Ch. 24-26 Flashcards
(87 cards)
1
Q
What are the four parts of the lymphatic system?
A
- Lymph=a fluid similar to plasma, does not have plasma proteins
- lymphatic vessels=network that carries lymph away from peripheral tissues to the venous system
- lymphoid tissue & organs=found throughout the body
- lymphocytes, phagocytes and other immune system cells
2
Q
What are the four lymphatic and immune functions?
A
- drain excess interstitial fluid=3L needs to be reabsorbed, not for exchange, just collected; uses WBC to “clean”, returns to blood
- Lymph=interstitial fluid as soon as it enters lymphatic system
- transport dietary lipids
- carryout immune responses=immune system contained in lymphatic system
3
Q
What are the lymphatic capillaries?
A
for collection only; closed at one end, contain valves, one way flow into capillary & back to the heart; have large diameters & thinner walls than blood capillaries; located b/t cells, run with capillaries
4
Q
What are the structures within lymphatic capillaries?
A
Endothelial cells= important in maintaining one way flow into capillaries
anchoring filaments=used to keep lymphatic caps open, prevents collapse
lacteals=specialized caps in small intestine to carry lipids from diet (chyle=liquid white fat from lacteals)
5
Q
Describe lymphatic flow:
A
blood caps (blood)->interstitial space (IF)->lymphatic caps (lymph)->lymphatic vessels->lymphatic ducts->subclavian veins (blood)
6
Q
What are the primary organs and tissue where lymphatic stem cells divide and develop?
A
Red bone marrow=hemocytoblasts produce B cells & pre-T cells
thymus gland=matures (educates) T cells
7
Q
What are the secondary organs & tissue, where the immune response occurs (battlefield)?
A
Lymph nodes=lymph flows from one node to the next
spleen
lymphatic nodules
8
Q
Describe lymph nodes:
A
There are about 600 located along lymph vessels; concentrated in breast, axillary, & groin
9
Q
What are the parts of the lymph node and what do they contain?
A
capsule=outer covering
outer cortex=contains mostly B cells and macrophages
inner cortex=contains mostly T cells
medulla=B cells, antibodies from plasma cells and macrophages
10
Q
Describe lymph node flow:
A
afferent lymphatic vessel (into node)->subscapular sinus->trabecular sinus->medullary sinus->efferent lymphatic vessel (out of node)
Designed to pass lymph by different WBC
11
Q
How does metastasis work?
A
secondary tumor sites can be predicted according to the direction of lymph flow from the primary tumor site
12
Q
What and where is the spleen?
A
largest single mass of lymphatic tissue, located on the left side b/t stomach and left kidney
13
Q
What are the parts of the spleen?
A
Capsule=outer covering, contains hilus (splenic arteries, veins, and efferent lymph vessels)
Parenchyma=center of spleen, white pulp (tissue, lymphocytes, macrophages located around artery) and red pulp (blood filled venous sinuses, contains RBCs, leukocytes and plasma cells)
14
Q
What are the spleen’s three functions?
A
- remove worn out RBCs
- store platelets (1/3 of body)
- produce blood cells when fetus
15
Q
Describe the flow through the spleen:
A
blood enters white pulp where it is phaged (rid of blood born pathogens)->into red pulp->into splenic veins->liver
16
Q
What and where is the thymus gland?
A
Sits on top of heart, covered by capsule, larger in kids than adults
17
Q
What are the parts of the thymus gland?
A
cortex=pre T cells (immature cells) collect here from red bone marrow, this is where they mature
medulla=contains more mature T cells
epithelial cells=helps educate T cells by positive selection, only 20% make it (then leave to collect in spleen, lymph nodes and lymphatic tissue)
18
Q
What and where are lymphatic nodules?
A
spread throughout the body; egg-shaped masses of lymphatic tissue not covered by a capsule
19
Q
Describe the lymphatic nodules in the oral cavity:
A
tonsils: (1) pharyngeal=posterior wall of nasopharnyx, (2) palatine=back side of oral cavity and (2) lingual=back base of tongue
20
Q
What is MALT?
A
Mucosa-Associated Lymphatic Tissue, spread throughout connective tissue of GI tract, urinary and reproductive systems
21
Q
What is the appendix?
A
mass of fused lymphoid nodules
22
Q
What is the innate defense of nonspecific resistance?
A
present at birth, offers immediate protection against a variety of pathogens, functions the same way regardless of the type of invader
23
Q
What are the human body’s physical and chemical barriers that discourage pathogens from penetrating the body (first line of defense)?
A
Skin=physical barrier
mucous membranes=trap many microbes & foreign substances
lacrimal apparatus=provides tears to wash away irritants to the eyes
saliva=reduces growth of microbes in the mouth
urine flow=cleanses urethra
gastric juice=strong acidity destroys many pathogens
24
Q
As part of the second line of defense, what do internal antimicrobial proteins do?
A
found in the blood and interstitial fluid, discourages growth of microbes
25
What is the complement system?
The complement system is made up of about 25 proteins that work together to assist, or “complement,” the action of antibodies in destroying bacteria. cause blood vessels to become dilated and then leaky, contribute to the redness, warmth, swelling, pain, and loss of function that characterize an inflammatory response.
26
What do interferons and tranferrins do?
interferons=prevent viruses from replicating
| transferrins=iron binding proteins, reduces iron needed for bacterial growth
27
What are Natural Killer Cells?
5-10% of lymphocytes, attack cells that display abnormal plasma membrane proteins, T-lymphocytes; are non-specific
28
Phagocytes are specialized cells that ingest microbes and other cellular debris (neutrophils, macrophages). How do they work?
Chemotaxis=chemically stimulated movement of phagocytes
Adherence=attachment of phagocyte to microbe
Ingestion=process of engulfing the microbe
Digestion=uses digestive enzymes & strong oxidates (H2O2)
Killing=digestion & oxidation kills microbe
29
What is inflammation and the reason for it?
Defensive response to tissue damage; it's an attempt to dispose of microbes, toxins, & foreign material at the site of injury to prevent the spread to other tissues and to prepare site for repair. ex: pathogens, abrasions, chemical irritation, cell disturbance, or extreme temperature
30
Describe the inflammation process:
Injured cells release prostaglandins, proteins, potassium ions; Changes interstitial environment & stimulates mast cells; Mast cells release histamine & heparin
Increased blood flow - raises local temperature, causes area to swell, redden, and become painful; blood clot forms - isolates it; complements break down bacteria & attract phagocytes; activated neutrophils attack debris & bacteria
phagocytes & foreign proteins activate body's specific defense system, macrophages clean up pathogens & cell debris, fibroblasts form scar tissue
31
What are the products of inflammation?
Necrosis=local tissue destruction
pus=mixture of debris & necrotic tissue
abscess=pus accumulated in an enclosed space
32
What is a fever and how does it work?
abnormal high body temperature that occurs because of hypothalamic thermostat reset; it intensifies effects of interferons, inhibits some microbe growth, & speeds up reactions that aid in attack & repair. (pyrogens=any material that causes the hypothalamus to raise body temp; pathogens, toxins, antibody complexes
33
Describe how immunity is an adaptive defense with specific resistance:
Immunity is the ability to mount a specific resistance against specific antigens.
Specific=signals out foreign substances for destruction, also recognizes self
memory=remembers antigens & kills it faster on next encounter
systemic=affects the whole body; not restricted to the area of infection
34
What are antigens and three common pathways they enter lymphatic tissue?
anything perceived as foreign due to surface proteins
1. enter bloodstream, trapped as they flow through spleen
2. penetrate skin, enter lymphatic vessels & lodged in lymph nodes
3. penetrate mucous membranes & become entrapped by MALT
35
What are antigen receptors & what do they signal T cells and B cells to do?
Before T cells leave thymus & B cells leave red bone marrow they insert specific proteins into the plasma membrane capable of recognizing specific antigens
T cells kill other cells, B cells produce plasma cells that produce antibodies
36
What are self-antigens and the classes of them?
Major Histocompatibility Complex (MHC)= these are the body's self antigens, a protein on the surface of all cells; how the body recognizes its own cells (except RBCs)
Class I MHC=all body cells
Class II MHC=appear only on activated T cells & cells of the thymus
37
How does cell-mediated immunity work? The first three steps.
Cells attacking cells; invasion by antigen
1. antigen is presented/gets noticed by bumping into WBC, APC (antigen presenting cell) migrates to lymphatic tissue to present antigen to T cell
2. Activation of T cells
3. Costimulation, activation is complete after a second chemical confirmation, prevents unneeded immune responses
38
How does cell-mediated immunity work? The last three steps.
4. Proliferate - makes copies of itself (divides) from a few to a thousand
5. Differentiate - forms different more specialized copies. Helper (CD4) recognizes MHC-IIs, secretes interleukin 2. Cytotoxic (CD8) recognizes antigens combined with MHC-Is (body cells with virus, tumor cell/cells gone bad). Memory - storage for future invasion
6. Elimination - how T cells kill - perforin punches holes in the plasma membrane of target cell ("spear"), lymphotoxin activates enzymes in target cell that destroy cells DNA ("poison")
39
How does antibody-mediated immunity work?
Invasion of antigen
1. Binding & activation of B cell - B cells can bind directly to antigen but are much more efficient when antigen is presented to B cells
2. costimulation by T helper cell
3. proliferate - B cells divide
4. differentiate - turn into memory & plasma cells; plasma cells live 4-5 days & produce hundreds to millions of antibodies, then they bind with antigen (w/ different results)
5. Antibody action
40
What is the antibody structure?
2 parallel pairs of polypeptide chains: 1 pair of heavy chains & 1 pair of light chains; each chain contains constant segments & variable segments
41
What is the IgG class of antibodies (immunoglobulins)?
IgG=most abundant (80%), protects against bacteria, viruses, toxins & triggers complement system, can cross placenta from M->F (immunity to newborns)
42
What is the IgA class of antibodies?
IgA=10-15%, found in secretions - tears, mucus, saliva, breast milk, GI - protects mucus membranes from bacteria & viruses (immunity to newborns)
43
What is the IgM class of antibodies?
IgM=5-10%, first secretion of plasma cells, activates complement system, are antigen receptors on B cells, anti-A & anti-B antibodies in blood plasma, first response, moves slow
44
What is the IgD class of antibodies?
IgD=rare, act as B cell antigen receptors, activation of B cells
45
What is the IgE class of antibodies?
IgE=rare, act as receptors on mast cells & basophils, involved with allergic & hypersensitivity reactions, help against parasitic worms
46
What are the actions of antibodies?
Neutralizing - stops reactivity
Cross Link Clumping - makes antigens stick together
Activating Complement - sequence of reactions that lead to inflammation & increased phagocytosis
Immobilizing - makes bacteria unable to move
Enhancing phagocytosis - 'flags' or marks antigen
Memory - primary response (days), secondary response (hours)
47
What is Naturally Acquired Active immunity?
Naturally Acquired Active=antigen is recognized by T cells & B cells->memory cells for cytotoxic T cells & antibody producing plasma B cells are produced.
(from human, body worked to make antibodies)
48
What is Naturally Acquired Passive immunity?
Naturally Acquired Passive=transfer of IgG (pregnancy) or IgA (breastmilk)
(from human body, body didn't work to make its own antibodies)
49
What is Artificially Acquired Active immunity?
Artificially Acquired Active=introduction of weakened or dead antigens to trigger body into making cytotoxic T memory cells & antibody plasma B cells (vaccinations)
(from a lab, body produced antibodies)
50
What is Artificially Acquired Passive immunity?
Injection of antibodies (serums)
| from a lab, body didn't work, antibodies inserted/not made
51
What are some immunity disorders/disease?
AIDS=kills CD4 cells, retrovirus
allergic reactions=abnormal second response
autoimmune diseases=5% of population, "poorly educated" B & T cells attack self->MS, SLE, RA
severe combined immunodeficiency disease (SCID)=bubble boy, genetics, lacks an immune system
Infectious mononucleosis=infects B cells
lymphomas=cancers of lymphatic organs, especially lymph nodes
SLE=kidney failure most common complication
52
What are the functions of the respiratory system?
```
provides for gas exchange
regulates blood pH
receptors for smell
filters inspired air
produces sound/speech
```
53
What are the structures in the respiratory system?
Upper respiratory system=nose & pharnyx
Lower respiratory system=larynx, trachea, bronchi & lungs
Conducting portion=all of the pipe connections leading to the lung tissue (150 ml)
Respiratory portion=lung tissue where gas exchange takes place (5-6 L)
54
What are the functions & anatomy of the nose?
to warm, moisten & filter air; detect olfactory stimulus (smell), modify speech
nares=external - nostrils, internal - posterior opening from nose to throat
nasal meatus=(superior, middle & inferior) meatus; groove-like passages
nasal conchae=(s, m, i) conchae=membranes
olfactory epithelium=lining in the superior conchae, olfactory receptors
55
What is the anatomy of the oral cavity?
oral cavity=space inside mouth
hard palate & soft palate=top of mouth, hard palate is anterior to soft palate
uvula=little punching bag at end of soft palate
56
What is the anatomy of the pharynx?
pharynx=lies posterior to nasal & oral cavities, functions as passageway for air & food.
Includes nasopharynx, oropharynx, laryngopharynx
57
Where is the nasopharynx and what are the structures within?
nasopharynx=most superior, lies posterior to nasal cavity
| Includes: eustachian tubes=equalizes pressure of middle ear, aka auditory tubes; pharyngeal tonsil=lymphatic tissue
58
Where is the oropharynx and what are the structures within?
oropharynx=lies posterior to oral cavity
| Includes: palatine & lingual tonsils=lymphatic tissue
59
Where is the laryngopharynx and what are the structures within?
laryngopharynx=most inferior, connects to both esophagus & larnyx
Includes: esophagus=posterior, leads to stomach (digestion); trachea=anterior, leads to lungs (respiratory)
60
What are the single anatomical structures of the larynx?
larynx=short passage that connects laryngopharynx w/ trachea
Thyroid cartilage=largest (adam's apple)
epiglottis=(flap) leaf-shaped cover of glottis, prevents food & drink from entering trachea
glottis=hole w/ folded membranes, contains vocal folds (true vocal cords)
cricoid cartilage=inferior wall of larynx (first lower ring)
ventricular folds=false vocal cords (skin apron)
61
What are the double anatomical structures of the larynx?
(2) arytenoid cartilage=influences position & tension on vocal cords (upside down V)
(2) corniculate cartilage=located at the apex of arytenoid cartilages
(2) cuneiform cartilage=support the vocal folds (small, tough to see)
62
What makes up the lung anatomy?
parietal pleura=outer covering, lines thoracic cavity
pleural cavity=fluid-filled space
visceral pleura=inner covering, covers lung
Lobes=R->superior, middle, inferior; L->superior & inferior
Fissures=L&R have oblique, R has horizontal
Apex=top & base=bottom
Hilus=place where blood vessels, bronchi, lymph vessels & nerves enter & exit (medial)
cardiac notch=space left our of lung for heart (L lung 10% smaller)
63
What makes up the "branches" of bronchial tree?
```
Trachea=divides unto L&R primary bronchi, has 16-20 horizontal cartilage rings
Primary bronchi (L&R)= R is more vertical & is more likely to have aspirated object, point of division=carina (triggers cough reflex)
secondary bronchi=one for each lobe (R=3, L=2)
Tertiary bronchi=10 in each lung, corresponds to each bronchopulmonary segments
bronchioles=cartilage decreases & smooth muscle increase as branches get smaller; terminal=smallest division
```
64
What makes up the "leaves" (ends) of the bronchial tree?
Alveoli=cup-shaped air pouches
| respiratory membrane=alveolar wall & capillary wall -> place of gas exchange
65
Describe the anatomy of alveoli.
terminal bronchiole=lobules->respiratory bronchiole->alveolar ducts (grape stems)->alveolar sacs (bunches of grapes)->alveoli (grapes)
66
How are alveoli connected to the pulmonary artery?
pulmonary capillaries cover outside of alveoli; it's how deoxygenated blood is made oxygenated
67
What are types of alveolar cells?
type 1=simple squamous epithelium, allows gas exchange
type 2=(septal) secretes surfactant, reduces surface tension, allows alveoli to stay open (premature babies lack this)
macrophages=present to take care of any pathogens or dust
68
Define respiration and the types of respiration
Respiration=process of gas exchange in the body
External=exchange of gases b/t lungs & blood in pulmonary caps (gain O2, lose CO2)
Internal=exchange of gases b/t systemic blood caps & tissue cells
69
What is Boyle's Law?
the volume of gas varies inversely with its pressure, if you double the size of a container you half the pressure
70
What is pulmonary ventilation?
pulmonary ventilation=breathing, flow of air in & out of lungs caused by pressure difference created by respiratory muscles
Inhalation (inspiration)=increases lung volume, diaphragm contracts, pulls lung downward, external intercostals raise ribs to expand chest, air enters lungs
exhalation (expiration)=decrease lung volume, quiet breathing, muscles relax, passive; forced expiration by abs& internal intercostals, active
71
What is surface tension and compliance in regards to ventilation?
surface tension=prevents expansion of alveoli, surfactant reduces surface tension
compliance=effort to stretch chest wall & lung. high=easy to inflate; low=hard to inflate
72
What are four things that decrease compliance?
1. scarring of lung tissue
2. lung tissue filled with fluid (pneumonia)
3. deficiency in surfactant
4. decrease in lung expansion
73
What are the muscles of inhalation? exhalation?
in=ext. intercostals, diaphragm
| ex=int. intercostals, 4 abdominals
74
What is tidal volume (TV)?
TV=500 mL, amount inhaled or exhaled w/ each breath at rest
75
what is inspiratory reserve volume (IRV)?
IRV=3100 mL, amount that can be forcefully inhaled after a tidal inhalation
76
What is expiratory reserve volume (ERV)?
ERV=1200 mL, amount that can be forcefully exhaled after a tidal exhalation
77
what is residual volume (RV)?
RV=1200 mL, amount remaining in lungs after forced exhalation
78
What is total lung capacity (TLC)?
TLC=IRV+TV+ERV+RV=6L (6000 mL), max amount of air in lungs
79
What is vital capacity (VC)?
VC=TV+IRV+ERV=4800 mL, max amount that can be expired after maximum inspiration
80
What is inspiratory capacity (IC)?
IC=TV+IRV=3600 mL, max amount that be inspired after tidal expiration
81
What is functional residual capacity (FRC)?
FRC=ERV+RV=2400 mL, volume remaining in lungs after tidal expiration
82
What is external and internal respiration?
external=(pulmonary), O2 & CO2 exchange b/t air in alveoli & pulmonary
internal=(systemic), O2 & CO2 exchange b/t blood & tissue cells
83
What are four factors that effect gas exchange?
1. partial pressure difference, increase partial pressure=increase in exchange
2. surface area available, increase area=decrease exchange
3. diffusion distance, increase distance=decrease exchange
4. molecular weight & solubility, CO2 (20 times) more rapid than O2
84
How is O2 transported and what decreases its affinity?
```
O2 binds to hemoglobin in RBCs (98%)
affinity=tightness of O2-hemoglobin bond
decrease in pH (increase in acidity)
partial pressure of CO2, increase in CO2
increase temp
```
85
How is CO2 transported?
dissolved CO2 in plasma=about 9% of CO2, diffuse into alveolar air & is exhaled
carbamino compounds=13% binds to amino acids & proteins in blood (mostly hemoglobin)
bicarbonate ions=78% as bicarbonate ions (HCO3) in blood plasma, reaction reverses in lungs & CO2 is exhaled
86
What causes patients to be hypoxic? anemic? ischemic? histotoxic?
hypoxic=decrease in partial pressure of O2 (high altitude or obstruction)
anemic=too little functioning hemoglobin
ischemic=reduced blood flow to tissues
histotoxic=tissues unable to use O2 given to them
87
What are the layers of the digestive tract?
mucosa=inner lining of GI tract (includes epithelium, lamina propia, muscularis mucosae)
submucosa=irregular connective tissue, contains blood & lymph vessels, neurons
muscularis=mostly smooth muscle, mixes and propels food through tract
