Lymphatic System Chapter 21 Full Test Bank

Anatomy & Physiology, 3e (McKinley)

Chapter 21 Lymphatic System

1) Which fluid does lymph most closely resemble?

A) Whole blood

B) Blood plasma

C) Interstitial fluid

D) Intracellular fluid

2) Lymph contains protein.

3) Lymph contains red blood cells.

4) Migration of cancerous cells through the lymphatic system to other regions of the body is called ________.

5) The central nervous system contains a dense network of lymphatic capillaries.

6) Lymphatic capillaries

A) cannot be discerned structurally from cardiovascular system capillaries.

B) originate as closed-ended tubes associated with blood capillary networks.

C) filter lymph.

D) concentrate lymph prior to passing it to larger lymphatic vessels.

E) include layers of smooth muscle for peristalsis.

7) Lymphatic capillaries originate in the

A) peripheral nervous system ganglia.

B) red bone marrow.

C) yellow bone marrow.

D) tissue spaces between cells.

E) cisterna chyli.

8) A lymphatic capillary that picks up dietary lipids in the small intestine is called a(n)

A) cisterna chyli.

B) lacteal.

C) afferent lymphatic vessel.

D) trabeculum.

E) efferent lymphatic vessel.

9) The force that drives fluid into lymphatic capillaries is

A) osmosis.

B) diffusion of both water and solutes.

C) endocytosis.

D) exocytosis.

E) hydrostatic pressure.

10) The path that fluid takes as it enters a lymphatic capillary is through

A) pores (fenestrations) in the cells of the capillary wall.

B) cell membrane leakage channels that allow diffusion.

C) vesicles that move the fluid across the cell (transcytosis).

D) spaces between capillary endothelial cells that are arranged as one-way flaps.

E) active transport protein pumps on endothelial cell membranes.

11) Structures that connect lymphatic capillary cells to surrounding tissue and prevent the capillaries from collapsing are called ________ filaments.

12) The lymphatic system's two main functions are to assist in

A) immunity and fluid balance.

B) blood cell production and endocrine function.

C) endocrine function and neural support.

D) neural support and blood sugar control.

E) removal of fats from the blood and inflammatory responses.

13) Lymph is transported through a network of increasingly larger lymphatic passageways. What is the correct order of these, from smallest diameter to largest diameter?

A) Capillaries - ducts - trunks - vessels

B) Ducts - capillaries - vessels - trunks

C) Vessels - capillaries - trunks - ducts

D) Ducts - vessels - capillaries - trunks

E) Capillaries - vessels - trunks - ducts

14) Lymphatic capillaries

A) are open at both ends.

B) are smaller in diameter than blood capillaries.

C) are like continuous capillaries in that they have many tight junctions.

D) lack a basement membrane.

E) are abundant in epithelial tissues.

15) Because lymphatic vessels have three tunics (intima, media, and externa) and valves, they structurally resemble

A) veins.

B) arterioles.

C) capillaries.

D) arteries.

16) Like veins, lymphatic vessels rely on skeletal muscle and respiratory pumps to help propel fluid through them.

17) Fluid collected in lacteals will be carried in ________ trunks.

A) bronchomediastinal

B) lumbar

C) intestinal

D) thoracic

18) The walls of the smallest lymphatic vessels contain muscle tissue that rhythmically propels lymph through the system.

19) The pulsing of arteries that are adjacent to lymphatic vessels provides a pressure on the vessels that helps them propel the lymph.

20) Of the lymphatic trunks, which ones drain lymph from deep thoracic structures?

A) Jugular trunks

B) Subclavian trunks

C) Bronchomediastinal trunks

D) Intestinal trunks

E) Lumbar trunks

21) Lymph from the head and neck is drained by the ________ trunks.

22) Subclavian trunks drain lymph from the

A) deep thoracic structures.

B) head and neck.

C) upper limbs, breasts, and superficial thorax.

D) abdominopelvic wall.

23) Which of the lymphatic trunks drain into the cisterna chyli?

A) Intestinal trunks

B) Lumbar trunks

C) Intestinal trunks and lumbar trunks

D) Subclavian trunks and jugular trunks

E) Bronchomediastinal trunks and intestinal trunks

24) Which is not drained by the right lymphatic duct?

A) Right side of abdomen

B) Right side of thorax

C) Right side of head and neck

D) Right shoulder

E) Right arm

25) The thoracic duct collects lymph from all of the following except the

A) abdomen.

B) left leg.

C) right arm.

D) right foot.

E) left shoulder.

26) The thoracic duct and the right lymphatic duct empty lymph into the

A) superior vena cava.

B) subclavian veins.

C) inferior vena cava.

D) azygos vein.

E) brachiocephalic veins.

27) Which would be the route taken by lymph traveling from lymphatic vessels in the right leg to the bloodstream?

A) Right lumbar trunk - cisterna chyli - thoracic duct - right subclavian vein

B) Right lumbar trunk - cisterna chyli - thoracic duct - left subclavian vein

C) Right lumbar trunk - right intestinal trunk - right lymphatic duct - right subclavian vein

D) Right femoral trunk - right lumbar trunk - right lymphatic duct - superior vena cava

E) Right femoral trunk - cisterna chyli - thoracic duct - left subclavian vein

28) The spleen is considered a primary lymphatic structure.

29) Although they are not a site of lymphocyte formation, ________ lymphatic structures provide sites where immune responses are initiated.

A) hemopoietic

B) primary

C) red marrow

D) secondary

30) The term "primary lymphatic structure" applies

A) only to red bone marrow.

B) to the spleen and lymph nodes.

C) to the red bone marrow and thymus.

D) only to lymph nodes.

E) to lymph nodes and MALT.

31) Tonsils are secondary lymphatic structures.

32) Red marrow is found within

A) the large cavities contained within the shafts of long bone.

B) compact bone canals.

C) spaces within spongy bone.

D) all osseous tissue of the appendicular skeleton.

33) The ossa coxae contain red marrow.

34) Which of the following does not contain red marrow?

A) Ribs

B) Sternum

C) Flat bones of the skull

D) Vertebrae

E) Long bones of digits

35) Where do T-lymphocytes mature?

A) Spleen

B) White bone marrow

C) Tonsils

D) Thymus gland

E) Thyroid gland

36) The letter "T" within "T-lymphocytes" stands for the ________.

37) B-lymphocytes are

A) antibody-producing red blood cells.

B) platelets that are generated in the thymus.

C) white blood cells that are generated in red bone marrow.

D) immune system cells that are generated in the tonsils.

E) blood cells found only in people with type B blood.

38) Which part of a thymic lobule contains mature lymphocytes?

A) Cortex

B) Medulla

C) Capsule

D) Trabecula

39) The thymus contains ________ lobes and is located ________.

A) 2; anterior to the laryngeal prominence (Adam's apple)

B) 2; in the mediastinum

C) 4; anterior to the laryngeal prominence (Adam's apple)

D) 4; in the mediastinum

40) The thymus is at its maximum size

A) at birth.

B) at puberty.

C) between 30 and 50 years of age.

D) in old age.

41) Fibrous extensions of the connective tissue capsule that surround thymic lobes are known as septa or ________.

42) The thymus contains lymphatic cells as well as secretory ________ tissue.

A) muscle

B) neural

C) epithelial

D) osseous

E) areolar

43) Lymphatic organs

A) contain a complete capsule of dense irregular connective tissue.

B) contain an incomplete capsule of dense irregular connective tissue.

C) lack a connective tissue capsule.

44) MALT is found in which layer of the wall of a hollow organ?

A) Epithelial

B) Lamina propria

C) Muscularis externa

D) Submucosa

45) With respect to the lymphatic system, what do the letters in the acronym MALT stand for?

A) Membrane-adhering lymphatic T-cells

B) Mucosa-associated lymphatic tissue

C) Multiple-antigen lymphocyte target

D) Multiple-antibody lymphocyte test

46) Which area does not contain MALT?

A) Urinary tract

B) Respiratory tract

C) Genital tract

D) Gastrointestinal tract

E) No exceptions; all choices contain MALT

47) Regions of MALT called Peyer patches are found in the

A) urinary bladder.

B) stomach.

C) vagina.

D) small intestine.

E) trachea.

48) Another name for a lymphatic follicle is a

A) lymphatic nodule.

B) white pulp.

C) lymph node medulla.

D) thymic lobule.

49) Lymphatic nodules consist of

A) central arteries and monocytes.

B) lymphatic cells, extracellular matrix, and an incomplete connective tissue capsule.

C) crypts, trabeculae, and Reed-Sternberg cells.

D) afferent vessels, efferent vessels, a cortex, and medulla.

E) a hilum that is located intermediate to two lobules.

50) The appendix contains lymphatic nodules.

51) Tonsils have multiple invaginated outer edges called ________ that help trap material.

A) crypts

B) trabeculae

C) sinuses

D) clefts

E) fissures

52) Which are not tonsils?

A) Adenoids

B) Palatine tonsils

C) Pharyngeal tonsils

D) Lingual tonsils

E) Palatoglossal tonsils

53) The main function of tonsils is to detect and protect against infections agents that are

A) in the blood.

B) in the lymph.

C) ingested or inhaled.

D) secreted by salivary glands.

54) The pharyngeal tonsils are located

A) along the posterior margins of the tongue.

B) in the posterior wall of the nasopharynx.

C) at the base of the palatoglossal arches.

D) in the posterolateral region of the oral cavity.

E) lateral to the uvula in the oropharynx.

55) What conditions would warrant removal of the spleen (splenectomy) or removal of the tonsils (tonsillectomy), and what prognosis or complications (if any) might result from these procedures?

56) Lymph nodes may be found individually, or clustered in specific regions of the body. Which cluster of lymph nodes receives lymph from the head and neck?

A) Inguinal lymph nodes

B) Cervical lymph nodes

C) Thoracic lymph nodes

D) Axillary lymph nodes

E) Abdominal lymph nodes

57) Which is not correct regarding lymph nodes?

A) They contain strands of lymphatic cells supported by medullary cords.

B) They are drained by efferent lymphatic vessels.

C) They contain macrophages.

D) They filter lymph.

E) No exceptions; all are true of lymph nodes.

58) Which is not correct regarding lymph nodes?

A) They are covered by a connective tissue capsule.

B) They contain a network of lymphatic sinuses.

C) Each node has an outer cortex and inner medulla.

D) Connective tissue bands called tendineae divide nodes.

E) Lymphatic nodules produce lymphocytes.

59) Lymph nodes

A) filter lymph.

B) contain a dense network of collagen fibers.

C) serve as auxiliary exchange surfaces for respiratory gases.

D) produce red blood cells.

E) serve as the main recycling centers for red blood cells and their parts.

60) When women with breast cancer undergo surgery to remove the tumor or the entire breast, the axillary lymph nodes are often removed as well. Why?

A) In removing the breast, the blood supply to the nodes is removed and they will inevitably cease to function.

B) The axillary lymph nodes receive lymph from the breast and may contain cancer cells.

C) The nerves that supply the axillary lymph nodes are often cut during the breast surgery.

D) It is impossible to remove the breast without physically damaging the lymph nodes.

E) With the removal of the breast, there is no further need for lymph drainage and filtering in that part of the body.

61) Typically, a hilum of a lymph node contains

A) one afferent lymphatic vessel.

B) one efferent lymphatic vessel.

C) numerous afferent vessels.

D) numerous efferent vessels.

62) The cortex of a lymph node contains multiple lymphatic nodules.

63) The term "swollen glands" is usually meant to refer to lymph nodes in which

A) the valves of afferent vessels are bulging.

B) macrophages are clogging afferent lymphatic vessels.

C) lymphocytes are proliferating in germinal centers.

D) phagocytes are consuming the infected lymph nodes.

E) macrophages are entering at the hilum.

64) Which lymphatic organ contains red pulp and white pulp?

A) Thymus gland and lymph nodes

B) Spleen and lymph nodes

C) Lymph nodes

D) Spleen

E) Thymus gland

65) Which is not a function of the spleen?

A) Serves as a platelet reservoir

B) Filters blood

C) Filters lymph

D) Recycles aged erythrocytes

E) Houses lymphocytes

66) One of the functions of the spleen is phagocytosis of bacteria in the blood.

67) In which abdominal quadrant is the spleen located?

A) Left upper quadrant

B) Right upper quadrant

C) Left lower quadrant

D) Right lower quadrant

68) The hilum of the spleen is part of its

A) concave anteromedial border.

B) concave posterolateral border.

C) convex anteromedial border.

D) convex posterolateral border.

69) Which is not correct regarding the spleen?

A) It has an outer cortex and inner medulla.

B) It is divided into sections by capsular extensions called trabeculae.

C) Its white pulp contains T-lymphocytes, B-lymphocytes, and macrophages.

D) Its blood is supplied by the splenic artery and drained by the splenic vein.

70) Within the red pulp of the spleen are enlarged capillaries called ________, which have a discontinuous basal lamina that allows blood cells to enter and exit easily.

A) splenic cords

B) trabecular vessels

C) splenic vessels

D) splenic sinusoids

E) trabecular cords

71) Which is not correct regarding the white pulp of the spleen?

A) Its cells include T-lymphocytes, B-lymphocytes, and macrophages.

B) Its cells are arranged in clusters that are circular in shape.

C) It contains a central artery.

D) It serves as a blood reservoir.

72) This figure shows the lymphatic system. Which number indicates the inguinal lymph nodes?

A) 1

B) 4

C) 5

D) 9

E) 10

73) This figure shows the lymphatic system. What structure does number 8 indicate?

A) Lymphatic nodule

B) Thymus gland

C) Cisterna chyli

D) Spleen

E) Adenoid

74) This figure shows a lymph node and its components. The region indicated by number 1 is a

A) germinal center.

B) mantle zone.

C) cortical sinus.

D) medullary cord.

E) medullary sinus.

75) This figure shows a lymph node and its components. What structure is indicated by number 4?

A) Medullary cord

B) Lymphatic nodule

C) Hilum

D) Trabecula

E) Lymphatic sinusoid

76) One of the functions of the lymphatic system is to transport fat.

77) The walls of lymphatic capillaries are only one cell thick.

78) The germinal center of a lymphatic nodule contains proliferating B-lymphocytes and macrophages.

79) The thymus gland begins to atrophy immediately after birth.

80) The spleen is essentially a giant lymph node, because it is encapsulated, has trabeculae, and filters lymph to remove antigens.

81) Obstruction of the flow of lymph in lymphatic vessels can lead to an accumulation of interstitial fluid in the tissues. This condition is characterized by pain and swelling, and is called ________.

82) A lymph nodule contains a germinal center surrounded by a region containing T-lymphocytes, dendritic cells, and macrophages; this outer region is known as a ________ zone.

83) Old or defective erythrocytes and platelets are engulfed within the lymph organ known as the ________.

84) It has been suggested that the lymphatic system evolved when animals became larger and the hydrostatic pressure in their circulatory systems rose. Explain how this suggestion is consistent with the function of the lymphatics—how does high blood pressure make lymphatic function essential? Also, what other advantages were gained by animals that developed lymphatic systems?