CHAPTER 6:CHAPTER 6:

THE LYMPHATIC AND THE LYMPHATIC AND IMMUNE SYSTEMSIMMUNE SYSTEMS

The Lymphatic SystemThe Lymphatic System

Functions and Functions and StructuresStructures– Lymph FluidLymph Fluid– Lymph VesselsLymph Vessels– Lymph NodesLymph Nodes– The TonsilsThe Tonsils– The Vermiform The Vermiform

AppendixAppendix– The SpleenThe Spleen– The ThymusThe Thymus

Pathology and Pathology and DiagnosticDiagnostic ProceduresProcedures– LymphadenitisLymphadenitis– LymphadenopathyLymphadenopathy– LymphangiogramLymphangiogram– LymphangiomaLymphangioma– LymphedemaLymphedema– SplenomegalySplenomegaly– SplenorrhagiaSplenorrhagia

Primary functions of the Lymphatic Primary functions of the Lymphatic System are:System are:

– Return cellular waste products and excess fluid Return cellular waste products and excess fluid from the tissues to the circulatory systemfrom the tissues to the circulatory system

– Absorb fats and fat-soluble vitamins from the Absorb fats and fat-soluble vitamins from the digestive system and transport them to the digestive system and transport them to the cellscells

– Serve as an important part of the immune Serve as an important part of the immune systemsystem

Lymph Fluid/Vessels/NodesLymph Fluid/Vessels/Nodes Lymph:Lymph:

– Lymph fluid, Lymph fluid, also known as interstitial fluid, intercellular, or also known as interstitial fluid, intercellular, or tissue fluid is a form of plasma that comes out from the tissue fluid is a form of plasma that comes out from the capillaries and into the spaces to provide food, oxygen, and capillaries and into the spaces to provide food, oxygen, and hormones to the cells.hormones to the cells.

– LymphLymph is the remaining or left over that fluid that has not been is the remaining or left over that fluid that has not been reabsorbed. It removes cellular waste products, pathogens, reabsorbed. It removes cellular waste products, pathogens, and dead blood cells from the surrounding tissues.and dead blood cells from the surrounding tissues.

Lymph VesselsLymph Vessels– Lymph capillariesLymph capillaries:: thin tubes that carry lymph from the tissues thin tubes that carry lymph from the tissues

to the larger to the larger lymph vessels.lymph vessels.– Have one-way valves that only allow lymph flow into the Have one-way valves that only allow lymph flow into the

thoracic cavitythoracic cavity

Lymph Nodes:Lymph Nodes: located in the lymph vessels, provide a site for located in the lymph vessels, provide a site for lymphocyte production and removes bacteria, viruses, and lymphocyte production and removes bacteria, viruses, and malignant cells out of the lymph fluid.malignant cells out of the lymph fluid.– Cervical: neckCervical: neck– Axillary: armpitAxillary: armpit– Inguinal: groinInguinal: groin

TonsilsTonsils– Form a protective ring around the nose an Form a protective ring around the nose an

upper throatupper throatAdenoidsAdenoids: located in the nasopharynx: located in the nasopharynxPalatinePalatine: located in the back of the throat, : located in the back of the throat,

visible through open mouthvisible through open mouthLingualLingual: located at the base of the tongue: located at the base of the tongue

Vermiform AppendixVermiform Appendix– Hangs from the lower portion of the cecum on Hangs from the lower portion of the cecum on

the large intestinethe large intestine– Located in the right lower quadrantLocated in the right lower quadrant– Peyer’s patches are located in the ileum, the Peyer’s patches are located in the ileum, the

last segment of the small intestine and hang last segment of the small intestine and hang from the intestinal walls.from the intestinal walls.

The SpleenThe Spleen– Located in the left upper quadrant, just posterior Located in the left upper quadrant, just posterior

to the stomachto the stomach– Filters foreign material and microorganisms from Filters foreign material and microorganisms from

the bloodthe blood– Is Is hemolytic:hemolytic: removes and destroys worn-out red removes and destroys worn-out red

blood cellsblood cells– Maintains balance between red blood cells and Maintains balance between red blood cells and

plasma in the circulation as it stores extra RBC’splasma in the circulation as it stores extra RBC’s– Forms lymphocytes and monocytes (wbc)Forms lymphocytes and monocytes (wbc)

The ThymusThe Thymus– Located superior to the heartLocated superior to the heart– Plays important role in the endocrine/immune Plays important role in the endocrine/immune

systemssystems

spleen

thymus

tonsils

appendix

WBCmonocyte

lymphocyte

Pathology and DiagnosticPathology and Diagnostic Procedures – Procedures – of Lymphatic Structuresof Lymphatic Structures

LymphadenitisLymphadenitis:: inflammation of lymph nodes inflammation of lymph nodes Lymphadenopathy:Lymphadenopathy: disease process usually disease process usually

involving enlargement of the lymph nodesinvolving enlargement of the lymph nodes Lymphangiogram:Lymphangiogram: Radiographic contrast study of Radiographic contrast study of

the lymph vessels and nodesthe lymph vessels and nodes Lymphangioma:Lymphangioma: benign mass of lymphatic benign mass of lymphatic

vesselsvessels LymphedemaLymphedema:: improper drainage of lymph improper drainage of lymph

vessels or veins resulting in abnormal vessels or veins resulting in abnormal accumulation of fluid in legs and anklesaccumulation of fluid in legs and ankles

Splenomegaly:Splenomegaly: enlargement of the spleen enlargement of the spleen Splenorrhagia:Splenorrhagia: bleeding from the spleen bleeding from the spleen

lymphadenectomy

lymphadenitis

splenectomy

thymectomy

tonsillectomy

Allergy testing

The Immune System – The Immune System – functions to functions to protect the body from harmful substancesprotect the body from harmful substances

Functions and Functions and StructuresStructures– The First Line of The First Line of

DefenseDefense– The Immune The Immune

ResponseResponse– Specialized Cells of Specialized Cells of

the Immune the Immune ReactionsReactions

– ImmunityImmunity– Immune System Immune System

Response FactorsResponse Factors

Pathology and Pathology and DiagnosticDiagnostic ProceduresProcedures– Allergic ReactionsAllergic Reactions– Autoimmune DisordersAutoimmune Disorders– ImmunodeficiencyImmunodeficiency

Treatment ProceduresTreatment Procedures– ImmunotherapyImmunotherapy– Antibody TherapyAntibody Therapy– ImmunosuppressionImmunosuppression

The First Lines of DefenseThe First Lines of Defense Intact Skin:Intact Skin: physical barrier to protect physical barrier to protect

foreign substances from entering the bodyforeign substances from entering the body

Respiratory system:Respiratory system: filters foreign filters foreign matter with nose hairs and mucous membranes, matter with nose hairs and mucous membranes,

expelled by sneezingexpelled by sneezing and coughingand coughing

Digestive System:Digestive System: destroys invaders destroys invaders that are swallowed or consumed with foodthat are swallowed or consumed with food

Lymphatic System:Lymphatic System: fights off invaders fights off invaders once they have entered the bodyonce they have entered the body

The Immune Response – The Immune Response – destroys destroys infectious microorganisms that enter the body infectious microorganisms that enter the body

through antigen-antibody reactionsthrough antigen-antibody reactions

Antigen:Antigen: virus, bacterium, or toxin that the virus, bacterium, or toxin that the body regards as foreignbody regards as foreign– Stimulates immune responseStimulates immune response

Antibody:Antibody: disease-fighting protein created by disease-fighting protein created by the immune system in response to that particular the immune system in response to that particular antigenantigen

Immune Reaction:Immune Reaction: antigen-antibody antigen-antibody reactionreaction– Forms antigen-antibody complexesForms antigen-antibody complexes– Tags potentially dangerous antigens to be Tags potentially dangerous antigens to be

recognized and destroyedrecognized and destroyed

Specialized Cells of the Specialized Cells of the Lymphatic SystemLymphatic System

LymphocytesLymphocytes:: WBC that attack specific microorganismsWBC that attack specific microorganisms– B CellsB Cells: most effective against viruses and bacteria that : most effective against viruses and bacteria that

are circulating in the bloodare circulating in the blood ComplementComplement ImmunoglobinImmunoglobin

– T CellsT Cells:: small circulating lymphocytes that have traveled small circulating lymphocytes that have traveled to the thymus to mature and kill invadingto the thymus to mature and kill invading organisms organisms on contacton contact

InterferonInterferon LymphokinesLymphokines Macrophage:Macrophage: protects the body by ingesting invading protects the body by ingesting invading

cellscells Phagocyte:Phagocyte: ingests and destroy substances such as ingests and destroy substances such as

cell debris, dust, pollen, and pathogens (phagocytosis)cell debris, dust, pollen, and pathogens (phagocytosis)

Immunity:Immunity:

the state of being the state of being resistant or not resistant or not susceptible to a specific susceptible to a specific diseasedisease– Natural:Natural: passed from passed from

mother to childmother to child– Acquired:Acquired: obtained by obtained by

the development of the development of antibodies during antibodies during attack of infectious attack of infectious diseasedisease

– Artificial:Artificial: immunizationimmunization

Response Factors:Response Factors: influence the immune influence the immune system’s ability to system’s ability to respondrespond– HealthHealth– AgeAge– HeredityHeredity– OpportunisticOpportunistic infection:infection:

a pathogen that a pathogen that normally does not normally does not cause disease but is cause disease but is able to cause illness in able to cause illness in a weakened host whose a weakened host whose resistance in decreased resistance in decreased by other diseaseby other disease

Pathology and DiagnosticPathology and Diagnostic Procedures of the Immune SystemProcedures of the Immune System

Allergic ReactionsAllergic Reactions– Cellular Response: localized sensitivity to allergenCellular Response: localized sensitivity to allergenItching, hives, erythemaItching, hives, erythema– Systemic reaction: anaphylaxis, severe response where Systemic reaction: anaphylaxis, severe response where

symptoms develop quickly and include blockage of air symptoms develop quickly and include blockage of air passages, drop in blood pressurepassages, drop in blood pressure

– Scratch Test and Antihistamines: identifying and Scratch Test and Antihistamines: identifying and treatment of allergenstreatment of allergens

Autoimmune Disorders: Autoimmune Disorders: immune system misreads normal immune system misreads normal antigens and develops antibodies to attack them (Tbl. 6.4)antigens and develops antibodies to attack them (Tbl. 6.4)– Crohn’s DxCrohn’s Dx– Diabetes mellitus, type 1Diabetes mellitus, type 1

Immunodeficiency: Immunodeficiency: one or more parts of the immune one or more parts of the immune system are deficient or missingsystem are deficient or missing– HIV: HIV: blood borne pathogen that invades and then blood borne pathogen that invades and then

impairs or kills cells of the immune system – impairs or kills cells of the immune system – AIDS = AIDS = advanced stages of HIVadvanced stages of HIV

Scratch Test

Treatment Procedures of the Treatment Procedures of the Immune SystemImmune System

– Immunotherapy:Immunotherapy: can be used in the can be used in the treatment of cancers by triggering the immune treatment of cancers by triggering the immune response to fight the malignancy.response to fight the malignancy.

– Antibody Therapy: Antibody Therapy: post exposure post exposure preventative measurepreventative measure

– Immunosuppressant: Immunosuppressant: treatment used to treatment used to interfere with the ability of the immune system interfere with the ability of the immune system to respond to stimulation by antigensto respond to stimulation by antigens

Pathogenic OrganismsPathogenic Organisms

BacteriaBacteria Fungus, Yeast, and ParasitesFungus, Yeast, and Parasites VirusesViruses

– Viral Infections:Viral Infections:Chicken PoxChicken PoxHerpes ZosterHerpes Zoster Infectious MononucleosisInfectious MononucleosisMeaslesMeaslesMumpsMumpsRabiesRabiesRubellaRubella

OncologyOncology Study of prevention, causes, and Study of prevention, causes, and

treatment of tumors and cancertreatment of tumors and cancer Terms Related to Oncology:Terms Related to Oncology:

– Tumor:Tumor: neoplasm, new and abnormal tissue neoplasm, new and abnormal tissue formation (angiogenesis)formation (angiogenesis)

– Benign:Benign: not recurring, nonmalignant, with a not recurring, nonmalignant, with a favorable chance of recovery (myoma)favorable chance of recovery (myoma)

– Malignant:Malignant: harmful, tending to spread, harmful, tending to spread, becoming progressively worse, and life-becoming progressively worse, and life-threateningthreatening

– Carcinoma in situ:Carcinoma in situ: malignant tumor still in it’s malignant tumor still in it’s original position, has not original position, has not metastasizedmetastasized (spread (spread from one place to another)from one place to another)