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Anatomy 232 > CH 21 > Flashcards

CH 21 Flashcards

1
Q

Immune system

A

not an organ system, but a cell population that inhibits all organ and defends the body from agents of disease.

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2
Q

Lymphatic system

A
  • fluid recovery
  • immunity
  • lipid absorption
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3
Q

Fluid recovery

A

fluid continually filters from the blood capillaries into the tissue spaces.

  • blood capillaries absorb 85%
  • 15% water and plasma proteins returned.
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4
Q

Immunity

A

excess fluid

  • passes through lymph nodes where immune cells stand guard against foreign matter
  • activate a protective immune response
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5
Q

Lipid absorption

A

Lacteals in small intestine absorb dietary lipids that are not absorbed by the blood capillaries.

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6
Q

Lymph

A

clear, colorless fluid, similar to plasma, but much less protein.
(Like interstitial fluid)

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7
Q

Lymphatic capillaries (terminal lymphatics)

A

penetrate nearly every tissue in body.

  • absent from CNS, cartilage, cornea, bone, and marrow.
  • gaps big enough for bacteria and cells to enter.

endothelium creates valve like flaps that open when interstitial fluid pressure is high, and close when low.

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8
Q

Natural killer cells

A

large lymphocytes that attack and destroy bacteria, transplanted tissue, host cells infected with viruses or turned cancerous.
-immune surveillance

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9
Q

T lymphocytes (T cells)

A

mature in thymus

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10
Q

B lymphocytes (B cells)

A

Activation causes proliferation and differentiation into plasma cells the produce antibodies
-mature in bone marrow

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11
Q

Macrophages

A

(leukocytes)

  • phagocytize tissue debris, dead neutrophils, bacteria, and other foreign matter.
  • process foreign matter and display antigenic fragments to certain T cells alerting the immune system to the presence of the enemy.
  • antigen-presenting cells (APC’s)
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12
Q

Dendritic cells

A

alter the immune system to pathogens that have breached their surface (within a certain tissue)

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13
Q

Reticular cells

A

Branched stationary cells that contribute to the storm of a lymphatic organ.
-act as APC’s in thymus where they stay

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14
Q

Lymphatic tissue

A

prevalent in body passages open to the exterior

-respiratory, digestive, urinary, and reproductive tracts.

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15
Q

Mucose-associated lymphatic tissue (MALT)

A

open to outside, where pathogens get through`

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16
Q

Lymphatic nodules (follicles)

Peyer patches:

A

constant feature of the lymph nodes, tonsils, and appendix

dense clusters in the ileum, the distal portion of the small intestine. (big lymph nodes)

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17
Q

Primary lymphatic organs

A
  • red bone marrow and thymus

- site where T and B cells become immunocompetent: able to recognize and respond to antigens

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18
Q

Secondary lymphatic organs

A
  • lymph nodes, tonsils, and spleen

- immunocompetent cells populate these tissues

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19
Q

Thymus

A

member of the endocrine, lymphatic and immune systems. (very active when young)
-Houses developing T cells,
-secretes hormones regulating their activity
-degeneration or involution with age.
(immune response less responsive)

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20
Q

_________ cells seal off cortex from medulla forming _______ barrier

produce?

A

reticular epithelial cells
blood-thymus barrier
-signaling molecules thymosin, thymopoietin, thymulin, interleukins, interferon. 2%

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21
Q

Lymph nodes

functions:

A

most numerous lymphatic organs.
-about 450 in young adult

cleanse lymph
act as site of T and B cell activation
(mostly around mucous membranes and orifaces)

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22
Q

Cervical lymph nodes

A

monitor lymph coming from head and neck

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23
Q

Axillary lymph nodes

A

receive lymph from upper limb and female breast

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24
Q

Thoracic lymph nodes

A

receive lymph from mediastinum, lungs, and airway.

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25
Q

Abdominal lymph nodes

A

monitor lymph from the urinary and reproductive systems

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26
Q

intestinal and mesenteric lymph nodes

A

in the groin and receive lymph from the entire lower limb

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27
Q

popliteal lymph nodes

A

receive lymph from the leg proper

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28
Q

When a lymph node is under challenges by and antigen:

A
  • lymphadenitis: swollen, painful, movable node responding to foreign antigen.
  • Lymphadenopathy: collectively term for all lymph node diseases.

stuck and painless= cancer
moveable and painful= fighting infection

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29
Q

Metastasis

A

cancer cells break free from the original, primary tumors, travel to other sites of the body, and establish new tumors.

  • can easily enter lymphatic vessels.
  • do not have CAM’s so they can move.they remove lymph nodes downstream.
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30
Q

Tonsils

A

patches of lymphatic tissue located at the entrance to the pharynx.

  • guard against ingested orr inhales pathogens
  • tonsillitis or tonsillectomy
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31
Q

3 main sets of tonsils

A

palatine- most often infected
lingual- pair at root of tongue
pharyngeal- single tonsil on wall of nasopharynx

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32
Q

Spleen

-functions

A

the bodies largest lymphatic organ.

  • blood production in fetus
  • blood reservoir (platelets)
  • erythrocyte gravyard: RBC disposal.

highly vascular and vulnerable to trauma and infection
-ruptured requires splenectomy

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33
Q

Pathogens

A

environmental agents capable of producing disease,

-infectious organisms, toxic chemicals, and radiation.

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34
Q

first line of defense against pathogens

A

external barriers, skin, and mucous membranes, lacrimal fluid, saliva, defecation, urination, coughing, sneezing. IgA antibodies, gastric juice.
stomach= hydrochloric acid pH 2%

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35
Q

Second line of defense

A

severe non specific defense mechanisms.

  • neutrophils and macrophages, complement, NK’s, eosinophils, interferon, inflammation, and fever.
  • effective against a broad range of pathogens.
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36
Q

Third line of defense

A

the immune system

  • defeats a pathogen, and leaves the body with a “memory” of it so it can defeat it in the future
  • lymphocytes (dead if they get through)
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37
Q

skin

A

make sit difficult for microorganisms to enter body.

  • toughness of keratin
  • too dry and nutrient poor for microbial growth.
  • defensins
  • acid mantle
  • commensal flora
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38
Q

Defensins:

acid mantle:

A

peptides that kill microbes by creating hole in their membranes.

thin film of lactic acid, fatty acids, which inhibits bacterial growth.

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39
Q

mucous membranes

A

digestive, respiratory, urinary and reproductive tracts are open and protected by these.

  • mucous traps microbes
  • LYSOZOME: enzyme destroys bacterial cell walls (IgA, commensal flora)
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40
Q

Subepithelial areolar tissue

A

viscous barrier of hyaluronic acid.

-hyaluronidase- enzyme used by pathogens to make hyaluronic acid less viscous.

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41
Q

Phagocytes

A

phagocytic cells witch a voracious appetite for foreign matter

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42
Q

5 types of leukocytes (2nd line)

A 
neutrophils
eosinophils 
basophils
monocytes
lymphocyte
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43
Q

Neutrohil

A
  • produce a cloud of bactericidal chemicals
  • first to arrive to bacterial infection
  • create killing zone
    (degranulation) - lysosomes discharge into tissue fluid.
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44
Q

Killing zone: respiratory burst

toxic chemicals

A

neutrophils rapidly absorb oxygen.

O2, H2O2, HCIO
-kill more bacteria with toxic chemicals than phagocytosis

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45
Q

Eosinophils

A
  • especially in mucous membranes.
  • stand guard against multicellular PARASITE, ALLERGENS, and other pathogens.
  • kill worms by making superoxide, hydrogen peroxide, and toxic proteins
  • Phagocytize antigen-antibody complexes
  • limit HISTAMINE and other inflammatory chemicals.
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46
Q

Basophils

Leukotrienes:

Histamine:

Heparin:

Mast cells

A

secrete chemicals that aid mobility and action of other leukocytes.

activate and attract neutrophils and eosinophils

a vasodilator, which increases blood flow. (speeds delivery of leukocytes to the area)

inhibits clot formation (anticoagulant) (impede leukocyte mobility)

also secrete these, type of CT cell very similar to basophils.

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47
Q

wandering macrophages

A

actively seeking pathogens.

-widely distributed in loose CT

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48
Q

Fixed macrophages

microglia found in___
alveolar macrophages in___
Hepatic microphages in _____

A

phagocytize only pathogens that come to them.

Brain (CNS)
lungs
liver

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49
Q

What are the two families of antimicrobial proteins?

A

interferons

complement system

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50
Q

interferons

A

secreted by certain cells infected by viruses.

  • no benefit to cell came from
  • alert neighboring cells and protect (paracrine hormone)
  • bind to surface receptors of near cells (activate second messenger systems)
  • activate NK cells and macrophages
  • NK cells destroy malignant cells
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51
Q

Complement system

activated complement brings about 4 methods of pathogen destruction:

3 routes of complement activation

A

a group of 30 or more globular proteins that make powerful contributions to both nonspecific resistance and specific immunity.
-synthesized mainly by liver,

inflammation, immune clearance, phagocytosis, cytolysis.

classical pathway, alternative pathway

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52
Q

Classical pathway

A
  • requires antibody molecule to get started.
  • part of specific community.
  • antibody binds to antigen on surface of the pathogenic organism. (forms antigen-antibody Ag–Ab complex)
53
Q

Alternative pathway

A
  • nonspecific, does not require antibody.

- C3 breaks down in the blood to C3a and C3b. (C3b binds to tamest like tumor cells, viruses, bacteria, and yeast)

54
Q

Inflammation

A
  • C3a stimulates mast cells and basophils to secrete histamine and other inflammatory chemicals.
  • Activates and attracts neutrophils and macrophages.
  • speeds pathogen destruction
55
Q

Immune clearance

A
  • C3b binds with antigen-antibody complexes to RBC’s.
  • these RBC’s circulate through liver and spleen.
  • macrophages strip of complexes leaving RBC’s unharmed.
  • Principle means of clearing foreign antigens from blood stream.
56
Q

Phagocytosis

A
  • Neutrophils and macrophages CANNOT phagocytize “naked” bacteria, viruses, or other pathogens.
  • C3b assists them by opsonization.
57
Q

Cytolysis

A
  • C3b splits other complement proteins.
  • Bind to enemy cell.
  • attract more complement proteins–membrane attack complex forms (forms a hole in the target cell)(electrolytes leak in, water flows in rapidly, cell ruptures)
58
Q

How do NK cells attack and destroy?

A
  • NK’s bind to it.
  • release perforins
  • Secrete granzymes (induce apoptosis)
59
Q

Fever

A

an abnormal election of body temperature.

  • pyrexia, febrile
  • results from trauma, infections, drug reactions, brain tumors, and other causes.

an adaptive defense mechanism.

  • promotes interferon activity
  • elevates metabolic rate and accelerates tissue repair
  • inhibits reproduction of bacteria and viruses.
60
Q

stages of fever

A

onset
stadium
defervescence

61
Q

Reye syndrome

A

serious disorder in children younger than 15 following an acute viral infection such as chickenpox or influenza.

  • swelling of brain neurons.
  • 30% die
  • triggered by aspirin for fever

Antipyretics: fever reducing medication by inhibiting PGE2.

62
Q

5 signs of inflammation

A 
redness
swelling
heat
pain
loss of function
63
Q

Cytokines

A

class of chemicals that regulates inflammation and immunity.

  • secreted mainly by leukocytes.
  • neutrophils (acute), macrophages, lymphocytes (chronic)
64
Q

3 major processes of inflammation

A
  • mobilization of body defenses
  • containment and destructions of pathogens
  • tissue cleanup and repair

acute (8-10 days)
chronic (2 weeks+)

65
Q

mobilization of defenses

margination:

diapedesis:

A

neutrophil behavior

selecting cause leukocytes to adhere to blood vessel walls.

(emigration) leukocytes squeeze between endothelial cells into tissue space.

66
Q

priority of inflammation is to:

A

prevent the pathogens from spreading through the body.

  • fibrinogen that filters into tissue fluid clots (forms a sticky mesh that walls off microbes)
  • Heparin prevents clotting at site of injury.
67
Q

Chemotaxis

A

attraction to chemicals such as bradykinin and leukotrienes that guide them to the injury site (diffusion gradient)

68
Q

macrophages and T cells secrete ________ to stimulate leukopoiesis.

A

colony stimulating factor

Neutrophilia- bacterial infection
eosinophilia- elevated count in allergy or parasitic infection.

69
Q

Monocytes

A

the primary agents of tissue cleanup and repair .

  • arrive in 8012 hours and become macrophages
  • engulf and destroy bacteria, damaged host cells, and dead and dying neutrophils.
70
Q

Edema

Lymphatics:

A

contributes to tissue cleanup

collect and remove bacteria, bacteria, dead cells, proteins, and tissue debris better than blood capillaries.

71
Q

Pus

_____: accumulation of pus in a tissue cavity.

A

accumulation of dead neutrophils, bacteria, other cellular debris, and tissue fluid form a pool of yellowish fluid.

Cyst/abcess

72
Q

platelet drived growth factor

A
  • stimulates fibroblasts to multiply.

- synthesizes collagen.

73
Q

_______ delivers oxygen, amino acids, and other necessities for protein synthesis.

A

Hyperemia

74
Q

increased ____ increases metabolic rate, speeds mitosis, and tissue repair.

A

heat

75
Q

________ forms a scaffold for tissue reconstruction.

A

fibrin clot

76
Q

____makes us limit the use if a body part so it has a chance to rest and heal.

A

Pain

congenital insensitivity to pain (CIPA): no pain

77
Q

2 characteristics distinguish immunity from nonspecific resistance.

A

specificity

memory

78
Q

cellular (cell-mediated) immunity

A

T cells

  • lymphocytes directly attack and destroy foreign cell or diseased host cells.
  • kills (injured) cells that harbor them.
  • Cytotoxic T’s
79
Q

Humoral (antibody-mediated) immunity

A

B cells

  • mediated by antibodies that do not directly destroy a pathogen.
  • indirect attack where antibodies assault the pathogen.
  • B (plamsa) cells
80
Q

Cytotoxic T’s

A

cells attacking cells

-endogenous antigens (own cells that are infected with viruses)

81
Q

B (plamsa) cells

A

indirect attacks though antibodies

82
Q

Natural active immunity

A

production of ones own antibodies or T cells as a result of infection or natural exposure to antigen.

83
Q

Artificial active immunity

A

production of ones own antibodies to T cells as a result of vaccination against disease.

84
Q

_______: consists of dead or attenuated (weakened) pathogens that stimulate the immune response without causing the disease

A

Vaccine

85
Q

_______: Constant immunizations to stimulate immune memory to maintain a high level of protection.

A

Booster shots

86
Q

Natural passive immunity

A

temporary immunity that results from antibodies produced by another person.
-fetus acquires antibodies from mother through placenta (IgG), milk (IgA, IgM, IgG)

87
Q

Artificial passive immunity (emergencies)

A

temporary immunity that results from the injection of immune serum (antibodies) from another person or animal (rabbits)
-treatment for snakebites, etc.

88
Q

Hapten

A

too small to be antigenic themselves.

  • must combine with a host macro.
  • create complex body sees as foreign.
  • cosmetics, detergents, etc.
  • penecillin
89
Q

Negative selection

2 forms:

A

T cells that fail either test must be eliminated.

  • clonal deletion: self reactive T cells die and macrophages phagocytize them.
  • Anergy: self reactive T cells remain alive but unresponsive.
90
Q

B cells that react to self-antigens undergo either ____ or ______, same as T cell selection.

A

anergy

clonal deletion

91
Q

__________ synthesize antigen surface receptors, divide rapidly, produce immunocompetent clones.

A

Self-tolerant B cells

92
Q

Antigen presenting cells (APC’s)

A

required to help T cells recognize exogenous antigens.
(2nd line alert 3rd line)
-dendritic cells, macrophages, reticular cells, and B cells function as APC’s.

93
Q

Function APC’s depends on ___________

A

Major histocompatibility (MCH) complex proteins.

  • act as id tags that label every cell belonging to you.
  • structurally unique for everyone except twins.
94
Q

antigen processing

A

-APC encounters antigen (foreign)
-internalizes it by endocytosis
-digests it into molecular fragments
-displays fragments (epitopes) in the grooves of the MHC protein.
(now lymphocytes can recognize) (cytotoxic T’s and helper T’s)

95
Q

Cytotoxic T cells: (T8, CD8, or CD8+)

A

killer T cells

-effectors of cellular immunity; carry out attack. (endogenous antigens from own cells infected by virus)

96
Q

Helper T cells: (T4, CD4, CD4+)

A

help promote Tc cell and B cell action and nonspecific resistance. (the generals)
-HIV attacks no 3rd line

97
Q

Regulatory T cells: T-regs

A

inhibit multiplication and cytokine secretion by other T cells; limit immune response.
-suppress immune response

98
Q

Memory T cells

A

descend from cytotoxic T cells

-responsible for memory in cellular immunity.

99
Q

e R’s of immunity

A

recognize
react
remember

100
Q

antigen presentation

A

(recognize) APC’s give info to cytotoxic and helper T’s.

cytotoxic= endogenous
helper= both
101
Q

Tc cells respond only ______ proteins. (our own injured cells)

A

MHC-1 proteins

102
Q

Th cells respond only to ______ (from proteins)

A

MHC-2 proteins

103
Q

T cell must check twice to see if it is really bound to a foreign antigen–______. why?

A

co-stimulation

  • helps ensure the immune system does not launch an attack in the absence of an enemy.
  • would turn against ones own body and injure out tissues.
104
Q

Successful _____ will trigger ______

A

costimulation

clonal selection

105
Q

B lymphocytes of humoral immunity produce __________ that bind to antigens and tag them for destruction by other means

A

antibodies

106
Q

IgA

provides ____ passive immunity to newborns

A

found in mucous, saliva, tears, milk, and intestinal secretions (non-blood)
-prevents pathogens adherence (neutralize)

-natural

107
Q

IgD

A

B cell transmembrane antigen receptor.

-thought to function in B cell activation by antigens

108
Q

IgE

A

transmembrane protein on basophils and mast cells.

-produces immediate hypersensitivity reactions

109
Q

IgG

A

constitutes 80% of circulating antibodies (blood and lymph)
-crosses placenta to fetus, secreted in secondary immune respinse, complement fixation, HDN?

HDN=hemolytic disease of newborn (2nd child in double if Rh+) take rogam

110
Q

IgM

A

blood and lymph

-secreted in primary immune response, angulation of RBC’s, complement fixation. (transfusion reactions)

111
Q

Neutralization

A

antibodies mask pathogenic region of antigen (IgA)

112
Q

Complement fixation

A

Antigen binds to IgM or IgG, antibody changes shape, initiates complement binding which leads to inflammation, phagocytosis, immune clearance, or cytolysis.
– Primary defense against foreign cells, bacteria, and mismatched RBCs

113
Q

Angulation

A

(IgM)

– Antibody has 2 to 10 binding sites; binds to multiple enemy cells immobilizing them from spreading

114
Q

Precipitation

A

– Antibody binds antigen molecules (not cells); creates antigen–antibody complex that precipitates, phagocytized by eosinophils

115
Q

primary immune response

– As plasma cells produce antibodies, the ____ (level in the blood plasma) rises

A

immune reaction brought about by the first exposure to an antigen.

-antibody titer (titer gets low need a booster)

116
Q

secondary (anamnestic) response

A

if exposed to the same antigen
– Plasma cells form within hours
– IgG titer rises sharply and peaks in a few days
– Response is so rapid that the antigen has little chance to exert a noticeable effect on the body
– IgG remain elevated for weeks to years
• Conferring long-lasting protection
• Memory does not last as long in humoral immunity as in cellular immunity
• Boosters

117
Q

Immune response may be:
– Too vigorous
– Too weak
– Misdirected against wrong targets

A
  • allerige
  • HIV
  • autoimmune disease
118
Q

hypersensitivity

  • alloimmunity
  • autoimmunity
  • allergies
A

an excessive immune reaction
against antigens that most people tolerate
-reaction to transplanted tissue from another person.
-abnormal reactions to ones own tissues

119
Q

Type I (acute) hypersensitivity

A

– Includes most common allergies
– IgE-mediated reaction that begins within seconds of exposure
– Usually subsides within 30 minutes, although it can be severe to fatal
– Clinical signs include:
• Local edema, mucus hypersecretion and congestion, watery eyes, runny nose, hives, and sometimes cramps, diarrhea, and vomiting
– Examples: food allergies, hay fever, and asthma—local inflammatory reaction to inhaled allergens

120
Q

Anaphylaxis

A

– Immediate, severe type I reaction

– Local anaphylaxis can be relieved with antihistamines

121
Q

anaphylactic shock

A

Severe, widespread acute hypersensitivity that occurs when an allergen is introduced to the bloodstream of an allergic individual
– Characterized by bronchoconstriction, dyspnea (labored breathing), widespread vasodilation, circulatory shock, and sometimes death

treatment: epinephrine causes bronchodilation.

122
Q

Asthma

allergic (extrinsic) asthma:

nonallergic (intrinsic) asthma:

A

– Most common chronic illness in children
– Allergic (extrinsic) asthma is most common form • Respiratory crisis triggered by inhaled allergens
– Nonallergic (intrinsic) asthma
• Triggered by infections, drugs, cold dry air, exercise, or emotions

123
Q

Type 2 (anti-body dependent cytotoxic)

A

Occurs when IgG or IgM attacks antigens bound to cell surfaces
• Examples: blood transfusion reaction, pemphigus vulgaris, and some drug reactions

124
Q

Type 3 (immune complex)

A

– Occurs when IgG or IgM form antigen–antibody complexes
– Examples: autoimmune diseases—acute glomerulonephritis and in systemic lupus erythematosus, a widespread inflammation of the connective tissues

125
Q

Type 4 (delayed)

A

– Cell-mediated reaction in which the signs appear 12 to 72 hours after exposure
– Begins when APCs in lymph nodes display antigens to helper T cells
• Examples: haptens in cosmetics and poison ivy, graft rejection, TB skin test, beta cell destruction that causes type 1 diabetes mellitus

126
Q

Severe combines immunodeficiency disease (SCID)

A

hereditary lack of T and B cells

  • no 3rd line
  • must live in protective enclosures
  • x linked recessive, boys get it.
127
Q

Acquired immunodeficiency syndrome (AIDS)

A

– Non hereditary diseases contracted after birth

128
Q

HIV

A

• HIV is transmitted through blood, semen, vaginal secretions, breast milk, or across the placenta
• Most common means of transmission – Sexual intercourse (vaginal, anal, oral)
– Contaminated blood products
– Contaminated needles
• Not transmitted by casual contact
• Undamaged latex condom is an effective barrier to HIV, especially with spermicide nonoxynol-9

129
Q

Who eats and delivers HIV?

A

APC’s they don’t destroy it but it then destroys helper T’s

Anatomy 232 (12 decks)

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