Lymph System Flashcards
What does liver damage do to levels of albumin in blood?
How does this affect oncotic pressure?
Decreases the levels of albumin in blood
It decreases oncotic pressure
What is oncotic pressure?
force pulling fluid back into capillaries d/t proteins
2 main functions of Lymphatic system
- ) Fluid Balance- lacteals (in capillary beds) take-up fluid from interstitium, fluid is returned to systemic circulation.
- ) Immune Surveilance- filter fluid scanning for bacteria and other pathogens
Which is higher in the blood compared to the lymph?
Electrolytes
Total Protein
IgG
Cholesterol
electrolytes are same in both lymph and serum
total protein greater in serum
IgG higher in serum
Cholesterol higher in serum
What are the Starling forces that cause interchange between intervascular and interstitial space?
Net hydrostatic pressure (pressure on the capillary d/t capillary hydrostatic pressure and intersitial hydrostatic pressure)
Net oncotic pressure [pressure exerted by proteins in blood plasma (capillary oncotic pressure) vs intersitium (interstitial oncotic pressure)]
Capillary filtration- how permeable the capillaries are
Factors effecting capillary permeability
fever, sepsis, infection, inflammation, burns, etc.
What is the net effect of increased intravascular hydrostatic pressure? (downstream obstruction)
increase in capillary hydrostatic pressure resulting in flitration into the interstitium. Lacteals of lymph cannot return all of excess fluid into circulation so edema/ascites results.
causes: Heart failure, cirrhotic liver disease
What is the net effect of fluid in decreased intravascular oncotic pressure (decreased protein in blood)?
decrease in capillary oncotic pressure resulting in decreased re-absorption of fluid into serum, this leads to increased fluid in interstitium leading to edema/ascites.
Causes:
hypalbuminemia from;
-Malnutrition (low protein intake)
-Liver failure (not enough protein produced)
-Nephrotic syndrome (too much protein lost in urine)
When does increased capillary filtration occur?
Burns, inflamm, toxic damage: sepsis, pancreatitis, inhalation injuries
What is the net effect of fluid in lymphatic obstruction?
Lymphatic obstruction is the inability to absorb fluid from the interstitium leading to edema.
Causes:
Lymphoma
Metastatic Cancers
Surgical removal of lymph nodes
Primary lymphoid organs are?
bone marrow
thymus
secondary lymphoid organs are?
- Spleen,
- Lymph nodes
- MALT (mucosal associated lymphoid tissue, ex- tonsil, peyers patches)
What types of cells are formed in the bone marrow?
Granulocytes (neutrophils, eosinophils, basophils)
Agranulocytes; Lymphocytes (T and B), Monocytes (Mf in tissue)
Cells formed in the lymph tissue?
Lymphocytes from precursor cells that originate in marrow)
WBC found in the blood
- PMN neutrophils
- PMN eosinophils
- PMN basophils
- Monocytes
- Lymphocytes
- Plasma cells occasionally
Lymphocytes are store ____.
Lifetime is how long?
lymph organs
weeks to months
WBC get into tissues by___
WBC move around once inside the tissues by_____
WBC are attracted to inflamed tissue areas by____
- ) diapedesis
- ) amoeboid motion
- ) chemotaxis
3 factors determining whether or not phagocytosis occurs
How smooth is it? (rough surface increases phagocytosis)
- ) protective protein coat (without coat more easily phagocytosed)
- )Opsonization (yummy, tags cells for phagocytoses)
Most important function of Mf and neutrophils?
PHAGOCYTOSIS!!!
What cells make up the Reticuloendothelial System?
What tissues are part of this system?
How long do these cells remain in the tissues?
Monocytes-Mf
Skin/SubQ- histocytes Lymph Nodes Lungs Liver (Kupffer Cells) Spleen & Bone marrow Brain (Microglia)
Mf Months-Years
Function of Spleen?
Asplenia- more susceptible to bacterial pathogens such as? What vaccines should they get?
filters blood
Streptococcus pneumoniaem Haemophilus influenzae
pneumo and H. Flu vaccine
Describe the composition of the spleen.
Red pulp- vascular, where RBC are recycled, detects and responds to foreign substances in blood, acts as blood reservoir
White pulp- lymphoid-like, has germinal centers rich in B cells and abys, T cells surround vessels (PALS).
PALS- periarterial lymphoid sheaths, mostly T cells
What is the Walling off effect of Inflamm?
fibrinogen clot act in intersitial tissues which help block fluid flow, this prevents entrance of bacteria….also makes region more difficult to treat with abx.
Inflamm response to tissue injury
- vasodilation
- increased capillary permeability
- clotting of fluid in interstitial spaces
- a.)migration of granulocytes and monocytes d/t release of prostaglandins, histamine, heparin, bradykinin, seratonin
b. ) local mf act first, neutrophils invade via chemotaxis, second mf invasion, increased production of granulocytes and monocyte from bone marrow. - swelling of tissue cells
Walling off effect can result in______ and why?
boils/furuncles (abcesses)
why: infection such as staph. aureus gets walled off or contained to one region resulting in boils/abcesses, this makes them difficult to treat w/ abx.
Treatment of abcess?
I&D
incision and drainage
What makes up exudate?
necrotic tissue, dead neutrophils and MF, tissue fluid
Which type of cells attack parasites?
eosinophils
Basophils and mast cells are released when? What do they secrete?
Allergic Rxn
histamine, bradykinin, serotonin
