8B: The impact of lymphatic disorder and associated treatments-
I was given the opportunity to take part in a work placement programme, and being a
part of this means that I got to observe specialist laboratory work, practice a range of
scientific techniques, as well as getting some experience in medical research into the
function of the lymphatic system, including some possible disorders and options for
treatments for these. In this report I will be showing my knowledge I have gained on
this topic, focusing on the normal functioning of the lymphatic system, a disorder
associated with the lymphatic system, and treatments used to help in these. I have
also included a case study looking at my chosen disorder, lymphatic filariasis, which
goes into what the patient’s symptoms were, as well as what treatment was used to
help reduce the symptoms.
How each structure in the lymphatic system work in a healthy state:
Lymph vessels are shaped like tubes in the body, and their role is to carry fluids,
known as lymph, from the tissues and back into the blood to circulate, and all of this
occurs in one direction, unlike regular blood vessels. The smallest vessel in the
lymphatic system is called the lymph capillaries, and this is where it all begins. They
are structured to allow for fluid to travel into the vessel, but they cannot then leave
after, and this is due to the layer of cells that surrounds the vessel. The lymph
capillaries gradually get larger, and the largest lymphatic vessel this can go to are
called the lymphatic trunks or ducts. The vessels travel to the subclavian vein, where
the fluid is taken back into the blood. There is a layer of muscle that goes all around
the lymph vessels, and as this muscle contracts, it pushes the lymph through.
The lymph vessels contain extrinsic and intrinsic pumps, and these help in moving the
lymph forward by carrying out different motive forces. These movements, as well as
the use of the lymphatic valves are there to ensure the lymph fluid moves in the
centre of the vessels in one direction. The intrinsic pump depend on the intrinsic rapid
contractions of the smooth muscle to create the forces needed. The extrinsic pump
depends on the repeated compression and expansion of the lymphatic vessels, and
this is done by covering the extrinsic tissue forces to create the pressure gradients so
the lymph can then move in the middle.
The extrinsic pumps are found to mainly be in the lymph system around the heart,
skeletal muscle, thorax, and the wall of the gut. The intrinsic pumps are needed as
they ensure the flow of lymph in most of the other areas.
The vessels also contain valves which are there to ensure the lymph travels in one
direction. These valves are known as intraluminal leaflet valves, and its role is to lead
the flow back towards the heart.
So, the lymph vessels main responsibilities are to help in absorbing fats, as well as fat
soluble vitamins that come from the digestive tract. They also help in defending the
body against any microorganisms and diseases trying to attack the body. They take
the extra tissue fluid back into the blood to circulate. Throughout this process, the
lymphatic vessels go past lymph nodes, passing lymph through to help with filtration.
Two of the main lymph vessels are called the thoracic duct and the right lymphatic
duct.
The thoracic duct is located near the bottom of the spine, it is responsible for the
collection of lymph from the pelvis, abdomen as well as the lower chest area. This
,vessel travels up the chest, where it empties the lymph into the blood via a large vein
by the left side of the neck.
The right lymphatic duct gets the lymph from the right side of the neck area, as well
as the chest and arm. It then doesn’t travel far as it then also disposes of the lymph
into the blood via a vessel which is also located at the right side of the neck.
Lymph nodes are found in the neck and back, armpits, groin, stomach, and chest. In
addition, there are small bundles of lymph nodes around the oesophagus and airways,
called the tonsils and adenoids. The fluid (lymph) is transported using the lymphatic
vessels to the lymph nodes. Their role is to rid the lymph of any harmful substances
and waste products that may be mixed in. The nodes have immune cells in them
which are known as lymphocytes, and these are there to ensure that bacteria and
cancer cells are rid of. Once this process has been complete, the lymph fluid can be
taken back to the blood through the rest of the lymph vessels.
The lymph nodes are small, bean shaped organs, and are surrounded by connective
tissue and divided into sections called lymph nodules. The nodules are dense masses
of lymphocytes and macrophages, these are separated by lymph sinuses.
These lymphocytes in the lymph nodes include B and T cells. The B lymphocytes are
present there to aid in making antibodies. Antibodies are able to bind together with
pathogens or other unknown substances, or ‘invaders’ in the body, and they can then
neutralise them. This is extremely important as it ensures that infected cells are
destroyed. T lymphocytes are responsible for destroying any infected or cancerous
cells in the body and to prevent infections, these are known as CD8+ t-cells (cytotoxic
t-cells or killer t-cells). As well as this, they can also aid the B cells to destroy
pathogens and the cytotoxic t-cells by activating them, these types of t-cells are
known as CD4+ t-cells (helper t-cells).
Axillary lymph nodes are found in the armpits, and like that of all lymph nodes, its role
is to filter any harmful substances from the lymph fluid before it goes into the blood
circulation. This specific lymph node’s function is to drain the upper limb, the breast
and the trunk found over the umbilicus.
A sub-group of cubital lymph nodes are known as supratrochlear nodes, and their
specific function to drain the lymph fluid from the forearm, as well as some fingers,
including the middle, ring, and little fingers.
The abdominal lymph nodes drain the lymph fluid from the abdominal organs as well
as any deeper structures there. Examples of some abdominal lymph nodes that are
part of this are the pre-aortic, para-aortic, common iliac, and internal and external iliac
groups.
Inguinal lymph nodes are located in the groin, and their purpose is to help in the
defence against infections threatening the body. The lymph fluid is passed though the
nodes, and then the immune cells are responsible for filtering out the bacteria or other
threats from it. For these lymph nodes, there is a drainage pathway for the legs, as
well as the genitals and pelvic area.
The popliteal lymph nodes are located around the knee, and they drain the lymph
fluid from the deeper structures around there like the distal leg as well as the foot.
Typically, there are around 2 to 9 lymph nodes located in the fat tissue around the
vessels of the popliteal fossa (Behind the knee joint between the muscles of the thigh
and the leg).
, The bone marrow is located in the centre of the bones, and is a gelatinous tissue,
either red, called myeloid tissue, or yellow, called fatty tissue. Red bone marrow is
responsible for all the red blood cells as well as the platelets around up to 70% of the
lymphocytes in the body. The other lymphocytes start in the red bone marrow, though
grow fully in the other lymphatic tissues, such as the thymus, spleen, as well as the
lymph nodes. The function of the red bone marrow is to help, alongside the liver and
spleen, to get rid of worn red blood cells. The yellow bone marrow is responsible for
storing the fats. This is helpful as it keeps up a good environment for the bones to
function properly.
Your bone marrow can make blood cells from the stem cells located there. The stem
cells are able to grow into the types of blood cells needed in the body, such as red
blood cells, platelets as well as white blood cells. Lymphocytes are a type of white
blood cell that grow in the bone marrow, and the B lymphocytes can fully grow here,
whereas the T lymphocytes fully grow in the thymus.
The thymus gland is located between the lungs in the chest area. This gland’s role is
to produce white blood cells, more specifically T-lymphocytes, and these are made to
help fight in the case of there being an infection. The thymus gland grows to be its
largest when we are children and makes lots of T cells ready for when we are to grow
into teenagers, once this is done, the thymus once again begins to get smaller and
will be less active.
The thymus gland has a lobular structure and has a flat, irregular shape. The lobules
are made up of follicles, and these have medullary and cortical components. The
cortical part is mostly made of lymphocytes, the medullary part contains less
lymphocytes but more epithelial cells in comparison to the cortical part.
The thymus contains the CD4 and CD8 like in the lymph nodes. The lymphocytes here
mature and become specialised t-cells and once they have fully matured, they then
enter the blood stream.
The tonsils are found near the digestive and respiratory tract openings at the back of
the throat, and they are two small areas of tissue. They play an important role in
helping to fight of any infections, as in the case of a threat of infection, they are the
first response that will occur from the body.
Lacteals are located in the small intestine and are the ends of the lymphatic
capillaries. This is the main place where the dietary lipids and any lipid-soluble
nutrients are drained whilst in the form of lymph fluid, and this then is returned to the
blood circulation through the thoracic duct. As well as this, lacteals can also be a place
to transport any immune cells allocated in the stromal area of the villi.
The spleen is found above the abdomen to the left side and is underneath the ribcage.
This organ’s role in the lymphatic system is to clean out any worn red blood cells and
break them down, as well as any germs from the bloodstream using the white blood
cells it releases. The spleen also is in charge of the storage of some products, like iron,
of the worn red blood cells, and this can then be used later, or released into the blood
and transported to the liver or bone marrow to be reused.
The spleen is the largest lymphatic organ in the body and is surrounded by connective
tissue which also divides the organ into lobules. The spleen is similar in shape to a
lymph node, though is much larger in size. This is made up of two types of tissue, red
pulp, and white pulp. The red pulp is made up of veins with thin walls which are filled
I was given the opportunity to take part in a work placement programme, and being a
part of this means that I got to observe specialist laboratory work, practice a range of
scientific techniques, as well as getting some experience in medical research into the
function of the lymphatic system, including some possible disorders and options for
treatments for these. In this report I will be showing my knowledge I have gained on
this topic, focusing on the normal functioning of the lymphatic system, a disorder
associated with the lymphatic system, and treatments used to help in these. I have
also included a case study looking at my chosen disorder, lymphatic filariasis, which
goes into what the patient’s symptoms were, as well as what treatment was used to
help reduce the symptoms.
How each structure in the lymphatic system work in a healthy state:
Lymph vessels are shaped like tubes in the body, and their role is to carry fluids,
known as lymph, from the tissues and back into the blood to circulate, and all of this
occurs in one direction, unlike regular blood vessels. The smallest vessel in the
lymphatic system is called the lymph capillaries, and this is where it all begins. They
are structured to allow for fluid to travel into the vessel, but they cannot then leave
after, and this is due to the layer of cells that surrounds the vessel. The lymph
capillaries gradually get larger, and the largest lymphatic vessel this can go to are
called the lymphatic trunks or ducts. The vessels travel to the subclavian vein, where
the fluid is taken back into the blood. There is a layer of muscle that goes all around
the lymph vessels, and as this muscle contracts, it pushes the lymph through.
The lymph vessels contain extrinsic and intrinsic pumps, and these help in moving the
lymph forward by carrying out different motive forces. These movements, as well as
the use of the lymphatic valves are there to ensure the lymph fluid moves in the
centre of the vessels in one direction. The intrinsic pump depend on the intrinsic rapid
contractions of the smooth muscle to create the forces needed. The extrinsic pump
depends on the repeated compression and expansion of the lymphatic vessels, and
this is done by covering the extrinsic tissue forces to create the pressure gradients so
the lymph can then move in the middle.
The extrinsic pumps are found to mainly be in the lymph system around the heart,
skeletal muscle, thorax, and the wall of the gut. The intrinsic pumps are needed as
they ensure the flow of lymph in most of the other areas.
The vessels also contain valves which are there to ensure the lymph travels in one
direction. These valves are known as intraluminal leaflet valves, and its role is to lead
the flow back towards the heart.
So, the lymph vessels main responsibilities are to help in absorbing fats, as well as fat
soluble vitamins that come from the digestive tract. They also help in defending the
body against any microorganisms and diseases trying to attack the body. They take
the extra tissue fluid back into the blood to circulate. Throughout this process, the
lymphatic vessels go past lymph nodes, passing lymph through to help with filtration.
Two of the main lymph vessels are called the thoracic duct and the right lymphatic
duct.
The thoracic duct is located near the bottom of the spine, it is responsible for the
collection of lymph from the pelvis, abdomen as well as the lower chest area. This
,vessel travels up the chest, where it empties the lymph into the blood via a large vein
by the left side of the neck.
The right lymphatic duct gets the lymph from the right side of the neck area, as well
as the chest and arm. It then doesn’t travel far as it then also disposes of the lymph
into the blood via a vessel which is also located at the right side of the neck.
Lymph nodes are found in the neck and back, armpits, groin, stomach, and chest. In
addition, there are small bundles of lymph nodes around the oesophagus and airways,
called the tonsils and adenoids. The fluid (lymph) is transported using the lymphatic
vessels to the lymph nodes. Their role is to rid the lymph of any harmful substances
and waste products that may be mixed in. The nodes have immune cells in them
which are known as lymphocytes, and these are there to ensure that bacteria and
cancer cells are rid of. Once this process has been complete, the lymph fluid can be
taken back to the blood through the rest of the lymph vessels.
The lymph nodes are small, bean shaped organs, and are surrounded by connective
tissue and divided into sections called lymph nodules. The nodules are dense masses
of lymphocytes and macrophages, these are separated by lymph sinuses.
These lymphocytes in the lymph nodes include B and T cells. The B lymphocytes are
present there to aid in making antibodies. Antibodies are able to bind together with
pathogens or other unknown substances, or ‘invaders’ in the body, and they can then
neutralise them. This is extremely important as it ensures that infected cells are
destroyed. T lymphocytes are responsible for destroying any infected or cancerous
cells in the body and to prevent infections, these are known as CD8+ t-cells (cytotoxic
t-cells or killer t-cells). As well as this, they can also aid the B cells to destroy
pathogens and the cytotoxic t-cells by activating them, these types of t-cells are
known as CD4+ t-cells (helper t-cells).
Axillary lymph nodes are found in the armpits, and like that of all lymph nodes, its role
is to filter any harmful substances from the lymph fluid before it goes into the blood
circulation. This specific lymph node’s function is to drain the upper limb, the breast
and the trunk found over the umbilicus.
A sub-group of cubital lymph nodes are known as supratrochlear nodes, and their
specific function to drain the lymph fluid from the forearm, as well as some fingers,
including the middle, ring, and little fingers.
The abdominal lymph nodes drain the lymph fluid from the abdominal organs as well
as any deeper structures there. Examples of some abdominal lymph nodes that are
part of this are the pre-aortic, para-aortic, common iliac, and internal and external iliac
groups.
Inguinal lymph nodes are located in the groin, and their purpose is to help in the
defence against infections threatening the body. The lymph fluid is passed though the
nodes, and then the immune cells are responsible for filtering out the bacteria or other
threats from it. For these lymph nodes, there is a drainage pathway for the legs, as
well as the genitals and pelvic area.
The popliteal lymph nodes are located around the knee, and they drain the lymph
fluid from the deeper structures around there like the distal leg as well as the foot.
Typically, there are around 2 to 9 lymph nodes located in the fat tissue around the
vessels of the popliteal fossa (Behind the knee joint between the muscles of the thigh
and the leg).
, The bone marrow is located in the centre of the bones, and is a gelatinous tissue,
either red, called myeloid tissue, or yellow, called fatty tissue. Red bone marrow is
responsible for all the red blood cells as well as the platelets around up to 70% of the
lymphocytes in the body. The other lymphocytes start in the red bone marrow, though
grow fully in the other lymphatic tissues, such as the thymus, spleen, as well as the
lymph nodes. The function of the red bone marrow is to help, alongside the liver and
spleen, to get rid of worn red blood cells. The yellow bone marrow is responsible for
storing the fats. This is helpful as it keeps up a good environment for the bones to
function properly.
Your bone marrow can make blood cells from the stem cells located there. The stem
cells are able to grow into the types of blood cells needed in the body, such as red
blood cells, platelets as well as white blood cells. Lymphocytes are a type of white
blood cell that grow in the bone marrow, and the B lymphocytes can fully grow here,
whereas the T lymphocytes fully grow in the thymus.
The thymus gland is located between the lungs in the chest area. This gland’s role is
to produce white blood cells, more specifically T-lymphocytes, and these are made to
help fight in the case of there being an infection. The thymus gland grows to be its
largest when we are children and makes lots of T cells ready for when we are to grow
into teenagers, once this is done, the thymus once again begins to get smaller and
will be less active.
The thymus gland has a lobular structure and has a flat, irregular shape. The lobules
are made up of follicles, and these have medullary and cortical components. The
cortical part is mostly made of lymphocytes, the medullary part contains less
lymphocytes but more epithelial cells in comparison to the cortical part.
The thymus contains the CD4 and CD8 like in the lymph nodes. The lymphocytes here
mature and become specialised t-cells and once they have fully matured, they then
enter the blood stream.
The tonsils are found near the digestive and respiratory tract openings at the back of
the throat, and they are two small areas of tissue. They play an important role in
helping to fight of any infections, as in the case of a threat of infection, they are the
first response that will occur from the body.
Lacteals are located in the small intestine and are the ends of the lymphatic
capillaries. This is the main place where the dietary lipids and any lipid-soluble
nutrients are drained whilst in the form of lymph fluid, and this then is returned to the
blood circulation through the thoracic duct. As well as this, lacteals can also be a place
to transport any immune cells allocated in the stromal area of the villi.
The spleen is found above the abdomen to the left side and is underneath the ribcage.
This organ’s role in the lymphatic system is to clean out any worn red blood cells and
break them down, as well as any germs from the bloodstream using the white blood
cells it releases. The spleen also is in charge of the storage of some products, like iron,
of the worn red blood cells, and this can then be used later, or released into the blood
and transported to the liver or bone marrow to be reused.
The spleen is the largest lymphatic organ in the body and is surrounded by connective
tissue which also divides the organ into lobules. The spleen is similar in shape to a
lymph node, though is much larger in size. This is made up of two types of tissue, red
pulp, and white pulp. The red pulp is made up of veins with thin walls which are filled
