1. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 1 The Language Of Medicine 9 th edition Davi-Ellen Chabner

2. Chapter 14 Lymphatic and Immune Systems Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 2

3. 3 Chapter Goals  Identify the structures and analyze terms related to the lymphatic and immune systems.  Learn basic terminology, combining forms, and other word parts related to these systems.

4. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 4 Chapter Goals (cont’d)  Identify laboratory tests, clinical procedures, and abbreviations.  Apply your new knowledge to understanding medical terms in their proper contexts, such as medical reports and records.

5. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 5 Chapter 14 Lesson 14.1

6. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 6 Introduction Lymph: clear watery fluid that surrounds body cells and flows in system of lymph vessels throughout the body  originates in blood  rich in lymphocytes and monocytes  flows in lymph capillaries and vessels  flows through lymph nodes and lymphatic organs (liver, spleen, thymus, and nodes)  absorbs lipids in the intestine

7. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 7 Introduction (cont’d) Lymphatic System Functions 1.Transports proteins and fluid that have leaked, back to the bloodstream 2.Lymphatic vessels absorb lipids from intestines and transport them to the bloodstream 3.Lymphocytes and monocytes protect the body by mounting a cellular attack on foreign cells and organisms.

8. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 8 Interstitial Fluid and Lymph Capillaries

9. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 9 Interstitial Fluid and Lymph Capillaries (cont’d)

10. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 10 Blood and Lymph

11. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 11 Blood and Lymph (cont’d)

12. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 12 Lymphatic System Anatomy  Lymph capillaries  Lymph vessels  Lymph nodes

13. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 13 Lymph Nodes  Macrophages phagocytose foreign substances.  B lymphocytes (B cells) produce antibodies.  T lymphocytes (T cells) attack bacteria and foreign cells.

14. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 14 Location of Lymph Nodes

15. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 15 Location of Lymph Nodes (cont’d)

16. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 16 Lymph Nodes

17. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 17 Lymph Nodes (cont’d)

18. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 18 Spleen Destroys old red blood cells Destroys old red blood cells Filters microorganisms and other foreign material out of the blood Filters microorganisms and other foreign material out of the blood Activates lymphocytes during blood filtration (B cells produce antibodies) Activates lymphocytes during blood filtration (B cells produce antibodies) Stores blood, especially erythrocytes (RBCs) and platelets Stores blood, especially erythrocytes (RBCs) and platelets

19. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 19 Thymus Gland Provides immunity in fetal life and in early years of growth. Provides immunity in fetal life and in early years of growth. Makes cells immunocompetent in early life Makes cells immunocompetent in early life Early removal from an animal impairs its ability to make antibodies and produce cells to fight antigens Early removal from an animal impairs its ability to make antibodies and produce cells to fight antigens

20. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 20 Immune System Natural immunity: genetic predisposition  Phagocytosis  Macrophages  Natural killer cells

21. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 21 Immune System (cont’d) Acquired immunity  Active  by contracting a disease  by vaccination  stem cell transplant

22. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 22 Immune Response B lymphocytes are responsible for humoral immunity.  originate in bone marrow from stem cells  transform into plasma cells to produce immunoglobulins, antibodies that neutralize antigens

23. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 23 Immune Response (cont’d)  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 promote antibody synthesis by B cells and stimulate other T cells.  Suppressor T cells inhibit B and T cells.

24. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 24 Dendritic Cells  Dendric cells are a macrophage derived from monocytes.  They recognize and digest foreign antigens.  They present antigens on surface to stimulate B and T cells.  They transfer immunity by exposing dendritic cells in culture; then transfuse them and get them to stimulate T and B cells.

25. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 25 Immunotherapy Examples  Vaccines: killed tumor cells that produce cytokines that enhance the immune response  Dendritic cells: cultured and exposed outside body and reinfused  Monoclonal antibodies (MoAb): multiple copies of cells or genes that kill tumor cells  Donor lymphocyte infusions: T cells, infused after allogeneic stem cell or bone marrow transplant, attack tumor (leukemia treatment)

26. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 26 QUICK QUIZ: QUICK QUIZ: 1.Lymphocyte that originates in the bone marrow and transforms into a plasma cell to secrete antibodies? A.dendritic cell B.helper T cell C.B cell D.cytotoxic T cell

27. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 27 2. Which is the formation of antibodies and lymphocytes after exposure to an antigen? A.cell-mediated immunity B.acquired immunity C.natural immunity QUICK QUIZ: (cont’d) QUICK QUIZ: (cont’d)

28. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 28 COMBINING FORMS  immun/oprotection  lymph/olymph  lymphaden/olymph node  splen/ospleen  thym/othymus gland  tox/opoison Combining FormMeaning Combining Forms, Prefixes, and Terminology

29. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 29 PREFIXES  ana-again, anew  inter-between PrefixMeaning Combining Forms, Prefixes, and Terminology (cont’d)

30. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 30 Chapter 14 Lesson 14.2

31. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 31 Disorders of the Lymphatic and Immune Systems Immunodeficiency  Acquired Immunodeficiency Syndrome (AIDS)  destroys T helper cells (CD4+ cells)  opportunistic infections  malignancies (Kaposi sarcoma, Wasting syndrome)

32. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 32 Opportunistic Infections with AIDS  Candidiasis  Cryptococcus (Crypto)  Cryptosporidiosis  Cytomegalovirus (CMV) infection  Herpes simplex  Histoplasmosis (Histo)  Mycobacterium avium-intracellulare (MAI) infection  Pneumocystis pneumonia (PCP)  Toxoplasmosis (Toxo)  Tuberculosis (TB)

33. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 33 Drugs to Treat AIDS  Reverse transcriptase inhibitors (RTI) inhibit viral enzyme called reverse transcriptase.  Protease inhibitors inhibit viral proteolytic enzyme.  Combiniation of RTI and Protease inhibitors is HAART (highly active anti-retroviral therapy).

34. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 34 Hypersensitivity  Allergy: abnormal sensitivity acquired by exposure to antigen  Ranges from allergic rhinitis or hay fever to anaphylaxis allergic rhinitis or hay fever to anaphylaxis  Other allergies: atopic dermatitis atopic dermatitis asthma asthma urticaria (hives) urticaria (hives)

35. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 35 Malignancies  Lymphoma: malignant tumor of lymph nodes and lymph tissue  Hodgkin 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

36. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 36 Staging of Hodgkin Disease

37. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 37 QUICK QUIZ: QUICK QUIZ: 3. What is a malignant condition associated with AIDS? A.anaphylaxis B.non-Hodgkin lymphoma C.Kaposi sarcoma D.Hodgkin disease

38. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 38 Laboratory Tests  CD4+ cell count: measures the number of CD4+ T cells (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)

39. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 39 Clinical Procedure  Computed 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.

40. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 40 COMBINING FORMS  axill/o ___________  cervic/o ___________  immun/o ___________  inguin/o ___________  lymph/o ___________  lymphaden/o ___________ Combining Form Meaning Review Sheet

41. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 41 COMBINING FORMS  axill/o armpit  cervic/o neck; cervix (neck of uterus)  immun/o immune; protection; safe  inguin/o groin  lymph/o lymph  lymphaden/o lymph gland (node) Combining Form Meaning Review Sheet (cont’d)

42. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 42 COMBINING FORMS  splen/o ___________  thym/o ___________  tox/o ___________ Combining Form Meaning Review Sheet (cont’d)

43. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 43 COMBINING FORMS  splen/o spleen  thym/o thymus gland  tox/o poison Combining Form Meaning Review Sheet (cont’d)

44. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 44 SUFFIXES  -cytosis ___________  -edema ___________  -globulin ___________  -megaly ___________  -oid ___________  -pathy ___________ Suffix Meaning Review Sheet (cont’d)

45. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 45 SUFFIXES  -cytosis condition of cells; slight increase in numbers  -edema swelling  -globulin protein  -megaly enlargement  -oid resembling  -pathy disease; emotion Suffix Meaning Review Sheet (cont’d)

46. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 46 SUFFIXES  -penia ___________  -phylaxis ___________  -poiesis ___________  -stitial ___________  -suppression ___________ Suffix Meaning Review Sheet (cont’d)

47. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 47 SUFFIXES  -penia deficiency  -phylaxis protection  -poiesis formation  -stitial to set; pertaining to standing or positioned  -suppression to stop Suffix Meaning Review Sheet (cont’d)

48. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 48 PREFIXES  ana- ___________  auto- ___________  hyper- ___________  inter- ___________  retro- ___________ Prefix Meaning Review Sheet (cont’d)

49. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 49 PREFIXES  ana- up; apart; backward; again; anew  auto- self; own  hyper- above; excessive  inter- between  retro- behind; back; backward Prefix Meaning Review Sheet (cont’d)

50. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 50 QUICK QUIZ: QUICK QUIZ: 4. What is the name of the fluid that lies between cells throughout the body? A.atopy B.lymphadema C.interstitial D.lymphopoiesis

51. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 51 QUICK QUIZ: (cont’d) 5. Malignant tumor of the lymph nodes and spleen marked by the presence of Reed-Sternberg cells in lymph nodes… A.HIV B.Kaposi sarcoma C.Non-Hodgkin lymphoma D.Hodgkin disease