LYMPH
LYMPHATIC VESSELS
LYMPHOID TISSUE
LYMPHOCYTES
LYMPHATIC DRAINAGE
LYMPHATIC TISSUE
• NON CAPSULATED
• DIFFUSE LYMPHATIC TISSUE
• LYMPHATIC NODULES
• CAPSULATED
• LYMPH NODES
• SPLEEN
• THYMUS
LYMPHATIC FUNCTIONS
 LYMPHATIC VESSELS- Drain from
tissue spaces protein containing fluid that
escapes from blood capillaries
 LYMPH NODES- Filter lymph of foreign
substances through phagocytosis by
macrophages;T-cells that destroy directly or
indirectly
 TONSILS- Produce lymphocytes and
antibodies
LYMPHATIC
FUNCTIONS(CONTD)
– SPLEEN- Produces antibody producing
plasma cells.Stores and releases blood
– THYMUS GLAND- Produces t—cells
that destroy microbes directly or
indirectly
LYMPHATIC VESSELS
•
ORIGINATE BETWEEN TISSUE SPACES AS
MICROSCOPIC VESSELS
• THEY ORIGINATE THROUGHOUT THE BODY BUT
NOT IN
AVASCULAR TISSUE
CNS
SPLEENIC PULP
BONE MARROW
DIFFERENCE B/W LYMPHATIC VESSEL
AND BLOOD VESSEL
• LYMPHATIC
VESSEL
BLOOD VESSEL
•
•
•
•
 SMALLER
 LESS PERMEABLE
 DO NOT END
BLINDLY. THEY
HAVE ARTERIAL
END AND VENOUS
END
 BIDIRECTIONAL
SLIGHTLYL LARGER
MORE PERMEABLE
ENDS BLINDLY
FLUID FLOW
UNIDIRECTIONAL
• HAVE THINNER
WALLS,MORE
VALVES,CONTAIN
LYMPH NODES AT
VARIOUS INTERVALS
• Lymphnodes are
encapsulated centres of
lymphocyte differetiation
and proliferation
FUNCTIONS
 Generate mature and prime B and T cells
 Add antibodies to circulation
 Filter particles, microbes from lymph
LYMPH NODE
• OVAL OR BEAN SHAPED
• LOCATED ALONG THE LENTH OF LYMPH
VESSEL
• LYMPH NODE OF HEAD AND NECK
• 2 GROUPS: .CIRCULAR
.OUTER CIRCLE
.INNER CIRCLE
.CERVICAL
LYMPH NODE(CONTD)
OUTERCIRCLE:






SUBMENTAL
SUBMANDIBULAR
BUCCAL
POST AURICULAR
PRE AURICULAR
OCCIPITAL
INNER CIRCLE:
 RETROPHARYNGEAL
 PRETRACHEAL
 PARATRACHEAL
LYMPH NODE(CONTD)
• CERVICAL :
-SUPERFICIAL
-DEEP
Jugulodigastric
Juguloomohyoid
Causes of cervical lymphadenopathy
• I . INFECTION
•
BACTERIAL / VIRAL / PARASITIC
1.
Adenovirus
2.
CMV
3.
Enterovirus
4.
EBV
5.
Herpes simplex
6.
Staphlococcus infection
7.
Cat Scratch Diseas
II. NEOPLASIA
1.
Hodgkin's disease
2.
Lymphomas
3.
Leukemia
4.
Metastatic disease
PRIMARY
• III. MISCELANIOUS
SARCOIDOSIS / DRUG REACTION/C T
DISEASES
• SLE
CLINICAL EXAMINATION OF
LYMPH NODE
• EXTRA ORAL, BIDIGITAL PALPATION
BIMANUAL PALPATION
•
DO NOT EXTEND THE NECK AS
STERNOCLEIDO MASTOID MUSCLE SHOULD
BE RELAXED WHILE PALPATING
C/E OF LYMPH
NODE(CONTD)
IF A NODE IS PALPABLE, NOTE ITS
.SITE
.SIZE
.NUMBER
.TEXTURE
.TENDERNESS
.FIXATION TO SURROUNDING
TISSUE
.MATTING/COALSCENCE
Investigations
• HISTORY
• CLINICAL EXAMINATION
– TEMP/ DRAINAGE/ DENTAL & MUCOSAL /ENT
• SPECIAL INVESTIGATION
– BLOOD PICTURE
– CHEST X RAY
– SEROLOGY
– KVIEM TEST
– MANTOUX TEST
– FNAC / FNAB
– BIOPSY
C/E OF LYMPH NODE [ differential
diagnosis]
PALPABLE NODE CHARACTERISTICS
 ACUTE INFECTION—LARGE,SOFT AND TENDER
 CHRONIC INFECTION—LARGE,FIRM,LESS
TENDER,MOBILE
 LYMPHOMA—RUBBERY HARD,PAINLESS
MULTIPLE
 TUBERCULOSIS—MULTIPLE,MATTED
 MALIGNANCY—STONY HARD AND FIXED