Mízní sytém - Info-Brno.cz

Mízní sytém - Info-Brno.cz

Mzn systm Lymfatick tkn a systm lymfatickch cv - vasa lymphatica. buky tvoen v kostn deni, v thymu, lymfatickch uzlinch, ve slezin a v lymfoidn tkni GIT a respiranho systmu. Napojeno pmo na lymfatick cvy, me bt i oddleno (slezina). Fetln lymfocyty z kostn den. st vycestuje do thymu, kde se diferencuje v T lymfocyty. Ostatn lymfocyty (B) se v deni pomnouj a usdluj se v sekundrnch lymfatickch orgnech (slezina, tonsily

lymfatick tk steva a respiranho traktu). T lymfocyty - bunn imunita, B lymfocyty - humorln imunita - produkuj protiltky typu globulinu. monocytomakrofagov systm - fagocytosa Mza - lymfa Vznik z tkovho moku - bezbarv, ir tekutina Intersticiln mok je tvoen bukami a filtrac z plasmy stnou kapilr. Do lymfy se vstebvaj blkoviny, cholesterol a tuky

ve form mastnch kyselin (chylus). S tuky se vstebvaj i vitaminy rozpustn v tucch (A, D, E, K), steroidn hormony, elezo, md a vpnk. Do lymfatickch kapilr prostupuj interendotelovmi trbinami buky - lymfocyty, leukocyty a makrofgy Mznmi cvami se mohou it i ndorov buky metatazovn. Mzn cvy

zanaj slep tenkostnn cvy (stna ten ne u il) nesouvisl bazln lamina endothel bez pr a bez zonulae occludentes vt mnostv chlopn do prbhu cv vloeny mzn uzliny u

hlavnch kmen dobe vyvinuta tunica media, na rozdl od tenk tunica Mzn cvy Pi zstav odtoku lymfy vznik mzn otok lymfedm Tkn bez vlivu lymfatickho systmu vlasy, nehty,

epidermis, rohovka, sklivec, oka, chrupavka, nervov tk, kostn de elephantiasis Lymfa - systmem lymfatickch cv a uzlin odvdna do iln cirkulace pomoc dvou mznch kmen ductus thoracicus,

ductus lymphaticus dexter. Dva mzovody (nepravideln dlen tla) ductus thoracicus

pars abdominalis pars thoracia pars cervicalis dexter truncus lymphaticus dx.

cisterna chyli Mzn uzliny (nodi lymphatici) pouzdro (capsula) + trmeky (trabeculae) hilus kra (cortex) parakortikln vrstva de (medulla)

nodi lymphoidei konvexn st - aferentn vasa afferentia hilum vasa aff. et eff. capsula, trabeculae subkapsulrn sinusy cortex - folliculi

peritrabekulrn a parakortikln sinusy paracortex, medulla hust lymfatick tk s plasmatickmi bukami tributrn (spdov) oblast Mzn uzlina (x 8)

Mzn uzlina (x 50) Funkce uzliny a) produkce lymfocyt, b) filtrace lymfy, c) dky tvorb T a B lymfocyt uzliny zabezpeuj obranou schopnost tla humorln a bunn imunita

Pnevn Lymfografie Lymfatick systm ensk pnve Neopouzden lymfatick tk D-MALT (diffuse mucosa-associated lymphoid tissue) voln rozptlen

buky v GIT O-MALT (organized mucosa-associated lymphoid tissue) n.l. v GIT nodi lymphoidei solitarii nodi lymphoidei aggregati appendix vermiformis B-ALT (bronchial ALT) doln cesty

Nodi lymphoidei aggregati (ilei) Mandle (Tonsillae) agregace sten opouzden lymfatick tkn pod epitelem

produkce lymfocyt Waldeyerv lymfatick okruh tonsilla lingualis (crypta, noduli) tonsilla palatina (fossulae, cryptae, capsula) - siln pouzdro tonsilla pharyngea (fossulae, cryptae, noduli) = adenoidn vegetace

- nejsou krypty, slab pouzdro tonsilla tubaria Tonsilla palatin a Lymfatick orgny Brzlk (thymus)

Slezina (lien) Mzn uzliny (nodi lymphatici) Mandle (tonsillae) Brzlk (thymus)

lymfoepitelov orgn primrn lymfatick orgn lobus dx. et sin. lobuli, cortex, medulla (lobuli thymici accessorii) obalen vazivem

relativn nejvt pi narozen (12-14g) podlh involuci a tukov pemn pozstatky jsou patrn i ve st mediastinum superius za sternem 30-40 g novorozenec

pod ttnou lzou - a na perikard 16 g postupn involuce od puberty po 50. roce nhrada tukovou tkn

Brzlk - vvoj ventrln vbek 3. ebern vchlipky mediokaudln sestup proliferace endodermu 10. tden - osdlen kmen. bukami /lymfocyty/ z krevnch ostrvk, jater i kostn den

z mesenchymu vrst vazivovch sept Brzlk - vvoj Brzlk T- lymfocyty, makrofgy, thymocyty, epithelov retikulrn buky Hassalova tlska (de)

Funkce Produkce lymfocyt v lalcch thymu. Jeho epitelov buky secernuj adu ltek, ovlivujcch tvorbu a diferenciaci lymfocyt. kolka pro lymfocyty klonln selekce Tlymfocyt, kter rozpoznvaj antigeny tlu vlastn Lymfocyty jsou svou funkc T lymfocyty a jsou odpovdny za bunnou imunitu. st epitelovch bunk v prbhu ivota odumr a jejich zbytky jsou pod

mikroskopem patrn jako Hassalova tlska. Myasthenia gravis tvorba protiltek proti nervosvalovm plotnkm capsula /tunica fibrosa/

tunica serosa /peritoneum/ facies diaphragmatica visceralis (renalis, gastrica, colica, pancreatica) trmce pulpa bl

(folliculi lymphatici) pulpa erven (Billrothovy provazce) Slezina

(lien, splen) extremitas ant., post. margo inf., sup. hilum splenicum, sinus splenicus

lig. splenorenale, gastrosplenicu m, splenicocolicum splen accessorius Slezina (splen, lien) Slezina (12x zvteno)

Slezina - cvn zsoben A. lienalis (truncus coeliacus) aa. trabeculares aa. centrales - v periarteriln lymfatick pochv vtviky zsobujc blou

pulpu kon jako aa. penicillatae sinus lienis (v erven pulp) oteven vs. uzaven obh prothl endotelie, trbiny, BL peruovan

Slezina funkce Tvorba lymfocyt v bl pulp imunologick filtr krve vychytvn antigen Aktivace B lymfocyt - zdroj protiltek Perzistuj pak jako plasmatick buky vhoda pi opakovan infekci krevn hbitov zsobrna krve

prenatln msto hematopoezy Slezina klinick vznam normln nehmatn splenomegalie dvojdob ruptura sleziny splenektomie vy nchylnost k infekcm a ndorovm onemocnnm

Mzn uzliny (nodi lymphatici) tributrn oblasti regionln uzliny sentinelov uzlina znty bolestiv zduen

ndory nebolestiv zduen elefantiza TNM klasifikace HLAVA a KRK n.l. cervicales anteriores

laterales n.l.c. profundi n.l.c. superficiales podl v. jugularis int. podl n.

accessorius Jazyk 3 smry + pes stedn ru do druhostrann ch uzlin

Axilla 40 uzlin 5 skupin Mln lza 4 kvadrant y pes stedn ru

axilla pectorales (Sorgius), subscapulares interpectorales laterales centrales, apicales (infraclaviculares nodi parasternales nodi

supraclaviculares plexus subareolaris, plexus circumareolaris abd. spojky (epigastrick cesta) Sekundrn lymfedm HK po exenteraci axilrnch uzlin Plce ve

doprava (truncus lymphaticus dexter) doleva jen horn 3 segmenty

lev plce !!! aludek 6 skupin regionlnch uzlin (+ anulus lymphoideus cardiae) metastzy supraklavikulrnch uzlin

vlevo Nodi gastrici nodi pylorici nodi pancreaticolienalis nodi pancreaticoduodenales nodi hepatici nodi mesenterici nodi colici et paracolici nodi rectales et pararectales

n.l. lumbales mza z vajenku i varlete ! Uzliny podl velkch cv v retroperitoneu Nodi lumbales

Nodi iliaci comm. Nodi iliaci ext. Nodi iliaci int.- nodi parauterini (Bayer)/ nodu retroprostatici Nodi axillares Nodi lymph ing. spf et profundi konetiny+zevni genitl, doln tetina vaginy, pars analis recti

Konetiny - kolektory

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