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Haematology > Lymphatics > Flashcards

Lymphatics Flashcards

1
Q

what are the two types of components of the lymphoid system?

A

Central (Primary)

Peripheral (Secondary) lymphoid tissues

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2
Q

what are the Central (Primary) lymphoid tissues?

A

o Bone marrow

o Thymus

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3
Q

what are the Peripheral (Secondary) lymphoid tissues?

A 
o	Lymph nodes
o	Spleen
o	Tonsils (Waldeyer’s ring)
o	Epithelio-lymphoid tissues
o	Bone marrow
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4
Q

precursor lymphoid cells that mature in the thymus become…

A

T cells

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5
Q

precursor lymphoid cells that mature in the bone marrow become…

A

B cells

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6
Q

what is the function of the lymphoid system?

A

• Filtration of circulatory fluids
• Location for cells of the immune system
(lymphoid and accessory)

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7
Q

what is the function of the lymphatic system?

A

Return lymph to the circulation

- fluid homeostasis, prevents oedema

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8
Q

what does the lymphatic system allow?

A

o Cell traffic
o Cell trapping
o Interaction with of cells and “molecules” with cells of the immune system – protective function

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9
Q

where are lymph nodes located?

A

Located along the course of lymphatic vessels

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10
Q

what are the structural features of lymphatic vessels?

A

o blind-ending vascular channels that collect fluid from tissues and return to blood stream
o passive movement of fluid
o valves ensure direction of flow

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11
Q

what is the flow of lymph drainage into lymphnodes?

A

Afferent channels - capsule - peripheral sinus - subcapsular sinus - hilus - efferent lymphatic

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12
Q

where do the efferent lymphatic vessels drain to?

A

Drains to:
- cisterna chyli / thoracic duct
- L jugular, subclavian or bronchomediastinal trunks
- R jugular, subclavian or bronchomediastinal trunks
And then to venous system at junction of L or R subclavian and jugular veins

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13
Q

what is the role of lymphnode groups?

A

drain particular territories

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14
Q

what is the histology of lymphnodes?

A
  • Follicles separated by interfollicular tissues (home to T cells)
  • B cells get activated in pale zone = germinal centre
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15
Q

what immune cells are found in lymph nodes?

A

B cells
T cells
NK cells
Also Mononuclear phagocytes, APCs and dendritic cells.

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16
Q

B cells are largely associated with what structure in the lymphnode?

A
  • Associated with follicles and germinal centres
  • Intrafollicular
  • Plasma cells – mainly in the medulla
17
Q

what are the different types of lymphnode enlargement?

A
  • Lymphadenopathy
  • Localised, more wide-spread or generalised
  • Peripheral or Central (internal)
18
Q

what are the causes of lymphadenopathy?

A

o Local inflammation - Infection, vaccination, dermatopathy
o Systemic inflammation - Infection, Autoimmune / CT disorders
o Malignancy - Haematological, Metastatic
o Others - e.g. Sarcoidosis, Castlemans Disease; IgG4 related disease

19
Q

what is the normal size and weight of the spleen?

A

up to 150-200g and 12x7x3cm

20
Q

what are the two key aspects of the spleen?

A
  • Diaphragmatic surface

* Visceral surface - Left Kidney, gastric fundus, tail of pancreas, splenic flexure of colon.

21
Q

what is the blood supply of the spleen?

A

Supplied by splenic artery (branch of coeliac axis) and drained by splenic vein (with SMV forms portal vein

22
Q

what is the structure of the spleen?

A

– An encapsulated organ.

– Parenchyma includes red pulp and white pulp

23
Q

what does the red pulp of the spleen contain?

A

sinusoids and cords.

24
Q

what does the white pulp of the spleen contain?

A

– comprises the peri-arteriolar lymphoid sheath (PALS).

– This is expanded by lymphoid follicles

25
Q

what are the features of splenic sinusoids?

A
  • fenestrated
  • lined by endothelial cells
  • supported by hoops of reticulin.
26
Q

what are the features of splenic cords?

A

contain macrophages and some fibroblasts and cells in transit (RBC, WBC, PC and some CD8+ T cells)

27
Q

what is the role of splenic red pulp?

A

acts as a filter for the blood
• Detect, retain and eliminate unwanted, foreign or damaged material
• Facilitate immune responses to blood borne antigens

28
Q

what is the role of splenic white pulp?

A

APCs in the white pulp present antigen to immune reactive cells

29
Q

what are the clinical features of splenomegaly?

A

 Dragging sensation in LUQ
 Discomfort with eating
 Pain if infarction

30
Q

what is the triad of clinical features of hypersplenism?

A

splenomegaly, fall in one or more cellular components of blood, correction of cytopenias by splenectomy

31
Q

what are the infective causes of splenomegaly?

A

Wide range: EBV, Malaria, TB, Typhoid, Brucellosis, Leishmaniasis, Trypanosomiasis,

32
Q

what is a type of splenic atrophy?

A

hyposplenism

33
Q

what are the causes of hyposplenism?

A

splenectomy

• Coeliac disease, Sickle cell disease, Sarcoidosis, Iatrogenic – non-surgical

34
Q

what are the clinical features of hyposplenism?

A

Howell-Jolly bodies, other red cell abnormalities (hypernucleated), immune deficiency

35
Q

what are the congestive causes of splenomegaly?

A

Portal (Hepatic cirrhosis, portal/splenic vein thrombosis, cardiac failure)

36
Q

what are the haematological causes of splenomegaly?

A

Lymphoma/leukaemia, haemolytic anaemia, ITP, Myeloproliferative disorders

37
Q

what are the inflammatory causes of splenomegaly?

A

Rheumatoid arthritis, SLE

38
Q

what are the storage disease causes of splenomegaly?

A

Gaucher’s, Niemann-Pick disease

39
Q

what are the miscellaneous causes of splenomegaly?

A

Amyloid, Tumours (primary and metastatic), cysts

Haematology (13 decks)

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