home Adviсe Lymphatic system. Myths and reality. The vital role of the lymphatic system What organs are included in the lymphatic system

Lymphatic system. Myths and reality. The vital role of the lymphatic system What organs are included in the lymphatic system

Lymphatic system – an integral part of the vascular system, which drains tissues through the formation of lymph and conducts it into the venous bed (additional drainage system).

Up to 2 liters of lymph are produced per day, which corresponds to 10% of the volume of fluid that is not reabsorbed after filtration in the capillaries.

Lymph is the fluid that fills the lymphatic vessels and nodes. It, like blood, belongs to the tissues of the internal environment and performs trophic and protective functions in the body. In its properties, despite its great similarity with blood, lymph differs from it. At the same time, lymph is not identical to the tissue fluid from which it is formed.

Lymph consists of plasma and formed elements. Its plasma contains proteins, salts, sugar, cholesterol and other substances. The protein content in lymph is 8-10 times less than in blood. 80% of the formed elements of lymph are lymphocytes, and the remaining 20% are other white blood cells. There are normally no red blood cells in lymph.

Functions of the lymphatic system:

Tissue drainage.

Ensuring continuous circulation of fluid and metabolism in human organs and tissues. Prevents the accumulation of fluid in the tissue space with increased filtration in the capillaries.

Lymphopoiesis.

Transports fats from the site of absorption in the small intestine.

Removal from the interstitial space of substances and particles that are not reabsorbed in the blood capillaries.

Spread of infection and malignant cells (tumor metastasis)

Factors ensuring lymph movement

Filtration pressure (caused by the filtration of fluid from blood capillaries into the intercellular space).

Constant formation of lymph.

Availability of valves.

Contraction of surrounding skeletal muscles and muscular elements of internal organs (lymphatic vessels are compressed and lymph moves in the direction determined by the valves).

The location of large lymphatic vessels and trunks near blood vessels (the pulsation of the artery compresses the walls of the lymphatic vessels and helps the flow of lymph).

Suction action of the chest and negative pressure in the brachiocephalic veins.

Smooth muscle cells in the walls of lymphatic vessels and trunks .

Table 7

Similarities and differences in the structure of the lymphatic and venous systems

Lymphatic capillaries– thin-walled vessels, the diameter of which (10-200 microns) exceeds the diameter of blood capillaries (8-10 microns). Lymphatic capillaries are characterized by tortuosity, the presence of narrowings and expansions, lateral protrusions, the formation of lymphatic “lakes” and “lacunae” at the confluence of several capillaries.

The wall of the lymphatic capillaries is built from a single layer of endothelial cells (in the blood capillaries there is a basement membrane outside the endothelium).

Lymphatic capillaries No in the substance and membranes of the brain, cornea and lens of the eyeball, spleen parenchyma, bone marrow, cartilage, epithelium of the skin and mucous membranes, placenta, pituitary gland.

Lymphatic postcapillaries– an intermediate link between lymphatic capillaries and vessels. The transition of the lymphatic capillary to the lymphatic postcapillary is determined by the first valve in the lumen (the valves of the lymphatic vessels are paired folds of the endothelium and the underlying basement membrane lying opposite each other). Lymphatic postcapillaries have all the functions of capillaries, but lymph flows through them only in one direction.

Lymphatic vessels are formed from networks of lymphatic postcapillaries (capillaries). The transition of a lymphatic capillary into a lymphatic vessel is determined by a change in the structure of the wall: along with the endothelium, it contains smooth muscle cells and adventitia, and in the lumen there are valves. Therefore, lymph can flow through the vessels only in one direction. The area of the lymphatic vessel between the valves is currently designated by the term "lymphangion" (Fig. 58).

Rice. 58. Lymphangion is a morphofunctional unit of a lymphatic vessel:

1 – segment of the lymphatic vessel with valves.

Depending on the location above or below the superficial fascia, lymphatic vessels are divided into superficial and deep. Superficial lymphatic vessels lie in the subcutaneous fat above the superficial fascia. Most of them go to the lymph nodes located near the superficial veins.

There are also intraorgan and extraorgan lymphatic vessels. Due to the existence of numerous anastomoses, intraorgan lymphatic vessels form wide-loop plexuses. The lymphatic vessels emerging from these plexuses accompany the arteries, veins and exit the organ. Extraorgan lymphatic vessels are directed to nearby groups of regional lymph nodes, usually accompanying blood vessels, often veins.

Along the path of the lymphatic vessels there are The lymph nodes. This is what causes foreign particles, tumor cells, etc. are retained in one of the regional lymph nodes. The exceptions are some lymphatic vessels of the esophagus and, in isolated cases, some vessels of the liver, which flow into the thoracic duct, bypassing the lymph nodes.

Regional lymph nodes organs or tissues are lymph nodes that are the first on the path of lymphatic vessels carrying lymph from a given area of the body.

Lymphatic trunks- these are large lymphatic vessels that are no longer interrupted by lymph nodes. They collect lymph from several areas of the body or several organs.

There are four permanent paired lymphatic trunks in the human body.

Jugular trunk(right and left) is represented by one or several vessels of small length. It is formed from the efferent lymphatic vessels of the lower lateral deep cervical lymph nodes, located in a chain along the internal jugular vein. Each of them drains lymph from the organs and tissues of the corresponding sides of the head and neck.

Subclavian trunk(right and left) is formed from the fusion of the efferent lymphatic vessels of the axillary lymph nodes, mainly the apical ones. It collects lymph from the upper limb, from the walls of the chest and mammary gland.

Bronchomediastinal trunk(right and left) is formed mainly from the efferent lymphatic vessels of the anterior mediastinal and superior tracheobronchial lymph nodes. It carries lymph away from the walls and organs of the chest cavity.

The efferent lymphatic vessels of the upper lumbar lymph nodes form the right and left lumbar trunks, which drain lymph from the lower limb, walls and organs of the pelvis and abdomen.

A non-permanent intestinal lymphatic trunk occurs in approximately 25% of cases. It is formed from the efferent lymphatic vessels of the mesenteric lymph nodes and 1-3 vessels flow into the initial (abdominal) part of the thoracic duct.

Rice. 59. Basin of the thoracic lymphatic duct.

1 – superior vena cava;

2 – right brachiocephalic vein;

3 – left brachiocephalic vein;

4 – right internal jugular vein;

5 – right subclavian vein;

6 – left internal jugular vein;

7 – left subclavian vein;

8 – azygos vein;

9 – hemizygos vein;

10 – inferior vena cava;

11 – right lymphatic duct;

12 – cistern of the thoracic duct;

13 – thoracic duct;

14 – intestinal trunk;

15 – lumbar lymphatic trunks

The lymphatic trunks flow into two ducts: the thoracic duct (Fig. 59) and the right lymphatic duct, which flow into the veins of the neck in the area of the so-called venous angle, formed by the connection of the subclavian and internal jugular veins. The thoracic lymphatic duct flows into the left venous angle, through which lymph flows from 3/4 of the human body: from the lower extremities, pelvis, abdomen, left half of the chest, neck and head, left upper extremity. The right lymphatic duct flows into the right venous angle, which brings lymph from 1/4 of the body: from the right half of the chest, neck, head, and from the right upper limb.

Thoracic duct (ductus thoracicus) has a length of 30-45 cm, is formed at the level of the XI thoracic – 1st lumbar vertebrae by the fusion of the right and left lumbar trunks (trunci lumbales dexter et sinister). Sometimes at the beginning the thoracic duct has extension (cisterna chyli). The thoracic duct is formed in the abdominal cavity and passes into the chest cavity through the aortic opening of the diaphragm, where it is located between the aorta and the right medial crus of the diaphragm, the contractions of which help push lymph into the thoracic part of the duct. At the level of the VII cervical vertebra, the thoracic duct forms an arc and, going around the left subclavian artery, flows into the left venous angle or the veins that form it. At the mouth of the duct there is a semilunar valve that prevents blood from entering the duct from the vein. The left bronchomediastinal trunk (truncus bronchomediastinalis sinister), which collects lymph from the left half of the chest, flows into the upper part of the thoracic duct, as well as the left subclavian trunk (truncus subclavius sinister), which collects lymph from the left upper limb and the left jugular trunk (truncus jugularis sinister), which carries lymph from the left half of the head and neck.

Right lymphatic duct (ductus lymphaticus dexter) 1-1.5 cm long, is being formed at the fusion of the right subclavian trunk (truncus subclavius dexter), carrying lymph from the right upper limb, the right jugular trunk (truncus jugularis dexter), collecting lymph from the right half of the head and neck, the right bronchomediastinal trunk (truncus bronchomediastinalis dexter), bringing lymph from the right half of the chest. However, more often the right lymphatic duct is absent, and the trunks that form it flow into the right venous angle independently.

Lymph nodes of individual areas of the body.

Head and neck

In the head area there are many groups of lymph nodes (Fig. 60): occipital, mastoid, facial, parotid, submandibular, submental, etc. Each group of nodes receives lymphatic vessels from the area closest to its location.

Thus, the submandibular nodes lie in the submandibular triangle and collect lymph from the chin, lips, cheeks, teeth, gums, palate, lower eyelid, nose, submandibular and sublingual salivary glands. Lymph flows from the forehead, temple, upper eyelid, auricle, and walls of the external auditory canal into the parotid lymph nodes, located on the surface and in the thickness of the gland of the same name.

Fig.60. Lymphatic system of the head and neck.

1 – anterior ear lymph nodes; 2 – posterior ear lymph nodes; 3 – occipital lymph nodes; 4 – lower ear lymph nodes; 5 – buccal lymph nodes; 6 – mental lymph nodes; 7 – posterior submandibular lymph nodes; 8 – anterior submandibular lymph nodes; 9 – lower submandibular lymph nodes; 10 – superficial cervical lymph nodes

There are two main groups of lymph nodes in the neck: deep and superficial cervical. Deep cervical lymph nodes accompany the internal jugular vein in large numbers, and superficial ones lie near the external jugular vein. In these nodes, mainly in the deep cervical nodes, there is an outflow of lymph from almost all the lymphatic vessels of the head and neck, including the efferent vessels of other lymph nodes in these areas.

Upper limb

There are two main groups of lymph nodes in the upper limb: ulnar and axillary. The ulnar nodes lie in the cubital fossa and receive lymph from some of the vessels of the hand and forearm. Through the efferent vessels of these nodes, lymph flows into the axillary nodes. The axillary lymph nodes are located in the fossa of the same name, one part of them lies superficially in the subcutaneous tissue, the other in the depths near the axillary arteries and veins. Lymph flows into these nodes from the upper limb, as well as from the mammary gland, from the superficial lymphatic vessels of the chest and the upper part of the anterior abdominal wall.

Thoracic cavity

In the chest cavity, the lymph nodes are located in the anterior and posterior mediastinum (anterior and posterior mediastinal), near the trachea (peritracheal), in the area of the tracheal bifurcation (tracheobronchial), at the gates of the lung (bronchopulmonary), in the lung itself (pulmonary), and also on the diaphragm (upper diaphragmatic), near the heads of the ribs (intercostal), near the sternum (periosternal), etc. Lymph flows from the organs and partially from the walls of the chest cavity into these nodes.

Lower limb

On the lower limb, the main groups of lymph nodes are popliteal and inguinal. The popliteal nodes are located in the fossa of the same name near the popliteal artery and vein. These nodes receive lymph from part of the lymphatic vessels of the foot and leg. The efferent vessels of the popliteal nodes carry lymph mainly to the inguinal nodes.

Inguinal lymph nodes are divided into superficial and deep. The superficial inguinal nodes lie below the inguinal ligament under the skin of the thigh on top of the fascia, and the deep inguinal nodes lie in the same area, but under the fascia near the femoral vein. Lymph flows into the inguinal lymph nodes from the lower limb, as well as from the lower half of the anterior abdominal wall, perineum, from the superficial lymphatic vessels of the gluteal region and lower back. From the inguinal lymph nodes, lymph flows into the external iliac nodes, which are related to the pelvic nodes.

In the pelvis, the lymph nodes are located, as a rule, along the blood vessels and have a similar name (Fig. 61). Thus, the external iliac, internal iliac and common iliac nodes lie near the arteries of the same name, and the sacral nodes lie on the pelvic surface of the sacrum, near the median sacral artery. Lymph from the pelvic organs flows mainly into the internal iliac and sacral lymph nodes.

Rice. 61. Lymph nodes of the pelvis and the vessels connecting them.

1 – uterus; 2 – right common iliac artery; 3 – lumbar lymph nodes; 4 – iliac lymph nodes; 5 – inguinal lymph nodes

Abdominal cavity

There are a large number of lymph nodes in the abdominal cavity. They are located along the blood vessels, including the vessels passing through the hilum of the organs. So, along the abdominal aorta and inferior vena cava near the lumbar spine there are up to 50 lymph nodes (lumbar). In the mesentery of the small intestine, along the branches of the superior mesenteric artery, there are up to 200 nodes (superior mesenteric). There are also lymph nodes: celiac (near the celiac trunk), left gastric (along the greater curvature of the stomach), right gastric (along the lesser curvature of the stomach), hepatic (in the area of the hilum of the liver), etc. Lymph from the organs flows into the lymph nodes of the abdominal cavity. located in this cavity, and partly from its walls. The lumbar lymph nodes also receive lymph from the lower extremities and pelvis. It should be noted that the lymphatic vessels of the small intestine are called lacteal, since lymph flows through them, containing fat absorbed in the intestine, which gives the lymph the appearance of a milky emulsion - hilus (hilus - milky juice).

In our article today:

Introduction.

To maintain life, along with the supply of nutrients, energy resources and oxygen, it is also necessary to remove metabolites and toxic substances from tissues. It has been experimentally established that with complete fasting (only with water intake), humans and higher Animals can live for 10-20 days, whereas if excretory dysfunction occurs, death occurs within the first day.

In addition to the kidneys, the lungs, intestines, and sweat glands also perform excretory functions. In Ancient Egypt, when meeting friends, instead of “how are you?” asked each other: “How do you sweat?” It is known that with profuse sweating, the body is freed from many toxins, and this is very important for health. Previously, it was believed that the removal of metabolites and toxic substances from the body mainly relates to the function of the blood flowing through one or another excretory system.

It has now been established that excretory and many other functions of the body are closely related not only to blood, but also to lymph. Removing toxic substances from the body in various ways is possible with the coordinated operation of a single drainage system - the lymphovenous bed. The scientific study of lymph goes back at least three hundred years. However, intensive study of it began relatively recently.

It has now been established that lymph circulation performs numerous important functions, and its disruption leads to the development of severe complications and aggravates the course of many diseases. Today, opportunities have been found to influence the course and development of various pathological processes in the body through the lymphatic system. Effects on the lymphatic system have become widely used in immunology, oncology, cardiology, toxicology, and traumatology. There was even a new term - “lymphotherapy”. Endolymphatic administration of various drugs is widely used in medical practice. In various pathological processes, endo- and exotoxins enter the lymph much faster than the blood. The high efficiency of removing “poisoned lymph” from the body through a catheterized thoracic duct (for various types of intoxication, burns, damage to the liver and pancreas, thrombosis, peritonitis, myocardial infarction, extreme and terminal conditions) has been proven both experimentally and in the clinic.

One of the secrets of the lymphatic system has been revealed - its role in the body's immune reactions. There is an assumption that the lymphatic system is a morphological synonym of the immune system, and lymphocytes are its leading link. The presence of two independent, but jointly creating immunological reactions, T- and B-lymphocytes was discovered. Today, lymphology is developing rapidly. Stimulation of lymphatic tissue drainage is assessed as one of the principles of pathogenetic therapy for a wide variety of (especially severe) diseases.

Lymph of a healthy person.

What is lymph?

It is believed that the aquatic environment is the basis of all processes occurring in the body, and maintaining its constancy is the basis of homeostasis. When talking about a liquid medium, we usually mean blood, which is functionally connected to all tissues and cells of the body. It provides tissues and organs with oxygen, nutritional, plastic material, promotes the removal of toxic and unnecessary metabolic products from the body, carries out neurohumoral function and thermoregulation.

The protein fraction of blood is vital. Its gamma globulin fraction, for example, is necessary for the biosynthesis of antibodies and enhancing protective mechanisms. All abnormalities in the body are immediately reflected in the blood picture. Along with blood, there are no less important liquid environments in our body - lymph, interstitial, cerebrospinal fluid and others - closely related to blood. The humoral direction, founded by Hippocrates, has been continuously modified over the course of twenty centuries of history, acquiring the modern form of the doctrine of humoral environments and humoral transport. It is generally accepted that the humoral transport system, including general blood circulation and movement in the “blood - tissue - lymph - blood” chain, is functionally unified.

Lymph (translated as clean water, moisture) is a transparent liquid of a slightly yellowish color, a cloying odor and a salty taste. Some researchers call lymph only the liquid that is located in the lumen of the lymphatic tract (lymphatic capillaries, vessels and sinuses of the lymph nodes). Lymph is an interstitial fluid separated from the interstitium by a highly permeable layer of endothelium. It plays an essential role in maintaining the balance of tissue fluids.

This is where the concept of tissue lymph comes from. A potential lymph-forming substrate is the interstitial fluid. In the ground substance, in the networks of collagen and elastic fibers, there are fixed and mobile elements of the interstitial tissue: pericytes, macrophages, fibrocytes (collagen producers), endothelial cells, lymphocytes, etc. All of them participate in certain processes that ensure the normal functioning of the microcirculation system, metabolism substances, production of vasoactive amines, mobility of interstitial substances, protective reactions of the body. The composition of lymph changes not only depending on the state of the body, but also on the functions of the organ from which it flows.

The amount of lymph in the body is not precisely determined. It is believed that the lymphatic vessels of a person with a body weight of 60 kg at rest, on an empty stomach, contain 1200-1500 ml of lymph. It primarily consists of lymphocytes (there are up to 20,000 of them in the lymph of the thoracic duct in 1 mm3) - the main protective cells of the body. In a person, 35,546 billion lymphocytes enter the blood through the thoracic duct per day.

The chemical composition of lymphoplasm is close to blood plasma, but contains less protein. There is relatively more albumin in lymph than in blood plasma, since they, having a smaller molecule, diffuse more quickly into the lymphatic capillaries. The lymph of the thoracic duct contains fibrinogen and prothrombin; it coagulates more slowly than blood, forming a loose clot consisting of fibrin strands and white blood cells. Lymph, like blood, contains all the formed elements, except platelets and red blood cells, which enter it during pathological conditions (shock, tumor growth, inflammation, etc.). In terms of mineral composition, lymph also resembles blood plasma. In first place is sodium chloride (67% solid residue), which gives the lymph a salty taste. Sodium carbonate accounts for 25%. Calcium, magnesium, and iron ions are also present in the lymph (in small quantities). The main cations of lymph are sodium, potassium, calcium, magnesium, anions are chlorine, phosphorus and protein, which behaves like an anion in the alkaline environment of lymph. In samples of peripheral lymph, many microelements were found that are of great importance in the physiology and pathology of the body.

To date, the presence of a special lymphatic system has been established, which includes lymph nodes, follicles, tonsils, spleen, thymus (thymus gland). The main functioning element of the lymphatic system is the lymphocyte. In an adult, lymphocytes circulating in the blood make up about 30% of the total number of leukocytes (in children under 5 years old - about 50%). Mature (small) lymphocytes make up the bulk of lymphoid tissue and over 95% of lymph cells.

Particular attention should be paid to the role of the thymus. It was experimentally established that as a result of removal of the thymus in a newborn animal, the lymphatic system did not develop. Such animals constantly suffered from intestinal disorders, inflammation, various infections, and after a while they inevitably died. It turned out that removal of the thymus led to the almost complete disappearance of lymphocytes from the blood - cells that play a leading role in the body's defense reactions.

In newborn animals, this caused a few weeks later a complex of phenomena known as “wasting disease” (severe aplasia of lymphoid tissue, cachexia, lethargy, diarrhea). If the thymus was transplanted into experimental animals, their immune system was restored.

The main morphological substrate of immunogenesis is lymphoid organs. In cases where the liver, kidneys, and skin exhibit immunological activity, there are serious reasons to attribute this activity not to the specific parenchyma of these organs, but to the lymphoid or undifferentiated mesenchymal cells that have penetrated into them. When the thymus is weak, pneumonia develops, influenza and other diseases become severe.

The thymus differs from other organs of the lymphatic system in a number of histological features. The lymphoid elements that mainly make up the thymus are morphologically identical to peripheral blood lymphocytes, but differ from the latter in the nature of their response to physical, chemical, hormonal and immunological influences and to infection. The totality of lymphoid organs in the conditions of a whole organism functions as a single system. The unity of this system is ensured by two main factors: 1) general hormonal and, probably, neuroreflex regulation; 2) special functional connections between individual lymphoid organs.

There is a clear specialization in the lymphoid organ system. The first, and sometimes the only object of action of the antigen and, accordingly, the antibody-producing organ are the regional lymph nodes. It has been shown that with the introduction of antigens, the amount of antibodies increases in the regional lymph nodes, and at an earlier date, in a higher titer than in the blood serum. Sometimes a similar function can be performed by accumulations of lymphoid tissue or undifferentiated mesenchymal cells directly at the site of invasion of the antigenic factor (in the intestines, lungs, etc.). If a significant dose of antigen, without being retained by a regional node, penetrates into the blood, the spleen, distant lymph nodes, lymphoid elements of the bone marrow, etc. are also included in the process of antibody formation.

Cells of the lymphoid type are found in all vertebrates. However, only in higher vertebrates is lymphoid tissue clearly separated from myeloid tissue. One can therefore think that the single lymphomyeloid hematopoiesis observed in higher vertebrates in the embryonic period represents a kind of recapitulation. The new stage in the development of lymphoid tissue was due to the emergence and improvement of the body’s special drainage system - lymphatic vessels.

The reduced (compared to blood) content of leukocytes and antibodies in the lymph, the initial distance of the lymphatic vessels from the main accumulations of lymphoid tissue, the ease of spread of infectious agents throughout the body with the flow of lymph - all this required the emergence of lymph nodes. Their appearance contributed to the protection constancy of the internal environment of the body not only due to the inherent barrier function of the lymph nodes, but also due to the fact that the body now had the opportunity to develop means of specific immunological defense (antibodies, sensitized lymphocytes) in response to a local antigenic stimulus before the infectious agent enters the bloodstream.

The place of formation of lymph, the roots of the lymphatic system are the lymphatic capillaries, which, together with post-capillaries, lymphatic vessels, lymph nodes and the main collector trunks, serve as lymphatic pathways. Since the functions of lymphatic vessels and the main collector lymphatic trunks consist only of conducting lymph, and the lymph nodes perform barrier, protective, exchange and reservoir functions, the structure of these sections of the lymphatic pathways differs significantly from each other.

The lymphatic system itself begins with lymphatic capillaries, which are closely connected with blood capillaries. Their diameter is several times larger than blood vessels and reaches 35 microns. The body has reserve capillaries that fill when lymph formation increases. It has been established that there are no lymphatic capillaries and vessels in the brain and spinal cord, meninges, bones, eyeball, cornea, hyaline cartilage, epidermis, and placenta. There are relatively few of them in muscles and dense connective tissue anatomical formations (ligaments, fascia, tendons). They are unevenly distributed in the glands. Lymphatic capillaries form dense networks in the subcutaneous tissue, in the walls of internal organs, serous membranes, and joint capsules.

The architecture of the networks of lymphatic capillaries and plexuses of lymphatic vessels corresponds to the design of organs and their functions, while the processes of lymph formation are determined primarily by the state of permeability of the walls of blood capillaries and lymphatic terminals, and the mobility of the interstitial gel. Unlike blood vessels, movement in lymphatic capillaries is one-way.

Lymphatic capillaries merge and become lymphatic vessels. The larger the lymphatic vessel, the greater the distance from it are the capillaries and venules. Conversely, blood capillaries are almost closely adjacent to thin lymphatic vessels and postcapillaries. Depending on the structure of the middle membrane, lymphatic vessels are divided into two groups: non-muscular and muscular. Amuscular vessels are formed by a layer of endothelial cells, which is surrounded by a connective tissue membrane containing collagen and elastic fibers. Most human lymphatic vessels, especially in the lower half of the body, in the lower extremities, are muscular.

The structure of the lymphatic vessels, as we see, is not the same. This variability can be observed in the structure of even the same vessel in its different sections. The valve system assumes unidirectional lymph flow. However, in pathological conditions, in the presence of an obstruction to the flow of lymph (blocking transport routes, lymph nodes) due to overstretching of blood vessels and insufficiency of valves unable to hold the “column” of lymph, as well as due to a decrease in the contractile activity of the muscular layer of the vessel wall (it is saturated with toxin transudate) the flow of lymph from an undamaged area can cause its reverse flow with the opening of lymphovenous anastomoses or the formation of lymphatic collaterals.

Lymph nodes are located along the path of superficial and deep lymphatic vessels and through them they receive lymph from those tissues, organs or areas of the body in which the vessels originate. Such nodes are called regional or regional. The lymphatic system of mammals is characterized by the presence of a large number of lymph nodes: in a dog, for example, there are on average 60 nodes, and in humans - 460. Some authors consider the lymph node to be a key site of lymph flow. They contain smooth muscle elements and can contract under neurohumoral influences. There are afferent lymphatic vessels, through which lymph flows to the lymph nodes, and efferent vessels, through which lymph flows away. The number of those who bring is greater than the number of those who take out. Lymph nodes and primary nodules lying on the paths of lymph flow not only determine the nature of lymphodynamics, but also leave a significant imprint on the cellular composition of lymph. The circulation of fluid from the blood into the tissues, its movement in the tissues, its entry from the tissues into the blood and lymph - all these are parts of a single system of humoral transport.

Particularly important here is the SAF system (coagulation, anticoagulation, fibrinolysis) in the blood and lymph. By actively influencing the SAF, it is possible to control the movement of fluid from the blood into the tissues and from the tissues into the lymph, which can be important in medical practice.

What ensures the movement of lymph?

It was discovered that amphibians and reptiles have so-called lymphatic hearts - special contractile organs, the walls of which contain muscle elements. The frog has two pairs of “lymphatic hearts”, and the tailed amphibians have 15 paired lateral “lymphatic hearts” and 8-10 “lymphatic hearts” in the scapular, pelvic and other areas. In birds, “lymphatic hearts” can be observed only at the stage of embryonic development, and in mammals there are no such hearts at all. The movement of lymph in them occurs due to the contraction of skeletal muscles, the suction ability of the chest, the movement of large nearby arterial pulsating vessels, etc. Some authors argue that the lymph nodes of warm-blooded animals have taken on the function of the disappeared lymphatic hearts. But it’s hard to agree with this. It should be noted that more lymph flows into the node than flows out. Lymph nodes absorb lymph like a sponge, but do not give it all away; some of the lymph is retained in the node. It is more correct to assume that in warm-blooded animals the lymph nodes are additional organs of lymphopoiesis, which developed in connection with a more intense metabolism. It is believed that the function of the disappeared lymphatic hearts was taken over by the wall of the lymphatic vessel, since only in warm-blooded animals do the lymphatic vessels acquire a characteristic clear-shaped shape with well-developed muscle fibers in the walls and a valve apparatus uniquely designed to regulate the flow of lymph.

An extremely important discovery in the field of lymphodynamics was the discovery of rhythmic pulsation of the thoracic duct in humans. As you can see, lymph circulation is an extremely complex process. The information available in the literature indicates the important role of electrolytes and a number of trace elements in its functioning. For the contractile activity of the muscles of the lymphatic vessels, for example, calcium ions are needed. When they are removed, the mechanical activity of the smooth muscle cells of the lymphatic vessels immediately stops. Manganese ions have an inhibitory effect on the contraction of lymphatic vessels. Lithium and cobalt salts (in doses higher than biotic) expand the lymphatic capillaries, and salts of rubidium, selenium and partly copper (also in doses higher than biotic), increasing the rhythmic contraction of the neuromuscular apparatus of the wall of the lymphatic vessels, accelerate lymph flow.

Unlike the circulatory system, as already mentioned, the lymphatic system is characterized by a unidirectional flow. This circumstance makes it possible to quite accurately determine its initial link - the “fixed reference point”. Lymphatic capillaries should be considered such an initial point, since only their contents fully correspond to the term “lymph”. In humans, the central collector of lymph is the thoracic duct. Numerous lymphatic vessels flow into it, collecting lymph from the lower extremities, pelvis, abdomen, left half of the chest, from the heart and left lung, from the left upper limb, from the left half of the head and neck. This main lymph collector is supplemented by the right lymphatic duct, which is formed from the confluent lymphatic vessels of the right half of the head, neck, chest and right upper limb. It drains into the right venous angle. In a biological sense, the lymphatic system is considered closed (closed), but communicates with the circulatory system at the confluence of the thoracic and right lymphatic ducts.

Basic functions of the lymphatic system.

The primary task of the lymphatic system, as well as the circulatory system, is to provide all organs and tissues of the body with nutritional, energy and plastic materials and remove metabolites and toxic substances from there. The lymphatic system is not only transport, but also a physiologically active link; it makes its own independent, far from unambiguous contribution to the composition and condition of products transported through the vessels.

It plays a particularly important role concentration, barrier, immune functions, which may be influenced by SAF factors. The lymphatic system takes an active part in the metabolism of proteins, fats, vitamins, etc. The participation of lymph nodes in the processes of digestion and metabolism is obviously determined phylogenetically - throughout the evolution of vertebrates, the association of lymphatic tissue with the digestive canal can be traced.

Feeding animals a diet rich in fat causes hypertrophy of all lymphatic tissues, especially the tonsils, lymph nodes and intestinal follicles. There was an increase in the number of free macrophages with trapped fat. Fasting leads to a decrease in the number of lymphocytes, and the fat content in the nodes decreases.

Lymph nodes are also involved in protein metabolism and in the production of a number of blood proteins (including immunoglobulins). An increase in protein concentration was noted during the passage of lymph through the lymphatic vessels, especially at low speed. The participation of lymphatic capillaries and postcapillaries in metabolism is predetermined by their orientation and location in vascular microstructures. They are located in areas of maximum filtration of liquids and substances - in the area of the venular section of the capillary network and post-capillary segments of venules.

Of particular interest is the study of the endothelium of lymphatic capillaries in a number of diseases when metabolic processes and the permeability of vascular membranes are disrupted. In such cases, the released protein permeates the ground substance of the connective tissue structures surrounding the capillaries. The main point that causes a number of pathological changes with increased capillary permeability is the blockade of active elements of connective tissue that extend beyond the vascular walls. Violation of the permeability of the walls of blood capillaries and other parts of the microvasculature entails disordered transport of fluids, blood cells pass into the tissues, and then into the lumen of the lymphatic capillaries.

Almost all lymphoid organs (with the exception of the thymus) have a barrier function - the ability to retain and, if possible, neutralize foreign particles and substances entering the organ. Due to the special structure of lymphoid organs and the phagocytic activity of their cells, most lymphoid organs retain and neutralize bacteria that have entered the lymph. The importance of the lymph nodes is especially great, they fix microorganisms even before they enter the bloodstream and are therefore a kind of “first line of defense” of the body. The barrier function of lymphoid organs, being a nonspecific factor of immunity, is at the same time a necessary prerequisite for the formation of a specific immunological reaction of a given organ and the entire organism as a whole.

The lymph nodes also absorb other foreign substances. Some of them (mascara, thorium, oily products) linger in the lymph nodes forever. Even direct rinsing of the nodes does not help. Numerous facts show that lymph nodes play the role of a biological rather than a mechanical filter. However, in cases where the cellular and humoral resources of a given organ and the entire organism as a whole are insufficient to neutralize the pathogenic factor, the barrier function turns out to be unfavorable: the lymphoid organ becomes a reservoir, a source of real danger. Let's take, for example, chronic tonsillitis, foci of infection in the lymph nodes due to tuberculosis, brucellosis, metastasis to regional nodes of tumor cells, etc.

The endothelium of lymphatic capillaries is extremely sensitive to mechanical, chemical, temperature and other influences and responds to them by changing permeability. Endothelial cells are capable of adsorbing protein particles, lipids and other substances. This property of cells is very important, as it is aimed at ensuring the absorption of liquid with toxins dissolved in it, as well as the absorption of foreign particles, bacteria, and viruses.

The formation of lymphocytes occurs in the tissue of the nodes. They enter the lymph flow, and then through the thoracic and right lymphatic ducts into the blood. The number of lymphocytes in the lymph flowing from the lymph node is greater than in the incoming one.

Lymph and the body's immune system.

It has long been known that the body’s protective function largely depends on the lymphatic system. This question was first developed by the outstanding Russian scientist I.I. Mechnikov. He explained immunity by the phenomenon of intracellular digestion of microbes and called this process phagocytosis. Subsequently, humoral factors of immunity were identified, which primarily include antibodies. The active participation of lymphoid organs has also been established in the implementation of humoral immunity factors. It has now been established that phagocytosis (the main nonspecific factor) and antibodies (the main specific factors of immunity) act together and form the basis of immunological resistance.

The central figure of the immune system is the lymphocyte, and the substrate for the formation of specific immunological reactions is lymphoid tissue. The totality of human lymphoid organs and tissues is the thymus gland (thymus), spleen, lymph nodes, group lymphatic follicles and other lymphoid accumulations, bone marrow and peripheral blood lymphocytes. The leading function of lymphoid organs is maintaining a constant internal environment of the body.

The bulk of lymphocytes are formed in the lymph nodes and lymphatic follicles of the digestive tract. In addition, they can be produced in the spleen, thymus and bone marrow.

The nature and degree of participation of various lymphoid organs in immunological processes varies. Some lymphoid organs (lymph nodes, spleen) are a direct substrate of the process of immunogenesis, others (thymus gland, bursa of Fabricius) participate in them indirectly, regulating the immunoreactivity of the lymph nodes and spleen.

Lymphoid cells are capable of performing their characteristic immunological function autonomously, sometimes even against other cells of the organism in which they are located. At the same time, the level of their immunoreactivity is regulated by hormonal and, possibly, reflex mechanisms.

A number of studies have shown the ability of large lymphocytes and cells of germinal centers of lymphoid tissue to produce antibodies, normal gammaglobulins, and macroglobulins. The question of the ability of small lymphocytes to produce antibodies remains controversial. It is believed that the main precursors of cells that synthesize antibodies are immature cells of lymphoid tissue: hematocytoblasts and lymphoblasts (large lymphocytes). It is unclear, however, whether these cells are the target of the antigen or an intermediate link in the chain of cellular transformations. Large lymphocytes store immunological information (memory) about a previous antigenic stimulus for at least 600 cell generations.

Lymphoid organs after primary immunization acquire a specifically increased reactivity to this antigen. The expression of this altered immunoreactivity is, firstly, the ability to respond to smaller doses of antigen and, secondly, more rapid and vigorous formation of antibodies (revaccination effect). Increased immunoreactivity as a result of previous contact with the antigen is the main factor in delayed-type allergic reactions. The immunological memory of lymphoid cells is an essential factor in the body's anti-infective defense.

Recent work has shown the very important role of the thymus gland not only in immunity, but also in the formation of the lymphoid system. This gland is actually the first central lymphoid organ, where T-lymphocytes mainly mature. This type of lymphocyte constantly undergoes training in the thymus gland and learns the ability to separate “us” from “stranger.” After this, killers (“killers”) and helpers (“helpers”) respectively perform their functions. In addition, the thymus releases hormone-like substances into the blood that promote the maturation of T-lymphocytes. It supplies other lymphoid organs with lymphocytes, especially in the early postembryonic period.

The thymus and spleen are a kind of peripheral lymph nodes that take an active part in the neurohumoral regulation of the lymphatic system. Removal of the thymus in newborn animals causes persistent pathological changes, among which the leading factor is systemic hypoplasia of lymphoid tissue.

Spleen cells, like cells of lymphoid nodes, are characterized by immunological memory - the ability to respond to repeated injection of antigen with faster and more intense production of antibodies. In addition to antibodies, the spleen also produces lymphocytes or lymphocyte-like cells, which migrate to other organs and there become cells that produce antibodies.

The body's resistance to infections and other pathogenic factors depends not only on the ability to develop a highly specialized immune response, but also on numerous so-called nonspecific defense reactions of the body. Such reactions include, for example, the impermeability of normal skin and mucous membranes to a wide variety of microorganisms and the presence of bactericidal substances in skin secretions, gastric juice, blood and other body fluids (saliva, tears, etc.). Specific and nonspecific protective factors act together. The importance of the lymphatic system is not limited to what has been said. The development of the study of lymph helps to identify its new functions.

Factors affecting lymph and lymph flow.

Conventionally, they can be divided into internal and external, natural and artificial.

Among the internal factors regulating lymph flow, an important role is played by the intrinsic activity of lymphatic vessels. Internal factors are inherent in the lymphatic system itself. The concept of the internal forces of lymph flow includes lymph formation and contractile activity of lymphatic vessels and nodes. The power of lymph formation is the initial volume of lymph, without which lymph flow is impossible.

In the transport of lymph, one should also take into account the viscosity of the lymph flowing from the periphery, which can change if lymph formation is disrupted, the tone of the lymphatic valves, external pressure on the wall of the lymphatic vessel from muscular contractions of the organ and adjacent blood vessels, as well as values characterizing the mechanical properties of the wall of the lymphatic vessel - thickness and radius of lymphangions, elastic properties of its wall. The intensity of lymph formation correlates with the intensity of blood circulation.

Previously, it was believed that external factors (respiratory movements of the lungs, rhythmic changes in the volume of the intestines, spleen, pulsation of the walls of blood vessels and contractions of skeletal muscles) were decisive in the promotion of lymph. Proof of this was the almost complete cessation of lymph flow from the immobilized limb. Subsequently, the appearance of edema was established after prolonged immobilization of the limb (in the experiment) and, along with dilatation of the lymphatic vessels, dystrophic changes in their wall. This indicates a violation of the trophism of the lymphatic vessels. The noted changes in the lymphatic vessels did not appear immediately, but after several weeks and even months. It has been noted, however, that during catheterization of the lymphatic vessel of the lower limb in anesthetized animals, lymph does not flow out.

Many different mechanisms and factors are involved in the regulation of lymph movement, which is determined by the need to ensure the reliability of the functions performed by the lymphatic system. Lymph nodes have their own contractile activity, similar to lymphatic vessels. It is likely that smooth muscle motility contributes to (and under certain conditions changes) the transport capacity of lymph nodes. The movement of lymph through the node may be facilitated by arterial pulsation. The presence of good innervation and smooth muscle suggests the influence of the nervous system on lymph flow through the lymph nodes.

Among the factors of lymph flow, the most significant after the own contractile activity of the lymphatic vessels are passive and active muscle movements, peristalsis of the gastrointestinal tract, pulsation of arteries and veins. The factors of lymph flow also include the influence of the frequency and strength of heart contractions on lymph flow.

The lymph flow in the thoracic duct (the main collector of the vascular network of the lymphatic system) is affected by many constant factors (their own contractile activity of the lymphatic vessels, breathing, blood pressure, aortic pulsation), the intensity of which can determine or contribute to the movement of lymph. Temporary factors (contractions of skeletal muscles, activity of the digestive system) can also largely determine the volume of lymph entering the venous system.

High sensitivity of lymphatic vessels to thermal factors was noted. It has been proven that hypothermia reduces the tone of lymphatic vessels by two and a half times. Hypokinesia has a particularly negative effect on lymph flow. Massage helps enhance the transport function of lymph. Dosed stimulation of lymph flow through passive movements of the injured limb with a certain frequency, duration and periodicity significantly reduces the toxicity of peripheral lymph.

Lymph This is an absolutely amazing system.

Let's start with what lymph is. Imagine any organ (liver, kidneys), the cells it consists of, and the vessels through which nutrition comes. All intercellular fluid, of which we have 50-60 liters, flows from here into the lymphatic vessels, passes through customs, i.e. pus goes through separate ducts out through the vagina, armpits, nose, mouth, sputum, and pure lymph goes further. Moreover, all lymph through the lymphatic system goes only in one direction: from bottom to top.

The heart pushes blood into the organs through the vessels, in the organs the fluid from the blood exits into the intercellular tissue, 10% of the fluid returns back into the blood, the rest of the fluid from the organ flows up the lymphatic ducts. Therefore, all lymphatic vessels go from bottom to top. If they massage you from top to bottom, they destroy the lymphatic system. All massages should start from the fingertips and work towards the central trunk. If a facial massage is done incorrectly, without taking into account the lymphatic ducts, then nothing will happen except swelling.

We all have a heart that pumps blood to all organs. Now imagine that the fluid has left the organ and then it flows through the lymphatic vessels without pushing effects and without suction from above. How does lymph move? Lymphatic vessels all are located inside the muscles. And the lymphatic heart is the muscles. There is no other mechanism for lifting lymph. The lymph vessel is surrounded by muscle tissue, and only when the muscle contracts is the lymph pushed upward. There is no other mechanism.

Therefore, sedentary people always have swelling and lymph congestion. There are no cardiac edemas, only lymphatic ones.

What is edema? Imagine a leg. The lymphatic vessel in it is damaged, the fluid does not come out. This means there will be swelling. The heart can push such water clots, but it is not very easy for it, because it needs to create such pressure from a height of one and a half meters in order to push this fluid. This is a very heavy load, and naturally the left ventricle of the heart is damaged. Therefore, if there is swelling of the legs, legs, knees and above, this is all called the lymphatic system. Lymph nodes cannot be touched, they cannot be massaged, they cannot be heated, they cannot be touched, and nothing at all can be done with them. Lymph nodes are living sacs in which white blood cells live. Moreover, leukocytes don’t just live there, they work there, their place of work is there. Every second they destroy bacteria there, treat them against fungi, viruses, and all kinds of protozoa. And all this is released into the nose and various other areas of disembarkation.

The first site of discharge is the vagina in women and the urethra in men. If there are any viral foci, protozoa or bacteria, then the first thing, regardless of age, will be discharge from the genitals.

The second springboard is the intestines. Pus (dead white blood cells) in the stool indicates that the white blood cells are successfully fighting viruses, etc.

The next springboard is the armpits, through which lymph leaves along with hormones. Therefore, under no circumstances should you use 24-hour deodorants, because we chemically stop lymphatic secretion, and all lymph goes into the mammary glands.

The next springboard for the landing of pus is the nasal tonsils or adenoids. In everyone who has problems with the adenoids, the lymph is affected by infections: streptococcus, fungi, staphylococcus, etc.

The next springboard is the tonsils. Sore throats. And then there are deep nodes - the larynx, pharynx, trachea, bronchi and lungs.

Why is it important to know how lymph flows? Because all edema in the body will be regarded by doctors as cardiovascular pathology, i.e. heart failure. In fact, most often this is a lymphatic pathology: blockage of the lymph nodes or contamination of the common lymphatic collector.

The water that is in the intercellular space is not just water. Hyaluronic acid is dissolved in it; this acid can be in two states: thick jelly or liquid jelly. At high temperatures it becomes liquid jelly, and at low temperatures it becomes thick jelly. Therefore, when we drink diaphoretic herbs, our lymph becomes liquefied and we begin to sweat; the lymph comes out through the vessels. When we jump into a cold pool, the lymph thickens and the lymphatic drainage stops.

If the jelly is thick all the time, i.e. a person does not take a steam bath, does not cleanse himself, drinks bad water, the water does not pass, then it will not be possible to exit the blood vessel into the intercellular space, and the body will increase blood pressure in order to push through all the nutrients, oxygen, etc. under pressure.

Lymph differs from blood only in color. Lymph is white blood. It differs from blood only in red blood cells. All red blood cells remained inside the vessels. They are not allowed to go anywhere. All other microcells: leukocytes, macrophages, they can travel territorially. They can leave the blood, move into the lymphatic vessel, move along the lymphatic vessel, work in the lymph nodes, go into the tissues, patrol, look for cancer cells there, look at some other cells, take these cells back, and either destroy them in the lymphatics nodes, or removed through the skin. If it doesn’t go into the lymph, the body refuses to accept it, then there is another way out through the skin. For example, mushrooms will always go through the skin. They will never go through the lymph, because one mushroom is followed by a hundred more mushrooms. And therefore they are always discharged in the form of diathesis over large lymph nodes. If a child has a fungus, then the diathesis will be in the elbow folds, knee dimples, and inguinal folds. Everything that is associated with the skin in these places is lymph damage.

What spoils the lymphatic system and causes disturbances?

1. Psychology. First of all, stress, especially severe stress, affects the lymph and immunity.

2. Food!!! Canned food, preservatives, chemical acids, citric acid, formaldehyde (lightly smoked and smoked, pickled products), enzyme inhibitors (jams, shelf-stable milk/sour cream). Eating food with enzyme inhibitors leads to complete destruction of the lymphatic system.

3. Water. For the lymphatic system, water must be special. Warm. Cold is very dangerous for lymph. The worst thing is the ice cream. When a person eats ice cream, his lymphatic vessels are paralyzed, lymphocytes stop moving, and immunity decreases tenfold. At this moment, there is a colossal proliferation of bacteria and viruses. For some people, drinking a couple of sips of milk from the refrigerator is enough to give them a sore throat. Sore throat is a total infectious process of damage to the lymphatic system. And it simultaneously affects the heart, kidneys, ovaries, thyroid gland, joints, heart valves, etc.

4. Temperature. High temperature is dangerous for lymph. Temperatures above 40 degrees are contraindicated. It is IMPOSSIBLE to warm the lymph nodes! Keeping a laptop on your lap, taking hot foot baths, or hot compresses are prohibited.

5. A B C D E!!! It is necessary to reduce the number of the BVGD population. When we fight bacteria, lymph cells also die. That's why lymph doesn't like fighting to the death. It is better when BVGD stops reproducing. A fungus, for example, can die of old age, bacteria can stop reproducing and die of old age. For example, a person was blown away. What does this mean? It is impossible to blow a person away. This is an incorrect expression. There was a blow in your right ear while you were driving in the car, your ear hurt. What happened? When you were driving, the temperature on the right was 36.6, and on the left it was 35.2 at the moment when the air was blowing. This turned out to be enough to reduce the speed of lymph flow through the capillaries by two to three times and so that the leukocytes did not come to their proper places, and the bacteria simply managed to multiply. Because bacteria are absorbed every second, and if you sit on a cold stone somewhere, then, accordingly, in the ovarian zone, the prostate gland zone, the lymph flow will decrease, and bacteria will be able to multiply. Therefore, if you want the body not to lose its immunity, it must be at a more/less comfortable temperature. Unless you are hardened, of course. If you harden yourself with quick douches, then it’s normal, but for a healthy person.

6. System cleaning. When you start cleansing the lymph, there should be a result. There will be mucus from the nose, throat, sweating, and mucus in the intestines. Cleaning is carried out only with sorbents: clay, activated carbon... If during Colo-Vada a cough, runny nose, and mucus in the intestines begin, it means that lymph cleansing has begun. This is fine. It is impossible to extinguish such a cough. There should be profuse sweating. If you go to the bathhouse for the purpose of cleaning, then the bathhouse should be from 40 to 70 degrees. Before the bath, drink a lot of warm water. There will be a discharge of about 1 kg of lymph. If you raise the bathhouse temperature higher, then the emergency sweat sluices will simply turn on, and you will begin to sweat through your nose, forehead, etc. If a person is bleeding from his forehead, it means his armpits are not working. A person must sweat in certain places designed for this. Inguinal folds, armpits, back of the neck, popliteal fossae, ankle joints, in some cases, palms and feet. In women it may also be under the breasts.

7. Enzymes+ bacteria. There should be a sufficient number of them. The better everything is in place in the intestines, the better Lifa feels.

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The fluid that enters the tissue is lymph. The lymphatic system is an integral part of the vascular system, ensuring the formation of lymph and lymph circulation.

Lymphatic system - a network of capillaries, vessels and nodes through which lymph moves in the body. Lymphatic capillaries are closed at one end, i.e. end blindly in tissues. Lymphatic vessels of medium and large diameter, like veins, have valves. Along their course there are lymph nodes - “filters” that retain viruses, microorganisms and the largest particles found in the lymph.

The lymphatic system begins in the tissues of organs in the form of an extensive network of closed lymphatic capillaries that do not have valves, and their walls have high permeability and the ability to absorb colloidal solutions and suspensions. Lymphatic capillaries turn into lymphatic vessels equipped with valves. Thanks to these valves, which prevent the reverse flow of lymph, it flows only towards the veins. Lymphatic vessels flow into the lymphatic thoracic duct, through which lymph flows from 3/4 of the body. The thoracic duct drains into the cranial vena cava or jugular vein. Lymph through the lymphatic vessels enters the right lymphatic trunk, which flows into the cranial vena cava.

Rice. Diagram of the lymphatic system

Functions of the lymphatic system

The lymphatic system performs several functions:

The protective function is provided by the lymphoid tissue of the lymph nodes, which produces phagocytic cells, lymphocytes and antibodies. Before entering the lymph node, the lymphatic vessel divides into small branches that pass into the sinuses of the node. Small branches also extend from the node, which unite again into one vessel;
the filtration function is also associated with the lymph nodes, in which various foreign substances and bacteria are mechanically retained;
the transport function of the lymphatic system is that through this system the main amount of fat enters the blood, which is absorbed in the gastrointestinal tract;
the lymphatic system also performs a homeostatic function, maintaining a constant composition and volume of interstitial fluid;
The lymphatic system performs a drainage function and removes excess tissue (interstitial) fluid located in the organs.

The formation and circulation of lymph ensures the removal of excess extracellular fluid, which is created due to the fact that filtration exceeds the reabsorption of fluid into the blood capillaries. Such drainage function The lymphatic system becomes obvious if the outflow of lymph from some area of the body is reduced or stopped (for example, when the limbs are compressed by clothing, the lymphatic vessels are blocked due to injury, they are crossed during surgery). In these cases, local tissue swelling develops distal to the compression site. This type of edema is called lymphatic.

Return to the bloodstream of albumin filtered into the intercellular fluid from the blood, especially in highly permeable organs (liver, gastrointestinal tract). More than 100 g of protein returns to the bloodstream per day with lymph. Without this return, protein losses in the blood would be irreplaceable.

Lymph is part of the system that provides humoral connections between organs and tissues. With its participation, the transport of signal molecules, biologically active substances, and some enzymes (histaminase, lipase) is carried out.

In the lymphatic system, the processes of differentiation of lymphocytes transported by lymph along with immune complexes that perform functions of the body's immune defense.

Protective function The lymphatic system is also manifested in the fact that foreign particles, bacteria, remains of destroyed cells, various toxins, and tumor cells are filtered out, captured and in some cases neutralized in the lymph nodes. With the help of lymph, red blood cells released from blood vessels are removed from tissues (in case of injuries, vascular damage, bleeding). Often the accumulation of toxins and infectious agents in the lymph node is accompanied by its inflammation.

Lymph is involved in the transport of chylomicrons, lipoproteins and fat-soluble substances absorbed in the intestine into the venous blood.

Lymph and lymph circulation

Lymph is a filtrate of blood formed from tissue fluid. It has an alkaline reaction, it does not contain, but contains fibrinogen and, therefore it is able to coagulate. The chemical composition of lymph is similar to that of blood plasma, tissue fluid and other body fluids.

Lymph flowing from different organs and tissues has a different composition depending on the characteristics of their metabolism and activity. Lymph flowing from the liver contains more proteins, lymph - more. Moving along the lymphatic vessels, lymph passes through the lymph nodes and is enriched with lymphocytes.

Lymph - a clear, colorless liquid contained in the lymphatic vessels and lymph nodes, in which there are no red blood cells, platelets and many lymphocytes. Its functions are aimed at maintaining homeostasis (return of protein from tissues to the blood, redistribution of fluid in the body, milk formation, participation in digestion, metabolic processes), as well as participation in immunological reactions. Lymph contains protein (about 20 g/l). Lymph production is relatively small (most of all in the liver); about 2 liters are formed per day by reabsorption from the interstitial fluid into the blood of the blood capillaries after filtration.

Lymph formation caused by the passage of water and dissolved substances from blood capillaries into tissues, and from tissues into lymphatic capillaries. At rest, the processes of filtration and absorption in the capillaries are balanced and lymph is completely absorbed back into the blood. In case of increased physical activity, the metabolic process produces a number of products that increase the permeability of capillaries for protein and its filtration increases. Filtration in the arterial part of the capillary occurs when the hydrostatic pressure increases above the oncotic pressure by 20 mm Hg. Art. During muscular activity, the volume of lymph increases and its pressure causes the penetration of interstitial fluid into the lumen of the lymphatic vessels. Lymph formation is promoted by an increase in the osmotic pressure of tissue fluid and lymph in the lymphatic vessels.

The movement of lymph through the lymphatic vessels occurs due to the suction force of the chest, contraction, contraction of the smooth muscles of the wall of the lymphatic vessels and due to the lymphatic valves.

Lymphatic vessels have sympathetic and parasympathetic innervation. Excitation of the sympathetic nerves leads to contraction of the lymphatic vessels, and when parasympathetic fibers are activated, the vessels contract and relax, which increases lymph flow.

Adrenaline, histamine, serotonin increase lymph flow. A decrease in the oncotic pressure of plasma proteins and an increase in capillary pressure increases the volume of outflowing lymph.

Lymph formation and quantity

Lymph is a fluid that flows through lymphatic vessels and forms part of the internal environment of the body. The sources of its formation are filtered from the microvasculature into the tissues and contents of the interstitial space. In the section on microcirculation, it was discussed that the volume of blood plasma filtered into tissues exceeds the volume of fluid reabsorbed from them into the blood. Thus, about 2-3 liters of blood filtrate and intercellular fluid that are not reabsorbed into the blood vessels enter per day through the interendothelial cracks into the lymphatic capillaries, the system of lymphatic vessels and return to the blood again (Fig. 1).

Lymphatic vessels are present in all organs and tissues of the body with the exception of the superficial layers of skin and bone tissue. The largest number of them is found in the liver and small intestine, where about 50% of the total daily volume of lymph in the body is formed.

The main component of lymph is water. The mineral composition of lymph is identical to the composition of the intercellular environment of the tissue in which the lymph was formed. Lymph contains organic substances, mainly proteins, glucose, amino acids, and free fatty acids. The composition of lymph flowing from different organs is not the same. In organs with relatively high permeability of blood capillaries, for example in the liver, lymph contains up to 60 g/l of protein. Lymph contains proteins involved in the formation of blood clots (prothrombin, fibrinogen), so it can coagulate. The lymph flowing from the intestines contains not only a lot of protein (30-40 g/l), but also a large number of chylomicrons and lipoproteins formed from aponroteins and fats absorbed from the intestines. These particles are suspended in the lymph, transported by it into the blood and give the lymph a similarity to milk. In the lymph of other tissues, the protein content is 3-4 times less than in blood plasma. The main protein component of tissue lymph is the low molecular weight fraction of albumin, which is filtered through the capillary wall into the extravascular spaces. The entry of proteins and other large molecular particles into the lymph of the lymphatic capillaries is due to their pinocytosis.

Rice. 1. Schematic structure of the lymphatic capillary. Arrows show the direction of lymph flow

Lymph contains lymphocytes and other forms of white blood cells. Their quantity in different lymphatic vessels varies and ranges from 2-25 * 10 9 / l, and in the thoracic duct it is 8 * 10 9 / l. Other types of leukocytes (granulocytes, monocytes and macrophages) are found in lymph in small quantities, but their number increases during inflammatory and other pathological processes. Red blood cells and platelets can appear in the lymph when blood vessels are damaged or tissues are injured.

Absorption and movement of lymph

Lymph is absorbed into lymphatic capillaries, which have a number of unique properties. Unlike blood capillaries, lymphatic capillaries are closed, blind-ending vessels (Fig. 1). Their wall consists of a single layer of endothelial cells, the membrane of which is fixed to extravascular tissue structures using collagen threads. Between endothelial cells there are intercellular slit-like spaces, the dimensions of which can vary widely: from a closed state to a size through which blood cells, fragments of destroyed cells and particles comparable in size to blood cells can penetrate into the capillary.

The lymphatic capillaries themselves can also change their size and reach a diameter of up to 75 microns. These morphological features of the structure of the wall of lymphatic capillaries give them the ability to change permeability over a wide range. Thus, when skeletal muscles or smooth muscles of internal organs contract, due to the tension of collagen threads, interendothelial gaps can open, through which intercellular fluid and the mineral and organic substances it contains, including proteins and tissue leukocytes, freely move into the lymphatic capillary. The latter can easily migrate into the lymphatic capillaries also due to their ability to amoeboid movement. In addition, lymphocytes formed in the lymph nodes enter the lymph. The entry of lymph into the lymphatic capillaries is carried out not only passively, but also under the influence of negative pressure forces that arise in the capillaries due to the pulsating contraction of the more proximal sections of the lymphatic vessels and the presence of valves in them.

The wall of lymphatic vessels is built of endothelial cells, which on the outside of the vessel are covered in the form of a cuff by smooth muscle cells located radially around the vessel. Inside the lymphatic vessels there are valves, the structure and principle of operation of which are similar to the valves of the venous vessels. When the smooth muscle cells are relaxed and the lymphatic vessel is dilated, the valve leaflets are open. When smooth myocytes contract, causing a narrowing of the vessel, the lymph pressure in this area of the vessel increases, the valve flaps close, the lymph cannot move in the opposite (distal) direction and is pushed proximally through the vessel.

Lymph from the lymphatic capillaries moves into the postcapillary and then into the large intraorgan lymphatic vessels that flow into the lymph nodes. From the lymph nodes, through small extra-organ lymphatic vessels, lymph flows into larger extra-organ vessels that form the largest lymphatic trunks: the right and left thoracic ducts, through which lymph is delivered to the circulatory system. From the left thoracic duct, lymph enters the left subclavian vein at the site near its junction with the jugular veins. Most of the lymph moves into the blood through this duct. The right lymphatic duct delivers lymph to the right subclavian vein from the right side of the chest, neck and right arm.

Lymph flow can be characterized by volumetric and linear velocities. The volumetric flow rate of lymph from the thoracic ducts into the veins is 1-2 ml/min, i.e. only 2-3 l/day. The linear speed of lymph movement is very low - less than 1 mm/min.

The driving force of lymph flow is formed by a number of factors.

The difference between the hydrostatic pressure of lymph (2-5 mm Hg) in the lymphatic capillaries and its pressure (about 0 mm Hg) at the mouth of the common lymphatic duct.
Contraction of smooth muscle cells in the walls of lymphatic vessels that move lymph towards the thoracic duct. This mechanism is sometimes called the lymphatic pump.
Periodic increase in external pressure on the lymphatic vessels, created by contraction of skeletal or smooth muscles of internal organs. For example, contraction of the respiratory muscles creates rhythmic changes in pressure in the chest and abdominal cavities. The decrease in pressure in the chest cavity during inhalation creates a suction force that promotes the movement of lymph into the thoracic duct.

The amount of lymph formed per day in a state of physiological rest is about 2-5% of body weight. The rate of its formation, movement and composition depend on the functional state of the organ and a number of other factors. Thus, the volumetric flow of lymph from the muscles during muscle work increases 10-15 times. 5-6 hours after eating, the volume of lymph flowing from the intestines increases and its composition changes. This occurs mainly due to the entry of chylomicrons and lipoproteins into the lymph.

Compressing the leg veins or standing for long periods of time makes it difficult for venous blood to return from the legs to the heart. At the same time, the hydrostatic blood pressure in the capillaries of the extremities increases, filtration increases and an excess of tissue fluid is created. Under such conditions, the lymphatic system cannot sufficiently provide its drainage function, which is accompanied by the development of edema.

The lymphatic system is part of the vascular system, which successfully adds to the venous system and takes part in metabolism.

An important function of the lymphatic system is to remove foreign bodies from the circulatory system, as well as cleanse tissues and cells. From the tissues of the organs, the fluid first enters the lymphatic system, where it is filtered using the lymph nodes, and then the lymph through large vessels enters the thoracic lymphatic duct, where it flows from the chest into a large vein.

The lymphatic system consists of:

Capillaries that form networks in all organs and tissues and are designed to remove fluid;
Vessels formed from connections of capillaries. The vessels have valves, thanks to which the lymph moves only in one direction;
Nodes that interrupt vessels and divide them into vessels entering the node and leaving it. In the nodes, the lymph leaves all foreign bodies and microbes, and is also enriched with lymphocytes and is sent through other vessels to the thoracic lymphatic flow and the right lymphatic flow.

The functions of the lymphatic system also include:

Retention of toxins and bacteria;
Return of electrolytes and proteins from tissues to the blood;
Removal of foreign bodies and red blood cells;
Production of lymphocytes and antibodies;
Transfer of products absorbed from food;
Excretion of products through urine.

Organs of the lymphatic system:

Bone marrow. All blood cells are created in it. Stem cells created in the myeloid tissue of the bone marrow enter the immune system.
The spleen, which contains a large collection of lymph nodes. It breaks down dead blood cells. It reacts sharply to foreign bodies and produces antibodies.
Thymus. It takes stem cells, turning them into T-lymphocytes (cells that destroy malignant cells and foreign bodies).

What does enlarged lymph nodes indicate?

Lymphadenopathy, or enlarged lymph nodes, is quite common. For a healthy person, the norm is a slight increase in the submandibular lymph nodes (no more than 1 cm), as well as an increase in the inguinal lymph nodes (no more than 2 cm).

If the increase exceeds acceptable limits, a biopsy and additional research may be required. Enlarged lymph nodes of the lymphatic system may indicate the following diseases:

On the sides of the neck - sarcoidosis, mononucleosis, tuberculosis and vaccination against it, as well as lymphoma and upper respiratory tract infections;
In front and behind the ears - rubella;
Above the collarbone – tuberculosis, toxoplasmosis, stomach cancer (above the left collarbone);
Under the lower jaw – problems with the gums or chronic tonsillitis;
Under the arms – hand infections, breast cancer, sarcoidosis;
On the bends of the elbows – sarcoidosis;
In the groin - inflammation of the genitourinary system or the presence of a specific infection (herpes, syphilis), leg infections.

Enlargement and inflammation of all groups of lymph nodes is an early symptom of HIV infection.

With lymphoma, the nodes become mobile and painless, and with metastases, they become fused and dense.

Diseases of the lymphatic system

Any disease does not pass without leaving a trace for all body systems. The lymphatic system responds to the disease primarily by enlarging the lymph nodes.

The main diseases of the lymphatic system are:

Adenoids and chronic tonsillitis, when the tonsils cease to perform a protective function, becoming a source of infection. As a rule, in case of prolonged infection, they are removed.
Acute lymphadenitis is inflammation of the lymph node caused by bacteria. The disease is accompanied by redness, pain, and sometimes suppuration. The disease rarely occurs alone; more often it occurs as a result of inflammation of the area through which lymph flows.
Chronic lymphadenitis. As a rule, this disease is a companion to other infectious diseases (syphilis, tuberculosis).
Tumors of lymphatic vessels. They can be either malignant (lymphangiosarcoma) or benign (lymphangioma).

Lymphatic system cleansing

For the full functioning of the lymphatic system, it is necessary, at a minimum, to move a lot. If a person leads a sedentary lifestyle, breathing exercises, exercises and long walks can help. It is important to know that movement cleanses the body and eliminates lymph stagnation.

Cleansing of the lymphatic system is carried out through saliva, since the salivary glands are part of the general lymphatic system. The salivary glands draw out all dead cells and waste from the body and remove them through the gastrointestinal tract.

The easiest way to cleanse the lymphatic system daily is ginger. To do this, after eating you need to suck, chew and swallow a piece of ginger. This method is much more beneficial for the lymphatic system than a glass of water. Ginger irritates the mucous membranes and causes increased salivation.

The second way to cleanse the lymphatic system is juice. It is necessary to drink juice for several weeks, consisting of four parts apple and carrot juice and one part beet juice. It will be useful to add ginger root or ginger infusion to the juice.