Vessels & Fluid

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Study Tools For Vessels & Fluid

Lymph node anatomy (Image)
Lymphatic Circulation (Image)
Lymph System Anatomy (Cheatsheet)
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Outline

Overview

  1. Functions of the Lymph Vascular System
    1. Immune responses
      1. Produce T-lymphocytes → cell-mediated immunity
      2. Produce B-lymphocytes & plasma cells → humoral immunity
      3. Macrophages present to ‘clean’ fluid
    2. Return fluids and proteins back to blood

Nursing Points

General

  1. Lymphatic Vessels
    1. Lymph-capillaries
      1. Similar to blood capillaries in size
      2. Dead-end sacs
      3. Intermingled with blood capillaries in tissues
    2. Lymphatic collecting vessels
      1. Form by fusion of capillaries
      2. Similar to veins, thinner walled, contain valves
      3. Skeletal muscle contractions move lymph through vessels
      4. Interconnect lymph nodes
    3. Lymphatic ducts
      1. Cisterna chyli @ L2
        1. Receives from vessels in legs
        2. Then splits into R & L Lymphatic ducts
      2. Right lymphatic duct
        1. Drains from R. upper quadrant
      3. Left lymphatic duct
        1. Drains from left side of body and both legs
        2. Larger than R side
      4. Final drainage
        1. Right lymphatic duct → right subclavian vein
        2. Left lymphatic duct → left subclavian vein
  2. Lymph Fluid
    1. Almost identical to blood plasma except FAR less protein
    2. Formation and circulation
      1. Blood plasma filtered → “tissue fluid” → Enters lymph caps → “lymph fluid” → Collecting vessels → Lymph ducts → Right or left subclavian vein → Cycle repeats

Assessment

  1. Lymphedema
    1. Lack of transport d/t occluded vessels
    2. Accumulation of fluid in tissues

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Transcript

In this lesson, we are going to take a look at the lymphatic system.

So to get started in the first thing we need to take a look at all the functions of the lymphatic system. The lymphatic system is part of the immune system, and its purpose really here is to produce the mature T lymphocytes & B lymphocytes, and plasma cells. Even though the cells don’t originate in the lymphatic system this is where they are actually stored and mature so that they’re ready for use. The other thing is that the lymphatic system also houses macrophages, which go to the sites of infection and they actually destroy any sort of pathogen. So they essentially clean all the fluid out. The other thing in lymphatic system does is that it returns fluids and proteins and back to the blood through lymphatic circulation which we’re getting to get into.

When we talk about the lymph system the first thing you need to know is that the lymph system is a complementary system to the circulatory system. And just like the cardiovascular system, there are different sizes of vessels that have different purposes. So starting at the smallest size, we have these things called lymph capillaries. They’re similar to size of a blood capillaries but they don’t have a continuous system. They essentially have these dead end sacs, that are very porous and allow for any of that fluid that gets lost outside of the cardiovascular system to get pulled into the lymphatic system to get put back into circulation. Now the lymph capillaries are in close proximity to the blood capillaries and they’re all intermingled.

Once the fluid is put back into the lymph system starting at these lymph capillaries, the fluid then migrates through these tubes called lymph collecting vessels. And they’re formed essentially by the fusion of capillaries and they’re similar to veins even though they have thinner walls and they contain valves. And valves are one of the most important functions of these vessels. The lymph system doesn’t have a heart or a pump to continue to propel the lymph fluid through the system, so there has to be a way for it to move. This happens by a couple of ways. The first one is at these valves, and they are very important. The valves open for fluid to pass through them, and then they close to keep the fluid from going backward. The other thing is that skeletal muscle around all of the lymph vessels squeezes the lymph vessels and propels the fluid forward to the system. At different areas there are these interconnecting lymph nodes, which help to filter out all of the lymph fluid from different types of pathogens and allows the immune system to do its job.

At some point, just like the cardiovascular system, this lymphatic system has to get the fluid back to its starting point. So as lymph fluid comes from the vessels that has to go back up to the circulatory system and essentially is going to end by emptying the lymph fluid into a vein. But it has to make its way up first. So from the lower extremities these lymph vessels dump the lymph fluid into these lymphatic ducts. From the lower extremities, they enter into a lymphatic duct called the cisterna chyli and that’s at about the space of L2. It’s going to receive that lymph from the lower extremities and then it splits into the right and left lymphatic ducts. The right lymphatic duct drains from the right upper side, and then the left lymphatic duct drains from the left side and both of the legs.

As this fluid moves through the lymphatic system, it’s going to enter back into the cardiovascular system at the subclavian veins. On the right side it’s going to enter into the right subclavian vein and for the left side is going to enter into the left subclavian vein. Because this is a low pressure system at this area, it allows for easy transport of this fluid to go from the lymphatic system back into the cardiovascular system where it mixes with blood and it can transport all of the nutrients that it needs to.

Now let’s take a second to talk about lymphatic fluid. The lymphatic fluid is nearly identical to plasma, but it has less protein. During the transport of the lymphatic fluid, what happens is blood plasma is filtered through this fluid exchange and this happens at the level of the high-pressure capillary arterioles. Because of this high pressure system, this tissue fluid gets filtered, and as it leaks out and then re enters back into the lymph system as lymph fluid and it’ll enter at the level of lymph capillaries. Then is transported through those collecting vessels to the lymphatic ducts, and then it re-enters the cardiovascular system through that subclavian vein.
Okay so let’s recap.

We were talking about the lymphatic system, remember that its main purpose is to return the blood back to the circulatory system and it houses those mature T & B lymphocytes so that it helps with the immunity.

The lymph capillaries are the first stage of returning that lymph fluid back into the circulatory system, and then it travels to those lymphatic ducts.

The cisterna chyli is the main area that receives lymph from the legs and then it split into the right and left lymphatic ducts.

Valves and skeletal muscle contraction are the main source of propelling that lymph fluid back up to the level of the heart.

And lastly lymph fluid is the fluid that’s being transported back into the circulatory system. It contains far less Protein than blood plasma, but it also serves to filter out that fluid at the same time.
And that’s it for our lesson on lymphatic vessels and fluid. Make sure you check out all the resources attached to this lesson. Now, go out and be your best selves today, and as always, happy nursing!

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Concepts Covered:

  • Cardiac Disorders
  • Musculoskeletal Trauma
  • Integumentary Disorders
  • Neurologic and Cognitive Disorders
  • Oncology Disorders
  • EENT Disorders
  • Respiratory Disorders
  • Gastrointestinal Disorders
  • Hematologic Disorders
  • Communication
  • Test Taking Strategies
  • Pregnancy Risks
  • Fundamentals of Emergency Nursing
  • Concepts of Mental Health
  • Basics of NCLEX
  • Prioritization
  • Emotions and Motivation
  • Tissues and Glands
  • Skeletal System
  • Muscular System
  • Nervous System
  • Sensory System
  • Circulatory System
  • Hematologic System
  • Respiratory System
  • Digestive System
  • Urinary System
  • Endocrine System
  • Reproductive System
  • Labor Complications
  • Disorders of Pancreas
  • Eating Disorders
  • Neurological Emergencies
  • Noninfectious Respiratory Disorder
  • Vascular Disorders
  • Upper GI Disorders
  • Lower GI Disorders
  • Liver & Gallbladder Disorders
  • Urinary Disorders
  • Sexually Transmitted Infections
  • Female Reproductive Disorders
  • Renal Disorders
  • Integumentary Disorders
  • Integumentary Important Points
  • Immunological Disorders
  • Shock
  • Endocrine and Metabolic Disorders
  • Musculoskeletal Disorders
  • Musculoskeletal Disorders
  • Neurological Trauma
  • Central Nervous System Disorders – Brain
  • Central Nervous System Disorders – Spinal Cord
  • Peripheral Nervous System Disorders
  • Emergency Care of the Neurological Patient
  • Respiratory Emergencies
  • Infectious Respiratory Disorder
  • Oncologic Disorders
  • Studying
  • Cardiovascular Disorders
  • Basic
  • Adult
  • Pediatric
  • Neonatal
  • Emergency Care of the Trauma Patient
  • Emergency Care of the Cardiac Patient
  • Emergency Care of the Respiratory Patient

Study Plan Lessons

The 5-Minute Assessment (Physical assessment)
General Assessment (Physical assessment)
Integumentary (Skin) Assessment
Neuro Assessment
Head/Neck Assessment
EENT Assessment
Heart (Cardiac) and Great Vessels Assessment
Thorax and Lungs Assessment
Abdomen (Abdominal) Assessment
Lymphatic Assessment
Peripheral Vascular Assessment
Musculoskeletal Assessment
Genitourinary (GU) Assessment
Communicating with Patients
SATA
Absolute Words
Nursing Process
What do you want me to know?
Duplicate Facts
Repeating Words
Denying Feelings
NCLEX® Question Traps
Opposites
Same
Priority
Acute vs Chronic
Hierarchy of O2 Delivery
Nutrition Assessments
Abuse
Therapeutic Communication
Nurse-Patient Relationship
Thinking Like a Nurse
Critical Thinking
Prioritization
Triage
Maslow’s Hierarchy of Needs in Nursing
Overview of the Nursing Process
Skin Structure & Function
Skeletal Anatomy
Bone Structure
Development of Bones
Joints
Muscle Anatomy (anatomy and physiology)
Muscle Cytology
Skeletal Muscle
Muscle Contraction
Muscle Physiology
Nervous System Anatomy
Membrane Potentials
Nerve Transmission
Autonomic Nervous System (ANS)
Spinal Cord
Cranial Nerves
Sensory Basics
Intro to Circulatory System
The Heart
Cardiac Cycle
Electrical Activity in the Heart
Cardiac (Heart) Physiology
Blood Vessels
Blood Pressure (BP) Control
Blood Plasma
Blood Grouping
Vessels & Fluid
Respiratory Structure & Function
Breathing Movements
Breathing Control
Respiratory Functions of Blood
Digestive System Anatomy
Mouth & Oropharynx
Esophagus
Stomach Video
Small Intestine
Large Intestine
Liver & Gallbladder
Urinary System Anatomy (Anatomy and Physiology)
Renal (Kidney) Structure & Function
Renin Angiotensin Aldosterone System (RAAS)
Formation & Excretion of Urine
Renal (Kidney) Fluid & Electrolyte Balance
Renal (Kidney) Acid-Base Balance
Pituitary Gland
Thyroid Gland
Adrenal Gland
Pancreas
Male Reproductive Anatomy (Anatomy and Physiology)
Female Reproductive Anatomy (Anatomy and Physiology)
Epithelial (Skin) Tissues
Types of Epithelial (Skin) Tissue
Glands
Connective Tissues
Membranes
Fluid Compartments
Fluid Pressures
Fluid Shifts (Ascites) (Pleural Effusion)
Isotonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Hypertonic Solutions (IV solutions)
Potassium-K (Hyperkalemia, Hypokalemia)
Sodium-Na (Hypernatremia, Hyponatremia)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Phosphorus-Phos
Heart (Cardiac) Sound Locations and Auscultation
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology for Hemorrhagic Stroke (CVA)
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Nursing Care and Pathophysiology for Arterial Disorders
Nursing Care and Pathophysiology for Aortic Aneurysm
Venous Disorders (Chronic venous insufficiency, Deep venous thrombosis/DVT)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
GERD (Gastroesophageal Reflux Disease)
Nursing Care and Pathophysiology for Pancreatitis
Nursing Care and Pathophysiology for Diverticulosis – Diverticulitis
Nursing Care and Pathophysiology for Hemorrhoids
Nursing Care and Pathophysiology for Appendicitis
Nursing Care and Pathophysiology for Cholecystitis
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Nursing Care and Pathophysiology of BPH (Benign Prostatic Hyperplasia)
Nursing Care and Pathophysiology for Syphilis (STI)
Nursing Care and Pathophysiology for Herpes Simplex (HSV, STI)
Nursing Care and Pathophysiology for Menopause
Nursing Care and Pathophysiology of Glomerulonephritis
Pressure Ulcers/Pressure injuries (Braden scale)
Nursing Care and Pathophysiology for Herpes Zoster – Shingles
Skin Cancer
Integumentary (Skin) Important Points
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Breast Cancer
Diabetes Management
Nursing Care and Pathophysiology for Sepsis
Fluid Volume Deficit
Fluid Volume Overload
Nursing Care and Pathophysiology for Rheumatoid Arthritis (RA)
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology of Osteoporosis
Nursing Care and Pathophysiology for Compartment Syndrome
Fractures
Casting & Splinting
Impulse Transmission
Cerebral Metabolism
Blood Brain Barrier (BBB)
Levels of Consciousness (LOC)
Routine Neuro Assessments
Adjunct Neuro Assessments
Brain Death v. Comatose
Intracranial Pressure ICP
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for Parkinsons
Miscellaneous Nerve Disorders
Tension and Cluster Headaches
Migraines
Nursing Care and Pathophysiology for Ischemic Stroke (CVA)
Stroke Assessment (CVA)
Stroke Therapeutic Management (CVA)
Stroke Nursing Care (CVA)
Seizure Causes (Epilepsy, Generalized)
Seizure Assessment
Seizure Therapeutic Management
Nursing Care and Pathophysiology for Seizure
Neurological Fractures
Spinal Cord Injury
Nursing Care and Pathophysiology for Meningitis
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Nursing Care and Pathophysiology for Pulmonary Edema
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology of Pneumonia
Isolation Precautions (MRSA, C. Difficile, Meningitis, Pertussis, Tuberculosis, Neutropenia)
Coronavirus (COVID-19) Nursing Care and General Information
Artificial Airways
Airway Suctioning
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Nursing Care and Pathophysiology for Pulmonary Embolism
Lung Sounds
Alveoli & Atelectasis
Gas Exchange
Wound Care – Assessment
Aortic Aneurysm – Management Nursing Mnemonic (CRAM)
Aortic Aneurysm – Thoracic signs Nursing Mnemonic (PEE BADS)
Bacterial Endocarditis – Symptoms Nursing Mnemonic (Be Joan Of Arc)
Cardiac Valves Blood Flow Nursing Mnemonic (Toilet Paper my Ass)
Circulatory Checks (5 P’s) Nursing Mnemonic (The 5 P’s)
Coronary Arteries – Location Nursing Mnemonic (I have a RIGHT to CAMP if you LEFT off the AC)
Cor Pulmonale – Signs & Symptoms Nursing Mnemonic (Please Read His Text)
CHF Treatment Nursing Mnemonic (UNLOAD FAST)
Cyanotic Defects Nursing Mnemonic (The 4 T’s)
Heart Failure-Left-Sided Nursing Mnemonic (CHOP)
Heart Failure-Origin Nursing Mnemonic (Left – Lung|Right – Rest)
Heart Failure – Right Sided Nursing Mnemonic (HEAD)
Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)
Hypertension- Complications Nursing Mnemonic (The 4 C’s)
Hypertension – Nursing care Nursing Mnemonic (DIURETIC)
Increase MAP Nursing Mnemonic (VAK)
Murmur locations Nursing Mnemonic (hARD ASS MRS. MSD)
Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)
Vascular Disease – Deep Vein Thrombosis Nursing Mnemonic (HIS Leg Might Fall off)
Vascular disease – Raynaud’s symptoms Nursing Mnemonic (COLD HAND)
Digestion & Absorption
Nutrition-related Diseases
CPR-BLS (Basic Life Support)
Advanced Cardiovascular Life Support (ACLS)
Pediatric Advanced Life Support (PALS)
Neonatal Resuscitation Program (NRP)
Prioritizing Assessments
Triage in the ER
Critical Incident Management
Aggressive & Violent Patients
Legal & Ethical Issues in ER
EMTALA & Transfers
Trauma Survey
Blunt Thoracic Trauma
Penetrating Thoracic Trauma
Blunt Abdominal Trauma
Penetrating Abdominal Trauma
Crush Injuries
Head Trauma & Traumatic Brain Injury
Massive Transfusion Protocol
Acute Coronary Syndrome (ACS)
Aneurysm & Dissection
Cardiopulmonary Arrest
Dysrhythmia Emergencies
Heart (Heart) Failure Exacerbation
Hypertensive Emergency
Arterial Pressure Monitoring
Rapid Sequence Intubation
Pulmonary Embolism
Acute Respiratory Distress
Ventilator Settings
Acute Confusion
Intracranial Hemorrhage
Increased Intracranial Pressure
Stroke (CVA) Management in the ER
Seizure Management in the ER
Sodium and Potassium Imbalance for Certified Emergency Nursing (CEN)