Aging of the skin results in a loss of elasticity and the appearance of wrinkles University of Baghdad College of Nursing Department of Basic Medical Sciences Overview of Anatomy and Physioloy –II Second Year Students Asaad Ismail Ahmad , Ph.D. Electrolyte and Mineral Physiology asaad50.2011@gmail.com 2012 - 2013 ANATOMY AND PHYSIOLOGY - II Brief Contents 1- Cardiovascular System 2- Blood 3- Lymphatic System 4- Urinary System 5- Male Reproductive System 6- Female Reproductive System 7- Sensory Function Asaad Ismail Ahmad, Ph.D in Electrolyte and Mineral Physiology College of Nursing – University of Baghdad / 2012 – 2013 asaad50.2011@gmail.com Text book Martini FH. Fundamentals of Anatomy and Physiology, 5th ed. Prentice Hall, New Jersey, 2001. References: 1.Barrett KE, Barman SM, Boitano S, Brooks HL. Ganong's Review of Medical Physiology, 23rd ed. McGraw Hill, Boston, 2010. 2.Drake RL, Vogl W, Mitchell AWM. Gray's Anatomy for Students. Elsevier, Philadelphia, 2005. 3.Goldberger ,E. 1975.A Primer of Water Electrolyte and Acid-Base Syndromes. 5th ed., Lea and Febiger ,Philadelphia. 4. Martini, FH and Welch K. Applications Manual Fundamentals of Anatomy and Physiology,4th ed., Prentice Hall, NewJersey, 1998. 5.Maxwell, MH and Kleeman CR. 1980.Clinical Disorders of Fluid and Electrolyte Metabolism. McGraw-Hill Book Company, New York. 6.McKinley M, and O'Loughlin VD. Human Anatomy, McGraw Hill, Boston, 2006. 7.Nutrition Foundation.1984.Present Knowledge in Nutrition. 5th ed., Nutrition Foundation, Inc , Washington, D.C. 8.Vander A, Sherman J, Luciano D., Human Physiology, 7th ed., McGraw Hill, Boston, 1998. LYMPHATIC SYSTEM LYMPHATIC SYSTEM Contents: 1. Anatomy of Lymphatic System 2. Physiology of Lymphatic System Asaad Ismail Ahmad, Ph.D in Electrolyte and Mineral Physiology College of Nursing – University of Baghdad / 2012 – 2013 asaad50.2011@gmail.com 8th LECTURE Physiology of Lymphatic System ( Immune System). 1. Functions of Lymphatic System 2. Nonspecific Defenses 3. Specific Defenses Asaad Ismail Ahmad, Ph.D in Electrolyte and Mineral Physiology College of Nursing – University of Baghdad / 2012 – 2013 asaad50.2011@gmail.com Wood engraving of Louis Pasteur watching Joseph Meister receive the rabies vaccine. [From Harper’s Weekly 29:836; courtesy of the National Library of Medicine.] Nobel Prizes for immunologic research Year Recipient Country Research 1901 Emil von Behring Germany Serum antitoxins 1905 Robert Koch Germany Cellular immunity to tuberculosis 1908 Elie Metchnikoff Russia Role of phagocytosis (Metchnikoff) and antitoxins (Ehrlich) in immunity Paul Ehrlich Germany 1913 Charles Richet France Anaphylaxis 1919 Jules Border Belgium Complement-mediated bacteriolysis 1930 Karl Landsteiner United States Discovery of human blood groups 1951 Max Theiler South Africa Development of yellow fever vaccine 1957 Daniel Bovet Switzerland Antihistamines 1960 F. Macfarlane Burnet Australia Discovery of acquired immunological Peter Medawar Great Britain tolerance 1972 Rodney R. Porter Great Britain Chemical structure of antibodies Gerald M. Edelman United States 1977 Rosalyn R. Yalow United States Development of radioimmunoassay 1980 George Snell United States Major histocompatibility complex Jean Daussct France Baruj Benacerraf United States 1984 Cesar Milstein Great Britain Monoclonal antibody Georges E. Köhler Germany Niels K. Jerne Denmark Immune regulatory theories 1987 Susumu Tonegawa Japan Gene rearrangement in antibody production 1991 E. Donnall Thomas United States Transplantation immunology Joseph Murray United States 1996 Peter C. Doherty Australia Role of major histocompatibility complex Rolf M. Zinkernagel Switzerland in antigen recognition by by T cells Characteristic “butterfly” rash over the cheeks of a young girl with systemic lupus erythematosus. P.467 Acute tonsillitis EDEMA EDEMA : 1- Accumulation of excess Fluid in fluid compartment. Or : 2- Chronic Swelling of a Part due to Accumulation of Interstitial Fluid (Lymph) Secondary to Obstruction of Lymphatic Vessels or Lymph Nodes. Asaad Ismail Ahmad, Ph.D in Electrolyte and Mineral Physiology Physiology of Lymphatic System FUNCTIONS OF LYMPHATIC SYSTEM 752 1- Production, maintenance and distribution of lymphocyte in a balance ratio 2- To return tissue fluid to the blood to maintain blood volume. 3- To protect ( immune) the body against pathogens and other foreign material. 4- Distribution of hormones, nutrients and waste products from their tissues of origin to the general circulation. Asaad Ismail Ahmad, Ph.D in Electrolyte and Mineral Physiology ONE OF THE GREATEST POINT IN MEDICAL CRISIS IS CONTROL OF IMMUNE SYSTEM **** There are two ways to control immune system 1- PHYSIOLOGICAL CONTROL (immune modulators to restore cell component) 2- MEDICAL CONTROL The first one is not yet enough, therefore we need to look for the possibility of restoring The physiological control of immune system, through the possibility of using immune modulators to restore cell component which Could maintain the homeostasis power of the cells and then healthy body. Asaad Ismail Ahmad, Ph.D in Electrolyte and Mineral Physiology IMMUNITY Immunity may be defined as the ability to destroy pathogens or other foreign material and to prevent further cases of certain infectious diseases. Immunity are two types: 1-INNATE IMMUNITY (NONSPECIFIC DEFENSES ) 2-ADAPTIVE IMMUNITY ‘’ SPECIFIC DEFENSES “ ( IMMUNE RESPONSES ) also called Acquired immunity INNATE IMMUNITY “ NONSPECIFIC DEFENSES “ NONSPECIFIC HOST DEFENSES BARRIERS 1- Anatomic barriers Skin Mucous membranes 2- Physiologic barriers Low pH. 3- Chemical mediators (defensive chemical ) Lysozome, Interferon, complement, cytokines 4- Defensive Cells: Phagocytic cells and NK – cell (natural killer cell) 5- Inflammatory barriers ( chemical defenses ) 6- Fever Asaad Ismail Ahmad, Ph.D in Electrolyte and Mineral Physiology NONSPECIFIC DEFENSES 764 “INNATE IMMUNITY” INNATE IMMUNITY “ NONSPECIFIC DEFENSES “ Barriers ( anatomical and physiological barrier ) 1. Unbroken stratum corneum and sebum; living epidermal cells secrete defensins 2. Subcutaneous tissue with WBCs 3. Mucous membranes and areolar CT with WBCs; upper respiratory epithelium is ciliated 4. HCl in gastric juice 5. Lysozyme in saliva and tears Asaad Ismail Ahmad, Ph.D in Electrolyte and Mineral Physiology Continue: INNATE IMMUNITY “ NONSPECIFIC DEFENSES “ Defensive Chemical 1. Interferon blocks viral reproduction 2. Complement proteins lyse foreign cells, attract WBCs, and contribute to inflammation 3. Inflammation—the response to any kind of damage; vasodilation and increased capillary permeability bring tissue fluid and WBCs to the area. Purpose: to contain the damage, eliminate the cause, and make tissue repair possible. Signs: redness, heat, swelling, and pain Continue: INNATE IMMUNITY “ NONSPECIFIC DEFENSES “ Defensive cells 1. Phagocytes—macrophages, neutrophils eosinophils; macrophages also activate the lymphocytes of adaptive immunity 2. Langerhans cells and other dendritic cells— activate lymphocytes 3. Natural killer cells—destroy foreign cells by rupturing their cell membranes 4. Basophils and mast cells—produce histamine and leukotrienes (inflammation) INNATE IMMUNITY ( Barriers ) “ NONSPECIFIC DEFENSES “ INNATE IMMUNIT (Defensive Cells) “ NONSPECIFIC DEFENSES “ INNATE IMMUNIT(Chemical Defenses) “ NONSPECIFIC DEFENSES “ ADAPTIVE IMMUNITY “ SPECIFIC DEFENSES “ ( IMMUNE RESPONSES ) Asaad Ismail Ahmad, Ph.D in Electrolyte and Mineral Physiology Adaptive Immunity are of two types: 1- Humoral Immunity (Antibodies, Ab) produce by B- lymphoctes 2- Cellular Immunity produce by T- lymphocytes Asaad Ismail Ahmad, Ph.D in Electrolyte and Mineral Physiology COMPONENT OF ADAPTIVE IMMUNE RESPONSE ( Components of Specific Immune System) 123456- Cellular Component Complement System Kinin System Coagulation Cascade (system) Fibrinolytic System Cytokines ( immune modulators ) “ immune system hormones” “ Immunotransmitters “ Asaad Ismail Ahmad, Ph.D in Electrolyte and Mineral Physiology IMMUNE CELLS The immune cells consist of the 1- T – lymphocytes ( cellular immunity ) are : a- Cytotoxic T-cells b- Helper T- cells 2- B – lymphocytes and plasma cell (humoral immunity) 3- Macrophages the accessory cells such, which aid in processing and presentation of antigens to the lymphocytes. Cytokines Cytokines are molecules that form a Communication link between immune cells and other tissues and organs of the body. Asaad Ismail Ahmad, Ph.D in Electrolyte and Mineral Physiology IMMUNITY 1- HUMORAL IMMUNITY ‘’ SPECIFIC DEFENSES “ Antibody-Mediated - Humoral Immunity Asaad Ismail Ahmad, Ph.D in Electrolyte and Mineral Physiology IMMUNITY ‘’ SPECIFIC DEFENSES “ Antibody-Mediated (Humoral) Immunity 1- Does involve antibody production; is effective against pathogens and foreign cells. 2. B cells and helper T cells recognize the foreign antigen; the B cells are antigen specific and begin to divide. 3. Memory B cells will remember the specific foreign antigen. 4. Other B cells become plasma cells that produceantigenspecific antibodies. 5. An antigen–antibody complex is formed, which attracts macrophages (opsonization). 6. Complement fixation is stimulated by antigen–antibody complexes. The complement proteins bind to the antigen– antibody complex and lyse cellular antigens or enhance the phagocytosis of noncellular antigens. TYPES OF ANTIBODIES Name Location IgG Blood, Extracellular fluid IgA External secretion (tears, saliva etc) IgM IgD IgE Blood B lymphocytes Mast cells or basophils FUNCTIONS • Crosses the placenta to provide passive immunity for newborns • Provides long-term immunity following recovery or a vaccine • Present in breast milk to provide passive immunity for breast-fed infants • Found in secretions of all mucous membrane • Produced first by the maturing immune system of infants • Produced first during an infection (IgG production follows) • Part of the ABO blood group • Receptors on B lymphocytes • Important in allergic reactions (mast cells release histamine) ALLERGIC RESPONSE ANTIGEN Foreign antigens: chemical compound stimulate antibody production or other immune responses, and include bacteria, viruses, fungi, protozoa, and malignant Asaad Ismail Ahmad, Ph.D in Electrolyte and Mineral Physiology ANTIGEN and ANTIBODY DIAGNOSTIC TESES INVOLVE ANTIBODY 1- Complement fixation test determines the presence of a particular antibody in the patient’s blood, but does not indicate when the infection occurred. 2- Antibody titer determines the level or amount of a specific antibody in the patient’s blood 3- Fluorescent antibody test uses antibodies tagged with fluorescent dyes, which are added to a clinical specimen such as blood, sputum, or a biopsy of tissue. 2- Cellular Immunity IMMUNITY ‘’ SPECIFIC DEFENSES “ Cell-Mediated (cellular) Immunity 1-Does not involve production of antibodies; is effective against intracellular pathogens (such as viruses, fungi )malignant cells, and grafts of foreign tissue. 2. Helper T cells recognize the foreign antigen, are antigen specific, and begin to divide to form different groups of T cells. 3. Memory T cells will remember the specific foreign antigen. 4. Cytotoxic (killer) T cells chemically destroy foreign cells and produce cytokines to attract macrophages Adaptive immunity. (A) Cell-mediated immunity. IMMMUNE DISORDERS 1- Allergy and Hypersensitivity (Anaphylaxis) 2- Autoimmune disease 3- Immunodeficiency 4- Inflammation 5- Tumor 6- Cancer