Lymphatics

Question 1

What are the three anatomic components of the lymphatic system?

Answer 1

lymph fluid, lymphatic vessels, and organized lymphatic tissues/ organs

Question 2

what is the physiologic function of the lymphatic system?

Answer 2

it plays a major role in numerous homeostatic mechanisms of the body; maintain fluid balance, tissue cleansing, defense, and nutrition

Question 3

when does lymphatic development begin?

Answer 3

during the 5th week of gestation

Question 4

what happens when fluid overload occurs?

Answer 4

the lymphatic system helps prevent tissue damage by clearing the excess

Question 5

what does the lymph node act as?

Answer 5

a purifying filter

Question 6

how does the lymphatic system act as a defense mechanism?

Answer 6

lymph fluid brings toxins into contact with the organized lymph tissues, which contain high concentrations of immune cells

Question 7

how does the lymphatic system aid in nutrition?

Answer 7

via fat absorption via chylomicrons

Question 8

how do chylomicrons travel?

Answer 8

via lacteals into larger lymph vessels, which drain into the thoracic duct, which then drains into the venous system

Question 9

What is lymph fluid?

Answer 9

substances that leak out of the arterial capillaries into the interstitium–> gets taken up by the lymphatic capillaries

Question 10

what are the 4 tissues that do not have lymphatic vessels?

Answer 10

epidermis (including hair and nails), endomysium of muscle, cartilage, and bone marrow

Question 11

what is the pathway of lymph?

Answer 11

terminal lymphatics–> collecting vessels–>afferent lymph vessels–>lymph nodes–> efferent lymph vessels–>lymphatic trunks–> thoracic duct or right lymphatic duct–>venous system

Question 12

where does lymph formation begin?

Answer 12

in the interstitial space of tissues with the initial lymphatics/terminal lymphatics/ lymph capillaries

Question 13

what makes up the collecting vessels?

Answer 13

chains of muscular units called lymphangions

Question 14

what do lymphangions look like?

Answer 14

two-leaflet bicuspid valves

Question 15

what is the role of the lymphangions?

Answer 15

they contract regularly throughout the lymphatic system move lymph in peristaltic waves

Question 16

what is the innervation of the collecting vessels?

Answer 16

autonomic inenrvation

Question 17

what is the most highly organized lymphoid tissue?

Answer 17

lymph nodes

Question 18

what are the two types of lymph nodes?

Answer 18

superficial and deep

Question 19

what is the pathway of lymph flow through a lymph node?

Answer 19

afferent lymphatics-subcapsular space-outer cortex-deep cortex-medullary sinus-efferent lymphatics

Question 20

what region of the lymph node is rich in B cells?

Answer 20

outer cortex

Question 21

what region is dominated by T cells?

Answer 21

deep cortex

Question 22

where are the germinal centers found in the lymph node?

Answer 22

in the outer cortex

Question 23

what do the lumbar lymphatic trunks drain lymph from?

Answer 23

lower limbs and pelvic organs

Question 24

what do the intestinal lymphatic trunks drain lymph from?

Answer 24

the abdominal viscera

Question 25

what do the bronchomediastinal lymphatic trunks drain lymph from?

Answer 25

portions of the thorax

Question 26

what do the subclavian lymphatic trunks drain lymph from?

Answer 26

upper limbs

Question 27

what do the jugular lymphatic trunks drain lymph from?

Answer 27

portions of the neck and head

Question 28

what do the lymphatic vessels (efferent lymphatics) drain into?

Answer 28

lymphatic trunks

Question 29

where is the cisterna chyli located?

Answer 29

at the level of L1-L2

Question 30

what do the lymphatic trunks of the lower body drain into?

Answer 30

the cisterna chyli

Question 31

what does the cisterna chyli give rise to?

Answer 31

the thoracic duct

Question 32

what does the right lymphatic duct drain?

Answer 32

right head/neck, RUE, right thorax, heart, lungs (EXCEPT the LUL)

Question 33

what is virchow's node?

Answer 33

an enlarged node at the left supra-clavicular point

Question 34

what is an enlarged virchow's node indicative of?

Answer 34

intra-thoracic/ abdominal cancer

Question 35

what are enlarged epitrochlear nodes (medial epicondyle) indicative of?

Answer 35

secondary syphilis

Question 36

where is the spleen located?

Answer 36

beneath ribs 9-11 on the left

Question 37

what does it mean when it is said that an organ is pressure-sensitive?

Answer 37

movement of the diaphragm drives the organ's fluid movement

Question 38

where is half of the body's lymph formed?

Answer 38

in the liver

Question 39

where is the thymus located?

Answer 39

anterior mediastinum

Question 40

what replaces the thymus after puberty involutes?

Answer 40

fatty tisse

Question 41

what is the function of the thymus?

Answer 41

maturation site for T cells; there is little to no function in adults

Question 42

what are the 3 types of tonsils and where are they located?

Answer 42

all located in the posterior oropharynx; palatine, lingual, and pharyngeal

Question 43

what is the visceral lymphoid tissue?

Answer 43

the GALT and the pulmonary lymphoid tissue

Question 44

what two cell types make up the GALT?

Answer 44

peyer's patches and lacteals

Question 45

what is normal interstitial fluid pressure?

Answer 45

negative -6.3 mmHg

Question 46

what happens when the interstitial fluid pressure rises above 0?

Answer 46

the lymph capillaries collapse and flow ceases

Question 47

what could cause the interstitial fluid to rise above 0?

Answer 47

increased hydrostatic pressure, decreased plasma colloid osmotic pressure, increased capillary permeability

Question 48

with each breath, what does contraction of the thoracic diaphragm cause?

Answer 48

it increases the negative intrathoracic pressure , which pulls the fluid centrally

Question 49

when might the pelvic diaphragm contractions be dysfunctional?

Answer 49

dysmenorrhea, endometriosis, post labor and delivery, BPH

Question 50

what is the effect of increased sympathetic tone on lymph valves?

Answer 50

it causes tighter valves, so therefore there is decreased lymph flow into the venous system

Question 51

what is the effect of increased sympathetic tone on lymphatic smooth muscle?

Answer 51

it causes decreased peristalsis, which leads to lymphatic congestion

Question 52

what are the main effects of edema?

Answer 52

compression of local structures, decreased tissue waste removal, decreased pathogen clearance and immunity

Question 53

what are two absolute contraindications of lymphatic OMT?

Answer 53

anuria and necrotizing fasciitis

Question 54

what are the fascial patterns of Zinc?

Answer 54

they describe the fascial restriction patterns that cause restriction of lymphatic flow

Question 55

which zinc pattern is indicative for treatment?

Answer 55

uncompensated patterns