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Lymphatic and Immune System
Charles C. Cook, MD A & P
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ObjectivesList 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.
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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.
Objectives
3
List the anatomical features and functions of lymph nodes.
Describe the major locations of lymph nodes.List major lymph structures and their location.
ThymusPharyngeal tonsils (adenoids)Palatine tonsilsLingual tonsilsSpleen
Function
Objectives
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Define the following terms.Immune systemPathogensInfectionImmunity
Nonspecific ImmunitySpecific Immunity
Autoimmunity
Objectives
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Functions of the Lymphatic System
Circulates body fluidTransports excess tissue fluid
Defends the bodyAbsorbs lipids
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Lymphatic VesselsLymphatic capillariesLymphatic vesselsLymph nodesLymphatic trunksCollecting ducts
Thoracic ductRight lymphatic duct
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Lymphatic Capillaries
ORIGINATE AS MICROSCOPIC CLOSED END TUBES - IN SPACES BETWEEN CELLS
More porousSimple squamous epithelium (endothelium)
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Lymphatic Vessels
FORMED FROM CAPSSIMILAR to VEINSVALVES gives beaded appearanceFollow veins
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Lymph Nodes
Structures located along the lymphatic pathways.
They contain large numbers of lymphocytes.
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Lymphatic Trunks
Collects lymph from the most proximal group of
each chain of nodes
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Lymphatic TrunksLumbarIntestinalBronchomediastinalSubclavianJugular
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Collecting ducts
Thoracic duct
Right lymphatic duct –
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Collecting DuctsThoracic Duct
Largest and l- o- n- g- e- r
Receives ¾ of body’s lymphDrains into left subclavian vein
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Cisterna Chyli
Dilated portion of the beginning of the
thoracic duct in the lumbar region
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Cisterna Chylireceives lymph from
Lower abdomenPelvis, &Lower limbs
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Collecting Ducts
Right Lymphatic DuctRight thorax and empties into the right subclavian vein
Drains Right side of head, neck and right arm
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Lymph
Clear, watery fluidFound inside lymphatic vessel
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Function of Lymph
Transports various foreign particles such as bacteria and viruses
Returns protein back to blood as well as excess tissue fluids
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Movement of Lymph
Skeletal muscle contraction
PressureValves
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MILKING ACTION
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How can a massage affect Lymph flow?
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Movement of Lymph
Contraction of diaphragm
Pressure changes33
Edema
Accumulation of fluid in the tissue
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Can a patient develop edema after an
amputation of an extremity?
Can this be prevented?37
Structure of *LNsBean shaped Vary in size (usually about 1 in.)
Afferent----EntranceEfferent----Exits at the Hilium
*LN denotes lymph nodes throughout presentation 38
Lymph NodesMore afferent vessels than efferent
covered by fibrous capsule
contain dense masses of lymphocytes and macrophages (nodules)
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LYMPH NODE
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MAJOR LOCATIONS OF LYMPH NODES
CERVICAL REGIONAXILLARY REGIONINGUINAL REGIONPELVIC CAVITYABDOMINAL CAVITYTHORACIC CAVITY
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Functions of LNs
Produces lymphocytesFilters interstitial compartment
Contains macrophages
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ThymusLocated within the superior mediastinum. Aprox. 40 gms
First source of lymphocytes before birth
Development of T-CellsThymosin
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TonsilsProtects mouth
Pharyngeal tonsil (Adenoid)
Palatine tonsilsLingual tonsils
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Spleen
Largest Lymphatic organFilters blood not lymphProduction of B-CellsNormal volume ---- 350 ml
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SpleenDefenseHematopoiesisRBC and platelet destruction
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SpleenLocation
Left hypochondriac region
Below diaphragmAbove left kidneyBehind fundus of stomach
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The SpleenWhy 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?
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Immunity TermsImmune systemPathogensInfectionImmunity
Nonspecific ImmunitySpecific Immunity
Autoimmunity
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Immune system
Body’s defense against disease
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Pathogens
Microorganism that causes disease
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Infection
CAUSED BY THE DISEASE - CAUSING AGENTS
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Immunity
THE BODY’S ABILITY TO RESIST PATHOGENS
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AutoimmunityAttack launched due to failure to distinguish from self and non-self substances
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Questions??
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Nonspecific ImmunityGeneral Protection
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Species Resistant
Resistance of a disease of one species compared to another
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Mechanical Barriers(Physical barriers)
1st Line of defenseSkin Mucous membrane
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Chemical barriers
2nd Line of defensePepsinLysozymeVaginal secretions
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Interferon
Released by virus-infected cells to stop division of
malignant cells
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InflammationIs there anything good about inflammation?
Required for healing
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Inflammation(Nonspecific)
Due to damaged tissue cells
Response to tissue invasion
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InflammationRedness PainHeatSwelling
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Stages of Inflammation
1.Vasodilatation2.Phagocyte migration3.Repair
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PhagocytosisNeutrophils (Microphages)
Monocytes (Macrophages)
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Specific ImmunitySpecific Protection
AntigensInventory of self substancesDevelop receptors for non-self Foreign proteins are recognized
Immune response80
Specific ImmunityHaptens
Smaller molecules that combine with larger
ones to ignite an immune response
IE… Penicillin and lipid toxin in poison ivy
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Specific Immunity
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LymphocytesOriginates from stem
cells in red bone marrow
Immature T-cellsImmature B-cells
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All Lymphocytes
Accounts for 20-30 % of the circulating WBC population
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Functions of Lymphocytes
T-CellsCell-mediated immunitySecrete lymphotoxins - kills antigen-bearing cells
Secrete lymphokines (Cytokines) - stimulate the immune activity of other cells
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T-CellsCell-mediated immunity
Attacks:
Parasites, fungi, and bacteriaSome cancer cellsForeign tissue transplants
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Functions of Lymphocytes
B-CellsResponsible for antibody-mediated immunity
Mature in plasma cellsPlasma cells--- synthesize and secrete antibodies
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B (bone marrow - derived) Cells Accounts for 10-15 % of the circulating lymphocytes
Can differentiate into Plasma cells
Plasma cells Antibodies
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B-Cells Antibody-mediated immunity
Attacks:
Antigens dissolved in body fluids
Extracellular pathogens, primarily bacteria
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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
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Actions of Antibodies
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Complement Activation Normally inactive Becomes active when antibody combines w/ complement
Actions: Inflammation, lysis, and phagocytosis
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Precipitation – antigens become insoluble
Lysis- ruptures membraneAgglutination - Clumping of antigens
Neutralization – covers toxic portions
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Immune ResponsesPrimary immune
responseResponse of B & T cells after 1st exposure
Memory cells
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Immune ResponsesSecondary immune
response
Reaction time is faster due to memory cells
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Types Of
Immunity
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NATURALLY ACQUIRED ACTIVE IMMUNITY
NON-DELIBERATE EXPOSURE TO A
PATHOGEN
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PASSAGE OF ANTIBODIES FROM
THE MOTHER TO THE FETUS
NATURALLY ACQUIRED PASSIVE IMMUNITY
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ARTIFICIALLY ACQUIRED ACTIVE IMMUNITY
DELIBERATE INJECTION OF PATHOGEN
(Vaccination)IE…FLU Shot
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ARTIFICIALLY ACQUIRED PASSIVE IMMUNITY
INJECTION OF ANTIBODIESShort Term
IE…Gamma Globulin / HEP A
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Given the antibodyIE. Flu ShotIE. IgA, GChicken Pox
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Types Of Allergic
Reactions108
ALLERGIC REACTION
EXAGGERATED IMMUNE RESPONSE
(ALLERGEN)Normally doesn’t occur
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Allergic ReactionsDelayed-reaction allergy
Immediate-reaction allergy
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DELAYED
AFFECT ANYONEREPEATED/PROLONGED SKIN EXPOSURE
T-CELL ACTIVATEDAPPROX: 48HRS REACTIONPoison Ivy 111
IMMEDIATE REACTION
OCCURS IN MINUTESINDIVIDUALS GENETICALLY PREDISPOSED
B-CELL ACTIVATEDRELEASE OF HISTAMINESINFLAMMATORY RESPONSE
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It’s A Wrap
Questions??
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