Lymphatics And Respiratory System

The Lymphatic System

The Lymphatic System
Includes the lymph, lymphatic vessels, lymph nodes, lymphoid organs (tonsils, spleen and thymus)
Primary Functions:
1. Maintains fluid homeostasis
2. Absorbs lipids from the GIT
3. Filters blood (spleen)
4. Contains lymphocytes participating in immunity

The Lymph
Fluid similar to composition as plasma
Without RBC and less proteins
Special Lymph from the GIT is loaded with fats and is called CHYLE

Fig. 14.2

The Lymph vessels
Carry fluid away from tissues into the venous circulation
These are NOT present in the central nervous system, Bone marrow, epidermis and cartilage
They resemble vein because they have valves

3 mechanisms of edema formation
1. Decrease oncotic pressure  cirrhosis and kwashiorkor
2. Increased hydrostatic pressure  CHF and prolonged standing
3. Lymphatic obstruction or destruction  filiariasis, lymph node dissection

Lymphatic duct
1. Right lymphatic duct- drains the right side of the head and the upper right side of the thorax and the right extremities
2. Thoracic duct- drains the rest of the body

The Lymphatic organs
1. Tonsils
A. palatine
B. pharyngeal
C. lingual
D. tubal

The lymphatic organs
2. Lymph nodes
Small round structures of lymphoid tissue
Major lymph nodes are the axillary,
inguinal and cervical
Filters lymph
Activates the immune system
Removes microorganisms from the blood

The lymphoid organs
3. The spleen
Reddish, flat organ lying next to the 9 th and 10 th rib in the left upper quadrant
Functions:
Repository of old RBC
Activates the immune system
Storage of Blood
Sequesters bacteria
MOST COMMONLY INJURED
in BLUNT abdominal trauma

The lymphoid organs
4. Thymus
Bilobed organ in the superior mediastinum
Lymphocytes from the bone marrow mature and grow as T-lymphocytes
Positive selection= T-cells that react to foreign antigen are selected
Negative selection= T-cells that do not react to the self-antigen are selected

IMMUNITY
Innate or Non-specific
1. Mechanical- skin, mucus, saliva, urine
2. Chemical- enzymes, lysozymes
3. Vascular Blood cells- Neutrophils and macrophages
4. Inflammation
Specific Immunity
1. Cellular Immunity- T-cell system
2. Humoral Immunity- B-cell system

Non-specific Immunity
Inflammatory response
Reaction of the vacularized living tissues to injury
Classic signs:
1. Rubor- redness
2. Calor- heat
3. Tumor- swelling
4. Dolor- pain
5. Functio laesa- loss of function

Inflammation
Initial reaction  Vasoconstriction!
VC  VD  VP (due to HISTAMINE)
VD  Redness and Heat
VP  Swelling
Bradykinin, Prostaglandin, compression of tissues  pain

Specific Immunity: T cell
T-cells originate in the bone marrow and mature in the thymus
4 types of T-cells
1. Cytotoxic T cells- kill infected cells, cancer cells and transplanted cells
2. Helper T cells- help the humoral immunity
3. Suppressor T cells- suppress that actions of cytotoxic and Helper cells
4. Memory T cells- for recall and specificity

Specific Immunity: B cells
B cells are produced and mature in the bone marrow
B cells  helped by Helper cells  turn into Plasma cells  secrete ANTIBODIES

ANTIBODIES
Are proteins that can combine with antigens and function for:
1. Opsonization
2. Neutralization
3. Activation of complement system

ANTIBODIES types
Five classes
1. Ig M- priMary response, pentaMer
2. Ig G- secondary response, most abundant, can cross placenta
3. Ig A- secreted by the body (sIgA)
4. Ig D- receptor for B cells
5. Ig E- allergic and parasitic reactions

TYPES OF IMMUNITY
1. Natural Immunity
Active natural
Passive natural
2. Artificial Immunity
Active artificial
Passive artificial

Fig. 14.18

End of Immune System

THE RESPIRATORY SYSTEM

The Respiratory System
Composed of the air conducting system and the respiratory unit (lungs)
Major function is RESPIRATION
Commonly divided into UPPER RESPIRATORY tract and LOWER RESPIRATORY tract

Ventilation and Respiration
VENTILATION- movement of air from the atmosphere into the lungs and out of the lungs
EXTERNAL RESPIRATION- exchange of gases between the alveoli and the blood
INTERNAL RESPIRATION- exchange of gases between the blood and the tissues

The Respiratory System
Commonly divided into
UPPER RESPIRATORY tract and
LOWER RESPIRATORY tract

The UPPER Respiratory tract
The nose, pharynx and larynx

The LOWER respiratory tract
Composed of The trachea down to the Lungs

The NOSE
Made up of nasal bones and cartilages
The NASAL cavity is made up of bones, cartilages and turbinates or conchae
The nostril is the external opening
The choanae is the internal opening

Functions of the nose
1 . Hairs or vibrissae filter large particles
2. Blood vessels warm the air
3. Mucus serves to humidify the air
4. Phonation

The Pharynx
Musculo-membranous tube from behind the nasal cavity to the level of the cricoid cartilage (C6)

The Pharynx
3 component parts
1. Nasopharynx
2. Oropharynx
3. Laryngopharynx

The Larynx
Upper expanded portion of the trachea
Made up of cartilages
3 Unpaired- Cricoid, Thyroid and Epiglottis ( cUte)
6 Paired- Cuneiform, Corniculate and Arytenoid (pACC)
Function: air passageway and phonation

The vocal cords
1. False vocal cords
2. True vocal cords
3. Glottis- the space between the true vocal cords and is the narrowest portion of the adult airway

Fig. 15.4

Lower airway: Trachea
Called windpipe
Made up of 15-20 C-shaped cartilage
10-11 inches
Lined with pseudostratified
ciliated epithelium

Bronchus
RIGHT Bronchus
Wider
Shorter
More vertical
Left bronchus
Narrower
Longer
More horizontal

Bronchioles
Primary bronchus  secondary bronchus  tertiary bronchus  terminal bronchioles
Respiratory bronchioles belong to the respiratory unit

Respiratory unit
Respiratory bronchioles
Alveolar ducts
Alveolar sacs
alveolus

The Pleura
Surrounds the lungs and provide protection
1. Parietal pleura- in the chest wall
2. Visceral pleura- intimately attached to the lungs
3. Pleural space- in between the two

Diaphragm

Respiratory Physiology
1. Ventilation and gas exchange
2. Mechanics of breathing
3. Gas transport
4. Pulmonary volumes and capacities
5. Respiratory control

Ventilation
Ventilation is the movement of air into the lungs
Air (oxygen) moves by the process of diffusion from the higher concentration in the alveoli to the pulmonary capillaries

Mechanics of breathing

Gas exchange
Respiratory membrane is thin which facilitates gas exchange
Rate of diffusion depends on the thickness of the membrane, surface area and partial pressure of gases

Gas transport
1. OXYGEN- majority is transported in the blood loosely bound to hemoglobin- oxyhemoglobin
2. CARBON DIOXIDE- majority is transported in the blood in the RBC as BICARBONATE

Fig. 15.8

LUNG VOLUMES
1. Tidal volume – TV
2. Inspiratory Reserve Volume- IRV
3. Expiratory Reserve Volume- ERV
4. Residual volume- RV

LUNG CAPACITIES
Lung volume + another lung volume
1. Inspiratory Capacity- IC
2. Functional Residual Capacity- FRC
3. Vital capacity- VC
4. Total Lung capacity- TLC

NOT CLINICALLY measured
1. Residual volume
2. Functional residual volume
3. Total lung capacity

Control of Respiration: Central
Respiratory center in the medulla
Controls the rate and depth of respiration
Increased CO2 is the most potent stimulus

Control of Respiration: Peripheral
1. Chemoreceptors in the carotid and aortic bodies
Sensitive to changes in pH and O2
Decreased O2  increase respiration
Decreased pH (acidosis)  increase respiration
2. Herring-Breurer reflex
Stretch receptors in the lungs limit the inspiration

ASSESSMENT
Normal Breathing pattern:
12-21 respiratory rate
Active inspiration with contraction of diaphragm
Passive expiration with relaxation of diaphragm
Steady rhythm and regular rate and size
I:E ratio is 1:2

Abnormal breathing pattern
1. Cheyne-Stoke’s
2. Biot’s
3. Kussmaul’s
4. Agoral

Breathing rates
1. Eupnea- 12-21
2. Bradypnea- 11 and below
3. Tachypnea- 22 and above
4. Dyspnea- difficulty of breathing

Breathing Position
1. Platypnea- inability to breath in an upright position
2. Orthopnea- difficulty in breathing in any position except upright

Breath sounds: Normal
1. Bronchial or Tracheal- in the sternum
2. Bronchovesicular- in the interscapular area
3. Vesicular- lung periphery

Adventitious Breath sounds
1. Rales or crackles
2. Stridor
3. Wheeze
4. Rhonchi
5. Friction rub

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Lymphatics And Respiratory System

by Nurse ReviewDotOrg on Oct 05, 2007

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Lymphatics And Respiratory System — Presentation Transcript