The lymphatic system

introduction

The lymphatic system of the human body is an important part of our immune system (defense system).
It consists of the so-called lymphatic organs and a lymphatic system that is closely connected to the bloodstream. In addition to defense, it also plays an important role in the transport of fluids and the transport of dietary fats.

Lymphatic organs

Lymphatic organs are organs that specialize in differentiating and multiplying lymphocytes (a subgroup of white blood cells that are our body's cellular defense system).
A basic distinction is made between primary and secondary lymphatic organs.
The formation and maturation of lymphocytes takes place in the primary lymphatic organs. In the case of T lymphocytes this is the thymus, in the case of B lymphocytes the bone marrow.
Secondary lymphatic organs are those in which the lymphocytes meet their corresponding antigens, whereupon a specific defense reaction develops. The secondary lymphatic organs also include the spleen, as well as the lymph nodes, the tonsils (Tonsils), the appendix of the appendix and the lymphatic tissue in the small intestine (Peyer's plaques).

Read detailed information on the subject: Lymphatic organs

Figure lymphatic system

Figure lymph nodes: lymphatic system (A) and lymph nodes in the neck and head area (B)

Lymphatic system

  1. Head lymph nodes -
    Nodi lymphoidei capitis
  2. Cervical lymph nodes -
    Nodi lymphoidei cervicales
  3. Mouth of the breast duct
    in the left arm-head vein -
    Thoracic duct
    Left brachiocephalic vein
  4. Mouth of the right main
    lymph duct in the right
    Arm head vein -
    Dexter lymphatic duct
    Vena brachiocephalica dextra
  5. Superior vena cava -
    Superior vena cava
  6. Axillary lymph nodes -
    Nodi lymphoidei axillares
  7. Milk breast duct -
    Thoracic duct
  8. Lymph vessels -
    Vasa lymphatica
  9. Abdominal lymph nodes -
    Nodi lymphoidei abdominis
  10. Pelvic lymph nodes -
    Nodi lymphoidei pelvis
  11. Inguinal lymph nodes -
    Nodi lymphoidei inguinales
  12. Mandibular lymph nodes -
    Nodi lymphoidei submandibulares
  13. Anterior cervical lymph nodes -
    Nodi lymphoidei cervicales anteriores
  14. Superficial lateral cervical lymph nodes -
    Nodi lymphoidei cervicales
    lateral superficiales
  15. Deep lateral cervical lymph nodes -
    Nodi lymphoidei cervicales
    lateral profundi
  16. Mastoid lymph nodes -
    Nodi lymphoidei mastoidei
  17. Occipital lymph nodes -
    Nodi lymphoidei occipitales
  18. Facial lymph nodes -
    Nodi lymphoidei faciales
  19. Parotid lymph nodes -
    Nodi lymphoidei parotidei

You can find an overview of all images from Dr-Gumpert under: medical images

Lymphatic system

The lymphatic system runs through the entire body.
It is said that the lymph vessels begin “blind” and, unlike the blood system, do not form a circulation. You have to imagine it like this:
The human bloodstream is used, among other things, to transport nutrients to every part of the body.
To do this, the arteries branch out down to the smallest detail. These vessels are called capillaries, which eventually become thicker again, where the venous part of the vascular system begins. The blood plasma including nutrients emerges from the vessels in the capillary region. 90% of the volume is then taken up again by the veins and passed on, but 10% initially remains in the intercellular spaces.
The remaining 10% of the fluid (normally around 2 liters per day in healthy people) is absorbed by the lymph capillaries and is called lymph from here.
The structure of the lymphatic system is similar to that of the venous system: Here, too, the vessels become larger and larger, contain valves and, for the most part, use the muscle pump to convey the fluid.
They usually run parallel to the veins.

Lymph nodes can be found again and again along the lymph vessels, which are usually arranged in small groups. These have a filter function: They check the liquid flowing through them for foreign bodies and pathogens and clean them off if necessary. This task is carried out by certain cells, especially lymphocytes and macrophages. The now purified blood continues through the larger lymph vessels (collecting ducts).
A structure of particularly great importance is the thoracic duct (Milk breast duct), which carries the lymph of the entire lower half of the body and finally flows into the left vein angle together with the lymph fluid of the upper left half of the body.
The lymph in the upper right half of the body, on the other hand, flows into the right vein angle. The term venous angle refers to the point where the internal jugular vein and the subclavian vein meet. It is located at the entrance to the breast. At this point, the lymph is returned to the blood vessel system.

You can find detailed information on this topic at: Lymphatic system

Function of the lymphatic system

The lymphatic system is not only used to remove foreign bodies or pathogens, but also to remove fluids from the tissue. If this evacuation does not work properly (for example because there is an obstruction to drainage or an insufficiency in the lymph vessels), fluid collects in the tissue, which in the worst case can lead to lymphedema.

Functions of the lymphatic system

The lymphatic system absorbs water from the tissue and transports it to the heart and thus back into the circulation. Together with the water, fats, metabolic products and other substances are transported. In addition, the reabsorbed lymph at the so-called lymph nodes is checked for any pathogens by cells of the immune system. The lymphatic system thus plays an important role in the transport of substances and plays a central role in defense against disease. In the human body, tissue is supplied with nutrients and oxygen by the finest blood vessels, so-called capillaries. The walls of these capillaries are permeable so that part of the fluid in the blood can pass into the tissue together with the nutrients it contains. The red blood cells, on the other hand, remain entirely within the capillaries due to their size.

Together with the metabolic and waste products of the tissue cells, a large part of this fluid also returns to the blood vessels, which transport the blood towards the heart as veins. However, about 10% of the fluid that has escaped from the vessels cannot be resorbed for physical reasons and would therefore remain in the tissue permanently. Since this is around two liters per day, increasing water retention would be the result. The lymphatic system prevents this, however, by absorbing excess water in the tissue and returning it to the cardiovascular system. It can also transport large and particularly lipophilic substances. These usually cannot pass through the blood vessel walls. Dietary fats absorbed in the intestine, which are known as microscopic fat bubbles, are particularly important here Chylomicrons be transported in the lymphatic system.

Another important task of the lymphatic system is the defense against disease. All of the resorbed lymph must pass through at least one lymph node before it can return to the bloodstream. The lymph nodes contain a large number of cells of the immune system that recognize and fight pathogens. Most of the immune cells are Lymphocytes. These cells belong to the so-called adaptive immune response. They are able to attack and eliminate pathogens that the body has already had contact with particularly effectively. Lymph nodes are distributed all over the body, but are particularly common in certain regions. These include the side neck, armpits and groin. The internal organs also have their own lymph node stations along the spine.

Diseases of the lymphatic system

There are some situations in which the lymph nodes have to work harder than usual, namely when there are more pathogens, cell debris and / or foreign bodies in the blood and thus also in the lymph.
A classic example of this is infection. When there is increased activity in the lymph node, it swells in response. Since the lymph is first cleaned in the lymph nodes, which are the first station in the drainage area, for example in the case of infections in the throat or nose, swollen lymph nodes in the neck and swollen lymph nodes in the neck and lower jaw area are found.

In the case of worse diseases such as generalized infectious diseases, blood poisoning or malignant processes such as leukemia, lymphoma or other types of cancer, the lymph nodes in the entire body can be enlarged (sometimes massively).

If you find swollen lymph nodes that cannot be directly linked to a local event and that persist over a longer period of time, you should definitely consult a doctor in order to rule out an underlying disease.

The lymphangitis

One of the diseases that affect the lymphatic system itself is lymphangitis, in which lymph vessels become inflamed.

Colloquially, this is often incorrectly referred to as "Blood poisoning“And is relatively rare. Lymphangitis can be caused by pathogens (e.g. bacteria, parasites) that have penetrated through a wound as a result of an injury, for example.

In addition, insect bites, snakebites and some medications (like chemotherapy drugs) represent a cause. Since this often affects the superficial lymphatic tracts, these become visible as red stripes under the skin.

As the inflammation spreads, the strips migrate towards the heart. These strips represent the inflamed lymph vessels and are often swollen, slightly warmed, and painful.

Itchy eczema or blistering in the corresponding skin areas can follow. Often there is a general feeling of illness.

Fever, chills, and tachycardia (Racing heart) can also occur.
Therapy is based on the severity of the clinical picture. If immobilization of the affected part of the body, alcohol bandages and anti-inflammatory ointments are not sufficient, antibiotic therapy is started.

Usually the disease heals completely. However, if not properly treated, it can develop into a chronic course.

Read more on this topic: Lymphangitis - How Dangerous Is It?

The lymphedema

Another disease that is also rare is lymphedema.
This can occur if the lymph drainage is disturbed. Then the lymph fluid builds up in the body tissue or collects between the cells.

Often the extremities (Arms legs) affected, which then swell.

Most of the time this is a painless process. Later, if left untreated, the swelling may turn into fibrosis (Connective tissue proliferation), with the skin becoming coarse and thickening over time.

If the swelling hardens and does not go away even after the legs are raised, this is called irreversible swelling.In addition, the swelling can cause nerve damage and poor circulation.

One cause may be the previous removal of lymph nodes (Lymph node extirpation). Other organ diseases, venous diseases, cancer diseases and treatments, radiation, infections and genetic defects can also lead to damage in the lymphatic system.

Lymphedema cannot be eliminated with medication. Lymph drainage and compression treatments are effective.

Appropriate skin care must also be carried out if the skin is damaged. Far more women than men suffer from lymphedema (in a ratio of 9 to 1). The reason for this uneven distribution is not yet known.

Find out all about the topic here: Lymphedema.

How can you stimulate the lymphatic system?

The lymphatic system can be stimulated in different ways. Some are presented below. First of all, you should ensure adequate hydration (about 2-3L of water per day), as this also stimulates the lymph fluid to keep moving.

Muscle activity also supports the lymph flow, as the lymph vessels between the muscles are so rhythmically pressed together and the lymph can then be transported upwards like a pump.

Rope or trampoline jumping is ideal for stimulating the lymphatic system. Long walks, swimming or cycling are also suitable.

Appropriate breathing can also help stimulate lymph flow. When breathing, maintain a straight posture and inhale deeply into your abdomen. These "Breathing technique“Can be performed both sitting and standing.

Alternating showers stimulate the circulation, which also gets the lymphatic system going. A dry brush massage can also help.

Schüsslersalze (Calcium carbonicum) should help to activate the lymph flow.

In addition, physiotherapists often offer "Manual lymph drainage" at.
The skin is gently moved in the direction of the lymph drainage. This stimulates the lymph vessels to take up more of the lymph that has accumulated.
This method is the method of choice for irritation caused by chronic inflammation such as tennis elbow or tendinitis.

It is also used to reduce swelling more quickly after an operation or bruise / other injury.

Cellulite and lipedema are also areas of application for the "Manual lymphatic drainage“.
This method should not be used in acute inflammation. In this case the "Manual lymph drainage“It can even be harmful, as there is a risk that pathogens that are in the lymph will be pushed through the lymph nodes before the immune system has been able to switch off the pathogens.

Therefore, the application of the "Manual lymphatic drainage“To be discussed with a doctor. If these measures do not help, acupuncture massage can also be tried.

How can you cleanse the lymphatic system?

Everything that stimulates the lymphatic system also helps to cleanse it.
Another point with which the cleansing of the lymphatic system is supported is the observance of the right diet. Too much animal fat and protein should be avoided.
Sugar and sweets should be restricted, as should milk and eggs.

Whole grain bread should be preferred over white bread. Celery / juice helps with lymph congestion, as it has a cleansing and detoxifying effect. Adequate hydration also helps to cleanse the lymphatic system, as does adequate exercise.

A visit to the sauna or steam bath cleanses the lymphatic system and should be considered, provided that no other disease speaks against it. Detoxification cures should only be carried out in consultation with a doctor or alternative practitioner, as they can cause more damage than help if carried out incorrectly.

How can you strengthen the lymphatic system?

To strengthen the lymphatic system, homeopathic remedies such as Lymphdiaral and Lymphomyosot offered.
Their intake should be discussed with a doctor or pharmacist. In the Naturopathy Aromatic therapies are also used to strengthen the lymphatic system, using aromatic essences such as spruce, garlic, rosemary, sage and clove. If these are to be taken orally, the therapy should be supervised by a therapist.

The main lymphatic drainage systems

In the head and neck area

Around a third of all lymph nodes in the human body are located in the head and neck area, as the nasopharynx is a key entry point for pathogens. The lymph is channeled from a superficial into a deep system before it is filtered for the first time in regional lymph node stations. Pathogens that have penetrated the body can be recognized in the lymph nodes and an immune reaction can be started.

Large lymph node stations in the area of ​​the head and neck are found below the chin, in the area of ​​the jaw angle (jaw joint), on the occipital bone (occiput = the part of the skull located at the back of the neck), on the mastoid, behind the ears, along the large ones venous vessels in the neck area and above the collarbone.

From the regional lymph nodes, the lymph flows along the lymphatic pathways into so-called collective lymph nodes. The deep cervical lymph nodes form the collection point for the lymph from the head and neck area.

From there, the lymph flows along the large veins in the neck area into the dexter or sinister jugular trunk, before flowing into a large vein leading to the heart at approximately the level of the collarbone.
On the right, the jugular trunk opens into the dexter lymphatic duct, which ends at the right angle of the vein. On the left, the jugular trunk ends in the thoracic duct, which in turn ends in the left vein angle.

Swollen lymph nodes in the head and neck area are a common examination finding. If they are painful and thickened, this most likely indicates an inflammation, the cause of which is usually a simple infection.
In the case of lymph nodes that are painless, thickened and additionally hardened for a long time, a tumor disease can be the cause, which is why a doctor should be consulted for clarification in the case of chronically swollen lymph nodes.

The cervical lymph nodes can also be swollen in diseases that are not primarily located in the head and neck area. Since the lymph is diverted from the entire body into the left and right vein angles, which are located at the base of the neck, these can be affected retrograde. This means that the inflammation travels from below (the corners of the veins) opposite to the lymph flow up to the cervical lymph nodes.

In the face

As with the entire head, a distinction is made between a superficial and a deep lymphatic system on the face. This lymphatic system collects the lymph from all over the face. This also includes the lymph from the various sensory organs of the head. While the superficial system mainly collects the lymph from the skin, the deep system collects the lymph from the muscles, joints and nerves.

Small lymphatic ducts predominantly run in the face area. There are only a few lymph nodes on the face. The first larger lymph node stations are located below the chin, in the corner of the jaw and in the area of ​​the ears.

In addition, there is a pronounced lymph system in the oropharynx area (Waldeyer throat ring). This lymph system consists of numerous immune cells and lymphatic tissue and is of crucial importance in the detection of pathogens.

In the chest

The female breast also has a connection to the lymphatic system. This can be done either sideways over the armpit or in the middle along the sternum. The most important drainage route is the side via the armpit. The lymph first flows to the lymph nodes in the armpits. Then it flows back to the middle of the body in deeper layers and finally reaches the heart. This involves passing through a number of lymph nodes. It starts with the lymph nodes in the armpit. The first lymph node that the lymph reaches is called the sentinel lymph node. The English name is also often used Sentinel used. This is particularly important in the case of breast cancer. Often, daughter tumors reach the associated lymph nodes via the lymphatic system, where they can establish themselves and grow. The associated sentinel lymph nodes are always the first to be affected. When diagnosing and assessing breast cancer, it is therefore important to know about any spread to the lymph nodes. During breast cancer screening and regular self-monitoring, the armpit should always be palpated for swollen lymph nodes.

You might also be interested in the following articles:

  • Tissue samples in breast cancer
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On the arm

The lymph drainage on the arm is similar to that on the leg. A distinction is also made between a superficial and a deep lymphatic system.
The superficial system collects the lymph from the skin, while the deep system collects the lymph from muscles, joints and nerves.

The superficial system first flows into the deep system before the lymph is filtered in regional lymph node stations. These are located on the arms in the area of ​​the large veins. From there, the lymph is directed towards the large collecting lymph nodes located in the armpit area.

After another filtration, the lymph vessels run along the large venous vessels and flow into the bloodstream at about the level of the collarbone. On the right side the lymph flows into the ductus lymphaticus dexter, which ends in the right vein angle. Left in the thoracic duct, which in turn ends in the left vein angle.

On the leg

Lymph drainage on the legs occurs through a superficial and a deep system. The superficial system mainly absorbs the lymph from the skin, while the deep system collects the lymph from muscles, joints and nerves.

The further course of the lymphatic drainage is based on the course of the veins. Regional lymph node stations are located in the hollow of the knee, where the first filtration of the lymph takes place.

The large collective lymph node stations are located in the bar. In these the entire lymph of the leg is collected and carried on together into the lymphatic systems of the pelvis.