Lymphatics And Respiratory System

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Lymphatics And Respiratory System

  1. 1. The Lymphatic System <ul><li>Includes the lymph, lymphatic vessels, lymph nodes, lymphoid organs (tonsils, spleen and thymus) </li></ul><ul><li>Primary Functions: </li></ul><ul><li>1. Maintains fluid homeostasis </li></ul><ul><li>2. Absorbs lipids from the GIT </li></ul><ul><li>3. Filters blood (spleen) </li></ul><ul><li>4. Contains lymphocytes participating in immunity </li></ul>
  2. 4. The Lymph <ul><li>Fluid similar to composition as plasma </li></ul><ul><li>Without RBC and less proteins </li></ul><ul><li>Special Lymph from the GIT is loaded with fats and is called CHYLE </li></ul>
  3. 6. Fig. 14.2
  4. 7. The Lymph vessels <ul><li>Carry fluid away from tissues into the venous circulation </li></ul><ul><li>These are NOT present in the central nervous system, Bone marrow, epidermis and cartilage </li></ul><ul><li>They resemble vein because they have valves </li></ul>
  5. 8. 3 mechanisms of edema formation <ul><li>1. Decrease oncotic pressure  cirrhosis and kwashiorkor </li></ul><ul><li>2. Increased hydrostatic pressure  CHF and prolonged standing </li></ul><ul><li>3. Lymphatic obstruction or destruction  filiariasis, lymph node dissection </li></ul>
  6. 9. Lymphatic duct <ul><li>1. Right lymphatic duct- drains the right side of the head and the upper right side of the thorax and the right extremities </li></ul><ul><li>2. Thoracic duct- drains the rest of the body </li></ul>
  7. 11. The Lymphatic organs <ul><li>1. Tonsils </li></ul><ul><li>A. palatine </li></ul><ul><li>B. pharyngeal </li></ul><ul><li>C. lingual </li></ul><ul><li>D. tubal </li></ul>
  8. 12. The lymphatic organs <ul><li>2. Lymph nodes </li></ul><ul><li>Small round structures of lymphoid tissue </li></ul><ul><li>Major lymph nodes are the axillary, </li></ul><ul><li>inguinal and cervical </li></ul><ul><li>Filters lymph </li></ul><ul><li>Activates the immune system </li></ul><ul><li>Removes microorganisms from the blood </li></ul>
  9. 13. The lymphoid organs <ul><li>3. The spleen </li></ul><ul><li>Reddish, flat organ lying next to the 9 th and 10 th rib in the left upper quadrant </li></ul><ul><li>Functions: </li></ul><ul><ul><li>Repository of old RBC </li></ul></ul><ul><ul><li>Activates the immune system </li></ul></ul><ul><ul><li>Storage of Blood </li></ul></ul><ul><ul><li>Sequesters bacteria </li></ul></ul><ul><ul><li>MOST COMMONLY INJURED </li></ul></ul><ul><ul><li>in BLUNT abdominal trauma </li></ul></ul>
  10. 14. The lymphoid organs <ul><li>4. Thymus </li></ul><ul><li>Bilobed organ in the superior mediastinum </li></ul><ul><li>Lymphocytes from the bone marrow mature and grow as T-lymphocytes </li></ul><ul><li>Positive selection= T-cells that react to foreign antigen are selected </li></ul><ul><li>Negative selection= T-cells that do not react to the self-antigen are selected </li></ul>
  11. 16. IMMUNITY <ul><li>Innate or Non-specific </li></ul><ul><li>1. Mechanical- skin, mucus, saliva, urine </li></ul><ul><li>2. Chemical- enzymes, lysozymes </li></ul><ul><li>3. Vascular Blood cells- Neutrophils and macrophages </li></ul><ul><li>4. Inflammation </li></ul><ul><li>Specific Immunity </li></ul><ul><li>1. Cellular Immunity- T-cell system </li></ul><ul><li>2. Humoral Immunity- B-cell system </li></ul>
  12. 17. Non-specific Immunity <ul><li>Inflammatory response </li></ul><ul><li>Reaction of the vacularized living tissues to injury </li></ul><ul><li>Classic signs: </li></ul><ul><li>1. Rubor- redness </li></ul><ul><li>2. Calor- heat </li></ul><ul><li>3. Tumor- swelling </li></ul><ul><li>4. Dolor- pain </li></ul><ul><li>5. Functio laesa- loss of function </li></ul>
  13. 18. Inflammation <ul><li>Initial reaction  Vasoconstriction! </li></ul><ul><li>VC  VD  VP (due to HISTAMINE) </li></ul><ul><li>VD  Redness and Heat </li></ul><ul><li>VP  Swelling </li></ul><ul><li>Bradykinin, Prostaglandin, compression of tissues  pain </li></ul>
  14. 19. Specific Immunity: T cell <ul><li>T-cells originate in the bone marrow and mature in the thymus </li></ul><ul><li>4 types of T-cells </li></ul><ul><li>1. Cytotoxic T cells- kill infected cells, cancer cells and transplanted cells </li></ul><ul><li>2. Helper T cells- help the humoral immunity </li></ul><ul><li>3. Suppressor T cells- suppress that actions of cytotoxic and Helper cells </li></ul><ul><li>4. Memory T cells- for recall and specificity </li></ul>
  15. 20. Specific Immunity: B cells <ul><li>B cells are produced and mature in the bone marrow </li></ul><ul><li>B cells  helped by Helper cells  turn into Plasma cells  secrete ANTIBODIES </li></ul>
  16. 21. ANTIBODIES <ul><li>Are proteins that can combine with antigens and function for: </li></ul><ul><li>1. Opsonization </li></ul><ul><li>2. Neutralization </li></ul><ul><li>3. Activation of complement system </li></ul>
  17. 22. ANTIBODIES types <ul><li>Five classes </li></ul><ul><li>1. Ig M- priMary response, pentaMer </li></ul><ul><li>2. Ig G- secondary response, most abundant, can cross placenta </li></ul><ul><li>3. Ig A- secreted by the body (sIgA) </li></ul><ul><li>4. Ig D- receptor for B cells </li></ul><ul><li>5. Ig E- allergic and parasitic reactions </li></ul>
  18. 23. TYPES OF IMMUNITY <ul><li>1. Natural Immunity </li></ul><ul><ul><li>Active natural </li></ul></ul><ul><ul><li>Passive natural </li></ul></ul><ul><li>2. Artificial Immunity </li></ul><ul><ul><li>Active artificial </li></ul></ul><ul><ul><li>Passive artificial </li></ul></ul>
  19. 24. Fig. 14.18
  20. 25. <ul><li>End of Immune System </li></ul>
  21. 26. THE RESPIRATORY SYSTEM
  22. 27. The Respiratory System <ul><li>Composed of the air conducting system and the respiratory unit (lungs) </li></ul><ul><li>Major function is RESPIRATION </li></ul><ul><li>Commonly divided into UPPER RESPIRATORY tract and LOWER RESPIRATORY tract </li></ul>
  23. 28. Ventilation and Respiration <ul><li>VENTILATION- movement of air from the atmosphere into the lungs and out of the lungs </li></ul><ul><li>EXTERNAL RESPIRATION- exchange of gases between the alveoli and the blood </li></ul><ul><li>INTERNAL RESPIRATION- exchange of gases between the blood and the tissues </li></ul>
  24. 29. The Respiratory System <ul><li>Commonly divided into </li></ul><ul><li>UPPER RESPIRATORY tract and </li></ul><ul><li>LOWER RESPIRATORY tract </li></ul>
  25. 30. The UPPER Respiratory tract <ul><li>The nose, pharynx and larynx </li></ul>
  26. 31. The LOWER respiratory tract <ul><li>Composed of The trachea down to the Lungs </li></ul>
  27. 32. The NOSE <ul><li>Made up of nasal bones and cartilages </li></ul><ul><li>The NASAL cavity is made up of bones, cartilages and turbinates or conchae </li></ul><ul><li>The nostril is the external opening </li></ul><ul><li>The choanae is the internal opening </li></ul>
  28. 33. Functions of the nose <ul><li>1 . Hairs or vibrissae filter large particles </li></ul><ul><li>2. Blood vessels warm the air </li></ul><ul><li>3. Mucus serves to humidify the air </li></ul><ul><li>4. Phonation </li></ul>
  29. 34. The Pharynx <ul><li>Musculo-membranous tube from behind the nasal cavity to the level of the cricoid cartilage (C6) </li></ul>
  30. 35. The Pharynx <ul><li>3 component parts </li></ul><ul><li>1. Nasopharynx </li></ul><ul><li>2. Oropharynx </li></ul><ul><li>3. Laryngopharynx </li></ul>
  31. 36. The Larynx <ul><li>Upper expanded portion of the trachea </li></ul><ul><li>Made up of cartilages </li></ul><ul><ul><li>3 Unpaired- Cricoid, Thyroid and Epiglottis ( cUte) </li></ul></ul><ul><ul><li>6 Paired- Cuneiform, Corniculate and Arytenoid (pACC) </li></ul></ul><ul><li>Function: air passageway and phonation </li></ul>
  32. 38. The vocal cords <ul><li>1. False vocal cords </li></ul><ul><li>2. True vocal cords </li></ul><ul><li>3. Glottis- the space between the true vocal cords and is the narrowest portion of the adult airway </li></ul>
  33. 39. Fig. 15.4
  34. 40. Lower airway: Trachea <ul><li>Called windpipe </li></ul><ul><li>Made up of 15-20 C-shaped cartilage </li></ul><ul><li>10-11 inches </li></ul><ul><li>Lined with pseudostratified </li></ul><ul><li>ciliated epithelium </li></ul>
  35. 41. Bronchus <ul><li>RIGHT Bronchus </li></ul><ul><li>Wider </li></ul><ul><li>Shorter </li></ul><ul><li>More vertical </li></ul><ul><li>Left bronchus </li></ul><ul><li>Narrower </li></ul><ul><li>Longer </li></ul><ul><li>More horizontal </li></ul>
  36. 42. Bronchioles <ul><li>Primary bronchus  secondary bronchus  tertiary bronchus  terminal bronchioles </li></ul><ul><li>Respiratory bronchioles belong to the respiratory unit </li></ul>
  37. 43. Respiratory unit <ul><li>Respiratory bronchioles </li></ul><ul><li>Alveolar ducts </li></ul><ul><li>Alveolar sacs </li></ul><ul><li>alveolus </li></ul>
  38. 44. The Pleura <ul><li>Surrounds the lungs and provide protection </li></ul><ul><li>1. Parietal pleura- in the chest wall </li></ul><ul><li>2. Visceral pleura- intimately attached to the lungs </li></ul><ul><li>3. Pleural space- in between the two </li></ul>
  39. 46. Diaphragm
  40. 47. Respiratory Physiology <ul><li>1. Ventilation and gas exchange </li></ul><ul><li>2. Mechanics of breathing </li></ul><ul><li>3. Gas transport </li></ul><ul><li>4. Pulmonary volumes and capacities </li></ul><ul><li>5. Respiratory control </li></ul>
  41. 48. Ventilation <ul><li>Ventilation is the movement of air into the lungs </li></ul><ul><li>Air (oxygen) moves by the process of diffusion from the higher concentration in the alveoli to the pulmonary capillaries </li></ul>
  42. 49. Mechanics of breathing
  43. 50. Gas exchange <ul><li>Respiratory membrane is thin which facilitates gas exchange </li></ul><ul><li>Rate of diffusion depends on the thickness of the membrane, surface area and partial pressure of gases </li></ul>
  44. 51. Gas transport <ul><li>1. OXYGEN- majority is transported in the blood loosely bound to hemoglobin- oxyhemoglobin </li></ul><ul><li>2. CARBON DIOXIDE- majority is transported in the blood in the RBC as BICARBONATE </li></ul>
  45. 52. Fig. 15.8
  46. 53. LUNG VOLUMES <ul><li>1. Tidal volume – TV </li></ul><ul><li>2. Inspiratory Reserve Volume- IRV </li></ul><ul><li>3. Expiratory Reserve Volume- ERV </li></ul><ul><li>4. Residual volume- RV </li></ul>
  47. 54. LUNG CAPACITIES <ul><li>Lung volume + another lung volume </li></ul><ul><li>1. Inspiratory Capacity- IC </li></ul><ul><li>2. Functional Residual Capacity- FRC </li></ul><ul><li>3. Vital capacity- VC </li></ul><ul><li>4. Total Lung capacity- TLC </li></ul>
  48. 57. NOT CLINICALLY measured <ul><li>1. Residual volume </li></ul><ul><li>2. Functional residual volume </li></ul><ul><li>3. Total lung capacity </li></ul>
  49. 58. Control of Respiration: Central <ul><li>Respiratory center in the medulla </li></ul><ul><li>Controls the rate and depth of respiration </li></ul><ul><li>Increased CO2 is the most potent stimulus </li></ul>
  50. 59. Control of Respiration: Peripheral <ul><li>1. Chemoreceptors in the carotid and aortic bodies </li></ul><ul><ul><li>Sensitive to changes in pH and O2 </li></ul></ul><ul><ul><li>Decreased O2  increase respiration </li></ul></ul><ul><ul><li>Decreased pH (acidosis)  increase respiration </li></ul></ul><ul><li>2. Herring-Breurer reflex </li></ul><ul><ul><li>Stretch receptors in the lungs limit the inspiration </li></ul></ul>
  51. 60. ASSESSMENT <ul><li>Normal Breathing pattern: </li></ul><ul><li>12-21 respiratory rate </li></ul><ul><li>Active inspiration with contraction of diaphragm </li></ul><ul><li>Passive expiration with relaxation of diaphragm </li></ul><ul><li>Steady rhythm and regular rate and size </li></ul><ul><li>I:E ratio is 1:2 </li></ul>
  52. 61. Abnormal breathing pattern <ul><li>1. Cheyne-Stoke’s </li></ul><ul><li>2. Biot’s </li></ul><ul><li>3. Kussmaul’s </li></ul><ul><li>4. Agoral </li></ul>
  53. 62. Breathing rates <ul><li>1. Eupnea- 12-21 </li></ul><ul><li>2. Bradypnea- 11 and below </li></ul><ul><li>3. Tachypnea- 22 and above </li></ul><ul><li>4. Dyspnea- difficulty of breathing </li></ul>
  54. 63. Breathing Position <ul><li>1. Platypnea- inability to breath in an upright position </li></ul><ul><li>2. Orthopnea- difficulty in breathing in any position except upright </li></ul>
  55. 64. Breath sounds: Normal <ul><li>1. Bronchial or Tracheal- in the sternum </li></ul><ul><li>2. Bronchovesicular- in the interscapular area </li></ul><ul><li>3. Vesicular- lung periphery </li></ul>
  56. 65. Adventitious Breath sounds <ul><li>1. Rales or crackles </li></ul><ul><li>2. Stridor </li></ul><ul><li>3. Wheeze </li></ul><ul><li>4. Rhonchi </li></ul><ul><li>5. Friction rub </li></ul>

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