Symptoms of obstructed lymphatic flow

Lymphatic obstruction means that the patient's lymph is blocked during the return process and cannot return normally, and the blood circulation function is not very normal. The symptoms are not too obvious. The main symptoms are often feeling of respiratory dysfunction, or mild nausea and loss of appetite. However, this is not too serious and can be relieved as long as you pay attention to rest and reasonable recovery.

Reflow Process

1. The driving force for the continuous production of lymph The organ that produces lymph is the lymphatic capillary. The beginning of the lymphatic capillary is blind-ended and its wall is composed of a single layer of endothelial cells. There is no or only a discontinuous basement membrane outside the tube wall. The connections between endothelial cells are imbricate, with one cell edge overlapping another, and the gap between the two cells can sometimes be more than 0.5 microns. The overlapped cell edges hang freely inward, forming a one-way valve that opens into the lumen. In addition, there are microfilaments attached to the outside of endothelial cells. The microfilaments are connected to the surrounding tissues by hyaluronic acid in the interstitial space.

The above characteristics make lymphatic capillaries more permeable than blood capillaries. Some substances that cannot pass through capillaries easily, such as proteins, bacteria, foreign matter, cancer cells, etc., can more easily enter the lymphatic vessels. An adult produces about 2 to 4 liters of lymph fluid per day, which is roughly equivalent to the amount of plasma in the whole body. On the other hand, the endothelial cells in the walls of lymphatic capillaries form a one-way valve that opens into the vessel.

Tissue fluid is only allowed to move into the tube and cannot flow back out. Therefore, as lymph fluid continues to be produced, the pressure in the lymphatic capillaries also increases, making it the driving force for the continuous advancement of lymph fluid in the lymphatic vessels. This driving force is the main force of lymph return in the resting state.

2. Pressure changes outside the lymphatic vessels. In addition to the one-way valves that open into the capillary lymphatic vessels, there are also many valves inside the lymphatic vessels. There is a valve every few millimeters in large lymphatic vessels, and there are more valves in small lymphatic vessels. The valve points toward the heart. When the pressure outside the lymphatic vessels changes, the pressure inside the lymphatic vessels changes accordingly, thereby prompting the lymph fluid in the vessels to flow centripetally. The pulsation of the extralymphatic arteries, the contraction of muscles, the changes in the pressure in the thoracic and abdominal cavities during breathing movements, etc. can all change the pressure outside the lymphatic vessels.

During the pulsation of the extralymphatic artery, when the blood vessel dilates, the pressure in the lymphatic vessels adjacent to the blood vessel increases, and the pressure inside the vessel also increases accordingly, thereby pushing the lymph in the lymphatic vessels to flow centripetally; when the blood vessel contracts, the pressure applied to the lymphatic vessels is removed, which reduces the pressure on the lymphatic vessels, making the pressure inside the vessels here lower than that in the surrounding lymphatic vessels, thereby attracting the lymph in the starting lymphatic vessels to flow here.

In this way, as the extralymphatic artery pulsates, the lymph fluid in the lymphatic vessels will be pushed centripetally in segments. During muscle contraction, the lymphatic vessels are compressed as the muscles contract, thereby promoting the centripetal flow of lymph. In clinical practice, changing the pressure outside the lymphatic vessels is often used as a means to treat diseases or prevent lesions, such as using massage to promote lymphatic return to accelerate the disappearance of local edema.

Of course, during exercise, in addition to muscle contraction, muscle blood vessels will also dilate, capillary pressure will increase, lymph production will increase, and lymph return can also be promoted. Therefore, during exercise, the amount of lymph return can reach 3 to 14 times that of resting state.

During breathing movements, when you inhale, the chest cavity expands, the intrathoracic pressure decreases, and the pressure of the large veins in the chest cavity also decreases, which can attract the lymph fluid in the lymphatic trunk to flow rapidly into the blood circulation. At the same time, when the intrathoracic pressure decreases, the pressure of the thoracic duct and the right lymphatic duct also decreases, which increases the pressure difference between the lymphatic duct and the peripheral lymphatic vessels, and promotes faster lymph return. In addition, during inhalation, the diaphragm descends and the intra-abdominal pressure increases, which can squeeze the lymph fluid of the abdominal organs to flow toward the chest.