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Sunday, April 28, 2024

General anatomy of lymphatic system

 

Lymphatic system

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Cells of lymphatic system: lymphocyte is the principal cells of lymphatic tissue which are responsible for functioning immune system

Cells of lymphatic or immune system:

1. Different types of lymphocyte:

a)     T lymphocyte: i) helper T cells (this lymphocyte stimulate the development of other lymphocytes so it is known as master lymphocyte, in HIV this cell is destroy by HIV virus, so other cells of immune system became inactive) ii) cytotoxic T cells iii) suppressor T cell  iv) memory T cell  

b)     B lymphocyte         c) natural killer cells

2. Antigen presenting cells:

a)Macrophages  b) Kupffer cells of the liver c)Langerhan’s cells in the epidermis d) Dendritic cells of spleen and lymph nodes

 

Lymphocyte

Origin

Maturation and differentiation occur in

Final destination

T lymphocyte

Bone marrow

Thymus

Mid & deep zone of lymph node, in peri-arterial lymphatic sheath of spleen, mucosa associate lymphatic tissue

B lymphocyte

Bone marrow

Bone marrow

superficial zone of lymph node, around the peri-arterial lymphatic sheath of white pulp of spleen, mucosa associate lymphatic tissue

Components of lymphatic system:

  1. Lymph vessels: lymph capillaries, lymphatic vessels and terminal lymphatic duct
  2. Lymphatic organs: primary and secondary lymphatic organs

                             Brief description of components of lymphatic system

Lymph: tissue fluid when enters in the lymphatic system is known as lymph. They conveys macromolecules like

protein, duct, carbon, cancer cells, bacteria etc.

Lymph vessels

Collect lymph

Drain lymph into the

Number

Lymph capillary: they begin blindly in the tissue space around the blood capillaries

Lymph Capillary  collects lymph from tissue space

Afferent lymph vessels

Many

Lymph vessels

 

 

 

Afferent lymph vessels

Collect lymph from lymph capillary

Adjacent lymph node

Many & located around the capsule

 of lymph node

Efferent lymph vessels

Collect lymph from lymph node

Drain lymph into terminal lymphatic ducts

One in number, exit lymph node through in hilum

Terminal lymphatic duct : two in number

 

 

 

i) right lymphatic duct

Collect lymph from right side of head and neck, right upper limb & chest

Drain lymph into the venous system at the junction between right  internal jugular vein and rt subclavian vein

 

ii) thoracic duct

Collect lymph from whole body except right side of head and neck, right upper limb & chest

Drain lymph into the venous system at the junction between left internal jugular vein and left subclavian vein

 

 

Primary lymphatic organ:  1. Bone marrow  2. Thymus

Why bone marrow and thymus is primary lymphatic organ?

Ans: In these organs, the cells of immune system became mature and differentiate so they are known as primary lymphatic organ. After maturation and differentiation an immune cells (lymphocyte) can distinguish between self antigen and non-self antigen. So a mature lymphocyte destroy non-self antigen but not react with self antigen.

Secondary lymphatic organ: 1. Lymph node 2.Spleen 3.Tonsils 4. Mucosa associated lymphatic tissue: BALT (bronchus associate lymphatic tissue), GULT(gut associate lymphatic tissue)  

What is the function of secondary lymphatic organs?

Ans : They only proliferate the cells of immune system ( lymphocytes)  but maturation and differentiation is not possible in secondary lymphatic organ 

Thymus:

1. Type of organ: lympho-epithelial organ 2. Location:  in the superior mediastinum.  3. Parts: It has two lobes

4. Cells of thymus:  i) Developing T lymphocytes (which come from bone marrow lymphoid stem cells) 

     ii) epithelioreticular cells

5. Development:

           i) Lymphocyte: mesodermal in origin

           ii) Epithelium primordium : developed from the endoderm of 3rd and 4th pharyngeal pouches.

 

6. Thymus function: Maturation and differentiation of T lymphocytes so they can distinguish between self antigen and non-self antigen.

7. Histological features of thymus :

a) Capsule is present which penetrate and divides the thymus into incomplete lobules.

b) Each lobulus is divided into outer cortex and inner medulla

c) Outer cortex of each lobulus contain large number of developing T lymphocytes but contain no lymphatic nodule

d) Medullary tissue contain Hassall’s corpuscles which are formed by epithelioreticular cells

 

8. Blood thymic barrier

  • Lining endothelium of the capillary  wall
  •  Basal lamina of endothelial cells
  •  Macrophages in the surrounding  perivascular connective tissue
  •  Basal lamina of epithelioreticular    cells
  •  Epithelioreticular cells

Important of blood thymic barrier: Prevent entering of antigen into the thymic cortex

 

9. Two important negative points of Thymus:

    i) It contains no lymphatic nodules and  ii) No B lymphocytes

 

 10. Thymic or Hassall’s corpuscles

         Are distinguishing feature of thymic medulla. It is formed by epithelioreticular cells

         The epithelioreticular cells are concentrically arranged and cytoplasm of the cells contain keratohyalin granules, lipid droplet and intermediate filaments

Involution of the thymus:  After puberty much of the parenchyma of the thymus, in particular cortical lymphoid tissue, is replaced by adipose tissue.

Lymph node

 

Lymph nodes are small encapsulated organs located along the pathway of lymphatic vessels   

Diameter: 1mm to 2 cm

Two types of lymphatic vessels are connected with lymph node: they are - the afferent and efferent lymph vessels

Afferent lymph vessels: convey lymph toward the L. node and penetrate the capsule at multiple sites

Efferent lymph vessels: convey lymph away from the lymph node and leave at the hilum. It is one in number.

Functions of lymph node:

  1. Filter the lymph 2.Produce lymphocytes 3. Initiation of immune responses 4.phagocytosis

3. Histological features of Lymph node:

  1. capsule is present
  2. sub-capsular sinus is present
  3. Outer cortex contains lymphatic nodules. Superficial part of cortex contain B lymphocytes and deeper zone of cortex contain T lymphocyte
  4. inner medulla  contain medullary cord which composed of B lymphocyte and plasma cells  

5. What is lymph?

Ans: Tissue fluid, when enters into the lymphatic system is known as lymph

Lymph contains macromolecules of proteins and large particles – dust, carbon, bacteria, cancer cells etc. 

What is trabeculea? Ans: they are the part of capsule which enter in to the organ

What do you mean by sinuses of lymph node? Ans: these are empty spaces within a lymph node where lymph flows.

6. Lymph circulation: lymph enters into lymph capillaries then through afferent lymphatic vessels enters into subscapsular sinus of lymph nodes then trabecular sinuses of lymph node then medullary sinuses of lymph node then through efferent lymph vessel the lymph leave the lymph node and drain into the venous system

7. Cells present within the lymph nodes: T & B lymphocyte, dendritic cells, macrophages

 8. What is lymphatic nodule?

Ans: small collection of lymphocytes found in mucosa of different organs like ileum, appendix, bronchus etc.

Types of lymphatic nodule: primary and secondary lymphatic nodules

When a germinal center appears in a lymphatic nodule the lymphatic nodule known as secondary L nodule

9. What is germinal center: it is the site of lymphocyte production mainly B lymphocyte. It is a pale

Staining area situated within a lymphatic nodule contain immature lymphoblast. It is found in secondary lymphatic nodule.

Spleen: It is the largest accumulation of lymphoid tissue in the body.

Function: i) Removal of old red blood cells ii) Immune response iii) Reservoir of blood

iv) Formation of erythrocyte in fetal life

Histological features of spleen:

Capsule: a dense irregular connective tissue which is covered the spleen

Trabeculae: emerges from the capsule which divides the splenic pulp into incomplete compartments

Splenic pulp: functionally and morphologically it is divided into two compartments -white pulp & red pulp

White pulp: It is composed of periarterial lymphatic sheaths and lymphatic nodules with germinal centers.

Both periarterial lymphatic sheaths ( housing T –lymphocyte) & lymphatic nodules ( housing B- lymphocyte) surround the eccentrically located central artery, a distinguishing characteristic of the spleen.

Red pulp:It is formed by splenic cord and splenic sinusoid

Splenic cord contains T & B Lymphocytes,Reticular cells & fibers,Macrophages, Plasma cells,Many blood cells-Erythrocytes,Platelets, Granulocytes

Splenic sinusoids: is formed by Discontinuous endothelial cells & Incomplete basal lamina

Closed circulation:

Splenic artery the trabecular artery central artery penicillar arteries terminal  arterial capillaries (TAC) splenic sinusoids splenic vein

Open circulation:

Splenic artery the trabecular artery central artery penicillar arteriesterminal  arterial capillaries (TAC) red pulp splenic sinusoids splenic vein

Cells of lymphatic system:

  (The principal cell of the lymphatic system is lymphocyte. They are two categories   T and B lymphocytes)

1.      T lymphocyte : helper T cell , cytotoxic T lymphocyte, suppressor T lymphocyte, memory cell

2.     B lymphocytes

3.     Natural killer cells

4.    Macrophages

5.      Dendritic cells of spleen and lymph nodes macrophages,

6.      Plasma cells

7.      Reticular cells & antigen presenting cells

Antigen presenting cells

         Macrophages

         Kupffer cells of the liver

         Langerhan’s cells in the epidermis

         Dendritic cells of spleen and lymph nodes

B lymphocytes
Tonsils 
 1.      Lining epithelium : non-keratinized stratified squamous epithelium

2.     Tonsillar crypts: invagination of lining epithelium

Lymphatic nodules with germinal centre  

Clinical anatomy: head and neck : tonsil

 Quinsy/Peritonsillar abcess

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In chronic tonsillitis, it is a buildup of pus in the peri-tonsillar area. The loose areolar tissue that divides the tonsillar bed from the capsule is where pus from the peri-tonsillar abscess (Quinsy) collects.

                  Tonsillectomy in the palatine region
It is the palatine tonsil removed surgically. When having a tonsillectomy:
There is a chance that the paratonsillar veins will rupture severely.
from the facial artery's tonsillar branch.
A damage to the glossopharyngeal nerve may result in loss of taste and general feeling from the back 1/3 of the tongue.

It is surgical removal of palatine tonsil. During tonsillectomy:

Severe haemorrhage may occur

From the paratonsillar veins.

From tonsillar branch of facial artery.

Glossopharyngeal nerve may be injured causing loss of general and taste sensation from the posterior 1/3rd of the tongue.

Clinical anatomy : head and neck : Adenoids

 Adenoids

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Definition: Adenoid refers to pharyngeal tonsil hypertrophy or enlargement.
Problem: it obstructs the nasopharynx, making it harder to breathe via the nose. It can also induce phonation difficulty, snoring, persistent sinus infections and sleep apnea. Moreover, it can obstruct the auditory tube's pharyngeal aperture, impairing hearing, cause recurrent ear infections is occurred.

Nervous tissue and nervous system

 Nervous tissue and nervous system 

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Component of nervous tissue:

Neuron and neuroglia  

Parts of a neuron: cell body and process- 1) Dendrite 2) Axon

Classification of neuron:

Classification of neuron
According to the polarity:

1.      unipolar

2.      bipolar

3.      multi-polar

According to function

  1. Sensory neuron: unipolor and bipolor

Motor neuron: multipolor

 Nervous system

Division of nervous system:

         Structurally / anatomically NS is two types,

1.      Central nervous system: Brain, Spinal cord

2.      Peripheral nervous system: Cranial nerves, Spinal nerves, Autonomic nerves

         Functionally NS is two types

  1. Somatic nervous system,
  2. Autonomic nervous system,

 

What is the composition of   nervous tissue?

  1. Neuron ( nerve cell )         

       2. Neuroglia

Different parts of neuron: 

             Neuron ( nerve cell )         

             a) Nerve cell body  

             b) Processes  i) Dendrite      ii) Axon

Component of grey and white matter:

 

         Gray matter: a) nerve cell  bodies

                           b)abundant cell processes

                                 c)glial cells

         White matter: a) nerve fibres

                             b) glial cells

Location of gray & write matter in the CNS:

         Brain,

      outer part or cortex forms by gray matter

      inner core or medulla forms by white matter

         Spinal cord,

      outer part or cortex forms by white matter

      inner core or medulla forms by gray matter

Classification of neuron
According to the polarity:

1.      unipolar

2.      bipolar

3.      multi-polar

According to function

  1. Sensory neuron
  2. Motor neuron
  3. Inter-nuncial

  Nucleus: a collection of nerve cell bodies in the CNS:

example

Dorsal nucleus of vagus

Nucleus ambiguous,

Nucleus of tractus solitarius

Ganglia: a collection of nerve cell bodies  out side the CNS

             a) sensory ganglia of spinal nerves (posterior root ganglia) and cranial  nerves

             b) autonomic ganglia

Tract: a bundle of nerve fibers (axon) connecting neighboring or distant nuclei of the CNS is a tract

Structure of a peripheral nerve

The nerve trunk is surrounded by a dense connective tissue sheath called the epineurium.

the bundles of nerve fibers are surrounded by a connective tissue sheath, called perineurium

A loose delicate connective tissue covers the individual nerve fiber called endoneurium.

 What is myelin sheath?

Axon of neuron is covered by sheaths which are modified cell membranes of schwann cells in PNS and oligodendrocytes  in CNS

Function of myelination

         It acts as an insulator

         Helps in impulse conduction

What is synapse?

         The synapse is the specialised junctions between two or more adjacent neurons.

What are the types of synapses?
According to the location of synapse in the post synaptic neurons

Q.9. Definition and types of receptors

Receptors : it is a special sensory nerve ending which receives impulse from outside and within the body

Anatomical types of receptors:

Non- Encapsulated: free nerve ending

                                 Merkel’s disc

Encapsulated: Meissner’s corpuscle

                        Pacinian’s corpuscle

                        Ruffini’s corpuscle  

(Functionally five types

  1. Mechanoreceptors:
  2. Thermoreceptors:
  3. Nocireceptors:
  4. Electromagnatic receptors:
  5. Chemoreceptors: )

Q.10. Nervous tissue character:

    1. it is composed of  Neuron  and neuroglial cells
    2. Extracellular matrix is absent

Classification of neuron
According to the polarity:

Myelin sheath of PNS derived from schwann cells

Myelin sheath of CNS derived from oligodendrocytes

Peripheral nerve plexuses

         Peripheral nerves sometimes divides into branches in their course that join neighboring peripheral nerves form a network of nerves called nerve plexus.

         Example: brachial plexus, lumbar plexus, sacral plexus etc.

Receptors : it is a special sensory nerve ending which receives impulse from outside and within the body

Functionally five types

  1. Mechanoreceptors:
  2. Thermoreceptors:
  3. Nocireceptors:
  4. Electromagnatic receptors:
  5. Chemoreceptors:

Anatomical types of receptors:

Encapsulated: Pacinian corpuscle

                           Meissner’s corpuscle

                           Non-encapsulated: free nerve ending

Reflex: A reflex may be defined as an involuntary response to a stimulus.

It consists of the following anatomical structures: 1) a receptor organ

2) an afferent neuron

3) an effector neuron

4) an effector organ

 

 Reflex may be divided into 4 groups:

      1) Superficial (or skin and mucous membrane) reflexes

          Corneal reflexes, gag reflexes

      2) Deep (or myotatic) reflexes

           Jaw jerk, knee jerk

      3) Visceral ( or organic) reflexes

          Pupillary reflex

      4) Pathological (or abnormal) reflexes

          Ankle clonus, Babinski’s sign

 


What is gray and whitematter :

Grey matter:

  • Nerve cell  bodies
  •  abundant cell process
  •  Glial cells
  • blood vessels

White matter:

·         Nerve fibres

·         Glial cells

·         blood vessels

Location of grey and white matter:

Inner grey matter and outer white matter: spinal cord

Outer gr 

         Nucleus: a collection of nerve cell bodies in the CNS: example: nucleus ambiguous ,  nucleus of tractus solitarius  

 

         Ganglia: a collection of nerve cell bodies  out side the CNS

             a) dorsal root ganglia

             b) celiac ganglia

·         Tract: a bundle of nerve fibers (axon) connecting neighboring or distant nuclei of the CNS is a tract

·         Ascending tract : anterior and lateral spinothalamic tract

·         Descending tract: anterior and lateral corticospinal tract

Q.7. define nerve and discuss structure of peripheral nerve

Nerve: are bundles of nerve fibers surrounded by connective tissue sheaths.

Structure of a peripheral nerve

·         A loose delicate connective tissue covers the individual nerve fiber called endoneurium.

         the bundles of nerve fibers are surrounded by a connective tissue sheath, called perineurium

         The nerve trunk is surrounded by a dense connective tissue sheath called the epineurium.

Q. 8. Examples of somatic and autonomic nerves plexuses

         Somatic nerve plexus: Example: brachial plexus, lumbar plexus, sacral plexus etc.

         Autonomic nerve plexus: hypogastric nerve plexus

 

Q.9. Definition and types of receptors

Receptors : it is a special sensory nerve ending which receives impulse from outside and within the body

Anatomical types of receptors:

Non- Encapsulated: free nerve ending

                                 Merkel’s disc

Encapsulated: Meissner’s corpuscle

                        Pacinian’s corpuscle

                        Ruffini’s corpuscle  

(Functionally five types

  1. Mechanoreceptors:
  2. Thermoreceptors:
  3. Nocireceptors:
  4. Electromagnatic receptors:
  5. Chemoreceptors: )


Triad vs diad of muscular tissue

 Triad vs diad of muscular tissue 

T tubule also known as transverse tubule is substructure of skeletal muscle .

It is formed by deep invagination of sacrolemma of skeletal muscle and two sets of terminal  of sarcoplasmic reticulum, So one tubule and two sacroplasmic reticulum, these three structure formed triad of skeletal muscle. 

Each skeletal muscle cells contain thousands of triad . T tubules are place perpendicular to skeletal muscle fibers . 

Triad place at AI junction of sarcomere of skeletal muscle 

it form anatomical basis of excitation contraction coupling, 

A stimulation start from neuromuscular junction, pass through the T tubule, calcium release from sarcoplasmic reticulum 

in cardiac muscle T tubule contain only one terminal cisterna so known as diad