LABEX 20 Lymphatic System

COURSE
LABORATORY MANUAL
2021 Edition
Department of Human Anatomy

Emilio Aguinaldo School of Medicine
1
Emilio Aguinaldo Corporation
School of Medicine
Preface to the 2021 edition

___________________________________________________________________
The Department of Human Anatomy acknowledges the

immense contribution of its former Department
Chairman; Dr. Fernando Peraldo for his authorship, and
dedication in coming up with laboratory exercises suited
for the medical student in Anatomy. The laboratory
exercises are constantly being improved to further
develop competencies related to the course. With the
ongoing pandemic, the department will do its best to
encourage the student to use available social media
resources to understand the questions being required for
each exercise.
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Table of Contents
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ACTIVITY ACTIVITY TITLE PAGE

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20 Lymphatic System
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REFERENCES
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ACTIVITY NO. 20: Lymphatic System
NAME: RUTUJA DILIP GADE DATE: 18/08/2023 SIGNATURE:
Learning objectives:
After going through this study unit, the student will be able to:
1. Draw and Identify and label the histological parts of the following organs of the
lymphatic system: thymus, tonsils, lymph node and spleen
2. Identify the different parts of the lymphatic system (Gross and systemic)
3. Describe the anatomical and histological features of the lymphatic system.
4. Differentiate the features of the lymphatic system with that of the circulatory system.
Materials and methods:

• E references a histology videos and atlas of virtual dissection of lymphatic organs
Procedures:
• Answer the following and complete all required questions:
A Key Term Assessment
Instructions: Given a set of l terminologies associated with the lymphatic system,
describe/define these terminologies.
Anatomical Terms Definition/Description
Dense lymphoid tissue

➢ Dense Lymphoid tissue: presence of lymphocytes in the form of nodules
➢ Classification Dense Lymphoid Tissue: Nodules are found either in
association with mucous membranes of viscera or as discrete encapsulated
organs
Primary Lymphoid organs

➢ Primary Lymphoid Organs refer to Immune System Organs in which
Lymphocytes form and mature
➢ These organs include the bone marrow and the thymus. They create special
immune system cells called lymphocytes.
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MALT
MUCOSA-ASSOCIATED LYMPHOID TISSUE
➢ immune cells located diffusely in the digestive, respiratory, or urogenital

mucosa; a smaller collection of lymphoid tissue that are formed mainly of
nodular aggregates
➢ The mucosa-associated lymphoid tissue (MALT), also called mucosa-
associated lymphatic tissue, is a diffuse system of small concentrations of
lymphoid tissue found in various submucosal membrane sites of the body
Peyer’s patches
➢ Peyer's patches are groupings of lymphoid follicles in the mucus membrane
➢ hey form an important part of the immune system by monitoring intestinal
bacteria populations and preventing the growth of pathogenic bacteria in the
intestines.
➢ ileum and appendix; simple columnar epithelium; M cells with apical
microfolds; intracellular pockets on basal side
Germinal centers
➢ Germinal centers or germinal centres (GCs) are transiently formed structures
within B cell zone (follicles) in secondary lymphoid organs – lymph nodes, ileal
Peyer's patches, and the spleen
➢ main structure where antigen-activated B cells diversify their immunoglobulin
genes by somatic hypermutation (SHM) to generate high-affinity antibodies.
➢ Germinal centers form in the center of B cell follicles; during this process,
primary follicle cells are pushed to the periphery, where they form a mantle
zone around the germinal center. The mantle zone also contains some
memory B cells. A secondary follicle is made up of a germinal center and
surrounding mantle zone.
Red Pulp
components of splenic pulp
➢ Consists of blood-filled sinusoids (stave cells) and splenic cords (Bill Roth)
➢ Where old or non-functional RBCs removed from blood
➢ Central arteriole that enters the red pulp loses PALS and become short
straight penicillin arterioles that continue as capillaries
➢ Macrophages degrade old or defective RBCs; iron from hemoglobin is
recycled (transferrin); heme can be bound to hemopexin or metabolized to
bilirubin and excreted in the bile
Red pulp is a loose spongy tissue with chords of reticular cells located between venous
sinuses that contains lymphocytes, macrophages, granulocytes, and plasma cells
White Pulp
components of splenic pulp
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➢ 20% of spleen
➢ Consists of lymphoid nodules & the periarteriolar lymphoid sheaths (PALS)
➢ Small trabecular arteries enter the pulp as central arterioles enveloped by
PALS which are T cells, dendritic cells, macrophages, plasma cells
White pulp is composed of lymphoid nodules and loose collections of lymphocytes

surrounding small arterioles.
Hassall’s corpuscles
➢ groups of epithelial cells within the thymic medulla.
➢ formed from eosinophilic type VI epithelial reticular cells arranged
concentrically.
➢ They can be spherical or ovoid and their epithelial cells contain keratohyalin
and bundles of cytoplasmic fibres.
➢ assall's corpuscles produce chemical signals that instruct dendritic cells in the
thymus to induce development of regulatory T cells -- critically important
immune system cells that patrol the body looking for "bad" T cells that can
produce autoimmune disease
Marginal zone (spleen)

➢ The marginal zone is the region at the interface between the non-lymphoid
red pulp and the lymphoid white-pulp of the spleen.
➢ Marginal zone (MZ) B cells are strategically located at the interface between
the circulation and the white pulp of the spleen, where they provide a first
line of defence by rapidly producing IgM and class-switched IgG antibodies in
response to infections by blood-borne viruses and encapsulated bacteria.
BALT ➢ Bronchus-associated lymphoid tissue (BALT) is a tertiary lymphoid

structure. It is a part of mucosa-associated lymphoid tissue (MALT), and it
consists of lymphoid follicles in the lungs and bronchus. BALT is an effective
priming site of the mucosal and systemic immune responses.
T cells
➢ T cells are part of the immune system and develop from stem cells in the
bone marrow. They help protect the body from infection and may help fight
cancer. Also called T lymphocyte and thymocyte.
➢ major components of the adaptive immune system.
➢ Recognize and destroy tagged antigens and proliferate
➢ Two major types of T cells
➢ Cytotoxic T cells bind to antigen on plasma membrane of target cells and
directly destroy the cells
➢ Helper T cells activate B cells, cytotoxic T cells, Natural Killer cells and
macrophages
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B. Evaluation of Learning
Instructions: Given the following questions, fill in each blank with the correct answer.
Questions Answers
1. Give the 1. lymphatic System Consists of a group of cells, tissues & organs that monitor body surfaces and
histological internal fluid and react to potentially harmful substances.
basis that 2. Examples of immune response Reaction against microorganisms: bacteria, viruses,
explains the parasites Reaction against tumor cells Allergic reactions: Hay fever Autoimmune reaction:
lymphatic Arthritis Graft rejection Appendix
system 3. Functions of the Lymphatic System 1. Monitor body surfaces and fluid compartments (e.g.
epidermis, mucosae, interstitium) 2. React to the presence of potentially harmful antigens
recognized as “non-self” 3. Autoimmune diseases (rheumatoid arthritis, type I diabetes, etc.)
4. Components of the Lymphatic System A. Cells 1. Lymphocytes (B, T, natural killer) 2. APC
(dendritic cells, Langerhans’ cells & macrophages) B. Lymphatic “tissue”– diffuse and nodular C.
Lymphatic “organs” (lymph nodes, spleen, thymus) D. Lymphatic vessels that carry the cells and
fluid
5. Classification of Lymphatic Organs I. Primary lymphoid organs 1. Thymus 2. Bone marrow 3.
Lymphatic nodules of the distal intestinal tract II. Secondary (effector) lymphoid organs/tissue 1.
Spleen & lymph nodes 2. Mucosal associated lymphoid tissue (MALT)
6. Primary Lymphoid Organs The bone marrow, thymus and Peyer’s patch are the initial
“education centers” of the immune system. In these organs, lymphocytes (T cells in the thymus,
B cells in bone marrow and gut) differentiate into immunocompetent cells (i.e. they can
recognize “self” vs. “nonself”). This differentiation is said to be antigen- independent.
7. Secondary Lymphoid Organs This is where immunocompetent lymphocytes differentiate into
immune effectors & memory. These lymphocytes then carry out their functions in the: •
connective tissue • secondary lymphoid organs • mucosal surfaces lining epithelia
8. Lymphocytes in peripheral blood smear These are B and T-cells that have undergone antigen-
INDEPENDENT differentiation and are trafficking through the bloodstream on their way to
lymphoid organs/tissue.
9. Cytokines and chemokines (along with selectins and integrins) mediate Extravasation of
lymphocytes into tissues.
10. MALT: intraepithelial lymphocytes: γδT-cells (neither helper or cytotoxic): first to see antigens U-
M Histology Collection
11. Intraepithelial lymphocytes Shown here in resp. epith. Homing mediated by “addressins” (a sort
of lymphocyte “GPS”)
12. LYMPH NODE Secondary lymphoid nodule/follicle • Contain germinal centers • Arise when B-
lymphocytes are presented with appropriate antigen, receive T-cell help, and then begin
proliferating as lymphoblasts • Lymphoblasts differentiate into plasma cells or memory cells.
2. Give the
histological ➢ The lymphatic system and the venous system both transport body fluids.
similarities ➢ They work under very low pressure, have a series of valves in them to keep the fluid moving in
between veind one direction.
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and lymphatic ➢ Lymphatic vessels are similar to veins in that they contain valves to prevent backflow, and use the
vessels. contraction of nearby skeletal muscles to help move lymph along.
3. Cite three
differences
between Systemic Capillaries Lymphatic Capillaries
systemic Form part of the systemic circulatory system, Form part of the lymphatic system, carrying
capillaries and carrying blood from arteries to veins lymph (a clear fluid) towards the venous system
lymphatic
capillaries. Have continuous endothelium, which permits Have discontinuous endothelium, which permits
the passage of oxygen, nutrients, and waste the passage of larger molecules such as proteins,
products cells, and bacteria
Blood flows under pressure in systemic Lymph flows under low pressure in lymphatic
capillaries capillaries
Red blood cells can pass through systemic
capillaries, which helps in the exchange of Red blood cells cannot pass through lymphatic
gases and nutrients capillaries
Play a role in gas exchange, nutrient delivery, Play a role in maintaining fluid balance and
and waste removal immune function
Drain into venules, which eventually form veins Drain into larger lymphatic vessels that
that return blood to the heart eventually empty into veins in the neck region
Found in almost all tissues and organs of the Found in most tissues, except for the CNS, bone
body marrow, and avascular tissues
Help prevent the accumulation of fluid in the
Help maintain blood pressure and fluid tissues and transport immune cells to lymph
balance in the body nodes for activation
4. What is the ➢ The thoracic duct is the largest lymphatic vessel in the human body. Around 75% of the lymph
lymphatic from the entire body (aside from the right upper limb, right breast, right lung and right side of
structure that the head and neck) passes through the thoracic duct.
drains most of ➢ Tributaries -
the body? ➢ Main tributaries: left and right lumbar lymph trunks, left and right intestinal lymph trunks (their
confluence is called cysterna chyli)
➢ Additional tributaries: mediastinal lymph trunks, left jugular trunk, left bronchomediastinal
trunk, left subclavian trunk
➢ Drainage -
➢ Drains from: 75% of the body -> all region except for the right arm, right breast, right lung, right
side of the head and neck (which are drained by the right lymphatic duct)
➢ Drains to: venous angle (Pirgoff's angle) between left subclavian vein and left internal jugular vein
5. Insert and The thoracic duct is the larger of the two lymphatic ducts, responsible for draining most of the
label an image lymph from the body into the left venous angle. It originates in the cisterna chyli, which is a
of this dilation at the base of the thorax that receives lymph from the lower extremities, pelvis,
structure and abdomen, and lower thorax. The thoracic duct then ascends through the aortic hiatus of the
describe its diaphragm, runs superiorly in the posterior mediastinum, and enters the neck via the superior
thoracic aperture.
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location.
(Question 4)
In the neck, the thoracic duct arches laterally over the left subclavian artery and vein before
terminating into the junction of the left subclavian and left internal jugular veins. The duct is
typically around 38-45 cm long and has a diameter of about 2 mm. Its walls contain smooth
muscle fibers that help propel lymph along its course. The thoracic duct also has numerous
valves that prevent backflow of lymph.
The course of the thoracic duct can be divided into several parts, including the abdominal,
retroperitoneal, thoracic, and cervical parts. Along its course, the thoracic duct receives lymph
from various regions of the body, including the left side of the head and neck, left upper limb, left
thorax, abdomen, and lower extremities.
6. What is the ➢ The cisterna chyli is the abdominal origin of the thoracic duct, and it receives the bilateral
cisterna chyli? lumbar lymphatic trunks
Give a brief ➢ The cisterna chyli is a large midline lymphatic collecting structure located just inferior to the aortic
description. hiatus of the diaphragm. It collects lymphatics from the lower extremities via left and right lateral
branches and from the intestinal tract via an intestinal branch. The cisterna chyli tapers at its
superior aspect and becomes the thoracic duct.
7. Which three ➢ There are three superficial regions on each side of the body where lymph nodes tend to cluster.
anatomical ➢ These areas are the inguinal nodes in the groin, the axillary nodes in the armpit, and the cervical
areas where nodes in the neck.
lymph nodes
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are densely ➢ Note three areas where lymph nodes are densely clustered: inguinal, axillary, and cervical
clustered? regions of the body.
➢ Lymph nodes are most densely distributed toward the center of the body, particularly around the
neck, intestines, and armpits.
8. Describe the ➢ Each lymph node has fewer efferent than afferent vessels, lymph flow stagnates somewhat within
structural the node.
characteristic/s ➢ Allows time for the generation of an immune response and for macrophages to remove debris
that explain a from the lymph before it re-enters blood vessel system
slow flow of
lymph through
a lymph node.
Explain why
this is ideal.
9.Describe the
role of B cells ➢ B cells are involved in the humoral immune response, which targets pathogens loose in blood
and T cells in and lymph, while T cells are involved in the cell-mediated immune response, which targets
the immune infected cells.
system ➢ B cells are activated by free-floating antigens in the blood or lymph. T cells are activated by
respectively. membrane-bound antigens. One has a major role in antibody production, while the other has a
major role in cytotoxicity.
➢ B cells play a central role in the immunopathogenesis of glomerulonephritis’s and transplant
rejection. B cells secrete antibodies that contribute to tissue injury via multiple mechanisms. In
addition, B cells contribute to disease pathogenesis in autoimmunity and alloimmunity by
presenting antigens as well as providing costimulation and cytokines to T cells. B cells also play
an immunomodulatory role in regulating the immune response by secreting cytokines that
inhibit disease onset and/or progression.
C. CRITICAL THINKING ACTIVITIES
CTA A
Identification
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Instructions: Given the following diagrams; identify and label each of the following:
Labeling:
1. Cervical lymph nodes
2. AXILLARY LYMPH NODES
3. TRACHEOBRANCHEAL LYMPH NODES
4. THORACIC DUCT
5. RIGHT LYMPHATIC DUCT
CTA B
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Labeling:
1. DEEP CERVICAL LYMPH NODES
2. AXILLARY LYMPH NODES
3. TRACHEOBRACHIAL LYMPH NODES
4. JUGULAR TRUNK
5. THORACIC DUCT
Labeling:
1. CISTERNA CHYLLI
2. MESENTERIC LYMPH NODES
3. INGUINAL LYMPH NODES
4. INTERMEDIATE LYMPH NODES
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LABELING –
A. TONSILS
B. CERVICAL LYMPH
NODES
C. THORACIC DUCT
D. THYMUS
E. SPLEEN
F. PEYER’S PATCHES
G. INGUINAL LYMPH
NODES
H. LYMPHTIC VESSELS
I. BONE MARROW
J. CISTERNA CHYLLI
K. AXILLARY LYMPH
NODES
L. RIGHT LYMPHATIC
DUCT
Drawing
Instructions: Draw and label each of the histology of the following lymphatic organs:
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a. Thymus
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b. Tonsils (palatine)
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c. Lymph Node
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d. Spleen
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ANSWERS TO THE OBJECTIVE –
OBJECTIVE 1,2,3 ANSWERED IN GUIDE QUESTIONS
OBJECTIVE 4
DIFFERENCE BETWEEN LYMPHATIC AND CIRCULATORY SYSTEM –
CIRCULATORY SYSTEM LYMPHATIC SYSTEM

DEFINITION The system compromised of A network of tissues and organs that
cardiovascular system and the lymphatic transport lymph throughout the body
system that carries out the body’s
transportation activity
VEINS AND Cardiovascular system has veins and Lymphatic system lacks blood and the two
ARTERIES arteries types of vessels i.e. veins and arteries
TRANSPORTATION Move through the heart arteries, Lymph just flows through lymphatic vessels
OF FLUIDS capillaries, veins, lungs
TRANSPORTING Contains plasma, erythrocytes, Consist of lymphocytes, which help create
FLUID leukocytes and platelets the immune response
TRANSPORT OF Cardiovascular system transport Lymphatic system cannot transport gasses
RESPIRATORY respiratory system
GASSES
MATERIALS Carries deoxygenated food material and Lymphatic vessels system only carries
CARRYING wastes from the cells to and from digested fats
organs.
FUNCTION IN Leukocytes in blood pose a defense Lymphocytes of the lymphatic systems help
IMMUNE against the invading foreign bodies and in the building immunity.
RESPONSE toxins
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LABORATORY ACTIVITY GRADING SHEET

CRITERIA POOR FAIR GOOD EXCELLENT
Demonstrates drawings and illustrations clearly and 0 1 2 3
accurately
Completely and accurately answers guide questions 0 1 2 3
Participates actively in class/group discussion and 0 1 2 3
activities
Accomplishes and submits laboratory manual on time 0 1 2 3
Score: ___/12 x100 = ______%

References
➢ https://www.khanacademy.org/science/in-in-class-12-biology-india/xc09ed98f7a9e671b:in-in-
human-health-and-disease/xc09ed98f7a9e671b:in-in-types-of-immunity-and-the-immune-
system/a/adaptive-immunity
➢ https://www.khanacademy.org/science/in-in-class-12-biology-india/xc09ed98f7a9e671b:in-in-
human-health-and-disease/xc09ed98f7a9e671b:in-in-types-of-immunity-and-the-immune-
system/a/adaptive-immunity
➢ Hoffman, W., Lakkis, F. G., & Chalasani, G. (2016). B Cells, Antibodies, and More. Clinical journal
of the American Society of Nephrology : CJASN, 11(1), 137–154.
https://doi.org/10.2215/CJN.09430915

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COURSE

Department of Human Anatomy

Preface to the 2021 edition

The Department of Human Anatomy acknowledges the

ACTIVITY ACTIVITY TITLE PAGE

ACTIVITY NO. 20: Lymphatic System

NAME: RUTUJA DILIP GADE DATE: 18/08/2023 SIGNATURE:

Materials and methods:

Anatomical Terms Definition/Description

Dense lymphoid tissue

Primary Lymphoid organs

➢ immune cells located diffusely in the digestive, respiratory, or urogenital

White pulp is composed of lymphoid nodules and loose collections of lymphocytes

Marginal zone (spleen)

BALT ➢ Bronchus-associated lymphoid tissue (BALT) is a tertiary lymphoid

C. CRITICAL THINKING ACTIVITIES

ANSWERS TO THE OBJECTIVE –

OBJECTIVE 1,2,3 ANSWERED IN GUIDE QUESTIONS

DIFFERENCE BETWEEN LYMPHATIC AND CIRCULATORY SYSTEM –

CIRCULATORY SYSTEM LYMPHATIC SYSTEM

LABORATORY ACTIVITY GRADING SHEET

Score: _/12 x100 = ____%

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