1. Unit I: Lymphatic System and Immunity Competency: 1H09. Analyze the anatomy and physiology of the lymphatic system. Specific Objectives: 1H09.01- Describe the structure of the lymphatic system. 1H09.02- Analyze the function of the lymphatic system. 1H09.03- Identify the characteristics and treatment of common lymphatic disorders. 1H09.04- Apply standard precautions.

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4. 1. LYMPH- fluid that goes between capillary blood and tissues. Functions:

5. LYMPH VESSELS They transport excess tissue fluid back into circulatory system.

6. LYMPH NODES Produce lymphocytes, filter out harmful bacteria. A cluster of lymph nodes can be found under the arms and neck.

7. SPLEEN Produces lymphocytes and monocytes, it’s a blood reservoir, recycles old red cells.

8. THYMUS GLAND- produces T- LYMPHOCYTES After puberty, the gland begins to shrink and is replaced by connective tissue and fat. The main function of the thymus gland is in the processing and maturation of special lymphocytes called T- cells.

9. LYMPH Straw-colored fluid (similar to plasma) INTERSTITIAL FLUID or tissue fluid because it is in the spaces between cells Composed of H2O, lymphocytes, some granulocytes, O2, digested nutrients, hormones, salts, CO2, and urea. NO red blood cells or protein molecules (too large)

10. LYMPH Carries digested food, O2 and Hormones to cells Carries wastes back to capillaries for excretion Since the lymphatic system has no pump, skeletal muscle action squeezes lymph along. Valves prevent backward flow

11. Lymph Vessels Closely parallel veins Located in almost all tissues and organs that have blood vessels Tissue lymph enter small lymph vessels which drain into larger vessels called lymphatics – they flow into one of two large, main lymphatics – the THORACIC DUCT (largest vessel) and right lymphatic duct. THORACIC DUCT gets lymph from left side of chest, head and neck, abdominal area and lower limbs  left subclavian vein  superior vena cava  heart. Lymph flows only in one direction – from body organs to the heart.

12. LYMPH NODES Tiny, oval shaped – size of pinhead to size of almond Located alone or grouped Site for lymph production and filter for screening out harmful substances If substance can’t be destroyed, node becomes inflamed

13. TONSILS Masses of Lymphatic tissue that produce lymphocytes and filter bacteria – they get smaller in size as person gets older ADENOIDS – tonsils on upper part of the back of the throat

14. SPLEEN Sac-like mass of lymphatic tissue Upper left abdominal cavity, just below diaphragm Forms lymphocytes and monocytes Filters blood Stores large amounts of RBCs – contracts during vigorous exercise or loss of blood, to release RBCs Destroys or removes old fragile RBCs

15. THYMUS GLAND Upper, anterior thorax, above the heart Thymus is also considered an endocrine gland

16. Immunity Immunity – the body’s ability to resist bacterial invasion and disease. Two general types – natural and acquired. NATURAL IMMUNITY – at birth, inherited and permanent. Includes: Unbroken skin Mucus and tears Blood phagocytes Local inflammation ACQUIRED IMMUNITY – body’s reaction to invaders

17. PASSIVE ACQUIRED IMMUNITY Acquired artificially by injecting antibodies to protect from a specific disease Immediate immunity Lasts 3-5 weeks Used when someone exposed to measures, tetanus, infectious hepatitis Mother provides newborn with some passive immunity

18. ACTIVE ACQUIRED IMMUNITY – lasts longer, two types NATURAL ACQUIRED IMMUNITY - result of having had and recovered from a disease. For example, a child who had measles will usually not get it again – child’s body has manufactured antibodies. ARTIFICIAL ACQUIRED IMMUNITY - comes from being vaccinated IMMUNIZATION – artificial resistance to a particular infection by artificial means Antigen injected into a person to stimulate production of antibodies

19. Disorders of the Lymphatic System ADENITIS – swelling in the lymph glands

20. TONSILLITIS In childhood, they may become infected, enlarged, and cause difficulty swallowing Surgery done in extreme cases

21. HODKIN”S DISEASE Cancer of the lymph noses, painless swelling of lymph nodes is early symptoms. Rx – chemotherapy and radiation

22. LYMPHADENITIS Enlargement of the lymph nodes, occurs when infection is present and body is attempting to fight off the infection.

23. INFECTIONOUS MONONUCLEOSIS Caused by virus Frequently in young adults and children Spread by oral contact ( kissing) Symptoms – enlarged lymph nodes, fever, physical and mental fatigue,  Leukocytes Rx - bedrest

24. HYPERSENSITIVITY When the body’s immune system fails to protect itself against foreign material, and instead, the antibodies formed irritate certain body cells. An abnormal response to a drug or allergen. An ALLERGEN is an antigen that causes allergic reaction responses. (Examples of allergens – ragweed, penicillin, bee stings, foods,etc.)

25. ANAPHYLAXIS Severe, sometimes fatal allergic reaction Antigen-antibody reaction stimulates a massive secretion of histamine Symptoms – breathing problems, headache, facial swelling, falling blood pressure, stomach cramps, and vomiting Rx - adrenaline

27. EPIPEN Emergency treatment for anaphylaxis

28. AIDS/HIV Acquired Immunodeficiency Syndrome Caused by HTLV-III (human T-lymphotrophic virus type III) Commonly caused HIV or Human Immunodeficiency Virus. Affects not only homosexual males but all populations The patient with AIDS cannot fight off cancers and most infections Three responses to HIV infection: 1. AIDS 2. ARC (AIDS – related complex) 3. A symptomatic infection Screening tests for HIV/AIDS are available

29. AIDS Most severe type if HIV infection Subject to OPPORTUNISTIC INFECTIONS – a healthy person would fight off these infections, but a person with AIDS has a compromised immune response. Symptoms of AIDS 1. Prolonged fatigue 2. Persistent fevers or night sweats 3. Persistent, unexplained cough 4. Thick coating in throat or on tongue 5. Easy bruising, unexplained bleeding 6. Appearance of purple lesions on mucous membranes or skin that don’t go away 7. Chronic diarrhea 8. Shortness of breath 9. Unexplained lymphadenopathy 10. Unexplained weight loss, 10lbs or more, in less than 2 months Incubation period: 1 month to 12 years

30. AIDS-RELATED COMPLEX (ARC) Has HIV but not AIDS and develops other conditions such as: Chronic Diarrhea Chronic lymphadenopathy Unexplained weight loss If life threatening opportunistic infections develop, then individual is said to have AIDS

31. ASYMPTOMATIC INFECTION – Has HIV but no symptoms. High-Risk Groups for AIDS – EVERYONE who participates in risky behaviors. Transmission by: 1. Sex with someone who is HIV positive 2. Sharing needles with infected IV drug users 3. At birth from infected mother Cannot be spread by: 1. Casual contact 2. Through air, feces, food, urine or water 3. Coughing, sneezing, embracing, shaking hands and sharing eating utensils Prevention: 1. Avoid risky behaviors 2. Standard precautions

32. STANDARD PRECAUTIONS Guidelines to be used in patient care setting Must be used when there is contact with blood, and any body fluid (except sweat), mucous membranes and non-intact skin. Handwashing – the single most effective way to prevent infection. 1. Wash hands after touching body fluids, even if gloves are worn. 2. Use plain (non-antimicrobial) soap 3. Wash for a minimum of 10 seconds Gloves – worn when touching blood, body fluids, and non- sterile dressings, etc.

33. Mask, eye protection, face shield and gown – during patient care activities that may generate splashes or sprays of blood, body fluids,etc. Patient care equipment and linens – handle with care, don’t let it touch you or clothing, clean or discard appropriately. Occupational Health and Bloodbourne Pathogens Beware of needles! Never recap used needles. Dispose of all needles and sharp objects in sharp container. Use mouthpieces, resuscitation bags, or other ventilation devices as alternative to mouth- to-mouth resuscitation A patient who contaminates the environment should be in a private room or relatively isolated area. The AIDS Patient  Sometimes treated as outcasts  Healthcare worker should be supportive  Use of gloves for normal patient contact is not necessary