#8 Reticuloendothelial

system and function

of the spleen

Objectives :

●Define the term Reticuloendothelial system (RES).

●Describe the cellular components of RES.
●Describe the functions of the RES.
●Define the structural function of the spleen.
●Describe the functions of the spleen.
●Understand the basic concept of the indication and risks of spleenectomy.

Doctors’ notes

Extra

Important

Resources: 435 Boys’ & Girls’ slides | Guyton and Hall 12th & 13th
edition
Editing file
[email protected]
Reticuloendothelial system (RES)

Mononuclear phagocyte system ‫ﺪﯾﺪﺠﻟا ﻢﺳﻻا‬

❖Definition:
●
‫عﺎﻓد زﻛارﻣ‬
●

●
●
●
‫بﯾﺑﺣ دھﺎﺷ روﺗﻛد ﺔﯾﻣﺳﺗ‬
Another definition : The aggregate of the phagocytic cells, including certain cells of the bone
marrow, lymphatic system, liver, and spleen, that have reticular and endothelial characteristics and
function in the immune system's defense against foreign bodies. RES is located in reticular
connective tissue, which is found around the kidney, the spleen, and lymph nodes, as well as in
bone marrow.

Cellular components of RES

components

Guyton corner : The total combination of monocytes, mobile macrophages, fixed tissue macrophages, and a few
specialized endothelial cells in the bone marrow, spleen, and lymph nodes is called the reticuloendothelial system.
However, all or almost all these cells originate from monocytic stem cells; therefore, the reticuloendothelial system is
almost synonymous with the monocyte-macrophage system. Because the term reticuloendothelial system is much
better known in medical literature than the term monocyte-macrophage system, it should be remembered as a
generalized phagocytic system located in all tissues, especially in the tissue areas where large quantities of particles,
toxins, and other unwanted substances must be destroyed.
 Macrophages:

Macrophages can be:

1- Fixed in tissues (often)
2- Mobile: to ingest large
particles

Types of macrophages

Type

Location Brain lungs

Chemotaxis > Margination > Diapedesis > Phagocytosis

Diapedesis: the passage of blood cells through the intact walls of the capillaries

Extra:

HSC = Hematopoietic stem cells

Formation of Macrophages

How can monocytes transform into

macrophages ?

Guyton corner :Tissue Macrophages Provide a Against Infection.

Within minutes after inflammation begins, the macrophages already present in the tissues immediately begin their
phagocytic actions. When activated by the products of infection and inflammation, the first effect is rapid enlargement
of each of these cells. Next, many of the previously sessile (immobile) macrophages break loose from their
attachments and become mobile, forming the first line of defense against infection during the first hour or so. The
numbers of these early mobilized macrophages often are not great, but they are lifesaving.
 *Boys slides only.

Neutrophils
●
●
●
●
●

Neutrophils’ granules

Primary granules Secondary granules Tertiary granules

● ● ●
● ●
● ● ●

Myeloperoxidase)
Hypochlorite acid)

●
So what is the general functions of RES?

★
★
1. Direct immune
function ★
(Phagocytosis)
★

●
●
●
●Macrophages are more potent
phagocytes than neutrophils

★
★
2. Indirect Immune
function
★

Breakdown of aging
RBC

Storage and
circulation of iron
Direct anti-inflammatory function (phagocytosis):

A scanning
electron
microscope image
of a single
neutrophil
(yellow)
engulfing anthrax
bacteria
(orange)
Phagocytosis (cont.)

Microbial killing
Just read them to insure that you understand all of the phagocytic
function

Direct phagocytic function of RES (explanation)

Indirect phagocytic function of

RES
●
●

●
Here guys i want to tell you that phagocytosis is either due to inflammatory response or
apoptotic bodies that get ingested from macrophage and degraded to be cleared from the body

Reticuloendothelial System Monocytes/Macrophage System

in different tissues.
 Lymphoid Organs

Thymus: Lymph nodes: Spleen:

Spleen
❖Main
Characteristics:
•

•
•
•

•
 ❖ Structural Functions of the Spleen:

Structural Functions of the Spleen

splenic sinuses

Immune Functions of the

Spleen:

1.

2
.
General Functions of the
Spleen:
(1)

(2)

(1) While the bone marrow is the primary site of hematopoiesis in the adult, the spleen has important hematopoietic functions
up until the fifth month of gestation. After birth, erythropoietic functions cease, except in some hematologic disorders. As a
major lymphoid organ and a central player in the reticuloendothelial system, the spleen retains the ability to produce
lymphocytes and, as such, remains a hematopoietic organ.
(2) Spherocytes are sphere-shaped RBCs rather than bi-concave disk shaped. Found in all hemolytic anemias to some degree.
 Guyton corner : THE SPLEEN AS A RESERVOIR FOR STORING RED BLOOD CELLS
The spleen has two separate areas for storing blood: the venous sinuses and the pulp.
The sinuses can swell the same as any other part of the venous system and store whole blood.
In the splenic pulp, the capillaries are so permeable that whole blood, including the red blood cells, oozes through the
capillary walls into a trabecular mesh, forming the red pulp. The red cells are trapped by the trabeculae, while the plasma
flows on into the venous sinuses and then into the general circulation. As a consequence, the red pulp of the spleen is a
special reservoir that contains large quantities of concentrated red blood cells. These concentrated red blood cells can
then be expelled into the general circulation whenever the sympathetic nervous system becomes excited and causes the
spleen and its vessels to contract. As much as 50 milliliters of concentrated red blood cells can be released into the
circulation, raising the hematocrit 1 to 2 percent.
In other areas of the splenic pulp are islands of white blood cells, which collectively are called the white pulp. Here
lymphoid cells are manufactured that are similar to those manufactured in the lymph nodes. They are part of the body’s
immune system.

Guyton corner : Blood-Cleansing Function of the Spleen — Removal of Old Cells

Blood cells passing through the splenic pulp before entering the sinuses undergo thorough squeezing. Therefore, it is to
be expected that fragile red blood cells would not withstand the trauma. For this reason, many of the red blood cells
destroyed in the body have their final demise in the spleen. After the cells rupture, the released hemoglobin
and the cell stroma are digested by the reticuloendothelial cells of the spleen, and the products of digestion are mainly
reused by the body as nutrients, often for making new blood cells.

Splenectomy
❖Indications:
1.

2.
3.
(1)

4. (2)

5.

6.

7.
❖Risks and Complications:
1.
2.
3.
4.
5.

(1) Hereditary elliptocytosis, also known as ovalocytosis, is an inherited blood disorder in which an abnormally large number
of the patient's RBCs are elliptical rather than the typical biconcave disc shape
(2) Idiopathic thrombocytopenic purpura (ITP) is a disorder that can lead to easy or excessive bruising and bleeding. The
bleeding results from unusually low levels of platelets. Splenectomy is typically performed only after other treatments have
failed to reduce the symptoms.
● There are two diseases for which a splenectomy is the only treatment—primary cancers of the spleen and a blood disorder
called hereditary spherocytosis (HS). Read more
 Summary
● RES:

●
 Summary

Neutrophils Neutrophil granules

● Primary Secondary Tertiary

granules granules granules

●
● ● ●
● ●
●
● ●
MCQs
 ‫نﺎﻣﯾﻠﺳ آل رﻣﻋ‬ ‫يرﺎﻣﻌﻟا ﺔﻟوﺧ‬
‫دﺎﻣﺣﻟا زﯾزﻌﻟادﺑﻋ‬ ‫يردﯾﺣﻟا دوﺟﻧ‬
‫يرﺎﯾﺳﻟا نﻣﺣرﻟادﺑﻋ‬ ‫لﯾوطﻟا ةروﻧ‬
‫نﺎﯾﻧوﺑأ دﻣﺣﻣ‬ ‫رﯾﻐﺻﻟا ةوﻟوﻟ‬
‫ﮫﻛرﺑﻟا نﻣﺣرﻟادﺑﻋ‬ ‫طاوﺳﻟا نﯾﺟﻟ‬
‫ﮫﺳﯾﻔﻧﻟا مﯾھارﺑإ‬ ‫ﻲﺗﺑﺳﻟا نازر‬
‫رﺷﺑﻟا دﻣﺣﻣ‬ ‫ﻲﻣﯾﻠﺳﻟا ﻰﺑر‬
‫ﻲﺑﯾﺗﻌﻟا رﻣﻋ رﻌﻔﻟا‬ ‫سرﺎﻔﻟا ﺎﻣﯾد‬
‫ةزﻣﺣ رﻔﻌﺟﻟا‬ ‫ﻲﻧﯾرﻌﻟا ﺔﻟوﺧ‬
‫ﷲدﺑﻋ نﺎﯾﺣﺿﻟا‬ ‫فﯾرﺷﻟا كﻼﻣ‬
‫ﷲدﺑﻋ يدﻼﺑﻟا نﺳﺣ‬ ‫ﻲﻧﯾﺳﺣﻟا ةرﯾﻧﻣ‬
‫ﻲﺳﺎﻣﺷﻟا نﺳﺣ‬ ‫ﻲﺑرﺣﻟا جورﻣ‬
‫زاوﻔﻟا دﻣﺣﻣ‬ ‫ﻲﻛﺎﻟﻣﻟا نﺎﻧﻓأ‬
‫ﻲﻧﺎﺑﯾﺣﺳﻟا دﻣﺣﻣ‬ ‫ﻲﻣﯾزﺣﻟا لﻻد‬
‫دوﻌﻟا لﺋاو فاورﻟا‬ ‫ﻲﻧﺎطﺣﻘﻟا دﺎﻧر‬
‫فاور يرﮭﺷﻟا رﻣﻋ‬ ‫ﺔﻔﯾﻠﺧﻟا ةرﺎﺳ‬
‫ازودﻧﻣ حرﻓ‬
‫لﯾﻘﻌﻟا ﻲﻣ‬
‫زارﺧﻟا ةروﻧ‬
‫ﺔﻔﯾﻠﺧﻟا ةرﺎﺳ‬
‫لﺎﯾﺧﻟا ةروﻧ‬
‫ﺔﺳﯾﻔﻧﻟا دﻏر‬
‫ﻲﻟوﻠﺳﻟا ةرﯾﻧﻣ‬
‫مﯾرﻛﻟادﺑﻌﻟا فوﻧ‬
‫يزﻧﻌﻟا ﺎﮭﺳ‬
‫ﻲﻧﺎطﺣﻘﻟا ةروﻧ‬