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OS Final Fall 1 > Lymphatics > Flashcards

Lymphatics Flashcards

1
Q

3 Components of Lymphatic System

A
  1. lymph fluid
  2. lymphatic vessels
  3. organized lymph tissue
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2
Q

Embryology

  • Mesoderm
  • Endoderm
A
  • Mesoderm: lymphatic vessels, nodes, spleen

- Endoderm: thymus and part of tonsils

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3
Q

Fluid Balance

A

30 L fluid capillary–> interstital space

-90% to capillaries; 10% lymphatic system

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4
Q

Nutrition

A
  • fat absorbed via chylomicrons
  • travel via lacteals–> larger lymph vessels–> thoracic duct–> venous system
  • returns proteins to vasculature
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5
Q

What tissues do not have lymphatic vessels

A
  • epidermis
  • endomysium of muscle
  • cartilage
  • Bone marrow
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6
Q

Lymphatic Vessels Route

A

Terminal lymphatics->collecting vessels->afferent lymph vessels->lymph node->efferent lymph vessels->lymphatic trunks->thoracic duct or R lymphatic duct->venous system

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7
Q

Terminal Lymphatics

A
  • lymph formation starts interstitial space with initial lymphatics
  • lined by leaky endothelium and enchored to ECM
  • go into collecting vessels
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8
Q

Collecting Vessels

A
  • have two-leaflet bicuspid valves to prevent retrograde flow
  • contains smooth muscle
  • autonomic innervation
  • afferent prior to lymph node and efferents drain the node
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9
Q

Lymph Nodes

A
  • superficial and deep
  • filtration of lymph fluid
  • maturation of lymphocytes
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10
Q

Path of Lymph Flow through a Node

A
  1. Afferent brings lymph to node
  2. subscapsular space: reticular fiber, dendritic cells initial immune response
  3. Outer Cortex: B cells
  4. Deep Cortex: T Cells
  5. Medullary Sinus: B cells and plasma cells
  6. Efferent lymph exits through Hilum
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11
Q

Lymphatic Trunk

A 
Lumbar- drains lymph from lower limb and pelvic organs
Intestinal- drains abdomen 
Bronchomediastinal- drains thorax
Subclavian- drains upper limbs
Jugular- drains upper head and neck
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12
Q

Cisterna Chyli

A
  • located at L1-2
  • drains lower body
  • gives rise to thoracic duct
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13
Q

Thoracic Duct

A
  • pierces Sibsons fascia twice and empties into L subclavian and L IJV
  • Drains L head/neck, L UE, L thorax/abdomen, LL
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14
Q

Right Lymphatic Duct

A
  • origin from R jugular and subclavian trunk
  • terminates at R subclavian R/IJV junction
  • Drains R head/neck, R UE, R thorax, heart, lungs
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15
Q

Spleen

A
  • location: beneath ribs 9-11 on left
  • characteristics: largest mass of lymphoid tissue, pressure sensitive
  • Functions: destroys damaged RBC, clears bacteria, synthesizes immunoglobulin
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16
Q

Liver

A
  • Location: RUQ
  • Characteristic: pressure sensitive, relies on diaphragm
  • Function: half lymph formed here, clears bacteria, gate keeper
17
Q

Thymus

A
  • Location: anterior mediastinum
  • Characteristic: disappears at puberty
  • Function: matures T cells
18
Q

Tonsils

A
  • Location: 3 types
  • Characteristics: enlarged in childhood
  • Function: provide cells to influence and build immunity early in life, nonessential to adults
19
Q

Appendix

A
  • Location: large intestine
  • Characteristics: has lymphoid pulp
  • Function: part of GALT
20
Q

GALT

A
  • Gastrointestinal Assoc. Lymphoid Tissue
  • contains Peyers patches in ileum and lacteals in small bowel
  • filters toxins
21
Q

Mech of Flow

  • Thoracic Diaphragm
  • Pelvic Diaphragm
A
  • Thoracic: contraction increases neg pressure and pulls fluid and exerts force on cisterna chyli
  • Pelvic: helps move fluid from LE and pelvis to thoracic duct
22
Q

SNS effects on

  • lymph valves
  • smooth muscle
A
  • lymph valves: increased tone-> tighter valves-> decreased lymph flow to venous system
  • Smooth muscle: increased tone-> decreased peristalsis-> lymphatic congestion
23
Q

Edema

A
  • increased edema-> continued increase in pressure-> lymphatic vessel collapse-> more edema
  • compression of local structures: vascular-> delivery of O2, nutrients, neuronal-> decreased sensation, pain
  • decreased tissue waste removal
  • decreased immunity
  • fibrosis
24
Q

Absolute Contraindications for Lymphatic OMT

A
  • Anuria

- Necrotizing fasciitis

25
Q

Seq of Treatment

A
  1. open inlet, myofascial restrictors
  2. maximize diaphragmatic functions: abdominal and pelvic diaphragms
  3. increase pressure differentials or transmit motions: pumps
  4. mobilize targeted tissue fluids

OS Final Fall 1 (3 decks)

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