CHAPTER 28 The Lymphatic and Immune Systems © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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. © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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. © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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 © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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 © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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 © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 28-7 Lymphatic Pathways (cont.) • Efferent lymphatic vessels trunks lymphatic • Lymphatic collecting ducts – Thoracic duct – Right lymphatic duct • Empty into blood stream Lymph System © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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 © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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 © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 28-11 Lymph Nodes • Small, glandular structures • Afferent lymphatic vessels ~ lymph to node • Efferent lymphatic vessels ~ lymph from node © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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 © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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 © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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 © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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. © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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 © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 28-18 Non-Specific Defenses • Species resistance • Chemical barriers • Mechanical barriers • Phagocytosis – phagocytes surround and destroy pathogens and unwanted debris – Skin – Mucous membranes © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 28-19 Non-Specific Defenses • Fever • Inflammation – Stimulates removal of iron from blood – Redness – Activates phagocytic cells – Swelling – Heat – Pain © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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 © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 28-21 Specific Defenses • Antibodies – respond to specific antigens • Complements – work with antibodies • WBCs – lymphocytes and macrophages © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 28-22 Specific Defenses • Cytokines – assist in immune response regulation • Monokines – Increase B cell production – Stimulate WBC production © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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 © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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 © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 28-26 Specific Defenses (cont.) • Cytotoxic T cells • Helper T cells – Increase antibody formation • Memory T cells – Memory cell formation – B cell formation – Phagocytosis © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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 © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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 ___ © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 28-29 Antibodies • Immunoglobulins • IgA – prevents pathogens from entering body • IgD – thought to control B cell activity • IgE – involved in triggering allergic reactions © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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 © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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 © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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. © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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 © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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 © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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 © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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. © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 28-37 Major Immune System Disorders • Cancer – Uncontrolled growth of abnormal cells – Carcinogen – Signs/symptoms vary – Treatment based on staging © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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. © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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. © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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 © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 28-41 Major Immune System Disorders (cont.) • Allergies (cont.) – Signs/symptoms are based on where exposure occurs – Treatment • Antihistamines, decongestants • Epinephrine for anaphylaxis © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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 © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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) © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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 © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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 © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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. © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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. © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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. © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 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. © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part. 28-50 End of Chapter 28 Thought is an infection. In the case of certain thoughts, it becomes an epidemic. ~Wallace Stevens © 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.