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Chapter 22
THE LYMPHATIC SYSTEM, NONSPECIFIC RESISTANCE TO
DISEASE, AND IMMUNITY
Outline and Objectives
INTRODUCTION
1. Explain the importance of resistance to disease with emphasis on nonspecific
resistance and immunity actions in protection against pathogens.
THE LYMPHATIC SYSTEM
2. Describe the general importance of lymph.
Overview of Functions of the Lymphatic System
3. List the functions of the lymphatic system.
Lymphatic Vessels and Lymph Circulation
4. Describe the organization of lymph vessels.
Lymphatic Capillaries
5. Describe the general cellular structure, distribution, and operation of
lymphatic capillaries, then note the special location and duty of lacteals.
Lymph Trunks and Ducts
6. Describe the anatomic relationship of lymph nodes to the principal lymphatic
trunks.
Formation and Flow of Lymph
7. Give the reasons for accumulation and then clearance of proteins and fluids
from the interstitial space, and indicate the route through which the lymph
flows due to the peculiar lymphatic architecture and sources of pressure.
Lymphatic Organs and Tissues
8. Identify the primary and secondary lymphatic organs and their distributions
and general functions.
Thymus Gland
9. Discuss the location, histology, and evolution of the thymus gland, and its
effect on T-lymphocyte maturation.
Lymph Nodes
10. Describe the cellular structure of lymph nodes with respect to the variety of
immune cells that inhabit distinct realms within the node, and the path of
lymph flow.
11. Describe how the lymph system, especially nodes, generally operates in the
initiation of an immune response to pathogens.
12. Discuss the manner in which the lymph system facilitates the spread of cancer
cells in metastasis.
Spleen
13. Describe the overall structure and cellular composition of the spleen along
with the positioning of red and white pulp tissues.
14. Discuss the job of the spleen in processing red blood cells and in the immune
reaction.
Lymphatic Nodules
15. Specify the names, locations, and aggregate forms of the different mucosaassociated lymphoid tissues.
DEVELOPMENTAL ANATOMY OF THE LYMPHATIC SYSTEM
16. Describe the development of the lymphatic system.
NONSPECIFIC RESISTANCE TO DISEASE
17. List the primary mechanisms that are responsible for nonspecific resistance.
First Line of Defense: Skin and Mucous Membranes
18. List the major means by which the skin and mucous membranes act as the first
line of defense against pathogens.
Second Line of Defense: Internal Defenses
Antimicrobial Proteins
19. List and describe the effects of the antimicrobial proteins.
Natural Killer Cells and Phagocytes
20. Discuss the location and role of natural killer cells in attacking microbes,
infected body cells, and cancer cells.
Inflammation
21. Describe the symptoms and basic stages of inflammation, and the substances
that contribute to the inflammatory process.
22. Define and give examples of abscesses and ulcers.
Fever
23. Discuss the initiating factors and beneficial physiological responses thought to
be attributable to fever.
SPECIFIC DEFENSE: IMMUNITY
24. Define immunity and discuss its properties of specificity and memory.
Formation of T Cells and B Cells
25. State the site of origin and general nature of development of
immunocompetence for B cells and T cells.
Types of Immune Responses
26. Distinguish how the T cells and B cells are involved with cell-mediated and
antibody-mediated immunity, respectively, and so can deal with different
types of pathogens.
Antigens
27. Discuss the characteristics of antigens and give some examples of antigens.
28. Describe the three routes an antigen can use to get past the nonspecific
defenses.
Chemical Nature of Antigens
29. Characterize the biochemical nature of primary and subsidiary forms of
complete antigens and the antigens’ relation to size and complexity.
30. Discuss what response emerges if an antigen is small enough to instigate
reactivity but not immunogenicity.
Epitopes
31. Evaluate the capacity of segments of a pathogenic macromolecule to stimulate
a reaction by specific B cells and T cells, and describe how this can lead to
autoimmune responses.
Diversity of Antigen Receptors
32. Discuss the mechanism by which mini-genetic recombination and somatic
mutation allow B cells and T cells to construct antigen receptors to a billion
different antigens that the body has never encountered.
Major Histocompatibility Complex Antigens
33. Describe the roles of the major histocompatibility complex (MCH) in foreign
antigen recognition and the type of cells in the body that possess the two
different classes of MHCs.
34. Discuss histocompatibility testing.
Pathways of Antigen Processing
35. Discriminate between the circumstances that initiate a response by either B
cells or T cells, and how the distinct conditions are related to MHC-antigen
production.
Processing of Exogenous Antigens
36. Give the details in the sequence of processing of exogenous antigens by
antigen presenting cells (APCs) from endocytosis to MHC-antigen display on
the cell membrane.
Processing of Endogenous Antigens
37. Describe the processing of endogenous antigens
Cytokines
38. Discuss the nature and function of cytokines.
39. Discuss the therapeutic use of cytokines.
CELL-MEDIATED IMMUNITY
40. Describe the general path of development of T cells from activation by an
antigen to effector cells that eliminate the pathogen related to the antigens.
Activation, Proliferation, and Differentiation of T Cells
41. Discuss the operation and reason for the first and second signals that activate
only specific T cells, and then explain the function of their proliferation and
differentiation.
Types of T Cells
42. Discuss the actions of the three principal T cells in terms of their means of
initial activation, costimulators, cytokine secretion, and interactions with other
immune cells, as well as antigens and/or pathogens.
Helper T Cells
43. Discuss the activation and activity of helper T cells.
Cytotoxic T Cells
44. Discuss the activation and activity of cytotoxic T cells.
Memory T Cells
45. Discuss the function of memory T cells.
Elimination of Invaders
46. Describe the two mechanisms used by cytotoxic T cells to destroy body cells
that have been invaded by pathogens.
Immunological Surveillance
47. Describe immunological surveillance and the cells involved.
48. Discuss the phenomenon of graft rejection.
ANTIBODY-MEDIATED IMMUNITY
49. Discuss the general locations and response of specific B cells to specific
antigens.
Activation, Proliferation, and Differentiation of B Cells
50. Describe the scheme through which B cells are activated and costimulated to
increase the number, transformation, and output of antibodies which will
attack only the antigen that initially activated each specific B cell.
Antibodies
51. Define an antibody.
Antibody Structure
52. Discuss the way that the three regions of the antibody protein can have
different arrangements of the constant and variable portions to form countless
types of receptor sites and five functional classes of antibodies.
Antibody Actions
53. Discuss the five actions provided by antibodies in the elimination of
pathogenic antigens.
54. Discuss the ways in which monoclonal antibodies are produced and can be
employed to investigate medical conditions.
Complement System
55. Describe the interactions between complement proteins that are inacted by the
two start-up pathways and result in activation of inflammation, opsonization,
and cytolysis.
Immunological Memory
56. Discuss how the differentiation of B cells leads to the primary production of
antibodies, and then a rapid and magnified reaction in the secondary response
to the reappearance of the same antigen.
57. Explain how immunologic memory impacts the recurrence of an infection by
a previously encountered pathogen.
SELF-RECOGNITION AND IMMUNOLOGICAL TOLERANCE
58. Explain how B cells and T cells are developed through MHC self-recognition
positive selection, and then how immunologic tolerance is developed through
deletion-anergy negative selection.
59. Explain how tumor immunotherapy and cytokine therapy work and what are
some counterindications.
AGING AND THE IMMUNE SYSTEM
60. Describe the effects of aging on the immune system.
DISORDERS: HOMEOSTATIC IMBALANCES
61. Discuss AIDS in terms of epidemiology, pathogenesis of the HIV virus, signs
and symptoms, progression to AIDS, and treatment.
62. Discuss the basic types of hypersensitivity reactions.
63. Discuss the causes and symptoms of infectious mononucleosis.
MEDICAL TERMINOLOGY
64. Define medical terminology associated with the lymphatic system.