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Lymphatic System Analysis

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Gross Anatomy of the Lymphatic System
Rather than describing the lymphatic system as an organ, it is better understood as a complex system which includes capillaries, vessels, cells, organs, ducts, lymph nodes and valves which all contribute to linking different structures together in order to transport excess fluid from the body tissues to the bloodstream and permeate pathogens from the blood (2, 3).
Figure 2.

Figure 1.
The lymphatic vessels form a major element of the lymphatic system and are extensively distributed in most areas of the body excluding the central nervous system, bone marrow, bones, teeth, eyeball and avascular tissues such as cartilage (1,3) as illustrated in Figure 1. The lymphatic vessels themselves initiate as lymphatic
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As with all surgical procedures, adenotonsillectomy poses a series of potential complications in children, although these are only occasional (8). There have been a series of studies which have focused on the complications resulting from adenotonsillectomy. The Helmus study carried out on children under three indicated a low complication rate, although children in this study underwent adenotonsillectomy for chronic recurrent infections rather than for airway obstruction. Whilst Richmond et al. found a higher rate of postoperative airway complication for children who underwent surgery for airway obstruction. Berkowitz and ZalZal numerically identified a 10.5% complication rate in 190 children who underwent adenotonsillectomy for airway obstruction (9). These studies also signified that the main complications associated with adenotonsillectomy in young children are analogous to airway obstruction, postoperative haemorrhage and …show more content…
Airway obstruction is mainly categorised in the immediate postoperative and laryngoscopy, an example of a type of airway obstruction is a greater complication in children than adults (13). Acute airway obstruction may occur if blood or clots build up in the hymopharynx which can happen at any point between the patient awakening, extubation ort even at a later period. On are instances a patient’s airways can become blocked if any loose tonsular tissue is not detached during surgery or if loose teeth and surgical instruments are found in the airway (10). Likewise, medical management after adenotonsillectomy may result in airway obstruction. For example, promethazine, an antihistamine used as an antiemetic to treat postoperative nausea, vomiting and pain has been recognised to have adverse side effects including cardiac arrest, respiratory depression, apnea and seizures. However, this drug should rarely if ever be used in paediatric patients. Also, obesity can increase the risk of respiratory complications and a recent report identified that almost 21% of patients undergoing adenotonsillectomy in 2012 were overweight and obese. As a result this greatly increased the risk of attempts at laryngoscopy. In addition an analysis in 2012 demonstrated that

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