Lymphatic and Immune
System Anatomy
For the module Anatomy and Physiology 2 (ANP01Y2)
As developed by Dr N Jooste
For the programme Medical Imaging and Radiation Sciences
2025
1
Introduction
The lymphatic system returns fluids leaked from blood vessels back to the cardiovascular system, while
lymphoid organs and tissues provide the structural basis of the immune system.
Revise your cardiovascular system knowledge from Y1 using your prescribed textbook.
Define the following new terms:
• Lymphatic vessel
• Lymph
• Lymphatic node
• Lymphoid organs
• Diffuse lymphoid tissue
• Lymphoid follicles
2
Venous Arterial
Here we consider the circulatory function of the lymphatic system.
system system
Heart
Fluid leaks from the capillary beds into surrounding tissues for nutrient
Lymph duct and gas exchange. Most of this fluid is reabsorbed at the venous end of
Lymph trunk the capillary beds. But some of the fluid remains in the tissue spaces –
this is called interstitial fluid and must be returned to circulation.
Lymph node
The lymphatic vessels collect excess interstitial fluid. Once the
Lymphatic interstitial fluid is within the lymphatic vessels it is called lymph
system
Unlike the cardiovascular system, the lymphatic vessels are a one-way
Lymphatic system collecting lymph at the capillary beds and allowing it to flow
collecting
vessels, towards the heart.
with valves
Lymph
capillary
Tissue fluid
(becomes
Consider what would happen if one of these
lymph) lymphatic vessels were to become blocked.
What is this clinical condition called?
Loose connective
Blood tissue around
capillaries capillaries
3
Fibroblast in loose
connective tissue Flaplike
minivalve
Tissue fluid
Tissue cell
Lymphatic
capillary
Blood
capillaries
Filaments
Endothelial anchored to
Arteriole Venule cell connective
tissue
Notes:
The lymphatic capillaries are blind-ended between the blood capillaries and tissue
cells.
Lymphatic capillaries are traditionally reported to be absent from bones, teeth, bone
marrow and the central nervous system. However, a relatively recent discovery
identified lymphatic capillaries in the meninges of the brain.
The lymphatic capillaries are very permeable due to flap-like endothelial cells and
anchoring collagen filaments. This permeability allows transport of large particles
such as proteins, cell debris and pathogens.
Lacteals are special lymphatics that absorbs fat from the small intestine. The content
of the lacteals is called chyle.
4
The right lymphatic Internal Esophagus
duct: Right jugular trunk
• Drains lymph from
jugular veins Trachea
the right upper limb, Right lymphatic
Left jugular trunk The thoracic duct:
and the right side of duct
the head and thorax • Drains lymph from
Left subclavian the rest of the body
• Empties into the Right subclavian trunk • Empties into the
blood at the junction
of the right internal
vein blood at the junction
Left subclavian vein of the left internal
jugular and Right broncho-
subclavian veins jugular and
mediastinal trunk
Left broncho- subclavian veins
Brachiocephalic mediastinal
veins trunk
Superior vena cava
Azygos vein
Ribs
Thoracic duct The lymphatic system lacks a
pumping mechanism.
Hemiazygos vein
Investigate the anatomical
Cisterna chyli structures of the lymphatic
system and surrounding
Right lumbar tissues/organs that promotes
trunk
the flow of lymph towards the
heart.
Left lumbar trunk
Inferior vena cava
Intestinal trunk
Notes:
Lymphatic capillaries drain into ever bigger vessels. Collecting vessels have thinner
walls and more valves than veins. Superficial collecting vessels travel with veins and
deep collecting vessels travel with arteries.
Collecting vessels join to form trunks. There are five lymphatic trunks in the body: the
lumbar, bronchomediastinal, subclavian, jugular and intestinal trunks. All trunks
except for the intestinal trunk are paired.
The lymphatic trunks drain into one of two lymphatic ducts. The right lymphatic duct
drains the right upper limb, right side of the head and the right side of the thorax.
This duct empties into the right venous angle, which is where the right internal
jugular vein and the right subclavian vein meet.
The thoracic duct arises from the dilated cisterna chyli and drains the lower limbs,
abdomen, left thorax, left upper limb and left side of the head. The thoracic duct
empties into the left venous angle, which is the junction of the left internal jugular
vein and the left subclavian vein.
5
Internal Regional
jugular vein lymph
nodes:
Entrance of Cervical
right lymphatic nodes
Lymph nodes are lymphoid
duct into vein
organs, that are clustered along
Entrance of
thoracic duct the lymphatic vessels to detect
into vein
Axillary and destroy microorganisms and
Thoracic duct
nodes debris circulating in the lymph.
They also play a role in activating
Cisterna chyli
an immune response.
Aorta
Inguinal
Collecting nodes
lymphatic
vessels Consider the main regional lymph
nodes depicted in the image. Try to
estimate where an infection would be
located if each of these lymph node
Drained by the right lymphatic duct clusters becomes infected
Drained by the thoracic duct (separately).
6
The lymph node is a bean-shaped organ surrounded by a
Afferent
lymphatic
Cortex dense fibrous capsule. Capsule tissue turns inward to form
• Lymphoid follicle trabeculae.
vessels
• Germinal center
• Subcapsular sinus
The outer cortex contains follicles with germinal centers. B-
lymphocytes are contained within these germinal centers. T-
Efferent
lymphatic
lymphocytes can be found in the deeper parts of the cortex.
vessels
The central medulla contains cords that extend from the
cortex. In between the cords are lymph sinuses; these large
spaces are patrolled by macrophages.
Lymph enters the convex side of the lymph node through the
Hilum
afferent vessels, then moves through the subcapsular space,
Medulla sinuses of the cortex and sinuses of the medulla. Lymph
` • Medullary exits at the concave hilum through the efferent vessels.
cord
• Medullary
sinus
Note there are more afferent vessels
than efferent vessels. Why would
Trabeculae that be?
Capsule
7
The spleen is the largest lymphoid organ, and its
functions include, lymphocyte proliferation, immune
surveillance and response, extracting aged/defective
blood cells, storing blood platelets and a site of
hematopoiesis in the fetus.
The spleen is located on the left side of the abdominal
cavity, just inferior to the diaphragm.
The splenic artery and vein will enter/exit at the hilum of
• Spleen
the spleen.
Diaphragm
Spleen
Adrenal
gland
Left
kidney
Splenic
artery
Pancreas
8
Capsule
Trabecula
Splenic cords
Histologically the spleen contains a
Splenic sinusoids
fibrous capsule with trabeculae that
extend inward. Arterioles
and
The white pulp of the spleen capillaries
contains lymphocytes arranged on Red pulp
reticular fibers. The white pulp is White pulp
clustered around central arteries.
Central artery
The red pulp consists of Splenic artery
erythrocytes and macrophages.
Splenic vein
Splenic cords made up of reticular
connective tissue scaffolding are
separated by splenic sinusoids.
Match specific splenic functions to
either white pulp or red pulp.
9
Why would the thymus have an epithelium
scaffolding? Carefully consider the thymus’s
• Thymus
function and the function of epithelium. Where
do they overlap?
The thymus functions during the early years for T-
lymphocyte maturation. It also secretes thymic
hormone and will atrophy after puberty.
The thymus is a bilobed organ found superiorly in the
thorax between the heart and the sternum.
Each thymic lobule contains an outer cortex with
rapidly dividing T-lymphocytes and an inner medulla
with thymic corpuscles. An important distinction
between the thymus and other lymphoid organs is the
fact that the thymus does not have a reticular
connective tissue scaffolding, but an epithelium
scaffolding.
10
MALT (Mucosa
Associated Lymphoid
Tissue): these are
lymphoid follicles
• Tonsils distributed throughout
the mucous
membranes of the
body. MALT includes
tonsils, Peyer’s patches
and the appendix.
• Peyer’s patches
(aggregated
What is the purpose of
lymphoid nodules
in small intestine) the MALT in the
locations associated
• Appendix
with each of the
structures listed on the
image?
11
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