BACHELOR OF SCIENCE IN NURSING

ANPH 111 (Anatomy and Physiology)

COURSE MODULE COURSE UNIT WEEK
3 15 17
The Lymphatics System

ü Read course and unit objectives

ü Read study guide prior to class attendance
ü Read required learning resources; refer to unit terminologies for jargons
ü Proactively participate in classroom discussions
ü Participate in weekly discussion board (Canvas)
ü Answer and submit course unit tasks.

VanPutte, Cinnamon. Regan, Jennifer. Russo, Andrew (2016). Seeley’s Essentials of Anatomy &
Physiology Penn Plaza, New York, New York, McGraw-Hill Education, 10th Edition

Computer device or smartphone with internet access (at least 54 kbps; average data
subscription will suffice)
At the end of the course unit (CM), learners will be able to:

Cognitive

• Explain how the lymphatic system is functionally related to the cardiovascular system
and the immune defenses.
• Name the two major types of structures composing the lymphatic system.
• Describe the source of lymph, and explain its formation and transport.
• Describe the functions of lymph nodes, tonsils, thymus, Peyer’s patches, and spleen.
• Name the importance of Phagocytes and several antimicrobial substances produced by
the body that act in innate body defense.
• Describe how fever helps protect the body.
• Define antigen and hapten, and name substances that act as complete antigens.
• Explain the function(s) of antibodies, and describe clinical uses of monoclonal antibodies.
• Distinguish between active and passive immunity.

Affective
• Listen attentively during class discussions
• Demonstrate tact and respect of other students’ opinions and ideas
• Accept comments and reactions of classmates openly

Psychomotor
• Participate actively during class discussions
• Follow class rules and observe compliance to Netiquette
• Use critical thinking to identify areas of care that could benefit from additional research or
application of evidence-based practices
• Integrate knowledge of trends in Anatomy and Physiology

Active immunity - Immunity that results when the body manufactures its own antibodies or
T cells against a pathogen
Allergen - Environmental substance that triggers an allergic response
Anaphylaxis - Severe, immediate hypersensitivity reaction affecting the entire body
Antibody - Substance produced by B lymphocytes in response to a specific antigen
Antigen - Any molecule that triggers an immune response
Cellular immunity - Immune response that targets foreign cells or host cells that have
become infected with a pathogen
Chemotaxis - The movement of white blood cells to an area of inflammation in response to
the release of chemicals from the injured cells
Complement - A group of proteins in the blood that, through a cascade of chemical
reactions, participate in nonspecific immunity
Diapedesis - Process in which neutrophils enzymatically digest a portion of the capillary
basement membrane, allowing them to leave the vessel and enter inflamed tissue
Histamine - Substance secreted by injured or irritated cells that produces local
vasodilation, among other effects
Humoral immunity - Immune response that uses antibodies to target pathogens outside
the host cells
Hyperemia - Increased blood flow to an area
Immunoglobulins - Antibodies
Inflammation - An immunological response to injury, infection, or allergy, marked by
increases in regional blood flow, immigration of white blood cells, and release of chemical
toxins
Interferon - Protein released from virus-infected cells that helps protect nearby cells from
invasion
Lymph - Clear, colorless fluid filling lymphatic capillaries
Lymph nodes - Kidney-shaped masses of lymphatic tissue that lie along lymphatic vessels
Macrophage - Important phagocyte that remains fixed in strategic areas
Natural killer cells - Unique group of lymphocytes that continually roam the body seeking
out pathogens or diseased cells
Neutrophils - Phagocytes that accumulate rapidly at sites of acute injury
Nonspecific immunity - First and second lines of defense; immune response aimed at a
broad range of pathogens
Passive immunity - Immunity that results when someone receives antibodies from another
person or animal
Phagocytosis - Process by which phagocytes engulf and destroy microorganisms
Pyrexia - Fever
Specific immunity - The third line of defense; immune response targeted at a specific
pathogen
Spleen - The body’s largest lymphatic organ; contains masses of lymphocytes
T lymphocytes - Lymphocytes that participate in both cellular and hu- moral immunity; also
called T cells
Thymus gland - Lymphoid organ where T cells mature; located in the mediastinal cavity
Tonsils - Masses of lymphoid tissue that form a protective circle at the back of the throat
 11.1 LYMPHATIC SYSTEM
§ Consists of two semi-independent parts:
§ Lymphatic vessels
§ Lymphoid tissues and organs
§ Lymphatic system functions
§ Transports escaped fluids from the cardiovascular system back to the blood
§ Plays essential roles in body defense and resistance to disease

11.1.1 Lymphatic Vessels

§ Lymph consists of excess tissue fluid and plasma proteins carried by
lymphatic vessels
§ If fluids are not picked up, edema occurs as fluid accumulates in
tissues
§ Lymphatic vessels (lymphatics) pick up excess fluid (lymph) and
return it to the blood
§ Form a one-way system
§ Lymph flows only toward the heart
§ Lymph capillaries
§ Weave between tissue cells and blood capillaries
§ Walls overlap to form flaplike minivalves
§ Fluid leaks into lymph capillaries
§ Capillaries are anchored to connective tissue by filaments
§ Higher pressure on the inside closes minivalves
§ Fluid is forced along the vessel

Figure 15.1 Special Structural Features of Lymphatic Capillaries

*Photo and content taken from Essentials of Human Anatomy & Physiology by Marieb & Keller (2018)
(a) Structural relationship between blood capillaries and lymph capillaries. Black arrows indicate direction of fluid movement. (b) Lymph capillaries begin as
blind-ended tubes. The endothelial cells forming their walls overlap one another, forming flaplike minivalves.
 Figure 15.2 Distribution of Lymphatic Vessels and Lymph Nodes
*Photo and content taken from Essentials of Human Anatomy & Physiology by Marieb & Keller (2018)

§ Lymphatic collecting vessels

§ Collect lymph from lymph capillaries
§ Carry lymph to and away from lymph nodes
§ Return fluid to circulatory veins near the heart
§ Right lymphatic duct drains the lymph from the right arm and
the right side of the head and thorax
§ Thoracic duct drains lymph from rest of body
 § Lymphatic vessels are similar
to veins of the cardiovascular
system
§ Thin-walled
§ Larger vessels have
valves
§ Low-pressure,
pumpless system

§ Lymph transport is aided by:

§ Milking action of skeletal
muscles
§ Pressure changes in
thorax during breathing
§ Smooth muscle in walls
of lymphatics

Figure 15.3 Relationship of Lymphatic

Vessels to Blood Vessels
*Photo and content taken from Essentials of Human
Anatomy & Physiology by Marieb & Keller (2018)

11.1.2 Lymph Nodes

§ Lymph nodes filter lymph before it is returned to the blood
§ Harmful materials that are filtered
§ Bacteria
§ Viruses
§ Cancer cells
§ Cell debris
§ Defense cells within lymph nodes
§ Macrophages—engulf and destroy bacteria, viruses, and other
foreign substances in lymph
§ Lymphocytes—respond to foreign substances in lymph
§ Structure:
§ Most lymph nodes are kidney-shaped, less than 1 inch long, and
buried in connective tissue
§ Surrounded by a capsule
§ Divided into compartments by trabeculae
§ Cortex (outer part)
§ Contains follicles—collections of lymphocytes
§ Germinal centers enlarge when antibodies are released by
plasma cells
 § Medulla (inner part)
§ Contains phagocytic macrophages

§ Flow of lymph through nodes

§ Lymph enters the convex side through afferent lymphatic vessels
§ Lymph flows through a number of sinuses inside the node
§ Lymph exits through efferent lymphatic vessels
§ Because there are fewer efferent than afferent vessels, flow is
slowed

Figure 15.4 Structure of a Lymph Node

*Photo and content taken from Essentials of Human Anatomy & Physiology by Marieb & Keller (2018)
Longitudinal section of a lymph node and associated lymphatics. Notice that several afferent lymphatics enter the node, whereas
fewer efferent lymphatics exit at its hilum.

11.1.3 Other Lymphoid Organs

§ Several other lymphoid organs contribute to lymphatic function (in
addition to the lymph nodes)
§ Spleen
§ Thymus
§ Tonsils
§ Peyer’s patches
§ Appendix
 Figure 15.5 Lymphoid Organs
*Photo and content taken from Essentials of Human Anatomy & Physiology by Marieb & Keller (2018)

11.1.4 Spleen
§ Located on the left side of the abdomen
§ Filters and cleans blood of bacteria, viruses, debris
§ Provides a site for lymphocyte proliferation and immune
surveillance
§ Destroys worn-out blood cells
§ Forms blood cells in the fetus
§ Acts as a blood reservoir

11.1.5 Thymus
§ Found overlying the heart
§ Functions at peak levels only during youth
 11.1.6 Tonsils
§ Small masses of lymphoid tissue deep to the mucosa
surrounding the pharynx (throat)
§ Trap and remove bacteria and other foreign pathogens
§ Tonsillitis results when the tonsils become congested
with bacteria
11.1.7 Peyer’s Patches
§ Found in the wall of the small intestine
§ Similar lymphoid follicles are found in the appendix
§ Macrophages capture and destroy bacteria in the
intestine
11.1.8 Mucosa-associated Lymphoid tissue (MALT)
§ Includes:
§ Peyer’s patches
§ Tonsils
§ Appendix
§ Acts as a sentinel to protect respiratory and digestive
tracts

11.2 BODY DEFENSES

§ Two mechanisms that make up the immune system defend us from foreign
materials
§ Innate (nonspecific) defense system
§ Adaptive (specific) defense system
§ Immunity—specific resistance to disease
§ Immune system is a functional system rather than an organ system in an
anatomical sense

Figure 15.6 Overview of the Body’s Defenses

*Photo and content taken from Essentials of Human Anatomy & Physiology by Marieb & Keller (2018)
 § Innate (nonspecific) defense system
§ Mechanisms protect against a variety of invaders
§ Responds immediately to protect body from foreign materials
§ Adaptive (specific) defense system
§ Fights invaders that get past the innate system
§ Specific defense is required for each type of invader
§ The highly specific resistance to disease is immunity

11.2.1 Innate (Nonspecific) Defense System

§ Innate body defenses are mechanical barriers to pathogens (harmful or
disease-causing microorganisms) and include:
§ Body surface coverings
§ Intact skin
§ Mucous membranes
§ Specialized human cells
§ Chemicals produced by the body
© 2018 Pearson Education, Inc.

11.2.1.1 Surface Membrane Barrier: FIRST LINE OF DEFENSE

§ Surface membrane barriers, such as the skin and mucous
membranes, provide the first line of defense against the
invasion of microorganisms
§ Protective secretions produced by these membranes
§ Acidic skin secretions inhibit bacterial growth
§ Sebum is toxic to bacteria
§ Mucus traps microorganisms
§ Gastric juices are acidic and kill pathogens
§ Saliva and tears contain lysozyme (enzyme
that destroys bacteria)
 11.2.1.2 Internal - Cells and Chemicals: SECOND LINE
§ Cells and chemicals provide a second line
of defense
o Natural killer cells and phagocytes
o Inflammatory response
o Chemicals that kill pathogens
o Fever
§ Natural killer (NK) cells
o Lyse (burst) and kill cancer cells,
virus-infected cells
o Release chemicals called perforin
and granzymes to degrade target
cell contents

§ Inflammatory response
o Triggered when body tissues are
injured
o Four most common indicators
(cardinal signs) of acute
inflammation
§ Redness
§ Heat
§ Pain
§ Swelling (edema)
Figure 15.7 Flowchart of Inflammatory Events
*Photo and content taken from Essentials of Human Anatomy &
Physiology by Marieb & Keller (2018)

§ Inflammatory response (continued)

§ Damaged cells release inflammatory chemicals
§ Histamine
§ Kinin
§ These chemicals cause:
§ Blood vessels to dilate
§ Capillaries to become leaky
§ Phagocytes and white blood cells to move into the area (called
positive chemotaxis)
§ Functions of the inflammatory response
§ Prevents spread of damaging agents
§ Disposes of cell debris and pathogens through phagocytosis
§ Sets the stage for repair
§ Process of the inflammatory response
§ Neutrophils migrate to the area of inflammation by rolling along the vessel
wall (following the scent of chemicals from inflammation)
§ Neutrophils squeeze through the capillary walls by diapedesis to sites of
inflammation
§ Neutrophils gather in the precise site of tissue injury (positive chemotaxis)
and consume any foreign material present

Figure 15.8 Phagocyte Mobilization During Inflammation

*Photo and content taken from Essentials of Human Anatomy & Physiology by Marieb & Keller (2018)

§ Phagocytes
§ Cells such as neutrophils and macrophages engulf foreign material by
phagocytosis
§ The phagocytic vesicle is fused with a lysosome, and enzymes digest the
cell’s contents
Figure 15.9 Phagocytosis by a Macrophage
*Photo and content taken from Essentials of Human Anatomy &
Physiology by Marieb & Keller (2018)

§ Antimicrobial proteins
§ Enhance innate defenses by:
§ Attacking microorganisms directly
§ Hindering reproduction of microorganisms
§ Most important types
§ Complement proteins
§ Interferon

§ Antimicrobial proteins: complement proteins

§ Complement refers to a group of at least 20 plasma proteins that circulate
in the plasma
§ Complement is activated when these plasma proteins encounter and
attach to cells (known as complement fixation)
§ Membrane attack complexes (MACs), one result of complement fixation,
produce holes or pores in cells
§ Pores allow water to rush into the cell
§ Cell bursts (lyses)
§ Activated complement enhances the inflammatory response
 Figure 15.10 Activation of Complement, Resulting in Lysis of a Target Cell
*Photo and content taken from Essentials of Human Anatomy & Physiology by Marieb & Keller (2018)

§ Antimicrobial proteins: interferons

§ Interferons are small proteins secreted by virus-infected cells
§ Interferons bind to membrane receptors on healthy cell surfaces to
interfere with the ability of viruses to multiply

§ Fever
§ Abnormally high body temperature is a systemic response to invasion by
microorganisms
§ Hypothalamus regulates body temperature at 37ºC (98.6ºF)
§ The hypothalamus thermostat can be reset higher by pyrogens (secreted
by white blood cells)
§ High temperatures inhibit the release of iron and zinc (needed by bacteria)
from the liver and spleen
§ Fever also increases the speed of repair processes
11.2.2 Adaptive (Specific) Body Defense: THIRD LINE
§ Adaptive body defenses are the body’s specific defense system, or
the third line of defense
§ Immune response is the immune system’s response to a
threat
§ Antigens are targeted and destroyed by antibodies
§ Three aspects of adaptive defense
§ Antigen specific—the adaptive defense system recognizes
and acts against particular foreign substances
§ Systemic—immunity is not restricted to the initial infection
site
§ Memory—the adaptive defense system recognizes and
mounts a stronger attack on previously encountered
pathogens
§ Two arms of the adaptive defense system
§ Humoral immunity = antibody-mediated immunity
§ Provided by antibodies present in body fluids
§ Cellular immunity = cell-mediated immunity
§ Targets virus-infected cells, cancer cells, and cells of
foreign grafts

§ Antigens
§ Antigens are any substance capable of exciting the immune
system and provoking an immune response
§ Examples of common nonself antigens
§ Foreign proteins provoke the strongest
response
§ Nucleic acids
§ Large carbohydrates
§ Some lipids
§ Pollen grains
§ Microorganisms (bacteria, fungi, viruses)
§ Self-antigens
§ Human cells have many protein and carbohydrate
molecules
§ Self-antigens do not trigger an immune response in
us
 § The presence of our cells in another person’s body
can trigger an immune response because they are
foreign
§ Restricts donors for transplants
§ Haptens, or incomplete antigens, are not antigenic by
themselves
§ When they link up with our own proteins, the immune
system may recognize the combination as foreign and
respond with an attack
§ Found in poison ivy, animal dander, detergents, hair
dyes, cosmetics

11.3 CELLS OF THE ADAPTIVE DEFENSE SYSTEM

§ Crucial cells of the adaptive system
§ Lymphocytes—respond to specific antigens
§ B lymphocytes (B cells) produce antibodies and oversee humoral
immunity
§ T lymphocytes (T cells) constitute the cell-mediated arm of the
adaptive defenses; do not make antibodies
§ Antigen-presenting cells (APCs)—help the lymphocytes but do not
respond to specific antigens

11.3.1 Lymphocytes
§ Arise from hemocytoblasts of bone marrow
§ Whether a lymphocyte matures into a B cell or T cell depends on
where it becomes immunocompetent
§ Immunocompetence
§ The capability to respond to a specific antigen by binding to it with
antigen-specific receptors that appear on the lymphocyte’s surface
§ T cells develop immunocompetence in the thymus and oversee cell-
mediated immunity
§ Identify foreign antigens
§ Those that bind self-antigens are destroyed
§ Self-tolerance is important part of lymphocyte “education”
§ B cells develop immunocompetence in bone marrow and provide
humoral immunity
§ Immunocompetent T and B lymphocytes migrate to the lymph nodes
and spleen, where encounters with antigens occur
 § Differentiation from naïve cells into mature lymphocytes is complete
when they bind with recognized antigens
§ Mature lymphocytes (especially T cells) circulate continuously
throughout the body

Figure 15.11 Lymphocyte Differentiation and Activation

*Photo and content taken from Essentials of Human Anatomy & Physiology by Marieb & Keller (2018)

11.3.2 Antigen-presenting cells (APCs)

§ Engulf antigens and then present fragments of them on their own
surfaces, where they can be recognized by T cells
§ Major types of cells behaving as APCs
§ Dendritic cells
§ Macrophages
§ B lymphocytes
§ When they present antigens, dendritic cells and macrophages
activate T cells, which release chemicals
 11.4 HUMORAL (ANTIBODY-MEDIATED) IMMUNE RESPONSE
§ B lymphocytes with specific receptors bind to a specific antigen
§ The binding event sensitizes, or activates, the lymphocyte to undergo clonal
selection
§ A large number of clones is produced (primary humoral response)
§ Humoral (Antibody-Mediated) Immune Response
§ Most of the B cell clone members (descendants) become plasma cells
§ Produce antibodies to destroy antigens
§ Activity lasts for 4 or 5 days
§ Plasma cells begin to die
§ Some B cells become long-lived memory cells capable of mounting a rapid attack
against the same antigen in subsequent meetings (secondary humoral response)
§ These cells provide immunological memory

Figure 15.12 Clonal Selection of a B cell

*Photo and content taken from Essentials of Human Anatomy & Physiology by Marieb & Keller (2018)
The initial meeting with the antigen stimulates the primary response, in which the B cell divides rapidly, forming many clones (clonal selection), most of
which become antibody-producing plasma cells. Cells that do not differentiate into plasma cells become memory cells, which are primed to respond to
subsequent exposures to the same antigen. Should such a meeting occur, the memory cells quickly produce more memory cells and larger numbers of
effector plasma cells with the same antigen specificity. Responses generated by memory cells are called secondary responses.
 Figure 15.13 Primary and Secondary Humoral Responses to Antigen
*Photo and content taken from Essentials of Human Anatomy & Physiology by Marieb & Keller (2018)
In the primary response, the level of antibodies in the blood gradually rises and then rapidly declines. The secondary response is
both more rapid and more intense, and the antibody level remains high for a much longer time.

11.4.1 Active Immunity

§ Occurs when B cells encounter antigens and produce antibodies
§ Active immunity can be:
o Naturally acquired during bacterial and viral infections
o Artificially acquired from vaccines

11.4.2 Passive Immunity

§ Occurs when antibodies are obtained from someone else
§ Naturally acquired from a mother to her fetus or in the breast milk
§ Artificially acquired from immune serum or gamma globulin
(donated antibodies)
§ Immunological memory does not occur
§ Protection is short-lived (2–3 weeks)
§ Monoclonal antibodies
§ Antibodies prepared for clinical testing for diagnostic services
§ Produced from descendants of a single cell line
§ Exhibit specificity for only one antigen
§ Examples of uses for monoclonal antibodies
§ Cancer treatment
§ Diagnosis of pregnancy
§ Treatment after exposure to hepatitis and rabies
 Figure 15.14 Types of Humoral Immunity
*Photo and content taken from Essentials of Human Anatomy & Physiology by Marieb & Keller (2018)
There are two overall types of humoral immunity, active and passive. Darker green boxes signify naturally acquired immunity,
whereas lighter green boxes show artificially acquired immunity.

§ Antibodies (immunoglobulins, Igs)

§ Constitute gamma globulin part of blood proteins
§ Soluble proteins secreted by activated B cells (plasma cells)
§ Formed in response to a huge number of antigens
§ Antibody structure
§ Four polypeptide chains, two heavy and two light, linked by disulfide
bonds to form a T- or Y-shaped molecule
§ Antibody classes
§ Antibodies of each class have slightly different roles and differ structurally
and functionally
§ Five major immunoglobulin classes (MADGE)
§ IgM—can fix complement
§ IgA—found mainly in secretions, such as mucus or tears
§ IgD—important in activation of B cell
§ IgG—can cross the placental barrier and fix complement; most
abundant antibody in plasma
§ IgE—involved in allergies
Marieb, E. N., & Keller, S. M. (2018). Essentials of Human Anatomy & Physiology. New York, New
York: Pearson Education, Inc.

Rizzo, D. C. (2016). Fundamentals of Anatomy and Physiology (Fourth ed.). Boston, Massachussetts:
Cengage Learning.

Thompson, G. S. (2015). Understanding Anatomy & Physiology: A Visual, Auditory, Interactive

Approach,2nd Edition. Philadelphia: F. A. Davis Company.

Tortora, G. J., & Freudenrich, C. C. (2011). Visualizing Anatomy & Physiology. John Wiley & Sons, Inc.
VanPutte, C., Regan, J., & Russo, A. (2016). Seeley's Essentials of Anatomy & Physiology. New York,
New York: McGraw-Hill Education.

To set the tone right, we will help each other in the appreciation of the initial phase of
Anatomy and Physiology by accomplishing the Course Task/s in Canvas