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Anatomy and physiology II > Test #3 > Flashcards

Test #3 Flashcards

1
Q

What are the functions of the lymphatic system?

A

Fluid Balance: Excess interstitial fluid (30L leaves capillaries, 27L goes back to them, leaving 3L of lymph) enters lymphatic capillaries, becoming lymph. Fluid could accumulate in interstitial space if not working properly, causing edema.

Fat Absorption: Lacteals absorb fat in the digestive tract (lymphatic capillaries in the digestive tract), this lymph is called chyle.

Defense: Microorganisms and other foreign substances are filtered in lymph by lymph nodes. (blood also does this by the spleen)

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2
Q

What are the components of the lymphatic?

A

Lymph: Water and solutes from the Plasma (ions, nutrients, gases, some proteins) and cells (hormones, enzymes, waste products) ESSENTIAL FOR FLUID BALANCE

Lymphatic vessels: More permeable than blood capillaries

lymphatic tissue
Lymphatic nodules
Lymph nodes
Tonsils
Spleen
Thymus
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3
Q

How do lymphatic capillaries compare to blood capillaries?

A

Lymphatic capillaries are more permeable than blood capillaries because of their importance for fluid balance.

Lymphatic capillaries move by autospasms, inspiration, and skeletal muscle (smooth in capillaries)

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4
Q

Where are lymphatic capillaries not found?

A

Nervous system, bone marrow, and tissues without blood vessels (cartilage, cornea, epidermis)

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5
Q

Describe lymphatic tissue?

A

Lymphatic tissues contain lymphocytes (WBC derived from bone marrow but may mature elsewhere), monocytes, and dendritic cells. Also have fine collagen reticular fibers produced by reticular cells that filter microorganisms and other particles by trapping them.

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6
Q

Encapsulated Vs. Nonencapsulated lymphatic tissue?

A

Encapsulated: Lymph nodes, spleen, thymus (EVERYTHING ELSE IS NONENCAPSULATED::: NONENCAPSULATED TISSUES CAN BE FOUND WITHIN ENCAPSULATED TISSUES)

Nonencapsulated: mucosa-associated lymphoid tissue (MALT). This is found beneath the epithelium as the first line of attack against invaders.

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7
Q

What is MALT?

A

MALT is what makes up our lymphatic nodules (denser aggregations, found in loose connective tissue) in our respiratory, urinary and reproductive systems (in digestive system lymphatic nodules are known as peyers patches)

DIFFUSE LYMPHATIC TISSUE IS ALL OF THE LYMPHOCYTES AND MACROPHAGES BLENDING IN WITH OTHER TISSUES AROUND THE NODULES OR NODES AND SPLEEN

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8
Q

Describe the characteristics and functions of lymph nodes?

A

These are the structures that filter lymph ONLY THE LYMPH NODES DO THIS!! (spleen filters blood).

Substances are removed by phagocytosis or nodes stimulate lymphocytes to proliferate in GERMINAL CENTERS.

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9
Q

What is the importance of the Germinal Centers in lymph nodes?

A

This is where the lymphocytes proliferate after being stimulated by filtered substances in lymph node.

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10
Q

What is the structure of the thymus?

A

Cortex (numerous lymphocytes) and medulla (fewer lymphocytes) HAS NO RETICULAR FIBERS (internal network is formed by epithelial cells with long processes)

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11
Q

Where is the thymus located?

A

In the superior mediastinum (very close to the heart); grows rapidly during first year, then stays same size through adulthood before decreasing in size after 60 years.

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12
Q

What is the importance of the thymus?

A

Site of the maturation of T cells (many are produced here, but most degenerate) those that react to foreign substances remain, the ones that react to healthy body tissue degenerate.

B CELLS MATURE IN RED BONE MARROW!!

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13
Q

Where are the tonsils found, what are they and what are their names?

A

The tonsils are large groups of lymphatic nodules (denser aggregations of lymphatic tissue) in the nasopharyx and oral cavity, provide protection against bacteria and harmful material, they form a ring around the border of the oral cavity and the pharynx.

NONENCAPSULATED

The names of the tonsils are:
Palatine (tonsils)
Pharyngeal (adenoids)
Lingual

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14
Q

What are the functions of the spleen?

A

Destroys defective RBCs

Detects and responds to foreign substances

Acts as a limited reservoir for blood

FILTERS THE BLOOD!! NOT LYMPH!!!

LOCATED IN LEFT SUPERIOR SIDE OF ABDOMEN

THERE ARE RETICULAR CELLS FORMING RETICULAR FIBERS HERE

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15
Q

What can happen as a result of abdominal trauma?

A

The spleen can be ruptured (may need removed, the body will be fine), this can result in a lot of bleeding because it is a limited reservoir (may result in shock or death)

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16
Q

What are the main divisions of immunity?

A

Innate or nonspecific resistance: physical barriers (skin, tears, saliva, mucous membranes, mucus, cilia (respiratory tract), coughing, sneezing) or chemical mediators (lysozyme, mucus, sebum) and cells (phagocytosis or inflammatory response)

Adaptive or specific immunity: Humoral (antibodies) or cell-mediated
specificity: able to recognize a SPECIFIC substance

memory: ability to remember previous encounters with a particular substance and respon rapidly.

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17
Q

Do innate and adaptive immunity work independent from one another?

A

NO, these divisions work together.

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18
Q

What are the chemical mediators of innate immunity?

A

Surface Chemicals: Lysozymes that lyse cells; acid secretions (sebum in the skin and HCL in the stomach) prevent microbial growth or kill microorganisms; mucus on mucous membranes trap substances till they can be killed.

Histamine: an amine released from mast, basophils, and platelet cells that cause vasodilation, increase vascular permeability, stimulate gland secretions, cause smooth muscle contraction of airway passages and attract eosinophils.

Kinins: polypeptides derived from plasma proteins that cause vasodilation, increase vascular permeability, stimulate pain receptors and attract neutrophils.

Interferons: Proteins produced by most cells that interfere with viral growth and infection. in neighboring cells= paracrine

Complement: group of plasma proteins that increase vascular permeability, stimulate release of histamine, activate kinins, lyse cells, promote phagocytosis, attract neutrophils, monocytes, macrophages, and eosinophills.

Prostaglandins: Group of lipids that can cause smooth muscle relaxation and vasodilation, increase vascular permeability and stimulate pain receptors.

Leukotrienes: These are a group of lipids produced by mast cells that cause prolonged smooth muscle contractions (especially in bronchioles), increase vascular permeability and attract neutrophils and eosinophils.

Pyrogens: chemicals released by neutrophils monocytes, and other cells that stimulate fever production.

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19
Q

What do all of the chemical mediators of innate immunity do?

A

Increase vascular permeability and attract immune-related cells.

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20
Q

General concepts of complement?

A

Group of 20 proteins circulating in blood

Activated in cascade form

Alternative pathway: Innate immunity (C3 binds with foreign substance, attracts macrophages)

Classical pathway: adaptive immunity (requires antigens and antibodies)

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21
Q

What is the end result after activation of complement?

A

Activated complements can form membrane attack complexes (MAC) that make channels through the plasma membrane

Attach to surface of bacterial cells to stimulate phagocytosis (called opsonization)

Attract immune system cells to site of infection and promote inflammation

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22
Q

What is opsonization?

A

Activated complement proteins attach to the surface of bacterial cells, this stimulates phagocytosis.

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23
Q

What is chemotaxis?

A

Movement toward the source of chemotactic factors. (parts of microbes or chemicals that act as chemical signals and attract WBCs)

SO NOT ONLY CAN COMPLEMENT ATTRACT WBCS, SO CAN CERTAIN PARTS OF THE MICROBES THEMSELVES

24
Q

What is phagocytosis?

A

Endocytosis by neutrophils and macrophages.

25
Q

What are the functions of the cells of innate immunity?

A

WBCs: chemotaxis and phagocytosis

Neutrophils- first responders, phagocytic power, first to enter infected tissue, last only a few hours, regularly cross GI tract providing protection.

Macrophages: These are large phagocytic monocytes that have migrated from blood to tissue, can ingest larger particles and live longer than neutrophils

Basophils and mast cells: promote inflammation when activated by INNATE OR ADAPTIVE system (Basophils are motile, leave the blood and enter infected tissues, mast cells (mastocytes) are non-motile; they are already in the tissues.

Eosinophils: reduce inflammation by breaking down chemicals produced by basophils and mast cells. ALSO SECRETE ENZYMES THAT KILL SOME PARASITES

Natural killer Cells: a type of lymphocyte that (lyse tumor and virus-infected cells). These attack whole classes of cells, not a specific kind of cell.

26
Q

What is the difference between macrophages and monocytes?

A

Macrophages are monocytes that have left the blood and gone to the infected tissue.

27
Q

What signs/symptoms of inflammation result from chemical mediators?

A

Heat, swelling, redness, pain (These are all classical signs)

chemotaxis (heat, redness, swelling)

increased vascular permeability (heat, redness, swelling)

increased blood blow (heat redness, swelling)

Increased number of white blood cells and chemical mediators at site of injury (pain)

(all of these are caused by histamine, leukotrienes, kinins, and prostoglandins)

Pain is also cause by increased acidity due to an increase in free H+ ions

28
Q

systemic and chronic inflammation Vs. acute and local?

A

acute has a rapid onset and last a shorter time, and local means it is in more specific parts of body where injury is.

systemic is a widespread infammatory response that can be caused by and infection (sepsis), or burns, pancreatitis, trauma and surgery.

29
Q

what is chronic inflammation?

A

related to lipids and the fact that there is a problem with fat metabolism where the adipocytes secrete signaling molecules that trigger inflammation. (excessive fat means inflammation)

30
Q

What is an antigen? (Adaptive)

A

Large molecule stimulant (marker): foreign- not produced by the body, introduced from outside (bacteria, viruses, other microorganisms that cause disease) pollen, animal dander, feces of mites, foods and drugs can cause an overreaction of immune system called an allergic reaction.
Self-antigens - produced by the body, used as markers to allow adaptive immune response to differentiate self from non-self. (response to self tumor cells are helpful but response to other self-antigens causing tissue destruction is known as auto-immune disease.

31
Q

What is a hapten? (Adaptive)

A

These are smaller molecules that have to combine to larger proteins to produce an adaptive immune response. (poison ivy) Also can trigger allergic reactions. (penicillin)

32
Q

What are epitopes? (adaptive)

A

These are on the surface of antigens and are know as antigenic determinants, which are specific regions of an antigen recognized by a lymphocyte. One antigen can have different epitopes.

33
Q

What are the main types of adaptive immunity?

A

Humoral or Antibody-mediated - B cells

Cell-mediated - T cells

34
Q

What are the common characteristics of the two types of adaptive immunity? (adaptive)

A

proliferation

differentiation

memory

35
Q

What are the different responses of Humoral immunity?

A

Primary response - B cells proliferate and differentiate into memory B cells and plasma cells

Secondary response - during later exposure the memory B cells that were created during the primary response proliferate and differentiate into more memory B cells and more plasma cells, a faster and greater response (memory)

36
Q

What are the different responses of Cell-mediated immunity? (adaptive)

A

Cytotoxic T cells are activated by the antigen on surface of a cell, then the cytotoxic T cells proliferate and differentiate into memory T cells and more cytotoxic T cells, the cytotoxic T cells that are produced release cytokines that trigger inflammation and initiate phagocytosis as well as activate more T cells, the cytotoxic T cells also kill the target cells upon contact causing them to lyse (burst)

The memory T cells trigger a later response that is similar to how the secondary response in humoral immunity works, just with T cells. (memory)

37
Q

What are the cells of adaptive immunity?

A

B cells: differentiate into plasma (produce antibodies, directly or indirectly responsible for destroying antigen) or memory B cells (generate a quick and effective response to a previously recognized antigen)

Effector T cells: citotoxic T cells (lysis (breaking cell membrane of microorganism) and production of cytokines)

Regulatory T cells: helper T cells (activate B cells and effector T cells) and suppressor T cells (inhibit B cells and effector T cells)

Memory T cells (response to antigen against which the immune system has previously reacted)

Dendritic cells (process antigen and is involved in the activation of B and T cells)

38
Q

How and where are lymphocytes activated? (adaptive)

A

Stem cells create pre-B and pre-T cells in the red bone marrow:

Pre-B cells: these mature into B cells in the red bone marrow and travel to the lymph nodes through the circulation.

Pre-T cells: these go to the thymus to mature before going to the lymph nodes through the circulation.

Two ways they are activated: Antigenic receptors (T cell and B cell receptors on surface of lymphocyte directly bind with antigenic dterminant)

OR MHC (major histocompatibility complex)

39
Q

What is positive selection? (adaptive)

A

This ensures the survival of lymphocytes that react against foreign antigens, they then proliferate to form clones.

40
Q

What is negative selection? (adaptive)

A

This is the elimination of clones of lymphocytes that are highly reactive against self-antigens.

41
Q

What is tolerance? (adaptive)

A

This is a state of unresponsiveness of lymphocytes to a specific antigen, usually to self-antigens (ones own cells).

42
Q

What are the differences between MHC I and MCH II?

A

Major Histocompatability Complex

MHC I - Found on the surface of ALL nucleated cells (not in platelets or RBCs), bind and display epitopes of antigens synthesized inside the cell to immune system (self-antigens), can also present epitopes of foreign antigens, also send message to immune system without an antigen bond (many MCH I = normal and healthy/ few to no MCH I = abnormal and kill) STIMULATES DESTRUCTION

MHC II - naturally found on surface of certain phagocytic cells of the immune system (dendritic, macrophages, monocytes and B cells), bind and display antigens that are captured from phago/endocytised material to immune system, non-self antigens are phagocytised and various epitopes are bound to them and displayed to other cells of immune system, DOES NOT STIMULATE DESTRUCTION, displays a wanted poster telling cells that can recognize and destroy it to multiply, predominant mechanism for presenting internalized antigens (MCH I is also present on antigen presenting cells), dendritic, macrophages, monocytes and B cells are known as professional “APC” BUT other cells can also express MHC II called “non prefessional APC”

43
Q

Concept of costimulation?

A

helps T or B cells to be fully activated and proliferate other than epitope presentation.

Two Ways: By cytokines

by surface molecules, binding between two or more addictional membrane proteins present in interacting cells strengthens the interaction between cells allowing complete activation of lymphocyte.

if costimulation doesn’t occur, the cell exhibits ANERGY (B or T cell doesn’t respond to an antigen) THIS NORMALLY OCCURS WHEN A T OR B CELL ENCOUNTERS A SELF-ANTIGEN

44
Q

What are the different types of antibodies and their characteristics?

A

IMMUNOGLOBULINS
IgG - MOST COMMON, slowly produces during initial infection and lasts a long time so the body will be ready for secondary infection for a quick response. HIGH LEVELS OF IGG INDICATE A PREVIOUS OR PAST INFECTION

IgM - Produces in initial infection a lot and lasts a short time, IgG is slowly being produced. HIGH LEVELS OF IGM INDICATE A RECENT OR CURRENT INFECTION.

IgA - secreted in saliva, tears, and milk, important for immune protection in newborns.

IgE - Stimulate inflammatory response through mast and basophils.

IgD - function as antigen-binding receptors on B cells

45
Q

What are the functions of the respiratory system?

A

Regulation of blood pH

Production of chemical mediators - ACE (angotensin convertase) (vasoconstriction, helps angotensin I to Angotensin II (active form) to promote vasoconstriction, raising blood pressure.

Voice production - movement of vocal folds makes sound and speech

Olfaction - smell occurs when airborne molecules are drawn into nasal cavity

Protection - against microorganisms by preventing entry and removing them from respiratory surfaces.

46
Q

What is the importance of pH regulation?

A

Altered by changing blood carbon dioxide levels. faster pH regulation than other systems. (the faster you breath the more CO2 is released from the body (lowering pH). FINE TUNING OF BLOOD PH

47
Q

Difference between tracheostomy and cricothyrotomy?

A

tracheotomy - a cut in the trachea

tracheostomy - leaving the cut open (not an emergency, an elective procedure) at the trachial level

cricothyrotomy - done in an emergency procedure (quick access) at the cricothyroid ligament. (like when there is an obstruction)

48
Q

Importance of diaphragm for respiration?

A

allow the thoracic cavity to increase 2/3 in volume, (differences in pressure)

49
Q

What are the muscles of expiration?

A

internal intercostals and abdominal muscles

50
Q

alveolus and respiratory membrane: cells their characteristics and functions?

A

terminal bronchiole branch into respiratory bronchioles (very few alveoli) and then turn into alveolar ducts (more alveoli) and ending into alveolar sacks(2 or 3 alveoli at terminus).

RBC - found in capillaries.

Type I pneumocyte - thin squamous epithelial cells, form 90% of surface of alveolus. gas exchange function

Type II pneumocyte - round to cube shaped secretory cells, produce surfactant, help alveoli expand

Dust Cells - phagocytic cells (immune function)

NO CILIA HERE, ALL IMMUNE FUNCTION DONE BY DUST CELLS (MACROPHAGES)

51
Q

What are the layers of the respiratory membrane?

A

alveolus

thin Layer of fluid lining the alveolus

alveolar epithelium (simple squamous epithelium)

Basement membrane of alveolar epithelium

Thin interstitial space

basement membrane of capillary endothelium

capillary endothelium composed of simple squamous epithelium

ALVEOLAR TISSUES HAVE ELASTIC FIBERS AROUND THEM THAT ALLOW RECOIL

52
Q

Boyles law?

A

A general law for gases (PV = nRT

air moves from an area of higher pressure to an area of lower pressure. PRESSURE IS INVERSELY PROPORTIONATE TO VOLUME

this means that if the volume of the thoracic cavity is increasing (diaphragm contracts), then the pressure on the alveoli gets smaller and they begin expanding.

During expiration volume in alveoli decreases, the pressure increases making it higher than atmospheric pressure pushing air put.

53
Q

Pulmonary surfactant and surface tension?

A

surface tension has to do with film of fluid linings in the alveoli, this is where water interfaces with air, polar water molecules are attracted to each other and the alveolar surface (this helps make the alveoli collapse as the air pushes on the water and alveoli. (THIS AND ELASTIC RECOIL BY ELASTIC FIBERS IN ALVEOLAR WALL ARE THE COMPONENTS OF LUNG RECOIL)

Surfactant reduces the surface tension (detergants are surfactants), because of its hydrophobic and hydrophilic regions, philic bind to water while phobic regions face the air, this changes the orginal air-liquid interface preventing the lungs from collapsing by preventing the air from have so much cohesion power (with surfactant a surface tension of 30mmHg becomes 3mmHg)

In prematture neonates they may not have enough surfactant causing respiratory distress syndrome. (generally in less than 7 months)

54
Q

oxygen-hemoglobin dissociation curve?

A

98.5% of oxygen is transported by hemoglobin, 1.5% is dissolved in plasma

hemoglobin saturation is when the number of heme groups in hemoglobin (of 4) is 4. O2 saturation is the number of saturated hemoglobin

When oxygen saturation is low (during exercise) this is because the hemoglobin has released most of its oxygen to the tissues (73%) Po2 decreases, and during rest saturation is higher because the hemoglobin is retaining its saturation (23% released) pO2 increases

55
Q

what happens to the curve during changes in pH, CO2 levels, and temperature?

A

pH - as it lowers the curve shifts to the right (increase in release of oxygen, decreases oxygen in hemoglobin at any PO2) as it raises it shifts to the left (decrease in release of oxygen, increase in amount of oxygen in hemoglobin) BOHR EFFECT (free H ions combine with hemoglobin changing its shape so oxygen can no longer bind to it)

CO2 - right shift at increase and left shit at decrease. (higher co2 raises pH)

temperature - right shift at increase (increase in metabolism) and left shift at decrease.

Immune responses require more oxygen (inflammation and its production of more free H+ ions)

Fever = increased temperature = right shift

Anatomy and physiology II (7 decks)

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