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Histology > Lymphatic System > Flashcards

Lymphatic System Flashcards

1
Q

Flow through different lymphatic vessels?

A

1 = lymphatic capillaries
–> LNs throughout
2 = lymphatic trunks (internal jugular & subclavian - are more)
3 = lymphatic ducts (x2 = right lymphatic duct & thoracic duct)

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2
Q

What are lymphatic vessels?

A

Collective name for different things lymph flows through

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3
Q

Functions of lymphatic system?

A

-Lymphatic vessels transport excess fluid away from interstitial spaces in most tissues & return to bloodstream
-Lacteals (in lining of the small intestine) absorb digested fats, then transport fats to venous circulation
-Organs of lymphatic system help defend body against infection by disease-causing agents (foreign substances & microorganisms) - immune surveillence & defence
-Helps maintain fluid balance by accumulating tissue fluid & WBCs in lymph vessels & returning to blood

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4
Q

What are lacteals?

A

Special type of lymphatic capillary

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5
Q

Components of lymphatic system?

A

-Lymphatic capillaries
-Lymphatic vessels
-Lymphatic trunks
-Lymphatic ducts

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6
Q

Features of lymphatic capillaries?

A

-Blind-ended =don’t know where originate
-Highly permeable
-Single/1 layer of endothelial cells
-Walls have valves - stops backflow of lymph once in capillaries back into interstitial space
-Diameter will inc when lymph enters

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7
Q

How does lymph form?

A

1 = nutrients, O2 forced out blood capillary (arteriole end) by high pressure (hydrostatic) = into interstitial space - forms interstitial fluid
2 = tissues swell - not all fluid enters cells
3 = waste (CO2, urea) reabsorbed into blood capillary (venule end)
4 = excess interstitial fluid - absorbed by lymphatic capillaries (surround blood capillaries) - once in these = lymph

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8
Q

How does lymph enter lymphatic capillaries?

A

Valves in walls will open when anchoring filaments are pulled by the surrounding swelling tissue (so lymph flows in 1 direction only)

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9
Q

What causes lymph to travel through lymphatic vessels?

A

-Bulging of contracting skeletal muscles + pulsation of nearby arteries
-Contraction of Tunica media (2nd layer of blood vs has smooth muscle)
-Normal movement of limbs & trunk

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10
Q

How is lymph reintroduced into the circulatory system (right side)?

A

-Lymph from right upper side of body
-Lymph empties from right lymphatic duct @ right venous angle (junction of right internal jugular vein & right subclavian vein)
-So re-enters venous (circulatory) system
-Flows via superior vena cava to right atria of heart

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11
Q

How is lymph reintroduced into the circulatory system (left side)?

A

-Lymph from left side of body & lower right side (limbs & lower trunk)
-Lymph empties from thoracic duct @ left venous angle (junction of left internal jugular vein & left subclavian vein)
-So re-enters venous (circulatory) system
-Flows via superior vena cava to right atria of heart

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12
Q

What are the 2 locations that ALL lymph travels to - one or the other?

A

-Right lymphatic duct
-Thoracic duct

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13
Q

What are examples of primary lymphoid organs?

A

▪ Bone marrow, where B & T cell development occurs (B cells mature here too)
▪ Thymus, the site of T cell maturation

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14
Q

What are primary lymphoid organs?

A

-Where lymphocytes develop & mature
(development of immunocompetent lymphocytes)
-Do not directly participate in immune response

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15
Q

What are examples of secondary lymphoid organs?

A

▪ Lymph nodes
▪ Mucosa-associated lymphoid tissue (MALT)
▪ Spleen
▪ Tonsils

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16
Q

What are secondary lymphoid organs?

A

Where lymphocytes travel to, to perform their immune functions
-Trap antigens & provide sites for interactions of APCs w/ immunocompetent lymphocytes

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17
Q

What are lymphoid cells?

A

-B cells
-T cells
-NK cells
-Plasma cells
-Dendritic cells
-Macrophages

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18
Q

What are B cells?

A

Develop in the bone marrow
-Responsible for producing immunoglobulins (antibodies)
-Differ­entiate = B memory cells & plasma cells (provide humoral immunity)

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19
Q

What do T cells do?

A

-Originate in bone marrow, mature in the thymus
-Seed secondary lymphoid tissue
-Dif­ferentiate = helper, memory, & cytotoxic cells
-Provide cell-mediated immunity & assist B lymphocytes in their humoral response

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20
Q

What do NK cells do?

A

-Arise from bone marrow
-Stimulated by interferon to recognize & kill “non-self” cells (antigens)

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21
Q

What do plasma cells do?

A

Differentiate from B lymphocytes - produce humoral antibodies

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22
Q

What do dendritic cells & macrophages do?

A

-Phagocytose foreign matter
-Present antigens to lymphocytes
-Secrete immunomodulatory factors

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23
Q

What are the 3 types of lymphocytes?

A

-B cells
-T cells
-NK cells

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24
Q

What do lymphoid nodules, LNs & spleen do?

A

Involved w/ production of humoral antibodies
-Where B cells migrate to from bone marrow

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25
Q

Structure of lymph node?

A

-Fibrous CT capsule - often adipose tissue surrounds
-Convex surface where afferent lymph vessels enter
-Afferent lymph vessels enter
-Efferent lymph vessels exit
-Hilum = where arteries (enter) & veins (leave)
-Medullary cords = from cortex to medulla - contain B cells
-Medullary sinuses = continuation of intermediate sinuses in cortex

-Cortex
-Paracortex
-Medulla
-High endothelial venules

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26
Q

What is the cortex of LNs?

A

Contains primary lymphoid follicles - develop into secondary

-Germinal centre (inner) = B cells activation & clonal expansion - specific (to antigens) & memory B cells
-Mantle zone (outer) = inactive B cells
(GC = IN ALL SECONDARY LYMPHOID TISSUES = give plasma & memory B cells)

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27
Q

What is the paracortex of LNs?

A

Site of T cells activation & clonal expansion = specific (to antigens) & memory T cells

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28
Q

What is the medulla of LNs?

A

Site of plasma cell maturation & antibody secretion

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29
Q

What are the high endothelial venules of LNs?

A

-Also in appendix, Peyer’s patches, tonsils
-Cuboidal lining
-Allow lymphocytes to move through endothelium (= diapedesis)
WHERE LYMPHOCYTES COME FROM

30
Q

Where does the ‘cleaning & drainage’ occur in LNs?

A

Cortex & paracortex

31
Q

Flow of blood & lymph into & out of LNs?

A

-Afferent lymph vessel = enters (into outer cortex) - carries unfiltered lymph
-Efferent lymph vessel (have valves) = exits
(lymph flows from medullary sinuses into efferent vessels)

32
Q

Label this image of a LN.

A

-Bean-shaped encapsulated organs
-Situated scattered along collecting lymphatic vessels
-Cleanse the lymph from pathogens
-Co – cortex (has lymphoid follivles)
-Me – Medulla (has plasma cells and macrophages)
-Ca - capsule

33
Q

What is the sentinel LN?

A

Hypothetical 1st LN (or group) draining a cancer
(Not in a specific region)

34
Q

How does a series LNs draining certain regions of body connect?

A

Via lymph vessels

35
Q

How can metastasis occur, or infections spread?

A

By formation of chains of LNs - from one part of body to another

36
Q

What does a sentinel node biopsy show?

A

Determine extent of breast cancer dissemination/spread - so decide extent of the resection (cutting) (AXILLARY)

37
Q

Where is the thymus?

A

-Inferior to neck
- In superior thorax - posterior to sternum

38
Q

Structure of thymus?

A

2 lobes, numerous lobules

Lobules:
-Outer cortex = development of immature T cells - darker stain as inc no. of T cells & closely packed cells - T cells gain immunocompetence
-Inner medulla = delete self-reactive T cells (develops self-tolerance) - lighter stain as fewer cells & fewer
—> made of lymphocytes + Hassal corpuscle

Hassal corpuscles of medulla
-Contain ERC (epithelia reticular cells) ensure no self-reactive T cells survive (would attack body’s own cells)
-Epithelial cells = secrete proteins (thymosins) = cause T cell maturation (once leave thymus)

39
Q

When does thymus start & stop growing?

A

-Originates = in early embryo
-Stops = at puberty

40
Q

Label image.

A
41
Q

How do T cells move in the thymus?

A

Move from cortex —> to medulla
(as medulla is where self-tolerance is developed) - delete self T cells - this occurs when come into contact w/ many epithelial reticular cells - if recognise self proteins as pathogen = epithelial cells destroy them

42
Q

What are antigens of body’s cells called?

A

Self-antigens

43
Q

What are Hassal/thymidine corpuscles of thymus made of?

A

-Type VI (6) epithelial reticular cells
(primary cells involved with making sure that no T cells self-tolerant)

44
Q

What are the 3 components of the blood thymus barrier?

A

1 = capillary endothelium
2 = perivascular CT space (macrophages here)
3 = type I epithelial reticular cells (w/ their basal lamina)

45
Q

Role of the blood thymus barrier?

A

-Protects developing immature T cells & separates them from mature immunocompetent lymphocytes circulating in bloodstream
—> prevents premature exposure of lymphocytes to foreign and self-antigens so no immune reaction

46
Q

What is DiGeorge Syndrome (CATCH 22) characterised by?

A

-Congenital heart disease
-Abnormal face (ear anomalies, wide-set eyes, long face, nasal abnormalities)
-Thymic aplasia or hypoplasia
-Cleft palate
-Hypocalcemia (secondary to
hypoparathyroidism)
-22: Microdeletion of chromosome 22q11

47
Q

What is Thymic aplasia or hypoplasia seen in children w/ DiGeorge Syndrome?

A

No thymus (or underdeveloped) = due to congenital failure - die young due to infection - as no T cell

48
Q

Location of spleen?

A

-Left hypochondria
-Inferior to the diaphragm
-Ribs 9-10 (post to stomach)

49
Q

Immune role of the spleen?

A

-Inner defence organ - secondary lymphoid organ
-Filters blood from splenic artery
-Responds to foreign antigens in blood
-Breaks down & recycles aged RBCs & platelets

50
Q

Spleen structure?

A

-Hilum - blood vs & nerves enter
-Spaces (venous sinuses) in chambers filled w/ blood (NOT lymph)

51
Q

What are the 2 types of tissue in lobules of spleen?

A

-White pulp
-Red pulp

52
Q

What is white pulp tissue in spleen?

A

Contains mostly B cells & periarterial lymphatic sheath (PALS) = sleeve of T cells surrounding central arteriole

53
Q

What is red pulp tissue in spleen?

A

-Contains mostly splenic cords (Billroth) suspended in loose reticular CT (contains B & T cells) -Splenic cords = surrounded by splenic sinuses lined by endothelial cells & surrounded by reticular fibers

54
Q

Which stains darker/densely, red or white pulp (in spleen)?

A

White pulp as contains more lymphocytes (= basophilic) than red pulp (red pulp contains more RBCs than lymphocytes)

55
Q

What is white pulp made of?

A

-Periarterial lymphatic sheath (PALS) = surrounding 2ndary lymphoid (splenic) nodule
-2ndary lymphoid follicle = has Corona & germinal centre
-Central artery (of PALS) - gives rise to sinuses in marginal zone
-Whole white pulp = surrounded by marginal zone

56
Q

What is red pulp made of?

A

-Splenic sinuses separated by splenic cords - contain lots of RBCs, macrophages & other immune cell
-Rod-shaped endothelial cells line splenic sinuses w/ strands of incomplete basal lamina around outside
MZ =

57
Q

Summarise spleen structure & roles of red & white pulp.

A
58
Q

What are splenic sinuses in red pulp?

A

Unique sinusoidal vessels lined by highly elongated endothelial cells w/ large nuclei bulging into sinus lumen

59
Q

Where are splenic cords (Billroth) in red pulp, & what is in them?

A

-Between sinusoids
-Made of fibrils & CT cells w/ large pop of monocytes & macrophages

60
Q

How are cell components of white pulp & LNs different?

A

Antigens enter spleen from blood NOT from lymph

61
Q

Role of red pulp?

A

Filter - removes aged & damaged RBCs & microorganisms from circulating blood
-Storage site for RBCs

62
Q

How do old RBCs get removed in red pulp?

A

Rupture through vascular spaces = cellular debris
–> remove by macrophages in splenic sinuses

63
Q

How do macrophages destroy foreign particles?

A

Phagocytosis - as these pathogens may be in blood as go through sinuses

64
Q

Structure of sinuses of red pulp?

A

-Lined by flattened endothelial cells - rest on discontinuous BM - interrupted by many slits RBCs move through

65
Q

What is the immune role of the tonsils?

A

Has MALT - where lymphoid cells concentrate on mucosal surfaces (& on solid glands) = give defence

66
Q

What are the 3 types of tonsils?

A

-Palatine
-Lingual
-Pharyngeal

67
Q

Which type of tonsil is the largest, & what is its structure?

A

-Palatine - stratified squamous epithelium = folds into crypts (C)
F = lymphoid follicles (under ep)
-Ep surrounded by tonsillar lymphoid tissue (L)
-Crypt contains bacterial colonies (= normal)

68
Q

Where are lymphoid nodules?

A

Lymphoid organs

69
Q

Structure of nodules in tonsils?

A

Encapsulated aggregations of diffuse and nodular lymphoid tissues located in lamina propria

70
Q

Where does GALT (type of MALT) include?

A

-Tonsils
-Peyer’s patches (ileum)
-Lymphoid follicles (appendix)

71
Q

How is the lymphoid tissue in GALT/MALT arranged?

A

Into follicles (often w/ germinal centres - part of 2ndary lymphoid nodules)

72
Q

What do MALT function same as?

A

LNs - protect body from infective organisms (on mucosal surfaces)

Histology (14 decks)

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