The Lymphatic System

Question 1

Lymphatic system functions

Answer 1

Drains excess interstitial fluid
Transports dietary lipids from GI tract to blood
Immune responses

Question 2

What type of nutrient is transported from the GI tract to the blood by lymph

Answer 2

Lipids

Question 3

What role does lymph have in cancer

Answer 3

Spreads malignancy

Question 4

Are hydrostatic and osmotic pressure in the arteriolar end of the capillary bed high or low

Answer 4

High hydrostatic pressure
Low osmotic pressure

Question 5

Are hydrostatic and osmotic pressure in the venous end of the capillary bed high or low

Answer 5

Low hydrostatic pressure
High osmotic pressure

Question 6

What generates the high hydrostatic pressure in the arteriolar end of capillary beds

Answer 6

Pressure in arterioles system

Question 7

What generates the high osmotic pressure in the venous end of capillary beds

Answer 7

Protein remains in blood but H2O has been forced out

Question 8

Where does lymphatic fluid come from

Answer 8

Excess interstitial fluid

Question 9

How much excess interstitial fluid is drained by the lymphatic system a day

Answer 9

3 litres

Question 10

Are lymph vessels 1 or 2 directional

Answer 10

1

Question 11

How is 2 way flow of lymph prevented

Answer 11

Valves

Question 12

What is the sequence of lymph vessels from lymphatic capillary to lymphatic duct

Answer 12

Lymphatic Capillary -> lymphatic collecting vessels -> lymph nodes -> lymph trunk -> lymphatic duct

Question 13

Lymphatic filariasis

Answer 13

Roundworm infection of lymph nodes blocking lymphatic drainage so interstitial fluid builds up in tissues

Question 14

Lymph node

Answer 14

Small mass of lymphoid tissue located along the length of the lymphatic vessels which lymph is filtered through

Question 15

Why do lymph nodes swell during infection

Answer 15

Increased numbers of lymphocytes

Question 16

Which vessels does lymph enter and leave the lymph nodes through

Answer 16

Enters through afferent lymphatic vessels
Leaves through efferent lymphatic vessels

Question 17

What separates different regions within lymph nodes

Answer 17

Trabeculae

Question 18

What parts of the body have lymph drained to the right lymphatic trunk

Answer 18

Right arm and right side of head + neck

Question 19

What parts of the body does lymph drain to the thoracic duct

Answer 19

Lower limbs, abdomen, left arm, left head +neck

Question 20

Where is the venous angle

Answer 20

Where internal jugular vein meets the subclavian vein

Question 21

Inflammation of which node may suggest stomach cancer

Answer 21

Virchow node

Question 22

What layer of tissue are superficial lymphatic vessels found in

Answer 22

Subcutaneous

Question 23

What do superficial lymphatic vessels drain into

Answer 23

Deep lymphatics

Question 24

Where are the 3 sites of superficial lymph nodes

Answer 24

Cervical
Axillary
Inguinal

Question 25

Which vessels do the superficial cervical lymph nodes run along

Answer 25

External jugular vein

Question 26

Which vessel do the deep cervical nodes run along

Answer 26

Internal jugular vein

Question 27

Where do efferent vessels from the deep cervical nodes run to

Answer 27

Right jugular trunk

Question 28

Superficial cervical nodes

Answer 28

Occipital Retroauricular Parotid Buccal Submental Submandibular

Question 29

What structures are drained by the superficial cervical nodes

Answer 29

Tongue Tonsils Pinna Scalp Neck Thorax

Question 30

Which structures are drained by the deep cervical nodes

Answer 30

Tongue Tonsils Pinna Parotid Oropharynx Nose Paranasal sinuses Palate Larynx Trachea Oesophagus Middle ear

Question 31

When are lymph nodes readily palpable

Answer 31

Fighting infections

Question 32

What is the difference between lymph nodes during infection and malignancy

Answer 32

Infection - firm, tender, enlarged, warm Malignancy - firm, non tender, matted, fixed, size incr over time

Question 33

What can cause lymph nodes to become fixed and matted

Answer 33

Malignancy

Question 34

What is the most important factor in the spread of head and neck squamous cell carcinoma from primary sites

Answer 34

Metastatic neck disease

Question 35

What structures are removed in a radical neck dissection

Answer 35

Sternocleidomastoid Internal jugular vein Spinal accessory nerve Cervical lymph nodes

Question 36

What procedure involves removal of 3 or fewer of the SCM, IJV, spinal accessory nerve, and cervical lymph nodes

Answer 36

Modified radical neck dissection

Question 37

What procedure involves removal of 2 of the SCM, IJV, and spinal accessory nerve

Answer 37

Selective neck dissection

Question 38

Which lymph nodes does 75% of the lymph from the breast drain to

Answer 38

Axillary

Question 39

Nodes in axillary lymph nodes group

Answer 39

Humeral Pectoral Subscapular Central Apical Supraclavicular

Question 40

What structures are removed in a radical mastectomy

Answer 40

All breast tissue Nipple Axillary lymph nodes Portion of pec major

Question 41

What tissues/structures are removed in a modified radical mastectomy

Answer 41

Breast Nipple Most axillary nodes

Question 42

What is the difference between a radical mastectomy and a modified radical mastectomy

Answer 42

Radical removes all axillary lymph nodes and some of pec major, modified doesnt

Question 43

What is sentinel lymph node identification used for

Answer 43

Identify which lymph nodes need to be removed due to cancer

Question 44

What happens in sentinel lymph node identification

Answer 44

Radioactive subastance/dye injected into tumour -> stained nodes removed

Question 45

Where are inguinal lymph nodes located

Answer 45

Femoral triangle

Question 46

What are the 2 groups of inguinal lymph nodes

Answer 46

Vertical Horizontal

Question 47

What vessel do the vertical inguinal lymph nodes run along

Answer 47

Great saphenous vein

Question 48

Where do the horizontal inguinal lymph nodes run

Answer 48

Superficial to inguinal ligament

Question 49

Where are the deep inguinal nodes

Answer 49

Femoral canal

Question 50

Where do the superficial lymphatics from the anterior abdominal wall, perineum, and external genitalia ex testes drain to

Answer 50

Horizontal inguinal lymph nodes

Question 51

Where do internal organs drain lymph to

Answer 51

Deep nodes

Question 52

Pre aortic lymph nodes

Answer 52

Celiac Superior mesenteric Inferior mesenteric

Question 53

What is the beginning of the thoracic duct

Answer 53

Cisterna chyli

Question 54

Where does lymph from the common iliac nodes drain to

Answer 54

Lumbar nodes

Question 55

Where does lymph from the GI tract drain to

Answer 55

Pre aortic lymph nodes

Question 56

Where do the intestinal, right lumbar, and left lumbar trunks drain to

Answer 56

Cisterna chyli

Question 57

What nodes drain the thorax

Answer 57

Bronchomediastinal trunks Superior tracheobronchial nodes Bronchopulmonary nodes Inter pulmonary nodes Interlobar lymph vessels Sub pleural plexus Inferior trachea bronchial nodes

Question 58

What lymph nodes drain the heart

Answer 58

Inferior trachea bronchial nodes

Question 59

How does the thoracic duct cross the diapragm

Answer 59

Aortic hiatus

Question 60

Which part of the mediastinum is the thoracic duct in

Answer 60

Posterior

Question 61

What is the largest lymphoid organ

Answer 61

Spleen

Question 62

Which abdominal region is the spleen in, and which ribs is it under

Answer 62

Left hypochondrium 9-11th

Question 63

Roles of the spleen

Answer 63

Lymphocyte proliferation RBC filtration RBC destruction RBC storage

Question 64

What happens to the thymus after puberty

Answer 64

Progressive atrophy and replacement by fat

Question 65

Which part of the mediastinum is the thymus in

Answer 65

Superior

Question 66

Waldeyers ring

Answer 66

Ring of tonsils at the back of the mouth that acts as a barrier for pathogens

Question 67

4 tonsils

Answer 67

Palatine Lingual Pharyngeal Tubal

Question 68

Where are the tubal tonsils

Answer 68

Opening of Eustachian tube

Question 69

What are the pharyngeal tonsils termed when enlarged

Answer 69

Adenoids