Lymphatic system

Theory Assignment #1 Advances in novel drug delivery systems By Nargis Aman FA12-R60-006

Department of Pharmaceutical Sciences COMSATS Institute of Information Technology Abbottabad-Pakistan 2013

Lymphatic system

The lymphatic system is part of the circulatory system, comprising a network of conduits called lymphatic vessels that carry a clear fluid called lymph (from Latin lympha "water goddess") directionally towards the heart. The lymph system is not a closed system. The circulatory system processes an average of 20 liters of blood per day through capillary filtration which removes plasma while leaving the blood cells. Roughly 17 liters of the filtered plasma actually get reabsorbed directly into the blood vessels, while the remaining 3 liters are left behind in the interstitial fluid. The primary function of the lymph system is to provide an accessory route for these excess 3 liters per day to get returned to the blood. Lymph is essentially recycled blood plasma.

Lymphatic circulation
As blood circulates through the body, blood plasma leaks into tissues through the thin walls of the capillaries. The portion of blood plasma that escapes is called interstitial or extracellular fluid, and it contains oxygen, glucose, amino acids, and other nutrients needed by tissue cells. Lymph is the fluid that is formed when interstitial fluid enters the initial lymphatic vessels of the lymphatic system. The lymph is then moved along the lymphatic vessel network by either intrinsic contractions of the lymphatic passages or by extrinsic compression of the

lymphatic vessels via external tissue forces (e.g. the contractions of skeletal muscles). The organization of lymph nodes and drainage follows the organization of the body into external and internal regions; therefore, the lymphatic drainage of the head, limbs, and body cavity walls follows an external route, and the lymphatic drainage of the thorax, abdomen, and pelvic cavities follows an internal route. Although most of this fluid seeps immediately back into the bloodstream, a percentage of it, along with the particulate matter, is left behind. The lymphatic system removes this fluid and these materials from tissues, returning them via the lymphatic vessels to the bloodstream, and thus prevents a fluid imbalance.

Lymphatico-venous communications
Once within the lymphatic system, the extracellular fluid, that is called lymph now, drains into larger vessels called the lymphatics. These vessels converge to form one of two large vessels called lymphatic trunks, which are connected to veins at the base of the neck. One of these trunks, the right lymphatic duct, drains the upper right portion of the body, returning lymph to the bloodstream via the right subclavian vein. The other trunk, the thoracic duct, drains the rest of the body into the left subclavian vein.

Figure: lymphatic nodes and cirulation

Lymph is transported along the system of vessels by muscle contractions, and valves prevent lymph from flowing backward. The lymphatic vessels are punctuated at intervals by small masses of lymph tissue, called lymph nodes that remove foreign materials such as infectious microorganisms from the lymph filtering through them.

Figure: Lymphatico-venous communications

Lymph nodes
A lymph node is an organized collection of lymphoid tissue, through which the lymph passes on its way to returning to the blood. Lymph nodes are located at intervals along the lymphatic system. Several afferent lymph vessels bring in lymph, which percolates through the substance of the lymph node, and is drained out by an efferent lymph vessel. a lymph node consists of lymphoid follicles in the outer portion called the "cortex" which contains the lymphoid follicles, and an inner portion called "medulla," which is surrounded by the cortex on all sides except for a portion known as the "hilum." The hilum presents as a depression on the surface of the lymph node, which makes the otherwise spherical or ovoid lymph node bean-shaped. The efferent lymph vessel directly emerges from the lymph node here. The arteries and veins supplying the lymph node with blood enter and exit through the hilum. All lymph nodes have the primary function of the production of lymphocytes, which help defend the

body against microorganisms and against harmful foreign particles and debris from lymph before it is returned to the blood stream. The primary function of every lymph node is production of lymphocytes, which help defend the body against microorganisms and against harmful foreign particles; and the removal of debris from lymph before it is returned to the blood stream.

Figure: A lymph node showing afferent and efferent lymphatic vessels Adenoids (Pharyngeal Tonsil) The adenoids, also known as the pharyngeal tonsils, are a part of the lymphatic system located in the back of the throat and up into the nasal cavity. Much like the tonsils (palatine tonsils), the adenoids are made up of folded lymphatic tissue, lined with epithelial cells, house mucosal glands, and are covered in cilia and mucus. One single such fold is termed an adenoid. The hair-like cilia on the ciliated epithelial cells wave within the throat like seaweed along the shore, constantly sweeping materials out of the throat to catch possible infectious agents, coat them in mucus, and send the resulting mass to the stomach for digestion before the allergens, viruses, etc. can be drawn into the lungs to cause infection.

Figure: adenoids and tonsils Cervical Nodes (Immune and Lymphatic Systems of the Head and Neck) The cervical nodes are one of the six major locations of lymph nodes. They are grouped along the lower border of the jaw, in front of and behind the ears, and deep in the neck along the larger blood vessels. They drain the skin of the scalp, face, tissues of the nasal cavity, and the pharynx.

Figure: cervical nodes Mediastinal Nodes (Immune and Lymphatic Systems of the Upper Torso) The mediastinal nodes are a group of lymph nodes located in the mediastinum, which is a section in the central part of the chest, just between the lungs.

Figure: mediastinal nodes Immune and Lymphatic Systems of the Leg and Foot The primary structures of the lymphatic and immune systems in the lower extremities are the lymph vessels. The large bones of the leg are also important, as these contain bone marrow that produces a large number of lymphocytes. The primary structures of the lymphatic and immune systems in the lower abdomen and pelvis are the cisterna chyli. Cysterna chyli The cisterna chyli is a dilated sac at the lower end of the thoracic duct into which lymph from the intestinal trunk and two lumbar lymphatic trunks flow. It receives fatty chyle from the intestines and thus acts as a conduit for the lipid products of digestion. It is the most common drainage trunk of most of the body's lymphatics. The bones of the pelvic girdle also as they contain red bone marrow which produces white blood cells.

Figure: cisterna chyli Cubital Nodes The cubital nodes or epitrochlear nodes (also called cubital lymph nodes or cubital glands) are two sets of lymphatic nodes located near the elbow of each arm. There is a superficial cubital node and a deep cubital node for each arm, together draining both the forearm and the hand on the ulnar side of the arm.

Inguinal Nodes The inguinal nodes are lymph nodes that are located in the legs and groin area. The nodes in this area receive lymph from the legs, the outer portion of the genitalia and the lower abdominal wall. Peyer's Patches Peyer's patches (or Peyer patches) are round or ovoid bundles of lymphatic tissue made up of unencapsulated lymphatic cells that protect the mucous membranes of the small intestines (the ileum) from infection.

Popliteal Nodes The popliteal nodes, or popliteal lymph nodes, include six or seven nodes and are located in the legs near the knees at the popliteal fossa.

Spleen
The spleen is a brown, flat, oval-shaped lymphatic organ that filters and stores blood to protect the body from infections and blood loss. The spleen is located between the stomach and the diaphragm at the left side of the abdominal body cavity. Spongy inner tissue within the spleen contains many tiny blood vessels and hollow sinuses that store blood. The spleen can release its stored blood into circulation to replace blood lost during a traumatic injury. Many platelets are also stored with the blood in the spleen to help form blood clots to prevent further blood loss.

figure: structure and location of spleen and thymus.

Thymus Gland
The thymus gland is a gland that forms part of the immune system. It is situated in the upper part of the chest, and is made up of two lobes that join in front of the trachea. Each lobe is made of lymphoid tissue, consisting of tightly packed white blood cells and fat. Its function is to transform lymphocytes (white blood cells developed in the bone marrow) into T-cells (cells developed in the thymus). These cells are then transported to various lymph glands, where they play an important part in fighting infections and disease. Swelling of lymph glands and fever are a signal that immune cells are multiplying to fight off invaders of the body: bacteria, fungi, viruses or parasites.

Functions
The lymphatic system is an extensive drainage network that helps keep bodily fluid levels in balance and defends the body against infections. It is made up of a network of lymphatic vessels that carry lymph a clear, watery fluid that contains protein molecules, salts, glucose, urea, and other substances throughout the body.

It is responsible for the removal of interstitial fluid from tissues It absorbs and transports fatty acids and fats as chyle from the digestive system It transports white blood cells to and from the lymph nodes into the bones The lymph transports antigen-presenting cells (APCs), such as dendritic cells, to the lymph nodes where an immune response is stimulated.

Function of the fatty acid transport system

Lymph vessels called lacteals are present in the lining of the gastrointestinal tract, predominantly in the small intestine. Fats (lipids) are passed on to the lymphatic system to be transported to the blood circulation via the thoracic duct. (There are exceptions, for example medium-chain triglycerides (MCTs) are fatty acid esters of glycerol that passively diffuse from the GI tract to the portal system). The enriched lymph originating in the lymphatics of the small

intestine is called chyle. The nutrients that are released to the circulatory system are processed by the liver, having passed through the systemic circulation.

Immune and Lymphatic Systems

The immune and lymphatic systems are two closely related organ systems that share several organs and physiological functions. The immune system is our bodys defense system against infectious pathogenic viruses, bacteria, and fungi as well as parasitic animals.

Immune and Lymphatic System Anatomy

Red Bone Marrow and Leukocytes Red bone marrow is a hematopoietic tissue containing many stem cells that produce blood cells. All of the leukocytes, or white blood cells, of the immune system are produced by red bone marrow. Leukocytes can be further broken down into 2 groups based upon the type of stem cells that produces them: myeloid stem cells and lymphoid stem cells.

Myeloid stem cells

Myeloid stem cells produce monocytes and the granular leukocytes (eosinophils, basophils, and neutrophils).

Monocytes
Monocytes form 2 types of cells: macrophages and dendritic cells. Macrophages. Monocytes respond slowly to infection and once present at the site of infection, develop into macrophages. Macrophages are phagocytes able to consume pathogens, destroyed cells, and debris by phagocytosis. Dendritic cells. Monocytes also develop into dendritic cells in healthy tissues of the skin and mucous membranes. Dendritic cells are responsible for the detection of pathogenic antigens which are used to activate T cells and B cells. Granular Leukocytes

Eosinophils. Eosinophils are granular leukocytes that reduce allergic inflammation and help the body fight off parasites. Basophils. Basophils are granular leukocytes that trigger inflammation by releasing the chemicals heparin and histamine. Neutrophils. Neutrophils use chemotaxis to detect chemicals produced by infectious agents and quickly move to the site of infection.

Lymphoid stem cells produce T lymphocytes and B lymphocytes.

T lymphocytes. T lymphocytes, are cells involved in fighting specific pathogens in the body. T cells may act as helpers of other immune cells or attack pathogens directly. After an infection, memory T cells persist in the body to provide a faster reaction to subsequent infection by pathogens expressing the same antigen. B lymphocytes. B lymphocytes are also cells involved in fighting specific pathogens in the body. Once B cells have been activated by contact with a pathogen, they form plasma cells that produce antibodies. Antibodies then neutralize the pathogens until other immune cells can destroy them. Natural killer cells. Natural killer cells are able to respond to a wide range of pathogens and cancerous cells. NK cells travel within the blood and are found in the lymph nodes, spleen, and red bone marrow where they fight most types of infection. ----------------------------