Chapter 19

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Chapter 19
2013-01-23 19:28:50
Inflammation Immune Response

Medical Surgical Nursing
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  1. WBC- normal adult values
  2. Iron level- normal adult values
    60-90 g/100mL
  3. neutrophils
    (aka granulocytes) 55-70% of total WBC count. Increased in acute pus forming infection, decreased in overwhelming bacterial infection (older adult)

    • Growth of a stem cell into a mature neutrophil is 12-14 days.
    • Life span is 12-18 hours.
    • Can only take part in one episode of phagocytosis.
  4. lymphocytes
    20-40%. Increased in chronic bacterial and viral infection, decreased in sepsis
  5. monocytes
    (aka macrophages) 5-10% of total WBC count. Increased in protozoan, rickettsial, and tuberculosis infections. Fixed or non fixed. Limited activity until mature.
  6. eosinophils
    • 1-4% of total WBC count. Increased in parasitic infection.
    • Come from myeloid line. # of eosinohils increased during allergic reactions.
  7. Basophils
    0.5-1.5% of total WBC count. Normal during infection. Come from myeloid line.  Functions by releasing chemicals including heparin, histamine, serotonin, etc.
  8. Leukocytes involved in inflammation
    • Neutrophil
    • Macrophage
    • Monocyte
    • Eosinophil
    • Basophil
  9. Leukocytes involved in antibody-mediated immunity
    • B-lymphocyte
    • Plasma Cell
    • Memory Cell
  10. Leukocytes involved in cell-mediated immunity
    • Helped/inducer T Cells
    • Cytotoxic/cytolytic T Cell
    • Natural Killer Cell
  11. Macrophages
    come from the committed myeloid stem cells in the bone marrow. The liver, sleep, and intestinal tract contain a large number of these cells.

    Have long life spans and partake in many phagocytic events.
  12. Seven steps involved in Phagocytosis
    • Exposure and Invasion
    • Attraction
    • Adherence
    • Recognition
    • Cellular ingestion
    • Phagosome formation
    • Degradation
  13. Age related immune changes- Inflammation
    • Neutrophil function defective
    • absence of leukocytosis
    • compromised thermoregulation
  14. Age related immune changes- antibody mediated immunity
    • Diminished capability to produce new antibodies
    • decline in natural antibodies
    • decreased response to antigens
    • decreased antibody response time
  15. Age related immune changes- cell mediated immunity
    • decreased thymus gland function
    • decreased number of T lymphocytes
  16. Stage 1 of Inflammation response
    • Vascular part
    • Involves changes in blood vessels
    • Cause redness and warmth of tissues. The increased bloodflow delivers nutrients to injured tissues.
    • Macrophage is major cell in stage 1.
  17. Stage 2 of inflammation response
    • Cellular exudate part of response.
    • Neutrophil is most active cell in this stage.
    • Arachidonic acid cascade starts.
  18. Stage 3 of inflammation response
    tissue repair and replacement.
  19. Seven steps needed to produce a specific antibody directed against a specific antigen
    • exposure
    • antigen recognition
    • lymphocyte sensitization
    • antibody production and release
    • antigen-antibody binding
    • antibody binding reactions
    • sustained immunity or memory
  20. self tolerance
    ability to recognize own cell's vs. foreign cells
  21. human leukocyte antigen
    • UPC code for individuals
    • present on nearly all body cells
    • determine tissue type
  22. 'systems' involved in the immune system
    GI system, nervous system, endocrine system
  23. 5 cardinal signs of inflammation
    warmth, redness, swelling, pain, loss of function.
  24. cytokines
    CMI regulates the immune system by production and activity of cytokines. These are small protein hormones produced by many WBCs.