Lymphatic system & Vascular Surgery

Questions on General Surgery Lymphatic System .( 6) 

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Q) Thoracic duct drains into?

a) Left IJV

b) Right IJV

c) Cisterna chyli

d) Abdominal cavity

Ans a)

Lymph sacs develop at 6–7 weeks. These cisterns enlarge and develop communications that permit lymph from the lower limbs and abdomen to drain via the cisterna chyli into the thoracic duct, which  drains into the left internal jugular vein at its confluence with the left subclavian vein.

Lymph from head and right arm drains via a separate lymphatic trunk, the right lymphatic
duct, into the right internal jugular vein.

Q2) Prograde lymphatic flow does not depend on 

a) Muscle contraction and external pressure

b) Contraction and relaxation of lymphangions

c) Prevention of reflux due to valves

d) Serum oncotic pressure

Ans d 

It depends on : 

  1. Transient increases in interstitial pressure secondary to
    muscular contraction and external compression;
    2 the sequential contraction and relaxation of lymphangions;
    3 the prevention of reflux because of valves.

Transport in the thoracic and right lymph ducts also depends upon intrathoracic (respiration)
and central venous (cardiac cycle) pressures.

ref Bailey 996

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a) <0.7

b) >0.7

c) ).7 and above

d) ).7 and below

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