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Lymphatic and Immune System Charles C. Cook, MD A&P 1 Objectives List the functions of the lymphatic system. Trace the pathway of lymph starting at the lymph capillary. Describe the characteristics of lymph capillaries. Compare and contrast lymph vessels and veins. Describe the location and function of lymph nodes. Describe the location & function of lymphatic trunks. List the collecting ducts, their location, & the individual areas of the body they drain. 2 Objectives Identify the cisterna chyli’s location and the areas of the body from which it receives lymph. List the functions of lymph. List the characteristics of lymph. Describe the mechanism by which lymph is propelled. Define edema and how it may accumulate after cancer surgery. 3 Objectives List the anatomical features and functions of lymph nodes. Describe the major locations of lymph nodes. List major lymph structures and their location. Thymus Pharyngeal tonsils (adenoids) Palatine tonsils Lingual tonsils Spleen Function 4 Objectives Define the following terms. Immune system Pathogens Infection Immunity Nonspecific Immunity Specific Immunity Autoimmunity 5 6 Functions of the Lymphatic System Circulates body fluid Transports excess tissue fluid Defends the body Absorbs lipids 7 Lymphatic Vessels Lymphatic capillaries Lymphatic vessels Lymph nodes Lymphatic trunks Collecting ducts Thoracic duct Right lymphatic duct 8 Lymphatic Capillaries ORIGINATE AS MICROSCOPIC CLOSED END TUBES - IN SPACES BETWEEN CELLS More porous Simple squamous epithelium (endothelium) 9 10 Lymphatic Vessels FORMED FROM CAPS SIMILAR to VEINS VALVES gives beaded appearance Follow veins 11 12 Lymph Nodes Structures located along the lymphatic pathways. They contain large numbers of lymphocytes. 13 14 Lymphatic Trunks Collects lymph from the most proximal group of each chain of nodes 15 16 Lymphatic Trunks Lumbar Intestinal Bronchomediastinal Subclavian Jugular 17 Collecting ducts Thoracic duct Right lymphatic duct – 18 Collecting Ducts Thoracic Duct Largest and l- o- n- g- e- r Receives ¾ of body’s lymph Drains into left subclavian vein 19 Cisterna Chyli Dilated portion of the beginning of the thoracic duct in the lumbar region 20 Cisterna Chyli receives lymph from Lower abdomen Pelvis, & Lower limbs 21 22 23 Collecting Ducts Right Lymphatic Duct Right thorax and empties into the right subclavian vein Drains Right side of head, neck and right arm 24 25 26 Lymph Clear, watery fluid Found inside lymphatic vessel 27 28 Function of Lymph Transports various foreign particles such as bacteria and viruses Returns protein back to blood as well as excess tissue fluids 29 Movement of Lymph Skeletal muscle contraction Pressure Valves 30 MILKING ACTION 31 How can a massage affect Lymph flow? 32 Movement of Lymph Contraction of diaphragm Pressure changes 33 Edema Accumulation of fluid in the tissue 34 35 36 Can a patient develop edema after an amputation of an extremity? Can this be prevented? 37 Structure of *LNs Bean shaped Vary in size (usually about 1 in.) Afferent----Entrance Efferent----Exits at the Hilium *LN denotes lymph nodes throughout presentation 38 Lymph Nodes More afferent vessels than efferent covered by fibrous capsule contain dense masses of lymphocytes and macrophages (nodules) 39 40 LYMPH NODE 41 MAJOR LOCATIONS OF LYMPH NODES CERVICAL REGION AXILLARY REGION INGUINAL REGION PELVIC CAVITY ABDOMINAL CAVITY THORACIC CAVITY 42 43 44 45 46 47 48 Functions of LNs Produces lymphocytes Filters interstitial compartment Contains macrophages 49 Thymus Located within the superior mediastinum. Aprox. 40 gms First source of lymphocytes before birth Development of T-Cells Thymosin 50 51 52 Tonsils Protects mouth Pharyngeal tonsil (Adenoid) Palatine tonsils Lingual tonsils 53 54 Spleen Largest Lymphatic organ Filters blood not lymph Production of B-Cells Normal volume ---- 350 ml 55 Spleen Defense Hematopoiesis RBC and platelet destruction 56 Spleen Location Left hypochondriac region Below diaphragm Above left kidney Behind fundus of stomach 57 The Spleen Why is the spleen considered a lymphatic organ although it does not filters lymph? Have you ever experienced pain in your side while you were running? 58 Immunity Terms Immune system Pathogens Infection Immunity Nonspecific Immunity Specific Immunity Autoimmunity 59 Immune system Body’s defense against disease 60 Pathogens Microorganism that causes disease 61 Infection CAUSED BY THE DISEASE CAUSING AGENTS 62 Immunity THE BODY’S ABILITY TO RESIST PATHOGENS 63 Autoimmunity Attack launched due to failure to distinguish from self and non-self substances 64 Questions?? 65 Nonspecific Immunity General Protection 66 Species Resistant Resistance of a disease of one species compared to another 67 Mechanical Barriers (Physical barriers) st 1 Line of defense Skin Mucous membrane 68 69 Chemical barriers nd 2 Line of defense Pepsin Lysozyme Vaginal secretions 70 Interferon Released by virusinfected cells to stop division of malignant cells 71 72 Inflammation Is there anything good about inflammation? Required for healing 73 Inflammation (Nonspecific) Due to damaged tissue cells Response to tissue invasion 74 Inflammation Redness Pain Heat Swelling 75 Stages of Inflammation 1. Vasodilatation 2. Phagocyte migration 3. Repair 76 77 Phagocytosis Neutrophils (Microphages) Monocytes (Macrophages) 78 79 Specific Immunity Specific Protection Antigens Inventory of self substances Develop receptors for non- self Foreign proteins are recognized 80 Specific Immunity Haptens Smaller molecules that combine with larger ones to ignite an immune response IE… Penicillin and lipid toxin in poison ivy 81 Specific Immunity 82 Lymphocytes Originates from stem cells in red bone marrow Immature T-cells Immature B-cells 83 All Lymphocytes Accounts for 20-30 % of the circulating WBC population 84 85 Functions of Lymphocytes T-Cells Cell-mediated immunity Secrete lymphotoxins - kills antigen-bearing cells Secrete lymphokines (Cytokines) - stimulate the immune activity of other cells 86 T-Cells Cell-mediated immunity Attacks: Parasites, fungi, and bacteria Some cancer cells Foreign tissue transplants 87 88 Functions of Lymphocytes B-Cells Responsible for antibodymediated immunity Mature in plasma cells Plasma cells--- synthesize and secrete antibodies 89 B (bone marrow - derived) Cells Accounts for 10-15 % of the circulating lymphocytes Can differentiate into Plasma cells Plasma cells Antibodies 90 B-Cells Antibody-mediated immunity Attacks: Antigens dissolved in body fluids Extracellular pathogens, primarily bacteria 91 92 93 94 Types of Antibodies Immunoglobin G (IgG) – occurs in plasma and tissue fluid (Placenta) Immunoglobin A (IgA) – found in secretions of exocrine glands (Breast milk) Immunoglobin M (IgM) – develops in blood plasma 95 Actions of Antibodies 96 Complement Activation Normally inactive Becomes active when antibody combines w/ complement Actions: Inflammation, lysis, and phagocytosis 97 Precipitation – antigens become insoluble Lysis- ruptures membrane Agglutination - Clumping of antigens Neutralization – covers toxic portions 98 99 Immune Responses Primary immune response Response of B & T cells after 1st exposure Memory cells 100 Immune Responses Secondary immune response Reaction time is faster due to memory cells 101 Types Of Immunity 102 NATURALLY ACQUIRED ACTIVE IMMUNITY NON-DELIBERATE EXPOSURE TO A PATHOGEN 103 NATURALLY ACQUIRED PASSIVE IMMUNITY PASSAGE OF ANTIBODIES FROM THE MOTHER TO THE FETUS 104 ARTIFICIALLY ACQUIRED ACTIVE IMMUNITY DELIBERATE INJECTION OF PATHOGEN (Vaccination) IE…FLU Shot 105 ARTIFICIALLY ACQUIRED PASSIVE IMMUNITY INJECTION OF ANTIBODIES Short Term IE…Gamma Globulin / HEP A 106 Chicken Pox IE. IgA, G IE. Flu Shot Given the antibody 107 Types Of Allergic Reactions 108 ALLERGIC REACTION EXAGGERATED IMMUNE RESPONSE (ALLERGEN) Normally doesn’t occur 109 Allergic Reactions Delayed-reaction allergy Immediate-reaction allergy 110 DELAYED AFFECT ANYONE REPEATED/PROLONGED SKIN EXPOSURE T-CELL ACTIVATED APPROX: 48HRS REACTION Poison Ivy 111 IMMEDIATE REACTION OCCURS IN MINUTES INDIVIDUALS GENETICALLY PREDISPOSED B-CELL ACTIVATED RELEASE OF HISTAMINES INFLAMMATORY RESPONSE 112 It’s A Wrap Questions?? 113 114 115