Lymphatic system and hematopoietic organs Flashcards

1
Q

What is the lymphatic system?

A

Tissues and organs which produce, store and carry white blood cells

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2
Q

What does the lymphatic system do?

A

Fight infections and other diseases

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3
Q

What does the lymphatic system include?

A

Bone marrow
Spleen
Thymus
Lymph nodes
Lymphatic vesels

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4
Q

What does the lymphatic system filter?

A

Pathogens from the blood

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5
Q

3 parts of the lymphatic system

A

Lymphatic
Lymph nodes
Lymphoid organs

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6
Q

What fluid does the lymphatic system clean?

A

The interstitial fluid/extracellular fluid

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7
Q

What is extracellular fluid similar to?

A

Plasma

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8
Q

Different name for white blood cells

A

Lymphocytes

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9
Q

Which are our infection-fighting cells?

A

White blood cells

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10
Q

Is the lymphatic system one way/unidirectional or bi-directional?

A

Unidirectional

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11
Q

Primary function of the lymphatic system

A

Transport excess interstitial fluid from the intertital space back to the blood circularion

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12
Q

What does the lymphatic system use to transport the interstitial fluid back to the blood circulation?

A

Thoracic duct

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13
Q

Does the blood circulation have a one way or bi-directional course?

A

Bi-directional

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14
Q

What are the lymphatic vessels that come before the lymph nodes called?

A

Afferent lymphatic vessels

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15
Q

What are the lymphatic vessels that come after the lymph nodes called?

A

Efferent lymphatic vessels

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16
Q

Do lymphatic capillaries have a continuous basal membrane?

A

No it has a discontinuous basal membrane

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17
Q

Where are the elastic fibers found?

A

Only the capillaries

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18
Q

What kind of junction I found in the lymphatic cappilaires?

A

Button like junction

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19
Q

What kind of junction I found in the lymphatic ducts?

A

Zipper like junctions (has to be tight)

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20
Q

Are there valves in the lymphatic vessels?

A

Yes

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21
Q

What is the part of the vessels between two valves called?

A

Lymphangion

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22
Q

Different name for Lymphangion

A

Primitive hearts

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23
Q

4 types of external compression of the lymphatic vessels

A

Skeletal muscles
Cardiac muscle
Smooth muscles
Intestinal peristalsis

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24
Q

What happens when there is lymphatic pump dysfunction?

A

Lowered lymph flow
Increased Edema formation
Increased inflammatory cytokines and cells retention and local immune deficiency

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25
Q

Does the lymphatic system have a central pump?

A

No

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26
Q

What does the right lymphatic duct drain?

A

The right upper part of the trunk, right upper limb and right side of the head and neck

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27
Q

What are lymphoid organs classified as?

A

Primary or secondary organs

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28
Q

Which are the primary lymphoid organs?

A

Thymus and bone marrow

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29
Q

What are the primary lymphoid organs responsible for?

A

The production and maturation of lymphocytes

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30
Q

Which are the secondary lymphoid organs?

A

Spleen
Peyer’s patches
Appendix
Tonsils
Lymph nodes

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31
Q

What are the secondary lymphoid organs responsible for?

A

Further maturation of lymphocytes and initial of immune

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32
Q

What kind of organs are lymph nodes?

A

Full organs

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33
Q

Where are lymph nodes located?

A

Along the course fo the lymphatic collectors

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34
Q

What do the lymph nodes contain?

A

Lymphocyte B
Lymphocyte T

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35
Q

Shape of lymph nodes

A

Ovoid/bean shape

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36
Q

Size of lymph nodes

A

few mm - 1 cm

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37
Q

Where does lymphocyte B originate?

A

Bone marrow

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38
Q

Where does lymphocyte T originate?

A

Thymus

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39
Q

Are lymph nodes solid or hollow organ?

A

Solid organ

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40
Q

What is the lymph node built up of?

A

Capsule
Parenchyma
Trabecular of the capsule hilum

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41
Q

What is the stroma of the lymph node made up of?

A

Dense connective tissue and reticular stroma

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42
Q

Where in the lymph node are the plasma cells found?

A

In the medulla

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43
Q

Where in the lymph node are the macrophages cells found?

A

The medulla

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44
Q

Where in the lymph node are the lymphocytes cells found?

A

The medulla

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45
Q

How many efferent vessels from each lymph node?

A

1

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46
Q

How many afferent vessels in each lymph node?

A

Several

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47
Q

When does the follicles goes from primary to secondary?

A

When the b-cells go from naive to memory b-cells

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48
Q

What does the cortex of an unstimulated lymph node consist of?

A

Primary follicles composed of naive B cells

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49
Q

What are naive B cells?

A

Small, mature lymphocytes with condensed chromatin and scant cytoplasm

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50
Q

What is the location of the maturation of T-lymphocytes?

A

Thymus

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51
Q

Where is the thymus located?

A

Mostly in the anterior mediastinum and small part in the neck
Retrosternal

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52
Q

Is the thymus paired or unpaired?

A

Unpaired

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53
Q

What is each lobe of the thymus formed by?

A

A cortex and a medulla

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54
Q

Name of the neck of the thymus

A

Cornua of the thymus

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55
Q

Name of the lobes of the thymus

A

Thymic lobes

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56
Q

What is found inside the capsule of the thyroid?

A

The parenchyma (lymphoid tissue)

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57
Q

4 cells types of the thymus

A

T lymphocytes
TEC (thyme endothelial cells)
Macrophages
Dendritic cells

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58
Q

What allows for thymus homing?

A

Markers of the cell surfaces

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59
Q

What is positive selection?

A

Survival signal

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60
Q

What is negative selection?

A

Death signal

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61
Q

2 types of early fatal TEC

A

cTEC (cortex)
mTEC (medulla)

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62
Q

In which bones is there bone marrow?

A

Long bone

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63
Q

How much of total body weight is made of bone marrow?

A

3-5%

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64
Q

Where does hematopoiesis take place?

A

Bone marrow

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65
Q

What does the spleen consist of?

A

Large encapsulated mass of vascular and lymphoid tissue

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66
Q

Where is the spleen situated?

A

Upper left quadrant of the abdominal cavity

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67
Q

Which is the largest secondary lymphoid organ?

A

The spleen

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68
Q

Main spleen function

A

Destroy aged erythrocytes, aged platelets and repair young erythrocytes

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69
Q

What is the color and consistency of the spleen?

A

Dark red
Soft

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70
Q

What takes over hemocatheresis if the spleen is removed?

A

The liver

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71
Q

2 surfaces of the spleen

A

Diaphragmatic surface (external)
Visceral surface (internal)

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72
Q

Which surface of the spleen is convex?

A

The diaphragmatic surface

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73
Q

Which ribs does the spleen project on?

A

9-11th

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74
Q

Which rib is at the mid axis of the spleen?

A

10th

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75
Q

4 impressions on the visceral surface of the spleen

A

Gastric impression
Renal impression
Pancreatic impression
Colic impression

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76
Q

3 borders of the spleen

A

Superior/anterior border
Inferior/posterior border
Internal border

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77
Q

How much is the spleen covered by the peritoneum?

A

Entirely

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78
Q

Which artery supplies the spleen?

A

Splenic artery

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79
Q

Which vein drains the spleen?

A

Splenic vein

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80
Q

Which is the largest branch of the celiac trunk?

A

The splenic artery

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81
Q

What is white pulp in the spleen made of?

A

Lymphoid tissue

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82
Q

What does the white pulp in the spleen do?

A

Immune response

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83
Q

What does the red pulp in the spleen do?

A

Filtration of the blood (hemocateresis)

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84
Q

What does the splenic artery branch into when entering the hilum?

A

Trabecular arteries

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85
Q

What does the trabecular arteries in the spleen branch into when entering the white pulp?

A

Central arterioles

86
Q

What are the central arterials in the spleen covered by?

A

Seath of lymphocytes

87
Q

What does the central arterioles branch into when entering the red pulp?

A

Penicillar arterioles

88
Q

What do the penciller arterioles branch into?

A

Terminal capillaries

89
Q

What does the sinusoid of the spleen do?

A

Removal of damaged and aged erythrocytes

90
Q

Where in the spleen does immune screening happen?

A

White pulp

91
Q

What does the interstitial fluid enter the lymphatic system through?

A

Small lymphatic capillaries (internal or terminal lymphatics)

92
Q

What are the larger vessels in the lymphatic system called?

A

Pre-collectors
Collectors
Trunks
Ducts

93
Q

What is the interstitial fluid called when inside the lymphatics?

A

Lymph

94
Q

What prevents retrograde flow in the lymph vessels?

A

One-way valves (like in veins)

95
Q

What can lymph contain?

A

Proteins
Minerals
Fats
Nutrients
Cancer cells
Foreign invaders
Infection-fighting white blood cells

96
Q

What does the lymphatic vascular system regulate?

A

Tissue fluid
Homeostasis
Immune cell trafficking
Absorption of dietary fats

97
Q

Primary function of the lymphatic system?

A

Transport excess interstitial fluid from the interstitial space back to the blood circulation via the thoracic duct

98
Q

Does the lymphatic system play an important role in the dissemination of cancer cells?

A

Yes

99
Q

At which level does the lymphatic circulation start?

A

At the capillary level

100
Q

Do pre-collector vessels have valves?

A

Yes

101
Q

Which vessels have propulsive activity?

A

Afferent and efferent lymphatic vessels

102
Q

5 places where the major lymphatic trunks can be found

A

Intestinal
Lumbar
Bronchomediastinal
Subclavian
Jugular

103
Q

Name of 2 lymphatic ducts

A

Thoracic and right lymphatic

104
Q

Are lymphatic capillaries blind ends?

A

Yes

105
Q

How much are lymphatic endothelial cells covered by basement membrane?

A

Only partially

106
Q

What facilitates interstitial fluid and cellular entry into the lymphatic capillaries?

A

The button structures

107
Q

What anchors the lymphatic epithelial cells to the elastic components of the extracellular matrix?

A

Button structures

108
Q

2 routes of entry for interstitial fluids to the lymphatic capillaries

A

Paracellular
Transcellular

109
Q

What do lymphatic capillaries converge into?

A

Precollectors

110
Q

What do precollerctors converge into?

A

Lymphatics

111
Q

Where are zippers located?

A

Among the collector lymphatic epithelial cells

112
Q

Which lymphatic vessels have complete basement membrane and smooth muscle cell layers?

A

Lymphatics

113
Q

What allows for unidirectional lymph flow?

A

Lymphatic valves

114
Q

Which junctions are continuous, button or zipper?

A

Zipper

115
Q

What acts as primary valves for fluid and cell entry into lymphatics ?

A

Button junctions

116
Q

Which endothelial cells have button-like junctions?

A

Endothelial cells of initial lymphatics

117
Q

Which vessels have zipper-like junctions?

A

Collecting lymphatics and blood vessels

118
Q

Which junctions create the endothelial barrier in collecting lymphatics and blood vessels?

A

Zipper-like junctions

119
Q

What makes it possible for lymphangions to perform rhythmic contractions?

A

The fact that they are innervated with sympathetic and parasympathetic nerves

120
Q

What does the rhythmic contractions of the lymphangion do?

A

Pushes the lymph forward

121
Q

What is the propulsion of lymph a result of?

A

The combination of both active and passive mechanisms

122
Q

Do lymphatic capillaries have basement membranes?

A

No they lack basement membranes

123
Q

Are larger collecting lymphatics permeable?

A

No impermeable

124
Q

What transport lymph back to the venous circulation?

A

Collecting lymphatics

125
Q

Does the collecting lymphatics transport the lymph at high or low pressure

A

Low as it operates without a central pump

126
Q

Since the collecting lymphatic are a low pressure transport system what have they developed to facilitate fluid transport?

A

Features such a valves and smooth muscle cells which provide an intrinsic pumping force

127
Q

Which are the 2 largest lymphatic vessels?

A

Trunks and ducts

128
Q

Which lymphatic duct drains the most, the right lymphatic duct or the thoracic?

A

The thoracic (3/4th of the body)

129
Q

Which trunks drains the lymph of the abdomen and pelvis?

A

Left and right lumbar trunks
Intestinal trunk

130
Q

Which trunks drains the lymph of the head and neck?

A

Right and left jugular trunks

131
Q

Which trunks drains the lymph of the upper limb?

A

Right and left subclavian trunks

132
Q

Which trunks drains the lymph of the thoracic viscera?

A

Right and left broncomediastinal trunks

133
Q

Which is the largest duct in the body?

A

The thoracic duct

134
Q

Where does the thoracic duct originate?

A

The cisterna chyli

135
Q

Where is the cisterna chyli?

A

In the abdomen at level of T12

136
Q

How does the thoracic duct pass into the thorax?

A

Through the aortic hiatus of the diaphragm

137
Q

Where does the thoracic duct run?

A

Between the aorta (on the left) and the azygos vein (on the right) and posteriorly to the oesophagus

138
Q

Where does the thoracic duct end?

A

At the confluence of the internal jugular vein with the left subclavian vein

139
Q

How much of the whole body lymph does the thoracic duct drain?

A

3/4ths

140
Q

Is the right lymphatic duct constant?

A

No

141
Q

Where does the right lymphatic duct empty?

A

Into the right subclavian vein

142
Q

What do high endothelial venules allow for?

A

The entry of the lymphocytes into the node

143
Q

What happens to the lymph once its inside the lymph node?

A

It is filtered by immune cells of the parenchyma (mainly B and T lymphocytes)

144
Q

What does the cortex of an UNSTIMULATED lymph node consist of?

A

Primary follicles composed of naive B cells with an underlying meshwork of follicular dendritic cells

145
Q

What happens when a lymph nodes becomes activated by being exposed to antigen?

A

Germinal centers form in the center of B cell follicles
Primary follicle cells are pushed to the periphery where they form a mantle zone around the germinal center

146
Q

What makes up the mantle zone?

A

Primary follicles and a few memory B cells

147
Q

What is a secondary follicle made up of?

A

A germinal center and surrounding mantle zone

148
Q

What is a sentinel lymph node?

A

The first lymph node to which cancer cells are most likely to spread from a primary tumor

149
Q

Can there be more than one sentinel lymph node?

A

Yes

150
Q

Which organ controls and harmonises the entire immune system and the immune functioning of the organism?

A

The thymus

151
Q

Where do T-progenitor cells replicate and undergo maturation?

A

In the thymus

152
Q

What is the thymus covered by on the side?

A

Mediastinal part of the pleura parietalis

153
Q

Which large vessels and nerves run behind the thymus?

A

Aortic arch
Brachiocephalicae vein
Superior vena cava

154
Q

Where do large vessels and nerves run in relation to the thymus?

A

Behind

155
Q

What is the thymus connected to the thyroid gland by?

A

The thyrothymic ligament

156
Q

What moulds the shape of the thymus?

A

Adjacent structures

157
Q

What lies anteriorly to the thymus?

A

Sternohyoid and sternothyroid muscles and fascia
Manubrium sterni

158
Q

Which vein might be partly embedded in the thymus?

A

The left brachiocephalic vein

159
Q

What is the thymus in contact with posteriorly?

A

Vessels of the superior mediastinum
Upper part of the thoracic trachea
Anterior surface of the heart

160
Q

What cells types are found in the thymus?

A

Maturing T lymphocytes
Thymic endothelial cells (TEC)
Macrophage
Dendritic cells

161
Q

What is positive selection?

A

Survival signal

162
Q

What is negative selection?

A

Death signal

163
Q

Which cells enter the thymus to begin commitment to the T cell lineage?

A

Bone marrow derived lymphoid progenitor cells

164
Q

What does positive selection delineates selection of thymocytes into?

A

CD4, T-helper
CD8, cytotoxic T cell lineage

165
Q

Where do the cells migrate in the thymus after positive selection?

A

To the medulla

166
Q

What mediates negative selection in the thymus?

A

mTECs

167
Q

What happens to the cells in the thymus when they after positive selection go to the medulla?

A

They go through negative selection

168
Q

What does the process of thymopoiesis result in?

A

A population of peripheral blood and lymphoid sites with naive CD4+ and CD8+ T cells and CD4+ regulatory T cells (tregs)

169
Q

What does the establishment of self-tolerance in the thymus depend on?

A

Promiscuous gene expression (pGE) of tissue-restricted antigens (TRAs) by TECs

170
Q

What does the spleen consist of?

A

A large encapsulated mass of vascular and lymphoid tissue

171
Q

Which quadrant of the abdominal cavity is the spleen situated in?

A

Upper left/left hypochondrium

172
Q

Between what is the spleen located?

A

Between the fundus of the stomach and the diaphragm

173
Q

Which position is the spleen in?

A

Supramesocolic

174
Q

Is the spleen entirely lined by the peritoneum or only partly?

A

Entirely

175
Q

What is the supralateral aspect of the spleen shaped by?

A

The left dome of the diaphragm

176
Q

What is the inferomedial aspect of the spleen shaped by?

A

The splenic flexure of the colon, the left kidney and the stomach

177
Q

2 main functions of the spleen

A

Destroying aged erythrocytes (hemocatheresis) and aged platelets (catharsis of the platelets)
Repair young erythrocytes (pitting)

178
Q

What does the spleen process, blood or lymph?

A

Blood (its a second lymphoid organ)

179
Q

What does the spleen have reservoirs for?

A

Granulocytes and platelets

180
Q

Which is the external surface of the spleen?

A

Diaphragmatic surface

181
Q

Which is the internal surface of the spleen?

A

Visceral surface

182
Q

Which ribs does the projection of the spleen on the thoracic cage correspond to?

A

9th, 10th and 11th rib

183
Q

Which ligaments hold the spleen to the abdominal wall?

A

Folds of peritoneum:
Splenorenal
Phrenicocolic
Phrenicosplenic
Gastrosplenic ligament

184
Q

What attaches the spleen to the stomach?

A

The gastrosplenic ligament

185
Q

Which is the largest branch of the celiac trunk?

A

The splenic artery

186
Q

Where is the fibrous capsule of the spleen thick?

A

At the level of the hilum

187
Q

2 main components of the spleen

A

Red pulp
White pulp

188
Q

What is the white pulp of the preen composed of?

A

Lymphoid tissue

189
Q

What does the splenic artery divide into when it enters the hilum?

A

Trabecular arteries

190
Q

What does the trabecular arteries follow?

A

The course of the trabeculae

191
Q

What are the branches of the trabecular arteries that enters the white pulp called?

A

Central arterioles

192
Q

What are the central arterioles surrounded by?

A

A sheath of lymphocytes

193
Q

What happens to the death of lymphocytes that surround the central arterioles when they leave the white pulp and enter the red pulp?

A

It is lost

194
Q

What are the branches of central arterioles in the red pulp called?

A

Penicillar arterioles

195
Q

2 routes of blood flow though the splenic red pulp?

A

Open circulation
Closed circulation

196
Q

What is blood enclosed by in the closed circulation of the red pulp?

A

Epithelium cells

197
Q

What is the sinusoid of the human spleen like?

A

Barrel-like

198
Q

What does the sinusoid of the human spleen do?

A

Remove damaged or aged erythrocytes
Permits migration of leukocytes from the cords of billroth into the circulation

199
Q

How much of the blood in the spleen goes through the open circulation?

A

90%

200
Q

In which circulation of the spleen does immune screening take place?

A

Both

201
Q

What does the blood drain through in the open circulation of the spleen?

A

Through the walls of the capillaries

202
Q

What does the blood undergo when crossing the wall of the sinusoids to reenter the circulation in the open circulation?

A

Macrophage selection

203
Q

What happens to the capillaries in the closed circuit of the spleen?

A

It does directly into the sinusoids

204
Q

What lines the sinusoids?

A

Incomplete endothelium that is unique to the spleen

205
Q

What are the endothelial cells of the sinusoids called?

A

Stave cells

206
Q

What are stave cells connected by?

A

Intercellular junctions which alternate with intercellular slits

207
Q

What doe white pulp have the same organisation as?

A

Lymphnodes

208
Q

What is the term for unencapsulated lymphoid tissue that exists in the walls of the alimentary, respiratory, reproductive and urinary tracts and the skin?

A

Mucosa-associated lymphoid tissue (MALT)

209
Q

Subclasses of mucosa-associated lymphoid tissue

A

Gut-associated lymphoid tissue (GALT)
Bronchus-associated lymphoid tissue (BALT)

210
Q

Where are the lymphoid cells of MALT located?

A

In the lamina proprietor and the submucosa as discrete follicles or nodules

211
Q

What is the Waldeyer’s ring?

A

Circumpharyngeal ring of MALT which surrounds the openings into the digestive and respiratory tracts

212
Q

What is the Waldeyer’s ring made up by?

A

The tonsils and smaller collections of lymphoid tissue