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My Body Logs > Lecture 23 - Lymphatic System > Flashcards

Lecture 23 - Lymphatic System Flashcards

1
Q

What is the alternate name for the Lymphatic System?

A

Reticuloendothelial system (RES)

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2
Q

Where is lymph NOT found?

A

In the CNS (Brain and spinal cord)

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3
Q

How is the Lymphatic system organised?

A

Lymph
Lymphatic vessels
Lymphoid tissues and organs

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4
Q

What is the pH of lymph?

A

7.4

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5
Q

What is Chyle?

A

Lymph from the GI tract that contain fats and dissolved lipids so is cloudy

Contains CHYLomicrons and fat sol vitamins

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6
Q

What are the smallest type of lymphatic vessels to the largest?

A

Lymphatic capillaries
Lymphatic vessels
Lymphatic Trunks
Lymphatic Ducts

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7
Q

How are lymphatic capillaries held in place and what type of fibrous protein makes these fibres?

A

Reticulin fibres

Made by Collagen III

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8
Q

What is unique about the endothelial cells of lymphatic capilaries?

A

They are not attached to a basement membrane

They are overlapping

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9
Q

What contributes to the flow of lymph through lymphatics?

A

Muscle contraction from surrounding muscle helps propel lymph

The lymphatic trunks and ducts have smooth muscle cells in there walls preventing them from expanding to much. This aids the flow of lymph against gravity

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10
Q

Where are lymphatic vessels found and how does lymph flow?

A

Near cardiovascular vessels( capillaries, arteries and veins)

Unidirectional
Flows superficial to deep (outside to inside)

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11
Q

How does a lymphatics capillary compare to a vein?

A

Both low pressure systems
Both have valves

Lymph capillaries don’t have cells unless infection
Lymph capillaries squeezed by veins and arteries propelling lymph

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12
Q

Generally how does lymph flow?

A

Excess tissue fluid collected by Lymphatic capillary
Lymphatic capillary——> Lymphatic vessel
Lymphatic vessel ——> lymphatic node
Lymphatic node——> lymphatic trunk
Lymphatic duct ——> Drains lymph back into venous circulation

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13
Q

What duct drains lymph from the the Upper Right Quadrant (RUQ) back into venous circulation?
What is the name of the blood vessel that it drains it into?

A

The Right Lymphatic duct
Into the Right Subclavian vein

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14
Q

What duct drains lymph from the body that is NOT from the RUQ?
What is the name of the blood vessel t drains it into?

A

The Thoracic duct
Left subclavian vein

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15
Q

Name 3 clinically important lymph nodes

A

Cervical lymph nodes (neck)
Inguinal lymph nodes (groin)
Axillae lymph nodes (Armpit)

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16
Q

What is the structure of a Lymph node?

A

Kidney shaped
Have nodules called Follicles
Each nodule has multiple afferent lymphatic vessels and efferent lymphatic vessels

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17
Q

What is the Concave hilum of the lymph node?

A

Where the single efferent lymphatic vessel leaves the lymph node
Where the feeding artery and draining vein enter and leave the lymph node

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18
Q

Which region of the lymph node contains the nodules/follicles/germinal centres of the lymph node?

A

Cortex

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19
Q

What cells are contains within the follicles/nodules of a lymph node?

A

Immune cells:
-Macrophages
-Dendritic cells
-B and T lymphocytes
-Plasma cells

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20
Q

What is the main connective tissue fibre found in a lymph node?

A

Reticulin made by collagen 3
Made by reticular cells (modified fibroblasts)

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21
Q

How can you identify a follicle/nodule/germinal centre in a lymph node?

A

Outer ring of dark purple
Inner lighter pink centre

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22
Q

What is the difference between B cells and T cells?

A

T cells attack invaders that invade the inside of cells

B cells attack invaders outside cells

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23
Q

What is a follicular dendritic cell?
What is the function of a follicular dendritic cell?

A

A type of dendritic cell which resides in the follicles of the lymph node

They act as Professional Antigen Presenting Cells (APCs)
They cause B cell proliferation in memory B cells
Last for many years (immunity)

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24
Q

What is the function of T helper cells?

A

They stimulate/help B cells make antibodies by binding to B cells with the antigen receptor for that pathogen

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25
Q

Which of the lymphocytes B or T need to be presented with the antigen?

A

T lymphocytes need to have the antigen presented to them

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26
Q

What is the importance of Macrophages and Follicular dendritic cells in the immune response?

A

They acts as APCs
They present antigen to naive T cell
Naive T cell activitated
Produces T memory cells and T helper cells
T helper cells help B cells proliferate and produce antibodies

27
Q

What is Lymphadenopathy?

A

Enlarged lymph nodes

28
Q

What can cause Lymphadenopathy?

A

Infections (germinal centres/nodules fill with lymphocytes)
Cancers can mestastatise to lymph nodes
Lymphoma (malignancy/cancer of the lymphoid tissue itself)

29
Q

What are 2 types of lymphoma?

A

Hodgkin lymphoma (treatable and curable)
Non-Hodgkin lymphoma (incurable/fatal)

30
Q

What are the 2 primary lymphatic organs and where are they located?

A

Thymus - in the mediastinum
Bone marrow - red marrow of bone

31
Q

What are the secondary lymphatics organs?

A

Spleen
Tonsils
Appendix
Payers patches
Diffuse lymphatic nodules
Lymph nodes

32
Q

What is the structure and function of the Thymus?

A

Similar to lymph node but with no hilum

Responsible for maturing immature T cells to mature T cells

33
Q

What is a Myasthenia crisis?

A

Changes to Thymus due to Myasthenia gravis cause inability to swallow and breath due to weakened muscles

34
Q

What is the structure and function of the Spleen?

A

Similar to lymph node but separated to red and white pulp
Both immune and haemopoietic, it filters blood look lymph nodes filter lymph

35
Q

Describe the position of the spleen

A

Inferior to the diaphragm and posterior to the stomach

36
Q

What are the immune functions of the spleen? (White pulp)

A

Antigen presentation by APCs
Activation and proliferation of B and T lymphocytes
Remove large antigens from blood

37
Q

What are the Haemopoietic functions of the spleen? (Red pulp)

A

Removes and destroys old,damaged, abnormal erythrocytes and platelets
Retrieves iron from haemoglobin of broken down RBCs
Erythrocyte and platelet storage

38
Q

Why is a ruptured spleen so dangerous?

A

Rich blood supply
Severe loss of blood if ruptured, blood would fill abdomen

39
Q

What is a splenectomy?

A

Surgical Removal of the spleen

40
Q

What is the body at risk of following a splenectomy?

A

Infection from encapsulated bacteria and malaria

41
Q

List 3 encapsulated bacteria
NHS

A

Neisseria meningitidis
Haemophilus influenzae
Streptococcus pneumoniae

42
Q

What can cause Splenomegaly?

A

Enlarged in response to local infection
Enlarges in response to systemic infection (glandular fever, malaria, septicaemia)

43
Q

What are the 3 tonsils and where are they located?

A

Adenoids (nasopharynx)
Palatine tonsils (oropharynx)
Lingual tonsils (oropharynx)

44
Q

Where do the nodules reside in the tonsils?

A

Below surface invaginations in regions called crypts
Crypts increase surface area

45
Q

What is the function of the tonsils?

A

Prevent pathogen ingress through oral and nasal routes

46
Q

Which of the tonsils are only visible when swollen?

A

Lingual tonsils

47
Q

What are the most visible tonsils called and what does white patches on it when swollen indicate?

A

Palatine tonsils
White patches indicate that the infection is from Group A Strep bacteria
Aka Strep.pyogenes

48
Q

What is the term to describe the 3 tonsils together? (Adenoid, Palatines and lingual tonsils?

A

Waldeyers ring

49
Q

Where is the Vermiform appendix located and what is its structure?

A

Inferior and attached to the caecum
Nodules inferior to the surface invaginations know as crypts

50
Q

What is the function of the Vermiform appendix?

A

Prevents pathogen ingress through GI routes
Prevent pathogen ingress from ileum

51
Q

What does MALT stand for?

A

Mucosa-associated lymphoid tissues

52
Q

What type of Associated lymphoid tissue are the payers patches?

A

GALT = appendix/payers patches

53
Q

Where are payers patches located and what is there function?

A

Inferior and attached to ileum

Prevents pathogen ingress through digestion

54
Q

What are the 4 key functions of the lymphatic system?

A

Fluid balance (returning interstital fluid to circulation)
Transporting fat and fat sol vitamins
Defence against pathogens and disease
Storing erythrocytes and destroying eythrocytes

55
Q

What is a sentinel lymph node?

A

The first node to receive lymph form area of a primary tumour

56
Q

Why do Sential lymph nodes swell withi metastatic cancers?

A

Cancer cell breaks off fro tumour (exosome) and invades myeloid cell in sentinel node
Causes proliferation of cancerous cells. Abusing the sentinel node to swell

57
Q

What are the 2 ways which Sentinel nodes can be used to detect cancer (e.g breast cancer)?

A

First set of lymph nodes that will swell will be the Axilla or pectoral nodes
A frozen section can be taken in theatre to identify malignant epithelial cells

Or fluorescent dye injected into tumour, dyes tumour and sentinel lymph node so all the tumour and affectd lymph node can be removed

58
Q

What is lymphodaema?

A

Swelling due to build up of lymph fluid in body

59
Q

What is Primary lymphodaema?

A

It is lymphodaema with congenital cause
So born with defect in lymphatic system

60
Q

What is secondary lymphodaema?

A

Lymphodaema caused by damage to the lymphatic system that is not a congenital cause
It developed properly but Is now damaged

61
Q

What infections can cause Lymphodaema?

A

Cellulitis (bacterial)
Filariasis (elephant Itis) Parasitic worm invades lymph

62
Q

What is the lympha press system?

A

Use to treat lymphodaema by pushing fluid up to other lymph nodes

Problem: if cause of lymphodaema is cancer/metastatic then you are spreading the cancer

63
Q

What are the 4 functions of the Lymphatic system?

A

-Removes interstitial fluid from tissues
-Absorbs and transports fatty acids and fats as Chyle from the digestive system
-Transports whitest blood cells to and from the lymph nodes and back into the bones
-Transports antigen-presenting cells like dendritic cells to the lymph nodes where the immune response is stimulated

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