The Lymphatic System Alternative to venous drainage Superficial lymph vessels subcutaneous tissue follow veins Deep lymph

ph vessels follow arteries Tissue fluid tiny lymph capillaries valved lymph vessel All eventually drain into veins throughout the body, many via thoracic duct

Lymph Cells are surrounded by tissue fluid. Contains diffusible compounds from blood and cells, similar to plasma. Tissue fluid may drain into a capillary plexus or a lymphatic network. Eventually destination will be back to the circulatory system. Function: -Drainage of excess fluid -Transportation of fat at the lacteals of the GIT (specialised lymph channels) -Transport of particles / debris / foreign bodies -Production of lymphocytes -Endothelial cell lined -No basement membrane -Blind ending tubes -Drain into larger lymphatic vessels -None in the CNS, cornea or bone marrow

Lymph Capillaries

Lymphatic vessels -Same 3 layers as other vessels -Very thin walls -Valves ensure direction of travel -Also rely on external muscular contraction in the vicinity of the vessel to drive return from periphery to the heart -Vessels converge on lymph nodes. A single vessel leaves -Large vessels are trunks. These drain into collecting ducts, thoracic and right lymphatic Lymph Nodes -Valved lymph vessels open into nodes throughout the body (1-25mm diameter) -Many vessels drain into the node, efferent vessels leave -Node contains a supportive framework and lymphocytes / macrophages -Functions are filtration / phagocytosis / production of lymphocytes

Distribution of Lymph Nodes Superficial Clusters (often associated with veins) Deep Clusters (associated with major arteries) -Horizontal -Vertical -neck / inguinal / etc -coeliac / superior mesenteric / iliac / etc

Cervical Nodes

-superficial drainage of head -ring at junction of head and neck -deep cervical along IJV (all drain into these) -superficial cervical along EJV (ear and parotid) -infrahyoid -prelaryngeal -pre and para tracheal -retropharyngeal

Inguinal Nodes

-Superficial

-Horizontal

-anterior abdominal wall below umbilicus -perineum -lower half of anal canal -urethra and external genitalia -back below iliac crests -superficial lymph from lower limb -drain superficial group and deep thigh

-Vertical -Deep Other Lymphoid Organs Thymus

-10 40g -bone marrow lymphatic stem cells are sent here to develop into T-lymphocytes -some enter blood / lymph system -some stay -involutes after puberty

Spleen

-1,3,5 dimensions in inches -9,11 are its adjacent ribs -200g -Structure Red pulp (supplied by blood) White pulp (rows of lymphocytes and macrophages along blood vessels) No afferents (not connected to lymphatics) -Function Erythropoesis (fetal) Lymphocytes (development of) Phagocytosis Removal of old red cells and iron recycling Fighting infection

Bone Marrow-site of production of lymphocytes

Problems Vessels -Malignant cells may multiply and spread within the lymph system -Infection spread if phagocytosis ineffective -Lymphangitis (inflammation spread along the path of lymph vessels) -Obstruction from tumour -Infection (acute / chronic , localised / generalised) -Lymphoma (chronic / acute diseases) -Metastase (spread of disease from one organ to another) -Splenomegaly (increased size of the spleen) from infection, circulatory congestion via backflow from liver, disease of blood (aneamias, chronic myeloid leukaemia) and tumours (primary /secondary)

Nodes

Spleen