Chapter 22
THE LYMPHATIC SYSTEM, NONSPECIFIC RESISTANCE TO DISEASE, AND IMMUNITY
Outline and Objectives
INTRODUCTION
1. Explain the importance of resistance to disease with emphasis on nonspecific resistance and immunity actions in protection against pathogens.
THE LYMPHATIC SYSTEM
2. Describe the general importance of lymph.
Overview of Functions of the Lymphatic System
3. List the functions of the lymphatic system.
Lymphatic Vessels and Lymph Circulation
4. Describe the organization of lymph vessels.
Lymphatic Capillaries
5. Describe the general cellular structure, distribution, and operation of lymphatic capillaries, then note the special location and duty of lacteals.
Lymph Trunks and Ducts
6. Describe the anatomic relationship of lymph nodes to the principal lymphatic trunks.
Formation and Flow of Lymph
7. Give the reasons for accumulation and then clearance of proteins and fluids from the interstitial space, and indicate the route through which the lymph flows due to the peculiar lymphatic architecture and sources of pressure.
Lymphatic Organs and Tissues
8. Identify the primary and secondary lymphatic organs and their distributions and general functions.
Thymus Gland
9. Discuss the location, histology, and evolution of the thymus gland, and its effect on T-lymphocyte maturation.
Lymph Nodes
10. Describe the cellular structure of lymph nodes with respect to the variety of immune cells that inhabit distinct realms within the node, and the path of lymph flow.
11. Describe how the lymph system, especially nodes, generally operates in the initiation of an immune response to pathogens.
12. Discuss the manner in which the lymph system facilitates the spread of cancer cells in metastasis.
Spleen
13. Describe the overall structure and cellular composition of the spleen along with the positioning of red and white pulp tissues.
14. Discuss the job of the spleen in processing red blood cells and in the immune reaction.
Lymphatic Nodules
15. Specify the names, locations, and aggregate forms of the different mucosa-associated lymphoid tissues.
DEVELOPMENTAL ANATOMY OF THE LYMPHATIC SYSTEM
16. Describe the development of the lymphatic system.
NONSPECIFIC RESISTANCE TO DISEASE
17. List the primary mechanisms that are responsible for nonspecific resistance.
First Line of Defense: Skin and Mucous Membranes
18. List the major means by which the skin and mucous membranes act as the first line of defense against pathogens.
Second Line of Defense: Internal Defenses
Antimicrobial Proteins
19. List and describe the effects of the antimicrobial proteins.
Natural Killer Cells and Phagocytes
20. Discuss the location and role of natural killer cells in attacking microbes, infected body cells, and cancer cells.
Inflammation
21. Describe the symptoms and basic stages of inflammation, and the substances that contribute to the inflammatory process.
22. Define and give examples of abscesses and ulcers.
Fever
23. Discuss the initiating factors and beneficial physiological responses thought to be attributable to fever.
SPECIFIC DEFENSE: IMMUNITY
24. Define immunity and discuss its properties of specificity and memory.
Formation of T Cells and B Cells
25. State the site of origin and general nature of development of immunocompetence for B cells and T cells.
Types of Immune Responses
26. Distinguish how the T cells and B cells are involved with cell-mediated and antibody-mediated immunity, respectively, and so can deal with different types of pathogens.
Antigens
27. Discuss the characteristics of antigens and give some examples of antigens.
28. Describe the three routes an antigen can use to get past the nonspecific defenses.
Chemical Nature of Antigens
29. Characterize the biochemical nature of primary and subsidiary forms of complete antigens and the antigens’ relation to size and complexity.
30. Discuss what response emerges if an antigen is small enough to instigate reactivity but not immunogenicity.
Epitopes
31. Evaluate the capacity of segments of a pathogenic macromolecule to stimulate a reaction by specific B cells and T cells, and describe how this can lead to autoimmune responses.
Diversity of Antigen Receptors
32. Discuss the mechanism by which mini-genetic recombination and somatic mutation allow B cells and T cells to construct antigen receptors to a billion different antigens that the body has never encountered.
Major Histocompatibility Complex Antigens
33. Describe the roles of the major histocompatibility complex (MCH) in foreign antigen recognition and the type of cells in the body that possess the two different classes of MHCs.
34. Discuss histocompatibility testing.
Pathways of Antigen Processing
35. Discriminate between the circumstances that initiate a response by either B cells or T cells, and how the distinct conditions are related to MHC-antigen production.
Processing of Exogenous Antigens
36. Give the details in the sequence of processing of exogenous antigens by antigen presenting cells (APCs) from endocytosis to MHC-antigen display on the cell membrane.
Processing of Endogenous Antigens
37. Describe the processing of endogenous antigens
Cytokines
38. Discuss the nature and function of cytokines.
39. Discuss the therapeutic use of cytokines.
CELL-MEDIATED IMMUNITY
40. Describe the general path of development of T cells from activation by an antigen to effector cells that eliminate the pathogen related to the antigens.
Activation, Proliferation, and Differentiation of T Cells
41. Discuss the operation and reason for the first and second signals that activate only specific T cells, and then explain the function of their proliferation and differentiation.
Types of T Cells
42. Discuss the actions of the three principal T cells in terms of their means of initial activation, costimulators, cytokine secretion, and interactions with other immune cells, as well as antigens and/or pathogens.
Helper T Cells
43. Discuss the activation and activity of helper T cells.
Cytotoxic T Cells
44. Discuss the activation and activity of cytotoxic T cells.
Memory T Cells
45. Discuss the function of memory T cells.
Elimination of Invaders
46. Describe the two mechanisms used by cytotoxic T cells to destroy body cells that have been invaded by pathogens.
Immunological Surveillance
47. Describe immunological surveillance and the cells involved.
48. Discuss the phenomenon of graft rejection.
ANTIBODY-MEDIATED IMMUNITY
49. Discuss the general locations and response of specific B cells to specific antigens.
Activation, Proliferation, and Differentiation of B Cells
50. Describe the scheme through which B cells are activated and costimulated to increase the number, transformation, and output of antibodies which will attack only the antigen that initially activated each specific B cell.
Antibodies
51. Define an antibody.
Antibody Structure
52. Discuss the way that the three regions of the antibody protein can have different arrangements of the constant and variable portions to form countless types of receptor sites and five functional classes of antibodies.
Antibody Actions
53. Discuss the five actions provided by antibodies in the elimination of pathogenic antigens.
54. Discuss the ways in which monoclonal antibodies are produced and can be employed to investigate medical conditions.
Complement System
55. Describe the interactions between complement proteins that are inacted by the two start-up pathways and result in activation of inflammation, opsonization, and cytolysis.
Immunological Memory
56. Discuss how the differentiation of B cells leads to the primary production of antibodies, and then a rapid and magnified reaction in the secondary response to the reappearance of the same antigen.
57. Explain how immunologic memory impacts the recurrence of an infection by a previously encountered pathogen.
SELF-RECOGNITION AND IMMUNOLOGICAL TOLERANCE
58. Explain how B cells and T cells are developed through MHC self-recognition positive selection, and then how immunologic tolerance is developed through deletion-anergy negative selection.
59. Explain how tumor immunotherapy and cytokine therapy work and what are some counterindications.
AGING AND THE IMMUNE SYSTEM
60. Describe the effects of aging on the immune system.
DISORDERS: HOMEOSTATIC IMBALANCES
61. Discuss AIDS in terms of epidemiology, pathogenesis of the HIV virus, signs and symptoms, progression to AIDS, and treatment.
62. Discuss the basic types of hypersensitivity reactions.
63. Discuss the causes and symptoms of infectious mononucleosis.
MEDICAL TERMINOLOGY
64. Define medical terminology associated with the lymphatic system.