LYMPHATIC SYSTEM

Syllabus
Lymph and lymphatic system, composition, formation and circulation
Spleen: Structure, functions and disorders
Disorders of lymphatic system.
LYMPHATIC SYSTEM
Lymphatic system is a system of lymph channels or lymph vessels, through which lymph flows.
It is a one-way system
It allows the lymph flow from tissue spaces towards the blood.
It works in association with circulatory system.
Components of lymphatic system
The lymphatic system consist of
1. Lymph, a fluid
2. Lymphatic vessels that transport the lymph.
3. Lymphoid tissues and organs
- Primary organs- Thymus gland, red bone marrow
- Secondary organs- Spleen, lymph nodes,
Accessary lymphoid tissues -- tonsils, vermiform appendix and Peyer’s patches
LYMPH
Lymph is a clear, pale-yellow fluid that passes through lymphatic vessels.
Composition
It is formed by 96% water and 4% solids.

Formation
As the blood circulates, the colourless fluid portion of the blood leaks out from the blood capillaries into interstitial
spaces in between the cells.
This fluid carries nutrients, O2 and hormones which are taken up by the surrounding cells.
A small amount of interstitial fluid will left after absorption by the cells which is called lymph
Lymph now enters lymph capillaries due to the increased permeability of lymph capillaries, then to lymph vessels,
lymph node and other lymphatic organs
It is then drained into the venous blood (subclavian vein) just before venous blood reaches the heart (RA).
Sequence of Lymph flow
Fluid from blood capillaries reaches interstetial space
Lymph flow from the interstetial space towards the lymph capillaries then to lymph vessels and then to lymbh node
Lymph passes from lymph node to lymph vessels and then to lymph trunks
From Lymph trunk it reaches into two main channels, the thoracic ducts (left lymphatic duct) and the right lymphatic
duct.
Left lymphatic duct receives lymph from the left side of body (ie. the left side of the head, thorax, neck, left arm,
lower trunk, legs) and transport it into left subclavian vein that reaches circulatory system.
Right lymphatic duct collect lymph from the right side of the body (right side of the head, neck, thorax, and right arm).
This duct opens into right subclavian vein that reaches circulatory system.
About 120ml of lymph flows into blood per hour.
Out of this, about 100ml/hour flows through thoracic duct and 20ml/hour flows through the right lymphatic duct.
Blood vessels → Interstetial fluid → lymph capillaries → Lymph nodes → lymph vessels → lymph trunk →
thoracic ducts (left lymphatic duct) and right lymphatic duct → left and right subclavian vein→ Heart
Functions of lymph
Nutritive: Nutrition and oxygen is supplied to low blood areas
Drainage: Maintains constant volume and composition of tissue fluid by removing excess interstetial fluids and
metabolites
Transport of proteins: Lymph transport proteins from to the blood through tissue spaces.
Absorption of fats: Lymph flow serves as an important route for intestinal fat (dietary lipid) absorption. This is why
lymph appears milky after a fatty meal.
Removal of toxins: Bacteria, toxins and other foreign bodies are removed from tissues
Immunity: It plays an important role in immunity by production and transport of lymphocytes.
It is responsible for redistribution of fluid in the body.
Lymphatic Vessels and Lymph Circulation
Lymphatic vessels begin as lymphatic capillaries (located in the spaces between cells) which are closed at one end.
Lymphatic capillaries unite to form larger lymphatic vessels, which resemble veins in structure but have thinner walls
and valves.
Along the lymphatic vessels, lymph flows through lymph nodes, bean-shaped organs consisting of masses of B cells
and T cells.
Lymphatic capillaries
Lymphatic capillaries have greater permeability than blood capillaries and thus can absorb large proteins and
molecules.
They are larger in diameter than blood vessels that permits interstitial fluid to flow into them but not out.
The ends of endothelial cells that make up the wall of a lymphatic capillary overlap.
When pressure is greater inside the lymphatic capillary, the cells adhere more closely and the lymph cannot move back
into interstitial fluid.
When excess interstitial fluid accumulates and causes cell swelling, that making the openings between cells of limph
capillaries even larger so that more fluid can flow into the lymphatic capillary.
In the small intestine, specialized lymphatic capillaries called lacteals carry dietary lipids into lymphatic vessels and
into the blood.
The presence of these lipids causes production of creamy white lymph called chyle.
Lymph Trunks and Ducts
Lymph passes from lymphatic capillaries into lymphatic vessels and then to lymph nodes.
As lymphatic vessels exit lymph nodes in a particular region of the body, they unite to form lymph trunks.
The principal trunks
→ Lumbar trunks-drain lymph from the lower limbs, 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.
Lymph passes from lymph trunks into two main channels, the thoracic ducts (left lymphatic duct) and the right
lymphatic duct.
Left lymphatic duct receives lymph from the left drainage area (ie. the left side of the head, thorax, neck, left arm,
lower trunk, legs) and transport it into left subclavian vein.
Right lymphatic duct collect lymph from the right drainage area (right side of the head, neck, thorax, and right arm)
and transport it into right subclavian vein.
From subclavian vein lymph reaches to heart

LYMPHATIC ORGANS AND TISSUES

Based on their function, lymphatic organs and tissues are classified into 3 groups:
1. Primary lymphatic organs and tissues- Red bone marrow and thymus
2. Secondary lymphatic organs and tissues-Lymph nodes and spleen
3. Accessory lymphatic organs - Tonsils, Vermiform appendix and peyer's patches
Primary lymphatic organs
1. Thymus gland
It is a bilobed pinkish grey colour organ located in the mediastinum, between the sternum and aorta.
At birth, it weighs about 10-15g, reaching maximum size just before puberty and weighing about 30-40g.
Thymus consists of two lobes covered by capsule
Each lobe consists of outer cortex (deep staining) and central medulla (light staining).
The cortex and medulla is composed of large numbers of T cells, epithelial cells and macrophages.
 Maturation of T-lymphocytes takes place in thymus gland.
Cortical cells produce hormone called thymosin which helps in the maturation of T lymphocytes.
Functions
1.Thymosin secreted by thymus helps in the maturation of T lymphocytes
2.Thymoprotein or thymin secreted by thymus is responsible for the differentiation of lymphocytes to T-lymphocytes
3.Thymosin also stimulate some enzymes

2. Red bone marrow

It is a soft, spongy nutrient rich tissue present at the end of long bones (femur) or in flat bones (sternum, bones of
skull).
The red bone marrow acts as the site of production of blood cells.
B-Lymphocyte undergo maturation in the red bone marrow
Secondary lymphatic organs and tissues
1. Spleen
Largest lymphatic organ which is oval or bean in shape and is purplish in colour.
It is highly vascularised and measures about 12cm Length, 7cm width and 2.5cm thickness.
It is located in the left between the stomach and diaphragm.
Spleen is surrounded by dense connective tissue capsule, which is covered by serous membrane called visceral
peritoneum.
Capsule extends into the interior to form trabeculae.
The capsule, trabaculae, reticular fibres, fibroblast constitutes the stroma (supporting connective tissue) of the spleen.
The spaces between trabaculae contain the splenic tissue.
These tissues contain the lymphoid tissues called as Malpighian corpuscles.
Spleen has a hilum through which the splenic artery, vein and lymphatic vessels pass.
The interior part of the spleen is called splenic pulp or parenchyma consisting of white and red pulp.
White pulp contains lymphocytes and macrophages
Red pulp contains blood filled sinusoids called splenic or Billroth's cord.
These cords consist of mononuclear phagocytes, lymphocytes, plasma cells and monocytes.
Functions
1. Production of blood cells (hemopoiesis) during fetal life
2. Phagocytes of spleen engulf and break down worn out, damaged and abnormal RBCs thus releasing Hb.
3. Harmful microorganisms or antigen- antibody complexes and other foreign substances are removed and filtered by
phagocytes of spleen.
4. Immunological functions of the spleen include: trapping of antigen, production of antibody and activation of
macrophages.
2. LYMPH NODE (LYMPH GLAND)
Lymph nodes are small, oval or bean shaped structures located along the network of lymphatic vessels.
They are abundantly found in the head, neck, axillae, abdomen and pelvis.
Lymph nodes in these areas are also known as mucosa associated lymphoid tissue (MALT).
These nodes are filled with lymphocytes that collect, destroy and remove bacteria and viruses in the lymph.

Lymph node has two regions:

1) Stroma- constitute supporting framework
2) Parenchyma- it is the functioning part of the lymph nodes and is divided into cortex, paracortex and medulla
Cortex- Cortex is the superficial part of lymph node contains B lymphoctyes
Paracortex- The region between cortex and medulla. It contains T-lymphocytes
Medulla- Medulla is the deeper part of lymph node, contains B and T -lymphocytes, macrophagic cells and antibody
producing plasma cells migrated from cortex
Functions of lymph node
1) Kills bacteria by phagocytosis
3) They act as mechanical filters to prevent microbial entry into the blood
4) Production of plasma proteins like gamma globulin
5) Spread of cancer cells to body are temporarily blocked in lymph node.
6) Helps to fight infections and thus helps in immune responses.
7) Helps in the absorption of excess fluid and it return to the blood stream
8) Helps in the absorption of fats and fat soluble vitamins.
Accessory lymphoid organs
Accessory lymphoid tissue consists of unorganized lymphoid tissues scattered at various sites in the body to remove
foreign components. Eg;-
1. Vermiform appendix: arises from the caecum as a fine tube closed at one end, containing lymphoid tissues.
2. Peyer's patches: aggregations of lymphoid follicles found in the lining of the small intestine.
3. Tonsils: These are 5 tonsils which form a ring at the junction of the oral cavity and oropharynx and at the junction
of the nasal cavity and nasopharynx. They are:
a) Paired palatine tonsils- at the posterior region of oral cavity
b) Paired lingual tonsils- located at the base of the tongue
c) Single pharyngeal tonsils- located at the base of nasopharynx.
DISORDERS OF THE LYMPHATIC SYSTEM
1. Lymphadenitis
2. Lymphangitis
3. Lymphoma-Hodgkin's disease (HD) and Non-Hodgkin's lymphoma (NHL)
4. Tonsillitis
5. Splenomegaly
6. Lymphatic insufficiency or lymphatic obstruction or lymphoedema
1. Lymphadenitis
It is an acute infection of the lymph nodes due to bacteria, virus and protozoa.
Symptoms - Fever (100-102°F) along with chills, loss of appetite, general weakness, swollen lymph node caused by
accumulation of fluid.
2. Lymphangitis
It is the infection of the lymph vessel walls due to bacteria
Symptoms-swollen lymph vessels, fever (100-104°F) with chills, headache, loss of appetite, appearance of red streaks
from infected areas to the arm pit
3. Lymphoma- Type of cancer of the lymphatic tissue. They are:
a) Hodgkin's disease (HD)- (Reed sternberg cells are present) b) Non-Hodgkin's lymphoma (NHL)- (Reed sternberg
cells are absent)
It is characterized by painless swelling of lymph nodes in neck, under arm,etc, fever, excessive night sweating, fatigue,
weight loss and itchy skin.
4. Tonsilitis
It is caused by bacterial or viral infections resulting in the swelling and inflammation of tonsils
5. Splenomegaly:
Enlargement of spleen occurs due to viral infections, circulatory disorders, blood disease, carcinoma etc.
6. Lymphatic insufficiency or lymphatic obstruction or lymphoedema
Dysfunction of lymphatic system in which Lymphatic fluid accumulate in the interstitial tissue and cause swelling,
usually in arms and legs