Deck 9: Lymphatic System

Question 1

Which nodes are also called Virchow nodes?

A) Internal mammary
B) Anterior axillary
C) Deep cervical
D) Supraclavicular

Answer 1

Supraclavicular

Question 2

Cells that line the lymph node sinuses perform the specific function of:

A) fat absorption.
B) fetal immunization.
C) hematopoiesis.
D) phagocytosis.

Answer 2

phagocytosis.

Question 3

Mr. Walker is a 21-year-old man who complains of a sore throat. On examination, you note red, swollen tonsils. The lymph nodes located nearest the palatine tonsils are the ________ nodes.

A) supraclavicular
B) retropharyngeal
C) submental
D) submandibular

Answer 3

retropharyngeal

Question 4

Lymphoid tissue normally regresses to adult size by:

A) 2 years of age.
B) 5 years of age.
C) 10 years of age.
D) puberty.

Question 5

Which nodes are most often associated with inflammation?

A) Shotty
B) Movable
C) Fixed
D) Tender

Question 6

Which risk factor is least likely to result in someone contracting HIV infection?

A) Multiple sexual contacts
B) Hemophilia
C) Intravenous drug use
D) Working with AIDS patients

Question 7

Lymph ducts merge into the venous system at the:

A) portal vein.
B) pulmonic vein.
C) subclavian vein.
D) vena cava.

Question 8

Which landmark is the dividing line between the anterior and posterior cervical triangles?

A) Clavicle
B) Cervical spine
C) Sternocleidomastoid
D) Sternum

Question 9

An organ that is essential to the development of protective immune function in the infant but has little or no demonstrated function in the adult is the:

A) spleen.
B) liver.
C) thymus.
D) pancreas.

Question 10

Lymph flows faster in response to:

A) increased metabolic activity.
B) decreased blood volume.
C) decreased metabolic rate.
D) decreased permeability of the capillary walls.

Question 11

Mr. Shea is a 45-year-old patient who presents to the office for multiple complaints. The examination of the upper left quadrant of the abdominal cavity is essential to the evaluation of the immune system because of the location of which organ?

A) Spleen
B) Liver
C) Stomach
D) Pancreas

Question 12

Mrs. Farrel brings in her 6-year-old son with complaints of a sore throat and fever. As the health care provider, you are concerned about his tonsils and adenoids. Enlarged tonsils and adenoids may obstruct the:

A) thoracic duct.
B) esophagus.
C) nasopharyngeal passageway.
D) external auditory meatus.

Question 13

A congenital defect in the immune system of a 2-week-old infant may be suspected if:

A) there are small femoral nodes palpable.
B) the umbilical cord has not yet dropped off.
C) the tonsils are visible.
D) the thymus is visible on a chest radiograph.

Question 14

Ms. Hartzel is a 33-year-old patient who presents to the office with complaints of enlarged lymph nodes in her neck. During your examination, which part of the hand is used to assess lymph node size?

A) Pads of the fingers
B) Tips of the fingers
C) Palm
D) Ulnar surface

Question 15

As adults age, their ability to resist infection is reduced because of the lymphatic nodes becoming more:

A) fibrotic.
B) mucoid.
C) porous.
D) profuse.

Question 16

Nodes located nearest the elbow are the ____________ nodes.

A) supraclavicular
B) axillary
C) epitrochlear
D) popliteal

Question 17

Mr. McDonnel is a 29-year-old patient who presents to the office with complaints of enlarged lymph nodes just inferior to the chin. Nodes that are palpable just inferior to the chin are the ______________ nodes.

A) infraclavicular
B) submental
C) submandibular
D) parotid

Question 18

Which of the following organs does not have lymphatic vessels?

A) Brain
B) Kidneys
C) Liver
D) Lungs

Question 19

Equipment for examining the lymphatic system includes a:

A) caliper.
B) centimeter ruler.
C) goniometer.
D) syringe and needle.

Question 20

Mrs. Sing is a 44-year-old patient who presents to the office with a complaint of enlarged lymph nodes. When enlarged, which lymph nodes are most likely to be a sign of pathology (e.g., malignancy)?

A) Occipital
B) Anterior cervical
C) Supraclavicular
D) Femoral

Question 21

Obstruction of the nasopharynx, pulmonary hypertension, and risk of sleep apnea may be associated with excessively enlarged:

A) branchial cleft cysts.
B) cystic hygromas.
C) palatine tonsils.
D) thyroglossal duct cysts.

Question 22

Which disorder is a dysfunction of cell-mediated immunity?

A) Acute idiopathic polyneuritis
B) Acquired immunodeficiency syndrome
C) Epstein-Barr virus (EBV) mononucleosis
D) Systemic lupus erythematosus (SLE)

Question 23

Which of the following findings indicates that the examiner is assessing a blood vessel rather than a lymph node?

A) A bruit
B) Inflammation
C) Tenderness
D) Redness

Question 24

The most important clue to the diagnosis of immunodeficiency disease in a child is:

A) family history.
B) illness in siblings.
C) previous hospitalizations.
D) serious recurring infections.

Question 25

Nodes located over the mastoid process are the ____________ nodes.

A) preauricular
B) postauricular
C) occipital
D) epitrochlear

Question 26

Enlarged inguinal nodes are likely to be associated with:

A) genital herpes.
B) pelvic inflammatory disease.
C) uterine cancer.
D) testicular cancer.

Question 27

The harder and more discrete a node, the more likely that there is a(n):

A) innocent cause.
B) infection.
C) malignancy.
D) metabolic disease.

Question 28

Mrs. Black is a 49-year-old patient who presents to the office with complaints of fatigue and joint pain. When examining the epitrochlear nodes, which joint should be supported?

A) Elbow
B) Knee
C) Shoulder
D) Wrist

Question 29

Large palatine tonsils are common in:

A) children.
B) adolescents.
C) young adults.
D) older adults.

Question 30

A red streak that follows the course of the lymphatic collecting duct is a finding associated with:

A) Hodgkin disease.
B) lymphangitis.
C) lymphedema.
D) lymphoma.

Question 31

To palpate the inguinal nodes, you should have the patient:

A) bend over a table and cough.
B) lie supine with knees slightly flexed.
C) lie supine with legs extended.
D) stand and cough vigorously.

Question 32

To find the infection site associated with acute lymphangitis, the examiner should look ________ to the inflammation.

A) proximal
B) distal
C) contralateral
D) anterior

Question 33

Which disorder is characterized by a single node that is chronically enlarged and nontender in a patient with no other symptoms?

A) Retropharyngeal abscess
B) Streptococcal pharyngitis
C) Mononucleosis
D) Toxoplasmosis

Question 34

Initial signs and symptoms of Epstein-Barr virus mononucleosis usually include:

A) pharyngitis, fever, and malaise.
B) bleeding gums and spontaneous nosebleeds.
C) headache, visual disturbance, and rash.
D) inguinal adenopathy and painful urination.

Question 35

Tender nodes associated with cat scratch disease are usually found in which area?

A) Epitrochlear area
B) Popliteal area
C) Axilla
D) Inguinal area

Question 36

It is not unusual to find enlarged postauricular and occipital nodes in:

A) children younger than 2 years.
B) school-age children.
C) adolescents.
D) adults.

Question 37

Nodes located at the base of the skull are the ____________ nodes.

A) preauricular
B) postauricular
C) occipital
D) epitrochlear

Question 38

The most common causes of acute suppurative lymphadenitis are:

A) HIV and herpes zoster.
B) Haemophilus influenzae and adenovirus.
C) herpes simplex types 1 and 2.
D) streptococcal and staphylococcal organisms.

Question 39

When examining lymph nodes near a joint in the arm or leg, which of the following maneuvers is likely to facilitate the examination?

A) Extension of the extremity
B) Circumduction of the extremity
C) Flexion of the extremity
D) Rotation of the extremity

Question 40

Transillumination is performed during an examination of the lymphatic system to:

A) detect lymphatic pulsation.
B) distinguish nodes from cysts.
C) evaluate nodal contours.
D) observe erythematous lesions.

Question 41

The nurse tells her patient with lymphadenopathy not to rub the swollen lymph node because this would result in:

A) spreading the infection.
B) enlarging the node.
C) slowing the lymphatic drainage.
D) making the node more fibrotic.

Question 42

Normal lymph is composed primarily of _________________.

Question 43

Serum sickness is usually characterized first by the appearance of:

A) lymph node enlargement.
B) joint pain.
C) urticaria.
D) fever.

Question 44

Hodgkin disease is most common in ______________________.

Question 45

What is the most frequent cause of edema of the lower extremities?

A) Deficiency of vitamins and minerals
B) Excessive walking or running
C) Prolonged sitting or standing
D) Use of table salt

Question 46

Which of the following conditions will stimulate lymph node enlargement?

A) Graves disease
B) Lymphangioma
C) Esophageal reflux
D) Parotid swelling