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Cardiorespiratory CC > Lymphatics > Flashcards

Lymphatics Flashcards

1
Q

Lymphatic System Functions

A

Drain excess Interstitial Fluid
Transport dietary lipids
Protect against invasion
Unwanted role in providing pathway for spread of malignancy

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2
Q

What happens if 3L interstitial fluid not reabsorbed

A

Oedema

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3
Q

Components of lymphatic system

A

Lymph- 3L of IF that circulates
Lymphatic capillaries
Lymphatic vessels –> drain into trunks–> into ducts in venous system

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4
Q

Capillaries wall

A

Single wall

Porous membrane

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5
Q

Capillaries composition

A

Endothelial cells
Have loose flap arrangement
Permeable to hormones, fats + proteins found in ISF
Anchored by collagen filaments in interstitium

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6
Q

ECF reabsorption

A

Most ECF reabsorbed by capillaries

Approx 17L/day

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7
Q

Capillaries absorption MOA

A

When pressure in interstitium increases, flaps open –> allow influx of ISF
If pressure decreases, the flap closes

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8
Q

Lacteals

A

Specialised lymphatic capillaries
Found interspersed within the villi in the intestines
Help fatty molecules that cannot access the capillary bed to be absorbed
–> transported into venous system

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9
Q

Lymphatic plexus

A

Collection of lymphatic vessels within the capillary bed

Widen to become lymphatic capillaries

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10
Q

Flow of lymph

A

Lymphatic collecting vessels –> lymph nodes (filter lymph)–> drain into lymphatic trunk –> drain into lymphatic duct –> venous system in neck

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11
Q

Elephantitis (Lymphatic filariasis)

A

Roundworm larvae transported by mosquito
Hide within lymphatic system + obstruct vessels within lymphatics
Lymph can’t drain into venous system
Tissues begin to swell

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12
Q

Elephantitis complication

A

Scrotal Hydrocele

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13
Q

Lymphatic vessels pressure

A

Low pressure conduits

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14
Q

Aiding flow of Lymph

A 
Musculo-venous pump
Valves to prevent backflow
Pressure changes in thorax
Pulsations
Smooth muscle in walls of trunks + ducts
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15
Q

Musculo-venous pump

A

Milking action of active skeletal muscle

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16
Q

Pressure changes in thorax

A

Pressure decreases in thorax –> vessels dilate –> flow of lymph

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17
Q

Deep lymphatics

A

Bundles in sheaths of CT with arteries

Pulsations of artery –> help promote flow of lymph

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18
Q

Inferior Lymphatic trunks

A

Lumbar trunks

Intestinal trunk

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19
Q

Lumbar trunk

A

Drain fluid from legs

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20
Q

Intestinal trunk

A

Drain fluid from intestines, spleen + liver

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21
Q

Superior Lymphatic trunks

A

Bronchomediastinal trunk- joining of smaller trunks
Subclavian trunks
Jugular trunks

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22
Q

Right Lymphatic Duct

A

Terminal end of lymphatic system on RHS
Drains at junction of internal jugular vein + right subclavian vein
Drains R Upper quadrant (right side of head, neck, thorax + right arm)

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23
Q

Thoracic Duct

A

Drains rest of body
Begins in abdomen as cisterna chyle
Duct ends at left venous angle in venous system

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24
Q

Lymph nodes

A

Only structures that can filter lymph

–> macrophages remove + destroy microorganisms + debris

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25
Q

Unfiltered lymph journey

A

Enters lymph nodes through afferent lymphatic vessels
Dendritic cells (APC) detect pathogen if present in lymph
Present antigen to B lymphocytes
B lymphocytes produce antibodies
Antibodies in lymph neutralize pathogen
T lymph attack antibody tagged pathogen

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26
Q

Superficial nodal components

A

Drains the skin

All eventually drain into deeper nodes

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27
Q

Cervical nodes

A

Drain lymph above clavicle

Vessels enter along course of External Jugular Vein

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28
Q

Axillary nodes

A

Drain lymph between clavicle + umbilicus

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29
Q

Inguinal nodes

A

Drain lymph below umbilicus

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30
Q

Deeper nodal components

A

Drain structures of thorax, abdomen, pelvis + perineum

31
Q

Deep cervical nodes

A

Vertical chain along Internal Jugular Vein (posterior to SCM)
Efferent vessels form right and left jugular trunks

32
Q

Palpable lymph nodes

A 
Submental
Submandibular
Tonsillar
Parotid
Preauricular
Posterior auricular
Occipital
Superficial cervical
Deep cervical
Supraclavicular
33
Q

Nodes that drain into central nodes

A 
Humeral nodes (arm)
Pectoral nodes (anterior chain)
Subscapular nodes
34
Q

Central nodes

A

Generally palpable in apical (infraclavicular) nodes

Drain into apical (infraclavicular) nodes

35
Q

Apical nodes

A

Drain into supraclavicular nodes

36
Q

Axillary nodes lymph journey

A

Humeral + Pectoral + Subscapular nodes –> central nodes –> apical nodes –> supraclavicular nodes –> subclavian lymphatic trunk –> right (or left) venous angle

37
Q

Sentinel lymph nodes

A

First nodes/groups of nodes along route of tumour/infection spread that will collect inflammatory products or products from tumour itself

38
Q

Breast exam

A

Can take biopsy
Radioactive dye injected around area
Probe follows its course in sentinel node
Sentinel node removed + analysed

39
Q

Radical Mastectomy

A

If sentinel node removed contains tumorous material, must remove nodes in that region as precaution
Breast tissue removal + lymph node removal
–> reduces lymphatic vessels/area for fluid can return to lymph system –> lymphoedema

40
Q

Lymphoedema from radical mastectomy

A

Can take up to 12 months to progress due to disruption of flow in lymph system
Approx 20% of patients will have

41
Q

Lymph drainage abdomen (below umbilicus) + lower limb

A

2 groups of superficial inguinal lymph nodes which are palpable (horizontal + vertical)

42
Q

Horizontal lymph nodes

A

Run superficial to inguinal ligament

Superficial lymphatics from anterior abdominal wall, perineum + external genitalia (excluding gonads)

43
Q

Para-aortic nodes

A

Drain gonad lymph

44
Q

Vertical lymph nodes

A

Lie along termination o great saphenous vein

Drain majority of superficial lymphatics from leg

45
Q

Deep inguinal nodes

A

Efferents from superficial lymph nodes drain into here
Not palpable
Also receive lymphatics from deep structures of leg
Efferents to external iliac nodes

46
Q

Vertical + Deep Inguinal lymph node clearance

A

Cancerous lymphatic fluid has retracted from sole of foot
Has presented in both vertical + horizontal superficial lymph nodes
Inguinal lymph node clearance during surgery to remove malignant melanoma

47
Q

Deep drainage of thorax

A

Subpleural plexus –> interlobar lymph vessels

And other nodes

48
Q

Interpulmonary nodes

A

Within lung tissue itself

49
Q

Bronchopulmonary nodes

A

Nodes at junction of lungs + bronchus

50
Q

Inferior tracheobronchial nodes

A

Receive from the heart

At junction of trachea + bronchus

51
Q

Superior tracheobroncal nodes

A

Above carina

52
Q

Paratracheal nodes

A

Along sides of trachea

53
Q

Posterior mediastinal node

A

Associated with aorta

In close association with tracheobronchial nodes

54
Q

All nodes in lungs etc

A

Drain into bronchomediastinal trunks

55
Q

External and internal iliac nodes

A

Common iliac nodes
Lumbar lymph nodes
R + L lumbar trunks

56
Q

Vessels from abdomen

A

Pre-aortic lymph nodes

Intestinal lymph trunk

57
Q

Cisterna chyle

A

Dilation that marks beginning of thoracic duct
Located anterior to L1 and L2
Intestinal + R + L lumbar trunks drain into here

58
Q

Virchow’s Node/ Trosier’s Sign

A

Supraclavicular nodes on LHS
Associated with gastric cancer, and cancers in abdomen
Receive drainage from abdomen

59
Q

Infants + children

A

Lymph tissue increases to 2x adult mass between 6-9 yo, then goes back to adult level by puberty
Tonsils larger during childhood

60
Q

Older adults

A

No. + Size of lymph nodes decreases with age
Nodes more fibrotic + fatty –> impaired ability to resist infection
Thymus lost

61
Q

Lymphoid organs

A 
Only lymph nodes filter lymph, even if tissue make up of lymphoid organs (excluding thymus) is reticular connective tissue
Spleen
Thymus
Peyer's patches of intestine
Tonsils/Adenoids
Myeloid tissue in BM
62
Q

Spleen

A

Behind stomach
Filters blood
Provides site for lymphocyte proliferation, immune surveillance + response
Blood cleansing functions
Extract aged + defective blood cells + platelets

63
Q

White pulp spleen

A

Lymphocytes (immunity)

64
Q

Red pulp spleen

A

Macrophages to clear up debris

65
Q

Spleen function pt 2

A

Stores/releases breakdown of RBCs
Stores platelets
Lot of lymphoid tissue can congregate around splenic artery

66
Q

Spleen in foetus

A

Involved in haemopoiesis

67
Q

Left hemidiaphragm

A

Stomach + spleen

68
Q

Thymus location

A

Inferior neck + superior thorax deep to sternum

69
Q

Thymus function

A

Secretes 2 polypeptides which cause differentiation + maturation of T cells

  • -> thymopoietin
  • -> thymosins (cause T lymphocytes to become immunocompetent)
70
Q

Thymus growth

A

Prominent in newborns
Continues to grow 1st year when highly active
After puberty starts to atrophy

71
Q

Tonsils

A

Create ring-like structure which trap pathogens which are ingested or inhaled
Receptor mediated immune response

72
Q

Tonsil names

A 
Named according to location
Palatine
Lingual
Pharyngeal (adenoids if enlarged)
Tubal
73
Q

Peyer’s patches

A

Large isolated clusters of lymphoid tissue in wall of distal SI
Lymphoid follicles also concentrated in wall of appendix

74
Q

Peyer’s patches MOA

A

Destroy bacteria –> prevent pathogens from breaching intestinal wall
Generate memory lymphocytes for long term immunity

Cardiorespiratory CC (34 decks)

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