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What are the 3 defense systems of the body?
- normal body functions (skin, saliva, mucous, etc)
- inflammatory response
- immune response- forming agents to go kill/destroy/contain the invader
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What is immunity?
resistance to or protection from an individuals environment
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What is an internal chemical system whose purpose is to enhance reactivity to material that us foreign to the body?
immune system
- born with immunity
- vaccines/already having the diease
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What is an antigen?
material recognized as foreign by the immunologic system
invader
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How does the immune system recognize antigens?
by producing antibodies specific for each antigen
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What are antibodies derived from?
lymphocytes
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What type of lymphocytes originate from lymph tissue in alimentary tract or bone marrow?
B cells
- major defense of bacteria
- specific to each target antibody
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What keeps the immunity system in balance?
immune surveillance
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What makes antibodies?
lymphocytes
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Where do T cells originate from?
thymus
major protector against virus's and fungi
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What are the little informants that figure out what the antigen is and tells the B cells what antibodies to make?
T-helper cells
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What are T-suppressor cells?
- keep the B's in check
- dont let B cells produce too much
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What cells are really strong, and go out and directly kill antigens?
cytotoxic T cells
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What are natural killer cells?
- not B or T
- go directly kill antigens
- defense against cancer
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What is the immune process?
- antigen is broken down by macrophages
- then presented to T cells
- will either:
- *program a group of B cells to produce antibody with T helpers
- *suppression of production of antibody with T cells
- *directly kill
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What is an immunoglobulin?
- plasma proteins that contain antibodies
- once antibodies are formed, they circulate in plasma
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What are the 5 classes of immunogobulins?
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What immunoglobulin is secreated in body fluids (tears, saliva, mucosal tracts:bronchi, intestinal)?
- IgA
- interact with antigens before they get to the tissues and cause damage
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What is IgG?
- gestation
- transmitted from mom to placenta to baby
- gets in babys system, and then baby is protected for first 6 months against diseases mom has alread had
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What immunologobulin fights against bacteria that enters the blood system, and is very large?
IgM
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What is IgE?
defends the respiratory tract and released histamines to fight-> makes us snotty
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What immunoglobulin is found in serum, and it is not sure what they do?
IgD
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What is type 1: anaphylactic-atopic allergy?
- immediate reaction to antigen the person has already become exposed to
- mediated by IgE
hay fever, environmental (asbestos), food allergies
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What is type2: cytotoxic-type hypersensitivity?
- IgG's and IgM's
- reaction to transfusion
- erythroblastosis fetalis (poke babies foot and test RH factor to be sure blood is compatible)
- myasthenia gravis (immune diease, body is attacking itself, antibodies are attacking neurotransmitters, lots of weakness/atrophy-juice isnt getting to the brain)
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What is type 3:immune complex diseases?
- activates a lot of inflammation over a long period of time
- RA (systemic, through the whole body, lots of organ problems also, symmetrical on both sides of body)
- systemic lupus erythematosis
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What is type 4 delayed hypersensitivity?
- tissue reaction in response to subcutaneous antigen (skin)
- the more the person is exposed, the worse they get
- poison ivy
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What are some examples of type 1 hypersensitivity reactions/diseases?
- hay fever
- chronic environment
- allergic asthma
- anaphylactic reactions
- anaphylactic shock
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What are some examples of type 2 hypersensitivity reactions/diseases?
- reactions to transfusions
- erythroblastosis fetalis
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What are some examples of type 3 hypersensitivity reactions/diseases?
- rheumatoid arthritis
- lupus
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What are some examples of type 4 hypersensitivity reactions/diseases?
- poison ivy
- cosmetics
- paints
- dyes
- graft rejections
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What is the inability of the immune system to differeniate between self and nonself antigens?
autoimmunodeficiency
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What is systemic lupus erythematosus?
- chronic inflammatory disease of the kidneys, joints, and skin
- antigen/antibody overdeposit in tissues and cause vasculitis/synovitis (overactivity of immune system)
- bc circulating immune complexes deposit in almost all tissues, virtually every organ is affected
- women>men
- varies in severity
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What occurs in pts with lupus?
- b-cell hyperactivity (out of control, working too hard, t suppressors not working)
- autoantibody production
- tissue injury (glomerulonephritis, vasculitis, arthritis, butterfly rash on face)
etiology unknown (possibly virus, hormones, genetics, drugs)
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What is inflammation of the kidneys?
glomerulonephritis
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What is vasculitis?
inflammation of blood vessels
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What is Sjogrens disease?
- soft tissues become thick and inflexible
- autoimmune
- etiology unknown
- females>males
- very dry eyes and salivary glands
- can effect jts and skin
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What is the hardening of the skin/excessive deposition of collagen into tissues/thick, inflexible, stiff?
- scleroderma
- etiology unknown
- mostly women
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What is the etiology of AIDS?
HIV-detected through blood test
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How does AIDS attack the body?
- virus enters white blood cells
- virus attacks t cells and multiplies
- t cells no longer stimulate defense response
- immune system weakened
- body susceptible to opportunistic diseases
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What are the 3 stages of AIDS?
- asymptomatic
- arc- AIDS related complex - decreased immune
- AIDS- full blown
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What are some common opportunistic infections of AIDS?
- herpes virus - mouth
- candida-mouth - fungal infection- mouth,lungs
- pneumocystitis carnii - lungs, pneumonia
- intestinal protozoa- GI- diarrhea
- kaposi's sarcoma- LE vascular malignancy
- can also directly affect the brain leading to cerebral atrophy and dementia
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How can someone be exposed to AIDS?
- body fluids especially during sexual contact
- IV drug users
- blood transfusions not screened for AIDS prior to march 1985
- mother can infect newborn
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What musculoskeletal system conditions may PT treat in an AIDS pt?
- polymyositis- inflammation of many mm
- polymyopathy- m weakening
- muscle wasting/atrophy
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What nervous system conditions may PT treat in an AIDS pt?
- CNS infection - brain, spinal cord
- vascular complications
- neoplasms
- spinal cord
- syndromes
- cerebral atrophy
- cerebral hemorrhage
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What type of emotional reactions may an AIDS pt have?
- anger
- anxiety
- discrimination
- guilt
- depression
- denial
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What are some PT problems associated with PWA?
- decreased resp. status
- pain
- decreased m strength-decondition-fatigue
- decreased mobility -> jt motion, skin integrity (thin, tears)
- neurological deficits/dysfunction (balance, coordination, abnormal tone, cognition, neuropathies-numbness, tingling)
- amb/gait problems
- endurance/fatigue problems
- education/safety
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What are some PT interventions that can be used with AIDS pts?
- respiratory;chest PT
- pain- TENS, ES, US, H20, relaxation techniques
- strength
- decreased mobility-stretching/strenghtening, posture correction
- ROM exers
- neurological deficits-facilitation/inhibition techniques, activities appropriate for each deficit
- amb- gait training, assistive device
- endurance-aerobic exers, monitor vitals
- education/safety- protection of skin, maintenance of ROM energy conservation, joint protection, posture
be creative, innovative, flexible
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