9 blood, lymph, and immune systems classroom activity to accompany medical terminology systems,...

9Blood, Lymph, and

Immune Systems

Classroom Activity to Accompany Medical Terminology Systems, Seventh EditionBarbara A. Gylys ∙ Mary Ellen Wedding

Lecture NotesA PowerPoint PresentationLecture NotesA PowerPoint Presentation

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9 BLOOD, LYMPH, AND IMMUNE SYSTEMS

Structure and Function

•Blood• Composed of formed elements

• Erythrocytes, which transport O2 to cells and remove CO2 from the cells

• Leukocytes, which provide protection against invasion by pathogens and aid in the healing process

• Platelets, which provide a mechanism for blood clotting

• Formed elements suspended in a liquid called plasma

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BLOOD, LYMPH, AND IMMUNE SYSTEMS9

Structure and Function Exercise

1. What are the three main formed elements in blood?

2. What are the main functions of leukocytes?

3. What is the main function of platelets (thrombocytes)?

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1. What are the three main formed elements in blood? Erythrocytes, leukocytes, and platelets or thrombocytes

2. What are the main functions of leukocytes?Provide body defense against infection and aid in tissue repair

3. What is the main function of platelets (thrombocytes)? Provide a blood clotting mechanism when injuries cause bleeding

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Combining Forms Exercise

List the CFs for: 1. blood:2. cell:3. red:4. white:

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1. blood: hem/o, hemat/o2. cell: cyt/o3. red: erythr/o4. white: leuk/o

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5. blood clot:

6. Embolus (plug):

7. clumping, gluing:

8. serum:

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5. blood clot: thromb/o

6. Embolus (plug): embol/o

7. clumping, gluing: agglutin/o

8. serum: ser/o

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9. nucleus:

10.iron:

11.swallowing, eating:

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9. nucleus: kary/o, nucle/o

10.iron: sider/o

11.swallowing, eating: phag/o

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Complete the Medical Word Exercise

1. fear of blood (or bleeding): /o/

2. red blood cell: /o/

3. separation, destruction, loosening of a blood clot: /o/lysis

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1. fear of blood (or bleeding): hem/o/phobia

2. red blood cell: erythr/o/cyte

3. separation, destruction, loosening of a blood clot: thromb/o/lysis

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4. large blood cell: /o/

5. formation, production of blood :/o/poiesis

6. standing still of blood: /o/

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4. large blood cell: macr/o/cyte

5. formation, production of blood :hem/o/poiesis or hem/o/poiesis

6. standing still of blood: hem/o/stasis

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Build Medical Words Exercise

1. cells that are white:

2. tumor composed of blood:

3. resembling a thrombus:

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1. cells that are white: leuk/o/cytes

2. tumor composed of blood: hemat/oma

3. resembling a thrombus: thromb/oid

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4. decrease or deficiency of iron:

5. cell that swallows or eats (injests):

6. abnormal condition of a blood clot:

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4. decrease or deficiency of iron: sider/o/penia

5. cell that swallows or eats (injests): phag/o/cyte

6. abnormal condition of a blood clot: thromb/osis

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Structure and Function

•Lymphatic system• Lymph nodes• Lymph vessels and lymph

fluid• Tonsils, thymus, and

spleen

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Structure and Function (continued)

•Lymphatic system (continued)

• Network of vessels that drain excess interstitial fluid from tissue spaces and return it to the blood

• Maintains the cells that defend the body against disease-causing agents, such as bacteria, viruses, and cancerous cells

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1.What is the function of the lymphatic system?

2.How does the lymphatic system maintain fluid balance?

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1.What is the function of the lymphatic system? It helps maintain fluid balance and defends the body against invading microorganisms.

2.How does the lymphatic system maintain fluid balance? It drains excess tissue fluid from interstitial spaces and returns it to the blood.

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List the CFs for:

1.tonsil:

2.neck:

3.thymus:

4.spleen:

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1. tonsil: tonsill/o

2. neck: cervic/o

3. thymus: thym/o

4. spleen: splen/o

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5. lymph vessel:

6. chest:

7. groin:

8. lymph gland (node):

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5. lymph vessel: lymphangi/o

6. chest: thorac/o

7. groin: inguin/o

8. lymph gland (node): lymphaden/o

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9. gland:

10.lymph:

11.vessel (usually blood or lymph):

12.iron:

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9. gland: aden/o

10.lymph: lymph/o

11.vessel (usually blood or lymph): angi/o

12.iron: sider/o

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13. foreign, strange:

14.lymph vessel:

15.swallowing, eating:

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13. foreign, strange: xen/o

14. lymph vessel: lymphangi/o

15. swallowing, eating: phag/o

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1. tumor of the thymus gland: /

2. cell that swallows or eats (ingests):/ /

3. formation or production of lymph:/ /poiesis

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1. tumor of the thymus gland: thym/oma

2. cell that swallows or eats (ingests):phag/o/cyte

3. formation or production of lymph:lymph/o/poiesis

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4. tumor of a lymph vessel: /

5. process of clumping, gluing:/ation

6. study of immunity: / /logy

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4. tumor of a lymph vessel: lymphangi/oma

5. process of clumping, gluing: agglutin/ation

6. study of immunity: immun/o/logy

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1. enlargement of the spleen:

2. formation or production of lymph:

3. inflammation of a lymph gland (node):

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1. enlargement of the spleen: splen/o/megaly

2. formation or production of lymph: lymph/o/poiesis

3. inflammation of a lymph gland (node): lymphaden/itis or lymph/aden/itis

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4. disease of lymph glands:

5. specialist in the study of immunity:

6. tumor of the thymus gland:

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4. disease of lymph glands: lymphaden/o/pathy

5. specialist in the study of immunity: immun/o/logist

6. tumor of the thymus gland: thym/oma

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7. (red) cell that is large:

8. decrease or deficiency in red blood cells:

9. decrease or deficiency in white blood cells:

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7. (red) cell that is large: macr/o/cyte

8. decrease or deficiency in red blood cells: erythr/o/cyt/o/penia or erythr/o/penia

9. decrease or deficiency in white blood cells: leuk/o/cyt/o/penia or leuk/o/penia

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Diseases and Conditions

Iron deficiency anemia•Decrease in RBCs caused by insufficient iron in the diet•Large, central paleness (pallor) in RBCs on microscopic examination •Most common anemia in the U.S.•Common in adolescents and premenopausal women during menses

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Diseases and Conditions (continued)

Iron deficiency anemia (continued)

•Signs and symptoms• Extreme fatigue• Cold hands and feet• Headaches

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Iron deficiency anemia (continued)

•Treatment• Depends on the severity and cause of the

anemia• Oral or parenteral (intramuscular or IV) iron

supplements• Dietary modifications, which are commonly

sufficient to restore lost iron reserves• Red cell transfusions possibly required in elderly

patients

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Pernicious anemia•Caused by inadequate levels of vitamin B12

•Characteristic formation of large, abnormal RBCs

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Pernicious anemia (continued)

•Signs and symptoms• Weakness, nausea, vomiting• Inflammation of nerves (neuritis)• Muscular incoordination• Lightheadedness and impaired memory• Neurological signs and symptoms progress

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Pernicious anemia (continued)

•Treatment• Vitamin B12 injections• Dietary, such as including red meats and liver• Possibly lifelong treatment required

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Sickle cell anemia•Hereditary form of anemia in which RBCs take on an abnormal, crescent shape •Clumping of crescent-shaped RBCs, preventing them from passing through blood vessels•Impaired circulation and chronic organ damage

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Sickle cell anemia (continued)

•Signs and symptoms• Anemia (in all individuals with sickle cell anemia)• Episodic attacks of intense pain (pain crises) in

arms, legs, or abdomen• Jaundice in white of the eye (sclera)• Painful crises possibly triggered by infections,

stress, and extremes in temperature• Clinical manifestations in many body systems

and organs

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Sickle cell anemia (continued)

•Treatment• Analgesics• Adequate hydration• Regular blood transfusions, which are useful

in decreasing the severity of the disease• In severe cases, bone marrow transplant

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Clinically Related Exercise

1. A 15-month-old Lebanese child brought to the ED is crying inconsolably. A specialized blood test revealed crescent-shaped RBCs. This result confirms (pernicious anemia, iron deficiency anemia, sickle cell anemia).

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1. A 15-month-old Lebanese child brought to the ED is crying inconsolably. A specialized blood test revealed crescent-shaped RBCs. This result confirms (pernicious anemia, iron deficiency anemia, sickle cell anemia).

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2. Ms. T. complains of fatigue and headaches and appears pale and listless. She says her periods have been excessively heavy for the last year. A complete blood count shows a low hemoglobin and hematocrit. The differential shows RBCs with a large, central pallor. The tentative diagnosis is (pernicious anemia, iron deficiency anemia, sickle cell anemia).

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2. Ms. T. complains of fatigue and headaches and appears pale and listless. She says her periods have been excessively heavy for the last year. A complete blood count shows a low hemoglobin and hematocrit. The differential shows RBCs with a large, central pallor. The tentative diagnosis is (pernicious anemia, iron deficiency anemia, sickle cell anemia).

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3. Mrs. R. arrives at the clinic with fatigue and impaired muscular function. Her blood tests reveal she has enlarged RBCs. The doctor prescribes injections of vitamin B12 and charts her condition as (leukemia, iron deficiency anemia, pernicious anemia).

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3. Mrs. R. arrives at the clinic with fatigue and impaired muscular function. Her blood tests reveal she has enlarged RBCs. The doctor prescribes injections of vitamin B12 and charts her condition as (leukemia, iron deficiency anemia, pernicious anemia).

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4. Mr. A. is diagnosed with iron deficiency anemia. He is told that there is insufficient iron in his RBCs, causing them to have a very light color, clinically described as (hypochromic, metachromic, hyperchomic).

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4. Mr. A. is diagnosed with iron deficiency anemia. He is told that there is insufficient iron in his RBCs, causing them to have a very light color, clinically described as (hypochromic, metachromic, hyperchomic).

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5. Mrs. J. has been a vegan for 5 years. She complains of tiredness, feeling cold in her feet, and having brittle nails. These symptoms are consistent with (iron deficiency anemia, pernicious anemia, sickle cell anemia).

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5. Mrs. J. has been a vegan for 5 years. She complains of tiredness, feeling cold in her feet, and having brittle nails. These symptoms are consistent with (iron deficiency anemia, pernicious anemia, sickle cell anemia).

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Leukemia•Malignancy of the bone marrow•Proliferation of white blood cells (WBCs) that are unable to carry on their normal function•Crowding out of RBCs and platelets by WBCs, leading to anemia and bruising and bleeding problems•Acute and chronic forms

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Leukemia (continued)

•Signs and symptoms• Splenomegaly, hepatomegaly, and

lymphadenopathy• Fatigue, malaise, easy bruising, and exercise

intolerance• Night sweats and joint pain• Some forms asymptomatic until late in the

disease

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Leukemia (continued)

•Treatment• Depends on the type of leukemia and the

stage of development• Variety of chemotherapeutic agents• Bone marrow transplants

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1. Mrs. K. is diagnosed with leukemia and asks the nurse to explain this disease. How should the nurse respond?

2. Ms. B. complains of fatigue, bruising, and tiring easily during exercise. While examining Ms. B., the physician discovers an enlargement of the liver and charts her Dx as

.

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1. Mrs. K. is diagnosed with leukemia and asks the nurse to explain this disease. How should the nurse respond? It is a malignancy of the blood-forming tissues of the bone marrow.

2. Ms. B. complains of fatigue, bruising, and tiring easily during exercise. While examining Ms. B., the physician discovers an enlargement of the liver and charts her Dx as hepatomegaly.

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3. Mr. Z. is diagnosed with leukemia. His chemotherapy treatment results in a low WBC count. Dr. M. prescribes a unit of blood to decrease the possibility of contracting an infection. This administration of blood is called a blood (collection, purifier, transfusion).

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3. Mr. Z. is diagnosed with leukemia. His chemotherapy treatment results in a low WBC count. Dr. M. prescribes a unit of blood to decrease the possibility of contracting an infection. This administration of blood is called a blood (collection, purifier, transfusion).

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4. Mr. K. suffers from leukemia and presents to the hospital for a bone marrow transplant. Transplantation of bone marrow from a donor is known as a(n) (autologous, cadaveric, homologous) transplant.

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4. Mr. K. suffers from leukemia and presents to the hospital for a bone marrow transplant. Transplantation of bone marrow from a donor is known as a (autologous, cadaveric, homologous) transplant.

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5. Mrs. J.’s past history indicates that she suffers from an autoimmune disease that manifests as a chronic abnormal enlargement of her lymph nodes. The physician charts this disease of the lymph nodes as (adenoid, adenocyst, adenopathy).

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5. Mrs. J.’s past history indicates that she suffers from an autoimmune disease that manifests as a chronic abnormal enlargement of her lymph nodes. The physician charts this disease of the lymph nodes as (adenoid, adenocyst, adenopathy).

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Lymphedema•Abnormal accumulation of fluid within tissues•Especially common in the arms and legs•Possibly caused by injury to the tissue (as in burns) or blockage of the lymph channels•Possibly leading to fibrosis and inflammation of the tissues

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Lymphedema (continued)

•Signs and symptoms• Generalized swelling of an arm or leg that may

occur after surgery when a chain of lymph nodes has been removed

• Most common cause: radical mastectomy with removal of underarm lymph nodes

• Ineffective drainage of tissue fluid, causing edema• Other causes: injury (trauma), radiation therapy,

surgery, skin infections, and tumors

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Lymphedema (continued)

•Treatment• Compression (usually with multilayered

bandages) to limit swelling and promote lymph drainage

• Manual lymph drainage• Elevation of the body part to promote drainage• Range-of-motion exercises

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1. Mrs. P. presents with swelling and excessive accumulation of lymph under her arm after a radical mastectomy. Dr. R. diagnoses this condition as (lymphoma, lymphomegaly, lymphedema).

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1. Mrs. P. presents with swelling and excessive accumulation of lymph under her arm after a radical mastectomy. Dr. R. diagnoses this condition as (lymphoma, lymphomegaly, lymphedema).

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2. Dr. J. detects lymphedema as he examines Mrs. L. after her radical mastectomy. He explains that this condition is due to the excision of her underarm lymph nodes, which prevents drainage of lymph fluid. The term for excision of lymph nodes is (adenectomy, lymphectomy, lymphadenectomy).

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2. Dr. J. detects lymphedema as he examines Mrs. L. after her radical mastectomy. He explains that this condition is due to the excision of her underarm lymph nodes, which prevents drainage of lymph fluid. The term for excision of lymph nodes is (adenectomy, lymphectomy, lymphadenectomy).

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3. Mr. S. presents with a large, painful node in his groin. The doctor believes a lymphatic blockage exists and orders an x-ray of the lymph gland. This diagnostic procedure is called (lymphadenotomy, lymphadenorrhaphy, lymphadenography).

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3. Mr. S. presents with a large, painful node in his groin. The doctor believes a lymphatic blockage exists and orders an x-ray of the lymph gland. This diagnostic procedure is called (lymphadenotomy, lymphadenorrhaphy, lymphadenography).

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4. Ms. D. was scratched on the arm by her new kitten. Three days later a large lump appeared under her arm. After examination, the doctor diagnosed cat-scratch fever with a resulting inflammation of the lymph gland. The doctor charted this diagnosis as (lymphadenopathy, lymphadenitis, lymphocele).

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4. Ms. D. was scratched on the arm by her new kitten. Three days later a large lump appeared under her arm. After examination, the doctor diagnosed cat-scratch fever with a resulting inflammation of the lymph gland. The doctor charted this diagnosis as (lymphadenopathy, lymphadenitis, lymphocele).

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Kaposi Sarcoma•Malignancy of connective tissue that causes purple, red, or brown patches to form under the skin and mucous membranes

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Kaposi Sarcoma (continued)

•Lesions that generally appear on the legs and spread to the face, neck, back, and mouth•Possible invasion of internal organs, including the lungs, intestines, and liver•Closely associated with HIV infection and considered an “AIDS-defining condition”

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•Signs and symptoms• Purple, red, or brown patches on the skin or

mucous membranes• Weight loss due to pain caused by eating when

lesions are in the mouth or throat• Dyspnea when found in the lungs• Appearance first on lower extremities but

spreading to upper body, face, mucous membranes of the throat, and internal organs

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•Treatment• Depends on stage of infection and degree of

metastasis• Commonly radiation therapy, chemotherapy,

surgery, and immunotherapy• Palliative treatment and good oral hygiene

(essential)

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1. Mr. C. is diagnosed with Kaposi sarcoma and asks the doctor to explain the disease. How should the doctor respond?

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1. Mr. C. is diagnosed with Kaposi sarcoma and asks the doctor to explain the disease. How should the doctor respond? It’s a malignancy of connective tissues, especially of the skin, mucous membranes, and lymph vessel lining that is usually associated with HIV.

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2. Mr. M. is scheduled for a treatment that administers natural immune substances produced in a laboratory to destroy cancer cells. This type of treatment is charted as (hormone therapy, chemotherapy, immunotherapy).

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2. Mr. M. is scheduled for a treatment that administers natural immune substances produced in a laboratory to destroy cancer cells. This type of treatment is charted as (hormone therapy, chemotherapy, immunotherapy).

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3. Mr. Z. has a history of HIV and presents with purplish brown papules on both arms and legs. The doctor suspects he has a CA that is associated with AIDS. This type of cancer is known as Kaposi .

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3. Mr. Z. has a history of HIV and presents with purplish brown papules on both arms and legs. The doctor suspects he has a CA that is associated with AIDS. This type of cancer is known as Kaposi sarcoma.

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4. Mrs. R. is a recent liver transplant patient. The doctor prescribes drugs to prevent her transplanted liver from being rejected by her body. The drugs she is taking to suppress her immune system and prevent organ rejection are known as (hormone therapy, chemotherapy, immunosuppressives).

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4. Mrs. R. is a recent liver transplant patient. The doctor prescribes drugs to prevent her transplanted liver from being rejected by her body. The drugs she is taking to suppress her immune system and prevent organ rejection are known as (hormone therapy, chemotherapy, immunosuppressives).

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Systemic Lupus Erythematosus •Autoimmune disease•Development of antibodiesthat attack the skin, joints,and other organs of the body•Mild to life-threatening disease•Pattern of “flares” and remissions •More common in women

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Systemic Lupus Erythematosus (continued)

•Signs and symptoms• Fatigue, joint pain, anemia• Abnormal blood clotting and

edema• Butterfly-shaped rash over the

nose and cheeks

• Sensitivity to light and sun

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Systemic Lupus Erythematosus (continued)

•Treatment• Anti-inflammatories• Corticosteroids• Antimalarials• Immunosuppressives• Anticoagulants

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Thrombocytopenia•Deficiency in the number of circulating platelets•Most common cause of hemorrhagic disorders•Serious threat to hemostasis because of the vital role that platelets play in coagulation

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Thrombocytopenia (continued)

•Signs and symptoms• Bruising• Bleeding from the nose and

gums• Prolonged bleeding after

injury or dental procedures• Petechiae on the skin (as shown in the

illustration)

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Thrombocytopenia (continued)

•Treatment• Treatment of the underlying cause of the platelet

deficiency• Whole blood transfusions• Packed red blood cell transfusions• Platelet transfusions

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Vocabulary Challenge Exercise

1. antibody (immunoglobulin):

2. antigen:

3. ascites:

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1. antibody (immunoglobulin): protein produced by B cells that protects against substances that are potentially harmful to the body

2. antigen: substance recognized by the immune system that will elicit the production of antibodies

3. ascites: accumulation of serous fluid in the thoracic or abdominopelvic cavity

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4. ecchymosis:

5. petechiae:

6. titer:

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4. ecchymosis: purple, irregularly formed hemorrhagic area under the skin; also called bruise

5. petechiae: small, pinpoint hemorrhages under the skin

6. titer: blood test that measures the amount of antibodies in blood; commonly used as an indicator of immune status

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Medical and Surgical Procedures

•Blood transfusion• Whole blood, blood cells, or plasma given by

intravenous transfusion• Complete correction of blood loss

• Two types• Autologous

• Homologous

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Medical and Surgical Procedures (continued)

•Bone marrow transplant• Aspiration of red bone marrow from the hip bone

of a matched donor• Destruction of all cancerous cells with

chemotherapy or radiation (which destroys all cells in the red bone marrow)

• Transfusion of donated bone marrow cells, which travel through the blood to the bones and implant

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Medical and Surgical Procedures (continued)

•Lymphangiectomy• Excision of one or more pathological lymph

vessels• Treatment for cancer

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1. Mr. B. undergoes diagnostic tests that confirm he has a tumor composed of lymphatic vessels. The tumor must be excised. The physician charts excision of lymphatic vessels as .

2. Mr. A. is diagnosed with leukemia and referred to a specialist. The physician who specializes in treatment of blood disorders is called a .

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1. Mr. B. undergoes diagnostic tests that confirm he has a tumor composed of lymphatic vessels. The tumor must be excised. The physician charts excision of lymphatic vessels as lymphangiectomy.

2. Mr. A. is diagnosed with leukemia and referred to a specialist. The physician who specializes in treatment of blood disorders is called a hematologist.

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3. Mr. J. is diagnosed with leukemia. His physician recommends chemotherapy and bone marrow radiation followed by replacement of healthy bone marrow cells, a treatment called (bone marrow transplant, bone marrow aspiration, bone marrow biopsy).

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3. Mr. J. is diagnosed with leukemia. His physician recommends chemotherapy and bone marrow radiation followed by replacement of healthy bone marrow cells, a treatment called (bone marrow transplant, bone marrow aspiration, bone marrow biopsy).

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4. Mr. D. has several enlarged nodes in his neck. To confirm his diagnosis, the physician orders removal of a small sample of tissue for laboratory evaluation. This procedure is known as a(n) (biopsy, ablation, resection).

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4. Mr. D. has several enlarged nodes in his neck. To confirm his diagnosis, the physician orders removal of a small sample of tissue for laboratory evaluation. This procedure is known as a(n) (biopsy, ablation, resection).

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Diagnostic Procedures•Bone marrow aspiration

• Withdrawal of bone marrow for microscopic evaluation (usually from pelvic bone or, rarely, the sternum)

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Diagnostic Procedures (continued)

•Complete blood count (CBC)•Hemoglobin (Hgb)•Hematocrit (Hct)•Tissue typing

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1. process of recording lymph vessel(s):

2. process of recording lymph gland(s):

3. study of serum:

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1. process of recording lymph vessel(s): lymph/angi/o/graphy or lymphangi/o/graphy

2. process of recording lymph gland(s): lymph/aden/o/graphy or lymphaden/o/graphy

3. study of serum: ser/o/logy

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Pharmacology

•Anticoagulants•Immunizations•Immunosuppressants•Thrombolytics

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1. Mr. G. is diagnosed with a thrombus. To dissolve the blood clot the physician prescribes a(n) (immunization, immunosuppressant, thrombolytic).

2. To prevent the formation of a postsurgical blood clot, the physician prescribes a(n) (anticoagulant, immunization, immunosuppressant).

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1. Mr. G. is diagnosed with a thrombus. To dissolve the blood clot the physician prescribes a (immunization, immunosuppressant, thrombolytic).

2. To prevent the formation of a postsurgical blood clot, the physician prescribes an (anticoagulant, immunization, immunosuppressant).

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3. To prevent rejection of Mr. K.’s recently transplanted kidney, the physician prescribes a(n) (anticoagulant, immunosuppressant, thrombolytic).

4. AMA recommends vaccinations to induce immunity to certain infectious diseases. These vaccinations are known as (anticoagulants, immunizations, immunosuppressants).

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3. To prevent rejection of Mr. K.’s recently transplanted kidney, the physician prescribes an (anticoagulant, immunosuppressant, thrombolytic).

4. AMA recommends vaccinations to induce immunity to certain infectious diseases. These vaccinations are known as (anticoagulants, immunizations, immunosuppressants).

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9 blood, lymph, and immune systems classroom activity to accompany medical terminology systems,...

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