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Increased Lymph Production – Causes of Ascites (Nursing)

by Rhonda Lawes, PhD, RN

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      Slides Liver Cirrhosis Ascites Peripheral Edema.pdf
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      Reference List Medical Surgical Nursing and Pathophysiology Nursing.pdf
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    Transcript

    00:00 So let's talk about the lymph system.

    00:03 I'm gonna give the lymph system a little love because I got to be honest with you.

    00:08 Most people in nursing school know the least about the lymphatic system.

    00:12 We don't often delve into it enough and there's really a lot to know.

    00:17 So let's talk about how that works.

    00:19 Now you're looking at a chest wall, right? You see the heart there, you see the lungs, but I want you to pay attention to the thoracic duct.

    00:28 Now, we've got some vessels there in green.

    00:30 And that represents the lymphatic system.

    00:34 Now the liver is more involved in the lymphatic system than you may have recognized.

    00:39 Because the liver produces 25 to 50% of the lymph that's flowing through the thoracic duct.

    00:47 Okay so you know where the liver is right, so were on the right side of your body.

    00:51 Now it is the producer of almost up to half of the lymph that's flowing through the thoracic duct.

    00:59 The thoracic duct Is the largest vessel in the body.

    01:04 So remember we're going to show a little love here to the lymphatic system.

    01:08 So let's spend some time here.

    01:11 You've got the liver, it produces a large amount of the lymph that flows through the thoracic duct.

    01:16 And the thoracic duct is the largest lymphatic vessel in the body.

    01:21 I've got a lot of words there, but I'd love for you to take some extra notes write some extra things on your notes so you can lay that down as an important piece of information about the lymph system.

    01:34 Now a healthy liver has an abundance of lymphocytes like natural killer cells, natural killer T cells, and it utilizes other cells to present antigens.

    01:46 So what's really important in our immune response and our defense systems in the body.

    01:52 Now from the thoracic duct go ahead and put your finger back on that, remember, it's the largest lymphatic vessel in the body from the thoracic, lymph is emptied back into the blood circulation.

    02:05 Okay so these guys are mixing and mingling all throughout your body and it's the lymph system that's responsible for that.

    02:12 Now lymph vessels in the liver, they retain fluid and they regulate the immune system.

    02:18 So we've got a lot of words here.

    02:21 Let's make sure you get the key ones.

    02:23 Liver makes up to half of the lymph that is flowing through the thoracic duct, which is the largest one in the lymph system, right? We follow that thoracic duct up because we know lymph is empty back into the blood circulation through that thoracic duct.

    02:39 And it's those lymph vessels, they're in the liver that retain fluid and regulate the immune system.

    02:46 So I think you already see where this is going.

    02:49 We won't focus on that here, but if your liver is struggling so is your immune system.

    02:54 So let's look closer at this lymphatic system.

    02:58 The lymphatic vascular system is the one that removes interstitial fluid from the tissues in the body and returns it to the bloodstream.

    03:06 Remember that big guy the thoracic duct, right.

    03:09 Now we're going to look at how that lymph interacts with the interstitial tissues.

    03:14 You'll see on the picture. This should look familiar to you.

    03:17 We use this same graphic to help you understand how albumin moves to the intravascular space attracts sodium and therefore water follows, but remember the outside of those capillary that's the interstitial tissue.

    03:33 Well, this is where the lymphatic system really comes into play.

    03:38 Now take a look at our model.

    03:40 You see the female client there and she's got all this green lines running through her body.

    03:46 Those are the vessels.

    03:48 Those are meant to represent the lymphatic vessels.

    03:51 Now the lymphatic system gets kind of complicated.

    03:54 Thymus you got these special cells, but what I want you to really focus on is take a look at how complex that is.

    04:01 Know that this is the system that's going to drain the fluid from the tissues in the interstitial spaces and get it back into the bloodstream.

    04:11 Those if this system is overloaded or it's not functioning, tissues are going to have issues because it's not going to be able to move that fluid.

    04:21 Now the interstitial fluid is called lymph, once it enters a lymphatic capillaries.

    04:27 There's a fun fact try that one at dinner.

    04:29 But when you hear us talking about lymph, it's interstitial fluid once it is entered the lymphatic capillaries.

    04:37 So lymphatic fluid is similar to blood plasma and it also contains some white blood cells.

    04:43 Those are important points.

    04:44 Don't just brush over those.

    04:46 So think about, quiz yourself.

    04:48 When does interstitial fluid become lymph? When it's in the lymphatic capillaries, good.

    04:54 So lymphatic fluid is similiar to blood plasma, and it also contains white blood cells.

    05:02 Those are really important points to make sure you have solid in your mind as we progress through the rest of the video.

    05:08 So that wraps up the section on increased lymph.

    05:11 Remember I didn't give you really solid reasons as to why and how that happens, but we know that it does.

    05:18 Make sure you're clear on what the lymph system does, how it's similar lymph to blood, what had has that's the same as blood.

    05:26 What's different, and how it removes fluid from the interstitial spaces and gets it back into the bloodstream.


    About the Lecture

    The lecture Increased Lymph Production – Causes of Ascites (Nursing) by Rhonda Lawes, PhD, RN is from the course Liver Cirrhosis (Nursing).


    Included Quiz Questions

    1. The liver produces 25-50% of the lymph flowing through the thoracic duct
    2. Lymph vessels in the liver retain fluid and regulate the immune system
    3. Lymph contains white blood cells and is similar to blood plasma
    4. From the liver, lymph is emptied back into circulation
    5. The lymphatic system removes fluid from the blood and returns it to the tissues
    1. When the interstitial fluid enters the lymphatic capillaries
    2. When the interstitial fluid enters the liver
    3. When the interstitial fluid has been filtered by the lymphatic system
    4. When the interstitial fluid is in the tissues

    Author of lecture Increased Lymph Production – Causes of Ascites (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN


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