Blood TWO & Lymphatic

Leukocytosis

excess WBC, often from leukemia

Leukemia

Cancer of blood cells often results in excess and immature WBCs

Leukopenia

Insufficient WBCs, reasons could be from HIV, Chemotherapy, or autoimmune disease

Chemotherapy

Chemicals used to treat cancer; block fast-dividing cells

Myeloid Leukemia

Excess granulocytes or monocytes

Lymphoid Leukemia

Excess lymphocytes

Acute

rapid onset and quick progression

Chronic

Slow, sometimes, are simply monitored

Fluid Recovery (function of the lymphatic system)

Starling forces are not perfectly balanced, and excess water (15%) that leaves capillaries accumulates in interstitial fluid

What happens when the lymphatic system fails to recover fluid?

Lymphedema, swelling!

Lymph fluid builds up (clear fluid composed of water, solutes, WBCs, and possible pathogens)

Immune Surveillance (function of the lymphatic system)

Fluid is filtered through lymph nodes where WBCs (B & T cells, macrophages) surveil it

lipid absorption (function of the lymphatic system)

Lipids are absorbed from the small intestine into lacteals (lymphatic vessels) before joining the common circulation and eventually making their way to organs for use/storage

Lymphatic Circulation

Lymphatic capillaries (lymphatics) flow through lymph

nodes on their way to collecting vessels, and then more

lymph nodes and onto lymphatic trunks and finally into

one of two collecting ducts

What does the Right Lymphatic duct drain?

The right upper torso, right arm, and right side of head/neck.

Where does the Right Lymphatic duct dump its contents?

Into the right subclavian vein.

What does the Thoracic duct drain?

The left side of the head and torso, left arm, and everything below the diaphragm.

Where does the Thoracic duct dump its contents?

Into the left subclavian vein.

What structure is included in the Thoracic duct?

The cisterna chyli.

What is cisterna chyli

Enlarged sac of the thoracic duct that receives lymph from the small intestine

Glial-lymphatic (glymphatic)

The CNS has its own system for clearing waste

Lymph nodes filter how much per node

99% of impurities

Medulla (Lymph node structure)

Packed with T cells, blood vessels deliver lymphocytes

What are Sinuses (Lymph node structure) packed with?

Macrophages

Spleen pulps

Red pulp: sinuses filled with RBCs and reserve monocytes and platelets

White pulp: lymphocytes and macrophages along arterioles

Antigen

A cell surface ID marker, may be foreign or native

Antibody

An immune protein that will recognize antigens with specificity

A allele

makes A-type antigen

What chromosome is the ABO gene?

Chromosome 9

B allele

makes B-type anitgen

O allele

no antigen

If you have A-type blood, what antibodies do you have?

Anti-B

If you have B-type blood, what antibodies do you have?

Anti-A

If you have O-type blood, what antibodies do you have?

both anti-A and anit-B

If you have AB-type blood, what antibodies do you have?

no antibodies produced

Aggulation

clumping of cells

What is the universal donor?

Type O-

What is the universal recipient?

Type AB+

What is Rh factor?

It is the positive antigen present on RBC if the individual as it

What happens if the mom has Rh- and the fetus has Rh+, but the blood never crosses over?

Nothing happens, since there is no exposure, there is no effect

What happens if the mom has Rh- and the fetus has Rh+, and the mom is exposed to the fetal blood?

Anti-D antibodies are made to protect. If this is the first pregnancy, then both are good. But if this is the second pregancy that mom and fetus are different in Rh, then the anti-D will attack the fetus.

What substance would build up in the fetus with the rupture of RBCs?

Bilirubin, because RBC rupture causes breakdown of hemoglobin, hemoglobin breaks down into bilirubin

Hemolytic disease of the newborn (HDN)

Hemolysis (rupture) of fetal RBCs due to incompatibility of fetal RBCs with pregnant female

immune system (something on fetal RBCs is deemed foreign)

Erythroblastosis fetalis

The fetus starts to make a lot of immature RBCs

What is the classic way to obtain donor bone marrow?

Remove donor marrow by a large needle, usually inserted into a pelvic bone (flat bone)

Assume a person is blood type A+. What blood types can

they safely receive? Who can they donate to?

Receive: A+, A-, O+, O-

Donate: AB+, A+

An infant is blood type O+. You don't know either parent's

blood type. Which is not possible for a parent's blood

type: A-, B+, AB+, O-

AB+

What causes pernicious anemia? What is its anemia

classification type?

pernicious = lack of vitamin B12 and failure to support rapid RBC

division, macrocytic anemia/inadequate erythropoiesis

How would a phlebotomist know somebody recently ate a fatty meal?

Trace the circulatory route for evidence of a fatty meal

intestine cisterna chyli thoracic duct left subclavian vein

for joining circulation

What explains tissue swelling after damage to

lymphatic vessels?

Accumulation of fluid due to poor

lymphatic drainage

Which lymph nodes would you

biopsy to check for metastatic

breast cancer?

Axillary

What blood cancer category best fits

the blood smear shown?

Lymphocytic or lymphoblastic leukemia

(excess lymphocytes;

-cytic = chronic, -blastic = acute)

Innate Immunity

Does NOT require specific

recognition of pathogens

Barrier Defense (Innate Immunity)

Skin

Nonselective secretions:

mucus, saliva, tears,

stomach acid

Inflammation (Innate Immunity)

not all

inflammation is bad, this

is a form of cell signaling

Phagocytosis (Innate Immunity)

"eating"

and destroying pathogens

by macrophages,

neutrophils, and dendritic

cells

Adaptive Immunity

Requires prior exposure to a pathogen. Cells then respond and

some form a "memory" for that pathogen. The immune system

can better respond to that SAME pathogen in the future.

What does Adaptive Immunity involve?

Lymphocytes: B cells and T cells

• major histocompatibility complex (MHC) interactions and

signaling

• Antibodies