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Thursday, 25 April 2013

Histology (bone and cartilage)


Bismillahirahmanirrahim

OK.. now I'll share about 'Cartilage' in our body =)

Cartilage arise from mesenchymal. It consist of :

1. Cell (Chondrocyte & Chondroblast)
2.Connective tissue
3. Ground substance (Non vascular. Got nutrient from diffusion)

There are 3 types of cartilage :
1. Hyaline cartilage
2. Elastic cartilage
3. Fibro cartilage


Hyaline and elastic cartilage were covered by 'perichondrium'. 
Perichondrium consist of 2 layers.
1. Outer : vascular connective tissue + type I collagen
2. Inner : chondrogenic that give rise to chondroblast (that secrete cartilage matrix)

Cartilage matrix produce and maintain chondrocyte & chondroblast. Contain large aggregate of proteoglycan and highly hydrated.

Mature cell for cartilage : Chondrocyte (enclose in lacunae)

"Hyaline cartilage"



* Most common : serve skeletal muscle
* Can be replace by bone during endochondral ossification
*Contain type II collagen
*Can be found : 
(TEN BeBaL)

T- Trachea
E-End of Ribs
N- Nose
B-Bronchi
B-Bone
L-Larynx

"Elastic cartilage"



*For structural support & increase flexibility
*Contain : elastic fibre in matrix & highly flexible
* Found in :
(EEA)

E-External ear
E-Epiglottis
A-Auditory tube

" Fibro cartilage"



*Dense bundle of type I collagen
*Function:
(TBR)
 T-Tensile strength
B- Bear weight
R- Resist compression

*Found in :
-Invertebral disc
-Certain joint
-symphysis pubis


"Bone"



Picture above shows 'compact bone'

Info based on picture :

- In compact bone, collagen fibre arranged in lamellae
- Deep to periosteum is circumferential lamellae
-Lamellae surrounding bone marrow
-Osteon also exist and known got 'Haversian system'.
-Between Harversian system : central canal

Bone matrix :

-Highly vascularized (calcified diffusion)
-Major component : Collagen fibre
-Glycoprotein component bind to calcium (mineraliztaion)

Bone usually continually remodal those thing :

1. mineral needs
2. Mechanical stress
3. Thinning/disease

There are 2 hormone involve in this :
1.Thyroid :- Inhibit action of osteocyte. Thus, decrease the bone re-absorption.
2.Parathyroid hormone :- Stimulate osteocyte. Increase bone reabsorption and  release calcium into blood.

Okay.. Now, lets talk about 'cell in bone'
Basically, we need to know 3 things :

1. Osteoprogenitor cell that located in :
(PEOP
P-Periosteum
E-Endosteum
O-Osteon
P-Perforating canal

2. Osteoblast :
-It's on bone surface
-Synthesized bone matrix

3. Osteocyte :
-mature cell of osteoblast
- Branch located in lacunae
-Use canaliculi for communication and exchange
-maintain bone & blood homeostasis in terms of calcium and phosphate

Ok.. I hope you enjoying this :)



Histology (Blood vessel)



Bismillahirahmanirrahim

Ok.. basically, we have blood vessel that consist of artery and veins. But do you know that there is stages between them. Ok, I start with the important part :

1. Arteries
2. Arterioles
3.Capillaries / Sinusoids
4.Venule
5.Vein

(Can't you see o_O , the stages of blood vessel before it can reach the vein? hee)

Then, cell that made up blood vessel is endothelial cell (endothelium).
 It got flattened endothelial cell. From surface view, it has polygonal shape. The cytoplasm consist of ER, mitochondria, Microfilament and intermediate filament that provide mechanical support to cell.

What is the funtion of endothelial cell?

1. Sensitive towards increase in 
-Pressure of blood
-blood flow
-Oxygen tension

2. Secrete substance that can cause vasodilation

3.Produce factors that control coagulation of blood.

Okay.. now we enter the main topic in Histologic view :)

Actually, arteries can be categorized into 3 types:

1. Elastic artery
2.Muscular artery
3.Arterioles

And each types got those layer :
-Intima
-Media
-Adventitia

"ARTERY"

Muscular artery


For Intima :
Elastic artery : -'thickest'consist of :- endothelium (thin squamous epithelium). Subendothelium:-consist of connective tissue (fibroblast,smooth muscle, collagen). Internal elastic lamina :- not clearly seen.

Muscular artery : this part (intima), is consider 'thinner' than elastic artery. Internal elastic lamina can be seen clearly.Got numerous little fold 

Arterioles : Consist of endothelial and subendothelial. Subendothelial consist of reticular fibre and elastic fibre.

For Media :


Left : muscular artery.
Right : elastic artery

Elastic artery : Is the 'thickest' in this layer. Made up  most of 'elastic fibre' / Lamina of elastin. Got small amount of smooth muscle and collagen fibre.
Muscular artery : 'thinner' compare to elastic in this layer. More 'smooth muscle' in this layer. Got minority elastic fibre and collagen fibre.
Arterioles : For large arterioles:- got 2 layers of smooth ms. For small arteriole :- got single layer of smooth ms.

For Adventitia :

Elastic artery : 'thinner' in adventitia. Consist of fibroblast and collagen fibre.

Muscular artery : 'thicker' in adventitia. Same cotain as elastic.

Arterioles :Thin also. Same contain.



Ok.. not forgetting one critically important part : capillaries.

Capillaries got 2 types :
1. Small - consist of single layer of endothelium
2. Large : consist of 2 or more layer of endothelium

Nucleus can be seen greatly flattened in the cell.

Not only that, it also again categorized into 2 two types :
1. Continuous
Endothelium :- no interruption of layer around lumen.
Adjacent cell of endothelium :- fuse completely. means continous wall of capillaries.
Can be found in the Muscle, Nervous tissue and Connective tissue.
  
2. Fenestrated
There is interruption in endothelium by circular fenestration. Pores exist in 6-7 mm. 
Usually found in pancraeas, intestinal tract, kidney cortex and endocrine gland.

Same function as capillaries but with different features is : Sinusoids.
*It have 'broader' lumen than capillaries
* Can be found in : liver, bone marrow, certain endocrine gland and lymphoid organ.
*Consist of :- 1. endothelium 2. thin layer of connective tissue.
* May be incomplete. Thus, blood have direct contact with tissue.
* Deficiency : -fenestrated & discontinuos of sinusoids (e.g. Spleen)

Some place, rather than endotheial cells, it was replace by macrophages.

For" veins ":

Got 3 types arrange in stages :
1. Postcapillaries/ small vein
2. Medium size vein
3. Large vein

1. Small vein.

* no adventitia.

* The Intima :- consist of endothelial -cuboidal. (Got reticular fibre and pericytes.) subendothelial layer. .

*The media :- Contain contractile pericytes

2. Medium size vein :

The intima : got endothelial, basal lamina, reticular fibre but no internal elastic lamina.
Media : Got smooth muscle fibre. Thinner. Loose organise. A lot of 'collagen fibre'. Minor elastic and fibroblast.
Adventitia : Collagenous. Thickest.bundle of collagen and elastic fibre.

3. Large veins :

Intima : Got endothelium. Basal lamina. Reticular fibre and sub endothelial (thick:-fibroblast and elastic fibre)
Media : Thin. Circularly arrange- smooth muscle. Loosely arrange- connective tissue. (e.g. in pulmonary vein and portal vein)
Adventitia : 'Thick'. Rich of elastic fibre. Got vaso vasorum, to supply oxygen tissue. Found in inferior vena cava.Longitudinally smooth muscle and connective tissue.

Comparison between large artery and large vein.

Large Artery  
Tunica media : Thickest coat   
Tunica adventitia : Thin. (Fibroblast & collagen fibre)      
Vaso vasorum : present         

Large Vein
Tunica media : Thinner layer
Tunica adventitia : Thick. (Elastic and collagen fibre)
Vaso vasorum : seen


Okay.. what type of disoder that people usually get?

1. Arteriosclerosis : hardening of arteries due to thickening of collagen
2. Atherosclerosis : hardening of arterial wall due to atheroma (fibrous fatty tissue)
3. Aneurysm : ballooning of weak part of arterial wall.
4. Veins :- * varicosities and thrombosis due to impair valve in vein.
*Obstruction of lymphatic vessels due excessive fluid at tissue then produce edema.


Tuesday, 23 April 2013

Physiology (Nerve potential and properties of nerve) 1st year


Bismillahirahmanirrahim

Good morning any of my friend in Malaysia =)

Ok, this morning I've read about Nerve potential and properties of nerve :) In shaa Allah I'll share what I read and what information that still stick in my head ;P

Ok.. first of all, in this topic, we must consider those few basic things :

1. What is mixed nerve?
2. What is Compound Nerve Action Potential (CNAP)?
3. Classification of nerve fibre according to Erlanger-Gasser
4. How impulse was send in myelinated and unmyelinated nerve fibre.
5. What factors influence conduction of nerve impulse?

Ok..

1. What is mixed nerve?

Mixed nerve is family of nerve fibre that have various speed of conduction.

2. Compund Nerve Action Potential (CNAP) is when action potential shows multiple peak.

Subthreshold stimulus : no response
Threshold stimulus : low response
Maximal threshold : propotional until it strong enough to excite all axon
Suprathreshold: no more increase of action potential.

3. Classifiction of nerve fibre according to Erlanger-Gasser.

There 3 types of nerve fibre.. (A, B, C)

#A#
Divided further into 
Alpha : For motor of somatic neuron. 
The biggest one with diameter 12-20 micron and velocity 70-120 m/s.

Beta: (TPM)- Touch, Pressure, Motor. 
Diameter: 4-12 micron and velocity : 30-70 m/s.

Gamma: Motor for muscle spindle.
Diameter 3-6 micron. Velocity: 15-30 m/s

Delta: (PuCaT)-Pain, Cold, Touch
Diameter: 2-5 micron. Velocity: 12-30 m/s

#B#
Function in preganglionic autonomic nerve
Diameter : < 3 micron
Velovity:3-15 m/s

#C#

Divided into:

1. Dorsal root
For pain and temperature
Diameter : 0.04 - 1.2 micron, velocity: 0.5 - 2.7 m/s

2. Sympathetic fibre
For post ganglionic sympathetic
Diameter : 0.3-1.3 micron
Velocity : 0.7-2.3 m/s


4. Impulse in myelinated nerve fibre:
- faster conduction 
-soltatory - leap from one myelin sheath to another myelin sheath
- Energy-efficient mode of conduction. Because it only open one channel at 'a node' rather than many channel in each adjacent segment of membrane.
-maintain: low intracellular Na+, low extracellular K+. Thus only small region of membrane repolarized and depolarized. Less ATP used for sodium-potassium pump.

In unmyelinated nerve fibre:
Conduction is slow. 
-no soltatory.


5. Factors that influence conduction of nerve impulse.
(6 factors)

1. Myelination
2.Diameter of nerve fiber. (Greater diameter, greater velocity)
3.Temperature (High temperature, high conduction)
4. Pressure (Pressure block blood supply to nerve, thus, nerve temporarily stop sending impulse ; numbness occur)
5. Local anaesthetics (loss sensation at particular part)
6.Hypoxia


Histology (Nervous Tissue) (1st year)


Bismillahirahmanirrahim

Asalamua'laikum wbt :) hey you there ;) Are you okay? hee. Please3x.. I beg you, put one 'smile' on your face :D

Ok, today, Najwa will share with all you about "Nervous Tissue"

In our body, we have nervous tissue that function to send impulses in order to give signal. If you put your hand on hot kettle or Malaysian called it 'cerek', you'll immediately take up your hand right? Impossible if you just let it stay like nothing is happening :P If you do.. then prove it to me :P hehe.

Okay!
Nervous tissue actually consist of two types of cell :

1. Neuron (nerve cell)
2. Neuroglia (host of supportive cell)

For neuron, the typical structure is like shown in the picture below;


It got :
1. Body cell / soma that have nucleus inside it that surrounded by cytoplasm called perikaryon.
2. It also have lots of processes there called dendrites
3. And long slender process called axon.

Ok.. neuron was divided into 3 types :
1. Unipolar
2. Bipolar
3. Multipolar

For "neuroglia", there is variety of supportive cells can be seen. E.g. 

1.Purkinje cell in the cerebellar cortex


2.Oligodendrocytes of the brain
                                      (it's quite simple in structure compare to fibrous astrocyte)



3. Fibrous astrocyte of the brain
                                                              (more complex in structure)



4. Microglia of the brain
(This one more slender and don't have much processes)



5. Schwann cell
                              (This picture just show 'nuclei' of neurolemmocyte which is schwann cell)


6. Ependymal cell
                                                     (*I don't have the picture for this, sorry*)

Okay... we've been through the neuron and glial cell. Now, we move to myelinated nerve fibres.
How doest it form?

Before that, I'll explain to the different between 'myelinated and unmyelinated' nerve fibres.

Myelinated: Surrounded by multiple layer of Schwann cell. Divided into segment by 'nodes of Raniver' or internodal segment.
Unmyelinated : surrounded by 'only single layer' of schwann cell.

Erm..how does the myelin sheath form?

ok..


First, there is axon, and there is schwann cell. Then, axon will invaginate into Schwann cell.


Second, the invagination of axon into Schwann cell will form 'mesoaxon'. 


Last one, after it form mesoaxon, the mesoaxon will round the axon several times, then it form adjacent layer.The adjacent layer between mesoaxon was fill with lipid. Thus, Lipid + mesoaxon will form 'myelin sheath'.

Outside of the myelin sheath, there is thin layer of cytoplasm = neurolemma. Neurolemmal sheath also call Schwann sheath.

What is the function of myelinated axon?
1. Increase velocity of conduction of impulse
2. Decrease the energy expanded conduction

Where is this axon terminate?
*Telodendria*
(End in the small swelling)
Usually it terminate when come into contact with another neuron called 'synapse'.


Our 'large peripheral nerve' enclosed by 3 different layers:


(From outside - inwards)

1. Epineurium
2.Perineurium
3. Endoneurioum

#Epineurium#
*Held together fasciculi
*consist of : Fat which cushion the nerve fibre. Loss of fat in certain patient, give pressure to nerve when compress, and it leads to paralysis.

#Perineurium#
*Held 'each' fascicle
* consist of: flattened cell separated by collagen fibre
*Function: control in and out substance of axon


#Endoneurium#
*Held each fibre
* Consist : Delicate loose connective tissue consisting of small fibrils of collagen, fibroblast, fixed macrophages, capillaries, perivascular mast cell & extracellular fluid.

Okay my dear friend :) now we have to enter into important topic.
" Autonomic ganglia (Sympathetic ganglia) & Sensory ganglia (Dorsal root ganglia"



What's the difference?

Ok..

Autonomic :



1. Multipolar neuron
2. Nissl substance are not well define
3. Myelinated fibre

Sensory :




1. Unipolar neuron
2. Nissl substance are well define
3. Unmyelinated & thin myelinated


Ok.. thats all for now :) see u later :D



Monday, 22 April 2013

Revision Pathology. 22 April 2013 (First year)


Bismillahirahmanirrahim

" Revision for pathology"

Ok.. we have some Q & A in class today :)
its about 'molecular basic of cancer'

Some question had been asekd to us :

1. What is genetic information?

Answer:I conclude the answer like this;
* Letter : nucleotides
*sentence : genes
*paragraph: chromosome
*book : genome

2. Where is located the information for Gene?

Answer: In nucleus.
information stored in DNA in the form of sequence of nucleotides

3. How many nucleotides in human genome?

Answer: 3 billion nucleotides approximately

4. State the properties of 'cancer cell'.

Answer : 
* Loss of contact inhibition
*Loss of adhesion/cohesion
*Loss of anchorage dependence
*Express cell surface proteases (facilitate invasion)
*Increase expression of laminin receptors for anchorage

5. List the hormone dependent tumor.

Answer:
It divided into two; benign and malignant.

benign: leiomyoma uterus & fibroadenoma breast
malignant: Carcinoma; breast, endometrium, prostate

6. Mention step involve in carcinogenesis.

Answer:
* At the molecular level, carcinogen affect:
1. growth promoting, proto-oncogen
2. cancer suppressor gene
3. Genes that suppress apoptosis

7. Describe about multistep process in cancer.

Answer: 
Basically, two improtant step must be remember. 

1. Initiation step (Initiator; permanent, irreversible DNA damage)

In initiator, they are 2 ways:
*Direct acting : no change in chemical composition
*Indirect acting : metabolic conversion is required
#but initiation itself is not sufficient for  carcinogenesis, it needs promotion step# 

2.Promotion step ( proliferation, altered differentiation & clonal expansion of initiated cell)

*DNA not directly damage
*Reversible
*Not carcinogenic  by themselve
*Can induce 'only in initiated cell'


*prime target is DNA*


Ok =) from the basic, we can understand, that in order to form cancer, 'thing' that must be mutate first is DNA itself. Some destruction in nucleotide sequence may influence growth of some cell in certain region in our body.

I've heard before, that you can actually cure those cancer by performing 'tahajud malam' regularly. Keep holding on to Him. The Creator; Allah.. =)


Measure blood pressure. 22 April 2013 (First year)



Bismillahirahmanirrahim..

How are you there? =) Hope u'll be fine :)
Don't worry.. something that doesn't kill you, will make you stronger ;) keep your spirit up k :)

Ok, basically, I'll share with you what I studied this morning.And actually, we're practising for the upcoming community visit at Orang Asli Village in Tapah. As first year medical student, yeah... we are just expose to the sphygmomanometer & stethoscope. To hold those thing this morning also kind of awkward :P First time..Okay..  Maybe, I can give this post a title that is..

" How to measure Pulse Rate and Blood Pressure"




We learn to take patient's blood pressure step by step :

First : Before starting phase

1. Introduce ourself
2.Explain the procedure and inform consent to carry it out
3. Tell him/her, that he/she might feel discomfort as the cuff inflated, and thet the blood pressure measurement have to be repeated.

#And make sure your white coat didn't cause hypertension to the patient as patient might feel anxious when they feel you want to do something harm to their body :) calm them down before you start#

Second : Procedure to record pulse rate (PR)

* For convenience, its better to take radial pulse as it is superficial artery. Easy to detect it. You might use watch that has a second's hand.
*Explain the patient what you want to do
* Calm the patient, and make him/her relax.Because distressed patient might have faster pulse. Noted also if patient took medication before they come, because it might alter pulse rate.
*place 3 fingers along radial artery at wrist. Feel the pulse with middle finger, applying gentle pressure with the other 2 fingers.
*Count the pulse for a full minute
*make sure patient is comfortable
*Document your finding on patient's observation chart
*If the pulse irregular, note it in the document
*Record any change and irregularities

Third : Procedure to record Blood Pressure (BP)

 There are two methods can be use:

1. Palpatory method (Only to recored systolic BP)

* The patient right arm, put it horizontally at the level of mid sternum
* Place the vertical column so it is eye level
* Locate the radial pulse
*Put cuff to the patient's arm, up from the elbow and below shoulder level. Make sure it fit appropriately. Put your 2 fingers under the cuff, if it still can fit in, so it consider okay.
*Inflate the cuff till the radial pulse disappear.
* Reduce the pressure in the cuff gradually at rate 2-3 mmHg till you start feeling the pulse again.Record the pressure at this point (when you feel the pulse again) because it is 'approximate systolic BP'

2. Auscultatory method (To record systolic and diastolic BP)

* First, detect the brachial artey about 2 cm above antecubital fossa
* Put in cuff with appropriate size and procedure like I told 'above'.
* Inflate the cuff 20-30 mmHg more than approximate systolic BP.
(Normal BP : 120/80 mmHg)
* Place the stethoscope over the brachial artery, make sure it does not touching the cuff k :) because the sound might be affected
* Start reduce pressure in the cuff 2-3 mmHg.
- First korotkov sound :systolic BP
- Muffling and disappearence of the Korotkov sound : diastolic BP

(systolic is when our heart pump the blood, diastolic is when our heart in relax state and blood fill into it)

* Record BP, systolic over diastolic :) 'Don't make mistake by round off this position k ;)
* If the patient have high BP at first reading e.g 140/90, you may take the reading back after asking the patient to keep calm and relax first.
*If patient have history in postural hypotension, take the reading in standing position immediately after taking the reading in siiting position.




Last : After procedure

* Ensure the patient is comfortable
* Tell the patient his/her BP and explain its significance
* Hypertension can only be confirm after some repeating measurement taken over time
* Thank the patient

Ok.. hope we can apply it better in clinical year 2 years after :)
Hope you enjoy this :)

<3 you all =D

Sunday, 21 April 2013

Histology (Lymphoid Tissue)


SubhanAllah..Badan kita ada 'Lymphoid tissue'..



Bismillahirahmanirrahim

Some share with all of you regards 
Histological view
"Lymphoid tissue" =)
Allah create us with specific design in our body that function to:
1. Drain interstitial fluid in the form of lymph into our blood circulation.
2. Filter dust from the lungs and antigen in the blood
3.To produce lymphocyte that fight against infection
4. Absorb and transport of fat from intestine.

And that specific design called 'lymphatic system' ;)

So..
Let me introduce all of you to our own body mechanism, that actually some of us  not even realized their present :P

ok..

Lymphoid tissue can be found in :
1. Lymphoid organ:
-spleen
-thymus
-lymph nodes
-tonsil

2.Non-lymphoid organ:
-Mucosa-Associated Lymphoid Tissue (MALT)
-Gut-Associated Lymphoid Tissue (GALT)
How to detect them histologically?

1.In Spleen.. we can see those things in order to know is it spleen or not:
-white pulp; have central artery, have splenic nodule that contain B and T lymphocyte, macrophages and plasma cells. It will look like purplish that accumulate at onee place.
-Red pulp; contain splenic sinsoids. It is a blood filter, damage red blood cell with be filter here. 
-No afferent lymphatic vessel
-Have capsule

2.In Thymus.. its different, we can see..
-Medulla; light staining
-cortex;dark staining
-and the most important detection is 'thymic corpuscle' or 'Hassal's corpuscle'


3. Lymph nodes
Capsule (outside)
-Medulla; (near to hilum-where efferent vessel,artery,veins out)
-Cortex; near capsule. More outside. We can see lymphoid nodule and germinal center there. Lymphoid nodule got two types : primary and secondary;primary got abundant of B lymphocytes and secondary consist of large lympocyte,macrophages, small lymphocyte surrounding germinal centre.
(*T-lymphocte abundant in diffuse tissue*)

4. Tonsil
Ok.. in tonsil, it is quite different from the other, because.. our body got three different types of tonsils..

1- Palatine tonsil
We can detect it by present of stratified squamous epithelium,crypt and lymphoid nodule

2-Pharyngeal tonsil
We can detect it when we see pseudostratified columnar epithelium. (Pseudostratified means; it looks like columnar,but actually,it does not.. the cell 'tindih-menindih' then look like columnar when actually it is not)

3.Lingual tonsil
Same like palatine tonsil, we can see stratified squamous epithelium

So.. basically.. for tonsil.. we can detect 'stratified squamous epithelium' and 'crypt'

#In Non-lymphoid organ, what can we detect is Peyer's pathches#
E.g. in Gut-Associated Lymphoid Tissue
(Peyer's patches is aggregation of lymphoid nodule in the ileum)-look like 'jejari-jejari' la.. :) hihihi


Haha :D actually, this is the way I can 'share' and 'boost up' my memory. huhu.Don't blank2 ar.. If u can't understand it, just skip meh..

But actually it is good to know about your own body right.. ;) selama ni, kita xsedar pun bahawa badan kita ni ada benda specific cenggini. Yang fungsi dia sa...ngat! besar. Tanpa lymphoid tissue, xda lymphoid organ, tanpa lymphoid organ, xda lymphatic system ;) cuma yang ni, dia zzzOOOmMMM innnNN sket guna microscope, tu yang jumpa mcam2 nama tuh o_O haha :D I hope all of u can enjoy this share about 'lymphoid tissue' ;)

Luv u all :D

Jangan lupa puji Allah untuk ciptaanNya ni.. Allah is the BEST Creator ever ;)

Physiology (Lymphatic system)


Allahuakbar. Let see how lymphatic system in our body do their work ;) (Physiologically)


Bismillahirahmanirrahim..

Asalamua'laikum everyone..I've already share with all of you about lymphoid tissue where we can view it histologically. Now, I'd like to share it in a slight different view; physiologically. :)

Ok.. first, we need to talk about:
 'Lymphatic system organization'
-Actually, lymphatic system is an accessory route to drain fluid from the interstitial space into blood. 
-It carry protein and large particulate matter that cannot enter the capillaries.
-All tisuue in our body got lymphatic system, except :
*CNS (Central Nervous System), 
*Superficial portion of the skin
*endomysium of muscle & bones
($cause they already have "prelymphatics"$)

And then..

Lymph will drain into two parts of our body:
1. Thoracic duct
-Lymph will drain from; lower part of the body, left side of head,neck, and chest.
-They will drain into Left internal jugular and subclavian vein

2. Right lymphatic duct
- Lymph will drain from; Right side of head, neck and chest
-They will lastly drain into Right internal jugular and subclavian vein.

Now, we move to :
"Lymphatic Circulation"

This time, we need to talk about Lymphatic vessel. Actually, lymphatic vessel function is to drain back lymph (interstitial fluid)back  into blood stream.

But how they do it?

Ok.. first,we must know that unlike artery, lymphatic vessel don't have pump to pump the lymph in reverse direction. In order to move the lymph, lymphatic channel have:

-contraction and relaxation of smooth muscle
-then, they have valve
-and by the help adjacent arterial pulsation

After we know about how lymph flow in our lymphatic system, lets discuss about one of the vessel in lymphatic system, that is : Lymphatic Capillaries.

How about the structure? Can you tell me? ok..let me tell you :D

Lymphatic capillaries actually function to permit passage of high molecular weight substance into the lymph.They have:

- Anchoring filament ; attach endothelial cells surrounding into connective tissue
-Valve : Endothelial cell overlap, and free edge flap inward.
-Actomysin filament : Contractile filament for rhytmic contraction

In steps, they'll do it like this:
1. Valves will trap the lymph. Not to let the lymph flow backwards.
2.Contraction of anchoring filament.
3.Contraction of contractile filament (actomysin filament)

Where actually valve presence along lympahtic vessel in certain area in our body? Ok let me tell u :)
1. In intestine; valve presence restricted to EXIT of lymphatic vessel
2.In skin and skeletal muscle, valve presence THROUGHOUT the lymphatic vessel.

Ok.. we're done with lymphatic circulation..
Now let me tell you about :
"Lymph Composition"

Actually, composition of lymph not so different with blood plasma. At terminal, lymph composition quite similar as interstitial fluid. But it differs according to which tissue it drains.

For example, in terms of Protein concentration:
-In Interstitial fluid, it is - 2g/dl
-Lymph form in liver as high as - 6g/dl
-     ,,                intestine  ,,       - 3-4 g/dl
-     ,,                thoracic   ,,       - 3-5 g/dl
Lymph, is major routes for absorption of FAT from GIT and other large particle e.g. bacteria.


How do lymph form?

Actually, lymph come from interstitial fluid.

1. Increase in interstitial fluid protein
2. Cause increase in colloid osmotic pressure.
3. Favor fluid attraction into interstitial space
4. Increase both volume and pressure of interstitial fluid.
5 As pressure of interstitial fluid increase, the lymph flow also increase
6. Carries away excess of interstitial fluid and protein

The relationship between lymph flow and inerstitial fluid pressure is :
The higher the interstitial fluid pressure, the higher the lymph flow.

When the pressure is (-), then, the lymph flow is just normal. As the pressure lose (-) and start gain (+), then, lymph flow increase and if over excessive, it can cause 'edema' (swelling in skin due to accumulation of fluid)

Is there any factors that can increase lymph flow?

Yes of course..

1. Anything that increase interstitial fluid, will also increase lymph flow.
2. Lymphatic 'pump'.
-Contraction & relaxation of smooth muscle
-external factors that compress the lymph vessel : e.g. contraction of surrounding skeletal muscle and arteries pulsation.Movement of the part of the body and etc
-Lympahtic capillary pump (actomysin filament)

How to calculate rate lymph flow?
 ok, this is it;

Rate of lymph flow = Product of interstitial fluid pressure X acyivity of lymph pump

1/10 fluids enter back to blood stream through lymphatic system rather than venous system
100 ml flows through thoracic duct
20 ml flows into circulation

Thus, total, our lymph flow is 120 ml / hour or equal to 2-3 L each day.

Thus, the main funtion of lymphatic system also :: "Controlling"
It control : volume, pressure and protein concentration of interstitial fluid and also.

Not only that,it also a "Drainage system" that expel dead cells, bacteria, and other waste and filter the lymph before it is return into the blood.

Last, al "Immune system". It produce lymphocyte to combat infection.

Disorders relate with lymphatic system is :

1. Filariasis :obstruction of lymphatic system (Lymphedema)
2. Lymphadenopathy : Increase in size of lymph nodes
3.Lymphadenitis / Lymphangitis : Inflammation of the lymph nodes.
4.Lymphoma : cancer that arise from lymph node.

Ok my fren.. :) I think, its enough for now. Don't forget to say Alhamdulillah as much as possible for the lymphatic system that Allah gave us ;) Physiologically, it help us in maintainig our body circulation ;)

Good morning~ and read with LOVE ;)