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Flashcards in The Lymphatic System Deck (28)
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1

Lymphatic Development 

 

Mesoderm produces?

Endoderm produces?

Mesoderm: Lymphatic vessels, lymph nodes, spleen & myeloid tissue

 

 

Endoderm: Thymus and parts of the tonsils

 

*Take home message: We have lymphatics early on (5th week)

2

Physiologic functions of Lymphatic system?

-Immue 

 

-Digestive

 

-Fluid Balance

 

-Waste

3

Spleen

 

Location

Characteristics

Functions

Location: Under ribs 9-11 on left

 

Characteristics: Largest single mass of lymphoid tissue, pressure sensitive

 

Functions: Destroy damaged/deformed RBCs, synthesize Ig's, Clear bacteria

4

Anatomically, what drives splenic fluid movement?

Movement of the diaphragm 

5

Liver

 

Location

Characteristics

Functions

Location: RUQ

 

Characteristics: Pressure sensitive 

 

Functions: 1/2 of body's lymph formed in liver, clears bacteria, "gate-keeper" of shared hepatobiliary-pancreatic venous and lymphatic drainage

6

Thymus 

 

Location

Characteristics

Functions

Location: Anterior mediastinum 

 

Characteristics: Large during infancy, and size peaks at 2 y/o. After puberty, replaced by fatty tissue. 

 

Functions: Maturation site for T cells, little/no function in adults. 

7

Tonsils

 

Location

Characteristics

Functions

Location: 3 types, all in posterior oropharynx

 

Characteristics: Most are visible until 6-9m/o, remain enlarged throughout childhood

 

Functions: Provide cells to influence and build immunity early in life, nonessential to adult immune function

8

Appendix

 

Location

Characteristics

Functions

Location: Proximal end of the cecum

 

Characteristics: contains lymphoid pulp

 

Functions: part of the gut associated lymphoid tissue (GALT)

9

Visceral Lymphoid Tissue 

 

What is GALT?

GALT = 

 

Gastrointenstinal Associated Lymphoid Tissue 

 

Includes: 

Peyer's patches, Lacteals

10

What tissues DO NOT have lymphatic vessels (however use direct diffusion)?

-Epidermis 

-Endomysium (inner lining of muscle cells)

-Cartilage

-Bone marrow

11

What is the order of lymphatic drainage starting from lymphatic capillaries?

Lymphatic capillaries --> 

Collecting lymphatics --> 

Afferent lymphatic vessels --> 

Efferent lymphatic vessels --> 

Thoracic duct/R lymphatic duct -->

Venous system

12

How is extracellular fluid sucked into lymphatic vessels?

Low level negative pressure

13

The lymphatic collectors consist primarily of chains of muscular units called _____________, which contain _________

 

These are aka?

Lymphangions 

 

 two-leaflet bicuspid valves

 

"lymphatic hearts"

14

Lymph nodes

 

Location

Characteristics

Functions

Location: ALL OVER

 

Characteristics: Superficial and deep types

 

Functions: filtration of lymph fluid, matruation of lymphocytes, phagocytosis of bacteria and cellular debris

15

Describe the path of lymph flow through a lymph node 

1. Afferent lymphatics 

2. Subcapsular space

3. Outer cortex

4. Deep cortex

5. Medullary sinus 

6. Efferent lymphatics

16

What lymph node is this?

Virchow's node 

17

What lymph node is associated here?

Epitrochlear Nodes

 

*Associated with secondary syphilis 

18

Mechanisms of Flow: Direct Diaphragmatic Pressure 

 

 

What are the two diaphragms involved?

Thoracic Diaphragm 

 

Pelvic Diaphragm (4 muscles)

19

What are the effects of sympathetic nervous system on lymph valves?

Increased sympathetic tone --> 

 

Tigher valves --> 

 

DECREASED LYMPH FLOW INTO THE VENOUS SYSTEM

20

What happens with a poorly functioning lymphatic system?

EDEMA

21

What are the effects of edema?

-Compression of local structures (decreased delivery of O2, nutrients, meds, hormones, decreased neuronal sensation)

 

-Decreased tissue waste removal 

 

-Decreased pathogen clearance and immunity

22

What are the indications for lymphatic OMT?

1. Edema, tissue congestion or lymphatic stasis 

 

2. Infection 

 

3. Inflammation

 

*Chronic conditions should be approached with caution. Gentler techniques, shorter, but more frequent treatment sessions preferred

23

What are absolute contraindications for lymphatic omt?

Anuria 

 

Necrotizing fasciitis

 

Pt. unable to tolerate treatment

 

Pt. refuses treatment, lol

24

Principles of Diagnosis from a Lymphatics approach 

 

Describe the general 5 steps 

1. Evaluate risk-benefit ratio

 

2. Evaluate fascial patterns of ZINK

 

3. Evaluate diaphragms/fascia

 

4. Evaluate for somatic dysfunction

 

5. Evaluate tissue congestion

25

What is the COMMON ZINK compensatory pattern?

L/R/L/R

 

80% of healthy people 

26

What is the UNCOMMON ZINK compensatory pattern?

R/L/R/L

 

20% of healthy people

27

Un-compensated zink patterns usually arise from...

Trauma 

 

 

*Usually symptomatic 

28