Lymphatics

Question 1

What are 2 main functions of the lymphatic system?

Answer 1

• Maintaining fluid balance
• Immunity

Question 2

What are 3 secondary functions of the lymphatic system?

Answer 2

• Distribution of fluids and nutrients
• Absorbing lipids from the small intestine
• Haematopoiesis

Question 3

What is haematopoiesis?

Answer 3

Formation of new blood cells

Question 4

Where does plasma filter into?

Answer 4

Interstitial spaces from capillaries

Question 5

What happens when interstitial spaces receive plasma?

Answer 5

• Cells receive nourishment
• Cells discard waste material to tissue

Question 6

What happens to waste material discarded by tissue?

Answer 6

Most of it is absorbed by tissue cells or re-enters the blood, a small percentage remains behind

Question 7

What happens if too much fluid remains behind?

Answer 7

• Oedema
• Tissue destruction or death

Question 8

What does the lymphatic system filter out?

Answer 8

• organisms
• toxic products

Question 9

What are the two types of lymphatic filtration?

Answer 9

• mechanical: particles
• biological: phagocytosis

Question 10

What happens if microorganisms infect the node?

Answer 10

lymphadenitis

Question 11

What does the lymphatic system carry from the intestine?

Answer 11

• Absorbed fat
• Other nutrients

Question 12

What is the final site for the maturation of some types of lymphocytes and monocytes?

Answer 12

• The lymphoid tissue of lymph nodes

Question 13

What are the components of the lymphatic system?

Answer 13

• Lymph
• Lymphatic vessels (tubes)
• Lymph nodes
• Isolated nodules
• Lymphoid structures eg. tonsils, spleen

Question 14

What are some functions of the spleen?

Answer 14

• Defence
• Haematopoiesis
• Phagocytosis of RBCs and platelets
• Blood reservoir

Question 15

What is lymph?

Answer 15

a clear fluid containing tissue fluid, proteins, lymphocytes

Question 16

What does lymph resemble?

Answer 16

• Interstitial fluid
• Blood plasma

Question 17

What does lymph not do?

Answer 17

Clot- leakage can be fatal over time

Question 18

What are lymphatic vessels?

Answer 18

Thin-walled vessels which transport lymph to the general circulation

Question 19

What do lymphatic vessels do?

Answer 19

Transport lymph to the general circulation by a one-way valve system (lymph only flows towards the heart)

Question 20

What are the two different types of lymphatic vessels?

Answer 20

• lymphatic capillaries in intracellular space and join to form…
• Large lymphatics (trunks, ducts)

Question 21

What are the main lymphatic trunks?

Answer 21

• Right lymphatic duct
• Thoracic duct

Question 22

How are lymphatic capillaries anchored to connective tissue?

Answer 22

tiny filaments

Question 23

What do lymphatic capillaries have a high degree of?

Answer 23

Permeability

Question 24

What is an important clinical feature of lymphatic capillaries?

Answer 24

Ability to pass very large molecules

Question 25

What are some differences between veins and lymphatic vessels?

Answer 25

- Thinner walls - More valves - Lymph nodes along course

Question 26

What type of lymphatic capillaries are present in the intestinal mucosa?

Answer 26

- Lacteals: highly specialised to absorb fats and other nutrients - have milky lymph- chyle

Question 27

Describe lymph flow

Answer 27

- no muscular pump - flows slowly: approx 3l/day - valves ensure one way flow - skeletal muscle contraction and breathing movements assist this

Question 28

What trunk drains lymph from the head and neck?

Answer 28

Jugular

Question 29

What trunk drains lymph from the upper limbs?

Answer 29

Subclavian

Question 30

What is the thoracic duct?

Answer 30

A major lymphatic channel that begins in the abdomen and terminates in the junction between the LIJ and the left subclavian veins

Question 31

What do lymph nodes do?

Answer 31

Filter toxic products from the lymph to prevent their entry into the blood vascular system - phagocytosis - Haematopoiesis

Question 32

How many lymph nodes are there?

Answer 32

More than 100 tiny oval or bean shaped nodes (vary in size and shape)

Question 33

Where are lymph nodes located?

Answer 33

Clusters along the lymphatic vessels (sometimes grouped ie neck, groin, axilla

Question 34

What do lymph nodes contain?

Answer 34

- Organised lymphoid tissue - contain lymphocytes which are the white blood cells of the immune system and remove toxic products - Afferent and efferent vessels

Question 35

What are the classifications of lymph nodes?

Answer 35

- superficial or deep - primary or secondary

Question 36

What constitutes a normal lymph node?

Answer 36

- Small, soft - Moveable - Cannot visualise or palpate in EO

Question 37

Where are tonsils located?

Answer 37

Near airway and food passages to protect against disease and toxic products- first line of defense

Question 38

What is the pharyngeal lymphoid (Waldeyers) ring?

Answer 38

Masses of lymphoid tissue in a protective ring at the back of the throat under the mucosa

Question 39

What constitutes the Waldeyers ring?

Answer 39

- pharyngeal tonsils (adenoid) - tubal tonsils - palatine tonsils - lingual tonsils

Question 40

Where does the Waldeyers ring drain to?

Answer 40

- Sup. deep cervical lymph nodes (specifically the jugulodigastric lymph node)

Question 41

Why is lymphoid tissue examination important?

Answer 41

- Lymphoid tissue can be involved in spreading infections and cancers

Question 42

What is meant by proper clinical examination?

Answer 42

- Patient consent - Proper explanation - Systematic approach - Recording of findings - Referrals as required

Question 43

What does an infected lymph node feel like?

Answer 43

soft, tender, mobile

Question 44

What does a cancerous lymph node feel like?

Answer 44

bony, hard, fixed? - Cancer cells can travel in lymphatic vessels slowly to other nodes- spreads rapidly if reaches blood circulatory system

Question 45

What does lymphoma feel like?

Answer 45

- firm - large multinodular - rubbery