S6) Lymphatic System Flashcards

1
Q

How does the lymphatic system work in relation to the venous system?

A

The lymphatic system collects 3 litres per day of interstitial fluid and returns it to the venous system

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2
Q

State the names of the fluid and vessels of the lymphatic system

A
  • Fluid – lymph
  • Vessels – lymphatics
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3
Q

Identify the cells of the lymphatic system

A
  • Lymphocytes: B cells, T cells and NK cells
  • Supporting cells: follicular dendritic cells and macrophages
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4
Q

Identify the tissues of the lymphatic system

A

Mucosal associated lymphatic tissue (MALT):

  • Gut-associated lymphatic tissue (GALT)
  • Bronchus-associated lymphatic tissue (BALT)
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5
Q

Identify the organs of the lymphatic system

A
  • Lymph nodes
  • Thymus
  • Spleen
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6
Q

Identify the lymphatic nodules of the lymphatic system

A
  • Tonsils
  • Peyer’s patches
  • Vermiform appendix
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7
Q

What 3 factors help to propel lymph along?

A
  • Skeletal muscle movement
  • Pressure changes in the thorax during breathing
  • Pulsations of adjacent arteries
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8
Q

Describe the arrangement of lymphatic vessels in the body

A
  • Lymphatics tend to lie adjacent to arteries and veins
  • Lymphatics are arranged into superficial and deep (deep to the deep fascia)
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9
Q

In which region of the body are there no lymphatics?

A

The Central Nervous System

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10
Q

What are the functions of lymph nodes?

A
  • Serve as filters for lymph: traps antigen, processes antigen and presents processed antigen to T cells
  • Contains macrophages, B cells and T cells which work to produce an inflammatory response (macrophages) then an immune response (B & T cells)
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11
Q

Approximately how many lymph nodes are there in the human body?

A

700

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12
Q

Describe the structure of each lymph node

A
  • Afferent lymphatics that enter via the convex surface
  • Efferent lymphatics that leave via the hilum
  • Feeding artery that leaves via the hilum
  • Draining vein that leaves via the hilum
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13
Q

How do lymphocytes enter lymph nodes?

A
  • Enter via the feeding artery
  • Leave via the efferent lymphatics
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14
Q

Account for possible causes of lymphadenopathy

A
  • Infection as germinal centres in lymph nodes fill with lymphocytes
  • Lymphoma as cancer metastasises to afferent lymphatics
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15
Q

Lymph nodes contain professional antigen presenting cells (APCs).

What is the role of such cells?

A

APCs are specially equipped with immunostimulatory receptors to acquire and present antigens which allows for enhanced activation of T cells

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16
Q

What is the structure, function and location of follicular dendritic cells?

A
  • Structure: contain antigen-antibody complexes adhere to its dendritic processes
  • Function: cause proliferation of B cells, in particular, memory B cells
  • Location: found in germinal centres
17
Q

Outline the inflammatory response

A
  • Initial reaction of the body to an antigen
  • Mediated by neutrophils and/or macrophages
  • Degradation of the antigen may lead to presentation of a portion of the antigen to elicit a specific immune response
18
Q

Outline the humoral response

A

- Humoral immunity is B lymphocyte mediated

  • It involves B lymphocytes which transform into plasma cells that synthesise and secrete a specific antibody
19
Q

What is cell-mediated immunity?

A

Cell-mediated immunity is when T cells need antigen presenting cells (macrophages, B lymphocytes) to recognise antigens

20
Q

What is the importance of cell-mediated immunity?

A

Important in defence against:

  • Viral, fungal and mycobacterial infections
  • Tumour cells
  • Transplant rejection
21
Q

Outline the structure, function and location of the thymus gland

A
  • Structure: fully formed and functional at birth, involutes after puberty and ends up being mostly fat
  • Function: maturation of bone marrow derived stem cells into immunocompetent T cells (thymic cell education)
  • Location: found in superior mediastinum
22
Q

The spleen is the largest lymphatic organ and has a very rich blood supply.

Outline its immune functions

A
  • Antigen presentation
  • Activation and proliferation of B and T lymphocytes
  • Production of antibodies
  • Removal of macromolecular antigen from blood
23
Q

The spleen is the largest lymphatic organ and has a very rich blood supply.

Outline its haemopoietic functions

A
  • Removal and destruction of old, damaged and abnormal erythrocytes and platelets
  • Retrieval of iron from erythrocyte haemoglobin
24
Q

Discuss the implications of a splenectomy

A
  • Splenectomy increases the risk of infection by encapsulated bacteria e.g. the meningococcus, malaria
  • Splenectomy increases the risk of DVT and pulmonary embolism
25
Q

Which organs/structures perform the spleen’s functions after a splenectomy?

A

Liver and bone marrow take over the removal & destruction of old RBCs

26
Q

Distinguish between the lymph node and spleen response to infection

A
  • Lymph nodes enlarge in response to local infection
  • Spleen enlarges in response to systemic infection e.g. glandular fever, malaria, septicaemia
27
Q

What is phagocytosis?

A

Phagocytosis is a specific form of endocytosis by which cells internalise solid matter, including microbial pathogens

28
Q

Identify the professional phagocytes of the immune system

A
  • Macrophages
  • Neutrophils
  • Immature dendritic cells
29
Q

Outline the 5 steps in the process of phagocytosis

A

⇒ Binding of opsonins and/or PAMPs to cell surface receptors on the phagocyte

⇒ Receptor clustering which triggers phagocytosis

⇒ Cell membrane then extends around the target, forming a phagosome

⇒ Phagosome fuses with lysosomes & acidifies to form a phagolysosome

⇒ Contents are degraded by hydrolytic enzymes

30
Q

What is opsonisation?

A

Opsonisation is the molecular mechanism whereby molecules, microbes, or apoptotic cells are chemically modified to have stronger interactions with cell surface receptors on phagocytes and NK cells

31
Q

What effect does opsonisation have?

A
  • With the antigen coated in opsonins, binding to immune cells is greatly enhanced
  • Opsonisation also mediates phagocytosis via signal cascades from cell surface receptors
32
Q

What is complement?

A

Complement consists of a group of serum proteins that activates inflammation, destroys cells and participates in opsonisation

33
Q

Complement proteins respond in a sequential manner called the complement cascade.

Describe the Classical pathway in the complement cascade

A

Classical pathway – C1 is activated when it binds to an antigen-antibody complex

34
Q

Complement proteins respond in a sequential manner called the complement cascade.

Describe the Alternative pathway in the complement cascade

A

Alternative pathway – C3b is activated when it reacts with antigens such as bacterial cell wall

35
Q

What are the results of both of the different complement cascades ?

A
36
Q

What is oedema?

A

Oedema is an accumulation of an excessive amount of watery fluid in cells, tissues or serous cavities

37
Q

What is lymphoedema?

A

Lymphoedema is swelling (especially in subcutaneous tissues) due to obstruction of lymphatic vessels or lymph nodes and the accumulation of large amounts of lymph in the affected region

38
Q

Describe the appearance of lymphoedema

A

Lymphoedema is non-pitting oedema due to the build-up of lymph and protein in the interstitial space

39
Q

How does oedema change with position?

A
  • If someone is standing up, oedema often appears first at the ankles (gravity)
  • If someone is lying down/sitting in bed, the oedema is expected to appear in the sacral region