LYMPHATIC SYSTEM
MUDr. Hisham El Falougy, PhD. [email protected] Lymphoid cells
Lymphoid organs: primary and secondary
Lymphoid vessels
lymph The lymphoid cells
B lymphocytes
Plasma cells
Humeral immunity (IgG, IgA, IgM, IgD, IgE)
B memory cells
The lymphoid cells
T lymphocytes
Cellular imunity
Cytotoxic cells
Helper cells
Supressor cells
T memory cells The lymphoid cells
Antigen-presenting cells
Macrophages
Epidermal Langerhans cells
Dendritic cells of lymphoid organs
M cells The primary lymphoid organs
Bone marrow
Red bone marrow
Yellow bone marrow
Thymus
The secondary lymphoid organs
Spleen
Lymph nodes
Unencapsulated lymphoid tissue
Tonsils LYMPHATIC SYSTEM
FUNCTIONS:
TRANSPORTS EXCESS INTERSTITIAL FLUID
ABSORBS AND TRANSPORTS FAT FROM
INTESTINE
IMMUNOLOGICAL FUNCTION LYMPH AND LYMPH CAPILLARIES
LYMPH CAPILLARIES
SMALLEST LYMPHATIC VESSELS
CLOSED-ENDED TUBES
FORM NETWORK
IN THE INTERCELLULAR SPACES
LACTEALS (SMALL INTESTINE) LYMPH AND LYMPH CAPILLARIES
LYMPH CAPILLARIES
ENDOTHELIUM
LACK A BASAL LAMINA
PERMAEABLE TO LARGER MOLECULES
LYMPH AND LYMPH CAPILLARIES
LYMPH CAPILLARIES ABSENT FROM:
AVASCULAR STRUCTURES
CNS
BONE MARROW
VERY FEW IN ENDOMYSIUM OF SKELETAL MUSCLES
LYMPH AND LYMPH CAPILLARIES
LYMPH
FILTRATE OF PLASMA
CLEAR AND COLOURLESS
DENSE AND MILKY
CHYLE LYMPHATIC VESSELS
LYMPH CAPILLARIES JOIN INTO LARGER LYMPHATIC VESSELS
PASS TO LOCAL OR REMOTE LYMPH NODES
REPAIR EASILY
Lymphatic vessels and lymph
Vasa lymphocapillaria
Rete lymphocapillare
Collectores lymphatici (vasa lymphatica)
Vasa afferentia and Vas efferens
Trunci lymphatici
LYMPHATIC VESSELS
SAME LAYERS OF VEINS
TUNICA INTIMA (ENDOTHELIUM+FIBROUS TISSUE)
TUNICA MEDIA (SMOOTH MUSCLE)
TUNICA ADVENTITIA(CONNECTIVE TISSUE+NERVE FIBERS)
CONTAIN VALVES
TUNICA INTIMA
SEMILUNAR
MOVEMENT OF LYMPH
FILTERATION PRESSURE
CONTRACTION OF MUSCLES
PULSATION OF ARTERIES
RESPIRATORY MOVEMENTS
NEGATIVE BP IN BRACHIOCEPHALIC VEINS
SMOOTH MUSCLES IN TUNICA MEDIA LYMPH NODES
ENCAPSULATED OVAL BODIES
0.1-2.5 cm LONG
LYING IN THE COARSE OF LYMPHATIC VESSELS
HILUM:
BLODD VESSELS ENTER AND LEAV
EFFERENT LYMPH VESSLE EMERGES LYMPH NODES
SEVERAL AFFERENT LYMPHATIC VESSELS ENTER PERIPHERALLY
CORTEX
MEDULLA LYMPH NODES
CAPSULE AND TRABECULAE
COLLAGEN, FIBROBLASTS, ELASTIN
RETICULUM
RETICULIN
IN SPACESES ENCLOSED BY CAPSULE AND TRABECULAE
SUPPORTS CELL MASSES LYMPH NODES
LYMPHATIC CHANNELS
PASSAGE OF LYMPH
ENDOTHELIUM
MACROPHAGES
T AND B LYMPHOCYTES
SUBCASULAR SINUS
CORTICAL SINUSES
MEDULLARY SINUSES
LYMPH NODES
LYMPHOID FOLLICLES
GERMINAL CENTER (LYMPHOBLSTS)
MANTLE ZONES
MEDULLARY ZONES
LYMPH NODES
FUNCTIONS
LYMPH FILTERS
EXPOSURE OF FOREIGEN MATERIAL TO MACROPHAGES
TRAPPING OF ANTIGENS
PRODUCTION OF LYMPHOCYTES
IMMUNE RESPONSE
CIRCULATION OF LYMPHOCYTES
TOPOGRAPHICAL NAMING OF LYMPH NODES
SUPERFICIAL OR DEEP
RELATED VASCULATURE
RELATED ORGAN
GENERAL TOPOGRAPHICAL POSITION Regional lymph nodes
Head
Nodi occipitales
Nodi mastoidei
Nodi parotidei
Nodi submandibulares
Nodi faciales
Nodi submentales Neck
Nodi cervicales laterales superficiales
Nodi cervicales laterales profundi
Nodi cervicales anteriores superficiales
Nodi cervicales anteriores profundi
Truncus jugularis dexter et sinister The upper limb
Nodi cubitales superficiales et profundi
Nodi lymphatici axillares
Nodi brachiales
Nodi interpectorales (Node of Sorgius)
Nodi paramammarii
Nodi subscapulares
Nodi centrales
Nodi apicales Plexus lymphoideus axillaris Truncus subclavius LYMPHATIC DRAINAGE OF MAMMARY GLANDS
PECTORAL LYMPH NODES
SUBSCAPULAR LYMPH NODES
APICAL LYMPH NODES (SUPERIOR REGION)
AXILLARY NODES RECEIVE 75% OF LYMPH
PARASTERNAL LYMPH NODES
Thorax
Nodi parasternales
Nodi intercostales
Nodi prevertebrales
Nodi phrenici superiores Thorax
Nodi mediastinales anteriores
Nodi mediastinales posteriores
Nodi pulmonales
Nodi bronchopulmonales
Nodi tracheobronchiales (superiores et inferiores
Nodi paratracheales
Truncus bronchomediastinalis Pelvis and abdomen
Nodi iliaci externi
Nodi iliaci interni
Nodi sacrales
Nodi iliaci communes
Nodi lumbales
Nodi epigastrici inferiores
Nodi phrenici inferiores
Truncus lumbalis Pelvis and abdomen
Nodi paravesicales
Nodi paravaginales
Nodi parauterini
Nodi pararectales
Nodi coeliaci
Nodi gastrici
Nodi hepatici
Nodi pancreaticoduodenales
Nodi lienales
Nodi mesenterici
Nodi ileocolici
Nodi colici Truncus intestinalis The lower limb
Nodi poplitei
Nodi inguinales superficiales
Nodi inguinales profundi
Ductus thoracicus
Ductus lymphaticus dexter LYMPHATIC VESSELS
TWO PRINCIPAL LYMPHATIC VESSELS
THORACIC DUCT
DRAINS LYMPH FROM: LOWER LIMBS, ABDOMEN,
LEFT THORACIC REGIN, LEFT UPPER LIMB, LEFT
SIDE OF HEAD AN NECK
DRAINS INTO THE JUNCTION OF LEFT SUBCLAVIAN
VEIN AND LEFT INTERNAL JUGULAR VEIN LYMPHATIC VESSELS
TWO PRINCIPAL LYMPHATIC VESSELS
DRAINS LYMPH FROM: RIGHT THORACIC REGION,
RIGHT UPPER LIMB, RIGHT SIDE OF HEAD AN NECK
DRAINS INTO THE JUNCTION OF RIGHT
SUBCLAVIAN VEIN AND RIGHT INTERNAL JUGULAR
VEIN THORACIC DUCT
LEFT JUGULAR TRUNK LEFT SUBCLAVIAN TRUNK LEFT BRONCHOMEDIASTINAL TRUNK BILATERAL DESCENDING THORACIC LYMPH TRUNKS BILATERAL ASCENDING LUMBAR TRUNKS LEFT UPPER INTERCOSTAL TRUNKS MEDIASTINAL TRUNKS ABDOMINAL CONFLUENCE OF LYMPH TRUNKS
CISTERNA CHYLI
LUMBAR TRUNKS
INTESTINAL LYMPH TRUNKS RIGHT LYMPHATIC DUCT
RIGHT JUGULAR TRUNK
RIGHT SUBCLAVIAN TRUNK
RIGHT BRONCHOMEDIASTINAL TRUNK Unencapsulated lymphoid tissue
Lymphoid follicles (nodules)
Urinary tract
Digestive tract (Peyer’s patches)
Upper respiratory tract
Tonsils
Palatine
Pharyngeal
Lingual
Pharyngeal circle of Waldeyer
Tonsilla tubaria