DOCSLIB.ORG

The Peripheral Vascular System Anatomy and Physiology Arteries

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Peripheral Vascular System Anatomy and Physiology Arteries The Peripheral Vascular System Anatomy and Physiology Arteries Arteries contain 3 concentric layers of tissue: - the intima - the media - the adventitia The intima The endothelium of the intima has metabolic properties, it synthetizes: - regulators of thrombosis (i.e. prostacyclin, plasminogen activator and heparinlike molecules) - prothrombotic molecules (i.e. plasminogen activator inhibitor) - modulates blood flow and vascular reactivity (vasoconstrictors like endothelin - vasodilators like prostacyclin) It also regulates: • Immune and inflammatory reactions through elaboration of: - interleukins - adhesion molecules - histocompatibility antigens The media and adventitia • The media is composed of SMOOTH MUSCLE CELL that dilate and constrict to accommodate blood pressure flow • Small arterioles called the VASA VASORUM perfuse the media • The adventitia is composed of connective tissue containing nerve fibers and the vasa vasorum Arteria pulses palpable in the arms: - The brachial artery - The radial artery - The ulnar artery Pulses palpable in the leg: - The femoral artery - The popliteal artery - The dorsalis pedis artery - The posterior tibial artery Veins Veins are thin-walled and highly distensible The venous intima consists of NONTHROMBOGENIC ENDOTHELIUM Protruding into the lumen are VALVES the promote unidirectional venous return The media contains elastic tissue and smooth muscle that change vein caliber in response to venous pressure Veins from the arm, upper trunk and head and neck drains into the SUPERIOR VENA CAVA Veins from the legs and lower trunk drain upward into the INFERIOR VENA CAVA The superficial vein of the leg include: - The great saphenous vein - The small saphenous vein The lymphatic system • Drains lymph fluid from body tissue and returns it to the venous circulation • Lymph fluid is filtered through lymph nodes (only superficial ones are accessible to physical examination) • Vascular and immune function Lymphatics of upper limb • EPITROCHLEAR NODES drain from the ulnar surface of the foreharm and hand • AXILLARY NODES drain the rest of the arm Lymphatics of lower limb The SUPERFICIAL INGUINAL NODES include 2 groups: • The horizontal group (below the inguinal ligament) • The vertical group (near the upper part of the saphenous vein) The horizontal group The vertical group drains drains: a corresponding region of the leg - superficial portion of the lower abdomen and buttock - external genitalia (not the testes) - anal canal - perianal area and the lower vagina Lymphatics of lower limb Lymphatics from the portion of the leg drained by the small saphenous vein join the deep system at the popliteal space Peripheral vascular disorders Common or concerning symptoms Abdominal, flank, or back pain Pain in the arms or legs Intermittent claudication Cold, numbness, pallor in the legs; hair loss Swelling in calves, legs, or feet Color change in fingertips or toes in cold weather Swelling with redness or tenderness Peripheral arterial disease • Peripheral arterial disease (PAD) is a common manifestation of atherosclerosis affecting 12% to 29% of community populations • Prevalence increases with age and presence of cardiovascular risk factors Risk factors for lower extremity PAD Age 50, or younger if diabetes or atherosclerosis risk factor of smoking, dyslipidemia, hypertension, or hyperhomocysteinemia Age 50 to 69 and history of smoking or diabetes Age 70 or older Leg symptoms with exertion or ischemic rest pain Abnormal lower pulses Known atherosclerotic coronary, carotid, or renal artery disease PAD warning signs Fatigue, aching, nubness or pain that limits walking or exertion in the legs; in case identify the location Any poorly healing or nonhealing wounds of legs or feet Any pain present when at rest in the lower leg or foot and changes when standing or supine Abdominal pain after meals and associated “food fear” and weight loss (suggest intestinal ischemia of the celiac or superior or inferior mesenteric arteries) Any first-degree relatives with an abdominal aortic aneurysm (prevalence is of 15% to 28%) SYMPTOM LOCATION suggests the site of arterial ischemia: • Buttock, hip: aortoiliac • Erectile dysfunction: iliac- pudendal • Thigh: common femoral or aortoiliac • Upper calf: superficial femoral • Lower calf: popliteal • Foot: tibial or peroneal Abdominal Aortic Aneurysm (AAA) • AAA is defined as an infrarenal aortic diameter ≥ 3cm • It s found in over 50% of older male smokers • Rupture and mortality increases when the aortic diameter extends 5.5cm • Palpation is useful when the diameter reaches ≥ 4cm Risk factors of AAA Smoking Age 65 or older Family history Coronary artery disease PAD Hypertension Hyperlipidemia Painful peripheral vascular disorders Intermittent Atherosclerosis claudication (ateriosclerosis obliterans) Rest pain Acute Arterial Arterial Disorders Occlusion Raynaud’s Disease and Phenomenon Painful peripheral vascular disorders Superficial Thrombophlebitis Deep Venous Venous Disorders Thrombosis (DVT) Chronic Venous Insufficiency (deep) Painful peripheral vascular disorders Thromboangiitis Obliterans (Buerger’s Disease) Compartment Syndrome Acute Lymphangitis Techniques of peripheral arterial examination Important areas of examination The arms The abdomen The legs Size, symmetry, skin Aortic width Size, symmetry, skin color color Redial pulse, brachial Pulsatile mass Femoral pulse and pulse inguinal lymph nodes Epitrochlear lymph Popliteal, dorsalis pedis nodes and posterior tibial pulses Peripheral edema Key components of peripheral arterial examination Measure blood pressure in both arms Palpate carotid upstoke, ausculatate for bruits Auscultate for aortic, renal and femoral bruits; palpate aorta and determine maximanl diameter Palpate brachial, radial, ulnar, femoral, popliteal, dorsalis pedis, and posterior arteries Inspect ankles and feet color, temperature, skin integrity; note any ulcerations; check for hair loss, trophic skin changes, hypertrophic nails Arms Inspect both arms, notice: • Size, symmetry and any swelling • Venous pattern • Color and texture of the skin and the color of the nails beds • Palpate the RADIAL PULSE If you suspect arterial insufficiency feel for the BRACHIAL PULSE • Feel for one or more EPITROCHLEAR NODES If a node is present note its size, consistency and tenderness Epitrochlear nodes are difficult or impossible to identify in most normally healthy people Abdomen Listen for the AORTIC, RENAL AND FEMORAL BRUITS • Palpate and estimate the width of the abdominal aorta in the epigastric area (especially in older adults due to higher risk of AAA) • Assess for a pulsatile mass Legs Inspect both legs. Notice: • Size, symmetry and any swelling • Venous pattern and nay venous enlargement • Any pigmentation, rashes, scars or ulcers • Color and texture of the skin, the color of the nails beds, and the distribution of hair Palpate the SUPERFICIAL INGUINAL NODES: • Note their size, consistency and tenderness • Nontender discrete inguinal nodes up to 1-2cm in diameter are frequently palpable in normal people The peripheral arteries • The FEMORAL PULSE • The POPLITEAL PULSE The peripheral arteries • The DORSALIS PEDIS PULSE • The POSTERIOR TIBIAL PULSE The peripheral veins • Note the color of the skin • Look for edema • Check for pitting edema (depression caused by pressure from your thumb for at least 2 sec) If EDEMA is present look for possible causes in the peripheral vascualr system: • recent deep venous thrombosis (DVT), • chronic venous insufficiency from previous deep DVT or incompetence of the venous valves, • lymphedema Try to identify any venous tenderness that may accompany DVT (may have no demonstrable signs) Ask the pt to stand and inspect the saphenous system for varicosities Special Techniques Evaluating the arterial supply to the hand • Ulnar, radial and brachial pulse • The Allen test Postural color changes of chronic arterial insufficiency If pain or diminished pulses suggest arterial insufficiency look for postural color changes: • Raise both legs until maximal pallor of the feet (within 1min) • Ask the pz to sit up (legs dangling down) Note the time required for: - Return of pinkness (about 10 sec) - Filling veins of feet and ankles (about 15 sec) Mapping varicose veins Transmit pressure waves along the blood- filled veins with pt standing Evaluating the competency of venous valves Assess the vascular competency in communicating veins and saphenous system: Pt supine, elevate legs about 90° Occlude the great saphenous vein in the upper tigh by manual compression (enough to occlude the vein but not the deeper vessels) Ask the pt to stand While keeping the vein occluded watch for venous filling in the leg Normally the saphenous vein fills from below (about 35 sec) Rapid filling of superficial veins (while the saphenous is occluded) indicate incompetent valves in communicating veins After the pt stands for 20 sec release the compression and look for sudden additional venous filling Normally there is none (competent valves block retrogade flow) .
Load more

Recommended publications
  • Why Are Spider Veins of the Legs a Serious and a Dangerous Medical
    1 Anti-aging Therapeutics Volume 9–2007 Prevention or Reversal of Deep Venous Insufficiency and Treatment: Why Are Spider Veins of the Legs a Serious and A Dangerous Medical Condition? Imtiaz Ahmad M.D., F.A.C.S a, b, Waheed Ahmad M.D., F.A.C.S c, d a Cardiothoracic and Vascular Associates (Comprehensive Vein Treatment Center), Hamilton, NJ, USA b Robert Wood Johnson University Hospital, Hamilton, NJ, USA. c Comprehensive Vein Treatment Center of Kentuckiana, New Albany, IN 47150, USA. d Clinical professor of surgery, University of Louisville, Louisville, KY, USA. ABSTRACT Spider veins (also known as spider hemangiomas) unlike varicose veins (dilated pre-existing veins) are acquired lesions caused by venous hypertension leading to proliferation of blood vessels in the skin and subcutaneous tissues due to the release of endothelial growth factors causing vascular neogenesis. More than 60% of the patients with spider veins of the legs have significant symptoms including pain, itching, burning, swelling, phlebitis, cellulites, bleeding, and ulceration. Untreated spider veins may lead to serious medical complications including superficial and deep venous thrombosis, aggravation of the already established venous insufficiency, hemorrhage, postphlebitic syndrome, chronic leg ulceration, and pulmonary embolism. Untreated spider vein clusters are also responsible for persistent low-grade inflammation; many recent peer- reviewed medical studies have shown a definite association of chronic inflammation with obesity, cardiovascular disease, arthritis, Alzheimer’s disease, and cancer. Clusters of spider veins have one or more incompetent perforator veins connected to the deeper veins causing reflux overflow of blood that is responsible for their dilatation and eventual incompetence.
    [Show full text]
  • Cardiovascular System 9
    Chapter Cardiovascular System 9 Learning Outcomes On completion of this chapter, you will be able to: 1. State the description and primary functions of the organs/structures of the car- diovascular system. 2. Explain the circulation of blood through the chambers of the heart. 3. Identify and locate the commonly used sites for taking a pulse. 4. Explain blood pressure. 5. Recognize terminology included in the ICD-10-CM. 6. Analyze, build, spell, and pronounce medical words. 7. Comprehend the drugs highlighted in this chapter. 8. Describe diagnostic and laboratory tests related to the cardiovascular system. 9. Identify and define selected abbreviations. 10. Apply your acquired knowledge of medical terms by successfully completing the Practical Application exercise. 255 Anatomy and Physiology The cardiovascular (CV) system, also called the circulatory system, circulates blood to all parts of the body by the action of the heart. This process provides the body’s cells with oxygen and nutritive ele- ments and removes waste materials and carbon dioxide. The heart, a muscular pump, is the central organ of the system. It beats approximately 100,000 times each day, pumping roughly 8,000 liters of blood, enough to fill about 8,500 quart-sized milk cartons. Arteries, veins, and capillaries comprise the network of vessels that transport blood (fluid consisting of blood cells and plasma) throughout the body. Blood flows through the heart, to the lungs, back to the heart, and on to the various body parts. Table 9.1 provides an at-a-glance look at the cardiovascular system. Figure 9.1 shows a schematic overview of the cardiovascular system.
    [Show full text]
  • 29 Assessing the Cardiovascular and Lymphatic Systems
    29 Assessing the Cardiovascular and Lymphatic Systems LEARNING OUTCOMES 1. Describe the anatomy, physiology, and functions of the 5. Explain techniques used to assess cardiovascular and cardiovascular and lymphatic systems. lymphatic structure and function. 2. Describe normal variations in cardiovascular assessment 6. Identify manifestations of impaired cardiovascular structure findings for the older adult. and functions. 3. Give examples of genetic disorders of the cardiovascular system. 4. Identify specific topics for consideration during a health history assessment interview of the patient with cardiovascu- lar or lymphatic disorders. CLINICAL COMPETENCIES 1. Complete a health history for patients having alterations in 3. Assess an ECG strip and identify normal rhythm and cardiac the structure and functions of the cardiovascular or lymphatic events and abnormal cardiac rhythm. systems. 4. Monitor the results of diagnostic tests and communicate 2. Conduct and document a physical assessment of cardiovas- abnormal findings within the interprofessional team. cular and lymphatic status. MAJOR CHAPTER CONCEPTS • Correct structure and function of the cardiovascular and • Manifestations of dysfunction, injury, and disorders affecting lymphatic systems are vital to the transport of oxygen and the cardiovascular and lymphatic systems may be detected carbon dioxide throughout the body and for the return of during a general health assessment as well as during focused excess tissue fluids back to the bloodstream. cardiovascular and lymphatic system
    [Show full text]
  • Microlymphatic Surgery for the Treatment of Iatrogenic Lymphedema
    Microlymphatic Surgery for the Treatment of Iatrogenic Lymphedema Corinne Becker, MDa, Julie V. Vasile, MDb,*, Joshua L. Levine, MDb, Bernardo N. Batista, MDa, Rebecca M. Studinger, MDb, Constance M. Chen, MDb, Marc Riquet, MDc KEYWORDS Lymphedema Treatment Autologous lymph node transplantation (ALNT) Microsurgical vascularized lymph node transfer Iatrogenic Secondary Brachial plexus neuropathy Infection KEY POINTS Autologous lymph node transplant or microsurgical vascularized lymph node transfer (ALNT) is a surgical treatment option for lymphedema, which brings vascularized, VEGF-C producing tissue into the previously operated field to promote lymphangiogenesis and bridge the distal obstructed lymphatic system with the proximal lymphatic system. Additionally, lymph nodes with important immunologic function are brought into the fibrotic and damaged tissue. ALNT can cure lymphedema, reduce the risk of infection and cellulitis, and improve brachial plexus neuropathies. ALNT can also be combined with breast reconstruction flaps to be an elegant treatment for a breast cancer patient. OVERVIEW: NATURE OF THE PROBLEM Clinically, patients develop firm subcutaneous tissue, progressing to overgrowth and fibrosis. Lymphedema is a result of disruption to the Lymphedema is a common chronic and progres- lymphatic transport system, leading to accumula- sive condition that can occur after cancer treat- tion of protein-rich lymph fluid in the interstitial ment. The reported incidence of lymphedema space. The accumulation of edematous fluid mani- varies because of varying methods of assess- fests as soft and pitting edema seen in early ment,1–3 the long follow-up required for diagnosing lymphedema. Progression to nonpitting and irre- lymphedema, and the lack of patient education versible enlargement of the extremity is thought regarding lymphedema.4 In one 20-year follow-up to be the result of 2 mechanisms: of patients with breast cancer treated with mastec- 1.
    [Show full text]
  • Aortic Intramural Hematoma Associated with Primary Aldosteronism
    대한내분비학회지: 제 24권 제 3 호 2009 □ 증 례 □ 10.3803/jkes.2009.24.3.217 1) Aortic Intramural Hematoma Associated with Primary Aldosteronism 전남대학교 의과대학 내과학교실 정진욱․조동혁․정동진․정민영 Aortic Intramural Hematoma Associated with Primary Aldosteronism Jin Ook Chung, Dong Hyeok Cho, Dong Jin Chung, Min Young Chung Department of Internal Medicine, Chonnam National University Medical School ABSTRACT Intramural hematoma of the aorta is a variant of aortic dissection characterized by the absence of direct communication between the false lumen and the true lumen of the aorta. Primary aldosteronism, which is an uncommon cause of hypertension, may direct alter arterial structure through the pleiotropic effects of aldosterone as well as pressure-mediated indirect alterations. There have been several reported cases of aortic dissection in patients with primary aldosteronism, which suggests a causal relationship between the two diagnostic entities. However, intramural hematoma has not been described in a patient with primary aldosteronism. We describe a case of aortic intramural hematoma in a patient with primary aldosteronism and speculate about the causal relationship between these two entities. (J Korean Endocr Soc 24:217~220, 2009) ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ Key Words: aorta, hematoma, hyperaldosteronism Introduction is suppressed[2]. Primary aldosteronism may cause direct alterations in arterial structure through the pleiotropic Intramural hematoma of the aorta is a variant of aortic effects of aldosterone, as well as indirect alterations through dissection characterized by the absence of direct communi- pressure effects[3]. There have been several reported cases cation between the false lumen and the true lumen of the of aortic dissection in patients with primary aldosteronism, aorta[1].
    [Show full text]
  • Lower Limb Venous Drainage
    Vascular Anatomy of Lower Limb Dr. Gitanjali Khorwal Arteries of Lower Limb Medial and Lateral malleolar arteries Lower Limb Venous Drainage Superficial veins : Great Saphenous Vein and Short Saphenous Vein Deep veins: Tibial, Peroneal, Popliteal, Femoral veins Perforators: Blood flow deep veins in the sole superficial veins in the dorsum But In leg and thigh from superficial to deep veins. Factors helping venous return • Negative intra-thoracic pressure. • Transmitted pulsations from adjacent arteries. • Valves maintain uni-directional flow. • Valves in perforating veins prevent reflux into low pressure superficial veins. • Calf Pump—Peripheral Heart. • Vis-a –tergo produced by contraction of heart. • Suction action of diaphragm during inspiration. Dorsal venous arch of Foot • It lies in the subcutaneous tissue over the heads of metatarsals with convexity directed distally. • It is formed by union of 4 dorsal metatarsal veins. Each dorsal metatarsal vein recieves blood in the clefts from • dorsal digital veins. • and proximal and distal perforating veins conveying blood from plantar surface of sole. Great saphenous Vein Begins from the medial side of dorsal venous arch. Supplemented by medial marginal vein Ascends 2.5 cm anterior to medial malleolus. Passes posterior to medial border of patella. Ascends along medial thigh. Penetrates deep fascia of femoral triangle: Pierces the Cribriform fascia. Saphenous opening. Drains into femoral vein. superficial epigastric v. superficial circumflex iliac v. superficial ext. pudendal v. posteromedial vein anterolateral vein GREAT SAPHENOUS VEIN anterior leg vein posterior arch vein dorsal venous arch medial marginal vein Thoraco-epigastric vein Deep external pudendal v. Tributaries of Great Saphenous vein Tributaries of Great Saphenous vein saphenous opening superficial epigastric superficial circumflex iliac superficial external pudendal posteromedial vein anterolateral vein adductor c.
    [Show full text]
  • Comprehensive Review of the Superficial Veins of the Forearm from a Historical, Anatomical and Clinical Point of View
    IJAE Vol. 124, n. 2: 142-152, 2019 ITALIAN JOURNAL OF ANATOMY AND EMBRYOLOGY Circulatory system Comprehensive review of the superficial veins of the forearm from a historical, anatomical and clinical point of view Lucas Alves Sarmento Pires1,2,*, Albino Fonseca Junior1,2, Jorge Henrique Martins Manaia1,2, Tulio Fabiano Oliveira Leite3, Marcio Antonio Babinski1,2, Carlos Alberto Araujo Chagas2 1 Medical Sciences Post Graduation Program, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil 2 Morphology Department, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil 3 Interventional Radiology Unit, Radiology Institute, University of São Paulo Medical School, São Paulo, Brazil Abstract The superficial veins of the forearm are prone to possess different patterns of anastomosis. This is highly significant, as venipunctures in the upper limb are among the most performed procedures in the world and they often rely on the veins of the cubital fossa. In addition, the relationship of these veins to the cutaneous nerves are also prone to vary and are often uncer- tain. These veins are also manipulated in the creation of arteriovenous fistula for dialisis, which remains as the best choice of treatment for renal failure patients. Such fistulas are often per- formed on the wrist or the cubital fossa, with the cephalic vein or basilic vein. It is known that anatomical variations of the vessels and nerves on the cubital fossa may induce the profession- als to error, and one of the most common complications of venipuncture are accidental nerve puncture, which can lead to paresthesia and pain. We aim to perform a comprehensive review of the venous arrangements of the cubital fossa and their clinical aspects, as well as of veni- puncture from a historical perspective and of the complications of venipuncture and arterio- venous fistula from an anatomical point of view, with the purpose of compiling available data and help healthcare professionals to reduce puncture errors or arteriovenous fistula complica- tions and improve patient care.
    [Show full text]
  • Lymphatic Tissue Engineering and Regeneration Laura Alderfer1, Alicia Wei1 and Donny Hanjaya-Putra1,2,3,4,5,6*
    Alderfer et al. Journal of Biological Engineering (2018) 12:32 https://doi.org/10.1186/s13036-018-0122-7 REVIEW Open Access Lymphatic Tissue Engineering and Regeneration Laura Alderfer1, Alicia Wei1 and Donny Hanjaya-Putra1,2,3,4,5,6* Abstract The lymphatic system is a major circulatory system within the body, responsible for the transport of interstitial fluid, waste products, immune cells, and proteins. Compared to other physiological systems, the molecular mechanisms and underlying disease pathology largely remain to be understood which has hindered advancements in therapeutic options for lymphatic disorders. Dysfunction of the lymphatic system is associated with a wide range of disease phenotypes and has also been speculated as a route to rescue healthy phenotypes in areas including cardiovascular disease, metabolic syndrome, and neurological conditions. This review will discuss lymphatic system functions and structure, cell sources for regenerating lymphatic vessels, current approaches for engineering lymphatic vessels, and specific therapeutic areas that would benefit from advances in lymphatic tissue engineering and regeneration. Keywords: Lymphangiogenesis, Tissue Engineering, Disease Modeling, Wound Healing, Lymphedema, Stem Cells, Biomaterials, Interstitial Fluid, Regeneration I. Introduction to the Lymphatic System and its role Interstitial fluid (IF) is a plasma filtrate that is generated Function by transcapillary filtration and is governed by Starling The lymphatic system is nearly ubiquitous in the human forces, the net difference between hydrostatic and body, present in all tissues except the epidermis, cartil- osmotic pressures, at the microcirculatory level [9]. In age, eye lens, cornea, retina, and bone marrow [1, 2]. order to maintain fluid homeostasis, lymph formation in The main functions of the lymphatic system include the initial lymphatic vessels must be balanced by the net fluid homeostasis and interstitial fluid drainage, immune flux of plasma being filtered out [4].
    [Show full text]
  • Lymph and Lymphatic Vessels
    Cardiovascular System LYMPH AND LYMPHATIC VESSELS Venous system Arterial system Large veins Heart (capacitance vessels) Elastic arteries Large (conducting lymphatic vessels) vessels Lymph node Muscular arteries (distributing Lymphatic vessels) system Small veins (capacitance Arteriovenous vessels) anastomosis Lymphatic Sinusoid capillary Arterioles (resistance vessels) Postcapillary Terminal arteriole venule Metarteriole Thoroughfare Capillaries Precapillary sphincter channel (exchange vessels) Copyright © 2010 Pearson Education, Inc. Figure 19.2 Regional Internal jugular vein lymph nodes: Cervical nodes Entrance of right lymphatic duct into vein Entrance of thoracic duct into vein Axillary nodes Thoracic duct Cisterna chyli Aorta Inguinal nodes Lymphatic collecting vessels Drained by the right lymphatic duct Drained by the thoracic duct (a) General distribution of lymphatic collecting vessels and regional lymph nodes. Figure 20.2a Lymphatic System Outflow of fluid slightly exceeds return Consists of three parts 1. A network of lymphatic vessels carrying lymph 1. Transports fluid back to CV system 2. Lymph nodes 1. Filter the fluid within the vessels 3. Lymphoid organs 1. Participate in disease prevention Lymphatic System Functions 1. Returns interstitial fluid and leaked plasma proteins back to the blood 2. Disease surveillance 3. Lipid transport from intestine via lacteals Venous system Arterial system Heart Lymphatic system: Lymph duct Lymph trunk Lymph node Lymphatic collecting vessels, with valves Tissue fluid Blood Lymphatic capillaries Tissue cell capillary Blood Lymphatic capillaries capillaries (a) Structural relationship between a capillary bed of the blood vascular system and lymphatic capillaries. Filaments anchored to connective tissue Endothelial cell Flaplike minivalve Fibroblast in loose connective tissue (b) Lymphatic capillaries are blind-ended tubes in which adjacent endothelial cells overlap each other, forming flaplike minivalves.
    [Show full text]
  • Regulatory Roles of Endothelial Cells in Cancer
    REGULATORY ROLES OF ENDOTHELIAL CELLS IN CANCER MASSACHUSETTS INSTIilr By OF TECHNOLOGY Joseph W. Franses JUN 0 8 2011 B.S. Chemical Engineering, B.S. Chemistry Purdue University, 2005 LIBRARIES SUBMITTED TO THE HARVARD-M.I.T. DIVISION OF HEALTH SCIENCES AND TECHNOLOGY IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY IN BIOMEDICAL ENGINEERING ARCHW AT THE MASSACHUSETTS INSTITUTE OF TECHNOLOGY MAY 2011 @ Massachusetts Institute of Technology All riahts reserved Signature of Author Hara-Mi i ULivision oT Health Sciences and Technology May 16, 2011 Certified by: Elazer R. Edelman, M.D.-Ph.D. Thomas D. and Virginia W. Cabot Professor of Health Sciences and Technology, M.I.T. Thesis Supervisor Accepted by: Ram Sasisekharan, Ph.D. Edward Hood Taplin Professor of Health Sciences and Technology and Biological Engineering, M.I.T. Director, Harvard-M.I.T. Division of Health Sciences and Technology REGULATORY ROLES OF ENDOTHELIAL CELLS IN CANCER By Joseph W. Franses Submitted to the Harvard-M.I.T. Division of Health Sciences and Technology on May 16, 2011 in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy in Biomedical Engineering Advisor: Elazer R. Edelman, Thomas and Virginia Cabot Professor of Health Sciences and Technology, M.I.T. Thesis committee chair: David A. Housman, Ludwig Professor of Biology, M.I.T. Thesis committee: 1. Sangeeta N. Bhatia, Professor of Health Sciences and Technology and Professor of Electrical Engineering and Computer Science, M.I.T. 2. David T. Scadden, Gerald and Darlene Jordan Professor of Medicine, Harvard University Abstract This thesis describes the biochemical regulatory impact of endothelial cells, the cells that line all blood vessels, in cancer.
    [Show full text]
  • Lymphatic System Urls
    Lymphatic System URLs Human Anatomy & Physiology 16 http://www.howstuffworks.com/immune-system.htm http://www.thebody.com/step/immune.html http://www.emc.maricopa.edu/faculty/farabee/BIOBK/ BioBookIMMUN.html & http://www.cayuga-cc.edu/about/facultypages/greer/ r http://www.acm.uiuc.edu/sigbio/project/updated- lymphatic/lymph1.html http://www.pblsh.com/Healthworks/lymphart.html Karen Webb Smith Unit Fou Introduction A. The lymphatic system is closely associated with the cardiovascular system and is comprised of a network of vessels that circulate body fluids. B. Lymphatic vessels transport excess fluid away from interstitial spaces between cells in most tissues & return it to the bloodstream. C. Lymphatic vessels called lacteals (located in the in the lining of the smallsmall intestine) absorb fats resulting from digestion, & then transport fats to the circulatory system. D. The organs of the lymphatic system help defend Lymphatic vessels against disease. transporting fluid from interstitial spaces to the bloodstream Lymphatic Pathways A. Lymphatic pathways start as lymphatic capillaries that merge to form larger vessels that empty into the circulatory system. (This is key to understanding this chapter.) B. Lymphatic Capillaries *are microscopic, close-ended tubes that extend into interstitial spaces forming networks that parallel the networks of the blood capillaries *walls consist of single layer squamous epithelial cells which enables interstitial fluid to enter the lymphatic capillaries *lymph – the fluid inside a lymph capillary C. Lymphatic Vessels *walls of lymphatic vessels are thinner than walls of veins * have semilunar valves to prevent backflow of lymph *lymph nodes – specialized lymph organs that are composed of a mass of lymphoid tissue located along the course of a lymphatic vessel D.
    [Show full text]
  • Circulatory and Lymphatic System Infections 1105
    Chapter 25 | Circulatory and Lymphatic System Infections 1105 Chapter 25 Circulatory and Lymphatic System Infections Figure 25.1 Yellow fever is a viral hemorrhagic disease that can cause liver damage, resulting in jaundice (left) as well as serious and sometimes fatal complications. The virus that causes yellow fever is transmitted through the bite of a biological vector, the Aedes aegypti mosquito (right). (credit left: modification of work by Centers for Disease Control and Prevention; credit right: modification of work by James Gathany, Centers for Disease Control and Prevention) Chapter Outline 25.1 Anatomy of the Circulatory and Lymphatic Systems 25.2 Bacterial Infections of the Circulatory and Lymphatic Systems 25.3 Viral Infections of the Circulatory and Lymphatic Systems 25.4 Parasitic Infections of the Circulatory and Lymphatic Systems Introduction Yellow fever was once common in the southeastern US, with annual outbreaks of more than 25,000 infections in New Orleans in the mid-1800s.[1] In the early 20th century, efforts to eradicate the virus that causes yellow fever were successful thanks to vaccination programs and effective control (mainly through the insecticide dichlorodiphenyltrichloroethane [DDT]) of Aedes aegypti, the mosquito that serves as a vector. Today, the virus has been largely eradicated in North America. Elsewhere, efforts to contain yellow fever have been less successful. Despite mass vaccination campaigns in some regions, the risk for yellow fever epidemics is rising in dense urban cities in Africa and South America.[2] In an increasingly globalized society, yellow fever could easily make a comeback in North America, where A. aegypti is still present.
    [Show full text]