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WorksheetsLymphatic system for paramedics
Total questions: 60
Worksheet time: 36mins
The fluid, originating from the blood capillaries, that is formed in the spaces between the cells is known as:
interstitial fluid
blood
lymph
plasma
Why can erythrocytes (red blood cells), platelets and protein plasma not be found in the interstitial fluid and lymph?
They are too big to pass through the capillary walls
It can change the shape of the capillaries
They are too small to pass through the capillary walls
They are red in colour
The main structural difference between lymphatic capillaries and blood capillaries is:
Lymph capillaries are blind-ended
Lymph capillaries are continuous
Lymph capillaries are thicker
ONLY Lymph capillaries consist of a single layer of endothelial cells
Which of the following is NOT found in lymph?
Lymphocytes (defence cells)
Erythrocytes (red blood cells)
Glucose
Plasma proteins
Select all that are main functions of the Lymphatic System:
Return excess fluid to bloodstream (tissue drainage)
Transport fatty acids and glycerol
Transport oxygen/glucose
Remove and destroy pathogens (production and maturity of lymphocytes which fight infection)
Reduce the number of leukocytes
Which of the following is NOT found in the lymphatic system?
Tonsils
Lymph node
Lacteal
Thoracic duct
Heart
Check all that apply - what are the functions of lymph nodes, small oval/bean shaped organs which lie along the length of lymph vessels ?
Lymphocytes can mature or multiply there
Destroy organic material as contain antibodies and macrophages
Filter the lymph fluid of other inorganic particles
Transport lipids and fats
Remove waste products from respiration
The condition shown here, when there is accumulation of interstitial fluid in the body tissue.
Oedema
Inflamation
Thrombosis
Blood clot
Special lymphatic vessels in the small intestine that absorb fats and fat soluble materials (eg. fat soluble vitamins) and transport them from the digestive tract to the blood are called ____.
Peyer's patch
villi
lymph nodes
lacteals
What part of the lymphatic system (lying in the left hypochondriac region of the abdomen between the fundus of the stomach and diaphragm) filters foreign material from blood and destroys ageing or damaged cells from the bloodstream?
How is lymph moved through lymphatic vessels (choose three)?
Changes in thoracic (chest) pressure linked to the breathing cycle
Regular pulsation of large arteries
Lymphocytes originate from stem cells in bone marrow. Where do T- lymphocytes mature?
thoracic duct
spleen
Valves in lymphatic capillaries open to ensure lymph flows in one direction only (towards the thorax) when pressure outside the capillary is:
High
Low
In equilibrium with the capillary
Which is LEAST similar to lymph?
Blood
Interstitial fluid
Blood plasma
Lymphatic capillaries are permeable (=will allow to pass through) to:
cancer cells
bacteria
viruses
large proteins
Lymph enters the bloodstream from the collecting ducts at the two (right and left).....
Aorta
Hepatic Veins
Pulmonary Veins
Subclavian Veins
Choose statements that are TRUE about lymph nodes:
contain B- and T-cell lymphocytes
filter blood
destroy pathogens and cancer cells
produce antibodies
Organ of the lymphatic system contained within a capsule of peritoneum, containing up to 350ml blood, slightly oval in shape, and like the liver, is an important site of fetal blood cell production.
Thymus
Tonsils
Spleen
Bone Marrow
Mucosa-associated lymphoid tissue - MALT (not enclosed within a capsule) - found within walls of small intestine which do not filter lymph but are still important in early detection of invaders:
Bone Marrow
Peyer's Patches
Spleen
Appendix
Arteriole
Vein
Capillary
Which of the following is responsible for fighting diseases?
Leucocytes (white blood cells)
Erythrocytes (red blood cells)
Platelets
Lymph
What is the name of the uncapsulated lymphoid tissue found in the back of the throat, ideally placed to intercept swallowed or inhaled antigens?
thymus
spleen
tonsils
liver
What name is given to enlargement of the spleen which can be caused when lots of lymphocytes are being produced during serious infection?
splenomegaly
phagocytosis
erythropoiesis
lymphangitis
What do we call the bean-shaped structures that are scattered around the body as part of the lymphatic system?
lymph capillaries
tonsils
spleen
lymph nodes
Which of these statements about lymph nodes are true?
Packed with immune and defence cells like macrophages and lymphocytes
Drain lymph back into the circulatory system
Filter foreign particles (bacteria, cells from malignant tumours), worn out or damaged tissue cells) from the lymph
Unlike the spleen, can be exposed to diseases spread by lymph
What do we call the large lymphatic vessels that drain lymph back into the circulatory system?
lymph capillaries
lymph veins
lymph nodes
lymph ducts
Which phrase best describes the structure of lymph capillaries?
strong and thick
thin and leaky
waterproof and tough
solid and sealed
What are the three main functions of the lymphatic system?
Drains and filters tissue fluids, transports fats & fights infection.
Prevent swelling, transports oxygen to tissues & fights infection
Removes toxins & waste, restores salt balance in the blood & stores lymphocytes
Fights against infection, makes white blood cells, stores fats for energy
Tissue fluid would flow backwards, potentially causing oedema, or tissue fluid build-up
Immunity that can be acquired naturally, such as when we are exposed to a bacterial or viral infection, or that can be acquired artificially, such as when we receive a vaccine, is known as ____.
antigen presentation
passive immunity
active immunity
congenital immunity
The main collecting duct of the lymphatic system, about 40cm long, is the left lymphatic duct, also known as the ____.
jugular trunk
thoracic duct
subclavian artery
trabeculae
Which is the correct pathway of lymph in lymphatic system?
Blood capillary - Interstitial space - Lymphatic capillary - Lymphatic ducts - Lymphatic vessel - Subclavian veins
Interstitial space - Blood capillary - Lymphatic capillary - Lymphatic vessel - Lymphatic ducts - Subclavian veins
Blood capillary - Interstitial space - Lymphatic capillary - Lymphatic vessel - Lymphatic ducts - Subclavian veins
Interstitial space - Blood capillary - Lymphatic capillary - Lymphatic vessel - Subclavian veins - Lymphatic ducts -
In the lacteals of the small intestine, fats are absorbed into the lymphatics. The lymph here has a milky appearance, it is known as.....
chyle
micelles
chylomicrons
fats
The ____ lymph nodes are in your knee.
popliteal
iliac
The adenoids are tonsils lying at the back of the nasal cavity on the upper posterior wall of the pharynx. They can swell as a result of respiratory infection., interfering with breathing. These are called the (a) tonsils.
Which of these are the three main groups of tonsils?
Pharyngeal
Palatine
Lingual
Peritoneal
The maturation of the thymus gland is controlled by which hormone?
Thyroxine
Thymosin
Glucagon
Aldosterone
Lymphangitis is inflammation of.....
lymph vessels
lymph nodes
spleen
thymus gland
Infection of lymph nodes is called.......
lymphangitis
lymphadenitis
lymphadenopathy
lymphedema
Swelling in tissues whose lymphatic drainage has been obstructed in some way is known as (a)
What are the most common causes of lymphatic obstruction?
low grade inflammation and fibrosis of the lymph vessel
tumours
surgery
lymphoedema
What are the most common consequences of lymphatic obstruction?
low grade inflammation and fibrosis of the lymph vessel
tumours
surgery
further lymphoedema
Mastectomy (breast removal) can also lead to swelling of the arm on the same side. Why is this?
Cancer cells may have already spread to the lymph nodes
Axillary nodes may have also been removed during the surgery, obstructing lymph drainage
Pathogens may have entered the lymph vessels
Metastases (secondary tumours)
Lymphangitis, or inflammation of lymph vessels, can be caused when the defensive cells in the lymph nodes are unable to destroy all of the microbes from an acute bacterial infection. A streptococcus pyogenes infection of the hand could then result in....
Metastases in the armpit
A red line extending from hand to axilla
Hodgkin lymphoma
Further infection passing into the blood stream
Lymphadenitis (acute infection of lymph nodes) is caused by microbes transported in lymph from other areas of infection.
True
False
Usually
In acute lymphadenitis, chemotaxis can occur. What does this mean?
Enlargement of lymph nodes
Congestion of lymph nodes with blood
Directed movement of defensive cells into tissues - large numbers of phagocytes attracted to the site
The normal proliferation of defence cells and antibody production
Acute lymphadenitis is secondary to a number of conditions. Tick all that might be triggers or causes.
Measles
Tuberculosis
Syphilis
Cat scratch fever
A highly contagious viral infection, usually of young adults, spread by direct contact. Viruses multiply in the pharynx, spread to cervical lymph nodes then to lymphoid tissue around the body. Common complication is chronic fatigue syndrome.
Measles
Syphillis
Glandular fever (infectious mononucleosis)
Hodgkin lymphoma
Hodgkin lymphoma (malignant disease most common in males 20-35 or 50-70 years old) : Symptoms (check all that apply)
Painless enlargement of lymph glands throughout the body
Reduced immunity as lymphocyte function is depressed (recurrent infection)
Liver cirrhosis
Anaemia
Non-Hodgkin lymphoma - classified according to degree of malignancy. Check the box which relates to LOW GRADE NHL?
Well differentiated cells in tumour, disease progress is slow, death occurs after several years.
Poorly differentiated cells in tumour, disease progress is rapid, death can occur in weeks or months.
Non-Hodgkin lymphoma - classified according to degree of malignancy. Check the box which relates to HIGH GRADE NHL?
Well differentiated cells in tumour, disease progress is slow, death occurs after several years.
Poorly differentiated cells in tumour, disease progress is rapid, death can occur in weeks or months.
Splenomegaly (enlargement of the spleen) - which of these is NOT a potential cause?
Blood borne microbes (eg. tuberculosis, typhoid fever, malaria, glandular fever)
Circulatory disorders where blood flow through liver is restricted (eg. liver cirrhosis or right sided heart failure)
Blood diseases (eg. anaemia, leukaemia)
Tumours (more often caused by metastases from elsewhere in the body)
Bone marrow failure
Principle disorders of the Thymus Gland might include...... (check all that would be possible)?
Autoimmune diseases like thyrotoxicosis or Addison's disease
Tumours which can press on trachea, oesophagus or veins in the neck
Glandular fever
Myasthenia gravis
Bone marrow is classified as a lymphoid tissue because...
it filters blood
it produces mature T-lymphocytes
it produces plasma proteins
lymphocytes are produced there
