Anatomy - Lymphatic System; Study Guide CHAPTER 20: ALL QUESTIONS AND ANSWERS:

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 1) Lymph leaves a lymph node via . 1) A) afferent lymphatic vessels B) efferent lymphatic v essels C) the cortical sinus D) the subscapular sinus A) B) C) D) 2) Large clusters of lymph nodes occur in all of the following locations except the . 2) A) cervical region B) axillary region C) lower extremities D) inguinal region A) B) C) D) 3) Lymph capillaries are absent in all but which of the following? 3) A) bones and teeth B) CNS C) bone marrow D) digestive organs A) B) C) D) 4) Select the correct statement about lymphoid tissue. 4) A) Lymphoid macrophages secrete antibodies into the blood. B) Lymphoid tissue is predominantly reticular connective tissue. C) Once a lymphocyte enters the lymphoid tissue, it resides there permanently. D) T lymphocytes act by ingesting foreign substances. A) B) C) D) 5) Which of the following is not a mucosa- associated lymphatic tissue? 5) A) Peyer's patch B) appendix C) thymus D) tonsil A) B) C) D) 6) Which of the following is not a method that maintains lymph flow? 6) A) breathing B) valves in lymph vessel walls C) skeletal muscle contraction D) smooth muscle contraction A) B) C) D) 7) Functions of the spleen include all of those below except . 7) A) storage of blood platelets B) storage of iron C) removal of old or defective blood cells from the blood D) forming crypts that trap bacteria A) B) C) D) 8) The thymus is the only lymphoid organ that does not: 8) A) produce hormones B) have a cortex and medulla C) have lymphocytes D) directly fight antigens A) B) C) D) 9) Which cells become immunocompetent due to thymic hormones? 9) A) monocytes B) basophils C) lymphocytes D) macrophages A) B) C) D) 10) Which of the following is not a normal component of lymph? 10) A) red blood cells B) plasma proteins C) ions D) water A) B) C) D) 11) Which lymphatic structure drains lymph from the right upper limb and the right side of the head and thorax? A) lumbar trunk B) right lymphatic duct C) cisterna chyli D) thoracic duct A) B) C) D) 11) 12) The tonsils located at the base of the tongue are the . 12) A) palatine tonsils B) Peyer's tonsils C) lingual tonsils D) pharyngeal tonsils A) B) C) D) 13) Select the correct statement about lymphocytes. 13) A) T cells are the precursors of B cells. B) The two main types are T cells and macrophages. C) T cells are the only form of lymphocyte found in lymphoid tissue. D) B cells produce plasma cells, which secrete antibodies into the blood. A) B) C) D) 14) Lymphoid tissue that appears as a swelling of the mucosa in the oral cavity is called a(n) . 14) A) Peyer's patch B) tonsil C) appendix D) thymus A) B) C) D) 15) Which of the following is not a function of lymph nodes? 15) A) produce lymphoid cells and granular WBCs B) act as lymph filters and activate the immune system C) produce lymph fluid and cerebro- spinal fluid D) serve as antigen surveillance areas A) B) C) D) 16) A sentinel node is . 16) A) a lymph node found in the intestinal lamina propria B) a small node in the spleen C) the first node at the junction of all the lumbar trunks D) the first node to receive lymph from an area suspected to be cancerous A) B) C) D) 17) Digestive tract- associated lymphatic tissue includes all of the following except . 17) A) islets of Langerhans B) lingual tonsils C) palatine tonsils D) Peyer's patches A) B) C) D) 18) Select the correct statement about lymph transport. 18) A) Lymph transport is faster than that occurring in veins. B) Lymph transport is only necessary when illness causes tissue swelling. C) Lymph transport depends on the movement of adjacent tissues, such as skeletal muscles. D) Under normal conditions, lymph vessels are very high- pressure conduits. A) B) C) D) 19) What is a bubo? 19) A) an infected lymph node B) a wall in a lymph node C) an infected Peyer's patch D) a lobe of the spleen A) B) C) D) 20) Which of the following are functions of lymphoid tissue? 20) A) house and provide a proliferation site for lymphocytes B) house and provide a proliferation site for neutrophils C) furnish an ideal surveillance vantage point for lymphocytes and macrophages D) A and C A) B) C) D) 21) The thymus is most active during . 21) A) fetal development B) old age C) childhood D) middle age A) B) C) D) 22) What effect does age have on the size of the thymus? 22) A) The size of the thymus decreases continuously from birth to death. B) The thymus is not affected by age. C) The size of the thymus increases continuously from birth to death. D) The thymus initially increases in size and then decreases in size from adolescence through old age. A) B) C) D) 23) Which of the following is not a function of the lymphatic system? 23) A) carrying out immune responses B) draining excess interstitial fluid C) transporting respiratory gases D) transporting dietary fats A) B) C) D) 24) Antibodies that act against a particular foreign substance are released by . 24) A) lymph nodes B) medullary cords C) plasma cells D) T lymphocytes A) B) C) D) 25) Small organs associated with lymphatic vessels are termed . 25) A) lymph nodes B) axillary nodes C) cisterna chyli D) lymph follicles A) B) C) D) 26) The lymphatic capillaries are . 26) A) as permeable as blood capillaries B) more permeable than blood capillaries C) completely impermeable D) less permeable than blood capillaries A) B) C) D) 27) Both lymph and venous blood flow are heavily dependent on . 27) A) skeletal muscle contractions and differences in thoracic pressures due to respiratory movement B) two- way valves C) contraction of the vessels themselves D) the pumping action of the heart A) B) C) D) 28) Peyer's patches are found in the . 28) A) ileum of the small intestine B) jejunum of the small intestine C) duodenum of the small intestine D) large intestine A) B) C) D) 29) Which of the following would not be classified as a lymphatic structure? 29) A) Peyer's patches of the intestine B) tonsils C) spleen D) pancreas A) B) C) D) 30) When the lymphatic structures are blocked due to tumors, the result is . 30) A) abnormally high lymph drainage from the distal region B) severe localized edema distal to the blockage C) shrinkage of tissues distal to the blockage due to inadequate delivery of lymph D) increased pressure in the lymphatics proximal to the blockage A) B) C) D) 31) The distal portion of the small intestine contains clumps of lymph follicles called . 31) A) villi B) Peyer's patches C) rugae D) islets of Langerhans A) B) C) D) SHORT ANSWER. Write the word or phrase that best completes each statement or answers the question. 32) Explain the term MALT. What is its function? 32) Answer: ……………... Figure 20.2 Using Figure 20.2, match the following: 33) Cortex. 33) 34) Describe the mechanisms by which lymphatic fluid is moved through the lymphatics. 34) Answer: ………………. Figure 20.2 Using Figure 20.2, match the following: 35) Medulla. 35) 36) List the functions of the spleen. 36) Answer: …………. 37) The pulp of the spleen forms cuffs around the central arteries. 37) 38) Where are the lymph node aggregations most dense? 38) Answer: ……………… 39) Lymphatic are formed from the union of the largest collecting vessels. 39) 40) How does the lymphatic system both help and hinder the spread of cancer through the body? Answer: ………………………. 40) Figure 20.1 Using Figure 20.1, match the following: 41) Entrance of thoracic duct into subclavian vein. 41) 42) Lymphatic collecting vessels. 42) Answer: 43) Tonsils have blind- ended structures called . 43) rypts Figure 20.2 Using Figure 20.2, match the following: 44) Medullary cord. 44) 45) Characterize lymph transport in terms of rate, volume, and ability to change. 45) Figure 20.2 Using Figure 20.2, match the following: 46) Efferent vessels. 46) 47) Hassall's corpuscles are always found in the lighter- colored regions of the thymus. 47) 48) The thoracic duct of the lymphatic system empties into the _ . 48) 49) Highly specialized lymph capillaries called _ are present in the villi of the intestinal mucosa. 50) How does the structure of a lymph node allow lymphocytes and macrophages to perform their protective function? 49) 50) Figure 20.1 Using Figure 20.1, match the following: 51) Cisterna chyli. 51) 52) The are the simplest lymphoid organs and are found at the entrance to the pharynx. 52) 53) What is the consequence of obstruction of the lymphatics? 53) Figure 20.2 Using Figure 20.2, match the following: 54) Trabecula. 54) 55) Name the tonsils and state their body locations. 55) 56) How do the lymph capillaries differ from blood capillaries? 56) . 57) Describe the structural and functional relationship of the vessels of the blood vascular system and the lymphatic system. 57) Figure 20.1 Using Figure 20.1, match the following: 58) Axillary node(s). 58) 59) Thoracic duct. 59) 60) How is the skeletal system tied to the lymphatic system? 60) 61) What is the special role of the thymus gland? 61) y secreting hormones, the thymus gland causes T lymphocytes to become immunocompetent. 62) The appendix, tonsils, and Peyer's patches are examples of . 62) TRUE/FALSE. Write 'T' if the statement is true and 'F' if the statement is false. 63) When tissues are inflamed, lymphatic capillaries develop openings that permit uptake of large particles such as cell debris, pathogens, and cancer cells. True False 63) 64) All lymphatic organs are composed of epithelial tissue. 64) True False 65) Lymphatic capillaries are permeable to proteins. 65) True False 66) Peyer's patches are clusters of lymphoid tissue found primarily in the large intestine. 66) Answer: True False 67) Lymphoid tissue is mainly reticular connective tissue. 67) True False 68) Because lymph vessels are very low- pressure conduits, movements of adjacent tissues are important in propelling lymph through the lymphatics. True False 68) 69) An infected lymph gland is called a bubo. 69) True False 70) The most important role of the spleen is to provide a site for lymphocyte proliferation and immune surveillance and response. True False 70) 71) Digested fats are absorbed from the intestine by the lymph capillaries. 71) True False 72) Lymphocytes reside temporarily in lymphoid tissue, then move to other parts of the body. 72) True False 73) The lymphatic capillaries function to absorb the excess protein- containing interstitial fluid and return it to the bloodstream. True False 74) The cisterna chyli collects lymph from the lumbar trunks draining the upper limbs and from the intestinal trunk draining the digestive organs. True False 75) About 3 liters of fluid are lost to the tissue spaces every 24 hours and are returned to the bloodstream as lymph. True False 73) 74) 75) 76) If even a small part of the spleen is left in a ten- year- old child, it will most likely regenerate itself. 76) True False 77) All the lymphoid organs are well developed before birth. 77) Answer: True False 78) The simplest lymphoid organs are the lymph nodes. 78) True False 79) All lymphoid organs develop from mesoderm. 79) True False 80) Lymph always flows away from the heart. 80) True False 81) Chyle is delivered to the blood via the lymphatic system. 81): True False MATCHING. Choose the item in column 2 that best matches each item in column 1. Match the following: 82) Protein- containing fluid within lymphatic vessels. 83) Receives lymph from most of the body. 84) Isolated clusters of lymph follicles found in the wall of the small intestine. 85) Small organs intimately associated with lymphatic vessels. 86) Largest lymphatic organ. 87) Stores blood platelets. A) Lymph B) Peyer's patches C) Spleen D) Thoracic duct E) 82) 83) 84) 85) 86) 87) ESSAY. Write your answer in the space provided or on a separate sheet of paper. 88) Describe why the prognosis of cancer is best when there is no detectable spread from the region of the primary tumor to the lymph nodes. 89) A man involved in a traffic accident is rushed to the emergency room of a hospital with severe internal bleeding. Examination reveals a ruptured spleen. What is the treatment of choice and what is the likely long- term outcome (prognosis)? 90) Lymphedema may occur as a complication after a radical mastectomy, in which lymph nodes have been removed. Explain why it might occur. 91) A nurse palpated enlarged lymph nodes. Describe signs and symptoms that help to distinguish cancerous lymph nodes from infected lymph nodes. Answer: Tender nodes are usually due to inflammation, whereas hard, fixed nodes are suggestive of malignancy. 92) As the human immunodeficiency virus (HIV) progresses, some individuals develop persistent generalized lymphadenopathy. Explain why this may occur. 93) A woman had a mastectomy that included the removal of axillary lymph nodes on her left side. What can she expect regarding her left arm and why? 94) A mother takes her son to the doctor and describes the following symptoms that she has observed. The child is running a fever, has flu- like symptoms, and his lymph glands are very swollen and sore to the touch. Of what significance are the swollen and sore lymph glands? 95) While passing through a village on safari you notice a man with one enormous leg and one normal- sized leg. What could have caused the increased size of the swollen leg?