Lymphatic Exam

Question 1

Function of lymphatic system

Answer 1

Production of lymphocytes and antibodies
Phagocytosis
Absorption of fat and fat soluble substances in the gut
Movement of lymph fluid/ drainage of interstitial space
Manufacture of blood when marrow is stressed
Spread of malignancy

Question 2

Evaluation of lymphatic drainage

Answer 2

blood capillaries - lymph from interstitial space - lymph cap - lymph veins - lymph ducts - large circulatory veins
Flow through node: Interstitium - afferent lymphatic - capsule - cortex - medulla - efferent lymphatic - either blood or secondary lymph organ.

Question 3

Examination of the spleen and why

Answer 3

LUQ btwn stomach and diaphragm. Percussion of the spleen should have dullness between 6th – 10th ribs. If it is larger, may indicate an enlarged spleen, however a full stomach may also mimic this. Another way to assess spleen enlargement it to percuss the lowest intercostal space; this should be tympanic with expiration/inspiration; If tympanic changes to dullness the spleen may be enlarged. When palpating the spleen, if it is felt, it is enlarged.
Why: Essential for examination of immune system; spleen is usually the first immunological response to blood borne antigens

Question 4

Common expected finding of lymph system

Answer 4

Normal nodes may not be palpable, prior inflammation may be palpable, children under 12 yrs: shots facial, cervical and inguinal nodes

Question 5

Lymphadenopathy

Answer 5

enlargement of the lymph nodes, may be palpable in superficial nodes
Localized - suggests regional infection or disease
Generalized - suggests a systemic inflammatory infectious or malignant process

Question 6

Lymphedema

Answer 6

Edema due to excess lymph fluid is tissues, due to obstruction in lymph vessels/nodes, caused by inadequate lymph drainage, Non pitting, often iatrogenic

Question 7

Lymphadenitis

Answer 7

infection and inflammation of lymph nodes. May result in skin breakdown and ulcerations of overlying tissue - bulbous. ID edematous, erythematous tissues. Node firm, contender, inflammation without warmth

Question 8

Lymphangitis

Answer 8

Acute, inflammation of one or more lymph vessels due to infectious agent. ID - red streaks appears like ‘blood poisoning following ducts and blood vessels, indurated and palpable.

Question 9

Documentation of lymph abnormality

Answer 9

Location, size, shape, color, temperature, consistency, tenderness, mobility, margins.

Question 10

Lymphatic Circulation

Answer 10

R. Drainage area: R lymph duct - R subclavian vein
L. Drainage area: Thoracic duct - L subclavian vein
L supraclavicular node: Verchow Node (important in assessment for cancer b/c of L Drainage area, specifically indicates and or L thoracic malignancy)

Question 11

Functions of the spleen

Answer 11

Filter, destroy and recycle old red blood cells
Produce antibodies
Store red blood cells
Filter microorganisms from the blood