LYMPHATIC SYSTEM

1. LYMPHATIC VESSELS2. LYMPHOID TISSUES AND ORGANS

FUNCTION: PICK UP EXCESS TISSUE FLUID AND RETURN IT TO THE BLOODSTREAM

LYMPH

EDEMA – ACCUMULATION OF FLUID IN THE TISSUES

LYMPHATICS

• ONE - WAY SYSTEM• BETWEEN TISSUE CELLS AND BLOOD CAPILLARIES• REMARKABLY PERMEABLE (ENDOTHELIAL CELLS FORMING THE WALL OVERLAP AND ACT AS MINIVALVES)• PROTEINS, CELL DEBRIS, BACTERIA, VIRUSES, CANCER CELLS WHICH DO NOT NORMALLY ENTER BLOOD VESSELS CAN ENTER LYMPH VESSELS• LOW PRESSURE, PUMPLESS BUT WITH MILKING ACTION OF MUSCULAR, RESPIRATORY, SMOOTH MUSCLE OF LARGE LYMPHATICS

LYMPH CAPILLARIES

LYMPHATIC COLLECTING VESSELS

LARGE DUCTS: 1. RIGHT LYMPHATIC DUCT ( FROM RIGHT

ARM, RIGHT SIDE OF HEAD AND THORAX)2. THORACIC DUCT:THE REST OF THE BODY

LYMPH NODES

• HELP PROTECT THE BODY BY REMOVING FOREIGN MATERIAL (BACTERIA AND TUMOR CELLS) • PROTECT THE BODY BY PRODUCING LYMPHOCYTES• LARGE CLUSTERS IN INGUINAL, AXILLARY, CERVICAL REGIONS• OUTER CORTEX CONTAIN LYMPHOCYTES, INNER MEDULLA CONTAIN PHAGOCYTIC MACROPHAGES

OTHER LYMPHOID ORGANS

1. SPLEEN 2. THYMUS GLAND3. TONSILS4. PEYER’S PATCHES OF THE INTESTINE5. BITS OF LYMPHATIC TISSUES IN EPITHELIAL

AND CONNECTIVE TISSUES OF THE BODY

- COMMON FEATURE: PREDOMINANCE OF RETICULAR CT AND LYMPHOCYTES

SPLEEN- FILTERS BLOOD- DESTROY WORN- OUT RBC- STORE PLATELETS AND ACT AS BLOOD

RESERVOIR- HEMATOPOEISIS IN FETUS BUT ONLY

PRODUCE LYMPHOCYTES IN ADULTS

THYMUS GLAND- LYMPHATIC MASS OVERLYING THE HEART- PRODUCES THYMOSIN HORMONE

TONSILS- RING THE PHARYNX- TRAP AND REMOVE ANY BACTERIA

ENTERING THE THROAT - ( TONSILLITIS)

PEYER’S PATCHES - PREVENT BACTERIA FROM PENETRATING

THE INTESTINAL WALL

BODY DEFENSES

1. NON- SPECIFICFIRST LINE – INTACT SKIN AND MUCOUS MEMBRANE

SECOND LINE – CELLULAR AND CHEMICALPHAGOCYTES, NATURAL KILLER CELLS,

INFLAMMATORY RESPONSE, FEVER2. SPECIFIC (IMMUNE SYSTEM) THIRD LINE - FUNCTIONAL SYSTEM THAT RECOGNIZES FOREIGN

MOLECULES ( ANTIGENS) AND ACTS TO INACTIVATE OR DESTROY THEM

WHEN IMMUNITY IS DOWN – AIDS, CANCER,

- SPECIFIC - SYSTEMIC - IT HAS MEMORY

ANTIGEN – ANY SUBSTANCE CAPABLE OF EXCITING OUR IMMUNE SYSTEM AND PROVOKING AN IMMUNE RESPONSE (NONSELF)

SELF- ANTIGENS – INVENTORY OF ALL SELF ANTIGENS DURING DEVELOPMENT AND RECOGNIZED AS SELF BUT STRONGLY ANTIGENIC TO OTHER PEOPLE

ALLERGIES – CAUSED BY HAPTEN (INCOMPLETE ANTIGEN)

CELLS OF THE IMMUNE SYSTEM

1. LYMPHOCYTESB LYMPHOCYTES – PRODUCE ANTIBODIES

- DEVELOP IN BMT LYMPHOCYTES – CELL MEDIATED

IMMUNITY- DEVELOP IN THYMUS

2. MACROPHAGESARISE FROM MONOCYTESENGULF FOREIGN PARTICLESPRESENT FRAGMENTS OF ANTIGENS ON

THEIR SURFACE

INTERACT WITH LYMPHOCTES IN IMMUNE RESPONSE

ACTIVE IMMUNITYWHEN B CELL ENCOUNTER ANTIGENS AND

PRODUCE ANTIBODIES AGANST THEM

1. NATURALLY ACQUIRED2. ARTIFICIALLY ACQUIRED

PASSIVE IMMUNITYANTIBODIES ARE OBTAINED FROM THE

SERUM OF AN IMMUNE HUMAN OR ANIMAL DONOR

1. NATURAL2. ARTIFICIAL

ANTIBODIES (IMMUNEGLOBULINS)SOLUBLE PROTEINS SECRETED BY

ACTIVATED B CELLS IN RESPONSE TO AN ANTIGENBINDS WITH THE SPECIFIC ANTIGEN

RESPIRATORY SYSTEM

FUNCTIONAL ANATOMY INCLUDES:

NOSE PHARYNXLARYNXTRACHEABRONCHI AND SMALLER BRANCHES

- CONDUCTING PASSAGEWAYS THAT ALLOW AIR TO REACH THE LUNGS

- PURIFY, HUMIDIFY, WARM INCOMING AIR

LUNGS – ALVEOLI (ACTUAL AIR EXCHANGE)

NOSE

NOSTRILS (EXTERNAL NARES)NASAL CAVITY DIVIDED BY NASAL SEPTUM

OLFACTORY RECEPTORS – IN SUPERIOR PORTION

RESPIRATORY MUCOSA WITH RICH NETWORK OF THIN- WALLED VEINS TO WARM THE AIR

STICKY MUCUS MOISTEN THE AIR AND TRAP BACTERIA AND OTHER DEBRISCILIATED CELLS CREATE A GENTLE CURRENT THAT MOVES THE MUCUS POSTERIORLY TO THE PHARYNX, SWALLOWED AND DIGESTED IN STOMACH JUICES (SLOW IN COLD WEATHER)

NASAL CONCHAE- 3 MUCOSA COVERED LOBES- INCREASE SURFACE AREA- INCREASE AIR TURBULENCE

PALATE - SEPARATES NASAL CAVITY FROM ORAL

CAVITY-HARD PALATE-SOFT PALATE

CLEFT PALATE – FAILURE OF THE BONES FORMING THE PALATE TO FUSE MEDIALLY

PARANASAL SINUSES – FRONTAL, MAXILLARY, ETHMOID, SPHENOID

NASOLACRIMAL DUCT ALSO EMPTY IN NASAL CAVITY

RHINITIS – INFLAMMATION OF THE NASAL MUCOSASINUSITIS -

PHARYNX

“THROAT”5 INCHES LONGMUSCULARWHERE AIR AND FOOD PASS

AIR FROM NASAL CAVITY FOOD FROM MOUTHNASOPHARYNX NASOPHARYNXOROPHARYNX OROPHARYNXLARYNGOPHARYNX LARYNGOPHARYNXLARYNX ESOPHAGUS (POSTERIOR)

PHARYNGOTYMPANIC TUBE DRAINS TO NASOPHARYNXOTITIS MEDIA USUALLY FOLLOWS SORE THROAT

TONSILS – CLUSTERS OF LYMPHATIC TISSUES IN PHARYNX

LARYNX

“VOICEBOX”MADE UP OF 8 RIGID CARTILAGES

FLAP OF ELASTIC CARTILAGE (EPIGLOTTIS)LARYNX MOVES UP AND EPIGLOTTIS TIPS ON SWALLOWING AND FOOD IS DIVERTED TO ESOPHAGUSCOUGH REFLEX – TRIGGERED IF ANYTHING OTHER THAN AIR ENTERS THE LARYNX

THYROID CARTILAGE (ADAM’S APPLE) – BIGGEST CARTILAGE

TRUE VOCAL CORDS (VOCAL FOLDS)GLOTTIS – SLITLIKE PASSAGEWAY BETWEEN VOCAL FOLDS

TRACHEA

“WINDPIPE”4 INCHES, LEVEL OF 5TH THORACICC – SHAPED RINGS OF HYALINE CARTILAGETRACHEA IS LINED BY CILIATED MUCOSA WHICH BEATS CONTINUOUSLY IN A DIRECTION OPPOSITE TO THE INCOMING AIRSMOKING INHIBITS CILIARY ACTIVITY AND ULTIMATELY DESTROYS CILIA

HEIMLICH MANEUVER

TRACHEOSTOMY

MAIN BRONCHI

RIGHT AND LEFT FROM THE DIVISION OF THE TRACHEARUNS OBLIQUELY BEFORE IT PLUNGES INTO THE HILUSRIGHT MAIN BRONCHUS IS WIDER, SHORTER, STRAIGHTER (COMMON SITE OF FOREIGN BODY BEING LODGED)

LUNGS

APEX – NARROW SUPERIOR PORTIONBASE – BROAD AREA RESTING ON THE DIAPHRAGM

RIGHT LUNG – 3 LOBESLEFT LUNG – 2 LOBES

VISCERAL PLEURAPARIETAL PLEURA

PLEURAL FLUIDPLEURISY - INFLAMMATION

BRONCHIOLES – SMALLEST OF THE CONDUCTING PASSAGEWAYS

RESPIRATORY TREE – ALL HAVE REINFORCING CATILAGES ON WALLS EXCEPT FOR THE SMALLEST

CONDUCTING ZONERESPIRATORY ZONE (RESPRIRATORY BRONCHIOLE, ALVEOLAR DUCTS, ALVEOLAR SACS, ALVEOLI)

WEIGH 2 ½ LBS SOFT AND SPONGY

RESPIRATORY MEMBRANE: (AIR-BLOOD BARRIER)

SINGLE THIN LAYER OF SQUAMOUS EPITHELIAL CELLS OF ALVEOLI AND CAPILLARY WALLS (AIR IN ALVEOLI AND BLOOD INSIDE CAPILLARIES)

GAS EXCHANGE IS SIMPLE DIFFUSION

50- 70 SQUARE METERS OF SURFACE AREA

ALVEOLAR PORES – CONNECT NEIGHBORING SACS, ALTERNATE ROUTE OF AIR TO REACH ALVEOLI

MACROPHAGES –

CUBOIDAL CELL WHICH MANUFACTURE SURFACTANTIRDS

RESPIRATION:

1. PULMONARY VENTILATION (BREATHING)2. EXTERNAL RESPIRATION 3. RESPIRATORY GAS TRANSPORT4. INTERNAL RESPIRATION

BREATHING:

INSPIRATIONINVOLVES DIAPHRAGM AND INTERCOSTAL

MUSCLES

EXPIRATIONPASSIVE PROCESS IN HEALTHY (NATURAL

ELASTICITY OF THE LUNG)

ACTIVE PROCESS: (USE OF MUSCLES)ASTHMACHRONIC BRONCHITIS, PNEUMONIA

ATELECTASIS – COLLAPSE OF LUNG TISSUEPNEUMOTHORAX

RESPIRATORY VOLUME AND CAPACITIES

500 ML OF AIR MOVED IN AND OUT OF THE LUNGS DURING NORMAL, QUIET BREATHING – TIDAL VOLUME

INSPIRATORY RESERVE VOLUME – AMOUNT OF AIR THAT CAN BE TAKEN IN FORCIBLY ( 2100- 3200 ML)

EXPIRATORY RESERVE VOLUME – AMOUNT OF AIR THAT CAN BE FORCIBLY EXHALED AFTER A NORMAL EXPIRATIION (1200 ML)

RESIDUAL VOLUME (1200 ML) – REMAINS IN THE LUNGS EVEN AFTER FORCEFUL EXPIRATION)

VITAL CAPACITY – TOTAL AMOUNT OF EXCHANGEABLE AIR ( 4800 ML)

VC = TV + IRV + ERV

DEAD SPACE VOLUME – IN CONDUCTING ZONE PASSAGEWAYS (150 ML)FUNCTIONAL VOLUME – 350 ML

SPIROMETER – MEASURES RESPIRATORY CAPACITIES

RESPIRATORY SOUNDS

BRONCHIAL SOUNDS – PRODUCED BY AIR RUSHING THROUGH LARGE RESPIRATORY PASSAGEWAYS

VESICULAR SOUNDS – SOUNDS PRODUCED AS AIR FILLS THE ALVEOLI

CRACKLEWHEEZE

HYPOXIA – INADEQUATE OXYGEN DELIVERED TO TISSUES

CYANOSIS

CARBON MONOXIDE POISONINGCO – COLORLESS, ODORLESS,

COMPETES WITH OXYGEN VIGOROUSLYCHERRY RED APPEARANCERX: 100% OXYGEN

NEURAL CENTERS FOR RESPIRATION: MEDULLA AND PONS

NORMAL RATE – 12- 15/ MIN.

HYPERPNEAAPNEA

SUPPRESSION IN DRUG INTAKE (MORPHINE, ALCOHOL,SLEEPING PILLS)

INVOLUNTARY CONTROL OF BREATHING

HYPERVENTILATION