Head & Disease Test 2: Chapters 8, 9

Immune System is a major part of the body’s:

Defense System

Abnormal Immune Response can result in:

Persisten Infections

Allergies

Autoimmune disorders

Cancer

The Immune System:

Responds to certain entities that are perceived as foreign; Recognizes a specific invading antigen as foreign; stores the response in its memory cells.

Why does the immune system store the response in memory cells?

To protect the body again if the invading antigen returns.

Why does the Immune System recognize a specific invading antigen as foregin?

Because it develops a specific response to that parcticular antigen.

The Immune System consists of:

Lymphoid Structures

Immune Cells

Tissues concerned with immune cell development

Immune Cells

Lymphocytes

Lymphocytes originate in:

Bone marrow, then mature either in the thymus (T-cell) or the bone (B-cells).

The Thymus is the site of maturation for:

T-cells

Bone is the site of maturation for:

B-cells

Antigens:

Immunogens that can be foreign substances or human cell surface antigens; Unique to each patient.

What is essential for the immune response to occur?

Macrophages

Macrophages develop from monocytes (WBC) in the:

Liver

Lungs

Lymph Nodes

Other Tissues

T-cells are the:

Primary cell in the immune response.

T-cells (T lymphocytes) arise from:

Stem cells in the bone marrow that travel to the thymus for additional information and develop cell membrane receptors.

Cell-Mediated Immunity develops:

As T-cells with protein receptors on the cell surface recognize antigens on the surface of target cells. Because of surface protein receptors, they directly destroy invading antigens.

T-cell are primarily effective against:

Virus Infected Cells

Cancer Cells

Foreign Cells

Fungal or Protozoal Infections

B-Cells are responsible for:

Humoral Immunity

B-cells arise from:

Stem cells in the bone marrow and then mature in the bone marrow.

B-cells are produce:

Antibodies or immunoglobulins that then attack invading cells.

B-cells are found where and are most effect against?

They are found in the general blood circulation and most effective against bacteria and viruses.

2nd Line of Defense (Primary Response):

Initial exposure to an antigen, which recognized and processed; initiation of development of antibodies/T-cells begins.

3rd Line of Defense (Secondary Response):

A repeat exposure to the same antigen occurs; Memory cells produce large numbers of matching B or T cells quickly.

Two types of Active Immunity:

Active Natural and Artificial Immunity

Active Natural Immunity:

Acquired by direct exposure to an antigen (exposure to the actual illness-get sick); you are producing the antibodies.

Active Artificial Immunity:

Develops when a specific antigen is introduced into the body (immunization)

What both things stimulate the production of a person’s own antibodies?

Active Natural & Artificial Immunity

Active Immunity:

Develops when the person develops their own B/T cells in response to a specific antigen.

The body develops B/T cells in response to a specific antigen taking:

Usually a few weeks to occur but lasts for years because they are retained.

Passive Immunity:

Occurs when antibodies are transferred from another person.

Two types of Passive Immunity:

Passive Natural & Artificial Immunity

Passive Natural Immunity:

Occurs when immunity is transferred from mother to fetus.

Passive Artificial Immunity:

Results from injection of antibodies from person/animal into another (plasma from someone else blood that contains antibodies); Immediate effects but only temporary protection because memory cells are not retained.

Immunizations:

Occurrence of infectious diseases, such as polio, that has declined where vaccines have been widely used.

A booster:

An additional immunization, 5-10 years after initial immunization, and promotes a better secondary response.

Immune Response has Unique Antigens:

On an individual cell surfaces that helps immune system to distinguish foreign cells from normal ones.

Immune System Components:

Lymphoid strctures

Immune Cells

Immune Tissues

Chemical Mediators

Lymphoid Structures:

Lymph nodes

Spleen

Tonsils

Immune Cells:

Lymphocytes & Macrophages

Immune Tissues:

Bone marrow & Thymus

Chemical Mediators:

Histamine

Cytokines

Prostaglandins

Antigens are also called:

Immunogens

Diagnostic Test:

A test of immune function may qualitatively or quantitatively measure serum immunoglobulins

Viral Mutation have:

Various strains of viruses mutate (change slightly over time)

Types of Transplants include:

Allograft

Autograft

Xenograft

Allograft:

Between a human & another human. Graft between individuals of the same species but different genotype.

Autograft:

Grafts taken from another area of a patients'‘ own body.

Xenograft:

Tissue graft or organ transplant from a donor of a different species (nonhuman to human)

Target Heart Range (THRR)

THR=(Intensity % X (Max HR - Resting HR)) + Resting HR

Max HR is

220 minus age

Roles of PTA with Immune Response & Exercise:

Exercise can help flush bacteria or viruses out of lungs and improve circulation of WBC and macrophages to needed areas. Keep intensity of exercise around 50% for THRR and allow breaks in between to not go over.

Autoimmune Disorder:

When a patient develops antibodies to their own cells material, antibodies can then attack the body tissues.

Autoantibodies:

Antibodies formed against self-antigens

Autoimmune Disorders Examples:

Addison’s Disease

Celiac Disease

Crohn’s Disease

Collagen Autoimmune Diseases:

Collagen is attacked, which collagen is the main component of connective tissue and found in all body structures.

Systemic Lupus Erythemmatosus (SLE)

Causes initial characteristic of butterfly shaped facial rash, involves large amounts of circulating autoantibodies against DNA & increased red blood cells and platelets that are attracted body connective tissue.

Role of PTA with Systemic Lupus: SHORT ANSWER QUESTION

Can’t exercise with lupus flare, but can take part into a low impact exercise when not flared up. Regular exercise can battle fatigue, if a flare is occurring, then exercise should stop or at least reduce intensity and duration. Advise the patent to keep a journal to see if exercise contributes to lupus flares. The sun trigger a flare up, so encourage a hat, or some type of cover. Appropriate low impact exercise includes walking, yoga, swimming, and aquatic aerobics.

Scleroderma:

Characterized by hardened, thickened, and shrunken connective tissues, mimics other diseases, and there is no cure.

Role of PTA with Scleroderma: SHORT ANSWER QUESTION

PT should include breathing exercises, stretching, strengthening, and relaxation therapy. Focus on keeping joints flexible through movement and general strengthening of core, arms, legs, and face. Regular long term exercise will help maintain functional ROM throughout all joints and lessen pain to improve function.

Fibromyalgia:

May involve any fibromuscular tissues, affects the back of the head, neck, shoulders, thorax, lower back, and thighs. Affects women 7x more then men.

Fibromyalgia is also called:

Fibromyositis, fibrositis, and myofascial pain syndrome (pain usually confined to a certain area or trigger points)

Role of PTA with Fibromyalgia:

Pt is battling pain and fatigue, so goal is finding an exercise the pt can tolerate without increase in pain afterwards. Many pts avoid exercise which can result in weight gain which exacerbates symptoms. Use equipment that supports body weight like NuStep, recumbent bike, and aquatic therapy.

Immunodeficiency Is caused by:

The loss of function of immune system components and leads to increased risk of infection and cancer. (HIV/AIDS and Chronic Fatigue Syndrome)

Causes of Immunodeficiency Disorders:

Viral Infections

Liver Disease

Use of Immunosuppressive drugs

Chemotherapy

Radiation

AIDS (Acquired Immunodeficiency Syndrome):

Involves progressive impairment of the immune system

HIV (Human Immunodeficiency Virus)

A chronic infectious disease that develops over a long, latent period and then is followed by AIDS

Stages of HIV:

Asymptomatic

Early Symptomatic

Advanced

Asymptomatic of HIV

no symptoms in general

Early Symptomatic of HIV:

Malaise and Fatigue

Advanced of HIV:

May involve the CNS, PNS, and Autonomic Nervous Syste

HIV is a what type of virus?

Retroviruses (containing RNA) that affects the CD4 T-helper cells, also attacking the macrophages and CNS.

Role of PTA with HIV/AIDS

Standard Precautions should be followed with appropriate PPE worn if body fluids are present, Regular exercise can help combat heart disease, strokes, diabetes, and osteoporosis. Goals are to reduce pain, improve mobility, and promote independence.

Chronic Fatigue Syndrome:

Long-term, severe, and disabling fatigue, no significant muscle weakness. May be linked to viral infections, immune system , and hormonal imbalances.

Treatments of Chronic Fatigue Syndrome:

Antidepressants

Dietary Supplements

High-dose vitamins

Role of PTA with Chronic Fatigue Syndrome:

Very important to monitor rest and recover for these pts to prevent exhaustion and experiencing a set back. Use THRR to prescribe intensity of care and use a journal to record response to exercise. Mild exercise with a min of 3 minutes between sets.

Hypersensitivity Reactions:

Allergic reactions that may cause hay fever, skin rashes, anaphylaxis, and vomiting.

Common allergies to foods include:

Nuts, shellfish, and strawberries

Common allergies to drugs include:

Asprin, penicillin, local anesthetics, and sulfa drugs.

Anaphylaxis or Anaphylactic Shock

A severe systemic condition: Airway obstruction, severe hypoxia, decreased blood pressure.

Role of PTA with Hypersensitivity Reactions:

Important to always ask a pt if they have any known allergies or sensitivities, signs of anaphylaxis would be airway problems, breathing problems, and circulation problems.

Osteoblasts:

Bone-building cells, responsible for the formation of the bone matrix.

Osteoclasts:

Responsible for resorption of bone and removing the mineral content and organic matrix.

Osteocytes:

Mature bone cells, actively involved in maintaining the bone matrix.

Cartilage:

Supports bones that adjoin each other, providing cushioning and protecting, also keeps bones from rubbing together.

Common Skeletal Diseases/Injuries:

Musculoskeletal Diseases, Bone Fractures, and Muscle disorders.

Musculoskeletal Diseases cause:

pain, decreased mobility, swelling, and deformity.

Bone Fractures:

Displaced fractures are easier to recognize as they displaced bone and are often associated with high pain lvls.

Nondisplaced fractures still caused pain, and are not easy to recognize.

Muscle Disorders cause:

Weakness & Atrophy.

Kyphosis:

A “humped” curvature of the thoracic spine; AKA humpback or hunchback.

Types of Kyphosis:

Postural

Scheuermann’s

Gibbus Deformity

Congenital

Nutritional

Postural Kyphosis:

The most common type, can be corrected by learning better posture techniques.

Pathology of Kyphosis:

An upper spinal area that is curved forward, often results in chronic pain and causes breathing difficulties, and can be the result of Arthritis.

Diagnosis of Kyphosis:

Kyphosis is diagnosed by physical examination and X-rays.

Treatment of Kyphosis:

Physical therapy, medications, & surgery.

Lordosis:

Commonly referred to as “Swayback”; exaggerated inward anterior curve of lumbar spine; causes abdomen and buttocks to protrude.

Diagnosis of Lordosis:

Lordosis is diagnosed through patient history, examination, range of motion tests, neurological tests, and spinal x-rays

Treatment of Lordosis:

Exercises- strengthening of core muscles, encourage use of gluteal muscles rather than smaller paraspinal muscles when extending hip

Scoliosis:

A lateral curvature of the spine, affects females more than males.

Pathology of Scoliosis:

Scoliosis usually causes back pain, rib or shoulder blade hump, unaligned hip and shoulders.

Diagnosis of Scoliosis:

Based on bending movements, wherein the spine moves to one side while the shoulder blade moves upward.