ANATOMY AND

1st Year, 1st Semester

PHYSIOLOGY MIDTERMS

LYMPHATIC SYSTEM

FLUID BALANCE

- Draining excess interstitial fluid and plasma protein

- The lymphatic system and immune system provide
different defenses against pathogens such as
bacteria and viruses.
- Carries fluid from tissues to the circulatory system
- The lymphatic system includes the lymph,
lymphocytes, lymphatic vessels lymph nodes, tonsils,
the spleen, and the thymus gland.
COMPONENTS
- The lymphatic system consists of fluid called lymph,
lymphatic vessels, lymphatic tissues in lymph organs
and other masses and red bone marrow.
- The primary tissue of the lymphatic system is
lymphatic tissue, a specialized type of reticular
connective tissue that contains large numbers of
lymphocytes.
Ø Lymphocytes
• B and T lymphocytes
• 20-25% of Leukocytes
• smallest WBC
• Functions: produce antibodies, allergic
reaction
FUNCTIONS OF THE LYMPHATIC SYSTEM
- Fluid Balance
- Fat/Lipid Absorption
- Defense
from tissue spaces
- Lymph (meaning clear spring water) — contains
water and solute that is derived from two sources
o substances in plasma, such as ions, nutrients,
gases, and some proteins, pass from blood
capillaries into the interstitial spaces and become
part of the lymph
o substances such as hormones, enzymes, and
waste products derived from cells within the
tissues are also part of the lymph
o When plasma is filtered by flood capillaries, it passes
into the interstitial spaces and becomes interstitial
fluid. When this fluid passes into the lymphatic
capillaries, it is called lymph.
o Contains 97% water and 3% WBC
o drains tissue spaces of excess interstitial fluid that
escaped from blood capillaries and return the protein
to the cardiovascular system
o Of the fluid that leaves the capillaries, about 90% is
returned. The 10% that does not return becomes part
of the tissue fluid that surrounds the tissue cells.
Small CHON molecules may leak through the
capillary wall and increase the osmotic pressure of
the interstitial fluid (edema). Lymph capillaries pick up
the excess interstitial fluid and CHONs and return
them to venous blood. After the fluid enters the lymph,
it is called lymph.

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FAT ABSORPTION
- The lymphatic system absorbs fats and other
substances from the digestive tract
- On the lining of the small intestine are special
lymphatic vessels, called Lacteals
- Fats enter the lacteals and pass through the
lymphatic vessels to the venous circulation
- Chyle (juice)- the milky fluid that is fatty in content
composing the lymph passing through the lymphatic
vessel
- mixture of lymph and nutrients
- carried by lacteals to lymph vessels in
intestinal wall
DEFENSE
- Microorganisms and other foreign substances are
filtered from lymph to lymph nodes and from the blood
by the spleen. In addition, the lymphocytes and other
cells are capable of destroying microorganisms and
foreign substances.
LYMPHATIC CAPILLARIES AND VESSELS
- Lymphatic vessel carries lymph away from the
tissues. Valves in the vessels ensure the one-way
flow of the lymph
- Skeletal muscle contraction, contraction of the
lymphatic vessel smooth muscle, and the thoracic
pressure changes move the lymph through the
vessels
LYMPHATIC CAPILLARIES
- Carries fluid in one direction from tissues to
circulatory system
- Fluid moves from blood capillaries into tissue spaces
Ø Lymphatic Capillaries:
• tiny, closed-ended vessels
• fluid moves easily into
• in most tissues
• join to form lymphatic vessels
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MIDTERMS
- Lymphatic vessels begin as blind-ended lymph
capillaries, (microscopic vessels between cells),
occurring singly or in networks.
- Consist of simple squamous epithelium; no basement
membrane, so fluid moves easily into them
- They are found throughout the body with the
exception of the central nervous system, bone
marrow, portions of the spleen, and tissues that lack
blood vessels, i.e. epidermis and cartilage.
- Lymphatic capillaries merge to form larger lymphatic
vessels, which in turn, converge to form lymphatic
ducts.
- Lymphatic vessels have thinner walls and more
valves than veins.
- Valves in the vessels ensure the one-way flow of the
lymph.
- Valves are responsible for the beaded appearance of
small lymphatic vessels.
- Has no pump unlike blood
Lymphatic Capillaries are not present in:
• Central nervous system
• Bone marrow
• Tissues without blood vessels such as epidermis
and cartilage
LYMPHATIC VESSELS
Ø Lymphatic vessels:
• resemble small veins
• where lymphatic capillaries join
• one way valves
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PHYSIOLOGY MIDTERMS

Ø Right lymphatic duct:

• where lymphatic vessels from right upper limb and
right head, neck, chest empty
• empties into right subclavian vein

Ø Thoracic duct:
• rest of body empties from lymphatic vessels
• empties into left subclavian vein

LYMPHATIC CIRCULATION

- Small lymphatic vessels join to form larger ones

called lymphatic trunks (There are 6 major
lymphatic trunks in the body, each responsible for
draining filtered fluid from one region of the the body.),
which drain large regions. Lymphatic trunks merge
until the lymph enters the two lymphatic ducts.
• Lymphatic capillaries merge to form larger
lymphatic vessels, which in turn, converge to form
lymphatic ducts. These vessels will drain the
lymph into the left and right subclavian veins,
respectively.
• The thoracic duct drains into the left subclavian
vein. The right lymphatic duct drains into the right
subclavian vein.

FACTORS AFFECTING LYMPHATIC

VESSEL COMPRESSION:
a. Contraction of surrounding skeletal muscle during
activity
b. Periodic contraction of smooth muscle in the
lymphatic vessel
c. Pressure changes in the thorax during breathing
• Lymph flows primarily as a result of the “milking
action” of skeletal muscle contractions and
respiratory movements. It is also aided by valves
located within the lymphatic vessels.
• The milking action of skeletal muscle contractions
compresses lymphatic vessels (as well as veins)
and forces lymph toward the subclavian veins.
Lymph flow is also maintained by pressure
changes that occur during inhalation. Lymph flows
from the abdominal region, where the pressure is
higher, toward the thoracic region, where it s
lower. When the pressure reverse during
exhalation, the valve prevent backflow of lymph.

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PHYSIOLOGY MIDTERMS

LYMPHATIC CIRCULATION 3 GROUPS OF TONSILS:

1. Palatine Tonsils
2. Pharyngeal Tonsil
3. Lingual Tonsil

- Tonsils are multiple aggregations of large lymphatic

nodules embedded in mucous membranes. They
include the palatine and lingual tonsils in the
oropharynx, as well as the adenoids in the
nasopharynx.
- The tonsils are strategically situated to protect against
antigens that enter the nasopharynx and oropharynx
and function to produce lymphocytes and antibodies.
- The tonsils form a protective ring of lymphatic tissues.

SUMMARY OF LYMPHATIC PATHWAY

LYMPH NODES
- Rounded structures that vary in size
- Located near lymphatic vessels
- Groin, armpit, neck
LYMPHATIC ORGANS
- Lymph passes through lymph nodes before entering
- The lymphatic organs are the thymus, lymph nodes
blood
and lymphatic nodules, spleen, and bone marrow.
- Lymph moves through and immune system
- Is activated (lymphocytes produced) if foreign
THE TONSILS
substances are detected
- Removal of microbes by macrophages

• Located along lymphatic vessels

• Oval or bean-shaped; usually less than 2-5 cm.
• lymph nodes consist of masses of B cells and T cells
surrounded by a capsule.
• Large groups of lymph nodes are located at site
where lymphatic vessels enter the torso: in groin
(inguinal), armpits (axillary), and neck (cervical).
• Lymphatic nodules are egg-shaped masses of
lymphatic tissue that are not encapsulated. Nodules
are present in the gastrointestinal, urinary and
reproductive tracts.
• Lymph enters the nodes through afferent lymphatic
vessels and exits through efferent lymphatic vessels.

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While passing through the nodes, lymph is filtered to
remove foreign substances.
• Widely distributed throughout the body along the
lymphatic pathways where they filter the lymph
before it is returned to the blood.
• Not present in the central nervous system.
• There are three superficial regions on each side of
the body where lymph nodes tend to cluster. These
areas are the inguinal nodes in the groin, the axillary
nodes in the armpit, and the cervical nodes in the
neck. The typical lymph node is surrounded by a
connective tissue capsule and divided into
compartments called lymph nodules. The lymph
nodules – dense masses of lymphocytes and
macrophages and are separated by spaces called
lymph sinuses.
• Several afferent lymphatic vessels, which carry
lymph into the node, enter the node on the convex
side.
• Moves through the lymph sinuses and enters an
efferent lymphatic vessel, which carries the lymph
away from the node.
• There are more afferent vessels than efferent
vessels = passage of lymph through the sinuses is
slowed down = allow time for the cleansing process.
• The efferent vessel leaves the node at an indented
region called the hilum.
SUPERFICIAL LYMPH NODES
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SPLEEN
- Lymphocytes & macrophages
- Immune response
- Phagocytosis
- The spleen is the largest single mass of lymphatic
tissue in the body and is found between the stomach
and the diaphragm in the left upper quadrant (LUQ).
- Roughly the size of a clenched fist
- Location: left superior corner of abdominal cavity
- Trabeculae divide the spleen into small,
interconnected compartments containing 2
specialized types of lymphatic tissues
a. White Pulp – surrounds the arteries within the
spleen; responds to foreign substances and worn
out RBCs
b. Red Pulp – associated with veins; filled with
machrophages and RBC; phagocytize foreign
substances and worn out RBCs
- An immunologic filter of the blood.
- Made up of B cells, T cells, macrophages, dendritic
cells, natural killer cells and red blood cells.
- In addition to capturing antigens from the blood that
passes through the spleen, migratory macrophages
and dendritic cells bring antigens to the spleen via the
bloodstream.
- The spleen functions to produce B-cells and
antibodies, and T-cells and to phagocytose bacteria
and worn-out or damaged red blood cells and
platelets.
- The spleen is also a storage organ for blood. Holds
small volume of blood in emergency situations such
as hemorrhage. Contraction of the smooth muscle in
splenic blood vessels and splenic capsule cause
movement of small amount of blood out of the spleen
into the general circulation.
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PHYSIOLOGY MIDTERMS

THYMUS - Each lobe is surrounded by a thin connective tissue

capsule.
- Cortex-dark staining areas – with numerous
lymphocytes
- Medulla – lighter staining central portion ; has fewer
lymphocytes

PEYER’S PATCHES

- A two-lobed organ
- posterior to the sternum, medial to the lungs, superior
to the heart (superior mediastinum)
- Roughly triangular in shape
- Increases in size until 1st year of life then remains
same size after
- Decreases in size after 60 y/o and in older adults
- Much is replaced by fatty tissues by age 40
- The thymus processes lymphocytes that move to
other lymphatic tissue to respond to foreign
substances
- Function: Produce mature T cells. Immature T-
lymphocytes formed in bone marrow mature in the
thymus. Only about 2% of these immature T cells do - Found in the walls of small intestines
mature here. - Consist of MACROPHAGES
- Immature thymocytes leave the bone marrow and - Prevents penetration of pathogens in the intestinal
migrate into the thymus. wall
- Through a remarkable maturation process, T cells - Peyer’s patches + tonsils = MALT
that are beneficial to the immune system are spared, - Resemble tonsils
while those T cells that might evoke a detrimental - Always present in tremendous numbers in intestine,
autoimmune response are eliminated. The mature T preventing bacteria from penetrating the intestinal
cells are then released into the bloodstream. wall
- Together with tonsils, form what is referred to as
MUCOSA-ASSOCIATED LYMPHATIC TISSUE
(MALT)
- Protect upper respiratory tract and digestive tract
from never-ending attacks of foreign matter

LYMPHATIC SYSTEM OVERVIEW (YT VIDEO)

- A drainage system that removes excess fluid from
body tissues and returns it to the bloodstream
- Subsystem of both the circulatory and immune
system
- Major Purpose of Circulatory System: To bring
- T cells, dendritic cells, epithelial cells, macrophages oxygen and nutrients to body tissues and remove
- Clear out debris of dead and dying cells wastes. This exchange happens in the smallest bv
- Site of T cells maturation called capillaries.

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- Blood plasma containing nutrients moves out of
capillaries at the arterial end of capillary beds, while
tissue fluid containing wastes reabsorbs back in at the
venous end
- However, not all of the fluid is drawn back to the
bloodstream at this point
- About 15% of it is left in the tissues and would cause
swelling if accumulated, this is where the Lymphatic
System comes into play.
- Lymphatic System — picks up the excess fluid and
returns it to the circulatory system
- Blood Circulatory System — Closed Loop
- Lymphatic System — one-direction, open-ended
network of vessels
- Lymphatic vessels begin as lymphatic capillaries
made of overlapping endothelial cells
- The overlapping flaps function as a one-way valve
- When fluid accumulates in the tissue, interstitial
pressure increases pushing the flaps inward, opening
he gaps between cells, allowing fluid to flow in
- As pressure inside the capillary increases, the
endothelial cells are pressed outward, closing the
gaps, thus preventing backflow
- Unlike blood capillaries, the gaps in lymphatic
capillaries are so large that they allow bacteria,
immune cells such as macrophages, and other large
particles to enter
- This makes the lymphatic system a useful way for
large particles to reach the bloodstream
- For example, it is used for dietary fat absorption in the
intestine
- Once inside lymphatic vessels, the recovered fluid is
called lymph
- Lymph flow is enabled by the same forces that
facilitate blood flow in the veins
- It goes from lymphatic capillaries to larger and larger
lymphatic vessels and eventually drains into the blood
stream via the subclavian veins
- On the way, it passes through a number of lymph
nodes, which serve as filters, cleansing the fluid
before it reaches the bloodstream
- Lymph nodes are small bean-shaped structures
scattered throughout the lymphatic network
- They are most prominent in the areas where the
vessels converge
- Lymph nodes contain macrophages and dendritic
cells that directly “swallow up” any pathogens, such
as bacteria or viruses, that may have been taken up
from an infected tissue
- They also contain lymphocytes: T-cells and B-cells,
which are involved in adaptive immune response, a
process that produces activated lymphocytes and
antibodies specific to the invading pathogen
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MIDTERMS
- These are then carried by the lymph to the
bloodstream to be distributed wherever they are
needed
- The lymphatic system also includes lymphoid organs:
- Primary Lymphoid Organs:
• The Thymus and Bone Marrow are the sites
of lymphocyte production, maturation and
selection
- Selection is the process in which lymphocytes learn
to distinguish between self and non-self, so they can
recognize and destroy pathogens without attacking
the body’s own cells.
Mature Lymphocytes then leave the primary for the
Secondary Lymphoid Organs—Lymph Nodes, Spleen,
and Lymphoid Nodules—whether they encounter
pathogens and become activated
INTRODUCTION TO THE LYMPHATIC SYSTEM (YT
VIDEO)
- “Lymph” = “clear water” in Latin
o it describes the fluid that flows through the
lymphatic vessels and lymph nodes which make
up the lymphatic system
3 Major Roles of the Lymphatic System
1. Returns fluid from the tissues back to the heart
2. Helps large molecules like hormones and lipids
enter the blood
3. Helps with immune surveillance to keep
infections running amok
- The blood in the arteries is under a lot of pressure
because it needs to reach every little nook and cranny
of the body
- The arteries branch out into narrower and narrower
arteries, and then arterioles, and finally gets to the
capillaries—which have walls that are only cell thick
and are slightly porous
- Red Blood Cells are too big to fit through capillary
pores, but small proteins like albumin and fluid can
make it through
- Everyday 20 liters of fluid water and protein, seep out
of the capillaries and becomes part of the interstitial
fluid between cells
- About 17 liters gets quickly reabsorbed right back into
the capillaries, but that leaves 3 liters of fluid behind
in the tissues each day
- This 3 liters of fluid needs to find a way back into the
blood so that the body’s interstitial fluid volume and
blood volume both stay constant over time
- That’s where the lymphatic vessels, or lymphatics,
come in to play. They collect excess fluid and return
it to the blood
- Once the interstitial fluid is in the lymphatic vessels,
it’s called lymph
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- How can there be 20L of fluid seeping out each day if
the blood volume is only 5 liters, but remember that
the 5 liters is constantly in motion and that it gets
recycled over and over in a single day
- Unlike the circulatory system, the lymphatic system
isn’t a closed loop because fluid and proteins make
their way into the microscopic lymphatic capillaries,
and all of the collected lymph is dumped into the veins
- Lymphatic capillaries are the smallest lymphatic
vessels and are located throughout the interstitial
space
- Lymphatic capillaries are extremely permeable
because their walls are made of endothelial cells that
only loosely overlap, forming one-way minivalves.
- These endothelial cells are anchored to structures in
the interstitial space buy collagen filaments, which
allows the lymphatic capillaries to remain flexible but
retain their overall shape
- When the pressure in the interstitial space is greater
than pressure in the lymphatic capillary, the
endothelial minivalves open up, allowing fluid to enter
- When the pressure in the interstitial space is less than
the pressure in the lymphatic capillary, the endothelial
minivalves are pushed shut, keeping the lymph inside
- Once the lymph is inside the lymphatic capillaries, it
travels through bigger and thicker-walled vessels,
then trunks, and then ducts
- There’s no pump pushing the lymph through the
lymphatic system; instead, smooth muscle in the
lymph vessels reacts to the pulsing of nearby arteries
by squeezing to get things started, and then the
squeezing of skeletal muscles, which normally
contract throughout the day, exert external pressure
to keep the lymph moving along eventually reaching
a nearby lymphatic trunk
- To keep the lymph from sliding backwards, the
lymphatic vessels have valve just like the veins.
- The lymphatic trunks are named after the regions of
the body that they drain the lymph from:
o Two lumbar trunks, two broncho mediastinal
trunks, two subclavian trunks, and two jugular
trunks, as well as one intestinal trunk
- From there, the lymph is delivered to either the right
lymphatic duct which collects lymph from the right arm
and the right side of the head and chest, or the
thoracic duct, which is much bigger and collects
lymph from the rest of the body
- The right lymphatic duct dumps lymph into the
junction of the right jugular vein and the right
subclavian vein, and the thoracic duct dumps lymph
into the same junction on the left side of the body
- That particular spot is perfect because it’s where the
pressure is very low, making it much easier for the
lymph to flow in
- The lymphatic system has key advantages:
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o It can pick up larger molecules, like hormones, that
are too large to get into the capillaries, and get
them into the blood stream
o The lymphatic system can also help get nutrients
to the tissues
§ For example: During a meal, fatty acids get
packaged into balls of fat called
chylomicrons by the small intestine
§ But like the hormones, these are too large
to move across capillaries, instead, the
chylomicrons go into special lymphatic
vessels called lacteals, which get their
name from the fact that the lymph that flows
through them looks like milk
§ The chylomicrons slowly make their way up
into the thoracic duct and get dumped into
the venous blood
§ The lymphatic system also plays an
important role in immune function
- Lymphoid organs remove foreign material from the
lymph to keep it from entering the bloodstream, and
act as lookout points for the body’s immune defenses.
- Some lymphoid organs are in the form of diffuse
lymphoid tissue, where they are just a loose
arrangement of lymphoid cells and protein, this is
typical in the lining of the gastrointestinal and
respiratory tract
- Another type of lymphoid organ are lymph nodes,
which are tightly packed balls of lymphoid cells and
protein
- Hundreds of lymph nodes cluster along the lymph
vessels, each one a few millimeters to about 1-2 cm
in size
- When they’re concentrated along the lymph trunks,
you can feel them, especially in the neck, armpit, and
groin
- They can also be found in the intestinal wall, where
they’re called Peyer's Patches.
- When an infection gets into the tissue, it can slip into
a lymphatic capillary and move into a lymphatic
vessel
- Unfiltered lymph fluid drains into a nearby lymph node
where any pathogen or piece of a pathogen is quickly
detected by a dendritic cell – a type of antigen—
presenting cell that serves up pieces of anything in
destroys to other immune cells
- In the lymph nodes, dendritic cells continuously
sample the lymph and present antigens that they
come across to the B cells which are a type of
lymphocyte that can make antibodies
- B cells are designed to only react a foreign antigens,
and if the dendritic cell presents something foreign,
the B cells turns into a plasma cells and starting
cranking out antibodies which flow into the lymph
exited the lymph node
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PHYSIOLOGY MIDTERMS

- There are also circulating the T cells, which are

another type of lymphocyte that move between the
lymph nodes, lymph, and blood on the lookout for
pathogens and infected or abnormal cells that have
been tagged by antibodies
- Spleen—is about the size of a fist, and sits on the left
side of the body below the diaphragm and on top of
the stomach; lymphoid organ
- The spleen has both white pulp and red pulp
- White Pulp—where antibody-coated bacteria are
filtered out of circulation and antibodies are generated
by B cells
- In a sense, the white pulp of the spleen is like a giant
lymph node, although unlike a lymph node which
receives unfiltered lymphatic fluid, the spleen
receives blood
- Red Pulp— This is where old and defective blood
cells are destroyed and their parts, the hemoglobin,
the heme chain, and the iron are either broken down
or recycled
- The spleen is also a helpful in that it keeps a RBC
and platelets available , in case they are suddenly
needed by the body. An organ that’s got your back in
emergency
- Thymus—In the upper part of the chest, just below
where a necklace might lie ; most active in the
neonatal period and pre-adolescent years and then
slowly atrophies and gets replaced by fat after
puberty ; involved in the development of T cells-
making sure that any T cells that react to self-
antigens, antigens that are normally found in the
body, are promptly destroyed
- Tonsils—includes the adenoid, tubal tonsils, palatine
tonsils, and lingual tonsils. Together they form a ring
of lymphoid tissue around the throat, and their main
job is to trap pathogens from the food you eat and air
you inhale

QUICK RECAP: The lymphatic system refers to the one-

way network of lymphatic vessels that allows lymph, a
clear fluid that’s squeezed out of the blood, to transport
nutrients to the cells and act as a method of waste
removal. Lymph is cleansed at lymph nodes throughout
the lymphatic system, which play an important role in
immune function

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