Lymphatic vessels on the face. Impaired lymph clotting ability

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 empty 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. Scheme lymphatic system

Functions of the lymphatic system

The lymphatic system performs several functions:

provides a protective function lymphoid tissue lymph nodes, producing 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 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 surgical operation). 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 is carried out, biologically active substances, some enzymes (histaminase, lipase).

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

Protective function The lymphatic system is also manifested in the fact that in the lymph nodes foreign particles, bacteria, remains of destroyed cells, various toxins, as well as tumor cells. 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. She has alkaline reaction, it lacks, but contains, fibrinogen and, therefore it is able to coagulate. Chemical composition lymph is similar to that of blood plasma, tissue fluid and other body fluids.

Lymph flowing from different organs and fabrics, has 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 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 mmHg. 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 increased osmotic pressure tissue fluid and lymph in lymphatic vessels.

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

Lymphatic vessels have sympathetic and parasympathetic innervation. Excitation sympathetic nerves leads to contraction of lymphatic vessels, and when parasympathetic fibers are activated, the vessels contract and relax, which enhances 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 the fluid that flows through the lymphatic vessels and is part of internal environment 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 surface layers skin and bone tissue. The greatest number of them is found in the liver and small intestine, where about 50% of the body’s total daily lymph volume 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 intestine. 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. Main protein component tissue lymph is a low-molecular-weight fraction of albumin that filters 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 The structure of the wall of lymphatic capillaries gives them the ability to change permeability over a wide range. Thus, when skeletal muscles contract or smooth muscle internal organs 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 extraorgan lymphatic vessels, lymph flows into larger extraorganic vessels that form the largest lymphatic trunks: the right and left thoracic ducts, through which lymph is delivered to circulatory system. From the left thoracic duct, lymph enters the left subclavian vein in a place near its connection 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 right half 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, reduction respiratory muscles creates rhythmic changes in pressure in the chest and abdominal cavities. Decrease in pressure in chest cavity when inhaling, it 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.

Compression of leg veins or prolonged standing makes it difficult to return venous blood from feet to 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. The lymphatic system in such conditions cannot provide sufficiently its drainage function, which is accompanied by the development of edema.

Lymphatic system

The lymphatic system is a network of vessels that penetrate organs and tissues containing a colorless liquid - lymph.

Only brain structures, epithelial skin and mucous membranes, cartilage, spleen parenchyma, eyeball and placentas do not contain lymphatic vessels.

The lymphatic system, being an integral part of the vascular system, carries out tissue drainage along with veins through the formation of lymph, and also performs functions specific to it: barrier, lymphocytopoietic, immune.

The lymphocytopoietic function of the lymphatic system is ensured by the activity of the lymph nodes. They produce lymphocytes that enter the lymphatic and bloodstream. In peripheral lymph, which is formed in capillaries and flows through the lymphatic vessels before they flow into the lymph nodes, the number of lymphocytes is less than in the lymph flowing from the lymph nodes.

The immune function of the lymphatic system is that plasma cells that produce antibodies are formed in the lymph nodes. B and T lymphocytes, responsible for humoral and cellular immunity.

The barrier function of the lymphatic system is also carried out by the lymph nodes, in which foreign particles, microbes, and tumor cells arriving with the lymph are retained and then absorbed by phagocytic cells.

The blood flowing in the blood capillaries does not have direct contact with the tissues of the body: the tissues are washed by lymph.

Having left the blood capillaries, the lymph moves in the interstitial crevices, from where it passes into thin-walled capillary lymphatic vessels, which merge and form larger trunks. Eventually, all the lymph flows through two lymphatic trunks into the veins near their confluence with the heart. The number of lymphatic vessels in the body is many times greater than the number of blood vessels.

Unlike blood, which moves freely through vessels, lymph flows through special accumulations of connective (lymphatic) tissue, the so-called lymph nodes (Fig. 4).

The flow of lymph through the lymphatic vessels is determined by numerous factors: a) constant pressure formed lymph; b) contraction of the walls of lymphangions; c) pulsation of blood vessels; d) movement of various segments of the body and limbs; e) contraction of smooth muscles in the walls of organs; f) suction effect of the chest cavity, etc.

Rice. 4. Direction of lymph flow to lymph nodes

Lymphatic vessels, under the influence of the nervous system, are capable of active contractile function, i.e., the size of their lumen can change or the lumen can be completely closed (exclusion from lymphatic drainage). The tone of the muscular membrane of the lymphatic vessels, as well as the activity of blood vessels, is regulated by the central nervous system.

Lymph nodes are organs of lymphocytopoiesis and antibody formation, located along the lymphatic vessels and together with them form the lymphatic system. Lymph nodes are located in groups.

From numerous lymph nodes head and neck Let's note the superficial lymph nodes located on the back of the head (occipital nodes); under the lower jaw - submandibular lymph nodes and along the lateral surfaces of the neck - cervical lymph nodes. Lymphatic vessels pass through these nodes, originating from cracks in the tissues of the head and neck.

IN mesentery of the intestine there are dense clusters of mesenteric lymph nodes; All the lymphatic vessels of the intestine, originating in the intestinal villi, pass through them.

From lymphatic vessels lower limbs it should be noted the superficial inguinal lymph nodes located in groin area, and femoral lymph nodes located slightly below the inguinal nodes - on the anterior inner surface of the thighs, as well as popliteal lymph nodes.

From the lymph nodes of the chest and upper extremities, it is necessary to pay attention to the axillary lymph nodes, located quite superficially in axillary region, and ulnar lymph nodes located in the ulnar fossae - near the internal tendon of the biceps muscle. Lymphatic vessels pass through all these nodes, originating in the crevices and tissues of the upper limbs, chest and upper back.

The movement of lymph through tissues and vessels is extremely slow. Even in large lymphatic vessels, the speed of lymphatic flow barely reaches 4 mm per second.

Lymphatic vessels merge into several large vessels - the vessels of the lower extremities and lower torso form two lumbar trunks, and the lymphatic vessels of the intestine form the intestinal trunk. The fusion of these trunks forms the largest lymphatic vessel of the body - the left, or thoracic, duct, into which the trunk flows, collecting lymph from the left upper half of the body.

Lymph from the right half of the upper body is collected in the other large vessel- right lymphatic duct. Each of the ducts flows into the general blood stream at the confluence of the jugular and subclavian veins.

Inside the lymphatic vessels, like veins, there are valves that facilitate the movement of lymph.

Acceleration of lymph flow during muscle work is a consequence of an increase in the area of capillary filtration, filtration pressure and volume of interstitial fluid. Under these conditions, the lymphatic system, by removing excess capillary filtrate, is directly involved in the normalization of hydrostatic pressure in the interstitial space. Promotion transport function The lymphatic system is simultaneously accompanied by stimulation and resorption function. The resorption of fluid and plasma proteins from the intercellular space into the roots of the lymphatic system increases. The movement of fluid in the direction of blood - interstitial fluid - lymph occurs due to changes in hemodynamics and an increase in the transport function (ability) of the lymphatic bed. By removing excess fluid from tissues and redistributing it within the extracellular space, the lymphatic system creates conditions for normal transcapillary exchange and weakens the effect of a rapid increase in the volume of interstitial fluid on cells, acting as a kind of damper. The ability of the lymphatic bed to both remove and partially deposit fluid and proteins leaving the blood capillaries is important mechanism its participation in the regulation of plasma volume under conditions physical activity.

To the number central mechanisms, playing a large role in phase changes in lymph flow during dosed muscular work and in recovery period, include changes in the neurohumoral support of muscle activity and lymph circulation processes, changes in the functional state of organs, motor activity skeletal muscles, external respiration parameters.

Currently, there is a real opportunity to actively influence functional state lymphatic system (Mikusev Yu. E.). Physical lymphostimulators include:

Local irritants(compresses, mustard plasters, cups);

Physical therapy products;

Eastern reflexology methods;

Electromagnetic fields;

Hyperbaric oxygenation.

Methods of stimulating lymph formation and lymph circulation:

1. Lymph-stimulating substances. Substances that affect hemodynamics:

A. Increasing hydrodynamic blood pressure and reducing plasma osmolarity (creating a water load).

B. Due to their molarity, they promote the flow of fluid into the vascular system and thereby increase the hydrodynamic pressure of the blood.

C. Influencing rheological properties blood and lymph.

2. Agents that affect the microlymphohemocirculatory system:

A. Changing the permeability of cell membranes.

B. Affecting the receptor structures of the microvascular bed (? - mimetics, ?-adrenergic blockers).

3. Drugs that act on the central and intermediate links in the regulation of general and local hemodynamics (vasomotor center and heart).

4. Substances that affect the mechanisms that produce or contribute to the movement of lymph.

Biological methods of lymphostimulation:

Intravenous drip infusion of autologous blood;

Intravenous drip infusion of central autolymph;

The use of a class of bioorganic compounds that act as neurotransmitters.

On upper limb lymphatic vessels begin on the dorsal and palmar surfaces of the fingers with transversely lying stems. The latter, having reached the lateral surfaces of the fingers, are collected into larger trunks that rise vertically to the palm (Fig. 5).

Rice. 5. Location of the lymphatic network on the upper limbs

This arrangement of the lymphatic pathways determines the technique of stroking and rubbing the fingers. Massage techniques should be carried out in the following way:

Under the influence of massage, the movement of all body fluids, especially blood and lymph, accelerates, and this happens not only in the massaged area of the body, but also in distant veins and arteries. For example, foot massage can cause redness skin heads.

The massage therapist needs to become thoroughly familiar with the location of the lymphatic tract network and the directions in which the massage should be performed.

On the palmar and dorsal surfaces - in the transverse direction;

Along the side surface - straight up.

Next, the vessels of the dorsal surface of the hand go mainly along the interosseous spaces and rise to the forearm, and the vessels of the palm are directed along a radius from the center of the palm to the elevations thumb and little finger. From the palm, the vessels pass to the forearm and shoulder almost vertically and reach the axillary nodes. From the dorsum of the hand, lymphatic vessels, bending around the shoulder, also go to these nodes; while part of them goes around the shoulder in front, and the other part - behind. Ultimately, all the vessels of the upper limb pass through one of the axillary nodes and some of them also through the elbow nodes.

Therefore, when massaging the forearm, the massage therapist’s hand should move in the direction of the nodes located in the elbow bend, and when massaging the shoulder - in the direction of the nodes located in the armpit and the nodes lying above the internal condyle.

On the lower limb, collecting from the dorsum and plantar sides of the foot, the lymphatic vessels rise on both sides of the ankles; at the same time, in the inner side of the thigh and lower leg, the vessels go straight up to the inguinal nodes; vessels running along the anterior and outer surface limbs, reach inguinal fold, bending around the thigh in front; the vessels running along the posterior and inner surface, bending around the thigh from behind, also reach the same group of inguinal nodes. Some of the lymphatic vessels pass through two or three nodes located in the popliteal fossa (Fig. 6)

Rice. 6. Location of the lymphatic network on the lower limb

In connection with the indicated location of the lymphatic pathways, the massage therapist’s hand, when performing massage techniques on the lower leg muscles, is directed to the nodes located in the popliteal fossa, and on the thigh muscles - to the nodes lying under the Poupart ligament.

Two large groups of axillary and inguinal nodes play the role of centers; not only all the lymphatic vessels of the extremities flow into them, but also the vessels of the general integument of the body.

Thus, on level lumbar region spine there is, as it were, a lymphatic division: the lymph of the integument of the upper part of the body and all the lymph of the upper extremities passes through axillary nodes, and the lymph of the lower extremities and integuments located below the lumbar line - through inguinal nodes(Fig. 7)

Rice. 7. Lymphatic network to: A) anterior surface of the body; b) the back surface of the body and the direction of massage movements

Consequently, the direction of movement of the massage therapist’s hands when massaging the muscles of the chest, upper and middle back is towards the axillary nodes of the corresponding side. When massaging the muscles of the lumbosacral region, the hands move towards the inguinal nodes.

In the neck, the lymphatic vessels lie over and deep below the sternocleidomastoid muscle. A plexus is formed from them, which accompanies the carotid artery and jugular vein and forms one near the lower end of this vein. common trunk, flowing into the upper end of the thoracic duct.

When massaging the head and neck, the massage therapist’s hand movements are directed downward (Fig. 8).

Rice. 8. Lymphatic network: A) lateral and posterior surfaces of the head and neck; b) facial area and scalp

1. All movements when performing various massage techniques are made along the lymphatic flow towards the nearest lymph nodes.

2. The upper limbs are massaged towards the elbow and axillary nodes; lower - towards the popliteal and inguinal; The breasts are massaged from the sternum to the sides, to the armpits; back - from spinal column to the sides: to the armpits when massaging the upper and middle back, to the groin - when massaging the lumbosacral area; The neck muscles are massaged in the direction of the massage therapist’s hands downwards, towards the subclavian nodes.

3. Lymph nodes are not massaged.

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Popular about the LYMPHATIC SYSTEM,

or Don't let the lymph stagnate!

Lymph movement is youth!

Move blood through arteries forces the muscular vascular organ - the heart, and the movement of blood through the veins is ensured by the muscular-valvular structure of the veins. This is how the large and small circles of blood circulation function.

But the lymphatic bed does not have such a “drive”. The movement of lymph is slow and is achieved through muscles. The main muscle for driving lymph is the diaphragm. This is a kind of “heart” of the lymphatic system. During physical activity and deep breathing“belly”, the amplitude of movement of the diaphragm increases, and lymph circulation increases, i.e. its stagnation is eliminated.

With obesity and the absence of certain physical activities, lymph stagnation occurs in any lymph nodes. At the same time, waste products of cells accumulate in the intercellular spaces (fragments of disintegrated lipids, proteins, waste products, etc.), which even gradually grow into connective tissue fibers (doctors call this process fibrosis). And these cells simply begin to rot - sluggish cells appear oncological diseases, hypertension, allergies, etc.

Lymph cleansing occurs through saliva. The salivary glands belong to the lymphatic system, have access to the oral cavity and, together with saliva, carry waste and impurities from their system into the digestive tract for their further removal from the body.

When under stress, the mouth usually becomes dry, saliva is not produced, and stagnation occurs in the lymphatic system. And the person is given water to drink. But this is not advisable to do. It is better to stimulate the secretion of saliva by sucking the lips to release saliva in the mouth, and make swallowing movements.

You can also use it to enhance saliva production. chewing gum, half an hour after eating, put salt on the tip of a knife under your tongue.

Should be abandoned bad habit- drink drinks immediately after eating third and have fruit for dessert. Do not store yesterday’s food in the refrigerator, since it (especially when heated) is rich in toxins that appear from the proliferation of putrefactive bacteria, and after consumption it fills with ballast the entire intercellular space and lymph system in the human body.

The lymphatic system is a system that even doctors have little understanding of. They never seriously studied it. The lymphatic system works in one direction. All lymph flows from bottom to top. Swelling in the legs, arms, eyes, lower back, joints - this is all lymph. A bacteria, virus or fungus enters the body. What does lymph do? A large lymph node, for example, the genital tract, is located near the impact. Lymph nodes block the infection from passing further.

If gonorrhea passed through the body and entered the brain, then people would die immediately. Lymphocytes emerge from the lymph nodes, and they patrol the entire mucous membrane, urethra, and vagina. If they find something there, they eat it and take it back to the lymph nodes. In the lymph nodes, all this is lysed, activated and thrown out. The first route of lymph discharge in the body is the vagina and urethra. Everything that is connected with leucorrhoea in women, discharge in men, indicates that someone lives in the body, and the lymph eats this someone, at its own cost. own life, and deletes. The second route of evacuation is in the intestine, which contains tens of thousands of small lymph nodes.

Up to 50% of poisons are released through sweat and armpits. Nowadays people use deodorants that keep you from sweating for 24 hours. They don't sweat under their armpits, but their palms do sweat. They're still doing it cosmetic surgeries when the lymphatic ducts are cut. The forehead should not sweat. If your armpits are clogged, the entire surface of your body sweats. This indicates the second degree of damage and contamination of the lymph. The face should be relatively dry, and there should be leakage from under the arms, because there is a powerful sweat collector there. There are not very many sweat glands on the face.

Adenoids are lymph nodes. Everyone who breathes through their mouth has adenoids, which are enlarged lymph nodes in the nose.

The salivary glands are the most powerful detoxification organ. Up to half a liter of toxic sputum is released through saliva. If a child drools on the pillow, then this indicates serious problems with the lymphatic system. If a person or child sweats in a dream, this may indicate that he has pinworms, lamblia, or something else. Children should not sweat even when they have a fever environment 30C. Their sweat system is poorly developed. If small child at night wet head, that means he is sick. Everything in a child must go through the kidneys and intestines.

Larynx. Chronic laryngitis or pharyngitis- These are the lymph nodes of the pharynx and larynx. With this diagnosis in a person chronic infection chronic fungus or chronic streptococcus. They are candidates for chronic lymphatic system disease.

Tonsils are the most powerful springboard for various bacteria. Streptococcus always comes through the tonsils. These are sore throats and rheumatism. Staphylococcus will not go through the tonsils. It goes through the nose. Sinusitis is a lesion of the lymphatic system, not the respiratory system. There is nothing in the nose, there are only holes for air and membranes 1 micron thick. Everything else there is pus.

Where does pus come from? From the abdomen, from the lymph, from the blood, from the intercellular spaces, and exit through the nose. Staphylococcus has this path. The fungus will never go through the nose. The fungus is released through nearby organs. If it is a foot one, then it will stand out there. The skin will crack. The lymphatic system will never drag the fungus into the nose, because it will not drag it. It will interrupt all lymphatic collectors. The lymphatic system will open the skin and release lymph fluid directly between the toes. The lymph nodes of the bones will never miss the fungus. If the whole body is affected by the fungus, fungal bronchitis begins. The deep lymph nodes of the bronchi are connected, and the person may begin to bronchial asthma (we're talking about not about psychosomatics, when a person attracts attention to himself with illness).

Joint inflammation is a lesion of the lymphatic system. Everyone believes that swelling in the legs is cardiac or renal. Edema can only be lymphatic. The heart is exhausted and cannot pump blood. But it is not blood that is retained in the legs, but lymph. Elephantiasis is a lesion of the lymph when clogged inguinal lymph nodes, and the liquid does not rise. Swelling of the hands is a blockage of the axillary lymph nodes. Puffiness of the eyes is a blockage of the submandibular and facial lymph nodes. This indirectly indicates kidney blockage. If the kidneys secrete less fluid than needed, then there is more of it in the body.

SO:

For the functioning of the lymphatic system, it is not enough just to “take a pill”– for people leading sedentary lifestyle in life, at a minimum, you need to do breathing exercises, “breathe with your stomach,” do at least minimal exercise, try to walk more. This allows you to partially eliminate lymph stagnation.

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 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 shaped 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 into 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 – thoracic duct cistern;

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 -1 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 forms in the abdominal cavity and passes into the chest cavity through aortic orifice diaphragm, where it is located between the aorta and the right medial leg of the diaphragm, contractions of which help push lymph into chest part duct. At level 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. IN top part The thoracic duct flows into the left bronchomediastinal trunk (truncus bronchomediastinalis sinister), which collects lymph from the left half of the chest, 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. In the parotid lymph nodes, located on the surface and in the thickness of the gland of the same name, lymph flows from the forehead, temple, upper eyelid, auricle, walls of the external auditory canal.

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 general 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 flows from the organs 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).

The lymphatic vessels of the face are closely related to blood vessels the same area (Fig. 21). Lymph from the facial organs is drained through a system of nodes, which are topographically divided into three sections: the first is the facial lymph nodes, the second is the submandibular lymph nodes, and the third is the cervical lymph nodes. The facial nodes make up the buccal (Igl. buccalis) and parotid (Igl. paratideae) lymph nodes; the group of submandibular nodes constitutes the submandibular

lustrous (Igl. submaxillares) and chin (Igl. submentales);

the group of cervical nodes includes the lingual (Igl. omohyoidea and sub-digastrica) and the cervical - superficial and deep. The lymph of the facial region enters the truncus lymphaticus jugularis through the lower deep cervical nodes(see Fig. 21).

An independent lymphatic region is the mucous membrane of the maxillary sinus; in the lips and cheeks there is a distinction between the subcutaneous lymphatic region and the submucosal region. The lymphatic vessels of these areas gather at the upper and lower transitional folds and close at the branches of the external carotid artery. In the mucous membrane oral cavity distinguish, in addition to the indicated labio-cervical lymphatic area with their own comparatively superficial ways outflow, respectively i0b

natural palatal and lingual networks of lymphatic vessels with deeper pathways of lymph outflow.

Lymphatic drainages of the buccal areas form a plexus, which spreads according to the branching facial vein. Lymphatic vessels upper teeth are grouped according to the anterior, lateral and posterior teeth and penetrate from the depths of the bone through those existing in the anterior wall upper jaw bone tubules and the infraorbital foramen to the anterior surface of the bone and from here are directed down to the submandibular lymph nodes. In the lower jaw, on the contrary, the lymphatic vessels of the teeth penetrate from the mandibular canal through the tubules and the mandibular groove to the lingual surface of the jaw and from here are sent to the lymph nodes of the floor of the oral cavity.

This network of lymphatic vessels flows mainly into the submandibular lymph nodes - into the anterior, middle and posterior groups of lymph nodes. The lymphatic vessels of the lower lip, lower front teeth and gums flow into the anterior group of lymph nodes; in the middle - vessels of the infraorbital region, nose, all upper teeth and the remaining lower teeth. Sometimes the lymphatic vessels of the upper molars are directed to the deeper posterior group. submandibular lymph nodes, where the lymph vessels of the lower molar region are directed even less often. The vessels of the area of the lower central teeth flow into the mental lymph nodes (Fig. 22). The ratio of lymphatic vessels to the submandibular lymph nodes is not constant. There are often various options.

The submandibular lymph nodes are located on the inside of the edge of the lower jaw as follows. Anterior to the submandibular salivary gland there are anterior and middle groups of lymph nodes, with the anterior ones in front of the external maxillary artery and the middle ones behind it. The posterior group of lymph nodes is located behind the submandibular salivary gland. The mental lymph nodes are located in the midline of the chin between the geniohyoid muscles.

When injecting local anesthesia on the face, the condition of the submandibular lymph nodes should be taken into account, since they are the main filter for the absorbing anesthetic fluids injected in this area. Obstructed or slow lymphatic drainage due to changes in the lymphatic vessels

and nodes may negatively affect the results of anesthetic injections.

The condition of the lymphatic vessels and nodes of the head and neck, naturally, plays a big role in accidental complications associated with anesthetic injections in the maxillofacial area (injection of decomposed solutions of novocaine or adrenaline, accidental injection of one or another instead of an anesthetic harmful liquid, introduction of infection, etc.).

By the location and condition of the affected lymph nodes that can be palpated, it is sometimes possible to determine the origin of the disease that developed after surgical intervention inflammatory process, whether it arises from a wound after an extraction (or other operation) or after an anesthetic injection.

The condition of the lymphatic vessels and nodes when an anesthetic injection is complicated by an infection is of great prognostic significance.

The submandibular lymph nodes are palpated in two ways: simultaneously on both sides or on each side separately. In both methods, the patient is asked to slightly tilt his head down. In the first method, the doctor, standing behind the patient, places the ends of the three middle fingers into the submandibular areas being examined, feels the soft tissues of the floor of the mouth and, sliding his fingers towards the lower edge of the lower jaw and back, reveals the condition of the submandibular lymph nodes (Fig. 23). In the second method, the doctor places his right hand on the patient’s head from the front while examining the submandibular area on the right with the fingers of his left hand (Fig. 24) and - left hand when he examines the same area on the left with the fingers of his right hand (Fig. 25).

Palpation of the mental lymph nodes is done with the middle fingers of the right hand while tilting the patient's head down with the left hand (Fig. 26).