Chapter-22-Lymphatic-System.pdf | Slides Nursing

Chapter 22a

Lymphatic System

The function of the lymphatic system is to maintain blood volume by picking up fluid

from the interstitial environment and returning it to circulation. This amounts to about 3

liters of fluid each day. This also promotes mixing of the ECF divisions (plasma and

interstitial fluid) and enhances delivery of substances to cells.

The lymphatic system also transports fats (and fat soluble vitamins) that have been

absorbed from the GI tract. AND, it houses the body’s defenses. This includes cells,

tissues and organs that are responsible for defending the body against environmental

threats (pathogens) and internal threats such as cancer cells. The lymphatic capillaries

intercept invading microbes when collecting interstitial fluid which is then exposed to

defense cells in the nodes.

Anatomy Overview

o Lymph is the fluid of the lymphatic system. It contains leukocytes, proteins

(though less than the blood), fats and microbes (if any are present)

o Lymphatic vessels transport the lymph, also called “lymphatics.” This network

extends from the lymphatic capillaries to the subclavian veins where the lymph

enters circulation.

o Lymphatic tissues are either diffuse tissues or nodules.

o Diffuse lymphatic tissue is MALT…mucoca associated lymphatic tissue.

This includes lymphocytes scattered along tracts, including the respiratory

tract (BALT), digestive tract (GALT), urinary tract and reproductive tract.

o The lymphatic nodules are aggregates of lymphocytes and macrophages.

They are found in the walls of the pharynx (tonsils), the appendix, and the

ileum (Peyer’s Patches)

o Lymphatic organs differ from tissues in that they have a CT capsule. This

includes bone, lymph nodes, thymus and spleen.

o The primary lymphatic organs are the bone and the thymus. They are

primary because this is where lymphocytes mature. The B-lymphocytes

mature in bone, and the T-lymphocytes mature in the thymus. After they

mature they circulate!

o The secondary lymphatic organs are where most of the immune responses

occur, and they contain mature B and T cells. These are the lymph nodes

and the spleen.

Lymphatic Vessels

The lymphatic vessels are found closely associated with blood vessels. However, unlike

blood vessels it is not a closed-circuit system…the lymphatic vessels are a one-way

system that have a definitive beginning and end. They begin at the capillaries and end at

the two main ducts that empty into the subclavean veins.

The LYMPHATIC CAPILLARIES are found everywhere in the body except for the

CNS, cartilage, cornea, bone and marrow. They are highly permeable and they collect

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Chapter 22a Lymphatic System The function of the lymphatic system is to maintain blood volume by picking up fluid from the interstitial environment and returning it to circulation. This amounts to about 3 liters of fluid each day. This also promotes mixing of the ECF divisions (plasma and interstitial fluid) and enhances delivery of substances to cells. The lymphatic system also transports fats (and fat soluble vitamins) that have been absorbed from the GI tract. AND, it houses the body’s defenses. This includes cells, tissues and organs that are responsible for defending the body against environmental threats (pathogens) and internal threats such as cancer cells. The lymphatic capillaries intercept invading microbes when collecting interstitial fluid which is then exposed to defense cells in the nodes. Anatomy Overview o Lymph is the fluid of the lymphatic system. It contains leukocytes, proteins (though less than the blood), fats and microbes (if any are present) o Lymphatic vessels transport the lymph, also called “lymphatics.” This network extends from the lymphatic capillaries to the subclavian veins where the lymph enters circulation. o Lymphatic tissues are either diffuse tissues or nodules. o Diffuse lymphatic tissue is MALT…mucoca associated lymphatic tissue. This includes lymphocytes scattered along tracts, including the respiratory tract (BALT), digestive tract (GALT), urinary tract and reproductive tract. o The lymphatic nodules are aggregates of lymphocytes and macrophages. They are found in the walls of the pharynx (tonsils), the appendix, and the ileum (Peyer’s Patches) o Lymphatic organs differ from tissues in that they have a CT capsule. This includes bone, lymph nodes, thymus and spleen. o The primary lymphatic organs are the bone and the thymus. They are primary because this is where lymphocytes mature. The B-lymphocytes mature in bone, and the T-lymphocytes mature in the thymus. After they mature they circulate! o The secondary lymphatic organs are where most of the immune responses occur, and they contain mature B and T cells. These are the lymph nodes and the spleen. Lymphatic Vessels The lymphatic vessels are found closely associated with blood vessels. However, unlike blood vessels it is not a closed-circuit system…the lymphatic vessels are a one-way system that have a definitive beginning and end. They begin at the capillaries and end at the two main ducts that empty into the subclavean veins. The LYMPHATIC CAPILLARIES are found everywhere in the body except for the CNS, cartilage, cornea, bone and marrow. They are highly permeable and they collect

The capillaries are called LACTEALS in the GI tract. interstitial fluid, which is excess filtrate from the blood capillaries and leaked plasma proteins. In contrast to blood capillaries, the lymphatic capillaries: o Are blind-ended “pockets” (terminal lymphatics) o Have large diameters, for less resistance o Have thinner walls with little to no basement membrane (less pressure) o Endothelial cells overlap to form one-way valves o Tethered to surrounding tissue by protein filaments...this prevents collapse The COLLECTING VESSELS receive lymph from the capillaries. They run together with arteries and veins…often bound up in the same CT. They also have the same tunics as veins, but have thinner walls and more valves. The valves form bulges along the vessel, giving it a beaded appearance. There are both superficial and deep collecting vessels, relating to how close they are to the surface. The superficial lymphatics are subcutaneous and in areolar CT of mucous membranes (GI, respiratory, urinary, reproductive tracts), and serous membranes (pleural, pericardial, peritoneal). Everything else is a deep ymphatic vessel…and these are larger vessels associated with deep arteries and veins. The LYMPHATIC TRUNKS a formed where large collecting vessels converge. Right lumbar trunk Left lumbar trunk Cisternae chyli Intestinal trunk Thoracic Duct Left jugular trunk empties into left subclavian vein Left subclavian trunk Left bronchomediastinal trunk Right jugular trunk Right subclavian trunk Right Lymphatic Duct Right bronchomediastinal trunk empties into right subclavian vein The Lymphatic Vessels and Flow The lymphatic vessels have 1-way valves that rely on pumps to move the lymph. The pumps are the skeletal muscle pump and the respiratory pump. The skeletal muscles squeeze the lymphatic vessels when they are contracted. The respiratory muscles change the volume of the thoracic cavity to move air in/out of lungs. This causes changes in pressure, which is transmitted to the lymphatic vessels for pumping action. There are two other things that also help…the pulse pressure of nearby arteries, and the smooth muscle contractions in response to stretching.

The fixed macrophages clean and filter lymph as it passes through on its way back into circulation. It removes microbes, dead or dysfunctional cells and cell debris. If any present antigens activate B & T-cells then you have an immune response! The lymph nodes are clustered in a few strategic areas…the cervical nodes, axillary nodes and inguinal nodes. They are also found along the mesenteries (gut) and along airways leading to the lungs. The goal is to catch anything before it gets into circulation. When someone says they have “swollen glands”, they are so totally wrong. They really mean that they have infected lymph nodes! The thymus is located in the superior mediastinum, right above the heart. It is active in children up until about age 2 as the immune system is developing, and then begins to atrophy as the immune system takes hold and thrives! The collagen fibers of the CT capsule extend inward to form left and right lobes, and form septae that divide the lobes into lobules. Each little globby is a lobule. The lobules contain the cortex and medulla. T-cells proliferate/develop in the cortex and migrate to the medulla to mature. They then leave the thymus via the medullary blood vessels. T-cell activity is regulated by thymosins…the hormone secreted by the thymus! Unlike other lymphoid tissues/organs, the thymus consists of reticular epithelial cells that form the blood-thymus barrier. This separates the cortex from the medulla, protecting immature T-cells from being exposed to antigens in the blood. The cells also secrete thymosins…thymosin, thymopoietin, thymulin. The spleen is the largest collection of lymphoid tissue in the body. It is lateral to the stomach on the left side…liver is on the right. Blood comes in to the spleen via the splenic artery and it leaves through the renal vein. Along the way the blood is exposed to macrophages and lymphocytes…the spleen CLEANS AND FILTERS BLOOD! The pathway goes like this: Splenic artery to trebecular arteries that pass through the white pulp (lymphocytes and macrophages are here), then go to the capillaries that feed into the red pulp , which then leads to the sinusoids then small veins to trabecular veins to splenic vein. Note that the spleen cleans and filters blood…it removes abnormal blood cells and debris via macrophages, and stores Fe ++ recycled from RBCs. The spleen initiates the immune response as antigens in the blood are presented to T & B-cells when they pass through the pulp. Some diseases and infections cause the spleen to enlarge such as TB and leukemia. A rupture of the spleen causes internal hemorrhage. This is extremely difficult to repair, so the spleen is removed. You can live without a spleen because other lymphatic organs perform the same functions…such as the liver and red bone marrow. Note that these people would be at a higher risk for bacterial infection.

Marieb, E. N. (2006). Essentials of human anatomy & physiology (8th ed.). San Francisco: Pearson/Benjamin Cummings. Martini, F., & Ober, W. C. (2006). Fundamentals of anatomy & physiology (7th ed.). San Francisco, CA: Pearson Benjamin Cummings.

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