Vasc. U1 Lymphatic History PDF.pdf

The History of the Lymphatic System Unit 1 What do you know about the lymphatic system? ◦ What is the lymphatic system? ◦ Where is it? ◦ What does it do? ◦ What kind of tissues make up the lymphatic system? Do you know any specific ones? The Lymphatic System ◦ An open ended network of vessels,...

The History of the Lymphatic System Unit 1 What do you know about the lymphatic system? ◦ What is the lymphatic system? ◦ Where is it? ◦ What does it do? ◦ What kind of tissues make up the lymphatic system? Do you know any specific ones? The Lymphatic System ◦ An open ended network of vessels, tissues and organs that carries lymph ◦ A vital component of the immune system ◦ A role in maintaining fluid homeostasis by moving fluid from tissues to the cardiovascular system ◦ A pathway to allow the uptake of dietary lipids ◦ But how was the lymphatic system discovered? The Word Lymph ◦ Recognising the medical advances made in ancient Greece and Rome ◦ Ancient Greece: Nymph ◦ Mythical creature living in fresh flowing water ◦ Rome: Lympha ◦ Goddess of fresh water Medical Research in Relation to the Lymphatic System: A Time-Line First description in anatomical atlas Infected cervical lymph nodes discovered Defined as a systemic circuit 320 BC 460 310 BC BC 199 AD 1622 980 625 AD 1500 1787 1680 1674 1712 Linked to cancer 1917 1902 1970-80s 1927 MLD schools Recognised also in human intestines First mention, with work on animal intestines Process of lymph formation discovered 460 BC- Hippocrates ◦ The first recorded mention of the lymphatic system ◦ Whilst recording findings following dissections of dogs ◦ “Small vessels of white blood in the intestines” ◦ Chyle 310 BC- Herophilus and Erasistratus ◦ Some of the first to conduct human dissections in Greece ◦ Similar vessel system recognised surrounding tissues of human intestines ◦ Recognised that the liquid is not blood and is contained within a separate group of vessels Despite texts, there is no other evidence this true! 625 AD- The First Tonsillectomy ◦ Paul of Aegina performs the tonsillectomy ◦ ‘Protocol’ of procedure remains for 1200 years ◦ The group of specialised tissues removed are in fact infected lymph nodes ◦ Originally thought to be tissues collecting nasal secretions 690AD- Ancient Indian and Islamic Medicine ◦ Link discovered between a parasite and vessels within the human body ◦ These vessels were neither arteries or veins Social Distaste towards Human Dissection ◦ Through history shifts in culture changed… ◦ Previously, animal dissection accepted, allowing theories of human anatomy ◦ Number of human dissections minimal due to values of Catholic church and Roman society. ◦ Early 15th century- permission given for human dissections in French Universities ◦ Over 200 errors noted in the accepted anatomical atlas 1622 AD- Gaspare Aselli ◦ The first medical atlas is produced detailing the lymphatic vessels in the human intestine tissue ◦ The presence of specialised cells and valves within this system are discovered and recorded 1674- Jean Pecquet ◦ The largest vessels of the lymphatic system are described ◦ The expansion from the intestines through to the cardio vascular system is recognised The System Continues to Grow… ◦ 1680- Thomas Bartholin is the first to recognise that the system of vessels runs through the entire human body ◦ He names it the lymphatic system ◦ 1787- Mascagni recognises that this system is open ended, unlike the cardiovascular system, and produces a systemic atlas ◦ 1902- Virchow makes early descriptions of cancer and links them to lymphatic nodes The 1780s… Around the same time Mascagni detailed the lymphatic system in an anatomical atlas, vaccination was being established and small pox was eradicated. 1927- Starling ◦ If the system is open ended, how does the lymph arrive? ◦ Starling makes groundbreaking discoveries on the formation of lymph, which comes to be known as Starling’s principle From Discovery to Management ◦ 1917- Winiwarter is the first to use manual lymphatic drainage (MLD) in the treatment of lymphoedema in hospitals ◦ 1970-1980s- Training schools in MLD open firstly in Germany and then through Europe, where treatments of lymphoedema have then been developed through to present day ◦ Treatments used through history includeMLD, elevation, compression, prescribed exercises and education to allow long term management ◦ The effectiveness is continually assessed to this day, with new treatments being developed, and previously treatments being assessed for their effectiveness in different classifications of lymphoedema Recent Advances And Future Research ◦ It has long been understood that a correlation exists between lymph node involvement and poor cancer prognosis ◦ 1950-present day: ◦ Tumours discovered to release a lymphangiogenesis growth factor ◦ Certain tumours increase the number of lymphatic pathways, as well as their width ◦ This aids transport of cancerous cells to surrounding lymph nodes and then further along the pathways ◦ This growth factor is released prior to metastases appearing in lymphatic nodes ◦ Can anti-growth factors be used to prevent metastases occurring? The Mysterious Vascular System ◦ Due to the vessels being nearly invisible and the fluid virtually disappearing in cadavers, our knowledge of the lymphatic system remains relatively undeveloped compared to the cardiovascular system ◦ If the lymphatic system could be removed, we would die within 48 hours ◦ It moves over 3 litres of fluid a day ◦ ……but it has no pump The Lymphatic System V Cardiovascular System: A Time-Line First description in anatomical atlas Systemic circuit recognised as arteries shown to be between arteries and veins 16001500 BC First mention by ancient Egyptians who recognise link between arteries and heart Defined as a systemic circuit 320 BC 460 BC 310 BC 199 AD 1622 980 625 AD 1500 1787 1680 1674 1712 1917 1902 1970-80s 1927 Recognised also in human intestines First mention, with work on animal intestines Process of lymph formation discovered Lymphatic Units to Cover: ◦ Unit 2: Lymphatic system anatomy and physiology ◦ Unit 3: Lymphatic pathways ◦ Unit 4: Lymph formation ◦ Unit 5: An alternative diagnosis: lipoedema QUIZ On your smart phone, visit: Kahoot.it