LYMPHATIC SYSTEM

MUDr. Hisham El Falougy, PhD.hisham.elfalougy@fmed.uniba.sk

Lymphoid cells

Lymphoid organs: primary and secondary

Lymphoid vessels

lymph

The lymphoid cells

B lymphocytes

Plasma cells

Humeral immunity (IgG, IgA, IgM, IgD, IgE)

B memory cells

The lymphoid cells

T lymphocytes

Cellular imunity

Cytotoxic cells

Helper cells

Supressor cells

T memory cells

The lymphoid cells

Antigen-presenting cells

Macrophages

Epidermal Langerhans cells

Dendritic cells of lymphoid organs

M cells

The primary lymphoid organs

Bone marrow

Red bone marrow

Yellow bone marrow

Thymus

The secondary lymphoid organs

Spleen

Lymph nodes

Unencapsulated lymphoid tissue

Tonsils

LYMPHATIC SYSTEM

FUNCTIONS:

TRANSPORTS EXCESS INTERSTITIAL FLUID

ABSORBS AND TRANSPORTS FAT FROM

INTESTINE

IMMUNOLOGICAL FUNCTION

LYMPH AND LYMPH CAPILLARIES

LYMPH CAPILLARIES

SMALLEST LYMPHATIC VESSELS

CLOSED-ENDED TUBES

FORM NETWORK

IN THE INTERCELLULAR SPACES

LACTEALS (SMALL INTESTINE)

LYMPH AND LYMPH CAPILLARIES

LYMPH CAPILLARIES

ENDOTHELIUM

LACK A BASAL LAMINA

PERMAEABLE TO LARGER MOLECULES

LYMPH AND LYMPH CAPILLARIES

LYMPH CAPILLARIES ABSENT FROM:

AVASCULAR STRUCTURES

CNS

BONE MARROW

VERY FEW IN ENDOMYSIUM OF SKELETAL MUSCLES

LYMPH AND LYMPH CAPILLARIES

LYMPH

FILTRATE OF PLASMA

CLEAR AND COLOURLESS

DENSE AND MILKY

CHYLE

LYMPHATIC VESSELS

LYMPH CAPILLARIES JOIN INTO LARGER

LYMPHATIC VESSELS

PASS TO LOCAL OR REMOTE LYMPH

NODES

REPAIR EASILY

Lymphatic vessels and lymph

Vasa lymphocapillaria

Rete lymphocapillare

Collectores lymphatici (vasa lymphatica)

Vasa afferentia and Vas efferens

Trunci lymphatici

LYMPHATIC VESSELS

SAME LAYERS OF VEINS

TUNICA INTIMA (ENDOTHELIUM+FIBROUS TISSUE)

TUNICA MEDIA (SMOOTH MUSCLE)

TUNICA ADVENTITIA(CONNECTIVE TISSUE+NERVE

FIBERS)

CONTAIN VALVES TUNICA INTIMA

SEMILUNAR

MOVEMENT OF LYMPH

FILTERATION PRESSURE

CONTRACTION OF MUSCLES

PULSATION OF ARTERIES

RESPIRATORY MOVEMENTS

NEGATIVE BP IN BRACHIOCEPHALIC VEINS

SMOOTH MUSCLES IN TUNICA MEDIA

LYMPH NODES

ENCAPSULATED OVAL BODIES

0.1-2.5 cm LONG

LYING IN THE COARSE OF LYMPHATIC

VESSELS

HILUM:

BLODD VESSELS ENTER AND LEAV

EFFERENT LYMPH VESSLE EMERGES

LYMPH NODES

SEVERAL AFFERENT LYMPHATIC

VESSELS ENTER PERIPHERALLY

CORTEX

MEDULLA

LYMPH NODES

CAPSULE AND TRABECULAE

COLLAGEN, FIBROBLASTS, ELASTIN

RETICULUM

RETICULIN

IN SPACESES ENCLOSED BY CAPSULE AND

TRABECULAE

SUPPORTS CELL MASSES

LYMPH NODES

LYMPHATIC CHANNELS

PASSAGE OF LYMPH

ENDOTHELIUM

MACROPHAGES

T AND B LYMPHOCYTES

SUBCASULAR SINUS

CORTICAL SINUSES

MEDULLARY SINUSES

LYMPH NODES

LYMPHOID FOLLICLES

GERMINAL CENTER (LYMPHOBLSTS)

MANTLE ZONES

MEDULLARY ZONES

LYMPH NODES

FUNCTIONS

LYMPH FILTERS

EXPOSURE OF FOREIGEN MATERIAL TO

MACROPHAGES

TRAPPING OF ANTIGENS

PRODUCTION OF LYMPHOCYTES

IMMUNE RESPONSE

CIRCULATION OF LYMPHOCYTES

TOPOGRAPHICAL NAMING OF LYMPH NODES

SUPERFICIAL OR DEEP

RELATED VASCULATURE

RELATED ORGAN

GENERAL TOPOGRAPHICAL POSITION

Regional lymph nodes

Head

Nodi occipitales

Nodi mastoidei

Nodi parotidei

Nodi submandibulares

Nodi faciales

Nodi submentales

Neck

Nodi cervicales laterales superficiales

Nodi cervicales laterales profundi

Nodi cervicales anteriores superficiales

Nodi cervicales anteriores profundi

Truncus jugularis dexter et sinister

The upper limb Nodi cubitales superficiales et profundi

Nodi lymphatici axillares Nodi brachiales

Nodi interpectorales (Node of Sorgius)

Nodi paramammarii

Nodi subscapulares

Nodi centrales

Nodi apicales

Plexus lymphoideus axillaris

Truncus subclavius

LYMPHATIC DRAINAGE OF MAMMARY GLANDS

PECTORAL LYMPH NODES

SUBSCAPULAR LYMPH NODES

APICAL LYMPH NODES (SUPERIOR REGION)

AXILLARY NODES RECEIVE 75% OF LYMPH

PARASTERNAL LYMPH NODES

Thorax

Nodi parasternales

Nodi intercostales

Nodi prevertebrales

Nodi phrenici superiores

Thorax

Nodi mediastinales anteriores

Nodi mediastinales posteriores

Nodi pulmonales

Nodi bronchopulmonales

Nodi tracheobronchiales (superiores et inferiores

Nodi paratracheales

Truncus bronchomediastinalis

Pelvis and abdomen

Nodi iliaci externi

Nodi iliaci interni

Nodi sacrales

Nodi iliaci communes

Nodi lumbales

Nodi epigastrici inferiores

Nodi phrenici inferiores

Truncus lumbalis

Pelvis and abdomen Nodi paravesicales

Nodi paravaginales

Nodi parauterini

Nodi pararectales

Nodi coeliaci

Nodi gastrici

Nodi hepatici

Nodi pancreaticoduodenales

Nodi lienales

Nodi mesenterici

Nodi ileocolici

Nodi colici

Truncus intestinalis

The lower limb

Nodi poplitei

Nodi inguinales superficiales

Nodi inguinales profundi

Cisterna chyli

Ductus thoracicus

Ductus lymphaticus dexter

LYMPHATIC VESSELS

TWO PRINCIPAL LYMPHATIC VESSELS

THORACIC DUCT

DRAINS LYMPH FROM: LOWER LIMBS, ABDOMEN,

LEFT THORACIC REGIN, LEFT UPPER LIMB, LEFT

SIDE OF HEAD AN NECK

DRAINS INTO THE JUNCTION OF LEFT SUBCLAVIAN

VEIN AND LEFT INTERNAL JUGULAR VEIN

LYMPHATIC VESSELS

TWO PRINCIPAL LYMPHATIC VESSELS

RIGHT LYMPHATIC DUCT

DRAINS LYMPH FROM: RIGHT THORACIC REGION,

RIGHT UPPER LIMB, RIGHT SIDE OF HEAD AN NECK

DRAINS INTO THE JUNCTION OF RIGHT

SUBCLAVIAN VEIN AND RIGHT INTERNAL JUGULAR

VEIN

THORACIC DUCT

LEFT JUGULAR TRUNK

LEFT SUBCLAVIAN TRUNK

LEFT BRONCHOMEDIASTINAL TRUNK

BILATERAL DESCENDING THORACIC LYMPH TRUNKS

BILATERAL ASCENDING LUMBAR TRUNKS

LEFT UPPER INTERCOSTAL TRUNKS

MEDIASTINAL TRUNKS

ABDOMINAL CONFLUENCE OF LYMPH TRUNKS CISTERNA CHYLI

LUMBAR TRUNKS

INTESTINAL LYMPH TRUNKS

RIGHT LYMPHATIC DUCT

RIGHT JUGULAR TRUNK

RIGHT SUBCLAVIAN TRUNK

RIGHT BRONCHOMEDIASTINAL TRUNK

Unencapsulated lymphoid tissue

Lymphoid follicles (nodules)

Urinary tract

Digestive tract (Peyer’s patches)

Upper respiratory tract

Tonsils

Palatine

Pharyngeal

Lingual

Pharyngeal circle of Waldeyer

Tonsilla tubaria