Test 5 (lymphatics) Flashcards
(135 cards)
1
Q
Functions of microcirculations
A
- Control delivery of nutrients
- Remove waste products
- Maintain ionic concentrations
- Transport hormones
**Most significant**
- Transport of nutrients & removal of cell excreta
2
Q
anatomy from artery to venules and their size
A
nutrient artery - > 50 mcm
organ
branches 6-8x
arterioles - 20 mcm
branches 2-5x
metarterioles - 5-9 mcm
capillaries - 5 mcm
venous end of capillary - 9 mcm
venules
3
Q
describge arterioles
A
- Highly muscular; contain smooth muscle
- Diameter can change easily d/t smooth muscle
- Major resistance vessels
- Regulate regional blood flow to capillary beds
4
Q
describe metarterioles
A
- Contain smooth muscle
- intermittent, not continuous
- Precapillary sphincter
5
Q
describe venules
can they contract?
A
- Contain smooth muscle; weaker coat
-
Collecting channels
- Storage or capacitance vessel
- Pressure in venules is much less than that of arterioles, but can still contract considerably even though they have a weak muscle layer
6
Q
describe wall of capillaries
- wall is ____ layer of ___cells
- surrounded by____ _____.
A
capillaries:
- wall is unicellular layer of endothelial cells
- surrounded by basement membrane
7
Q
capillaries:
- total capillary wall thickness
- internal diameter
- anatomical feature used for diffusion
- diameter of capillary pores
- contains smooth muscle?
A
capillaries:
- total thickness of wall 0.5 mcm
- internal diameter 4-9 mcm
- anatomical feature used for diffusion: intercellular clefts
- diameter of capillary pores 25 x that of H2O
- O2 & CO2 lipid soluble/readily pass
- contains smooth muscle? devoid of smooth muscle
8
Q
Capillaries: Vasomotion
- Blood flow is ___ mm/sec & ___continuous/intermittent__ in capillaries
- Contraction & relaxation of ______ & ______ sphincters
A
Capillaries: Vasomotion
- Blood flow is 1 mm/sec & intermittent in capillaries
- Contraction & relaxation of metarterioles & precapillary sphincters
9
Q
Capillaries: Vasomotion
Most important determinant
A
oxygen (nutritive flow)
10
Q
___ arterioles control blood flow to each tissue and local conditions in the tissues will control _____diameter;
A
- Small arterioles control blood flow to each tissue and local conditions in the tissues will control arteriolar diameter;
- each tissue controls its own blood flow in relation to body needs.
11
Q
- At point where each true capillary originates form metarteriole, there is a ____ muscle fiber that encircles this area (where arteriole becomes ____) and is called the ____ ____, and it opens and closes the entrance to the capillary
A
- At point where each true capillary originates form metarteriole, there is a smooth muscle fiber that encircles this area (where arteriole becomes capillary) and is called the Precapillary sphincter, and it opens and closes the entrance to the capillary
12
Q
- this part of capillaries
- Thin, slit like, curving channel; “interdigitated junction”
- Passageways in many organs that connect interior of capillary with the exterior
- used for diffusion
A
- intercellular clefts
13
Q
Intercellular clefts
- Interrupted by ____ attachments that hold cells together while fluid is allowed to move freely through the cleft
- Usually has _____ spacing that is about ___nanometers, which is slightly ____ than albumin molecule
- The rate of _____ motion of water molecules plus water soluble ions and small solutes is ____ that all of these substances diffuse with ease b/w the interior and exterior of the capillaries through these clefts.
A
Intercellular clefts
- Interrupted by protein attachments that hold cells together while fluid is allowed to move freely through the cleft
- Usually has uniform spacing that is about 6-7 nanometers, which is slightly smaller than albumin molecule
- The rate of thermal motion of water molecules plus water soluble ions and small solutes is rapid that all of these substances diffuse with ease b/w the interior and exterior of the capillaries through these clefts.
14
Q
how many capillaries in body
A
10 billion
15
Q
- “small caves” inside capillary cell
A
Plasmalemmal vesicles
aka “caveolae”
16
Q
- Plasmalemmal vesicles (caveolae)
Formed by proteins called ____that are associated with molecules of ____and _____
Precise function is unclear, it is believed to play role in _____ (engulfing material from outside cell), and ______ of macromolecules across the endothelial cell (transport after endocytosis)
A
- Plasmalemmal vesicles (caveolae)
Formed by proteins called caveolins that are associated with molecules of cholesterol and sphingolipids
Precise function is unclear, it is believed to play role in endocytosis (engulfing material from outside cell), and transcytosis of macromolecules across the endothelial cell (transport after endocytosis)
17
Q
- Caveolae at surface of cell appear to take up small packets of ___ or ___ fluid that contain plasma ___ ; these vesicles move through ___cell and discharge the plasma and proteins by ___ into interstitial fluid
A
- Caveolae at surface of cell appear to take up small packets of plasma or extracelluar fluid that contain plasma proteins ; these vesicles move through endothelial cell and discharge the plasma and proteins by exocytosis into interstitial fluid
18
Q
- Diameter of capillary pores ___ x that of H2O molecules (__nanometers)
A
Diameter of capillary pores
- 25 x that of H2O molecules (0.3 nanometers)
19
Q
- NaCl, Glucose, K+, CL- etc have______diameters;
- describe pore permeability
A
- NaCl, Glucose, K+, CL- etc have intermediate diameters; pore permeability varies according to the substance trying to enter
20
Q
- devoid of smooth muscle, not capable of active constriction but do contain actin and myosin so can alter shape
A
“True” capillaries
21
Q
Blood flow is ___mm/sec &_______in capillaries
A
capillaries
- Blood flow is 1 mm/sec & intermittent
22
Q
vasomotion
- Contraction & relaxation of metarterioles & precapillary sphincters alternating in a cycle of about__ to ___ times per minute = vasomotion
A
- Contraction & relaxation of metarterioles & precapillary sphincters alternating in a cycle of about 6-12 times per minute = vasomotion
23
Q
Vasomotor
- Most important determinant is___ (____ flow)
- Vasomotion is affected by ____ levels
A
Vasomotor
- Most important determinant is oxygen (nutritive flow)
- Vasomotion is affected by O2 levels
24
Q
- this change in leveol of O2 allows more blood to flow through capillaries to supply tissues
A
- Low PO2 allows more blood to flow through capillaries to supply tissues
- When tissue O2 concentration goes below normal, vasomotion occurs more often and periods last longer=increased quantities of O2 released to tissues=nutritive flow
25
* Impact of O2 on capillary blood flow provides \_\_\_\_\_\_\_. (hard to make question out of this just)
* Impact of O2 on capillary blood flow provides **autoregulation**
26
* **Nonnutritive flow** (aka ____ flow) regulated by \_\_\_\_
* **Nonnutritive flow** (aka **shunt** flow) regulated by **ANS**
27
summary
* nutritive flow regulated by
* nonnutritive flow regulated by
summary
* **nutritive flow** regulated by **O2**
* **nonnutritive** flow regulated by **ANS**
28
Even though blood flow is intermittent, since there are so many capillaries in body their overall function is \_\_\_\_\_.
**Average function of capillary system**
* Even though blood flow is intermittent, since there are so many capillaries in body their overall function is **averaged.**
* Average rate of **blood flow**
* Average **capillary pressure**
* Average **rate of transfer of substances b/w blood and ISF**
29
* ______ of capillaries contains substances involved in contraction/relaxation of vascular smooth muscle in response to local tissue metabolic requirements.
* **Endothelium** of capillaries contains substances involved in contraction/relaxation of vascular smooth muscle in response to local tissue metabolic requirements.
30
**Local Control of Capillary BF**
* capillary blood flow is regulated by:
**Local Control of Capillary BF**
capillary blood flow is regulated by:
* **delivery of O2 and other nutrients**
* **removal of products of metabolism**
* or **maintenance of ionic balance and pH.**
31
**2 Theories** **to explain local control of capillary BF:** both state that vessels will dilate to increase blood flow d/t ____ or in response to a _____ substance in response to hypoxemia.
* **Vasodilator theory**
* **Oxygen-demand theory**
* both state that **vessels will dilate to increase blood flow** d/t **hypoxemia** or in response to a **vasodilator** substance in response to hypoxemia.
32
* **prostacyclin**
* comes from where
* what principle fx
* does what to smooth
* **Prostacyclin** – from **arachidonic acid** by **prostacyclin synthase**
* Principal function **– *inhibit platelet adherence & aggregation***
* **Relaxation** of vascular smooth muscle by **release of cAMP**
33
* Nitric oxide (NO) – released by stimulation from \_\_\_\_\_
* Release can be stimulated by what
* Synthesized where
* **Nitric oxide (NO)** – released by stimulation from vasoactive substances
* Release can be **stimulated by** **shear stress of blood flow**
34
NO is synthesized in endothelial cells by __ \_\_\_ in response to what?
Synthesized in endothelial cells by nitric oxide synthase in response to
* **Ach**
* **ATP**
* **bradykinin**
* **Histamine**
* **serotonin**
* **Substance P**
35
pathophys of NO on smooth muscle
* Activates **guanylate cyclase** and this activates **cGMP** = **relax smooth** muscle
* Ach causes increase of Nitric oxide synthase activity which causes production of NO that interacts with guanyl cyclase, creating cGMP and leading to relaxation of smooth muscle.
36
affects vascular tone and BP
**Endotholin**
37
endothelin
* A - does what
* B - does what
* A is vascular smooth muscle, causes **constriction**
* B causes **constriction** **and** **vasodilation**
38
**Diffusion** of substances through cell membrane is **determined by**: (4)
**Diffusion** of substances through cell membrane is determined by:
* **Lipid solubility**
* **Water solubility**
* **Size of molecule**
* **Concentration difference from one side of membrane to the other: most important method of transport is diffusion**
39
**Diffusion** of substances thru cell membrane
* **Results from** ____ motion of ___ molecules & _____ substances
**Diffusion** of substances thru cell membrane
* Results from thermal motion of H2O molecules & dissolved substances
40
the most important means by which substances move from plasma to ISF is thru
**diffusion**
41
* Rate at which H20 diffuses through the capillary membrane is about **\_\_\_** x as fast as the rate of plasma flows through capillary.
* Rate at which H20 diffuses through the capillary membrane is about **80** x as fast as the rate of plasma flows through capillary.
42
* Pores are about ___ nanometers, about \_\_\_x the diameter of H20 molecules
* **Pores** are about **6-7** nanometers, about **20x the diameter of H20 molecules**
43
About **\_\_\_** of the total volume of the body consists of spaces b/w cells which are called the **interstitium**
About **1/6** of the **total volume of the body** consists of spaces b/w cells which are called the **interstitium**
44
**Interstitium & ISF** - 2 major structures
**Interstitium & ISF** - 2 major structures
## Footnote
**•Collagen fiber bundles**
**•Proteoglycan filaments**
45
* Collaged extend long distances in the interstitium
* Extremely strong and provide most of the tensional strength of the tissues
* **Collagen fiber bundles**
46
part of IS & ISF
* Extremely thin parts of IS & ISF which are coiled or twisted molecules
* composed of about ___ and ___ (give % too)
* Look like “brush pile” on microscope
**Proteoglycan filaments**
* Extremely thin parts of IS & ISF which are coiled or twisted molecules
* composed of
* **98% hyaluronic acid**
* **2% protein**
* Look like “brush pile” on microscope
47
* Fluid comes from filtration and diffusion from capillaries, same constituents as plasma but much lower protein concentration b/c cannot pass easily through capillary
* ISF trapped in proteoglycan filaments
* **Tissue gel**
48
* free fluid amount is usually \_\_\_%
* Diffusion through gel occurs about ___ to \_\_\_% as rapidly as it does through free fluid
**free fluid**
* **normally less than 1%** but can expand tremendously with tissue edema until one half or more of the edema fluid becomes freely flowing fluid independent of the proteoglycans filaments
* **Diffusion** through **gel** occurs about **95-99%** as rapidly as it does through **free fluid**
49
fluid filtration
* Colloid osmotic pressure cause fluid movement by ____ from interstitial space into blood
**filtration**
* Colloid osmotic pressure cause fluid movement by **osmosis** from interstitial space into blood
50
Movement of fluid volume from plasma & ISF determined by:
**Starling forces**
51
list and describe all straling forces variables and their function.. don't let me down
* **Capillary pressure**
* Forces fluid outward
* **Interstitial fluid pressure**
* Forces fluid inward to capillary if positive, outward if negative
* **Plasma colloid osmotic pressure**
* Osmosis of fluid inward through capillary membrane
* **Interstitial fluid colloid osmotic pressure**
* Osmosis of fluid outward through capillary membrane
52
symbols for these
* Capillary pressure
* Interstitial fluid pressure
* Plasma colloid osmotic pressure
* Interstitial fluid colloid osmotic pressure
* Capillary pressure **(Pc)**
* Interstitial fluid pressure **(Pif)**
* Plasma colloid osmotic pressure **(**∏**p)**
* Interstitial fluid colloid osmotic pressure **(**∏**if)**
53
**Net filtration pressure**
* **sum of 4 forces**
* **NFP =**
**Net filtration pressure**
* sum of 4 forces
* **NFP = Pc - Pif - (∏****p) + (∏****if)**
* **multiply this by Kf (cap filtration coeff) to get get the rate of fluid FILTRATION.**
* **Filtration = Kf x NFP**
54
**NFP**
* **Sum is (+)** – net fluid **\_\_\_\_**occurs across capillary
* **Sum is (-)** – net fluid **\_\_\_\_\_**from __ into \_\_\_
* normally which one + or -?
* **Sum is (+)** – net fluid **filtration** occurs across capillary
* **Sum is (-)** – net fluid **absorption** from interstitial spaces into capillary
* **Normally slightly positive so flow into capillary**
55
* Capacity of capillary membranes to filter water for a given NFP
* Determined by number and size of pores in each capillary as well as number of capillaries in which blood is flowing
**Capillary filtration coefficient (Kf)**
56
Capillary filtration coefficient (Kf)
* value in this format
* **mL/min per mmHg NFP**
57
* **Filtration =**
* **Filtration = Kf x NFP**
58
**Primary force** for driving fluid transport between capillaries & tissues
**Capillary Hydrostatic Pressure**
* Primary force for driving fluid transport between capillaries & tissues is hydrostatic P
59
* Defined as pressure of any fluid enclosed in a space
* Depends on which organ and tissue capillary is located in
**Capillary Hydrostatic Pressure**
60
**Capillary Hydrostatic Pressure**
* Fluid \_\_\_\_out at arteriolar end; \_\_at venular end
* (absorption vs filtration)
**Capillary Hydrostatic Pressure**
* Fluid **filters** out at arteriolar end; **reabsorbs** at venular en
61
**capillary hydrostatic pressure**
* Arterial end ~ **\_\_\_ mmHg**
* venous end ~ **\_\_\_ mmHg**;
* mean ~ **\_\_\_mmHg**
* Generally **\_\_\_** mm Hg (average) more than pressure in venous end
**capillary hydrostatic pressure**
* Arterial end ~ **25 mmHg**
* venous end ~ **10 mmHg**
* mean ~ **17 mmHg**
* Generally **15-25 mm Hg (average)** **more than pressure in venous end**
62
**ISF Hydrostatic Pressure**
**ISF Hydrostatic Pressure**
* **~ - 6.3 mmHg**
* some references 3 mmHg; 5 mmHg)
63
* \_\_\_pressure holds tissues together at a minimal distance so that _____ can occur
* Loss of ____ pressure allows fluid to accumulate in interstitial spaces=edema
* **Negative pressure** holds tissues together at a minimal distance so that **diffusion** can occur
* **Loss of negative** pressure allows fluid to accumulate in interstitial spaces=**edema**
64
**Colloid Osmotic Pressure**
* **Plasma:** determined by **\_\_\_\_** in the plasma-responsible for osmotic pressure in plasma and ISF.
**Colloid Osmotic Pressure**
* **Plasma:** determined by **proteins** in the plasma-responsible for osmotic pressure in plasma and ISF.
65
**only** components that cannot pass through pores
**Proteins** are the only components that cannot pass through pores.
66
**proteins COP**
\_\_ mmHg
* \_\_\_% from \_\_\_
* \_\_\_% from \_\_\_
**proteins COP**
**28 mmHg**
**•80% from albumin**
**•20% from globulins**
67
Protein
* ____ in nature so likes to bind __ drugs
* (a-b) balance/binding
Protein
* **Basic** in nature so **likes to bind acidic** drugs
68
protein type
* Natural and acquired immunity
* Weakly acidic so binds to basic drugs
* **20%** of protein from **globulins**
* **Natural and acquired immunity**
* **Weakly acidic so binds to basic drugs**
69
* protein type that is \<0.3%
* Clotting
* **Fibrinogen** is \<0.3%
* Clotting
70
* Normal plasma is about __ mm Hg osmotic pressure; __ mm of this is caused by molecular effects of dissolved protein and 9 mm is causes by ___ \_\_\_\_\_
* extra osmotic pressure caused by Na+, K+, and other cations held in the plasma by proteins.
* Normal plasma is about **28** mm Hg osmotic pressure; **19 mm** of this is caused by molecular effects of dissolved protein and 9 mm is causes by **Donnan effect**
* extra osmotic pressure caused by Na+, K+, and other cations held in the plasma by proteins.
71
\_\_\_ plasma proteins attract ___ charged ions
**Negative** plasma proteins **attract + charged ions**
72
* **ISF:** determined by ____ in the ISF
* **\_\_ mmHg colloid osmotic pressure**
* **ISF:** determined by **proteins** in the ISF
* **8 mmHg colloid osmotic pressure**
73
* ISF: Protein concentration about \_\_\_% of that in plasma
* *Contains more protein than plasma but b/c volume of ISF is so much greater than plasma throughout body, average protein content is only about \_\_\_% of what you find in plasma, or 3 g/dL and 8 mm Hg*
* **ISF:** Protein concentration about **40% of that in plasma**
* *Contains more protein than plasma but b/c volume of ISF is so much greater than plasma throughout body, average protein content is only about **40%** of what you find in plasma, or 3 g/dL and 8 mm Hg*
74
**Lymphatics**
* Composed of these:
**Lymphatics**
* Composed of these:
1. **Vessels**
2. **Nodes**
3. **Organs**
1. **Thymus**
2. **Tonsils**
3. **Spleen**
4. **Bone marrow**
4. **Lymph & lymphocytes**
75
Order of lymph system
1. **L Capillaries** (smallerst)
* Smallest vessels – first to receive lymph – drain into larger vessels
2. **L Vessels** from various regions of body merge to form lymphatic trunks.
3. **Nodes**
4. **Trunks** – from collecting vessels
5. **Ducts**
76
**5 major Tunks**
and list where they are coming from
**5 major Tunks**
1. **Lumbar** – lymph from lower limbs
2. **Intestinal** – receives chyle and lymph from digestive organs
1. **Chyle**
1. milky fluid consisting of fat droplets and lymph
2. Drains from lacteals of the small intestines into lymph system during digestion
3. **Bronchomediastinal** - lymph from thoracic viscera
4. **Subclavian** – lymph from upper limbs and thoracic wall
5. **Jugular** – lymph from head & neck
77
**Ducts (3)**
**Ducts (3)**
1. **Cisterna chyli**
2. **Thoracic duct**
3. **Right lymphatic duct**
78
drains ¾ of the lymph of body
**Thoracic duct**
79
formed by **lumber & intestinal trunks** merge at start of thoracic duct
**Cisterna chyli**
* formed by lumber & intestinal trunks merge at start of thoracic duct
80
Most important function of lymphatics (2)
Most important function of lymphatics
## Footnote
**•Return of proteins into circulation**
**•Maintenance of low-protein concentration in ISF**
81
* There are proteins and other solutes that cannot be absorbed tissue spaces into capillaries.
* If these proteins not removed **hhh'what** happens? (that was a dad joke for Mina form Aleks)
* There are proteins and other solutes that cannot be absorbed tissue spaces into capillaries.
* If these proteins not removed
* **↑↑↑ ISF colloid osmotic pressure**
* **Life threatening edema occurs within a few hours**
* **Death within 24 hours**
82
* Areas of body without lymph drainage have ***\_\_\_\_\_***
* ALL areas of body have lymph channels *except: (4)*
* Areas of body **without lymph** drainage have ***prelymphatics***
* ALL areas of body have lymph channels *except:*
* **Superficial portions of skin**
* **CNS**
* **Endomysium of muscles**
* **Bones**
83
* reabsorption pressure causes about ___ of fluid that has come out of arterial ends to be reabsorbed at venous end
* remaining ___ flows into lymph vessels and returns to venous blood
* this adds to be ___ L per day
* reabsorption pressure causes about **9/10** of fluid that has come out of arterial ends to be reabsorbed at venous end
* remaining **1/10** flows into lymph vessels and returns to venous blood
* this adds to be **2 -3 L per day**
84
Virtually all lymph vessels in lower body will empty into __ \_\_\_
Virtually all lymph vessels in lower body will empty into **thoracic duct**
85
* **Thoracic duct (\_\_\_ mm diameter)**
* Lymph from ___ body
* Empties into circulation at junction
* Lymph from \_\_side of head, left arm & parts of chest
* **Thoracic duct (2 mm diameter)**
* Lymph from **lower** body
* Empties into circulation at junction at **LEFT IJ Vein and LEFT SC vein**
* Lymph from **left side of head, left arm & parts of chest**
86
**Right lymph duct**
drain from what parts
* **Right lymph duct**
* **right side of neck and head**
* **right arm**
* **parts of right thorax**
87
* Endothelial cells of lymphatic capillary are attached by ___ \_\_\_\_\_ to surrounding connective tissue
* Endothelial cells of lymphatic capillary are attached by **anchoring filaments** to surrounding connective tissue
88
Lymphatics have ___ at **tips of** **terminal capillaries** (where ISF enters lymphatic system) & along ____ vessels
Lymphatics have **valves** at **tips of** **terminal capillaries** (where ISF enters lymphatic system) & along **larger** vessels
89
* **Formation of Lymph**
* Derived from **\_\_\_**
* Protein concentration different depending on which organ/tissue its draining from
* **Formation of Lymph**
* Derived from **ISF**
* Protein concentration different depending on which organ/tissue its draining from
90
* **Protein concentrations** in the following:
* **ISF**![]()
* **Lymph**![]()
* **Liver**
* **Intestinal**
* **Thoracic duct**
* 2/3 of total lymph from __ and \_\_
* **Protein concentrations** in the following:
* ISF ![]() **2 g/dL**
* Lymph ![]() **1.8 g/dL**
* Liver derived lymph as high as **6.0 g/dL**
* Intestinal Lymph ~ **3 – 4 g/dL**
* Thoracic duct ~ **3.5 g/dL**
* **bc 2/3 of total lymph from liver and intestines**
91
* **Major channel for absorption of nutrients** from **\_\_ \_\_\_**, esp. for \_\_
* **Major channel for absorption of nutrients** from **GI system,** esp. for **fats**
* Sometimes **thoracic duct fat can be 1-2%**
92
* ____ particles that enter lymph system are destroyed and removed as they pass by lymph nodes
* **Large particles** that enter lymph system are **destroyed and removed** as they pass by lymph nodes
93
* **Rate of Lymph Flow**
* \_\_mL/hr through thoracic duct (at rest)
* __ mL/hr through other channels
* Total __ mL/hr
* Total \_\_L/day
* **Rate of Lymph Flow**
* **100 mL/hr** through **thoracic duct (at rest)**
* **20 mL/hr** through **other channels**
* **Total 120 mL/hr**
* Total **2-3L/day**
94
* 2 primary factors determine lymph flow:
* 2 primary factors determine lymph flow:
* **ISF pressure**
* **Activity of lymph pump**
95
* Rate of lymph flow
* product of what?
* ISF pressure = **\_\_mmHg**
Rate of lymph flow:
* **ISF pressure x activity of lymphatic pump**
* ISF pressure = **- 6 mmHg**
96
**ISF pressure**
* Factors that cause this to become more negative will have what affect on lymph flow?
* **If ISF = 0 mmHg** (atmospheric pressure)
* Flow will **\_\_**
**ISF pressure**
* Factors that cause this to become more negative **will not affect flow of lymph flow much**
* If **ISF = 0 mmHg** (atmospheric pressure)
* Flow will **increase 20X**
97
* **Factors that increase ISF causing increase lymph** flow (4): (indicate INC or DEC as well for each factor)
* Factors that **increase ISF causing increase lymph flow**
* **INC capillary hydrostatic pressure**
* **DEC plasma colloid osmotic pressure**
* **INC interstitial fluid colloid osmotic pressure**
* **INC permeability of the capillaries**
98
* All of the factors that INC ISF and INC lymph flow will cause fluid to move into interstitium which increases these things all at the same time (3):
* All of these factors above cause fluid to move into interstitium which increases these things all at the same time
* **ISF volume**
* **ISF pressure**
* **Lymph flow**
99
* This happens when **ISF pressure becomes greater than atmospheric pressure**
* Lymph flow has **maximum flow rate:**
100
* how does lymphatic vessels contract?
* **When a collecting lymphatic or a larger vessel is stretched with fluid, the smooth muscle in the walls of vessels starts to contract**
101
* Thoracic duct can generate pressures as great as __ -\_\_\_ mmHg
* Thoracic duct can generate pressures as great as **50-100 mmHg**
102
* \_\_\_\_\_\_lymph capillaries can also pump lymph
* If excess fluid enters, what happens?
* **Terminal** lymph capillaries can also pump lymph
* If excess fluid enters:
1. **lymphatic capillaries causing swelling**
2. **valves close causing increase in pressure**
* lymph is pushed forward towards collecting lymphatics
103
* **Lymphatic capillary endothelial cells** have few contractile filaments of \_\_\_\_-\_\_\_\_\_ which adds to pumping mechanism
* **Lymphatic capillary endothelial cells** have few contractile filaments of **actin-myosin** which adds to pumping mechanism
104
Pumping due to **external intermittent compression** of lymphatics (listed in order of importance) (4):
* Pumping due to **external intermittent compression** of lymphatics (listed in order of importance)
1. **Contraction of surrounding skeletal muscles**
2. **Movement of parts of the body**
3. **Pulsations of arteries adjacent to lymphatics**
4. **Compression of tissues by objects outside the body (i.e. tourniquet)**
105
* Both can cause **intrinsic intermittent compression** of vessel walls
* **Lymphatic pump**
* **Lymphatic capillary pump**
106
* Central role in controlling these 3 things:
* Central role in controlling
* 1) **ISF protein concentration**
* Proteins that leak out of arterioles tend to accumulate in interstitium (IS)
* INC ISF colloid osmotic pressure
* 2) **ISF volume**
* INC ISF colloid osmotic pressure favors fluid filtration
* 3) **ISF pressure**
* INC volume (IS) = INC ISF pressure = INC rate of lymph flow
107
* __ \_\_\_\_ pressure holds body tissues together
* If lost, edema develops
* **Negative ISF** pressure holds body tissues together.
* Creates vacuum.
* If lost, edema develops
108
Edema results from inability of lymph vessels to transport fluid. What are 4 causes?
* Results from inability of lymph vessels to transport fluid. Causes:
* **Damage of lymphatic vessels**
* **Excessive fluid administration**
* **Capillary fluid leakage** (dt increased permeability)
* **Low serum protein concentration**
* **Elevated CVP**
109
beside in periphery, where can edem'er set in?
* Also accumulates in potential spaces
* **Pleural cavity**
* **Pericardial**
* **Synovial**
110
* One of areas most prone to develop edema
excessive fluid in **peritoneal space**
ascities
111
* Increase pressure in liver (i.e. cirrhosis, heart failure) causes _____ of protein containing fluids from surface of liver into peritoneal cavity
* Increase pressure in liver (i.e. cirrhosis, heart failure) causes **transudation** of protein containing fluids from surface of liver into peritoneal cavity
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* Part of lymph carries bacteria/invaders to tissues
* Involved in removal/destruction of these substances
* **Most important tissue of immune system**
**Lymphoid Tissue** (part of lymph tissue)
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* Attack and destroy specific organisms or toxins. Located in many parts of body where lymphoid tissue is.
* **Lymphocytes**
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* **Primary Organs** – lymphocyte generation
* **Primary Organs** – lymphocyte generation
* **Bone marrow**
* **Thymus**
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* **Secondary Organs** – primary role and main organs
* **Secondary Organs** – activation & initiation
* **Lymph nodes**
* **Spleen**
* **MALT**
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**MALT:** where and what?
* **MALT** (mucosa associated lymphoid tissue) found in:
* **palatine tonsils**
* **nasopharyngeal tonsils**
* **Peyer’s patches in small intestines**
* **Lymphoid nodules in respiratory**
* **Urogenital system**
* **Skin**
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* lymphocytes arise from what primary organ?
* **bone marrow**
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* \_\_\_% of B-cells complete development and mature into B- lymphocytes
* Leave bone marrow via __ \_\_\_
* Characterized by various arrangement of ___ on their surface
* Life span: \_\_days
* **25 %** of B-cells complete development and mature into B- lymphocytes
* Leave bone marrow via **central sinuses**
* Characterized by various arrangement of **immunoglobins on their surface**
* **Life span**: **3-4 days**
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* T-cells develop in ___ from bone marrow-derived _____ cells
* First migrate to outer region of ___ (this is called a **\_\_\_\_ cortex**)
* T-cells develop in **thymus** from bone marrow-derived **progenitor cells**
* First migrate to outer region of **thymus** (this is called a **thymic cortex**)
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* 2 types of immunity of lymph and what does each involve?
* 2 types of immunity
* 1) **Humoral**
* ****involves **antibodies produced by B-cells**
* 2) **Cellular**
* ****involves **attacks on cells**
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* Life span of T cells: **\_\_\_ days**
* compare T to B-cell number wise
* Life span of T cells: **100-200 days**
* **T-cells 4-5x \> B-cells**
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* INC ![]() lymphocytes means what?
* INC ![]() lymphocytes means systemic response to **most viral & some bacterial** infections
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important role of T cells in relation to B-cells
* Important role in **controlling immune response of B-lymphocytes**
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* Some lymphoid cells (regardless, whether in lymphoid or thymus) can develop into cancer: (2)
* Some (regardless, whether in lymphoid or thymus) can develop into cancer:
* **Hodgkins Lymphoma**
* **Nonhodgkins Lymphoma**
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* site of maturation for T lymphocytes
* secretes what hormone to stimulate T-cell formation
* most active when?
* mature when?
* mostly what by age 75
* site of maturation for T lymphocytes **thymus**
* secretes what hormone to stimulate T-cell formation **thymosin**
* most active when? **childhood**
* mature by **puberty**
* mostly what by age 75? **fat (atrophy)**
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* Largest organ of lymphatic system
**spleen**
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Primary functions of spleen (3)
* Primary function of spleen
* **Filter blood (removes damaged cells, cellular debris, pathogens)**
* **Storage of platelets**
* **Houses & aids in maturation of B lymphocytes**
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* red and white pulp in spleen
* one that is responsible for housing and aiding maturation of lymphocytes and clearing lymph system of debris
**white pulp**
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* **Tonsils**
* House what cells?
* Serve to protect what organs?
* Four groups form what ring and what are the individual names of those 4?
* **Tonsils**
* House **lymphocytes** and **macrophages**
* Serve to protect **lungs and GI tract** from disease-causing agents that enter via **nose or mouth**
* Four groups form ring (**Waldeyer’s ring**)
* **Palatine, pharyngeal, lingual and tubal**
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* at pillars (back of throat)
* Referred to as tonsils that are taken out
* Small and diamond shaped and sit btw palatine arches on either side of pharynx just beyond base of tongue
* Primarily lymphoid tissue
* Organized as follicles and crypts that are covered by mucous membranes
**Palatine**
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tonsils
* Adenoids
* Located in nasopharyngeal border
**pharyngeal tonsils**
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where are **peyer's patches** located in GI
* Small masses of lymphatic tissue found throughout the
* **ilium**
* **jejunum**
* **duodenum**
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List some characteristics of Lymph node
* shape
* surrounded by
* single or grouped?
* deep vs superficial (locations)
* size
* amount
Lymph node
* **Bean-shaped structure**
* **Surrounded by a capsule of connective tissue**
* **Usually occur in groups**
* **Superficial: in subcu connective tissue**
* **Deeper: in fascia of muscles & in various body cavities**
* **Tiny, can be 0.5-1 cm size**
* **up to 450**
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* most commonly used to help stage breast cancer & melanoma
* Also colorectal, gastric, esophageal, head & neck, thyroid & non-small cell lung cancer
**•Sentinel lymph node** biopsy most commonly used to help stage breast cancer & melanoma
•Also colorectal, gastric, esophageal, head & neck, thyroid & non-small cell lung cancer
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