Immuno Flashcards
Where are all leukocytes produced? Where do B and T cells mature?
Bone marrow via hematopoiesis; bone marrow and thymus (primary lymphoid organs). T cells move to thymus as they develop
Which cells are part of humoral immunity vs cell-mediated immunity?
B cells, ab, complement, soluble mediators vs T cells, PMNs, NK cells, macs, cellular mediators
Name different barriers of nonspecific/innate immunity
Physical: skin, epithelial tight junctions, physical removal (cough/sneeze, peristalsis, cilia, vomiting/diarrhea, sloughing dead cells), flushing (tears, urine). Chemical: GI tract/stomach acid/lysozymes/pH, mucous membranes, sebum, fatty acids, antimicrobial peptides, pulm surfactant. Biological: microbiome influenced by where you live, diet, exer, stress, dz, meds, gender/age. BOTH INNATE N ADAPTIVE CELLS = PART OF CELL MEDIATED RESPONSE
innate vs adaptive immunity
rapid onset (1d), no memory, general specificity, doesn’t react to self, actions cont to adaptive phase vs delayed onset (7d) since cells = activated by APCs, has memory –> faster & stronger response and resolves at higher titers, highly specific, doesn’t react to self
Active vs passive immunity. Give examples of natural and artificial of each
Ab made during immune response –> MEMORY vs ab passed down. NA actually getting dz; AA vaccines vs NP mom passing ab to fetus via placenta; AP receiving ab or T cells as med tx
MALT vs GALT vs BALT vs NALT
Mucous-associated lymphoid tissue; lymphoid tissue at mucosal surfaces Ex: GALT, BALT, NALT vs Gut-associated lymphoid tissue; Ex: tonsils, adenoids, Peyer’s patches, appendix, igA, M cells, antimicrobial peptide vs Bronchus-associated lymphoid tissue; Ex: goblet cell and mucin production, surfactant, igA vs Nasal-associated lymphoid tissue; Ex: mucous lining of nostril, goblet cell, brush cells, igA
purpose and basic process of hematopoiesis?
generation of immune and non-immune cells, occurs in bone marrow. hematopoietic stem cells differentiate into diff cell type => pluripotent thru mult steps w/ differentiation pathways determined by mix of cytokines, growth factors, etc that the developing cell binds
which cells are APCs?
macs, DCs, B cells
Diff types of T cells?
helper/CD4 T cells and cytotoxic/CD8 T cells (conventional); regulatory/suppressor T cells - tone down immune system after infection and promote self tolerance, NKT, and gamma-delta T cells (nonconventional)
What are NETs?
matrix formed of DNA extruded by PMNs after phagocytosis to which degraded nuclear proteins bind in addition to granular enzymes; traps large particles like bacteria then degrades and kills them; AG INDEP
How to differentiate lymphocytes since they all look similar?
specific markers by stains (ex: stain CD3, CD4 and CD8 to find CD4+ and CD8+ T cells)
immunoprotection vs immunopathology
protection against pathogens vs inappropriate immune response that dmgs host (over-exuberant immune response, autoimmune dz, rejecting grafts)
barrier defenses vs immune organs vs immune cells vs soluble molec for immune system
keep pathogens out of body (skin, mucous membranes) vs where immune cells = made and reside (spleen, tonsils, lymph nodes) vs fight pathogens (macs, lymphocytes); cells = not technically part of immune response but do secrete during immune response vs help defend against pathogen (complement, cytokines, ab)
lymphatic fluid vs lymphatic vessels vs lymphoid tissues/organs
made of water, immune cells, proteins, electrolytes, dend cells w/ ag, soluble ag, free microbes, ca cells, leuks; plasma leaked from capillaries and into lymph system; if leaked from capillaries and into tissue/interstitium => interstitial fluid (but don’t let fluid stay in tissue –> go to lymph vessels, picks up path and carry to 2nd lymph organ –> innate & adaptive immune cell fight pathogens, DOESN’T CONTAIN RBCs vs collects and returns tissue fluids to lymph organ & collects and returns lymph fluids to bloodstream, same structure as blood vessels: tunica intima, tunica media, tunica adventita; open ended vessels, fenestrations, one-way valves, connects lymph nodes, tethered to surrounding tissue by collagen filaments => anchoring filaments, permeable d/t adjacent endothelial cells, vs survey lymph fluid or pathogens/debris, activate and upregulate adaptive immunity (ex: spleen, lymph node)
3 main functions of lymph system
remove edema fluid from tissues/interstitium, 85% re-enter circ and 15% stay in lymphatic system and returned to circ (if not efficient –> lymphedema); transport lipids from intestine to circulation, special lymph capillaries (lacteals) and blood capillaries w/ villi = along surface of sm intestine, lacteals absorbed lipids and lipid-sol vit –> lacteals contain high fat liquid content => chyle; generate and mediate immunity
primary vs secondary lymph organs
where immune cells develop from stem cells to mature inactivated leukocytes (ex: bone marrow, thymus) vs where mature but naive B/T cells encounter ag; optimize interaction in innate and adaptive immune cells w/ ag and e/o; organ inc in size during activations b/c inc number of B/T cells, APCs activate naive B/T cells (ex: spleen, lymph nodes)
bone marrow vs thymus
in interior of hollow bones, where stem cells become B/T cells => hematopoiesis, 50/50 stem cells & fat cells (fat cells inc in age b/c stem cells already differentiated), stem cells can also become mesenchymal cells (repair connective tissue) or endothelial cells (repair dmged blood vessels) vs in upper anterior chest (cortex = dark purple, contains immature T cells; medulla = light purple, contains mature T cells), where T cell maturation occurs, involutes w/ age, relates to immunosenescence (dec immune fxn), absent thymus => DiGeorge syndrome
spleen vs lymph nodes vs tonsils
upper L abd behind stomach; red pulp - stores blood, macs & dendritic cells, site for extramedullary hematopoiesis if bone marrow fails; white pulp - follicles made of B cells, germinal centers develop w/in follicles and contain activated B cells –> make plasma cells and ab –> activates adaptive immune response, periarteriolar lymphoid sheaths (PALS) formed by T cells; marginal zone - b/w red pulp and white pulp, where ag = trapped and presented to splenic B/T cells; filters blood by removing ag vs similar architectural traits w/ spleen like cortex and medulla (T cell zones = paracortex, B cell zones = follicles and germinal centers, central vasc region = medulla, subcapsular sinus = marginal zone), enclosed by fibrous capsule, concentrated w/ pathogens at entry; enlarge during lymphocyte proliferation => lymphadenopathy, connected by lymph vessels for delivery of ag to B/T cells and release ag-activated T cells and ab vs 3 sets: palatine - back of throat (we see), pharyngeal - adenoids, lingual - base of tongue (we don’t see); have crypts that develop into follicles and catch pathogens from food or oral secretions; fight infxns of upper resp and digestive systems
process of lymph node
activate B/T cells to start primary adaptive immune response or reactive secondary response; pathogens enter -> dend cells present at barrier surfaces and take up pathogen -> enter lymph vessels to go to nearest lymph node via afferent lymphatics or other secondary lymph organ -> present ag to B/T cells -> activated T cell or ab leave lymph node to infected tissue
where are cervical vs axillary vs inguinal vs mesenteric lymph nodes?
neck & shoulders vs armpit vs GU area vs abd cavity near sm intestine
bulk fluid flow
movement of water and solute based upon pressure gradients; fluid filters at arterial end of capillaries into interstitium –> most interstitial fluid = reabsorbed at venous end of capillaries, remaining interstitial fluid enters lymph system => lymphatic fluid
key characteristics of lymph fluid
colorless/clear, similar to plasma but low protein conc, flows thru lymph channels, filtered by lymph nodes
overview of lymphatic flow
relies on muscle contractions (perilymphatic smooth muscle cells, pressure from movement of MSK tissue) (not a pump like cardiovasc system), breathing, 1 way system, massage, or passive compression (OMT), postural changes, contractions of lymph vessel walls; consists of lymph capillaries –> lymph fluid flow into convergent progressively bigger lymph vessels –> trunks –> RUQ lymphatic duct or thoracic duct and re-enter circ at R/L subclavian veins respectively –> superior vena cava
advantages vs disadvantages of edema
“washing” pathogens, ag, cellular debris from tissues vs cause tissue dmg if not removed –> interstitial fluid = reabsorbed into blood or taken up by lymph vessel and returned to blood
how does osteo med enhance lymph system?
uptake fluid and tissue ag into lymphatics, release leuks into lymphatics, inc ab responses
why do lymph pump techniques?
tx for thoracic cage (for resp), abd (spleen, liver, pancreas, bladder, colic, menstrual cramps, flatulence, post-surgical scars), feet/legs (pedal pumps); techniques reduce edema, inc circ and immune cell output into lymph system, clear pathogen, and improve immune surveillance
thoracic pump v auricular pump (Galbreath Maneuver)
inc lymph drainage from head and neck; tx upper & lower RTI, CHF, asthma, COP, post-surgical edema/lymphatic congestion); hands on ribs 2-4, pt inhales by mouth and exhales passively, dr follows force of exhale, dr maintains force, pt inhales again but dr put sl resistance and maintains force during exhale, rpt 4-5x, abruptly remove hand 1/3 of last inhalation vs mandibular manipulation to open/close Eustachian tube in “pumping action” –> drain ear; tx middle ear infections; dr has 1 hand on chin (thumb and forefinger on jawbone, other hand on forehead to hold pt in place, as pt opens mouth –> dr gently moves lower jaw to the side away from ear w/ acute otitis media (AOM) and holds it there for 3-5s, releases jaw, rpt 3x
factors leading to disruption of blood flow? results?
dmg of vessel (infectious or physical processes –> chronic inflamm), removal of vessel during surgery. results in scar tissue or fibrosis reduces lymphatic flow in vessel –> buildup of lymph fluid in tissue => lymphedema; dz condition - elephantiasis, after breast surgery, ca, infections
