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UNIT 9 The Immune System 11 - 1 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. The Function of the Immune System  The function of the immune system is to create effective immune responses to continually defend the body against antigens. 11 - 2 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Lymphatic System Function  Network of vessels that transport fluids  Lymphatic vessels carry away excess fluid from interstitial spaces and return it to blood stream  Attacks foreign particles, cancer cells and toxins 11 - 3 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Overview  https://study.com/academy/lesson/functio ns-of-the-lymphatic-system.html 11 - 4 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Lymphatic Pathways  Lymphatic Capillaries      Microscopic tubes Extend into interstitial spaces Parallel to blood capillaries Simple Squamous epithelium Fluid is called lymph (limf) 11 - 5 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Lymphatic Pathways  11 - 6 Lymphatic Vessels  Similar to veins, but thinner  Have flap like valves to prevent backflow of lymph (like veins)  Larger vessels lead to specialized organs called lymph nodes  After leaving lymph nodes, vessels merge to form even larger lymph trunks Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 11 - 7 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Lymphatic Pathways  Lymphatic Trunks & Collecting Drains   Lymphatic trunks, which drain lymph, are named for the region they serve Join one or two collecting ducts   Thoracic duct Right lymphatic duct 11 - 8 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Lymphatic Pathways  Lymphatic Trunks & Collecting Ducts  Thoracic Duct – Longer and larger collecting duct   Received lymph from: lower limbs, abdominal region, left upper limb and left side of the thorax, head and neck Empties into left subclavian vein near the junction of the left jugular vein 11 - 9 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 11 - 10 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Lymphatic Pathways  Lymphatic Trunks & Collecting Ducts  Right Lymphatic Duct    Receives lymph from: right side of head and neck, right upper limb, and right thorax Empties into right subclavian vein near junction of right jugular vein After leaving collecting ducts, lymph enters venous system and becomes part of plasma 11 - 11 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Lymphatic Pathway  Lymphatic capillary  lymphatic vessel  lymph node  lymphatic vessel  lymphatic trunk  collecting duct  subclavian vein 11 - 12 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Tissue Fluid & Lymph   Lymph is tissue fluid that has entered a lymphatic capillary Lymph formation depends on tissue fluid formation 11 - 13 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Tissue Fluid Formation  Tissue fluid originates from blood plasma  Composed of water & dissolved substances that leave blood capillaries  Capillary blood pressure causes filtration of water and other molecules from the plasma 11 - 14 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Lymph Movement   Lymph is under low hydrostatic pressure and may not flow readily without outside help These forces include:    Skeletal muscle Smooth muscle Breathing 11 - 15 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Lymph Movement  Skeletal Muscle  Contracting skeletal muscle compresses lymphatic vessels and moves lymph in these vessels  Vessels have valves  lymph can only travel towards collecting duct  Smooth Muscle  Smooth muscle in walls of lymphatic trunks can contract & compress lymph inside, moving it forward 11 - 16 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Lymph Movement  Breathing    Creates relatively low pressure in thoracic cavity during inhalation At the same time, diaphragm increases pressure in abdominal cavity This forces lymph from abdominal vessels to thoracic vessels 11 - 17 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. The Organs of the Immune System     Bone marrow Thymus Lymph nodes Spleen     Tonsils Adenoids Appendix Peyer’s patches: clumps of lymph tissue 11 - 18 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 11 - 19 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Lymph Nodes   Located along lymphatic pathways Contain many lymphocytes and macrophages – fight invading organisms 11 - 20 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Lymph Nodes  Structure  Vary in size & shape, but usually less than 2.5cm long, bean shaped  Hilum – indented region where blood vessels and nerves join  Lymphatic vessels exit from here  Capsule of connective tissue enclose nodes  Peyer’s Patches – aggregations of nodules scattered throughout ileum region of small intestine 11 - 21 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 11 - 22 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Locations 11 - 23 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Functions of Lymph Nodes   Filtering potentially harmful particles from lymph before returning it to blood stream Immune Surveillance – lymphocytes & macrophages 11 - 24 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Thymus   Large during infancy/childhood – shrinks during puberty Connective tissues extend inward from surface, subdividing the gland into lobules   Abundant lymphocytes Most cells (thymocytes) are inactive, but some mature into Tcells that leave thymus & provide immunity 11 - 25 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Thymus 11 - 26 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Spleen      Largest lymphatic organ Resemble lymph node, but the spaces of the spleen contain blood instead of lymph White Pulp – islands throughout spleen. Contains many lymphocytes Red Pulp – RBC, lymphocytes, macrophages Filters blood, like lymph nodes filter lymph 11 - 27 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Spleen 11 - 28 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Body Defenses Against Infection  Innate (nonspecific) defense   General, protect against many pathogens Adaptive (specific) defense  Precise, targets certain pathogens  https://study.com/academy/lesson/what-isthe-immune-system-our-bodys-defenseagainst-pathogens.html 11 - 29 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Innate Defenses  Species Resistance – each species has a specific set of diseases that is unique to it   Mechanical Barriers – 1st line of defense   11 - 30 Ex: Pathogens that cause measles and mumps affect humans, but not other species Skin & mucus membranes (hair, mucus, sweat) https://study.com/academy/lesson/theinnate-immune-system-definition-andcomponents.html Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Innate Defenses  Chemical Barriers – Enzymes in body fluid  Ex: Gastric juice & tears contain enzymes and antibacterial agents that kill many pathogens  Lymphocytes and fibroblasts produce interferons in response to viruses or tumor cells  Once released from virus-infected cell, interferon binds to receptors on uninfected cells, causing them to produce proteins that block replication of a variety of viruses 11 - 31 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Innate Defenses  Fever – higher body temperature causes liver and spleen to hold on to iron.   Bacteria & fungi need iron to produce in high temperatures Phagocytosis – neutrophils & monocytes are blood’s most active phagocytes  Removes foreign particles from lymph as it moves from interstitial spaces to blood stream Innate Defenses  Inflammation – tissue response to injury or infection, causing localized redness, heat, and pain   Results in walling off of the site so infection cannot spread Brings more blood to area with phagocytes to remove microorganisms   Heat speeds up phagocytes Infected cells stimulate WBC to area. In bacterial infections, this may create pus 11 - 33 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Adaptive Defenses  Antigens   Things the immune system sees as non-self, such as bacteria, viruses, fungi, and parasites The body responds by destroying them or rendering them ineffective. 11 - 34 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Adaptive Defenses  Lymphocyte Origins  Before birth, red bone marrow releases undifferentiated lymphocytes into circulation  About half reach the thymus where they develop into T Cells » Other T Cells reside in lymphatic organs, lymph nodes, thoracic duct and spleen  Other non-T lymphocytes remain in red bone marrow until they differentiate into B cells 11 - 35 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Adaptive Defenses  Lymphocyte functions  T cells attach to foreign, antigen bearing cells and interact directly (cell to cell contact)   Cellular immune response B cells, when stimulated by antigen, grow and divide into plasma cells that produce antibodies or immunoglobulins  Humoral immune response 11 - 36 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. T Cells  Act directly on target cells and provide cell-mediated immunity 11 - 37 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. The 4 Types of T Cells 1. Helper T cells   2. Suppressor T cells  11 - 38 Produce proteins that help other lymphocytes and phagocytes perform their functions Also help B lymphocytes make antibodies Stop or turn off T cell actions when the “battle” is under control (continued) Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. The 4 Types of T Cells 3. Memory T cells  4. Have a memory from previous experiences with specific antigens and are prepared to act immediately upon recontact Killer T cells   Can directly kill infected or malignant cells and those cells carrying a target antigen Can attach to the target and insert toxic chemicals that make holes in the membrane and destroy the cell before it can reproduce 11 - 39 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. How NK Cell Action Differs from Phagocytic Action   Natural killer (NK) cells can kill cancer cells and cells infected with viruses without using antibodies or having prior exposure to the antigen. This is done by injecting a toxin into the membrane to destroy the cell, instead of eating it as phagocytes would. 11 - 40 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Major Histocompatibility Complex (MHC)   Molecules that function as biochemical “fingerprints” This serves as the “ID” for cells so they are marked and recognized as self. 11 - 41 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. The Purpose of MHC    MHC markers enable the immune system to achieve its primary function of communication. The body can recognize cells as self and non-self. This promotes homeostasis through the destruction of damaged or dead cells. 11 - 42 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. The Role of the B Cell   B lymphocytes produce antibodies in a process called humoral immunity B cells have 2 stages of development: 1. 2. Cells insert molecules of one specific antibody into the cell membrane. The antibody contacts antigens and they change into an antigen-antibody complex. 11 - 43 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. The Body’s 3 Main Lines of Defense 1. First line of defense: barriers    11 - 44 Anatomic barrier: the skin, mucous membranes, and intestinal tract Biochemical barrier: sebaceous glands, tears, and sweat Mechanical: coughing, urination, and skin cells slough off (continued) Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. The Body’s 3 Main Lines of Defense 2. Second line of defense: the inflammation process   11 - 45 Begins within seconds of an injury or invasion Area becomes red, swollen, and warm to the touch (continued) Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. The Body’s 3 Main Lines of Defense 3. Third line of defense: antibody defense   This is our immunity. Results from a dual-system response and involves the actions of specific cells and other immune system components to attack the antigen. 11 - 46 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 3 Basic Services of the Immune System 1. 2. 3. Identifies self and destroys non-self substances Maintains a normal internal environment (homeostasis) Conducts continual surveillance 11 - 47 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Allergens   The result of an inappropriate response to a harmless substance such as grass, cat hair, etc. This results in the condition known as an allergy. 11 - 48 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Allergic Reactions    Immune attack against a non-harmful substance Similar to immune response – synthesize lymphocytes, antibodies may bind antigens, but allergic reactions may damage tissues Allergy testing  https://www.youtube.com/watch?v=atOI5c_u NIs 11 - 49 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Tissue Rejection Reaction    Recipient’s immune system may recognize the donor’s cell surfaces as foreign Resembles cellular immune response Immunosuppressive drugs are used to prevent this  Suppresses formation of antibodies and T cells 11 - 50 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Autoimmunity   Attack against self Immune system fails to distinguish self from non-self 11 - 51 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Vaccines  https://study.com/academy/lesson/immu nization-and-vaccination.html  https://study.com/academy/lesson/antibio tics-and-vaccines.html 11 - 52 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Diseases and Disorders 11 - 53 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. https://study.com/academy/lesson/immunedeficiency-diseases-definitions-types.html 11 - 54 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.  https://study.com/academy/lesson/autoi mmune-diseases-andhypersensitivity.html 11 - 55 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. AIDS    Acquired immunodeficiency syndrome The most advanced stage of the human immunodeficiency virus (HIV) This syndrome renders the body’s immune system ineffective. 11 - 56 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. How AIDS Destroys the Immune System   The virus invades the T cells and macrophages. With the helper T cells disabled, the macrophages do no act, the B cell antibodies are diverted, and there is no NK cell formation. 11 - 57 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 5 Ways to Acquire the AIDS Virus 1. 2. 3. 4. 5. Unprotected sex with an infected partner Sharing drug needles or syringes HIV-positive mother passes it on to her child Blood transfusions Accidental needlesticks and contact with infected blood 11 - 58 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 4 High-Risk Behaviors to Avoid 1. 2. 3. 4. High-risk sexual activities Using intravenous drugs and sharing needles Having multiple sex partners Untreated sexually transmitted diseases 11 - 59 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. The 3 Most Common Opportunistic Diseases  Pneumocystis carinii pneumonia   Kaposi’s sarcoma   Lung infection with fever, cough, and dyspnea Form of cancer that appears as purplish skin blotches Candidiasis  Yeast infection that can attack the mouth, esophagus, and vagina 11 - 60 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Cancer    A group of diseases characterized by the growth of abnormal cells These cells accumulate and form tumors that may compress, invade, or destroy normal tissue. The spread of a tumor to a new site is called metastasis. 11 - 61 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. The Classifications of Cancer  Cancer is classified according to its cellular origin    Carcinomas arise from epithelial tissue. Sarcomas arise from connective tissue. Leukemias arise from blood and bloodforming organs. 11 - 62 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Describing Grading and Staging of Cancer   Grading describes the degree of cell differentiation from grade I to grade IV Grade I   Cells are well differentiated. Grade IV  Cells are undifferentiated. 11 - 63 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Staging     Staging identifies the extent of the spread of the disease T: size of the primary tumor N: presence or absence of regional metastasis M: presence or absence of distant metastasis 11 - 64 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 4 Types or Categories of Carcinogens 1. 2. 3. 4. Chemical: arsenic, tobacco, benzene, etc. Viral: Epstein-Barr, hepatitis B, leukemia, etc. Physical: asbestos, radiation, etc. Familial: melanoma, leukemia, etc. 11 - 65 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Chronic Fatigue Syndrome  A debilitating disorder that causes overwhelming fatigue that lasts at least 6 months and does not go away with rest 11 - 66 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Lymphedema  Swelling of body tissues caused by an accumulation of lymphatic fluid 11 - 67 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Lymphedema Wrapping  https://www.youtube.com/watch?v=jC6LzOlI1w 11 - 68 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Lupus    Chronic disease that causes changes in the immune system This disorder causes inflammation. Lupus can involve only a few body organs or can cause serious, lifethreatening problems. 11 - 69 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. How Lupus Affects the Immune System and Major Body Organs  Usually protective antibodies are produced in large quantities, but they react against the person’s own normal tissues 11 - 70 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Rheumatoid Arthritis  A chronic systemic inflammatory autoimmune disease that affects the joints and surrounding muscles, tendons, ligaments, and blood vessels 11 - 71 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Diagnostic Tests and Treatments 11 - 72 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 3 Categories of Diagnostic Testing 1. 2. 3. Biopsies: visual examination of cells removed by needle aspiration, excision, or bone marrow aspiration Lab tests: Blood, semen, and urine are evaluated for abnormal cancer cells and tumor markers. Tumor imaging: x-rays, CT scans, and MRIs 11 - 73 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Major Cancer Treatment Methods     Surgery Chemotherapy Radiation: external beam therapy Radiation: brachytherapy      Radiation: biosurgery Biological response modifiers Gene therapy Complementary therapy Alternative therapy 11 - 74 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Immunization and Vaccinations   The deliberate introduction of an antigen into the body, which causes a minor reaction in the patient After injection, the body produces an antigen-antibody complex and eventually memory cells against the disease are produced. 11 - 75 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. Boy in a Bubble  https://www.youtube.com/watch?v=4CFP dUAj41Y 11 - 76 Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.