lymphatic lecture

Question 1

lymphatics during gestation and growth

Answer 1

b egins in 5th week of development, present by 20 weeks
immature at birth
- matures and changes until puberty
- decline in geriatric population

Question 2

spleen location

Answer 2

• beneath ribs 9,10, 11 on left

- between left hemi-diaphragm and peritoneal cavity

Question 3

half of the bodys lymph is formed in

Answer 3

liver

Question 4

what is the “gate-keeper of shared hepato-biliary-pancreatic venous and lymphatic region

Answer 4

liver

Question 5

organs clearing bacteria

Answer 5

liver

spleen

Question 6

this organ has little or no lymphatic function in adult

Answer 6

thymus

Question 7

thymus location and development

Answer 7

• superior mediastinum, anterior to great vessels, extending into neck
• large in infant (greatest at age 2) involutes after puberty; replaced by fatty tissue in adults

Question 8

this organ provides cells to influence and build immunity early in life but nonessential in adults

Answer 8

tonsils

Question 9

tonsils - names and location

Answer 9

• multiples areas in ring formation in posterior oropharynx
• palatine - lateral pharynx
• lingual - posterior 1/3 of tongue
• pharyngeal - adenoids at nasopharyngeal border

Question 10

appendix location

Answer 10

medial surface of the cecum

Question 11

visceral lymphoid tissue

Answer 11

respiratory system - filtration of toxins form lungs
GI system - peyer’s patches (distal ilium)
- lacteals - lymphatic capillaries in each villi in small bowel
- fats enter circulation via GI system

Question 12

PRIMARY purpose of lymph nodes is?

Answer 12

filtration of lymph

Question 13

how many lymph nodes in body?

Answer 13

400-450

Question 14

superficial nodes receive lymph from ? and drain into which groups?

Answer 14

from skin/ deep tissues of upper and lower extremities/ head and neck
into 
- cervical
- axillary
- inguinal
[CIA!!!]

Question 15

cervical drainage

Answer 15

head/ supraclavicular and upper extremity drain to jugular nodes

Question 16

axillary drainage

Answer 16

infraclavicular to umbilicus, drain to axillary nodes and then subclavian

Question 17

inguinal drainage

Answer 17

caudal to umbilicus drain to inguinal nodes and then lumbar

Question 18

lymph channels/ ducts perfuse all tissue of body except

Answer 18

CNS
epidermis (includes hair and nails)
endomysium of muscles and cartilage 
bone marrow
selected portions of peripheral nerves
exceptions still possess direct diffusion

Question 19

lymph nodes unite with

Answer 19

thoracic duct or

right lymphatic duct

Question 20

what is associated with intra-abdominal or thoracic carcinoma/ cancer

Answer 20

virchow’s node

located in left supraclavicular region

Question 21

thoracic duct locaiton and path

Answer 21

• largest lymph vessel
• lies agaisnt vertebral column (between aorta and azygous vein)
• on right side but at T4!!! crosses over, moves left of midline and connects to the junction of left cub-clavian and left brachiocephalic veins

Question 22

superficial nodes in head/ neck region?

Answer 22

submental

- virchow’s

Question 23

superficial nodes in abdomen

Answer 23

cisterna chyli

celiac

Question 24

superficial nodes in upper extremity

Answer 24

• deltopectoral
• axillary
• cubital

Question 25

superficial nodes in lower extremity

Answer 25

- superificial inguinal | - popliteal

Question 26

what is the cisterna chyli formed from and where is it located

Answer 26

- dilatation of distal thoracic duct | - anterior to L1-2 and posterior to right crura of diaphragm

Question 27

duct drains into thoracic duct

Answer 27

- left side of head and neck - left arm - left side of thorax - left and right lower body - viscera of thoracic

Question 28

right lymphatic duct drains...

Answer 28

- right head and neck - right arm - right chest

Question 29

right lymphatic duct connects to

Answer 29

venous system at jugular-subclavian junction

Question 30

overall path of lymph gluide

Answer 30

froma rterial capillaries into interstitium and | single-cell lymphatic vessels

Question 31

functions of lymphatic system

Answer 31

- fluid balance - purification and cleansing - defense - nutrition

Question 32

how much excess flluid from pleura, peritoneum, pericardium and joints can the lymph system absorb

Answer 32

excess of 3 liters/ 24 hours

Question 33

how is lymph system involved in nutrition

Answer 33

- returns protein back to vascular system - bind to nutrients - absorbed via lymph system

Question 34

what is normal intersitial fluid pressure, will increase or decrease in it increase flow? where the efficiency ceiling at?

Answer 34

normal = -6.3 mmHg increase in pressure will increase flow - efficiency ceiling at 0 mmHg, after that collapses vessels and obstructs flow

Question 35

intristitial fluid pressure is increased by

Answer 35

- increased arterial capillary pressure (hypertension) - decreased plasma colloidal osmotic pressure (hepatic cirrhosis) - increased interstitial fluid protein (starvation/ plasma hypoalbuminemia) - increased capillary permeability (toxins = rattlesnake poisoning)

Question 36

distension of larger vessels and smaller vessels contraction to help lymph flow is an example of an

Answer 36

intrinsic pump

Question 37

direct pressure on vesels moving lymph and internally exerted pressure e.g. respiration, pressure gradients, crura acting on cisterna chyli are examples of an

Answer 37

extrinsic pump

Question 38

pelvic diaphragm's movement of itnerstitial fluid from pelvis is important in

Answer 38

- dysmenorrhea - preparation for labor and delivery - prostate irritation in benign prostatic hypertrophy and other prostate problems

Question 39

what is the goal of OMT for lymphatic system

Answer 39

balanced, well functioning lymphatic system in which no edema occurs

Question 40

in OMT you always start at the level of the... where is it located?

Answer 40

thoracic duct - thoracic inlet | - junction of the duct and left subclavian vein/ brachiocephalic vein

Question 41

what are the areas of treatment in OMT

Answer 41

``` 1- thoracic 2- abdomen 3 - upper extremity 4- lower extremity 5 - head and neck start and finish with thoracic inlet!!! ```

Question 42

thoracic duct may be dilated 16x its normal size in

Answer 42

Congestive Heart failure | - cant do OMT coz patient can't lay supine due to fluid overload

Question 43

contraindications to general lymphatic treatment

Answer 43

- early carcinoma/ metastatic cancer - osseous fracture - acute bacterial infection (102 F > temp;otherwise cause septic spread) - acute hepatitis - infectious mononucleosis - circulatory disorders (venous obstruction, embolism and hemorrhage) and coaguloapathies - anuria (not producing urine e.g. needsdialysis) - CHF (some techniques)

Question 44

major organs for lymphatic system

Answer 44

``` spleen liver tonsils thymus visceral (GI and pulmonary) ```