The Lymphatic System

1. The Lymphatic System Medical Foundations

2. Anatomy Tonsils and Adenoids:Help protect you from infection by trapping germs coming in through your mouth and nose. Lymph Nodes: Found in clusters in neck, armpit, and groin, house leukocytes where they filter blood.

3. Anatomy Lymphatic Vessels: Carry lymph (clear, watery fluid with proteins, salts, glucose, etc) located in neck and groin Thymus: Store leukocytes, house T cells (that destroy foreign antigens).

4. Anatomy Spleen: in the upper left quadrant, protects the body by clearing out worn out red blood cells and other foreign bodies Peyer’s Patches:lymphoid follicles in the small intestine

5. Anatomy Appendix: The lining of the appendix is filled with lymphatic tissue, which produces antibodies. Bone Marrow: store leukocytes, house mature B cells (that seek out antigens and signal to the T cells to kill)

6. Functions of the Lymphatic System • Carrying Away Waste • Lymph fluid is pushed through capillaries • Allow gases, water, and nutrients to pass through cells • Nourish cells with food, take away waste • Fighting Infection • Lymph fluid enters lymph nodes, where macrophages fight off foreign bodies • When a person has an infection, germs collect in lymph nodes

7. Problems of the Lymphatic System • Lymphadenopathy • Swollen or enlarged lymph nodes • Caused by infection • Lymphadenitis • An infection in the lymph node • Caused by bacterial infection • Lymphoma • Cancers that start in the lymph nodes • Caused by uncontrolled multiplying of cells

8. Problems of the Lymphatic System • Splenomegaly • An enlarged spleen, vulnerable to ruptures • Caused by viral infections, e.g. mono • Tonsillitis • Infection of the tonsils • Caused by increase in bacteria

9. Scenario 34: A Wild Night in the ER You are working the second shift in the emergency room at a small community hospital. You do not mind working there on Wednesday nights as it is usually pretty quiet. Tonight though, the waiting room is packed and they just keep coming.

10. Scenario 34: A Wild Night in the ER You have seen 16 patients, and they all have complained of the same symptoms: severe headache, severe vomiting, diarrhea, and abdominal cramps. The patients range in age from 5 to 36 and the only things they have in common is that they were all at the same amusement park earlier today and they all state that the symptoms came on very suddenly. You are afraid you might have an epidemic on your hands.

11. Scenario 34: A Wild Night in the ER The emergency physician notifies the health department, and they ask him if diagnostic tests for Salmonella have been done. He instructs you to obtain a routine urine specimen and stool specimen from each of the patients. Once you have obtained the stool specimens, he tells you to test them each for occult blood. He tells you to take all precautions because he is not sure what disease this is and it might be contagious.

12. Questions to Answer • What personal protective equipment will you need and what standard precautions will you need to take? • How will you protect the patient’s confidentiality and privacy in a crowded emergency room that may only have curtains separating the patient’s exam room? • Why would you need to notify the health department?

13. Sterile Field • Never reach across the top of the field • Reach in from the sides to add to the field • Never turn your back to a sterile field • 2 inches around the border are contaminated • Anything below the level of the tray is contaminated

14. Methods to Remove Sterile Articles from Sterile Wraps • Drop Method • Mitten Method • Transfer Forceps

15. Sterile Field • Keep Sterile field dry • Pathogens move quickly through wet surfaces • Take care when pouring solutions into a sterile field • When you put on sterile gloves, only handle sterile items