1. Chapter Nine
Blood, Lymphatic, and Immune Systems
Mastering Healthcare Terminology/Chapter 9

2. Quote “The family you come from isn’t as important as
the family you are going to have.”
– Ring Lardner
How is this quotation true or not true? Students may comment on genetic disorders or the effect a parent’s decisions may have on their children’s health.

3. Circulation Video

4. Functions of the Blood and Specialties/Specialist
Transportation
Regulation
Protection from infection
Protection from blood loss
Specialty
Hematology
Specialist
Hematologist
The blood, lymphatic, and immune systems are three integrated systems that help the body maintain homeostasis, a steady state.
The functions of the blood are to provide transportation of gases (oxygen and carbon dioxide), hormones, nutrients, salts, and cells that defend the body; to regulate the body’s fluid and electrolyte balance, acid--base balance, and body temperature; to protect the body from infection; and to protect the body from loss of blood through the action of clotting.
Hematology is the study, diagnosis, and treatment of diseases of blood and blood-forming organs. The specialist in this field is a hematologist.
Mastering Healthcare Terminology/Chapter 9

5. Functions of the Lymphatic System
Cleansing
Returning
Providing a pathway
Defending
The lymphatic is responsible for cleaning the cellular environment, returning proteins and tissue fluids to the blood (as a means of drainage), providing a pathway for the absorption of fats and fat-soluble vitamins into the bloodstream and defending the body against disease.
Mastering Healthcare Terminology/Chapter 9

6. Function of the Immune System and Specialty/Specialist
Defending
Specialty
Immunology
Specialist
Immunologist
The immune system is responsible for defending the body against disease via the immune response. The combining form immun/o means safety or protection. Immunology is the study, diagnosis, and treatment of diseases that affect the body’s ability to defend itself. The specialist in this field is an immunologist.
Immunology is the study, diagnosis, and treatment of diseases that affect the body’s ability to defend itself. The specialist in this field is an immunologist.
Mastering Healthcare Terminology/Chapter 9

7. Interrelationship of Hematic, Lymphatic, and Immune Systems Homeostasis:
Discuss the diagram and how all three systems share a common goal of defending the body to sustain life.
Mastering Healthcare Terminology/Chapter 9

8. Positive and Negative Feedback Loops

9. Relationship of Lymphatic Vessels to the Circulatory System
The blood and lymph flow through separate but interdependent channels. Both are systems composed of vessels and the liquids that flow through them. The immune system, a complex system of levels of protection for the body, includes both blood and lymphatic cells.

10. Hematic System Blood and vessels Hematopoiesis Blood composition
Blood cells
Erythrocytes (erythr/o)
Leukocytes (leuk/o)
Thrombocytes (thromb/o)
Plasma
Composition of blood
Hematopoiesis (hemat/o = blood + -poiesis = formation) is the process of the formation of blood. All blood cells originate from a single type of cell called a stem cell.
The liquid tissue of blood is composed of a solid portion that is made up of cells and a liquid portion called the plasma. The cells make up approximately 45% of the total blood volume, and plasma is the other 55%. These numbers vary slightly depending on an individual’s sex, but are important in the measurement of a hematocrit, a test that will be discussed in the diagnostic terms section.
The three types of blood cells are red blood cells called erythrocytes, white blood cells called leukocytes, and clotting cells called thrombocytes or platelets.
To have an idea of their relative numbers, in a milliliter of blood there are 4.2 to 5.8 million red blood cells, 5000 to 9000 white blood cells, and 250,000 to 400,000 thrombocytes.
Blood itself accounts for about 8% of the total body volume and the average volume of blood is about 10.5 pts or 5 liters (think of your favorite soda) in a 150-lb (or 68-kg) person.
Mastering Healthcare Terminology/Chapter 9

11. Did You Know?
The process of blood formation is called hematopoiesis. All blood cells originate from a single type of cell called a stem cell. Hematopoietic stem cell research is currently an exciting area of healthcare investigation. The National Institutes of Health has a website that keeps an updated list of news titled NIH Stem Cell Information at

12. Components of Blood (hemat/o, hem/o)
Erythrocytes
Hemoglobin
RBC life cycle
Erythropoietin
Hemosiderin
Hemolysis
Morphology (morph/o)
Aside from the function of transporting oxygen and carbon dioxide throughout the body, the blood must also carry a protein-iron pigment called hemoglobin.
Red blood cells are formed in the bone marrow as a result of stimulation by a hormone in the kidneys called erythropoietin (erythr/o = red [blood cell] + -poietin = forming substance).
The life cycle of a red blood cell is about 4 months or 120 days, after which time it decomposes into hemosiderin (hem/o + siderin = iron substance), which is an iron pigment resulting from hemolysis (-lysis = breaking down). Aside from the hemosiderin, bilirubin is also a byproduct of the decomposition. The iron is stored in the liver for recycling and the bile pigments are excreted by the liver.
The morphology of blood cells is important (morph/o = shape). Normal blood cells have a biconcave, disk-like shape, which moves easily throughout the vessels. In some disorders, such as sickle cell anemia, the shape of the cells is changed, which results in dysfunction and disease.
Erythrocytes
From Thibodeau and Patton: Anatomy and physiology, ed 6, Mosby
Mastering Healthcare Terminology/Chapter 9

13. Components of Blood (cont’d)
Leukocytes (granulocytes and agranulocytes)
Granulocytes/polymorphonucleocytes
Eosinophils (eosin/o)
Neutrophils (neutr/o)
Basophils (bas/o)
Leukocytes, in general, protect the body from invasion by pathogens. There are two main types of these white blood cells.
The first type, granulocytes (also called polymorphonucleocytes), are named for the small grains within the cytoplasm and mutlilobed nuclei. Granul/o = little grain. Poly- means many + morph/o = shape + nucle/o = nucleus + -cyte = cell. The two names are used interchangeably and you should be familiar with both. There are three types of granulocytes:
Eosinophils (eosin/o = rosy-colored + -phil = attraction) are cells that absorb a rosy-colored acidic dye, which causes them to have a reddish color. An increase in eosinophils is usually the body’s response to defending itself against allergens.
Neutrophils (neutr/o = neutral) are cells that are neither acidic nor alkaline, and they stain a lavender/purplish color. An increase in neutrophils is normal when the body is combating bacteria in pyogenic (py/o = pus + -genic pertaining to producing) infections. The cells perform the function of phagocytosis (phag/o = eat, swallow), where they consume the “enemies” and remove the debris from the battlefield.
Mastering Healthcare Terminology/Chapter 9

14. Components of Blood (cont’d)
Agranulocytes/mononuclear leukocytes
Monocytes
Lymphocytes
Agranulocytes are the second type of leukocyte. Notice that an a- has been added denoting the absence of the small grains in the appearance of these cells. They, too, have another name: mononuclear leukocytes, because their nuclei have only one nucleus.
Although these cells originate in the bone marrow, they mature only after entering the lymphatic system.
There are two types: monocytes and lymphocytes.
Monocytes are named for their single, large nucleus. These cells are transformed into cells call macrophages (macro- = large + -phage = eat, swallow), which eat pathogens and are called out for severe infections.
Lymphocytes are cells that are important in the immune response, meaning that they recognize or remember dangerous foreign substances and manufacture a substance to neutralize them. The foreign substances are termed antigens and the neutralizing substances are called antibodies.
Mastering Healthcare Terminology/Chapter 9

15. Clicker Question Thrombocytes: A. are clotting cells
B. are white blood cells
C. protect the body against disease
D. carry hemoglobin
Are clotting cells
Thromb/o = clotting, clot
Mastering Healthcare Terminology/Chapter 9

16. Components of Blood (cont’d)
Thrombocytes/platelets
Coagulation
Agglutination (agglutin/o)
Factor X/thrombokinase
Prothrombin  thrombin
Fibrinogen  fibrin
Hemostasis
Thrombocytes (platelets) have a round or oval shape and the name platelet comes from their appearance as little plates.
These cells aid in the coagulation (clotting) of the blood, which is the process of changing a liquid to a solid.
The process of coagulation begins with agglutination, which is a clumping of the cells.
The cells release a substance called Factor X (formerly called thrombokinase), which, in the presence of calcium, reacts with the blood protein, prothrombin.
Prothrombin then forms thrombin.
Thrombin converts to form another blood protein, fibrinogen.
Fibrinogen is then converted to fibrin, which eventually forms a mesh-like fibrin clot.
Hemostasis (hem/o =blood + -stasis = stopping, controlling), or the control of blood flow, is then achieved.
Clotting process
Mastering Healthcare Terminology/Chapter 9

17. Components of Blood (cont’d)
Plasma
Composition
Serum = plasma – clotting proteins
Serology
Plasma, the liquid portion of blood, is composed of:
Water.
Inorganic substances (calcium, potassium, sodium).
Organic substances (glucose, amino acids, fats, cholesterol, hormones).
Waste products (urea, uric acid, ammonia, creatinine).
Plasma proteins (serum albumin, serum globulin) and clotting proteins (fibrinogen and prothrombin).
Serum is plasma minus the clotting proteins (fibrinogen and prothrombin). Serology is the branch of laboratory medicine that studies blood serum for evidence of infection by evaluating antigen--antibody reactions in vitro (in living tissue).
Mastering Healthcare Terminology/Chapter 9

18. Blood Groups A, B, AB, O Antigens – agglutinogens
Antibodies – agglutinins
Universal donor
Universal recipient
Rh factor
Human blood is divided into four major blood groups. They are named A, B, AB, and O. The differences are due to antigens present on the surface of an individual’s blood cells. Remember that antigens are substances that produce an immune reaction by their nature of being perceived as foreign to the body. Because of this recognition as “foreign,” the body produces substances called antibodies to neutralize the “invader.” In blood, the antigens are called agglutinogens [because they are substances that produce (gen) clumping substances (agglutin/o)] and the antibodies are called agglutinins.
Type A blood has A antigens, type B has type B antigens, type AB has type a and type B antigens, and type O has neither A nor B antigens.
So, if a type A individual is transfused with type B blood, the blood will agglutinate because type B blood is perceived as foreign. However, this same type A individual could be transfused with type O blood, because it has neither type A nor type B antigens.
Type O blood, therefore, is the universal donor, because it has no antigens that will cause a reaction with any of the blood types. Type AB, however, is referred to as a universal recipient, because it has both type A and type B antigens.
The Rh factor, another antigen, is important in pregnancy because a mother who is Rh- can develop antibodies to an Rh+ fetus in the first pregnancy and cause hemolysis (-lysis = destruction) of the fetus’ blood in subsequent pregnancies.
ABO blood groups
Mastering Healthcare Terminology/Chapter 9

19. Clicker Question The universal donor of blood groups is: A. Type A
B. Type B
C. Type AB
D. Type O
Type O
Type O has neither antigen A nor antigen B.
Mastering Healthcare Terminology/Chapter 9

20. Lymphatic System Lymph/interstitial fluid Lymph vessels (lymphangi/o)
Role of agranulocytes
Monocytes
Lymphocytes
Lymph vessels (lymphangi/o)
Lymph nodes/lymph glands (lymphaden/o)
Lymph organs
The lymphatic system is composed of lymph, also called interstitial fluid, which is the fluid surrounding the cells; lymph vessels, which are small valvular structures; lymph glands (also called lymph nodes); and lymph organs (tonsils, adenoids, appendix, spleen, thymus gland, Peyer patches, and lymphoid tissue).
Monocytes and lymphocytes pass out of the bloodstream and into the lymphatic fluid through the capillary walls in the spaces between cells in the body tissue. Monocytes change into macrophages, destroy pathogens, and collect debris from damaged cells. Lymphocytic function will be discussed with the immune system.
Lymph moves in one direction (hence the valves in the lymph vessels) in order to prevent pathogens from flowing through the body. From the lymph vessels, the flow continues to the lymph gland and on to either the right lymphatic duct or the thoracic duct, both of which empty into the subclavian veins in the neck. Once back in the venous blood, the lymph is recycled through the body for another round. The system filters out the microorganisms as the lymph passes through its various systemic structures.
The major lymph glands are the cervical (cervic/o = neck), axillary (axill/o = armpit), inguinal (inguin/o = groin), and mediastinal nodes.
Use the diagram to identify lymph glands and lymph organs; indicate the significance of the thoracic duct and the right lymphatic duct.
Lymphatic system
Mastering Healthcare Terminology/Chapter 9

21. Immune System (immun/o)
Role of cytokines
Levels of defense
First line/ nonspecific
Second line/ nonspecific
Third line/ specific immunity
The immune system is composed of organs, tissues, cells, and chemical messengers that interact to protect the body from external invaders and its own internally altered cells.
Cytokines (cyt/o = cell + -kine = movement) are the chemical messengers that are secreted by cells of the immune system that direct immune cellular interaction.
Lymphocytes secrete lymphokines and monocytes and macrophages secrete monokines. Interleukins (inter- = between = -leukin white substance) are a type of cytokine that sends messages “between” leukocytes to direct protective action.
The levels of defense provided by the immune system are divided into a first line, which is a nonspecific immunity; a second line, which is another type of nonspecific immunity; and a third line of defense, which is a specific type of immunity.
Levels of defense
Mastering Healthcare Terminology/Chapter 9

22. Immune System (cont’d)
Nonspecific immunity: First line
Mechanical
Physical
Chemical
The first line of defense includes three different methods of warding off pathogens, without having to recognize them. They are:
Mechanical: the barrier of the intact skin, the sticky mucus on mucous membranes.
Physical: coughing, sneezing, vomiting, diarrhea.
Chemical: tears, saliva, perspiration.
Mastering Healthcare Terminology/Chapter 9

23. Immune System (cont’d)
Nonspecific immunity: Second line
Phagocytosis (phag/o)
Inflammation
Pyrexia (pyr/o)
Protective proteins
Interferons
Complement proteins
Natural killer (NK) cells
The second line of defense comes into play if the pathogens make it past the first line of defense. These include:
Phagocytosis: the neutrophils and monocytes.
Inflammation: heat, swelling, redness, and pain.
Pyrexia: fever (pyr/o = fire).
Protective proteins:
Interferon disrupts viral replication.
Complement proteins: inactive forms that are activated in the presence of bacteria to lyse (destroy) an organism.
Natural killer cells: a specific type of lymphocyte that acts nonspecifically to kill cells infected by certain viruses and cancer cells.
Mastering Healthcare Terminology/Chapter 9

24. Immune System (cont’d)
Specific immunity: Third line
Body’s identification of pathogen/antigen
Antibodies/immunoglobulins formed
Process may be:
Genetic
Acquired
Active: natural or artificial
Passive: natural or artificial
Specific immunity means that the immune response is tailored for a particular organism. The antibodies formed for the particular antigens are termed immunoglobulins. The recognition of the pathogen can be genetically determined or acquired.
If genetically determined, individuals inherit the ability to resist certain diseases because of their species, race, sex, or individual genetics.
Acquired forms of immunity are either active or passive.
Active acquired immunity
Natural immunity is the development of memory cells to protect an individual from a second exposure (because individuals were exposed to chicken pox and came down with it, they are then immune to another round).
Artificial immunity: vaccinations (immunizations) use a weakened form to enable the body to form antibodies.
Passive acquired immunity
Natural passive immunity is the passage of antibodies through the placenta or breast milk.
Artificial passive immunity is the use of Ig harvested from a donor who developed immunity against specific antigens.
Mastering Healthcare Terminology/Chapter 9

25. Clicker Question
Sneezing, coughing, and vomiting are examples of which level of immune defense?
A. first level
B. second level
C. third level
D. fourth level
First level
This is a physical means of defense
Mastering Healthcare Terminology/Chapter 9

26. Terms Related to Blood Dyscrasias
Anemia
Acute posthemorrhagic anemia
Chronic blood loss
Sideropenia
Pernicious anemia
B12 deficiency
Folate deficiency
Hypovolemia
Note that the term dyscrasia is used only with blood disorders.
The term anemia is a bit of a misnomer (an- no, not, without + -emia – blood condition). Patients with anemia are not literally “without blood,” they are just lacking a specific constituent of blood or may be deficient in the normal blood volume.
An acute posthemorrhagic anemia is a red blood cell deficiency caused by blood loss.
Chronic blood loss is long-term internal bleeding that may cause anemia.
Sideropenia is a deficiency of iron in the blood (sider/o = iron + -penia = deficiency). This may be due to chronic blood loss, inadequate iron intake, or unspecified causes. It is a type of an iron deficiency anemia.
Pernicious anemia is a progressive anemia that results from a lack of intrinisic factor essential for the absorption of vitamin B12.
B12 deficiency is an insufficient blood level of cobalamin, also called vitamin B12, which is necessary for mature RBCs. It may be caused by inadequate dietary intake or by the absence of intrinsic factor, a subsance necessary for B12 absorption.
Folate deficiency is an anemia that results from a lack of folate from dietary, drug-induced, congenital, or other causes.
Hypovolemia (vol/o = volume) is a deficiency of the volume of circulating blood.
Mastering Healthcare Terminology/Chapter 9

27. Terms Related to Hemolytic Anemias
Aplastic anemia
Autoimmune acquired hemolytic anemia
Nonautoimmune acquired hemolytic anemia
Pancytopenia
Thalassemia
Sickle cell anemia
Aplastic anemia (plast/o = formation) is a suppression of bone marrow function leading to a reduction in RBC production. Usually idiopathic, this often fatal disorder may be caused by hepatitis, radiation, or cytotoxic agents. It is also referred to as hypoplastic anemia.
Hemolytic anemias are caused by the destruction of red blood cells. If the type is an autoimmune acquired hemolytic anemia, the patient’s own immune system is responsible for the destruction of RBCs. If it is nonautoimmune acquired hemolytic anemia, it may be drug induced or caused by an infectious agent.
Pancytopenia is a deficiency of all (pan-) blood cells that is caused by dysfunctional stem cells.
Thalassemias are a group of inherited disorders of people of Mediterranean, African, and Southeast Asian descent, in which the anemia is the result of a decrease in the synthesis of hemoglobin. This results in a decreased production and increased destruction of RBCs.
Mastering Healthcare Terminology/Chapter 9

28. Sickle Cell Anemia
Approximately 8% of African-Americans carry the sickle cell gene, and 1 in 400 are affected with the disease. Sickle cell anemia is expressed only in individuals who inherit the gene from both parents. If only one gene is present, the patient is said to have the sickle cell trait.
Sickle cell anemia is an inherited anemia characterized by crescent-shaped RBCs. The change in morphology (morph/o = shape, form) causes the RBCs to block the small-diameter capillaries, which results in a decreased blood supply to the cells. A sickle cell crisis is an acute, painful exacerbation of sickle cell anemia. Use the diagrams to discuss how the morphology of sickle cells causes dysfunction.
Mastering Healthcare Terminology/Chapter 9

29. Clicker Question Which type of anemia is an iron deficiency?
A. pernicious anemia
B. sideropenia
C. aplastic anemia
D. thalassemia
Sideropenia
Sider/o = iron + -penia = deficiency
Mastering Healthcare Terminology/Chapter 9

30. Terms Related to Coagulation Disorders
Hemophilia
Polycythemia vera
Purpura
Thrombocytopenia
Purpura
From Swartz: Textbook of physical diagnosis, history and examination, ed 5, Saunders
Hemophilia is a group of inherited bleeding disorders characterized by a deficiency of one of the factors necessary for the coagulation of blood. The suffix –philia means a tendency; in this case, to bleed.
Polycythemia vera is a chronic increase in the number of RBCs and the concentration of hemoglobin. Vera signifies that this is not a sequela of another condition.
Purpura is a bleeding disorder that is characterized by hemorrhage into the tissues. Purpura comes from the Latin word for purple.
Thrombocytopenia is a deficiency of platelets (thrombocytes) that causes an inability of the blood to clot. This is the most common cause of bleeding disorders.
Mastering Healthcare Terminology/Chapter 9

31. Terms Related to Leukocytic Diseases
Leukocytosis
Eosinophilia, basophilia, neutrophilia
Lymphocytosis, monocytosis
Leukopenia
Eosinopenia, neutropenia
Lymphocytopenia, monocytopenia
Leukocytosis is an abnormal increase of white blood cells. The suffix –cytosis means an abnormal increase of cells. Abnormal increases in each type of granulocyte are termed eosinophilia, basophilia, and neutrophilia. Here the suffix –philia means a slight increase. An abnormal increase of each type of agranulocyte is termed lymphocytosis and monocytosis.
Leukopenia is an abnormal decrease in white blood cells (-penia = deficiency). Specifically, these would be neutropenia, esosinopenia, monocytopenia, and lymphocytopenia. You may see the term written as leukocytopenia.
Given the functions of white blood cells, why would a deficiency of white blood cells be a problem? (less protection from pathogens)
Mastering Healthcare Terminology/Chapter 9

32. Terms Related to Lymphatic Disorders
Edema
Lymphedema
Hypersplenism
Mononucleosis
Epstein-Barr virus
Splenomegaly
Edema is an abnormal accumulation of fluid in the interstitial spaces of tissues. Edema is one of those terms that can stand alone or as a suffix meaning swelling.
Lymphedema is an accumulation of lymphatic fluid and resultant swelling caused by obstruction, removal, or hypoplasia of lymph vessels.
Hypersplenism is an increased function of the spleen, resulting in hemolysis (destruction of blood cells).
Mononucleosis is an increase in the number of mononuclear (mono- = one) cells in the blood caused by the Epstein-Barr virus. This can result in splenomegaly (-megaly = enlargement).
Edema
From Bloom and Ireland: Color atlas of diabetes, ed 2, Mosby-Wolfe
Mastering Healthcare Terminology/Chapter 9

33. Clicker Question
What is a group of inherited bleeding disorders characterized by a deficiency of one of the factors necessary for the coagulation of blood?
A. purpura
B. thrombocytopenia
C. hemophilia
D. polycythemia vera
C.  hemophilia

34. Terms Related to Lymphatic Disorders
Lymphadenitis
Lymphadenopathy
Lymphangitis
Lymphocytopenia
Lymphocytosis
Lymphadenitis is an inflammation of a lymph node (lymphaden/o = lymph gland/node).
Lymphadenopathy is a disease of the lymph nodes or vessels that may be localized or generalized.
Lymphangitis is an inflammation of the lymph vessels.
Lymphocytopenia is a deficiency of lymphocytes (-penia = deficiency).
Lymphocytosis is an abnormal increase of lymphocytes (-cytosis is an abnormal increase of cells).
Lymphangitis
From Thibodeau and Patton: Anatomy and physiology, ed 6, Mosby
Mastering Healthcare Terminology/Chapter 9

35. Terms Related to Immune Disorders
Acquired immunodeficiency syndrome (AIDS)
Allergy/hypersensitivity
Allergen
Anaphylaxis
Immediate reaction vs. Delayed reaction
Autoimmunity
Acquired immunodeficiency syndrome (AIDS) is caused by the human immunodeficiency virus (HIV), transmitted through body fluids via sexual contact or intravenous exposure. HIV attacks the helper T cells, which causes a diminished immune response.
An allergy (also called a hypersensitivity) is an immune system’s overreaction to irritants that are perceived as antigens. The substance that causes the irritation is termed an allergen.
Anaphylaxis is an extreme form of allergic response in which the patient suffers severe decreased blood pressure and constriction of the airways. The name for the condition comes from the original thought that this was a lack of protection (ana- without + -phylaxis = protection), not an overreaction of the body to the perceived threat.
An immediate allergy is a hypersensitivity caused by IgE. Examples are grass and tree pollens.
A delayed allergy is caused by activated T cells that respond to an exposure of the skin to a chemical irritant up to 2 days later. An example would be poison ivy. The resulting rash is called contact dermatitis.
Mastering Healthcare Terminology/Chapter 9

36. Terms Related to Benign Neoplasms
Thymoma
The only type of benign neoplasm for the blood, lymphatic, and immune systems is a thymoma. This noncancerous tumor is of epithelial origin and is often associated with myasthenia gravis.
Mastering Healthcare Terminology/Chapter 9

37. Terms Related to Malignant Neoplasms
Acute lymphocytic leukemia (ALL)
Acute myelogenous leukemia (AML)
Chronic lymphocytic leukemia (CLL)
Chronic myelogenous leukemia (CML)
Acute lymphocytic leukemia (ALL) is also termed acute lymphoblastic leukemia. It is characterized by the uncontrolled increase in the number of immature lymphocytes. It is the most common type of leukemia for individuals under the age of 19 years. Note that lymphocytes are a form of white blood cells.
Acute myelogenous leukemia (AML) is a rapidly progressive form of leukemia that develops from immature bone marrow stem cells. Note the myel/o in the term meaning bone marrow.
Chronic lymphocytic leukemia (CLL) is a slowly progressing form of leukemia in which immature white blood cells proliferate. This form is most frequently seen in middle age or older patients, seldom in children.
Chronic myelogenous leukemia (CML) is a slowly growing form of leukemia in which immature bone marrow cells proliferate. Like CLL, it occurs most frequently in middle aged (or older) adults, rarely in children.
Did you notice that both acute forms grow rapidly, while both chronic forms grow slowly? And both chronic forms seldom occur in children.
Leukemia
From Damjanov: Anderson’s pathology, ed 10, Mosby
Mastering Healthcare Terminology/Chapter 9

38. Terms Related to Malignant Neoplasms (cont’d)
Hodgkin lymphoma
Non-Hodgkin lymphoma
Multiple myeloma
Malignant thymoma
Hodgkin lymphoma (also called Hodgkin disease) is a cancer of the lymphatic system that is diagnosed by the detection of a type of cell specific only to this disorder, the Reed-Sternberg cells.
Non-Hodgkin lymphoma is a collection of all other lymphatic cancers except for Hodgkin lymphoma. It is the more numerous of the two lymphomas and is the sixth most common type of cancer found in the United States.
Multiple myeloma (also called plasma cell dyscrasia or myelomatosis) is a rare malignancy of the plasma cells formed from B lymphocytes. It is called multiple because the tumors are found in many bones. If it occurs in only one bone, the tumor is referred to as a plasmacytoma.
A malignant thymoma (also called a thymic carcinoma) is a rare malignancy of the thymus gland that is particularly invasive, and unlike its benign form, is not associated with autoimmune disorders.
Note that these terms related to malignancy do not contain the suffixes -carcinoma or -sarcoma.
Hodgkin lymphoma
From Thibodeau and Patton: Anatomy and physiology, ed 6, Mosby
Mastering Healthcare Terminology/Chapter 9

39. Age Matters Pediatrics Geriatrics Hypersensitivities
Hemolytic disease of the newborn
Acute lymphocytic leukemia
Geriatrics
Hypovolemia
Non-Hodgkin lymphoma
Acute myelogenous leukemia
Note that although leukemias occur both in the very young and the elderly, these are different forms.
Mastering Healthcare Terminology/Chapter 9

40. Clicker Question
Which of the following is a term that means “disease of the lymph glands”?
A. lymphangitis
B. lymphadenitis
C. lymphadenopathy
D. lymphedema
Lymphadenopathy
Lymphaden/o = lymph gland + -pathy = disease
Mastering Healthcare Terminology/Chapter 9

41. Terms Related to Imaging
Lymphadenography
Lymphangiography
Splenic arteriography
A lymphadenography (lymphaden/o = lymph gland/node) is a radiographic imaging of the lymph gland after injection of a radiopaque substance. It is also called a lymphography.
Lymphangiography is a radiographic visualization of a part of the lymphatic system after injection with a radiopaque substance.
A splenic arteriography is a radiographic imaging of the spleen with the use of a contrast medium.
Lymphangiogram
From Frank et al: Merrills atlas, ed 10, Mosby
Mastering Healthcare Terminology/Chapter 9

42. Terms Related to Laboratory Tests
AIDS tests--ELISA, Western blot
Allergy testing
Blood cultures
Complete blood cell count (CBC)
Comprehensive
metabolic panel (CMP)
Coombs’ antiglobulin test
Allergen patch test
AIDS tests, such as ELISA and the Western blot test, are done to detect the presence of HIV types 1 and 2.
Allergy testing is a series of tests involving a patch, scratch, or intradermal injection of an attentuated amount of an allergen to test for hypersensitivity.
A basic metabolic panel is a group of blood tests to measure calcium glucose, electrolytes such as sodium, potassium, chloride, creatinine, and blood urea nitrogen.
Blood cultures are blood samples that are submitted to propagate microorganisms that may be present. Cultures may be indicated for bacteremia (bacteria in the blood) or septicemia (an infection in the blood ) or to discover other pathogens such as fungi, viruses, or parasites.
A complete blood cell count (CBC) is a set of 12 tests, including RBC (red blood cell count), WBC (white blood cell count), Hb (hemoglobin), Hct/PCV (hematocrit/packed-cell volume), and diff (WBC differential).
A comprehensive metabolic panel (CMP) is a set of 14 blood tests that add protein and liver function tests to the BMP. Glucose is also measured by a different method than in the basic panel.
A Coombs antiglobulin test is a blood test to diagnose hemolytic disease of the newborn (HDN), acquired hemolytic anemia, or a transfusion reaction.
From Habif: Clinical dermatology, ed 4, Mosby
Mastering Healthcare Terminology/Chapter 9

43. Terms Related to Laboratory Tests (cont’d)
Diff count
Erythrocyte sedimentation rate (ESR)
Hemocrit (hCT)/packed-cell volume (PCV)
Hemoglobin (Hgb, Hb)
Mean corpuscular hemoglobin (MCH)
Mean corpuscular hemoglobin concentration (MCHC)
A diff count is a measure of the numbers of the different types of WBCs.
An erythrocyte sedimentation rate is the measurement of the time it takes for mature RBCs to settle out of a blood sample after an anticoagulant is added. An increased ESR may indicate an inflammation.
Hematocrit (also called a packed cell volume) is a measure of the percentage of RBCs in the blood.
Hemoglobin is an iron-containing pigment of RBCs that carries oxygen to tissues.
Mean corpuscular hemoglobin is a test to measure the average weight of hemoglobin per RBC. It is used in diagnosing anemia.
A mean corpuscular hemoglobin concentration test is done to measure the concentration of hemoglobin in RBCs. This test is useful for measuring a patient’s response to treatment for anemia.
Mastering Healthcare Terminology/Chapter 9

44. Terms Related to Laboratory Tests (cont’d)
Monospot
Prothrombin time (PT)
Partial thromboplastin time (PTT)
Schilling test
White blood cell count (WBC)
A monospot test is done to detect mononucleosis.
Prothrombin time is a test that measures the amount of time taken for clot formation. It is used to determine the cause of unexplained bleeding, to assess the levels of anticoagulation in patients taking warfarin or with vitamin K deficiency, and to assess the ability of the liver to synthesize blood-clotting proteins.
Partial thromboplastin time is a test of blood plasma to detect coagulation defects of the intrinsic system; it is used to detect hemophilias.
A Schilling test is a nuclear medicine test to diagnose pernicious anemia and other metabolic disorders.
A white blood cell count is the measurement of the number of leukocytes in the blood. An increase may indicate the presence of an infection; a decrease may be caused by radiation or chemotherapy.
Mastering Healthcare Terminology/Chapter 9

45. Clicker Question
Which test measures the percentage of red blood cells in the blood?
A. Hgb
B. Hct
C. CBC
D. ESR
Hct: Hematocrit
Mastering Healthcare Terminology/Chapter 9

46. Terms Related to Blood Disorder Interventions
Apheresis
Leukapheresis
Plasmapheresis
Plateletpheresis
Blood transfusion
Autologous
Autotransfusion
The term apheresis means removal, either as a suffix or as a stand alone term. In regard to blood, it is the temporary removal of blood from a donor, the separation and removal of one or more components, and the reinfusion of the remaining blood back into the donor. Leukapheresis is a removal of white blood cells (leuk/o = white).
Plasmapheresis is a removal of plasma.
Plateletpheresis is a removal of platelets (thrombocytes).
Blood transfusions are the intravenous transfer of blood from a donor to a recipient.
If an autologous transfusion, it is a process in which the donor’s own blood is removed and stored for future use.
If an autotransfusion, it is the process of transfusing the patient with his or her own blood from an active bleeding site in cases of major surgery or trauma after anticoagulation and filtering.
Autologous blood transfusion
Mastering Healthcare Terminology/Chapter 9

47. Did You Know?
The term apheresis is from a Greek word meaning removal. It may also be used as a suffix (-apheresis) to create a term that means to remove blood constituents, such as leukapheresis, the removal of WBCs.

48. Terms Related to Bone Marrow Interventions
Bone marrow transplant (BMT)
Autologous
Homologous
A bone marrow transplant is the removal of healthy bone marrow from either the patient or a donor for later transplantation.
An autologous transplant (auto- means self) is bone marrow tissue taken from the patient before treatment to be reintroduced later to form healthy blood cells.
A homologous transplant (homo- means same) is the transplantation of healthy bone marrow from a donor to a recipient to stimulate the formation of new blood cells.
Discuss the benefits and/or risks of transfusions and transplants.
Mastering Healthcare Terminology/Chapter 9

49. Terms Related to Lymphatic and Immune System Interventions
Adenoidectomy
Biopsy of lymphatic structures
Lymphadenectomy
Splenectomy
An adenoidectomy is the removal of the pharyngeal tonsils (the adenoids).
Biopsies of lymphatic structures are removal of the lymph nodes or lymphatic tissue as a means of diagnosis and treatment.
A lymphadenectomy is the removal of a lymph node (the same as a lymph gland).
A splenectomy is the removal of the spleen.
Discuss how a biopsy can be a diagnostic and a therapeutic procedure.
Mastering Healthcare Terminology/Chapter 9

50. Clicker Question
Which of the following can be used as a suffix or stand alone term to mean removal?
A. apheresis
B. poiesis
C. fusion
D. porosis
A. apheresis
Mastering Healthcare Terminology/Chapter 9

51. Pharmacology: Circulatory Drugs
Anticoagulants
Antiplatelets
Blood flow modifiers
Colony-stimulating factor (CSF)
Erythropoietic agents
Anticoagulants are drugs that prevent or delay the coagulation of blood and the formation of thrombi (blood clots). Examples include heparin, warfarin (Coumadin), enoxaparin (Lovenox), anisindione (Miradon), and lepirudin (Refludan).
Antiplatelets inhibit the function of platelets or destroy them. Examples include aspirin, clopidogrel (Plavix), dipyridamole (Persantine), ticlopidine (Ticlid), and abciximag (ReoPro).
Blood flow modifiers are drugs that promote blood flow by keeping platelets from clumping or decreasing blood viscosity. Examples include the prescription medications cilostazol (Pletal) and pentoxifylline (Trental) and the herbal product ginkgo biloba.
Colony-stimulating factors (CSFs) are agents that stimulate the production of white blood cells in the bone marrow. The two kinds are granulocyte CSF (G-CSF) and granulocyte-macrophage CSF (GM-CSF). Available synthetic agents of each type are filgrastim (Neupogen) and sargramostim (Leukine), respectively.
Erythropoietic agents are growth factors that increase the production of RBCs by stimulating erythropoiesis. Two available agents are epoetin-alfa (Epogen, Procrit) and darbepoetin-alfa (Aranesp).
Mastering Healthcare Terminology/Chapter 9

52. Pharmacology: Circulatory Drugs
Hematinics
Hematopoietic agents
Hemostatics
Thrombopoietic factors
Hematinics are drugs that increase the number of erythrocytes and/or hemoglobin concentration in the erythrocytes usually to treat iron-deficiency anemia. Examples are iron supplements and B-complex vitamins.
Hematopoietic agents are agents that stimulate blood cell production. Subdivisions of this class include colony-stimulating factors, erythropoietic agents, and thrombopoietic factors.
Hemostatics are drugs that help stop the flow of blood (-static = controlling the flow of blood). Examples include aminocaproic acid (Amicar) and tranexamic acid (Cyklokapron).
Thrombopoietic factors are agents that stimulate the production of thrombocytes or platelets. Oprelvekin (Neumega) is an available agent.
Mastering Healthcare Terminology/Chapter 9

53. Pharmacology: Lymphatic and Immune Drugs
Antihistamines
Anti-IgE agents
Antineoplastics
Antiretrovirals
Corticosteroids
Cytotoxic agents
Antihistamines are drugs that block histamine receptors to manage allergy symptoms. Examples include clemastine (Tavist), diphenhydramine (Benadryl), loratadine (Claritin), and fexofenadine (Allegra).
Anti-IgE (immunoglobulin E) agents are monoclonal antibodies used to treat allergic asthma and allergic rhinitis. Omalizumab (Xolair) is the first available agent in this class.
Antineoplastics are drugs used to treat cancer by preventing the growth or promoting the destruction of neoplastic (tumor) cells. Numerous drugs, including methotrexate and rituximab (Rituxan), fall into this category.
Antiretrovirals are drugs that manage the replication of HIV and its progression into AIDS. Examples include zidovudine or AZT (Retrovir) and efavirenz (Sustiva).
Corticosteroids are drugs (also known as steroids) that suppress the immune system and reduce inflammation. Examples include fluticasone (Flovent, Flonase), hydrocortisone (Cortizone), and prednisone (Deltasone).
Cytotoxic agents are drugs used as immunosuppressants or antineoplastics in order to damage or destroy cells.
Mastering Healthcare Terminology/Chapter 9

54. Pharmacology: Lymphatic and Immune Drugs (cont’d)
Immunosuppressants
Leukotriene receptor antagonists
Protease inhibitors
Vaccines (immunizations)
Immunosuppressants are drugs that reduce the immune response. Examples include azathioprine (Imuran), cyclophosphamide (Cytoxan), cyclosporine (Sandimmune), and tacrolimus (Prograf).
Leukotriene receptor antagonists are drugs that block leukotrienes to manage later stages of allergic reactions; they are used, in particular, to manage allergic asthma. The two agents in this class are montelukast (Singulair) and zafirlukast (Accolate).
Protease inhibitors are antiretroviral drugs used to treat HIV infections. By blocking the production of an essential enzyme called protease, these drugs keep the virus from replicating. Examples are indinavir (Crixivan), nelfinavir (Viracept), and saquinavir (Invirase).
Vaccines (immunizations) are substances administered to induce immunity or reduce the pathologic effects of a disease. Examples are the masles, mumps, rubella vaccine, and chicken pox vaccine.
Discuss the reasons for the use of an immunosuppressant.
Mastering Healthcare Terminology/Chapter 9

55. Clicker Question Which type of drug controls the flow of blood?
A. hematinics
B. anticoagulants
C. hematopoietics
D. hemostatics
Hemostatics
-static = pertaining to stopping/controlling
Mastering Healthcare Terminology/Chapter 9

56. Sort these terms into their correct categories
1. thalassemia
2. phagocytosis
3. hematocrit
4. apheresis
5. anaphylaxis
Categories
__ A+P
__ Pathology
__ Diagnostic Procedures
__ Therapeutic Interventions
A+P--phagocytosis
Pathology--thalassemia, anaphylaxis
Dx--hematocrit
Tx--apheresis

57. Parting Thought “There is only one corner of the universe you
can be certain of improving, and that’s your own
self.”
–Aldous Huxley
Questions?
Mastering Healthcare Terminology/Chapter 9