Applied Anatomy and Physiology for Manual Therapists
Applied Anatomy and Physiology for Manual Therapists
Detailed Outline and Resources for Lesson Planning
Every teacher’s lesson plan is different due to a number of variables including content, class length, personal teaching style, students’ needs,
available resources, and materials. This ancillary has been created to provide you with a detailed outline of the contents of Applied Anatomy and
Physiology for Manual Therapists by chapter. Additional resources available to you through LWW as well as suggestions for presentation, learning
exercises, and group activities are listed to help you put together an engaging and effective lesson plan for your class.
Chapter 12 — Immunity and Healing
Learning Objectives:
Upon completion of this chapter, the student will be able to:
1. Explain the function of the immune system and discuss its relationship with and importance to manual therapy practices.
2. Explain the difference between primary and secondary lymphoid tissues.
3. Name, locate, and describe the general function of the primary and secondary lymphoid tissues.
4. Explain the difference between nonspecific defenses and specific immune responses.
5. List the nonspecific immune defenses of the body and explain how each mechanism works.
6. Name and describe the roles of the primary lymphocytes involved in antibody-mediated and cell-mediated immune responses.
7. Discuss the difference between naturally and artificially acquired immunity and give examples of active and passive forms of each.
8. Discuss the immune system changes that commonly occur with aging.
9. Define the field of study known as psychoneuroimmunology and explain what implications this discipline may bring to the practice of manual
therapy.
Archer&Nelson-Detailed Outline & Resources for Lesson Planning-CH12-PA&LN-07.09.11
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Applied Anatomy and Physiology for Manual Therapists
Detailed Outline
Introduction to immunity and healing
 Define pathogens
 Immunity = protection or resistance to infection and disease
 Involves many body systems and processes
 Define healing (physically and holistically)
 Define psychoneuroimmunology (PNI) and foreshadow later
information/discussion
Obj
Text
pages
PPt
slides
1
310
1-2
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Lymphoid tissues and organs
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 Note that lymphoid is used instead of lymphatic (lymphoid
for immune structures related to lymphocytes vs. lymphatic
meaning related to lymph fluid return)
 Lymphoid (immune) tissue not physically connected but
scattered throughout the body:
o Primary lymphoid tissues where mature
lymphocytes are produced include (Fig 12-2):
 Red bone marrow produces B cells
 Thymus produces T cells
o Secondary lymphoid organs are sites of immune
responses and include (Fig 12-1):
 Lymph nodes
 Filtering stations for foreign
particles (macrophages eat)
 Pathogens recognized by
lymphocytes set off response and
node swells
 Spleen
 Left upper quadrant above stomach
 Similar function to nodes, but filters
blood instead of lymph
 Also serves as blood bank
 MALTs include:
 Peyer patches in SI
 Tonsils (Fig 12-3)
 Appendix
Archer&Nelson-Detailed Outline & Resources for Lesson Planning-CH12-PA&LN-07.09.11
S&RG
Additional Resources and Sample Activities
If your program includes energy and/or Eastern practices,
this chapter provides many opportunities to make links
between Western understandings of A&P and energy,
spirit, life force, Qi etc.
Ex 1,2
Refer students to the Pathology Alert: Tonsillitis and
discuss as an example of a localized infection. Compare
with appendicitis and/or hepatitis (other organ infections).
Use S&RG Ch 12, Ex 2, as an in-class review exercise for
primary versus secondary lymphoid tissues
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Applied Anatomy and Physiology for Manual Therapists
Non-specific (innate) immune defenses
 Universal responses not directed at any specific pathogen or
foreign invader (Table 12-1)
 Define microbes
 These defenses include:
o Physical barriers – skin, mucous membranes
o Chemical barriers – sebum, sweat, tears, saliva,
gastric juices, urine, vaginal secretions
o Internal antimicrobial proteins – interferons,
complement proteins, transferrins, antimicrobial
peptides
o Phagocytes – neutrophils, monocytes, and
macrophages that do phagocytosis (Fig 12-4)
(define chemotaxis)
o Natural killer (NK) cells – destroy infected cells
via cytolysis
o Inflammation – chemical and cellular processes
that enhance vasodilation, capillary permeability,
clot formation, and phagocytosis (define pus)
o Fever – elevated body temperature (discuss
purpose)
4,5
Specific (adaptive) immune responses
 Acquired over time with exposure to pathogens that trigger
responses of specific B and/or T lymphocytes
 Define antigen and antigen receptors
 There are 2 types of specific responses:
o AMI (humoral) = involve B cells and antibodies
(Fig 12-5)
 B cell recognizes specific antigen and is
activated
 Activated B cell produces:
 Plasma cells – produce antibodies
(immunoglobulins)
 Memory B cells – remember
exposure
 Antibodies find other antigens and form
complexes that neutralize or destroy invader
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8-14
Ex 1,3,5
Either refer students to Table 12-1 or ask students to create
their own mind map or table that summarizes the innate
immune defenses (S&RG) as an in-class review activity.
Refer students to the Pathology Alert: Allergies. Define
allergen and discuss signs and symptoms of anaphylaxis.
Review cautions for manual therapists.
Use the video animation to show the chemical and cellular
responses involved in inflammation (Immune: acute
inflammation).
Ask students to compare inflammation in response to
tissue injury versus infection. If hydrotherapy is taught in
your program, ask students why one situation is treated
with RICE, while the other is treated with moist heat.
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Ex 1,4,5
Remind students of RBC antigens that create blood
groups discussed in Ch 10.
Refer students to and discuss the Pathology Alert:
Autoimmune Diseases.
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Applied Anatomy and Physiology for Manual Therapists
o CMI = T cells (Fig 12-6)
 APC presents antigen to T cell that
Use video animation to show and summarize the specific
immune responses of the body (Immune: Immune
response).
recognizes it and is activated
 Activated T cell produces:
 Cytotoxic T cells – go out and kill
the antigen
 Memory T cells – remember the
exposure
 Helper T cells – release cytokines
that promote T cell growth and
plasma cell production of antibodies
 Suppressor T cells – shut down
immune response when no longer
needed
 Fig 12-7 summarizes immune responses
Provide students a blank of Fig 12-7 (S&RG Ch 12, Ex 4)
and ask them to complete it as an in-class review activity.
Ask them to track their questions as they complete it and
follow up the exercise with Q&A.
Break students into pairs and have them write a story or
analogy for immune processes (S&RG Ch 12, Ex 5).
Acquisition of immunity
 Define immunological memory
 Explain difference between first and second exposure
responses
 Naturally acquired immunity = without medical intervention
o Active – exposed to pathogen in everyday life and
develop own immunity
o Passive – baby receiving antibodies during
gestation or through breast-feeding
 Artificially acquired immunity = with medical intervention
(immunizations)
o Active – receive antigen (altered, dead, small
dosage) and develop own immunity
o Passive – receive antibody
 Table 12-2 summarizes immunity acquisition
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18-20
Aging and the immune system
 Identify common changes in the immune system related to
aging:
o B & T cells become less responsive
o Thymus shrinks and number of T cells drops
o Decrease in number and activity of NK cells
increases incidence of cancer
8
320
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Archer&Nelson-Detailed Outline & Resources for Lesson Planning-CH12-PA&LN-07.09.11
Ex 1,6
Use S&RG Ch 12, Ex 6, as an in-class review activity.
Leave time for Q&A after completion.
Discuss with students how these changes may affect their
manual therapy treatments when working with the elderly.
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Applied Anatomy and Physiology for Manual Therapists
o
o
System less responsive to vaccinations
Incidence of autoimmune dysfunction increases
Psychoneuroimmunology
 Describe history of Cartesian division of mind-body-spirit
 Peptide network:
o Define peptide, ligand
o Ligands create responses in any cell with receptors,
whether immune cells, neurons, or others
o Ligand receptors densest in limbic system and other
areas of brain associated with emotions
 Share your own thoughts on healing:
o Biomedical versus holistic
o Applications for manual therapists
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Ex 1;
GrA 1
Provide time for students to discuss the implication of PNI
for their practice of manual therapy and share their
thoughts on healing. Refer to S&RG Ch 12, GrA 1, for
suggestions to spur discussion.
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