clin phys exam 2

immune system

system of biological structures and processes within an organism that protects from and helps fight dieases, is specific and has memory

when immune system isnt working:

can result in localized or systematic infection or disease

primary function of immune system

protect our body from damage

3 major functions of immune system

• it tries to recognize and remove abnormal “self” cells

• it removed bead or damaged cells, as well as old RBCs

• it protects the body from disease-causing pathogens

self cells

particles (proteins or other molecules) that are a part of or made by our bodies. Non-reactivity of immune system to self particles is called tolerance

non-self cells

refers to particles that are not made by your body and are recognized as potentially harmful. Sometimes called foreign bodies

examples of non-self cells

any bacteria, parasites, toxic chemicals, allergens and other diseases causing pathogen

• Includes any cells that become defective and threaten to do harm (i.e. cancer)

immunity

the body’s ability to protect itself

antigen

foreign substance in body that does not have the characteristic cell surface markers of that indivisual and can elicit an immune response, recognized as non-self

anti-body

produced in response to antigen, protein moleculre structured in a way tat they only interact with the antigen that induced their synthesis

what are anti-bodies produced by

B cells

anti-bodies are also called

immunoglobin

main purpose of innate immunity

immediately prevent the spread and movement of foreign pathogens throughout the body

examples of innate immunity

cough reflex, enzymes in tears, skin oils

1st line of defense

skin, mucous and membrane secretions, normal flora

surface barriers

the primary defense against infectious disease

intact skin

protects external boundries

mucous membranes

protects internal boundries

both intact skin and mucous membranes

release chemical secretions which restrict the growth of microbes on their surface

2nd line of defense

innate immune cells, inflammation, complement, antimicrobial substances

role of 2nd line of defense

detection and identification of pathogen, communication with other immune cells to rally response, recrutment of assitance and coordination of the response, destriction or suppression of pathogens

two types of 2nd line of defnese

non-specific phagocytes and specific lymphocytes

innate immunity APCs present…

from brith and the body immediate immune respone to invasion

Innate immunity APCs consist of…

physical chemical and cellular defenses

innate immunity APCs are ____ to any one pathogen

NOT specific

innate immunity APCs response is…

NOT remembered by immune system

four components of innate immunity

• physical/chemcial barriers(skin/mucous membranes)

• phagocytic barriers(eat bad cells)

• Component system, Blood proteins: complement proteins that help link pathogen recognition and the physical response (inflammation)

• Cytokines: mediate and regulate immune and inflammatory responses, produced in response to microbes. (macrophages, neutrophils, NK cells)

cytokines system

proteins

cytokines structure and function

mediate and regulate immune and inflammatory response, produced in response to microbes

phagocytes, mast cells, neutrophils, eosinophils, basophils, monocytes, lymphocytes systems

leukocytes/WBCs/nonspecific/innate

phagocytes stucture and function

eats bad cells:neutrophils and monocytes

mast cells structure and function

contains histamines that dilates blood vessels when released

neutrophils structure and function

Phagocytosis, die after they eat bad cells. Dead neutrophils=pus

eosinophils structure and function

Defense against nematodes and parasitic infections. Active in many responses

basophils structure and function

Aid in allergic reactions, contain histamine that dilated B.Vs when released

monocytes structure and function

Clear up debris after neutrophils eat bad cells

lymphocytes structure and function

Produce antibodies and NK cells kill viruses, tumor cells, infected cells

B lymphocytes(B cells) system

humoral immunity, cell mediated

B lymphocytes(B cells) structure and function

produce antibodies

T lymphocytes, sensitized T cells, cytotoxic T cells, helper T cells, and regulatory/suppressor T cells system

cell mediated immunity

T lymphocytes structure and function

Specific cells that can search, recognize, and destroy hiding pathogens

Sensitized T cells structure and function

Produced after interaction with specific antigen

cytotoxic T cells structure and function

directly kill antigens once activated.

helper T cells structure and function

regulate B cell activation (assist in their maturation and produce antibody)

regulatory/suppressor T cells structure and function

suppress activation of the immune system and prevent pathogenic selfreactivity

adaptive/acquired immunity

third(final) line of defense, utilized when specific pathogen has infiltrated past 2nd line

Both B and T cells…

differentiate to form memory cells after activation, to remember particular pathogens

active aquired immunity

protection acquired by introduction of an antigen into responsive host (vaccine)

natural antibodies

made after exposure to infection

artifical antibodies

made after gatting a vaccination

passive acquired immunity

when a person is given an antibody to a disease, only provided temporary immunity

natural transmission

antibodies transferred from mother to baby via milk

artificial transmission

antibodies acquired from an immune serum medicine

types of acquired immune response

humoral immunity and cell mediated immunity

humoral immunity

decribes pathway by which antibodies are produced by B lymphocytes to target exogenous antigens

5 types of antibodies

IgG, IgM, IgA, IgD, and IgE

cell mediated immunity

describes a pathway that does not result in antigen produced by T lymphocytes but instead targets endogenous antigens

role of helper T cells in cell mediated immunity

constituting 75% of all T cells, assist the B cells to mature and produce antibody by secreting protein mediators called lymphokines

role of cytotoxic T cells in cell mediated immunity

directly kill antigens once activated

role of regulatory/suppressor T cells in cell mediated immunity

suppress activation of the immune system and prevent pathogenic selfreactivity, or autoimmune disease

Innate/natural immunity response

immediate

innate/natural immunity antigen dependancy

indepentent

innate/natural immunity changes with age

exterior defense affected by thinning of skin, phagocytes, eosinophils, and basophils

adaptive/acquired immunity response

long time

adaptive/aquired immunity antigen dependancy

dependant

adaptive/acquired immunity changes with age

• Older adults have difficulty mounting protective immune responses to newly encountered antigens

• Decline in production of naive T and B cells

• Decline in antibody production may be due to insufficient T cell help

where are most immune cells produced

bone marrow

primary lymphatic organs

bone marrow and thymus

bones that still contain red blood marrow in adulthood

ribs breastbone and pelvis

how does bone marrow change over time

at birth many bone contain it which actively creates immune cells, over time it turns into fatty tissue

thymus

t cells mature here, coordinate processes of innate and adaptive immune systems

secondary lymphatic organs

lymph nodes, spleen, tonsils, and mucous membranes

lymph nodes role in immune response

filters, traps germs and activate creation of antibodies, swell and painful when active

spleen’s role in immune response

stores immune cells, phagocytes act as filter for germs, breaks down RBCs, and stores and breaks down platelets

tonsils role in immune response

can stop germs from entering the body through mouth or nose, contain lots of WBCs

walderyers ring

palatine and lingual tonsils, adenoids from a ring around the opening of the throat from mouth and nose

if palatine tonsils are removed

lymph tissue on side of throat can preform functions

mucous membranes

line body cavities and canals that lead to the outside (respiratory, digestive, urogenital, nose, eyes, trachea, bladder, etc)

factors that alter the immune system

age, gender, hormonal, nutrition, environment pollution, burns, medication, sleep disturbances, exposure to toxic chemicals, presence of concurrent illnesses, hospitalization, surgery, general anesthesia, splenectomy, stress, psychospiritual well-being, SES

factors that increase exposure to pathogens

Latrogenic: Catheter, Nasogastric tubes, Endotracheal tubes, Chest tubes, Implanted prosthesis, External fixation devices, Intercranial pressure monitor

interations between immune and CNS

endocrine factors can alter immune function, immune response can alter both endocrine and CNS response

exercise and immune system

the immune system is enhanced during moderate exercise, monitor activity, increasing intensity can endanger patient

strenuous or intense activity is followed by

impairment of the immune system

exercise causes an

increase in neutrophils and stimulates phagocytosis

NK enhancemnt

increased number of NK cells and their function/activity in the blood

what happens to NK concentration after intense exercise of long duration

concentration and cytolytic activity declines below pre-exercise values

brisk exercises increases…

WBC count in proportion to intensity

cortisol

primary stress hormone, fuels fight or flight instinct, Manages how your body uses fats, carbohydrates, and proteins, Regulates blood pressure, Keeps inflammation low, Increases blood sugar, Controls sleep/wake cycle, Boosts energy so you can handle stress and restores balance afterward

Immunodeficiency disease

lack of response, increased risk of developing infection

primary immunodeficiency

born with weak immune system, congenital lack of B or T cell activity

primary B cell defect

lack antibodies

primary T cell defect

thymus missing or abnormal

secondary immunodeficiency

acquired due to viral infection, drugs, radiation (Leukemia, Hodgkin, Cancer Chemo and Radiation, HIV (Human Immunodeficiency Virus))

Advanced HIV

AIDS(aquired immune deficincy syndrome)

AIDS diagnosis value

T cell(CD4) count below 200/mm³

acute infection of HIV

2-4 weeks, symptoms include rash fever, flu, fatigue, sore throat

asymptomatic HIV

1-20 years, positive antibody test for HIV by no symptoms, CD4 cells declining

early symptomatic HIV

length is variable, persistant generalized adenopathy, non-specific symptoms like fatigue, diarrhea fever, etc, neurological symptoms

AIDs

immune system breaks down, easy to become sick, neurologic manifestations can involve CNS, ANS, and PNS

Not everyone who is exposed to HIV

becomes infected