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00:16 All right, everything looks like it's now. Up here you guys got

00:20 slides are good. You don't have slide yet. You're like, don't

00:23 , I'm gonna I'm gonna catch you . All right, So we have

00:26 couple of people who are still taking test today, so I want to

00:29 their grades in and then give you the calculations on thursday plus it's valentine's

00:34 and I don't want people depressed on day. Yeah, no, actually

00:39 really is. I just looked at graph and I was like, these

00:42 are making things ugly. So I to just kind of get them out

00:45 the way um what we're gonna be over the next couple of days,

00:48 think it's five lectures in this unit then we have a test and then

00:52 have like a week before spring So we have like two lectures for

00:56 unit, three before spring break. this unit was one is one of

00:59 really weird units because what we're going be dealing with is kind of an

01:03 of the vascular system in lymphatic. then what we do is we go

01:08 we start talking about the immune system the immune system can be pretty

01:12 And I'm not saying that to scare because I'm gonna try to keep it

01:15 at the at the most simplest but there are aspects of it that

01:18 be pretty wonky. And then what do is we jump into respiration,

01:22 is actually pretty easy, right? mean you guys understand the concepts of

01:27 . Excellent. That you understand the system right now. What I will

01:31 , you know with regard to the is I did notice, I mean

01:35 exams are about where I'd expect to there a little bit lower than

01:38 but it's been like eight years or eight years, four years since I've

01:41 this class. So I the last I thought it was pre pandemic.

01:47 . And so I had you over the pandemic, we saw a

01:51 drop in performances across all courses. so we're kind of playing catch up

01:56 as students as well as faculty trying bring people back up to a level

02:01 was pre pandemic. And so seeing grades on this, I'm not

02:04 Alright. They're not bad grades. just not as good as they used

02:08 be. It's like a three or Point difference on the average, but

02:11 talk about it more on Thursday. , but what I do want to

02:14 before doing that because some of you in panic mode. So first

02:18 don't panic. All right, this literally the first test out of four

02:23 we have a curve and we still 75% of the class of homeworks.

02:28 mean, trust me, you have much to do before you have to

02:32 panicking that it's just a waste of and effort. There there are more

02:36 to worry about Like um is it to rain this afternoon is more important

02:41 now than worrying about this class. ? So, we just gotta

02:44 we just gotta ask ourselves, are interested in it? Are we interested

02:47 the material? Right. If you're this class, you should be

02:51 Right. Because you have a Everyone here has a goal, a

02:54 term goal of medicine of some right? Anyone here just taking it

02:58 fun, Your hair taking it for . I'm awesome because that means you're

03:03 also. But but you gotta keep in terms of, okay, I'm

03:07 to learn how to be a learner you're about to go into a field

03:11 things are going to be lots of the only way it's gonna be

03:17 There's nothing that you're gonna do from on out. That's gonna be

03:20 you can't do, right? No gonna drop you into something, but

03:23 just lots of information that you have be able to hold on to and

03:27 . And so part of this is learning process of organizing information. All

03:31 . And so if this is new you, I mean, you

03:34 people who took me in a P , they've heard this talk over and

03:37 and over and over and over and again. And it's not me mad

03:40 you. It's just I'm just warning . That's the big hurdle. There's

03:44 hard about it. I mean, think the hardest thing about medicine is

03:48 blood and bodily fluids of all right? But you guys plan on

03:54 that. You knew that right? in their their bodily fluids involved.

03:57 all good with bodily fluids, you there's some people here planning on

04:02 There's mouths getting in other people's I just now. All right.

04:10 part of this is while we're going and think about how to organize this

04:15 . The first thing you should ask at the beginning of classes. What

04:18 I trying to learn today? I'll usually tell you not. Everyone

04:22 tell you today, we're learning about lymphatic system and it's right there.

04:26 that's our starting point. And so the end of the class, you

04:30 to ask yourself, what was it I learned? And hopefully you'll be

04:34 to say I learned about the lymphatic . Alright. And that leads to

04:40 questions of you trying to organize that down. What is it about the

04:44 system I have to learn about and you're dealing with anatomy and physiology.

04:47 two questions its structure and function. really easy to get stuck on the

04:52 part because that's usually the easy It's like here are the names of

04:56 the things and where they are. that's like pointing out the inside of

04:59 engine and saying Okay. That's that that that But it doesn't ask

05:02 how does it work? That's where other half is. How does this

05:06 work? And that usually catches Alright, So part of this is

05:10 looking at the structure and then asking does it do? And so

05:14 hopefully we'll be able to walk through . We're gonna look at the lymphatic

05:18 as a whole, in terms of does it do? And then we're

05:22 look at specific structures and ask, do they do? And we're gonna

05:26 how they do their their things based how they're built. Okay, That's

05:31 kind of the big thing. And after today, we're gonna deal with

05:35 immune system. And hopefully over the three lectures, you're going to start

05:39 why I can go around licking floors door knobs and not die. I

05:45 that sounds gross, but you're designed battle everything in this planet. That's

05:51 to kill you, actually, everything the universe. That's trying to kill

05:54 . It's kind of cool, And you're gonna see how the body

05:58 that and it starts here today, then after the immune system, that's

06:02 you go into respiration respiration, as mentioned, is kind of a

06:05 actually, it's coupled with the Because what you're doing with the heart

06:10 your pumping oxygen, the gas is you gotta go where do I get

06:14 gasses and breathing in and breathing So that's how they kind of get

06:18 . All right. So, that's of the big overview of this unit

06:21 immunity. Lymphatic community and respiration. it kind of just builds on what

06:26 just learned. And so our starting here is what is the lymphatic

06:30 And the picture that hears from your is basically it's a network of

06:35 Have we learned about vessels already? kind of vessels do we learn about

06:40 vessels which are arteries and veins, great, you already understand lymphatic vessels

06:48 you understood those things, We're now the same thing, but it's in

06:52 different system. Okay, So, we're building on something we've already

06:57 This is kind of the easy Right? So, it's vessels and

07:00 it's a whole bunch of tissues and . All right. We don't really

07:05 about lymphatic sol that much. All . But you're gonna see it's

07:09 oh, I actually do know what structures are. I deal with them

07:13 the time. I just don't think them. All right. So,

07:16 terms of its functionality, the first that the lymphatic system does. I

07:21 , we're gonna get down here to more interesting stuff, but the first

07:25 that it does is it deals with fluids that have escaped from the

07:30 Alright, We're gonna see here that blood that's leaving through the capillaries?

07:35 know, all that fluid. And in the blood the fluid that's leaving

07:38 the capillaries? More of it stays of the blood vessel, then actually

07:42 in through the process of filtration and . And if that happens well,

07:47 end up with no fluid in your . So that's a bad thing.

07:50 so the lymphatic are responsible for taking excessive fluid that's stuck outside your blood

07:56 and moving it back in kinda Alright. But we usually don't think

08:02 the lymphatic that way. We usually about it about the second thing

08:05 it plays a major role in defending microorganisms and other pathogens that find their

08:12 into our body. Alright, So plays a major role in the immune

08:17 , defense against disease. Alright, , it does two things it houses

08:24 and produces the immune sites. All . And the second thing that it

08:29 is it serves as a point of . Now, we're gonna I'm gonna

08:34 an example a little bit later But whenever you think of the immune

08:37 , I want you to think of of two things and it doesn't matter

08:39 one you think of. I want to think of police forces or armies

08:43 we might actually have to use both them as examples. Alright. But

08:47 two things are what your immune system like. And so do police have

08:52 point of surveillance. Have you ever police kind of hanging out in particular

08:57 , right. What they're doing is watching for crime. Usually the police

09:01 see watching for crime are the ones the highway waiting for me to come

09:04 by. Right? And what are looking for? They're looking like,

09:08 , here's somebody going 90 miles an . That's a $400 ticket. Woo

09:12 . I get points right now. never catch me because I always catch

09:16 first. I see them way up and then I slow down pretend like

09:19 not doing anything right? But that's of a surveillance, right? That's

09:23 surveillance is. So when you think surveillance, it's watching for the things

09:28 are going on. So the lymphatic plays a role in that third.

09:32 plays a role in transporting fats. it actually has a role in the

09:36 system. C pro I mean not . Fats are not a molecule that

09:43 be sequestered away. Right? They to hang out where other fat

09:47 And so your cell uh plasma membranes fats. And so if if it

09:52 left up to the fat, all would do is they would incorporate themselves

09:55 plasma membranes and they would hang out and nothing would ever happen. But

09:59 fats have to go to a certain of connective tissue. They're located in

10:03 specific areas in your body. And we need to move fats to those

10:08 for storage and we need to move to the tissues that are going to

10:12 them. So fat is actually being all over your body when you eat

10:19 it goes into the cells that line intestines and it can't get out unless

10:25 packaged with very large proteins and very proteins. And these fats then can't

10:31 the cells. They have to go through a vesicles system. And so

10:35 they're released out into the surrounding interstitial they can't get into capillaries because they're

10:41 big. And so you use the to move them into the bloodstream to

10:46 them wherever they need to go. you've learned about these at some point

10:50 life or at least heard them may have learned about them. Have you

10:53 of HDL and LDL S. And . L. D. L.

10:55 . And yada yada yada. Those are the packaged fats and that's

11:02 way that we move them from the to the sites where that fat is

11:09 to go. So that's the lymphatic and we'll we'll deal with those when

11:13 primarily when we get to the digestive . But it's important introduces the second

11:19 is that are the fourth the fourth that it does, it plays a

11:23 in moving proteins that have escaped from blood into or back into the

11:29 Alright so again proteins are usually too to pass through the capillaries. But

11:35 you for some reason dilated capillary and escape out inappropriately. Or maybe you

11:41 inflammation or something that's taking place or blood vessel and you have these materials

11:46 proteins that shouldn't be out of the . They should be inside the blood

11:50 , what we need to get them in. And so the lymphatic serve

11:54 that as that pathway to move them in from the interstitial fluid back into

12:00 lymphatic and then ultimately back to the vessels. Alright, so, those

12:05 kind of the primary things. The thing I have here is uh it's

12:10 when we think about it, when think about lymphatic, we're usually coupling

12:14 with something else. And if you at that whole list, it's

12:16 okay, up here we have cardiovascular , we have immune system here,

12:19 have digestive system. And this is , primarily cardiovascular. So, when

12:24 think of the lymphatic system, it's of the the saddle stepbrother right of

12:29 these other systems. But it's highly important because it allows these other

12:35 to do their job. So, starting point is gonna be dealing right

12:39 with these vessels and then we're gonna up with those tissues and those organs

12:44 we're looking at all. Right. , are we okay with kind of

12:47 big picture overview of what the lymphatic Yeah. Ok, so,

12:54 I guess I gotta talk about the first lymph. Alright. We've talked

12:59 long time ago in A. And . One and I'm looking first at

13:02 M. P. One, you we talked about there being fluid in

13:05 body. Right? We said they fluid inside the cells and we have

13:08 outside the cells. What do we the fluid inside the cells? Intracellular

13:13 . And what do we call the outside the cells? Extra cellular

13:17 Then we divided up the extra cellular into compartments. We said that the

13:21 cellular fluid around the cells is That's a harder one. Interstitial.

13:26 thought I heard it over there. , it's interstitial. Interstitial means in

13:30 the cells fluid and then the fluid inside the blood vessels is referred to

13:38 we learned that one in this class . It starts with the p

13:42 All right now, notice we have and we've compartmentalized the fluid in different

13:49 , but the fluid is still It's water plus stuff. The differences

13:53 the extra cellular and intracellular fluid is ratios of the stuff. Notice that

14:00 not even talking about what the stuff . It's just the stuff the difference

14:03 the blood and the interstitial fluid is stuff. Alright, lymph is water

14:13 stuff. So what makes it different the interstitial fluid and what makes it

14:18 than the plasma is basically its location the ratios of the stuff. All

14:24 now really what we're gonna see here what this slide and all the other

14:29 are gonna kind of point out is when blood escapes. Alright, so

14:32 plasma escapes out into the interstitial it becomes interstitial fluid. The difference

14:38 the interstitial fluid and the plasma specifically the presence of the plasma proteins.

14:44 , so that's what makes them So they're basically the same. Except

14:48 taken one thing out. The difference the lymph and the interstitial fluid is

14:54 . Interstitial fluid is around the cells when I move into a lymphatic

14:58 it's still the same fluid. It's in a different location and we just

15:02 it a special name. We call lymph. All right. So,

15:07 you see lymph, it's nothing It's just named differently from because of

15:12 it's located. Alright, that's kind the key thing here. So,

15:17 way that it works, lymph originates interstitial fluid. So, it's out

15:21 in between the cells that fluid remember up because we had a capillary

15:26 we had fluid filter out of the bed into the interstitial space and then

15:31 had fluid moved back into the capillaries the process of reabsorption and some of

15:37 fluid stays behind and that's interstitial fluid if too much of it stays

15:44 we lose fluid from the blood how blood fluid you have in your blood

15:48 now, roughly? Five liters remember, I never asked you and

15:53 not asking to memorize that even though guys have done a very good job

15:56 memorizing because I've asked you like six now, right? But the reason

15:59 giving you that number is because the of movement as we go through is

16:05 can think about, we move about liters of blood per day through your

16:09 system. That's a whole bunch, ? So 20 of it filters out

16:15 that 70 217 returns back into the system. Okay, that's not

16:22 Right? But you only have five . So that just shows you how

16:25 the blood is moving through your So, of those five liters,

16:30 of them over the course of the , remain back in the interstitial fluid

16:37 would leave two L of fluid in blood, which basically means your blood

16:42 turn into sludge and it's really hard push sludge around. So we don't

16:46 it stuck in the interstitial space. want it back in the blood

16:49 And so this is what the lymphatic . It takes that three liters that

16:54 supposed to come back through filtration and says, no, no, I'm

16:57 return it back. And so I'm to pick up that Extra three L

17:02 through the lymphatic vessels. I'm gonna it back through into the bloodstream.

17:08 , in essence, you don't lose three leaders, it's returned through a

17:12 route. That makes sense. Kind sort of. All right now,

17:17 numbers aren't important. It's just the is that I don't return as much

17:22 as I filter out. So the the blood that filters out doesn't come

17:27 completely the way that it came So I have to use a secondary

17:31 and that's what the lymphatic vessels All right now, as I mentioned

17:35 terms of its what it's made up . It's the same thing as interstitial

17:38 . It's water plus all the salts came with it through the plasma there

17:43 exchange that took place. So, not even worrying about what that

17:46 So, it's just the idea is it's the same material that was in

17:49 plasma. What it's missing is the proteins. Alright. If there are

17:55 , they're they're escaped proteins and the that shouldn't have been there.

18:00 And these are gonna be returned back the length. All right now.

18:04 you may have damage to the Right? So you can end up

18:08 some celery debris if you like, your knee, for example. Open

18:11 the wound bacteria and other stuff can in there and it's down inside the

18:16 fluid and it's going to go wherever fluid goes. And I also mentioned

18:21 do cancer cells move around the body they take advantage of the space that's

18:26 your body. And so, metastasizing will follow the flow of the fluid

18:32 breast cancer. The place they look see if you have metastasized breast cancer

18:39 the lymph nodes in the axillary right? They basically look for they

18:46 put a radioactive isotope in there and basically goes and binds itself to the

18:51 cells. And then they start looking see where it is. And if

18:54 get radioactive lymph nodes, they know the cancer has metastasized. It's the

18:59 thing that they do. All So, the idea here is lymphatic

19:04 themselves have a secondary pathway to Alright. So what we have here

19:10 we have a series of vessels. again, I'm just gonna go

19:13 So you can see here we have network and all the green things when

19:16 draw green in this. This these the lymphatic. So, this is

19:20 an easier view from your textbook. can again see your capillary bed and

19:24 the very end here, mixed in in the capillaries are these blunt

19:29 So you can see that they look little tiny fingers. They're blunt ended

19:33 capillaries. And these are the lymphatic . All right there called the initial

19:39 . Alright, now they are located the terminal end. So the smallest

19:45 is the beginning of the lymphatic And what we're gonna do is we're

19:49 create a series of vessels that are to get bigger and bigger and bigger

19:52 then returning back to the venus side the vasculature near the heart.

19:58 So, here, in the lymphatic don't have a pump system.

20:04 We are going to be dependent upon things to drive fluid back towards the

20:11 . Alright. And we're not going the heart. We're going to the

20:15 near the heart. All right. , our capillaries are the smallest

20:20 You can see that they're blunt ended intertwined. So, that means they're

20:23 that same space as the capillaries So, they're right in the place

20:26 they need to be in order to the fluid that has escaped. All

20:31 . And they're everywhere. They're all all the connective tissue, wherever you

20:35 capillaries. That's basically where you're going find these things. All right.

20:39 only place you're not gonna see them in a vascular tissue. What does

20:43 vascular mean without blood vessels? Okay. Now, what's interesting about

20:51 capillaries is that they're structurally different than we saw in the vasculature.

20:56 When we looked at capillaries, we blood cells or sorry, the helium

21:01 basically two cells are side by side they're attached to each other by a

21:05 of tight junctions that we said were . Remember, So, things can

21:10 in between the cells and you can the cells kind of going around,

21:13 I'll do it this way. So you can see the two cells are

21:16 to each other and that's what you in kind of a capillary here,

21:21 cells are arranged differently. They're arranged such a way that the cells are

21:26 shingles. You can kind of see the picture how they're looking like

21:30 Right? You can see this one that one which overlaps the next

21:34 which overlaps the next one and so all the way around. All

21:38 So they have what are called free . And this is beneficial because these

21:44 edges serve or act like valves. ? So when the pressure on a

21:53 that has overlapping, I'm gonna just over here since you're writing furiously once

21:58 push on this part. This this cell. Okay. Ur ur ur

22:04 hydrostatic pressure. And I want you push on that cell, that one

22:08 there. See does it open? on the other cell and it opens

22:15 when the pressure on the outside is . What it does is it causes

22:20 cell that is overlapped right to move fluid can flow in between but pressure

22:27 this side keeps that valve shut. on the back side where it's opening

22:33 keep that that cell or that pathway . So the movement of fluid into

22:40 out of the initial capillaries is dependent the pressure in the surrounding interstitial

22:46 Oh my goodness. We gotta talk pressures. Yeah. Remember I said

22:50 are gonna show up all over the . This is one of those

22:53 Okay, so what we're dealing with is an environment that we're looking at

22:59 pressure on either side. If the pressure is greater outside the capillaries,

23:04 causes that overlap cell to open fluid flows in. If pressure inside

23:11 capillaries greater than the outside, it the valve shut or the overlap cells

23:15 , fluid can't escape. It only one path and that's to follow the

23:21 of the capillary. That's what the picture kind of looks like here

23:26 look, see I'm open up. so the fluid is following the

23:30 Now, the other thing is because are blunt ended, they're kind of

23:33 just squiggle into the space and we want things to have freedom of movement

23:39 the body. We want things to stuck where they are. Right?

23:43 so they have what are called anchoring , very different. And so they're

23:47 into the space and that keeps them being shoved around and pushed around by

23:52 fluids in the surrounding environment. All . The other thing that does is

23:57 prevents the vessel itself from collapsing from pressure because you're being pulled in all

24:03 directions. So that's kind of our point is this capillary. So the

24:14 , as I said, is what the driving force behind the movement of

24:19 fluid as the pressure in that space the fluid wants to go into the

24:25 and because we now have flow which dependent upon pressure, anything in that

24:31 space is gonna move by bulk flow that fluid. All right, So

24:38 have a little tiny bacterium that's found way through a scraping your knee into

24:42 interstitial space. It's just kind of around going, well, this is

24:45 nice kind of place. Lots of around here, things for me to

24:49 lots of sugars. Oh, and warm too. I can divide every

24:53 minutes. This is awesome. I'm gonna hang out here and I'm just

24:57 move around with this fluid. Whatever me I'm gonna consume. And it's

25:01 floating along in that fluid and it's all right, and it's gonna follow

25:05 pressure and it can find its way the lymphatic system and now it's trapped

25:11 now your lymphatic and your immune system deal with it. Oh, I

25:15 escape proteins. I don't want to energy hunting down on my escaped

25:21 Right? I want my proteins to in my blood. What do I

25:24 ? Well, the proteins are gonna bulk flow. Oh, the fluids

25:28 this way. I'm just gonna cruise with the fluid. I'm not doing

25:31 . I'm just sitting here and I back into the lymphatic and now I

25:35 no choice but to return back to vasculature. So, what we have

25:40 is a mechanism that is passive dependent pressures, driving things into the lymphatic

25:48 to be dealt with. Alright, they're following the movement of the

25:53 which is what we refer to as flow so far. So good.

26:00 . So capillaries are going to get and bigger and bigger and they form

26:04 are called the lymphatic vessels. Which a very generic term for the vessels

26:10 there. We don't call them they're just lymphatic vessels. And so

26:13 can magic capillaries converge into a larger . These are the vessels they're found

26:19 over the place. If they're found the surface, we refer to them

26:21 superficial. Um I don't know, you have you ever gotten like a

26:26 infection that caused like cap like a a lymphatic vessel to kind of grow

26:34 the surface of the skin. It's a common thing, but I've seen

26:37 happen in several people and I guess we worked in hospitals and were around

26:42 little animals that like to bite us stuff. And so you can get

26:46 response and you can actually see on surface like this vein kind of grow

26:51 it's starting to fill with fluid that be superficial because near the surface All

26:56 , another one is deep and typically are like with the deep veins and

27:01 deep arteries. So when you think the arteries and the veins that are

27:04 through your body. Think about that not traveling by themselves, they have

27:08 third partner, that's the lymphatic that's with them. All right. In

27:14 of structure, they look exactly like blood vessels. They have all three

27:19 . So they have the the internal external and the media internals inside,

27:23 is on the middle, external is the outside. Alright. They have

27:28 because we're trying to drive fluid to heart. We don't want it to

27:32 around inside the blood vessel. Or , the lymphatic vessel. So the

27:37 are there to to serve as one to propel the fluid towards the

27:44 Now, because we don't have a , we're now going to be dependent

27:47 a whole bunch of different things to drive the fluid forward. Alright.

27:52 we have pressure that's pushing it towards heart, but it's not enough to

27:56 it by itself. So the valves gonna serve a purpose to make sure

28:01 the as that lymph is moving towards heart, that it's not gonna go

28:03 flow. But we're gonna use the pump and the respiratory pump, just

28:07 we did with the blood. Those used as a way to kind of

28:11 and pull the leg towards the We also are gonna have the musculature

28:16 the vessels that are near it. , if these three things are side

28:20 side, every time an artery expands contracts, it's gonna press up against

28:25 lymphatic vessel? And it's going to up against it. And every time

28:28 pushed up against is that causes a squeezing of the lymphatic vessel. And

28:33 that propels the fluid towards the So we refer to it maybe as

28:40 vascular pump. Alright. And then some smooth muscle. Remember if we

28:44 all three tunics, we have smooth inside that uh that tunica media.

28:49 so that smooth muscle goes through a of rhythmic contractions like so and helps

28:55 squeeze and propel the fluid towards the . All right. So smallest level

29:04 . Capillaries become vessels, vessels turn the second largest structure which are called

29:14 trunks. Actually, it's the largest . Sorry, I'm trying to find

29:21 button here. There we go. . Because I don't really know if

29:24 next one is really considered a vessel not. All right. Lymphatic

29:29 So, capital reserve vessels, vessels trunks. Now, the trunks are

29:34 kind of these very, very large . They're named for the region from

29:37 they are collecting the limp from the . All right. This is not

29:41 best picture. I've complained about it and I can't find a better one

29:46 isn't too complicated. So, I'm using this one. So, just

29:49 bear. All right. What I to point out here is that they're

29:54 . The trunks are paired except one , which is gonna be the intestinal

29:58 , which is way down here. jugular where's your jugular vein?

30:03 So that's where you're gonna be And you can see in our little

30:06 up here here you can see the , there's the left jugular or

30:10 left jugular and right jugular trunks. they are draining the fluid that has

30:16 up in the head region. the subclavian. Where's your clavicle?

30:24 . So sub means below that. right. And if you look here

30:28 the picture we're gonna see here's the subclavian over here. Here's the right

30:33 . Do you see that they're converging at the same point with the

30:38 Alright, the left jugular and the jugular uh trunk. Then we have

30:44 fun one, the bronco medial Where's your media steinem? Alright,

30:50 your bronchi where they located? Over ? Within the lungs. So basically

30:55 we're dealing with the structures that are with the thorax. Alright, so

31:00 here you can see there is the media style. Notice the direction of

31:04 arrow that's pointing up. So here the subclavian, there's the jugular,

31:08 the bronco medial style over here. thing here we have the jugular here

31:13 have the subclavian. And over off to the side. Not this

31:18 one, but the little tiny one there, that is the bronco medial

31:23 right. So it's dealing with the regions? And the names tell you

31:27 they're coming from? All right. then finally we have the lumbar ones

31:31 that's way down below. So here's left lumbar, here is the right

31:34 trunk. So you can just think are they dealing with? Their dealing

31:37 the lower regions uh the abdominal structures what they're doing is they're branching off

31:43 deal with stuff further down as The last one is the intestinal

31:49 The intestinal trunk deals with the lower , the pelvis and the abdominal pelvic

31:53 . Alright, So what we're doing we basically we've divided up the body

31:57 we're saying this is where all the fluid is coming in, we're gonna

32:01 from these capillaries into these vessels into larger trunks and then larger trunks are

32:07 into the final structure which really is a vessel. Although this is a

32:12 large structure. So I'll go ahead call it a vessel which is the

32:17 . All right, so the ducks where we're going to enter into the

32:25 ? The venus vasculature. Alright, one of the things I want to

32:31 out there's just there's two of there's two ducks and they this picture

32:36 why it's showing here is because it what these two ducks are responsible

32:42 The right duct is responsible for just upper quadrant of your body. So

32:48 the upper right hand side. So the thoracic region, This half of

32:53 head and that limb. Alright. then the the thoracic duck is responsible

33:01 everything else. Okay, so fairly right lymphatic duck is basically you can

33:09 here I am joining together the I'm joining together the jugular and the

33:16 medial style, the right. They together and they join and create that

33:21 right lymphatic duck. That right lymphatic empties into the the the vein at

33:28 junction of the subclavian and the jugular and it's gonna ultimately empty into the

33:36 my voice is starting to go into . Um It's going to empty into

33:40 superior vena cava. So do you all that fluid from that right hand

33:45 ? That upper right quadrant is joining to go right back into the

33:53 When we deal with the thoracic duct going to join all the three of

33:58 left that we talked about, The subclavian and the bronchial final they're joining

34:02 with the structures that are further down this larger thoracic duct and then thoracic

34:09 again joins up at the junction of jugular vein, the subclavian vein to

34:15 empty into the superior vena cava. , so all the fluid from the

34:20 of your body. Now there's one feature and I'm gonna point out why

34:25 is unique in just a moment, you can see down here, we

34:27 this bulge. The large structure at base of the thoracic duct. All

34:34 , this is called the cistern. Kiely. Alright, so when you

34:38 sister, know what do you think ? I hope sister. And I

34:42 you think. And if you don't the cistern is it's basically a a

34:47 um jug or jar. And what is what it's referring to. And

34:52 this is where all the vessels are into from the small intestine and the

35:01 intestine is important because it's one of major places where horrible nasty things can

35:05 into your body. It's also how getting fats into the lymphatic. And

35:14 you're gonna have a lot of of lymphatic structures associated around the gut.

35:21 for defense and two for fat And so these vessels because there's so

35:26 of them create this larger structure. the lymph in this area is

35:32 very rich in lipids. And so has a special name. We named

35:37 Kyle. I don't know why that's it is. So the lymph here

35:43 called Kyle. And so that's why the cistern Achille because it's collecting the

35:49 . Now how do you tell this limp from other lymph? It's because

35:54 lymphatic so I'm just gonna go off tell you a little bit more this

35:57 not important. Now it's gonna come and digestive lymphatic surround the digestive system

36:03 called lacked eels. When you hear , What do you think of

36:09 Which is referring to milk. So when you hear lax, you

36:14 be thinking milk. So why do think they call them lacked heels?

36:19 ? I'm I'm gonna I'm gonna remind here, but I'll just name things

36:23 what they do for what they look . Why do you think they call

36:25 black hills looks like they're filled with ? And it looks like they're filled

36:32 milk because they're full of fat. color is fat? White? So

36:36 look like they're little tiny. And that white fluid converges and that's what

36:42 Kyle is. It's less milky looking that point, but it's still milky

36:48 . That's why it was named Okay. Anyway, so, these

36:56 the structures of the vessels. We with the initial capital, initial capital

37:01 the lymphatic vessel, lymphatic vessels form different trunks and know how these trunks

37:08 to form these two ducks. Those the structures. Any questions about

37:17 Huh? Now, easy. This part should be, which shouldn't be

37:22 scary. All right. And the is, is the lymphatic sar not

37:26 hard because what we're gonna see here just a moment is that structurally,

37:30 though there's different organs, they all kind of structured the same.

37:35 So, in terms of the the vessels are like the blood

37:39 There's just some unique nomenclature that goes them and they behave slightly differently.

37:44 it's very similar to what we've seen . Right. Any any questions about

37:54 ? All right. So, let's within the tissues in the organs.

37:59 we put tissues and organs because what have here are structures that aren't quite

38:05 . I mean, there's definitely tissue but they're not organized well enough to

38:08 be called an organ. And so just like okay, well, it's

38:12 . Alright. Now there are two types of structures. Or we classify

38:17 lymphatic into two types of structures. have primary lymphatic structures and we have

38:23 lymphatic structures. And I said when dealing with the immune system, we're

38:27 with primarily with police forces or All right. And so I want

38:32 use that that imagery to help you primary and secondary structure. A primary

38:39 like police academy or like boot camp the military. Alright. This is

38:44 place where you're going to actually create cells that are responsible for the immune

38:52 . Alright, so, primary structures gonna be making and maturing the lymphocytes

38:59 there's two primary lymphatic structures. This just one of those things you

39:04 We have red marrow is one and thymus is the other. All

39:11 And where do we find red marrow the bone. Alright. We're gonna

39:15 about where in the bone in just second. Alright. Secondary lymphatic structures

39:19 where we do surveillance. Okay. , now you've got your badge.

39:26 ? Now you're being sent off to . This is where you are now

39:30 for the bad guys. All So, that's what the secondary structures

39:33 . So, this is where you're house the lymphocytes and other immune cells

39:38 other immune sites are going to be in these structures as well. And

39:42 job is to sit there and mark watch the fluid flowing through and looking

39:46 those things that shouldn't be there. right. And if they do,

39:53 attack it. So, the secondary include things like your lymph nodes,

39:59 your spleen, include your tonsils, these structures that are referred to as

40:04 nodules, and ultimately will call these that are referred to as the lymphatic

40:10 . So, I have one up called the malt. Alright. That's

40:13 mucosa associated lymphatic tissue. We'll see whole thing spelled out in just a

40:19 . Um But any place where you're see these aggregates of lymphatic tissues are

40:24 to as secondary lymphatic structures. so, primary red sorry, red

40:34 marrow and thymus. And so, gonna start with the red bone

40:38 Alright, This is uh a structure found within the tropically of the spongy

40:44 . So, if you didn't take P one, I encourage you to

40:47 back and take a look at the chapter in uh bone formation and bone

40:54 , really not the bones themselves, just what does this look like?

40:59 to understand where you're located. So, it's gonna be focused on

41:03 bone as adults, you don't have lot of red marrow. It's located

41:06 very specific locations with. So the bone for example is going to be

41:11 the flat bones of the skull. want to go there to get

41:14 It's going to be located in the , the ribs, the sternum is

41:19 place that we can go and grab again. Not a very fun

41:22 The Oscar doxa which are the ox . Do you guys remember the

41:27 Another fun place. And then the the proximal epiphany sees of a humerus

41:34 femur here. The femur. And you're looking at places that are

41:39 really hard to get marrow if you're to do a transplant. So just

41:43 of the hardest places in the body find this stuff. It's like it's

41:47 to get to. Alright, so who gives bone bone marrow transplant,

41:53 really going out of their way. right. So what do we do

41:58 the red bone marrow? Well, red bone marrow is responsible for meta

42:01 and so when we talk about how police is we've already seen all the

42:04 types of cells that are being made , but we're not interested in all

42:08 cells were interested in some very specific were interested in the lymphocytes.

42:14 And the reason we're interested in the because there's two basic types. We

42:19 the T cell and we have the cell? The T cell is named

42:26 T cell because even though it's born the bone bone marrow, it is

42:32 to the thymus for finishing school. of a better term. Alright,

42:38 other words, the thymus is where T. Cell matures and becomes immuno

42:43 cell. The B cell on the hand is born in the bone and

42:48 in the bone and matures in the . And then once it matures and

42:52 it goes to the secondary tissues. you now see where their names come

42:56 . B. For bone T for makes life easy, doesn't it?

43:03 . Okay, so the thymus is weird little structure, you probably never

43:09 think about it. In fact, time I think about the thymus I

43:13 confuse it with the thyroid. Please be like me. All right,

43:18 they're pretty close in terms of where structured and they both begin with th

43:21 that gets kind of confusing sometimes. right, let me just show you

43:25 here. There's your thyroid has nothing do with the immune system or the

43:33 . So ignore it for right our thymus sits down here near the

43:39 , between the lungs, further down trachea. Alright, now, if

43:45 pull it out this is kind of it looks like. Um If you

43:47 at this long enough actually you could turn around and see there's a big

43:51 picture of George Washington in this No one's gonna do. You see

43:54 big picture? You ever noticed that here? He's wearing a cravat and

44:00 kind of what it looks like. this big old, tough looking

44:03 If you see pictures of like the oats guy, you know, it's

44:08 thing that looks, does that kind looks like that, right? So

44:11 kind of looks like this structure and you are born, your thymus grows

44:19 , it just it's huge relative to rest of the size of your

44:23 And it will continue to be very active and very large and very

44:27 , primarily through the early stages of . At which point your body

44:32 well I think we've figured out t well enough and then it begins to

44:36 itself, becomes smaller and smaller and and it replaces all the cells and

44:40 tissues with fat because that's what your does. It does as you get

44:44 , everything gets replaced the fat and sucks because, you know,

44:50 but it's not particularly helpful or functional the adult. Alright. And the

44:57 for that is because we do pretty produce all the immune sites that we're

45:01 need to produce for a lifetime by time we hit puberty. All right

45:07 , the thymus is a unique structure it's one of just very few structures

45:13 the body that are separated from the of your body. It's what we

45:17 it, immuno privileged site. It has what is called a blood

45:24 barrier, or blood in this case a blood thymus barrier. So that

45:28 it's not exposed to the materials in body. It's separated from the rest

45:34 your body in that sense. So anything coming in because it does

45:38 to get blood right? It needs , but it doesn't allow the pathogens

45:44 foreign materials in your blood to find way into those structures. All

45:52 And the reason it needs to do , because the only way to produce

45:55 T cells in your body is to expose it to the weird things of

45:59 world. Alright. We're gonna talk T cell maturation two lectures from

46:05 Okay, So structurally, what we here is that it's encapsulated by connective

46:12 . So that's gonna be the first of its barrier and this connective tissue

46:17 down into the structure, creating these . Alright, so tropically simply is

46:24 a a strand is what what that . And so basically creates these compartments

46:29 we called lobbying. So you can this is a bi lobe by Lobel

46:36 . So there's load number one, load number two and has all these

46:39 tiny compartments. Those are the low . It's in these compartments where we're

46:44 doing a lot of the work of structure. Whenever we're looking at any

46:50 of structure, the outer region is to be referred to as the

46:55 The inner region is referred to as medulla. It's easy to forget.

46:59 those confused the way that I remember for middle. Alright. So when

47:04 look at the low beall, we see we have this outer region that's

47:09 to as the cortex and as you inward, that's where the medulla is

47:13 be. So materials from the blood not gonna be allowed to penetrate through

47:18 because of this barrier between the blood the structures on the inside. In

47:24 words, the end epithelium sit there only permit those things that it wants

47:29 pass in into that structure now. P1 people where did we see a

47:34 barrier before the brain? Right. brain is a unique structure that doesn't

47:41 for pathogens to pass through it. only way that pathogens get in is

47:47 if there's a tear through the blood or if something gets into the into

47:52 cerebral spinal fluid, and then that's all sorts of horrible things happen.

47:57 when you have a blood barrier, means the immune system can't pass it

48:02 . Alright. It's an immuno privileged is what is referred to as All

48:08 ? So, in terms of it's a whole bunch of epithelium,

48:12 produce a whole bunch of hormones that responsible for the T cell maturation

48:16 which we'll get into later. And you're gonna see is you're gonna see

48:20 cells all within this structure that are through this this this maturation process.

48:26 basically starting up as these really naive , you know, naive means,

48:33 mean if someone said you're naive, are they, what are they telling

48:37 ? Not? Stupid. Unknowledgeable. , so there's a distinction,

48:43 A knowledge means you've never been right? You've never been taught.

48:48 so what our t cells are doing they have to go through a process

48:52 being taught. Alright. And so gonna they're gonna mature here in this

48:59 and so in there you're gonna see levels of maturation and once they mature

49:05 they go, so secondary lymphatic structures a little bit different. So you

49:12 over here, you know, we this kind of cortex region, medulla

49:16 , we have these ridiculous, we've cells jammed in there. If you

49:19 closely, you'll see that there's some vessels as well. I'm trying to

49:22 where I can see one. Um , there's a core puzzle right

49:26 So they're just there, it's all up and so, you know,

49:29 basically maturing this, you've had this space, you have cells that are

49:35 and they're gonna be leaving as a after the maturation process. And what

49:39 gonna do is you're gonna arrive in that kind of look like this and

49:42 again is not every tissue looks like . This is just an electron

49:46 Trying to show you the mesh and network of what secondary lymphatic tissue

49:52 Alright. And so here you're not see lymphocytes, but you'll see macrophages

49:57 dendritic cells. So, a macrophage a mono site that has matured and

50:03 two different types of macrophages. One those macrophages that hang out in the

50:08 and don't ever move. We refer them as residents. So you'll see

50:12 macrophage sometimes they'll have other names as . And what they do is they

50:17 there and they just surveil it's let me see what what crosses my

50:22 . If something that's not supposed to their crosses my path, what do

50:25 do grab it and I gobble it . Big page eater, right?

50:33 me, I'm a big eater. right. The other types of cells

50:38 dendritic cells. Alright, when you the word dendrite, what do you

50:41 of? Do you think of little arms? Right. You think of

50:47 dendrites probably of the of the Those are those little tiny arms.

50:51 cells look like that they look like . Alright. Not pretty starfish,

50:55 the ones with like the thing. what they do is their arms are

50:58 there like this and they're kind of catch and they're just trying to see

51:02 anything comes my way that I can that's not supposed to be here.

51:06 grab it. And what I'm gonna is I'm gonna hand it off to

51:09 immune in sight. And I wanna that immune insight. No, here's

51:14 that shouldn't be here. And then immune insight is shouldn't recognize. It

51:19 will be uh be activated so that can attack it. So these are

51:24 type of what we refer to as antigen presenting cell and we'll see that

51:29 come up over and over again. . So they capture things that they

51:33 be here and they present them to immune insights primarily in the lymph

51:39 All right. So then you have immune cells that might be located within

51:44 . And what we're looking at here this network of articular fibers. And

51:48 if you sat here in A and . Wanna go, why do I

51:50 to learn all the different types of tissue? Because the primary lymphatic tissues

51:55 primarily ridiculous sites. Or not ridiculous . Reticulated nature. There's basically these

52:01 on which cells just kind of hang . So you can imagine fluid flows

52:06 in that space and gives them the to be able to access that

52:12 Now. Secondary lymphatic structures are either to be organs or what they're gonna

52:17 is they're gonna be not as well . And so we just refer to

52:21 as tissue or nodules. Alright. if you have a capsule we refer

52:30 as an organ. Complete capsules are be like the lymph nodes and the

52:34 . So what we're gonna do is gonna look at the lymph node and

52:36 once we look at the lymph we'll see that have the spleen

52:39 It's like, oh, they're exactly same in terms of their organization.

52:43 don't do the same thing. Otherwise would be both lymph nodes. But

52:48 they're very, very similar if you're a capsule or if you have an

52:52 capsule, that's just kind of the or this nodule. So when you

52:56 about your tonsils, everyone here still their tonsils who didn't have tonsils.

53:01 don't have tonsils. Alright. We're cool kids rest of y'all. You

53:07 find stuff, we have to work . You'll see why in a second

53:11 . Alright. Actually there's a lot than just the valentines, which is

53:14 they cut out tonsils. We have malt, we have the gulf,

53:17 have the we're not gonna talk about and all these other different types of

53:21 that are located all over the All right, not as well

53:25 Don't have capsules or have a partial . So let's start here with the

53:31 nodes. All of your body vary size and number. They're basically found

53:40 the length of the lymphatic vessels, vessels are traveling, you'll interrupt them

53:46 the way with lymph lymph nodes, can see in this picture kind of

53:49 they're located. There's some that are near the surface. There are some

53:52 are located deep within the body. and they're typically found in clusters.

53:57 so they're specifically located to serve as site of intercept in very, very

54:03 locations. All right. So you you'll see them embedded in connective tissue

54:08 you're not gonna be easy to find right? You have to kind of

54:12 around for them. But you will these very large clusters in some very

54:17 areas. So if you look here can see we have them in the

54:21 region. We have them over here the axillary region. We have them

54:25 here in the inguinal region and then have them here in the abdominal

54:28 in the mezzanine terry. Now, are four locations. What do these

54:36 locations have in common. What do think? It's like? Weird.

54:44 do you think? Say you say again, locate the middle of

54:51 Alright. What else? What I someone where you move. Okay.

54:56 . So let's think about what a node does remember. It's part of

55:00 lymphatic system. We know that we the lymphatic play a role in immune

55:05 but we don't know how yet. what do you think immune defense has

55:10 do with the cervical region, The region, the inguinal region as well

55:15 the mesen terek region. They have . Alright. And I know it's

55:23 sometimes it's like really that that's stupid obvious. Yes, but we have

55:28 kind of explain it sometimes. Let walk through. You don't hear live

55:33 the 5 2nd rule. Five second . You know? The five second

55:37 is right, right? You drop heels on the ground, you look

55:39 it, it's like picking up, on it. Eat it right?

55:43 . Five second rule. Right. knows what horrible bacteria hit ever ever

55:48 at a uh fast food restaurant? here worked at a fast food

55:54 Would you eat at your fast food after? See I look at the

55:58 when they do and they're like yeah not gonna tell you what they do

56:01 there. But let's just say there's why they put those signs up.

56:04 wash your hands. Alright. There's real horror story. Are you

56:10 No immune system. Alright, horrible can get into your body because we

56:17 everything into our pie holes. Number two, excellent region. Do

56:24 actually have any holes there? I some very very tiny ones. They're

56:28 basically little tiny pores right there, . Right? But because this is

56:34 space that's hot and warm and I um uh sermon is the word.

56:41 looking at not seb um No it . It's it's not cinnamon basically I'm

56:47 with proteins and fats and stuff. know this is like the ideal location

56:52 bacteria and the bacteria can work its into the slight small tears and

56:57 So this is a really good place bacteria can enter into your body because

57:01 won they reside there to begin And number two you provide them

57:06 And so this is another one. right inguinal area. What's overt about

57:11 one? Any any passageways in your in the England area? We'll just

57:19 with urethra and anus and then vagina do all those three things. Sound

57:26 to you guys. Yeah. So their horrible things that can find their

57:30 to your body in that way. . Right. So let's go ahead

57:34 just put like guard posts right around because really obvious. Alright, Mesen

57:42 , the Mesen terry is the fat surrounds the small intestines and the large

57:47 . Does it make sense that we put guard posts around the gut because

57:54 that we didn't kill or catch here going to find their way down into

57:59 digestive system and it's like that's like ride into the body. So lymph

58:06 are located where the things are gonna into the body. That kind of

58:12 sense. Right. Yeah. All right now you'll find them in

58:19 other places as well. They're located all sorts of areas Now. Let

58:23 just kind of point out what we're here is we're filtering out the

58:28 Alright, this is a filtration the lymph nodes are a secondary structure

58:34 there. A lymphatic second or secondary structure. And so their job is

58:39 surveil to create a place that allows immune insights and lymphocytes to surveil and

58:46 whether or not they need to activate immune response. All right, so

58:50 gotta macrophages that are there. Just of like Alright bring me the

58:54 bring me pathogens. Whatever happens to coming in. I'm just playing

58:58 Alright, Danger. And excels are the same thing. I'm just playing

59:01 . And then the lymphatic cells are there going I'm waiting to be told

59:04 be turned on to be activated. ready for the alarm to go off

59:08 that I can be activated and sent to where the site of infection

59:15 So that's the goal. Anyone here sick this year and felt their glands

59:21 swollen. Those are glands, those your lymph nodes. And what you're

59:28 when those glands swell up when your swell up is the proliferation of

59:35 You know what the word proliferate means to make many of. And so

59:39 you're doing is the nodes getting bid you've alerted the army and they're saying

59:44 need to make more soldiers right And so they start multiplying themselves so

59:49 they can attack that very specific So when you look at the structure

59:53 the lymph node, you need to in terms of those, those different

59:58 that we just described there right. need to have a place where the

60:01 comes in, where that fluid passes the cells and then ultimately serves as

60:06 place where the fluid can then leave then go to the next one.

60:11 that's what the structure looks like Alright. We have a capsule that

60:15 of serves as the boundary or the right? You can see that we

60:20 a little tiny tropically that move inward create these little tiny lobes. These

60:25 areas that can then focus in on activity that we just described. We

60:30 an outer region. What is the outer region called, starts what they

60:36 cortex. Inside region is called the . So we have an outer cortex

60:43 is divided up by these ridiculously, serves as the activation site for the

60:48 cells. So remember B cells are in the bone marrow, what they're

60:53 once they've matured and made they go to a structure like the lymph nodes

60:57 they hang out in the cortex and sit there and they twiddle their thumbs

61:01 they're activated. We'll talk about the later. Alright. But when they're

61:06 , what they do is they want make more of themselves, they clone

61:10 over and over and over again so they have an entire army to attack

61:14 one thing that activated them. Let me put it this way,

61:19 say you want to go beat up . Alright, A bully, A

61:23 who's trying to do horrible things to is are you going to attack one

61:27 after one person? After one I know you want to create an

61:31 of yourself. You want millions of to go and beat up on that

61:34 bully. And that's what the immune is doing. It activates itself and

61:40 and that's why the lymph node gets , really big. All right,

61:44 that's taking place out here. if you look at this, see

61:47 little white patches, those are called germinal centers. That's where the activated

61:52 cells localize. And then they start and then the outer region, this

61:56 where you're gonna have the surveillance immune where the macrophages are hanging out,

62:01 dendritic cells and the t cells are out. And what they're doing is

62:06 just kind of waiting to see what's my way. And how do I

62:11 these B cells in the inner This is where you're gonna start seeing

62:19 these uh cells as they're kind of from point to point to point.

62:24 they basically it's just that lymphoid tissues kind of moving out. So if

62:28 proliferating B cell, what you're doing you're growing and you're moving towards the

62:32 and then you get released and then you go into the body and you

62:38 see here that there's space. So we pointed out the white space in

62:41 , those are the germinal centers, out and around there and that yellow

62:45 in there, those are sinuses. when we hear the word sinus,

62:49 you need to think of is not thing that makes my nose get all

62:52 and stuff. When you think of sinus, it's a space in

62:56 So when we talk about the sinuses our bones, that's an open space

63:00 our bone. And so when we about a sinus and a lymph

63:03 it's an open space. So this where the fluid goes. So the

63:07 is wrapping around cells on these networks there's this open space of sinus.

63:13 we have a cortical sinuses, That's the white and that yellow space

63:17 there's a medullary sinus. So fluid gonna flow. This is just a

63:24 picture, It's the same thing we said, it just kind of shows

63:27 how this cartoon is supposed to match and you can kind of see in

63:31 , do you see the space the stuff? That's the sinus, you

63:34 up here where it's darker, that be the uh the uh proliferation center

63:42 the cortex. Alright. And then here that's that matrix that is sitting

63:46 watching the fluid as it comes So when we look at flow,

63:53 we're gonna see is we're gonna see whole bunch of different vessels entering into

63:56 lymph node. Think of it like all these streets going in the same

64:01 , what's gonna happen when all these converge, everyone keep going the same

64:08 ? What happens? You slow down that's what happens is all this fluid

64:14 to lymph node converges and it all down, which gives the immune

64:20 time to kind of check out what's on. Let's see what's here,

64:25 ? Police checkpoints guys ever ever driven like a drunk driving checkpoint?

64:32 I mean you usually see them kind out in the outskirts and stuff and

64:35 do they do? All the cars to slow down and what are the

64:37 doing? They're just looking for something looks suspicious, right? People sitting

64:43 straight doing this right, all pull them over, they're not looking

64:48 the people who are just like Get me through this, right?

64:52 they know there are certain signs that , hey, this person shouldn't be

64:58 . We need to check this one and that's what we're doing is we're

65:01 everything down so we have time to out the fluid that's passing through and

65:05 that fluid that passes through then exits through an different vessel. So you

65:09 in via a ferret and you move through the ferret and in the process

65:12 gonna pass through the cortex and the . So you're gonna go through the

65:16 , the cortical sinus and then you're ultimately move through the maxillary sinus before

65:21 leave. And then once you go the different you're now in another vessel

65:25 that vessel becomes an apparent vessel for next lymph node. So basically you're

65:30 go from vessel to node, two to node, two vessels and

65:34 And along the way you may not caught. If you're a pathogen in

65:38 first node, you might not be in the second node. You might

65:41 be caught in the third note, you will eventually get caught because eventually

65:47 gonna be a macrophage or an immune that's gonna recognize you and say you

65:53 toast, your trouble and we're gonna and get the whole immune system

66:00 All right. So lymph nodes are in clusters. So with the lymph

66:06 in mind, are we okay with lymph node? Does that kind of

66:08 sense? Those little tiny structures are over your body structurally does the structure

66:13 sense cortex medulla. Tropically capsule germinal . That's a little bit complex.

66:20 basically you have a surveillance center on outside and then you have that germinal

66:23 on the inside where all the cells waiting to be activated. That all

66:26 sense. Kind of sort of everyone trust her, you all all back

66:32 the back. You guys get it , have it over here. You

66:38 get it. So, that's that's danger when you're like, I don't

66:41 then. The question is, is is it that's confusing. Other than

66:46 you just learned it like three seconds , huh? Just lots. I'm

66:54 give you a hint. All This is the hint that you guys

66:58 hearing. Draw it, draw a . Simple. Just draw it

67:05 What are the different parts And what they do? Because if you know

67:08 lymph node, you know the That's where we're going next. The

67:14 . Lymph nodes are located along lymphatic . Okay, the spleen is a

67:23 structure. We don't have lots of . We only have one. And

67:27 located in association with blood vessels. right. You have the splenic

67:34 Splenic artery goes into the spleen. have the splenic vein coming out of

67:39 spleen. Okay, so, single blood vessels. Alright, structurally?

67:46 located on the left side of your . It's sits right over here,

67:50 to the kidney and the stomach. , how do I put this post

67:55 poster or lateral side sits next to diaphragm. So, you can see

67:59 sits right over here, But I mean, internally, in terms

68:03 the mat the micro structure, it's the same thing. I mean,

68:06 still have a capsule. We have ridiculously we have these different regions where

68:11 gonna be germination, and then we're have this particular structure on which immune

68:15 are gonna be localized. Alright. , structurally it's very, very

68:19 It's just now we're dealing with blood of dealing with length. So,

68:24 are we surveilling were surveilling blood? in my blood whenever you're looking at

68:33 organ and you're seeing where the blood enter and nerves enter. That's referred

68:37 as the helium. We're gonna see term again and again and again.

68:40 , just get used to seeing that , The helium. So connective tissue

68:49 . So, you can see in picture here's your connective tissue that right

68:53 ? That would be true, All right. Uh You're gonna see

68:58 it. You're gonna see lymphocytes, , you're gonna see macrophages and other

69:01 sites, just like you saw in node. But there's two regions within

69:08 structure. We have what is called pulp. And we have something called

69:12 pulp. All right. What do think they call it? White pulp

69:15 red pulp? Because when you look a microscope, you see something that

69:21 mean, stain looks a little white then out here looks a little

69:25 That's where the names come from. right. The white pope are like

69:32 germinal centers that are localized in the node here. We have branches,

69:38 splenic artery. So you have the artery comes in and it branches up

69:42 the spleen and those branches penetrate into center of that white pulp.

69:50 And so here is where you're gonna the T. Cells and you're gonna

69:53 B cells and you're gonna see macrophages they're just hanging out and they're looking

69:58 what is that blood bringing within this . Alright. So it's surveilling the

70:04 as it travels in. Alright. then that blood flows through sinuses in

70:11 area. So you can see all space, right? There's all that

70:14 stuff in space. So it flows the little blue things here are supposed

70:18 represent the sinuses in the picture up and so that the blood flows through

70:26 around those immune insights and is watching and then that blood then flows out

70:31 the red pulp. And here you're still have more B cells and macrophages

70:35 stuff. But the other thing that gonna have sitting in here are

70:39 Remember we talked about platelets, we majority of platelets aren't in circulation there

70:43 out in the spleen. So this why it's all red, is because

70:47 those platelets are sitting in there. right, And this is your platelet

70:52 . And so here those capillaries, those that side of space is allowing

71:00 fluid to come through and then it's eventually get picked up in the

71:05 Soy, do you remember that We talked about the capillary sinus

71:09 So the sinus swords form and now picking up fluid and then it's gonna

71:14 up and ultimately going to a small and then eventually joins up with the

71:19 splenic vein and then it leaves. so what the lymph node did for

71:24 lymphatic six, the spleen is doing the blood. So in terms of

71:29 , you're going from the splenic artery these small arteries. These branches are

71:33 central arteries from the central arteries, go into the sinus toys from the

71:37 oils, those join up to form . The venue will ultimately form up

71:41 form the splenic vein. So, watching the blood, looking for things

71:49 shouldn't be there. We're cleansing the . So here we're talking about those

71:54 blood cells, remember we said the is responsible for picking up the old

71:59 dying red blood cells, that's what do. They basically hit in that

72:04 and they start smashing up against the of these blood vessels and in the

72:08 and they tear themselves apart and that's you start cleansing the blood. And

72:15 , we said, it's the storage for the reservoirs. Now, one

72:20 thing about the spleen, this is your insights are produced very early on

72:24 development before you actually have bone So it's an early organ that's formed

72:29 its role kind of switches all I went a little long here,

72:38 I'm gonna just do the tonsils for real quick and then we'll be done

72:45 . I have three slides can we get the three slides since I talk

72:50 . Alright, so tonsils real These are are not quite organs are

72:54 more of a tissue. They have incomplete capsules, they're three pairs of

72:58 . You're most familiar with the The palantine is what those of us

73:02 got our tonsils taken out. Those to sit on the sides of your

73:06 right here. Kind of guard post make sure that the five second rule

73:10 get trapped in them. But we have one that's lingual that's further back

73:13 the tongue. And we have one up near the nasal cavity. This

73:18 is referred to as the forensic. , so nasopharynx. Alright. So

73:23 we're doing is we're protecting what we're what we're consuming and what makes them

73:29 is that they have this capsule, ? But what they have are these

73:34 so food particles and horrible nasty things trapped in them. And really what

73:39 looking for are those things that would uh pathogenic to your body. Should

73:45 getting trapped in there. This is bacteria would kind of hang out and

73:48 that bacteria are being exposed specifically to lymphocytes in these germinal centers and that

73:54 up the immune system so that your knows how to fight things.

74:00 So the things we put in our are alerting our immune system through the

74:06 . And then if you look at structurally, you'll see that they have

74:08 little nodules everywhere. Those are where gonna see these scattered lymphocytes with those

74:14 centers. So counsels fairly simple, . They're protecting against what I'm

74:22 The last little bit here is we're deal with the malt. There's others

74:25 these. These are just found all the body. These are lymphatic

74:30 What we're looking at this picture is digestive system and you can see each

74:34 these little circles right here is the nodules. So this right here would

74:38 the outer wall of the small There's your smooth muscle, this is

74:43 epithelium and up here would be the . And so what you can see

74:47 the lymphatic tissue sits between the lumen the rest of your body. It

74:52 a line of defense against the things you're trying to put through your body

74:56 the digestive system. And this is only place where you're gonna find this

75:01 of tissue. You have it in eye, You have it throughout the

75:05 , you have it um in the system, you have it in the

75:10 track, You have it in your . This stuff is everywhere To prevent

75:15 sorts of horrible things happening. You a line of defense between you and

75:20 outside world through these types of And again, what do you have

75:25 here? You have scattered immune You have macrophages and all they're doing

75:30 they're looking for those things that shouldn't there to alert your system to create

75:36 t cells that can then fight things are going to attack your body over

75:41 over and over again. So when come back, I'm sorry. It

75:45 so long. I'll get all the up because I'm an idiot. When

75:49 get back, we're gonna start dealing the immune system specifically and how it

75:53 and how your body is protected against . It's really

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