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The Lymphatic System and Lymphoid Organs

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The Lymphatic System and Lymphoid Organs The Lymphatic System and Lymphoid Organs Dr. Tatiana Jones, MD, PhD NCC What is Lymph? Lymph is the fluid that circulates throughout the lymphatic system. The lymph is formed when the interstitial fluid is collected through lymph capillaries. It is then transported through lymph vessels to lymph nodes before emptying ultimately into the right or the left subclavian vein, where it mixes back with blood. Since the lymph is derived from the interstitial fluid, its composition continually changes as the blood and the surrounding cells continually exchange substances with the interstitial fluid. Lymph returns protein and excess interstitial fluid to the circulation. Lymph has a composition comparable to that of blood plasma, but it may differ slightly. Lymph contains white blood cells. In particular the lymph that leaves a lymph node is richer in lymphocytes, in triglycerides (fat). What does Lymphatic System do? The main functions of the lymphatic system are as follows: 1. It collects and transports tissue fluids from the intercellular spaces in all the tissues of the body, back to the veins in the blood system (~3L/day); 2. It plays an important role in returning plasma proteins to the bloodstream; 3. Digested fats are absorbed and then transported from the villi in the small intestine to the bloodstream via the lacteals and lymph vessels; 4. New lymphocytes are manufactured in the lymph nodes; 5. Antibodies assist the body to build up an effective immunity to infectious diseases; 6. Lymph nodes play an important role in the defense mechanism of the body. They filter out micro-organisms (such as bacteria) and foreign substances such as toxins, etc.; 7. It transports large molecular compounds (such as enzymes and hormones) from their manufactured sites to the bloodstream. What is Lymphatic Fluid? • Fluids that is collected as it leaked from blood vessels to return back to blood • Lymphatic System Consists of three parts: 1. Network of lymphatic vessels (lymphatics) 2. Lymph – fluid in vessels 3. Lymphatic organs – cleanse lymph and host immune cells What organs belong to Lymphatic System? Central organs: 1. Bone Morrow 2. Thymus 3. Spleen Peripheral Organs: 1. Tonsils 2. Cervical Lymph Nodes 3. Right Lymphatic Duct (collect lymph from the upper right part of the body) 4. Thoracic Duct (collect lymph from the rest of the body) 5. Axillary Lymph Nodes 6. Cisterna Chyli (a dilated sac at the lower end of the thoracic duct into which lymph from the intestinal trunk and two lumbar lymphatic trunks flow. 7. Lymphatic Vessels of upper limbs 8. Lumbar Lymph Nodes 9. Inguinal Lymph Nodes 10.Lymphatic Vessels of low limbs 11.Mucosa Associated Lymphoid Tissue (MALT) 12.Appendix Distribution and special features of lymphatic capillaries. Venous system Arterial system Heart Lymphatic system: Lymph duct Lymph trunk Lymph node Collecting lymphatic vessels, with valves Lymphatic capillary Blood capillaries Tissue fluid Tissue cell Blood Lymphatic capillaries capillaries 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 Lymphatic capillaries are blind-ended tubes in which adjacent endothelial cells overlap each other, forming flaplike minivalves. How does Lymph flow? • One-way system; lymph flows toward heart • Lymph vessels (lymphatics) include: • Lymphatic capillaries • Collecting lymphatic vessels • Lymphatic trunks and ducts Lymphatic Capillaries • Similar to blood capillaries, except • Very permeable (take up proteins, cell debris, pathogens, and cancer cells) • Endothelial cells overlap loosely to form one-way mini valves • Anchored by collagen filaments, preventing collapse of capillaries; increased ECF volume opens mini valves • Pathogens travel throughout body via lymphatics • Similar to veins, except • Have thinner walls, with more internal valves • Anastomose more frequently • Collecting vessels in skin travel with superficial veins • Deep vessels travel with arteries • Nutrients supplied from branching vasa vasorum Lymphatic Trunks and Ducts • Formed by union of largest collecting ducts • Paired lumbar • Paired bronchomediastinal • Paired subclavian • Paired jugular trunks • Single intestinal trunk • Lymph delivered into one of two large ducts • Right lymphatic duct drains right upper arm and right side of head and thorax • Thoracic duct arises as cisterna chyli; drains rest of body • Each empties lymph into venous circulation at junction of internal jugular and subclavian veins on its own side of body The lymphatic system. Regional Internal lymph jugular vein nodes: Entrance of Cervical right lymphatic nodes duct into vein Entrance of thoracic duct into vein Axillary nodes Thoracic duct Cisterna Aorta chyli Inguinal Collecting nodes lymphatic vessels Drained by the right lymphatic duct Drained by the thoracic duct General distribution of collecting lymphatic vessels and regional lymph nodes. The lymphatic system. Right jugular trunk Internal jugular veins Right lymphatic Esophagus duct Trachea Right subclavian Left jugular trunk trunk Right subclavian Left subclavian vein trunk Left subclavian Right broncho- vein mediastinal trunk Entrance of Brachiocephalic thoracic duct veins into vein Superior Left broncho- vena cava mediastinal Azygos vein trunk Ribs Thoracic duct Hemiazygos Cisterna chyli vein Right lumbar trunk Left lumbar trunk Inferior vena cava Intestinal trunk Major lymphatic trunks and ducts in relation to veins and surrounding structures. Anterior view of thoracic and abdominal wall. Clinical – Homeostatic Imbalance •Lymphangitis: condition in which lymphatic vessels appear as painful red lines under the skin •Caused by inflammation of larger lymphatic vessels that contain vaso vasora • Vaso vasora become congested with blood • Larger lymphatics, like blood vessels, receive their nutrients from branching vasa vasorum . How do Lymphatic Vessels work? Lymphatic vessels, unlike blood vessels, only carry fluid away from the tissues. The smallest lymphatic vessels are the lymph capillaries, which begin in the tissue spaces as blind-ended sacs. Lymph capillaries are found in all regions of the body except the bone marrow, central nervous system, and tissues, such as the epidermis, that lack blood vessels. The wall of the lymph capillary is composed of endothelium in which the simple squamous cells overlap to form a simple one-way valve. This arrangement permits fluid to enter the capillary but prevents lymph from leaving the vessel. Small lymphatic vessels join to form larger tributaries, called lymphatic trunks, which drain large regions. Lymphatic trunks merge until the lymph enters the two lymphatic ducts. Like veins, the lymphatic tributaries have thin walls and have valves to prevent backflow of blood. There is no pump in the lymphatic system like the heart in the cardiovascular system. The pressure gradients to move lymph through the vessels come from the skeletal muscle action, respiratory movement, and contraction of smooth muscle in vessel walls. Lymphatic Capillaries Lymph is moved by: i. skeletal muscle action ii. changes in thoracic pressure iii. pulsation of nearby arteries iv. contractions of smooth muscle in walls of lymphatics The lymphatic vessels begin with the ‘blind-ended’ lymphatic capillaries between the interstitial tissues & cardiovascular system. Absent from bones, teeth, bone marrow, and CNS Lacteals: specialized lymph capillaries present in intestinal mucosa Absorb digested fat and deliver fatty lymph (chyle) to the blood How are Lymphatic Capillaries different from Blood Capillaries? Lymphatic Capillaries: (1) originate as blind pockets, (2) are larger in diameter, (3) have thin walls, (4) have a flat or irregular outline Lymph Transport • Lymph system is a low-pressure system like venous system • Lymph is propelled by same mechanisms: • Milking action of skeletal muscle • Pressure changes in thorax during breathing • Valves to prevent backflow • Pulsations of nearby arteries • Contractions of smooth muscle in walls of lymphatics • Physical activity increases flow of lymph; immobilization of area keeps needed inflammatory material in area for faster healing Clinical – Homeostatic Imbalance •Lymphedema: severe localized edema •Caused by anything that prevents normal return of lymph to blood •Examples: tumors blocking lymphatics or removal of lymphatics during cancer surgery •Lymphedema may improve if some lymphatic pathways remain and enlarge What cells are mainly present in lymph? Lymphocytes account for 20-30 percent of the circulating white blood cell population. However, circulating lymphocytes are only a small fraction of the total lymphocyte population. The body contains some 1012 lymphocytes, with a combined weight of over a kilogram. Other cells that are present in lymphoid organs •Macrophages phagocytize foreign substances; help activate T cells •Dendritic cells capture antigens and present them to lymphocytes, which activates lymphocytes responses •Reticular cells produce reticular fiber stroma that supports other cells in lymphoid organs Reticular connective tissue in a human lymph node. Macrophage Reticular cells on reticular fibers Lymphocytes Medullary sinus Reticular fiber Lymphoid Tissue •Houses, and provides proliferation site for lymphocytes •Surveillance vantage point for lymphocytes and macrophages •Largely reticular connective tissue – type of loose connective tissue What is Lymphoid Tissue? Lymphoid tissues
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