THE LYMPHATIC SYSTEM

ANATOMY OF THE LYMPHATIC SYSTEM

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WEBMD/ MYTHOS ANATOMY

Lymphatic System

The lymphatic system is not really a separate system of the body. It is considered part of the circulatory system since it consists of lymph, a moving fluid that comes from the blood and returns to the blood by way of the lymphatic vessels. Lymph carries some nutrients around the body, especially fat. It also distributes germ-fighting white cells. Lymph resembles plasma, but is more diluted and contains only about 5% of proteins and 1% of salts and extractives. It is formed from bits of blood and other body liquids, called interstitial fluid or tissue fluid, that collect in the spaces between cells. Some of the interstitial fluid goes back into the body through the capillary membrane, but most enters the lymphatic capillaries to become lymph. Along with this interstitial fluid, the lymph also picks up any particles that are too big to be absorbed through the capillary membrane. These include cell debris, fat globules, and tiny protein particles. The lymph then moves into the larger lymphatic vessels and through the lymph nodes and eventually enters the blood through the veins in the neck region. The lymphatic system is thus a secondary transport system. Lymph has no pump of its own. Its flow depends on pressure from the blood system and the massaging effect of the muscles.

Axillary Lymph Nodes

The axillary lymph glands are located in the armpit. They are divided into two sets: superficial and deep. These lymph nodes receive lymph from the vessels of the arm and the upper nodes receive lymph from vessels in the upper chest area near the pectoralis muscles (pectoralis major and pectoralis minor muscles) and the mammary glands. There are about 35 lymph nodes in the breast and armpit area. Most of the lymph nodes are located in or near the armpit. If cancer forms in the breast area it often spreads to the nodes because the lymph, along with other debris, can carry cancerous cells. Lymph flows in all directions, but about three-quarters of lymphatic vessels in the breast empty into the axillary nodes, which often become the first site of the cancer spread beyond the breast.

Cervical Lymph Nodes

The cervical lymph nodes are located in the neck. They are divided into two sets: superficial and deep. There are three sets of superficial lymph glands: the submaxillary, near the jaw, the suprahyoid, near the hyoid bone in the throat, and the cervical which are located along the course of the external jugular vein. The deep cervical glands are large glands that are situated near the pharynx, esophagus, and trachea. When you have a sore throat, white blood cells mass together in these nodes to fight the infection, which is why your throat will often feel swollen and tender.

Inguinal Lymph Nodes

The network of lymph vessels in the lower body passes lymph into the bean-sized inguinal nodes deep in the groin. The inguinal lymph nodes can be grouped as superficial and deep. The deep inguinal lymph nodes are situated near the femoral artery and vein. They recieve lymph from the lower limbs, external genitalia, and lower anterior abdominal wall. The superficial inguinal lymph nodes can be found along the greater saphenous vein. The recieve lymph from the external genitalia, and the superficial parts of the lower limbs.

Lymph Duct

The lymphatic duct is much shorter than the thoracic duct, only about 1/2 of an inch (1 centimeter) long. It receives lymph from right side of body above the liver and empties into right subclavian vein and internal jugular vein. Together with the thoracic, these ducts empty between 4 and 10 milliliters of lymph into the blood every minute.

Lymph Nodes

Lymph nodes, or lymph glands as they are sometimes called, are small oval structures normally the size of small kidney beans. They generally are located in clusters near veins at strategic points along medium-sized lymph vessels at the knee, elbow, armpit, groin, neck, abdomen and chest. Blood is cleaned and filtered in the lymph nodes, and germ fighting cells gather there during illness. This filtration process prevents bacteria, cancer cells, and other infectious agents from entering the blood and circulating through the system. The lymph nodes are the centers for production and storage of some of the white blood cells, namely the lymphocytes and monocytes, which are important elements of the body's immune mechanism. During any kind of infection, the nodes enlarge in their area of drainage due to the multiplication of lymphocytes in the node.

Popliteal Nodes

The small popliteal lymph nodes are four or five in number and surround the popliteal veins and arteries. They are clustered at the back part of the leg behind the knee joint. They help collect excess fluids from your feet and legs.

Spleen

The spleen is closely associated to both the circulatory and the lymphatic systems. It is an abdominal organ which lies between the bottom of the stomach and the diaphragm. It plays a role in the maintenance of blood volume, production of some types of blood cells, and recovery of material from worn out red blood cells. It is also involved in the removal of blood cells and bacteria from the blood.

Subclavian Vein (Left)

The subclavian vein is a continuation of the axillary vein (vein of the armpit) from the upper arm. A branch of the subclavian vein (right and left) extends from each arm. The vein then converges and extends from the first rib to the clavicle (collar bone), where it merges with the internal jugular vein to form the innominate. The subclavian veins are also important to the lymphatic system as a means of introcucing lymph back into the blood. The thoracic duct, which carries lymph, joins the left subclavian near the junction with the internal jugular vein. The lymphatic duct carries lymph to the right subclavian vein and also joins it near the junction with the internal jugular vein.

Subclavian Vein (Right)

Thoracic Duct

The thoracic duct is the channel for the collection of lymph from the portion of the body below the diaphragm and from the left side of the body above the diaphragm. It is a long duct, approximately 16 inches (40 centimeters) in the average adult. It extends from the lower spine (2nd lumbar vertebrae) to the left subclavian vein where it drains. The thoracic duct and the lymphatic duct, together, empty between 4 to 10 milliliters of lymph into the blood every minute

Thymus

Overlying the heart, the twin lobed thymus consists largely of developing lymphocytes. The thymus gland influences the activities of lymphoctyes in the spleen and lymph glands. The thymus produces a hormone which stimulates antibody production in the lymphoid tissue. Lymph carries white blood cells to this organ, where they multiply and change into special infection-fighting cells. After puberty, the thymus begins to shrink in size. Its role in the early years of life is not fully understood. It is believed it is important in the development of immunity.

The Immune System

The human body is continually exposed to disease producing organisms, called pathogens, and other harmful substances in the environment. Your immune system is your body's personal defense against these harmful invaders. The body's ability to counteract the effects of pathogens and other harmful agents is called resistance and it is dependent on a variety of defense mechanisms. Your immune system is made up of billions of special cells called white blood cells, lymphocytes, unique proteins called antibodies, chemicals that mediate immune response, and special organs that replenish and integrate the whole immune process. All of these defense mechanism must act together and are designed to react rapidly to provide protection against disease-producing organisms and their toxins. There are two aspects of the immune system's response to disease: innate and acquired. Natural, or innate, immunity is present from birth and is the first line of defense against the vast majority of infectious agents. Innate immunity involves barriers that keep harmful material from entering your body. Your skin provides an impenetrable barrier. The eyes use fluids, such as tears, and the presence of enzymes, such as lysozyme, that destroy bacteria. The respiratory system utilizes cilia, mucus, and coughing to get rid of foreign materials. If infection-causing organisms gets past these defenses, the body produces fever, inflammation, and other reactions designed to conquer the unwelcome invader. Inflammation causes an increase in the local blood supply so that large numbers of white blood cells can be brought to the area to fight the infection. Some of these white blood cells are phagocytes and macrophages that literally eat the invading microorganism. In most cases of minor infection, these cells solve the problem. If the pathogen succeeds in passing this barrier, a more complex process, involving other cells of the immune system, is necessary. To understand this process, lets examine what happens when a virus enters the body. When a virus enters your body an immune response begins automatically. A scavenger macrophage will eat the virus and display the viral antigen on its surface. Anything that can trigger an immune response is called an antigen. An antigen can be a germ such as a virus, or even a part of a virus. Other white blood cells in your body called "helper T-cells" will see the viral antigen and produce toxins that will destroy it. The helper T-cells then send chemical messages that activate lymphocytes called B-cells which make antibodies that recognize the viral antigen. These cells "remember" the specific disease organism and divide into many more cells. The resulting "clone" of identical cells starts producing very large numbers of antibodies that bind to all the organisms of that disease and destroy them. This process is called acquired immunity. It is a learning process of the immune system that develops either through exposure to invading microorganisms or as a result of immunization. It is estimated that your body has more than 100 million different kinds of antibodies, each one custom-built to identify a particular pathogen. If your body is exposed a second time, no symptoms occur because the organism is destroyed quickly- you are now immune to that particular pathogen.

Pharyngeal Tonsil (Adenoids)

The pharyngeal tonsils (tonsilla pharyngea), also known as adenoids, are a collection of lymphoid nodules located along the roof and posterior wall of the nasopharynx (upper throat). They vary in size in different individuals and are a part of the body's protection against infection. The tonsils contain germ-killing cells. The pharyngeal tonsil is sometimes referred to as Luschka's tonsil, after the German anatomist Hubert Luschka (1820-1875). When the pharyngeal tonsils become infected, they become inflamed and enlarge. The palatine tonsils and pharyngeal tonsils (adenoids) are two pairs of organs that seem to give more trouble than service to the body.

Palatine Tonsil

Two prominent, rounded bodies of lymphatic tissue, the palatine tonsils (tonsilla palatina), are located on each side of the tongue at the back of the mouth in the pharynx (throat). They lie beneath the mucous membrane lining mouth and are closely associated with the soft palate (roof of the mouth). They vary in size in different individuals and are a small part of the body's protection against infection. The tonsils are composed of lymphoid tissue, which contains germ-killing cells. When they become infected, they become inflamed in a condition known as tonsillitis. The tonsils and adenoids (also located in the pharynx) are two pairs of organs that seem to give more trouble than service to the body.

Lingual Tonsil

The lingual tonsils (tonsilla lingualis) are a pair of oval-shaped organs located at the back of the tongue behind the foramen cecum and the sulcus terminalis in the mucous membrane covering the tongue. They enlarge gradually from birth to about seven years of age and then shrinks. Each oval consists of a large number of lymphoid follicles. The lingual tonsils are part of the lymphatic system and are important to the body's defense against infection. They are composed of lymphoid tissue, which contains germ-killing cells. The tonsils help protect against upper respiratory tract infection.

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