Test 2 Flashcards
1
Q
Immune surveillance
A
The destruction of abnormal cells by NK cells in peripheral tissues
2
Q
Interferons
A
Chemical messengers that coordinate the defenses against viral infections
3
Q
Complement
A
A system of circulating proteins that assist antibodies in the destruction of pathogens
4
Q
Inflammation
A
Localized, tissue-level response that tends to limit the spread of an injury or infection
5
Q
Fever
A
An elevation of body temperature that accelerates tissue metabolism and body defenses
6
Q
Dominant inhibitory receptor
A
Prevents the activation of the NK cell. The MHC receptor is this
7
Q
Protectin
A
Intrinsic molecule that protects NK cells from their own perforins
8
Q
Interferon alpha
A
Signals neighboring uninfected cells to destroy RNA and reduce protein synthesis
9
Q
Interferon beta
A
Signals neighboring infected to cells to undergo apoptosis
10
Q
Interferon gamma
A
Activates immune cells
11
Q
Complement proteins work together in…
A
cascades
12
Q
Respiratory burst
A
Part of the Inflammation reaction. Neutrophils undergo this upon leaving the vasculature
13
Q
Pyrogen
A
Substance that induces a fever
14
Q
Hypothalamus orchestrates heat effector mechanisms through…
A
the autonomic nervous system
15
Q
Innate immunity
A
Nonspecific defense mechanisms that come into play immediately or within hours of an antigen’s appearance in the body
16
Q
Adaptive immunity
A
Antigen-specific immune response. Antigen first must be processed and recognized. Response is customized to antigen
17
Q
Adaptive immunity may be…
A
- Humoral (antibodies)
- cell-mediated
18
Q
Key to understanding immunity
A
The body must recognize self from non-self
19
Q
Lymphocyte characteristics
A
- Account for 20-40% circulating leukocytes
- Do not phagocytose foreign bodies
- Each type has distinct biochemical functions
20
Q
Self vs non-self recognition
A
MHC complex that recognizes surface antigens
21
Q
CD markers (Cluster of differentiation markers)
A
Tells whether a T cell responds to a class I or II MHC
22
Q
CD8 markers
A
Cytotoxic and suppressor T cells. Respond to MHC I proteins
23
Q
CD4 markers
A
Helper T cells. Respond to MHC ii Proteins
24
Q
CD25
A
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
