Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Chapter 20 – Lymphatic System Dr. Kim Wilson Overview of the Lymphatic System • Component of the circulatory system • Functions: • Maintains fluid balance in the internal environment and immunity • Collects absorbed fat from the intestines and transport it to the systemic veins Components of the Lymphatic System • • • • Lymph (lymphatic fluid) • Clear, watery, moving fluid derived from blood and tissue fluid • Closely resembles blood plasma in composition but has a lower percentage of protein; isotonic Lymphatic vessels (lymphatics) • Return lymph to the blood • Contain lymphocytes and other defensive cells Isolated structures containing lymphoid tissue: lymph nodes, aggregated lymphoid nodules, tonsils, thymus, spleen, and bone marrow (Figure 20-2) Interstitial fluid • Complex, organized fluid that fills the spaces between the cells and is part of the extracellular matrix • Resembles blood plasma in composition with a lower percentage of protein • Along with blood plasma, constitutes the extracellular fluid The Lymphatic System and Fluid Balance • Lymph transports tissue fluid, proteins, fats, and other substances to the general circulation • Fluid from plasma moves into interstitial spaces (some fluid accumulates) • As fluid builds up it is drained by the lymphatic vessels • Lymphatic vessels begin blindly in the intercellular spaces of the soft tissues; do not form a closed circuit • Lymph vessels act as drains to collect excess tissue fluid and return it to the venous blood just before it returns to the heart LYMPHATIC VESSELS (LYMPHATICS) • DISTRIBUTION and DRAINAGE • Start as microscopic lymphatic capillaries, consisting of a single layer of flattened endothelial cells • Lymphatic capillaries merge to form larger lymphatics and eventually form the main lymphatic trunks, the right lymphatic ducts, and the thoracic duct • Lymph from upper right quadrant empties into right lymphatic duct right subclavian vein • Lymph from rest of the body empties into the thoracic duct drains into left subclavian vein • Thoracic duct originates from a dilated structure known as the cisterna chyli (chyle cistern) in lumbar region of intestinal tract Lymphatic Drainage in the Head and Neck Structure of Lymphatic Vessels • Don’t form a closed ring like blood vessels • Similar to veins except for these exceptions: • Have thinner walls • Have more valves • Contain lymph nodes • Functions of the lymphatic vessels • Remove high-molecular-weight substances and particulate matter from interstitial spaces • Lacteals (lymphocytes in the villi of the small intestines) absorb fats and other nutrients from the small intestine Circulation of Lymph • From lymphatic capillaries, lymph flows through progressively larger lymphatic vessels to reenter blood at the junction of the internal jugular and subclavian veins (Figure 20-5) • The lymphatic pump • Lymphokinesis: the movement (flow) of lymph; can be visualized in a lymphangiogram (Figure 20-6) • Lymphokinetic actions: activities that result in a central flow of lymph LYMPH NODES • STRUCTURE • Oval, bean-shaped • Part of lymphatic vessels (lymph filters through each node) • House lymphocytes and monocytes • Trabeculae extend from the covering capsule toward the center of the node LYMPH NODES (cont.) • FUNCTION • Nodes are a type of biological filter • Once lymph enters a node, it moves slowly through sinuses to drain into the efferent exit vessel (Figure 20-10) • LOCATION • Most lymph nodes occur in groups • Groups with greatest clinical importance are • preauricular lymph nodes • submental and submaxillary groups • superficial cervical • superficial cubital, axillary, iliac • inguinal lymph nodes Functions of Lymph Nodes 1. Defense • How? Two mechanisms: • Filtration • Mechanical filtration: physically stopping particles from progressing further in the body • Biological filtration: biologic activity of cells destroys and removes particles • Phagocytosis • Reticuloendothelial cells remove microorganisms and other injurious particles from lymph and phagocytose them (biological filtration) • If overwhelmed, lymph nodes can become infected or damaged 2. Hematopoiesis • Final site for maturation of some lymphocytes and monocytes TONSILS • • Form a broken ring under the mucous membranes in the mouth and back of the throat—the pharyngeal lymphoid ring (Figure 20-17) • Palatine tonsils: located on each side of the throat • Pharyngeal tonsils: located near the posterior opening of the nasal cavity • Lingual tonsils: located near the base of the tongue • Tubal tonsils: located near the openings of the auditory (eustachian) tubes FUNCTION: Protect against bacteria that may invade tissues around the openings between the nasal and oral cavities; bacteria are trapped in tonsillar crypts and put in close contact with immune system cells THYMUS • • STRUCTURE • Pyramid-shaped lobes are subdivided into small lobules • Each lobule is composed of a dense cellular cortex and an inner, less-dense medulla LOCATION/APPEARANCE (Figure 20-18) • Primary central organ of lymphatic system • Single, unpaired organ located in the mediastinum, extending upward to the lower edge of the thyroid and inferiorly as far as the fourth costal cartilage • Thymus is pinkish gray in childhood; with advancing age, becomes yellowish as lymphoid tissue is replaced by fat THYMUS (cont.) • FUNCTIONS • Plays vital role in immunity mechanism • Source of lymphocytes before birth • Shortly after birth, secretes thymosin and other regulators, which enables lymphocytes to develop into T cells (Figure 20-19) SPLEEN • • LOCATION • Left hypochondrium, directly below the diaphragm, above the left kidney and descending colon and behind the fundus of the stomach STRUCTURE • Ovoid in shape • Surrounded by fibrous capsule with inward extensions that divide the organ into compartments • White pulp: dense masses of developing lymphocytes • Red pulp: near outer regions, composed of a network of fine reticular fibers submerged in blood that comes from nearby arterioles; composed of cords of white blood cells and related cells surrounded by sinusoids Functions of the Spleen • DEFENSE • Filtration and phagocytosis: monocytes live in the lining of blood vessels in the spleen carry out phagocytosis as blood passes through • HEMATOPOIESIS • Formation of blood cells (lymphocytes, monocytes, and platelets) • RBC AND PLATELET DESTRUCTION • By monocytes in blood vessels • BLOOD RESERVOIR • Stores large amounts of blood (350 ml) • In emergency, can squeeze blood into general circulation The Lymphatic Cycle Through Life • Dramatic changes throughout life • Organs with lymphocytes appear before birth and grow until puberty • Postpuberty • Organs atrophy through late adulthood • Shrink in size • Become fatty or fibrous • Spleen: develops early, remains intact • Overall function maintained until late adulthood • Later adulthood • Deficiency permits risk of infection and cancer • Hypersensitivity: likelihood of autoimmune conditions Summary of Main Points • Lymphatic system drains away excess water from large areas • Lymph is conducted through lymphatic vessels to nodes, where contaminants are removed • Lymphatic system benefits the whole body by maintaining fluid balance and freedom from disease