes-Mf

Skin/SubQ- histocytes
Lymph Nodes
Lungs
Liver (Kupffer Cells)
Spleen & Bone marrow
Brain (Microglia) 

Mf Months-Years

Question 21

Function of Spleen?

Asplenia- more susceptible to bacterial pathogens such as? What vaccines should they get?

Answer 21

filters blood

Streptococcus pneumoniaem Haemophilus influenzae

pneumo and H. Flu vaccine

Question 22

Describe the composition of the spleen.

Answer 22

Red pulp- vascular, where RBC are recycled, detects and responds to foreign substances in blood, acts as blood reservoir

White pulp- lymphoid-like, has germinal centers rich in B cells and abys, T cells surround vessels (PALS).

PALS- periarterial lymphoid sheaths, mostly T cells

Question 23

What is the Walling off effect of Inflamm?

Answer 23

fibrinogen clot act in intersitial tissues which help block fluid flow, this prevents entrance of bacteria….also makes region more difficult to treat with abx.

Question 24

Inflamm response to tissue injury

Answer 24

1. vasodilation
2. increased capillary permeability
3. clotting of fluid in interstitial spaces
4. a.)migration of granulocytes and monocytes d/t release of prostaglandins, histamine, heparin, bradykinin, seratonin
   b. ) local mf act first, neutrophils invade via chemotaxis, second mf invasion, increased production of granulocytes and monocyte from bone marrow.
5. swelling of tissue cells

Question 25

Walling off effect can result in______ and why?

Answer 25

boils/furuncles (abcesses)

why: infection such as staph. aureus gets walled off or contained to one region resulting in boils/abcesses, this makes them difficult to treat w/ abx.

Question 26

Treatment of abcess?

Answer 26

I&D

incision and drainage

Question 27

What makes up exudate?

Answer 27

necrotic tissue, dead neutrophils and MF, tissue fluid

Question 28

Which type of cells attack parasites?

Answer 28

eosinophils

Question 29

Basophils and mast cells are released when? What do they secrete?

Answer 29

Allergic Rxn

histamine, bradykinin, serotonin