Practical 2 - Lymphatic Flashcards
The immune system is a collection of….
immune cells
What is the lymphatic system?
Organ system where most immune responses occur
What are the two main types of lymphocytes?
T cells and B cells
Where are T and B cells first produced?
the bone marrow
Where do T and B cells mature?
T cells - thymus
B cells - red bone marrow
What type of immunity do the T cells provide?
cell-mediated immunity
What type of immunity do the B cells provide?
antibody-mediated immunity
What type of cells come from the T cells?
Memory T cells, Helpter T cells, Cytotoxic T Cells
What type of cells come from B cells?
Memory B cells, plasma cells
What do plasma cells do?
release antibodies
What do memory B cells do?
save the knowledge for later so that immune response is faster in the future
What do memory T cells (both C and H types) do?
save the info for later in case the antigen returns again
What do the cytotoxic T cells do?
kill things seen as a threat with the antigen
What does the helper T cell do?
gives the cytotoxic T cells permission to kill and differentiates into memory Th cells
What does the T cell directly differentiate into? What do those things differentiate into?
T cell —> cytotoxic Tc and helper Th
helper Th —> memory Th
cytotoxic Tc —> memory Tc
What do the B cells directly differentiate into?
plasma cells and memory B cells
When are T and B cells activated?
when an antigen is presented
What do the natural killer cells do?
kill cancer cells and infected host cells
What type of cell is a natural killer cell? What is their general purpose in the immune system?
They are a cytotoxic lymphocyte critical to the innate immune system, so they act immediately without “thinking”
What do monocytes/macrophages do?
“big eaters” which clear debris and present antigens to other cells
What do dendritic and reticular cells do?
present antigens to other cells
What is an antigen?
a molecule capable of causing an immune response
What is an antibody?
immunoglobulin, protein produced by plasma cells to bind a specific antigen and mark it for elimination or destruction
What types of antibodies do people with A, B, AB, and O blood have? Do not consider Rh.
A = anti-B
B = anti-A
AB = none
O = anti-A and anti-B
Where are the blood-type antigens found?
on erythrocytes
What type of antibodies do people who are Rh- and Rh+ have? Do not consider letter type.
Rh- = anti-Rh if they have been exposed to Rh+
Rh+ = none
What type of antibodies are the antibodies against A and B antigens? What type are the antibodies against Rh antigens?
A and B antibodies = IgM, big pentamers
Rh antibodies = IgG, smaller monomers
What happens to antibodies when blood donations are processed?
antibodies are removed
What 2 things happen if incompatible blood types mix?
agglutination and hemolysis (destruction of erythrocytes)
On a blood type plate, what does agglutination indicate? Give an example using the A well.
That antigen is present. So if A agglutinates, then the blood has A antigens. If Rh agglutinates, Rh antigen is present.
On a blood type plate, what does it mean if none of the wells have agglutination?
That person is O-
On a blood type plate, what does it mean if all of the wells have agglutination?
That person is AB+
What blood type is the universal recipient? Why?
AB+, because they have the antigens for everything and therefore no antibodies to anything
What blood type if the universal donor? Why?
O-, because they don’t have any antigens and therefore will not bind to any antibody that someone may have
Explain hemolytic disease of the newborn.
When a mother is Rh- and the baby is Rh+, during the birth the mother and baby’s blood mixes exposing her to the Rh antigen and develop antibodies. If she has a second Rh+ baby, the antibodies will cross the placenta and lead to hemolysis of fetal erythrocytes.
Why can the Rh antigens cross the placenta and cause harm, but the antigens from a baby with a different blood type (B instead of A, for example) is not dangerous?
Antibodies for a blood type letter are big, pentamer IgM that can’t cross that barrier. Rh antibodies are smaller IgG monomers that can cross the barrier.
What is agglutination? What is hemolysis?
agglutination: antibodies from one phenotype bind to the antigens of the other phenotype and cause the blood to get clumpy (not clots)
hemolysis: bursting (destruction) of the erythrocytes
What symptoms can happen in the second baby if a Rh- mother does not get RhoGAM?
the baby can have jaundice or a swollen liver
What is the function of the lymphatic system?
location for immune responses, collect and return ISF, deliver lipids and lipid soluble vitamins from small intestine to blood
What are the components of the lymphatic system?
lymphatic organs, tissues, vessels and lymph itself
Where is the lymphatic system? (vessels and nodes)
lymphatic vessels are everywhere, nodes are scattered by mostly in the trunk
What are the two ways that the components of the lymphatic system can be categorized?
organs vs. tissues
primary vs. secondary
In the lymphatic system, what makes something an organ? What are the lymphatic organs?
surrounded by a capsule
thymus, spleen, red bone marrow, lymph nodes
In the lymphatic system, what makes something a tissue? What are the lymphatic tissues?
no capsule
nodules (MALTs) and aggregations of nodules (Peyer’s patches, tonsils)
What makes something primary? What are the primary organs and tissues?
site of lymphocyte production and maturation (where they gain immunocompetence)
thymus, red bone marrow
What makes something secondary? What are the secondary organs and tissues?
sites where lymphocytes initiate adaptive immune response
spleen, appendix, lymph nodes, nodules, MALT, Peyer’s Patch, etc.
How is the spleen categorized? Where is it located?
secondary lymphatic organ, posterior and lateral to the stomach on the left side of the body
What does the spleen do in the lymphatic system?
filter blood, eliminate old erythrocytes, reservoir for thrombocytes
What are the 2 main features of the spleen’s histology? What do they look like?
white pulp (purple) and red pulp (redish pink)
What is in the red pulp of the spleen?
erythrocytes and thrombocytes
What is in the white pulp of the spleen?
lymphocytes and macrophages
What is the function of the lymph nodes?
filter lymph and site of T and B cell activation
Know the location of the cervical, inguinal, intestinal, iliac, submandibular, bronchial, axillary, and mammary nodes
Are there more afferent or efferent veins to the lymph node? Why?
more afferent because the cortex takes time to filter the lymph, so the amount coming in is more than the amount going out.
When lymph enters a node through the afferent lymphatic vessel, what does it pass through to get to the efferent lymphatic vessel?
afferent lymphatic vessel
subcapsular sinus
trabecular sinus
medullary sinus
efferent lymphatic vessel
What is a MALT? Where are they?
mucosa associated lymphoid tissue - single nodules in the connective tissue of mucous membranes
respiratory, GI, urinary, reproductive tracts
What is a Peyer’s patch?
aggregations of nodules in the small intestine
What are tonsils?
aggregations of nodules
Which tonsils are paired and singular?
1 pharyngeal
2 palatine
2 lingual
What are the features of lymphatic vessels?
thin walls, valves, nodes, contain lymph and leukocytes, closed at one end
What vein does all lymph eventually end up dumping into?
the subclavian veins
What facilitates the return of lymph to the heart?
muscle, respiratory, and arterial pumps, but primarily the rhythmic contraction of the lymphatic vessel after fluid stretches the walls
Which lymphatic vein dumps into the right subclavian vein?
The right lymphatic duct
What lymphatic vein dumps into the left subclavian vein?
the thoracic duct
What does the right lymphatic duct drain?
the right upper appendage, right half of the thoracic region, right half of the cervical region, and right half of the face and head
What does the thoracic duct drain?
both lower appendages, the abdomen, the left upper appendage, left half of the thoracic and cervical region, left half of the face and head
What is the general lymphatic flow?
location ISF, lymph capillaries, afferent lymph vessel, nodes, efferent lymph vessel, lymphatic trunk, duct, subclavian vein, right atrium
What do efferent lymph vessels connect?
word bank: nodes, trunks, ducts
nodes to trunks
Everything that dumps into the thoracic duct comes through the —–
cisterna chyli
What is elaphantiasis?
tropical disease characterized by gross enlargement of an area of the body, especially the limbs
What is elephantiasis caused by (another disease)?
lymphatic filariasis
How does a person acquire lymphatic filariasis?
moquito ingests blood from an infected person—> leaves infective larvae on skin —> filarial parasitic worm —> nest in lymphatic vessels and disrupt normal function
When are filarial parasitic worms usually acquired? How long do they live?
childhood, live 5-7 years
What are the signs and symptoms of elephantiasis?
starts asymptomatic, but then leads to lymphoedema (tissue swelling) and elaphantiasis (thickening of skin and tissue), bacterial infections
Why are bacterial infections common in elephantiasis?
lymphatic damage diminishes the defenses against bacteria
What is the prevalence of elephantiasis?
120 million people in the tropics and subtropic of Southeast Asia, India, Africa, and South America
What put a person at higher risk of elephantiasis?
repeated mosquito bites over several months where disease is common
How can elephantiasis be prevented?
mosquito nets, clothes that cover skin
What are treatments for elephantiasis, both parasitic and clinical symptoms?
parasite - diethylcarbamazine (DEC) kills the worms
clinical symptoms -
DEC is not effective
Doxycycline can prevent lymphedema from worsening
Lymphedema specialist for basic principles of care
Surgery in severe cases
How is elephantiasis acquired and trasmitted?
mosquitos
What chronic conditions does lymphatic filariasis lead to?
elephantiasis and lymphedema
Where does lymph from the inguinal node go to?
iliac and intestinal nodes
Where does the lymph from the iliac and intestinal nodes go to?
lumbar and intestinal trunks (both nodes to both trunks)
Where does the lymph from the submandibular node go to?
jugular trunk
Where does the lymph from the cervical node go to?
jugular trunk
Where does the lymph from the mammary nodes go to?
axillary nodes and straight to the subclavian trunk
Where does the lymph from the axillary nodes go to?
subclavian trunk
What trunks dump into the cysterna chyli?
lumbar and intestinal trunks
What trunks dump into the left side of the thoracic duct OR right lymphatic duct?
jugular and subclavian
What structure dumps straight into the thoracic duct?
cisterna chyli
Lymph from what nodes can end up in the right lymphatic duct OR left side of the thoracic duct?
submandibular, cervical, axillary, mammary
Lymph from what nodes goes only to the thoracic duct?
iliac, inguinal, intestinal
What are the four lymphatic trunks? What two dump into the thoracic duct only?
lumbar, intestinal, jugular, and subclavian. Lumbar and intestinal dump into the thoracic duct only.
What do the afferent lymph vessels do?
carry lymph to the nodes
