Lymphatic vessels on the face. Violation of the coagulation ability of the lymph

The fluid that enters the tissue is lymph. The lymphatic system is an integral part of the vascular system, providing 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. blindly end in tissues. Lymphatic vessels of medium and large diameter, like veins, have valves. Lymph nodes are located along their course - "filters" that trap viruses, microorganisms and the largest particles 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 are highly permeable and have the ability to absorb colloidal solutions and suspensions. Lymphatic capillaries pass 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 enter 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 that 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 depart from the node, which are combined 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 that is absorbed in the gastrointestinal tract enters the bloodstream;
the lymphatic system also performs a homeostatic function, maintaining the constancy of the composition and volume of the interstitial fluid;
the lymphatic system does drainage function and removes excess tissue (interstitial) fluid located in the organs.

The formation and circulation of lymph ensure 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 lymphatic system becomes apparent if the outflow of lymph from some area of the body is reduced or stopped (for example, when squeezing the limbs with clothing, blockage of the lymphatic vessels during their injury, crossing during surgical operation). In these cases, local tissue edema develops distal to the compression site. This type of edema is called lymphatic.

The return to the bloodstream of albumin, filtered into the intercellular fluid from the blood, especially in organs with highly permeable (liver, gastrointestinal tract). More than 100 g of protein returns to the bloodstream per day with lymph. Without this return, the loss of protein 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 signaling 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 protection organism.

Protective function of the lymphatic system is also manifested in the fact that foreign particles, bacteria, remnants of destroyed cells, various toxins are filtered out in the lymph nodes, and in some cases neutralized tumor cells. With the help of lymph, red blood cells that have left the blood vessels are removed from the tissues (in case of injuries, damage to blood vessels, 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 blood filtrate formed from tissue fluid. She has alkaline reaction, it is absent, 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 draining from various organs and fabrics, has different composition depending on the characteristics of their metabolism and activity. The lymph flowing from the liver contains more proteins, the lymph contains more. Moving along the lymphatic vessels, the 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 erythrocytes, there are platelets and many lymphocytes. Its functions are aimed at maintaining homeostasis (the return of protein from tissues to the blood, the redistribution of fluid in the body, the formation of milk, participation in digestion, metabolic processes), as well as participation in immunological reactions. The lymph contains protein (about 20 g/l). Lymph production is relatively low (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 filtering.

Lymph formation due to the transition of water and dissolved substances from the blood capillaries to the tissues, and from the tissues to the lymphatic capillaries. At rest, the processes of filtration and absorption in the capillaries are balanced and the lymph is completely absorbed back into the blood. In the case of increased physical activity in the process of metabolism, a number of products are formed that increase the permeability of capillaries for protein, its filtration increases. Filtration in the arterial part of the capillary occurs when the hydrostatic pressure rises 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. Lymphatic formation is promoted by an increase osmotic pressure tissue fluid and lymph in the lymphatic vessels.

The movement of lymph through the lymphatic vessels occurs due to the suction force chest, contraction, contraction 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 a contraction of the lymphatic vessels, and when the parasympathetic fibers are activated, the vessels contract and relax, which increases the lymph flow.

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

Formation and amount of lymph

Lymph is a fluid that flows through the lymphatic vessels and is part of the internal environment organism. The sources of its formation are filtered from the microvasculature into the tissues and the 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 fluid of the intercellular medium that are not reabsorbed into the blood vessels per day enter the lymphatic capillaries, the system of lymphatic vessels through the interendothelial clefts, and return to the blood again (Fig. 1).

Lymphatic vessels are found in all organs and tissues of the body with the exception of surface layers skin and bone tissue. Most of them are found in the liver and small intestine, where about 50% of the total daily volume of the body's lymph is formed.

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

Rice. 1. Schematic structure of a lymphatic capillary. The arrows show the direction of lymphatic flow.

Lymph contains lymphocytes and other forms of white blood cells. Their number in different lymphatic vessels varies and is in the range of 2-25 * 10 9 / l, and in the thoracic duct is 8 * 10 9 / l. Other types of leukocytes (granulocytes, monocytes and macrophages) are contained in the lymph in a small amount, but their number increases with inflammatory and other pathological processes. Red blood cells and platelets can appear in the lymph when blood vessels are damaged and tissue injuries.

Absorption and movement of lymph

Lymph is absorbed into the lymphatic capillaries, which have a number of unique properties. Unlike blood capillaries, lymphatic capillaries are closed, blindly ending vessels (Fig. 1). Their wall consists of a single layer of endothelial cells, the membrane of which is fixed with the help of collagen filaments to extravascular tissue structures. 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 the lymphatic capillaries gives them the ability to change the permeability over a wide range. Thus, during contraction of skeletal muscles or smooth muscle internal organs due to the tension of the collagen filaments, interendothelial gaps can open, through which the intercellular fluid, the mineral and organic substances contained in it, 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, which are formed in the lymph nodes, enter the lymph. The flow 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 parts of the lymphatic vessels and the presence of valves in them.

The wall of the 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 functioning of which are similar to the valves of the venous vessels. When smooth myocytes are relaxed and the lymphatic vessel is dilated, the valve leaflets open. With the contraction of smooth myocytes, which causes narrowing of the vessel, the pressure of the lymph in this area of the vessel increases, the valve flaps close, the lymph cannot move in the opposite (distal) direction and is pushed through the vessel proximally.

Lymph from the lymphatic capillaries moves into postcapillary and then into large intraorgan lymphatic vessels that flow into the lymph nodes. From the lymph nodes, through small extraorganic lymphatic vessels, lymph flows into larger extraorganic vessels that form the largest lymphatic trunks: the right and left thoracic ducts, through which the 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 to 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 the lymph flow is formed by a number of factors.

The difference between the hydrostatic pressure of the 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 the skeletal or smooth muscles of the internal organs. For example, abbreviation respiratory muscles creates rhythmic pressure changes in the thoracic and abdominal cavities. Pressure drop in chest cavity when inhaled, 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 muscular work increases by 10-15 times. After 5-6 hours after eating, the volume of lymph flowing from the intestine increases, its composition changes. This occurs mainly due to the entry of chylomicrons and lipoproteins into the lymph.

Clamping of the veins of the legs or standing for a long time leads to difficulty returning venous blood from feet to heart. At the same time, the hydrostatic pressure of blood in the capillaries of the extremities increases, filtration increases and an excess of tissue fluid is created. The lymphatic system under such conditions cannot provide sufficient its drainage function, which is accompanied by the development of edema.

lymphatic system

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

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

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

Lymphocytopoietic function of the lymphatic system is provided by the activity of the lymph nodes. They carry out the production of lymphocytes, which enter the lymphatic and bloodstream. In the peripheral lymph, which is formed in the 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, 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.

Leaving 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. In the end, all the lymph through two lymphatic trunks flows 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 freely moves through the 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 the resulting 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; e) suction action 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 may change or the lumen is completely closed (shutdown from the lymph outflow). The tone of the muscular membrane of the lymphatic vessels, as well as the activity of the blood vessels, is regulated by the central nervous system.

Lymph nodes - organs of lymphocytopoiesis and the formation of antibodies, located along the lymphatic vessels and together with them making up the lymphatic system. Lymph nodes are located in groups.

From numerous lymph nodes head and neck 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 dense accumulations of mesenteric lymph nodes are located; through them pass all the lymphatic vessels of the intestine, originating in the intestinal villi.

From the lymphatics lower extremities superficial inguinal lymph nodes located in inguinal region, and femoral lymph nodes, located slightly below the inguinal nodes - on the anterointernal surface of the thighs, as well as popliteal lymph nodes.

From the lymph nodes of the chest and upper limbs, it is necessary to pay attention to the axillary lymph nodes, located rather superficially in armpit, and ulnar lymph nodes located in the ulnar fossa - at the internal tendon of the biceps muscle. Through all these nodes pass lymphatic vessels, originating in the cracks and tissues of the upper limbs, chest and upper back.

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

Lymphatic vessels merge into several large vessels - the vessels of the lower extremities and lower body 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 enters the general blood stream at the confluence of the jugular and subclavian veins.

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

The acceleration of lymphatic flow during muscular 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, removing excess capillary filtrate, is directly involved in the normalization of hydrostatic pressure in the interstitial space. Raise transport function lymphatic system is simultaneously accompanied by stimulation and resorption function. The resorption of fluid and plasma proteins from the intercellular space to 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 channel. Removing excess fluid from tissues, while redistributing it within the extracellular space, the lymphatic system creates conditions for the normal implementation of 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 system 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, which play an important role in phase changes in the lymph flow during dosed muscular work and in recovery period, include changes in the neurohumoral provision of muscle activity and lymph circulation processes, changes in the functional state of organs, motor activity skeletal muscles, parameters of external respiration.

There is now a real opportunity to actively influence functional state lymphatic system (Mikusev Yu. E.). Physical lymphostimulants include:

Local irritants(compresses, mustard plasters, banks);

Means of physiotherapy exercises;

Methods of oriental reflexology;

electromagnetic fields;

Hyperbaric oxygenation.

Methods for stimulating lymph formation and lymph circulation:

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

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

B. Contributing, due to their molarity, to the influx of fluid into the vascular system and thereby increasing the hydrodynamic pressure of the blood.

C. Influencing rheological properties blood and lymph.

2. Means that affect the system of microlymphohemocirculation:

A. Changing the permeability of cell membranes.

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

3. Drugs affecting 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 the movement of the lymph or contribute to it.

Biological methods of lymphostimulation:

Intravenous drip infusion of autologous blood;

Intravenous drip infusion of the central autolymph;

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

On upper limb lymphatic vessels begin on the back and palmar surfaces of the fingers with transverse trunks. The latter, having reached the lateral surfaces of the fingers, gather into larger trunks that rise vertically to the palm (Fig. 5).

Rice. 5. Location of the lymphatic network in the upper extremities

This arrangement of the lymphatic pathways determines the technique of stroking and rubbing the fingers. Massages should be in the following way:

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

The massage therapist needs to familiarize himself in detail with the location of the network of lymphatic tracts and with the directions in which the massage should be performed.

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

On the side surface - straight up.

Further, the vessels of the back surface of the hand go mainly along the interosseous spaces and rise to the forearm, and the vessels of the palm are directed along the radius from the center of the palm to the elevations thumb and little finger. From the palm of the hand, the vessels pass to the forearm and shoulder almost vertically and reach the axillary nodes. From the back surface of the hand, the lymphatic vessels, bending around the shoulder, also go to these nodes; while some of them go 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 ulnar nodes.

Therefore, when massaging the forearm, the masseur'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 back 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 back and inner surface, bending around the thigh from behind, also reach the same group of inguinal nodes. Part of the lymphatic vessels passes through two or three nodes located in the popliteal fossa (Fig. 6)

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

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

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

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

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

Consequently, the direction of movement of the masseur's hands when massaging the muscles of the chest, upper and middle parts of the 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 on top of the sternocleidomastoid muscle and deep below it. A plexus is formed from them, which accompanies the carotid artery and the jugular vein and, near the lower end of this vein, forms one common trunk, which flows into the upper end of the thoracic duct.

When massaging the head and neck, the movements of the massage therapist's hands are directed downwards (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 performed 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 chest is 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 inguinal - when massaging the lumbosacral region; the neck muscles are massaged in the direction of the massage therapist's hands downwards, to 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 causes the muscular vascular organ - the heart, and the movement of blood through the veins is provided by the muscular-valve structure of the veins. This is how the large and small circles of blood circulation function.

But the lymphatic channel does not have such a "drive". The movement of lymph is slow and is provided by the muscles. The main muscle for driving the lymph is the diaphragm. This is a kind of "heart" of the lymphatic system. During physical activity and deep breathing"belly" the amplitude of the movement of the diaphragm increases, and the circulation of the lymph increases, i.e. its stagnation is removed.

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

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

Under stress, it usually dries up in the mouth, saliva is not released, stagnation occurs in the lymphatic system. And the man is given water to drink. But this is undesirable. It is better to stimulate the secretion of saliva with sucking movements of the lips in order to release the saliva in the mouth and make swallowing movements.

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

Should be abandoned bad habit- Drink drinks immediately after meals on the third and have fruit for dessert. Do not store yesterday's food in the refrigerator, as it (especially heated) is rich in toxins that have appeared from the reproduction of putrefactive bacteria, and after eating it fills the entire intercellular space and lymphatic system in the human body with ballast.

The lymphatic system is a system that even doctors don't know well. They never seriously studied it. The lymphatic system works in one direction. All lymph flows from bottom to top. Swelling on the legs, arms, eyes, lower back, joints - it's all lymph. A bacterium, virus or fungus enters the body. What does lymph do? Near the hit is a large lymph node, for example, the genital tract. Lymph nodes block the passage of infection further.

If gonorrhea passed through the body and got into the brain, then people would die immediately. Lymphocytes come out of 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, this is all lysed, activated and thrown out. The first route of lymph flow in the body is through the vagina and urethra. Everything related to leucorrhea in women, discharge in men, suggests that someone lives in the body, and the lymph of this someone eats, at the cost of its own life, and deletes. The second escape route is in the intestine, which contains tens of thousands of small lymph nodes.

Up to 50% of poisons come out through sweat and armpits. Now people use deodorants, from which a person does not sweat for 24 hours. They do not sweat under the armpits, but the palms sweat. Still doing cosmetic surgery when the lymphatic ducts are cut. The forehead should not sweat. If the armpits are clogged, then the entire surface of the body sweats. This indicates the second degree of damage and pollution of the lymph. The face should be relatively dry, and under the armpits should flow, because there is a powerful sweat collector. There are not many sweat glands on the face.

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

The salivary glands are a powerful detoxifying organ. Up to half a liter of toxic sputum is excreted through saliva. If a child has saliva on the pillow, then this indicates serious problems of the lymphatic system. If a person or a child sweats in a dream, then this may indicate that he has pinworms, Giardia, or something else. Children should not sweat even at a temperature environment 30C. They have a poorly developed sweat system. If small child at night wet head means he is sick. In a child, everything should go through the kidneys, intestines.

Larynx. Chronic laryngitis or pharyngitis are the lymph nodes of the pharynx and larynx. With this diagnosis, a person chronic infection chronic fungus or chronic streptococcus. They are candidates for chronic lymphatic involvement.

Tonsils are the most powerful springboard for various bacteria. Streptococcus always goes through the tonsils. This is angina, 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 minks for air and membranes 1 micron thick. Everything else there is garbage.

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 way. The fungus through the nose will never go. The fungus is excreted through nearby organs. If it is foot, 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. She will kill all the lymphatic collectors. The lymphatic system will open the skin and eject the lymphatic fluid right between the fingers. The lymph nodes of the bones will never miss the fungus. If the whole body is affected by the fungus, then fungal bronchitis begins. The deep lymph nodes of the bronchi are connected, and a person may begin bronchial asthma (we are talking not about psychosomatics, when a person draws attention to himself with an illness).

joint inflammation is a lesion of the lymphatic system. Everyone believes that swelling in the legs is cardiac, renal. Edema can only be lymphatic. The heart is depleted and cannot pump blood. But it is not blood that lingers 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. Eye puffiness is a blockage of the submandibular and facial lymph nodes. This indirectly indicates blockage of the kidneys. If the kidneys secrete less fluid than they need, then there is more of it in the body.

SO:

For the functioning of the lymphatic system, it’s not enough just to “drink a pill”- for people leading sedentary image life at least needs to be done breathing exercises, “breathe with your stomach”, do at least minimal exercises, try to walk more. This allows you to partially eliminate the stagnation of the lymph.

Lymphatic system - an integral part of the vascular system that drains tissues by forming lymph and conducting 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 a fluid that fills the vessels of the lymphatic channel and nodes. It, like blood, belongs to the tissues of the internal environment and performs trophic and protective function. In its properties, despite the 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 is made up of plasma and shaped elements. Its plasma contains proteins, salts, sugar, cholesterol and other substances. The protein content in the lymph is 8-10 times less than in the blood. 80% of the formed elements of the lymph are lymphocytes, and the remaining 20% are the share of other white blood cells. There are no normal erythrocytes in the lymph.

Functions of the lymphatic system:

Tissue drainage.

Ensuring continuous fluid circulation 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 away 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 that ensure the movement of lymph

Filtration pressure (due to the filtration of fluid from the blood capillaries into the intercellular space).

Permanent formation of lymph.

Availability of valves.

Contraction of the surrounding skeletal muscles and muscle elements of the internal organs (they squeeze the lymphatic vessels and the lymph moves in the direction determined by the valves).

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

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

Lymph capillaries- thin-walled vessels, the diameter of which (10-200 microns) exceeds the diameter of blood capillaries (8-10 microns). The lymphatic capillaries are characterized by tortuosity, the presence of constrictions 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 (there is a basement membrane in the blood capillaries outside the endothelium).

Lymph 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 the lymphatic capillaries and blood 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 in only one direction.

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

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

1 - segment of the lymphatic vessel with valves.

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

There are also intraorganic and extraorganic lymphatic vessels. Due to the existence of numerous anastomoses, intraorganic lymphatic vessels form wide-looped plexuses. The lymphatic vessels emerging from these plexuses accompany the arteries, veins and exit the organ. Extraorganic lymphatic vessels are sent to nearby groups of regional lymph nodes, usually accompanying blood vessels, more often veins.

On the path of the lymphatic vessels are located The lymph nodes. This determines that foreign particles, tumor cells, etc. linger 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 organ or tissue - these are the lymph nodes that are the first in the path of the lymphatic vessels that carry lymph from this area of the body.

lymph 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 lymph trunks in the human body.

jugular trunk(right and left) is represented by one or more 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 upper 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 divert lymph from the lower limb, walls and organs of the pelvis and abdomen.

Inconsistent intestinal lymphatic trunk occurs in about 25% of cases. It is formed from the efferent lymphatic vessels of the mesenteric lymph nodes and flows into the initial (abdominal) part of the thoracic duct with 1-3 vessels.

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 - unpaired vein;

9 - semi-unpaired 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

Lymph 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 so-called venous angle formed by the union 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 limb. The right lymphatic duct flows into the right venous angle, through which lymph is brought from 1/4 of the body: from the right half of the chest, neck, head, 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 of 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 crus of the diaphragm, the contractions of which contribute to pushing the lymph into chest part duct. Level VII cervical vertebra the thoracic duct forms an arc and, having rounded 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 the penetration of blood from the vein into the duct. IN upper part thoracic duct joins the left bronchomediastinal trunk (truncus bronchomediastinalis sinister), collecting lymph from the left half of the chest, as well as the left subclavian trunk (truncus subclavius sinister), collecting lymph from the left upper limb and the left jugular trunk (truncus jugularis sinister), carrying lymph from the left half of the head and neck.

Right lymphatic duct (ductus lymphaticus dexter) 1-1.5 cm long, formed at the confluence of the right subclavian trunk (truncus subclavius dexter), which carries lymph from the right upper limb, the right jugular trunk (truncus jugularis dexter), which collects lymph from the right half of the head and neck, and the right bronchomediastinal trunk (truncus bronchomediastinalis dexter), which brings lymph from the right half of the chest. However, more often the right lymphatic duct is absent, and the trunks forming it flow into the right venous angle on their own.

Lymph nodes of certain areas of the body.

Head and neck

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

So, 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 - rear ear lymph nodes; 3 - occipital lymph nodes; 4 - lower ear lymph nodes; 5 - buccal lymph nodes; 6 - chin 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 in large numbers accompany the internal jugular vein, and superficial lie near the external jugular vein. In these nodes, mainly in the deep cervical ones, 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 on the upper limb: elbow and axillary. The ulnar nodes lie in the ulnar fossa and receive lymph from part of the vessels of the hand and forearm. Through the efferent vessels of these nodes, the lymph flows into the axillary nodes. 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 depth 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.

chest 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 bifurcation of the trachea (tracheobronchial), in the hilum 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 (peripheral), etc. Lymph flows from the organs and partially from the walls of the chest cavity into these nodes.

lower limb

On the lower extremity, 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 arteries and veins. These nodes receive lymph from part of the lymphatic vessels of the foot and lower leg. The efferent vessels of the popliteal nodes carry lymph mainly to the inguinal nodes.

Inguinal lymph nodes are divided into superficial and deep. Superficial inguinal nodes lie below the inguinal ligament under the skin of the thigh on top of the fascia, and 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 to the external iliac nodes, which are related to the nodes of the pelvis.

In the pelvis, the lymph nodes are located, as a rule, along the course of the blood vessels and have a similar name (Fig. 61). So, 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 to 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 course of the blood vessels, including the vessels passing through the gates of the organs. So, along the course of the abdominal aorta and the 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 lies 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 region of the gate 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. Lymph from the lower extremities and pelvis also enters the lumbar lymph nodes. It should be noted that the lymphatic vessels of the small intestine are called lactiferous, 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). The lymph of 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, and the third is the cervical. Facial nodes are buccal (Igl. buccalis) and parotid (Igl. paratideae) lymph nodes; the group of submandibular nodes is composed of the submandibular

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

the group of cervical nodes includes lingual (Igl. omohyoidea and sub-digastrica) and 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, the subcutaneous lymphatic region and the submucosa are distinguished. The lymphatic vessels of these areas are collected at the upper and lower transitional folds and closed 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 comparative superficial ways outflow, corresponding i0b

palatine and lingual networks of lymphatic vessels with deeper lymph outflow tracts.

The lymphatic drainage of the buccal regions forms a plexus that spreads according to the branching facial vein. Lymphatic vessels upper teeth are grouped accordingly to the anterior, lateral and posterior teeth and penetrate from the depth of the bone through the existing in the anterior wall upper jaw the bone tubules and the infraorbital foramen to the anterior surface of the bone and from here go 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 there are directed to the lymph nodes of the floor of the oral cavity.

The specified 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 - the vessels of the infraorbital region, nose, all upper teeth and other lower teeth. Sometimes the lymphatic vessels of the upper molars are directed to the deeper posterior group. submandibular lymph nodes, where the lymphatic vessels of the lower molar region are sent even less often. The vessels of the region of the lower central teeth flow into the submental lymph nodes (Fig. 22). The ratio of lymphatic vessels with submandibular lymph nodes is not constant. Often there are various options.

The submandibular lymph nodes are located on the inner side of the edge of the lower jaw as follows. Anterior 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 submental lymph nodes are located along the midline of the chin between the geniohyoid muscles.

In case of local injection anesthesia on the face, the condition of the submandibular lymph nodes should be taken into account, since they are the main filter of the anesthetic fluids injected in this area. Difficult or slow lymph flow due to changes in the lymphatic vessels

and nodes can adversely affect the results of pain injections.

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

By the localization and condition of the palpable affected lymph nodes, one can sometimes 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 in case of an anesthetic injection complicated by an infection is of great prognostic value.

Palpation of the submandibular lymph nodes is performed in two ways: simultaneously on both sides or on each side separately. In both methods, the patient is offered to slightly tilt his head down. In the first method, the doctor, being behind the patient, brings the ends of the three middle fingers to the examined submandibular areas, gropes for the soft tissues of the bottom of the mouth and, sliding his fingers towards the lower edge of the lower jaw and back, reveals the state of the submandibular lymph nodes (Fig. 23). In the second method, the doctor puts his right hand on the patient’s head from the front while examining the submandibular region on the right with the fingers of the left hand (Fig. 24) and - left hand when he explores the same area on the left with the fingers of his right hand (Fig. 25).

Palpation of the chin lymph nodes is performed with the middle fingers of the right hand when the patient's head is tilted down with the left hand (Fig. 26).