Exam 2

• -lymph nodes
• -thymus(active in childhood,Tcells)
• -spleen(filters) 
• -tonsils(lymph node WBC live here)
• -bursa equivalent(B cells) 
• -peyer's patch..appendix 
• -immunocompentent cells

• skin:barrier
• eyes:tears(mechanical rinse of eye) 
• nose: cilia, sneeze(mucous blankets...cough it up)
• URI:cilia, cough
• Mouth: saliva, enzymes
• GI: acid, normal flora
• BU: urine flow, PH

• destroy injurious agent
• prevent spread of injury 
• promote tissue repair
• *keep it local,,,bring immune cells to area-increases swelling

• Arise from same kind of stem cells that give rise to RBC
• 5 types: monocyte, neutrophil, basophil, eosinophil, lymphocyte

• released and ciruculates for 24 hours then moves to tissue location(lungs,liver, speeln, lymph nodes, peritoneal cavity) 
• produces growth factors for other WBC
• clears necrotic debris(macrophage) 
• second line of defense 
• plays a regulatory role( chemical messenger..monokine... stimulates chemotaxis)
• engulfs antigen and presents it to the B and T cells ...puts chunks of cell membrane (antibody) for other to see
• *can help other WBC and send SOS 
• *chemotaxis-other WBC moving to area due to chemicals sent by monokine

• )50-79%) of total WBC
• first line of defense 
• contains granules filled with lysosomal enzymes (breaks up stuff)
• immature(bands)
• mature(segs...takes 7-14 days to mature)

• contains granules containing histamine and heparin 
• lines respiratory tract
• associated with hypersensitivity reactions

• heprin-anticoagulant and brings more blood --to get more help
• histamine-causes swelling 
• -bleed/swell--wall it off and keep it there ...swells ultimatly due to location
• -resp-trying to reduce exposure to irritating stimuli

• (2-4% of leukocytes)
• found in GI and lungs 
• phagocytize parasites(eats them)
• release histaminease to alleviate allergic symptoms (turns of swelling, asthma may be low)

• precursor cells formed in fetal bone marrow..migrate to lymph nodes, thymus and spleen
• thymus cells become t cells 
• cells from other tissues(Bursa equivalent) become B cells 

• Mature B cells(plasma cell) activate to produce antibodies
• igM occurs first in fetal life..most effective against bacterial invasion
• igG -activates complement (clotting cascade..necessary for babies)-can cross placenta, effective against bacteria 
• IgA-found in saliva, tears, mucus, urinary tract, prevents adherence of antigens
• IgD -activates B lymphocytes to become plasma cells 
• IgE - important in allergic responses 

• liquid immunity B cells=plasma cells=antibody
• immunogloblins=antibodies

• agglutination
• precipitation
• opsonization
• lysis
• neutralization
• activation of complement

• T cells, release lymphokines(interleukin II) 
• -attracts other WBC to area
• -destroys target cells
• -inhibits viral replication
• -regulates other lymphocytes 
• -differentiate into subpopulations:cyotoxic, helper, suppressor, memory

• neutrophil
• macrophage
• monokin
• chemotaxis
• lymphocytes
• -b-antibodies
• -t-lymphokines
• ---b cell growth
• ---helper t production(bring more macrophages, make memory t cells)

• aging
• nutrition
• stress(cancer pt increased stress year before-->changed chemistry of immune system )
• steroids

• thymus begins to deterioate after age 50 
• decreases differention of T cells 
• decreases T cell action (esp helper t ) 
• decreased antibody levels 
• increased likelihood of auto-antibody production

• decreased protein intake(decreased t cell response)--can't make new cells 
• prolonged wound healing 
• decreased capability of neutrophils and macrophages

• lymphopenia
• neutropenia
• cortizone decreases inflammation which dampens immune response 

anabolic-at risk for hidden infections decrease immune .. may have an infection but show no symptoms

• self from non self.autoimmune disease body attacks self(rheumatoid arthritis,lupus(rash resembles a wolf bite or a butterfly rash on any organ) 
• penia-shortage of

• passive(give pre-formed antibodies such as hepB)
• active-vaccines developed form disease producing microorganisms or their antigens...tiny peive of virus or broken down

• protection of pt
• recognize high risk: elderly, malnourished, newborns, steroid uses, NG tube(decreased acid), antibiotic therapy(decreased vaginal activity)

• immunizations 
• actue or chronic infections 
• drug use(steroid, chemo therapy) 
• co morbidity(DM, ETOH, drug abuse)
• stressors 
• nutrition

• local signs 
• fever
• increased HR, RR (most sensitive) 
• malaise (not wanting to do anything)
• anorexia(lack of appetite) 
• headache 
• enlarged lymph nodes(lymphadenopathy-swelling lymph nodes)

• WBC(5-11,000)
• neutrophil count 
• lymphocyte count(esp in bacteria/viral infection) 
• monocyte count(esp in protozoan and Tb)

• primary interventions: id high risk, infection control, education, nutrition
• secondary : culture wounds, treat fever/pain/fluid loss, monitor VS