Lymphatic system

Dr. Suma Patil Amrita School of Ayurveda

Introduction
Components Lymph is the cleaer fluid found in the lymphatic vessels .

(LIMF=Clear fluid). Intrestital fluid and lymph are similar in nature, major difference between these is that -Intestinal fluid found in between cells and -lymph is located within lymphatic vessels and lymphatic tissue. Vessels lymphatic capillaries, vessels, ducts, subclavian vein. Structures & organsPrimary- Redbone marrow and thymus.

Secondary Lymph nodes, spleen, lymphatic nodules.

Intro
Functions Return tissue fluid to the bloodstream Transport lipids and lipid soluble vitams(ADEK)from

the digestive tract to the bloodstream Surveillance & defense

Composition of Lymph
Lymph is usually a clear, colorless fluid,

similar to blood plasma but low in protein Its composition varies from place to place; after a meal, for example, lymph draining from the small intestine, takes on a milky appearance (Chyle), due to lipid content. Lymph may contain macrophages, viruses, bacteria, cellular debris and even traveling cancer cells.

Lymphatic capillaries
These are slightly larger in diameter that blood

capillaries. They have unique structure that permits interstitial fluids to flow into them but not out.

Lymphatic circulationLymph trunks and ducts

Lymph passes from lymphatic capillaries into lymphatic vessels and

then through lymph nodes. Lymph nodes pass lymph either towards another node within the same group or onto another group of nodes. Most proximal nodes of each chain of nodes, the exiting vessels unite to form lymph trunk. The principle trunks are the Lumbar, Intestinal Broncho-mediastinal Subclavian Jugular trunk. Lymph passes from lymph trunks into two main channels Thoracic duct( Left lymphatic duct) Right lymphatic duct. Drains into venous blood.

Contd..
Right lymphatic duct

Drains right side of head & neck, right arm, right thorax Empties into the right subclavian vein

Thoracic duct

Drains the rest of the body Empties into the left subclavian vein

Lymphatic vessels start with lymphatic capillaries lymphatic ducts lymphatic trunks lymphatic collecting vessels

lymphatic capillary

Lymphatic vessels
Properties of lymphatic vessels
One way system toward the heart No pump Lymph moves toward the heart Milking action of skeletal muscle o Rhythmic contraction of smooth muscle in vessel walls

THORACIC DUCT Begins as a loosely dialated sac and connections in the abdomen called the CYSTERNA CHYLI. Drains both legs, and left side of body. Goes through thorax, receives tributaries from: LEFT SUBCLAVIAN TRUNK (from left arm) and LEFT JUGULAR TRUNK (left side of head left neck). Dumps into venous circulation at junction betweenandsubclavian vein and
left jugular vein. (Technically into left brachiocephalic vein.)

Thoracic duct
Largest lymphatic vessel in the body.

Extends from upper part of the abdomen to the

lower part of the neck crossing the posterior and superior part of the medi-astinum length is about 45 cms. Beaded appearance because presence of many valves in its lumen.

 Course- Begins as a dilation called Cisterna

Chyli in front of T12 / L2.

Enters thorax through the Aortic opening

diaphragm.
Ascends through posterior medi-astinum from rt

side to left side at the level of T5.

Through the superior medi-astinum along the

edges of the esophagus and reaches the neck.

 In the neck it arches laterally at the level of

transverse process of C7.

Lastly it descends in front of the first part of left

subclavian artery.
Ends by opening into the angle of junction

between the left subclavian and left internal jugular vein. It receives lymph from lf jugular left subclavian lf broncho-mediastinal trunks.

Cisterna Chyli
Is an elongated lymphatic sac. Is about 5-7 cms long. Situated in front of the L1 & L2 immediately to the

right of abdominal aorta. Overlapped by the Rt cruse of the diaphragm. Upper end continues with the thoracic duct . It receives lymph from the rt and lt lumbar trunk and from the intestinal trunk. Lumbar trunk- Drains lymph from lower limbs, wall and viscera of the pelvis, kidneys, adrenal glands and most of the abdominal walls. Intestinal trunk- Drains lymph from stomach, intestines pancreas, spleen, and part of the liver.

Copyright The McGraw-Hill Companies, Inc. Permission required for Brachiocephalic veins reproduction or display. Right internal jugular vein Right jugular trunk Right subclavian trunk Right subclavian vein Right bronchomediastinal trunk Superior vena cava Rib (cut) Intercostal muscle Azygos vein Thoracic duct T12 Diaphragm Right lumbar trunk Cisterna chyli Left lumbar trunk Intestinal trunk Left internal jugular vein Thoracic duct Left jugular trunk Left subclavian trunk Left bronchomediastinal trunk Left subclavian vein First rib (cut) Parietal pleura (cut) Thoracic lymph nodes Hemiazygos vein

Inferior vena cava (a)

Thoracic duct Right jugular trunk Right subclavian trunk Right bronchomediastinal trunk (b) Area drained by Left jugular trunk right lymphatic Left subclavian trunks shown in trunk part (b) Area drained by left lymphatic trunks and thoracic duct shown in part (b)

Left bronchomediastinal trunk (c)

Right Lymphatic Duct

Is about 1.2cms long. Drains lymph from the upper right side of the

body into venous blood via the rt. Subclavian vein. Three lymphatic trunks drain into it, they areRt. Jugular trunk drains the rt side of the head and neck. Rt. Subclavian trunk drains the rt upper limb. Rt. Broncho-mediastinal trunk drains the rt. side of the thorax and the heart, rt. Lung, and part of the liver.

Thymus Gland
Location between the sternum and aorta in

the mediastinum The capsule divides it into 2 lobes Development Infant Is larger having a mass of about 70 gms. Puberty maximum size Maturity decreases in size Old age- Weighs only 3 gms. After puberty adipose and areolar connective tissue begin to replace the thymic tissue. Function Differentiation and maturation of T cells. Before the thymus atrophies it populates the secondary lymphatic organs and tissues with T cells.

Thymus Gland

Lymph Nodes
Located along lymphatic vessels.

They are around 600 bean shaped lymph nodes.

They are scattered throughout the body-

Superficial and deep and usually occur in groups. Large group of lymph nodes are present near the mammary glands and in the axillae and groin.

Tonsils

Right lymphatic duct Thymus Axillary lymph node Mammary plexus

Cervical lymph node Thoracic duct Subclavian veins Thoracic duct Spleen Lacteals in intestinal wall Inguinal lymph node

Lymphatic vessel (transports lymph) Bone marrow

Lymph node
1-25mm long.

Covered by capsule of dense connective tissue

that extends into the node. The capsular extensions called trabecuelae which divides the node into compartments, provide support and route for blood vessels into the interior of a node. Internal of the capsule is a supporting network of reticular fibers and fibroblasts. The capsule, trabeculae, reticular fibers and fibroblasts constitute the stroma or framework of a lymph node.

Cont.
Parenchyma of lymph node.

Divided in to- cortex-outer cortex n inner

cortex. -Medulla. Outer cortex-contains egg shaped aggregates of B-cells called LYMPHATIC NODULES. L N consisting chiefly of B cells called primary lymphatic nodule. Inner cortex-also called the paracortex. -Does not contains lymphatic nodule.

Cont
MEDULLA-contains B cells , antibody

producing plasma cells and macrophages. Lymph flows through a node in one direction i e through afferent lymphatic vessels. which penetrate the node at several points. ALV contains many valves that open towards the center of the node. Such that the lymph is directing inwards. SINUSES-are series of irregular channels that contain branching reticular fibers, lymphocytes, and macrophages. 3 types-subcapsular ,trabecular, medullary

Cont..
Efferent lymphatic vessels-wider than

ALV. -few in number. Contains valves, that open away from the center of the node. ELV emerge from one side of lymph node at a slight depression called HILUS. Function- to filter lymph.

LYMPH NODE

.SPLEEN. Oval spleen is the largest single mass of lymphatic tissue in body. 12cm length. Located in the left hypochondriac, between the stomach and diaphragm. Like lymph nodes, spleen has hilus,through it pass the splenic artery, vein and efferent lymphatic vessels. Parenchyma of spleen-white n red pulp. White pulp-is lymphatic tissue consisting mostly of lymphocytes and macrophages. Red pulp-consists of blood filled venous sinuses and BILLROTHs cord , that contains red blood

Functions
Within white pulp, B cell and T cell carry out

immune function., similar to lymph nodes , while spleen macrophages destroy blood borne pathogens. Within red pulp- spleen performs 3 functions
1) Removal of ruptured ,worn out , defective blood

cells and platelets by macrophages. 2) Storage of platelets, up to one third of the bodys supply. 3) Production of blood cells during fetal life.

LYMPHATIC NODULES
Are egg-shaped masses of lymphatic tissue,not

surrounded by a capsule. Because they are scattered throughout the mucous membranes lining the gastrointestinal , urinary and reproductive tract and respiratory airways . lymphatic nodules in these areas are also referred to as MUCOSA-ASSOCIATED LYMPHATIC TISSUE(MALT). Although many LN are small and solitary, some occur in multiple large aggregation in specific part of the body. Among these are the 1) Tonsils in pharyngeal region. 2) peyers patches SI. 3) APPENDIX.

metastasis
The spread of a disease from one part of the

body to another can occur via lymphatic vessels. All malignant tumors eventually exhibit metastasis. Cancer cells may travel in the blood or lymph and establish new tumors where they lodge. Primary tumor site , secondary tumor site.

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