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75 Cards in this Set

  • Front
  • Back
Name the four parts of lymphatic functional anatomy.
1. Lymphatic capillaries
2. Collecting tubules
3. Lymphatic trunks
4. Collecting ducts
3 features of lymphatic capillaries
1. blind endothelial tubes
2. fibers runfrom endo. cells into extracellular matrix, preventing collapse of leaky vessels
3. large pores pass proteins
name the 7 lymphatic trunks
Intercostal, Mediastinal, Jugular, Gastric, Subclavian, External iliac, Internal iliac, (I'M Just Gay, or So Everyone Insists!)
Chest wall and pleura drained by?
thoracic viscera drained by?
Head and neck drained by?
arms drained by?
legs drained by?
external iliac
Pelvis drainewd by?
internal iliac
liver, spleen, stomach, pancreas drained by?
name a dilated saccule at the beginning of the thoracic duct
cysterna Chyli
cysterna chyli drains all lymphatic fluid from?
lower extremeties, pelvis, abdomen
what does the thoracic duct drain?
cysterna chyli, left head and neck, left arm, and left lung
the right thoracic duct drains what?
right head and neck, right arm, right thorax, heart and pericardium
largest lymphatic in the body?
thoracic duct
what prevents backflow in the lymphatics?
what regulates the peristalisis of the larger lymphatics ducts?
layer of smooth muscle innnervated by the sympathetic nervous system
On which side of the aorta is the thoracic duct?
right, from the aortic hiatus to the level of T4
what happens to the thoracic ducts at the T4 level?
It crosses to the left side of the spine and ascends thru the aortic arch
where does the thoracic duct exit the thorax and join the venous circulation?
exits thru the superior thoracic aperature, makes a U-turn to venous circulation
where does the thoracic duct join the venous circulation?
at the jucntion of the jugular and subclavian veins
what fasica does the thoracic duct traverse?
Sibson's fascia
what part of the body lacks lymphatics?
what does the CNS have in place of lymphatics?
endothelial tubes that empty directly into the cerebrospinal fluid of the subarachnoid space, then draining into the cerebral sinuses
4 functions of the lymph system?
1. maintain fluid balance
2. purification and cleansing of tissues
3. defense
4. nutrition
what % of plasma proteins diffusing from the vasculature are returned via the lymph?
How much fluid leaks out of capillaries daily? How much is not resorbed and returned by the vasculature?
30 liters, 10% or 3 liters
what is extracellular space cleansed of what 3 things by lymph?
1. particulate matter
2. exudates
3. bacteria
lymph nodes act as what?
purifying filters for removal of waste
what is the first line of defense to invading organisms inside the skin?
lymph, you dumb ass!
cellular defense (T-lymphocytes) or Humeral defense (B-lymphocytes and hence, immunoglobulins) in lymph?
proteins absorbed from the interstitium absorb many essetial nutrients from where?
the gut
after a fatty meal how much fat is in the lymph from th small intestine?
fatty lymph is called what?
what are the small lymphatics of the villi of the small intestine called?
what do lacteals absorb?
long chain fats, chylomicrons, cholesterol
5 mechanisms of flow?
1. interstitial pressure
2. peristalic action
3. arterial pulsation
4. muscle contraction
5. "Lymph heart"
normal interstitial pressure?
negative 6.3 mmHg
increasing interstitial pressure increases/decreases flow into lymph vessels
normal flow rate of interstitial fluoid into lymph vessels?
120 ml/hr
increasing pressure from -6.3 to O mmHg increases flow how much?
twenty fold
above what level of pressure does lymphatic flow stop? Why?
0 mmHg, the lymph capillary walls collapse
4 ways to increase interstitial pressure?
1. increase arterial capillary pressure
2. decrease plasma colloidal pressure (ex. cirrhosis of liver)
3. increased interstitial fluid protein (or plasma hypoalbuminemia as in starvation)
4. increased capilllary permeability (toxins from rattlesnake venom)
mechanism for pumping lymph from one segment to another?
lymphatic distension causes causes smooth muscle to contract propelling lymph to next section (past valve)
How do lymphatic capillaries contract?
via contractile myoendothelial fibrils in the endothelial cells, relaxation causes a slight suction and draws in more fluid
cyclic rate of peristalsis of lymph vessels?
6-8s/cycle, equal to the cranial rhythmic impulse or CRI
CRI has been recently demonstrated to be synchronous with the _____ wave in blood pressure recordings
Peristaltic gut motion is synchronized by ?
pacemakers in gut wall called interstitial cells of Cajal
what demonstrates sympathetic innervation?
hypersympathecotonia causing lymphoconstriction and decreased flow
arterial pulsation increases/decrease lymphatic flow?
increases, includes thoracic duct adjacent to aorta and spine
light/forceful skeletal muscle contraction increases lymph flow?
light/forceful skeletal muscle contraction collapses lymphatic vessels?
sedentary may have_______, due to decreased lymph flow
peripheral edema
what is the "lymph heart?"
diaphragmatic crura exert a pumping action on cysterna chyli, each breath squeezes the sponge
what structure possesses specialized giant lymphatic vessels on its inferior surface to absorb large amounts of peritoneal fluid produce by abdominal viscera?
Fuzzy-wuzzy wuz a bear,
Fuzzy-wuzzy had no hair,
Fuzzy-wuzzy wuzn't fuzzy,
wuz he?
What do you call 6 blonds standing ear-to-ear?
a wind tunnel
What do blonds wear to keep their ears warm?
Their socks
The diaphragm generates ____pressure in the thorax and _____pressure in the abdomen with contraction.
negative pressure in thorax, positive pressure in abdomen with diaphragmatic contraction
5 things that decrease diaphragmatic excursion?
1. asthma
2. emphysema
3. kyphosis
4. lordosis
5. scoliosis
what can increase lymphatic flow 15-20x?
vigorous exercise
5 diaphragms?
1.tentorium cerebelli and diaphragm sella
2. Sibson's fasciaa aka throacic inlet
3. diaphragm
4. pelvic floor
5. arches of the feet
how do the diaphragms move?
______in any diaphragm will impair all of the others
restrictor of tentorium cerebelli?
cranial somatic dysfunction
4 restrictors of thoracic inlet motion? as in diaphragmatic pump action restriction
1. T1 and R1 dysfunction (think scalen muscles and head posture)
2. manubrio-sternal dys
3. clavicular dys
4. contracture of Sibson's fascia
4 restrictors of respiratory diaphragm?
1. somatic dys L1-3
2. somatic dys R6-12
3. somatic dys xiphisternal joint (rare)
4. somatosomatic reflex (c3-5 via phrenic nerve causes hypertonicity)
4 restrictors of pelvic floor diaphragm?
1. innominate dys
2. sacral and coccygeal dys
3. pubic symphysis dys
4. scarring from childbirth, and perineal surgery
3 restrictors of arches of feet diaphragm?
1. arch collapse
2. dys in bones of ft
3. somatosomatic reflexes from the lumbar spine and SI joints
Unclog the ___ pipes before you try to pump the ______ ones
big, smaller
3 steps to correct respiratory diaphragm?
1. correct spinal curvature
2. correct somatic dys (C3-5 for phrenic, L1-3 for dia. crura, R6-12 diaphragm to ribs)
3. redome diaphragm
4 steps to correct pelvic floor?
1. innominate dys
2. sacral dys
3. pubic symphysis
4. ischiorectal fossa release on hypertonic/scarred musculature
indications for lymphatic treatment?
any site of edema or infection
CI to lymphatic techniques?
acute osseous fracture (fat embolism), bacterial infection with fever over 102F, certain stages of cancer (risk of metastasis), kidney failure (increases GFR, may precipitate CHF and Pulmonary edema),
uncompensated heart failure(pulmonary edema)
Lymphatic approach to OMT
1. remove obstruction to flow
2. free all diaphragms
3. apply external lymphatic pump techniques