The RES Flashcards
Anatomy of the neck lymph glands
- anterior cervical chain
- submandibular
- submental
- pre auricular
- post auricular
- occipital
- supra clavicular nodes
- run along the anterior aspect of the trap muscles.
recall the lymphatic system *thoracic duct
inserts itself into the brachiocephalic trunk
lymph node anatomy
size of a little finger nail
shaped like a bake bean
will be reported from the shortest axis (middle)
lymph nodes communicate with each other. flows out through hilum. blood vessel feeds in
what comes in: naive cells from the bone marrow and will be switched on/dampened/amplified. e.g. a B cell coming in and expresses the antibody. then there is a linkage chain (HLA) and any self antibodies will get deleted. if the linkage does not work properly- auto imminity.
(lymph nodes goes up to it, tells it what it’s going to delete and gets deleted if it’s auto reated)
can get EXPANDED in the secondary folliclce
Secondary follicle segment?
cortex= predominantly where B cells are
get amplified (secondary follicles will expand) = that’s why you get enlarged lymph nodes. capsules stretch
Secondary follicle segment?
- cortex= predominantly where B cells are
get amplified (secondary follicles are expanding) = that’s why you get enlarged lymph nodes. capsules stretch. if it happens slowly, the capsule can stretch slowly too. rapid expansion can be uncomftorble (infection, malignancy, rapidly growing aggressive non-hodgkin lymphoma infiltrating)
- paracortical area: contains T cells.
- medullary core: contains macrophages and plasma cells (antibody producing T cells)
- fat
the spleen
the biggest lymph node we have
sits in the L hypochondrium.
covered by the ribs
dimensions 5 inches (12.5 cm) in long anxis 1 x 3 x 5 x 7 x 9 x 11 1/3 superior part 2/3 bottom part
spleen has to be very big to be able to feel it
*examination
anatomy of the spleen
red pulp= highly vascular part to the spleen. thick capsule.
*tiny venous lakes that will accumulate in the blood
RBC come here to be removed (e.g. mishapen / target cell)
white pulp
*primary and secondary follicles
? macrophages will bite off a bit of the RBC which will have a bit of RNA- removal.
capsulated organisms
meningococcus / pneumococcus
immunological function provided by the spleen is critical to fight capsulated organisms.
if no spleen - give penicillin.
anatomy of the spleen
red pulp= highly vascular part to the spleen. thick capsule.
*tiny venous lakes that will accumulate in the blood
RBC come here to be removed (e.g. mishapen / target cell)
white pulp
*primary and secondary follicles
? macrophages will bite off a bit of the RBC which will have a bit of RNA- removal.
capsulated organisms
meningococcus / pneumococcus
immunological function provided by the spleen is critical to fight capsulated organisms.
if no spleen (hyposplenia= if you have coeliac you can have a dysfunction spleen) - give penicillin.. people with sickle cell should be on penicillin their whole life.
lymphomas
name according to the cell it originated from (e.g follicular lymphoma)
mantel cell lymphoma from the mantel zone
proliferation of the lymphatic structure early- - follicular lymphoma - mantel cell lymphoma - plasma cells
T cell lymphoma
sometimes just localised to the skin (outside of the skin is very bad)
B cell lymphoma
non hodgkin lymphoma (B cell)
hodgkin lymphoma
(mixture of everything, not just B cells) reed-sternerg cell, owl
age= 25-30 y/o
second peak= 60 y/o
B cell non hodgkin lymphoma
1) indolent
2) aggressive
B cell non-hodgkin lymphoma
1) indolent
2) aggressive (rapidly proliferative + constitutional symptoms)
* measure the LDH
mx: chemotherapy (radiotherapy can be treated for residual/local lymphomas. hodgkin lymphoma with a mediastinal mass)
RT can cause myelodysplasia / AML in later years.
chemotherapy for B NHL
RCHOP ritoximab *MOA cyclophosphomadie hydroxyrubacin oncovin (finapristine?) prednisolone
steroids side effects= weight gain.
normal lymphocyte development
look up autoimmunity ….
