Lymphatics

Question 1

Name 3 functions of the lymphatic system

Answer 1

1) Drain excess interstitial fluid
2) Transport dietary lipids from GI tract to blood
3) Protects against invasion through immune responses

Question 2

How many litres of interstitial fluid circulates?

Answer 2

3

Question 3

Where is most extracellular fluid reabsorbed

Answer 3

Capillaries

Question 4

What are lymphatic vessels

Answer 4

Larger capillaries that drain into ducts in venous system

Question 5

What is the function of lymph nodes

Answer 5

Filter the lymph along the way

Question 6

Define lymphati filariasis

Answer 6

Failure of lymph to drain back into the venous system so vessels swell up

Question 7

Main worldwide cause of lymphatic filariasis

Answer 7

Roundworm which is transmitted by a mosquito

Question 8

Is pressure high or low in lymphatic system

Answer 8

Low

Question 9

How is flow in the lymphatic system aided? (5)

Answer 9

• Milking action of skeletal muscle
• Valves to prevent backflow
• Pressure changes in thorax
• Lymph vessels close to arteries and arteries are pulsatile
• Smooth muscle in walls of trunks and ducts contracts

Question 10

What lymphatic trunks drain the legs?

Answer 10

Right and left lumbar

Question 11

What does the intestinal duct drain?

Answer 11

Intestines and liver into thoracic duct

Question 12

Name the 9 lymphatic trunks

Answer 12

Intestine
Right and left lumbar
Right and left subclavian
Right and left jugular
Right and left bronchomediastinal

Question 13

Where does the right lymphatic duct drain?

Answer 13

Junction of IVJ and subclavian vein (same as the left)

Question 14

What does the right lymphatic duct drain

Answer 14

Right upper quadrant

RIde side of head,neck, thorax and right arm

Question 15

What does the thoracic duct drain

Answer 15

Left side and rest of body

Question 16

Where does the thoracic duct begin and end?

Answer 16

Begins at cisterna chyle in abdomen

Ends at left venous angle

Question 17

How do lymph nodes filter lymph

Answer 17

Macrophages remove and destroy microorganisms and debris

Question 18

How do lymph nodes activate the immune system

Answer 18

Lymphocytes strategically located to monitor for presence of antigens

Question 19

How many lymph nodes are there in the body

Answer 19

600

Question 20

What do superficial components drain

Answer 20

The skin

Question 21

Where do cervical nodes drain

Answer 21

Above the clavicle

Question 22

Where do axillary nodes drain

Answer 22

Between clavicle and umbilicus

Question 23

Where do inguinal nodes drain

Answer 23

Below umbilicus

Question 24

Where do vessels enter the superficial lymph nodes to drain the head and neck

Answer 24

Along the course of the external jugular vein (over sternocleidomastoid)

Question 25

Where do you find the deep cervical nodes

Answer 25

Vertical chain along internal jugular vein

Question 26

What do the efferent vessels of the deep cervical nodes form

Answer 26

Right jugular trunk

Question 27

Which lymph nodes are palpabale

Answer 27

Superficial lymph nodes

Question 28

Which of the axillary nodes are palpable

Answer 28

Central node

Question 29

Where do humeral nodes come from

Answer 29

Arm

Question 30

Which of the axillary nodes are most anterior

Answer 30

Pectoral

Question 31

Where are subscapular nodes found

Answer 31

Under the scapula

Question 32

What are sentinel lymph nodes

Answer 32

First nodes that tumour arrives at

Question 33

In which 2 directions do the 2 groups of inguinal lymph nodes run

Answer 33

Horixonal- superficial to the inguinal ligament | Vertical- lie along termination of great saphenous vein

Question 34

What vessels make up horizontal lymph nodes

Answer 34

Superficial lymphatics from anterior abdominal wall, perineum, and external genitalia exlucing testes

Question 35

What vessels make up vertical lymph nodes

Answer 35

Majority of superficial lymphatic from legs

Question 36

Where do efferents from superficial lymph nodes drain to

Answer 36

Deep inguinal nodes

Question 37

Name the nodes responsible for deep drainage of the thorax

Answer 37

``` Interpulomonary nodes Superior trachebronchila nodes Inferior tracheobronchial nodes Interlobar lymph vessels Sub pleural plexus Paratrachael Bronchomediastinal trunks ```

Question 38

Where do the lymphatics of the post abdominal wall lie?

Answer 38

Aorta, inferior vena cava, iliac vessels

Question 39

Where do external and iliac ndoes drain to

Answer 39

Lumbar lymph nodes

Question 40

What forms the lumbar trunk

Answer 40

Efferents from lumbar lymph nodes

Question 41

Where do intestinal and right and left lumbar trunk drain to

Answer 41

Cisterna Chyle

Question 42

What vessels come from the abdomen

Answer 42

Pre aortic lymph nodes | Intestinal lymph trunk

Question 43

What is Trosiers' sign?

Answer 43

Hardened lump in supraclavicular nodes- abdominal cancers may metastasise to left supraclavicular lymph nodes

Question 44

How can lymph nodes differentiate between cancer and infection

Answer 44

``` Cancer= hard lymph ndoes Infection= tender lymph nodes ```

Question 45

Is lymph node distribution the same or different in children and adults

Answer 45

Same

Question 46

How does lymphoid tissue size change during childhood

Answer 46

Increases to twice adult mass between 6-9 years | Regresses to adult levels by puberty

Question 47

Are tonsils larger and smaller in childhood?

Answer 47

Larger

Question 48

How does lymph system change in older adults?

Answer 48

Number and size decreases with age Some elements are lost (thyroid) More fibrotic and fatty

Question 49

Name all of the lymph nodes accessible to examination in head and neck (11)

Answer 49

``` Preauricular Postauricular Occipital Tonsillar Submandibular Submental Superiro anterior cervical Deep cervical Posterior cervical Supraclavicular Infraclavicular ```

Question 50

Name all of the lymph nodes accesible to examination in the arm

Answer 50

``` Axillary nodes (anterior axillary/pectoral, lateral/ brachial, mid axillary/ central, posterior/ subscapular) Epitrochlear ```

Question 51

Name all of the lymph nodes accessible to examination in the legs

Answer 51

Superficial superior inguinal Superficial inferior inguinal Popliteal (sometimes)

Question 52

Do lymphoid organs filter lymph

Answer 52

No- just the lymph nodes do this

Question 53

Do organs typically have afferent lymphatics, efferent lymphatic or both

Answer 53

Efferents

Question 54

Functions of the spleen (5)

Answer 54

``` Site for lymphocyte proliferation Immune surveillance Cleanses blood Stores and releases breakdown products of RBC Erythrocyte production in foetus Stores platelets ```

Question 55

How does the spleen drain the blood?

Answer 55

Extracts aged and defective blood cells and platelets | Macrophages remove debris and foreign matter

Question 56

What does thymus secrete

Answer 56

Thymopoietin and thymosins

Question 57

Descibe anatomical positioning of thymus

Answer 57

Inferior neck and superior thorax | Deep to the sternum

Question 58

Name the 4 tonsils

Answer 58

Palatine Lingual Pharyngeal Tubal

Question 59

What are pharyngeal tonsils called if they're enlarged

Answer 59

Adenoids

Question 60

Functions of tonsils

Answer 60

Gather and remove some pathogens entering pharynx in food or inhaled air

Question 61

Define payers patches

Answer 61

Large isolated clusters of lymphoid tissue located in wall of distal small intestine

Question 62

Functions of peyers patches

Answer 62

- Destroy bacteria and prevent pathogens breaching intestinal wall - Generate memory lymphocytes for long term immunity