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The Lymphatic and Immune

Systems
PowerPoint presentation to accompany:

Medical Assisting
Third Edition

Booth, Whicker, Wyman, Pugh, Thompson


2009 The McGraw-Hill Companies, Inc. All rights reserved

32-2

Learning Outcomes
32.1

List the pathways and organs of the lymphatic system


and give their locations.

31.2

Define lymph and tell how it is circulated in the body.

31.3

Define the terms infection, pathogen, and antigen.

31.4

List and describe the nonspecific body defense


mechanisms.

31. 5

Explain the signs and causes of inflammation.

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32-3

Learning Outcomes (cont.)


32.6

Explain what is meant by body defenses.

32.7

Define B cells and T cells and describe their locations


and functions.

32.8

Explain the importance of MHC proteins.

32.9

List the different types of T cells and describe their


functions.

32.10 Explain how antibodies fight infection.

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32-4

Learning Outcomes (cont.)


32.11 List the different types of antibodies and tell how they
differ.
32.12 Define complement proteins and give their function.
32.13 Explain the difference between the primary immune
response and secondary immune response.
32.14 Explain the four different types of acquired immunities.
32.15 Describe the function of a vaccine.

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32-5

Learning Outcomes (cont.)


32.16 Define the terms cancer and carcinogen.
32.17 Describe how cancers are diagnosed and treated.
32. 18 Explain how cancers are classified.
32.19 Describe how allergies develop.
32.20 Describe the causes, signs and symptoms, and
treatments of other common immune disorders.

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32-6

Introduction

Immune system

Protects the body


against

Bacteria
Viruses
Fungi
Toxins
Parasites
Cancer

Lymphatic system

Works with immune


system to remove
disease-causing agents
Organs

Thymus
Spleen
Lymph nodes

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The Lymphatic System

Network of connecting vessels

Collects fluid (lymph) between cells and returns


it to bloodstream

Picks up lipids from digestive organs and


transports them to blood stream

Functions to defend the body against pathogens

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Lymphatic System: Pathways

Lymphatic capillaries

Extend into interstitial spaces


Permeable, thin walls pick up fluid, now lymph
Delivers lymph to lymphatic vessels

Lymphatic vessels

Deliver lymph to lymph nodes

Cells in nodes can remove pathogens from lymph and start an


immune response

Leaves nodes through efferent lymphatic vessels

Lymph
System

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Lymphatic System: Pathways (cont.)

Lymphatic trunks

Receive lymph from efferent lymphatic vessels


Deliver it to

Lymphatic collecting ducts

Thoracic duct

Lymph
System

Left side of head and neck, left arm, left side of thorax, entire
abdominopelvic area, and both legs

Right lymphatic duct

Right side of head and neck, right arm, and right side of chest

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Lymphatic System:
Tissue Fluid and Lymph

Interstitial fluid

Fluid in spaces between cells that has leaked


from blood capillaries and has not been picked
up by body cells
High in nutrients, oxygen, and small proteins
Becomes lymph

Pushed through lymphatic vessels by squeezing action


of neighboring skeletal muscles and breathing
movement

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32-11

Back

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Lymphatic System: Nodes

Small, glandular structures

Located along paths of


larger lymphatic vessels

Afferent lymphatic vessels


Lymph to node
Efferent lymphatic vessels
Lymph from node

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Lymphatic System: Nodes (cont.)

More lymph enters than can


leave at one time

Cells in nodes

Macrophages digest unwanted


pathogens
Lymphocytes start an immune
response against pathogen

Nodes can generate some


lymphocytes

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Lymphatic System:
The Thymus and Spleen

Thymus

Soft, bi-lobed organ

Located just above the heart in the mediastinum

Large in children, shrinks as we age

Functions

Same as lymph nodes

Also produces lymphocytes

Produces thymosin stimulates production of lymphocytes

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Lymphatic System:
The Thymus and Spleen (cont.)

Spleen

Largest lymphatic organ

Located in the upper left quadrant of abdominal cavity

Functions

Filters blood similarly to lymph nodes

Removes worn-out red cells

If removed (splenectomy), liver takes over most of its


function

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32-16

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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Defenses Against Disease

Infection

The presence of a
pathogen in or on the
body

Pathogen

A disease-causing agent

Innate immunity

Nonspecific defenses to
protect against
pathogens

Nonspecific defenses

Species resistance

Mechanical barriers

Chemical barriers

Phagocytosis

Fever

Inflammation

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Defenses Against Disease:


Specific Defenses

Immunities

Protect against very


specific pathogens
Antigens

Foreign substances in the


body

Haptens

Other substances

Proteins antibodies and


complements
WBCs lymphocytes and
macrophages
Lymph system

Foreign substances too


small to start an immune
response by themselves

Cytokines assist in
immune response regulation
Monokines increase B cell
production and stimulate
WBC production

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Defenses Against Disease (cont.)


Two major types of lymphocytes
B Cells and T Cells
Response

Recognize antigens in the body


BBcells
cells

Respond
Respondtotoantigens
antigensby
by

becoming
becomingplasma
plasmacells
cells

Plasma
Plasmacells
cellsmake
makeantibodies
antibodies

Memory
MemoryBBcells
cellsproduce
produce
stronger
strongerresponse
responsewith
withnext
next
exposure
exposuretotoantigen
antigen

TTCells
Cells

Cell-mediated
Cell-mediatedresponse
response

Bind to antigens on cells

Bind to antigens on cells


and
andattack
attackthem
themdirectly
directly

Secrete
Secretelymphokines
lymphokinesthat
that
increase
increaseTTcell
cellproduction
productionand
and
directly
directlykill
killcells
cellswith
withantigens
antigens
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Defenses Against Disease (cont.)

T cell activation

Begins when macrophage ingests and digests


pathogen with antigen on it
Antigens are placed on cell membrane of
macrophage
T cell recognizes and binds to antigen and the
major histocompatibility complex (MHC) on the
surface of the macrophage
Now can divide to form other types of T cells
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Defenses Against Disease (cont.)

Types

Cytotoxic T cells

Helper T cells

Protect body against viruses and cancer cells


Increase antibody formation, memory cell formation,
B cell formation, and phagocytosis

Memory T cells

Remember the pathogen that activated original T cell


Later exposures trigger an immune response more
effective than initial response
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Defenses Against 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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Apply Your Knowledge


ANSWER:
Identify whether each item refers to T cells, B cells, or NK cells:
NK Primarily target cancer cells
___

Right
B Respond to antigens by becoming plasma cells
___
on
T
___ Must be activated to respond to an antigen
Target!
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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Antibodies

Also called immunoglobulins

IgA

IgD

Prevents pathogens from entering body


Found on B cell membranes
Thought to control B cell activity

IgE

Found with IgA


Involved in triggering allergic reactions
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Antibodies (cont.)

IgG

Recognizes bacteria, viruses, and toxins


Activates complements

IgM

Large and binds to antigens on food, bacteria, or


incompatible blood cells
Activates compliments

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Antibodies (cont.)

Actions that occur when antibodies bind to antigens

Allow phagocytes to recognize and destroy antigens

Cause antigens to clump together, causing them to be


destroyed by macrophages

Cover the toxic portions of antigens, making them harmless

Activate complement

Group of proteins in serum that attack pathogens by forming holes


in them

Attract macrophages to pathogens and can stimulate inflammation


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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.

Very
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Immune Responses and


Acquired Immunity

Primary immune response occurs with first


exposure to antigen

Slow process
Memory cells are formed

Secondary immune response with next exposure to


same antigen

Quick and carried out by memory cells


Usually prevents person from developing disease from
the antigen
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Immune Responses and


Acquired Immunity (cont.)

Naturally acquired active immunity

Natural exposure to antigen having an illness


Makes antibodies and memory cells
Long-lasting

Artificially acquired active immunity

Injected with pathogen immunizations


Makes antibodies and memory cells
Long-lasting
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Immune Responses and


Acquired Immunity (cont.)

Naturally acquired passive immunity

Acquired from mother

Breast milk
Placenta

Short-lived

Artificially acquired passive immunity

Injected with antibodies (such as antivenom)


Short-lived
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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.
ANSWER: Immunization is an artificially acquired
immunity because 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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Major Immune System Disorders

Cancer

Uncontrolled growth of abnormal cells form malignant


tumors
200 known types
Treatment based on stage
0 very early; cancer cells localized
I spread to deeper layers or some in surrounding tissues
II spread to surrounding tissues but contained in primary site
III spread beyond primary site into nearby areas
IV spread to other organs
Recurrent reappeared after treatment
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Major Immune System


Disorders (cont.)

Allergies

Immune response to an allergen

IgE antibodies bind to allergens and stimulate mast cells


to release histamine and heparin

Can be excessive

Triggers allergic response

Allergy shots

Small amounts of allergen stimulates production of IgG to


prevent IgE from binding to antigen
IgG antibodies do not stimulate mast cells, so immune response
is not generated
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Major Immune System


Disorders (cont.)

Signs/symptoms

Inhaled allergens runny nose, sneezing, coughing, wheezing

Ingested allergens nausea, vomiting, diarrhea

Skin allergens rashes

Allergens in blood most life-threatening; can affect many


organs

Treatment

Antihistamines, decongestants OTC or prescription

Epinephrine for anaphylaxis vasoconstriction, increasing BP

Anaphylaxis life-threatening response


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Common Immune System Disorders

Autoimmune disease

Body attacks its own antigens


Examples

Scleroderma
Rheumatoid arthritis
Multiple sclerosis
Glomerulonephritis
Chrons disease
Diabetes mellitus, type I
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Common Immune System


Disorders (cont.)
Disorder

Description

AIDS

Development of severe signs and symptoms


caused by HIV as it destroys lymphocytes;
leaves immune system weakened and
susceptible to other diseases

Chronic fatigue
syndrome (CFS)

Condition of severe tiredness not relieved by


rest and not related to other illnesses

Lymphedema

Blockage of lymphatic vessels results in tissue


swelling that increases over time

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Common IS Disorders (cont.)


Disorder

Description

Mononucleosis Mono; highly contagious viral infection


spread through saliva of infected person
Systemic lupus
erythematous
(SLE)

Autoimmune disorder; antibodies produces that


target own cells and tissues; affects women
more often than men

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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


___

D. Autoimmune disease

A Severe tiredness
___

E. Lymphedema

C Uncontrolled growth of abnormal cells


___

F. Mononucleosis

D Body attack its own antigens


___

G. Allergy

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In Summary

Immune system is the bodys major line of defense

Primary function protect against infection, toxins, and


cancer
Specific or nonspecific defenses

Lymphocytes are major cells of immune system

Immune response may be primary or secondary

Medical assistant must understand immune system

Aseptic technique
Infection control
Educate patients
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End of Chapter

Thought is an
infection. In the
case of certain
thoughts, it
becomes an
epidemic.
~Wallace Stevens
2009 The McGraw-Hill Companies, Inc. All rights reserved

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