The lymphatic system is a system of specialized vessels and organs whose

main function is to return the lymph from the tissues back into the
bloodstream.

Lymphatic system is considered as a part of both the circulatory and

immune systems, as well as a usually neglected part of students'
books. The functions of the lymphatic system complement the
bloodstream functions, as it regulates the balance of fluids in
the body and filters the pathogens from the blood.

Key facts about the lymphatic system

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Definition The lymphatic system is a network of vessels and organs that regulates the
amount of fluid in the human body and defends it against infections.

Structure Lymphatic capillaries; lymphatic vessels, ducts and tracts; primary and
secondary lymphoid organs,

Function Fluid regulation; immune surveillance; transport of large molecules

Clinical relations Cancer spreading

The lymphatic system begins with the lymphatic capillary meshwork that collects
the excessive fluid from the tissues.
The lymph travels from the tissues through larger lymph vessels until it
reaches its destination point; the bloodstream. On the way, it traverses
lymphoid organs filled with immune cells that monitor if there are any
pathogens in the incoming lymph.

Lymph is a clear, yellowish fluid present in most tissues of the body. It is

created as a result of the filtration of the plasma. The plasma from the blood
diffuses through the porous capillary wall into the tissues to deliver nutrients.
After feeding the hungry cells on the periphery, the majority of fluid gets
reabsorbed back into the blood vessels, while around 10% of the fluid stays in
the tissue. That amount of residual fluid in the tissues is called the interstitial
fluid. When the interstitial fluid gets absorbed into the lymphatic capillaries it
becomes the lymph.

Similar to blood plasma, the lymph is composed mainly of water. The other components are
proteins, lipids, glucose, ions, and cells. Depending on where the lymph is produced, the
composition of lymph can vary (e.g. lymph produced in the gastrointestinal system is rich in
fats). A body of a healthy individual produces an average of 2 liters of lymph per day, but this
amount can vary greatly in pathological conditions.

Lymphatic capillaries

Lymphatic capillaries are the smallest lymphatic vessels that collect the interstitial fluid from the
tissues. They are organized in networks called lymphatic plexuses. Plexuses converge to make
larger lymphatic vessels that carry the lymph away from the tissues and into the bloodstream.

There are also special types of lymphatic capillaries called lacteals. These capillaries absorb
nutrients from the small intestine.

Lymphatic vessels
Efferent lymphatic vessel
Vas lymphaticum efferens
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Synonyms: none

The lymphatic vessels are divided into two large groups; superficial and
deep lymphatic vessels. The superficial vessels are located in the
subcutaneous layer of the skin where they collect the lymph from
the superficial structures of the body. They tend to follow the drainage
of the venous system and in the end, drain into deep lymphatic vessels. The
deep lymphatic vessels carry lymph from internal organs. In contrast to
the superficial vessels, the deep vessels are accompanied by the
arteries. These arteries lean onto the walls of the deep lymphatic
vessels, putting pressure upon them and helping the flow of the lymph.

Along the way, both superficial and deep lymphatic vessels go

through lymph nodes that monitor the content of the lymph. Lymphatic
vessels that carry lymph towards the lymph node are known as afferent,
whereas the vessels that carry lymph away from the lymph node are
called efferent lymphatic vessels.

The efferent vessels empty into the lymphatic trunks. The lymphatic trunks are named according
to the region of the body that they drain the lymph from. There are four pairs of trunks: lumbar,
bronchomediastinal, subclavian and jugular. There is also one unpaired intestinal lymph trunk,
that drains lymph from the majority of organs of the gastrointestinal tract. The duct opens in
the cisterna chyli which is the dilated origin of the thoracic duct.
Right lymphatic duct
Ductus lymphaticus dexter

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Synonyms: none

The lymphatic trunks then converge into the two lymphatic ducts; the right lymph duct and
thoracic duct.

 The right lymphatic duct collects lymph from the right upper limb and the right side of
the head and chest.
 The thoracic duct is a larger vessel and collects lymph from the rest of the body.

The lymphatic ducts take the lymph into the right and left subclavian veins, which flow into
the superior vena cava.

Lymphatic vessels vs. blood vessels

The lymphatic vessels should not be confused with blood vessels. First of all, the lymphatic
system is a one-way street starting blindly in the tissues and opening into the circulatory system
on the other end. On the other hand, the venous and arterial vessels of the circulatory
system vessels are connected by capillary networks and thus the blood flows in circles. The
lymphatic system doesn’t have a pump that can regulate the pressure of the flow of the lymph
like the circulatory system has (the heart). Instead, the lymph flows thanks to the movements of
the body, pulsation of the arteries and contractions of skeletal muscles. The lymphatic vessels
have valves that prevent the lymph flowing backwards.

Lymphatic vessels are located throughout the whole body but note that some tissues and organs
are lacking the lymphatic vessels (e.g. epidermis, cartilage, bone marrow, the structures of
the eye). For a long time, it has been believed that the central nervous system doesn't contain
lymph vessels. Now there is convincing evidence that the lymphatics do exist in some parts of
the central nervous system.

Lymph nodes

The lymph nodes are secondary lymphoid organs distributed throughout the whole body,
grouped according to the body regions they are in (e.g. axillary, pelvic, mediastinal lymph
nodes). An adult human has an average of 450 lymph nodes, most of which are located in
the abdomen.

The lymph nodes house lymphocytes and other immune

cells (e.g. macrophages, plasmocytes, dendrocytes). Thanks to the many
immune cells found within them, the lymph nodes serve as a filtration point for
the lymph that travels towards the venous system. In case the immunocytes
detect a foreign particle in the lymph (e.g. microorganism), they will start the
immune response to prevent the harming particle from disseminating
throughout the body.

Lymphocytes
Lymphocyte

Lymphocytus

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Synonyms: none

The lymphocytes are one of the body's main immune cells. They arise from the stem cells in the
primary lymphoid organs and belong to the part of the immune system called the acquired
immunity. After maturation, the lymphocytes are distributed mainly in the secondary lymphoid
organs.

According to their histology and functional characteristics, the lymphocytes are divided into
three major groups; B lymphocytes, T lymphocytes and natural killer (NK) cells. Their main role
is to establish a specific immune response to foreign particles (antigens). B lymphocytes destroy
the antigens indirectly, by producing antigen-specific antibodies that attach to antigens and mark
them for destruction. On the other hand, T lymphocytes and NK cells directly kill cells that are
infected by viruses or become cancerous.

Lymphoid organs and immunity

According to their function and structure, the lymphoid organs are divided into two
groups; primary and secondary lymphoid organs.

Primary lymphoid organs

Thymus

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Synonyms: Bries

The primary lymphoid organs serve as a nursery for the formation and development of the
lymphocytes. There are two primary lymphoid organs; the bone marrow and the thymus. The
bone marrow contains the stem cells from which the lymphocytes originate. B cells fully develop
in the bone marrow. On the other hand, the T cells arise from the stem cells in the bone marrow
but then travel to the thymus to complete their differentiation.

This process of development of both types of lymphocytes is called an antigen-native

development. After this initial development, the lymphocytes enter the bloodstream which
carries them throughout the body and disperses them in the connective tissues and the secondary
lymphoid organs.
Secondary lymphoid organs

The secondary lymphoid organs are the spleen, tonsils, vermiform appendix,
lymph nodes, and specialized lymphoid tissue of the mucosae (MALT).
When their maturation process in the primary organs ends, the
lymphocytes relocate into the specific areas of these secondary
lymphoid organs. There, they meet the antigens for the first time and
undergo final maturation process called the antigen-dependent activation. This
process prepares them for the battle against specific antigens.

Functions

The lymphatic system has several crucial functions for maintaining

body homeostasis which include: maintaining the body's fluid balance,
transportation of large molecules and immune surveillance.

The fluid balance is maintained by draining the extra fluid that remains
after the exchange of blood and nutrients between the tissues
and capillaries. If not regularly drained, this amount of fluid can
accumulate and cause swelling (edemas). Lymph also carries
the molecules that are too large to diffuse through the capillary wall (e.g.
proteins or lipids). This is why the small intestine has a vast lymphatic
drainage, as it is the site where the lipids and proteins are absorbed
from during food digestion. The lymphatic organs house
numerous immune system cells which surveil the content of the lymph as it
flows toward the venous system. If a foreign particle is detected, the
immune cells start an immune response to destroy the pathogen and
prevent the infection and damage.

Let’s recap the lymphatic system functions:

 The best-known function of the lymphatic system is its role in
body fluid balance regulation by returning the excess fluid and
proteins into the venous system.
 The lymph helps large molecules that cannot diffuse through the
capillary wall to enter the blood, like proteins or lipids.
 The lymph system also has a major role in immune surveillance
and fighting pathogens found in the body.