The Lymphatic System

Question 1

The Lymphatic and Immune Systems maintain ______ balance and protect body from _____ and ______.

Answer 1

fluid, infection, disease

Question 2

Fluid continually filters from the _____ ______ into the ______ spaces. The blood capillaries reabsorb about ___%. 15% (2 – 4 L/day) of the _____ and about half of the ______ ______ enters lymphatic system and then returned to the blood.

Answer 2

blood capillaries, tissue, 85, water, plasma proteins

Question 3

As the lymphatic system recovers excess tissue fluid, it also picks up _____ ____ and _______ from the tissues. On its way back to the bloodstream, the fluid passes through _____ _____ where immune cells stand guard against foreign matter. When they detect anything potentially harmful, they activate a _______ ______ _______.

Answer 3

foreign cells, chemicals, lymph nodes, protective immune response

Question 4

In the small intestine, special lymphatic vessels called _______ absorb dietary lipids that are not absorbed by the _____ ______.

Answer 4

lacteals, blood capillaries

Question 5

The recovered fluid:

Answer 5

lymph

Question 6

The ______ ______ transport the lymph.

Answer 6

lymphatic vessels

Question 7

The ______ _____ are composed of aggregates of lymphocytes and macrophages that populate many organs in the body.

Answer 7

lymphatic tissues

Question 8

Defense cells are especially concentrated in these organs. They are set off from surrounding organs by connective tissue capsules.

Answer 8

lymphatic organs

Question 9

_______ is usually a clear, colorless fluid, similar to blood plasma but low in ______. It originates as tissue/extracellular fluid that has been drawn into lymphatic capillaries.

Answer 9

Lymph, protein

Question 10

A ______ ______ consists of a sac of this endothelial cells. The cells are tethered to surrounding tissue by ______ filaments. They are _____ at one end. The gaps between them are large enough to allow ______ and cells entrance to lymphatic capillary. The overlapping edges of the ______ cells act as valve-like flaps that open with interstitial ______ ______.

Answer 10

lymphatic capillary, protein, closed, bacteria, endothelial, fluid pressure

Question 11

The lymphatic vessels form in the embryo by budding from the vein. The larger ones have a _____ _____ with endothelium and valves, a _____ _____ with elastic fibers and smooth muscle, and a thin outer _____ _____.

Answer 11

tunica interna, tunica media, tunica externa

Question 12

As the lymphatic vessels converge along their path, they become ______ and ______.

Answer 12

larger, larger

Question 13

The ____ _____ ____ receives lymph from the right arm, right side of head and thorax, and empties into the ____ _____ ____.

Answer 13

right lymphatic duct, right subclavian vein

Question 14

The _____ _____, on the left, is _____ and _____. It begins as a prominent sac in the abdomen called the ____ ____, receives lymph from below the diaphragm, left arm, left side of head, neck, and thorax, and empties into the ____ _____ ____.

Answer 14

thoracic duct, larger, longer, cisterna chyli, left subclavian vein

Question 15

Lymph flows at even lower pressure and speed than ____ _____. The flow is aided by the ______ _____ _____. Exercise greatly _____ lymphatic return. _____ _____ rhythmically squeeze lymphatic vessels.

Answer 15

venous blood, skeletal muscle pump, increases, arterial pulsation

Question 16

The ____ _____ aids flow from abdominal to thoracic cavity. Valves prevent ______ flow. Rapidly flowing blood in _____ ____, draws lymph into it.

Answer 16

thoracic pump, backward, subclavian veins

Question 17

______ ______ cells are large lymphocytes that attack and destroy bacteria, transplanted tissue, and host cells that are infected with viruses or have turned cancerous. They are responsible for ______ ______. These are not involved in specific defense like the ___ and ____ cells.

Answer 17

Natural killer (NK), non-specific surveillance, T, B

Question 18

___ _______ are lymphocytes that mature in the thymus.

Answer 18

T lymphocytes (T cells)

Question 19

___ ______ are lymphocytes that differentiate into plasma cells – connective tissue cells that secrete the _________ of the immune system.

Answer 19

B lymphocytes (B cells), antibodies

Question 20

All lymphocytes originate in ____ ____ ____.

Answer 20

red bone marrow

Question 21

T-cell precursors travel to the ______ to differentiate into T-cells.

Answer 21

Thymus

Question 22

B-cells originate in ____ ____ ____ and migrate to the _____ and lymph nodes.

Answer 22

red bone marrow, spleen

Question 23

The red bone marrow and thymus are regarded as _____ _____ _____ because they are the sites where B and T lymphocytes become ________: able to recognize and respond to antigens.

Answer 23

primary lymphatic organs, immunocompetent

Question 24

The lymph nodes, tonsils, and spleen are called _____ _____ _____ because they are populated with _________ lymphocytes.

Answer 24

secondary lymphatic organs, immunocompetent

Question 25

The _____ is a member of the endocrine, lymphatic, and immune systems. It houses developing ________ and secretes ______ that regulate their later activity. There is remarkable ______ with age.

Answer 25

thymus, lymphocytes, hormones, degeneration

Question 26

______ _____ are the most numerous lymphatic organs, numbering about ____ in a typical young adult. They serve two functions: to cleanse the _____ and to act as a site for ___ and ___ cell activation. ___ cells multiply and differentiate into plasma cells.

Answer 26

Lymph nodes, 450, lymph, T, B, B

Question 27

Several ____ ____ ____ lead into the lymph node along its convex surface. Lymph leaves the node through one to three _____ _____ ____ that leave the hilum.

Answer 27

afferent lymphatic vessels, efferent lymphatic vessels

Question 28

______ lymph nodes occur in deep and superficial groups in the neck, and monitor lymph coming from the head and neck.

Answer 28

Cervical

Question 29

_______ lymph nodes are concentrated in the armpit and receive lymph from the upper limb and the female breast.

Answer 29

Axillary

Question 30

______ lymph nodes occur in the thoracic cavity, especially embedded in the mediastinum, and receive lymph from the mediastinum, lungs, and airway.

Answer 30

Thoracic

Question 31

_______ lymph nodes occur in the posterior abdominopelvic wall and monitor lymph from the urinary and reproductive systems.

Answer 31

Abdominal

Question 32

________ and _______ lymph nodes are found in the mesenteries and adjacent to the appendix and intestines; they monitor lymph from the digestive tract.

Answer 32

Intestinal, mesenteric

Question 33

_______ lymph nodes occur in the groin and receive lymph from the entire lower limb.

Answer 33

Inguinal

Question 34

_______ lymph nodes occur at the back of the knee and receive lymph from the leg proper.

Answer 34

Popliteal

Question 35

The collective term for all lymph node diseases is ________.

Answer 35

lymphadenopathy

Question 36

Swollen, painful node responding to foreign antigen

Answer 36

lymphadentis

Question 37

Lymph nodes are common sites of ______ _____. Cancerous lymph nodes are wollen but relatively _____ and usually _______.

Answer 37

metastatic cancer, firm, painless

Question 38

_________ is a phenomena in which cancerous cells break free of the original _____ tumor, travel to other sites in the body, and establish new tumors.

Answer 38

Metastasis

Question 39

Metastasizing cancer cells can easily enter the ______ vessels. They tend to spread to the next node _______.

Answer 39

lymphatic, downstream

Question 40

The _______ is the body’s largest lymphatic organ. It produces blood cells in the _____. It is a blood ______. It is an “______ ______” - old fragile RBCs rupture as they squeeze through the capillary walls into the sinuses. Lymphocytes and macrophages of the white pulp monitor the blood for foreign ______.

Answer 40

spleen, fetus, reservoir, erythrocyte graveyard, antigens

Question 41

________ are environmental agents capable of producing disease. They include _____ _____, _____ _____, and _______.

Answer 41

Pathogens, infectious organisms, toxic chemicals, radiation

Question 42

The first line of defense consists of _______ _____, notably the skin and mucus membranes.

Answer 42

external barriers

Question 43

The second line of defense consists of several _______ _____ ______ against pathogens that break through the skin or mucus membranes. These defenses include _______ and _______, antimicrobial ______, immune _______, inflammation, and fever. They are effective against a wide range of pathogens.

Answer 43

nonspecific defense mechanisms, leukocytes, macrophages, proteins, surveillance

Question 44

The third line of defense is the _________ system, which not only defeats a pathogen but leaves the body with a ______ of it, enabling us to defeat it quickly in the future.

Answer 44

immune, memory

Question 45

With exceptions such as the axillary and pubic areas, the skin is too ____ and poor in ____ to support much microbial growth.

Answer 45

dry, nutrients

Question 46

______ are peptides that kill microbes by creating holes in their membranes.

Answer 46

Defensins

Question 47

The skin is also covered with a thin film of lactic acid ( the _____ _____) from sweat, which inhibits bacterial growth.

Answer 47

acid mantle

Question 48

Mucous physically traps _______.

Answer 48

microbes

Question 49

Mucus, tears, and saliva also contain _______, and enzyme that destroys bacteria by dissolving their cell walls.

Answer 49

lysozyme

Question 50

_________ spend most of their time wandering in the connective tissues killing bacteria. _________ are found especially in the mucous membranes, standing guard against parasites, allergens (allergy-causing antigens), and other pathogens. _______ secrete chemicals that aid the mobility and action of other leukocytes.

Answer 50

Neutrophils, Eosinophils, Basophils

Question 51

______ is an abnormal elevation of body temperature. _______is a local defensive response to tissue injury of any kind, including trauma and infection. The four cardinal signs are ____, _____, ____, and _____.

Answer 51

Fever, Inflammation, redness, swelling, heat, pain

Question 52

Antimicrobial proteins are know as ______ and the ______ ______.

Answer 52

interferons, complement system

Question 53

When certain cells (especially leukocytes) are infected with viruses, they secrete proteins called ________. These bind to _____ receptors of neighboring cells and activate _______-_______ systems within. They break down viral genes or prevent _________.

Answer 53

interferons, surface, second-messenger, replication

Question 54

Interferons activate ____ ____ cells and _______, which destroy infected cells before they can liberate a swarm of newly replicated ______. Activated ____ ____ cells destroy _____ cells.

Answer 54

NK, macropages, viruses, NK, malignant

Question 55

The ______ ______ is a complicated enzyme cascade made up of numerous serum glycoproteins. Each enzyme cascade has a similar terminal sequence which creates the ____ _____ _____.

Answer 55

complement system, membrane attack complex

Question 56

______ ______ is a phenomena in which natural killer (NK) cells continually patrol the body on the lookout for pathogens and diseased host cells.

Answer 56

Immune surveillance

Question 57

______ _____ cells attack and destroy bacteria, cells of transplanted organs, cells infected with viruses, and cancer cells.

Answer 57

Natural killer

Question 58

Upon recognition of an enemy cell, the NK cell binds to it and releases proteins called ______, which polymerize in a ring and create a hole in the plasma membrane.

Answer 58

perforins

Question 59

The NK cell also secretes a group of protein-degrading enzymes called _______, which enter the pore made by the perforins. Inside the enemy cell, the _______ destroy cellular enzymes and induce ________.

Answer 59

granzymes, granzymes, apoptosis

Question 60

Two characteristics distinguish immunity from nonspecific resistance: __________: Immunity is directed against a particular pathogen. _______: When reexposed to the same pathogen, the body reacts so quickly that there is no noticeable illness.

Answer 60

Specificity, Memory

Question 61

______ ______ (T-cells) employs lymphocytes that directly attack and destroy foreign cells or diseased host cells. It is a means of ridding the body of pathogens that reside ______ human cells, where they are inaccessible to antibodies.

Answer 61

Cellular (cell-mediated) immunity, inside

Question 62

________ _______ (B cells) is mediated by antibodies, which do not directly destroy a pathogen. It is an _______ attack in which antibodies, not the immune cells, assault the pathogen. This can work only against the _______ stages of infectious microorganisms.

Answer 62

Humoral (antibody-mediated) immunity, indirect, extracellular

Question 63

T-cells are exposed to antigens after a _______ destroys the pathogen.

Answer 63

macrophage

Question 64

Once exposed to antigen debris, the T-cell _____ and ______.

Answer 64

divides, specializes

Question 65

Cellular involves what four classes of T cells?

Answer 65

cytotoxic (Tc), helper (TH), regulatory (TR), and memory (TM)

Question 66

_____ cells are the “effectors” of cellular immunity that carry out the attack on enemy cells. They are called the killer T cells, but are not the same as natural killer cells.

Answer 66

Cytotoxic T (Tc)

Question 67

______ cells promote the action of Tc cells as well as playing key roles in humoral immunity and nonspecific resistance.

Answer 67

Helper T (TH)

Question 68

_______ cells inhibit multiplication and cytokine secretion by other T cells and thus limit immune responses.

Answer 68

Regulatory T (TR)

Question 69

__________ cells are descended from the cytotoxic cells and are responsible for memory in cellular immunity.

Answer 69

Memory T (TM)

Question 70

Helper T-cells divide/differentiate into ______ cells. They produce _______ which stimulate B-cells to respond, and produce ______ T-cells which physically destroy other pathogens.

Answer 70

effector, interleukins, cytotoxic

Question 71

B-cells differentiate into _____ cells and memory cells. _____ cells produce antibodies that are specifically meant to destroy antigens (pathogens). Memory cells will _______ the specific antigen, so on the next encounter, it will produce antibodies.

Answer 71

plasma, plasma, remember

Question 72

Both cellular and humoral immunity occur in three stages that we can think of as _____, ______, and _______ (or the three rs of immunity” – ________, ______, and _______).

Answer 72

recognition, attack, memory, recognize, react, remember

Question 73

Also called an __________, an antibody is a defensive gamma globulin found in the blood plasma, tissue fluids, body secretions, and some leukocyte membranes.

Answer 73

immunoglobulin

Question 74

The V regions of a heavy chain and light chain combine to form an _______-________ ____ on each arm, which attaches to the epitope of an antigen molecule.

Answer 74

antigen-binding site

Question 75

There are five classes of antibodies named ____, _____, _____, _____, _____, named for the structure of their ___ region.

Answer 75

IgA, IgD, IgE, IgG, IgM, C

Question 76

______ is found as a monomer is plasma and mainly as a ______ in mucus, tears, milk, saliva, and intestinal secretions. It prevents pathogens from adhering to epithelia and penetrating underlying tissues. Provides passive immunity to ______.

Answer 76

IgA, dimer, newborns

Question 77

______ is a transmembrane protein of B cells; though to function in activation of B cells by antigens.

Answer 77

IgD

Question 78

_____ is a transmembrane protein of basophils and mast cells. It stimulates them to release histamine and other chemical mediators of inflammation and allergy; important in immediate hypersensitivity reactions and in attracting ________ to sites of parasitic infection.

Answer 78

IgE, eosinophils

Question 79

______ is a monomer and constitutes about ___% of circulating antibodies in plasma. The predominant antibody secreted in the secondary immune response. ____ and IgM are the only antibodies with significant complement-fixation activity. It crosses the placenta and confers temporary immunity on the _______.

Answer 79

IgG, 80, IgG, fetus

Question 80

______ is a monomer that is a transmembrane protein of B cells, but is a pentamer in ______ and ______. It is the predominant antibody secreted in the primary immune response; very strong agglutinating and complement-fixation abilities.

Answer 80

IgM, plasma, lymph

Question 81

The human immune system is capable of containing as many as ______ ______ different antibodies. There are ______ genes in the human genome (each gene can represent a different antibody protein)

Answer 81

1 trillion, 35,000

Question 82

_______ ________ forms new combinations of DNA base sequences in somatic (nonreproductive) cells.

Answer 82

Somatic recombination

Question 83

______ ______ is a process where B cells in lymph nodules rapidly mutate creating new sequences.

Answer 83

Somatic hypermutation

Question 84

When a person is exposed to a particular antigen for the first time, the immune reaction is called the ______ ______. The appearance of protective antibodies is delayed for ___ to ___ days while naive B cells multiply and differentiate into _____ cells. As the plasma cells begin secreting antibody, the _______ _______ (level of the blood plasma) begins to rise. The primary response leaves one with a immune _______ of the antigen.

Answer 84

primary response, 3, 6, plasma, antibody titer, memory

Question 85

Memory B cells mount a quick _____, or ______ response if reexposed to the same antigen. Plasma cells form within ____, so the IgG titer rises sharply and peaks with a few ____. The response is so rapid that the antigen has little change to exert a noticeable effect on the body, and no illness results. The IgG remains elevated for ____ to _____, conferring lasting protection.

Answer 85

secondary, anamnestic, hours, days, weeks, years

Question 86

Memory does not last as long in _____ immunity as it does in _______ immunity.

Answer 86

humoral, cellular

Question 87

The immune system may be too ______, too _____, or misdirected against one’s own body; known as an __________ reaction.

Answer 87

vigorous, weak, autoimmune

Question 88

There are at least ____ _____ autoimmune diseases. These include _______ arthritis, Hashimoto’s thyroiditis, _______, Ankylosing spondylitis, _______ disease, ______ _____, and Myasthenia gravis.

Answer 88

one hundred, Rheumatoid, asthma, Crohne’s, Multiple Sclerosis

Question 89

______ ______ immunity is a temporary immunity that results from acquiring antibodies produced by another person. The only natural ways for this happen are for a fetus to acquire _______ from the mother through the ______ before birth, or for a baby to acquire them during _____-_____.

Answer 89

Natural passive, antibodies, placenta, breast-feeding

Question 90

______ ______ immunity is a temporary immunity that results from the injection of an immune serum obtained from another person or from animals that produced antibodies against a certain pathogen. _______ ______ is used for emergency treatment of snakebite, botulism, tetanus, rabies, and other diseases.

Answer 90

Artificial passive, Immune serum

Question 91

______ ______ immunity is the production of one’s own antibodies or T cells as a result of natural exposure to an antigen.

Answer 91

Natural active

Question 92

________ _______ immunity is the production of one’s own antibodies or T cells as a result of vaccination against disease.

Answer 92

Artificial active

Question 93

A ________ consists of dead of attenuated (weakened) pathogens that stimulate the immune response without causing the disease.

Answer 93

vaccine

Question 94

Periodic _______ _______ are given to restimulate immune memory and maintain a high level of protection.

Answer 94

booster shots

Question 95

In _____________ diseases the immune system fails to respond vigorously enough.

Answer 95

immunodeficiency

Question 96

_________ ________ ________ disease is a group of disorders caused by recessive alleles that result in a scarcity or absence of both T and B cells. Children with _____ are highly vulnerable to opportunistic infections and must live in protective enclosures.

Answer 96

Severe combined immunodeficiency, SCID

Question 97

_______ _________ diseases are nonhereditary diseases contracted after birth. The best known example is _______ _______ _______.

Answer 97

Acquired immunodeficiency diseases, acquired immunodeficiency syndrome (AIDS)

Question 98

______ is a group of conditions that involve a severely depressed immune response caused by infection with the ______ _______ _____.

Answer 98

AIDS, human immunodeficiency virus

Question 99

_______ invades helper T cells, NK cells, macrophages and dendritic cells by “tricking” them to internalize viruses by ____ _____ endocytosis.

Answer 99

HIV, receptor mediated

Question 100

_________ transcriptase from the AIDS retrovirus uses viral ____ as template to synthesize _____ in host cells. New DNA is inserted into host cell DNA (may be dormant for _____ to ______). When activated, it induces the host cell to produce new viral ____, _____ proteins , and _____ proteins. They are coated with bits of the host cell’s plasma membrane. They adhere to new host cells and repeat the process.

Answer 100

Reverse, RNA, DNA, months, years, RNA, capsid, matrix

Question 101

By destroying ____ cells, HIV strikes at the central coordinating agent of nonspecific defense, humoral immunity, and cellular immunity. Incubation period ranges from several _____ to __ years.

Answer 101

TH, months, 12

Question 102

AIDS signs and symptoms:
– early symptoms: flulike symptoms of chills and fever
– progresses to night sweats, fatigue, headache, extreme weight loss, lymphadenitis
– normal TH count is ____ to _____cells/L of blood, but in AIDS it is less than _____ cells/L
– person susceptible to opportunistic infections (Toxoplasma,
Pneumocystis, herpes simplex virus, cytomegalovirus, or tuberculosis)
– ________: white patches on mucous membranes
– ________ _______: cancer originates in endothelial cells of blood vessels causes purple lesions in skin

Answer 102

600, 1,200, 200, Candida (thrush), Kaposi sarcoma

Question 103

HIV is transmitted through ____, _____ ____, ____ ____, or across the placenta.

Answer 103

blood, semen, vaginal secretions, breast milk

Question 104

The most common means of HIV transmission are _____ _____, contaminated ______ _____, and contaminated _______.

Answer 104

sexual intercourse, blood products, needles

Question 105

HIV is not transmitted by casual contact. Undamaged ____ _____ is an effective barrier to HIV, especially with ______.

Answer 105

latex condom, spermicide

Question 106

The strategies against HIV include efforts to prevent its binding to ____ cells, disrupting the action of _____ ______, or inhibiting the assembly of new ______ or their release from ____ cells.

Answer 106

TH, reverse transcriptase, viruses, host

Question 107

The first anti-HIV drug approved by the FDA was azidothymidine (AZT), which inhibited _____ _____. Protease inhibitors inhibit _____ HIV needs to replicate. HIV develops drug ______, so medicines are used in combination. There are now more than ____ anti-HIV drugs on the market. None can eliminate HIV, and all have serious ____-_____.

Answer 107

reverse transcriptase, enzymes, resistance, 24, side-effects

Question 108

The only lymphatic organ with both afferent and efferent lymphatic vessels is

Answer 108

a lymph node

Question 109

Which of the following cells are involved in nonspecific resistance but not in specific defense? (helper T cells, cytotoxic T cells, natural killer cells, B cells, plasma cells)

Answer 109

natural killer cells

Question 110

The respiratory burst is used by _____ to kill bacteria.

Answer 110

neutrophils

Question 111

Which of these is a macrophage? (a microglial cell, a plasma cell, a reticular cell, a helper T cell, a mast cell)

Answer 111

a microglial cell

Question 112

The cytolytic action of the complement system is most similar to the action of _____.

Answer 112

perforin

Question 113

The cardinal signs of inflammation include all of the follow except (redness, swelling, heat, fever, pain)

Answer 113

fever

Question 114

Which of the following results from a lack of self-tolerance? (SCID, AIDS, systemic lupus erythematosus, anaphylaxis, asthma)

Answer 114

systemic lupus erythematosus

Question 115

Any organism or substance capable of causing disease is called a/an _______.

Answer 115

pathogen

Question 116

Mucous membranes contain an antibacterial enzyme called _______.

Answer 116

lysozyme

Question 117

______ is a condition in which one or more lymph nodes are swollen and painful to the tough.

Answer 117

lymphadenitis

Question 118

The movement of leukocytes through a capillary or venule wall is called ________.

Answer 118

diapedesis (emigration)

Question 119

In the process of ________, complement proteins coat bacteria and serve as binding sites for phagocytes.

Answer 119

opsonization

Question 120

Any substance that triggers a fever is called a/an _________.

Answer 120

pyrogen

Question 121

The chemical signals produced by leukocytes to stimulate other leukocytes are called _______.

Answer 121

interleukins

Question 122

Part of an antibody called the ______ binds to part of an antigen called the ______.

Answer 122

antigen binding site, epitope

Question 123

Self-tolerance results from a process called ______, in which lymphocytes programmed to react against self-antigens die.

Answer 123

clonal deletion

Question 124

Any disease in which antibodies attack one’s own tissues is called a/an ______ disease.

Answer 124

autoimmune