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1. Chapter 21 Lymphatic and Immune Systems
2. Components Lymph
Lymph vessels
___________, nodules, lymphatic organs, diffuse lymphatic tissue
________________
3. Immunity
Filters fluids from capillary beds
_____________________ _____________________
Lipid absorption
____________ in small intestine absorb lipids
Fluid recovery/balance
______________________ ________________ (2 to 4 L/day) from tissues and returns it to CVS Functions of Lymphatic System
4. Lymph and Lymphatic Capillaries _________________
clear, colorless fluid, ________ __________________________
Lymphatic capillaries
closed at one end
tied to tissue by ___________ ____________________
endothelial cells loosely overlapped
allow bacteria and cells to enter
____________________________ ____________________________ ____________________________
5. Lymphatic Vessels Large vessels composed of 3 layers
________________: endothelium and valves
tunica media: ______________ ________________________
tunica externa: thin outer layer
6. Route of Lymph Flow Lymphatic capillaries
Collecting vessels
_________________: drain major portions of body
7. Collecting ducts :
__________________ – R arm, R side of head and thorax; empties into R subclavian vein
__________________ - larger & longer, begins at the cisterna chyli; gets lymph from below diaphragm, L arm, L side of head, neck and thorax; empties into L subclavian vein
8. Mechanisms of Lymph Flow __________________________________
Moves by contractions of vessels
stretching of vessels stimulates contraction
aided by skeletal muscle pump
______________________ aids flow from abdominal to thoracic cavity
______________________________
Rapidly flowing blood in subclavian veins, draws lymph into it
Exercise _________________ lymphatic return
9. Lymphatic Cells __________________________ cells
responsible for immune surveillance
T lymphocytes
_____________________________
B lymphocytes
activation ? proliferation and differentiation into plasma cells ? antibodies
__________________________ Cells
_______________________________
_________________ (in epidermis, mucous membranes and lymphatic organs)
____________________ (also contribute to stroma of lymph organs)
10. Lymphatic Tissue ___________________________ tissue
mucous membranes and CT of organs
Mucosa-Associated Lymphatic Tissue (MALT): in passages open to exterior
Lymphatic nodules
dense oval masses of lymphocytes,
__________________: at junction of small to large intestine
11. Lymphatic Organs _______________ lymphatic organs
where T & B cells become immunocompetent
__________________________
_________________ lymphatic organs
immunocompetent cells live here
__________________________________
12. Lymph Node Lymph nodes - filter lymph
Fewer____________vessels, slows flow through node
____________________ divide node into compartments
Formed from capsule
containing stroma (reticular CT) and parenchyma (lymphocytes and APCs)
divided into cortex (lymphatic nodules) and medulla
________________________________________________
lymphocytes respond to antigens
13. __________________ Collective term for lymph node diseases
_____________________
swollen, painful node responding to foreign antigen
Lymph nodes are common sites for metastatic cancer
______________________ ______________________
14. Tonsils ____________________
pair at posterior margin of oral cavity
_____________________________
____________________
pair at root of tongue
____________________ (adenoid)
single tonsil on wall of pharynx
Covered by epithelium
Pathogens in tonsillar crypts and encounter lymphocytes
15. Thymus Trabeculae, divide parenchyma into lobules of cortex and medulla
Reticular epithelial cells
secretes hormones (______________________ _____________________________________)
______________________________________
______________________________________
Very large in fetus;________________ after age 14
Elderly: fatty, fibrous tissue
16. Spleen Parenchyma
_______________: sinuses filled with erythrocytes
white pulp: _________________________________
Functions
blood production in fetus
____________________________
____________________________
____________________________________________
17. Defenses Against Pathogens _________________________ - broadly effective, no prior exposure
first line of defense
______________________
second line of defense
____________________________________________
____________________________________________
________________________ - results from prior exposure, ____________________________ _________________________________________
third line of defense
______________________________
18. External Barriers ____________________
toughness of keratin
__________________________
____________: peptides, from neutrophils attack microbes
lactic acid (acid mantle) - sweat
_________________________________
stickiness of mucus
_______________: enzyme destroys bacterial cell walls
Subepithelial areolar tissue
tissue gel: ____________________________________
hyaluronidase: enzyme used by pathogens to spread
19. Leukocytes and Cutaneous Defenses Neutrophils
Eosinophils
Basophils
Monocytes
Lymphocytes
20. Neutrophils ________________________
Create a killing zone
__________________________
lysosomes discharge into tissue fluid
respiratory burst
_____________________________ (O2.-, H2O2, HClO)
21. ___________________ ____________________________________
_____________________________
Promote action of basophils, mast cells
Enzymes block excess inflammation, limit action of histamine
22. ___________________ Aid mobility and action of WBC’s by release of
_________________________________
? blood flow to infected tissue
_________________________________
prevents immobilization of phagocytes
23. __________________ ___________________________________
Specialized macrophages found in specific localities
____________________________
epidermis, oral mucosa, esophagus, vagina, and lymphatic organs
___________________ (CNS)
_____________________ (lungs)
hepatic macrophages (liver)
24. _________________ Circulating blood contains
80% T cells
15% B cells
5% NK cells
25. Antimicrobial Proteins _______________________
Secreted by cells infected by viruses
_____________________________
stimulate neighboring cells to produce antiviral proteins
_______________________________________
destroy infected host cells
____________________________________________
26. Antimicrobial Proteins (cont.) __________________________ in blood activated by pathogens
Mechanisms of action
enhanced inflammation
_____________________________
promoted by opsonization
_____________________________
membrane attack complex forms on target cell
immune clearance
Ag-Ab complexes carried to liver and spleen
27. Immune Surveillance __________________
destroy bacteria, transplanted cells, cells infected by viruses, and cancer cells
release _____________________ __________________________
28. ___________________ Response to tissue injury
limits spread/destroys pathogens
____________________
initiates tissue repair
____________________
small proteins regulate inflammation and immunity
____________________________________ factor, and chemotactic factors
29. Inflammation ______________________________
redness (erythema)
______________________ ? capillary permeability and filtration
heat caused by ____________________
_________________ ? inflammatory chemicals from damaged cells, pressure on nerves
30. Inflammation Three major processes
_______________________________
containment and destruction of pathogens
_______________________________
31. Mobilization of Defenses Leukocyte Deployment
________________
leukocytes adhere to blood vessel walls
___________________ (emigration)
leukocytes squeeze between endothelial cells into tissues
32. Containment and Destruction of Pathogens ____________________ traps pathogens
____________________ prevents clotting
pathogens are surrounded by clot
______________________
leukocytes are attracted to chemotactic chemicals
________________________________________
phagocytosis
respiratory burst
cytokines recruits macrophages and neutrophils
macrophages and T cells secrete colony-stimulating factor to stimulate leukopoiesis
33. Tissue Cleanup Monocytes agents of cleanup arrive in 8 to 12 hours, ? macrophages
____________ ? venous flow, ? lymphatic flow that favors removal of bacteria and debris
Formation of ____________
_______________________________________ _______________________________________ _______________________________________
34. ___________ Defense mechanism
promotes _______________________
inreases metabolic rate and tissue repair
inhibits pathogen reproduction
____________________________
_________________
resets body thermostat higher
> 105?F may ?delirium, 111?F- 115?F, coma-death
Stages of fever
onset, stadium,
_______________
35. Specific Immunity Specificity and memory
_______________________: cell-mediated (T cells)
____________________________: _____________ mediated (B cells)
36. Passive and Active Immunity Active
_________________________________ (produces memory cells)
produce antibodies or T cells ___________________________ ____________________________________________________
Artificial active immunity (produces memory cells)
____________________________________________________
___________________________
______________________________ (_________________)
temporary, fetus acquires antibodies from mother
______________________________________________
temporary, injection of immune serum (antibodies)
37. _________________ Trigger an immune response
___________________________
proteins, polysaccharides, glycoproteins, glycolipids
_________________________________
stimulate immune responses
Haptens
_______________________________________ _______________________________________ _______________________________________
38. Life Cycle of T cells Specific immunity depends on lymphocytes
_______________________________
_______________________________
maturing T cells to produce antigen receptors
immunocompetent T cell has antigen receptors
Deployment
naïve T cells colonize lymphatic tissue and organs
39. B Lymphocytes (B cells) Sites of development
fetal stem cells remain in bone marrow
________________________
B cells should not react to self antigens
or suffer clonal deletion
Self-tolerant B cells form B cell clones
________________________
40. Antigen-Presenting Cells (APCs) B cells and macrophages, display antigens to T cells
41. Cellular Immunity T cells attack foreign cells and diseased host cells; memory of Ag
Three classes of T cells
_______________________________________
Helper T cells: __________________________ _______________________________________
_______________________: provide immunity from future exposure
42. Attack Phase: Role of Helper T Cells ___________________
_________________ _________________
attract neutrophils, NK cells, macrophages
_________________ _________________
stimulate T and B cell mitosis and maturation
43. Attack Phase: _________________ Only T cells directly attack enemy cells
Killing mechanism
__________________________________
interferons - decrease viral replication and activates macrophages
_______________________________________
44. Memory ______________________
some T cells become long lived memory cells
T cell recall response
_______________________________________ _______________________________________
45. ____________ Immunity ____________________
B cell receptors bind antigen, take in and digest antigen then display epitopes
TH cell divide, differentiate ? plasma cells? antibodies to that antigen
Attack
_______________________
_______________________
_______________________
___________________
some B cells differentiate ? memory cells
46. Antibody Structure Protein
_________________
Light chain
__________________ __________________
Immune system capable of as many as 1 trillion different antibodies
47. Antibody Classes _______________________
Plasma, mucus, saliva, tears, milk, intestinal secretions
_______________________
B cell membrane antigen receptor
IgE: monomer
on mast cells
______________________________ ______________________________ ______________________________
_____________________
80% circulating, cross placenta to fetus, 2? immune response, complement fixation
_____________________
10% in plasma, 1? immune response, agglutination, complement fixation
48. Humoral Immunity - Attack ______________________
antibodies mask pathogenic region of antigen
________________________
antigen binds to IgM or IgG, antibody activates complement; primary defense against foreign cells, bacteria
__________________________
antibody has 2-10 binding sites; binds to multiple enemy cells immobilizing them
Precipitation
_____________________________________________ _____________________________________________
49. Hypersensitivity (Allergy) Excessive immune reaction against antigens that most people tolerate - allergens
Type I Antibody mediated (________), acute reaction
________________: anaphylactic shock
________________: pollen, dust cat dander
asthma
Type II Antibody mediated (___________), subacute
_______________________________
5-12 hours
Graves disease, myasthenia gravis
Type III Antibody mediated (__________), subacute
Antibody complexes ppt, 3-8 hours
________________________________________________
Type IV Cell mediated, delayed (12-72 hours)
__________________________________________
Poison ivy, TB test
50. Match Type 1
Type 2
Type 3
Type 4
51. Autoimmune Diseases Failure of self tolerance
cross-reactivity
__________________________________
changes in structure of self-antigens
Production of ______________________
52. Immunodeficiency Diseases Severe Combined Immunodeficiency Disease
hereditary lack of T and B cells
__________________________ __________________________
53. AIDS
HIV structure
enters helper T cells, macrophages and dendritic cells by receptor mediated endocytosis
_______________________________________ viral DNA inserted into host cell DNA, may be dormant for months to years Immunodeficiency Diseases
54. AIDS Signs and symptoms
early symptoms:
Flu-like chills and fever
Later
night sweats, fatigue, headache, extreme weight loss, lymphadenitis
normal TH count is 600 to 1,200 cells/?L of blood in AIDS it is < 200 cells/?L
opportunistic infections (Toxoplasma, Pneumocystitis, herpes simplex virus, CMV or TB)
_______________: white patches on mucous membranes
____________________: cancer originates in endothelial cells of blood vessels causes purple lesions in skin
55. HIV Transmission ____________________________________ ____________________________________
Most common:
sexual intercourse (vaginal, anal, oral)
contaminated blood products
contaminated needles
____________________________________
Latex condom is an effective barrier to HIV especially with spermicide nonoxynol-9
56. Treatment Strategies Prevent binding to CD4 proteins of TH cells
Disrupt reverse transcriptase, inhibit assembly of new viruses or their release from host cells
Medications
none eliminate HIV, all have serious side-effects
Resistance develops, meds used in combination
AZT azidothymidine
first anti-HIV drug, inhibits reverse transcriptase
Protease inhibitors
inhibit enzymes HIV needs to replicate
now more than 16 anti-HIV drugs