Blood, lymphatic,

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  • BLOOD
    Consists of approximately 45% cellular (formed) elements
    Erythrocytes
    Leukocytes
    Platelets (thrombocytes)
    Also consists of liquid or plasma (55%)
    Physiology of blood
    Erythrocytes distribute oxygen throughout body while removing carbon dioxide
    Contain hemoglobin, iron-containing protein which combines with oxygen and carbon dioxide
    Life span of 120 days
    Leukocytes protect body from disease
    Diapedesis is the process by which leukocytes move into tissue outside blood vessels to fight disease
    Types
    Granulocytes: neurtrophils, eosinophils, basophils
    Agranulocytes: monocytes, lymphocytes
    Thrombocytes help prevent blood loss
    Plasma carries nutrients and other essential products to cells and removes water products
    92% water
    Contains plasma proteins: albumins, globulins, fibrinogen
  • erythroblastosis fetalishemolytic disease of newborn resulting from incompatibility of blood causing an antigen— antibody reaction between maternal and fetal/newborn blood
  • Lymph Nodes
    Grouped in specific regions (submandibular, cervical, axillary, inguinal)
    Sites of residence and proliferation of leukocytes
    WBCs are phagocytes (engulf and destroy bacteria)
    Thymus Gland
    Located in thoracic cavity close to heart
    Endocrine organ that secretes hormone, thymosin
    Thymosin stimulates red bone marrow to produce T-lymphocytes
    Atrophies or involutes with age
    Spleen
    Located in left side of abdominal cavity
    Stores blood cells
    Removes substances from blood cells that are not functional (old RBCs and invasive microorganisms)
    Important in hematopoiesis and B-lymphocyte multiplication
    Tonsils
    Three pairs (composed of lymphatic tissue)
    Pharyngeal tonsils (adenoids) in nasopharynx
    Lingual tonsils located in base of tongue
    Palatine tonsils located in oral cavity
    Tonsils (continued)
    Help fight microorganisms that enter body through throat
    Peyer's patches
    Concentrations of lymphatic tissue located in small intestine
    Contains lymphocytes that destroy infectious agents that enter digestive tract
  • Fluid carried by lymph vessels
    Passed from blood into spaces around tissue cells (interstitial fluid)
    Similar to plasma except it has no RBCs, no platelets, and fewer proteins
    Most of fluid eventually returns to circulatory system
    Major function is to transport WBCs throughout body to fight infection
    Also transport fat from digestive system to blood (milky appearance)
    Lymphatics equipped with one-way valves to move lymph in one direction only
  • Blood, lymphatic,

    1. 1. © 1996 West Publishing Company Slide 15 -Slide 15 - 11 Blood, Lymphatic,Blood, Lymphatic, and Immune Systemsand Immune Systems Chapter 15Chapter 15
    2. 2. © 1996 West Publishing Company Slide 15 -Slide 15 - 22 Erythrocytes, Leukocytes,Erythrocytes, Leukocytes, and Thrombocytesand Thrombocytes Platelets (thrombocytes):purplePlatelets (thrombocytes):purple RBC (erythrocytes): redRBC (erythrocytes): red WBC (leukocytes)WBC (leukocytes) Monocytes: orangeMonocytes: orange Lymphocytes: greenLymphocytes: green
    3. 3. © 1996 West Publishing Company Slide 15 -Slide 15 - 33 Composition of BloodComposition of Blood • The average human being hasThe average human being has more that 10 pints of bloodmore that 10 pints of blood inin the body.the body. 55%55% of the blood is made up ofof the blood is made up of plasmaplasma constitutingconstituting thethe fluid part of the bloodfluid part of the blood. The. The cells and plateletscells and platelets that arethat are present in our blood make up thepresent in our blood make up the other 45%other 45% Plasma—55%Plasma—55% Red blood cellsRed blood cells PlateletsPlatelets White blood cellsWhite blood cells 45%45%
    4. 4. © 1996 West Publishing Company Slide 15 -Slide 15 - 44 Stem CellsStem Cells •AllAll blood cellsblood cells are produced in theare produced in the bone marrow.bone marrow. •Bone MarrowBone Marrow looks like a network of tiny littlelooks like a network of tiny little connected caves...similar to a honeycomb.connected caves...similar to a honeycomb. •Inside, are someInside, are some parent cellsparent cells calledcalled Stem CellsStem Cells.. • A Stem Cell can divide itself and produce a twin.A Stem Cell can divide itself and produce a twin. •ThisThis process of cell divisionprocess of cell division is calledis called mitosismitosis.. ThroughThrough mitosismitosis, the, the Stem CellStem Cell can keep on creatingcan keep on creating more and more Stem Cells just like itself.more and more Stem Cells just like itself. •Stem CellStem Cell can actuallycan actually "differentiate""differentiate" intointo red cellsred cells,, white cellswhite cells andand platelets!platelets!
    5. 5. © 1996 West Publishing Company Slide 15 -Slide 15 - 55 Hemopoetic Stem CellsHemopoetic Stem Cells Genetically treated stem cells, when reintroduced into theGenetically treated stem cells, when reintroduced into the patient's body are expected to naturally travel through the bloodpatient's body are expected to naturally travel through the blood stream to the bone marrow. Re-established there, these DNAstream to the bone marrow. Re-established there, these DNA treated and/or corrected stem cells are anticipated to producetreated and/or corrected stem cells are anticipated to produce millions of blood cell offspring with the desired effectmillions of blood cell offspring with the desired effect
    6. 6. © 1996 West Publishing Company Slide 15 -Slide 15 - 66 White Blood Cells (WBC) LeukocytesWhite Blood Cells (WBC) Leukocytes • White blood cellsWhite blood cells are an important part theare an important part the immuneimmune systemsystem. Their. Their rolerole is tois to defend the body againstdefend the body against infectioninfection byby pathogenspathogens.. • White blood cellsWhite blood cells are capable of passing through theare capable of passing through the walls ofwalls of capillariescapillaries in order to attack, kill and consumein order to attack, kill and consume intruderintruder pathogens!pathogens! • Types ofTypes of leukocytesleukocytes − lymphocytelymphocyte TT cellscells − lymphocytelymphocyte BB cellscells − MonocytesMonocytes − granulocytesgranulocytes
    7. 7. © 1996 West Publishing Company Slide 15 -Slide 15 - 77 • GranulocytesGranulocytes contain littlecontain little granulesgranules in theirin their cytoplasmcytoplasm, or, or cell mattercell matter.. − neutrophilsneutrophils,, basophilsbasophils andand eosinophilseosinophils − GranulocytesGranulocytes recognizerecognize signalssignals that enemythat enemy germsgerms send out when theysend out when they invadeinvade the bodythe body • MonocytesMonocytes andand lymphocyteslymphocytes dodo notnot contain anycontain any granulesgranules.. − granulocytesgranulocytes detect an enemydetect an enemy germgerm, they and, they and thethe monocytesmonocytes find it and eat itfind it and eat it (phagocytosis(phagocytosis)) − monocytemonocyte examinesexamines the bits of protein thethe bits of protein the germgerm was made ofwas made of to see howto see how it was putit was put togethertogether − monocytemonocyte calls on thecalls on the lymphocytelymphocyte TT cellcell (or(or HelperHelper TT cellcell) which learns to recognize what) which learns to recognize what the germ looks like.the germ looks like. White Blood Cells (WBC) LeukocytesWhite Blood Cells (WBC) Leukocytes
    8. 8. © 1996 West Publishing Company Slide 15 -Slide 15 - 88 • TheThe lymphocytelymphocyte TT cellcell then engages the help of thethen engages the help of the lymphocytelymphocyte BB cellcell whichwhich makes a special weaponmakes a special weapon calledcalled anan antibodyantibody to use against theto use against the germgerm.. − lymphocytelymphocyte BB cellcell produces copy after copy of theseproduces copy after copy of these antibodiesantibodies • When theWhen the antibodyantibody finds its target, thefinds its target, the germgerm is stunned,is stunned, wounded and killed.wounded and killed. • Then theThen the granulocytegranulocyte andand monocytemonocyte move in to finish itmove in to finish it offoff • There are betweenThere are between 7,000 to 25,000 white cells7,000 to 25,000 white cells in ain a singlesingle drop of blooddrop of blood White Blood Cells (WBC) LeukocytesWhite Blood Cells (WBC) Leukocytes
    9. 9. © 1996 West Publishing Company Slide 15 -Slide 15 - 99 • GranulocytesGranulocytes − NeutrophilsNeutrophils − BasophilsBasophils − EosinophilsEosinophils • AgranulocytesAgranulocytes − Monocytes (phagocytes)Monocytes (phagocytes) − LymphocytesLymphocytes > T-cell lymphocyteT-cell lymphocyte > B-cell lymphocyteB-cell lymphocyte White Blood Cells (WBC) LeukocytesWhite Blood Cells (WBC) Leukocytes SummarySummary
    10. 10. © 1996 West Publishing Company Slide 15 -Slide 15 - 1010 Platelets (thrombocytes)Platelets (thrombocytes) • help prevent bleedinghelp prevent bleeding andand make bloodmake blood clotclot when a blood vessel is brokenwhen a blood vessel is broken • plateletsplatelets looklook round and smoothround and smooth, but, but when they get busywhen they get busy plugging up cuts andplugging up cuts and woundswounds they become kind ofthey become kind of spiky andspiky and raggedragged around the edges.around the edges. • When anWhen an injuryinjury occurs to aoccurs to a blood vesselblood vessel wallwall, the, the plateletsplatelets respond by literallyrespond by literally throwing themselves over thethrowing themselves over the cutcut toto formform aa temporary plugtemporary plug within minuteswithin minutes slowingslowing the lossthe loss ofof bloodblood • plateletsplatelets alsoalso attract a proteinattract a protein found infound in plasmaplasma calledcalled fibrinfibrin and use it to formand use it to form aa dense nettingdense netting that trapsthat traps red blood cellsred blood cells and quicklyand quickly becomes a clotbecomes a clot
    11. 11. © 1996 West Publishing Company Slide 15 -Slide 15 - 1111 Blood clottingBlood clotting Blood clots (fibrin clots) are the clumpsBlood clots (fibrin clots) are the clumps that results when blood coagulates.that results when blood coagulates.
    12. 12. © 1996 West Publishing Company Slide 15 -Slide 15 - 1212 Red blood cells (erythrocytes, RBC))Red blood cells (erythrocytes, RBC)) • The scientific name for red blood cells is Erythrocytes. They are formed in the bone marrow and are created by a Stem Cell. • Red cells are the most numerous of all blood cells in the blood. They are produced at a rate of 4-5 billion every hour in an adult human! • When a red cell matures, it ejects its nucleus before entering the bloodstream. • It ends up looking a little like a doughnut, but without a hole in the middle. Red cells are 7-8 microns in diameter. Yet, they are the heaviest particles in the blood.
    13. 13. © 1996 West Publishing Company Slide 15 -Slide 15 - 1313 The role of red cells is to absorb oxygen through the little alveoli in your lungs and deliver it to all the muscles, tissues and organs in your body.      To do this, they travel through large arteries and tiny capillaries. Sometimes the capillaries are so small, the red cells have to squeeze and bend themselves in half to get through in order to release their load of oxygen! Red blood cells contain hemoglobin, a protein that carries oxygen. RBCsRBCs
    14. 14. © 1996 West Publishing Company Slide 15 -Slide 15 - 1414 Erythrocytes (RBCs)Erythrocytes (RBCs) But that's only half the trip! Because after they deliver the oxygen, the red blood cells pick up a CO2, a waste product. Then they make the return trip back to the lungs through the veins where the CO2 can finally be released every time you breathe out! Then, the red blood cells start the trip all over again. If you're wondering how long it takes to accomplish a round-trip... it takes, on average... only 30-45 seconds! Red blood cells have a life span of about 120 days. Then they die and are removed from circulation by the spleen.
    15. 15. © 1996 West Publishing Company Slide 15 -Slide 15 - 1515 PlasmaPlasma • TheThe blood cellsblood cells are mixed together in a slightlyare mixed together in a slightly yellowish liquid calledyellowish liquid called PlasmaPlasma.. • PlasmaPlasma is mostly made up ofis mostly made up of waterwater, but also contains, but also contains proteinsproteins,, sugarsugar andand saltsalt.. • In addition toIn addition to carryingcarrying blood cellsblood cells throughout yourthroughout your body,body, plasmaplasma also carriesalso carries hormoneshormones,, nutrientsnutrients andand chemicalschemicals, such as, such as ironiron.. • PlasmaPlasma has the important function of maintaining thehas the important function of maintaining the pHpH of theof the bloodblood at approximately 7.4.at approximately 7.4.
    16. 16. © 1996 West Publishing Company Slide 15 -Slide 15 - 1616 •Cheat SheetCheat Sheet -cytosis-cytosis slight increase in the number of cellsslight increase in the number of cells -emia-emia abnormal increase in the number of cellsabnormal increase in the number of cells -penia-penia abnormal decrease in the number of cellsabnormal decrease in the number of cells 1.1. LeukocytosisLeukocytosis 2.2. ErythrocytosisErythrocytosis 3.3. ThrombocytosisThrombocytosis 4.4. AgranulocytosisAgranulocytosis 5.5. LeukopeniaLeukopenia 6.6. ErythropeniaErythropenia 7.7. ErythremiaErythremia 8.8. LeukemiaLeukemia 9.9. ThrombocytopeniaThrombocytopenia 10.10. PancytopeniaPancytopenia A.A. Slight increase in the number of ALL blood cellsSlight increase in the number of ALL blood cells B.B. Decrease in the number of plateletsDecrease in the number of platelets (thrombocytes)(thrombocytes) C.C. abnormal, excessive, uncontrollable increase inabnormal, excessive, uncontrollable increase in the number of white blood cellsthe number of white blood cells D.D. Abnormal increase in the number of RBCAbnormal increase in the number of RBC E.E. Abnormal decrease in the number of RBCAbnormal decrease in the number of RBC F.F. Slight increase in the number of WBCSlight increase in the number of WBC G.G. Slight increase in the number of thrombocytesSlight increase in the number of thrombocytes (platelets)(platelets) H.H. Slight increase in the number of RBCSlight increase in the number of RBC I.I. Slight increase in the number of agranulocytes (aSlight increase in the number of agranulocytes (a type of WBC)type of WBC) J.J. Abnormal decrease in the number of WBCAbnormal decrease in the number of WBC
    17. 17. © 1996 West Publishing Company Slide 15 -Slide 15 - 1717 Laboratory TestsLaboratory Tests TypeType DescriptionDescription complete blood count (CBC)complete blood count (CBC) ofof number of erythrocytes,number of erythrocytes, leukocytes, and thrombocytesleukocytes, and thrombocytes in blood, also measures percentin blood, also measures percent of red blood cells and amountof red blood cells and amount of hemoglobinof hemoglobin hematocrit (HCT)hematocrit (HCT) percentagepercentage of erythrocytesof erythrocytes inin volume of bloodvolume of blood hemoglobin (Hb; Hgb)hemoglobin (Hb; Hgb) measures themeasures the amountamount of hemo-of hemo- globinglobin in a sample of bloodin a sample of blood lipid profilelipid profile determination ofdetermination of
    18. 18. © 1996 West Publishing Company Slide 15 -Slide 15 - 1818 Laboratory TestsLaboratory Tests TypeType DescriptionDescription partial thromboplastin timepartial thromboplastin time coagulation test whichcoagulation test which (PTT)(PTT) measures time formeasures time for sample of blood to clotsample of blood to clot following addition offollowing addition of thromboplastinthromboplastin platelet countplatelet count measuresmeasures amount of platelets in sample ofamount of platelets in sample of bloodblood prothrombin time (PT)prothrombin time (PT) coagulation test whichcoagulation test which measures time for clotmeasures time for clot formation following addition offormation following addition of
    19. 19. © 1996 West Publishing Company Slide 15 -Slide 15 - 1919 LaboratoryLaboratory ResultsResults Abnormal levels areAbnormal levels are shown byshown by ** Compare result withCompare result with numbers innumbers in ( ….)( ….) results Reference values
    20. 20. © 1996 West Publishing Company Slide 15 -Slide 15 - 2020 You knowYou know this stuff!this stuff! 1.1. HematopoiesisHematopoiesis 2.2. HemolysisHemolysis 3.3. HemostasisHemostasis 4.4. MorphologyMorphology 5.5. ThrombolysisThrombolysis 6.6. HyperchromiaHyperchromia 7.7. ThrombosisThrombosis 8.8. SpherocytosisSpherocytosis 9.9. PolychromiaPolychromia 10.10. HyperbilirubinemiaHyperbilirubinemia 11.11. ErythropoiesisErythropoiesis chrom/o—color spher/o—rounded morph/o—shape lysis—destruction poiesis—manufacture stasis--stoppage A.A. Stoppage or controlling of bloodStoppage or controlling of blood B.B. Manufacture of RBCManufacture of RBC C.C. Excessive amounts of bilirubin in the bloodExcessive amounts of bilirubin in the blood D.D. Abnormal condition of clots, blood clotAbnormal condition of clots, blood clot E.E. Red blood cells of many colorsRed blood cells of many colors F.F. Slight increase in the number of roundedSlight increase in the number of rounded RBCRBC G.G. Breakdown of a clot that is already formedBreakdown of a clot that is already formed H.H. Describing RBC that are over pigmentedDescribing RBC that are over pigmented I.I. Destruction of RBCDestruction of RBC J.J. Manufacture of blood cellsManufacture of blood cells K.K. Study of shapeStudy of shape
    21. 21. © 1996 West Publishing Company Slide 15 -Slide 15 - 2121 AnemiaAnemia • Anemia is a broad term used to describe eitherAnemia is a broad term used to describe either an abnormally low amount of blood in circulation,an abnormally low amount of blood in circulation, low hemoglobin or a decreased number of redlow hemoglobin or a decreased number of red blood cells (RBCs)blood cells (RBCs) − Blood lossBlood loss − Impaired RBC productionImpaired RBC production − Increased destruction of RBCIncreased destruction of RBC − Iron deficiencyIron deficiency − impaired Hg synthesis (sideroblastic anemia,impaired Hg synthesis (sideroblastic anemia, thalassemia [genetic], sickle cell anemia [genetic])thalassemia [genetic], sickle cell anemia [genetic]) − Vitamin b-12 deficiency (pernicious anemia)Vitamin b-12 deficiency (pernicious anemia)
    22. 22. © 1996 West Publishing Company Slide 15 -Slide 15 - 2222 Blood TypesBlood Types • Blood typesBlood types are based on specificare based on specific proteinsproteins calledcalled antigensantigens that arethat are found on the surface of red blood cells, andfound on the surface of red blood cells, and antibodiesantibodies found infound in plasma.plasma. • There areThere are fourfour basic blood types:basic blood types: − 1.1. Type AType A with A antigen on the red cells and anti-B antibodies in thewith A antigen on the red cells and anti-B antibodies in the plasma.plasma. − 2.2. Type BType B with B antigen on the red cells and anti-A antibodies in thewith B antigen on the red cells and anti-A antibodies in the plasma.plasma. − 3.3. Type ABType AB with both A and B antigens on the red cells and neitherwith both A and B antigens on the red cells and neither anti-A nor anti-B in the plasma.anti-A nor anti-B in the plasma. − 4.4. Type OType O with no A or B antigens on the red cells and both anti-A andwith no A or B antigens on the red cells and both anti-A and anti-Banti-B antibodies in the plasma.antibodies in the plasma. • If you are aIf you are a Type AType A person, you do not carry antibodies against A markers.person, you do not carry antibodies against A markers. But you do have antibodies against Type B blood.But you do have antibodies against Type B blood. • If you are aIf you are a Type BType B person, you have antibodies against Type A cells.person, you have antibodies against Type A cells. • If you are aIf you are a Type OType O, you have antibodies against both Type A and B!, you have antibodies against both Type A and B! Distribution of bloodDistribution of blood types in the UStypes in the US
    23. 23. © 1996 West Publishing Company Slide 15 -Slide 15 - 2323 Rh factorRh factor • protein substanceprotein substance present in the red blood cells of mostpresent in the red blood cells of most people, capable of inducing intensepeople, capable of inducing intense antigenic reactionsantigenic reactions.. • TheThe red blood cells of the 85%red blood cells of the 85% (later found to be 85%(later found to be 85% of the white population and a larger percentage ofof the white population and a larger percentage of blacks and Asians) contains the protein and isblacks and Asians) contains the protein and is RhRh positive.positive. • The blood of theThe blood of the remaining 15%remaining 15% lacked the factor andlacked the factor and was typedwas typed Rh negative.Rh negative. • Under ordinary circumstances, the presence or lack ofUnder ordinary circumstances, the presence or lack of the Rh factor has no bearing on life or health. It is onlythe Rh factor has no bearing on life or health. It is only when the two blood types are mingled in an Rh-when the two blood types are mingled in an Rh- negative individual that the difficulty arises,negative individual that the difficulty arises, since thesince the Rh factor acts as an antigen in Rh-negative persons,Rh factor acts as an antigen in Rh-negative persons, causing the production of antibodies.causing the production of antibodies. − Destruction of the cells (hemolysis) eventually resultsDestruction of the cells (hemolysis) eventually results
    24. 24. © 1996 West Publishing Company Slide 15 -Slide 15 - 2424 Sickle cell anemiaSickle cell anemia Red blood cells areRed blood cells are sicklesickle shapedshaped rather than biconcave,rather than biconcave, body'sbody's immune systemimmune system recognizes them asrecognizes them as abnormalabnormal and destroys them byand destroys them by phagocytosisphagocytosis,, reducing theirreducing their life spanlife span Phagocyte--Phagocyte-- Any cell thatAny cell that ingests andingests and destroys foreigndestroys foreign particlesparticles
    25. 25. © 1996 West Publishing Company Slide 15 -Slide 15 - 2525 Erythroblastosis FetalisErythroblastosis Fetalis •Can occur whenCan occur when mother is Rh- and fathermother is Rh- and father is Rh+is Rh+ •Blood cellsBlood cells from the unborn baby (fetal redfrom the unborn baby (fetal red blood cells) canblood cells) can cross over into thecross over into the mother's bloodstreammother's bloodstream, especially at, especially at delivery.delivery. •If theIf the blood typesblood types of mother and baby areof mother and baby are incompatible,incompatible, the mother's immune systemthe mother's immune system manufactures antibodiesmanufactures antibodies against the baby'sagainst the baby's blood.blood. •Usually, this incompatibility is not a factorUsually, this incompatibility is not a factor in a first pregnancyin a first pregnancy •In later pregnancies,the mother'sIn later pregnancies,the mother's antibodies will attack the fetal red bloodantibodies will attack the fetal red blood cellscells. If this happens, the fetus or baby can. If this happens, the fetus or baby can suffer severe health effects and may die.suffer severe health effects and may die. The use ofThe use of RhoGamRhoGam hashas greatly reduced the incidence ofgreatly reduced the incidence of RH hemolytic diseaseRH hemolytic disease *28wks, and after birth*28wks, and after birth *destroys any red blood cells*destroys any red blood cells from baby that have entered thefrom baby that have entered the bloodblood
    26. 26. © 1996 West Publishing Company Slide 15 -Slide 15 - 2626 Intrauterine transfusion forIntrauterine transfusion for erythroblastosis fetaliserythroblastosis fetalis Transfusions are performedTransfusions are performed using type O, Rh negativeusing type O, Rh negative bloodblood After the fetal blood type isAfter the fetal blood type is determined, it maydetermined, it may occasionally be possible tooccasionally be possible to use maternal blooduse maternal blood Perinatal survival rates forPerinatal survival rates for severely isoimmunizedseverely isoimmunized fetuses followingfetuses following intravascular transfusion areintravascular transfusion are reported in excess of 85%.reported in excess of 85%. infant's blood is withdrawn and the fresh, pre-warmed blood or plasma is injected.
    27. 27. © 1996 West Publishing Company Slide 15 -Slide 15 - 2727 Polycythemia VeraPolycythemia Vera •AnAn abnormal increase in blood cellsabnormal increase in blood cells ((primarily red blood cellsprimarily red blood cells)) resulting from increased blood cell production by the boneresulting from increased blood cell production by the bone marrow.marrow. •Causes a slowing of circulation andCauses a slowing of circulation and thickening of bloodthickening of blood •It is aIt is a rarerare disorder, occurring more frequently in men, and isdisorder, occurring more frequently in men, and is rarely seen in those under 40 years oldrarely seen in those under 40 years old Percentage of RBCs in the blood may become so high that the blood ceases toblood ceases to flow in some smaller vessels andflow in some smaller vessels and capillariescapillaries. In this photomicrograph, the RBCs are densely packed together
    28. 28. © 1996 West Publishing Company Slide 15 -Slide 15 - 2828 HemophiliaHemophilia genetic disordergenetic disorder characterized by dysfunctioncharacterized by dysfunction of blood-clotting mechanismof blood-clotting mechanism SymptomsSymptoms •BruisingBruising •SpontaneousSpontaneous bleedingbleeding •Bleeding into joints andBleeding into joints and associated pain andassociated pain and swellingswelling •Gastrointestinal tract and urinaryGastrointestinal tract and urinary tract hemorrhagetract hemorrhage •Blood in the urineBlood in the urine or stoolor stool •Prolonged bleeding from cuts,Prolonged bleeding from cuts, tooth extraction, and surgerytooth extraction, and surgery Tx—coagulants--Tx—coagulants-- Replace missingReplace missing clotting factors to aid in clottingclotting factors to aid in clotting process-process-
    29. 29. © 1996 West Publishing Company Slide 15 -Slide 15 - 2929 Bone marrow biopsy, bone marrow aspirationBone marrow biopsy, bone marrow aspiration A small amount ofA small amount of bone marrowbone marrow is removed during a boneis removed during a bone marrow aspiration. The procedure ismarrow aspiration. The procedure is uncomfortable,uncomfortable, butbut can be tolerated by both children and adults. The marrowcan be tolerated by both children and adults. The marrow can be studied to determine thecan be studied to determine the cause of anemia, thecause of anemia, the presence of leukemia or other malignancypresence of leukemia or other malignancy
    30. 30. © 1996 West Publishing Company Slide 15 -Slide 15 - 3030 Bone marrow transplantBone marrow transplant Autologous (vs allogenic)Autologous (vs allogenic) bonebone marrow transplantmarrow transplant
    31. 31. © 1996 West Publishing Company Slide 15 -Slide 15 - 3131 Human embryonic stem cellsHuman embryonic stem cells
    32. 32. © 1996 West Publishing Company Slide 15 -Slide 15 - 3232 Human embryonic Stem CellsHuman embryonic Stem Cells The researchers' next major goal is to figure out how to directThe researchers' next major goal is to figure out how to direct the stem cells to become whatever kind of cell they want.the stem cells to become whatever kind of cell they want.
    33. 33. © 1996 West Publishing Company Slide 15 -Slide 15 - 3333 Pharmaceutical AgentsPharmaceutical Agents AgentAgent DescriptionDescription antithrombotic therapy, anticoagulants (“blood thinners”)antithrombotic therapy, anticoagulants (“blood thinners”) preventsprevents clot formationclot formation by interfering with clottingby interfering with clotting mechanism E.g—baby aspirin,mechanism E.g—baby aspirin, Coumadin, heparinCoumadin, heparin thrombolytic agents (strokes, Mis)thrombolytic agents (strokes, Mis) eliminateseliminates clotclot by breakingby breaking down fibrin (urokinase,down fibrin (urokinase, streptokinase, TPA_streptokinase, TPA_
    34. 34. © 1996 West Publishing Company Slide 15 -Slide 15 - 3434 The Lymphatic SystemThe Lymphatic System
    35. 35. © 1996 West Publishing Company Slide 15 -Slide 15 - 3535 Lymph VesselsLymph Vessels •Contain lymph--Contain lymph--clear-to-clear-to- whitewhite fluidfluid made ofmade of chylechyle (fluid from the intestines(fluid from the intestines after digestion whichafter digestion which containscontains proteinsproteins andand fatsfats),), some red blood cells, andsome red blood cells, and many white blood cells,many white blood cells, especiallyespecially lymphocyteslymphocytes.. • LymphocytesLymphocytes are the cellsare the cells thatthat attack bacteriaattack bacteria in thein the blood.blood. •lymphatic systemlymphatic system filtersfilters fluid from around cellsfluid from around cells Major function of lymph is to transportMajor function of lymph is to transport WBC to body to fight infectionWBC to body to fight infection
    36. 36. © 1996 West Publishing Company Slide 15 -Slide 15 - 3636 Lymph nodesLymph nodes lymph nodes must be able tolymph nodes must be able to "dump" their phagocytes"dump" their phagocytes (infection-fighting leukocytes(infection-fighting leukocytes store there) quickly into thestore there) quickly into the general blood streamgeneral blood stream Lymph nodes act as aLymph nodes act as a filtration systemfiltration system—— PhagocytesPhagocytes engulf andengulf and destroy bacteriadestroy bacteria in thein the lymph—a process known aslymph—a process known as phagocytosisphagocytosis
    37. 37. © 1996 West Publishing Company Slide 15 -Slide 15 - 3737 Body Areas ServedBody Areas Served by the Two Lymph Ductsby the Two Lymph Ducts
    38. 38. © 1996 West Publishing Company Slide 15 -Slide 15 - 3838 Immune SystemImmune System (Slide 1 of 4)(Slide 1 of 4) • Primary organs − Red bone marrowRed bone marrow wherewhere B-lymphocytesB-lymphocytes (B cells) mature(B cells) mature − Thymus glandThymus gland wherewhere T-lymphocytesT-lymphocytes (T cells) mature, spleen is(T cells) mature, spleen is the major organ in which antibodies are synthesized andthe major organ in which antibodies are synthesized and released into circulation.released into circulation. • Secondary organsSecondary organs − SpleenSpleen whichwhich removes foreign agentsremoves foreign agents fromfrom bloodblood − Lymph nodesLymph nodes which removewhich remove foreign agents fromforeign agents from lymphlymph ThymusThymus SpleenSpleen
    39. 39. © 1996 West Publishing Company Slide 15 -Slide 15 - 3939 Immune SystemImmune System (Slide 2 of 4)(Slide 2 of 4) • Nonspecific Defense SystemNonspecific Defense System (Protects body against(Protects body against infection in generalized way)infection in generalized way) − SkinSkin protects body organs against invasion fromprotects body organs against invasion from foreign matterforeign matter − Mucous membraneMucous membrane linings of digestive, respiratory,linings of digestive, respiratory, urinary, and reproductive tractsurinary, and reproductive tracts − PhagocytesPhagocytes are attracted to infected region toare attracted to infected region to destroy invaders by phagocytosisdestroy invaders by phagocytosis − Natural killer cellsNatural killer cells destroy cancerous cells or virus-destroy cancerous cells or virus- infected cellsinfected cells
    40. 40. © 1996 West Publishing Company Slide 15 -Slide 15 - 4040 Immune SystemImmune System (Slide 3 of 4)(Slide 3 of 4) • Nonspecific Defense System (continued)Nonspecific Defense System (continued) − ProteinsProteins > InterferonInterferon is released by cells that are infected byis released by cells that are infected by a virus, signals nearby healthy cells to resist virala virus, signals nearby healthy cells to resist viral replicationreplication > Assists in the process of phagocytosisAssists in the process of phagocytosis and actsand acts directly, in some cases, todirectly, in some cases, to rupture bacteria cellsrupture bacteria cells
    41. 41. © 1996 West Publishing Company Slide 15 -Slide 15 - 4141 Immune SystemImmune System (Slide 4 of 4)(Slide 4 of 4) • Specific Defense SystemSpecific Defense System (Uses WBCs that have(Uses WBCs that have specialized roles in fighting particular invaders)specialized roles in fighting particular invaders) − T-lymphocytes (killerT-lymphocytes (killer or cytotoxic) destroy infectedor cytotoxic) destroy infected cells directly by disturbing the cell's plasmacells directly by disturbing the cell's plasma membranemembrane − B-lymphocytesB-lymphocytes produce proteins called antibodiesproduce proteins called antibodies which are released into body fluids to combatwhich are released into body fluids to combat specific bacterial cellsspecific bacterial cells
    42. 42. © 1996 West Publishing Company Slide 15 -Slide 15 - 4242 How it works…How it works…
    43. 43. © 1996 West Publishing Company Slide 15 -Slide 15 - 4343 MatchingMatching 1.1. LymphangitisLymphangitis 2.2. LymphangiogramLymphangiogram 3.3. LymphocyteLymphocyte 4.4. LymphopeniaLymphopenia 5.5. ThymectomyThymectomy 6.6. SplenectomySplenectomy 7.7. Autoimmune diseasesAutoimmune diseases 8.8. LymphedemaLymphedema 9.9. LymphoblastLymphoblast 10.10. lymphadenopathylymphadenopathy A.A. diseases in which the body's own cells insteaddiseases in which the body's own cells instead of foreign cells are attacked by immune systemof foreign cells are attacked by immune system B.B. Surgical removal of the thymusSurgical removal of the thymus C.C. Abnormal decrease in the number ofAbnormal decrease in the number of lymphocyteslymphocytes D.D. Surgical removal of the spleenSurgical removal of the spleen E.E. Immature lymphocyteImmature lymphocyte F.F. Inflammation of the lymphatic vesselsInflammation of the lymphatic vessels G.G. Swelling of the lymph vessels due to lymphaticSwelling of the lymph vessels due to lymphatic obstructionobstruction H.H. Disease process of the lymph nodesDisease process of the lymph nodes I.I. X-ray of the lymph vessels using contrastX-ray of the lymph vessels using contrast mediamedia J.J. WBC that fights infectionWBC that fights infection
    44. 44. © 1996 West Publishing Company Slide 15 -Slide 15 - 4444 LymphedemaLymphedema • Swelling of the lymph vessels due to lymphatic obstructionSwelling of the lymph vessels due to lymphatic obstruction Post-mastectomyPost-mastectomy ElephantiasisElephantiasis--lymphedema usually--lymphedema usually affecting the legs or external genitals. Inaffecting the legs or external genitals. In tropical countries the most common causetropical countries the most common cause isis filariasisfilariasis, infestation with certain filaria,, infestation with certain filaria, small parasitic roundwormssmall parasitic roundworms
    45. 45. © 1996 West Publishing Company Slide 15 -Slide 15 - 4545 AnaphylaxisAnaphylaxis acute hypersensitivity reaction to an antigenacute hypersensitivity reaction to an antigen • hypersensitivity; allergie—hypersensitivity; allergie—side effects of defense system'sside effects of defense system's response to anresponse to an antigenantigen • AnaphylaxisAnaphylaxis is a sudden, severe,is a sudden, severe, potentially fatal, systemic allergicpotentially fatal, systemic allergic reactionreaction that can involve various areas of the body (such as the skin,that can involve various areas of the body (such as the skin, respiratory tract, gastrointestinal tract, and cardiovascular system)respiratory tract, gastrointestinal tract, and cardiovascular system) • SymptomsSymptoms usuallyusually occur within minutes to two hours after contact withoccur within minutes to two hours after contact with the allergy-causing substancethe allergy-causing substance • Individuals withIndividuals with asthma, eczema, or hay feverasthma, eczema, or hay fever are atare at greater relative riskgreater relative risk of experiencing anaphylaxisof experiencing anaphylaxis • CommonCommon causescauses of anaphylaxis includeof anaphylaxis include:: − FoodFood − MedicationMedication − Insect stingsInsect stings − latexlatex • TreatmentTreatment--Epi-pen (--Epi-pen (EpinephrineEpinephrine) and Benadryl) and Benadryl
    46. 46. © 1996 West Publishing Company Slide 15 -Slide 15 - 4646 Autoimmune diseaseAutoimmune disease body's own cells instead of foreign cells arebody's own cells instead of foreign cells are attacked by immune systemattacked by immune system • Systemic lupus erythematosus (SLE)Systemic lupus erythematosus (SLE) • Myasthenia gravis (MG)Myasthenia gravis (MG) • Immune Thrombocytopenic Purpura (sensitivity to own platelets!)Immune Thrombocytopenic Purpura (sensitivity to own platelets!) • Thyrotoxicosis (Graves' disease)Thyrotoxicosis (Graves' disease) • Insulin-dependent diabetes mellitus (IDDM or Type I diabetes)Insulin-dependent diabetes mellitus (IDDM or Type I diabetes) • Multiple sclerosis (MS)Multiple sclerosis (MS) • Rheumatoid arthritisRheumatoid arthritis • PsoriasisPsoriasis • Crohn’s diseaseCrohn’s disease In some autoimmune diseases, B cellsB cells mistakenly make antibodies against tissues ofmistakenly make antibodies against tissues of the body (self antigens)the body (self antigens) instead of foreign antigens. Occasionally, these autoantibodies either interfere with the normal function of the tissues or initiate destruction of the tissues.
    47. 47. © 1996 West Publishing Company Slide 15 -Slide 15 - 4747 Acquired Immunodeficiency SyndromeAcquired Immunodeficiency Syndrome AIDSAIDS • AIDSAIDS is anis an immunodeficiencyimmunodeficiency disorderdisorder caused by a virus thatcaused by a virus that destroys helper T cellsdestroys helper T cells and that isand that is harbored in macrophages as wellharbored in macrophages as well as helper (T4) T cells.as helper (T4) T cells. The AIDSThe AIDS virusvirus (HIV) splices its DNA into(HIV) splices its DNA into the DNA of the cell it infectsthe DNA of the cell it infects; the; the cell is thereafter directed to churncell is thereafter directed to churn outout new virusesnew viruses.. • SymptomsSymptoms:: lymphadenopathy,lymphadenopathy, fatigue, fever, weight loss,fatigue, fever, weight loss, opportunistic infection,opportunistic infection, splenomegalysplenomegaly
    48. 48. © 1996 West Publishing Company Slide 15 -Slide 15 - 4848 Opportunistic diseases of AIDSOpportunistic diseases of AIDS Kaposi's sarcoma (15% AIDS pts)Kaposi's sarcoma (15% AIDS pts) rare form of cancer of the lining ofrare form of cancer of the lining of blood capillariesblood capillaries Mycobacterium aviumMycobacterium avium anan opportunistic infectionopportunistic infection complex infectioncomplex infection amongamong AIDS patientsAIDS patients non-Hodgkin's lymphomanon-Hodgkin's lymphoma malignant tumor of lymphatic tissuesmalignant tumor of lymphatic tissues with enlargement of lymph nodeswith enlargement of lymph nodes Pneumocystis carinii parasitePneumocystis carinii parasite parasite that causes an opportunisticparasite that causes an opportunistic type of pneumoniatype of pneumonia tuberculosistuberculosis commoncommon opportunistic disease among AIDSopportunistic disease among AIDS
    49. 49. © 1996 West Publishing Company Slide 15 -Slide 15 - 4949 Kaposi’s sarcomaKaposi’s sarcoma •Rare vascular tumorRare vascular tumor • Kaposi's sarcoma isKaposi's sarcoma is seen in 15% of AIDSseen in 15% of AIDS patients in the Unitedpatients in the United States.States. •frequently on the facefrequently on the face and trunkand trunk
    50. 50. © 1996 West Publishing Company Slide 15 -Slide 15 - 5050 Acquired Immunodeficiency SyndromeAcquired Immunodeficiency Syndrome (AIDS)(AIDS) TreatmentTreatment (focused on life extension and symptom(focused on life extension and symptom reduction)reduction) TransmissionTransmission – ThroughThrough contaminated body fluidscontaminated body fluids exchangedexchanged through close or intimate contactthrough close or intimate contact – No evidence transmission through casual socialNo evidence transmission through casual social contactcontact – Sexual contact, contaminated syringes and needles,Sexual contact, contaminated syringes and needles, contaminated blood, contaminated donor organs,contaminated blood, contaminated donor organs, infected maternal-fetal transmissioninfected maternal-fetal transmission

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