THE LYMPHATIC SYSTEM.

THE LYMPHATIC SYSTEM

LYMPHATIC SYSTEM The body has a second transportation system, which consists of a network of lymphatic vessels and lymphoid organs. Called the lymphatic system, it has two major functions. First, it ensures that blood volume stays the same. Each day, some 51 pints (24 liters) of fluid leave the blood as it passes through the tissues. Most returns to capillaries, but some 6-8 pints (3-4 liters) remains.

This surplus, now called lymph, drains into lymphatic vessels and is emptied back into the bloodstream. Second it plays a major part in body defense. It contains cells, also found in the blood, called lymphocytes and macrophages, which form the immune system the body’s most powerful defense against disease.

LYMPHATIC SYSTEM Structures:
LYMPH – fluid that goes between capillary blood and tissues. LYMPH VESSELS – transport excess tissue fluid back into circulatory system. LYMPH NODES – produce lymphocytes, filter out harmful bacteria. SPLEEN – produces lymphocytes and monocytes, blood reservoir, recycles old red cells. Thymus gland – produces T-LYMPHOCYTES

LYMPH Straw-colored fluid (similar to plasma)
INTERSTITIAL FLUID or tissue fluid because it is in the spaces between cells Composed of H2O, lymphocytes, some granulocytes, O2, digested nutrients, hormones, salts, CO2 and urea. NO red blood cells or protein molecules (too large) Carries digested food, O2 and hormones to cells Carries wastes back to capillaries for excretion Since the lymphatic system has no pump, skeletal muscle action squeezes lymph along Valves prevent backward flow

LYMPH VESSELS Closely parallel veins
Located in almost all tissues and organs that have blood vessels Transport lymph

Tissue lymph enters small lymph vessels which drain into larger vessels called lymphatics
they flow into one of two large, main lymphatics – the THORACIC DUCT and right lymphatic duct.

THORACIC DUCT gets lymph from left side of chest, head and neck, abdominal area and lower limbs  left subclavian vein  superior vena cava  heart. Lymph flows only in one direction – from body organs to the heart.

Structures of the lymphatic system
Lymph vessels parallel to blood vessels 2.03 Remember the stuctures of the lymphatic system

Lymph vessels Lacteals Specialized lymph vessels in the small intestines 2.03 Remember the stuctures of the lymphatic system

LYMPH CAPILLARIES The smallest vessels in the lymphatic system, lymph capillaries form a branching network of dead-end tubes that, like blood capillaries, pass between tissue cells.

The thin walls of the lymph capillaries have tiny flaps that act like one-way swinging doors letting in excess tissue fluid – which has passed out of, but not returned to, blood capillaries – but not allowing it to flow back out into the tissues.

This clear, watery fluid, now called lymph, is carried onward into the larger lymphatic vessels

Lymph nodes Where are lymph nodes located? Why are there so many? 2.03 Remember the stuctures of the lymphatic system

LYMPH NODES Tiny, oval shaped - size of pinhead to size of almond
Located alone or grouped Site for lymphocyte production and filter for screening out harmful substances If substance can’t be destroyed, node becomes inflamed To protect us from infection/harmful substances

Occur along lymph vessels like beads on a string
Occur along lymph vessels like beads on a string. Lymph nodes filter lymph as it passes through them. Surrounded by a tough capsule, the spaces, or network of fibers that support macrophages and lymphocytes. These fibers slow the flow of lymph passing through while macrophages engulf and destroy bacteria, cancer cells, and debris, and lymphocytes launch their immune defenses. During infections, lymph nodes may swell up and become tender, a condition known as “swollen glands”

TONSILS Masses of lymphatic tissue that produce lymphocytes and filter bacteria – they get smaller in size as person gets older

2.03 Remember the stuctures of the lymphatic system
Tonsils 3 pairs Palatine tonsils sides of throat Adenoids upper throat Lingual tonsils back of tongue 2.03 Remember the stuctures of the lymphatic system

A ring of five tonsils (2 at the back of mouth, 2 at the back of tongue, & one in the upper throat) protect the entrance to the digestive & respiratory systems from bacteria carried in food and air. Bacteria migrate into the tonsils where they are trapped inside deep “crypts” & destroyed by lymphoctyes.

Say “aahhh” Why this is helpful? 2.03 Remember the stuctures of the lymphatic system

SPLEEN Sac-like mass of lymphatic tissue Largest lymphatic structure
Upper left abdominal cavity, just below diaphragm Forms lymphocytes and monocytes Filters blood Stores large amounts of RBCs – contracts during vigorous exercise or loss of blood, to release RBCs Destroys or removes old or fragile RBCs

THYMUS GLAND Upper, anterior thorax, above the heart

Thymus gland What is unique about the thymus gland? 2.03 Remember the stuctures of the lymphatic system

2.03 Remember the stuctures of the lymphatic system
Begins to disappear at puberty Also, classified as an endocrine gland Produces T-Lymphocytes 2.03 Remember the stuctures of the lymphatic system

The two lobed thymus gland carries out its most important functions in the early years of life.
It trains lymphoctyes to be effective as part of the body’s immune system. Unspecialized lymphocytes arrive in the blood from bone marrow. They mature in the thymus, becoming capable of attacking specific pathogen, then leave as T-cells (thymus-dependent) to be sent to lymphoid organs, blood and lymph

2.04 Understand the functions and disorders of the lymphatic system
What are the functions of the lymphatic system? 1 2 3 4 (Hint- They are listed on handout) Fluid Balance, Lymphocyte Production, Filtration, Immunity 2.04 Understand the functions and disorders of the lymphatic system

What are the functions of the lymphatic system? 1 Fluid Balance 2 Lymphocyte Production 3 Filtration 4 Immunity (Hint- They are listed on handout) Fluid Balance, Lymphocyte Production, Filtration, Immunity 2.04 Understand the functions and disorders of the lymphatic system

2.04 Understand the functions and disorders of the lymphatic system

Fluid balance Why is this important? What happens during this process? What is the relevance to health? ____Fluid IN ____Fluid OUT Lymph vessels transport excess fluid from body tissues back into the circulatory system. The fluid acts as an intermediary between the blood in the capillaries and the tissues. It carries digested food, oxygen and hormones into the cells. It carries metabolic waste out of the cells. 2.04 Understand the functions and disorders of the lymphatic system

Lymph vessels transport excess fluid from body tissues back into the circulatory system. The fluid acts as an intermediary between the blood in the capillaries and the tissues. It carries digested food, oxygen and hormones into the cells. It carries metabolic waste out of the cells. 2.04 Understand the functions and disorders of the lymphatic system

Lymphocyte production What are lymphocytes? What do they do? What is their relevance to health? They are a kind of agranulocyte wbc. They help the body by making and releasing antibody molecules and they also help prevent the formation of some cancer cells. 2.04 Understand the functions and disorders of the lymphatic system

They are a kind of agranulocyte WBC. They help the body by making and releasing antibody molecules they also help prevent the formation of some cancer cells. 2.04 Understand the functions and disorders of the lymphatic system

Filtration What does a filter do? How do filters relate to the lymphatic system? Lymph nodes filter out harmful bacteria. 2.04 Understand the functions and disorders of the lymphatic system

Lymph nodes filter out harmful bacteria 2.04 Understand the functions and disorders of the lymphatic system

Immunity What is immunity? Think about how sneezing relates to immunity. Immunity is the body’s ability to resist bacterial and viral invasion and disease. There are two types of immunity: natural and acquired. 2.04 Understand the functions and disorders of the lymphatic system

Immunity The body’s ability to resist bacterial invasion and disease.
2 general types – natural and acquired.

Natural immunity We have this at birth. It is inherited and permanent. It includes: Unbroken skin, mucus, tears, phagocytes (white blood cells) and local inflammation. We have this at birth. It is inherited and permanent. It includes: Unbroken skin, mucus, tears, phagocytes (white blood cells) and local inflammation. 2.04 Understand the functions and disorders of the lymphatic system

NATURAL IMMUNITY – at birth, inherited and permanent. Includes:
Unbroken skin sweat together with sebum produced by sebaceous glands, protects the skin. Both substances have antiseptic properties Mucus and tears tears produced by glands in the eyelids wash away dirt & contain an antiseptic substance

Blood phagocytes WBC that engulf & destroy invading organisms
Blood phagocytes WBC that engulf & destroy invading organisms. Two types: neutrophils & macrophages. Neutrophils circulate in the blood before being transferred to the tissues, where they seek out organisms. Macrophages also start in the bloodstream, where they are known as monocytes, before moving to the tissues where they become macrophages. Some macrophages stay in one place; others travel around looking for invading organisms. All phagocytes flow around organisms, wrapping them within a membrane that fuses with granules called lysosomes. These granules contain strong chemicals that digest the organisms, producing harmless substances that pass out through the cells’ membrane.

Natural immunity Discuss the body’s natural immune processes seen in this picture. 2.04 Understand the functions and disorders of the lymphatic system

Local inflammation This is the familiar warm, reddish, tender swelling that appears after an injury. At the site of the damage, tissue cells release histamine & other chemicals. They make the blood vessels wider, so that extra blood arrives, and more leaky, so that fluid passes into the tissues, aiding repair and making the area, swollen, and warm. These chemicals also attract phagocytes that destroy pathogens.

Acquired immunity: Passive Discuss passive acquired immunity This is artificially acquired by injecting antibodies to protect from a specific disease. This gives immediate immunity that will last 3-5 weeks. This is used when someone is exposed to tetanus or infectious hepatitis. A mother provides her newborn with SOME passive immunity. 2.04 Understand the functions and disorders of the lymphatic system

ACQUIRED IMMUNITY – body’s reaction to invaders
PASSIVE ACQUIRED IMMUNITY Acquired artificially by injecting antibodies to protect from a specific disease Immediate immunity Lasts 3-5 weeks Used when someone exposed to measures, tetanus, infectious hepatitis Mother provides newborn with some passive immunity

ACTIVE ACQUIRED IMMUNITY
Lasts longer, two types NATURAL ACQUIRED IMMUNITY – result of having had and recovered from a disease. For example, a child who had measles will usually not get it again – child’s body has manufactured antibodies.

ARTIFICIAL ACQUIRED IMMUNITY – comes from being vaccinated – provides artificial active immunity
IMMUNIZATION – artificial resistance to a particular infection by artificial means Antigen injected into a person to stimulate production of antibodies

Acquired immunity Active Artificial Should immunizations be required? Why or why not? 2.04 Understand the functions and disorders of the lymphatic system

Tonsillitis What are the symptoms? What are the usual treatments? Why would you have your tonsils removed? Swollen glands, fever. Sore throat, drainage. Treat the symptoms. If strep occurs > 5 times in a year or if tonsils are cryptic, they need to come out. 2.04 Understand the functions and disorders of the lymphatic system

In childhood, the tonsils may become infected, enlarged, and cause difficulty swallowing Swollen glands, fever. Sore throat, drainage. Treat the symptoms. If strep occurs > 5 times in a year or if tonsils are cryptic, they need to come out 2.04 Understand the functions and disorders of the lymphatic system

Lymphadenitis What is it? Lymph aden itis What are the symptoms? How is it treated? Enlargement of the lymph nodes: “Swollen glands” Occurs when the body is fighting infection. Treat the infection. 2.04 Understand the functions and disorders of the lymphatic system

LYMPHADENITIS enlargement of the lymph nodes occurs when
infection is present and body is attempting to fight off the infection. Tx. with antibiotics

Lymphedema What is it? What causes it? How is it treated? Lymphedema is a swelling that is caused by lymphatic fluid that has been blocked from draining into the circulatory system. It is treated with light (gentle) exercises, compression and massage. There is no cure. Photo used with written permission by the Mayo Clinic. 2.04 Understand the functions and disorders of the lymphatic system

Lymphedema is a swelling that is caused by lymphatic fluid that has been blocked from draining into the circulatory system. TX: with light (gentle) exercises, compression and massage. There is no cure. 2.04 Understand the functions and disorders of the lymphatic system

Scleroderma What is it? What causes it? What are some complications of scleroderma? How is it treated? A thickening of the skin and blood vessels. It is a type of autoimmune disorder, a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue. It involves changes in the skin, blood vessels, muscles, and internal organs. It is treated with anti-inflammatories, immunosuppressants. No cure. 2.04 Understand the functions and disorders of the lymphatic system

A thickening of the skin and blood vessels. It is a type of autoimmune disorder, (a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue) It involves changes in the skin, blood vessels, muscles, and internal organs. Difficulty moving, breathing, stiffening of skin TX: with anti-inflammatories, immunosuppressants. No cure. 2.04 Understand the functions and disorders of the lymphatic system

Hodgkin’s disease What is Hodgkin’s disease? What are the symptoms? How is it treated? Who is most likely to develop Hodgkin’s disease? Hodgkin’s disease is a cancer of the lymph nodes. The most common early symptom of the disease is painless swelling of the lymph nodes. It is treated with chemotherapy and radiation. People who have had mono or people that have AIDS are more likely to develop hodgkin’s. 2.04 Understand the functions and disorders of the lymphatic system

Hodgkin’s disease is a cancer of the lymph nodes. The most common early symptom of the disease is painless swelling of the lymph nodes. It is treated with chemotherapy and radiation. People who have had mono or people that have AIDS are more likely to develop Hodgkin’s. 2.04 Understand the functions and disorders of the lymphatic system

HODGKIN’S DISEASE

Infectious mononucleosis What is mononucleosis most often called? What causes it? How is it treated? Called “the KISSING disease” Caused by the Epstein-Barr virus Bedrest, treat the symptoms (extreme fatigue, fever, enlarged lymph nodes) 2.04 Understand the functions and disorders of the lymphatic system

INFECTIOUS MONONUCLEOSIS
Caused by the Epstein Barr virus Frequently in young adults and children Spread by oral contact (kissing) Known as the “kissing disease”

Symptoms – enlarged lymph nodes, fever, physical and mental fatigue,  leukocytes
Rx – bedrest

Lupus erythematosus What is the classic symptom of lupus? What other symptoms might present? How is lupus managed? What is the prognosis? 2.04 Understand the functions and disorders of the lymphatic system

Systemic lupus erythematosus (SLE) is an autoimmune disease, which means the body's immune system mistakenly attacks healthy tissue. This leads to long-term (chronic) inflammation. Almost everyone with SLE has joint pain and swelling 2.04 Understand the functions and disorders of the lymphatic system

Other SX: Chest pain when taking a deep breath, Fatigue, Fever with no other cause, General discomfort, uneasiness, or ill feeling (malaise), Hair loss, Mouth sores, Sensitivity to sunlight, Skin rash -- a "butterfly" rash over the cheeks and bridge of the nose affects about half of people with SLE. The rash gets worse in sunlight. The rash may also be widespread, Swollen lymph nodes There is no cure for SLE. The goal of treatment is to control symptoms 2.04 Understand the functions and disorders of the lymphatic system

HYPERSENSITIVITY When the body’s immune system fails to protect itself against foreign material, and instead, the antibodies formed irritate certain body cells. An abnormal response to a drug or allergen.

An ALLERGEN is an antigen that causes allergic responses
An ALLERGEN is an antigen that causes allergic responses. (Examples of allergens – ragweed, penicillin, bee stings, foods, etc.)

ANAPHYLAXIS severe, sometimes fatal allergic reaction
Antigen-antibody reaction stimulates a massive secretion of histamine Symptoms – breathing problems, headache, facial swelling, falling blood pressure, stomach cramps, and vomiting Rx – adrenaline, epipen

AIDS How is it diagnosed? What do these terms mean? HIV ARC Human Immunodeficiency Virus AIDS related complex- chronic diarrhea, chronic lymphadenopathy, wt. loss Acquired Immune Deficiency Syndrome 2.04 Understand the functions and disorders of the lymphatic system

AIDS/HIV Acquired Immunodeficiency Syndrome
Caused by HTLV-III (human T-lymphotrophic virus type III) Commonly caused HIV or Human immunodeficiency virus. Affects not only homosexual males but all populations The patient with AIDS cannot fight off cancers and most infections.

Between October 1980 and May 1981, five young, previously healthy homosexual men were treated for a pneumonia caused by a parasite, Pneumocystis carinii. Before this, P. carnii pneumonia occurred only in immunosuppressed patients, especially those receiving cancer therapy. At the same time, a rare and unusual blood vessel malignancy called Kaposi’s sarcoma was being diagnosed with increasing frequency in young homosexual males.

In 1981, twenty-six cases of Kaposi’s sarcoma had been diagnosed in young homosexual males. These cases were an early indication of an epidemic of a previously unknown disease. Later, it was called the Acquired Immunodeficiency Syndrome. (AIDS). It is said to be the third leading cause of death in young people.

Three responses to HIV infection:
AIDS ARC (AIDS-related complex) Asymptomatic infection Screening tests for HIV/AIDS are available

Screening tests Blood tests for presence of antibodies does not reach detectable levels until 1-3 months after infection Tests: ELISA- enzyme linked immunosorbent assay (detects antibodies but not the virus itself) Western Blot confirms the ELISA results

AIDS Most severe type of HIV infection
Subject to OPPORTUNISTIC INFECTIONS – a healthy person would fight off these infections, but a person with AIDS has a compromised immune response.

Opportunistic infections
Kaposi sarcoma Cervical cancer Parasitic infections (some pneumonias) Fungal infection – candidiasis Viral infections – herpes simplex, hepatitis B Higher risk for TB & syphilis

Symptoms of AIDS Prolonged fatigue Persistent fevers or night sweats
Persistent, unexplained cough Thick coating in throat or on tongue 5. Easy bruising, unexplained bleeding

Appearance of purple lesions on mucous membranes or skin that don’t go away
Chronic diarrhea Shortness of breath Unexplained lymphadenopathy 10. Unexplained weight loss, 10 pounds or more, in less than 2 months

AIDS-RELATED COMPLEX (ARC)
Has HIV but not AIDS and develops other conditions such as: Chronic diarrhea Chronic lymphadenopathy Unexplained weight loss

If life threatening opportunistic infections develop, then individual is said to have AIDS
ASYMPTOMATIC INFECTION - Has HIV but no symptoms. High-Risk Groups for AIDS – EVERYONE who participates in risky behaviors.

The AIDS Patient Sometimes treated as outcasts
Healthcare worker should be supportive Use of gloves for normal patient contact is not necessary

Transmission by: Sex with someone who is HIV positive
Sharing needles with infected IV drug users At birth from infected mother

Cannot be spread by: Casual contact
Through air, feces, food, urine or water Coughing, sneezing, embracing, shaking hands and sharing eating utensils Prevention: Avoid risky behaviors Standard precautions

Cancer What is cancer? Who gets cancer? Why is it included in the lymphatic system? Cancer occurs when a cell mutates and begins to divide rapidly, taking up nutrients and oxygen and crowding out normal cells. The normal tissue dies as the cancers progresses. Anyone can get cancer. It is usually caused by multiple exposures to carcinogens over a period of time. Some cancers, however are opportunistic, which means that a weakened immune system can make a person more susceptible. Some opportunistic cancers are Kaposi’s sarcoma, cervical cancer and cancers of the immune system, known as lymphomas. 2.04 Understand the functions and disorders of the lymphatic system

Cancer occurs when a cell mutates and begins to divide rapidly, taking up nutrients and oxygen and crowding out normal cells. The normal tissue dies as the cancers progresses. Anyone can get cancer. It is usually caused by multiple exposures to carcinogens over a period of time. 2.04 Understand the functions and disorders of the lymphatic system

Some cancers, however are opportunistic, which means that a weakened immune system can make a person more susceptible. Some opportunistic cancers are Kaposi’s sarcoma, cervical cancer and cancers of the immune system, known as lymphomas.

STANDARD PRECAUTIONS Guidelines to be used in patient care setting
Must be used when there is contact with blood, any body fluid (except sweat), mucous membranes and non-intact skin.

Handwashing – the single most effective way to prevent infection.
Wash hands after touching body fluids, even if gloves are worn. Wash hands immediately after removing gloves, between patient contacts. Use a plain (non-antimicrobial) soap Wash for a minimum of 10 seconds Gloves – worn when touching blood, body fluids, etc. Mask, eye protection, face shield and gown – during patient care activities that may generate splashes or sprays of blood, body fluids, etc. Patient care equipment and linens – handle with care, don’t let it touch your or clothing, clean or discard appropriately.

Occupational Health and Bloodbourne Pathogens
Beware of needles! Never recap used needles. Dispose of all needles and sharp objects in SHARPS container.

Use mouthpieces, resuscitation bags, or other ventilation devices as alternative to mouth-to-mouth resuscitation. A patient who contaminates the environment should be in a private room or relatively isolated area.

THE LYMPHATIC SYSTEM.

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THE LYMPHATIC SYSTEM.

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