Download Lymphatic System

Lymphatic System
1H09.01
Explain the structure of the lymphatic system.
A. Lymph
1. Straw-colored, similar to plasma
2. Interstitial fluid – in spaces between cells
3. Composed of H2O, lymphocytes, O2, digested nutrients, etc., but
no red cells or proteins (too large)
B. Lymph vessels
1. Closely parallel veins
2. Located in almost all tissues and organs that have blood vessels
3. Thoracic duct – largest lymph vessel
C. Lymph nodes
1. Tiny, oval shaped, size of pinhead to size of almond
2. Located alone or grouped
D. Tonsils
1. Get smaller as person gets older
2. Located in throat
3. Adenoids – tonsils on upper part of throat
E. Spleen
1. Sac-like mass of lymphatic tissue
2. Upper left abdominal cavity, just below diaphragm
F. Thymus – upper, anterior chest above the heart
1H09.02
Analyze the function of the lymphatic system.
A. Lymph – fluid that goes between capillary blood and tissues
1. Carries digested food, O2, and hormones to cells
2. Carries wastes back to capillaries for excretion
3. Since lymphatic system has no pump, skeletal muscle action
squeezes lymph along
4. Lymph in tissues is interstitial fluid
B. Lymph vessels – transport excess tissue fluid back into circulatory
system
1.
2.
3.
4.
C.
D.
E.
E.
Valves prevent backward flow
Lymph flows in only one direction – from body organs to heart
Closely parallel veins
Tissue lymph enter small lymph vessels which drain into larger
lymph vessesl (lymphatics) into two main lymphatics – the
thoracic duct and right lymphatic duct
Lymph nodes
1. Produce lymphocytes
2. Filter out harmful bacteria
3. If substance can’t be destroyed, node becomes inflamed
Tonsils
1. Lymph tissue that produces lymphocytes
2. They get smaller as a person gets older
Spleen
1. Produce lymphocytes and monocytes
2. Filter blood
3. Blood reservoir – stores large amounts of RBCs, contracts
during vigorous exercise or loss of blood to release RBCs
4. Recycles old red cells – destroys and removes old or fragile
RBCs
Thymus gland
1. Produces lymphocytes
Summer 2005 I.1
2. Also considered an endocrine gland
F. Immunity – body’s ability to resist disease
1. Natural immunity – at birth, inherited and permanent
a. Unbroken skin
b. Mucus and tears
c. Blood phagocytes
d. Local inflammation
2. Acquired immunity – body’s reaction to invaders
a. Passive acquired immunity – from injecting antibodies, only
lasts a few weeks
b. Active acquired immunity – lasts longer
i. Natural acquired immunity – result of recovering from
disease, body manufactures own antibodies and person
doesn’t get the disease again
ii. Artificial acquired immunity – from being vaccinated
3. Immunization – antigen injected into a person to stimulate
production of antibodies
1H09.03
Discuss characteristics and treatment of common lymphatic
disorders.
A. Tonsillitis
1. In childhood, tonsils become infected and enlarged
2. Difficulty swallowing
3. Tonsillectomy in extreme cases
B. Lymphadenitis (adenitis)
4. Swelling (enlargement) of lymph glands
5. Occurs when infection present and body making WBCs to fight
infection
B. Hodgkin’s disease
1. Cancer of lymph nodes
2. Painless swelling of lymph node early symptom
3. Rx – chemotheraphy and radiation
C. Mononucleosis
1. Caused by virus
2. Young adults and children
3. Spread by oral contact (kissing)
4. Symptoms – lymphadenitis, fever, fatigue,  leukocytes
5. Rx - bedrest
D. Hypersensitivity
1. Abnormal response to drug or allergen
2. Antibodies made in response to foreign material (allergen) irritate
certain body cells
3. Allergen – antigen that causes allergic response (Examp.
Ragweed, penicillin, bee stings, foods, etc.)
E. Anaphylaxis (Anaphylactic shock)
1. Severe or fatal allergic reaction
2. Antigen-antibody response stimulates massive secretion of
histamine
3. Symptoms – breathing problems, headache, facial swelling,
falling blood pressure, stomach cramps, vomiting
4. Rx – Adrenaline
5. Those prone should wear medic alert bracelet
Summer 2005 I.2
F. AIDS and HIV
1. Acquired immunodeficiency syndrome
2. Cause – HIV virus
3. Three responses to HIV infection:
a. AIDS – full disorder
b. ARC – AIDS-related complex
c. Asymptomatic infection
4. Screening test for HIV available
5. AIDS victim subject to opportunistic infections (cancer,
infections) that a healthy person would fight off but AIDS victim
has compromised immune response
6. Incubation period – 1 month to 12 years
7. Rx and prevention – advances being made
8. ARC – AIDS-related complex – HIV but not AIDS – less severe
symptoms
9. Transmission
a. Sex with someone HIV positive
b. Sharing needles with infected drug users
c. At birth from infected mother
10. Cannot be spread by casual contact, coughing, sneezing,
shaking hands and sharing eating utensils
11. Prevention – avoid risky behaviors and observe standard
precautions
1H09.04
Apply standard precautions.
A. Standard precautions
1. Used in patient care setting when there is contact with blood or
body fluids, mucous membrane or non-intact skin
2. Handwashing – single most effective way to prevent infection
a. Wash after touching body fluids, even if wearing gloves
b. Wash immediately after removing gloves and between
patient contacts
c. Use soap and friction
d. Wash for a minimum of 10 seconds
3. Personal protective equipment
a. Gloves – when touching blood and body fluids
b. Mask, goggles, face shield, gown – when patient care
activities can generate splashing or spray of blood, body
fluids
4. Patient care equipment and linens
a. Handle with care
b. Don’t let it touch your clothing, clean or discard appropriately
B. Occupational health and bloodbourne pathogens
1. Beware of needles
2. Never recap used needles
3. Dispose of all needles and sharp objects in sharps container
4. Use mouthpieces, resuscitation bags, or other ventilation devices
as alternative to mouth-to-mouth resuscitation.
5. A patient who contaminates the environment should be in a
private room or relatively isolated area.
C. The AIDS patient
1. Sometimes treated as outcasts
2. Healthcare worker should be supportive
3. Use of gloves for normal patient contact is not necessary
Summer 2005 I.3
Unit I: Lymphatic System
Terminology List
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
acquired immunity
adenoids
active acquired immunity
allergen
anaphylaxis (anaphylactic shock)
artificial acquired immunity
hypersensitivity
immunization
incubation period
interstitial fluid
lymph
lymph nodes
lymph vessels
lymphocytes
natural immunity
passive acquired immunity
spleen
standard precautions
thoracic duct
thymus
tonsils
vaccination
Disorders and Related Terminology
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
adenitis
AIDS/HIV
ARC
anaphylaxis (anaphylactic shock)
Hodgkin’s disease
hypersensitivity
lymphadenitis
mononucleosis
opportunistic infections
tonsillitis
tonsillectomy
Summer 2005 I.4
Functions:
1. LYMPH – fluid that goes between capillary
blood and tissues.
2. LYMPH VESSELS – transport excess tissue
fluid back into circulatory system.
3. LYMPH NODES – produce lymphocytes, filter
out harmful bacteria.
4. SPLEEN – produces lymphocytes and
monocytes, blood reservoir, recycles old red
cells.
5. Thymus gland – produces T-LYMPHOCYTES
Summer 2005 I.5
LYMPH

Straw-colored fluid (similar to plasma)

INTERSTITIAL FLUID or tissue fluid
because it is in the spaces between cells

Composed of H2O, lymphocytes, some
granulocytes, O2, digested nutrients,
hormones, salts, CO2 and urea.

NO red blood cells or protein molecules (too
large)

Carries digested food, O2 and hormones to
cells

Carries wastes back to capillaries for
excretion

Since the lymphatic system has no pump,
skeletal muscle action squeezes lymph
along

Valves prevent backward flow
Summer 2005 I.6
LYMPH VESSELS

Closely parallel veins

Located in almost all tissues and organs that
have blood vessels

Tissue lymph enters small lymph vessels
which drain into larger vessels called
lymphatics – they flow into one of two large,
main lymphatics – the
THORACIC DUCT and right
lymphatic duct.

THORACIC DUCT gets lymph
from left side of chest, head and
neck, abdominal area and lower
limbs  left subclavian vein 
superior vena cava  heart.

Lymph flows only in one
direction – from body organs to
the heart.
Summer 2005 I.7
LYMPH NODES

Tiny, oval shaped - size of pinhead to size
of almond

Located alone or grouped

Site for lymph production and filter for
screening out harmful substances

If substance can’t be destroyed, node
becomes inflamed
TONSILS
Masses of lymphatic tissue that produce
lymphocytes and filter bacteria – they get
smaller in size as person gets older

ADENOIDS – tonsils on upper part of the
throat
SPLEEN
 Sac-like mass of lymphatic tissue
 Upper left abdominal cavity, just below
diaphragm
 Forms lymphocytes and monocytes
 Filters blood
 Stores large amounts of RBCs – contracts
during vigorous exercise or loss of blood, to
release RBCs
Summer 2005 I.8

Destroys or removes old or fragile RBCs
THYMUS GLAND

Upper, anterior thorax, above the heart

Thymus is also considered an endocrine
gland
Immunity – the body’s ability to resist bacterial
invasion and disease. 2 general types – natural
and acquired.
NATURAL IMMUNITY – at birth, inherited
and permanent. Includes:




Unbroken skin
Mucus and tears
Blood phagocytes
Local inflammation
ACQUIRED IMMUNITY – body’s reaction to
invaders
Summer 2005 I.9
PASSIVE ACQUIRED IMMUNITY

Acquired artificially by injecting antibodies to
protect from a specific disease

Immediate immunity

Lasts 3-5 weeks

Used when someone exposed to measures,
tetanus, infectious hepatitis

Mother provides newborn with some passive
immunity
ACTIVE ACQUIRED IMMUNITY – lasts
longer, two types


NATURAL ACQUIRED IMMUNITY – result
of having had and recovered from a disease.
For example, a child who had measles will
usually not get it again – child’s body has
manufactured antibodies.
ARTIFICIAL ACQUIRED IMMUNITY –
comes from being vaccinated
Summer 2005 I.10
IMMUNIZATION – artificial resistance to a
particular infection by artificial means
 Antigen injected into a person to stimulate
production of antibodies
Summer 2005 I.11
Disorders of the Lymphatic System
ADENITIS – swelling in the lymph glands
TONSILLITIS
 In childhood, they may become infected,
enlarged, and cause difficulty swallowing
 Surgery done in extreme cases
LYMPHADENITIS – enlargement of the lymph
nodes, occurs when infection is present and
body is attempting to fight off the infection.
HODGKIN’S DISEASE – cancer of the lymph
nodes, painless swelling of lymph nodes is early
symptom. Rx – chemotherapy and radiation
INFECTIOUS MONONUCLEOSIS
 Caused by virus
 Frequently in young adults and children
 Spread by oral contact (kissing)
 Symptoms – enlarged lymph nodes, fever,
physical and mental
fatigue, 
leukocytes
 Rx – bedrest
Summer 2005 I.12
HYPERSENSITIVITY
 When the body’s immune system fails to
protect itself against foreign material, and
instead, the antibodies formed irritate certain
body cells.
 An abnormal response to a drug or allergen.
 An ALLERGEN is an antigen that causes
allergic responses. (Examples
of allergens – ragweed,
penicillin, bee stings, foods,
etc.)
ANAPHYLAXIS
 severe, sometimes fatal
allergic reaction
 Antigen-antibody reaction stimulates a
massive secretion of histamine
 Symptoms – breathing problems, headache,
facial swelling, falling blood pressure,
stomach cramps, and vomiting
 Rx – adrenaline
Summer 2005 I.13
AIDS/HIV

Acquired Immunodeficiency Syndrome

Caused by HTLV-III (human Tlymphotrophic virus type III) Commonly
caused HIV or Human immunodeficiency
virus.

Affects not only homosexual males but all
populations

The patient with AIDS cannot fight off
cancers and most infections.

Three responses to HIV infection:
1. AIDS
2. ARC (AIDS-related complex)
3. Asymptomatic infection

Screening tests for HIV/AIDS are available
AIDS



Most severe type of HIV infection
Subject to OPPORTUNISTIC INFECTIONS
– a healthy person would fight off these
infections, but a person with AIDS has a
compromised immune response.
Symptoms of AIDS
Summer 2005 I.14
1.
2.
3.
4.
5.
6.
Prolonged fatigue
Persistent fevers or night sweats
Persistent, unexplained cough
Thick coating in throat or on tongue
Easy bruising, unexplained bleeding
Appearance of purple lesions on mucous
membranes or skin that don’t go away
7. Chronic diarrhea
8. Shortness of breath
9. Unexplained lymphadenopathy
10. Unexplained weight loss, 10 pounds or
more, in less than 2 months
Incubation period: 1 month to12 years
AIDS-RELATED COMPLEX (ARC)
Has HIV but not AIDS and develops other
conditions such as:

Chronic diarrhea

Chronic lymphadenopathy

Unexplained weight loss
If life threatening opportunistic infections
develop, then individual is said to have AIDS
Summer 2005 I.15
ASYMPTOMATIC INFECTION - Has HIV but no
symptoms.
High-Risk Groups for AIDS – EVERYONE who
participates in risky behaviors.
Transmission by:
1. Sex with someone who is HIV positive
2. Sharing needles with infected IV drug users
3. At birth from infected mother
Cannot be spread by:
1. Casual contact
2. Through air, feces, food, urine or water
3. Coughing, sneezing, embracing, shaking
hands and sharing eating utensils
Prevention:
1. Avoid risky behaviors
2. Standard precautions
Summer 2005 I.16
STANDARD PRECAUTIONS


Guidelines to be used in patient care setting
Must be used when there is contact with
blood, any body fluid (except sweat),
mucous membranes and non-intact skin.
Handwashing – the single most effective way to
prevent infection.
1. Wash hands after touching
body fluids, even if gloves are
worn.
2. Wash hands immediately
after removing gloves,
between patient contacts.
3. Use a plain (non-antimicrobial) soap
4. Wash for a minimum of 10 seconds
Gloves – worn when touching blood, body fluids,
etc.
Mask, eye protection, face shield and gown –
during patient care activities that may generate
splashes or sprays of blood, body fluids, etc.
Summer 2005 I.17
Patient care equipment and linens – handle with
care, don’t let it touch your or clothing, clean or
discard appropriately.
Occupational Health and Bloodbourne
Pathogens
Beware of needles!
Never recap used needles.
Dispose of all needles and sharp objects
in sharps container.
Use mouthpieces, resuscitation bags, or
other ventilation devices as alternative to mouthto-mouth resuscitation.
A patient who contaminates the environment
should be in a private room or relatively isolated
area.
Summer 2005 I.18
The AIDS Patient
 Sometimes treated as outcasts
 Healthcare worker should be supportive
 Use of gloves for normal patient contact is not
necessary
Summer 2005 I.19