Lymphatic System Notes

Module # 32 Lymphatic System

32. 1 Lymph Circulation

❏ Lymph circulates throughout the body. It begins as interstitial fluid between cells
and filters into lymphatic capillaries, flowing into larger vessels and trunks, and
eventually returning to venous blood.

Lymph Vessels
❏ The left lymphatic duct, or Thoracic Duct is the largest in diameter of the
lymphatic ducts.
❏ The Thoracic Duct drains the left side of the head, neck, and chest, the left
upper limb, the left upper back, and the left chest wall.
❏ The Thoracic Duct receives lymph from numerous branches and trunks,
including the left jugular, left subclavian, and left bronchomediastinal
trunks.
❏ The Thoracic Duct begins in the abdomen anterior to the second lumbar
vertebra.
❏ The Thoracic Duct originates from a convergence of lymphatic trunks,
which sometimes form a sac known as the Cisterna Chyli.
❏ Passing upward, the thoracic duct enters the thorax through the aortic
hiatus of the diaphragm and ascends through the posterior mediastinal
cavity. It forms an arch above the clavicle and crosses anterior to the
subclavian artery.
❏ The Thoracic Duct ends by opening into the junction of the left subclavian
vein and the left internal jugular vein, which is also known as the left
venous angle, where it conveys lymph into the bloodstream.

Lymph Trunks
❏ In the left upper limb, superficial lymphatic vessels course alongside the
superficial veins, while deep lymphatic vessels accompany the deep
veins. Both types of vessels drain into the axillary lymph nodes.
❏ Major lymph node groups in the upper limb include the cubital lymph
nodes in the elbow region, as well as several subgroups in and around the
axillary region; the Humeral (later) axillary lymph nodes, the Deltopectoral
nodes, the Pectoral (anterior) nodes, the subscapular (posterior) nodes,
the central axillary (intermediate) nodes, and the apical (subclavicular,
medial) nodes.
 ○ Lymph form the axillary nodes on the left side of the body empties
into the subclavian trunk, which empties into the thoracic duct, or
left lymphatic duct.

Venous Blood
❏ Veins are vessels of the circulatory system that support circulation by
conveying blood to the heart.
❏ In the Systemic Circulation veins carry deoxygenated blood.
❏ The roles are reversed in the pulmonary circulation.
❏ The pulmonary veins transport oxygen-rich blood from the lungs to the left
ventricle. Veins and their branches of the systemic circulation carry
deoxygenated blood from body tissues into the vena cavas (superior,
inferior) and to the right atrium of the heart.
❏ Overall, veins are larger and more numerous than arteries. The walls of
veins, like those of arteries are composed of three coats or tunics: an
inner endothelial coat (tunica intima), a middle muscular coat (tunica
media), and an outer connective tissue coat (tunica adventitia).
❏ The walls of veins are thinner than those of arteries; and unlike arteries,
most veins contain valves that prevent the backflow of blood moving
toward the heart.
❏ Large numbers of valves are present in the veins of the limbs, especially
the lower limbs, which must conduct blood against the force of gravity.
❏ Veins are divided into 2 sets, superficial and deep, that anastomose, or
cross connect, frequently with each other.
❏ Superficial veins lie immediately beneath the skin.
❏ Deep veins generally are arranged in pairs and situated on either side of
the corresponding artery.

32. 2 Lymphatic Vessels and Veins

❏ Lymph empties into the bloodstream from the thoracic duct and right lymphatic
duct, at the junction between the subclavian and internal jugular veins.

Thoracic Duct (Left Lymphatic Duct)

❏ The Left Lymphatic Duct, or Thoracic duct, is the largest in diameter of the
lymphatic ducts.
❏ Thoracic duct drains the left side of the head, neck, and chest, the left
upper limb, the left upper back, and the left chest wall.
❏ The Thoracic Duct, receives lymph from numerous branches and trunks,
cluding the left jugular, left subclavian, and left bronchomediastinal trunks.
 ❏ The Thoracic duct begins in the abdomen anterior to the second lumbar
vertebra.
❏ The Thoracic Duct originates from a convergence of lymphatic trunks,
which sometimes form a sac known as the Cisterna Chyli.
❏ Passing upward, the thoracic duct enters the thorax through the aortic
hiatus of the diaphragm and ascends through the posterior mediastinal
cavity. It forms an arch above the clavicle and crosses anterior to the
subclavian artery.
❏ The Thoracic Duct ends by opening into the junction of the left subclavian
vein and the left internal jugular vein, which is also known as the left
venous angle, where it conveys lymph into the bloodstream.

Right Lymphatic Duct

❏ Lymph from the right side of the face and scalp drains toward the neck,
where it enters the submandibular, submental, mastoid, occipital, and
parotid nodes. From there, the Lymph drains into the right deep cervical
lymph nodes, which are located along the course of the right internal
jugular vein.
❏ Superficial tissues of the neck contain lymph vessels that drain into the
right superficial cervical lymph nodes alongside the right external jugular
vein. The right jugular lymphatic trunks empty into either the right
lymphatic duct or directly into the right venous angle (the junction of the
subclavian and internal jugular veins).

Subclavian Veins
❏ The Subclavian vein is the continuation of the axillary vein which drains
the arm.
❏ The Subclavian extends from the outer border of the first rib to the sternal
end of the clavicle, where it unites with the internal jugular to form the
brachiocephalic (innominate) vein.
❏ The subclavian vein usually contains a pair of valves near its termination.
❏ Tributaries of the subclavian vein include the circumflex scapular and its
extension, the suprascapular, as well as the external jugular veins.

Internal Jugular Veins

❏ The internal jugular veins are formed by the union of the inferior petrosal
and sigmoid sinuses (or dural sinuses) and the facial veins, and begin at
the jugular foramen at the base of the skull.
❏ At the root of the neck, each internal jugular vein unites with the
subclavian vein of that side to form a brachiocephalic (innomate) vein,
 which joins the brachiocephalic vein of the opposite side to form the
superior vena cava.
❏ The Internal Jugular contains a pair of valves at about 2.5 cm above its
termination.
❏ Tributaries of the Internal Jugular Vein include: Middle Thyroid, Superior
Thyroid, Facial Trunk, Retromandibular, anterior division.

32. 3 Thoracic Duct

❏ The Thoracic Duct, or left Lymphatic duct, begins at the Cisterna Chyli and
collects lymph from the left upper body and the entire body beneath the ribs.

Thoracic Duct
❏ The Left Lymphatic Duct, or Thoracic duct, is the largest in diameter of the
lymphatic ducts.
❏ Thoracic duct drains the left side of the head, neck, and chest, the left
upper limb, the left upper back, and the left chest wall.
❏ The Thoracic Duct, receives lymph from numerous branches and trunks,
cluding the left jugular, left subclavian, and left bronchomediastinal trunks.
❏ The Thoracic duct begins in the abdomen anterior to the second lumbar
vertebra.
❏ The Thoracic Duct originates from a convergence of lymphatic trunks,
which sometimes form a sac known as the Cisterna Chyli.
❏ Passing upward, the thoracic duct enters the thorax through the aortic
hiatus of the diaphragm and ascends through the posterior mediastinal
cavity. It forms an arch above the clavicle and crosses anterior to the
subclavian artery.
❏ The Thoracic Duct ends by opening into the junction of the left subclavian
vein and the left internal jugular vein, which is also known as the left
venous angle, where it conveys lymph into the bloodstream.

Cisterna Chyli
❏ The Cisterna Chyli is a lymphatic sac that, if present, forms the base of the
thoracic duct anterior to the first or second lumbar vertebra.
❏ The Cisterna Chyli is formed by the convergence of the right and left
lumbar lymphatic trunks and the intestinal lymphatic trunk.

Areas drained by Thoracic Duct

32. 4 Right Lymphatic Duct

❏ The right lymphatic duct collects lymph from the right upper body.
 Right Lymphatic Duct
❏ Lymph from the right side of the face and scalp drains toward the neck,
where it enters the submandibular, submental, mastoid, occipital, and
parotid nodes. From there, the Lymph drains into the right deep cervical
lymph nodes, which are located along the course of the right internal
jugular vein.
❏ Superficial tissues of the neck contain lymph vessels that drain into the
right superficial cervical lymph nodes alongside the right external jugular
vein. The right jugular lymphatic trunks empty into either the right
lymphatic duct or directly into the right venous angle (the junction of the
subclavian and internal jugular veins).

Areas drained by right lymphatic duct

32. 5 Lymph Trunks

❏ Lymph trunks are major lymphatic vessels that empty into the thoracic and right
lymphatic ducts.

Jugular Trunks and nodes

❏ Lymph from the right side of the face and scalp drains toward the neck,
where it enters the submandibular, submental, mastoid, occipital, and
parotid nodes. From there, the Lymph drains into the right deep cervical
lymph nodes, which are located along the course of the right internal
jugular vein.
❏ Superficial tissues of the neck contain lymph vessels that drain into the
right superficial cervical lymph nodes alongside the right external jugular
vein. The right jugular lymphatic trunks empty into either the right
lymphatic duct or directly into the right venous angle (the junction of the
subclavian and internal jugular veins).

Subclavian Trunks
❏ In the left upper limb, superficial lymphatic vessels course alongside the
superficial veins, while deep lymphatic vessels accompany the deep
veins. Both types of vessels drain into the axillary lymph nodes.
❏ Major lymph node groups in the upper limb include the cubital lymph
nodes in the elbow region, as well as several subgroups in and around the
axillary region; the Humeral (later) axillary lymph nodes, the Deltopectoral
nodes, the Pectoral (anterior) nodes, the subscapular (posterior) nodes,
 the central axillary (intermediate) nodes, and the apical (subclavicular,
medial) nodes.
○ Lymph form the axillary nodes on the left side of the body empties
into the subclavian trunk, which empties into the thoracic duct, or
left lymphatic duct.

Bronchomediastinal Trunks
❏ Lymph nodes and vessels in the thorax drain structures of the thoracic
wall and the thoracic cavity, including the heart, lungs, diaphragm, and
intercostal spaces,
❏ Lymph from the superior aspect of the diaphragm drains into the phrenic
nodes, and then into the parasternal nodes.
❏ The intercostal nodes, which empty into the intercostal trunk, drain the
intercostal spaces.
❏ From the lungs, lymph drains into the inferior and superior
tracheobronchial nodes, passing onward into the bronchomediastinal
trunks- the primary vessels draining the viscera of the thorax. The right
bronchomediastinal trunk may join the right lymphatic duct, and the left
may join the thoracic duct. The bronchomediastinal trunks can also open
independently into the venous angle on either side.

Lumbar Trunks
❏ Lymphatic vessels and nodes in the abdomen drain lymph from organs in
the abdominal cavity and from the abdominal walls.
❏ Most lymph from the abdomen drains into the intestinal and lumbar
lymphatic trunks, which converge at the level of the second lumbar
vertebra to form the cisterna chyli at base of the thoracic duct, or left
lymphatic duct.
❏ From the mesentery, lymph passes through the superior mesenteric lymph
nodes, which lie near the upper part of the superior mesenteric artery.
❏ A network of lymph vessels accompanying the renal veins drains the
kidneys.
❏ The liver, which produces up to one-half the lymph in the body, is
surrounded by numerous groups of lymph nodes. These groups include
the Hepatic, Left Gastric, Mediastinal, Cystic, Phrenic, and Celiac Nodes.
❏ Lymph draining from the hepatic nodes into the celiac nodes passes into
the cisterna chyli. Other vessels from the liver join the right lymphatic duct.
❏ Lymphatic drainage of the posterior abdominal wall occurs through
vessels and nodes as accompanying the inferior vena cava, the iliac
vessels and the aorta. These structures, which include the celiac nodes,
 mesenteric nodes and the iliac nodes, empty into the intestinal and lumbar
trunks.

Intestinal Trunk and Nodes

❏ Lymphatic vessels and nodes in the abdomen drain lymph from organs in
the abdominal cavity and from the abdominal walls.
❏ Most lymph from the abdomen drains into the intestinal and lumbar
lymphatic trunks, which converge at the level of the second lumbar
vertebra to form the cisterna chyli at base of the thoracic duct, or left
lymphatic duct.
❏ From the mesentery, lymph passes through the superior mesenteric lymph
nodes, which lie near the upper part of the superior mesenteric artery.
❏ A network of lymph vessels accompanying the renal veins drains the
kidneys.
❏ The liver, which produces up to one-half the lymph in the body, is
surrounded by numerous groups of lymph nodes. These groups include
the Hepatic, Left Gastric, Mediastinal, Cystic, Phrenic, and Celiac Nodes.
❏ Lymph draining from the hepatic nodes into the celiac nodes passes into
the cisterna chyli. Other vessels from the liver join the right lymphatic duct.
❏ Lymphatic drainage of the posterior abdominal wall occurs through
vessels and nodes as accompanying the inferior vena cava, the iliac
vessels and the aorta. These structures, which include the celiac nodes,
mesenteric nodes and the iliac nodes, empty into the intestinal and lumbar
trunks.

32. 6 Lymphocyte Production

❏ B cells are lymphocytes that develop and mature in red bone marrow inside
spongy bone, particularly in the vertebrae, sternum, ribs, and pectoral and pelvic
girdles.
❏ After maturing they colonise lymphatic tissues like the spleen and lymph nodes.
Some of them stay in the bloodstream until needed.

Vertebrae
❏ The Sacrum includes the Sacral Vertebra (s01-s05); these are the 25th
through 29th of the 33 vertebrae of the vertebral colum.
❏ These five vertebra fuse in early adulthood to form the sacrum, a
large triangular bone located between the hip bones.
❏ It’s upper part (base) articulates with the last lumbar vertebra by an
intervertebral disc (intervertebral fibrocartilage) and its lower part
(apex) articulates with the coccyx. The body of the first segment is
 large, resembling that of a lumbar vertebra, ut each succeeding
segment is smaller, flatterm and more curved.
❏ The upper half of the the lateral surface is a cartilage-covered
articulation for the ilium.
❏ The vertebral canal runs throughout the greater part of the bone,
forming a passage for the sacral nerves, and its walls are
perforated by the anterior and posterior sacral foramina, through
which these nerves exist.
❏ In the female the sacrum is shorter and wider than in the male and
directed more obliquely backward, increasing the size of the pelvic
cavity.

Sternum
❏ The Sternum is an elongated, flattened bone that forms the middle portion
of the anterior wall of the Thoracic cage and serves as an attachment for
several muscles.
❏ The Sternum’s superior end supports the clavicles and its margins
articulate with the costal cartilages of the first seven pairs of
vertebrosternal ribs (true ribs).
❏ The Sternum is about 17cm long and consists of three parts: 1) The
Quadrangular manubrium; 2) The longer thinner body of the sternum, and
the xiphoid process.
❏ Sternum is slightly convex in front, and broad and thick above, narrowing
at the point where the manubrium joins the body of the sternum, after
which it widens slightly again, then narrows to its lower extremity.
❏ The body of the sternum articulates, with the inferior border of the
manubrium forming the sternal angle, and the narrow inferior border
articulates with the xiphoid process.
○ The Xiphoid process is the smallest of the three parts and is
normally thin and elongated, but varies in form. It may be broad and
thin, pointed, bifid, perforated, curved, or deflected considerably to
the right or left.
❏ The Sternum is cartilaginous in youth, but is more or less ossified by
puberty, and is joined to the body by the age of 30 or 40.

Ribs
 ❏ The Thoracic Cage is a flexible framework of bones and cartilages in the
axial skeleton that contain and protect the principal organs of respiration
and circulation,
❏ The Thoracic Cage is conical in shape (narrow above and broad below)
and longer behing than in front.
❏ The Posterior Surface of the Thoracic Cage is formed by the 12 thoracic
vertebrae and the posterior parts of the vertebrosternal rubs (true ribs) and
the false ribs.
❏ The Anterior Surface of the Thoracic Cage is formed by the sternum and
the costal cartilages that connect the sternum to the true ribs.
❏ The Lateral Surface of the Thoracic Cage are formed by the lateral parts
of the true ribs and the false ribs.
❏ The lower opening of the Thoracic Cage is formed by the 12th thoracic
vertebra
(T12), false ribs 11-12, and by the cartilages of the tenth, ninth, eight (false), and
seventh (true) ribs, which ascend on either side to form the subcostal angle, from which
the xiphoid process projects.
○ The lower opening slopes obliquely downward and backward and is
closed by the diaphragm.
❏ The Thoracic Cage of the Female differs from that of the male in that its
capacity is less and the sternum is shorter and higher.

Pectoral Girdle
❏ The Clavicle makes up the anterior portion of the shoulder girdle (pectoral
girdle), the part of the appendicular skeleton that connects the bones of
the upper limbs to the axial skeleton.
❏ The Clavicle is long and doubly curved and articulates medially with the
cartilage of the first rib and the manubrium of the sternum and laterally
with the acromion of the scapula.
❏ The Clavicle’s upper surface is flat and rough and provides attachments
for the deltoids anteriorly and the trapezius posteriorly.
○ Medially, there’s a narrow area for the attachment of the pectoralis
major, and the superior border provides an attachment for the
sternocleidomastoid.

Pelvic Girdle
 ❏ The Pelvic Girdle of the skeletal system, a ring of bones attached to the
vertebral column, connect the bones of the lower limbs to the axial
skeleton.
❏ Attached to the sacrum of the vertebral column are two hip bones (os
coxae) that form the pelvic girdle.
○ Each hip bone is a large, flattened and irregularly shaped fusion of
three bones; 1) the ilium, 2) the ischium, 3) and the pubis.
○ Posteriorly, the ilia articulate with the sacrum.
○ Anteriorly, the pubic bones articulate with each other at the pubic
symphysis.
❏ The Pelvic Girdle supports the vertebral column and rests upon the lower
limbs.
❏ Along with the Coccyx and Sacrum, the Pelvic Girdle forms the walls of
the Pelvic Cavity, which protects some of the reproductive organs.
❏ The Female Pelvis is generally more delicate and shallower than the
male pelvis, the ilia are less sloped, and the superior aperture is larger
and more circular than in the male.

32. 7 Thymus
❏ T cells are lymphocytes that develop and mature in the thymus. After maturing,
they enter the bloodstream, then colonize lymphatic tissues like the spleen and
lymph nodes. Some of them stay in the bloodstream until needed.

Thymus
❏ The Thymus is an organ of the Lymphatic system that functions in body
defenses.
❏ In the Thymus, the lymphocytes are called T cells which form in red bone
marrow, then mature and become specialized.
❏ The Thymus also produces hormones that are thought to regulate the
development of T cells.
❏ The Thymus is largest in children and adolescents and consists of two
lateral lobes that are situated partly in the thoracic cage and partly in the
neck.
❏ At it’s largest, the thymus is about 5 cm long and 4 cm wide.
❏ The Thymus continues to grow until the time of puberty and then begins to
atrophy.
❏ At birth, the thymus weighs about 15 grams; at puberty it weighs about 35
grams; after this, it gradually decreases to 25 grams at 25 years, less than
15 grams at 60 years old, and about 6 grams at 70 years old.
 Spleen
❏ Spleen is an organ whose functions mostly contribute to body defenses.
❏ Spleen is considered part of the lymphatic system and is the largest
lymphoid organ.
❏ In an adult, the spleen is approximately 12 cm long and weighs about 200
grams.
❏ Spleen is located between the fundus of the stomach and the diaphragm;
it’s almost entirely surrounded by peritoneum and is held in position by two
peritoneal folds.
❏ The Spleen has an oblong, flattened form;contains a large number of
blood vessels; and is a dark-purplish color.
❏ Near the spleen’s medial border is a long fissure, the Hilum, for the
entrance and exit of the large branching splenic artery and vein, as well as
nerves.
❏ In cross-section, the spleen displays areas called Red Pulp and White
Pulp.
○ The Dark, reddish-brown pulp makes up most of its tissue.
○ The Semiopaque white pulp consists mainly of lymphocytes.
❏ The Spleens varied functions include; processing blood to remove dead
or defective red blood cells and platelets, recycling iron from red
blood cells, producing new red blood cells in the developing fetus,
and serving as a site where populations of lymphocytes increase.

Lymph Nodes
❏ Lymph from the right side of the face and scalp drains toward the neck,
where it enters the submandibular, submental, mastoid, occipital, and
parotid nodes. From there, the Lymph drains into the right deep cervical
lymph nodes, which are located along the course of the right internal
jugular vein.
❏ Superficial tissues of the neck contain lymph vessels that drain into the
right superficial cervical lymph nodes alongside the right external jugular
vein. The right jugular lymphatic trunks empty into either the right
lymphatic duct or directly into the right venous angle (the junction of the
subclavian and internal jugular veins).

32. 8 Spleen
❏ Inside the spleen, abnormal blood cells are consumed by cells called
macrophages, and lymphocytes carry out immune responses. The spleen also
stores iron from blood cells.
Spleen
 ❏ Spleen is an organ whose functions mostly contribute to body defenses.
❏ Spleen is considered part of the lymphatic system and is the largest
lymphoid organ.
❏ In an adult, the spleen is approximately 12 cm long and weighs about 200
grams.
❏ Spleen is located between the fundus of the stomach and the diaphragm;
it’s almost entirely surrounded by peritoneum and is held in position by two
peritoneal folds.
❏ The Spleen has an oblong, flattened form;contains a large number of
blood vessels; and is a dark-purplish color.
❏ Near the spleen’s medial border is a long fissure, the Hilum, for the
entrance and exit of the large branching splenic artery and vein, as well as
nerves.
❏ In cross-section, the spleen displays areas called Red Pulp and White
Pulp.
○ The Dark, reddish-brown pulp makes up most of its tissue.
○ The Semiopaque white pulp consists mainly of lymphocytes.
❏ The Spleens varied functions include; processing blood to remove dead
or defective red blood cells and platelets, recycling iron from red
blood cells, producing new red blood cells in the developing fetus,
and serving as a site where populations of lymphocytes increase.

32. 9 Spleen Histology

Slide 1: Spleen Structure

❏ The spleen is surrounded by a dense connective tissue capsule, and from this
capsule, connective tissue strands called Trabeculae extend into the spleen.
❏ The spleen is composed of two types of lymphatic tissue, white pulp and red
pulp, which are named according to their appearance in fresh tissue,
❏ The spleen is responsible for immune surveillance of the blood and removal of
damaged blood cells and platelets.

Slide 2: Spleen White Pulp

❏ White pulp consists of lymphocytes and macrophages that are clustered around
small splenic artery branches called Central Arteries.
→ The Lymphocytes perform immune functions, and the macrophages destroy blood-
borne pathogens.

Slide 3: Spleen Red Pulp

 ❏ Red Pulp consists of splenic cords composed of reticular fibers, fibroblasts, red
blood cells, macrophages, lymphocytes, plasma cells, and granulocytes that are
located between blood-filled venous sinuses.
❏ Macrophages in red pulp clean the blood, removing defective blood cells and
debris.
❏ Additionally, the spleen produces blood cells and stores platelets in the red pulp.

32. 10 Lymph Node Function

❏ Lymph nodes are capsules of tissue that filter lymph and contain lymphocytes
that destroy pathogens.

Lymph Nodes
❏ Lymph from the right side of the face and scalp drains toward the neck,
where it enters the submandibular, submental, mastoid, occipital, and
parotid nodes. From there, the Lymph drains into the right deep cervical
lymph nodes, which are located along the course of the right internal
jugular vein.
❏ Superficial tissues of the neck contain lymph vessels that drain into the
right superficial cervical lymph nodes alongside the right external jugular
vein. The right jugular lymphatic trunks empty into either the right
lymphatic duct or directly into the right venous angle (the junction of the
subclavian and internal jugular veins).

32. 11 Lymph Node Distribution

❏ Lymph nodes are clustered in areas where the head and limbs meet the torso
and near the intestines.
→ This distribution defends the torso from pathogens entering from the
extremities or from ingested food.

Major Lymph Node Groups

❏ The lymph vessels and nodes of the pelvis follow the course of the veins
of the pelvis, draining lymph from the urinary and reproductive organs and
other tissues of the pelvis.
❏ The superficial and deep inguinal lymph nodes, which lie in the upper part
of the femoral triangle beneath the inguinal ligament, receive lymph from
the lower limb, genitalia, gluteal region, and perineum.
❏ The external and internal iliac lymph nodes empty lymph into the common
iliac lymph nodes, which lie inferior to the lumbar nodes of the abdomen.
 ○ Together the lumbar and common iliac nodes carry lymph from the
pelvic region into the lumbar trunks and onwards into the cisterna
chyli at the base of the thoracic duct, or left lymphatic duct.

32. 12 Lymph Node Histology

Slide 1: Lymph Nodes Structure

❏ Lymph nodes filter lymph before it reenters the bloodstream.
❏ Lymph enters the nodes through the afferent vessels and passes through a
network of chambers -- the Trabecula and Subcapsular, Cortical and Medullary
sinuses.
→ Along the way, macrophages and lymphocytes neutralize or destroy pathogens,
and debris is removed.

→ Filtered lymph leaves the node through the efferent vessels.

Slide 2: Lymph Node Cortex and Medulla

❏ Each lymph node is surrounded by a dense connective tissue capsule, and from
this capsule, connective tissue strands called Trabeculae extend into the node.
○ Inside the capsule, the lymph node has a network of reticular fibers that
support its outer cortex and inner medulla.
○ As lymph flows through the subcapsular, trabecular, and medullary
sinuses of the lymph node, antigens from the lymph are either destroyed
by macrophages or they can activate nearby lymphocytes to launch an
immune response.

Slide 3: Lymph Node Cortex

❏ The outer part of the lymph node is the cortex, which is divided into the outer and
inner cortex.
❏ The Outer Cortex contains densely packed clusters of B cells, called Lymphatic
Nodules (follicles). When an antigen is detected, B cells are activated, forming a
germinal center in the lymphatic nodule. Germinal centers contain follicular
dendritic cells, macrophages, and activated B cells that divide and develop into
antibody-producing plasma cells and memory B cells.
❏ The Inner Cortex contains T cells and dendritic cells, When antigens are
detected, the T cells divide, forming ew T cells that migrate rom the lymph node
into the body to destroy antigens.
Slide 4: Lymph Node Medulla
❏ The Medulla of the lymph node is located interior to the cortex.
→ Lymphatic tissue extends from the cortex into the medulla, forming medullary cords
that contain antibody-producing plasma cells, macrophages, and B cells,

→ These cords are separated by large lymphatic capillaries called Medullary Sinuses,
which are surrounded by a network of reticular fibers with embedded macrophages.

→ As lymph passes through the sinuses, antigens from the lymph are ingested by the
macrophages.