UNIT-3

Lymphatic system

L
ymphatic system, a subsystem of the circulatory system in the vertebrate body that
consists of a complex network of vessels, tissues, and organs, that help rid the body
of toxins, waste and other unwanted materials. The lymphatic system also
maintain fluid balance in the body by collecting excess fluid and particulate matter from tissues
and depositing them in the bloodstream. It also helps defend the body against infection by
supplying disease-fighting cells called lymphocytes.

The lymphatic system primarily consists of lymphatic vessels, which are similar to the
circulatory system's veins and capillaries. The vessels are connected to lymph nodes, where the
lymph is filtered. The tonsils, adenoids, spleen and thymus are all part of the lymphatic system.

Lymphatic system consists of:

• Lymph(fluid)
• Lymphatic vessels (transport lymph)
• Lymph node ,
• Primary lymph organs : red bone marrow, thymus.

NOTES BY-PRAVEEN KUMAR DIXIT-ASSISTANT PROFESSOR-KSOP

 • Secondary lymphatic organ : spleen
• Diffuse lymphoid tissue Example. ( Peyer Patches) in Small Intestine
Definition:
◼ Lymph : A clear, watery, sometimes yellowish fluid derived from body tissues
that contains white blood cells and circulates throughout the lymphatic system,
returning to the venous blood stream through the thoracic duct. Platelets & RBC
are absent in lymph. Flows in a closed system of vessels.
◼ Composition of lymph :
⚫ 94% water + 6% solids
⚫ Solids : proteins, fats, carbohydrates, urea, creatinine, inorganic
substances,bicarbonates.
⚫ Consist of large no. of lymphocytes. (when lymph leaves a lymph node)

Functions of the Lymphatic System

The lymphatic system has three primary functions:
1. Drainage system of the body : Lymphatic vessels drain interstitial fluid from tissue spaces
and return it to the blood.

• 2. Transports of lipids from diet:Lymphatic vessels transport lipids and lipid-soluble vitamins
(A, D, E, and K) absorbed by the gastrointestinal tract. It facilitates absorption of fats and fat-
soluble nutrients in the digestive system.

3. Immunity booster: Lymphatic tissue contains lymphocytes which initiates highly specific
immune responses against any microbial infection.

Lymphatic circulation components:

Lymphatic Capillaries
• Unique one-way structure
• Slightly larger in diameter than blood capillaries.
• Permits interstitial fluid to flow in but not out.
• Contains endothelial cells that overlap one over another.
• When I.F pressure > lymph pressure

NOTES BY-PRAVEEN KUMAR DIXIT-ASSISTANT PROFESSOR-KSOP

 • i.e when interstitial fluid accumulates, I.F enters in lymphatic capillaries.
• Due to increased interstitial fluid,the anchoring filaments (of elastic fibres)
pull outward and gap open wider causes fluid to flow inside the lymphatic
capillaries.
• Cells separate slightly ----makes opening

•
• They extend out from the lymphatic capillary, attaching lymphatic endothelial cells to
surrounding tissues.
• When excess interstitial fluid accumulates and causes tissue swelling, the anchoring
filaments are pulled, making the openings between cells even larger so that more fluid
can flow into the lymphatic capillary.
Note: In the small intestine, specialized lymphatic capillaries called lacteals carry
dietary lipids into lymphatic vessels and ultimately into the blood. The presence of these
lipids causes the lymph draining from the small intestine to appear creamy white; such
lymph is referred to as chyle . Elsewhere, lymph is a clear, pale-yellow fluid . .

Lymphatic Vessels:
o Lymph capillaries Unite to form large lymphatic vessels
o Resemble veins in structure but thinner walls and more valves (cup shaped)
o Valves ensure lymph flows in one direction towards thorax.
o Muscle layer contraction -----onward movement of lymph.
o Passes through lymph nodes (Encapsulated organs with masses and B and T
cells)

NOTES BY-PRAVEEN KUMAR DIXIT-ASSISTANT PROFESSOR-KSOP

 o Vessels begin as lymphatic capillaries
o Closed at one end.
o Tiny vessels in between tissue cells.
o Cells that line walls overlap.
o Same structure as blood capillaries i.e single layer of endothelial cells.

Exception;
o Walls are thin & more permeable to I.F constituents.
o Slightly large diameter than blood capillaries

Lymph Trunks and Ducts

• As lymphatic vessels exit lymph nodes in a particular region of the body, they unite to
form lymph trunks.
• The 5 principal trunks are:
1. Lumbar
2. Intestinal
3. Bronchomediastinal
4. Subclavian
5. Jugular trunks .
• Lumbar trunks drain lymph from the lower limbs, the wall and viscera of the pelvis,
the kidneys, the adrenal glands, and the abdominal wall.
• Intestinal trunk drains lymph from the stomach, intestines, pancreas, spleen, and part
of the liver.
• Bronchomediastinal trunks drain lymph from the thoracic wall, lung, and heart.
• Subclavian trunks drain the upper limbs.
• Jugular trunks drain the head and neck.
Lymphatic ducts
• Lymph passes from lymph trunks into two main channels:
• The thoracic (left lymphatic) duct and the right lymphatic duct, and then drains into
venous blood.
• The thoracic (left lymphatic) duct is about 38–45 cm (15–18 in.) long and begins as
a dilation called the cisterna chyli anterior to the second lumbar vertebra. The thoracic

NOTES BY-PRAVEEN KUMAR DIXIT-ASSISTANT PROFESSOR-KSOP

 duct receives lymph from the right and left lumbar trunks at cisterna chyli and from
the intestinal trunk.
• In the neck, the thoracic duct also receives lymph from the left jugular, left subclavian,
and left bronchomediastinal trunks.
Note: The thoracic duct in turn drains lymph into venous blood at the junction of
the left internal jugular and left subclavian veins.
• The right lymphatic duct is about 1.2 cm (0.5 in.) long and receives lymph from the
right jugular, right subclavian, and right bronchomediastinal trunks. Thus, the right
lymphatic duct receives lymph from the upper right side of the body .
• From the right lymphatic duct, lymph drains into venous blood at the junction of the
right internal jugular and right subclavian veins.

Formation and Flow of Lymph

• Most components of blood plasma filter freely through the capillary walls to form
interstitial fluid, but more fluid filters out of blood capillaries than returns to them by
reabsorption .

NOTES BY-PRAVEEN KUMAR DIXIT-ASSISTANT PROFESSOR-KSOP

 • The excess filtered fluid—about 3 liters per day—drains into lymphatic vessels and
becomes lymph.
Note: Important function of lymphatic vessels is to return the lost plasma proteins to the
bloodstream. Like veins, lymphatic vessels contain valves, which ensure the one-way
movement of lymph.

FLOW OF LYMPH
Blood Capillaries

Interstitial Spaces ( I.F.)

Lymphatic Capillaries (Lymph)

Lymphatic vessels

Lymphatic trunks then Lymphatic ducts

[ Thoracic & Right Lymphatic duct]
Venous Blood at the junction of
internal jugular & subclavian
vein

Lymphatic Organs and Tissues

• Classified into two groups : Based on their functions.
• Primary lymphatic organs such as the red bone marrow (in flat bones and the
epiphyses of long bones of adults) and the thymus are the sites where stem cells divide
and become immunocompetent, that is, capable of mounting an immune response.
• Secondary lymphatic organs include lymph nodes, the spleen, and lymphatic nodules
(follicles)and tissues are the sites where most immune responses occur.

Thymus
• The thymus is a bilobed organ located in the mediastinum between the sternum and the
aorta .

NOTES BY-PRAVEEN KUMAR DIXIT-ASSISTANT PROFESSOR-KSOP

 • An enveloping layer of connective tissue holds the two lobes closely together, but a
connective tissue capsule separates the two.

• In infants, the thymus is large, with a mass of about 70 g .

• After puberty, adipose and areolar connective tissue begin to replace the thymic tissue.
The gland has atrophied considerably, and in old age it may weigh only 3 g . However,
some T cells continue to proliferate in the thymus throughout an individual’s lifetime.
• Extensions of the capsule, called trabeculae penetrate inward and divide each lobe into
lobules.
• Each thymic lobule consists of a deeply staining outer cortex and a lighter-staining
central medulla .
• The cortex is composed of large numbers of T cells and scattered dendritic cells,
epithelial cells, and macrophages. Immature T cells (pre-T cells) migrate from red bone
marrow to the cortex of the thymus, where they proliferate and begin to mature.
• Dendritic cells , which are derived from monocytes, .
• Each of the specialized epithelial cells in the cortex has several long processes that
surround and serve as a framework for as many as 50 T cells.
• These epithelial cells help “educate” the pre-T cells in a process known as positive
selection . Additionally, they produce thymic hormone (thymosin) that help in the
maturation of T cells.
• Only about 2% of developing T cells survive in the cortex. The remaining cells die
via apoptosis (programmed cell death).

NOTES BY-PRAVEEN KUMAR DIXIT-ASSISTANT PROFESSOR-KSOP

 • Thymic macrophages help clear out the debris of dead and dying cells. The surviving
T cells enter the medulla.
• Medulla consists of widely scattered, more mature T cells, epithelial cells, dendritic
cells, and macrophages . Some of the epithelial cells become arranged into concentric
layers of flat cells that degenerate and become filled with keratohyalin granules and
keratin. These clusters are called thymic (Hassall’s) corpuscles.
• T cells that leave the thymus via the blood migrate to lymph nodes, the spleen, and
other lymphatic tissues where they colonize parts of these organs and tissues.
Lymph Nodes

Key:
A-Capsule
B-Medulla
C-Hilus
Anatomy of Lymph Node
Structure: Bean-shaped lymph nodes.
They are scattered throughout the body, both superficially and deep, and usually occur
in groups . Large groups of lymph nodes are present near the mammary glands and in
the axillae and groin.Lymph nodes are 1–25 mm (0.04–1 in.) long and covered by a
capsule of dense connective tissue.

NOTES BY-PRAVEEN KUMAR DIXIT-ASSISTANT PROFESSOR-KSOP

 • Trabeculae the capsular extensions, divide the node into chambers which provide
support and a way to blood vessels within the node. Internal to the capsule is a
supporting network of reticular fibers and fibroblasts.
• The functioning part of a lymph node is divided into a superficial cortex and a deep
medulla. The cortex consists of an outer cortex and an inner cortex.
• Within the outer cortex are egg-shaped aggregates of B cells called lymphatic nodules
(follicles).
• A lymphatic nodule consisting chiefly of B cells is called a primary lymphatic nodule.
Most lymphatic nodules in the outer cortex are secondary lymphatic nodules , which
form in response to an antigenic challenge and are sites of plasma cell and memory B
cell formation. The center of a secondary lymphatic nodule contains a region of light-
staining cells called a germinal center where B cells, follicular dendritic cells (a special
type of dendritic cell), and macrophages present.
• The inner cortex does not contain lymphatic nodules. It consists mainly of T cells and
dendritic cells that enter a lymph node from other tissues.
• The medulla of a lymph node contains B cells, antibody producing plasma cells that
have migrated out of the cortex into the medulla, and macrophages.
• Lymph nodes function as a type of filter. As lymph enters one end of a lymph node,
foreign substances are trapped by the reticular fibers within the sinuses of the lymph
node. Then macrophages destroy some foreign substances by phagocytosis while
lymphocytes destroy others by immune responses. The filtered lymph then leaves the
other end of the lymph node .

NOTES BY-PRAVEEN KUMAR DIXIT-ASSISTANT PROFESSOR-KSOP

Spleen
• The oval spleen is the largest single mass of lymphatic tissue in the body, measuring
about 12 cm (5 in.) in length .
• It is located in the left hypochondriac region between the stomach and diaphragm.
• The superior surface of the spleen is smooth and convex and conforms to the concave
surface of the diaphragm. Neighboring organs make indentations in the visceral surface
of the spleen—the gastric impression (stomach), the renal impression (left kidney), and
the colic impression (left colic flexure of large intestine).
• Like lymph nodes, the spleen has a hilum. Through it pass the splenic artery, splenic
vein, and efferent lymphatic vessels.

NOTES BY-PRAVEEN KUMAR DIXIT-ASSISTANT PROFESSOR-KSOP

 • A capsule of dense connective tissue surrounds the spleen and is covered in turn by a
serous membrane, the visceral peritoneum.
• Trabeculae extend inward from the capsule. The capsule plus trabeculae, reticular
fibers, and fibroblasts constitute the stroma of the spleen.
• The parenchyma of the spleen consists of two different kinds of tissue called white pulp
and red pulp .
• White pulp is lymphatic tissue, consisting mostly of lymphocytes and macrophages
arranged around branches of the splenic artery called central arteries.
• The red pulp consists of blood-filled venous sinuses and cords of splenic tissue called
splenic (Billroth’s) cords.
• Splenic cords consist of red blood cells, macrophages, lymphocytes, plasma cells, and
granulocytes.
• Veins are closely associated with the red pulp. Blood flowing into the spleen through
the splenic artery enters the central arteries of the white pulp. Within the white pulp, B
cells and T cells carry out immune functions, similar to lymph nodes, while spleen
macrophages destroy blood-borne pathogens by phagocytosis.
• Within the red pulp, the spleen performs three functions related to blood cells:
1. Removal by macrophages of ruptured, worn out, or defective blood cells and platelets
2. Storage of platelets, up to one-third of the body’s supply
3. Production of blood cells (hemopoiesis) during fetal life.

Lymphatic Nodules

NOTES BY-PRAVEEN KUMAR DIXIT-ASSISTANT PROFESSOR-KSOP

 • Lymphatic nodules (follicles) are egg-shaped masses of lymphatic tissue that are not
surrounded by a capsule.
• Because they are scattered throughout the lamina propria (connective tissue) of mucous
membranes lining the gastrointestinal, urinary, and reproductive tracts and the
respiratory airways, lymphatic nodules in these areas are also referred to as mucosa-
associated lymphatic tissue (MALT).
• The tonsils in the pharyngeal region
• (Peyer’s patches) in the ileum of the small intestine.
• There are five tonsils:
• Pharyngeal tonsil or adenoid is embedded in the posterior wall of the nasopharynx.
• The two palatine tonsils lie at the posterior region of the oral cavity, one on either side;
these are the tonsils commonly removed in a tonsillectomy.
• The two lingual tonsils , located at the base of the tongue, may also require removal
during a tonsillectomy.

Allergic Reactions
◼ A person who is overly reactive to a substance that is tolerated by most other people is
said to be allergic or hypersensitive.
◼ Whenever an allergic reaction takes place, some tissue injury occurs.
◼ The antigens that induce an allergic reaction are called allergens.
◼ Common allergens are:
◼ Foods (milk, peanuts, shellfish, eggs),
◼ Antibiotics (penicillin, tetracycline),
◼ Vaccines (pertussis, typhoid),
◼ Venoms (honeybee, wasp, snake),
◼ Cosmetics, chemicals in plants such as poison ivy, pollens, dust, molds, iodine-
containing dyes.
There are four basic types of hypersensitivity reactions:
1. Type I (anaphylactic)
2. Type II (cytotoxic)
3. Type III (immune-complex)
4. Type IV (cell-mediated).

NOTES BY-PRAVEEN KUMAR DIXIT-ASSISTANT PROFESSOR-KSOP

 Note: The first three are antibody-mediated immune responses; the last is a cell-
mediated immune response.

Type I (anaphylactic) reactions

• Most common and occur within a few minutes after a person sensitized to an allergen
is re exposed to it.
• In response to the first exposure to certain allergens, some people produce IgE
antibodies that bind to the surface of mast cells and basophils. The next time the same
allergen enters the body, it attaches to the IgE antibodies already present. In response,
themast cells and basophils release histamine, prostaglandins, leukotrienes, and kinins.
• Collectively, these mediators cause vasodilation, increased blood capillary
permeability, increased smooth muscle secretion. As a result, a person may experience
inflammatory responses, difficulty in breathing through the constricted airways, and a
runny nose from excess mucus secretion.
• In anaphylactic shock, which may occur in a susceptible individual who has just
received a triggering drug or been stung by a wasp, wheezing and shortness of breath

NOTES BY-PRAVEEN KUMAR DIXIT-ASSISTANT PROFESSOR-KSOP

 as airways constrict are usually accompanied by shock due to vasodilation and fluid
loss from blood.
• This life-threatening emergency is usually treated by injecting epinephrine to dilate the
airways and strengthen the heartbeat.
Type II (Cytotoxic) reactions
• Type II (cytotoxic) reactions are caused by antibodies (IgG or IgM) directed against
antigens on a person’s blood cells (red blood cells, lymphocytes, or platelets) or tissue
cells.
• The reaction of antibodies and antigens usually leads to activation of complement. Type
II reactions, which may occur in incompatible blood transfusion reactions, damage cells
by causing lysis.
Type III (immune-complex) reactions
• Type III (immune-complex) reactions involve antigens, antibodies (IgA or IgM), and
complement. When certain ratios of antigen to antibody occur, the immune complexes
are small enough to escape phagocytosis, but they become trapped in the basement
membrane under the endothelium of blood vessels, where they activate complement
and cause inflammation. Glomerulonephritis and rheumatoid arthritis (RA) arise in this
way.

Type IV (cell-mediated) reactions

• Type IV (cell-mediated) reactions or delayed hypersensitivity reactions usually
appear 12–72 hours after exposure to an allergen. Type IV reactions occur when
allergens are taken up by antigen-presenting cells (such as Langerhans cells in the skin)
that migrate to lymph nodes and present the allergen to T cells, which then proliferate.
• Some of the new T cells return to the site of allergen entry into the body, where they
produce gamma-interferon, which activates macrophages, and tumor necrosis factor,
which stimulates an inflammatory response. Intracellular bacteria such as
Mycobacterium tuberculosis trigger this type of cell-mediated immune response, as do
certain haptens, such as poison ivy toxin. The skin test for tuberculosis also is a delayed
hypersensitivity reaction.
• Examples of Hypersensitivity Reactions:

NOTES BY-PRAVEEN KUMAR DIXIT-ASSISTANT PROFESSOR-KSOP

NOTES BY-PRAVEEN KUMAR DIXIT-ASSISTANT PROFESSOR-KSOP