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A&P 2 - E2 - P2
A&P 2 - Exam 2 - Part 2 - Lymphatic System
| Question | Answer |
|---|---|
| Two roles of the lymphatic system are _____________. | maintaining fluid balance and role in immunity |
| The LS plays a role in maintaining ____________ balance. | fluid |
| The LS returns _____________ fluid to blood. | interstitial |
| In the LS, excess fluid is NOT returned to ___________. | capillaries |
| The LS returns __________ to blood that incidentally leak from ____________. | proteins, capillaries |
| The LS is essential in maintaining _____________ pressure in the blood. | osmotic |
| If fluid is not returned to blood ___________ and death will result. | edema |
| The lymphatic system returns _______ and other substances to the blood. | fats |
| ____________ fluid fills the spaces between cells. | interstitial |
| Interstitial fluid is formed from ______________ leaking from capillaries. | blood plasma water |
| Interstitial fluid can also be formed by small amounts of __________ and other molecules that leak from capillaries. | protein |
| ___________ is a type of fluid found in lymphatic vessels. | lymph |
| ___________ is formed by interstitial fluid mixing with __________ after entering the lymphatic capillaries. | lymph, protein |
| What are the three substances that compose lymph? | water, protein, fat and other substances |
| Both __________ and ___________ fluid resemble blood plasma in composition. | lymph, interstitial |
| __________ are a type of lymphatic capillary that act as lymphatic drains in the intestines. | lacteals |
| Lymphatic capillaries begin as _________ ended capillaries. | blind |
| Endothelial cells of lymphatic capillaries are attached to tissue by connective tissue ___________. | filaments |
| Endothelial cells of lymphatic capillaries are attached to tissue by ____________ filaments. | connective tissue |
| In lymphatic capillaries pores between _____________ cells open as the volume of interstitial fluid ___________. | endothelial, increases |
| ___________ of lymphatic capillaries exist in tissues. | networks |
| The structure of lymphatic vessels resembles veins except, lymphatics have ______________ walls. | thinner |
| The structure of lymphatic vessels resembles veins except, lymphatics contain more _________. | valves |
| The structure of lymphatic vessels resembles veins except, lymphatics contain __________ nodes. | lymph |
| Lymphatic pumps are ___________ valves in lymphatics. | one-way |
| Five things that cause the movement of lymphatic pumps are ____________. | breathing, skeletal muscle contractions, arterial pulsations, postural changes, massage of soft tissue |
| Two functions of the lymph nodes are _________________. | defense, hematopoiesis |
| Two ways the lymph nodes function in defense are _____________. | filtration, phagocytosis |
| The lymph node is the site in hematopoiesis, where maturation of some lymphocytes and monocytes that migrated from ___________ occurs. | red marrow |
| The lymph node is the site in hematopoiesis, where maturation of some ________ and ________ that migrated from red marrow occurs. | lymphocytes, monocytes |
| The three tonsils are ____________. | palatine, pharyngeal and lingual |
| What tonsils are known commonly as the "tonsils" and are located on the left and right side of the back of the mouth? | palatine tonsils |
| Concerning the function of the thymus, immature ____________ formed in ___________ move to the thymus. | lymphocytes, red marrow |
| In the thymus, lymphocytes mature and are distributed to the _______, _________, and __________ before birth. | spleen, lymph nodes, lymphoid tissue |
| After birth the thymus secretes ___________. | thymosin |
| Thymosin, secreted by the thymus, enables lymphoctyes to develop into ___________. | T cells |
| In the spleen, blood first enters the __________ which is full of ____________. | white pulp, lymphocytes |
| In the spleen, after blood enters the white pulp it then enters the ___________. | red pulp |
| In the spleen, after blood enters the red pulp it then enters __________ and then into ________. | venous sinuses, veins |
| The spleen functions in hematopoiesis by the maturation of _________ and _________. | lymphocytes, monocytes |
| The spleen functions in hematopoiesis by forming _________ before birth. | red blood cells |
| Most organs containing developing lymphocytes quit growing at _________. | puberty |
| Lymphatic organs including the thymus, lymph nodes, and tonsils __________ over time. | atrophy |
| Which lymphatic organ remains intact and does NOT atrophy over time? | spleen |
| Structures of the Lymphatic System | Lymph Nodes, Tonsils, Spleen, Thymus, Red Bone Marrow |
| Begins to atrophy around the age of 14 | Thymus |
| Functions of the Lymphatic System | Maintenance of fluid balance, Absorption of fats, Immunity |
| How the lymphatic system maintains fluid balance | Absorbs remaining fluid in tissues and returns it to the bloodstream |
| Where does the lymphatic system absorb fats | Small intestines |
| Lymph nodes and lymphatic organs filter what out of lymph | Microorganisms and foreign particles |
| The loosely overlapping epithelial cells of the lymphatic vessels allow for what? | Quick diffusion |
| What do the protein filaments do? | Anchor the vessel to surrounding tissue to support the vessel and keep it from collapsing |
| Lymph on its way back to the heart is filtered where? | Lymph nodes |
| How do lymph nodes remove bacteria and other foreign particles? | Phagocytosis |
| Where do B-cell lymphocytes mature and what kind of response | Bone marrow where they differentiate into plasma cells which produce antibodies. Antibody-mediated response=extracellular pathogens, like bacteria (15%) |
| Where do T-cell lymphocytes mature and what kind of response | Thymus. Cell-mediated response= intracellular pathogens, like viruses, some cancer cells, and tissue transplants (80%) |
| What is contained inside a lymph node? | Macrophages |
| Why would a lymph node swell? | When breaking down foreign particles. |
| What is in the red pulp of the spleen? | Erythrocytes. |
| What is in the white pulp of the spleen? | Masses of lymphocytes |
| What are the functions of the spleen? | Immunity, Destruction of old RBCs Blood storage, Hematopoiesis |
| How does the spleen provide immunity | White pulp screens the blood for foreign antigens. |
| What are the three lines of defense for the immune system? | First: External Barriers Second: Nonspecific Immunity Third: Specific Immunity |
| What is Nonspecific immunity? | The production of phagocytic WBCs, the triggering of inflammation and fever (aims broad range of pathogens) |
| What is Specific immunity and what are the two types | When the body retains a memory of a pathogen, and specific antibodies respond if the pathogen is reintroduced (aims specific pathogens.)/passive & active |
| What are Natural killer cells? | Unique groups of lymphocytes that roam the body seeking pathogens or disease cells that attack self-cells (5%) |
| What is a lysozyme? | An enzyme that destroys bacteria found in mucus, tears, and saliva. |
| What is chemotaxis and when does it happen | When inflamed cells release a chemical that summons neutrophils/step 3 in mobilization of defenses |
| What do Interferons do? | Polypeptides that prevent viral replication by attacking viruses. Stimulates destruction of cancer cells. (produced from lymphocytes and macrophages) |
| What do the complement proteins do? | Inactive proteins in blood plasma, and when activated by pathogens, enhance immune, allergic, and inflammatory reactions by attacking bacteria. |
| Histamine is a _________ and increases ____________ | Vasodilator/capillary permeability |
| What kind of immunity is inflammation? | Nonspecific Immunity |
| What is ischemia? | Lack of O2 in the tissue |
| What is the term for fever and what kind of immunity | Pyrexia/nonspecific |
| What is a pyrogen? | A chemical produced by neutrophils and macrophages that stimulates the anterior hypothalamus to secrete PGE (prostaglandin E) (promotes fever) |
| What does PGE (Prostaglandin E) do? | Resets the body's temperature set point. |
| What are the four signs of inflammation? | Swelling, Redness, Heat, Pain/Tenderness |
| Why does swelling occur in inflammation? | increased capillary permeability and filtration causes fluid to leak out of vessels (edema) |
| Why does redness/heat occur in inflammation? | Blood rushes to the area (hyperemia) (erythema) |
| What happens when pain and tenderness occur in inflammation? | Inflammatory chemicals (bradykinin & prostaglandins) secreted by damaged cells puts pressure on nerves from swelling |
| What is Cellular (cell-mediated) immunity? | Antibodies attack/destroy/kill cells that have been infected (host cells). (uses T-cells) |
| What is Humoral (antibody-mediated) immunity? | Antibodies attack/destroy/kill pathogens outside of the cell in the plasma or on the surface of the cell (uses B-cells) |
| What is active immunity? | When the body makes its own antibodies or T-cells (long term) |
| What is passive immunity? | When immunity results from an injection of antibodies from another person or animal (short term) |
| What is natural active immunity? | When the body produces one's own antibodies or T cells in response to a pathogen (memory cells) |
| What is artificial active immunity? | When the body produces one's own antibodies or T cells in response to a vaccine. (memory) |
| What is natural passive immunity? | When a fetus or baby temporary acquires antibodies from the mother through the placenta or breastfeeding. (no memory) |
| What is artificial passive immunity? | When someone receives serum containing antibodies from a person or animal through an injection (antibodies) snakebite, rabies, and tetanus (no memory) |
| What are some examples of conditions that would call for artificial passive immunity? | AIDS, rabies, botulism |
| What do cytotoxic t-cells do? | Carry out the attack |
| What do helper t-cells do? | Help promote t cells and b cell action, support cytotoxic t-cells, secrete chemicals to trigger chemotaxis |
| What do memory t-cells do? | Remember the pathogen in case of future invasion. |
| How do the B-cells stop antigens? | Secreting antibodies that stop antigens. |
| What is an allergy? | Hypersensitivity of the immune system to an environmental substance that normally is not a problem. |
| What is produced upon the first exposure to an allergen? | Immunoglobulins (IgG) (Antibodies) |
| Type 2 hypersensitivity | Antibody-dependent, cytotoxic. IgM or IgG binds to antigens on cells and lyses them through complement fixation; transfusion reaction. (myasthenia gravis) |
| Type 1 (acute) hypersensitivity signs and symptoms | Anaphylaxis; Basophils produce inflammatory chemicals; Constriction of airways, vasodilation, Red, itchy, raised rash, swelling of face, lips, tongue, watery eyes, runny nose |
| What is anaphylactic shock? | Immediate allergic reaction that worsens to the point of circulatory shock and maybe even sudden death. |
| What is Diapedesis and when does it happen | Leukocytes squeeze between endothelial cells into tissue space/step 2 in mobilization of defenses |
| What is Margination and when does it happen | Leukocytes adhere to blood vessel walls (cell adhesion molecules.)/step 1 in mobilization of defenses |
| Mobilization of defenses | WBCs travel to and accumuate near vessel walls, but do not touch (margination), cells adhere to wall, then squeezes its way through the wall (diapedesis), then WBCs go through chemotaxis leading them to site of injury where they begin phagocytosis |
| What is serotonin | Secreted by basophils (during inflammation) and it is a vasoconstrictor |
| Inflammation | Heparin=anticoagulant. Histamine acts fast causing vasodilation and increase in capillary permeability. Serotonin vasoconstricts down stream causing more pressure and fluid near cell damage to send the bacteria to LS instead of further down the vessel. |
| Phagocytosis | Microbes adheres to outside of Phagocyte (macrophage) and phagocyte ingests (endocytosis) microbe (phagosome) where it fuses with lysosomes (phagolysosome)digests enzymes, last, exocytosis dead material out of cell/keep if antigens are present |
| Lymph flow mechanisms | Flows at low pressure/speed. Flow aided by skeletal muscle pump. Valves prevent backflow. Rapid flowing blood in subclavian veins draws lymph in. |
| What significantly increases lymph fluid return | Exercise |
| What lymphatic cells are antigen presenting cells | Macrophages, dendritic cells, reticular cells |
| Resistance | The ability to ward off a disease |
| Nonspecific (innate immune system) resistance | General defensive mechanisms effective on a wide range of pathogens (lacks specific responses to specific invaders.) Only recognizes self-cells. No immune memory. |
| Specific resistance (adaptive immunity) | The ability to fight a specific pathogen, ex: -pox, toxins, viruses (cell mediated immunity & antibody mediated.) Can recognize self/non-self. Has immune memory. |
| Nonspecific resistance examples | External mechanical & chemical barriers and internal nonspecific defenses: antimicrobial proteins, natural killer cells & phagocytes, and inflammation & fever |
| Mechanical protection | Skin (shedding), mucous membranes, and washing actions of tears, saliva, and urine. |
| Chemical protection | Sebum inhibits growth bacteria & fungus, sweat lysozymes break down bacterial cells, and acidic pH of gastric juice/vaginal secretions destroys bacteria |
| Transferrins proteins | Iron binding proteins that inhibit bacterial growth by reducing available iron |
| Abscess vs. ulcer | Accumulation of pus in a confined space not open to outside (pimple or boil--worse than ulcer due to being closed off and can get anaerobic infections)/open sore |
| Stasis ulcers | People with poor oxygen and nutrient supply to tissues of legs (diabetics with advance atherosclerosis) |
| Complement system: Classical pathway | C1 (complement protein) recognizes any antigen-antibody complex then it is activated, leading to a cascade of events: C3b (opsonization) |
| C3b | Is used for opsonization (marking cells) of microbes to promote phagocytosis. Also leads to C5a/b which leads to C6, C7, C8, C9 which forms MAC "mac attack" (membrane attack complex) = cytolysis of microbe, used for bacterial cells |
| Epitope | Smallest part of an antigen that stimulates the immune response |
| Hapten | Smaller substance that cannot trigger an immune response unless attached to body protein, ex: lipid of poison ivy |
| MHC Antigens | Major Histocompatibility Complex Antigens- How you recognize self from non-self. |
| Who carries and doesn't carry MHC1 | All nucleic cells (so RBCs do not) |
| Who carries MHC2 | Any cell that carries an antigen on the outside of the cell, so other cells don't attack them. Ex: macrophages, B cells, thymus cells |
| Processing of Exogenous Antigens | Foreign antigen in body fluid that gets phagocytized by APC (antigen-presenting cell), fragments of foreign antigen stick to MHC2 molecule on APC where it migrates to LS tissue to find T-cells |
| Processing of Endogenous Antigens | Viral or cancerous antigens produced within body cell where they become part of MHC1 molecule on cell's surface, it signals that a cell needs help because it is infected or cancerous. |
| Suppressor T cells | Limit cell-mediated attack after T cells have destroyed virus. Prevents auto immune disease |
| What are the 4 classes of T cells | 1. Cytotoxic (killer) T cells 2. Helper T Cells 3. Suppressor T cells 4. Memory T cells |
| What are the 5 classes of antibodies | IgA, IgD, IgE, IgG, IgM |
| IgA function | Monomer in plasma, found in body's secretions: mucus, saliva, tears, milk, etc. |
| IgD functions | Monomer, B cell membrane antigen receptor |
| IgE functions | Monomer, found on outside of basophils, tonsils, skin and mucus membranes, stimulants release of histamines, attracts eosinophils. |
| IgG functions | Monomer, 75-85% circulating, crosses placenta to fetus, secondary immune response, binds complement |
| IgM | Monomer, B cell membrane antigen receptor, pentamer in plasma, primary immune response, agglutination |
| Antibody actions | Complement activation, enhance phagocytosis by turning on eosinophils, opsinozation, agglutination & precipitation, neutralization of antigens by blocking effects of toxins (snake venom) |
| Primary immune response (immunological memory) | First exposure to antigen, response is steady & slow. Memory cells may remain for decades (IgM) |
| Secondary immune response with 2nd exposure (immunological memory) | 1000's of memory cells proliferate & differentiate into plasma cells & cytotoxic T cells. Recognition and removal is so quick, you're not even sick (IgG) |
| Type 3 hypersensitivity | Immune complex- Widespread antigen-antibody complexing, triggers intense inflammation (acute glomerulonephritis and in systemic lupus erythematosus) |
| Type 4 hypersensitivity | 12-72 hour delay. APC's in lymph nodes display antigens to helper T cells, which secrete interferon and lymphokines that activate cytotoxic T cells and macrophages (cosmetic & poison ivy-haptens) |
| Severe combined autoimmune deficiency disease | (boy in the bubble) Hereditary lack of T and B cells, vulnerability to opportunistic infection |
| AIDS | Invades helper T cells, macrophages, and dendritic cells by "tricking" them to internalize viruses by receptor mediated endocytosis. |
| What is a retrovirus | Uses viral RNA as template to synthesize DNA, new DNA inserted into host cell DNA, may be dormant for months to years (AIDS) |
| AIDS signs and symptoms | Early; flu-like chills and fevers. Progress to night sweats, fatigue, headache, extreme weight loss, lymphadenitis. Normal Th count is 600-1200 cells, but AIDS it is <200. Thrush; white patches on mucus membranes. Kaposi Sarcoma |
| Kaposi Sarcoma | Cancer originates in endothelial cells of blood vessels, causes purple/black lesions on skin |
| Tumor Immunotherapy | Cells with anti tumor activity are injected into bloodstream of cancer patient. Replaces patient's inactive cytotoxic T cells with interleukin-2 (called Lymphokine-activated killer cells; TAK.) Can cause tumor regression, but has severe complications. |
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