Unit 10_ Lymphatic System PDF

PRAYER BEFORE CLASS Holy Spirit, Divine Creator, true source of light and fountain of wisdom! Pour forth your brilliance upon my dense intellect, dissipate the darkness which covers me, that of sin and of ignorance. Grant me a penetrating mind to understand, a retentive memory, method and ease of le...

PRAYER BEFORE CLASS Holy Spirit, Divine Creator, true source of light and fountain of wisdom! Pour forth your brilliance upon my dense intellect, dissipate the darkness which covers me, that of sin and of ignorance. Grant me a penetrating mind to understand, a retentive memory, method and ease of learning, the lucidity to comprehend, and abundant grace in expressing myself. Guide the beginning of my work, direct its progress and bring it to successful completion. This I ask through Jesus Christ, true God, and true man, living and reigning with You and the Father, forever and ever. Amen.  UST General Santos School of Health Sciences Unit 10: The Lymphatic ANATOMY AND PHYSIOLOGY WITH PATHOPHYSIOLOGY System Course Content Lymphatic System Physiology ○ Innate Immunity ○ Adaptive Immunity Diseases of the Lymphatic System relevant to the Philippines Diagnostic Tests for Lymphatic System Disorders relevant to Medical Technologists Unit Intended Learning Outcomes: At the end of the unit, the student must be able to: describe the general functions of the lymphatic system integrate an understanding of its physiology with the pathophysiology of common diseases and conditions affecting this system Formative Assessment: GUESS THE WORD YMINTUMI Formative Assessment: GUESS THE WORD DOBELHTIWLOCELS Formative Assessment: GUESS THE WORD GIENTAN Formative Assessment: GUESS THE WORD SIDIEBOTAN Overview of Lymphatic System Components: Lymph Lymphatic vessels Lymphatic tissue Lymph nodules Lymph nodes Tonsils Spleen Thymus Overview of Lymphatic System Lymphatic capillaries and vessels remove excess fluid from tissues and absorb lipids from the small intestine. Lymph nodes filter _____, and the spleen filters _____ Functions of the Lymphatic System FLUID LIPID DEFENSE BALANCE ABSORPTION Functions of the Lymphatic System Approx. 30 L of fluid leave blood capillaries → enter the body's tissues daily ○ However, only 27 liters return to the blood ○ If the remaining 3 liters of fluid stay in the tissues → edema → tissue damage (potentially death) FLUID BALANCE Functions of the Lymphatic System Approx. 30 L of fluid leave blood capillaries → enter the body's tissues daily ○ However, only 27 liters return to the blood ○ If the remaining 3 liters of fluid stay in the tissues → edema → tissue damage (potentially death) FLUID Lymphatic ___________ collect these BALANCE excess 3 liters of fluid (lymph) Functions of the Lymphatic System Approx. 30 L of fluid leave blood capillaries → enter the body's tissues daily ○ However, only 27 liters return to the blood ○ If the remaining 3 liters of fluid stay in the tissues → edema → tissue damage (potentially death) FLUID Lymphatic capillaries collect these excess 3 BALANCE liters of fluid (lymph) _____ → lymphatic _______ → _____ ○ From blood plasma: ions, nutrients, gases, and proteins ○ From cells: hormones, enzymes, and waste products Functions of the Lymphatic System Lymphatic system absorbs lipids and other substances from the digestive tract through lacteals (lymphatic vessels located in the lining of the digestive tract) LIPID Lipids enter lacteals → lymphatic vessels → venous circulation ABSORPTION Functions of the Lymphatic System Lymphatic system absorbs lipids and other substances from the digestive tract through lacteals (lymphatic vessels located in the lining of the digestive tract) LIPID Lipids enter lacteals → lymphatic vessels → venous circulation ABSORPTION _____ Lymph passing through lymphatic vessels appears white d/t lipid content Functions of the Lymphatic System Microorganisms and other foreign substances are filtered: ○ from lymph by lymph nodes ○ from blood by spleen Lymphocytes and other cells are capable of DEFENSE destroying microorganisms and other foreign substances Anatomy of the Lymphatic System Lymph, lymphatic vessels, lymphatic tissues, and lymph nodes Tonsils Spleen Thymus Anatomy of the Lymphatic System Lymphatic vessels originate as small, dead-end tubes called lymphatic capillaries ○ Excess fluid from tissue spaces → tissue spaces → lymphatic capillaries → become lymph Lymphatic capillaries are found in most tissues of the body ○ Exceptions: ___, the bone marrow, and tissues without _____ _______ (such as cartilage, epidermis, cornea) Anatomy of the Lymphatic System Lymphatic capillaries are different from blood vessels in the following ways: ○ Lack a basement membrane ○ Their endothelial cells slightly overlap and are loosely attached to one another The lymphatic capillaries are far more _________ than blood capillaries Anatomy of the Lymphatic System The overlapping cells of the lymphatic capillary endothelium function as a series of one-way ______ ○ allow fluid to enter the capillary but prevent it from passing back into the interstitial spaces Anatomy of the Lymphatic System Anatomy of the Lymphatic System Lymph moves through lymphatic vessels by three mechanisms: ○ Contraction of lymphatic 1 vessels Lymph is pumped via smooth muscle contractions ○ Contraction of skeletal 2 muscles Surrounding skeletal muscle cells contract → lymphatic vessels are compressed → lymph is moved ○ 3 changes Thoracic pressure During inspiration, pressure in the thoracic cavity decreases, lymphatic vessels expand, and lymph flows into them. During expiration, pressure in the thoracic cavity increases, and lymphatic vessels are compressed, causing lymph to move. Anatomy of the Lymphatic System Lymph nodes: ○ round, oval, or bean-shaped bodies ○ distributed along the various lymphatic vessels After passing through the lymph nodes → lymphatic vessels form → lymphatic trunks Anatomy of the Lymphatic System Lymphatic trunks ○ Jugular trunks = Head and neck ○ Subclavian trunks = Upper limbs, superficial thoracic wall, and mammary glands ○ Bronchomediastinal trunks = Thoracic organs and the deep thoracic wall ○ Intestinal trunks = Abdominal organs ○ Lumbar trunks = Lower limbs, pelvic and abdominal walls, pelvic organs, ovaries or testes, kidneys, and adrenal glands Anatomy of the Lymphatic System The lymphatic trunks either connect to large veins in the thorax or join to yet larger vessels called lymphatic ducts, which then connect to the large veins Anatomy of the Lymphatic System Thoracic duct: largest lymphatic vessel ○ Approximately 38–45 cm in length ○ Extends from the twelfth thoracic vertebra to the base of the neck Drains lymph from the right side of the body inferior to the thorax and the entire left side of the body Lymphatic Tissue and Organs Lymphatic nodules are denser arrangements of lymphatic tissue organized into compact, somewhat spherical structures ○ Peyer patches = aggregations of lymphatic nodules in the distal half of the small intestine Lymph Nodes Small, round or bean-shaped structures ranging from 1 mm to 25 mm long ○ Distributed along the course of the lymphatic vessels Functions: ○ Filter the lymph, removing bacteria and other materials ○ In addition, lymphocytes congregate and proliferate within lymph nodes Lymph Nodes Overview of Immunity Innate immunity Adaptive immunity Immunity Ability to resist damage from foreign substances, harmful chemicals, and internal threats ______ IMMUNITY ________ IMMUNITY Nonspecific resistance Specific immunity Body defenses present at birth Acquired throughout a person’s lifetime Body recognizes and destroys foreign Body recognizes and destroys foreign substances BUT response is the same substances BUT response is faster and each time the body is exposed stronger each time the foreign substance is encountered Concepts: Specificity Ability of adaptive immunity to recognize a particular substance Example ○ innate immunity can act against bacteria in general, whereas adaptive immunity can distinguish among various kinds of bacteria M____y Ability of adaptive immunity to “remember” previous encounters with a particular substance Result: response is faster, stronger, and long lasting Innate Immunity Physical barriers White blood cells Inflammatory response Innate Immunity 1. ________ barriers: prevent microbes from entering the body or physically remove them from body surfaces 2. ________ mediators: act directly against microorganisms or activate other mechanisms to destroy microorganisms 3. Cells involved in ____________ and production of chemicals of the immune response Innate Immunity: Physical Barriers Prevent microbes from entering the body or physically remove them from body surfaces ○ Coughing and sneezing remove them from respiratory tract Skin and mucous membranes prevent entry of disease-causing agents into the body ○ Washed from the eyes by tears ○ Washed from the mouth by saliva ○ Washed from the urinary tract by urine ○ Ciliated mucous membranes sweep microbes trapped in the mucus to the back of the throat where they are swallowed Innate Immunity: Chemical mediators Molecules responsible for many aspects of the innate immunity Examples include: ○ Lysozymes in tears destroy microorganisms while mucus traps them to prevent them from reaching epithelial tissues ○ Histamine cause vasodilation, stimulates gland secretions (mucus and tear production) ○ Interferons interfere with virus production and infection ○ Complement attracts WBCs, promote phagocytosis ○ Pyrogens stimulate fever production Innate Immunity: Chemical mediators COMPLEMENT Group of proteins that destroy abnormal cells OR enhancing other components of immunity C1, C2, C3, C4, C5, C6, C7, C8, C9 Normally, they circulate in the blood in an inactive, nonfunctional form BUT they become activated in the complement cascade (series of reactions) INNATE: ALTERNATIVE PATHWAY Initiated when C3 becomes spontaneously activated If activated C3 does not interact with microorganisms → quickly inactivated If (+) infection, activated C3 combines with foreign substances Activated C3 becomes stabilized → stimulates the complement cascade Activated C3 & C5-9 → ________ ______ _______ (MAC) → ultimately destroys the cells Innate Immunity: White Blood Cells Most important cellular components of the immune system Produced in red bone marrow → released into blood → transported throughout the body To be effective: WBCs must move into the tissues where they are needed Attracted to chemical signals (chemotactic factors) Foreign body response to synthetic polymer biomaterials and the role of adaptive immunity - Scientific Figure on ResearchGate. Available from: https://www.researchgate.net/figure/Illustration-of-innate-and-adaptive-immune-system-cells-Innate-immune-responses-are_fig3_358644926 Innate Immunity: White Blood Cells C________S Movement toward the source of chemotactic factors PHAGOCYTOSIS Endocytosis by phagocytes (neutrophils and macrophages) Destruction of microbes or their parts, foreign substances, or dead cells from the body Foreign body response to synthetic polymer biomaterials and the role of adaptive immunity - Scientific Figure on ResearchGate. Available from: https://www.researchgate.net/figure/Illustration-of-innate-and-adaptive-immune-system-cells-Innate-immune-responses-are_fig3_358644926  Innate Immunity: White Blood Cells ______p__l First cells to leave blood and enter infected tissues; recruits other cells; phagocytosis and inflammation Monocyte Leaves the blood and enters tissues to become a macrophage Macrophage Most effective phagocyte; important in later stages of infection and in tissue repair; located throughout the body to “intercept” foreign sub- stances; processes antigens; involved in the activation of B cells and T cells Basophil Motile cell that leaves the blood, enters tis- sues, and releases chemicals that promote inflammation Foreign body response to synthetic polymer biomaterials and the role of adaptive immunity - Scientific Figure on ResearchGate. Available from: https://www.researchgate.net/figure/Illustration-of-innate-and-adaptive-immune-system-cells-Innate-immune-responses-are_fig3_358644926  Innate Immunity: White Blood Cells Mast cell Nonmotile cell in connective tissues that pro- motes inflammation through the release of chemicals __s_____i_ Enters tissues from the blood and defends against parasitic infections; participates in inflammation associated with asthma and allergies Natural Lyses tumor and virus-infected cells Killer (NK) Cell Foreign body response to synthetic polymer biomaterials and the role of adaptive immunity - Scientific Figure on ResearchGate. Available from: https://www.researchgate.net/figure/Illustration-of-innate-and-adaptive-immune-system-cells-Innate-immune-responses-are_fig3_358644926 INFLAMMATORY RESPONSE complex sequence of events involving many of the chemical mediators and cells of innate immunity Trauma, burns, chemicals, and infections can damage tissues, resulting in inflammation RECALL: 5 SYMPTOMS OF INFLAMMATION? Adaptive Immunity B and T cells Adaptive Immunity Ability of lymphocytes to recognize, respond to, and “remember” a particular substance Antigens: substances that stimulate the adaptive immunity ○ Foreign antigens: not produced by the body, introduced outside it Components of bacteria, viruses, other microorganisms Pollen, animal dander, food, drugs Transplanted tissues and organs ○ Self-antigens: produced by the body to stimulate adaptive immune response Tumor antigens Autoimmune disease Adaptive Immunity Antibody-mediated immunity Involves proteins called antibodies produced by ______ cells from B cells Ab found in plasma of blood, interstitial fluid, lymph Cell-mediated immunity Involves actions of _ ____s Cytotoxic T cells (CD8) Helper T cells (CD4) Foreign body response to synthetic polymer biomaterials and the role of adaptive immunity - Scientific Figure on ResearchGate. Available from: https://www.researchgate.net/figure/Illustration-of-innate-and-adaptive-immune-system-cells-Innate-immune-responses-are_fig3_358644926 Adaptive Immunity: Lymphocyte Activation General principles: Lymphocytes must recognize the antigen After recognition, lymphocytes must increase in # to destroy antigen Adaptive Immunity: Lymphocytes B cell After activation, differentiates to become plasma cell or memory B cell Plasma cell Produces antibodies that are directly or indirectly responsible for destroying the antigen Memory B cell Quick and effective response to an antigen against which the immune system has previously reacted; responsible for adaptive immunity Adaptive Immunity: Lymphocytes Cytotoxic T cell Responsible for destroying cells by lysis or by producing cytokines Helper T cell Activates B cells and cytotoxic T cells Regulatory T cell Inhibits B cells, helper T cells, and cytotoxic T cells Adaptive Immunity: Direct Effects of Antibodies Adaptive Immunity: Indirect Effects of Antibodies Adaptive Immunity: Indirect Effects of Antibodies Adaptive Immunity: Stimulation and Effects of T Cells Antigen activates T cells → series of divisions → cytotoxic and memory T cells Acquired Adaptive Immunity Disorders & Diagnostic Tests relevant to the Lymphatic System Effects of Aging on the Lymphatic System & Immunity Infections Hypersensitivities Effects of Aging on the Lymphatic System and Immunity Aging appears to have little effect on the lymphatic system’s ability to remove fluid from tissues, absorb lipids from the digestive tract, or remove defective red blood cells from the blood. However, aging has a severe impact on the adaptive immune system. Effects of Aging on the Lymphatic System and Immunity Thymus atrophies as we age → loses ability to produce new T cells ○ Decreased helper T-cell proliferation results in decreased antibody-mediated and cell-mediated immune responses to antigens Primary and secondary antibody responses decrease with age. The ability to resist intracellular pathogens decreases with age. Because these declines are most evident after age 60, it is recommended that regular ____________ be given before that age Infections of the Lymphatic System Lymphadenitis Inflammation of the lymph nodes Lymph nodes become enlarged and tender ○ Microorganisms are trapped and destroyed Infections of the Lymphatic System Lymphangitis Inflammation of the lymphatic vessels Visible red streaks in the skin that extend from the site of infection Diagnostic Tests Complete Blood Count Ultrasound (Lymph node) Fine needle aspiration ○ Gram stain of aspirated tissue ○ Culture of aspirated tissue Infections of the Lymphatic System Bubonic ______ Caused by a bacteria (Yersinia pestis) transmitted to humans via flea bites from rats Bacteria → blood → Septicemia → death Infections of the Lymphatic System Bubonic ______ Black Death in the Middle Ages Diagnostic Tests Bubonic ______ Lymph node aspirate Routine blood cultures Plague dipstick Immediate Hypersensitivities Symptoms occur within a few minutes of exposure to an antigen Antibodies are already present from prior exposure URTICARIA (aka Hives) Skin rash or localized ________; can be caused by an ingested antigen Immediate Hypersensitivities A____A Antigen combines with antibodies on mast cells or basophils in the lungs → inflammatory chemicals → cause constriction of the air tubes → patient has trouble breathing Immediate Hypersensitivities ANAPHYLAXIS Systemic allergic reaction often resulting from insect sting or drugs, such as penicillin Chemicals released from mast cells and basophils → systemic vasodilation, increased vascular permeability, drop in blood pressure, and possibly death Diagnostic Tests Complete Blood Count ○ Elevated eosinophils, basophils Allergy testing REVIEW Formative Assessment: GUESS THE WORD YMINTUMI Define IMMUNITY Formative Assessment: GUESS THE WORD DOBELHTIWLOCELS How will WHITE BLOOD CELLS be effective? Formative Assessment: GUESS THE WORD GIENTAN What are the 2 groups of ANTIGEN? Formative Assessment: GUESS THE WORD SIDIEBOTAN ANTIBODIES are produced by? Thank you!  UST General Santos School of Health Sciences Unit 10: The Lymphatic ANATOMY AND PHYSIOLOGY WITH PATHOPHYSIOLOGY System Dominican Blessing May God the Father bless us May God the Son heal us May God the Holy Spirit enlighten us Give us eyes to see with, ears to hear with, hands to do the work of God with, feet to walk with, and mouth to preach the word of salvation with; And may the angel of peace watch over us, and lead us at last by the Lord’s gift of the kingdom. Amen.