Chapter 14 Notes PDF

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CHAPTER 14 Chapter 14 is titled “Lymphatic and Immune Systems” in The Language of Medicine textbook. Introduction: 

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Lymph is a clear watery fluid that surrounds our body cells and flows in its own system of lymphatic vessels, and we refer to this as our lymphatic system o So just like we have a circulatory system that carries blood throughout our body and a heart that serves as a pump to have this work, we have a lymphatic system that consists of lymphatic vessels containing lymph o Lymph differs from blood  Lymph fluid does not contain erythrocytes or platelets, but it does contain a lot of white blood cell components, especially the lymphocytes and monocytes If you recall, these are the cellular elements of blood that have to do with immunity, so immunity is a major function our lymphatic system We have very thin walled vessels as that we refer to as lymph capillaries and they are found throughout our tissue spaces The fluid in these lymph capillaries is called lymph We also have clusters of these larger lymphatic vessels throughout our body that we refer to as lymph nodes We are going to look at the various parts of the body where lymph nodes are contained Lymph enters these large lymphatic vessels and then empty into the blood stream

The Lymphatic System has several functions, even though a big function is immunity as I said earlier   

It does serve as a drainage system to transport the proteins and fluids that we need that have leaked out of blood capillaries to get that back into the bloodstream via the veins Second, the lymphatic vessels also in the intestines, help to absorb fats from the small intestine and transport them into the blood stream Third, and biggest function of the lymphatic system relates to the immune system. It is our defense against foreign organisms, it is what fights off bacteria and viruses, etc.

Your textbook includes a table that shows a comparison of lymph and blood  

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Lymph is colorless, blood is red There is no pump in the lymphatic system, so lymph is moved through muscle movement and valves, whereas in our circulatory system, we have a heart that acts as a pump to move blood through our blood vessels Lymphatic System contains white blood cells only, mainly lymphocytes and monocytes, and blood contains erythrocytes, leukocytes, and platelets We have fluid on the lymphatic side which consists of water, protein, plasma components, and fat from the small intestine

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Whereas blood in the circulatory system, contains water, some proteins, salts, nutrients, lipids, and wastes This table shows a good comparison between lymphatic system and the circulatory system

Lymphatic System: Anatomy Moving on to the anatomy of the lymphatic system, your textbook includes a diagram     

The lymph capillaries begin at the spaces around all the cells throughout our body You will see Lymph vessels Then we have the collections of stationary lymph tissue, which are lymph nodes We have a few major sites of lymph node concentration You will see that our major sites of lymph node concentration include: o Cervical Lymph nodes that are located in the neck o Axillary Lymph nodes are located in the armpit o Mediastinum Lymph nodes are located in the chest specifically between the lungs o Mesenteric or Intestinal Lymph nodes which are located near the intestines and abdomen o Paraaortic Lymph nodes are located in the lumbar area o Inguinal Lymph nodes are located in the groin o So these are the major sites of lymph node concentration

Again since our lymphatic system has to do with fighting toxins, it is not uncommon if we have an infection, the patient could have enlarged lymph nodes 

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It is a bad sign and a good sign o It is a bad sign that the patient has an infection o It is a good sign because it shows the lymphatic system is trying to fight off the infection These cells are phagocytic, meaning they are trying to swallow all the toxins, to neutralize the toxins The Lymphatic System is a double edged sword in that it’s goal is to fight infection, and unfortunately when it tends to lose its battle, because it is interconnected, it can cause spread of these toxins to other parts of the body o For example, if a patient has breast cancer, it is not uncommon for a physician to take a sample of axillary lymph nodes, which are in close proximity of the breast, to be able to evaluate it for possible malignancy as well o Unfortunately, the lymph nodes are one of the most common secondary sites of cancer Remember your tonsils and adenoids are also made of lymph tissue as well

Immune System: Natural and Adaptive Immunity  

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The definition of Immunity is the body’s ability to fight off or resist toxins or organisms that are harmful to the body that can damage tissues, and lead to organ failure The definition of natural immunity is the resistance that someone has immediately and is present at birth o It is not dependent on the fact that the person has been previously exposed to the infectious agent or antigen o So an example of natural immunity, is after a bacterial infection, white blood cells respond immediately to the intruding antigens  Neutrophils would travel to the infected area and ingest the bacteria to begin their phagocytic process  You would have other white blood cells that would come in and try to participate in the body’s natural immunity against the infection In addition, to natural immunity, a healthy person would also be able to develop adaptive immunity o This is the body’s ability to be able to recognize and remember specific antigens that they have been exposed to in the past as an immune response o Another example of adaptive immunity is vaccination  You are given an injection of the actual virus itself, although it isn’t alive, and it doesn’t make you ill, it does stimulate your B cells to secrete antibodies to this antigen or virus, so if you are exposed to it at a later time, you would’ve already developed adaptive immunity Your textbook includes a diagram that depicts the different types of immunity o Remember natural immunity is present at birth o Adaptive immunity has to do with antibodies being produced after exposure to an antigen, and your body remembers, so when you have a second exposure, you get a faster and larger response

Vocabulary: You need to know the following Vocabulary terms listed in your textbook:        

Adaptive Immunity Adenoids Antibody Antigen Axillary Nodes Cervical Nodes Immunity Inguinal Nodes

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Lymph Lymph Capillaries Lymphoid Organs

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Lymph Node Lymph Vessel

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Mediastinal Nodes Mesenteric Nodes Natural Immunity Paraaortic Nodes Tonsils Toxin Vaccination Vaccine

Combining Forms: For the terminology regarding the combining forms of the lymphatic and immune systems, you need to know all of them listed in your textbook:      

immun/o means protection lymph/o means lymph lymphaden/o means lymph gland or lymph node splen/o means spleen thym/o means thymus gland tox/o means poison

Prefixes: For the terminology regarding the prefixes for the lymphatic and immune systems, you need to know all of them listed in your textbook:  

ana- means again inter- means between

Pathologic Conditions: In regards to pathologic conditions of the lymphatic and immune systems, I will go over the terms you need to know. You need to know the definition of the terms in bold to the right, you do not have to know all the detail unless I list it. Immunodeficiency In regards to immunodeficiency of the lymphatic and immune systems, you need to know the following terms:

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Acquired Immunodeficiency Syndrome (AIDS) is associated with the fact that the immune system is suppressed and not working o Characterized by opportunistic infections, infections that many people may get, but the body is able to fight off o Someone who has this diagnosis of AIDS, has a compromised immune system, so these opportunistic infections are a secondary manifestation of AIDS, and they are unable to fight off these infections o There can also be secondary neoplasms, and some neurologic problems as well o AIDS is caused by HIV (the Human Immunodeficiency Virus).  HIV destroys the T cells, and this is what disrupts the immune response from occurring, and just allowing infections to happen  HIV lowers the body’s resistance, and allows infection by bacteria and parasites; they are not easily contained by otherwise normal defenses o Your textbook includes a table showing some of the opportunistic infections associated with AIDS. This is not an all-inclusive list, these are just some opportunistic infections that are most commonly seen with people that have AIDS  Malignancies associated with AIDS include Kaposi Sarcoma  This is a cancer that arises from lining cells of the capillaries, and the patient can have dark purplish skin nodules  Your textbook shows a picture with a patient that has Kaposi Sarcoma and it is always associated with AIDS  These patients can also cancer of lymph nodes, lymphomas  Diagnosis of wasting syndrome, defined as weight loss, decrease in muscle strength, decrease in appetite, and decrease in mental activity can also occur with AIDS  Your textbook also shows a picture of a patient with wasting syndrome, so you can see the lack of muscle, and the loss of weight o Your textbook also includes a table that shows the common routes of transmission of the AIDS virus o It lists the known routes of transmission and whether it affects men, women, or newborns o Make sure you know the information covered in this table

Hypersensitivity In regards to hypersensitivity of the lymphatic and immune systems, you need to know the following terms: 

Allergy means an abnormal hypersensitivity that is acquired due to exposure to an antigen o Allergic reactions occur when a person is sensitive to an agent and has previously been exposed to the agent, and they react violently to a secondary or subsequent exposure

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The reaction can vary in intensity, it might simply be an allergic rhinitis or hay fever which is caused by pollen, or it can be serious which we would refer to has a systemic anaphylaxis which is an extraordinarily high hypersensitivity reaction that occurs through the body and can lead to serious drops in blood pressure, shock, respiratory distress, and edema Anaphylaxis can be life threatening Certainly there are some treatment options, but it is serious

Malignancies In regards to malignancies of the lymphatic and immune systems, you need to know the following terms: 

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Lymphoma is a malignant tumor of lymph nodes and lymph tissue o Hodgkin disease is a type of lymphoma, a malignant tumor of lymphoid tissue that occurs in the spleen and the lymph nodes. o Your textbook includes a figure that shows how Hodgkin disease is staged.  We use the term staging which helps us assess the extent of the spread of a disease.  For this example, there are 4 stages  Stage 1 would not be as serious as Stage 4 o Whenever the patient has involvement of a single lymph node, it would be considered Stage 1 o If there was involvement of 2 or more sites of the same side of the diaphragm, then this would be Stage 2 o Stage 3 would be disease on both sides of the diaphragm o Stage 4 would be widespread, and not just lymphatic involvement multiple places, but can also involve body organs like the liver, lung, bone marrow, skin, etc. This would be the highest level, most widespread Multiple Myeloma is a malignant tumor of bone marrow cells

Study Section: Refer to the Study Section in this chapter. You need to know the following terms: 

Allergen

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Anaphylaxis Hodgkin Lymphoma Human Immunodeficiency Virus (HIV) Kaposi Sarcoma Opportunistic Infections Wasting Syndrome

Laboratory Tests and Clinical Procedures: In regards to laboratory tests and clinical procedures of the lymphatic and immune systems I will go over the terms you need to know. You need to know the definition of the terms in bold to the right, you do not have to know all the detail unless I list it. Laboratory Tests In regards to laboratory tests of the lymphatic and immune systems, you need to know the following terms: 

ELISA is a lab test used to detect the anti HIV antibodies in the blood stream o If the result of this test is positive, they would perform another test, called a Western Blot test, which is a little more specific, and this test would detect anti HIV antibodies

Clinical Procedures In regards to clinical procedures of the lymphatic and immune systems, you need to know the following terms: 

Computed Tomography (CT) Scan is an x-ray image that is produced cross sectional

Abbreviations: You need to know the following abbreviations listed in your textbook, again, only the ones that I call out:     

AIDS – acquired immunodeficiency syndrome CMV – cytomegalovirus (causes opportunistic AIDS-related infection) HIV – human immunodeficiency virus (causes AIDS) HSV – herpes simplex virus KS – Kaposi sarcoma

This concludes the material for this chapter. Again I want to encourage you to work through all the exercises on the following pages after the chapter including the Practical Applications, Exercises, and Review Sheet. The Practical Applications section provides an opportunity for you to use your skill in understanding medical terms and to increase your knowledge of new terms. The Exercises section is designed to help you learn the terms presented in the chapter. Writing terms over and over again is a good way to study this new language. Your textbook also includes the answers for the Practical Applications and Exercises. The Pronunciation of Terms section is very helpful in that you are able to look at the pronunciation and try to make sure that you pronouncing the medical terms correctly, so hopefully you will be able to spell the terms correctly, and be able to communicate and converse with other allied health professionals. The Review Sheet are complete lists of the word elements contained in the chapter. They are designed to pull together the terminology and to reinforce your learning by giving you the opportunity to write the meanings of each word part in the spaces provided and to test yourself. All of these exercises will be very beneficial in helping you with your retention....