Immune System-Liz-Part 1

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Immune system-1st line of defense

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Skin

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Immune system is activated by

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minor injuries (cuts, bruises, burns, surgeries)

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Non-specific response(Inflammation)

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prevent or limit the entry of the invaders

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Specific Response

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when the inflammatory process is unable to destroy invading organisms- Ex: when you get the chicken pox and if you are re-exposed than that would be a specific response (when an invader comes in and is recognized)

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Resistant organisms

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MRSA/VRE/penicillin resistant strep/Resistant TB

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Erythrocyes

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are important for oxygenation and gas exchange

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Leukocytes

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are responsible for the infection and immune response

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Thrombocytes

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make you think about bleeding/clotting

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Erythrocytes, Leukocytes, Thrombocytes all produced where?

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Bone marrow

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Chemotherapy affects what?

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Bone marrow, so we will see decrease in RBC's, WBC's & thrombocytes-At huge risk for bleeding infection, and will have gas exchange problems

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Leukocytosis

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Elevated WBC > 10,000

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Leukocytosis may be due to what?

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Infection or, Certain kinds of drugs, severe emotional or physical stress, trauma/tissue damage, anemia, inflammatory disease, Leukemia, certain diseases like amoebas and yellow fever

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Leukopenia

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Low WBC count <4,000

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Leukopenia may be d/t what?

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Bone marrow suppression, collagen vascular disease, Disease of liver or spleen, radiation

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Immunocompetent

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Your body can respond to germs

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Immunocompromised

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Body does not have the ability to respond to germs Ex. AIDS and neutropenic pts

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Granulocytes

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Neutrophils, Basophils, Eosinophils

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Neutrophils

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Engulf the bacteria and foreign invaders, 1st to the scene, primary job is phagocytosis, They increase in bacterial infection

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What is a band?

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Immature Neutrophils

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Shift to the left

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Is an increase in bands which indicates bacterial infection

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Eosinophils

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allergic reactions and parasites, short lived only last 30 mins, FOund in respiratory and GI tract

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Basophils

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Non phagocytic, call them mat cells in tissue

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Which granulocyte releases mediators and what are they?

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Basophils-Histamines which is where hives come from

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Basophils contain what?

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Heparin, histamine, bradykinin, serotonin, protoglandins, leukatrines-all released during stress response

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Non-granulocytes (agranulocytes)

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Monocytes, macrophages, & Dendritic cells

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Monocyte

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2nd line of defense, phagocytic cells, active for two days then they attach to tissue

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Monocytes are differentiated by the tissue they reside in

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Histocytes, Kuppfer cells

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Histocytes

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In the loose connective tissue

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Kupffer cells

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in liver etc

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Monocytes become what in tissues?

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Macrophages-where they sit for sometimes years until they are activated

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Macrophages

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Important in chronic infections, encapsulate foreign matter(they are non-specific)

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Dendritic cells

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capture antigens and migrate to lymphoid tissue-serve as sentinels for antigens in most organ including heart, lungs, liver, kidney, & GI tract

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Lymphocytes 3 types

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T-Cells, B-Cells, Natural Killer Cells

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T-Cells

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Helpful with cell mediated immunity, Helper (CD4+), Supressor/Cytotoxic (CD8+)

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T-Cells mature where?

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Thymus gland

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B-Cells mature where?

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Bone Marrow

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B-cells

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Have memory (IgA, IgG, IgM)

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Plasma cells make what?

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Antibodies

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IgG more in what?

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Babies (passive immunity)

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Natural Killer Cells

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Large grandular cells which release proteins that cause targer cells to die (apoptosis)

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Narutal Killer Cells are found where?

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Spleen, Lymph Nodes, & bone marrow

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Antigen

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a marker that triggers the formation of a lymphocyte, they are recongnized as non-self on bacteria, blood, or transfusions

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Antibody

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molecules that bind to the antigens and are recognized by lymphocytes

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Antigen Presenting Cells (APC's)

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Macrophage that digests the foreign cell but leaves the antigens intact. Binds antigens to MHC molecules on the cell membrane

Front 45

Lymphoid system

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All throughout body, exists to recover proteins such as albumin for the vascular system and protect the bloodstream from invading organisms

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Lymph nodes

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Concentrated around the junction of lymphatic vessels-focused around where germs come in

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What does Lymph do?

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Clears protein containing fluid transported by the vessels

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first lymph funtion

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Filter foreign products or antigens from the lymph

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second lymph

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House and support proliferation of lymphocytes and macrophages

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Where are Lymph found?

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Neck, axilla, groin, and abdomen

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Main function of lymph nodes

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To protect the body from invading organisms r/t infection or viruses

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Spleen

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Largest lymphoid organ, this is where lymphocytes proliferate

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Only organ that can filter blood

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Spleen

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Spleen facts-

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Stores blood and platelets for future use, major storage depot for WBC's, major site for mounting the immune system

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Is the Spleen essential for life?

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NO

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What happens if you lose your spleen?

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Bone marrow and liver will take over responsibilities, those without it may be slightly more at risk for infection

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Thymus Gland

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in the center of chest over heart, reaches maximum size @ puberty and then atrophys down to a fatty area

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Thymus gland- t-cells

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Site for maturation of t-cells during fetal life and child-hood

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Bone Marrow

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Stores Hematopoietic stem cells

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Bone Marrow mostly found....

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In the hallow cavities of the long bones-Femur and Humerous mostly

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Where are the red blood cells made?

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Bone Marrow

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Lymphoid Tissue-GALT

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gut associated- Payers patches in the gut

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Lymphoid Tissue- MALT

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mucosal associated lymphoid tissue

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Lymphoid tissue-SALT

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Skin associated lymphoid tissue

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Non Specific Inflammatory Response- Barriers

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Skin, mucous membranes, body fluids( saliva, lysozyme, gastric juice)- in trouble when these break

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Non specific inflammatory response

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Inflammation caused from a splinter or something that is not specifically an antigen

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3 stages of inflammation

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Vascular response/ Cellular response/Healing process

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Vascular Response

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localizes invading bacteria and keeps them from spreading -damaged tissue releases histamines and Kinin-vasodilation and increased vessel permeability results in exudates

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Exudates have 3 functions

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brings nutrients to damaged tissue, dilutes bacterial toxin, transports cells needed for phagocytosis

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Serous exudate

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Redness-primarily plasma fluid and RBC's

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Sanguineous exudate

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Looks a lot like blood

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Serosanguineous exudate

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produced from moderate to severe tissue damage, contains lg amt of RBC

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Fibrinous exudate

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sticky network of fibrinogen that walla off the inflamed tissues and prevents spreading of infection

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Cellular response and phagocytosis

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begins less than an hour after injury, marked by the margination and emigration of leukocytes into the damaged tissue, chemotaxis and phagocytosis

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Cell response cont'd

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Neutrophils and macrophages begin working(pus formation-damaged tissue & WBC's)

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Neutropenic patients may not make what?

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A lot of Pus d/t they do not have a lot of WBC's

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Healing Process/Tissue Repair

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Labile cells, Stable cells, permanent/fixed cells

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Labile Cells

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Job is to regenerate continuously and keep repairing the body when it is damaged.

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Labile Cells are where?

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Bone marrow, epithelial cells of skin, GU & GI tract

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Stable Cells

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do not replicate throughout life but do so when necessary

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Stable cells are where?

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bones, liver, kidney, pancreas

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Permanent of fixed cells

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incapable of regeneration- replaced by scar tissue

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Permanent cells are where?

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skeletal, cardiac muscle, nerve cells

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Major chemical mediators of inflammation

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Histamine/Kinins/Prosaglandins/Leukotrienes

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Histamine

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cause vasodilation and increased capillary permeability producing redness, warmth, and edema

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Kinins

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Histamine like effect- chemotaxis and pain inducers

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Prostaglandins

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Histamine like effect-chemotaxis, pain, fever inducers

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Leukotrines

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smooth muscle constrictors, increased vasodilator permeability

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Cardinal signs of inflammation

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1.Redness-erythema

2.Heat-hyperemia

3.Swelling-edema

4.pain-dolar

5.Loss of function

6.Macrophage activity

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Interleukin 1

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Increases your body temp and causes drowsiness

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Systemic response to inflammation-Acute

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short term reaction of the body all types of tissue damage, immediate swelling and pain

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Acute systemic inflam- duration

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lasts up to 2 weeks

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Acute systemic inflam- S/SX

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FEVER, loss of appetite, chills, fatigue, tachycardia, increased RR, WBC > 12,000, increase size in lymph

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Chronic systemic response to inflam

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Involves cell proliferation and is debilitating

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Chronic systemic response to inflam-duration

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Can last for months to years

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Chronic systemic response to inflamdoes what?

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Increases exudates, scarring, fibroses resulting in severe tissue damage- Ex. granuloma formation in TB

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Factors that impair healing

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Nutrition, circulation, oxygenation, impaired immune system, chronic diseases ( DM, steroid use)