ANATOMY AND PHYSIOLOGY WITH PATHOPHYSIOLOGY (LEC)

Chapter 22: Lymphatic System

1st Semester l Finals l University of San Agustin l

Outline:
22.1 Functions of the Lymphatic
System
22.2 Anatomy of the Lymphatic
System
22.3 Immunity
22.4 Innate Immunity
22.5 Adaptive Immunity
22.6 Acquired Adaptive Immunity
22.7 Overview of Immune
Interactions
22.8 Immunotherapy
22.9 Effects of Aging on the
Lymphatic System and Immunity

22.1 FUNCTIONS OF THE LYMPHATIC

SYSTEM
 Fluid balance
o excess interstitial fluid enters
lymphatic capillaries and
becomes lymph (30L from
capillaries into interstitial fluid,
27L return leaving3L, called
lymph)
 Lipid Absorption
o absorption of fat and other
substances from digestive tract
via lacteals
o lymph fluid is called chyle
 Defense
o microorganisms and other
foreign substances are filtered
from lymph by lymph nodes and
from blood by spleen
22.2 ANATOMY OF THE LYMPHATIC
SYSTEM
 Also includes:
o lymph, lymphatic vessels,
lymphatic tissue, lymphatic
nodules, lymph nodes, tonsils,
spleen, and thymus
Lymphatic Vessels
 Lymphatic Vessels carry lymph away
from tissues
o originate as small ,dead-end
tubes called lymphatic
capillaries
 Lymphatic capillaries
o more permeable than blood
capillaries
o epithelium functions as series of
one-way valves
o found in all parts of the body
except the nervous system,
bone marrow, and tissues
without blood vessels (cartilage,
cornea, epidermis)
o lack basement membrane
o cells of the simple squamous
endothelium slightly overlap and
are loosely attached to one
another
 Movement of lymph through
vessels occurs by:
o (1) contraction of lymphatic
vessels: smooth muscle in
walls of lymphatic vessels
contain pacemaker cells
o (2) contraction of skeletal
muscles: surrounding muscle
compresses lymphatic vessels,
moving lymph along

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o (3) thoracic pressure
changes: pressure changes in
thoracic cavity causes lymph to
move
Lymph Formation and Movement
Anatomy of Lymph Vessel
 The overlap of edothelial cells
allows fluid to enter but prevents from
moving back into tissue (one way flow)
 Lymphatic capillaries join to form
lymphatic vessels
 Lymphatic vessels: have valves that
ensure one-way flow
o resembles small veins
 Lymph nodes: round, oval ,or bean
shaped bodies distributed along vessels
and filter lymph
o filters lymph through a series of
nodes and converges to form
lymphatic trunk
TRANSCRIBED BY: ALYSSANDRA FRANCINE S. DORAN |USA MLS 1-F
 Lymphatic trunks: found in jugular,
subclavian, broncomediastinal,
intestinal, lumbar
o large lymphatic vessels which
drains lymph from a major
portion of the body
 Lymphatic ducts: drain tissues of
body and move lymph into major veins
o largest lymphatic vessel
o right lymphatic duct: drains
right side of head, right-upper
limb, and right thorax
o thoracic duct: drains
remainder of the body
Mechanism of Lymph Movement
 Contraction of lymphatic vessels
 Contraction of skeletal muscles
 Thoracic pressure changes
Summary
 Excess interstitial fluid enters
lymphatic capillaries, forming lymph
 Lymphatic capillaries converge to
form lymphatic vessels
 Lymph passes through lymphatic
vessels and through lymph nodes,
where it is filtered
 Lymphatic vessels converge to form
lymphatic trunks
 Lymphatic trunks combine to form
lymphatic ducts, which empty into
thoracic veins
Lymphatic Tissue and Organs
 Lymphatic organ contain lymphatic
tissue(lymphocytes, macrophages,
and dendritic cells)
 Lymphocytes: B cells and T cells
 B cells originate and mature in red
bone marrow
 T cells are produce in red bone
marrow and mature in thymus
 Lymhpatic tissue is composed of
fine collagen reticular fibers
o produced by reticular cells
o act as filter to trap
microorganisms and other
particles
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 May or may not be encapsulated

o encapsulated: lymph nodes,
spleen, and thymus
o nonecapsulated: mucosa-
associated lymphoid tissue
(MALT) found beneath
epithelium as first line of attack
against invaders

Diffuse Lymphatic Tissue and Lymphatic

Nodules

 Diffuse lymphatic tissue

o dispersed lymphocytes and
macrophages blends with other
tissues
o associated with other types of
lymphatic tissue
 Lymphatic nodules
o denser aggregations
o numerous in loose connective
tissue of digestive (Peyer
Patches), respiratory, urinary,
and reproductive systems
(MALT)
o referred to as lymphatic
follicles when found in lymph
nodes and the spleen
Lymph Nodes
 Lymph nodes: small, round/bean-
shaped structures 1 to 25 mm long
o responsible for filtering lymph
 Types of lymph nodes based on
location:
o superficial lymph nodes (near
skin or subcutaneous tissue
beneath skin)
o deep lymph nodes
 Organized into cortex and medulla
with dense connective tissue capsule
surrounding
o trabeculae extend within
o reticular fibers form supporting
network

 Has afferent and efferent lymphatic

vessels
 Substances removed by
phagocytosis or stimulate
lymphocytes to proliferate in germinal
centers

 Cancer cells often migrate to lymph

nodes, are trapped there, and
proliferate
Tonsils
o they can move from lymphatic
system to circulatory system
 Large groups of lymphatic nodules
spreading cancer through body
in nasopharynx and oral cavity
 Forms a ring around the border
Lymph nodes throughout the body
between theoral cavity and the
pharynx
 Cervical and head lymph nodes
 Axillary lymph nodes
 Provides protection against
 Thoracic lymph nodes
bacteria and other harmful
 Abdominopelvic lymph notes
material
 Inguinal and popliteal lymph nodes
 Groups or types of tonsils:
o palatine (the “tonsils”)
o pharyngeal (the “adenoids”)
o lingual
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Spleen

 Located in left superior side of

abdomen
 Can be ruptured in traumatic
abdominal injuries resulting in
bleeding, shock, or death

 White pulp associated with arteries;

red pulp with veins

 Periarterial lymphatic sheath and

lymphatic nodules contain
lymphocytes and macrophages
 Splenic cords: reticular cells
producing reticular fibers

 Blood flows through at 3 different

rates:
o fast (most), slow, and
intermediate
o slow flow is via open
circulation; no direct capillary
connection between arteries and
veins (blood percolates through
splenic cords)

 Functions:
o destroy defective RBCs
o detects and responds to foreign
substances
o limited reservoir for blood
1. Branches from the trabecular arteries
are surrounded by periarterial
lymphatic sheaths
2. An arteriole enters a lymphatic nodule
and divides
3. 3.A few capillaries directly connect to a
venous sinus
4. The ends of most capillaries are
separated from the beginning of the
venous sinuses by a small gap
a. blood rapidly crosses the gap
5. Some capillaries empty into the splenic
cords.
a. blood percolates through the
splenic cords and passes
through the walls of the venous
sinuses
6. The venous sinuses connect to the
trabecular vein

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Thymus 22.3 IMMUNITY

 Thymus: bilobed gland in superior

 Immunity is the ability to resist
mediastinum
damage from foreign substances such
 Site of maturation of T cells
as microorganisms and harmful
 Secretes thymosin
chemicals
o important in T cell development
 Categories:
 Lobes surrounded by thin
 Innate or nonspecific resistance
connective tissue capsule
o physical barriers: prevents
 Trabeculae extend into gland dividing it
entry or re-move microbes
into lobules
(skin, tears, saliva, mucus)
o considered the acid mantle
 Increases in size first year of life
o remains same size until 60,
 Adaptive or specific immunity
then decreases in size after then
o specificity: ability to recognize
 Cortex: many lymphocytes a particular substance
 Medulla: fewer lymphocytes but has o memory: ability to remember
thymic corpuscles (involved in previous encounters with a
development of regulatory T cells) particular substance and
respond rapidly

22.4 INNATE IMMUNITY

 Physical barriers which prevent

microbes and chemicals from entering
the body
o skin, mucous membranes
o tears, saliva, and urine
o cilia in respiratory tract
o coughing and sneezing

Chemical Mediators

 Chemical mediators: molecules

responsible for aspects of innate
immunity
 Examples:
o histamine and kinins:
vasodilation and increases
vascular permeability during
inflammation
o interferons: viral defense
o complement: promote
inflammation and destroy
microbes
o prostaglandins and
leukotrienes: promote
inflammation
o pyrogens: promote fever

Complement

 Group of 20 proteins that circulate

 In blood in inactive form
 Become activated through complement
cascade

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 Classical or alternative pathway

o alternative pathway: part of
innate immunity. C3 binds with
foreign substances and attracts
macrophages
o classical pathway: part of
adaptive immunity. Requires
antibodies bound to antigens

 Activated complement proteins

can:
o form membrane attack
complex (MAC)and make
channel through plasma
membrane of microbe resulting
in cell lysis
o opsonization: complement
proteins attached to surface of
bacterial cells and stimulate
phagocytosis
o attract immune system cells
to site of infection and promote
inflammation
Interferons
Complement Cascade
 Interferons prevent viral
1. The classical pathway begins when an replication
anti-gen-antibody complex activates C4 o viruses use the molecular
2. Activated C4 forms a complex with C2 mechanisms of cells to
that activates C3 reproduce themselves
3. The alternative pathway begins when
C3 is spontaneously activated  Interferons are proteins that protect
4. Foreign substances and factors B, D, the body against viral infection and
and Stabilize activated C3 some forms of cancer
5. 5.Once C3 is activated, the classical  Interferons produced by infected
and alternative pathways are the same cell, but cause neighboring cells to
a. C3 activates C5 produce antiviral proteins
b. C5 activates C6
c. C6 activates C7 Movement of White Blood Cells
d. C7 activates C8
e. C8 activates C9  Chemotactic
o chemical signals white blood
6. Activate C3-C7 promote phagocytosis, cells are attracted to
inflammation, and chemotaxis (attracts o complement, leukotrienes,
cells) kinins, and histamine
7. Activated C5-C9 combine to form a
membrane attack complex (MAC),  Chemotaxis
which forms a channel through the o when white blood cells move
plasma membrane (only C9 of MAC is toward the source of substances
 Phagocytosis
shown)
o endocytosis and destruction of
particles by cells called
phagocytes

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Types of White Blood Cells
 Neutrophils
o small and phagocytic
o first cells to enter infected
tissue (lasts only a few hours)
o regularly cross wall of
gastrointestinal tract providing
protection
 Macrophages: large phagocytic cells
o derived from monocytes that
leave blood and enter tissues
and mature
o longer lived than neutrophils
o can ingest larger particles
o found beneath free surfaces
within sinuses(enlarged space
filled with macrophages)
 Basophils and Mast cells
o promote inflammation when
activated by innate or adaptive
system
o basophils are motile cells that
leave blood and enter infected
tissue
o mast cells are non-motile cells
in C.T.
 Eosinophils: leave blood and enter
tissues
o reduce inflammation by
breaking down chemicals
produced by basophils and mast
cells
o secrete enzymes that kill some
parasites
o increase in response to parasitic
infections or allergic reactions
 Natural killer cells: type of
lymphocyte produced in red bone
marrow
o account for up to 15% of
lymphocytes
o lyse tumor and virus-infected
cells
o recognize whole classes of cells
(not specific kind of cell)
22.5 ADAPTIVE IMMUNITY
 Adaptive immunity involves the
ability to recognize, respond to, and
remember a particular substance
 Stimulants:
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o foreign antigens and self
antigens
Cells of Adaptive Immunity
 B cell
o after activation, differentiates to
become plasma cell or memory
B cell
 Plasma cell
o produces antibodies that are
directly or in-directly
responsible for destroying the
antigen
 Memory B and T cell
o quick and effective response to
an antigen against which the
immune system has previously
reaction (responsible for
adaptive immunity)
 Cytotoxic T cell
o responsible for destroying cells
by lysis or by producing
cytokines
 Helper T cell
o activates B cells and cytotoxic T
cells
 Regulatory cells
o inhibits B cells, helper T cells,
and cytotoxic T cells
 Dendritic cell
o processes antigen and is
involved in the activation of B
cells and T cells
Antigens
 Large molecules
 Foreign: not produced by body
o introduced from outside like
bacteria, viruses, and other
microorganisms that cause dis-
ease
o Pollen, foods, and drugs cause
over reaction of immune system
called allergic reaction
 Self antigens: produced by body
o used as markers to allow
adaptive immune response to
differentiate self from non-self
o response to self tumor antigens
o response to self-antigens
resulting in tissue destruction
(auto-immune disease)
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Types of Adaptive Immunity

 Antibody-mediated: B cells
 Cell-mediated: T cells
o cytotoxic T cells which destroy
infected cells
o Helper T cells and
Regulatory T cells which
promote or inhibit both
antibody-mediated and cell-
mediated immunity

Origin and Development of Lymphocytes

 Positive selection
o ensures survival of lymphocytes Activation of Lymphocytes
that react against antigens
o these then proliferate and form  Lymphocytes must be able to
clones recognize the antigen
 After recognition, lymphocytes must
 Negative selection increase in number to effectively
o eliminates clones of destroy antigen
lymphocytes that react against
self-antigens Antigenic Determinants
o tolerance: a state of
unresponsiveness of lymphcytes  Antigenic determinants: specific
to a specific antigen, usually to
regions of a given antigen recognized
self antigens (one’s own cells)
by a lymphocyte
 Many different kinds of clones exist
because of genetic recombination
during development

Development of B and T cells

 Originate in red bone marrow

 Move to primary lymphatic organs
where they mature into functional cells
o B cells to bone marrow
o T cells to thymus

 Secondary lymphatic organs and

tissues
o lymphocytes interact with each
other, antigen-presenting cells
and antigens to produce the
immune response
o diffuse lymphatic tissue,
lymphatic nodules ,tonsils,
lymph nodes, and spleen
Antigen Receptors
 Antigen Receptors
o T cell antigen receptors and B
cell antigen receptors bind to
determinants
 T cell receptor consists of two
polypeptide chains
 B cell receptor consists of four
polypeptide chains (essentially an
antibody)

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 structure:
o (1) variable region: part that
combines with antigen
determinant of antigen
o (2) constant region:
responsible for activities of
antibodies like activating
complement or attaching to
various kinds of WBCs

Structure of an Antibody

Major Histocompatability Complex

Molecules

 Most lymphocyte activation involves

surface proteins called major
histocompatibility complex (MHC)
molecules

 MHC class I
o found on surface of nucleated
cells
o in concert with antigens that
Effects of Antibodies
were produced inside the cell
from digested virus particles
 Inactivate the antigen
o an antibody binds to an antigen
 MHC-restricted
and inactives it
o both MHC class I and foreign
 Bind antigens together
antigen are displayed together
 Activate the complement cascade
 MHC class II
o an antigen binds to an antibody:
o found on surface of antigen-
presenting cells as a result, the antibody can
o B cells, macrophages, activate complement proteins
monocytes, and dendritic cells which can produce
o display of MHC class II inflammation, chemotaxis, and
stimulates other immune lysis
system cells to respond to the
antigen

Antibody-mediated Immunity

 Antibody-mediated Immunity are

effective against extracellular antigens
including bacteria, viruses, protozoans,
fungi, parasites, and toxins when they
are outside cells

 Antibodies or Immunoglobulins
(Ig)
o classes: IgG, IgM, IgA, IgE, and
IgD

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Antibody Production Ways to Acquire Adaptive Immunity

 Primary response: occurs when a B  From Active Immunity and Passive

cell is first activated by an antigen
Immunity
o B cell proliferates to produce
plasma cells(antibody
production) and memory cells

 Secondary response: occurs during

layer exposure to same antigen
o memory cell divide rapidly to
form plasma cells and additional
memory cells
o generally a more faster and
greater response

Cell-mediated Immunity

 Cell-mediated immunity is most

effective against intracellular microbes
through the action of cytotoxic T cells
 Cytotoxic T cells function in two
ways:
o lyse virus infected cells, tumor
cells, and tissue transplants
(Major lysin is perforin: forms
a hole in the plasma membrane
of the target cell) 22.7 OVERVIEW OF IMMUNE
o produce cytokines, which INTERACTIONS
promote phagocytosis and
inflammation
 As in antibody mediated immunity,  Innate immunity, antibody-mediated
memory cells are produced immunity, and cell-mediated immunity
can function together to eliminate an
22.6 ACQUIRED ADAPTIVE IMMUNITY antigen.

 Immunization: deliberate exposure to 22.8 IMMUNOTHERAPY

antigen or antibody
 Active natural immunity: natural
exposure to an antigen
 Active artificial immunity:
vaccination (deliberate exposure to an
antigen called a vac-cine)
 Passive natural immunity: transfer
of anti-bodies from a mother to her
fetus or baby
 Passive artificial immunity: transfer
of an-tibodies (or cells) from an
immune animal to anon-immune
human
o Antiserum
o available for rabies, hepatitis,
measles, toxins, tetnus, and
venoms
 Immunotherapy treats diseases by
stimulating or inhibiting the immune
system.
22.9 EFFECTS OF AGING ON THE
LYMPHATIC SYSTEM AND IMMUNITY
1. Aging has little effect on the lymphatic
system’s ability to remove fluid from
tissues, absorb lipids from the digestive
tract, or remove defective red blood
cells from the blood.
2. Decreased helper T-cell proliferation
results in decreased antibody-mediated
and cell-mediated immune responses
to antigens.
3. Primary and secondary antibody
responses decrease with age.
4. The ability to resist intracellular
pathogens decreases with age.

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