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Flashcards in Test 2 Deck (252):
1

Immune surveillance

The destruction of abnormal cells by NK cells in peripheral tissues

2

Interferons

Chemical messengers that coordinate the defenses against viral infections

3

Complement

A system of circulating proteins that assist antibodies in the destruction of pathogens

4

Inflammation

Localized, tissue-level response that tends to limit the spread of an injury or infection

5

Fever

An elevation of body temperature that accelerates tissue metabolism and body defenses

6

Dominant inhibitory receptor

Prevents the activation of the NK cell. The MHC receptor is this

7

Protectin

Intrinsic molecule that protects NK cells from their own perforins

8

Interferon alpha

Signals neighboring uninfected cells to destroy RNA and reduce protein synthesis

9

Interferon beta

Signals neighboring infected to cells to undergo apoptosis

10

Interferon gamma

Activates immune cells

11

Complement proteins work together in...

cascades

12

Respiratory burst

Part of the Inflammation reaction. Neutrophils undergo this upon leaving the vasculature

13

Pyrogen

Substance that induces a fever

14

Hypothalamus orchestrates heat effector mechanisms through...

the autonomic nervous system

15

Innate immunity

Nonspecific defense mechanisms that come into play immediately or within hours of an antigen's appearance in the body

16

Adaptive immunity

Antigen-specific immune response. Antigen first must be processed and recognized. Response is customized to antigen

17

Adaptive immunity may be...

- Humoral (antibodies)
- cell-mediated

18

Key to understanding immunity

The body must recognize self from non-self

19

Lymphocyte characteristics

- Account for 20-40% circulating leukocytes
- Do not phagocytose foreign bodies
- Each type has distinct biochemical functions

20

Self vs non-self recognition

MHC complex that recognizes surface antigens

21

CD markers (Cluster of differentiation markers)

Tells whether a T cell responds to a class I or II MHC

22

CD8 markers

Cytotoxic and suppressor T cells. Respond to MHC I proteins

23

CD4 markers

Helper T cells. Respond to MHC ii Proteins

24

CD25

Activated T cells. The receptor for interleukins

25

CD3 markers

All T cells

26

The T cell must be ____ to confirm activation

Costimulated

27

Cytotoxic T cells may destroy a cell through...

perforin, lymphotoxin, or induction of apoptosis

28

Time period for cytotoxic T cell accumulation

Two days

29

memory Tc cells

Produced by cell division. Awaits reappearance of the antigen

30

Suppressor T cells

Control or moderate immune response by T cells and B cells

31

Helper T cells

Stimulate immune response by T cells and B cells

32

Memory Th cells

Await reappearance of antigen

33

Five B cell produced heavy chains

- IgG
- IgE
- IgD
-IgM
- IgA

34

IgG antibodies

Account for 80% of antibodies. Responsible for resistance against many viruses, bacteria, and bacterial toxins

35

igE antibodies

Basophils and mast cells. Release histamine

36

IgD antibodies

on B cell surfaces.

37

IgA

Glandular secretions such as mucus, tears, saliva, and semen

38

IgM antibodies

first class of antibody secretyed after an antigen is encountered. IgM concentration declines as IgG production accelerates.

39

Epitopes

Triggers B cell stimulation. Most microorganisms can have multiples.

40

Partial antigens are too ___ to trigger B cell activation

small. They cannot bind to MHC.

41

Seven mechanisms of antibody action

- Neutralization
- Opsonization
- Precipitation/agglutination/aggregation
- Attraction of phagocytes
- Stimulation of inflammation
- prevention of bacterial adhesion

42

Part of innate immune system relies on...

proteases and cytokines

43

Neutralization

Prevents recognition of cell surface markers by blocking recognition sites

44

Agglutination/Aggregation

Antibodies link large numbers of antigens together

45

Attraction of phagocytes

Antibodies attached to antigens attract eosinophils, neutrophils, and macrophages

46

Opsonization

Enhances phagocytosis of smooth antigens/microbes by allowing for more efficient binding

47

Stimulation of inflammation

Stimulate basophils and mast cells (WBCs that release heparin and histamine)

48

Prevention of bacterial adhesion

Most notably in the saliva, mucus, and perspiration

49

Antibody titer

The amount of antibody in the plasma

50

Primary response to antigens

Titer remains high as long as exposure to an antigen is ongoing or suppressor T cells inhibit further immune response

51

Secondary response to antigens

Memory B cells respond right away - antibodies tend to be more effective and secreted in massive quantities

52

When is functional cell mediated immunity established?

three months

53

Humoral immunity establishes when?

four months

54

Fetal immune system is dominated by?

Maternal IgG antibodies (passive immunity)

55

Maternal immunity

Antibodies pass from mother to baby across placenta (IgG) or in mother's milk

56

Cellular elements of the immunologic properties of human milk

- Macrophages
- T and B cell lymphocytes

57

Noncellular elements of the immunologic properties of human milk

- immunoglobins (Secretory IgA prodominant; also contains IgG, IgM, and IgE)

58

Immune tolerance

The degree of responsiveness of the immune system

59

Central tolerance

The way the immune system learns to discriminate self from non-self. Deletes autoreactive lymphocyte

60

Peripheral tolerance

Way of preventing hyper-reactivity of the immune system

61

Autoimmune disease

Loss of tolerance can lead to this

62

Positive selection of B and T cells

Must have correct compliment of CD markers to enter a functional state

63

Location of peripheral tolerance

Lymphoid organs

64

Autoimmunity

Occurs when there is the ability of self to recognize self

65

While a high level of autoimmunity is unhealthy;

a low level of autoimmunity may be beneficial

66

Autoimmune disorcers

Production of excessive antibodies

67

Activated B cells

Make autoantibodies against body cells

68

Different effects of autoimmune diseases

- Damage to or destruction of tissues
- Altered organ growth
- Altered organ function

69

Lupus

Most distinctive sign of lupus is a facial rash that resembles wings of a butterfly

70

Multiple sclerosis

A progressive disorder. Diagnosed based on tingling, numbness, uncontrolled tremors, among other symptoms

71

Celiac disease

Autoimmune disorder where ingestion of gluten leads to damage in the small intestine

72

Immunodeficiency disease

Occurs when the immune system fails to develop normally during embryology or the immune response is blocked/surpressed

73

Primary immunodeficiency (congenital immunodeficiencies)

Many of these disorders are hereditary and are autosomal recessive or X-linked.

74

Secondary immunodeficiencies

Also called acquired immunodeficiencies. Can result from various immunosuppressive agents.

75

Examples of secondary immunodeficiencies

Malnutricion, aging and particular medications

76

Zoonoses

A jump of disease or virus from an animal from human. Ex is HIV

77

AIDS

stage of infection that occurs when the immune system is so badly damaged that the body becomes vulnerable to opportunistic infections

78

Malignant tumors

DO NOT mutate more frequently than normal cells. It is the evolutionary context that matters

79

Monoclonal antibodies

Lab-made versions of immune system proteins. Antibodies are designed to attack a very specific part of a cancer cell

80

Immune checkpoint inhibitors

Inhibit the checkpoint to upregulate the immune response

81

Cancer vaccines

Some vaccines can help prevent or treat cancer

82

Costimulation acts as a

negative regulator of T cell activity

83

Vaccines protect

individuals

84

Herd immunity

mechanism that protects populations. Leads to reduction and eventual removal of a disease from the population.

85

Herd immunity threshold

Diseases exhibit this based on their mechanisms of transmissions

86

For airborn diseases, herd immunity breaks down at vaccination rates below

80-95%

87

For diseases requiring exchange of bodily fluids herd immunity breaks down at vaccination rates

below 30-50%

88

Infected people can spread measles from

four days before through four days after the rash appears

89

Logical fallacies

Tricks or illusions of thought often wrapped in technical language meant to decieve people or elicit an emotional response (fear)

90

Burden of proof

The burden of proof lies with someone who is making a claim, and is not upon anyone else to disprove

91

methylmercury

type of mercury found in certain kinds of fist. At high exposures it can be toxic to people

92

ethylmercury

cleared from the human body more quickly and therefore less likely to cause any harm

93

Side effect of thimerosal in vaccines

Most common are minor reactions, the redness and swelling at the injection

94

Thimerosal was taken out of childhood vaccines in the US in

2001

95

Four of the most successful vaccinations in medical history

- smallpox
- polio
- measels
- tetanus

96

Measels facts

- fever over 104 degrees, blindness, swelling of brain, pneumonia, and extreme discomfort

97

Tetanus facts

- caused by bacteria usually found in soil, duct, and manure and enter the body through breaks in the skin - usually cuts or puncture wounds caused by contaminated objects

98

General rule for vaccines

The more similar a vaccine is to the disease-causing form of the organism, the better the immune response to the vaccine

99

Live, attenuated vaccines

Vaccines produced by growing the virus in tissue cultures that will select for less virulent strains, or by mutagenesis or targeted deletions in genes required for virulence

100

Upsides of Live, attenuated vaccines

Contain a weakened version of the living microbe. Elicit strong cellular and antibody responses and often confer lifelong immunity with only one or two doses. Easy to produce

101

Downsides of live, attenuated vaccines

Remote possibility exists that an attenuated microbe in vaccine could revert to virulent form and cause disease. Usually needs to be refrigerated to stay potent

102

Inactivated vaccines

Produced by killing the disease-causing microbe with chemicals, heat, or radiation

103

Upsides to inactivated vaccines

-Such vaccines are more stable and safer than live vaccines.
-The dead microbes cannot mutate back to their disease causing state.
- Do not require refrigeration

104

Subunit Vaccines

Instead of the entire microbe, includes only the antigens that best stimulate the immune system. Can contain anywhere from 1 to 20 or more antigens

105

upsides to subunit vaccines

Because only contain the essential antigens and not all the other molecules that make up the microbe the changes of adverse reactions to vaccine are lower

106

Downsides to subunit vaccines

Don't know what antigens will trigger the response

107

Toxoid vaccines

Used when a bacterial toxin is the main cause of illness

108

Examples of toxoid vaccines

diphtheria, tetanus, and botulism

109

example of subunit vaccine

Hepatitis B

110

examples of inactivated vaccines

polio, annual flu shot

111

Conjugate vaccines

Created by covalently attaching a poor antigen to a strong antigen to elicit a stronger immunological response to the poor antigen

112

There are three types of influenza virus

-A,B, and C.
-A and B types can cause flu epidemics

113

Influenza A divided into subtypes based on two proteins on the surface of the virus:

-Hemagglutinin (H)
-Neuraminidase (N)

114

H1N1 influenza virus

- 1918 spanish influenza
- Bird to human

115

H2N2Influenza virus

- 1957 Asain influenza
- Ressaortment of H2Ns avian virus and H1N1 human virus

116

H3N2 Influenza virus

- 1968 Hong kong influenza
- reassortment of H3 avian virus and H2N2 human virus

117

Current vaccines produce antibodies that recognize

the hemagglutin, particularly the head region. It is the part of the virus that is most susceptible to antigenic drift

118

Antigenic drift

- Natural selection mediated by our own immune systems
- Flu evolves much more rapidly than do other viruses do

119

Antigenic shift

Movement of pathogens from domestic animals or wildlife to humans
origin of zoonoses

120

Challenges of living at altitude

- Hypoxia
- cold
-aridity
- solar radiation
-diet
- disease ecology
-lifestyle

121

Functions of the respiratory system

- Exchange of gases with external enviornment
- surface area for gas exchange
- Protect respiratory surfaces from debris and infection
- produce sounds of singing and speaking
- Detection of odors
- Regulate blood pressure and volume (conv. of angiotension II)

122

3 major parts of respiratory system

- Airway
- lungs
- muscle of respiration

123

Nose consists of...

External nose and nasal cavity

124

Naris (nostrils)

Two elliptical orifices on the external nose

125

Nasal septum

Separates the naris

126

Ala nasi

Lateral margin of nose, rounded and mobile

127

Nasal cavity has

- floor
- roof
- lateral wall
- medial or septal wall

128

Know floor of nasal cavity

- palatine process of maxilla and the horizontal plate of palatine bone
* know locations on skull

129

Know roof of nasal cavity

- nasal and frontal bone
- cribiform plate by ethmoid
- located beneath the anterior cranial fossa, posteriorly by the downard sloping body of the sphenoid
***know locations

130

Nasal septum consists of...

- Perpindicular plate of the ethmoid bone (superio)
- Vomer (inferior)
- septal cartilage (anterior)

131

Medial wall of nasal cavity

The nasal septum, which divides the nasal cavity into right and left halves. Has occeus and cartilagenous parts

132

Deviated septum

-typically caused by facial trauma
- extreme cases can become obstructive, but surgical repair is rare

133

Deviated septum

-typically caused by facial trauma
- extreme cases can become obstructive, but surgical repair is rare

134

Nasal concha

Nasal turbinate

135

Meatus

space below each concha

136

Function of Nasal turbinate

Responsible for filtration, heating, and humidification of air inhaled through the nose.
*marine bones

137

Openings into the nasal cavity

- Inferior meatus: Nasolacrimal duct
- Middle Meatus: maxillary sinus, frontal sinus, anterior ethmoid sinuses
- Superior meatus: posterior ethmoid sinuses

138

Skin of external noses supplied by...

branches of the opthalmic and maxillary arteries

139

Skin of the ala and lower part of the septum are supplied by...

branches from the facial artery

140

Kiessalbach's plexus

Responsible for the 90% of nosebleeds. Drying during inhalation

141

Posterior epistaxis

5-10% nosebleeds. occur at Woodruff's plecus. Located at posterior end of inferior turbinate. Occurs due to physiological deficiencies

142

Review Scent slide

- Olfactory tract
- olfactory plate
l lamina propria
- olfactory epithelium
- mucus layer

143

Location of paranasal sinuses

Found in the interior of the maxilla., frontal, sphenoid, and ethmoid bones
*study head CT to know location

144

Mucoperiosteumm

Mucus membrane attached directly to the periosteum. Lining of paranasal sinuses

145

Mastoid air cells

Sits within the mastoid process of the temporal bone

146

Functions of paranasal sinuses

- resonators of the voice
- reduce skull's weights
- help warm and moisten inhaled air (minimal gas exchange)
- act as shock absorbers in trauma
-contribute to facial shape/growth

147

Sinusitis/rhinosinutis

Sinus infection

148

Chronic rhinosinutis

May cause swollen membranes interfering with drainage, mucus buildup

149

The first pharyngeal arch divides into

Maxillary and mandibulary prominences

150

Know location of pharyngeal arches

- frontonasal prominence
- maxillary prominence
- mandibular arch

151

Each pharyngeal arch consists of

a core of neural crest derived mesenchymal tissue covered by surface ectoderm and on the inside by epithelium

152

The human has four pairs of...

Pharyngeal pouches

153

Look at picture of development of anterior pathway

- focus on lateral nasal process and maxillary process

154

Cleft lip and palate occurs in about

1 to 2 per 1000 births in developed world due to failure of prominence fusion

155

Know the different cartilages associated with anterior airways

- mandibular arch
- meckel's cartilage
-reichert's cartilage
- cardiac bulge
- hyoid arch
- bone of hyoid
- styloid ligament
-thyroid cartilage
-cricoid cartilage

156

Identify all structures of development of anterior airway on SEM or on diagram

- Frontonasal process
-Maxillary Process
-stomodeum
-mandibular process
-hyoid
-medial nasal and lateral nasal process

157

Laryngeal cartilages

- thyroid
- cricoid
-arytenoid
-Epiglottis (the lid)
-Corniculate
-Cuneform

158

Laryngeal ligaments

Thyrohyoid
Cricohyoid

159

Laryngeal innvervation

Vagus
Superior laryngeal nerve

160

Role of breathing (Larynx)

Open glottis

161

Role in cough reflex (Larynx)

Close, then open glottis

162

Role in swallowing (Larynx)

Close glottis

163

Role in voice (Larynx)

Close glottis and adjust vocal fold tension

164

True vocal cords

"Folds" or "ligaments"

165

Know structures of the larynx

- laryngeal
-thyroid cartilage
-cricoid cartilage
-tracheal cartilage
-trachea
-superior horns of thyroid cartilage
-epiglottis
-vocal fold

166

Phonation

Process of making sound

167

Air pressure system role in sound production

Provides and regulates air pressure to cause vocal folds to vibrate

168

Air pressure system organs

Diaphragm, chest muscles, ribs, abdominal muscles, lungs

169

Vibratory system role in sound production

Vocal folds vibrate, changing air pressure to sound waves producing "voiced sound", frequently described as a "buzzy sound"
Varies pitch of sound

170

Vibratory system organs

Voice box (Larynx)
Vocal folds

171

Resonating system role in sound production

Changes the "buzzy sound" into a person's recognizable voice

172

Resonating system organs

Vocal tract: throat (pharynx), oral cavity, nasal passages

173

Bernoulli effect

Caused by the low pressure created behind the fast moving air column during vocal fold vibration. This causes the bottom to close, followed by the top

174

Any change that affects the mucosal wave of vocal fold vibration...

can cause vocal problems

175

What changes can affect the mucosal wave of the vocal fold vibration?

-Stiffness of vocal fold layers, weakness or failure of closure, imbalance between R and L vocal folds from a lesion on one vocal fold

176

Voice as we know it =

Voiced sound + Resonance + articulation

177

Voiced sound

The sound produced by vocal fold vibration

178

Resonance

Voiced sound is amplified and modified by the vocal tract resonators (throat, mouth cavity, sinuses, and nasal passages). Resonators produce a person's recognizable voice

179

Articulation

The vocal tract articulators (tongue, soft palate, and lips)modify the voiced sound. The articulators produce recognizable words

180

Voice depends onf vocal fold...

vibration and resonance

181

110 cycles per second or hz (men)

lower pitch

182

180 to 220 cycles per second (women)

medium pitch

183

300 cycles per second (children)

higher pitch

184

Higher voice

increase in frequency of vocal fold vibration

185

Louder voice

Increase in amplitude of vocal fold vibrations

186

Articulation of the different vowel sounds depends on

- THe point of constriction
- the degree of constriction
-the degree of lip-rounding
- the degree of muscle tension

187

Voiced consonants

produced with the vocal cords vibrating

188

voiceless consonants

produced with the vocal cords open

189

Uvulars

consonants articulated with the back of the tongue against or near the uvula

190

Resonant frequency of each of our voices differ depending on

size and shape of:
-Vocal tract
-oral cavity
-nasal cavity
-paranasal sinuses

191

Larynx is mechanosensitive

glottis will close if it is irritated

192

Tradheotomy

cut between 2nd and 3rd tracheal cartilages

193

Esophagotracheal ridges

Separates lung buds from foregut when the diverticulum expands caudally

194

Esophagotracheal septum

The esophagotracheal ridges fuse to form this

195

Laryngeal orfice

How the respiratory primordium maintains its communication with the pharynx

196

Lingual frenulum

Serves as a guide for the foward growth of the tongue during early gestation

197

After birth

the tip of the ongue continues to elongate

198

Wharton's ducts

Two largest ducts in the center just in front of the attachment of the lingual frenulum. Source of "gleeking"

199

Ankyloglossia

tongue tied = short frenulum

200

Esophageal atresia

Abnormalities in partitioning of the esophagus and trachea by the tracheoesophageal septum

201

Tracheoesophageal fistulas

can or cannot be part of the esophageal artesia
*see diagram

202

Fistula

Abnormal connection

203

Artesia

Blind ending pouch

204

Pain from disease of the heart or its pericardial layers can be referred to

the upper shoulder via the phrenic nerve

205

know locations of right and left lung on model

- right phrenic nerve
- right lung
- left lung
- respiratory diaphragm
- left phrenic nerve

206

Phrenic nerve

Originates at C3-C5 and passes down between lung and heart to reach the diaphragm

207

Spinal injuries at C4 and above are

fatal without intervention

208

Irritation of the phrenic nerve is the cause of

hiccups

209

Esophagus lies _ to the trachea

Posterior

210

Trachealis muscle

Can decrease diameter of trachea to forcibly expel air (coughing)

211

Know locations inside trachea

- esophagus
- trachealis muscle
- mucosa
- submucosa
- submucous gland in submucousa
- hyaline cartilage

212

Trachea and bronchi locations

At level of carina, trachia divides into:
- main stem (primary) bonchi
- secondary (lobar) bonchi
- tertiary (segmenta) bonchi
* look at the diagram of both

213

Mucous membrane of the carina

is the most sensitive area of the trachea and larynx for triggering a cough reflex

214

The bronchi are not

Symmetric

215

Inhaled objects typically become lodged in the

right bronchus

216

Right bronchus compared to left

- wider
-shorter
- steeper
-2cm

217

Pleura diagram

- Parietal pleura parts: Cervical, costal, diaphragmatic, mediastinal
- pleural cavity
- costodiaphragmatic recess
- cardiac notch

218

Costodiaphragmatic recess

Lungs partially fill these during inhalation

219

Pleural effusion

Site of fluid buildup following traumatic injury

220

Pneumothorax

Accumulation of air in the pleural space

221

What does each lung contain?

- an apex
- three surfaces (costal, medial, and diaphragmatic)
- three borders (anterior, inferior, and posterior)

222

Know how to identify right and left lung through models

- right lung has 3 lobes
- left lung has 2

223

Hilium of the lung

a groove that allows passage of the primary bronchi, pulmonary vessels, nerves, and lymphatics

224

What forms the root of the lung?

Bronchi and pulmonary vessels, which extend from the trachea and heart

225

Lymph nodes collect

carbon, dust particles, and pollutants that were not filtered out by the pseudostratified columnar epithelium

226

Gas exchange can take place in the

- respiratory bronchioles and alveolar ducts
- also in alveoli

227

Know the general structure of respiratory apparatus

- bronchopulmonary segment which contains: smaller bronchi, bronchioles, terminal bronchile, respiratory bronchiol, alveoli

228

Pneumonia

Inflammation of lobules

229

Effects of pneumonia

Causes fluid to leak into alveoli
Compromises function of respiratory membrane

230

Spongy nature of the lung is due to

packing of millions of alveoli together

231

Type I cells in alveolus

Simple squamous cells forming lining

232

Type II cells in alveolus

Septal cells that secrete surfactant

233

Pulmonary surfactant

Mixture of lipids and proteins which is secreted by the epithelial type II cells into alveolar space

234

Function of primary surfactant

Reduce the surface tension at the air/liquid interface of the lung

235

Angiotension-converting enzyme (ACE)

Produced by endothelial cells. Converts angiotension I to Angiotension II. Active in regulation of blood volume

236

Sinusitis

Inflammation of nasal cavities

237

Pharyngitis

strep throat

238

laryngitis

Inflammation of the larynx

239

Bronchitis

Dry cough that may lead to pneumonia

240

Pneumonia

Inflammation of lungs, alveoli fill with fluid

241

Occult stage non-small lung cancer

Cancer cells found in sputum, but no tumor can be found in the lung by imaging tests or bronchoscopy

242

Stage 0 non-small cell lung cancer

Carcinoma in situ. Cancer tiny in size and has not spread into deeper lung tissues or outside of lungs

243

Stage I non-small cell lung cancer

Cancer may be present in the underlying lung tissues, BUT LYMPH NODES REMAIN UNAFFECTED

244

Stage II non-small cell lung cancer

The cancer may have spread to nearby lymph nodres or into crest wall

245

Tuberculosis

Highly contageous infection of lungs.
spreads through air
Antiobiotic resistance growing problem

246

Cystic fibrosis

- Thick, sticky mucus blocks airway
- bacterial infection
-widened airway
- blood in mucus

247

CFTR critical to

Involved in production of sweat, digestive fluids, and mucus.
Mutations involved with cystic fibrosis

248

Dichotomous branching forms

bronchial buds

249

After a pseudoglandular and canalicular phase, cells of the respiratory bronchioles change into

thin, flat cells, type I alveolar epithelial cells

250

Growth of the lungs after birth is primarily due to what

an increase in the number of respiratory bronchioles and alveoli and notto an increase in alveoli size

251

Embryonic breathing movements

strengthen respiratory muscles

252

One cause of respiratory distress

Lack of sufficient surfactant to prevent alveoli collapse