Lymphatic system appendix: Anatomy of the Lymphatic System
Anatomy of the Lymphatic System
The appendix has often been seen more as a nuisance rather than an important part of the human anatomy, often leading to its indiscriminate removal. However, it has recently been identified as playing an important part in our immune response.
There is much more to the lymphatic system than the network of vessels and nodes with which it is most commonly associated. Indeed there are several organs of the body that connect the lymphatic and immune systems together. Let’s start with one that many would not associate with the lymphatic system – Bone Marrow.
Bone Marrow
Red bone marrow is an extremely important part of the lymphatic system, as it produces lymphocytes – white blood cells that are responsible for identifying and destroying viruses, bacteria and other pathogens.
B LYMPHOCYTES are responsible for producing antibodies to fight a specific virus, bacteria or antigen that enters the body.
They mature in the red bone marrow before migrating through the blood to other lymphatic organs such as the spleen and lymph nodes where they await activation. This occurs when their specific antigen is picked up in the lymphatic fluid and detected in the lymph nodes.
T LYMPHOCYTES are also produced by red bone marrow, but mature in the thymus gland before migrating to other lymphatic organs. They are primarily responsible for destroying infected body cells and may also help fight cancer.
The Thymus
The thymus is a soft, roughly triangular organ located in the thoracic cavity. As a gland, it produces a number of hormones, but its role in the immune and lymphatic systems is much more significant.
The thymus is responsible for the maturing of T-Lymphocites that are produced by red bone marrow (see previous post), by teaching them to attack only viruses, bacteria and other pathogens rather than the body’s own cells. This is done in two stages.
In the first stage, the immature T-Lymphocytes are exposed to foreign bodies – or ‘antigens’.
Those T-Lymphocytes that react to these antigens are selected to survive and move onto the second stage.
Stage two involves the maturing T-Lymphocytes being presented with the body’s own antigens. T-Lymphocytes that react to these test positive for autoimmunity which means that they will attack the body’s own cells. These are eliminated.
The T-Lymphocytes that graduate Thymus University (a mere 2%!) are released into the bloodstream where they will either circulate looking for a fight or take up residence in a handy lymph node awaiting their call to action.
Unlike most organs that continue to grow as we age, the thymus enlarges during childhood then starts to shrink with the onset of puberty, as the immune system produces most of its T-Lymphocytes during childhood.
The Spleen
The spleen is located in the upper left part of the abdomen, protected by the rib cage and is the largest lymphatic organ in the body. As lymph nodes filter and clean lymphatic fluid, so the spleen does the same for our blood.
It does this in two ways; the first is by managing the quality and to some degree, quantity of blood in circulation and the second is by fighting infection
QUALITY CONTROL: As blood flows into the spleen a quality control check is carried out, to detect any red blood cells that are old or damaged. These are then broken down and any useful leftovers – iron for example – will be stored for later use
The spleen also acts as a reservoir for blood storing approximately 1 cup (250ml), ready to be released if there is a significant loss of blood (after an accident or any other trauma for example)
FIGHTING INFECTION: However it is the spleen’s role in fighting infection that marks it out as a lymphatic organ. The spleen is made up of approximately 20% lymphoid tissue where our old friends, lymphocytes are produced and mature. When any invaders are detected in the bloodstream, the spleen will act much like a lymph node and will create an army of lymphocytes to weaken or kill the bacteria, viruses, or other organisms that could cause infection.
The Tonsils
Once thought of as an unnecessary and obsolete part of the anatomy, the tonsils are actually large clusters of lymphatic cells located in the pharynx – the part of the throat behind the mouth and nasal cavity – and in childhood they are our first line of defence against bacteria, viruses and other pathogens attempting to enter the body through the mouth or nose.
There are in fact THREE sets of tonsils which each help fight infection and disease:
The PHARYNGEAL tonsils – or ‘adenoids’ are located at the base of the nasal cavity and they protect the lungs by producing lymphocytes to trap any bacteria and viruses that enter the body through the nose.
The PALATINE tonsils are the oval shaped masses that protrude from either side of the throat behind the mouth cavity. They prevent infection of the oesophagus and digestive tract by destroying pathogens attempting to enter the body via the mouth.
The LINGUAL tonsils sit at the very base of the tongue, and comprise lymphatic tissue containing T and B Lymphocytes that will be activated when harmful bacteria and viruses are detected.
Given their exposure to pathogens, it is not surprising the tonsils themselves are highly susceptible to infection and their removal (tonsillectomy) is still one of the most frequently performed childhood operations if recurring infection becomes problematic. However, the longer the tonsils can be retained, the better the opportunity the body has to develop immunity against the most common infections, making the tonsils less critical in the fight against infection and disease.
The Appendix
The appendix is a pouch of lymphatic tissue that is attached at the end of the large intestine (cecum), located in the lower-right area of the abdomen. The appendix has often been seen more as a nuisance rather than an important part of the human anatomy, often leading to its indiscriminate removal. However, it has recently been identified as playing an important part in our immune response.
Lymphatic tissue starts to appear in the appendix shortly after birth and reaches a peak between the second and third decades of life, decreasing rapidly thereafter and practically disappearing after the age of 60.
During the early years of development, the appendix has been shown to function as a lymphoid organ, assisting with the maturation of B-lymphocytes by exposing them to the wide variety of foreign bodies (antigens) that are present in the gastro-intestinal (GI) tract thereby providing a degree of local immunity.
Recent research has also found that lymphatic tissue encourages the growth of some beneficial gut bacteria that plays an important role in human digestion and immunity. According to the so-called ‘safe house theory’ the appendix protects a sample of this beneficial gut bacteria when certain diseases wipe them out from elsewhere in the GI tract. Once the immune system has rid the body of the infection, the bacteria emerge from the appendix and recolonise the gut.
The appendix was often routinely removed and discarded during other abdominal surgeries to prevent any possibility of any later attack of appendicitis. This is no longer the case, and in fact the tissue from a healthy appendix has been used in reconstructive bladder and renal surgery.
As a result, the appendix is no longer removed if it is healthy.
What Is an Appendix, and What Does It Do?
The ‘Safe House’ Theory of the Appendix
Some scientists now believe the appendix is not useless after all, and may help our guts recover after a gastrointestinal disease strikes.
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The appendix contains a particular type of tissue associated with the lymphatic system, which carries the white blood cells needed to fight infections. In recent years, scientists have found that lymphatic tissue encourages the growth of some beneficial gut bacteria, which play an important role in human digestion and immunity.
Studies have also shown that the lining of the gut contains a biofilm, or a thin layer of microbes, mucus, and immune system molecules — and these biofilms appear to be most pronounced in the appendix. (5)
According to the so-called “safe house” theory, the appendix protects a collection of beneficial gut bacteria when certain diseases wipe them out from elsewhere in the GI tract.
Once the immune system has rid the body of the infection, the bacteria emerge from the appendix biofilm and recolonize the gut. (6)
A review of the relevant available research published in 2016 concluded that the appendix is not a rudimentary organ but an “important part” of the immune system. (7)
Researchers have recently found that numerous animals, including great apes, other primates, opossums, wombats, rabbits, and certain rodents all have structures similar to the appendix. (8) The appendix, it seems, may have independently evolved in different animals at least 32 times over the course of history, suggesting the organ does have an important function. (4)
Potential Health Issues Involving the Appendix
Sometimes, the appendix can become inflamed and infected, resulting in a condition called appendicitis.
Appendicitis is often the result of an abdominal infection that has spread to the tiny organ, or some kind of obstruction that has blocked the small opening of the appendix.
Sources of blockage include, among other things:
- Hard pieces of stool
- Parasites or intestinal worms
- Ingested objects, including air gun pellets and pins
- Abdominal trauma
- GI tract ulcers
- Enlarged appendix lymphatic tissue
The infection or obstruction causes the bacteria in the appendix to grow out of control, and the organ can fill with pus and swell. Appendicitis causes intense abdominal pain and other GI symptoms, including vomiting and diarrhea. Removal of the appendix (an appendectomy) is often the necessary course of action, though increasingly, antibiotics may be recommended and used to treat the infection without the need for surgical intervention — depending on the severity of the case and other health factors in the individual patient. If the problem is left untreated, the pressure in the organ will increase until the appendix ruptures, or bursts.
When the appendix bursts, it spreads its content throughout the abdomen, potentially infecting the peritoneum, which is the silk-like membrane that lines the abdominal cavity.
A peritoneum infection, called peritonitis, can then lead to sepsis, a complication that’s potentially deadly if not treated aggressively. (9)
Additional reporting by Deborah Shapiro.
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Why an appendix is needed
The human body is a complex system.
Each organ, particle has its own function. And only one of them, according to many, is superfluous in this harmonious system. This is an appendix.
The appendix, or appendix, is an appendage of the caecum. The rudiment resembles a cylinder, its length reaches 12 cm, its diameter is 8 mm.
The appendix may have a different location: below, in the side, behind the caecum, may be adjacent to the kidney or ureter. This complicates the stage of diagnosis of the inflammatory process, and also complicates the operation.
The walls of the rudiment contain a large number of lymphatic vessels. They form a single network through which lymph enters the lymph nodes or solitary follicles. The lymphatic system of the appendix performs a protective function in inflammatory processes of the digestive system. But this is precisely the main cause of inflammation of the appendix.
Every year, 5 out of 1000 people are diagnosed with inflammation of appendicitis with an acute course of the disease.
Therefore, this disease is the main among the ailments requiring surgical intervention.
Should I have my appendix removed?
Many believe that the appendix is not involved in the process of digestion, which means that it can be removed without harm to the body, without waiting for the onset of the inflammatory process. In order to understand whether it is worth getting rid of the rudiment, you need to understand its functions.
The human body contains a large number of different microorganisms. They take part in the process of digestion and perform a protective function – they do not allow “foreign” pathogenic bacteria to penetrate into the body. “Good bacteria” and man create a symbiosis. Bacteria take food and a home from the human body, and in return help digest food and protect against harmful microorganisms. At this stage, the appendix with the function of a protective barrier is connected. Intestinal infections are often accompanied by diarrhea, which remove symbiont bacteria from the body.
But some of them remain in the appendix and begin to multiply. This helps fight the infection. If the appendix is removed, the patient develops dysbacteriosis.
We can conclude that it is not worth removing the appendix unnecessarily. This was confirmed by studies of the Americans. They began to cut out the appendix from infants. Further observations showed the fallacy of this action. Children could not digest their mother’s milk. They began to appear deviations in mental and physical development. The main reason for this was violations in the digestive system. Accordingly, there were problems with growth. Children with remote appendix were more likely to suffer from infectious diseases, intestinal infections, including dysbacteriosis. These observations forced the Americans to abandon this method of preventing appendicitis.
The operation should be performed only in case of acute inflammation of the rudiment. In this case, it is a vital surgical manipulation. If the operation is not carried out in time, sepsis and peritonitis will develop.
Therefore, at the first signs of an inflammatory process, contact our surgeon. He will conduct the necessary studies and, after confirming the diagnosis, will prescribe an operation.
Appendix: anatomy and functions
The appendix is considered in modern medicine to be a rudimentary organ, that is, it has lost its significance in the process of evolution of the organism. The appendix is tubular, 4.5 to 15 cm long and up to 10 mm in diameter. The organ has a mesentery that maintains its relative mobility and holds its topography. The appendix communicates with the cecum with a funnel-shaped opening, and its distal end ends blindly and communicates with the cavity of the caecum. The walls have a mucous, submucosal, serous and muscular layer.
Functions of the organ
The functional purpose of the rudimentary organ has not yet been fully elucidated. However, it has been reliably proven that the appendix performs secretory, endocrine and protective functions, supports the formation of healthy immunity and the maintenance of intestinal biocenosis.
The theory about the futility of appendicitis belongs to the Russian scientist I. Mechnikov. He believes that the appendix does not affect the physiological state of the body and does not impair health or quality of life when it is removed. In adulthood, the appendix completely atrophies and is not able to perform natural functions.
The appendix is considered an intestinal tonsil that stimulates the immune system, improves the body’s protective resources, contains beneficial microflora and regulates the level of lacto- and bifidobacteria in the intestine.
In the appendix there are many lymphatic vessels that form a single lymphoid network. Lymphatic fluid drains into lymph nodes or “solitary follicles” containing lymphoid tissue. The organ has a powerful lymphatic apparatus that regulates the outflow of lymph in the intestines.
Diseases of the appendix
The main disease of the appendix is appendicitis, an acute inflammation of the appendix. Sometimes there are chronic forms of appendicitis.
The disease proceeds with acute pain in the iliac region, hyperthermia, and other symptoms of intoxication. The patient has impaired digestion, vomiting, an abundance of gases, and constipation. Appendicitis is diagnosed on the basis of a digital examination of the vagina, rectum, blood biochemistry, positive tests according to Blumberg-Shchetkin, Sitkovsky and others.
Appendicitis is a common surgical pathology of the abdominal cavity and accounts for almost 85% of all urgent hospital admissions. Inflammation is most common in children of school age, in adults aged 25-30 years. For some people, the appendix does not become inflamed throughout life. Treatment is only surgical, involves the removal of the organ.
If in Russia and the CIS countries the removal of the appendix occurs according to indications, then abroad they increasingly offer removal as a preventive measure against the inflammatory process. In the United States, there was a practice when doctors removed the appendix when they were still babies in order to prevent an acute clinical situation in the future.
According to the results of tests and further observations of these children, their greater susceptibility to dysbacteriosis, intestinal infections, and impaired digestive functions was noted. Subsequently, preventive measures against appendicitis by appendectomy were discontinued.
The gut contains over a million micro-organisms, beneficial substances that are an essential part of healthy digestion. A symbiosis has been established between a person and the filling of his intestines. Bacteria receive a favorable environment for existence, and the microflora, in turn, is involved in the digestion of food, the formation of stool, and the evacuation of feces. The appendix performs a barrier function in infectious and inflammatory diseases of the intestinal tract.
With a weakened immune system, colonies of pathogenic microorganisms increase, leading to the development of intestinal inflammation: proctitis, paraproctitis. Children are more susceptible to infection, the development of intestinal viral diseases.