Livvi Greenie Exam 1 Semester 2 PDF

Digestive system Name & label all organs of the digestive tract in the correct sequence from when food enters the mouth to the exit from the body Mouth, pharynx, oesophagus, stomach, pyloric sphincter, duodenum, jejunum, ileum, cecum, ascending colon, transverse co...

Digestive system Name & label all organs of the digestive tract in the correct sequence from when food enters the mouth to the exit from the body Mouth, pharynx, oesophagus, stomach, pyloric sphincter, duodenum, jejunum, ileum, cecum, ascending colon, transverse colon, descending colon, sigmoid colon, anus. Name & describe the nine regions & four quadrants of the abdominopelvic cavities (List the organs contained in each region & each quadrant) Name & describe the six digestive system processes Name the four layers of the digestive tract in the correct sequence from innermost to outer layer. Describe the function of each layer and state the tissue type of each layer (this connects with the function) Layer Tissue Type Function Mucosa Epithelium Surrounds the lumen Protects and secretes Submucosa Dense, irregular connective Supports the mucosa tissue Contains nerves Muscularis Circular muscle Peristalsis and Longitudinal muscle segmental contraction through the GI tract. Serosa Areolar connective tissue Provides the partition between the internal organs and the abdominal cavity. Name the three layers of the peritoneum in the correct sequence, deep to superficial Visceral Layer covers organs Peritoneal Layer contains serous fluid Parietal Layer lines the abdominopelvic cavity State four functions of the tongue Tastes Manipulates food for chewing Aids swallowing Articulates speech State the health risks associated with tooth & gum disease Dental caries caused by plaque laid down by bacteria Plaque accumulates and forms a stony-hard calcified deposit between the teeth and gums Gums become red, sore swollen and bleed Can cause chronic inflammation which increases risk of heart disease and stroke State two functions of saliva Soften, moisten and dissolve food Cleans mouth and teeth Name the four contents of saliva & give a function for each Water Dissolves food and begins the process of digestion Salivary Amylase Digests starch to maltose Mucus Lubricates food for movement and swallowing Lysozyme Helps destroy bacteria State two situations that would reduce the production of saliva Dehydration Stimulation of the sympathetic nervous system Describe what would happen if saliva was not produced Difficulty chewing, moistening and swallowing Saliva is required to initiate chemical digestion State the location & function of the epiglottis The epiglottis covers the larynx and there was involuntary movement of food and fluids from the oropharynx to the oesophagus State the function of the oesophagus The oesophagus secretes mucus and transports food and fluid to the stomach through peristalsis Define dysphagia Difficulty swallowing State the major function of the stomach To compress, knead and mix food beginning the process of digestion State the function of stomach juice and the specific function of HCL & mucus in the stomach HCL – kills microbes in food, H+ ions are actively pumped in via proton pumps Mucus – protects the stomach wall from being damaged by the HCL Describe the homeostatic imbalances that can occur with prolonged or severe vomiting Can lead to dehydration and disrupt the electrolyte and pH balance – vomiting causes acid to be lost and the blood can become alkalotic.  Accessory organs (Liver, gall bladder & pancreas) Describe the anatomical position of the liver Occupies most of the Right Hypochondriac and Epigastric regions or Right and Left upper quadrants. State the seven functions for the liver 1. Bile production 2. Phagocytosis of RBCs and bacteria 3. Processing nutrients 4. Storage (Iron, Glycogen & Vitamins) 5. Formation of clotting factors and plasma proteins 6. Detoxification of alcohol, drugs and converts ammonia to urea 7. Heat production Describe and label the blood flow to, within & from the liver Name the two blood vessels that supply the liver & the vein that exits the liver Supply = Hepatic Portal Vein & Hepatic Artery Vein exiting = Hepatic Vein State the function of the stellate reticuloendothelial (Kupffer’s) cells Remove debris, bacteria and worn out blood cells from the blood as it flows past. Name the cells that produce bile Hepatocytes Describe (or draw) the pathway of bile from the liver to the duodenum Name the structure that stores bile and Describe the main function of bile Gallbladder Neutralise acid from the stomach Emulsification of fat to enable digestion and absorption of lipids Removal of waste (bilirubin) Describe the anatomical position of the pancreas Posterior to the stomach in the epigastric region State one exocrine function of the pancreas Produce pancreatic juice which flows into the duodenum with bile from the common bile duct.  Small and large intestines In correct sequence from the beginning name the three portions of the small intestine Duodenum, Jejunum, Ileum Describe two functions of the small intestine Chemical digestion – breakdown of chyme chemically using bile, enzymes and bicarbonate from the accessory organs. Mechanical digestion – peristalsis and segmentation Name the four structural features of the small intestine & state the overall function of these features Circular folds Force chyme to spiral through the lumen – slowing transit and increasing time for absorption Villi Contain blood capillaries and lacteals for fat absorption Microvilli Secretion of intestinal enzymes and absorption of nutrients Length Increased surface area for absorption State the function of intestinal juice Contains enzymes that convert disaccharides to mono saccharides and peptides into amino acids. Label the diagram of the sections of the large intestine & be able to describe the sections in correct sequence State four functions of the large intestine 1. Complete the absorption of water, ions and vitamins 2. Produce and absorb Vitamin B and Vitamin K 3. Movement of contents of the colon to the rectum 4. Formation of faeces 5. Defecation  Control of the digestive tract Name the main cranial nerve involved in regulating the digestive system The vague nerve (CNX) State the autonomic system that stimulates the digestive system The enteric nervous system controls gastric secretions & motility alongside hormonal control. Its control can be over-ridden by the sympathetic & parasympathetic control of the autonomic nervous system. Anger, fear & anxiety may inhibit GI function due to sympathetic stimulation The presence of food in digestive organs stimulates stretch receptors which activates parasympathetic & enteric neurons to enhance digestion in the organ. Name the two main reflexes that affect motility in the intestines with the stimulus for each reflex and the effect & location for each reflex Reflex Stimulus Effect & Location Gastroileal Reflex Stomach distention Peristalsis increases and chyme is moved from the small intestine into the caecum Gastrocolic Reflex Stomach distention Mass peristalsis in the colon which drives faeces into the rectum Describe the defecation reflex using the components of the reflex arc (stimulus, control centre & action of effectors) Stimulus - As faeces moves into the rectum it causes distension of rectum, this stimulates stretch receptors in the rectal wall. If there is insufficient bulk or lack of faeces the reflex will not occur. Control (reflex) centre located in the sacral spinal cord Effectors - lower colon & rectal wall contracts, internal anal sphincter relaxes, the external anal sphincter is under voluntary control; it relaxes if “allowed” Response - elimination of faeces cannot occur if there is damage to the neurons involved in the reflex arc or nerves that control the external anal sphincter (e.g. spinal injury, multiple sclerosis) Describe five effects of ageing on the digestive system  Nutrition Name the six types of nutrients 1. Water 2. Carbohydrates 3. Lipids 4. Proteins 5. Minerals 6. Vitamins State the major source of energy for the body Carbohydrates Name the three monosaccharides that are absorbed Glucose, fructose and galactose State the end products of digestion of triglycerides Monoglyceride and 2 fatty acids State five types of lipids & describe the major function for each type of lipid Lipid Function Fatty Acid Synthesis of triglycerides & phospholipids Catabolised to generate ATP Triglyceride Protection from injury, insulation from cold, energy storage Phospholipids Component of cell membranes & lipoproteins Steroids (cholesterol) Minor component in cell membrane, precursor to bile salts, vitamin D & steroid hormones Prostaglandins Local hormones released from damaged cells that intensify the effects of histamine & induce pain. Made from essential fatty acids. State the overall function of lipoproteins To transport lipids in the blood Name the three different types of lipoproteins & describe the specific function for each type HDL (High-Density Lipoprotein) Collects excess cholesterol from tissues and delivers it back to the liver LDL (Low-Density Lipoprotein) Transport cholesterol to the peripheral tissues VLDL (Very-Low-Density Lipoprotein) Deliver triglycerides to adipose tissue Describe the clinical significance of raised LDL High LDL = a diet high in cholesterol or a body making more cholesterol than needed LDL deposits this excess cholesterol into the artery wall where it forms a fatty plaque This plaque can build up and block or break away causing stroke and MI State the end product of the digestion of proteins & describe the overall function of these units Amino acids – these are absorbed into the blood and delivered to he cells where they are used to manufacture proteins Name seven different types of proteins & give one function for each type Structural protein Provide strength e.g. collagen and keratin Hormones Insulin – note not all hormones are proteins Contractile protein Allows shortening of muscle fibres e.g. actin & myosin Antibodies Provide protection/defence against foreign cells and bacteria Haemoglobin Transport of 02 Enzymes Speed up chemical reaction e.g. amylase, maltase & Lipase Neurotransmitters & ATP Small amounts and only some Name the four fat-soluble vitamins & describe one main function of each Explain the function of antioxidant vitamins Name & describe a main function for the minerals listed in the lecture notes  Introduction to pharmacology Define the three different drug names Chemical Name Describes the chemical composition – rarely used. Generic Name Derived from the chemical name, used when prescribing and in publications (also the internationally recognised name) enables generic drugs to be produced by many companies. Trade Name (trademark/brand name) The marketed name – marketed by a specific company/manufacturer/developer – generally more expensive. Define the term pharmacodynamics The study of the interaction between the drug, its molecular target and the pharmacological response What the drug does to the body Drugs do not produce new actions, they modify existing function Define the terms agonist & antagonist Agonist – Binds to and activates the receptor Antagonist – Binds to and deactivates the receptor Define the term pharmacokinetics How the body affects a specific drug after administration What the body does to the drug Name and describe the four pharmacokinetic processes in correct sequence Absorption Passage of Route of delivery medication from the Ability of the medication to dissolve site of Blood flow to the area of absorption administration into Body surface area the blood Lipid solubility Distribution Movement of the Blood supply (high = more movement) drug from the blood Capillary permeability into the body’s Cardiac function tissues Tissue binding Plasma protein binding Metabolism Process of chemical Genetics modification (usually Environmental factors by the liver) or the Disease state drug Age Excretion Removal of the drug PH from the body Drug properties Level of first pass metabolism Renal and liver function State five ways that drugs can be excreted Bile Faeces Expired air Sweat Breast milk Explain hepatic first pass effect Orally administered drugs travel first through the portal system and liver BEFORE entering the systemic circulation meaning a variable amount of drug may be extracted (metabolised) by the liver before entering the systemic circulation. Explain drug bioavailability Drug bioavailability is the amount of drug that is able to have an active effect – in drugs given intravenously there is no immediate metabolism meaning they are 100% bioavailable whereas drugs given orally undergo hepatic first pass metabolism so only a lower percentage (dependant on the drug) is bioavailable.  Musculoskeletal system State six functions of the skeletal system 1. Provide support by acting as a structural framework and a point of attachment for tendons and ligaments 2. Protect the internal organs (brain, heart lungs, etc.) 3. Assist body movements (in conjunction with muscles) 4. Store and release salts of calcium and phosphorus 5. House the red bone marrow which produces blood cells 6. Store triglycerides in adipose cells of yellow marrow Name the two divisions of the skeleton and state the specific function of each division Axial skeleton Bones of the skull, vertebral column, sternum & ribs Provides support & protection Appendicular skeleton Bones of the shoulder & hip girdles & upper & lower limbs Provides mobility for manipulation & locomotion Name and label the bones in each division (anterior & posterior view) Name the five types of bones and give an example for each type Long Humerus Short Trapezoid Flat Sternum Sesamoid Patella Irregular Vertebra Name the cranial bones and describe their collective function frontal, occipital, paired temporal & parietal bones Collectively they protect the brain Provides attachment for muscles that stabilize & move the head Name the four major facial bones and describe their collective function Nasal, zygomatic, maxilla & mandible bones Framework of the face with cavities for organs of sight, taste & smell & passages for air & food, secure the teeth, anchor the facial muscles of expression State three functions of the paranasal sinuses Reduce weight of the skull Help to resonate vocal sounds Lined with mucus membranes that warm and humidify air. State three functions of the vertebral column Allows multidirectional movement of the torso Transmits the weight of the trunk to the lower limbs Surrounds & protects the delicate spinal cord Provides attachment points for the ribs & muscles of the back & neck. Name the five sections of the vertebral column and state the number of vertebrae in each section Cervical (7), Thoracic (12), Lumbar (5), Sacrum, Coccyx Name the four normal curves of the vertebral column Cervical, Thoracic, Lumbar and Sacral Curves Name and describe three abnormalities of spinal curves Scoliosis: Abnormal lateral curvature of thoracic region Kyphosis: Dorsally exaggerated thoracic curve Lordosis: Accentuated lumbar curve Label the structural features of a vertebrae and describe the function of each Vertebra: body, vertebral arch, processes that are attachment sites for muscles that move the vertebral column & ligaments that stabilize it. Describe the difference between the vertebral foramen and the intervertebral foramen Vertebral foramen contains spinal cord Intervertebral foramen contains spinal nerve State the location and function of the intervertebral discs Located between the vertebra Intervertebral discs absorb compressive force & permit movement of the vertebral column State three functions of the thoracic cage Protects heart, lungs & great blood vessels Supports the shoulder girdles & upper limbs Provides attachment points for muscles of the neck, back, chest & shoulders Label the landmarks of the sternum State the number of ribs Ribs: 1-7 attached, 8-10 indirectly attached, 11 & 12 floating. Explain the difference between true and floating ribs True ribs are attached to the sternum via the costal cartilage (1-7 pair) Floating ribs are the 11th and 12th pair that have cartilage embedded in the muscles of the lateral body wall. State the function of the clavicle and scapula Clavicle transmits mechanical force from the upper limbs to the trunk The scapula provides points of attachment for muscles. Describe the function of the glenoid cavity Articulates with the humeral head at the shoulder joint allowing the arm to move relative to the torso In sequence from proximal to distal name (and label) the bones of the upper limb (arm) State the function of the pelvis Provide weight bearing support for the vertebra; column and the abdominopelvic organs Label the bones of the pelvis Name two joints of the pelvis Pubic symphysis (anteriorly) Sacroiliac (posteriorly) Describe four differences between the male and female pelvis In sequence from proximal to distal name (and label) the bones of the lower limb (leg) State the location of the calcaneus bone Heel Label the structures of the long bone and describe the function of each section (e.g. diaphysis) Briefly explain how bones grow in length (where does this growth occur) In adolescents, through the end of active growth, the epiphysis of the long bones contains hyaline cartilage and forms an “epiphyseal growth plate”. The growth plate is always actively dividing, this new cartilage ossifies and is deposited on the diaphyseal side of the plate causing the bone to elongate from each end. In adults, the epiphyseal cartilage is no longer present and elongation of bones has stopped. The epiphyseal growth plate becomes an “epiphyseal line” as growing cartilage is replaced by calcified bone. Describe the location of the periosteum tough outer fibrous layer inner layer osteoblasts, blood vessels & nerves. State four functions of the periosteum 1. Protects the bone 2. Point of attachment for ligaments and tendons 3. Nourishes bone tissue 4. Helps in fracture repair Name the two types of bone tissue. Describe the location of each type, the structures in each and the specific functions of each type. Type Location Structures Function Compact Bone External surface of Osteons Provides bones protection and strength to bones Spongy Bone Inside of bones Trabeculae Protects and and ends of long (plates) houses bone bones marrow Lightweight Name two main types of cartilage, the locations for each type and the specific functions for each type Type Location Function Articular Cartilage Inside the joint cavity of Allows smooth movement synovial joints of the joint and reduces friction Fibrocartilage Pubic symphysis Strength Intervertebral discs Highly compressible Menisci Allows for pressure and stretch Describe the components of bone tissue Connective tissues Cells Matrix Mineral salts Collagen Fibres Name and describe the specific functions of the four bone cells State the location, structure and function of the osteons Located in compact bone Tiny weight bearing pillars Provides protection and strength to bones Explain what occurs during bone remodelling State three factors that affect bone remodelling and the two hormones that control bone remodelling Explain the fracture repair process Step One Fracture hematoma blood vessels are torn in the forms osteons, periosteum, and surrounding tissues Blood leaks from the torn ends of the vessels & a mass of blood, called a hematoma, forms around the site of the fracture during the 6-8 hours after injury Bone deprived of nutrients dies & tissue at the site becomes swollen, painful & inflamed. Step Two Fibrocartilaginous callus Bone reconstruction begins with forms formation of a fibrocartilaginous  callus which bridges the broken bone ends & splints the bone. The callus consists of collagen fibers formed by fibroblasts and cartilage formed by chondroblasts Macrophages remove dead bone fragments & the hematoma. Process takes about 3 weeks Step Three Bony callus forms Osteoblasts convert fibrocartilage into a spongy bone callus which lasts about 3 – 4 months. Step Four Bone remodelling Spongy bone is replaced by compact bone. Removal of excess material from the exterior of the bone & within the bone cavity. The fracture line disappears, but evidence of the break remains. Often new bone is thicker & stronger at the repair site than originally State five factors that could delay bone healing 1. Tissue fragments between the bone ends that haven’t been removed by phagocytes 2. Deficient bloody supply 3. Poor alignment of bone ends 4. Continual mobility of bone ends 5. Illness, malnutrition, drugs and ageing Explain what happens to bone mass over the lifespan From birth to adolescence bone deposit exceeds bone resorption In young adults the rates are about the same Males have a heavier skeleton than females so loss of bone density in later life has less effect on males. In females bone loss begins after age 30. It accelerates greatly after age 45. (Rate of loss ~ 8% every 10 yrs.) Related to reducing oestrogen levels In males bone loss begins age 60 (Rate of loss ~ 3% every 10 yrs.) Testosterone levels decline after age 55 When does bone deposit exceed bone resorption and bone resorption exceed bone deposit Deposit exceeds resorption in Normal growth Resorption exceeds deposit in Osteoporosis State five factors that determine bone mass & explain how these are affected across the lifespan From birth to adolescence bone deposit exceeds bone resorption In young adults the rates are about the same Males have a heavier skeleton than females so loss of bone density in later life has less effect on males. In females bone loss begins after age 30. It accelerates greatly after age 45. (Rate of loss ~ 8% every 10 yrs.) Related to reducing oestrogen levels In males bone loss begins age 60 (Rate of loss ~ 3% every 10 yrs.) Testosterone levels decline after age 55 Define osteoporosis “Osteoporosis is a disease in which bone resorption by osteoclasts exceeds bone deposit by osteoblasts” Describe five risk factors associated with osteoporosis Describe four age related changes of the skeletal system Bone becomes more brittle & prone to Due to reduction in bone mass & density & fracture reduction in collagen: mineral ratio Articular cartilages diminish and thins. Bones move against one another & lead to rough bony growths & arthritis Height is reduced Because intervertebral discs thin, osteoporosis causes compression fractures of vertebrae Rigidity of the thoracic cage Costal cartilage ossifies produces shallow breathing resulting in less efficient gas exchange. Name the three types of joints, an example of each type of joint and the range of movement that can occur with each type Fibrous Sutures between cranial Little or no movement bones Cartilaginous Symphysis pubis, Small amount of movement intervertebral discs Synovial Knuckles, knees, elbow Lots of movement Label the diagram of the synovial joint Name two types of synovial joints Hinge joint Ball and socket joint State the function of the synovial membrane Lines the joint surfaces (except for the articulating cartilage) and produces synovial fluid. State four functions of synovial fluid 1. Reduces friction by lubricating the joint 2. Absorbs shock 3. Supplies cartilage with 02 and nutrients 4. Contains phagocytes State the range of movement that occurs at each joint (e.g. elbow – flexion & extension) Include the following movements:- hyperextension, circumduction, rotation, inversion, eversion, pronation, supination, dorsiflexion, plantar flexion Power point #3 in the musculoskeletal tab on Moodle Describe three age related changes that occur with joints Explain the difference between osteoarthritis and rheumatoid arthritis Osteoarthritis Rheumatoid Arthritis Degenerative disease Autoimmune disorder Deterioration of the articular cartilage Damage to the cartilage by the immune system Non-inflammatory Inflammation, swelling and pain Primarily affects weight bearing joints Eventual joint fusion Describe four functions of muscle tissue 1. Produce movement 2. Maintain posture and stabilise joints 3. Regulate organ volumes (sphincter) 4. Move substances within the body 5. Produce heat 6. Protect underlying structures Describe three functional characteristics of muscle tissue 1. Electrically excitable 2. Contracts when stimulated by an action potential 3. Stretches without being damaged 4. Elastic – can return to original shape after contraction or extension Name the three types of muscle, the general location and function for each type Skeletal Attached to bones Moves the skeleton Cardiac Forms the wall of the Causes the heart to beat heart Smooth Walls of the viscera and Changes diameter some hollow organs Explain what happens at the neuromuscular junction Name the specific neurotransmitter that causes skeletal muscle contraction Ach - Acetylcholine Describe how skeletal muscle contraction occurs Name the two contractile proteins involved in muscle contraction Actin Myosin Describe the difference between skeletal muscle contraction and smooth muscle contraction Smooth muscle contraction starts more slowly & lasts longer (relaxes more slowly) than skeletal muscle smooth muscle fibers are able to remain in a state of continued partial contraction = smooth muscle tone useful for maintaining blood pressure or a steady pressure on the contents of GI tract Define the terms atrophy and hypertrophy and give an example of what causes each Atrophy wasting away of muscles caused by disuse of the muscle or severing of the nerve supply the transition to connective tissue cannot be reversed Hypertrophy increase in the diameter of muscle fibers resulting from very forceful, repetitive muscular activity Describe the difference between a tendon and a ligament Describe the main age-related change that occurs to muscle tissue With aging there is a slow, progressive loss of skeletal muscle mass, which is replaced by fibrous connective tissue & fat. Begins at age 30 and by age 80 muscle strength decreases by about 50%. Regular exercise in an older person can rebuild muscle mass & dramatically increase muscle strength. Helps prevent falls. Walking improves neuromuscular function & enhances independent living. Label the anterior and posterior view of the major muscles included in the PowerPoint notes Describe the movement that occurs when specific muscles or muscle groups are contracted. Do this for each muscle or muscle group mentioned in the PowerPoint notes (e.g. contraction of the biceps causes flexion of the arm at the elbow) PowerPoint on Moodle in musculoskeletal tab State two specific functions of the pelvic floor muscles Support for the pelvic organs Sphincters for the urethra, vaginal and rectum Name three muscles used for IM (intramuscular) injections Gluteus Medius/ventro gluteal Lateral quadriceps/Vastus Lateralis Deltoid  Lymphatic system Describe the three functions of the lymphatic system Drain excess interstitial fluid from tissue spaces and return it to the blood. Transport lipids and lipid soluble vitamins from the villi in the small intestine to the blood As part of the immune system that destroys microbes and cancerous or foreign cells. Name the cells of lymph nodes and describe their role / function in the nodes B Cells (lymphocyte) Stimulate the immune responses T Cells (lymphocyte) Stimulate the immune responses Macrophages (phagocyte) Destroy foreign substances through phagocytosis The difference between B and T cells is that some mature in the Bone marrow (B cells) and the others mature in the Thymus (T cells) State the different locations of lymph nodes and lymphatic nodules Name three areas of lymphatic nodules Lymphatic nodules are concentrations of lymphatic tissue not surrounded by a capsule and scattered throughout the connective tissue of mucous membranes Peyer’s Patches (in the ileum of the small intestine) Appendix (lymph tissue that destroys bacteria) Tonsils Describe the anatomical position of the spleen & state three functions of the spleen Left hypochondriac region, between the stomach and diaphragm (size of a fist) Removes damaged blood cells and platelets Stores platelets (approx. 1/3) Produces blood cells during foetal life Performs immune function as per a lymph node Describe how / why cancer & infection spreads through the lymphatic tissue Lymphatic nodes can become overwhelmed by the number of pathogens which can multiply and cause infection in the lymph node and cancer cells can rapidly multiply and form a secondary tumour in the lymph Describe the differences between cancerous nodes and infected nodes Cancerous Firm, enlarged, non-tender and fixed to underlying structure Infected Soft, enlarged, tender and moveable  Innate Immunity Name the three lines of defence and classify each as either innate (non-specific) or adaptive (specific) defence Skin Defences that aim to Tears First Line prevent Innate Mucus (Non-Specific) microorganisms from Cilia entering the body. Friendly bacteria Defences that help to Phagocytosis eliminate Second Line Inflammation microorganisms that Innate (Non-Specific) Fever have penetrated the Antimicrobials body Defences that eliminate specific microorganisms that Third Line Antibodies have penetrated the Adaptive (Specific) Antigens body and protect the host against future attack Name the cells involved in phagocytosis and briefly describe the function of phagocytosis Neutrophils, Monocytes & Macrophages State the overall functions of inflammation Destroy the microbe (and its by-products) Prevent the spread of the microbe (fibrin wall) Clear the site of cellular debris and microbes Repair the damaged tissue Name and describe the three stages of inflammation 1. Vasodilation and increased permeability of blood vessels. 2. Phagocyte migration to the damaged tissue and phagocytosis of bacteria and cellular debris. 3. Tissue repair. Describe the role of fever in the inflammatory response Fever is the most important systemic response to body injury. Fever results when pyrogens trigger the hypothalamic thermostat to reset at a higher than usual temperature. Pyrogens include toxins and microbial components that are released by the phagocytosis of bacteria. Discuss the implications of treating a fever (what situations would you treat and why wouldn’t you treat) Benefits Complications Rising temperature slows the rate of Tachycardia – risk for older people and bacterial growth those with cardiac disease Increases the rate of reaction in the Increased metabolic rate can lead to body meaning defence mechanisms are acidosis faster Free iron is bound to transferrin and Dehydration & electrolyte imbalance stored in the liver making it unavailable to bacteria Person feels ill so they rest and have Delirium and coma more energy to fight the infection duration of infection is shorter and Seizures in young children tissue repair is enhanced Death if fever reaches 44-46 degrees. Define immunity and name the cells involved in adaptive immunity Immunity is the capacity of the immune system to successfully defend the body against a potentially infectious agent. Lymphocytes play a central role in adaptive immunity and the two types of lymphocytes are: T lymphocytes (T cells) and B lymphocytes (B cells) Both types of lymphocyte originate from stem cells in the bone marrow. Name & describe the two categories of adaptive immunity Category Antibody Mediated Cell Mediated Cell B Cells T Cells How they provide immunity They proliferate and produce T cells bind to the infected cells plasma cells that make (containing viruses, bacteria or antibodies cancer) and destroy them Location Circulate in the blood and body Lymphoid tissues and mucosal fluid sites Describe the primary & secondary immune response & the importance of the secondary response Name the classes of antibodies and give one example of the clinical significance for each (e.g. IgM, last a short time therefore presence of these indicates a very recent or current exposure to the antigen) IgG 80% of all antibodies in serum Protects against bacteria, toxins and viruses Triggers complement response Enhances Phagocytosis Can cross the placenta Longest lasting of all antibodies IgA 10-15% of antibodies in blood Most common antibody in secretions Found in mucus, saliva, tears, breast milk. Binds antigens before they invade the tissues IgM 5-10% of all antibodies First type to be produced when antigen encountered Lasts only a short time IgE Tiny amounts only Binds to mast cells and basophils that release histamine Involved in allergic reactions Plays a role in immunity to gut parasitic infections Describe the role of major histocompatibility complex (MHC) To prevent the immune system from attacking our own cells we have proteins on the surface of our cells which identify us as self. They are unique to an individual These proteins are the major histocompatibility complex (MHC) proteins All our cells (except RBC) have thousands of MHC protein surface markers built into the cell membrane. Following an organ transplant the donor MHC proteins are recognised & destroyed by the recipient’s immune system. So immunosuppressant drugs are given for life. Name the four types of acquired immunity & describe how immunity is achieved for each type Natural, active immunity Individual is exposed to the microbe Immune response is initiated Can cause the disease or cause a sub-clinical infection Immunity may be lifelong (chickenpox & measles) Natural, passive immunity IgG antibodies are passed from mother to baby across the placenta IgA antibodies are passed from mother to baby via breast milk Artificial, active immunity Vaccination The body produces antibodies, B and T cells in response to being deliberately exposed to a known antigen in order to create an immune response without causing the disease Artificial, passive immunity Injection of pre-formed antibodies from someone who is already immune Immediate but short-term protection Name the four different types of vaccines 1. Live, attenuated – the microbe is alive but the virulence is eliminated (lifelong immunity) e.g. MMR 2. Inactivated (Killed microbe) – as above but need boosters e.g. Influenza 3. Subunit vaccines – the vaccine only contains part of the pathogen instead of the whole thing and several boosters needed e.g. Hib, Pneumococcal 4. Toxoids – Produce antitoxins (antibodies that inactivate toxins) several boosters needed e.g. DTaP Explain why a booster vaccine might be needed Describe the concept of herd immunity List the undesirable responses of the immune system Hypersensitivity Reaction Autoimmune Disorder Immuno-compromised patient Attack against transplanted or foreign tissues (including blood) Chronic Inflammation Describe the age-related changes to the immune system Newborn immunity is educated and strengthens during encounters with bacteria and microbes – excessive antibiotic and antibacterial use can prevent normal development. With older age people are more susceptible to infection and malignancy, reduced response to vaccines, increased production of auto-antibodies and antibody levels do not increase as rapidly in response to an antigen.  Antimicrobial therapy Define selective toxicity The ability to kill a microbe without causing harm to the patient – achieved by targeting a structure of the pathogen which is different to humans. Define the terms bactericidal & bacteriostatic Bactericidal = directly kills the bacteria. Bacteriostatic = inhibits the growth of bacteria which then enables the body’s defences to remove the bacteria. Describe the difference between broad spectrum and narrow spectrum antibiotics, and explain the advantages & disadvantages of each Broad Kills a wide range of gram Can be given when positive and gram- treatment is required negative bacteria but also before identification of the destroys normal flora causative organism Narrow Only effective against a Targeted treatment for select group of pathogens known infection List four ways that antimicrobials work 1. Interfere with cell wall synthesis 2. Interfere with DNA replication 3. Inhibit protein synthesis 4. Interrupt metabolic reactions inside the cell Explain the term antibiotic resistance & give one example of an infection that is resistant The acquired ability of a microbe to resist the effects of an antimicrobial agent to which it is normally susceptible. MRSA, ESBL, VRE, PRSP. Describe three ways to reduce antibiotic resistance Avoiding inappropriate prescribing of antimicrobials Completing full courses of antibiotics in order to discourage survival and proliferation of resistant strains. Prescription of the most specific antibiotic available and avoidance of broad- spectrum antibiotics.