2-6-12 Monday

PHYS/PATH

digestion - lacteal
thymus: t cell- like K-12 for learning
monocytes: in blood; macrophages (same cell, different location) kupffer,
Non specific

Chemical and mechanical barriers
skin
mucous membrane
body secretion
reflexes

Phagocytosis: wbc takes in and destroys waste and foreign material
-neutrophils
-macrophages
natural killer cells: type of lymphocyte- help protect against cancer; looking for receptors; sugar suppresses these cells :(
can recognise body cells with abnormal membranes
secrete protein that breaks down cell membrane

Inflammation
reaction : heat, redness, swelling, pain ,puss
fever: phagocytes work, release subst., increases body temp
stim phagocytes, increase metabolism, decrease some organisms ability to multiply

Interferon: group of subst that prevent nearby cells from producing more virus
-IFN a
-IFN b
-IFN g
also acts non specifically on immune system cells

Specific defenses immunity
adaptive immunity; develops after birth, acquired naturally and artificially
Adaptive develops in person during lifetime, from encounters with specific harmful agents

antigens: foreign subst. that enters body
induces immune response
t cell- thymus (originate in bone marrow change to t cell in thymus)
b cell- bone marrow
becomes sensitive to specific agent
produce cell mediated immunity
-cytoxic t cell
-helper t cell
-regulatory t cell
-memory t cell
macrophages

B cells and antibodies
antibody (Ab) also know as immunoglobulin (Ig) is subst. produced in response to anitgen
-manufactured by b cells
-must mature in fetal liver or in lymphoid tissue
-provide humoral immunity
-contained in gamma globuin fraction of blood plasma

Antigen/Antibody reaction
-prevent attachment of pathogen
-cause clumping of antigen
-neutralise toxin
-aid phagocytosis
....

Types of vaccines
live: virus/bacteria into person; giving them the disease (best immune response)
attenuated: crippled version of live
toxoid: a piece of the bug
killed by heat or chemical
antigenic component
genetically engineered

Boosters: most don't give lifetime response
passive immunity (artifical)
----
acquired vs. adaptive
neutraphils- bact
b/t cells- viral
80% immune system is digestive
----

Path

Hypersensitivity
Type I: IgE: hay fever, food allergy, immediate reaction
Type II:
Type III:
Type IV: delayed reaction: contact dermis

Edema: swelling, fluid b/w cells 30% more than usual
mechanical: weak heart
chemical: salt

Lymphagitis: inflammation of lymph vessel
trauma or infection
MT with hangnails and lessions
strep and staph most common skin infection
S&S: all signs of inflam.
septicemia: blood poising/ red streaks, contra systemic
can be life threatening

Lymphoma: cancer of lymph nodes, spleen
delineation between lymphoma and lymphocytic leukemia
becoming hazy
2 types:
Hodgkin lymphoma (HL) 8000/yr
Non-Hodgkin lymphoma (NHL) 59000/yr
swollen lymph nodes, alcohol makes pain worse
HL: 15-34 yr olds
NHL: 60-70
mutation of B/T cells
HL: B cells mutate into large, malignant multinucleate
**Reed Sternberg cells
usually submandibular nodes, can be axillary, inguinal
growth in liver
NHL: less aggressive
risk: chemical
Epstein-Barr (mono), HIV.....
S&S: painless symptoms, anemia, fatigue, night sweats, loss appitite
Prognosis: 5yr. survival HL> 86% (kids >95%); NHL: 63%
legally, and board question, no massage

Mononucleosis: viral of salivary glands and throat- invades whole lymphatic syst.
90% Epstein-Barr (EBV)
fatigue for months/years
kissing disease
moves to b lymphocytes in spleen, liver, lymph nodes
incubation up to 60 days
similar to herpes, doesn't have to be active to spread
splenomegaly
debilitates the person; weak and exhausted
similar conditions/differential diag.: HIV/AIDS, measles, strep throat, rubelle
comp: can go Bell's palsy, meningitis, strep throat
Tx: antivirals don't work

Allergic Reaction: Type II IgE; not inherently hazardous
food,
asthma (eczema of lungs), hives
angiodema: massive swelling rapid onset
triggers: nuts, chocolate, fish, eggs etc
anaphylaxis: sever response
massive histamine release
trig: nuts, stings: more severe with each exposure
problem breathing biggest danger
Tx: antihistamines, epinephrine, epipen, O2

Chronic Fatigue Syndrome: causes could be ??? stress, endocrine imbalance
CNS function
hypothalamus-pituitary-adrenal (HPA) axis dysfunction
S&S: poor short term memory, sore throat, mm/jt pain, poor sleep, etc
differential diag: irritable bowel, fibromyalgia, depression, anxiety
Tx: lifestyle changes

Fever: 101F (38.3C)
1-infection
2-wbc increase
3-interleukin decrease; cytokine production increase?
?4- interleukin go to brain increasing temp.
Comp: 104-106 gets dangerous
dehydration, acidosis, brain damage
Death at 112-114 for adults
fever decrease too fast = shock/ increase fever too quick = seizure

HIV (human immunodeficiency virus)/ AIDS (acquired immune deficiency)
infect t helper cells: immune system doesn't know what to do
recognised in 1983: probably before that
90% heterosexual infections
blood, breast milk, semen, vaginal secretino: saliva very low risk, tears, sweat
-virus invader cells with CD4 receptor site
it's an RNA
progression
phase 1: 6 month window
phase 2:
phase 3: asymptomatic periods, meds prolong phase; 1-20 years average 10
Phase 4: HIV+ to AIDS, t cell drop
get rare infections
easily killed by bleach, unstable outside host
indicator disease: pneumoocystis carinii, CMV, Kaposi Sarcoma (herpes 8?)
Diag:
Tx: virus constantly mutates; hard to deal with
M: universal precautions; keep you safe

Lupus: attack various tissues by bodies own antibodies
autoimmune; butterfly rash over cheeks/nose
3 varieties
causes: systemic/ rash, change in brain, lung stuff, heart, kidneys
skin stuff isn't just skin
photosensitivity
ulcers
arthritis
massage contra in flares


FOR TEST/STUFF TO REVIEW

endocrine, blood, heart, blood vessels, lymph, path
H. puts calcium from bone to blood: parathyroid
---from blood to bone: calcitonin
H affects sodium/potassium: aldosterone
cushing too much cortisol/ physical appearance
acromegly: GH makes giant/gigantism in kids
Type I: autoimmune: islets of langerhans destroyed
adision: too little cortisol/ skin orange
ACTH: anterior pituitary/ adrenals
H. store in post. pit: oxytocin, antidiuretic H by hypothalamus
pineal gland: light/dark
thyroxcine: t4 thyroid (metab. body temp)
thymus: t cells; immune
hyperthyroid: thin, active/energy, heart palp, lack sleep
hypothyroid: fatigue, depress, weight increase, lat 3rd eyebrow
metabolic syndrome: Syn X: pre type II
insulin resistance: takes more to get sugar in (key cards)
2 things H made from: protein and lipids
H stim breast milk: prolactin
H activates vit D: parathyroid
RBC, Wbc, thrombocytes, megacaryocytes?
plasma=serum + clot
H kidney secret stim bone marrow production rbc, erythroprowheaton
lymphocyte: b/t cells
cookie monster cells: macrophages/monocytes
blood types: antennas and universals
struct of heart: myocardium mm, epi, endo, peri
chambers 4; function, veins, arteries, valves
systolic/diastolic
chorday tend____ with pulomonary mm (spelling)
Pacemaker: SA node, AV node, bundle of HIS, pejenkey
coronary artery: infarction
ischemia + time = infarction
athlerosclrosis: plaques
hypertension: pressure on blood vess
hepatic portal vein
valves, veins; DVT signs
arteries
good luck