Lymphoid Structure

Front 1

Primary immune system organs

Back 1

1- Bone marrow - immune cell production

B cell maturation

2- Thymus - T cell maturation

Front 2

Secondary immune system organs

Back 2

1- Spleen, lymph nodes, tonsil and peyers patches

2- Allows immune cells to interact with antigen

Front 3

Lymph nodes

Back 3

A - secondary follicular

B - area around secondary follicle

C - Paracortex

Front 4

Lymph node

Back 4

1- Secondary lymphoid organ that have many afferents, 1 or more deferents

2- Encapsulated with tribulations

3- Function are non- specific filtration of macrophages, circulation of B and T cells and immune response activation

Front 5

Follicle of the lymph nodes

Back 5

1- B cell localization and maturation

2- Primary follicle - dense and dormant

3- Secondary follicle - pale germinal center and active

Front 6

Medulla of the lymph nodes

Back 6

1- Medulla cord - closely packed lymphocytes and plasma cells

2- Medullary sinus- communicate with efferent lymphatics and contain reticular cells and macrophages

Front 7

Paracortex of medulla

Back 7

1- Contain T cells

2- Between follicle and medulla

3- Contain endothelial venous through which B and T cells enter from the blood

4- Not well developed in patients with DiGeorge syndrome

5- Enlarge in a extreme cellular immune response (EBV and other viral infections - paracortical hyperplasia- lymphaedmea

Front 8

Function of lymph node

Back 8

1- Regulate fluid from tissue

2- Filter fluid in lymph node

3- Trigger immune response

Front 9

What is the region immediately surrounding the germinal center in a secondary follicle

Back 9

Mentle zone

Front 10

Location of follicles found within a lymph node

Back 10

Located primarily in the outer vortex of the lymph node

Front 11

Cervical and supraclavivular lymph nodes

Back 11

1- Head and neck

2- Disease 1- upper respiratory tract infection

2- Infectious mononucleosis

3- Kawasaki disease

Front 12

Mediastinal lymph nodes

Back 12

1- Trachea and lymph nodes

2- Disease 1- Pulmonary TB

2- Sarcoidosis

3- Primary lung cancer

4- Granulomatous disease

Front 13

Hilar lymph node

Back 13

1- Lungs

2- Disease 1- Pulmonary TB

2- Sarcoidosis

3- Primary lung cancer

4- Granulomatous disease

Front 14

Ancillary lymph nodes

Back 14

1- Breast, upper limb, skin above umbilicus

2- Disease 1- Mastitis

2- Metastasis (esp breast Ca)

Front 15

Ancillary lymph nodes

Back 15

1- Breast, upper limb, skin above umbilicus

2- Disease 1- Mastitis

2- Metastasis (esp breast Ca)

Front 16

Celiac lymph nodes

Back 16

1- Liver, stomach, spleen, pancreas and upper duodenum

2- Disease 1- Mesenteric lymphadenitis

2- Typhoid fever

3- Ulcerative colitis

4- Celiac disease

Front 17

Superior mesenteric lymph nodes

Back 17

1- Lower duodenum, jejunim, ilium and colon to splenic flexure

2- Disease 1- Mesenteric lymphadenitis

2- Typhoid fever

3- Ulcerative colitis

4- Celiac disease

Front 18

Inferior mesenteric lymph nodes

Back 18

1- Colin splenic flexure to upper rectum

2- Disease 1- Mesenteric lymphadenitis

2- Typhoid fever

3- Ulcerative colitis

4- Celiac disease

Front 19

Para aortic lymph nodes

Back 19

1- Testes, ovaries, kidney, uterus (Fallopian tube)

2- Disease 1- Metastasis

Front 20

External iliac lymph nodes

Back 20

1- Superior bladder, body of uterus and cervix

2- Disease 1- STI

Front 21

Internal iliac lymph nodes

Back 21

1- Lower rectum to anal canal (above pectinate line) bladder, cervix, vagina (mid 1/3) prostate

2- Disease - STI

Front 22

Superficial Inhibin all lymph node

Back 22

1- Anal canal, scrotum, vulva, Skin below umbilicus ( except poplitial area)

2- Disease- STI

Medial foot/leg cellulitis

Front 23

Popliteal lymph nodes

Back 23

1- Dorsolateral aspect of foot, Posterior calf

2- Disease 1- Lateral foot/leg cellulitis

Front 24

Thoracic duct

Back 24

Thoracic duct drains below diaphragm the left thorax and upper limb into junction of left subclavian vein and internal jugular vein

Front 25

Right lymphatic duct

Back 25

1- Drain the right side of the body above the diaphragm into junction of right subclavian vein and internal jugular vein

Front 26

What chest condition can occur as a result of thoracic duct rupture

Back 26

Chylothorax

Front 27

What lymph node is likely to be enlarged in association with a malignancy in the abdomen or pelvis

Back 27

Supraclavicular lymph node ( virchow node)

Front 28

Which superficial lymph node is likely to be enlarged in a patient with gastric cancer

Back 28

Periumbilical (sister Mary Joseph node)

Left supraclavicular node (virchow node)

Front 29

Which disease is indicated by epitrochlear lymphadenopathy (draining hand and forearm)

Back 29

Secondary syphilis

Front 30

Which lymph node cluster is associated with a malignancy of the oral cavity

Back 30

Submandibular lymph nodes

Front 31

Spleen

Back 31

1- Located in LUQ, anterooateroial to left kidney protected by 9th-11th ribs

2- Sinusoids have long vascular channels in red pulp with fenestrated barrel hoop basement membranes

3- T cells are located in the periarteriolar lymphatic sheat (PALS) within the white pulp

4- B cells are located in the follicle of the white pulp

5- The marginal zone contains macrophages, specialized B cells and antigen presenting cells (APC) that capture blood born antigens for recognition by lymphatics

6- Splenic macrophages remove encapsulated organism

7- Splenic dysfunction (post splenectomy, HBSS autosplenectomy) decrease IgM- decrease complement activation - decrease C3b opsonisation- increase susceptibility to encapsulate organisms

8- Post splenectomy findings 1- Howell jolly bodies (nuclear remnant)

2- Target cells

3- Thrombocytosis (losss of sequestering)

4- Leukocytosis

Front 32

Encapsulated organisms

Back 32

1- Yersinia pestles

2- Strep pneumonia (and Group B)

3- Neisseria menigitides

4- Klebsiella pneumoniae

5- Haemophilus influenza type B

6- Salmonella typhi

7- Cryptoccocus neoformans

8- Pseudomonas aeruginosa

Front 33

Type of vaccine for patients with splenectomy

Back 33

Streptococcus pneumonia

Neisseria meningitidis

Haemophilus influenza B

Front 34

Post splenectomy blood finding

Back 34

1- Howell jolly body (nuclear remnant)

2- Target cells

3- Thrombocytosis (loss of sequestering)

4- Leuckocytosis

Front 35

Thymus

Back 35

1- Located in anteriosuperior mediastinum

2- Location of T cell differentiation and maturation

3- Encapsulated thymus epithelium is derived from the thirds pharyngeal pouch (endoderm) whit the thymus lymphocytes are mesodermal origin

4- Medulla is pale with mature T cells and hassle corpuscles containing epithelial reticular cells

5- Neonate thymus sail shaped on CXR involuted by age 3

6- Cortex is dense with immature T cells

7- Thymoma - neoplasm of the thymus

Associated with myasthenia graves, superior vena cava syndrome, pure red cell aplasia and good syndrome

Front 36

Thymoma

Back 36

1- Neoplasm of the thymus

2- Associated with myasthenia graves, superior vena cava syndrome, pure red cell aplasi and good syndrome

Front 37

What 2 immunodeficiency syndrome are commonly associated with a hypoplastic thymus or absent thymus shadow

Back 37

DiGeorge syndrome

Severe combined immunodeficiency (SCID)

Front 38

Diagnosis

Back 38

Sail shaped

Neonate thymus

Front 39

What structure surrounds the thymus

Back 39

Capsule

(It’s encapsulated)