lymphatic system and the peripheral vascular system

3 major groups of lymph nodes

cervical (neck) axilla (limbs) inguinal (body wall)

what does the brachial artery bifurcate into?

in the cubital fossa it bifurcates into the radial and ulnar arteries

which nodes receive lymph from the heart?

inferior tracheobronchial lymph nodes

reasons lymph nodes may swell

inflamm infection malignancy

external iliac artery becomes the femoral artery when...

it passes the inguinal ligament

venous angles

junction of the internal jugular vein and the subclavian vein, where lymph drains to

Subpleural lymphatic plexus

located within lung tissue drains lung parenchyma and visceral pleura

great saphenous vein

longest vein the body used for saphenous vein grafts eg for coronary artery bypass

median cubital vein

a communication vein between the cephalic and basilic veins commonly used for blood sampling

direction of lymphatic capillaries

accompany blood capillaries of most tissues

blood supply to the digits

palmar arches anastomose and give off branches to the digits

tracheobronchial nodes drain to...

paratracheal lymph nodes

major arteries of the leg and foot

popliteal posterior tibial fibular lateral plantar anterior tibial dorsalis pedis

small saphenous vein drains into...

popliteal vein

popliteal artery routes

post tibial artery to lateral plantar art to deep plantar arch anterior tibial to dorsalis pedis to arcuate art

profunda femoris supplies...

posterior and medial thigh plus anterolateral thigh

deep vein thrombosis

thrombosis of the small (and sometimes large) veins of the leg most common in deep leg veins can lead to PE in the pulmonary arterial tree (can be fatal) usually caused by prolonged periods of bed rest or dec in cardiac output

lymphoid organs

thymus bone marrow spleen lymph nodes lymphatic nodules in the appendix and G tract tonsils

location of the spleen

adjacent to the posterior portion of the 9th to 11th ribs closely related to stomach tail of pancreas sits on the spleen

how is lymph formed?

fluid from blood moves into interstital space at the art end of the capillaries (higher hydrostatic pressure than osmotic) most of the interstitial fluid moves back in at the end of the capillary remaining fluid enters the lymphatic system

collateral circulation

the alternate circulation path of blood around a blocked artery or vein (eg by nearby alternate vessels) v important for humans to be able to use their hands

Subpleural lymphatic plexus drains into

the bronchopulmonary (hilar) nodes (deep plexus drains first to pulmonary lymph nodes along lobar bronchi)

ascites

the pathological accumulation of fluid in the peritoneal cavity

superifcial palmar arch is a direct continuation of...

the radial artery

bronchomediastinal lymphatic trunk drains into...

the right lymphatic duct/ thoracic duct

Paratracheal lymph nodes drain into

the right or left bronchomediastinal lymph trunk

deep nodes drain the...

viscera

when does the femoral artery become the popliteal artery?

when it enters the popliteal fossa

func of network of lymphatic sinuses

allows lymph to flow through cortex and medullar regions lymphocytes pass between lymph and parenchyma macrophages and lymphocytes destroy microorganisms dendritic cells involved in beginning the immune response

femoral artery supplies..

anterior and anteromedial thigh

from where do the basilic and cephalic veins originate? where do they travel?

at the dorsal venous network they travel in the subcutaneous tissue

pulse points on upper arm

axillary brachial (in mid arm and cubital fossa) radial pulse (distal forearm and anatomical snuffbox) ulnar pulse (distal forearm)

cephalic vein drains into the...

axillary vein

superficial veins of the upper limb

basilic median cubital cephalic

how is the axillary vein formed?

basilic vein joins w the brachial vein to form the axillary

lymphatic vessel structure

begin as blind ended networks of lymphatic capillaries single layer of overlapping endothelial cells w incomplete basal lamina allows high level of permeability (so lymph can enter easily) one way valves

profunda brachii

blood supply of triceps brachii

lymphoma

cancer of lymphoid tissue can be hodgkins or non-hodkins

lymphatic filariasis

causes elephantiasis parasitic thread like worms from mosquito bite physically block lymphatic vessels

internal structure of the spleen

consists of a system of interconnected arteries and veins but also includes an extensive capillary network similarities to the histology of a lymph node

blood supply to the digits of the foot

deep plantar arch and arcuate artery give off branches to supply the digits

deep lymphatic vessels

drain deep structures eg internal organs tend to follow deep arteries

right lymphatic duct

drain right upper body quadrant into the right venous angle

superficial lymphatic vessels

drain skin and subcutaneous tissue tend to follow venous drainage

functions of the lymphatic system

drains excess tissue form interstitial (intercellular) compartment absorption and transport of fats from digestive system protects against infection immunological response

The thoracic duct drains lymph from

drains the rest of the body

common iliac arteries divide to form...

ext and int iliac arteries

major arteries of the thigh

external iliac profunda femoris femoral

pulse points in lower limb

femoral popliteal posterior tibial dorsalis pedis

deep veins of the lower limb

femoral profunda femoris anterior tibial dorsal venous arch popliteal posterior tibial fibular (accompany arteries)

great saphenous vein drains into...

femoral vein

(thoracic duct in a cadaver slide) which no indicates the thoracic duct?

17

the subclavian artery structure

3 parts divided by the anterior scalene muscle costocervivical trunk gives rise to the superior intercostal artery inferior thyroid artery supplies inferior larynx and inferior thyroid gland

which is superficial and which is deep - B and T cells ?

B = superficial (in lymphatic nodules) T = deep

exceptions to this rule

CNS splenic pulp bone marrow bone teeth

lymph nodes structure

Dense connective tissue capsule Superficial cortex contains lymphatic nodules - aggregates of B cells. Deep cortex contains T cells. Medulla contains medullary sinuses and B cells and plasma cells. Afferent vessels - drain lymph into node, enter at several points through capsule. Efferent vessel - drains lymph from node, leaves via hilum Artery and vein - lymphocytes enter node from capillaries (as well as through the lymph) Network of lymphatic sinuses

abdo aorta bifurcates at ___ to form the ____

L4 common iliac arteries

nerve supply to the spleen

from the celiac plexus

Lymphoedema

generalised leakage of lymph into the surrounding tissues not removed effectively by the lymphatic system causes swelling w pitting on pressure

major veins of the lower limb

great saphenous vein dorsal venous arch small saphenous vein

how does the spleen act as a blood reserve and have an immunological function?

holds a small but significant reserve of blood (in case of haemorrhagic shock) synthesises antibodies in its white pulp, and mature lymphocytes and macrophages removes antibody-coated microbes and antibody coated RBCs by way of blood and lymph node circulation

lymphatic system consists of..

lymph lymph nodes lymphocytes lymphoid organs lymphatic plexuses and lymphatic vessels

route of lymphatic drainage

lymphatic capillaries to lymphatic vessels to lymph nodes to lymphatic trunks to right lymphatic duct (right upper body quadrant) or thoracic duct (rest of body) to right/left venous angle

which side is the basilic vein on?

med (close to the Body)

clinical relevance of maj lymph nodes

metastases of cancer

be able to identify histology of lymph nodes

okay

be able to label histology of spleen eg in final slide

okay

ant scalene muscle

one of the lateral muscles of the neck, belonging to the scalene group It is deeply placed, lying behind the Sternocleidomastoid

lymphandenopathies

one or more enlarged lymph nodes as a result of infection/inflamm

structure of the thoracic duct

originates at the cisterna chyli (just below the diaphram) ascends along vertebral bodies between thoracic aorta and azygos vein crosses to left at the level of the sternal angle loops behind left internal jugular vein and drains at the venous angle

production of lymphocytes

produced and mature in the thymus and bone marrow (prim lymphatic organs) migrate to the 2ndary lymphatic organs and become activated

major arteries of the forearm and hand

radial ulnar deep and superficial palmar arches

deep veins of the lower arm

radial ulnar deep and sup palmar

main functions of the spleen

recycling of erythrocytes blood reserve immunological func

how does the spleen recycle erythrocytes?

removed old red blood cells metabolises haemoglobin removed from senescent RBCs therefore recycles iron

lymphoedema can result from

scar tissues tumour cells in lumen of, or compressing lymphatic vessels parasites blocking lymphatic vessels

structure of the spleen

similar in structure to a very large lymph node splenic hilum splenic artery splenic vein

deep veins of the upper arm

subclavian axillary brachial

arterial supply of the shoulder and arm

subclavian artery becomes the axillary artery (once x the lat border of the 1st rib) becomes the brachial artery (as it passes the lower body of teres major)

histology of lymph nodes

sup and deep cortex lymphatic nodules seen at slightly higher res more dense toward superficial cortex

bronchopulmonary nodes drain to...

superior and inferior tracheo bronchial nodes around the bifurcation of the trachea