Blood, Lymphatic System and Immune System

dr. Sri Lestari Sulistyo Rini, MSc

I. Function

A. Transport

• nutrients

• oxygen/carbon dioxide

• waste

B. Maintaining Homeostasis

• hormones

C. Protection

• immune system

II. Composition of blood

A. Plasma

• 91% water

• 9% suspended material

Proteins:

Albumin – most abundant ->water regulation

Globulins – transport steroid hormones

Fibrinogen – formation of clots

B. Formed elements

Derived from hemocytoblast stem cells

1. Erythrocytes (RBC)

• transports gases

• 1/3 volume hemoglobin

• Production:

Erythropoietin from Kidney (liver)

Red bone marrow

Iron required

• RBC cycle

120 days

Damaged RBC – liver and spleen

Macrophages

• Hemoglobin breakdown

Heme (iron) globin (protein)

Heme

Iron Biliverdin

Bone marrow

liver Bilirubin – bile pigment

2. Leukocytes (WBC)

no hemoglobin/has nucleus

immune response

hormones: interleukins and colony-stimulating (CSF)

a. Neutrophils

• granulocyte

• most numerous

• phagocytic cells (lysosomes)

b. Eosinophils

• granulocyte

• 1-3%

• control inflammatory & allergic response

c. Basophils

• granulocyte

• least common

• histamine (inflammatory) / heparin (prevents clots)

DARAH Eritrosit Leukosit

1. Granulosit Neutrofil Eosinofil Basofil

2. Agranulosit Limfosit Monosit

Trombosit (platelet)

d. Monocytes

• agranulocyte

• largest WBC

• after 3 days -> macrophages

• phagocytes with lysosomes

• ingests larger objects than Neutrophils

e. Lymphocytes

• agranulocyte

• cells of the immune system

• B cells (antibodies) / T cells immune response

3. Platelets (Thrombocytes)

• fragments of megakaryocytes

• hormone: thrombopioetin

• blood clotting/ mend blood vessels

C. Hemostasis

1. Platelet plug

• platelets bind to damaged vessel wall

• release chemical for more platelets

• platelets release serotonin (constriction)

2. Blood clot

• damaged vessel releases Thromboplastin

trombosit –- terpapar kolagen Adhenosin diphospat (ADP) dan tromboxan trombosit agregrasi di daerah luka

Proses pembentukan protombin : jalur instrinsik dan ekstrinsik

protombin menjadi trombin trombin mengubah fibrinogen fibrin

Retraksi bekuan –- luka menutupPlasminogen plasmin ---fibrinolisis

• Thromboplastin w/ platelets & calcium

Prothrombin Thrombin

• Thrombin acts on fibrinogen (in plasma)

fibrin threads

• fibrin threads create mesh

III Human blood groups

A. ABO blood type

1. Antigens (proteins) on RBC

2. Antibodies against other antigens

B. Rh blood type

1. Antigens on RBC

• Rh positive – has antigens

• Rh negative – no antigens

2. Antibodies against Rh

• Rh negative individual – antibodies after Rh+ encounter

3. Pregnancy

• Rh neg w/Rh+ fetus

• blood from fetus -> into mother’s blood

• 2nd pregnancy w/Rh+ fetus -> antibodies attack

Functions of the Immune System The function of the immune system

Protect the entire body from a variety of harmful substances.

Combining form: IMMUN/o immune,

protected and safe

Functions of the Lymphatic System Three primary functions:

Return excess lymph (interstitial) fluid to the blood.

Absorb fats and fat soluble vitamins from the digestive system and transport them to the cells.

Functions as part of the immune system to defend the body against foreign organisms.

Structures of the Immune System Immune system is not contained with in

a single organ or vessel Immune system depends on structures

from Lymphatic system Cardiovascular system Integumentary system

Structures of the Lymphatic System

Major structures of the lymphatic system:• Lymph vessels Lymph nodes• Lymph fluid Tonsils• Adenoids Spleen• Thymus Lymphocytes

Lymphatic System Lymph Fluid

intercellular Lymph Vessels

Lymph Capillaries > Lymph vessels Right lymphatic duct & Thoracic Duct Lacteals

Lymph Capillaries and Lymph Vessels Lymph Capillaries: thin walled tubes that

carry lymph from the tissue spaces to the larger lymphatic vessels.

Lymphatic Vessels: Have valves to prevent the backward

flow of fluid Lymph always flows toward the

thoracic cavity.

Lymph Fluid Clear, colorless tissue fluid that leaves the

capillaries and flows in the tissue spaces between cells.

Lymph fluid brings nutrients and hormones to the cells.

Carries waste products from these tissues pH 7,00

limfe mengalir dari cairan interstitial melalui pembuluh limfe thoracic duct right lymph duct

Berakhir di vena subclavia limfe masuk dalam darah ductus limphaticus kanan bagian kanan dari thoraks, leher dan kepala, sisanya Ductus thoracicus.Limfe membawa lemak dan vitamin yang larut dalam lemak absorbsi dari traktus gastrointestinal

Lymph Nodes

3 functions of the lymph nodes Produce lymph cells (lymphocytes) Filter lymph and trap substances from

inflammatory and cancerous lesions. Macrophages: located in lymph nodes can

engulf and destroy foreign substances.

Lymphatic System

•Cervical

•Axillary

•Inguinal

Major Lymph Node Sites

Cervical lymph nodes: located in the neck (CERVIC/o neck)

Axillary lymph nodes: located under the arms. (AXILL/o armpit)

Inguinal lymph nodes: located in the groin area of the lower abdomen. (INGUIN/o groin)

Appendix & Peyer’s patches: specialized lymph nodes located in the intestines.

The secondary lymphoid organs can be sub-divided into the Systemic (***) and Mucosal immune systems

NALT

BALT

GALT

RALT

Mucosal

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Tonsils and Adenoids

Tonsils and Adenoids: masses of lymphatic tissue that form a protective ring around the nose and upper throat.

Pharyngeal tonsil

Spleen Saclike mass of lymphatic tissue Produces lymphocytes and monocytes Filters microorganisms and other foreign

material from the blood. Stores red blood cells Maintains appropriate balance between

cells and plasma in the body

Immune System Defense

First Line of Defense Skin (Intact) free of cuts,

scrapes, or open sores. Skin is a physical barrier to prevent

entry of invading organisms

Immune System Defense Respiratory system is also a

primary line of defense foreign matter that is breathed in is

trapped by cilia (nose hairs) mucus secreted continually flushes

away foreign matter. Coughing and sneezing removes matter

also.

Immune System Defense Digestive system has a protective

function also. Destroys bacteria and other

invaders that are accidentally allowed or consumed with food.

Figure 8-42

Surface barrier / mucosal immunity

- Sekret dari lapisan kulit yang asam pH <7,0

- Saliva, air mata, sekret hidung yang mengandung lisozim

- Cairan lambung yang asam 0,9< pH > 3,0 dan enzim pencerna protein.

 

Antigen-Antibody Reactions Antigen: any substance such as a virus,

bacterium, or toxin that the body regards as foreign. Antigens stimulate the production to antibodies.

Antibodies: is a disease fighting protein developed by the body in response to the presence of a specific antigen.

Antigen – Antibody Reaction

The antigen – antibody reaction is also known as the Immune Reaction.

Binding antigens to antibodies to form antigen antibody complexes that render the toxic antigen harmless.

Lymphocytes Major class of white blood cells that

specialize so they can attack specific microorganisms.

3 types of lymphocytes Monocytes: Macrophage Histocytes

Monocytes

Lymphocyte formed in the bone marrow Transported to other parts of the body Become macrophages

Macrophages

• Type of lymphocyte• Protects the body by ingesting the

invading cells.

Histocytes

Large macrophages Found in loose connective tissue Two major types

T-Cells B-Cells

B Cells / Produced in bone marrow. Designed to make a specific antibody

against a specific antigen

Plasma Cells

(antibody specifically coded to match one antigen)- Effective against most free floating agents

B Cells or B lymphocytes

>Plasma Cells> secrete antibodiImmunoglobulin

Immunoglobulin MImmunoglobulin GImmunoglobulin AImmunoglobulin EImmunoglobulin D

Complement Series of complex proteins occurring

in normal serum. In an antigen - antibody reaction

complement aids phagocytes in the destruction of antigens.

LYSIS: destruction of a cells by penetrating the cell wall, allowing fluid in, causing the cell ruptures.

T Cells T cells are small, circulating

lymphocytes Produced in bone marrow T-cells live for years Primary function is to coordinate

immune defense and kill. Responsible for graft rejections.

Types of T Cells Helper T cell: secrete substances that

stimulate the production of antibodies by B cells.

Suppressor T cell: stops B-cell activity when this activity is no longer needed.

Memory T cell: remembers specific antigen and stimulate a faster and more intense response if the antigen returns.

T Cells or T lymphocytes Interferon Lymphokines Macrophage Phagocyte

Interferon Produced by T-cells Family of proteins released by cells

when invaded by a virus. Interferon induces non-infected cells

to form an antiviral protein that slow or stops the viral multiplication.

Lymphokines

Chemicals produced by the T cells Direct the immune response between

cells. Attract macrophages to the site

T lymphocytes become CD4+ or helper T cells, or they can become CD8+ cells, which in turn can become killer T cells, also called cytotoxic T cells.

Immune System in Action

Stage One viruses invade body to invade

cells and replicate. Macrophages eat invading viruses helper T cells activated.

Immune System in Action Stage Two

Helper T cells multiple Helper T cells attract complement

to the areas Helper T stimulate multiplication B

cells B cells start producing antibodies

Immune System in Action Step Three

Complement proteins break open cells invaded by the virus and spill the viral content

Antibodies produced by the B cells inactivate the viruses.

Immune System in Action Stage Four

Suppressor T cells halt the immune response

B-cells remain ready in case the same virus invades again

Immunity

Natural Immunity Acquired Immunity / Artificial

Immunity

Natural Immunity Natural Passive Immunity: passed from

mother to child before birth or immediately after birth through breast milk

Natural Active Immunity: Obtain by the development of antibodies during an attach of an infectious disease. (Example: chicken pox.)

Acquired Immunity

Artificial Active Immunity: process of artificially acquiring immunity through vaccination. (Immunization)

Artificial Passive Immunity: Acquired by receiving antiserum containing antibodies from another host. (Example: Snake bite)

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