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Ch 12: Lymphatic System Name (in ink)

Lymph Nodes and Other Lymphoid Organs

1. Match the terms in Column B with the appropriate descriptions in Column A. More than one choice may apply in some cases.

Column A

1. The largest lymphatic organ; also a blood reservoir

2. Filter lymph

3. Endocrine gland located in the mediastinum and important during infancy and youth; produces the hormone thymosin which programs the immune cells

4. Collectively called MALT (mucosa-associated lymphatic tissue)

5. Removes aged and defective red blood cells, recycles materials to liver

6. Prevent bacteria from breaching the intestinal wall

7. Traps pathogens trying to enter the throat

2. Edema due to lymph vessel blockage by parasite is

[pic]

3. The figure below depicts the lymphoid organs. Label the organs indicated by a leader line and add labels as necessary to identify the sites where the axillary, cervical, and inguinal lymph nodes would be located. Outline the portion of the body that is drained by the right lymphatic duct and color it green. The remainder of the body is drained by the thoracic duct. Both empty into subclavian veins.

Complete the statements about the nonspecific body defense by writing the terms in the answer blanks.

1. Disease-causing microorganisms are called

2. The system that responds immediately to protect the body from entry of any foreign substance is the

3. The three major nonspecific defenses are the (#3, 4, 5)

4.

5.

6. The specific defense system is commonly called the system.

7. This system mounts an attack against particular substances.

8. Two important immune cells are the (#8, 9)

9.

10. The first line of defense against invasion of pathogens is the physical or mechanical

11. The barrier that covers most of the exterior surface of the body is the

12. The barrier that covers body openings to the exterior is the

13. Besides serving as physical barriers, they produce chemicals, such as protein-digesting enzymes produced by the

14. The stomach mucosa also secretes acid.

15. Vaginal secretions and urine are acidic as well as the oil of the skin called

16. Saliva and lacrimal fluid contain the enzyme that destroys bacteria.

17. The sticky substance secreted by mucous membranes which line all body openings to the exterior is

18. The second line of defense depends on a nonspecific response triggered when body tissues are injured called the response.

19. The four cardinal signs of inflammation are

20. 21. 22.

23. Injured cells release the inflammatory chemical ____ which dilates capillaries and attracts phagocytes.

24. The second line of defense also includes cells that engulf foreign particles called

25. Cells that can cause lysis of cancer cells and infected cells are

5. Match the terms in Column B with the descriptions of mechanisms of the first line of defense in Column A. More than one choice may apply.

Column A

1. Have antimicrobial activity

2. Provide mechanical barriers

3. Provide chemical barriers

4. Entraps microorganisms entering exterior passages

5. Sweep mucus superiorly toward the mouth away from the lungs

6. Produced by the stomach

7. Found in tears and saliva

8. Oil of the skin

6. Match the terms in Column B with the descriptions of mechanisms of the second line of defense in Column A. More than one choice may apply.

Column A

1. Two types of phagocytic WBCs

2. Release chemicals that disintegrate the cell membrane of invaders

3. Four cardinal signs of the inflammatory response

4. Chemicals secreted by WBCs and macrophages that increase body temperature (cause fever)

5. Inactivated plasma proteins that become activated once attached to a foreign cell’s surface and carry out the MAC attack, causing lysis

6. Protein secreted by infected cells that binds to nearby cells to prevent the ability of a virus to enter the cell and multiply

7. Structure in the brain involved with regulation of body temperature

7. Explain the cause of each sign of the inflammatory response.

1. Redness:

2. Heat:

3. Swelling:

4. Pain:

8. Match the terms in Column B with the descriptions in Column A concerning the inflammatory response.

Column A

1. Accounts for redness and heat in an inflamed area

2. Inflammatory chemical released by injured cells (1st step in inflammatory response)

3. Promote release of white blood cells from the bone marrow

4. Cellular migration directed by a chemical gradient

5. Results from accumulation of fluid in tissues leaked from the bloodstream (swelling)

Fluid between cells is called

6. Phagocytic offspring of monocytes

7. Leukocytes pass (“walk”) through the wall of a capillary

8. First phagocytes to migrate into the injured area, dispose of debris and pathogens

9. Walls off the area of injury to prevent spread of damaging agents and prepare the area for repair

10. A mixture of dead neutrophils, cells, and pathogens

11. A sealed off area of pus due to fibrin mesh wall remaining in place

9. Check all phrases that correctly describe the role of fever in body protection. (Fever is NOT heat.)

1. Is a normal response to pyrogens

2. Protects by denaturing tissue proteins (unwinding inactivates proteins)

3. Reduces the availability of iron and zinc required for bacterial proliferation (gathered by the spleen)

4. Increases metabolic rate, speeds up repair

5. Stimulates complement fixation (attaches to membranes of invaders)

10. Complete the following description of the activation and activity of complement by writing the missing terms in the answer blanks.

1. The membrane attack complex is called the attack.

2. A system of plasma proteins that circulate in the blood in an inactive form is called

3. Complement is activated when it becomes attached to the surface of cells, such as bacteria, fungi, red blood cells.

4. One result of this complement fixation is that appear in the membrane of the foreign cell.

5. This allows to rush into the cell.

6. This causes the foreign cell to

7. Some of the chemicals released during complement fixation make the membranes of invaders sticky and easier for or “eating” of the destroyed cells.

8. This is called

Specific Body Defenses: The third line of defense is the immune response, a systemic response, slower but longer lasting.

11. Complete the following statements relating to antigens by writing the missing terms in the answer blanks.

1. Any substance capable of initiating an immune response is an

2. Of all the foreign molecules that act as antigens, the most potent are

3. Small molecules not usually antigenic, but when they bind to self-cell surface proteins, they may act as antigens are

4. The complex is then recognized as foreign, or

12. Using the key choices, select the term that completes the statement. Insert the term in the answer blanks.

Key Choices

A. Antigen(s) E. Cellular immunity I. Lymph nodes M. Precipitation

B. B cells F. Humoral immunity J. Macrophages N. Neutralization

C. Blood G. Lymph K. T cells O. Agglutination

D. Antibodies H. Phagocytosis L. Lysis P. Memory cells

1. Immunity is resistance to disease resulting from the presence of foreign substances called

2. When this resistance is provided by antibodies released to body fluids, the immunity is called

3. The major actors in this type of immune response are two lymphocyte populations, the

4. and the

5. The lymphocytes that form clones which become plasma cells are the

6. Plasma cells produce proteins capable of binding with specific antigens called immunoglobulins, or

7. When antibodies bind to specific sites on bacterial exotoxins or on viruses, they block their harmful effects. This antibody action is called

8. Antibodies can bind to more than one antigen at a time, forming antigen-antibody complexes that will cause clumping. This antibody action is called

9. When soluble antigens are made insoluble and settle out of solution, this antibody action is called

10. Another antibody action occurs when antibodies attached to cellular targets which helps complement attach (complement fixation) and cause

11. Agglutinated bacteria and precipitated antigens are more easily captured and engulfed in the process of

12. A few of the B cell clones remain to provide immunological memory for each antigen encountered, capable of responding to the same antigen later. These cells are called

13. When living cells provide the protection, the immunity is referred to as

14. Large phagocytic cells that act as accessory cells in the immune response are the

15. The lymphocytes that must bind to a macrophage that has engulfed and processed antigens before it is activated to form clones is the

16. Two body fluids in which pathogens can move through the body are (2 answers)

17. Since lymph is filtered through the many immune cells are present in these structures

Humoral (Antibody-Mediated) Response

13. The initial response to of the immune system to an antigen is called the primary response. When B cells encounter antigens and produce antibodies this is called active (humoral) immunity. The events will establish immunological memory. When antibodies are obtained from another source, such as when antibodies migrate through the placenta of a pregnant woman into the blood of her fetus, immunological memory does not occur in the fetal immune system. This is called passive immunity. Second and subsequent responses to a previously met antigen, using the memory cells, is more rapid and vigorous. If the following statements best describe a primary response, write P in the blank. If a secondary response is described, write S in the blank.

1. An individual is exposed to the chicken pox for the first time

2. A lag period of several days occurs before antibodies specific to the antigen

appear in the bloodstream, antibodies peak in 10 days

3. Antibody levels increase rapidly (within a few days) and remain high for an extended period

4. Immunologic memory is first established

5. A person has had the flu vaccine and five months later is exposed to the flu virus.

Cellular (Cell-Mediated) Response

14. Using the key choices, select the terms that correspond to the descriptions of substances or events by inserting the appropriate term or letter in the answer blanks.

Key Choices

A. Anaphylactic shock (anaphylaxis) D. Complement G. Interferon

B. Antibodies E. Perforin H. Inflammation

C. Chemotaxis factors F. Macrophages

1. A protein released by macrophages and activated T cells that helps to protect other body cells from viral multiplication

2. Any types of molecules that attract neutrophils and other protective cells into a region where an immune response is ongoing, including cytokines and lymphokines

3. Proteins released by plasma cells that mark antigens for destruction by phagocytes or complement, also called immunoglobulins

4. A consequence of the release of histamine and of complement activation, signs include redness, swelling, heat, pain

5. Chemical released by cytotoxic cells that causes perforations in or disintegration of a foreign cell’s membrane

6. A group of plasma proteins that amplifies the immune response by creating holes in the cell membrane so water rushes in, causing lysis of cellular pathogens

7. A phagocytic cell important in antigen presentation for activation and clonal selection of the T cells

8. A dangerous, systemic allergic response, causing circulatory collapse and death within minutes

15. Several populations of T cells exist. Match the terms in Column B to the descriptions in Column A. Place the correct term or letter response in the answer blanks.

Column A

1. Binds with B cells and releases chemicals that activate B cells, T cells, and macrophages

2. Activated by recognizing both its antigen and a self-protein presented on the surface of a macrophage (antigen presentation)

3. Turns off the immune response when the "enemy" has been defeated

4. Directly attacks and lyses cellular pathogens

5. Stimulates more rapid B-cell and T-cell clone production

6. Destroys cancer cells or foreign graft cells

At The Clinic Ch 12 Answer on your own paper to turn in.

1. Surgery was performed to remove lymphatic vessels associated with removal of a melanoma.

a. What is the function of lymph vessels? (p. 399)

b. What will happen if there are no lymph vessels to carry the surrounding interstitial fluid back to the blood? (p. 431)

c. How will the lymph be drained after lymphatic vessels have been surgically removed? (p. 431)

2. Joe Chang was skateboarding and fell into a stairway. The edge of a step hit him in the left side and ruptured his spleen. Joe almost died because he did not get to the hospital fast enough. Upon arrival, a splenectomy was performed. (p. 402-403)

a. What are three functions of the spleen?

b. How does the spleen increase blood pressure during a severe hemorrhage?

c. Will Joe require a transplant for spleen replacement? In other words, can he live without his spleen?

3. Mrs. Rogers reports to her physician complaining of recent blurred vision and clumsiness. Her medical history reveals she has fallen three times in the past month. She describes feeling dizzy and having tingling and numbness in her legs before each incident. Her doctor orders tests to determine if she has an autoimmune disease. (p. 425-426)

a. What is meant by autoimmune disease?

b. The tests will rule out four autoimmune diseases that may have these early symptoms. Describe each:

1) Rheumatoid arthritis 2) Myasthenia gravis 3) Multiple sclerosis 4) Grave’s disease

4. As an infant receives her first dose of oral polio vaccine, the nurse explains to her parents that the vaccine is a preparation of a weakened form of the virus. (p. 416-417)

a. What type of immunity will the infant develop? (include active or passive AND natural or artificial)

b. What is the term for a weakened form of a pathogen, often used in vaccines?

c. Name seven diseases that have been “wiped out” in the United States by vaccines.

5. Mr. Jones, an 80-year-old man, is grumbling about having to receive a flu vaccine every year. Flu viruses have a high mutation rate (undergo rapid genetic changes), which results in the appearance of new proteins on the viral protein coat which are used to enter and infect body cells.

a. What is an antigen? (p. 412)

b. Based on the ability of a virus to mutate (change its outer protein coat), why does the patient need to get a new flu shot each year? (p.418) Hint: Compare antibodies to a key.

6. A 20-year-old man is rushed to the emergency room after fainting. His blood pressure is alarmingly low, and he is having trouble breathing. His coworker reports the man collapsed shortly after being stung by a wasp. (p. 426)

a. What is this life-threatening, systemic condition called?

b. What has caused his hypotension?

c. What treatment must be given immediately to reverse the effects?

7. Patty is a strict environmentalist and a new mother. She is very much against using disposable diapers, but she is frustrated by the fact that her infant breaks out in a diaper rash when she uses cloth diapers. New cloth diapers do not cause the rash, but when she uses diapers she has washed, the baby gets a rash the next day. (p. 426-427)

a. Would this reaction be an immediate hypersensitivity or delayed hypersensitivity?

b. What is the term for delayed hypersensitivity reactions that follow contact with the skin?

c. What is your conclusion about what is causing the baby to react to the diapers?

8. James, a 36-year-old, appeared at the clinic in an extremely debilitated condition. He had purple-brown lesions on his skin and a persistent cough. A physical examination revealed swollen lymph nodes. Laboratory tests revealed a low lymphocyte count. Information taken during the personal history revealed that James had shared needles with other drug users in the past. The skin lesions proved to be evidence of Kaposi’s sarcoma. (p. 428-429)

a. What is Kaposi’s sarcoma?

b. What is the name of the virus that causes AIDS?

c. In what way does this virus affect the immune system?

9. About 6 months after an automobile accident in which her neck was severely lacerated, a young woman comes to the clinic for a routine checkup. Visual examination shows a slight swelling just inferior to her larynx at the position of the thyroid gland. Her skin is dry and her face is puffy. When questioned, the woman reports that she fatigues easily, has been gaining weight, and her hair is falling out. (p. 426)

a. What are “hidden” antigens?

b. What probably happened when her neck was cut?

10. A 59-year-old woman presents to the ER with chest pain and shortness of breath. Her medical history reveals that several weeks ago she may have had strep throat (streptococcus bacteria) that lasted for about a week. However, she never went to her doctor for antibiotics. She also claims she has had intermittent fever for the past several weeks. (p. 426)

a. What is the name of her disease?

b. Explain what has caused her signs and symptoms.

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Column B

A. Lymph nodes

B. Peyer's patches

C. Spleen

D. Thymus

E. Tonsils

Can you live without a spleen?

Column B

A. Hydrochloric acid

B. Lysozyme

C. Mucosae (mucous membranes)

D. Mucus

E. Protein-digesting enzymes

F. Sebum

G. Skin

H. Cilia

Column B

A. Redness

B. Macrophage

C. Heat

D. Pyrogens

E. Neutrophil

F. Swelling

G. Interferon

H. Pain

I. Hypothalamus

J. Complement

K. Natural killer cells

Column B

A. Chemotaxis

B. Abscess

C. Diapedesis

D. Edema

E. Fibrin mesh

F. Histamine

G. Increased blood flow

H. Cytokines

I. Macrophages

J. Neutrophils

K. Pus

Antibody actions:

1) Binds to exotoxins & prevents function -

2) Cross-linking antigen/antibody complexes cause clumping -

3) Soluble antigens become insoluble -

4) Proteins bind to antibodies attached to target cells, cause lysis -

Column B

A. Helper T cell

B. Killer T cell (cytotoxic cell)

C. Suppressor T cell

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