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A&P II The Lymphatic System, Nonspecific Resistance to Disease, and Immunity

front 1

What is the lymphatic system consisted of?

back 1

*A fluid called lymph flowing within lymphatic vessels(lymphatics)
*Several structures and organs that contain lymphatic tissue(specialized reticular tissue containing large numbers of lymphocytes)
*Bone marrow, which is the site of lymphocyte production

front 2

What are the lymphatic system functions?

back 2

*To drain interstitial fluid
*return leaked plasma proteins to the blood
*transport dietary fats
*protect against invasion by nonspecific and specific immune responses.

front 3

What do lymphatic vessels begin as?

back 3

Blind-ended lymph capillaries in tissue spaces between cells.

front 4

How is lymph formed?

back 4

Interstitial fluid drains into lymphatic capillaries, thus forming lymph.

front 5

Lymph capillaries merge to form larger vessels, called (a)_____ _____, which convey lymph into and out of structures called (b)_____ _____.

back 5

(a) Lymphatic vessels
(b) Lymph nodes

front 6

What is the passage of lymph?

back 6

*From arteries and blood capillaries(blood)
*To interstitial spaces(interstitial fluid)
*To lymph capillaries(lymph)
*To lymphatic vessels
*To lymph trunks
*To the thoracic duct or right lymphatic duct
*To the subclavian veins(blood)

front 7

Lymph flows as a result of ...

back 7

the milking action of skeletal muscle contractions and respiratory movements. It is also aided by lymphatic vessel valves which prevent backflow of lymph.

front 8

The _____ _____ is the main collecting duct of the lymphatic system and receives lymph from the left side of the head, neck, and chest, the left upper extremity, and the entire body below the ribs.

back 8

thoracic duct

front 9

The _____ _____ ______ drains lymph from the upper right side of the body.

back 9

right lymphatic duct

front 10

Among the lymphatic(lymphoid) tissue-containing components of the lymphatic system are ...

back 10

*diffuse lymphatic tissue
*lymphatic nodules
*lymphatic organs(lymph nodes,spleen, and thymus gland)

front 11

_____ _____ are encapsulated oval structures located along lymphatic vessels. They are scattered throughout the body, usually in groups.

back 11

Lymph nodes

front 12

What is the process once lymph enters the nodes?

back 12

*lymph enters nodes through afferent lymphatic vessels
*is filtered to remove damaged cells and microorganisms
*exits through efferent lymphatic vessels

front 13

Foreign substances filtered by the lymph nodes are trapped by (a)_____ _____ ______.

(b)_____ then destroy some foreign substances by phagocytosis and (c)_____ bring about the destruction of others by immune responses.

back 13

(a) nodal reticular fibers

(b) macrophages

(c) lymphocytes

front 14

_____ _____ are the site of proliferation of plasma cells and T cells.

back 14

lymph nodes

front 15

Why is the knowledge of the location of the lymph nodes and the direction of lymph flow important in the diagnosis and prognosis of the spread of cancer by metastasis?

back 15

Many cancer cells are spread by way of the lymphatic system, producing cluster of tumor cells where they lodge.

front 16

_____ are multiple aggregations of large lymphatic nodules embedded in a mucous membrane at the junction of the oral cavity and the pharynx.

back 16

tonsils

front 17

The tonsils include the (a)_____, (b)_____, and (c)_____ _____.

back 17

(a) pharyngeal(adenoid)

(b) palatine

(c) lingual tonsils

front 18

The tonsils are situated strategically to ...

back 18

protect against invasion of foreign substances and participate in immune responses by producing lymphocytes and antibodies.

front 19

The _____ is the largest mass of lymphatic tissue in the body and is found in the left hypochondriac region between the fundus of the stomach and the diaphram.

back 19

spleen

front 20

The spleen is a site of ...

back 20

* B cell proliferation into plasma cells
* phagocytosis of bacteria and worn-out or damaged red blood cells and platets
* storage of blood

front 21

Abdominal trauma frequently causes a _____ _____ which, due to its capacity for blood storage, may cause severe intraperitoneal hemorrhage and shock.

back 21

ruptured spleen

front 22

_____ (removal of the spleen) is required to prevent death from blood loss.

back 22

Splenectomy

front 23

The _____ ______ lies between the sternum and the heart and functions in immunity as the site of T cell maturation.

back 23

thymus gland

front 24

Lymphatic vessels develop from (a)_____ _____, which develop from (b)_____. Thus, they are derived from (c)_____.

back 24

(a) lymph sacs

(b) veins

(c) mesoderm

front 25

Lymph nodes develop from (a)_____ _____ that become invaded by (b)_____ _____.

back 25

(a) lymph sacs

(b) mesenchymal cells

front 26

The ability to ward off disease using a number of defenses is called _____.

back 26

resistance

front 27

Lack of resistance is called _____.

back 27

susceptibility

front 28

Disease-producing organisms

back 28

pathogens

front 29

_____ _____ refers to a wide variety of body responses against a wide range of pathogens and their toxins.

back 29

Nonspecific resistance

front 30

What are the three lines of defense?

back 30

1st line: mechanical and chemical factors/barriers

2nd line: antimicrobial substances
*transferrins
*interferon
*complement
*properdin

3rd line: (3 parts)
*phagocytosis
*inflammation
*fever

front 31

_____ _____ include the intact epidermis layer of the skin, mucous membranes, the lacrimal apparatus, saliva, mucus, cilia, the eppiglottis,and the flow of urine.

back 31

Mechanical defenses

front 32

_____ and _____ also may be considered mechanical processes that expel microbes.

back 32

Defecation and vomiting

front 33

_____ _____ are localized on the skin, in loose connective tissue, stomach and vagina.

back 33

Chemical factors

front 34

The skin produces _____, which has a low pH due to the presence of unsaturated fatty acids and lactic acid.

back 34

sebum

front 35

_____ is an enzyme component of sweat which also has antimicrobial properties.

back 35

Lysozyme

front 36

Areolar(loose) connective tissue contains _____ _____ , which helps contain infections to a localized area.

back 36

hyaluronic acid

front 37

(1)_____ _____ renders the stomach nearly sterile since its low pH(1.0 - 2.5)kills many bacteria and destroys most of their toxins;(2)_____ _____ also are slightly acidic.

back 37

(1) gastric juice
(2) vaginal secretions

front 38

_____ _____ work against colonization by viruses and bacteria and provide a second line of defense should microbes penetrate the skin and mucous membranes.

back 38

Antimicrobial substances

front 39

What are the four types of antimicrobial substances?

back 39

*transferrins
*interferon
*complement
*properdin

front 40

Body cells infected with viruses produce proteins called _____. Once produced and released from virus-infected cells _____ diffuses to uninfected neighboring cells and binds to surface receptors,inducing uninfected cells to synthesize antiviral proteins that interfere with or inhibit viral replication. _____ also enhance the activity of phagocytes and natural killer(NK) cells,inhibit cell growth, and suppress tumor formation.

back 40

Interferons(IFNs)

front 41

_____ ______ ______ have the ability to kill a wide variety of infectious microbes plus certain spontaneously arising tumor cells, their mechanisms of action and target recognition are poorly understood.

back 41

Natural killer (NK) cells

front 42

Natural killer cells are a type of _____.

back 42

T cells

front 43

A group of about 20 proteins present in blood plasma and on cell membranes comprises the _____ _____; when activated, these proteins enhance certain immune, allergic, and inflammatory reactions.

back 43

complement system

front 44

What are the three parts of the third line of defense?

back 44

*phagocytosis
*inflammation
*fever

front 45

_____ is the ingestion and destruction of microbes of any foreign particulate matter by cells called phagocytes.

back 45

Phagocytosis

front 46

What are the two categories of phagocytes?

back 46

*granulocytes(microphages--neutrophils and eosinophils)

*macrophages (fixed and wandering)

front 47

What are the four phases of the mechanism of phagocytosis?

back 47

*chemotaxis
*adherence
*ingestion
*killing

front 48

_____ occurs when cells are damaged by microbes, physical agents, or chemical agents. The injury may be viewed as a form of stress.

back 48

Inflammation

front 49

Inflammation is usually characterized by what symptoms?

back 49

*redness
*pain
*heat
*swelling
*loss of function may be a fifth symptom, depending on the sight and extent of the injury

front 50

The inflammatory response serves as a protective and defensive role by ...

back 50

*eliminating microbes, toxins, or foreign material from the site of injury
*preventing their spread to other organs
*preparing the site for tissue repair

It is an attempt to restore homeostasis.

front 51

What are the stages of the inflammatory response?

back 51

*vasodilation(increase in diameter of the blood vessels)and increased permeability of the blood vessels
*phagocyte migration
*repair

front 52

Among the substances that contribute to vasodilation, increased permeability and other aspects of the inflammatory response are ...

back 52

*histamine
*kinins
*prostaglandins(PGs)
*leukotrienes(LTs)
*complement

front 53

After phagocytes engulf damaged tissue and microbes, they eventually die, forming a pocket of dead phagocytes and damaged tissue and fluid called (1)_____. This must drain out of the body or it accumulates in a confined space, causing an (2)_____. An (3)_____ may result from a prolonged inflammatory response to continuously injured tissue.

back 53

(1) pus
(2) abscess
(3) ulcer

front 54

_____ is usually caused by infection from bacteria(and their toxins) and viruses. The high body temperature inhibits some microbial growth and speeds up body reactions that aid repair.

back 54

Fever

front 55

Specific resistance to disease involves the production of a specific lymphocyte or (1)_____ against a specific (2)_____ and is called (3)_____.

back 55

(1) antibody(Ab)
(2) antigen(Ag)
(3) immunity

front 56

The branch of science that deals with the responses of the body when challenged by antigens is called _____.

back 56

immunology

front 57

Both T and B cells derive from stem cells in _____ _____.

back 57

Bone marrow

front 58

T cells complete their maturation and develop immunocompetence(the ability to carry out immune responses if properly stimulated) in the ______

back 58

Thymus

front 59

Before T cells leave the thymus or B cells leave the bone marrow, they acquire several distinctive surface proteins; some function as _____ _____, molecules capable of recognizing specific antigens.

back 59

antigen receptors

front 60

_____ _____ _____ refers to destruction of antigens by T cells. It is particularly effective against intracellular pathogens, such as fungi, parasites, and viruses; some cancer cells; and foreign tissue transplants; thus, _____ always involves cells attacking cells.

back 60

Cell-mediated immunity (CMI)

front 61

_____ ______ ______ refers to destruction of antigens by antibodies. It works mainly against antigens dissolved in body fluids and extracellular pathogens,primarily bacteria, that multiply in body fluids but rarely enter body cells.

back 61

Antibody-mediated (humoral) immunity (AMI)

front 62

Often a pathogen provokes what type of immune response?

back 62

Both CMI and AMI

front 63

_____ are chemical substances that are recognized as foreign when introduced into the body. They are both immunogenic and reactive. They are large, complex molecules--most often proteins, but sometimes nucleoproteins,lipoproteins,glycoproteins, and certain large polysaccharides.

back 63

Antigens (Ags)

front 64

Specific portions of antigen molecules, called (1)_____ _____, or (2)_____ trigger immune response.

back 64

(1)antigenic determinants
(2)epitopes

front 65

Antigen receptors exhibit great diversity due to _____ ______.

back 65

genetic recombination

front 66

_____ ______ _____ _____ are unique to each person's body cells. These self-antigens aid in the detection of foreign invaders.

back 66

Major histocompatibility complex (MHC) antigens(also called human leucocyte associated, or HLA, antigens)

front 67

All cells except _____ desplay MHC class I antigens.

back 67

RBs

front 68

_____ can recognize and bind to antigens in extracellular fluid.

back 68

B cells

front 69

_____ can only recognize fragments of antigenic proteins that first have been processed and presented in association with MHC self-antigens.

back 69

T cells

front 70

_____ fragments from foreign antigens help stimulate MHC molecules.

back 70

Peptide

front 71

Most cells of the body can process and present _____ ______, antigens that were synthesized in a body cell(e.g. viral proteins from virus-infected cells).

back 71

endogenous antigens

front 72

Cells called _____ _____ _____ process exogenous antigens(antigens formed outside the body)and present them together with MHC class II molecules to T cells. _____ include macrophages, B cells, and dendritic cells.

back 72

Antigen-presenting cells(APCs)

front 73

Steps in processing and presenting and exogenous antigen by an APC are:

back 73

*phagocytosis or endocytosis of the antigen
*partial digestion
*fusion of vesicles
*binding of peptide fragmentsto MHC-II molecules
*exocytosis

front 74

_____ are small protein hormones needed for many normal cell functions. Some of them regulate immune responses.

back 74

Cytokines

front 75

An _____ is a protein that can combine specifically with the antigenic determinant on the antigen that triggered its production.

back 75

antibody (Ab)

front 76

Antibodies consist of _____ and _____ chains and _____ and _____ portions.

back 76

heavy (H) and light (L) chains
variable and constant portions

front 77

Based on chemistry and structure, antibodies are grouped into five principal classes, each with specific biological roles. What are the five classes?

back 77

IgG
IgA
IgM
IgD
IgE

front 78

In a(1) _____ ______ ______ ______, an antigen is recognized(bound), a small number of T cells proliferate and differentiate into a clone of (2)_____ ______(a population of identical cells that can recognize the same antigen and carry out some aspect of the immune attack), and the antigen(intruder) is eliminated.

back 78

(1)cell-mediated immune response
(2)effector cells

front 79

_____ ______ recognize antigens fragments associated with MHC molecules on the surface of a body cell.

back 79

T cell receptors (TCRs)

front 80

Proliferation of T cells requires _____, by cytokines such as interleukin(IL-1) and interleukin-2(IL-2), or by pairs of plasma membrane molecules, one on the surface of the T cell and a second on the surface of an APC.

back 80

co-stimulation

front 81

Name five subpopulations of T cells.

back 81

*Helper T cells(or T4 cells)
*Cytotoxic T cells(or T8 cells)
*Delayed-type hypersensitivity T cells
*Suppressor T cells
*Memory T cells

front 82

_____ display CD4 protein, recognize antigen fragments associated with MHC-II molecules, and secrete several cytokines, most importantly, interleukin-2

back 82

Helper T cells, or T4 cells

front 83

_____ develop from T cells that display CD8 protein and recognize antigen fragments associated with MHC-1 molecules.

back 83

Cytotoxic T cells or T8 cells

front 84

_____ produce cytokines and are important in hypersensitivity(allergic)responses.

back 84

Delayed-type hypersensitivity T cells

front 85

_____ are thought to be a class of T cells distinct from Th and Tc cells.They appear to down regulate immune responses by producing cytokines such as TGF-B which inhibits proliferation of B cells and T cells.

back 85

Suppressor T cells

front 86

_____ are programmed to recognize the original invading antigen, allowing initiation of a much swifter reaction should the pathogen invade the body at a later date.

back 86

Memory T cells

front 87

Cytotoxic T cells leave the lymphoid and migrate to the site of invasion, infection, or tumor formation. They recognize and attach to the target cell that bears the same antigen as the one that stimulated their activation and proliferation. They then eliminate invader cells by secreting (1)_____, which causes cytolysis; or (2)_____, which causes fragmentation of the DNA of a target cell. The also indirectly secrete (3)_____ _____ which attracts neutrophis and macrophages to the site and greatly increases their phagocytic activity. Finally, they detach from the target cell and can seek out and destroy another invader that displays the same antigen.

back 87

(1)perforin (directly)
(2)lymphotoxin (directly)
(3)gamma interferon (indirectly)

front 88

Whereas (1)_____ leave lymphoid tissue to meet a foreign antigen, (2)_____ stay put.

back 88

(1) cytotoxic t cells
(2) b cells

front 89

An activated B cell develops into a clone of antibody-producing plasma cells. These cells produce antibody at an incredible rate of (1)_____ molecules per second per cell for (2)_____ days until the plasma cell dies.

back 89

(1) 2000
(2) 4-5

front 90

The activated B cells that do not differentiate into plasma cells remain as _____, ready to respond more rapidly and forcefully should the same antigen appear at a future time.

back 90

memory b cells

front 91

(1)_____ _____ are pure antibodies produced by fusing a B cell with a tumor cell that is capable of proliferating endlessly. The resulting cell is called a (2)_____. They are important in measuring levels of a drug in a patient's blood and in diagnosis of pregnancy, allergies, and diseases such as hepatitis, rabies, and some sexually transmitted diseases.

back 91

(1)monoclonal antibodies (MAbs)
(2)hybridoma

front 92

_____ _____ is due to the presence of long-lived antibodies and very long-lived lymphocytes that arise in proliferation and differentiation of antigen-stimulated B and T cells.

back 92

Immunological memory