1. DR Amit Gupta ASSOCIATE PROFESSOR DEPT OF SURGERY
Lymphatic system
DR Amit Gupta
ASSOCIATE PROFESSOR
DEPT OF SURGERY

2. Lymph
What is lymph ?
Tissue fluid (interstitial fluid) that enters the lymphatic vessels

3. Formation and transport of tissue fluid

4. Lymphatic system
Essentially a drainage system accessory to venous system
larger particles that escape into tissue fluid can only be removed via lymphatic system

5. Functions Network that filters antigens from the interstitial fluid
Primary site of immune response from tissue antigens
Lymphatic drainage in all organs of the body except brain, eyes, marrow and cartilage
Flaccid thin walled channels  progressive caliber
600 lymph nodes in body
Slow flow, low pressure system returns interstitial fluid to the blood system
Primary site of immune response from tissue antigens

6. Components of lymphatics
Lymphatic Vessels
Lymphatic Organs
Lymphatic cells

7. Secondary lymphoid tissue

8. Lymphatic Capillaries
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Features of structure:
Blind end
Single layer of overlapping endothelial cells
More permeable than that of blood capillary
Absent from avascular structures, brain, spinal cord splenic pulp and bone marrow

9. Lymphatic Vessels Three layered wall but thinner than vein
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Three layered wall but thinner than vein
More numerous valves than in vein
Interposed by lymph nodes at intervals
Arranged in superficial and deep sets

10. Lymph Trunks Right and left jugular trunks
Right and left subclavian trunks
Right and left bronchomediastinal trunks
Right and left lumbar trunks
Intestinal trunk

11. Lymphatic Ducts
Right lymphatic duct
Thoracic duct

12. Lymphatic Cells Also called lymphoid cells
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Also called lymphoid cells
Located in both the lymphatic system and the cardiovascular system.
Work together to elicit an immune response.
Types of lymphatic cells are:
Macrophages
Epithelial cells
Dendritic cells
Lymphocytes

13. Lymphatic Organs Primary organs Secondary organs Red bone marrow
Thymus gland
Secondary organs
Lymph nodes
Lymph nodules
Spleen

14. Lymph nodes Capsular shell Fibroblasts and reticulin fibers
Macrophages
Dendritic cells
T cells
B cells
Immune response: flow of blood and lymph can increase as much as 25X can swell up to 15X normal size
Invasion by malignant cells or propagation of an inflammatory process

15. Head & Neck Nodes

16. Axillary Nodes

17. Inguinal Lymph nodes

19. Lymphangitis
 Inflammation of the lymph vessels
Commonest cause bacteria called streptococcus pyogenes(most common).
Lymph vessels appear as red streaks through the skin

21. Filariasis

22. Lymphedema
Occurs due to accumulation of lymphatic fluid in the interstitial tissue
Sometimes can be appreciated after wearing tight clothing or jewellary on affected limb

23. Lymphadenopathy Means a disease of the lymph nodes
Lymph nodes become swollen/ enlarged and may be painful to touch

24. Lymphomas
Cancers originating either from the lymphocytes in the lymph nodes or the lymphatic tissue in organs

25. Tonsillitis Infection of the pharyngeal tonsils Tonsils are swollen,
Fever and pain during swallowing usually present