Test #5: Lymphatic System Flashcards
How many functions of the lymphatic system?
3 functions
What are the 3 functions of the lymphatic system?
- Returns fluids leaked from the vascular system
- Protects the body against foreign matter
- Transports dietary fat
How much fluid is returned from the vascular system every day?
3 liters per 24 hours
What is the response that protects the body against foreign matter?
Immune response
How many parts to the basic anatomy of the lymphatic system?
5 parts
What are the 5 parts to the basic anatomy of the lymphatic system?
- Lymph vessels; 2. Lymph fluid; 3. Lymph cells; 4. Lymph tissue; and 5. Lymph organs
Lymph Vessels
Collect 10% of interstitial fluid left behind venous return.
How many types of lymph vessels?
6 types
What are the 6 types of lymph vessels?
- Lymph capillaries; 2. Lymph collecting vessels; 3. Lymph trunks; 4. Lymph ducts; 5. Cisterna Chyli; and 6. Lacteals
How big are lymph capillaries and where are they located?
a. Smallest of the lymphatic vessels.
b. Present everywhere you have blood capillaries (except the Central Nervous System and bone).
What are lymph capillaries designed to do and how?
a. They are designed to collect excess plasma left behind in the tissue.
b. They collect by hydrostatic pressure.
What is hydrostatic pressure?
The back pressure exerted on a membrane wall by a fluid.
Lymph Collecting Vessels
aka “lymphatics”
a. Lymph capillaries drain into these.
b. They follow alongside veins.
c. They are similar in structure to veins.
d. Many have valves.
Lymph Trunks
a. Lymph collecting vessels drain into these.
b. Lymph trunks drain major regions of the body.
What drains into lymph ducts and how many are there?
a. Lymph trunks drain into lymph ducts.
b. There are only 2.
What are the 2 lymph ducts?
- Right Lymphatic Duct; and 2. Thoracic Duct
What parts of the body drain into the right thoracic duct?
a. Right side of head
b. Right cervical
c. Right thoracic
d. Entire right upper extremity
What parts of the body drain into the thoracic duct?
Drains lymph from everywhere else
a. Left side of head
b. Left cervical
c. Left thoracic and abdomen
d. Entire left upper extremity
e. Pelvis and both lower extremities
Cisterna Chyli
Enlarged region at the proximal thoracic duct that collects lymph from the abdominal, thorax and lower extremities then travels up to the heart.
Where does the right lymphatic duct drain?
The right lymphatic ducts drains into the right subclavian vein -> right brachiocephalic vein -> superior vena cava -> right atrium.
Where does the thoracic duct drain?
The thoracic duct drains into the left subclavian vein -> left brachiocephalic vein -> superior vena cava -> right atrium.
Trace a drop of lymph from the right hallux to the heart.*
Lymph enters the lymph capillaries in the right hallux > drains into the lymph collecting vessels > drains into the lymph trunks > drains into the cisterna chyli > travels up the thoracic duct > drains into the left subclavian vein > drains into left brachiocephalic vein > drains into the superior vena cava > enters the right atrium of the heart.
Trace a drop of lymph from the right index finger (2nd digit) to the heart.*
Lymph enters the lymph capillaries in the right index finger > drains into the lymph collecting vessels > drains into the lymph trunks > drains into the right lymphatic duct > drains into the right subclavian vein > drains into right brachiocephalic vein > drains into the superior vena cava > enters the right atrium of the heart.
Lacteals
Specialized lymph capillaries which drain dietary fat in the small intestine.
Lymph Fluid
Lymph is filtered blood (interstitial fluid) which is collected by lymph capillaries.
Lymph Fluid: Characteristics
a. Clear fluid with dissolved fat and protein.
b. It may contain some waste product, electrolytes and cells (white blood cells).
c. It may have bacteria or viruses.
How many methods of lymph transport?
3 methods
What are the 3 methods of lymph transport?
- Skeletal muscle pump; 2. Respiratory pump; and 3. Contraction of lymph vessels
Lymph Fluid Transport: Skeletal muscle pump
Skeletal muscle contraction puts pressure on the lymph collecting vessels and forces lymph to flow toward the heart.
Lymph Fluid Transport: Respiratory pump
Diaphragm contracts increasing abdominal pressure. This puts pressure on the lymphatic vessels forcing lymph to flow toward the heart.
Lymph Fluid Transport: Contraction of lymph vessels
Large lymph vessels (trunks and ducts) have a thicker smooth muscle layer and can constrict to force lymph flow toward the heart.
How many types of lymph cells?
2 types
What are the 2 types of lymph cells?
- Lymphocytes; and 2. Macrophages
How many types of lymphocytes?
2 types
What are the 2 types of lymphocytes?
- B cells; and 2. T cells
What percentage of lymphocytes are B and T cells respectfully?
B cells - 30%
T cells - 70%
Where are B and T cells born?
They are born in red bone marrow.
Where do B and T cells become immunocompetent?
B cells - red _B_one marrow
T cells - _T_hymus gland
Where are B and T cells found in the body?
B cells - float in the blood and lymph but tend to anchor in lymph tissue (spleen & lymph nodes) to provide “immune surveillance”
T cells - travel in blood and lymph and circulate throughout the body needing to have foreign matter presented to them
What hormone is produced in the Thymus gland?
Thymosin
What is immunocompetence?
B and T cells learn to recognize and fight against foreign matter.
How many methods of lymphocyte mediated immunity?
2 methods
What are the 2 methods of lymphocyte mediated immunity?
- Antibody Mediated Immunity (AMI); and 2. Cell Mediated Immunity (CMI)
What method of lymphocyte mediated immunity do B and T cells fight by?
B cells - Antibody Mediated Immunity (AMI)
T cells - Cell Mediated Immunity (CMI)
Macrophages
a. A type of white blood cell with an insatiable appetite.
b. Phagocytize foreign matter.
c. They can leave the circulatory system.
d. They can act as an Antigen Presenting Cell (APC).
Lymph Tissue
Reticular fibers with lymphocytes and macrophages.
How many types of lymph tissue?
2 types
What are the 2 types of lymph tissue?
- Diffuse; and 2. Lymph follicles (nodules)
Lymph Tissue: Diffuse
Sheet-like lymph tissue found around organs providing a safety net.
Lymph Tissue: Lymph Follicles (Nodules)
Compacted reticular fibers with lymphocytes and macrophages found in lymph organs like the spleen.
Lymph Tissue/Organs: Tonsils
Falls between tissue and organs.
Unencapsulated lymphatic tissue present in the throat to trap debris entering the nose/mouth and to initiate an immune response.
How many types of tonsil tissue/organs?
4 types
What are the 4 types of tonsil tissue/organs?
- Palatine; 2. Lingual; 3. Pharangeal (Adenoids); and 4. Tubal
Tonsils: Palatine
Located at posterior oral cavity
Tonsils: Lingual
Located at base of tongue
Tonsils: Pharangeal (Adenoids)
Located in the throat between oral and nasal cavity
Tonsils: Tubal
Located at the openings of the auditory tubes
MALT
Mucosa Associated Lymph Tissue
Lymph tissue associated with mucus membranes (digestive, respiratory, urinary tracts, etc)
How many examples of mucosa associated lymph tissue (MALT)?
4 examples
What are 4 examples of mucosa associated lymph tissue (MALT)?
- Peyers patches in small intestines
- Appendix at proximal large intestine
- Tonsils
- Lymphoid nodules (respiratory tract bronchi)
How many lymph organs?
3 lymph organs
What are the 3 lymph organs?
- Lymph Nodes; 2. Spleen; and 3. Thymus
Lymph Nodes
a. Hundreds of kidney-shaped organs scattered around the body, many associated with connective tissue.
b. They are attached to lymph connecting vessels and they filter lymph of foreign matter.
c. They have more afferent than efferent vessels (more leading in than exiting).
How many regions of local accumulation of lymph nodes?
3 regions
What are the 3 regions of local accumulation of lymph nodes?
- Cervical (head and neck); 2. Axillary (U.E.); and 3. Inguinal (L.E.)
All are precautionary for massage.
Spleen
a. Located in the upper left quadrant, partially behind stomach.
b. Holds about 11 oz. of blood; filters blood (not lymph).
c. Destroys foreign matter and worn out red blood cells – “graveyard”
d. Responsible for immune surveillance (initiates an immune response)
e. B cell proliferation into plasma cells
Thymus
a. Located just above and partially overhanging the heart.
b. It is made up of epithelial cells, hormones and T cells. The hormone thymosin makes T cells immunocompetent.
c. Most active during puberty, then it atrophies and by old age the thymus is replaced by connective tissue and fat.
Vocab: Antigen
Anything that is foreign to the body (non-self).
Vocab: Pathogen
A disease-causing microorganism (bacteria or virus). An antigen that makes you sick.
How many major categories for fighting anything foreign in the body (non-self)?
2 major categories
What are the 2 major categories for fighting anything foreign in the body (non-self)?
- Non-specific defense; and 2. Specific defense
Non-Specific Defense
Any defense mechanism that is in place at birth to keep antigens out of the body. Provide general defense against anything foreign.
Non-Specific Defense: How many lines of defense are there?
2 lines of defense
Non-Specific Defense: What are the 2 lines of defense?
- First line of defense; and 2. Second line of defense
How many elements in the 1st line of defense?
3 elements (physical/chemical barrier)
What are the 3 elements in the 1st line of defense?
- Intact skin (epidermis); 2. Intact mucous membranes; and 3. Other physical/chemical defenses
1st line of defense: Intact skin (epidermis)
a. Tightly packed cells
b. Waterproofing layer
c. Keratin-dense protective protein
1st line of defense: Intact mucous membranes
“Sticky” to trap debris entering the nose/mouth
1st line of defense: Other physical/chemical defenses
Examples include: eyelashes, cilia, nose hairs, digestive acids, secretion on the skin (acid mantle), sneezing/coughing/vomiting reflexes, urine, acidity of vagina, etc.
How many elements in the 2nd line of defense?
4 elements (cellular & chemical defenses)
What are the 4 elements in the 2nd line of defense?
- Phagocytes; 2. Natural Killer Cells; 3. Inflammatory Response; and 4. Fever
2nd line of defense: Phagocytes
Macrophages (Langerhan’s cells), phagocytize antigens which enter connective tissue.
2nd line of defense: Natural Killer Cells*
a. A type of lymphocyte known as the “pit bull” of your defense mechanisms.
b. They will attack anything, mainly cancer and viruses.
c. They kill by chemical release to destroy the plasma membrane and nucleus.
d. Research indicates that massage therapy increases production of natural killer cells.
2nd line of defense: Inflammatory Response
Occurs anytime tissue (cells) are injured. The injured cells release chemicals which cause vasodilation to bring more blood to the area.
What are the classic signs of inflammation?
- Heat (increased blood flow and metabolic activity of WBCs)
- Redness (increased blood flow)
- Pain (increased pressure and chemicals irritate nerves)
- Swelling (edema – leaky capillaries)
- Decreased range of motion around joints
If inflammation is reported, how long do massage therapists need to avoid massage?
24-48 hours
2nd line of defense: Fever
a. Macrophage activity releases a chemical called Pyrogen which the Hypothalamus recognizes and resets your body temperature producing fever.
b. The fever causes your body to hold onto zinc and iron, which deprives bacteria.
c. The fever also increases the metabolic activity of your white blood cells.
Specific Defense
Our immune response.
How many characteristics of specific defense?
3 characteristics
What are the 3 characteristics of specific defense?
- Antigen specific; 2. Systemic; and 3. Memory
Specific Defense: Antigen specific
The response will only target the antigen that caused it.
Specific Defense: Systemic
Protection is not limited to the infection site.
Specific Defense: Memory
You will gain memory against the pathogen should you encounter it later in life.
How many cell types of the immune system?
3 types
What are the 3 cell types of the immune system?
- Antigen Presenting Cells; 2. B lymphocytes; and 3. T lymphocytes
Antigen Presenting Cells
APCs can be B cells or macrophages
What is the immune process for Antigen Presenting Cells?
The APC (B cell or macrophage) consumes the antigen via endocytosis > a lysosome (organelle) releases enzymes to break up and destroy the antigen > the antigen pieces are expelled form the APC via exocytosis > and displayed on the exterior of the plasma membrane for T cells to see.
Antibodies
a. Protein molecules which are specifically coded for the pathogen which triggered the immune response.
b. They do not fight; they attach to the pathogen marking it for destruction by other cells.
How many steps in the proliferation of B lymphocytes?
4 steps
What are the 4 steps in the proliferation of B lymphocytes?*
- The B cell enlarges and clones upon recognizing a pathogen
- Two daughter cells are produced, a plasma cell and a memory B cell
- The plasma cell produces antibodies at a rate of 2,000 per second; takes ~10 days to build up enough
- The memory B cell lies dormant awaiting another encounter with the pathogen in the future.
How many ways do we acquire immunity?
2 ways
What are the 2 ways we acquire immunity?
- Active immunity; and 2. Passive immunity
Active Immunity
You encounter the pathogen, battle against it and develop memory.
How do you naturally acquire active immunity?
You catch the disease and get sick.
How do you artificially acquire active immunity?
Vaccinations.
A weakened form of the pathogen is given to you. You don’t get sick, but you do develop memory.
Passive Immunity
You are given antibodies from a donor, and since you didn’t fight the pathogen no memory occurs.
How do you naturally acquire passive immunity?
Mother to child.
How do you artificially acquire passive immunity?
Examples include, snake bite kits, botulism, rabies, tetanus
How many steps in the proliferation of T lymphocytes?
6 steps
What are the 6 steps in the proliferation of T lymphocytes?*
- T cell enlarges and clones upon being presented with an antigen by an APC (B cell or macrophage).
- Four types of daughter cells are produced: 1) cytotoxic killer T cells; 2) helper T cells; 3) suppressor T cells; and 4) memory T cells.
- The cytotoxic killer T cells are the “main fighters” by releasing chemicals to destroy pathogens.
- The helper T cells are the “recruiters”; they don’t fight, but they release chemicals to alert other B cells and macrophages to fight the pathogen.
- The suppressor T cells don’t fight, but they release chemicals to shut off the battle once the pathogen has been defeated.
- The memory T cells lie dormant awaiting another encounter with the pathogen in the future.
Autoimmune Diseases
Your immune system attacks “self” or healthy tissue.
What are 2 theories of autoimmune diseases?
- Suppressor T cells don’t function and the battle is not turned off once the pathogen is defeated.
- Immunocompetent process was not sufficient.
Allergic Responses
The immune system gone awry.
How many types of allergic reactions?
2 types
What are the 2 types of allergic reactions?
- Delayed reaction (contact dermatitis); and 2. Immediate reaction
Allergic Response: Delayed reaction (contact dermatitis)
Chemicals such as soaps, detergents, perfumes, poison ivy, etc. cause T cells to accumulate under the skin and they begin to rapidly divide. Rashes and lesions in the skin can result.
Allergic Response: Immediate reaction
When pollens, bee sting, food allergies are introduced, B cells produce the wrong antibody (IgE). IgE attaches to mast cells, and when the antigen is reintroduced, they produce histamine causing vasodilation (redness, runny nose, watery eyes, respiratory airways to close down, etc.
