The Lymphatic

System
 The Lymphatic System
Includes the lymph, lymphatic
vessels, lymph nodes, lymphoid
organs (tonsils, spleen and thymus)
Primary Functions:
1. Maintains fluid homeostasis
2. Absorbs lipids from the GIT
3. Filters blood (spleen)
4. Contains lymphocytes
participating in immunity
 The Lymph
Fluid similar to composition
as plasma
Without RBC and less
proteins
Special Lymph from the GIT
is loaded with fats and is
called CHYLE
Fig. 14.2
 The Lymph vessels
Carry fluid away from tissues
into the venous circulation
These are NOT present in
the central nervous system,
Bone marrow, epidermis and
cartilage
They resemble vein because
3 mechanisms of edema
formation
1. Decrease oncotic pressure
cirrhosis and kwashiorkor
2. Increased hydrostatic
pressure CHF and prolonged
standing
3. Lymphatic obstruction or
destruction filiariasis, lymph
node dissection
 Lymphatic duct
1. Right lymphatic duct-
drains the right side of the
head and the upper right
side of the thorax and the
right extremities
2. Thoracic duct- drains the
rest of the body
 The Lymphatic organs
1. Tonsils
A. palatine
B. pharyngeal
C. lingual
D. tubal
 The lymphatic organs
2. Lymph nodes
Small round structures of lymphoid
tissue
Major lymph nodes are the axillary,
inguinal and cervical
Filters lymph
Activates the immune system
Removes microorganisms from the
blood
 The lymphoid organs
3. The spleen
Reddish, flat organ lying next to the
9th and 10th rib in the left upper
quadrant
Functions:
Repository of old RBC
Activates the immune system
Storage of Blood
Sequesters bacteria
MOST COMMONLY INJURED
The lymphoid organs
4. Thymus
Bilobed organ in the superior
mediastinum
Lymphocytes from the bone
marrow mature and grow as T-
lymphocytes
Positive selection= T-cells that
react to foreign antigen are
selected
 IMMUNITY
Innate or Non-specific Specific
1. Mechanical- skin, Immunity
mucus, saliva, urine
1. Cellular
2. Chemical- Immunity- T-
enzymes,
cell system
lysozymes
3. Vascular Blood 2. Humoral
cells- Neutrophils Immunity- B-
and macrophages cell system
4. Inflammation
 Non-specific Immunity
Inflammatory response
Reaction of the vacularized living
tissues to injury
Classic signs:
1. Rubor- redness
2. Calor- heat
3. Tumor- swelling
4. Dolor- pain
5. Functio laesa- loss of
 Inflammation
Initial reaction
Vasoconstriction!
VC VD VP (due to
HISTAMINE)
VD Redness and Heat
VP Swelling
Bradykinin, Prostaglandin,
compression of tissues pain
 Specific Immunity: T cell
T-cells originate in the bone marrow and
mature in the thymus
4 types of T-cells
1. Cytotoxic T cells- kill infected cells,
cancer cells and transplanted cells
2. Helper T cells- help the humoral
immunity
3. Suppressor T cells- suppress that
actions of cytotoxic and Helper cells
4. Memory T cells- for recall and
Specific Immunity: B cells
B cells are produced and
mature in the bone marrow
B cells helped by Helper
cells turn into Plasma
cells secrete ANTIBODIES
 ANTIBODIES
Are proteins that can
combine with antigens and
function for:
1. Opsonization
2. Neutralization
3. Activation of complement
system
 ANTIBODIES types
Five classes
1. Ig M- priMary response,
pentaMer
2. Ig G- secondary response, most
abundant, can cross placenta
3. Ig A- secreted by the body
(sIgA)
4. Ig D- receptor for B cells
 TYPES OF IMMUNITY
1. Natural Immunity
Active natural
Passive natural
2. Artificial Immunity
Active artificial
Passive artificial
Fig. 14.18
End of Immune System
THE RESPIRATORY SYSTEM
The Respiratory System
Composed of the air
conducting system and the
respiratory unit (lungs)
Major function is
RESPIRATION
Commonly divided into
UPPER RESPIRATORY tract
 Ventilation and
Respiration
VENTILATION- movement of air
from the atmosphere into the
lungs and out of the lungs
EXTERNAL RESPIRATION-
exchange of gases between the
alveoli and the blood
INTERNAL RESPIRATION-
exchange of gases between the
blood and the tissues
 The Respiratory System
Commonly divided into
UPPER RESPIRATORY tract
and
LOWER RESPIRATORY tract
The UPPER Respiratory
tract
The nose, pharynx and
larynx
 The LOWER respiratory
tract
Composed of The trachea
down to the Lungs
 The NOSE
Made up of nasal bones and
cartilages
The NASAL cavity is made up of
bones, cartilages and turbinates
or conchae
The nostril is the external
opening
The choanae is the internal
opening
 Functions of the nose
1. Hairs or vibrissae filter
large particles
2. Blood vessels warm the
air
3. Mucus serves to
humidify the air
4. Phonation
 The Pharynx
Musculo-membranous tube
from behind the nasal cavity
to the level of the cricoid
cartilage (C6)
 The Pharynx
3 component parts
1. Nasopharynx
2. Oropharynx
3. Laryngopharynx
 The Larynx
Upper expanded portion of the
trachea
Made up of cartilages
3 Unpaired- Cricoid, Thyroid and
Epiglottis ( cUte)
6 Paired- Cuneiform, Corniculate
and Arytenoid (pACC)
Function: air passageway and
 The vocal cords
1. False vocal cords
2. True vocal cords
3. Glottis- the space between
the true vocal cords and is
the narrowest portion of the
adult airway
Fig. 15.4
 Lower airway: Trachea
Called windpipe
Made up of 15-20 C-shaped
cartilage
10-11 inches
Lined with pseudostratified
ciliated epithelium
 Bronchus
RIGHT Bronchus Left bronchus
Wider Narrower
Shorter Longer
More vertical More horizontal
 Bronchioles
Primary bronchussecondary
bronchustertiary bronchus
terminal bronchioles

Respiratory bronchioles belong to

the respiratory unit
 Respiratory unit
Respiratory bronchioles
Alveolar ducts
Alveolar sacs
alveolus
 The Pleura
Surrounds the lungs and provide
protection
1. Parietal pleura- in the chest wall
2. Visceral pleura- intimately
attached to the lungs
3. Pleural space- in between the
two
Diaphragm
 Respiratory Physiology
1. Ventilation and gas exchange
2. Mechanics of breathing
3. Gas transport
4. Pulmonary volumes and
capacities
5. Respiratory control
 Ventilation
Ventilation is the movement of air
into the lungs
Air (oxygen) moves by the process
of diffusion from the higher
concentration in the alveoli to the
pulmonary capillaries
Mechanics of breathing
 Gas exchange
Respiratory membrane is thin
which facilitates gas exchange
Rate of diffusion depends on the
thickness of the membrane,
surface area and partial pressure
of gases
 Gas transport
1. OXYGEN- majority is transported
in the blood loosely bound to
hemoglobin- oxyhemoglobin
2. CARBON DIOXIDE- majority is
transported in the blood in the RBC
as BICARBONATE
Fig. 15.8
 LUNG VOLUMES
1. Tidal volume – TV
2. Inspiratory Reserve Volume- IRV
3. Expiratory Reserve Volume- ERV
4. Residual volume- RV
 LUNG CAPACITIES
Lung volume + another lung
volume
1. Inspiratory Capacity- IC
2. Functional Residual Capacity-
FRC
3. Vital capacity- VC
4. Total Lung capacity- TLC
NOT CLINICALLY measured
1. Residual volume
2. Functional residual volume
3. Total lung capacity
 Control of Respiration:
Central
Respiratory center in the medulla
Controls the rate and depth of
respiration
Increased CO2 is the most potent
stimulus
 Control of Respiration:
Peripheral
1. Chemoreceptors in the carotid and
aortic bodies
Sensitive to changes in pH and O2
Decreased O2 increase respiration
Decreased pH (acidosis) increase
respiration
2. Herring-Breurer reflex
Stretch receptors in the lungs limit the
inspiration
 ASSESSMENT
Normal Breathing pattern:
12-21 respiratory rate
Active inspiration with contraction
of diaphragm
Passive expiration with relaxation
of diaphragm
Steady rhythm and regular rate
and size
I:E ratio is 1:2
 Abnormal breathing
pattern
1. Cheyne-Stoke’s
2. Biot’s
3. Kussmaul’s
4. Agoral
 Breathing rates
1. Eupnea- 12-21
2. Bradypnea- 11 and below
3. Tachypnea- 22 and above
4. Dyspnea- difficulty of breathing
 Breathing Position
1. Platypnea- inability to breath in
an upright position
2. Orthopnea- difficulty in
breathing in any position except
upright
 Breath sounds: Normal
1. Bronchial or Tracheal- in the
sternum
2. Bronchovesicular- in the
interscapular area
3. Vesicular- lung periphery
 Adventitious Breath
sounds
1. Rales or crackles
2. Stridor
3. Wheeze
4. Rhonchi
5. Friction rub