chapter 22-25 exam physio

• Names and functions of different white blood cells

  • Neutrophils - attack bacteria
  • Lymphocytes - specific immunity
  • Monocytes - become macrophages
  • Eosinophils - attack parasites
  • Basophils - inflammation
• Names and functions of different types of lymphocytes

  • T-cells: cell-mediated immunity, made in thymus
  • Cytotoxic Tc - do the killing
  • Helper Th - secrete factor to proliferate cytotoxic cells
  • Suppressor Ts - kick in after infection
  • B-cells: antibody mediated immunity, make antibodies, develop into plasma cells
  • NK cells: natural killer cells, immune surveillance
  • Memory T cells - can easily become Tc and Th cells to quickly take care of pathogen
• NK Cells

  • If a cell is cancerous or infected it will have different proteins on its surface, NK cells will notice this and reorient their Golgi apparatus to create an immune synapse, secrete perforin to create a hole in the cells and break it open. They have a protective measure in their own cell membrane to keep the perforin from affecting itself
  • They respond much more quickly and have a wider range they can affect than B or T cells
• Interferons


  • Small proteins released by macrophages or activated lymphocytes, that interfere with viral replication inside the cell
• Complement System


  • Complement proteins that complete the action of antibodies
  • Attracts phagocytes
  • Stimulates phagocytosis
  • Destroy plasma membrane
  • Promotes inflammation
• Fever


  • Activated by pyrogens acting on hypothalamus (temperature regulating center), can be activated by toxin themselves (exogenous) or by released macrophages (endogenous) this stimulates metabolism and raises your body temperature
• Inflammation


  • Mast cells secrete a Histamine that increases blood flow that brings basophils=inflammation the more blood makes it red and warmer
  • Additional pathogens are kept from entering
  • Spread is slowed
• Active immunity


  Requires exposure: natural, getting a disease and building antibodies or vaccination, creates memory cells
• Passive immunity


  Receives protection from another source, e.g. breast milk or placenta, also immunotherapy, temporary
• Class 1 Major Histocompatibility Complex (MHC)


  • Expressed by all cells, in membrane, bind and display antigens, present to Tc and Ts cells, "I'm infected kill me" activates cell mediated immunity, the T cell then activates and leads to destruction of the non-self
• Class 2 Major Histocompatibility Complex (MHC)


  • Expressed by antigen presenting cells, macrophages and dendritic cells, present antigens to Th, "this is no good, get rid of this", present to pattern recognition receptors
• T cell activation


  1. Tc have random cell surface recognizer, self is eliminated, non-self goes into blood, need costimulation

  2. CD8 Tc, activated by exposure to antigen bound to MHC 1, the activation causes more Tc cells to proliferate and go find more of the same antigen and bind and get rid of it, killing does not happen till next bound cell

  3. CD4 Th, activated by antigen binding to MHC 2, they then divide to produce more helper and memory Th cells that secrete cytokines and stimulate cell-mediated cells (Tc) and antibody mediated (B cells)
• Covid-19 vaccine

  • It puts a little of the virus into you, active immunity, body makes memory cells and antibodies to recognize it easy in the future
  • RNA vaccine, spike protein is now copied and presented to helper T cell
• B cell activation

  Every B cell has its own antibody that can bind to a certain antigen, when it is bound a process called sensitization occurs, during sensitization, the antigen enter the B cell through endocytosis, then it presents on the surface of the B cell that is bound to a class 2 MHC, "stand by", once a T cell with the same antigen is activated, then it can activate and secrete cytokines that can promote B cell activation and stimulation, then B cells become plasma cells that secrete large amount of antibodies
• IgG antibody


  • Y shaped, 2 branches with a binding site, two heavy chains/light chains (variable regions, depend on what antigen you are binding), tail has complement binding site to kill cell, macrophage binding site (opsonization)
• Antibody classes


  • IgD - tail is anchored in cell membrane of B cell
  • IgM - 10 variable domains so it can bind a lot of antigens, but tails are hidden
  • IgG - normal cell
  • IgA - secreted, tails stuck together meaning complement binding domain and macrophage domain are covered, bind to parasites and cover them
  • IgE - constant region has different docking site that can bind to mast cells or basophil and induce inflammation or a rash
• Effects of antibody binding

  • Neutralization: Cover a toxin (IgM and IgG)
  • Precipitation and Agglutination: Clump everything together (IgM IgG)
  • Activation of complement (IgG)
  • Attraction of phagocytes (IgG)
  • Enhancement of phagocytes (IgG)
  • Stimulation of Inflammation (IgE)
  • Prevent adhesion to epithelium (IgA)
• Primary immune response


  Initial immune response, takes time because the appropriate B cells have to activate, sensitization, and become plasma cells, IgMs are first to appear, then IgG, peak at 2 weeks
• Secondary immune response


  Antigen appears a second time, memory cells, B cells can become plasma cells much quicker, more IgG and take care of it faster, last up to 20 years
• Autoimmunity


  • Ignores self, targets both tissues, makes autoantibodies, bad T cells are not gotten rid of
• Immunodeficiency


  • Immune system fails to develop or is blocked, gene is changed, no B or T cells
• Allergies


  • Inappropriate or excessive immune response, IgA make rash
• Stress


  • Long term stress --> glucocorticoids from zona fasciculata in adrenal medulla, they will reduce your immune system
• Structures of the respiratory system


  • Nasal cavity
  • Pharynx
  • Larynx
  • Trachea
  • Bronchi
  • Bronchioles
  • Alveoli
  • Ribs
  • Diaphragm
• Cells in respiratory epithelium

  • Goblet cells - secrete mucous, trap debris
  • Cilia - move mucous
  • Sensory - sense things in epithelium, work with nervous system
  • Stem - homeostasis, injury repair
• Autonomic nervous system regulation of airway muscles


  • Sympathetic - relax, allow more air flow in
  • Parasympathetic - contract, restrict air flow
• Structure and cell types in alveoli

  • Type 1 - simple squamous, do gas exchange
  • Type 2 - secrete surfactant, reduce surface tension
  • Macrophages - look for infection
  • Capillaries - gas exchange
  • Little balloon shaped structures, with sacs and or ducts
• Intrapulmonary pressure


  Force exerted by alveoli, lungs and diaphragm, negative pressure created by pulling diaphragm down and lungs up to pull air in, positive pressure on exhale by allowing lung to collapse
• Intrapleural pressure


  Pressure within pleural cavity, always stays negative, even on the exhale due to recoil of the lungs
• Respiratory volumes

  • Tidal volume - total amount of air you breathe in and out during a single respiratory cycle, average 500 mL
  • Inspiratory reserve - you can breathe in deeper, 3300 mL M 1900 mL W, 10 fold increase
  • Expiratory reserve - Amount of air that you can voluntarily breathe out at the end of a normal cycle, 1000 mL M, 700 mL W
  • Residual volume - Minimal volume, amount of air that would stay in your lungs even if they collapsed, 150 mL dead space
  • Almost 10-fold increase is possible
• O2 and CO2 partial pressures in blood as it passes through the lungs and tissues


  Inhaled air --> blood: blood gets oxygenated and releases CO2, PO2 40--->100, PCO2 45--->40

  Blood --> Tissue: tissues take the oxygen and give CO2, PO2 100--->40, PCO2 40--->45
• Describe the two forms of hemoglobin, How are they affected by O2partial pressure, temperature, 2,3-BPG, and pH

  75% saturation in tissues

  • All or none binding!
  • Taut- tense, oxygen bounces off low affinity(15)
  • Relaxed- Oxygen binds high affinity (75)
  • Left shift = high affinity Right shift = lower affinity
• Factors affecting hemoglobin-oxygen affinity

  Partial pressure - less means less O2 per breath, but exhaling more CO2 which raises pH

  2,3-BPG - body produces more in higher altitude to shift curve to right and allow more O2 release

  Temperature - higher temp, curve to right, drop more oxygen

  pH - lower pH (more acidic) shifts it to the right, muscles working harder and pumping out more CO2
• Fetal hemoglobin


  Has a high affinity, greater left shift, it steals O2 from mom, but the partial pressure is much lower, but it still releases it
• Le Chatelier's principle

  Relates to the reaction of CO2 and water in the respiratory system, produces bicarbonate
• Transport of O2 and CO2 in blood

  • Oxygen - 1.5% dissolved, 98.5% bound to hemoglobin

  CO2 - 7% dissolved, 23% bound to hemoglobin as carbaminohemoglobin, 70% converted to bicarbonate
• O2 and CO2 responses in tissues vs. lungs


  In tissues, O2 will fall off hemoglobin

  In lungs, the reverse happens for CO2 - bicarbonate will enter back into lungs in exchange for chloride, carbonic anhydrase adds back H+ to form CO2 which is then expelled
• Local regulation of breathing

  • Precapillary sphincters open if they need more oxygen

  Lungs: blood vessels dilate if there is extra oxygen, airways dilate if they need more oxygen
• Brainstem structures regulating breathing


  • Medulla: Dorsal, ventral, and pre-Botzinger complex respiratory rhythmic centers

  Pons: two structures
• Other influences on breathing


  • Chemoreceptors in medulla and aortic/carotid bodies sense pH, O2 and CO2

  Higher centers: Cerebral cortex, Limbic system

  Chest Cavity Hering-Breuer reflexes - inhaling deeply will then tell you to exhale