18 Lymphatic System Flashcards

(46 cards)

1
Q

How does the lymphatic system work in relation to the venous system?

A

Collects 3 litres per day of interstitial fluid and returns it to the venous system

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2
Q

State the names of the fluid and vessels of the lymphatic system.

A
  • Fluid – lymph
  • Vessels – lymphatics
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3
Q

Identify the cells of the lymphatic system

A
  • Lymphocytes: B cells, T cells and NK cells (natural killer)
  • Supporting cells: follicular dendritic cells and macrophages
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4
Q

Identify the organs of the lymphatic system

A
  • Lymph nodes
  • Thymus
  • Spleen
  • Appendix
  • Tonsils
  • Payer’s patches
  • (small masses of lymphatic tissue found throughout the ileum region of the small intestine)*
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5
Q

What 3 factors help to propel lymph along?

A
    • Skeletal muscle movement
    • Pressure changes in the thorax during breathing
    • Pulsations of adjacent arteries
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6
Q

Describe the arrangement of lymphatic vessels in the body

A
  • Lymphatics tend to lie adjacent to arteries and veins
  • Lymphatics are arranged into superficial and deep (lymph flows superficial–>deep)
  • Large vessels (ducts and trunks) eg in abdomen contain smooth muscle
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7
Q

In which region of the body are there no lymphatics?

A

The Central Nervous System

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8
Q

What are the functions of lymph nodes?

A
  • Serve as filters for lymph: traps antigen, processes antigen and presents processed antigen to T cells (contain APCs)
  • Contains macrophages, B cells and T cells which work to produce an inflammatory response (macrophages) then an immune response (B & T cells)
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9
Q

Approximately how many lymph nodes are there in the human body?

A

600-700

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10
Q

Describe the structure of a lymph node (general terms).

A

Shaped like kidney, mainly= CT fibre

  • Afferent lymphatics that enter via the convex surface
  • Efferent lymphatics that leave via the hilum
  • Feeding artery that leaves via the hilum
  • Draining vein that leaves via the hilum
  • Follicles=nodules containing immune dendritic cells
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11
Q

How do lymphocytes enter lymph nodes?

A
  • Enter via the feeding artery
  • Leave via the efferent lymphatics
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12
Q

Account for possible causes of lymphadenopathy

A
    • Infection as germinal centres in lymph nodes fill with lymphocytes
    • Lymphoma as cancer metastasises to afferent lymphatics
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13
Q

Lymph nodes contain professional antigen presenting cells (APCs).

What is the role of such cells?

A

APCs are specially equipped with immunostimulatory receptors to acquire and present antigens which allows for enhanced activation of T cells

(B cells don’t require APCs to recognise antigens)

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14
Q

What is the structure, function and location of follicular dendritic cells (found in lymphoid tissue)?

A
  • Structure: contain antigen-antibody complexes adhere to its dendritic processes
  • Function: cause proliferation of B cells, in particular, memory B cells
  • Location: found in germinal centres
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15
Q

Outline the humoral response (in terms of immunity).

A

- Humoral immunity is B lymphocyte mediated

  • It involves B lymphocytes which transform into plasma cells that synthesise and secrete a specific antibody
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16
Q

What is cell-mediated immunity?

A

Cell-mediated immunity is when T cells need antigen presenting cells (macrophages, B lymphocytes) to recognise antigens

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17
Q

Outline the structure, function and location of the thymus gland

A
  • Structure: fully formed and functional at birth, involutes after puberty and ends up being mostly fat
  • Function: maturation of bone marrow derived stem cells into immunocompetent T cells (thymic cell education)
  • Location: found in superior mediastinum
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18
Q

What are the functions of the spleen?

(The spleen is the largest lymphatic organ and has a very rich blood supply.)

A
  • IMMUNE:
      • Antigen presentation
      • Activation and proliferation of B and T lymphocytes= Production of antibodies
  • HAEMOPOIETIC
      • Removal + destruction of old, damaged erythrocytes/platelets
    • RBC storage
    • Iron retrieval from haemoglobin
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19
Q

Discuss the implications of a splenectomy (2)

A
    • Splenectomy increases the risk of infection by encapsulated bacteria e.g. the meningococcus and malaria
    • Splenectomy increases the risk of DVT and pulmonary embolism
20
Q

Which organs/structures perform the spleen’s functions after a splenectomy?

A

Liver and bone marrow take over the removal & destruction of old RBCs

21
Q

Distinguish between the lymph node and spleen response to infection.

A
  • Lymph nodes enlarge in response to local infection
  • Spleen enlarges in response to systemic infection e.g. glandular fever, malaria, septicaemia
22
Q

What is phagocytosis?

A

Phagocytosis is a specific form of endocytosis by which cells internalise solid matter, including microbial pathogens

23
Q

What is opsonisation?

A

Opsonisation is the molecular mechanism whereby molecules, microbes, or apoptotic cells are chemically modified to have stronger interactions with cell surface receptors on phagocytes and NK cells

24
Q

What effect does opsonisation have?

A
  • With the antigen coated in opsonins, binding to immune cells is greatly enhanced
  • Opsonisation also mediates phagocytosis via signal cascades from cell surface receptors
25
What is oedema?
**Oedema** is an accumulation of an excessive amount of watery fluid in cells, tissues or serous cavities
26
What is lymphoedema?
**Lymphoedema** is swelling (especially in subcutaneous tissues) due to obstruction of lymphatic vessels or lymph nodes and the accumulation of large amounts of lymph in the affected region
27
Describe the appearance of lymphoedema
**Lymphoedema** is non-pitting oedema due to the build-up of lymph and protein in the interstitial space
28
How does oedema change with position?
- If someone is standing up, oedema often appears first at the **ankles** (gravity) - If someone is lying down/sitting in bed, the oedema is expected to appear in the **sacral region**
29
Outline how fluid flows from the **capillaries** back to the **veins** via the lymphatics.
30
Which of the structures shown below is a lymphatic vessel and which is a small vein?
31
Describe the structure of a lymphatic capillary.
* Low pressure system w./ valves
32
Name some main areas where there are lymph nodes. (3) (clinically important)
* Neck (cervical) * Groin (inguinal) * Armpit (axillae)
33
Fill in the missing labels:
34
Where are *follicular dendritic cells* found and what is their function?
1. In germinal centres 2. Cause proliferation of B cells- as antigen antibody complexes adhere to them- can retain antigen for a month
35
Where is the spleen located and what is it's structure (in general terms)?
**Location:** Inferior to diaphragm, posterior to stomach **Structure:** Similar to lymph node BUT White pulp and Red pulp
36
Why is a ruptured spleen usually removed?
Risk of death by exsanguination (loss of blood)
37
Where can the tonsils be found?
Oropharynx and nasopharynx
38
What is the structure and function of the tonsils?
Nodules- reside inferior to surface invaginations Prevent pathogen ingress: * Surface epithelia- numerous microfold cells
39
Outline the **location**, **structure** and **function** of the Appendix (Veniform).
1. LOCATION Inferior&attched to ascending colon 2. STRUCTURE Nodules reside inferior to surface invaginations- many microfold cells 3. FUNCTION prevent pathogen ingress
40
Outline the Location, Structure and Function of Payer's patches?
LOCATION: inferior and attched to ileum STRUCTURE: nodules= on inferior surface of domes FUNCTION: Prevent pathogen ingress through digestion
41
What are the functions of the lymphatic system?(4)
1. **Fluid balance**-return interstitial fluid to circulation 2. **Transport- fats and fat-soulble vitamins**- from digestive system to venous circulation 3. **Defence against invading pathogens**-nodes filter out organisms/cancer cells 4. **Storage and destruction- aged erythrocytes** (spleen
42
What is a 'sentinel lymph node'?
First lymph node to which cancer cells are most likely to spread from a primary tumor eg breast cancer
43
Outline the relationship between sentinel lymph nodes and the prevention of a secondary tumour.
44
How is lymphodema treated? (4)
1. Compression hosiery 2. Specialised massage 3. Skincare 4. Exercises
45
What are the primary causes of lymphodema? (3)
46
What are the secondary causes of lymphodema? (4)
1. Surgery- node involvement 2. Radiotherapy- nodal fibrosis 3. Autoimmune- rheumatoid arthritis 4. Infections- cellulitis (vessel obstruction)