AP 3 Lymphatic System.txt

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AP 3 Lymphatic System.txt
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2011-04-18 22:49:22
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AP 3- Exam lymphatic system
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  1. CH 20: What are the the components of the lymphatic system?
    • -lymphatic vessels
    • -lymph, the fluid
    • -lymph nodes, cleanse fluid as it passes through
    • -lymph organs: spleen, thymus, tonsils
  2. What is interstitial fluid?
    the almost 3L of fluid that is forced out of the blood at the arterial ends of the capillary beds and remains behind in the surrounding tissue spaces. It also contains plasma proteins in it.
  3. What forces the interstitial fluid out?
    hydrostatic and colloid osmotic pressure
  4. What is the function of the lymphatic system?
    to transport leaked plasma proteins and fluids back to the cardiovascular system to ensure sufficient blood volume
  5. What is the function of lymphatic vessels?
    drainage vessels that collect that protein containing interstitial fluid (Lymph) to return it to the bloodstream
  6. Define Lymph?
    when interstitial fluid enters the lymphatic vessels/lymphatics
  7. What helps move the lymph in the vessels?
    • -milking action of skeletal muscle contraction
    • -thoracic pressure changes due to breathing
    • - rhythmic, pumping contraction of smooth muscle in vessel wall
    • - one-way valves in vessels
    • -3L of lymph enters bloodstream every 24 hrs
  8. Which way do lymphatic vessels flow?
    only to the heart
  9. What are the 4 types of lymphatic vessels?
    • -lymphatic capillaries
    • -lymphatic collection vessels
    • -lymphatic trunks
    • -lymphatic ducts
  10. What are lymphatic capillaries?
    • -beginning of the lymphatic vessels.
    • -microscopic and blind-ended
    • -weave all through the body except in avascular tissue (cornea, epithelial tissue layers of the skin), CNA, teeth, bone and bone marrow
    • -permeable: easily allow limp, proteins, cell debris, pathogens and cancer cells in
  11. What do they lymphatic capillaries look like?
    • -they have collagen filaments that anchor it to connective tissues
    • -they are made of endothelial cells that are loose and overlap each other
    • -they have flaplike minivalves that allow fluid in when pressure outside of the capillaries is greater than that on the inside. when pressure inside is greater than outside, the valves close
  12. What are lacteals?
    • -specialized lymphatic capillaries in the villi of the intestinal mucosa
    • -asborb the milky white digested fats from the intestine
  13. Define chyle?
    the fatty lymph in lacteals which is also delivered to the blood via lymphatic system
  14. Describe the flow of lymph through the vessels after the capillaries?
    • flows through larger, thicker-walled channels.
    • capilaries > lymphatic collection vessels > lymphatic trunks > lymphatic ducts
    • CVTD - Come Visit The Dog
  15. Describe the lymphatic collecting vessels/lymphatics?
    • -have more internal valves
    • -same 3 tunis as veins (Tunica interna, tunica media, and tunica externa) but thinner walled and anastomose (connect) more
  16. Describe lymphatic trunks?
    • -formed by the union of the largest collecting vessels and drain large areas of the body
    • -they are the paired (right and left) lumbar, bronchomediastinal (upper branches of the superior vena cave), subclavian and jugular and the singular intestinal trunk (inferior to the lumbar)
  17. Describe lymphatic ducts?
    • -found in thoracic region
    • -right lymphatic duct drains lymph from right arm and right side of head and thorax
    • -larger thoracic duct drains lymph from rest of body: left side of thorax, left upper limb and head
    • -both ducts drain lymph into venous circulation by entering subclavian veins on their respective side of the body
    • -subclavians merge with jugulars to form brachiocephalic veins
    • - left and right brachiocephalics merge to form superior vena cava which empties into heart
  18. What is cistern chyli?
    sac at lower end of thoracic duct which collects the lymph from the 2 large lumbar trunks that drain the lower limbs and from the intestinal trunk that drains the digestive organs
  19. Define Lymphedema?
    When lymph is blocked from returning to the venous circulation, localized swelling occurs but is eventually drained by regrowth of vessels that are not blocked
  20. Define elephantiasis?
    tropical parasitic worms clog lymph vessels, cause edema (swelling), sometimes extreme (example: legs or scrotum)
  21. Define Lymphocytes?
    • -lymphoid cells
    • -main warriors of the immune system arises in red bone marrow
    • -mature into T-cells and B-cells that protect body against antigens
  22. Function of Tcells?
    manage immune response and also destroy infected cells
  23. Function of Bcells?
    -produce plasma cells which are clones and secrete antibodies
  24. Function of macrophages?
    phagocytizing pathogens
  25. Function of Dendritic cells?
    capture antigen and bring back to lymph nodes
  26. Function of reticular cells?
    fibroblast like cells that produce reticular storm which is the network that supports the other cell types
  27. Describe lymphoid tissue?
    • -net-like framework of reticular connective tissue
    • -houses and provides a proliferation site for lymphocytes
    • -has an ideal surveillance vantage point for lymphocytes and macrophages
    • -they occupy the spaces of this tissue to monitor activities before they leave to patrol the blood.
  28. What are the different Lymphoid tissue "packages"?
    • -Diffuse lymphatic tissue of a few scattered reticular tissue elements found everywhere but specifically in the mucous membranes and in lymphoid organs
    • -lymphoid follicles (nodules) contain tightly packed reticular tissue called germinal centers. they form larger lymphoid organs like lymph nodes but are also found alone in the peyer's patches of the intestinal wall and in the appendix
  29. What occurs in germinal centers?
    b cells proliferate here when they produce plasma cells
  30. Describe lymph nodes?
    • -main lymphoid organ
    • -hundereds cluster along the lymphatic vessels of the body,
    • -protecting the trunk of the body and concentrated along the right and left cervical nodes (neck), axillary nodes(armpit),and inguinal nodes (groin) where lymphatic vessels merge into trunks
  31. Function of lymph nodes?
    • -filter lymph before it heads back to bloodstream: macrophages in the nodes remove debris and pathogens
    • -help activate the immune system: if lymphocytes see antigens here, an immune response is activated
  32. Structure of lymph nodes?
    • - small (~1 inch length), bean-shaped (hilus = indentation)
    • - surrounded by dense, fibrous capsule with extensions, trabeculae, that compartmentalize node interior
    • - cortex (outer region) with areas of densely packed cells (follicles/germinal centers) + medulla (inner region)
    • -Dendritic cells cover follicles and house Tcells
    • -contain medullary cords: thin inward exenstion of cortical lymphoid tissue in nodes that contain both lymphocytes and plasma cells
    • -and lymph sinuses: large capillaries crisscrossed with reticular fibers where numerous macrophages reside
  33. How does lymph circulate in the nodes?
    • - lymph enters convex surface of node via afferent lymphatic vessels
    • -then through the various subcapsular sinus
    • - and exits concave (hilus) surface via efferent lymphatic vessels (valves prevent back-flow)
    • -more afferent vessels than efferent to stagnate the flow in order to filter the lymph.
  34. What is lymphoma?
    cancer of lymphoid tissue
  35. What would cause nodes to swell?
    • -when they are infected, buboes, by microorganisms. become tender to touch
    • -cancer cells can become trapped there and infiltrate they nodes. swollen but not tender to touch
  36. Lymphoid Organ: Describe Spleen?
    • -largest lymphoid organ, rich in blood (houses great number of leukocytes and erythrocytes)
    • -located on left side of abdomen, just below diaphragm, curling around stomach
    • -splenic artery and vein enter/exit spleen from concave (hilus) side
  37. Functions of the spleen?
    • -provides site for lymphocyte proliferation and immune surveillance and response
    • -blood cleansing and filtering functions: old or defective RBC's and platelets phagocytized (RBC graveyard), removes debris, pathogens, and toxins from blood
    • -salvages iron for making new hemoglobin
    • -stores blood platelets
    • -site of erythrocyte production in fetus
  38. What is the spleen surrounded by?
    fibrous capsule thathas traveculae that extend inward like nodes which contain both lymphocytes and macrophages and erythrocytes
  39. What is the white pulp of the capsule?
    (high density of lymphocytes) functions primarily in immunity
  40. What is in the red pulp of the spleen capsule?
    • -RBC and blood borne pathogen disposal
    • -sites of venous sinuses
  41. Why can spleen be easily injured?
    because it's capsule is thing and can be injured by direct abdominal blow or infection causing it to rupture spilling blood in peritoneal cavity
  42. How is ruptured spleen treated?
    • - rupture requires immediate splenectomy to avoid internal hemorrhage and hypovolemic shock
    • - liver and bone marrow compensate for loss or it can regenerate from small part left intact in children
  43. Lymphoid Organ: Describe Thymus?
    • -located in mediastinum posterior to sternum and anterior to aortic arch
    • - or inferior to neck and extends into superior thorax
    • - important in childhood, from puberty on it gradually atrophies becoming fibrous and fatty
    • -like cauliflower, thymus composed of many lobules, each with outer cortex and inner medulla
    • -composed not of reticular connective tissue but of specialized epithelial cells called thymocytes
    • -only t-cells here, especially in cortex, no b-cells. and some macrophages
  44. Function of Thymus?
    -secretes hormones which cause T cells (T for thymus) to mature and become immunocompetent (T cells produced in bone marrow, mature in thymus, and go to lymph nodes)
  45. What are thymocytes?
    they are specialized epithelial cells that make up the thymus
  46. What are thymic (Hassall's) corpuscles?
    -involved in the development of regulatory T-cells
  47. Lymphoid Organ: Describe Tonsils?
    - found in ring around entrance to pharynx, appear as swellings of mucosa:
  48. Describe the 4 types of tonsils?
    • 1) palatine tonsils (largest) - at posterior of oral cavity- upper posterior part of throat, most often infected
    • 2) pharyngeal tonsils (adenoids) on posterior wall of nasopharynx - up by the ear
    • 3) lingual tonsil at base of tongue
    • 4) tubal tonsils at openings of auditory tubes into pharynx
  49. What are the functions of tonsils?
    • -gather and remove pathogens in inhaled air or ingested material
    • - many infoldings, or crypts, which trap bacteria
    • - lymphocytes initiate response
  50. What are tonsillar crypts?
    • -deep crevices in tonsil's epithelium cells that invite bacteria and pathogens to get trapped, work their way into lymphoid tissue and then get destroyed
    • -strategy to produce a wide variety of immune cells that have a memory for the trapped pathogens
  51. What is a tonsillectomy?
    • -removed (tonsillectomy) if severely infected (tonsillitis)
    • - "T&A"= tonsillectomy and adenoidectomy
  52. What is MALT (mucosa-associated lymphatic tissue):
    • - includes tonsils, Peyer's patches, and appendix and lymphoid follicles in the bronchi
    • - protects body from invaders entering digestive and respiratory tracts
  53. Describe Peyer's patches?
    • -large clusters of lymphoid follicles located in the wall of the distal oration of the small intestine (ileum)
    • -also found in the appendix
    • -function like tonsils
    • -destroy bacteria before they breach intestinal wall and create memory lymphocytes
  54. How does the lymphatic system develop?
    • -begins with vessels and then clusters of nodes which arise from lymph sacs forming on veins
    • -the thymus is the first lymphoid organ to appear, grows from lining of pharynx
  55. CH 21: Describe Nonspecific (or innate) defense system (or resistance)?
    • -first line of defense = external body membranes (skin + mucous membranes) prevent entry of microbes
    • - second line of defense = phagocytes, antimicrobrial proteins and other cells to inhibit spread of pathogen. hallmark is of inflammation called into action if first line penetrated.
  56. Describe Specific (or adaptive) defense system (or resistance)?
    • - third line of defense
    • - works against particular invaders
    • - functional, rather than anatomical, system many organs (particularly of the lymphatic system) involved in processes
    • - composed of trillions of immune cells (lymphocytes) found throughout body, and other substances
  57. Detail about first line of defense: skin and mucosa?
    • - cover outside of body and line all cavities open to exterior (digestive, respiratory, urinary, and reproductive tracts)
    • - closely packed, often heavily keratinized epithelial cells form barrier to pathogens and harmful substances
    • - outer cells of stratified squamous epithelium in skin are dead (viruses can't use) and continually desquamate (pathogens must swim against current)
    • - protective secretions
  58. What are the protective secretions of the skin + mucosa?
    • - sweat and sebum are acidic and bactericidal
    • - stomach acid kills pathogens (taking medications to reduce stomach acid increases chance of food poisoning)
    • - saliva and lacrimal fluid (tears) contain lysozyme (enzyme that kills bacteria)
    • - mucus traps microbes and other particles (often combined with ciliated cells that sweep along mucus + trapped material)
    • - urine is acidic, flushes out tract
  59. Details about the second line of internal defense: cells and chemicals?
    • -phagocytes arrive on the scene
    • -different types are neutrophils, eoisinophils and macrophages
    • - Natural killer cells involved
    • -inflammation and involved
    • -antimicrobial proteins involved
  60. Describe neutrophils?
    • - most common and abundant leukocyte and first to respond to infection
    • - granulocytes with nuclei of 3-5 lobes
    • - phagocytize pathogens and release bleach
    • - elevated neutrophil count suggests acute bacterial infection, such as appendicitis
    • -produce defensins that pierce pathogens membrane
  61. Describe eosinophils?
    • - less common leukocyte
    • - granulocyte with nuclei of 2 lobes
    • - somewhat phagocytic, more important in combating parasitic worms by release of noxious compounds
  62. Describe macrophages?
    • - called monocytes until leave the bloodstream for interstitial spaces
    • - big, agranular leukocytes that respond later to infection
    • - wander throughout tissues phagocytizing pathogens and debris (garbage collecting)
    • - elevated monocyte count suggests chronic bacterial infection, such as tuberculosis
    • -can be fixed to the liver or brain for example or roam freely like those in the lungs
  63. What is phagocytosis?
    • -phagocytes engulf debris after first lassoing it with it's cytoplasmic extensions
    • -need to be able to adhere to it before ingesting it with lysosomal enzymes
    • -if called upon by helper t-cells then additional free radicals are at their disposal to kill the foreign particle: called respiratory burst
  64. What does opsonization mean?
    when complement proteins or antibodies coat foreign particles making it easier for phagocytes to adhere to and ingest them
  65. Describe Natural Killer Cells?
    • - large, granular lymphocytes
    • - indiscriminately attack foreign, virus-infected, or cancer cells by opening holes in cell membrane
    • - enhance inflammatory response
  66. What does inflammation occur?
    • - response to injury (blow, burn, irritating chemicals, infections)
    • - inflammation of organ, structure, or tissue designated by ending -itis
  67. What is the function of inflammation?
    • -prevents the spread of damaging agents to nearby tissues
    • -disposes of cell debris and pathogens
    • -sets the stage for repair
  68. What are the 4 signs of inflammation?
    4 signs: redness, swelling, pain, heat
  69. Describe the inflammatory response?
    • 1) release of inflammatory mediators by damaged tissue and leukocytes:
    • - histamine (anti-histamines reduce inflammation)
    • - prostaglandins (aspirin + other analgesics counteract)
    • - others
    • 2) mediators cause vasodilation and consequent local accumulation of blood (including antibodies, leukocytes, and clotting factors) causes redness and heat
    • 3) mediators also increase permeability of capillaries fluid containing antibodies and clotting factors flows into tissue spaces and causes swelling, or edema (pressure on nerves, as well as bacterial toxins, result in pain) also dilutes toxins, brings in O2 and nutrients, and initiates clotting
    • 4) mediators attract phagocytic leukocytes (neutrophils and macrophages) by
    • chemotaxis

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