Lymphatic and Immune System, Exams of Nursing

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Questions And Answers

Lymphatic System - - correct answer ✅Network of organs and vein- like vessels Lymphatic System Functions - - correct answer ✅1. Fluid recovery (a) Capillaries collect most of fluid they pump out but the 15% that isn't picked up is picked up by lymphatic system

2. Immunity (a) inspects & picks up foreign cells & chemicals from tissues (b) activates immune responses
3. Lipid absorption (a) small intestine to lacteals to absorb dietary lipids Components of the Lymphatic System - - correct answer ✅1. Lymph = interstitial fluid that capillaries didn't pick up
4. Lymphatic vessels = transport lymph (similar to blood vessels) (a) empty into capillaries which penetrate tissue (b) collecting vessels to converged capillaries which travel beside veins & arteries and empty into lymph nodes
5. Lymphatic tissue = cells found in mucous membranes that have roles in defense and immunity
6. Lymphatic organs = defined sites w/ separation from neighboring tissue

Questions And Answers

(a) red bone marrow, thymus, lymph nodes, tonsils, & spleen

5. Lymphatic trunk (a) goes to converged collecting vessels (b) body has 6
6. Collecting ducts (a) go to converged lymphatic trunks (b) body has 2 Where does lymph come from and why do we call it lymph? - - correct answer ✅-Comes from interstitial fluid outside of lymph vessels -Becomes "lymph fluid" once it enters the lymph vessels -Plasma in the blood system gets pumped out into interstitial space and becomes interstitial fluid and gets picked up by lymphatic vessels and becomes lymph fluid Elephantiasis - - correct answer ✅Lymphatic system is not collecting fluid out of the leg Areas of lymph node concentration - - correct answer ✅Large intestine -A lot of mucous membrane

Questions And Answers

-several types of tissue -water absorption -lymphatic tissue picks up interstitial fluid, runs to the nodes where it is examined to see if bacteria is supposed to be there or if its foreign Lymphatic nodule - - correct answer ✅-Pyer patches in the ileum primarily and distal end portion of small intestine -Throughout the gut, there are monitoring cells NK cells - - correct answer ✅-Natural Killer cells -Attack and destroy bacteria/foreign cells -Innate ability T cells - - correct answer ✅-cell-mediated response -mature in thymus -Maturation Process

1. Develop surface antigen receptors to make them capable of recognizing antigens on APCs
2. Reticuloendothelial cells in the thymus test T cells by presenting 'self' antigens to them

Questions And Answers

3. Undergo selection (a) negative selection = 1st test - recognizing and responding appropriately to self antigen (b) positive selection = 2nd test - recognize non-self MHC B cells - - correct answer ✅-secrete antibodies -born in red bone marrow from pluripotent stem cells (PPSCs or HSCs) -mature in spleen -Maturation process:
4. Recognize self
5. Recognize non-self
6. Selected for then go off and form clones -Leave thymus and colonize lymphatic tissue and organs Macrophages - - correct answer ✅-Phagocytosis and antigen presentation (APCs) Dendritic cells (DC) - - correct answer ✅-APCs found in skin, mucous membranes

Questions And Answers

Reticular cells - - correct answer ✅-Branched stationary cells -APCs in thymus Leukopoiesis - - correct answer ✅ Red Bone Marrow - - correct answer ✅1. Function = blood formation & immunity

2. Consists of soft, loosely organized, highly vascular material
3. As cells mature, pass through reticular & ECs, enter sinus, & go to blood stream Thymus - - correct answer ✅1. Function = T cell maturation/lymphocyte development
4. Part of endocrine, lymphatic and immune systems
5. Consists of 2 lobes (w/ cortex & medulla) w/ multiple trabeculae (a) blood-thymus barrier separates the 2 portions
6. Produces thymosine, thymopoietin, thymulin, ILs, and IFNs Lymph nodes - - correct answer ✅1. Function = cleanse lymph, site for T and B cell activation
7. Consists of fibrous capsule w/ trabeculae

Questions And Answers

3. Found in neck, armpit, thorax, abdomen, intestines, groin, knees Tonsils - - correct answer ✅1. Function = guard against ingested/inhaled pathogens
4. Consists of epithelial covering, deep pits Spleen - - correct answer ✅1. Function = blood production (fetus), blood reservoir, RBC disposal, monitoring blood for foreign Ag
5. Consists of white & red pulp -Red pulp = sinuses filled w/ blood that help w/ monitoring to see if any antigens are there -White pulp = macrophages Immune system is critical for distinguishing self from non-self therefore it must... - - correct answer ✅1. Recognize own cells and structures as self -do nothing
6. Recognize everything foreign as non-self -remove foreign/pathogen Innate Defenses - - correct answer ✅-Innate = before any training of T and B cells

Questions And Answers

-Immunity you have BEFORE being exposed to antigen Adaptive Defenses - - correct answer ✅-Immunity you develop AFTER being exposed to an antigen First line of defense - - correct answer ✅1. Skin - mechanical barrier -Tough keratin, dry, nutrient poor, presence of defensins, acid mantle

2. Mucous membranes - protects tracts open to exterior -Mucus traps microbes and lysozymes destroy
3. Areolar Tissue - beneath epithelial and skin -Hyaluronic acid is not conducive to foreign bodies living in them Second line of defense - - correct answer ✅1. Cells - leukocytes & macrophages
4. Proteins - IFNs, Complement
5. Immune surveillance - NK cells
6. Fever - elevation of body temperature

Questions And Answers

Cells: 2nd Line of Defense - - correct answer ✅1. Neutrophils - produce cloud of bacteriocytol chemicals that create a killing zone around them -Absorb and release O2, CO2, various lysozymes

2. Eosinophils - guard cells -Recognize antigen-antibody complexes -Limit reactions of histamine -Stimulate basophils & monocytes
3. Basophils - aid in reaction of other leukocytes -Histamine-vasodilators that increase blood flows -Heparin slows down clotting
4. Lymphocytes -Majority become T lymphocytes Proteins: 2nd Line of Defense - - correct answer ✅1. Inhibit microbial reproduction -Short-term, nonspecific resistance to bacteria and viruses
5. IFNs - secreted by infected cells -Benefit neighboring cells to prevent viral replication -Activates NK cells & macrophages
6. Complement - > 30 proteins

Questions And Answers

-Activated by presence of pathogens - inflammation, immune clearance, phagocytosis, cytolysis -3 routes: Classical, Alternative, Lectin Complement line of defense - - correct answer ✅-All 3 pathways lead to C3 dissociating into C3a and C3b Membrane Attack Complex - - correct answer ✅- Complement proteins form ring in plasma membrane of target cell - cytolysis (a) C5b acts like a magnet and attracts C6, C7, and C (b) Come together and organize a structure of C9 proteins in order to punch through the membrane of the foreign cell (c) Complex puts a hole through the foreign cell that allows the plasma to flow in - cell loses its cytoplasm Immune Surveillance: 2nd Line of Defense - - correct answer ✅1. NK patrol body looking for pathogens and diseases cells

2. Attack & destroy bacteria, foreign cells (transplants), virus- infected cells, cancer cells Action of NK cell - - correct answer ✅-Part of innate immune system -non-specific

Questions And Answers

Fever: 2nd line of defense - - correct answer ✅1. Adaptive defense, abnormal elevation of body temp -initiated by exogenous pyrogens or trauma -promotes IFN activity, increased metabolic rate and tissue repair -inhibits bacterial & viral reproduction

2. Stages: onset, stadium, defervescence Inflammation: 2nd line of defense - - correct answer ✅1. Inflammation - local response to tissue injury -Limits and destroys pathogens -Removes debris -Initiates repair -Regulated by cytokines (IFNs, IL, TNF, chemokines, etc) -Requires mobilization of defense, containment and destruction of pathogen, tissue repair Specific/Adaptive Immunity - - correct answer ✅1. Characteristics: (a) Specificity - immunity directed against a particular pathogen (b) Memory - when re-exposed to same pathogen, body reacts quickly so no noticeable illness

Questions And Answers

-Following clonal selection, some Tc cells, Th cells, & B cells become memory cells

2. 2 types: (a) cellular (cell-mediated) immunity (b) humoral (antibody-mediated) immunity Cellular (cell-mediated) immunity - - correct answer ✅- T cells -Lymphocytes directly attack and destroy pathogen (foreign cells or diseased host cells) -Immune system remembers antigen to prevent them from causing disease in the future
3. Tc = cytotoxic/killer - attack enemy cells
4. Th = helper - help Tc cell and B cells action
5. Tregs = regulatory - limit response
6. Tm = memory - from Tc cells Humoral (antibody-mediated) immunity - - correct answer ✅-B cells -Mediated by antibodies that do not directly destroy a pathogen - antibodies tag antigens for destruction (a) antigen binds BCR and epitope is displayed in MHC (requires a Th cell)

Questions And Answers

Antigen-Presenting Cells (APCs) - - correct answer ✅1. Function = help T cells recognize antigen -DCs, macrophages, reticular cells, and B cells -depends on MHC proteins (identification tags unique for each individual)

2. Antigen processing: (a) APC encounters antigen (b) internalize (c) digest (d) display epitopes w/i MHC -MHC1 - every cell of the body, constantly produced, transported through the membrane -MHC2 - display only foreign antigens T cell activation - - correct answer ✅1. Dendritic cell (APC) from skin or other infection site
3. Lymph node
4. Antigen must be presented to T-cells by APCs in the context of MHC -Tc cell examines APC and finds in MHC2 complex an epitope and binds to the APC cell

Questions And Answers

4. Costimulation protein stimulates Tc or Th cell for clone selection
5. Cells come along and are able to bind to enemy cells and cause death of enemy cells by releasing perforins -If Th cells is activated and it will secrete interleukins which will attract NK cells and help Th and B cells Antibodies/Ab/Ig - - correct answer ✅-Tetramer -Antigen-binding site which provides specificity -Complement can also bind at complement binding site -constant regions that won't mutate or change -Defensive gamma globulin - found in the blood plasma, tissue fluids, body secretions & some leukocyte membranes 5 classes of antibodies - - correct answer ✅Named for the structure of their C (constant) region
6. IgA - monomer in plasma; dimer in mucus, saliva, tears, milk & intestinal secretions (a) prevents pathogen adherence to epithelia and penetrating underlying tissues (b) provides passive immunity to newborns
7. IgD - monomer; B cell transmembrane antigen receptor
8. IgE - monomer (basophils & mast cells)

Questions And Answers

(a) stimulates release of histamine and other chemical mediators of inflammation and allergy by attracting eosinophils to parasitic infections & producing immediate hypersensitivity reactions

4. IgG - monomer (80% of circulating antibodies) (a) Crosses placenta to fetus, secreted in secondary immune response, complement fixation
5. IgM - pentamer in plasma & lymph (a) secreted in primary immune response, agglutination, complement fixation Humoral Immunity - Attack - - correct answer ✅ Humoral Immunity Responses - - correct answer ✅1. Primary - 1st exposure
6. Secondary - re-exposed to same antigen