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