ANATOMY OF CIRCULATORY SYSTEM

By: Zekarias B. (MSc. Clinical Anatomy)

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 Introduction
The circulatory system is divided into
 Cardiovascular system
 Lymphatic system
 Cardiovascular system (cardio- heart; vascular -blood vessels) consists of three
interrelated components:
 Blood
 the heart and
 blood vessels
 Lymphatic system is consists of
 Lymphatic vessels and
 lymphoid tissues within the spleen, thymus, tonsils, and lymph nodes

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 Components of Cardiovascular system
1. The blood is the fluid in which materials are carried to and from the tissue
2. The heart is the driving force which propels the blood
3. The blood vessels are the routes by which the blood travels to and through the
tissues and back to the heart

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 1.Blood

Objective
 Describe blood components
 Describe formed elements
 Describe function formed elements(WBC, RBC, PC)
 Development of formed elements
 Identify feature of formed elements

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 Blood
Blood is a viscous fluid(solution) weighing 8% of total body weight
Blood has two components
1. The Blood Plasma, watery liquid part of blood  55% of blood weight
 Composed of 91.5% of water and
 8.5% solutes ( plasma proteins and waste, gas, nutrients, electrolytes, and regulators)
2. The formed element, the cells of blood and cell fragments  45 % of blood weight
 Red blood cells and white blood cells  99% of formed element
 Platelets(cell fragment)  1% of formed element

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 Composition of whole blood

•A tube of blood after centrifugation (center) has about 43% of its volume represented by erythrocytes in the bottom half
of the tube, a volume called the hematocrit.
•Between the sedimented erythrocytes and the supernatant light-colored plasma is a thin layer of leukocytes and
platelets called the buffy coat.
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Blood components

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 Formed Elements

 Reb blood cells

 Leukocytes
 Platelets

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 Red Blood Cells (RBC)/ Erythrocytes

 RBCs are important for carrying O2 to metabolically active cells and carrying back

to the CO2 lung

 Biconcave disc shaped (7-8 µm)

 Has no nucleus or other organelles
 The cytosol contains Hemoglobin molecules
 Hem- pigmented part containing Fe2+
 Globin - protein of 4 polypeptide chain

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Conte
Hemoglobin
 Fe2+ Binds O2 reversibly
 Globin part of hemoglobin binds
some Co2 and carry it lung.

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Con’t
Hematocrit
 The percentage of RBC in total blood is called Hematocrit
 Male – 40-54% of total blood volume
 Female – 38-46% of total blood volume

 A Hematocrit level less than 40 in male and 38 in female is defined as Anemia

 Reduce oxygenation perfusion of cell Cell death

 Hematocrit level above 54 in male and 46 in female is polycythemia

 Increase Blood pressure
 Increase risk of Blood Coagulation Ischemia

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ABO blood grouping

 Surface of RBCs has Glycolipid which serves as an antigen

 The antigen is used for determining blood group as A, B, AB and O

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Summary of ABO blood group interactions:

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White blood cells(WBCs)/Leukocytes
 WBC is can be :-
 Granular Neutrophils, Eosinophils, Basophils
 Agranular  Monocytes, Lymphocytes
 Granular cells has granules(Vesicle) containing chemicals

10-12µm 10-12µm 8-10µm

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 Con’t ….
 Agranular leukocytes- their granules are not visualized under light microscope
 Lymphocytes(6-9µm)
 T- cells
 Cytotoxic (CD8) T-lymphocytes
 Helper(CD4) T-lymphocytes
 B- cells
 NK natural killer cells
 Monocytes(12-20µm)
 Differentiates in to Macrophage as they migrated
to the effect site(in the tissue)

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White blood cells(WBCs)/Leukocytes
 Neutrophils respond first to bacterial invasion, carrying on phagocytosis and
releasing enzymes such as lysozyme that destroy certain bacteria.
 Monocytes take longer to reach the site of infection than neutrophils, but they
eventually arrive in larger numbers. Monocytes that migrate into infected
tissues develop into cells called wandering macrophages (macro- large; -
phages eaters), which can phagocytize many more microbes than neutrophils.
They also clean up cellular debris following an infection.

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White blood cells(WBCs)/Leukocytes
 Eosinophils leave the capillaries and enter interstitial fluid. They release
enzymes that combat inflammation in allergic reactions.
 Eosinophils also phagocytize antigen–antibody complexes and are effective
against certain parasitic worms. A high eosinophil count often indicates an
allergic condition or a parasitic infection
 Basophils are also involved in inflammatory and allergic reactions. They leave
capillaries, enter tissues, and can liberate heparin, histamine, and serotonin.
These substances intensify the inflammatory reaction and are involved in
allergic reactions.

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White blood cells(WBCs)/Leukocytes
 Three types of lymphocytes: B cells, T cells, and natural killer (NK) cells
 They are the major combatants in immune responses,
 B cells develop into plasma cells, which produce antibodies that help destroy
bacteria and inactivate their toxins.
 T cells attack viruses, fungi, transplanted cells, cancer cells, and some bacteria.
 Natural killer cells attack a wide variety of infectious microbes and certain
spontaneously arising tumor cells

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Con’t …

Functions of WBC
 Neutrophils bactericidal(phagocytosis)
 Eosinophils  anti parasitic, inflammation
 Basophils  inflammation
 Monocytes  Phagocytosis and antigen presenting
 Lymphocytes  adaptive immunity

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Platelets / thrombocytes
 important in platelet plug and clot formation to prevent bleeding
 Like RBCs platelets has no Nucleus.
 But harbors Granules(vesicle) containing chemicals.
 Measures 2-4µm in diameter
 Counts 150,000–400,000/µL
 Above normal count  thrombocytosis  Thrombosis
 Below normal count  thrombocytopenia  easily bleed

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 Megakaryocytes

Cell fragments( platelets)

(A) Passive platelet cells (PC)

rounded (B) activated PC with
multiple cell membrane projections

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 Development of Formed elements
• CFU-E –Colony forming
unit erythrocytes
• CFU-Meg –Colony
forming unite
megakaryocytes
• CFU-GM –Colony forming
unit granulocyte
Macrophage

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 Development of formed element
 The production of blood cell is called Hematopoiesis/Hemopoiesis
 Blood cell is a derivative of embryonic mesoderm
 Pluripotent stem cell(Hematopoietic stem cell) differentiates into :
1. Myeloid stem cells which differentiates into
 Erythrocytes , Thrombocytes , Granulocytes ( neutrophils, Eosinophils, Basophiles) and Monocytes

2. Lymphoid stem cells which differentiates into

 T – lymphocytes, B – lymphocytes, Natural killer(NK) cells

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 Where does hematopoiesis takes placed ?

Predominantly hematopoiesis is
takes placed :-
• First trimester – yolk sac
• Second trimester – liver
• Third trimester – bone marrow
• Post natal – bone marrow of irregular
and flat bones

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Formed elements summery
Tortora- page 363
 Number
 Characteristics
 Function

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 THE HEART
Objectives :
At the end session you should be able to Describe :-
 Heart
 Mediastinum
 Pericardium
 Features of heart
 Development of the heart
 Histology of the heart

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Heart

 The Heart is muscular organ that Pumps blood to the whole parts of body.
 The hollow four-chambered muscular heart is roughly the size of a clenched fist.
 It is on averages 255 grams in adult females and 310 grams in adult males.
 The heart is located in the thoracic cavity between the lungs in the mediastinum
 About two-thirds of the heart is located left of the midline with its apex pointing
downward and resting on the diaphragm.
 In the Mediastinum with its apex directed anteriorly, inferiorly and to the left

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 Mediastinum extends from the sternum in front to the vertebral column behind, and
from the thoracic inlet above to the diaphragm below.
 Mediastinum is a space located in the thoracic cavity bounded by:-

 Anteriorly – Sternum
 Posteriorly – vertebra (T1-T12)
 Superiorly – thoracic inlet (1st Rib)
 In both side – plural cavity
 Inferiorly– diaphragm
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Mediastinum parts
 Mediastinum has two parts by Plane of louis:-
 Superior mediastinum
 Great vessels

 Inferior mediastinum, is divided by the heart in to :-

 Anterior mediastinum
 Middle mediastinum- Heart resides hear
 Posterior mediastinum

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 Organization of Cardiovascular System

A closed system with two circuits

 Systemic Circuit – oxygenated blood
leaves the heart through the aorta and
returns to the heart through systemic
veins
 Pulmonary Circuit– deoxygenated
blood leaves the heart through
pulmonary arteries and returns to the
heart through pulmonary veins

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Pericardium
It is a triple-layered sac that encloses the heart

1.Fibrous pericardium
 It is the outer layer
 It is a strong layer of dense connective tissue
 It holds the heart in place and keeps it from overfilling with blood

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 Pericardium
2. Serous pericardium
 It is a double-layered closed sac sandwiched between the fibrous pericardium and the heart
 Parietal layer of the serous pericardium adheres to the inner surface of the fibrous
pericardium
 Visceral layer of the serous pericardium(epicardium) lies on the heart and is considered a
part of the heart wall
 Between parietal and visceral pericardium is pericardial space
 This cavity contain lubricating film of fluid called pericardial fluid.
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Heart wall
 The wall of the heart is composed of
three layers(From outer to inner):

Epicardium = continuous with the

pericardium

Myocardium = thick bundles of cardiac

muscle; the contractile part of the heart

Endocardium = think sheet of

endothelium that lines the heart chambers

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Histology of the heart

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Histology of the heart
Cardiac muscle
 Straight and branched muscle fibers(cells)
 Has 1-2 central nucleus unlike skeletal muscle fibers that has multiple peripheral
nucleuses
 The cells are connected to one other via Intercalated disc( desmosome + gap junction)
 Intercalated disc holds cells together during contraction of the heart (desmosome)
 And allows conduction of electric impulse to the adjacent myofibrils(gap junction)

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Cardiac muscle fiber(cell)

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Chambers and Valves
 The interior of the heart is divided into four chambers:
 right atrium
 left atrium
 right ventricle
 left ventricles
 The atria contract and empty simultaneously into the ventricles

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Chambers of heart

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Atria(atrium-singular)
 Each atrium has an ear-shaped expandable appendage called an auricle.
 The atria are separated from each other by the thin, muscular interatrial
septum
 Atrioventricular valves (AV valves) lie between the atria and ventricles

1.Tricuspid valve b/n right atrium and right ventricle

2. Bicuspid (mitral) valve b/n left atrium and left ventricle

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Right atrium
 The right atrium receives systemic venous blood from the superior and inferior vena
cava.
 The coronary sinus is an additional opening into the right atrium that receives venous
blood from the myocardium of the heart itself
Left Atrium
 After gas exchange has occurred within the capillaries of the lungs, oxygenated blood
is transported to the left atrium through two right and two left pulmonary veins

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 Ventricles
 The ventricles are separated from each other by the thick, muscular interventricular
septum
Right Ventricle
 Blood from the right atrium passes through the right atrioventricular (AV) valve to fill
the right ventricle.
 The right AV valve is characterized by three valve leaflets, or cusps.
 Each cusp is held in position by strong tendinous cords called chordae tendineae.
 The chordae tendineae are secured to the ventricular wall by cone-shaped papillary
muscles.
 These structures prevent the valves from everting , like an umbrella in a strong wind,
when the ventricles contract and the ventricular pressure increases

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Right ventricle…
 Ventricular contraction causes the right AV valve to close and the blood to
leave the right ventricle through the pulmonary trunk and to enter the
capillaries of the lungs via the right and left pulmonary arteries.
 The pulmonary valve lies at the base of the pulmonary trunk, where it prevents
the backflow of ejected blood into the right ventricle

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Left Ventricle
 The left ventricle receives blood from the left atrium.
 These two chambers are separated by the left atrioventricular (AV) valve.
 When the left ventricle is relaxed, the valve is open, allowing blood to flow
from the atrium into the ventricle
 When the left ventricle contracts the valve closes
 Closing of the valve during ventricular contraction prevents the backflow of
blood into the atrium
 The walls of the left ventricle are thicker than those of the right ventricle
because the left ventricle bears a greater workload, pumping blood through the
entire body

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 External features of the heart.
 The auricles
 Extension of atria

 The coronary sulcus

 Groove encircling the heart
 Externally demarcates above the atria and below
ventricles

 Anterior and posterior inter ventricular sulcus

 External demarcation of right and left ventricles

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Internal features of heart
 The heart has four chambers
 Upper two right and left Atrium
 Lower two  right and left ventricles

 Atrium and ventricles are separated by:-

 Tricuspid valve on the right and
 Bicuspid( mitral valve) on left side

 right and left atria are separated by

 interatrial septum

 right and left ventricles are separated by

 Interventricular
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Conti..
Atria
 has rough surface on the wall which are muscles called
pectinei
 Posterior surface is smooth where blood is flows into the
atria
Ventricles
 has rough muscular ridges called trabeculae cornea
 Finger like muscular projections called Papilla
 The tips of Papillary muscles are anchored to free
margins of cusps through tendon like fiberous
cords called chordae tendineae
 ( and maintains the closure and opening of tricuspid and
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 Anatomy of the heart Great Vessels of the Heart
 Superior and inferior vena cava – take deoxygenated blood from the body to the right
atrium
 Pulmonary trunk gives rise to

I. Pulmonary arteries (left and right) – take deoxygenated blood from right ventricle
to lungs for oxygen.
II. Pulmonary veins (left and right) – takes oxygenated blood from lungs to left atrium
 Aorta – takes blood away from left ventricle to rest of body

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Heart sounds
 the “lub dub”Sounds of the heart are due to the opening and closure of the valves
 S1 the “lub” sound is formed by the closure of mitral and tricuspid valves and
 S2 the “dub” sound due to the closure of the aortic and pulmonary valve.

valve are best heard at

 Aortic 2nd intercostal space on the right side
 pulmonic  2nd intercostal space on the left side
 Tricusped  4th intercostal Space on the left para sternal area
 Mitral valve  4th intercostal space on the Midclavicular line
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 Rate and Rhythm of heart contraction

 Rate and rhythm of heart contraction is regulated by

 Intrinsic ( conduction system of heart )
 Extrinsic (sympathetic and parasympathetic stimulation)

 Conduction system of heart is autonomic control of rhythm of myofibrils by myofibrils

 Specialized myocytes (sinoatrial(SA) node )  pacemaker of impulse
 Impulse generated propagates through gap junction and excites contraction of atria
 Then propagate to Aterioventricular(AV) node
 Which intern initiates the ventricular contraction through the Purkinje fibers
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Intrinsic Control System
1.Sinoatrial node (SA node): The pacemaker of the heart, Located in right atrium
SA node sends out electrical impulse, Impulse spreads over atria, making them
contract and, then the Impulse travels to AV node
2.Atrioventricular node (AV node): Conducting cell group between atria and
ventricle, Carries impulse to bundle of His
3.Bundle of His: Conducting fibers in septum (divider between left and right sides
of the heart, it divides into right and left branches to a network of b ranches in
ventricles (Purkinje Fibers)
4.Purkinje Fibers: Impulse shoots along Purkinje fibers causing ventricles to
contract

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Summary of conduction system
 SA node initiate impulse

 Conduct to cardiac muscle fibers in atria causing them to contract

 Impulse reach AV node

 Distribute through AV bundle and branches to purkinje fibers to papillary

muscles and walls of the ventricles

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 Intrinsic Extrinsic

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Cont…
 Rate of hear beat is influenced by:-
 Sympathetic (fight or flight) increases heart rate
 Parasympathetic(rest and ruminate) slows heart rate

 Cardiac plexus which has both sympathetic and parasympathetic fiber

innervates the heart
 The parasympathetic fibers are from Vagus nerve and sympathetic is from
cervical sympathetic trunks

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Development of the heart

 By week 3 of gestation heart tube is formed and starts beating

 The heart tube is mesodermal origin of the tri-laminar disc
 by early week 4 the heart tube starts folding and looping and is completed by the end
of the week(28 day of gestation)
 And heart full develops around Week 8

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Vessels
Objectives

At the end of these session you should be able to describe:-

 Histology of arteries, capillaries and veins
 Arterial branches
 Vein’s return

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 Histology blood vessels
 Tunica intima
 Simple squamous Epithelium  Endothelium
 Continues with endocardium
 Tunica media
 Muscular and elastic fibers
 Rate of Blood flow, pressure and hemostasis
 Tunica externa
 Collagen and elastic fibers
 Harbors nerve fiber and vasculations of the vessel
 Anchor the vessel with the surrounding tissue

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Blood vessels
 Artery
 Carries oxygenated blood from heart to
parts of body
 Pressure reservoir
 Regulate blood pressure
 Veins
 Returns low pressure blood to heart
 Has valves to blood flow against gravity
 Capillaries
 Exchange of substance with interstitial
space takes placed

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Aorta

Parts of Aorta
 Ascending
 Arch
 Descending
 Thoracic
 Abdominal aorta

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 Ascending aorta
 Right and left coronary artery  supply Heart
 Arch of aorta
 Brachiocephalic head neck and upper limb (right side)
 left common carotid  head and neck (left side)
 Left subclavian  neck and upper limb (left side)
 Thoracic aorta
 Posterior intercostal arteries
 Superior phrenic artery
 Abdominal aorta
 Celiac trunk for gut derivatives
 Superior mesenteric  mid gut derivatives
 Renal artery  kidneys
 Gonadal testicle in male and ovaris in female
 Inferior mesenteric  hind gut
 Common
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upper extremity arterial Anatomy

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upper extremity arterial Anatomy
 The upper extremity arterial system takes origin from the aortic arch .
 On the right, there is a common trunk, the innominate or right brachiocephalic artery, that
then bifurcates into the right common carotid artery (CCA) and subclavian artery. On the
left, the subclavian artery originates directly from the aortic arch.
 The subclavian artery continues to the lateral edge of the first rib where it becomes the
axillary artery.
 The axillary artery courses underneath the pectoralis minor muscle, crosses the teres major
muscle, and then becomes the brachial artery. The brachial artery continues down the arm
to trifurcate just below the elbow into the radial, ulnar, and interosseous (or median)
arteries.
 The radial and ulnar arteries are the dominant branches that continue to the wrist.

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upper extremity arterial Anatomy
 The radial and ulnar arteries typically (most common variant) join in the hand
through the superficial and deep palmar arches that then feed the digits through
common palmar digital arteries and communicating metacarpal arteries. The
radial artery takes a course around the thumb to send branches to the thumb
(princeps pollicis) and a lateral digital branch to the index finger (radialis
indices). It then goes on to form the deep palmar arch with the ulnar artery. A
superficial radial artery branch originates before the major radial artery branch
deviates around the thumb and then continues to join the ulnar artery through
the superficial palmar arch.

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upper extremity arterial Anatomy

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upper extremity arterial Anatomy
 Femoral Artery
 The main artery of the lower limb is the femoral artery. It is a continuation of the external
iliac artery (terminal branch of the abdominal aorta). The external iliac becomes the femoral
artery when it crosses under the inguinal ligament and enters the femoral triangle.
 In the femoral triangle, the profunda femoris artery arises from the posterolateral aspect
of the femoral artery. It travels posteriorly and distally, giving off three main branches:
 Perforating branches – Consists of three or four arteries that perforate the adductor
magnus, contributing to the supply of the muscles in the medial and posterior thigh.
 Lateral femoral circumflex artery – Wraps round the anterior, lateral side of the femur,
supplying some of the muscles on the lateral aspect of the thigh.
 Medial femoral circumflex artery – Wraps round the posterior side of the femur,
supplying its neck and head. In a fracture of the femoral neck this artery can easily be
damaged, and avascular necrosis of the femur head can occur.

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upper extremity arterial Anatomy
 After exiting the femoral triangle, the femoral
artery continues down the anterior aspect of
the thigh, through a tunnel known as
the adductor canal. During its descent, the
artery supplies the anterior thigh muscles.
 The adductor canal ends at an opening in the
adductor magnus, called the adductor
hiatus. The femoral artery moves through
this opening, and enters the posterior
compartment of the thigh, proximal to the
knee.  The femoral artery is now known as
the popliteal artery.

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 In addition to the femoral artery, there are other vessels supplying the lower limb.
 The obturator artery arises from the internal iliac artery in the pelvic region.  It
descends via the obturator canal to enter the medial thigh, bifurcating into two branches:
 Anterior branch –  This supplies the pectineus, obturator externus, adductor muscles
and gracilis.
 Posterior branch –  This supplies some of the deep gluteal muscles.
 The gluteal region is largely supplied by the superior and inferior gluteal arteries. These
arteries also arise from the internal iliac artery, entering the gluteal region via the greater
sciatic foramen.
 The superior gluteal artery leaves the foramen above the piriformis muscle, the inferior
below the muscle. In addition to the gluteal muscles, the inferior gluteal artery also
contributes towards the vasculature of the posterior thigh.

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 Arteries of head and neck
 The head and neck receives the majority
of its blood supply through the carotid
and vertebral arteries

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External Carotid Artery

 The external carotid artery supplies the areas of the head and neck external to the cranium. After
arising from the common carotid artery, it travels up the neck, passing posteriorly to the mandibular
neck and anteriorly to the lobule of the ear.
 The artery ends within the parotid gland by dividing into the superficial temporal artery and the
maxillary artery. It gives rise to six branches in total:
 Superior thyroid artery
 Lingual artery
 Facial artery
 Ascending pharyngeal artery
 Occipital artery
 Posterior auricular artery
 The facial, maxillary and superficial temporal arteries are the major branches of note. The maxillary
artery supplies the deep structures of the face, while the facial and superficial temporal arteries
generally supply superficial areas of the face.

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Branches of external carotid artery

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 Internal Carotid Artery
 The internal carotid arteries do not supply any structures in the neck, entering the
cranial cavity via the carotid canal in the petrous part of the temporal bone. Within
the cranial cavity, the internal carotid artery supplies:
 The brain
 Eyes
 Forehead

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 Vertebral Arteries
 The vertebral arteries are paired vessels which arise from the subclavian arteries, just
medial to the anterior scalenes. They ascend the posterior aspect of the neck, passing
through holes in the transverse processes of the cervical vertebrae (known as foramen
transversarium).
 The vertebral arteries enter the cranium via the foramen magnum and converge to
form the basilar artery – which continues to supply the brain. The vertebral arteries do
not supply any branches to the neck or other extra-cranial structures.

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Blood supply to the brain via the vertebral arteries

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Superior and inferior vena cavae

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 Superior vena cava(SVC)

 Superior vena cava is formed by the coalesces of the right and left brachio
cephalic veins
 Brachiocephlic veins are formed by internal jugular vein and subclavian
vein
 Internal jugular vein along with external jugular vein drains the head and
neck region.
 External jugular vein drains into the subclavian vein
 Basalic vein on the medial side of the arm and Cephalic vein on the lateral
side of arm are the major veins draining the upper limb.
 this two veins are connected by median cubital vein at cubital fossa
 Median cubital vein is common site for veins' blood supple withdrawal
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Inferior Vena cava(IVC)
 IVC is formed by the
coalescence of right and left
common iliac veins
 Common iliac vein is formed
when internal and external
iliac vein merges

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Lymphatic system
Objectives :-
 the components of the
lymphatic system, their
structure and their clinical
correlations.

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 Lymphatic system
 The lymphatic system is a series
of vessels and nodes that collect
and filter excess tissue fluid
(lymph), before returning it to the
venous circulation. It forms a
vital part of the body’s immune
defense.

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Lymphatic organs

Primary lymphatic organs :- formation and maturation of lymphocyte takes place

 Bone marrow – all blood cell are formed here
 Thymus gland – pre- T cell from bone marrow matures here.

Secondary lymphatic organs- reservoir of lymhpocyts

 Lymph nodes  memory B-cell and plasma cell are produced and filter lymph.
 Spleen hosts lymphocytes and platelet,
 Nodules hosts lymphocytes
 In addition, some lymphatic tissue is located in the tonsils, appendix, and in the
walls of the gastrointestinal tract.
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Lymphatics function
 Drain excess fluid from interstitial space to CVS
 Immunity
 Transport fatty acid and lipid soluble vitamins (A,D,E,K)
 Metastasis of cancer cell commonly takes lymphatic rout
 So knowing the drainage of helps to identify the extent(severity) of the cancer

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Lymph Vessels

 The lymphatic vessels transport lymph fluid around the body. There are two main systems of lymph
vessels – superficial and deep:
 Superficial vessels – arise in the subcutaneous tissue, and tends to accompany venous flow. They
eventually drain into deep vessels.
 Deep vessels – drain the deeper structures of the body, such as the internal organs. They tend
to accompany deep arteries.
 The drainage of lymph begins in lymph channels, which start as blind ended capillaries and gradually
develop into vessels. These vessels travel proximally, draining through several lymph nodes.
 Eventually the vessels empty into lymphatic trunks (also known as collecting vessels) – and these
eventually converge to form the right lymphatic duct and the thoracic duct.
 The right lymphatic duct is responsible for draining the lymph from the upper right quadrant of the
body. This includes the right side of the head and neck, the right side of the thorax and the right upper
limb. The thoracic duct is much larger and drains lymph from the rest of the body. These two ducts
then empty into the venous circulation at the subclavian veins, via the right and left venous angles.

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Lymph Nodes
 Lymph nodes are kidney shaped structures which act to filter foreign particles from the
blood, and play an important role in the immune response to infection.
 On average, an adult has around 400 to 450 different lymph nodes spread throughout the
body – with the majority located within the abdomen.

 Each node contains T lymphocytes, B lymphocytes, and other immune cells. They are
exposed to the fluid as it passes through the node, and can mount an immune response if
they detect the presence of a pathogen. This immune response often recruits more
inflammatory cells into the node – which is why lymph nodes are palpable during infection.

 Lymph fluid enters the node through afferent lymphatic channels and leaves the node via
efferent channels. Macrophages located within the sinuses of the lymph node act to filter
foreign particles out of the fluid as it travels through.

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Lymph nodes

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Cont

 They are capsulated

 Afferent lymphatic vessels blends with capsule and drain in to trabecula
 Efferent lymphatic vessels exit lymph node via the hilum.
 Lymph nodes have cortex and medulla
 Cortex hosts nodules where B-cells, dendritic cell and macrophages resides
 Medulla hosts T-cell and macrophages

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Major lymphatic node groups

 Popliteal
 Inguinal
 Iliac
 Mammary
 Axillary
 cervical

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Spleen

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 Cont….

 Spleens are located in the left hypochondria b/n

diaphragm and stomach
 It has hilum through w/h blood vessels inter and
exits
 Has grooved superior border and smoot inferior
border
 Has gastric ,renal and colic impression on its
inferior surface made by stomach, kidney and
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colon(splenic flexure)
 Cont
 Spleen has white pulp
 Surrounding the central artery
 composed of lymphatic tissues
 Red pulp
 Composed of splenic cord and sinusoid
 Splenic macrophages resides hear
 Function as site of platelets storage and
clean up worn out RBCs

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Nodules/ mucosa associated lymphatic tissue (MALT)

Palatine tonsils
 Nodules are un-capsulated lymphatic tissue
 Hence not considered as organs
 Scatered under mucosal lamina proper.
 Some are aggregated as mass
 Eg- tonsils and payers patch

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Thymus
 The thymus is a lobulated
lymphoid organ situated behind
the sternum and the upper four
costal cartilages, in the anterior
and superior mediastinum
 After puberty, the thymus
undergoes gradual involution and
is largely replaced by fat.

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 Tonsils
 Usually there are five tonsils, which form a ring at the junction of the oral cavity and oropharynx and at the
junction of the nasal cavity and nasopharynx
 The tonsils are strategically positioned to participate in immune responses against inhaled or ingested foreign
substances.
 The single pharyngeal tonsil or adenoid is embedded in the posterior wall of the nasopharynx

 The
two palatine tonsils lie at the posterior region of the oral cavity, one on either side; these are the tonsils
commonly removed in a tonsillectomy

 The paired lingual tonsils located at the base of the tongue, may also require removal during a tonsillectomy

 Tonsils do not filter lymph

 Tonsils contribute to the formation of lymphocytes

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Tonsil Anatomy

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