Lecture Notes

1. 9 Blood, Lymph, Immune Systems Lecture Notes Classroom Activity to Accompany Medical Terminology Systems, Sixth Edition Barbara A. Gylys ∙ Mary Ellen Wedding

2. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Structure • Blood • Composed of a liquid called plasma and solid components of cells • Three main types of cells: erythrocytes, leukocytes, and platelets

3. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Function • Blood • Transports oxygen and nutrients to cells. • Removes CO2 and metabolic waste products from cells.

4. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Structure • Lymphatic system • Lymph nodes • Lymph vessels and lymph fluid • Tonsils, thymus, and spleen.

5. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Function • Lymphatic System • Network of vessels that depends on pumping action of the heart to circulate its substances throughout the body. • Defends the body against disease-causing agents, such as bacteria, viruses, and cancerous cells.

6. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Structure and Function Exercise Q: What are the three main elements in blood? A: Erythrocytes, leukocytes, and platelets. Q: What is the main function of leukocytes? A: Provides body defense against infection and aids in tissue repair. Q: What is the main function of platelets (thrombocytes)? A: Initiates blood clotting when injuries occur. Q: What is the purpose of the lymphatic system? A: Transports excess fluid from interstitial spaces in tissues and returns it to the blood. Q: Besides circulating lymphatic substances, what is another primary function of the lymphatic system? A: Defends the body against foreign invaders and harmful agents.

7. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Leukemia Signs and Symptoms • Proliferation of white blood cells in circulation. • Fatigue, malaise, easy bruising, and exercise intolerance. • Some chronic forms are asymptomatic. • Splenomegaly and hepatomegaly.

8. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Leukemia Treatment • Depends on type and stage of leukemia. • Variety of chemotherapeutic agents. • Bone marrow transplants. • Blood transfusions. • Stem cell transplantation. • Use of antibiotics to prevent secondary infection.

9. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Clinically Related Exercise Q: Mrs. J is diagnosed with leukemia and asks the nurse to explain this disease. A: Nurse explains it is a malignancy of blood-forming cells of the bone marrow. Q: Mary presents with complaints of fatigue, bruising, and tiring easily during exercise. While examining Mary, the physician discovers an enlargement of the liver and charts her Dx as ________________. A: hepatomegaly Q: Mr. Z is diagnosed with leukemia and his blood test reveals a low white blood cell count. The physician advises him to undergo an infusion of blood to ward off possibility of infection. This infusion is known as a blood (collection, purifier, transfusion). A: transfusion

10. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Clinically Related Exercise (continued) Q: The physician charts his findings of an enlarged spleen as _____________. A: splenomegaly Q: John R suffers from leukemia and presents to the hospital for a bone marrow transplant. The procedure will reinfuse John’s own bone marrow and is known as a/an (autologous, cadaveric, indirect) transfusion. A: autologous

11. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Lymphedema Signs and Symptoms • Abnormal accumulation of lymph, usually in the extremities. • Symptoms eventually include pallor, weakness, lymph node enlargement, fatigue, fever, and weight loss. • As disease progresses, tachycardia, palpitations, and an increased incidence of infections are common.

12. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Lymphedema Treatment • When a person exhibits signs or symptoms or has anemia or thrombocytopenia, treatment with chemotherapy is usually initiated. • Radiation therapy or corticosteroids may also be tried. • Complications such as anemia, hemorrhage, or secondary infections must be treated promptly.

13. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Clinically Related Exercise Q: Mr. G presents with swelling and excessive accumulation of lymph in his right leg. The physician diagnoses this condition as (lymphoma, lymphomegaly, lymphedema). A: lymphedema Q: Dr. J detects lymphedema as he examines Mrs. L after her surgery. Dr. J explains that this condition is due to a blockage in the lymphatic system which prevents drainage of lymph fluid. It is also a common complication following removal of the breast, a surgical procedure called _______. A: mastectomy Q: The patient has a history of lymphedema and presents with a swollen, red area of skin that feels hot and tender in the right arm. The physician diagnoses this as skin infection, which is called (cellulitis, hepatitis, lymphadenitis). A: cellulitis

14. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Kaposi Sarcoma Signs and Symptoms • Purplish brown papules or plaques on skin and mucous membranes.

15. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Kaposi Sarcoma Signs and Symptoms (continued) • First appear on lower extremities but spread to upper body, face, mucous membranes of throat, and internal organs. • Closely associated with HIV infection and is considered an “AIDS-defining condition.”

16. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Kaposi Sarcoma Signs and Symptoms (continued) Treatment • Depends on stage of HIV infection and degree of metastasis. • Common treatment modalities include radiation therapy, chemotherapy, surgery, and immunotherapy. • Palliative treatment and good oral hygiene are essential.

17. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Clinically Related Exercise Q: John is diagnosed with Kaposi sarcoma (KS) and asks the medical assistant to explain this disease. A: He explains it’s a malignancy of connective tissues, especially the tissue found under the skin, mucous membranes, and in the lining of lymph vessels; usually associated with HIV. Q: Mr. M is scheduled for a treatment that uses natural immune substances produced in a laboratory that are administered to destroy cancer cells. This type of treatment is charted as (hormone therapy, chemotherapy, immunotherapy). A: immunotherapy

18. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Clinically Related Exercise (continued) Q: Mr. Z with a history of HIV+ presents with purplish brown papules on both arms and legs. The doctor suspects he has a CA that is associated with AIDs. This type of cancer is known as Kaposi ____________. A: sarcoma Q: A recent liver transplant patient presents with purplish brown discoloration on her face. The doctor explains she may have a cancer caused from the drugs she is taking to prevent her liver from being rejected by her body. The drugs she is taking to suppress her immune system and prevent organ rejection are known as (hormone therapy, chemotherapy, immunosuppressives). A: immunosuppressives

19. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Medical Vocabulary • anemia • anticoagulants • antigen • erythrocytes • hematologist • hematopoiesis • hemophilia • hemostasis

20. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Medical Vocabulary (continued) • immunodeficiency • lymphangioma • lymphocytes • lymphoma • macrocyte • mononucleosis • oncology

21. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Medical Vocabulary (continued) • pathogen • pernicious • phagocyte • Pneumocystis • thalassemia • thrombocytes • transfusion

22. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Diagnostic Procedures • Bone marrow aspiration • Bone marrow fluid is withdrawn for microscopic evaluation (usually from pelvic bone and rarely the sternum)

23. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Diagnostic Procedures (continued) • ELISA • Western blot • Tissue typing

24. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Word Building Exercise Q: Disease of a lymph gland: A: lymphadenopathy Q: Tumor of lymph that is fleshy (cancerous): A: lymphosarcoma Q: Study of serum: A: serology Q: Process of recording lymph vessel(s): A: lymphangiography Q: Process of recording lymph gland(s): A: lymphadenography Q: Cell that is red (red blood cell): A: erythrocyte

25. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Medical and Surgical Procedures • Blood transfusion • Bone marrow transplant • Lymphangiectomy

26. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Clinically Related Exercise Q: An MRI reveals a lymphangioma. The physician explains that the tumor needs to be excised. The term for excision of a lymph vessel is __________________. A: lymphangiectomy Q: Tom is diagnosed with leukemia and referred to a specialist in blood cell diseases. She prescribes a chemotherapy regimen. A physician who specializes in treatment of blood disorders is called a _____________________. A: hematologist Q: Bill is diagnosed with leukemia. His physician recommends irradiation and chemotherapy of the bone marrow followed by replacement of healthy blood cells. This type of treatment is called (bone marrow aspiration, bone marrow biopsy, bone marrow transplant). A: bone marrow transplant Q: Jason undergoes magnetic resonance imaging (MRI) that reveals a tumor composed of lymph vessels. This tumor is known as a ______________________. A: lymphangioma

27. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Pharmacology • Anticoagulants • Immunizations • Immunosuppressants • Thrombolytics

28. 9 BLOOD, LYMPH, AND IMMUNE SYSTEMS Clinically Related Exercise Q: Mr. B is diagnosed with a thrombus. To dissolve the blood clot the doctor prescribes a/an (immunization, immunosuppressant, thrombolytic). A: thrombolytic Q: To prevent the formation of a postsurgical blood clot, the physician prescribes a/an (anticoagulant, immunization, immunosuppressant). A: anticoagulant Q: To prevent rejection of Mary’s recently transplanted kidney, the physician prescribed a/an (anticoagulant, immunosuppressant, thrombolytic). A: immunosuppressant Q: The American Medical Association (AMA) recommends vaccination of immune globulins to induce immunity to certain infectious diseases. These vaccinations are known as (anticoagulants, immunizations, immunosuppressants) A: immunizations