Transcript The Profession of Medical Assisting

CHAPTER
28
The Lymphatic and
Immune Systems
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28-2
Learning Outcomes (cont.)
28.1 Describe the pathways and organs of
the lymphatic system.
28.2 Compare the nonspecific and specific
body defense mechanisms.
28.3 Explain how antibodies fight infection.
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28-3
Learning Outcomes (cont.)
28.4 Describe the four different types of
acquired immunities.
28.5 Describe the causes, signs and
symptoms, and treatments of major
immune disorders.
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28-4
Introduction
• Immune system
– Protects against
•
•
•
•
•
•
Bacteria
Viruses
Fungi
Toxins
Parasites
Cancer
• Lymphatic system
– Works with the
immune system
– Organs
• Thymus
• Spleen
• Lymph nodes
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28-5
The Lymphatic System
• Network of connecting vessels
• Functions to
– Collect lymph from between cells
– Collect lipids from digestive organs
– Defend the body against pathogens
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28-6
Lymphatic Pathways
• Lymphatic capillaries
– Collect fluid
– Deliver lymph to lymphatic vessels
• Lymph vessels – lymph to nodes
• Lymph nodes
– Remove pathogens
– Start immune response
Lymph
System
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28-7
Lymphatic Pathways (cont.)
• Efferent lymphatic vessels
trunks
lymphatic
• Lymphatic collecting ducts
– Thoracic duct
– Right lymphatic duct
• Empty into blood stream
Lymph
System
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28-9
The Lymphatic System (cont.)
Area Drained
by right
lymphatic duct
Right
lymphatic
duct
Lymph
nodes
Lymphatic
trunks
Left internal
jugular vein
Thoracic
duct
Left subclavian
vein
Thoracic
duct
Cisterna
chyli
Lymphatic
vessels
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28-10
Tissue Fluid and Lymph
• Interstitial fluid
– Fluid in spaces between cells
– High in nutrients, oxygen, and small proteins
– Fluid not picked up by cells  lymph
• Lymph moves by
– Squeezing action of skeletal muscles
– Squeezing action of breathing
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28-11
Lymph Nodes
• Small, glandular structures
• Afferent lymphatic vessels ~ lymph to
node
• Efferent lymphatic vessels ~ lymph from
node
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28-12
Lymph Nodes (cont.)
• Lymph pools in the nodes
• Cells in nodes
– Macrophages ~ digest unwanted pathogens
– Lymphocytes ~ start an immune response
against pathogen
• Nodes can generate some
lymphocytes
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28-14
The Thymus and Spleen
• Thymus
– Soft, bi-lobed organ located in the
mediastinum
– Functions
• Same as lymph nodes
• Also produces lymphocytes
• Produces thymosin – stimulates production of
lymphocytes
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28-15
The Thymus and Spleen (cont.)
• Spleen
– Largest lymphatic organ
– Upper left quadrant of abdominal cavity
– Functions
• Filters blood similarly to lymph nodes
• Removes worn-out red cells
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28-16
Apply Your Knowledge
What are the lymphatic collecting ducts and
what area do they drain?
ANSWER: The collecting ducts are:
Thoracic duct, which drains the left side of the head
and neck, left arm, left side of thorax, entire
abdominopelvic area, and both legs; and the right
lymphatic duct, which drains the right side of the head
and neck, right arm, and right side of the chest.
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28-17
Defenses Against Disease
• Infection – presence of a pathogen in or
on the body
• Pathogen – disease-causing agent
• Innate immunity – nonspecific defenses
• Immunities – specific defenses
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28-18
Non-Specific Defenses
• Species resistance
• Chemical barriers
• Mechanical
barriers
• Phagocytosis –
phagocytes
surround and
destroy pathogens
and unwanted
debris
– Skin
– Mucous
membranes
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28-19
Non-Specific Defenses
• Fever
• Inflammation
– Stimulates removal
of iron from blood
– Redness
– Activates
phagocytic cells
– Swelling
– Heat
– Pain
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28-20
Specific Defenses
• Immunities
• Antigens
– Foreign substances in the body
– On the surfaces of pathogens
• Haptens – foreign substances too small to
start an immune response
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28-21
Specific Defenses
• Antibodies – respond to specific antigens
• Complements – work with antibodies
• WBCs – lymphocytes and macrophages
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28-22
Specific Defenses
• Cytokines – assist in immune response
regulation
• Monokines
– Increase B cell production
– Stimulate WBC production
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28-23
Specific Defenses (cont.)
Two major types of lymphocytes
T Cells and B Cells
Diagram
Both recognize antigens in the body
T CELLS
Cell-mediated
response
Secrete
Lymphokines
B CELLS
Antibody-mediated
response
Plasma cells
Memory B cells
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28-25
Specific Defenses (cont.)
• T cell activation
– Macrophage ingests and digests a pathogen
with antigens on it
– Antigens are placed on the macrophage cell
membrane next to a major
histocompatibility complex (MHC)
– T cell binds to the antigen and MHC
Diagram
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28-26
Specific Defenses (cont.)
• Cytotoxic T cells
• Helper T cells
– Increase antibody
formation
• Memory T cells
– Memory cell
formation
– B cell formation
– Phagocytosis
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28-27
Specific Disease (cont.)
• Natural killer (NK) cells
– Type of lymphocyte
– Primarily target cancer cells
– Kill on contact
– Do not recognize a specific antigen
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28-28
Apply Your Knowledge
Identify whether each item refers to T cells, B cells, or NK
cells:
ANSWER:
NK Primarily target cancer cells
___
B Respond to antigens by becoming plasma cells
___
T Must be activated to respond to an antigen
___
T Bind to antigens on cells and attack them directly
___
NK Kill on contact
___
T Need macrophages and MHC for activation
___
B Make antibodies against specific antigen
___
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28-29
Antibodies
• Immunoglobulins
• IgA – prevents pathogens from entering
body
• IgD – thought to control B cell activity
• IgE – involved in triggering allergic
reactions
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28-30
Antibodies (cont.)
• IgG
– Recognizes bacteria, viruses, and toxins
– Activates complements
• IgM
– Binds to antigens on food, bacteria, or
incompatible blood cells
– Activates compliments
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28-31
Antibodies (cont.)
• Actions
– Allow phagocytes to recognize and destroy
antigens
– Cause antigens to clump together
– Cover the toxic portions of antigens
– Activate complements
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28-32
Apply Your Knowledge
What are the possible actions that occur when
antibodies bind to antigens?
ANSWER: Possible actions include:
 They allow phagocytes to recognize and destroy
antigens.
 They make antigens clump together, causing them to be
destroyed by macrophages.
 They cover the toxic portions of antigens to make them
harmless.
 They activate complements.
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28-33
Immune Responses and Acquired
Immunities
• Primary immune response
– Slow process
– Memory cells are formed
• Secondary immune response
– Quick and carried out by memory cells
– Usually prevents person from developing
disease from the antigen
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28-34
Immune Responses and Acquired
Immunities (cont.)
• Naturally acquired active
immunity
– Natural exposure to antigen
– Makes antibodies and memory cells
• Artificially acquired active immunity
– Injected with pathogen
– Makes antibodies and memory
cells
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28-35
Immune Responses and Acquired
Immunities (cont.)
• Naturally acquired passive immunity
– Acquired from mother
– Short-lived
• Artificially acquired passive immunity
– Injected with antibodies
– Short-lived
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28-36
Apply Your Knowledge
After you give an immunization to a 2-year-old,
her mother asks you why this will work to
prevent her from getting a disease. What would
you tell her?
ANSWER: Immunization is an artificially acquired
immunity . A person develops this immunity by
being injected with a pathogen and then making
antibodies and memory cells against the
pathogen.
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28-37
Major Immune System Disorders
• Cancer
– Uncontrolled growth of abnormal cells
– Carcinogen
– Signs/symptoms vary
– Treatment based on staging
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28-38
Major Immune System Disorders (cont.)
Stage Description
Very early cancer. Cancer cells are
Stage 0 localized in a few cell layers.
Cancer cells have spread to deeper cell
Stage I layers, or some may have spread to
surrounding tissues.
Cancer cells have spread to surrounding
Stage II tissues but are considered contained in the
primary cancer site.
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28-39
Major Immune System Disorders (cont.)
Stage
Description
Stage III
Cancer cells have spread beyond the
primary cancer site to nearby areas.
Stage IV
Cancer cells have spread to other
organs of the body.
Recurrent
Cancer cells have reappeared after
treatment.
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28-40
Major Immune System Disorders (cont.)
• Allergies
– Immune responses to an allergen
– IgE antibodies
• Bind to allergens
• Stimulate mast cells
– Allergy shots
– Anaphylaxis ~ life threatening allergic
response
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28-41
Major Immune System Disorders (cont.)
• Allergies (cont.)
– Signs/symptoms are based on where
exposure occurs
– Treatment
• Antihistamines, decongestants
• Epinephrine for anaphylaxis
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28-42
Common Diseases and Disorders of the
Immune System
• Autoimmune disease
– Body attacks its own antigens
– Examples
•
•
•
•
•
•
Scleroderma
Rheumatoid arthritis
Multiple sclerosis
Glomerulonephritis
Crohn’s disease
Diabetes mellitus, type I
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28-43
Common Diseases and Disorders of the
Immune System (cont.)
Disorder
Description
Acquired
immunodeficiency
syndrome
(AIDS)
Development of severe signs
and symptoms caused by HIV
as it destroys lymphocytes
(T cells); leaves immune
system weakened and
susceptible to other diseases
Condition of severe tiredness
not relieved by rest and not
related to other illnesses
Chronic fatigue
syndrome (CFS)
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28-44
Common Immune System Disorders (cont.)
Disorder
Description
Lymphedema
Blockage of lymphatic vessels
resulting in tissue swelling
Mononucleosis “Mono”; highly contagious viral
infection spread through saliva of
infected person
Systemic lupus Autoimmune disorder; produces
erythematous antibodies that target own cells
(SLE)
and tissues; affects women more
often than men
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28-45
Apply Your Knowledge
Matching:
ANSWER:
G Immune response to a substance
___
A. CFS
E Blockage of lymphatic vessels
___
B. SLE
F “Kissing disease”
___
C. Cancer
B “Butterfly” rash on face
___
disease
D. Autoimmune
E. Lymphedema
___
A Severe tiredness
___
C Uncontrolled growth of
abnormal cells
F. Mononucleosis
G. Allergy
___
D Body attacks its own antigens
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28-46
In Summary
28.1
The lymph system is composed of pathways known
as lymph vessels. In addition to the lymph vessels,
the organs of the lymphatic system include lymph
nodes, located throughout the body; the thymus, in
the mediastinum; and the spleen, located in the
LUQ.
28.2
Nonspecific body defenses include species
resistance, mechanical and chemical barriers,
phagocytosis, fever, and inflammation.
Specific defenses are immunities or defenses
against very specific antigens created by B cells, T
cells, and natural killer (NK) cells.
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28-47
In Summary (cont.)
28.3 Antibodies work in the following ways: phagocytosis,
antigen clumping, covering (inactivating) toxic
portions of antigens, and activating complements.
Antibodies are also known as immunoglobulins.
IgA prevents pathogens from entering the body;
IgD controls B cell activity;
IgE works with IgA in triggering allergic reactions;
IgG recognizes bacteria, viruses, and toxins and
activates complements; and
IgM binds to antigens on food, bacteria, or
incompatible blood cells. IgM also activates
complements.
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28-48
In Summary (cont.)
28.4
The four types of immune response are naturally
acquired active immunity, such as when someone
becomes ill and develops immunity; artificially
acquired active immunity, as when an injection is
given against a pathogen, preventing illness;
naturally acquired passive immunity, which occurs
when an infant has its mother’s immunity for a short
while after birth and through breast milk; and
artificially acquired passive immunity, which occurs
after injection of antibodies such as with an
antivenom.
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28-49
In Summary (cont.)
28.5
Diseases and disorders of the immune system
include HIV infection, AIDS, cancer, and allergies,
as well as other autoimmune diseases, in which the
body attacks its own antigens.
The signs, symptoms and treatments are as
numerous and varied as the diseases.
Some of the more common diseases and disorders
are discussed in the Common Diseases and
Disorders of the Immune System section near the
end of this chapter.
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28-50
End of Chapter 28
Thought is an
infection. In the
case of certain
thoughts, it
becomes an
epidemic.
~Wallace Stevens
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in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.