Anaphy Finals Anatomy & Physiology PDF

ANATOMY & PHYSIOLOGY LEC / PROF. BERNARD S. BARRANCO, RN, MAN ______________________________________________________________________________________________________________ FINALS OUTLINE...

ANATOMY & PHYSIOLOGY LEC / PROF. BERNARD S. BARRANCO, RN, MAN ______________________________________________________________________________________________________________ FINALS OUTLINE ➔ Secretes mucus to lubricate the eye. Lacrimal Apparatus I. Special Senses ○ Lacrimal gland - produces lacrimal fluid II. The Cardiovascular System ○ Lacrimal canals - drains lacrimal fluid. III. The Respiratory System Lacrimal sac IV. The Digestive System ➔ provides passage of lacrimal fluid towards nasal V. The Lymphatic cavity. VI. The Renal System Nasoclacrimal duct VII. The Reproductive system ➔ Empties lacrimal fluid into the nasal cavity. VIII. The Endrocine System IX. References C. Function of the Lacrimal Apparatus X. Trans Authorship Properties of Lacrimal Fluid Dilute salt solution (tears) SPECIAL SENSES Contains antibodies Developmental Aspects of the Special Senses 1. Fight antigens- foreign substance Formed early in embryonic development 2. Lysozyme (enzyme that destroys bacteria) Eyes are out growths of the brain Protects, moistens, and lubricates the eye All special senses are functional at birth Empties into the nasal cavity A. The Senses D. Extrinsic Eye Muscles General senses of touch (Tactile) Muscles attach to the outer surface of the eye Temperature - thermoreceptors (heat) Produce eye movements Pressure - mechanoreceptors (movement) Pain - mechanoreceptors When Extrinsic Muscles Contract…. Superior oblique = eyes look out and down Special Senses Superior rectus = eyes looks up Smell - chemoreceptors (chemicals) Lateral rectus = eyes look outward Taste - chemoreceptors Medial rectus = eyes look inward Sight - photoreceptors (light) Inferior rectus = eyes looks down Hearing - mechanoreceptors Inferior oblique = eyes look in and up Equilibrium - (balance) mechanoreceptors E. Structure of the Eye The Eye and Vision 70 percent of all sensory receptors are in the eyes Each eye has over a million nerve fibers Protection for the Eye Most of the eye is enclosed in a bony orbit: 1. Lacrimal (medial) 2. Ethmoid (posterior) 3. Sphenoid (lateral) 4. Frontal (superior) 5. Zygomatic and maxilla (inferior) Note: A cushion of fat surrounds most of the eye The wall is composed of three tunics: 1. Fibrous tunic - outside layer. B. Accessory Structures of the Eye 2. Choroid - middle layer Eyelids 3. Sensory tunic - inside layer ➔ brush particles out of eye or cover eye. Eyelashes ➔ trap particles and keep them out of the eye. Conjunctiva ➔ Membrane that lines the eyeliids ➔ Connects to the surface of the eye– forms a seal. BSN1-A | 1  2. Iris- pigmented layer that gives eye color (contracts to adjust the size of the pupil- regulates entry of light into the eye) Pupil – rounded opening in the iris F. The Fibrous Tunic H. Sensory Tunic (Retina) Sclera Contains receptor cells (photoreceptors) ○ Rods ○ Cones White connective tissue layer Signals leave the retina toward the brain through the optic Seen anteriorly as the “white of the eye” nerve Semi-transparent Signals pass from photoreceptors via a two neuron chain ○ Bipolar neurons and Ganglion cells Cornea Visual Pigment a. Rhodopsin – visual purple, in high concentration in RODS ○ Composed of opsin and retinal (a derivative of vitamin Transparent, central anterior portion A) protein. Allows for light to pass through (refracts, or bends, light ○ When light hits the protein it “bleaches”- turns yellow slightly) and then colorless. It straightens out and breaks down Repairs itself easily into opsin and retinal. The only human tissue that can be transplanted without fear of rejection I. Neurons of the Retina and Vision Rods G. Choroid Layer ○ Most are found towards the edges of the retina ○ Allow dim light vision and peripheral vision (more sensitive to light, do not respond in bright light) ○ Perception is all in gray tones Cones ○ Allow for detailed color vision ○ Densest in the center of the retina ○ Fovea centralis – area of the retina with only cones ○ Respond best in bright light No photoreceptor cells are at the optic disk or blind spot Blood-rich nutritive tunic Pigment prevents light from scattering (opaque- blocks light from getting in, has melanin) Modified interiorly into two structures 1. Ciliary body – smooth muscle (contracts to adjust the shape of the lens) BSN1-A | 2  Ishihara Chart J. Cone Sensitivity There are three types of cones N. Lens Different cones are sensitive to different wavelengths Biconvex crystal like structure ○ red - long Held in place by a suspensory ligament attached to the ○ green - medium ciliary body ○ blue - short Refracts light greatly Color blindness is the result of lack of one or more cone type O. Internal Eye Chamber Fluids Aqueous humor Watery fluid found in chamber between the lens and cornea K. How do we see colors? Similar to blood plasma To see any color, the brain must compare the input from Helps maintain intraocular pressure different kinds of cone cells – and then make other Provides nutrients for the lens and cornea comparisons as well. Reabsorbed into venous blood through the canal of The lightning-fast work of judging a color begins in the Schlemm retina, which has three layers of cells. Signals from the red and green cones in the first layer are compared by specialized red-green “opponent” cells in the second layer. These opponents' cells compute the balance between red and green light coming from a particular part of the visual field. Other opponent cells then compare signals from blue cones with the combined signals from red and green cones. L. Colorblindness An inherited trait that is transferred on the sex chromosomes (23rd pair) - sex-linked trait. Comes from a lack of one or more types of color receptors. Occurs more often in males. Most are green or red or both and that is due to lack of red receptors. Vitreous humor Another possibility is to have the color receptors missing Gel-like substance behind the lens entirely, which would result in black and white vision. Keeps the eye from collapsing M. Colorblindness Test Plates BSN1-A | 3  Lasts a lifetime and is not replaced P. Lens Accomodation Light must be focused to a point on the retina for optimal vision. S. Images Formed on the Retina The eye is set for distance vision (over 20 feet away) Blind Spot 20/20 vision - at 20 feet, you see what a normal eye would If the image is focused at the spot where the optic disk is see at 20 feet (20/100 - at 20, normal person would see at located, nothing will be seen 100) There are no photoreceptors – nerves and blood vessels The lens must change shape to focus for closer objects pass through this point. T. Visual Pathway Photoreceptors of the retina Optic Nerve Optic nerve crosses at the optic chiasma Optic tracts Thalamus (axons from optic radiation) Visual cortex of the occipital lobe Q. Myopia Nearsightedness, or myopia is the difficulty of seeing objects at a distance. ○ Myopia occurs when the eyeball is slightly longer than usual from front to back. ○ This causes light rays to focus at a point in front of the retina, rather than directly on its surface. ○ Concave lenses are used to correct the U. Eye Reflexes Internal muscles are controlled by the autonomic nervous system ○ Bright light causes pupils to constrict through action of radial (iris) ciliary muscles ○ Viewing close objects causes accomodation External muscles control eye movement to follow objects – voluntary, controlled at the frontal eye field R. Hyperopia Viewing close objects causes convergence (eyes moving medially) Hyperopia (farsightedness) Light entering the eye focuses behind the retina. SENSE OF HEARING Hyperoptic eyes are shorter than normal. Hyperopia is treated using a convex lens. A. The Ear Houses two senses ○ Hearing (interpreted in the auditory cortex of the temporal lobe) ○ Equilibrium (balance) (interpreted in the cerebellum) BSN1-A | 4  Receptors are mechanoreceptors Different organs house receptors for each sense Auricle Helps collect sound waves traveling through the air and directs them into the external acoustic meatus. B. Anatomy of the Ear The ear is divided into three areas ○ Outer (external) ear ○ Middle ear ○ Inner Vibrations from eardrum move the malleus These bones transfer sound to the inner ear E. Inner Ear or Bony Labyrinth Also known as osseous labyrinth- twisted bony tubes C. The External Ear Includes sense organs for hearing and balance Involved in hearing only Filled with perilymph Structures of the external ear ○ Pinna (auricle)- collects sound ○ External auditory canal- channels sound inward The External Auditory Canal Narrow chamber in the temporal bone- through the external auditory meatus Lined with skin Ceruminous (wax) glands are present Ends at the tympanic membrane (eardrum) D. The Middle Ear or Tympanic Cavity Air-filled cavity within the temporal bone Only involved in the sense of hearing Two tubes are associated with the inner ear ○ The opening from the auditory canal is covered by the Vibrations of the stapes push and pull on the membranous tympanic membrane (eardrum) oval window, moving the perilymph through the cochlea ○ The auditory tube connecting the middle ear with the The round window is a membrane at the opposite end to throat (Eustacian tube) relieve pressure. Allows for equalizing pressure during yawning or swallowing This tube is otherwise collapsed Bones of the Tympanic Cavity Three bones span the cavity ○ Malleus (hammer) ○ Incus (anvil) ○ Stapes (stirrip) A maze of bony chambers within the temporal bone ○ Cochlea ○ Scala Vestibuli - upper chamber ○ Scala Tympani - lower chamber ○ Vestibule ○ Semicircular canals BSN1-A | 5  F. Organ of Corti Located within the cochlea Receptors = hair cells on the basilar membrane Gel-like tectorial membrane is capable of bending hair cells Endolymph in the membranous labyrinth of the cochlear duct flows over it and pushes on the membrane) Cochlear nerve attached to hair cells transmits nerve impulses to auditory cortex on temporal lobe G. Mechanisms of Hearing Vibrations from sound waves move tectorial membrane (pass through the endolymph fluid filling the membranous labyrinth in the cochlear duct) Hair cells are bent by the membrane An action potential starts in the cochlear nerve The signal is transmitted to the midbrain (for auditory reflexes and then directed to the auditory cortex of the temporal lobe) Continued stimulation can lead to adaptation (over stimulation to the brain makes it stop interpreting the sounds) H. Organs of Equilibrium Receptor cells are in two structures ○ Vestibule ○ Semicircular canals I. Chemical Senses - Taste and Smell Equilibrium has two functional parts Both senses use chemoreceptors ○ Static equilibrium- in the vestibule ○ Stimulated by chemicals in solution ○ Dynamic equilibrium- in the semicircular canals ○ Taste has four types of receptors ○ Smell can differentiate a large range of chemicals Static Equilibrium Both senses complement each other and respond to many Maculae – receptors in the vestibule of the same stimuli ○ Report on the position of the head ○ Send information via the vestibular nerve J. Olfaction - The Sense of Smell Anatomy of the maculae: Olfactory receptors are in the roof of the nasal cavity ○ Hair cells are embedded in the otolithic membrane Neurons with long cilia ○ Otoliths (tiny stones) float in a gel around the hair Chemicals must be dissolved in mucus for detection cells Impulses are transmitted via the olfactory nerve Function of Maculae: Interpretation of smells is made in the cortex (olfactory ○ Movements cause otoliths to bend the hair cells area of temporal lobe) (gravity moves the “rocks” over and pulls the hairs) K. The Sense of Taste Dynamic Equilibrium Taste buds house the receptor organs Whole structure is the ampulla Location of taste buds Crista ampullaris – receptors in the semicircular canals ○ Most are on the tongue ○ Tuft of hair cells ○ Soft palate ○ Cupula (gelatinous cap) ○ Cheeks Action of angular head movements L. The Tongue and Taste ○ The cupula stimulates the hair cells The tongue is covered with projections called papillae ○ Movement of endolymph pushes the cupula over and ○ Filiform papillae – sharp with no taste buds pulls the hairs ○ Fungifiorm papillae – rounded with taste buds ○ An impulse is sent via the vestibular nerve to the ○ Circumvallate papillae – large papillae with taste buds cerebellum Taste buds are found on the sides of papillae ○ M. The Structure of Taste Buds Gustatory cells are the receptors Have gustatory hairs (long microvilli) Hairs are stimulated by chemicals dissolved in saliva Impulses are carried to the gustatory complex (pareital lobe) by several cranial nerves because taste buds are found in different areas ○ Facial nerve BSN1-A | 6  ○ Glossopharyngeal nerve THE CARDIOVASCULAR SYSTEM ○ Vagus nerve The cardiovascular system is a closed system of the heart Sweet receptors and blood vessels. ○ Sugars ○ The heart pumps blood into blood vessels ○ Saccharine ○ Blood vessels circulate the blood to all parts of the ○ Some amino acids body, to ALL cells. Sour receptors Functions: ○ Acids ○ to deliver oxygen and nutrients to all body cells, Bitter receptors ○ transport enzymes and hormones, and ○ Alkaloids ○ to remove carbon dioxide and other waste products Salty receptors from the cells. ○ Metal ions Umami ○ Glutamate, Heart ○ aspartate (MSG, meats) The long axis is directed obliquely, leftward, downward, and forward. Size of adult’s fist, weight < 1 pound Adult heart ➔ 12 cm long from its base at the beginning root of the aorta to the left ventricular apex. ➔ 8 to 9 cm wide transversely. ➔ 6 cm thick anteroposteriorly. MALE HEART 0.43% of body weight 280 to 350 g, with an average of 300 g FEMALE HEART 0.40% of body weight 230 to 300 g, with an average of 250g A. Location of the Heart The heart is medial to the lungs, posterior to the sternum, anterior to the vertebral column, and superior to the diaphragm. Its distal end, the apex, points to the left, terminating at the level of the 5th intercostal space. BSN1-A | 7  B. Positions of the Heart Pericardial Layers of the Heart Anterior View Heart Wall Epicardium (visceral pericardium ➔ outside layer of connective tissue on the surface of the heart. Inferior View Myocardium ➔ thick wall of cardiac muscle. C. Coverings of the Heart Endocardium Pericardium (Pericardial sac) ➔ inner epithelial & connective tissue lining of heart and valves. 1. Fibrous pericardium - sac made of tough connective tissue 2. Double-layered serous membrane (Serous pericardium): a. Parietal Pericardium - lines the interior of the fibrous pericardium. b. Visceral pericardium (epicardium) ➔ covers the heart ➔ It is part of the heart wall. ➔ the innermost layer of the pericardium and the outermost layer of the heart wall. NOTE: Serous fluid fills the pericardial cavity between parietal & visceral layers Fibrous Skeleton of the Heart Functions: 1. Structure support - firm base of the heart valves and openings of great vessels. 2. It anchors the cardiac muscle. BSN1-A | 8  3. An electrical insulator. Chambers of the Heart Atrium (R & L)—receive blood Heart Chambers – Internal each atria extends into a smaller, external chamber called 1. Interatrial septum – wall that separates atria an auricle 2. Pectinate muscles – internal ridges of myocardium in Ventricle (R & L)—inferior to the atria; expel blood out of right atrium and both auricles (absorber) the heart 3. Interventricular septum – wall that separates ventricles 4. Trabeculae carneae – internal ridges in both ventricles D. Chambers of the Heart (absorber) ATRIUM (R&L) receive blood each atria extends into a smaller, external chamber called an auricle. VENTRICLE (R&L) inferior to the atria; expel blood out of the heart Note: The chambers on the left are separated from the chambers on the right by a septum (wall of cardiac muscle) interatrial septum interventricular septum. ○ interatrial septum ○ interventricular septum E. Myocardial Thickness and Function Thickness of myocardium varies according to the function of the chamber Atria are thin walled, deliver blood to adjacent ventricles Ventricle walls are much thicker and stronger ○ right ventricle supplies blood to the lungs (little flow resistance) ○ left ventricle wall is the thickest to supply systemic circulation Thickness of Cardiac Walls BSN1-A | 9  ★ Myocardium of the left ventricle is much thicker than F. Heart Valves the right. GENERAL FUNCTIONS: When a chamber wall contracts blood is pumped through a valve. D. Developmental Aspects of the Heart Any backflow increases pressure on the cusps and closes Fetal heart structures that bypass pulmonary circulation the valves. ○ Foramen ovale connects the two atria AV valve closes during ventricular contraction; papillary ○ Ductus arteriosus connects pulmonary trunk and the muscles also contract pulling the chordae tendineae which aorta keep the valve cusps from prolapsing into the atrium. Atrial Septal Defect A hole between the two atria. It occurs about 10% of children born with congenital heart defects. Occurs during fetal lifed when partitioning process (during the formation of the heart chambers) does not occurs completely, leaving an opening in the interatrial septum. ASD is large or moderately large then it will allow a large amount of blood to pass through the opening into the right heart and the right ventricle and lungs will become overworked, and symptoms may be noted Symptoms ○ Delayed weight gain and poor growth ○ Child tires easily, especially when playing ○ Fatigue ○ Excessive sweating ○ Rapid breathing ○ Poor feeding ○ Shortness of breath ○ Frequent respiratory infections including pneumonia Most children have no symptoms and seem healthy. The mixing of blood through the ASD produces an overload of blood in the right heart (Usually well tolerated) Some of the atrial septal defects, if small enough, may become smaller with time and even close spontaneously. ➔ Semilunar Valves Prevent backflow of blood into the ventricles ➔ Aortic semilunar valve lies between the left ventricle and the aorta. ➔ Pulmonary semilunar valve lies between the right ventricle and pulmonary trunk NOTE: The valve cusps are held in place by chordae tendineae (“heart strings”) which originate from papillary muscles protruding from the inside of the ventricle wall Examples of Congenital Heart Defects BSN1-A | 10  ATRIOVENTRICULAR (AV) VALVES between each atrium and ventricle; allow blood flow from 1. Atrial Diastole (Ventricular filling) each atrium down into the ventricle AV valves open through ATRIA into the VENTRICLES ○ bicuspid/mitral valve (left side) Semilunar valves close ○ tricuspid valve (right side) 2. Atrial Systole Ventricle remains in diastole Atria contracts, forcing blood into the ventricles 3. Isovolumetric contraction Atrial systole ends, ventricular systole begins AV closes, preventing backflow of blood into the atria 4. Ventricular Systole (Ejection phase) Atrial systole ends, ventricular systole begins AV closes, preventing backflow of blood into the atria 5. Isovolumetric relaxation Ventricular diastole begins Semilunar valves closes to prevent backflow into the ventricles SEMILUNAR VALVES between ventricle and major heart artery; allow blood flow out of each ventricle through one of the major heart arteries; 3 cusps ○ Pulmonary valve (R ventricle & pulmonary trunk) ○ Aortic valve (L ventricle & aorta) Heartbeat Sound “lub” = when AV valves close “dup” = when semilunar valves close BSN1-A | 11  Coronary Arterial Supply 1. Left coronary artery (LCA) – 2 branches Anterior interventricular branch ➔ supplies blood to interventricular septum and anterior walls of both ventricles Circumflex branch ➔ passes around left side of heart in coronary sulcus, supplies left atrium and posterior wall of left ventricle; it gives off a left marginal branch 2. Right coronary artery (RCA) – 2 branches Right marginal branch ➔ supplies lateral side of R atrium and ventricle Posterior interventricular branch ➔ supplies posterior walls of ventricles Valve Pathology E. Microscopic Anatomy of Heart Muscle Incompetent valve can lead to backflow, heard as a “heart Cardiac muscle is striated, short, fat, branched, and murmur” and repumping (regurgitation) of the same blood interconnected. Stenosis = narrowing of valve increases workload on heart The connective tissue endomysium acts as both tendon and to pump out blood insertion. Treatment: valve repair or replacement Intercalated discs anchor cardiac cells together and allow free passage of ions. E. Paths of Blood Circulation Heart muscle behaves as a functional syncytium Cardiac Muscle Contraction Heart muscle: aorta carries oxygenated blood from the left ventricle to ○ Is stimulated by nerves and is self-excitable (automaticity) upper & lower body ○ Contracts as a unit pulmonary arteries : carries deoxygenated blood from ○ Has a long (250 ms) absolute refractory period right ventricle to lungs Cardiac muscle contraction is similar to skeletal muscle vena cava: carries deoxygenated blood from upper & contraction lower body into right atria pulmonary veins: carry oxygenated blood from lungs into Heart Physiology: Intrinsic Conduction System left atria Autorhythmic cells: ○ Initiate action potentials SYSTEMIC CIRCUIT ○ Have unstable resting potentials called pacemaker Q. How long does it take for a RBC to make a roundtrip potentials through the body (via systemic circuit)? ○ Use calcium influx ( rather than sodium) for rising phase ○ The entire blood supply passes through body once of the action potential every minute. CORONARY CIRCUIT The heart has its own network of blood vessels to supply the cardiac muscle cells coronary arteries & veins, capillaries BSN1-A | 12 PACEMAKER AND ACTION POTENTIALS OF THE HEART Heart Excitation Related to ECG P wave: atria depolarize QRS complex: ventricles depolarize T wave: end of the electrical activity in ventricles; repolarization of ventricular muscle. F. Cardiac Conduction System 1. SA (Sinoatrial) node: pacemaker, initiates heartbeat, sets heart rate; where? 2. AV node - electrical gateway to ventricles; where? fibrous skeleton - insulates atria from ventricle 3. AV bundle: pathway for signals from AV node 4. Right and Left bundle branches: divisions of AV bundle that enter interventricular septum. 5. Purkinje fibers - upward from apex spread throughout ventricular myocardium. Pathology of the Conduction System Fibrillation = an irregular & often rapid heart rate; decreases blood flow Tachycardia = more than 100 beats/min Bradycardia = less than 60 beats/min Electrocardiogram (ECG or EKG) Possible causes of atrial fibrillation is a recording of the electrical changes in the myocardium Abnormalities/damage to the heart’s structure due to: during a cardiac cycle ○ High blood pressure or Heart attacks ○ Abnormal heart valves ○ Congenital heart defects (you’re born with) ○ An overactive thyroid gland ○ Stimulants (medications, caffeine, tobacco, alcohol) ○ Improper functioning of SA node ○ Emphysema or other lung diseases ○ Viral infections ○ Stress due to pneumonia, surgery ○ Sleep apnea BSN1-A | 13  G. Cardiac Output THE RESPIRATORY SYSTEM 1. Amount of blood pumped by the ventricle in one minute The respiratory system is comprised of the upper airway and 2. Formula for cardiac output lower airway structures. = (heart rate) x (stroke volume*) The upper respiratory system filters, moisten and warms air *Volume of the blood pumped by a ventricle in one during inspiration. contraction The lower respiratory system enables the exchange of the gases to regulate serum PaO2, PaCO2 and pH. Example: ○ Normal cardiac output Air Passages Nose = (75 beats/min) x (70 mL/beat) 2 nostrils or nares = 5250 ml/min Nasal septum = 5 L/min ○ Divides nose into 2 nasal cavities Lined with mucous membrane with a rich blood supply Functions Cardiac Output (CO) and Reserve ➔ Warms Cardiac Output is the amount of the blood pumped by ➔ Moistens each ventricle in one minute ➔ Filters - CO is the product of the heart rate (HR) and stroke volume (SV) CILIA HR is the number of the heart beats per minute Tiny hair-like structures that help move dirt trapped in SV is the amount of the blood pumped out by a mucous to the esophagus ventricle with each beat. OLFACTORY RECEPTOR Cardiac Reserve is the difference between resting and Receptors for sense of smell maximal CO Regulation of Stroke Volume SV = end diastolic volume (EDV) minus end systolic volume (ESV) ○ EDV = amount of the blood collected in a ventricle during diastole ○ ESV = amount of blood remaining in a ventricle after contraction. LACRIMAL DUCTS Tear ducts Drain tears from the eye into the nose SINUSES Cavities in the skull that surround the nasal area Connected to nasal cavities by short ducts Function – warms and moistens air Lined with mucous membrane Provides resonance for the voice PHARYNX Throat Lies behind the nasal passages 3 sections - Nasopharynx - Oropharynx - Laryngopharynx BSN1-A | 14  LARYNX Voice box SURFACTANT Layers of cartilage Reduces surface pressure and prevents alveoli from - Largest is the thyroid cartilage commonly called the collapsing Adam's apple Contains ○ Vocal cords - Vibrate on exhaled air to produce sound - The tongue and lips act on the sound to produce speech ○ Epiglottis - Flap of cartilage that closes the larynx during swallowing and prevents food and liquids from entering the trachea ALVEOLI One cell thick and surrounded by capillaries Look like a cluster of grapes Allow the exchange of oxygen and carbon dioxide TRACHEA Windpipe Series of “C” shaped cartilage to keep the tube open to the back Divide into the right and left bronchi Continues to divide into smaller bronchioles A. CIRCULATION AND GAS EXCHANGE End in the alveoli Gas exchange at the lungs and in the body cells moves ○ Air sacs oxygen into cells and carbon dioxide out. Result of oxidation in the body tissues, carbon dioxide is produced and must be removed from the cells to prevent the build up of acid waste products. BRONCHIOLES AND ALVEOLI Bronchioles contain submucosal glands, which produce mucus that covers the inside lining of the airways. The bronchi and bronchioles are lined also with cells that have surfaces covered with cilia. These cilia create a constant whipping motion that propels IN THE ALVEOLUS (OXYGEN TRANSPORT) mucus and foreign substances away from the lung toward The respiratory surface is made up of the alveoli and the larynx. capillary walls. The walls of the capillaries and the alveoli may share the same membrane. The oxygen concentration in blood within the capillaries of the lungs is lower than in the lungs’ air sacs (alveoli) BSN1-A | 15  ○ There are two lungs. The left lung has two lobes and one lingula, and it weighs approximately 30 ounces (800 g); the right lung has three lobes and weighs 35 ounces (1,000 g). ○ Both lungs process the same amount of air. ○ In men each lung has a capacity of 3 quarts (3.2 l), and in women, 2 quarts (2.1 l). ○ 30,000 Bronchioles in each lung ○ 350 million ALVEOLI IN EACH LUNG (700 MILLION FOR BOTH) GAS EXCHANGE Air entering the lungs contains more oxygen and less carbon dioxide than the blood that flows in the pulmonary capillaries. PLEURA Covered by a double layer sac called the pleura OXYGEN TRANSPORT Hemoglobin binds to oxygen that diffuses into the bloodstream. DIAPHRAGM Dome-shaped muscle that separates the thoracic cavity from the abdominal cavity CARBON DIOXIDE TRANSPORT Carbon dioxide can dissolve in plasma, and about 70% forms bicarbonate ions. Some carbon dioxide can bind to hemoglobin for transport. Carbon dioxide has a higher concentration in the blood VENTILATION than in the alveoli, diffuses from the blood into the alveoli. Process of breathing Diaphragm ○ Muscle of respiration ○ Assisted by the intercostal muscles Phases of respiration ○ Inspiration Inhale ○ Expiration Exhale PROCESS OF RESPIRATION Controlled by the medulla oblongata in the brain AT THE CELLS An increase in amount of CO2 in the blood ,increases the Cells use up oxygen quickly for cellular respiration. rate of respiration Cells create carbon dioxide during cellular respiration, so Both involuntary and voluntary process CO2 levels in the cell are higher than in the blood coming to them. LUNGS Right lung 3 lobes Left lung 2 lobes due to the heart BSN1-A | 16  Apnea Period of cessation of breathing. Time duration varies; apnea may occur briefly during other breathing disorders (sleep apnea) Life threatening if sustained. B. PHYSIOLOGY Basic gas-exchange unit of the respiratory system is the alveoli. Alveolar stretch receptors respond to inspiration by sending signals to inhibit inspiratory neurons in the brain stem to prevent lung overdistension. During expiration stretch receptors stop sending signals to inspiratory neurons and inspiration is ready to start again. Cheyne-Stokes Oxygen and carbon dioxide are exchanged across the Regular cycle where the rate and depth of breathing alveolar capillary membrane by process of diffusion. increase, then decrease until apnea (usually about 20 Neural control of respirations is located in the medulla. The seconds) occurs. respiratory center in the medulla is stimulated by the concentration of carbon dioxide in the blood. C. BREATHING PATTERNS AND RESPIRATORY RATES EUPNEA Normal, breathing at 12-18 breaths/minute Biot’s respiration Period of normal breathing (3-4 breaths) followed by a varying period of apnea (usually 10 seconds to 1 minute) BRADYPNEA Slower than normal rate (< 10 breaths/minute), with normal depth and regular rhythm D. Breath Sounds Respiratory Auscultation & Percussion TACHYPNEA Rapid, shallow breathing > 24 breaths/minute Respiratory Patterns Hypoventilation ○ Vesicular – Normal Shallow, irregular breathing ○ Quiet – Consolidation, Collapse, or effusion Increased rate and depth of breathing (called Kussmaul’s ○ Polyphonic Wheeze – Asthma, COPD respiration if caused by diabetic Ketoacidosis) ○ Bronchial – Consolidation, Fibrosis ○ Fine Crackles – Pulmonary Fibrosis ○ Coarse Crackles – LRTI, Bronchiectasis, Effusion Duration Intensity Pitch Timing of the breath sounds in the respiratory cycle. E. Adventitious Sounds Affects the bronchial tree and alveoli may produce adventitious (additional) sounds. BSN1-A | 17  Adventitious sounds are divided into two categories: DIGESTIVE SYSTEM discrete, noncontinuous sounds (crackles) and continuous musical sounds (wheezes). A. ESSENTIAL ACTIVITIES OF THE DIGESTIVE SYSTEM Crackles To survive and perform its functions, the body needs Formerly referred to as “rales” are discrete, noncontinuous specific macromolecules (proteins, carbohydrates, and sounds that result from delayed reopening of deflated lipids) as well as water, vitamins, and minerals. airways. The digestive system breaks the macromolecules down Crackles reflect underlying inflammation or congestion and into smaller molecules the body can use are often present in such conditions as pneumonia, Carbohydrates break down from polysaccharides and bronchitis, heart failure, bronchiectasis, and pulmonary disaccharides into monosaccharides (like glucose), lipids fibrosis. break down from triglycerides into fatty acids and glycerol molecules, and proteins break down into amino acids. Wheezes Associated with bronchial wall oscillation and changes in 1. INGESTION airway diameter. ○ Food must be placed in the mouth before it can be Wheezes are commonly heard in patients with asthma, acted on chronic bronchitis, and bronchiectasis. ○ Active, voluntary process 2. PROPULSION / MOTILITY Rhonchi ○ Food must be propelled from one organ to the next Continuous low pitched, rattling lung sounds that often ○ SWALLOWING – food movement resemble snoring. ○ PERISTALSIS – Involuntary ; alternating waves of Obstruction or secretions in larger airways are frequent contraction and relaxation of the muscle in the organ causes of rhonchi. wall. They can be heard in patients with chronic obstructive 3. FOOD BREAKDOWN (Mechanical digestion)/ pulmonary disease (COPD), bronchiectasis, pneumonia, \SECRETION chronic bronchitis, or cystic fibrosis. ○ Prepares food for further degradation by enzymes by Rhonchi usually clear after coughing. physical fragmenting into small particles ○ Mixing of food in the mouth by the tongue , “Churning” of food in the stomach and segmentation Pleural Friction Rub ○ SEGMENTATION ( small intestine); moves food back Loud grating sound, generally throughout both phases of and forth across the internal wall of the organ respiration, and almost always is associated with pleuritis 4. FOOD BREAKDOWN / DIGESTION (Chemical digestion) (inflamed pleura rubbing on one another). ○ Large molecules are broken down to building block by The presence of a chest tube inserted into the pleural enzyme space also may cause a sound similar to a pleural rub. ○ Building block found in diet 1. Glucose – sugar 2. Fructose – abundant sugar in fruits 3. Galactose – found in milk 5. ABSORPTION (Small intestines) ○ Transport of digested end product from the lumen of the GI tract to the blood or lymph ○ Digested food must enter the mucosal cells by active or passive transport 6. 6. ELIMINATION / DEFECATION ○ Elimination of the “indigestible” residue from the GI tract via the anus ROLES OF MUSCLES The muscular system plays a key role in digestion. Peristalsis is the name for the involuntary muscle movements that keep food moving through your intestines. BSN1-A | 18  Ring-like muscles called sphincters serve as “gates” TONGUE between different parts of the digestive system. Muscle movements in the digestive system are controlled by the enteric nervous system (ENS), a part of the autonomic nervous system (ANS). B. MAIN GROUPS OF THE GASTROINTESTINAL TRACT ALIMENTARY CANAL ➔ Called as the GASTROINTESTINAL TRACT ➔ Continuous, coiled, hollow muscular tube that winds through the ventral cavity. ➔ Open on both end. ➔ CADAVER - Approximately 9 meters (30 feet) ➔ continuously mixes food with saliva during chewing and Includes: Oral cavity, pharynx, esophagus, stomach, initiates swallowing. small intestine, large intestine, and anus. ➔ Bony attachment: a. Hyoid bone b. Styloid process of the skull ACCESSORY DIGESTIVE ORGANS Papillae – found on the tongue surface that ➔ The accessory digestive organs (salivary glands, liver, contains taste buds or taste receptors. gallbladder, and pancreas) work in conjunction with the GI tract. STRUCTURE OF TASTE BUDS ➔ The teeth and tongue allow us to mechanically break down and swallow our food. C. ORGANS OF THE ALIMENTARY CANAL MOUTH Gustatory cells are the receptors ○ Have gustatory hairs (long microvilli) ○ Hairs are stimulated by chemicals dissolved in saliva Impulses are carried to the gustatory complex (parietal lobe) by several cranial nerves because taste buds are ➔ Called as the ORAL CAVITY (mucous membrane-lined found in different areas. cavity) ○ Facial nerve 1. Lips (labia) – protects the anterior opening ○ Glossopharyngeal nerve 2. Cheeks – forms the lateral wall ○ Vagus nerve 3. Hard palate – forms the anterior roof 4. Soft palate – forms the posterior roof 5. Uvula – fleshy fingerlike projection of the soft palate 6. Tongue – occupies the floor of the mouth 7. Lingual frenulum – fold of mucous membrane that secure the tongue to the floor of the mouth TASTE SENSATION ○ Sweet receptors Sugars Saccharine Some amino acids BSN1-A | 19  ○ Sour receptors It also contains an enzyme called pepsin, which helps with Acids the breakdown (digestion) of proteins. ○ Bitter receptors Ingested nutrients typically spend two to six hours in the Alkaloids stomach ○ Salty receptors Note: Acid reflux (gastroesophageal reflux or heartburn) Metal ions occurs when acid from the stomach escapes back up into ○ Umami the esophagus. \ Glutamate, aspartate (MSG, meats) LINGUAL FRENULUM Limits the posterior movement of tongue VILLUS Note: Small, fingerlike projection of the epithelial lining of the ○ “Tongue tied” - children with extremely short lingual intestinal wall frenulum Its role is to increase surface area and aid in the ○ movement of the tongue is limited leading to distorted absorption of nutrients and fluids. speech. The walls of the small intestine are covered in villi and microvilli (villi found in the cell membrane). PHARYNX Intestinal villi absorb nutrients from chyme (a mix of gastric Subdivided into: juices and partially-digested food from the stomach, as 1. NASOPHARYNX - respiratory passageway well as digestive enzymes from the liver and pancreas) 2. OROPHARYNX - posterior to the oral cavity through columnar epithelial cells of the mucosa (innermost 3. LARYNGOPHARYNX - continuous with the layer of the small intestine where chyme passes through esophagus the villus), called enterocytes. Note: The core of each villus, amino acids and sugars enter the ○ From mouth food passes through posteriorly the bloodstream via a dense capillary network, whereas OROPHARYNX and LARYNGOPHARYNX (common digested lipids enter the lymphatic system via a lymphatic passageway of food, fluids and air) capillary called a lacteal. Walls contain two (2) SKELETAL muscle layer Note: Intestinal villi are largest in the duodenum, ranging 1. Inner layer - runs longitudinally from.5 to 1.6 mm in length. 2. Outer layer - constrictor muscle Note: ○ Alternating contraction of these two muscle layers propels food going to the esophagus PHARYNX AND ESOPHAGUS Pharyngeal phase of swallowing (involuntary) ○ Oropharynx, the soft palate, and uvula close off the nasopharynx, starting the swallowing reflex. Esophageal phase (involuntary) ○ Muscle contractions in the esophagus take the bolus to the stomach. ○ This takes five to eight seconds. Note: The transition from the pharynx to the esophagus takes only one second. SMALL INTESTINES STOMACH About seven meters long, within the abdominal activity Bolus (masticated food + saliva) is mixed with gastric The mucosa that lines the inside of the small intestine is juice to form chyme. covered with numerous villi (sing.villus) that maximize the The stomach’s interior is extremely acidic. surface area for absorption. BSN1-A | 20  Secretions from the accessory glands further the JEJUNUM breakdown of macromolecules. The products of this breakdown are absorbed along with vitamins , minerals, and water. Blood vessels in the walls of the small intestine carry absorbed nutrients to the liver via the hepatic portal vein. Chyme moves from the stomach into the small intestine,where it spends about 12 hours. Small intestine has three (3) sections: ○ DUODENUM ○ JEJUNUM ○ ILEUM Note: Absorptive surface area is actually about 250 square Middle portion of the small intestine. meters (almost 2,700 square feet - tennis court) It is approximately 2.5 m long with a diameter of about 4 cm. Defined as the upper two-fifths of the remaining small intestine. The jejunum is thicker, darker in color, and more vascular than the ileum (the third segment of the small intestine) Large circular folds of submucosa called plicae circulares. The jejunum is attached to the posterior abdominal wall by the mesentery (extensive fold of the peritoneum) that allows free motion. Each coil can adapt to changes in form and position. ILIUM THREE SECTIONS OF THE SMALL INTESTINE DUODENUM The longest segment of the small intestine at about 3.5 m long, and is defined as the lower three-fifths of the remaining small intestine. The walls of the ileum are thinner and less vascular than those of the jejunum. The duodenum is the first segment of the small intestine, Its few plicae circulares are small and disappear gradually. where the absorption of nutrients begins. The terminal part of the ileum usually lies in the pelvis and Short and wide— (25cm long) comes to an end at the ileocecal sphincter, which acts as Role: Receive chyme. a valve to prevent backflow of material from the cecum. Chyme passes from the stomach into the duodenum The cecum is located at the beginning of the large through the pyloric sphincter. intestine, the site of the final steps of nutrient absorption Bile from the liver and pancreatic juices from the pancreas and the first stages of turning liquid waste into solid waste. mix where the pancreatic duct and common bile duct The mesentery anchors the ileum to the posterior converge. abdominal wall while allowing the coils of the ileum to Then pass into the duodenal papilla when the sphincter of move freely, as it does for the jejunum. Oddi is relaxed to aid in chemical digestion and to reduce acidity of the gastric juices. BSN1-A | 21 MESENTERY b. Secretion c. Absorption. ➔ The mucosa contains many circular folds and is covered in millions of villi. LARGE INTESTINE Attached to the small intestine. It is an extensive fold of peritoneum that supplies the small intestine with blood vessels, lymphatic vessels, and nerves and allows free motion so that each intestinal coil can adapt to changes in form and position. move freely, as it does for the jejunum. The small intestine empties into the large intestine (colon), LAYERS OF THE SMALL INTESTINE where the remainder of absorption of water, electrolytes, and vitamins occurs. The remaining undigested food is converted into a solid called feces, which moves through the large intestine and the rectum and is ultimately eliminated (leaves the body) through the anus. APPENDIX SEROSA ➔ The outermost layer of the small intestine which is continuous with the mesentery. ➔ It contains blood vessels and nerves, and it secretes fluid to lubricate the small intestine, protecting it from damage due to friction. Attached to the cecum is a tiny organ called the appendix. LONGITUDINAL MUSCLE LAYER Serving as a reservoir for gut bacteria. ➔ Located under the serosa Research has also shown that the appendix plays a role ➔ This muscle, in conjunction with the circular muscle, in the immune system in adults and the endocrine system contracts in peristaltic waves, moving food through in embryos. the intestines. If it becomes infected, the appendix is usually removed. ➔ The longitudinal muscle shortens the tract to facilitate Like the gallbladder and tonsils, many people live without the movement of chyme, while the circular muscle it. prevents chyme from traveling backwards. SUBMUCOSA D. ACCESSORY DIGESTIVE ORGANS ➔ composed of dense connective tissue to support the The accessory digestive organs (salivary glands, liver, mucosa and connect it to the muscular layers. gallbladder, and pancreas) work in conjunction with the GI ➔ It also contains blood vessels, lymphatic vessels, and tract. nerves to supply the mucosa. The teeth and tongue allow us to mechanically break MUSCULARIS MUCOSAE down and swallow our food. ➔ which comprises several thin layers of smooth muscle. ➔ It gently stimulates the mucosa and intestinal glands, helping to expel chyme and enhancing contact between mucosa and chyme in the lumen. MUCOSA ➔ the innermost layer; it surrounds the lumen through which the chyme passes. ➔ It has three principal functions: a. Protection of the inner environment, BSN1-A | 22  The peritoneal cavity is the fluid-filled space between the LIVER parietal and visceral peritoneum. This fluid allows the organs of the abdominal and pelvic cavities to move past one another smoothly Main digestive function of the liver is to produce bile Aids in the mechanical digestion of lipids in the small intestine, allowing for more efficient chemical digestion of triglycerides. GALL BLADDER The gallbladder stores, concentrates, and releases bile that the liver produces. You can live without a gallbladder. Cholecystectomy (gallbladder removal) is a common surgical procedure for patients with painful gallstones. PANCREAS The pancreas has exocrine and endocrine cells. The endocrine cells produce and secrete hormones such as insulin, which helps regulate blood glucose levels, and glucagon, which helps the liver convert glycogen to glucose. The exocrine cells produce digestive enzymes in a pancreatic juice to assist with digestive activities for proteins, carbohydrates, and fats PERITONIUM Serous membrane composed of mesothelium and connective tissues that lines the abdominal and pelvic cavities and surrounds the abdominal organs. It has two layers: a. Parietal peritoneum ➔ attached to the walls of the abdomen and pelvis b. Visceral peritoneum ➔ which covers the internal organs. BSN1-A | 23  plasma contains more protein molecules because THE LYMPHATIC SYSTEM these protein molecules are too big to fill out the capillary wall. 3 primary functions I. OVERVIEW - Drains excess interstitial fluid Immunity - Transports dietary lipids o Body’s defense and protection - Carries out immune responses Pathogens o Microbes (bacteria and viruses) that have the potential to COMPONENTS OF THE LYMPHATIC SYSTEM produce disease. 2 types of Immunity o Innate - Non-specific, present at birth o Adaptive - Specific response to a specific microbe, T cells, and B cells. A. ORIGIN, DEVELOPMENT & STRUCTURE OF BLOOD CELLS LYMPHATIC VESSELS AND LYMPH CIRCULATION Lymphatic Capillaries ❖ Closed at one end and located in spaces between cells - Cells overlap - Form lymphatic vessels Lymphatic Vessels ❖ Similar in structure to veins - Contains lymph nodes - Drains into a right lymphatic duct or thoracic duct Lymph Nodes ❖ Contains T cells and B cells - Filters lymph Pluripotent Stem Cell LYMPHATIC CAPILLARIES - Origin of all of your blood cells. Note how cells overlap, so if there is an excess of fluid outside - It either becomes a myeloid stem cell or your lymphoid it will go inside the capillary. However, if there is fluid already stem cell. occupying the inside of the capillary the cells tighten. - B. LYMPHATIC SYSTEM Lymph Lymphatic vessels Lymphatic organs Red Bone Marrow Lymphatic tissue - A specialized form of reticular connective tissue that contains a large number of lymphocytes. Most components of blood plasma from your blood capillaries filter out to form the interstitial fluid. Interstitial Fluid - Is the fluid that surrounds the cells of body tissues. LYMPH CIRCULATION - After the interstitial fluid passes into lymphatic vessels Thoracic Duct so which will include your lymphatic capillaries into your bigger vessel it is eventually called lymph. ❖ Junction of the left internal jugular and left subclavian Lymph: clear fluid veins. - So both the interstitial fluid and the lymph are chemically similar to blood plasma. However, blood  - Main lymph-collecting duct, receives lymph from the 600 bean-shaped nodes located along lymphatic left side of the head, neck, and chest; the left upper vessels limb; and the entire body below the ribs. Mammary glands, axillae, groin Right Lymphatic Duct Trap particles in reticular fibers ❖ Junction of the right internal jugular and right Macrophages and lymphocytes subclavian veins. ▪ Drain lymph from the upper right side of the body There are two pumps that aid in the return of venous blood to the heart. Respiratory Pump - The lymph flow is maintained by pressure changes that occur during inhalation. So when you breathe in the lymph flows from the abdominal region where the pressure is higher towards the thoracic region because of the expansion of your lungs. When the pressure reverses during exhalation the valves prevent the backflow of lymph. Skeletal Muscle Pump SPLEEN - Creates a milking action of the skeletal muscle Largest single mass of lymphatic tissue in the body contraction. The milking action forces the lymph Between the stomach and diaphragm; covered by a towards the subclavian veins due to the compression capsule of dense connective tissue of the vessels. This is similar to the return of venous White Pulp blood to the heart. ❖ Lymphatic tissue, consisting mostly of lymphocytes RELATIONSHIP OF LYMPHATIC VESSELS AND LYMPH and macrophages. NODES TO THE CARDIOVASCULAR SYSTEM - B and T cells: immune responses - Macrophages: phagocytosis Red Pulp ❖ Blood-filled venous sinuses and cords of splenic tissue consisting of red blood cells, macrophages, lymphocytes, plasma cells, and granular leukocytes. - (1) removal by macrophages of worn-out or defective blood cells and platelets - (2) storage of platelets, perhaps up to one-third of the body’s supply - (3) production of blood cells (hemopoiesis) during fetal life. LYMPHATIC NODULES Egg-shaped masses of lymphoid tissue. Gastrointestinal, urinary, reproductive tracts, and respiratory airways. Tonsils in the pharyngeal region and aggregated lymphatic follicles (Peyerʼs patches) in the ileum of the small intestine. Five tonsils - Pharyngeal tonsil or adenoid - Two palatine tonsils LYMPHATIC ORGANS AND TISSUES - Two lingual tonsils Primary Lymphatic Organs ❖ Sites wherein stem cells differentiate into T and B cells INNATE IMMUNITY - Red bone marrow First Line of Defense - Thymus ❖ Skin and mucous membranes Secondary Lymphatic Organs - Physical and chemical barriers ❖ Sites where most immune responses occur ❖ Epidermis - Lymph nodes - Epithelial layer of skin, physical barrier; removes - Spleen microbes via shedding - Lymphatic nodules o Mucous Membranes - Traps microbes via mucous THYMUS o Lacrimal apparatus 2 lobed; posterior to the sternum, medial to lungs, - Produces tears, lysozyme superior to the heart o Saliva Primary lymphoid organ for maturation of T cells - Oral cavity T cells, dendritic cells, epithelial cells, macrophages - Flow of urine, vaginal secretions, defecation and T cells (via blood) → lymph nodes, spleen, lymphatic vomiting. tissues o Chemical Barrier LYMPH NODES - Sebum, perspiration, gastric juice Second Line of Defense  - Internal antimicrobial substances - Phagocytes - Natural killer cells - Inflammation - Fever ANTIMICROBIAL SUBSTANCES Interferons - From lymphocytes, macrophages and fibroblasts - Interferes with viral replication Complement system - Normally inactive proteins in blood plasma and on plasma membranes - Stimulates cytolysis, chemotaxis, and opsonization FEVER Iron-binding proteins Abnormally high body temperature - Reduces the amount of available iron Occurs during infection and inflammation - Transferrin, lactoferrin, ferritin, hemoglobin Interleukin 1 from macrophages Antimicrobial proteins - Fever causing substances - short peptides that have a broad spectrum of Intensifies the effects of interferons, inhibits the growth antimicrobial activity of some microbes, and speeds up body reactions that - Dermicidin (produced by sweat glands), defensins and aid repair cathelicidins (produced by neutrophils, macrophages, SUMMARY OF INNATE DEFENSE and epithelia), and thrombocidin (produced by platelets) - Attract dendritic cells and mast cells PHAGOCYTES Phagocytes Specialized cells that perform phagocytosis (the ingestion of microbes or other particles such as cellular debris) ❖ Neutrophils ❖ Macrophages: from monocytes - Wandering macrophages: migrate to infected areas - Fixed macrophages: remain in certain locations, including the skin and subcutaneous layer, liver, lungs, brain, spleen, lymph nodes, and red bone marrow NATURAL KILLER CELLS 5-10% of lymphocytes in the blood ADAPTIVE IMMUNITY Have the ability to kill a wide variety of microbes and Specific types of cells or specific antibodies that destroy a certain tumor cells particular antigen Cellular destruction by releasing proteins that destroy Antigen the target cellʼs membrane - Any substance, such as microbes, foods, drugs, pollen, Spleen, lymph nodes, and red bone marrow or tissue that the immune system recognizes as foreign INFLAMMATION Immunology Nonspecific defensive response of the body to tissue damage - Branch of science that deals with the responses of the Four signs and symptoms of inflammation: body to antigens - Redness Immune system - Pain - Cells and tissues that carry out immune responses - Heat Self-tolerance - Swelling - Lack of reaction against self-tissues - (Sometimes) loss of function Histamine → Increased permeability and vasodilation Increased permeability → leakage → fibrin traps MATURATION OF THE T CELLS AND B CELLS microbes B cells and T cells Emigration of phagocytes Pus formation ❖ Lymphocytes - Collection of dead cells and fluids - Both develop in primary lymphatic organs (red bone marrow and the thymus) from stem cells that originate in red bone marrow ADAPTIVE IMMUNITY: ORIGIN OF B CELLS AND PRE-T CELLS FROM STEM CELLS IN RED BONE MARROW  - IgG, IgA, IgM, IgD, and IgE - Neutralize antigens, immobilize bacteria, agglutinate antigens, activate complement, and enhance phagocytosis. STRUCTURE OF AN ANTIBODY AND RELATIONSHIP FROM ANTIGEN TO ANTIBODY TYPES OF ADAPTIVE IMMUNITY Cell-mediated immunity CLASSES OF IMMUNOGLOBINS ❖ Cytotoxic T cells directly attack invading antigens - Cells attacking cells - Intracellular pathogens (viruses, bacteria, or fungi that are inside cells); some cancer cells; foreign tissue transplants Antibody mediated immunity ❖ B cells transform into plasma cells, which synthesize and secrete specific proteins called antibodies - Humoral immunity CLONIAL SELECTION: THE PRINCIPLE Clonal selection ❖ Process by which a lymphocyte proliferates and differentiates in response to a specific antigen - Occurs in secondary lymphatic organs - Clone of cells → effector cells and memory cells Effector cells ❖ Destruction or inactivation of the antigen - Active helper T cells - Active cytotoxic T cells PROCESSING AND PRESENTING AGENTS - Plasma cells Recognition that an antigen is present Memory Cells