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Lymphatic & Immune systems
J Clifford
118
Anatomy
Undergraduate 1
03/05/2012

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Term
3 functions of Lymphatic system
Definition
production and distribution of lymphocytes
Maintenance of blood volume
Alternate route for hormones & nutrients
Term
Compare and contrast lymphatic vessels and blood vessels in terms of structure and function.
Definition
the walls of lymph vessels are much thinner and more valves
the muscle layer in lymph vessel is much less developed, but there is more connective tissue;
blood capillaries form a continuous, open circuit, whereas lymph capillaries end blindly in the tissues;
lymph capillaries have a larger diameter than blood capillaries;
Term
Lymph is
Definition
the fluid that circulates throughout the lymphatic system. The lymph is formed when the interstitial fluid (the fluid which lies in the interstices of all body tissues)[1] is collected through lymph capillaries.
Term
Lymph Circulation:
Definition
Interstitial fluid is sucked into lymph capillaries (lacteals)to lymphatic collecting vessels to lymphatic trunks to the convex side of lymph nodes
Term
Cytokines (Greek cyto-, cell; and -kinos, movement) are
Definition
small cell-signaling protein molecules that are secreted by numerous cells and are a category of signaling molecules used extensively in intercellular communication
Term
A mast cell (also known as mastocyte and labrocyte[1]) is
Definition
a resident cell of several types of tissues and contains many granules rich in histamine and heparin.
Term
exudate
Definition
fluid containing clotting factors and antibodies
Term
Leukocytosis is
Definition
a raised white blood cell count
Term
CAMs
Definition
cell adhesion molecules
Term
hyperemia
Definition
congestion with blood
Term
margination is
Definition
the movement of leukocytes out of the circulatory system, towards the site of tissue damage or infection.
Term
Interferons (IFNs) are
Definition
proteins made and released by host cells in response to the presence of pathogens such as viruses, bacteria, parasites or tumor cells.
Term
hapten
Definition
incomplete antigen; allergic
Term
(MALT)
Definition
The mucosa-associated lymphoid tissue (also called mucosa-associated lymphatic tissue) is the diffusion system of small concentrations of lymphoid tissue found in various sites of the body, such as the gastrointestinal tract, thyroid, breast, lung, salivary glands, eye, and skin.
Term
Phagocytosis (from Ancient Greek φαγεῖν (phagein)
Definition
is the cellular process of engulfing solid particles by the cell membrane to form an internal phagosome by phagocytes and protists.
Term
Immunopathology:
Definition
Study of diseases resulting from dysfunctions within the immune function
Term
Lymphoid tissues:
Definition
thymus gland, spleen, lymph nodes, tonsils and adenoids, and similar tissues in the GI, respiratory, and reproductive systems
Term
B lymphocytes (B cells) :
Definition
important in producing circulating antibodies
Term
T lymphocytes (T cells):
Definition
mature into several types of cells capable of different functions
Term
Spleen:
Definition
acts like a filter, composed of red and white pulp
Term
Red pulp:
Definition
old and injured RBC’s are destroyed
Term
White pulp:
Definition
contains concentrations of lymphocytes
Term
Lymph nodes:
Definition
Connected by lymph channels and capillaries that remove foreign material from the lymph before it reaches the bloodstream
Centers for immune cell proliferation
Tonsils and adenoids also contain immune cells that defend the mucosal surfaces
Term
Natural (innate)Immunity:
Definition
nonspecific immunity present at birth
Provides a nonspecific response to any foreign invader regardless of what it is
Term
Acquired (adaptive)Immunity:
Definition
acquired during life, usually through immunizations or acquiring the disease
Term
Active acquired immunity:
Definition
immunologic defenses are developed by the person’s own body
Term
Passive acquired immunity:
Definition
acquired from other sources ie. In utero, breastfeeding, immune globulins and antiserums which are obtained from people with acquired immunity to diseases
Term
Granulocytes (cells):
Definition
neutrophils, eosinophils, basophils
Term
Granulocytes/purpose:
Definition
releases cell mediators such as histamine, bradykinin, and prostaglandins and engulf foreign bodies and toxins
Term
Non granulocytes:
Definition
(monocytes, lymphocytes)
Term
Monocytes:
Definition
phagocytic cells
Term
Lymphocytes:
Definition
B cells and T cells
Term
Inflammatory Response
Definition
Chemical mediators assist in minimizing blood loss, walling off invading organism, activating phagocytes, promoting formation of fibrous scar tissue and regeneration of injured tissue
Term
Phagocytic Immune Response:
Definition
First line of defense
WBC’s (granulocytes and macrophages) ingest foreign particles and the body’s own dying or dead cells
Term
Antibody Response:
Definition
B lymphocytes (B cells): manufacture antibodies
Term
Antibodies:
Definition
highly specific proteins transported in the bloodstream and disable foreign invaders
Term
Antigen:
Definition
small patch of proteins on the outer surface of the microorganism
Term
Cellular Immune Response:
Definition
Involves the T lymphocytes which turn into cytotoxic (or killer) T cells that attack the pathogens themselves
Term
Recognition Stage:
Definition
First step is the body recognizing antigens as foreign invaders
Uses lymph nodes and lymphocytes for surveillance
Foreign materials enter body, lymphocytes come into physical contact with the physical surface of the materials, removes antigen from surface or picks up imprint when re-exposed
Term
Proliferation Stage:
Definition
Circulating lymphocyte containing antigenic message returns to nearest lymph node
Stimulates dormant T and B lymphocytes to enlarge, divide, and proliferate
T cells turn into killer T cells
B cells produce and release antibodies
Lymph nodes enlarge
Term
Response Stage
Definition
Changed lymphocytes function as either humoral or cellular fashion
Humoral response – B cells
Cellular response – T cells
Sensitized lymphocytes return to lymph nodes and stimulate residing lymphocytes to become cells that will attack (killer T cells) or
Humoral response causes antibodies to be created
Term
Effector Stage:
Definition
Either the antibody of the humoral response or the killer T cell of the cellular response reaches and couples with the antigen on the surface of the foreign invader
Term
Antibodies:
Definition
Large proteins called immunoglobulins
Contains binding sites to specific antigens
Term
Agglutination:
Definition
causes clumping of antigens and facilitates phagosytosis
Term
Opsonization:
Definition
antigen-antibody molecule coated with sticky substance which facilitates phagocytosis
Term
Immunoglobulins
Definition
IgG (75%)
IgA (15%)
IgM (10%)
IgD (0.2%)
IgE (0.004%)
Guarding Against Many Different Enemies
Term
Helper T cells:
Definition
lymphocytes that attack foreign invaders (antigens) directly and stimulate the rest of the immune system
Term
Cytotoxic T cells (killer T cells): e
Definition
lymphocytes that lyse cells infected with virus by altering cell membrane
Term
Suppressor T cells:
Definition
lymphocytes that decrease B cell activity to a level at which the immune system is compatible with life
Term
Complement system
Definition
Defends the body against bacterial infection
Bridging natural and acquired immunity
Disposes of immune complexes and the by-products associated with inflammation
Term
Ionization:
Definition
Targeting of the antigen so that it can be easily engulfed and digested by the macrophages and other phagocytic cells
Term
Anaphylaxis:
Definition
activation of mast cells and basophils with release of inflammatory mediators that produce smooth muscle contraction and increased vascular permeability
Term
Interferons:
Definition
Have antiviral and antitumor properties
Produced by T cells, B cells, and macrophages
Modify immune response by suppressing antibody production and cellular immunity
Facilitate cytolytic role of macrophages and natural killer cells
Term
Protein depletion results in :
Definition
atrophy of lymphoid tissues, depressed antibody response, decreased T cell production and impaired phagocytic function
Term
Hypersensitivity:
Definition
is an abnormal heighten reaction to any type of stimuli. Reactions commonly do not happen on first exposure. They usually follow after an antibody reaction has taken place
Term
Primary Immunodeficiencies:
Definition
Rare disorders with genetic origins
Symptoms develop when protection from maternal antibodies decreases
Without treatment, infants and children with these disorders seldom survive to adulthood
Term
HIV/Primary infection:
Definition
Period from infection with HIV to the development of antibodies to HIV
Intense replication of virus and wide dissemination of HIV throughout body
Symptoms range from none to flu-like symptoms
During this window, person will test negative on the HIV antibody test
Term
By the time the HIV antibodies are detectable
Definition
(3 weeks or so) the virus is firmly established in the host
Term
HIV Viral set point:
Definition
balance between the amount of HIV in the body and the immune response which results in a steady state of infection
Term
During steady state the amt of HIV virus in circulation and number of infected cells equal:
Definition
the rate of viral clearance
Term
The higher the HIV viral set point...
Definition
the poorer the prognosis
Term
HIV/CDC category A:
Definition
more than 500 CD4 +T lymphocytes
Reaches viral set point, a chronic, clinically asymptomatic state begins
Starts about 6 months after infection and lasts about 8-10 years
Term
HIV/CDC category B:
Definition
200-499 CDC4+ T lymphocytes
Person becomes symptomatic and may include illnesses such as:Candidiasis (oropharyngeal, vulvovaginal), cervical dysplasia, fever (38.5C), diarrhea over 1 month, hairy leukoplakia (oral), herpes zoster, ITP, listeriosis, PID, peripheral neuropathy
Term
Candidiasis
Definition
Yeast Infection
Term
HIV/CDC category C:
Definition
less than 200 CD4+ T lymphocytes;Now patients have AIDS. patient reaches Category C they remain in Category C
This classification has implications for disability benefits, housing and food stamps. Candidiasis of bronchi, trachea, lungs, or esophagus
Invasive cervical cancer
CMV
Encephalopathy
Kaposi’s sarcoma
Lymphoma
Wasting syndrome
Term
HIV antibody tests:
Definition
3-12 weeks will test positive
Term
Viral load tests:
Definition
tracks viral load and response to treatment
Term
HIV/Treatment decisions based on:
Definition
viral load, CD4 T-cell count, and clinical condition of the patient
Term
Anti-HIV drugs attempt to:
Definition
block viral replication within cells
Term
Sample Nursing Diagnoses:
Definition
Impaired skin integrity
Risk for infection
Activity intolerance
Ineffective airway clearance
Pain
Social isolation
Imbalanced nutrition
Grieving
Knowledge deficit
Term
Sample Nursing Interventions:
Definition
Promote skin integrity
Promote usual bowel habits
Preventing infection
Improving nutritional status
Decreasing the sense of isolation
Coping with grief
Improving activity tolerance
Maintaining thought processes
Improving airway clearance
Relieving pain and discomfort
Term
Nutrition/AIDS
Definition
small, frequent, nutrient rich meals low in fluid intake b/c nausea/vomiting
Term
Cachexia
Definition
wasting syndrome
Term
Allergic Reaction:
Definition
Manifestation of tissue injury resulting from interaction between an antigen and an antibody
Term
Allergy:
Definition
inappropriate and often harmful response of the immune system to normally harmless substances
Term
Allergen:
Definition
the substance you are allergic to
Term
Atopy or atopic syndrome is :
Definition
a predisposition toward developing certain allergic hypersensitivity reactions.
Term
Antigen:
Definition
substance that induces the production of antibodies
Term
Antibody:
Definition
protein substance developed by the body in response to and interacting with a specific antigen, protects against antigens
Term
Uticaria:
Definition
hives
Term
Immunoglobulins:
Definition
Family of closely related proteins capable of acting like antibodies
Term
Mast cells:
Definition
connective tissue cells that contain heparin and histamine in their granules, produces of allergic skin reactions, asthma, and hay fever
Term
Sample Antihistamines:
Definition
Benadryl, Claritin, Zyrtec, Allegra, Zantac, Tagamet
Term
Histamine:
Definition
substance in the body, released from mast cells, that causes increased gastric secretion, dilation of capillaries, and constriction of the bronchial smooth muscle
Term
Leukotrienes:
Definition
Lipid signaling molecules that moderate the inflammatory response. Cause smooth muscle contraction, bronchial constriction, mucous secretion in the airways and hives
More potent than histamine in causing bronchospasm
Term
Leukotriene antagonists:
Definition
Singulaire, Accolate
Term
Anaphylactic (Type I) Hypersensitivity
Definition
Systemic reaction is characterized by edema in many tissues including the larynx, and is often accompanied by hypotension
Term
Anaphylaxis:
Definition
Characterized by vasodilation, increased capillary permeability, smooth muscle contraction, and eosinophilia
Term
Anaphylaxis/Systemic Reactions:
Definition
laryngeal stridor, angioedema, hypotension, and bronchial, GI, or uterine spasm
Term
Stridor is:
Definition
a high pitched wheezing sound resulting from turbulent air flow in the upper airway.
Term
Cytotoxic (Type II) Hypersensitivity:
Definition
Occurs when the system mistakenly identifies a normal constituent of the body as foreign; Occurs in Myasthenia Gravis where the body mistakenly generates antibodies against normal nerve ending receptors
Rh incompatibility in newborns and transfusion reactions are other examples
Term
Immune Complex (Type III) Hypersensitivity:
Definition
Involves immune complexes formed when antigens bind to antibodies
Complexes are then cleared from circulation by phagocytic action
When complexes are deposited into tissues or vascular endothelium, injury occurs
Joints and kidneys are particularly susceptible to this kind of reaction
Term
Delayed-Type (Type IV) Hypersensitity:
Definition
Occurs 24-48 hours after exposure to allergen
Mediated by sensitized T cells and macrophages
Sensitized T cells react with the antigen or purified protein derivative (PPD) at or near the site of injection
Signs and symptoms: erythema and itching are common
Examples: contact dermatitis, graft-vs-host disease, Hashimoto’s thyroiditis, and
Term
Contact Dermatitis:
Definition
Type IV delayed hypersensitivity reaction, acute or chronic skin reaction
Allergic
Irritant
Phototoxic
Photoallergic
Symptoms include: itching, burning, erythema, and edema followed by weeping, crusting and finally drying and peeling of skin
Term
Atopic Dermatitis:
Definition
Type I hypersensitivity reaction
Family history is common
Significant elevations in IgE and eosinophils
Large amounts of Histamine in skin
Excessive dryness with resultant itching
Chronic with remissions and exacerbations
Term
Dermatitis Medicamentosa:
Definition
Type I hypersensitivity reaction
Skin rash induced by the internal administration of certain medications
Rashes are the most common adverse reactions to medications and occur in approximately 2-3% of all hospitalized patients
Patients advised not to take drug again
Term
Urticaria (hives) is
Definition
a type I hypersensitive allergic reaction characterized by pink, edematous elevations that vary in size and shape, itchy and uncomfortable
Term
Angioneurotic edema:
Definition
involves the deeper layers of skin resulting in more diffuse swelling rather than discrete lesions
Term
Food Allergies:
Definition
Type I hypersensitivity reaction
Occurs in 0.1% to 7% of the population
Can cause mild allergy symptoms to anaphylaxis
Term
Latex allergy:
Definition
Allergic reaction to natural rubber proteins
Causes rhinitis, conjunctivitis, contact dermatitis, urticaria, asthma, and anaphylaxis
Term
Rheumatic Diseases:
Definition
More than 100 different types of disorders that primarily affect skeletal muscles, bones, cartilage, ligaments, tendons, and joints of males and females of all ages
Can be monoarticular or polyarticular
Inflammatory or noninflammatory
Term
Rheumatoid Arthritis
Definition
Autoimmune reaction primarily in synovial tissues
Phagocytosis produces enzymes within the joint
Enzymes break down collagen, causing edema, proliferation of the synovial membrane and ultimately pannus formation Pannus destroys cartilage and erodes the bone
This results in loss of articular surfaces and joint motion
Muscle fibers undergo degenerative changes
Tendon and ligament elasticity and contractile power are lost
Term
Rheumatoid Arthritis/SS
Definition
Joint pain, swelling, warmth, erythema, and lack of function are classic signs
Palpation of joint reveals spongy or boggy tissue
Fluid can usually be aspirated
Starts with small joints such as hands, wrists, and feet and then progresses to knees, shoulders, hips, elbows, cervical spine and TMJ. Joints become hot, swollen, and painful and are not easily moved
Patient tends to guard or protect joints through immobilization which can then cause contractures
Deformities of hands and feet are common
Term
Rheumatoid nodules :
Definition
develops in up to 50% of patients, usually nontender and moveable in SQ tissue
Term
RA diagnostics:
Definition
Positive rheumatoid factor
ESR elevated
RBC and CD4 are decreased
C-reactive protein and ANA may be positive
Arthrocentesis shows cloudy or milky synovial fluid
X-rays show bony erosions and narrowed joint spaces
Term
RA/treatment/early
Definition
Therapeutic doses of salicylates and NSAIDS
Antimalarials, gold, penicillamine or sulfasalazine
Methotrexate
Biologic response modifiers such as Enbrel and Remicade
Term
RA/treatment/moderate:
Definition
formal program of OT and PT to protect joints, pacing activities, work simplification, ROM, and muscle-strengthening exercises
Continue medication regime, add cyclosporine to enhance methotrexate
Term
RA/treatment/persistant:
Definition
reconstructive surgery and corticosteroids
Synovectomy: excision of synovial membrane
Tenorrhaphy: suturing a tendon
Arthrodesis: surgical fusion of the joint
Arthroplasty: surgical repair and replacement of the joint
Term
RA/treatment/advanced:
Definition
immunosuppressive agents such as high-dose Methotrexate, cyclophosphamide, and azathioprine
These are highly toxic meds and can produce bone marrow suppression, anemia, GI disturbances and rashes
Term
Systemic Lupus Erythematous:
Definition
is a Type III hypersensitivity reaction caused by antibody-immune complex formation.

SLE most often harms the heart, joints, skin, lungs, blood vessels, liver, kidneys, and nervous system. The course of the disease is unpredictable, with periods of illness (called flares) alternating with remissions. The disease occurs nine times more often in women than in men, especially in women in child-bearing years ages 15 to 35, and is also more common in those of non-European descent.
Term
Lupus (SLE)/causes/drugs:
Definition
hydralazine, procainamide, isoniazid, chlorpromazine, and some anto-seizure meds have been implicated in drug-induced SLE.. a (generally) reversible condition that usually occurs in people being treated for a long-term illness.
Term
Lupus and MS: What’s the Difference?
Definition
are both autoimmune diseases. Lupus triggers a response from the immune system that may attack various organs in the body. Multiple sclerosis, on the other hand, attacks myelin, the fatty protective layer over nerves fibers in the brain and spinal cord.
Term
Lupus/phamatherapy:
Definition
NSAIDS
Corticosteroids
Antimalarials
Immunosuppressive agents
Term
Gout:
Definition
a kind of arthritis that occurs when uric acid builds up in blood and causes joint inflammation.
Term
Gout/diagnoses:
Definition
light microscopy of the synovial fluid, acid crystals are seen within the polymorphonuclear leukocytes
Term
Gout/treatment:
Definition
Colchicine or NSAIDS are the treatment
For repeated episodes may treat prophylactically
Term
Fibromyalgia:
Definition
a common syndrome in which a person has long-term, body-wide pain and tenderness in the joints, muscles, tendons, and other soft tissues.
Term
Fibromyalgia/treatment:
Definition
NSAIDS
Tricyclics
Lyrica, Savella
Exercise
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