Chapter 14Lymphatic and Immune SystemsCopyright © 20.docx

Chapter 14
Lymphatic and Immune Systems
Copyright © 2008, 2005 by Saunders, an imprint of Elsevier
Inc. All rights reserved.
*
Learning ObjectivesIdentify the structures and analyze terms
related to the lymphatic and immune systems.Recognize terms
that describe various pathologic conditions affecting the
lymphatic and immune systems.
*
Learning Objectives (cont’d)Identify laboratory tests, clinical

procedures, and abbreviations that are pertinent to the lymphatic
and immune systems.Apply your new knowledge to
understanding medical terms in their proper contexts, such as
medical reports and records.
*
Chapter 14
Lesson 14.1
*
Introduction
Lymph: clear watery fluid that surrounds body cells and flows
in system of lymph vessels throughout the body.originates in
bloodrich in lymphocytes and monocytesflows in lymph
capillaries and vesselsflows through lymph nodes and lymphatic
organs (liver, spleen, thymus, and nodes)absorbs lipids in the
intestine

*Tonsils are aggregate lymphatic organs.Lymphocytes and
monocytes in lymph organs protect the body from foreign
invaders.What are the three functions of the lymphatic system?
Introduction
Lymphatic System Functions
Transports proteins and fluid that have leaked, back to the
bloodstream
Lymphatic vessels absorb lipids from intestines and transport
them to the bloodstream
Lymphocytes and monocytes protect the body by mounting a
cellular attack on foreign cells and organisms.
*Tonsils are aggregate lymphatic organs.Lymphocytes and
monocytes in lymph organs protect the body from foreign
invaders.What are the three functions of the lymphatic system?
Interstitial Fluid and Lymph Capillaries

*Have students label the figure….or use the next figure with has
the labels in place.Review the circulation of blood in blood
vessels. Compare and contrast with lymph in lymph capillaries.
How do the blood and lymph systems complement each
other?How are the structures of lymph vessels and veins
similar? (valves, no pump)
Interstitial Fluid and Lymph Capillaries
*Review the circulation of blood in blood vessels. Compare and
contrast with lymph in lymph capillaries. How do the blood and
lymph systems complement each other?How are the structures
of lymph vessels and veins similar? (valves, no pump)
Blood and Lymph
*Use this slide to continue your discussion from previous slide.
What happens in situations such as edema?

Blood and Lymph
*Use this slide to continue your discussion from previous slide.
What happens in situations such as edema?
Lymphatic System AnatomyLymph capillariesLymph
vesselsLymph nodes
*What are lymph capillaries and lymph vessels?What does each
do? Describe lymph nodes and what they do.
Location of Lymph Nodes
*Ask students to fill in the names and locations of the major
areas of the body occupied by lymph nodes.

Location of Lymph Nodes
*Ask students to fill in the names and locations of the major
areas of the body occupied by lymph nodes.
Lymph Nodes
*Point out and discuss elements and functions of each part in
this figure
Lymph Nodes
*Point out and discuss elements and functions of each part in
this figure

Lymph NodesMacrophages phagocytose foreign substances.
B lymphocytes (B cells) produce antibodies.
T lymphocytes (T cells) attack bacteria and foreign cells.
*What happens in a lymph node?How do T cells act to attack
foreign cells?
SPLEEN
Destroys old red blood cells.
Filters microorganisms and
other foreign material out of
the blood.
Activates lymphocytes during
blood filtration. B cells
produce antibodies.
Stores blood, especially
erythrocytes (RBCs) and
platelets
*The spleen and thymus gland are composed of lymph

tissue.Note their locations.What are the functions of the
spleen?Is the thymus proportionately larger in infants or adults?
Why?
THYMUS GLAND
Provides immunity in fetal life
and in early years of growth.
Makes cells immunocompetent
in early life.
Early removal from an animal
impairs its ability to make
antibodies and produce cells to
fight antigens.
*The spleen and thymus gland are composed of lymph
tissue.Note their locations.What are the functions of the
spleen?Is the thymus proportionately larger in infants or adults?
Why?
Immune System
Natural immunity: genetic predisposition
PhagocytosisMacrophagesNatural killer cells

*Why is it important for infants to possess natural immunity at
birth?What is an example of genetic predisposition? (Humans
cannot contract feline leukemia.)
Immune System (cont’d)
Acquired/ Adaptive
immunityActiveby contracting a diseaseby vaccinationstem cell
transplant
*Ask students to provide an example for each method of
acquiring active immunity.Ask students what vaccinations they
have had.
Immune ResponseB lymphocytes are responsible for humoral
immunity. originate in bone marrow from stem cellstransform
into plasma cells to produce immunoglobulins, antibodies that
neutralize antigens

*
Immune Response (cont’d)T lymphocytes are responsible for
cell-mediated immunity. The function of T cells
varies:Cytotoxic T cells (T8 cells) attach to and attack
antigens.Other T cells secrete interferons and interleukins that
help cells respond to antigens.Helper T cells (CD4+) promote
antibody synthesis by B cells and stimulate other T
cells.Suppressor T cells inhibit B and T cells.
*T-cell lymphocytes originate from bone marrow stem cells.
They are processed in the thymus gland.
Dendritic CellsA macrophage derived from
monocytes.Recognize and digest foreign antigens.Present
antigens on surface to stimulate B and T cells.Transfer
immunity by exposing dendritic cells in culture; then transfuse
them and get them to stimulate T and B cells.
*Some of the dendritic cell work (sensitizing them in a culture)

is under investigation in clinical studies used to treat tumors
and tumor antigens, thus getting the patient’s own immune
system to attack the tumor.
Immunotherapy ExamplesVaccines: killed tumor cells produce
cytokines that enhance the immune responseDendritic cells:
cultured and exposed outside body and reinfusedMonoclonal
antibodies (MoAb): multiple copies of cells or genes that kill
tumor cellsDonor lymphocyte infusions: T cells, infused after
allogeneic stem cell or bone marrow transplant, attack tumor
(leukemia treatment)
*
QUICK QUIZ:
Lymphocyte that originates in the bone marrow and transforms
into a plasma cell to secrete antibodies?
dendritic cell
helper T cell
B cell
cytotoxic T cell

*
CORRECT Answer is B, helper T cell, see page 533 LOM 83.
2. Which type of immunity is the formation of antibodies and
lymphocytes after exposure to an antigen?
Cell-mediated immunity
Acquired/ adaptive immunity
Natural immunity
QUICK QUIZ:
*
CORRECT Answer is B, acquired immunity
COMBINING FORMS
immun/o protection lymph/o lymphlymphaden/o
lymph nodesplen/o spleenthym/o thymus
glandtox/o poison
Combining Form Meaning
COMBINING FORMS, PREFIXES, AND TERMINOLOGY

*
PREFIXES
ana- again, anew
inter- between
Prefix Meaning
COMBINING FORMS, PREFIXES, AND TERMINOLOGY
*
Chapter 14
Lesson 14.2
*

Disorders of the Lymphatic and Immune Systems
ImmunodeficiencyAcquired Immunodeficiency Syndrome
(AIDS)destroys T helper cells (CD4+ cells)opportunistic
infectionsmalignancies
(Kaposi sarcoma, Wasting syndrome)
*
Opportunistic Infections with AIDS CandidiasisCryptococcus
(Crypto)Cryptosporidiosis Cytomegalovirus (CMV)
infectionHerpes simplexHistoplasmosis (Histo)Mycobacterium
avium-intracellulare (MAI) infectionPneumocystis pneumonia
(PCP)Toxoplasmosis (Toxo)Tuberculosis (TB)
*Ask students to provide symptoms for the opportunistic
infections listed.
Drugs to Treat AIDS

Reverse transcriptase inhibitors (RTI) (e.g. Epivir) inhibits viral
enzyme called reverse transcriptase Protease inhibitors (PI)
(e.g. nelfinavir, amprenavir) inhibit viral proteolytic
enzymeCombiniation of RTI and Protease inhibitors is HAART
(highly active antiretroviral therapy)
*HIV needs protease at a later stage than it needs RT to make
viral parts that will spread throughout the body.
HYPERSENSITIVITYAllergy: abnormal sensitivity acquired by
exposure to antigenRanges from
allergic rhinitis or hay fever to anaphylaxisOther allergies:
atopic dermatitis
asthma
urticaria (hives)
*Review examples of hypersensitivity reactions. Discuss
reactions that students have had.What is anaphylaxis? Why is it
dangerous?What is the common name for urticaria?
MALIGNANCIESLymphoma: malignant tumor of lymph nodes

and lymph tissueHodgkin disease (Reed-Sternberg cell)Non-
Hodgkin lymphoma (follicular lymphoma, large cell lymphoma)
Multiple myeloma: malignant tumor of bone marrow cells
Thymoma: malignant tumor of the thymus
*Ask students to define associated
terms:SplenomegalyLymphadenopathyRadiotherapy
Staging of Hodgkin Disease
*Ask students to define associated terms, and reuse them
correctly in another
context:MediastinumExtranodalExtralymphaticSplenectomy
QUICK QUIZ:
3. What is a malignant condition associated with AIDS?
anaphylaxis
non-Hodgkin lymphoma
Kaposi sarcoma
Hodgkin disease

*
CORRECT Answer is C, Kaposi sarcoma.
Laboratory TestsCD4+ cell count: measures the number of
CD4+ Tcells (helper T cells) in the bloodstream with patients
with AIDS
ELISA test: detects anti-HIV antibodies; Western blot given as
follow-up
Immunoelectrophoresis: separates immunoglobulins (IgG, IgM,
IgE, IgA, IgD)
Viral load tests: measure amount os AIDS virus in the
bloodstream
*ELISA is an acronym that stands for what? (enzyme-linked
immunosorbent assay)For what conditions is
immunoelectrophoresis utilized?
Clinical ProcedureComputed tomography (CT) scan:
X-ray imaging in the transverse plane produces cross-
sectional views of anatomic structures. These x-ray views show
abnormalities of lymphoid organs, such as lymph nodes, spleen

and thymus gland.
*
COMBINING FORMS
axill/o ___________cervic/o
___________immun/o ___________inguin/o
___________lymph/o ___________lymphaden/o
___________
Suffix Meaning
REVIEW SHEET
*
COMBINING FORMS
axill/o armpitcervic/o neck; cervix (neck of
uterus)immun/o immune;protection;safeinguin/o
groinlymph/o lymphlymphaden/o lymph gland

(node)
Suffix Meaning
REVIEW SHEET
*
COMBINING FORMS
splen/o ___________thym/o
___________tox/o ___________
Suffix Meaning
REVIEW SHEET
*
COMBINING FORMS
splen/o spleenthym/o thymus glandtox/o

poison
Suffix Meaning
REVIEW SHEET
*
SUFFIXES
-cytosis ___________-edema ___________-
globulin ___________-megaly ___________-oid
___________-pathy ___________
Suffix Meaning
REVIEW SHEET
*
SUFFIXES

-cytosis condition of cells; slight
increase in numbers-edema swelling-globulin
protein-megaly enlargement-oid resembling-pathy
disease; emotion
Suffix Meaning
REVIEW SHEET
*
SUFFIXES
-penia ___________-phylaxis ___________-
poiesis ___________-stitial ___________-
suppression ___________
Suffix Meaning
REVIEW SHEET
*

SUFFIXES
-penia deficiency-phylaxis protection-poiesis
formation-stitial to set; pertaining to standing or
positioned-suppression to stop
Suffix Meaning
REVIEW SHEET
*
PREFIXES
ana- ___________auto- ___________hyper-
___________inter- ___________retro-
___________
Suffix Meaning
REVIEW SHEET
*

PREFIXES
ana- up; apart; backward; again; anewauto- self;
ownhyper- above; excessiveinter-
betweenretro- behind; back; backward
Suffix Meaning
REVIEW SHEET
*
QUICK QUIZ:
4. What is the fluid that lies between cells throughout the
body?
A. atopy
B. lymphadema
C. interstitial
D. lymphopoiesis

*
CORRECT Answer is C, interstitial fluid.
QUICK QUIZ:
5. Malignant tumor of the lymph nodes and spleen marked by
the presence of Reed-Sternberg cells in lymph nodes…
HIV
Kaposi sarcoma
Non-Hodgkins lymphoma
Hodgkin disease
*
CORRECT Answer is D, Hodgkin disease

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