The Lymphatic System

Includes the lymph, lymphatic vessels, lymph

nodes, lymphoid organs (tonsils, spleen and
thymus)
Primary Functions:
1. Maintains fluid homeostasis
2. Absorbs lipids from the GIT
3. Filters blood (spleen)
4. Contains lymphocytes participating in
immunity
 The Lymph
Fluid similar to composition as
plasma
Without RBC and less proteins
Special Lymph from the GIT is
loaded with fats and is called
CHYLE
Fig. 14.2
 The Lymph vessels
Carry fluid away from tissues into
the venous circulation
These are NOT present in the
central nervous system, Bone
marrow, epidermis and cartilage
They resemble vein because they
have valves
 3 mechanisms of edema
formation
1. Decrease oncotic pressure
cirrhosis and kwashiorkor
2. Increased hydrostatic pressure
CHF and prolonged standing
3. Lymphatic obstruction or
destruction filiariasis, lymph node
dissection
 Lymphatic duct
1. Right lymphatic duct- drains
the right side of the head and
the upper right side of the
thorax and the right extremities
2. Thoracic duct- drains the rest
of the body
 The Lymphatic organs
1. Tonsils
A. palatine
B. pharyngeal
C. lingual
D. tubal
 The lymphatic organs
2. Lymph nodes
Small round structures of lymphoid tissue
Major lymph nodes are the axillary,
inguinal and cervical
Filters lymph
Activates the immune system
Removes microorganisms from the blood
 The lymphoid organs
3. The spleen
Reddish, flat organ lying next to the 9th and 10th rib
in the left upper quadrant
Functions:
Repository of old RBC
Activates the immune system
Storage of Blood
Sequesters bacteria
MOST COMMONLY INJURED
in BLUNT abdominal trauma
The lymphoid organs
4. Thymus
Bilobed organ in the superior mediastinum
Lymphocytes from the bone marrow
mature and grow as T-lymphocytes
Positive selection= T-cells that react to
foreign antigen are selected
Negative selection= T-cells that do not
react to the self-antigen are selected
 IMMUNITY
Innate or Non-specific Specific Immunity
1. Mechanical- skin, 1. Cellular
mucus, saliva, urine
Immunity- T-cell
2. Chemical- enzymes,
lysozymes
system
3. Vascular Blood cells- 2. Humoral
Neutrophils and Immunity- B-cell
macrophages system
4. Inflammation
 Non-specific Immunity
Inflammatory response
Reaction of the vacularized living tissues to
injury
Classic signs:
1. Rubor- redness
2. Calor- heat
3. Tumor- swelling
4. Dolor- pain
5. Functio laesa- loss of function
 Inflammation
Initial reaction Vasoconstriction!
VC VD VP (due to HISTAMINE)
VD Redness and Heat
VP Swelling
Bradykinin, Prostaglandin,
compression of tissues pain
 Specific Immunity: T cell
T-cells originate in the bone marrow and
mature in the thymus
4 types of T-cells
1. Cytotoxic T cells- kill infected cells, cancer
cells and transplanted cells
2. Helper T cells- help the humoral immunity
3. Suppressor T cells- suppress that actions of
cytotoxic and Helper cells
4. Memory T cells- for recall and specificity
 Specific Immunity: B cells
B cells are produced and
mature in the bone marrow
B cells helped by Helper
cells turn into Plasma cells
secrete ANTIBODIES
 ANTIBODIES
Are proteins that can combine
with antigens and function for:
1. Opsonization
2. Neutralization
3. Activation of complement
system
 ANTIBODIES types
Five classes
1. Ig M- priMary response, pentaMer
2. Ig G- secondary response, most
abundant, can cross placenta
3. Ig A- secreted by the body (sIgA)
4. Ig D- receptor for B cells
5. Ig E- allergic and parasitic reactions
 TYPES OF IMMUNITY
1. Natural Immunity
Active natural
Passive natural
2. Artificial Immunity
Active artificial
Passive artificial
Fig. 14.18
End of Immune System
THE RESPIRATORY SYSTEM
 The Respiratory System
Composed of the air conducting
system and the respiratory unit
(lungs)
Major function is RESPIRATION
Commonly divided into UPPER
RESPIRATORY tract and LOWER
RESPIRATORY tract
Ventilation and Respiration
VENTILATION- movement of air from the
atmosphere into the lungs and out of the
lungs
EXTERNAL RESPIRATION- exchange of
gases between the alveoli and the blood
INTERNAL RESPIRATION- exchange of
gases between the blood and the tissues
 The Respiratory System
Commonly divided into
UPPER RESPIRATORY tract and
LOWER RESPIRATORY tract
The UPPER Respiratory tract
The nose, pharynx and larynx
The LOWER respiratory tract
Composed of The trachea
down to the Lungs
 The NOSE
Made up of nasal bones and
cartilages
The NASAL cavity is made up of
bones, cartilages and turbinates or
conchae
The nostril is the external opening
The choanae is the internal opening
 Functions of the nose
1. Hairs or vibrissae filter
large particles
2. Blood vessels warm the air
3. Mucus serves to humidify
the air
4. Phonation
 The Pharynx
Musculo-membranous tube from
behind the nasal cavity to the
level of the cricoid cartilage (C6)
 The Pharynx
3 component parts
1. Nasopharynx
2. Oropharynx
3. Laryngopharynx
 The Larynx
Upper expanded portion of the trachea
Made up of cartilages
3 Unpaired- Cricoid, Thyroid and
Epiglottis ( cUte)
6 Paired- Cuneiform, Corniculate and
Arytenoid (pACC)
Function: air passageway and phonation
 The vocal cords
1. False vocal cords
2. True vocal cords
3. Glottis- the space between the
true vocal cords and is the
narrowest portion of the adult
airway
Fig. 15.4
 Lower airway: Trachea
Called windpipe
Made up of 15-20 C-shaped
cartilage
10-11 inches
Lined with pseudostratified
ciliated epithelium
 Bronchus
RIGHT Bronchus Left bronchus
Wider Narrower
Shorter Longer
More vertical More horizontal
 Bronchioles
Primary bronchussecondary
bronchustertiary bronchus terminal
bronchioles

Respiratory bronchioles belong to the

respiratory unit
 Respiratory unit
Respiratory bronchioles
Alveolar ducts
Alveolar sacs
alveolus
 The Pleura
Surrounds the lungs and provide
protection
1. Parietal pleura- in the chest wall
2. Visceral pleura- intimately attached
to the lungs
3. Pleural space- in between the two
Diaphragm
 Respiratory Physiology
1. Ventilation and gas exchange
2. Mechanics of breathing
3. Gas transport
4. Pulmonary volumes and capacities
5. Respiratory control
 Ventilation
Ventilation is the movement of air into
the lungs
Air (oxygen) moves by the process of
diffusion from the higher concentration
in the alveoli to the pulmonary
capillaries
Mechanics of breathing
 Gas exchange
Respiratory membrane is thin which
facilitates gas exchange
Rate of diffusion depends on the
thickness of the membrane, surface
area and partial pressure of gases
 Gas transport
1. OXYGEN- majority is transported in
the blood loosely bound to hemoglobin-
oxyhemoglobin
2. CARBON DIOXIDE- majority is
transported in the blood in the RBC as
BICARBONATE
Fig. 15.8
 LUNG VOLUMES
1. Tidal volume – TV
2. Inspiratory Reserve Volume- IRV
3. Expiratory Reserve Volume- ERV
4. Residual volume- RV
 LUNG CAPACITIES
Lung volume + another lung volume
1. Inspiratory Capacity- IC
2. Functional Residual Capacity- FRC
3. Vital capacity- VC
4. Total Lung capacity- TLC
NOT CLINICALLY measured
1. Residual volume
2. Functional residual volume
3. Total lung capacity
Control of Respiration: Central
Respiratory center in the medulla
Controls the rate and depth of
respiration
Increased CO2 is the most potent
stimulus
 Control of Respiration:
Peripheral
1. Chemoreceptors in the carotid and aortic
bodies
Sensitive to changes in pH and O2
Decreased O2 increase respiration
Decreased pH (acidosis) increase respiration
2. Herring-Breurer reflex
Stretch receptors in the lungs limit the inspiration
 ASSESSMENT
Normal Breathing pattern:
12-21 respiratory rate
Active inspiration with contraction of
diaphragm
Passive expiration with relaxation of
diaphragm
Steady rhythm and regular rate and size
I:E ratio is 1:2
Abnormal breathing pattern
1. Cheyne-Stoke’s
2. Biot’s
3. Kussmaul’s
4. Agoral
 Breathing rates
1. Eupnea- 12-21
2. Bradypnea- 11 and below
3. Tachypnea- 22 and above
4. Dyspnea- difficulty of breathing
 Breathing Position
1. Platypnea- inability to breath in an
upright position
2. Orthopnea- difficulty in breathing in
any position except upright
 Breath sounds: Normal
1. Bronchial or Tracheal- in the sternum
2. Bronchovesicular- in the interscapular
area
3. Vesicular- lung periphery
Adventitious Breath sounds
1. Rales or crackles
2. Stridor
3. Wheeze
4. Rhonchi
5. Friction rub