Lymphatic & Immunity System

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Chapter 14
Lymphatic and Immune Systems

Learning Objectives

Identify the structures and analyze terms related to the lymphatic and immune systems.
Recognize terms that describe various pathologic conditions affecting the lymphatic and immune systems.

Learning Objectives (cont’d)

Identify laboratory tests, clinical procedures, and abbreviations that are pertinent to the lymphatic and immune systems.
Apply your new knowledge to understanding medical terms in their proper contexts, such as medical reports and records.

Chapter 14
Lesson 14.1

Introduction

Lymph: clear watery fluid that surrounds body cells and flows in system of lymph vessels throughout the body.

originates in blood
rich in lymphocytes and monocytes
flows in lymph capillaries and vessels
flows through lymph nodes and lymphatic organs (liver, spleen, thymus, and nodes)
absorbs lipids in the intestine

Tonsils are aggregate lymphatic organs.
Lymphocytes and monocytes in lymph organs protect the body from foreign invaders.
What are the three functions of the lymphatic system?

Introduction

Lymphatic System Functions

Transports proteins and fluid that have leaked, back to the bloodstream

Lymphatic vessels absorb lipids from intestines and transport them to the bloodstream

Lymphocytes and monocytes protect the body by mounting a cellular attack on foreign cells and organisms.

Tonsils are aggregate lymphatic organs.
Lymphocytes and monocytes in lymph organs protect the body from foreign invaders.
What are the three functions of the lymphatic system?

Interstitial Fluid and Lymph Capillaries

Have students label the figure….or use the next figure with has the labels in place.
Review the circulation of blood in blood vessels.
Compare and contrast with lymph in lymph capillaries.
How do the blood and lymph systems complement each other?
How are the structures of lymph vessels and veins similar? (valves, no pump)

Interstitial Fluid and Lymph Capillaries

Review the circulation of blood in blood vessels.
Compare and contrast with lymph in lymph capillaries.
How do the blood and lymph systems complement each other?
How are the structures of lymph vessels and veins similar? (valves, no pump)

Blood and Lymph

Use this slide to continue your discussion from previous slide.
What happens in situations such as edema?

Blood and Lymph

Use this slide to continue your discussion from previous slide.
What happens in situations such as edema?

Lymphatic System Anatomy

Lymph capillaries
Lymph vessels
Lymph nodes

What are lymph capillaries and lymph vessels?
What does each do?
Describe lymph nodes and what they do.

Location of Lymph Nodes

Ask students to fill in the names and locations of the major areas of the body occupied by lymph nodes.

Location of Lymph Nodes

Ask students to fill in the names and locations of the major areas of the body occupied by lymph nodes.

Lymph Nodes

Point out and discuss elements and functions of each part in this figure

Lymph Nodes

Point out and discuss elements and functions of each part in this figure

Lymph Nodes

Macrophages phagocytose foreign substances.

B lymphocytes (B cells) produce antibodies.

T lymphocytes (T cells) attack bacteria and foreign cells.

What happens in a lymph node?
How do T cells act to attack foreign cells?

SPLEEN

Destroys old red blood cells.

Filters microorganisms and

other foreign material out of

the blood.

Activates lymphocytes during

blood filtration. B cells

produce antibodies.

Stores blood, especially

erythrocytes (RBCs) and

platelets

The spleen and thymus gland are composed of lymph tissue.
Note their locations.
What are the functions of the spleen?
Is the thymus proportionately larger in infants or adults? Why?

THYMUS GLAND

Provides immunity in fetal life

and in early years of growth.

Makes cells immunocompetent

in early life.

Early removal from an animal

impairs its ability to make

antibodies and produce cells to

fight antigens.

The spleen and thymus gland are composed of lymph tissue.
Note their locations.
What are the functions of the spleen?
Is the thymus proportionately larger in infants or adults? Why?

Immune System

Natural immunity: genetic predisposition

Phagocytosis
Macrophages
Natural killer cells

Why is it important for infants to possess natural immunity at birth?
What is an example of genetic predisposition? (Humans cannot contract feline leukemia.)

Immune System (cont’d)

Acquired/ Adaptive

immunity

Active
by contracting a disease
by vaccination
stem cell transplant

Ask students to provide an example for each method of acquiring active immunity.
Ask students what vaccinations they have had.

Immune Response

B lymphocytes are responsible for humoral immunity.
originate in bone marrow from stem cells
transform into plasma cells to produce immunoglobulins, antibodies that neutralize antigens

Immune Response (cont’d)

T lymphocytes are responsible for cell-mediated immunity. The function of T cells varies:
Cytotoxic T cells (T8 cells) attach to and attack antigens.
Other T cells secrete interferons and interleukins that help cells respond to antigens.
Helper T cells (CD4+) promote antibody synthesis by B cells and stimulate other T cells.
Suppressor T cells inhibit B and T cells.

T-cell lymphocytes originate from bone marrow stem cells. They are processed in the thymus gland.

Dendritic Cells

A macrophage derived from monocytes.
Recognize and digest foreign antigens.
Present antigens on surface to stimulate B and T cells.
Transfer immunity by exposing dendritic cells in culture; then transfuse them and get them to stimulate T and B cells.

Some of the dendritic cell work (sensitizing them in a culture) is under investigation in clinical studies used to treat tumors and tumor antigens, thus getting the patient’s own immune system to attack the tumor.

Immunotherapy Examples

Vaccines: killed tumor cells produce cytokines that enhance the immune response
Dendritic cells: cultured and exposed outside body and reinfused
Monoclonal antibodies (MoAb): multiple copies of cells or genes that kill tumor cells
Donor lymphocyte infusions: T cells, infused after allogeneic stem cell or bone marrow transplant, attack tumor (leukemia treatment)

QUICK QUIZ:

Lymphocyte that originates in the bone marrow and transforms into a plasma cell to secrete antibodies?

dendritic cell

helper T cell

B cell

cytotoxic T cell

CORRECT Answer is B, helper T cell, see page 533 LOM 83.

2. Which type of immunity is the formation of antibodies and lymphocytes after exposure to an antigen?

Cell-mediated immunity

Acquired/ adaptive immunity

Natural immunity

QUICK QUIZ:

CORRECT Answer is B, acquired immunity

COMBINING FORMS

immun/o protection
lymph/o lymph
lymphaden/o lymph node
splen/o spleen
thym/o thymus gland
tox/o poison

Combining Form Meaning

COMBINING FORMS, PREFIXES, AND TERMINOLOGY

PREFIXES

ana- again, anew

inter- between

Prefix Meaning

COMBINING FORMS, PREFIXES, AND TERMINOLOGY

Chapter 14
Lesson 14.2

Disorders of the Lymphatic and Immune Systems

Immunodeficiency

Acquired Immunodeficiency Syndrome (AIDS)
destroys T helper cells (CD4+ cells)
opportunistic infections
malignancies

(Kaposi sarcoma, Wasting syndrome)

Opportunistic Infections with AIDS

Candidiasis
Cryptococcus (Crypto)
Cryptosporidiosis
Cytomegalovirus (CMV) infection
Herpes simplex

Histoplasmosis (Histo)
Mycobacterium avium-intracellulare (MAI) infection
Pneumocystis pneumonia (PCP)
Toxoplasmosis (Toxo)
Tuberculosis (TB)

Ask students to provide symptoms for the opportunistic infections listed.

Drugs to Treat AIDS

Reverse transcriptase inhibitors (RTI) (e.g. Epivir) inhibits viral enzyme called reverse transcriptase
Protease inhibitors (PI) (e.g. nelfinavir, amprenavir) inhibit viral proteolytic enzyme
Combiniation of RTI and Protease inhibitors is HAART (highly active antiretroviral therapy)

HIV needs protease at a later stage than it needs RT to make viral parts that will spread throughout the body.

HYPERSENSITIVITY

Allergy: abnormal sensitivity acquired by exposure to antigen
Ranges from

allergic rhinitis or hay fever to anaphylaxis

Other allergies:

atopic dermatitis

asthma

urticaria (hives)

Review examples of hypersensitivity reactions. Discuss reactions that students have had.
What is anaphylaxis? Why is it dangerous?
What is the common name for urticaria?

MALIGNANCIES

Lymphoma: malignant tumor of lymph nodes and lymph tissue
Hodgkin disease (Reed-Sternberg cell)
Non-Hodgkin lymphoma (follicular lymphoma, large cell lymphoma)

Multiple myeloma: malignant tumor of bone marrow cells

Thymoma: malignant tumor of the thymus

Ask students to define associated terms:
Splenomegaly
Lymphadenopathy
Radiotherapy

Staging of Hodgkin Disease

Ask students to define associated terms, and reuse them correctly in another context:
Mediastinum
Extranodal
Extralymphatic
Splenectomy

QUICK QUIZ:

3. What is a malignant condition associated with AIDS?

anaphylaxis

non-Hodgkin lymphoma

Kaposi sarcoma

Hodgkin disease

CORRECT Answer is C, Kaposi sarcoma.

Laboratory Tests

CD4+ cell count: measures the number of CD4+ Tcells (helper T cells) in the bloodstream with patients with AIDS

ELISA test: detects anti-HIV antibodies; Western blot given as follow-up

Immunoelectrophoresis: separates immunoglobulins (IgG, IgM, IgE, IgA, IgD)

Viral load tests: measure amount os AIDS virus in the bloodstream

ELISA is an acronym that stands for what? (enzyme-linked immunosorbent assay)
For what conditions is immunoelectrophoresis utilized?

Clinical Procedure

Computed tomography (CT) scan:

X-ray imaging in the transverse plane produces cross-sectional views of anatomic structures. These x-ray views show abnormalities of lymphoid organs, such as lymph nodes, spleen and thymus gland.

COMBINING FORMS

axill/o ___________
cervic/o ___________
immun/o ___________
inguin/o ___________
lymph/o ___________
lymphaden/o ___________

Suffix Meaning

REVIEW SHEET

COMBINING FORMS

axill/o armpit
cervic/o neck; cervix (neck of uterus)
immun/o immune;protection;safe
inguin/o groin
lymph/o lymph
lymphaden/o lymph gland (node)

Suffix Meaning

REVIEW SHEET

COMBINING FORMS

splen/o ___________
thym/o ___________
tox/o ___________

Suffix Meaning

REVIEW SHEET

COMBINING FORMS

splen/o spleen
thym/o thymus gland
tox/o poison

Suffix Meaning

REVIEW SHEET

SUFFIXES

-cytosis ___________
-edema ___________
-globulin ___________
-megaly ___________
-oid ___________
-pathy ___________

Suffix Meaning

REVIEW SHEET

SUFFIXES

-cytosis condition of cells; slight increase in numbers
-edema swelling
-globulin protein
-megaly enlargement
-oid resembling
-pathy disease; emotion

Suffix Meaning

REVIEW SHEET

SUFFIXES

-penia ___________
-phylaxis ___________
-poiesis ___________
-stitial ___________
-suppression ___________

Suffix Meaning

REVIEW SHEET

SUFFIXES

-penia deficiency
-phylaxis protection
-poiesis formation
-stitial to set; pertaining to standing or positioned
-suppression to stop

Suffix Meaning

REVIEW SHEET

PREFIXES

ana- ___________
auto- ___________
hyper- ___________
inter- ___________
retro- ___________

Suffix Meaning

REVIEW SHEET

PREFIXES

ana- up; apart; backward; again; anew
auto- self; own
hyper- above; excessive
inter- between
retro- behind; back; backward

Suffix Meaning

REVIEW SHEET

QUICK QUIZ:

4. What is the fluid that lies between cells throughout the body?

A. atopy

B. lymphadema

C. interstitial

D. lymphopoiesis

CORRECT Answer is C, interstitial fluid.

QUICK QUIZ:

5. Malignant tumor of the lymph nodes and spleen marked by the presence of Reed-Sternberg cells in lymph nodes…

HIV

Kaposi sarcoma

Non-Hodgkins lymphoma

Hodgkin disease

CORRECT Answer is D, Hodgkin disease