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1

Lymphatic system

Network of tissues and organs that primarily consists of lymph vessels, lymph nodes and lymph

2

What are components of the lymphatic system? (4)

1. Tonsils
2. Adenoids
3. Spleen
4. Thymus

3

How many lymph nodes are part of the human body?

600-700

4

What do lymph nodes do?

Filter the lymph before it returns to the circulatory system
- lot more lymph going in than coming out

5

What are the functions of the lymphatic system? (4)

1. Transport clean fluids back to the blood
2. Drains excess fluids from the tissues
3. Removes debris from the cells of the body
4. Transports fats from the digestive system

6

What direction does lymph flow?

Only one direction
- upward toward the neck

7

How does lymph flow?

It goes into the venous blood stream through the subclavien veins
- which are located on either sides of the neck near the collarbones

8

What are the 2 drainage systems of the lymphatic system?

1. Right
2. Left

9

What does the right drainage system handle? (2)

1. The right arm
2. Chest

10

What does the left drainage system handle?

Clears all of the other areas of the body
- including both legs, the lower trunk, the upper left portion of the chest, and the left arm

11

Where do afferent lymphatic vessels enter the lymph node?

At the hilus

12

What happens inside a lymph node?

It gets scrutinized by macrophages and lymphocytes ready to mount an immune response

13

Where does lymph exit from a lymph node?

Efferent lymphatic vessel

14

How does lymph get cleaned?

By passing through several nodes

15

Why is it significant that there are more afferent then efferent lymphatic vessels?

Because there is a lot more going into the lymph node than coming out because its filtering

16

Infection

Infected material may enter lymph vessels from infected tissues and if the phagocytosis is not effective then infection may spread from node to node

17

Lymphagitis

Inflammation of lymph vessels

18

Lymphadenitis

Infection of lymph nodes

19

Lymphadenopathy

Enlargement of lymph nodes

20

Splenomegaly

Enlargement of the spleen

21

Lymphoedema

Swelling in tissues whose lymphatic drainage has been obstructed in some way

22

Where are the 2 cervical chains located?

1. Anterior
2. Posterior

- important to scan all the way down to the clavicle and up to the ear

23

What should a normal lymph node look like? (10)

1. Small
2. Oval
3. Hilum present
4. Moderate echogenicity
5. Sharp margins, no structural changes
6. Soft tissue edema
7. Central vessel on Doppler
8. Single vascular pedicle
9. Regular vascular pattern
10. Low impedence

24

When does enlargement of the cervical lymph nodes commonly occur?

With a viral infection

25

What is the reactive lymph nodes look like?

Same as the normal lymph nodes

26

What is the difference between normal and reactive lymph nodes?

Reactive nodes are are usually small, firm and non-tender and they may persist for weeks to months

27

What do abnormal lymph nodes look like? (11)

1. Large
2. Rounded
3. Hilum absent
4. Hypoechoic
5. Irregular, angular, blurred margins
6. Structural changes
7. No edema
8. Peripheral vessel on Doppler
9. Multiple vascular pedicles
10. Chaotic vascular pattern
11. High impedance

28

Lymphatic obstruction

Lymph vessel is obstructed, and lymph accumulates distal to the obstruction
- lymphoedema

29

What is the result of lymphatic obstruction?

Swelling and the size of the area affected depend on the size of the vessel involved

30

What does lymphedema lead to?

Low-grade inflammation and fibrosis of the lymph vessel and further lymphoedema