Anatomy and Physiology Final

DOÑA TRINIDAD ROMUALDEZ MEDICAL FOUNDATION
CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE

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(1st SEMESTER S.Y. 2023-2024)
LIVER
ANATOMY:
● The liver is the largest internal organ of the body and weighs
about 1.36 kg (3 pounds). The liver is located in the right
upper quadrant of the abdomen, tucked against the inferior
surface of the diaphragm.
● The posterior surface of the liver is in contact with right ribs
5–12. The liver consists of two major lobes, the right lobe
and the left lobe.
● The two lobes are separated by a connective tissue septum,
called the falciform ligament. Two smaller liver lobes, the
caudate lobe and the quadrate lobe, can be seen from an
inferior view. Also seen from the inferior view is the porta,
which is the “gate” through which blood vessels, ducts, and
nerves enter or exit the liver.
● The liver receives blood from two sources:
➢ The hepatic artery (25%) – a blood vessel that delivers oxygenated blood to the liver, which supplies
liver cells with oxygen.
➢ The hepatic portal vein (75%) – a major blood vessel that carries nutrient-rich blood from the
digestive tract to the liver. Blood exits the liver through hepatic veins. The hepatic veins empty into
the inferior vena cava. Many delicate connective tissue septa divide the liver into lobules with portal
triads at their corners.
● Hepatic cords, formed by platelike groups of liver cells called hepatocytes, are located between the center
and the margins of each lobule. The hepatic cords are separated from one another by blood channels
called hepatic sinusoids.
● The sinusoid epithelium contains phagocytic cells that help remove foreign particles from the blood. Blood
from the hepatic portal vein and the hepatic artery flows into the sinusoids and mixes together. The mixed
blood flows toward the center of each lobule into a central vein.
● The central veins from all the lobes unite to form the hepatic veins, which carry blood out of the liver to the
inferior vena cava.
● The liver contains a system of ducts to deliver bile and other secretions to the duodenum. The hepatic
ducts converge and empty into the right and left hepatic ducts to transport bile out of the liver. The right
and left hepatic ducts unite to form a single common hepatic duct.
The major liver cells cooperate and maintain liver functions include:
➢ Kupffer cells, the resident macrophage in the liver, comprise the largest population of resident tissue
macrophages in the body. Kupffer cells play a critical role in the innate immune response; their
localization in the hepatic sinusoid allows them to efficiently phagocytize pathogens entering from the
portal or arterial circulation. It also serve as a first line of defense against particulates and
immunoreactive material passing from the gastrointestinal tract via the portal circulation and may be
considered as a final component in gut barrier function. Kupffer cells thus play a major anti-
inflammatory role by preventing the movement of these gut-derived immunoreactive substances from
travelling past the hepatic sinusoid. Thus, it comprises the major phagocytic activity of what was
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classically termed the reticular-endothelial system and now more properly called the mononuclear
phagocytic system.’
➢ Hepatic stellate cells are located in the space of Disse between the sinusoidal endothelial cells and
hepatic epithelial cells, and account for 5%–8% of the cells in the liver. In a healthy liver, stellate cells
are quiescent and contain numerous vitamin A lipid droplets, constituting the largest reservoir of
vitamin A in the body. When the liver is injured due to viral infection or hepatic toxins, hepatic stellate
cells receive signals secreted by damaged hepatocytes and immune cells, causing them to
transdifferentiate into activated myofibroblast-like cells. As the primary extracellular matrix–producing
(ECM-producing) cells in the liver, activated stellate cells generate a temporary scar at the site of injury
to protect the liver from further damage. In addition, hepatic stellate cells secrete cytokines and growth
factors that promote the regeneration of hepatic epithelial cells. In chronic liver disease, prolonged and
repeated activation of stellate cells causes liver fibrosis, as characterized by widespread scar
formation and perturbation of liver architecture and function. During the regression of liver fibrosis,
the number of activated hepatic stellate cells is greatly reduced by the induction of cellular senescence
and apoptosis, or by the return to the quiescent state.
PHYSIOLOGY:
● The liver processes nutrients and detoxifies harmful substances from the blood. The liver also produces
an important digestive fluid called bile. It plays a crucial role in metabolism and has a multitude of
functions: digestion and secretion, storage and processing of nutrients, detoxification of harmful
chemicals, and synthesis of new molecules. An important contributor to the liver’s digestive functions is
bile. Bile also contains excretory products, such as cholesterol, fats, and bile pigments. Bilirubin is a bile
pigment that results from the breakdown of hemoglobin. Gallstones may form if the amount of cholesterol
secreted by the liver becomes excessive and is not able to be dissolved by the bile salts. Neural and
hormonal stimuli regulate the secretion and release of bile.
● The liver can remove sugar from the blood and store it in the form of glycogen. It can also store lipids,
vitamins, copper, and iron. This storage function is usually short-term. Foods are not always ingested in
the proportion needed by the tissues. If this is the case, the liver can convert some nutrients into others.
● The liver also transforms some nutrients into more readily usable substances. The liver is an important
line of defense against many of those harmful substances. It detoxifies them by altering their structure,
which makes their excretion easier
● The liver also removes other substances from the blood and excretes them into the bile. The liver can
also produce unique new compounds. Many of the blood proteins, such as albumins, fibrinogen,
globulins, and clotting factors, are synthesized in the liver and released into the blood.
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GALLBLADDER
ANATOMY:
● A pear-shaped, hollow, saclike organ that lies in a shallow
depression on the inferior surface of the liver, to which it is
attached by loose connective tissue.
FUNCTION:
● The function of the gallbladder is to store and concentrate bile.
When required, the gallbladder releases bile into the cystic
duct by contraction of its muscular wall. This happens as
stomach contents are released into the duodenum, especially
after a fatty meal.
HEART
ANATOMY:
● The heart is a hollow, muscular organ located in the center of the thorax, where it occupies the space
between the lungs (mediastinum) and rests on the diaphragm. It weighs approximately 300 g (10.6 oz);
the weight and size of the heart are influenced by age, gender, body weight, extent of physical exercise
and conditioning, and heart disease. The heart pumps blood to the tissues, supplying them with oxygen
and other nutrients.
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● The heart is composed of three layers. The inner layer, or endocardium, consists of endothelial tissue
and lines the inside of the heart and valves. The middle layer, or myocardium, is made up of muscle
fibers and is responsible for the pumping action. The exterior layer of the heart is called the epicardium.
● The heart is encased in a thin, fibrous sac called the pericardium, which is composed of two layers.
Adhering to the epicardium is the visceral pericardium. Enveloping the visceral pericardium is the parietal
pericardium, a tough fibrous tissue that attaches to the great vessels, diaphragm, sternum, and vertebral
column and supports the heart in the mediastinum. The space between these two layers (pericardial
space) is normally filled with about 20 mL of fluid, which lubricates the surface of the heart and reduces
friction during systole.
PHYSIOLOGY:
● The cardiac conduction system generates and transmits electrical impulses that stimulate contraction of
the myocardium. Under normal circumstances, the conduction system first stimulates contraction of the
atria and then the ventricles.
● The heart rate is determined by the myocardial cells with the fastest inherent firing rate. Under normal
circumstances, the SA node has the highest inherent rate (60 to 100 impulses per minute), the AV node
has the second- highest inherent rate (40 to 60 impulses per minute), and the ventricular pacemaker
sites have the lowest inherent rate (30 to 40 impulses per minute).
● Both the sinoatrial (SA) node (the primary pacemaker of the heart) and the atrioventricular (AV) node
(the secondary pacemaker of the heart) are composed of nodal cells. The SA node is located at the
junction of the superior vena cava and the right atrium. The SA node in a normal resting adult heart has
an inherent firing rate of 60 to 100 impulses per minute; however, the rate changes in response to the
metabolic demands of the body.
● The cardiac cycle refers to the events that occur in the heart from the beginning of one heartbeat to the
next. The number of cardiac cycles completed in a minute depends on the heart rate. Each cardiac cycle
has three major sequential events: diastole, atrial systole, and ventricular systole. These events cause
blood to flow through the heart due to changes in chamber pressures and valvular function during diastole
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and systole. The cardiac output in a resting adult is 4 to 6 L/min but varies greatly depending on the
metabolic needs of the body. Cardiac output is computed by multiplying the stroke volume by the heart
rate. Stroke volume is the amount of blood ejected from one of the ventricles per heartbeat. The average
resting stroke volume is about 60 to 130 mL.
CENTRAL NERVOUS SYSTEM

ANATOMY:
The central nervous system (CNS) consists of the brain and spinal cord. The brain is housed within the
braincase; the spinal cord is in the vertebral column.
The Brain
• Accounts for approximately 2% of the total
body weight; in an average young adult, the
brain weighs approximately 1400 g,
whereas in an average older adult, the brain
weighs approximately 1200 g (Hickey,
2014).
• The brain is divided into three major areas:
the cerebrum, the brain stem, and the
cerebellum.
1. The cerebrum is composed of two
hemispheres, the thalamus, the
hypothalamus, and the basal ganglia.
2. The brain stem includes the midbrain,
pons, and medulla.
3. The cerebellum is located under the
cerebrum and behind the brain stem.
PHYSIOLOGY:
● The CNS communicates with the rest of the body through the nerves, which are bundles of fibers that
transmit signals to and from the CNS. The CNS is the processing center of the body and consists of the
brain and the spinal cord. Both of these are protected by three layers of membranes known as meninges.
For further protection, the brain is encased within the hard bones of the skull, while the spinal cord is
protected with the bony vertebrae of our backbones.
● A form of protection is cerebrospinal fluid, which provides a buffer that limits impact between the brain
and skull or between spinal cord and vertebrae. Sensory information travels from the body to the spinal
cord before reaching the brain. This information ascends upwards using first, second, and third-order
neurons.
● First-order neurons receive impulses from skin and proprioceptors and send them to the spinal cord.
They then synapse with second-order neurons.
● Second-order neurons live in the dorsal horn and send impulses to the thalamus and cerebellum.
● Lastly, third-order neurons pick up these impulses in the thalamus and relay it to the somatosensory
portion of the cerebrum. Somatosensory sensations are pressure, pain, temperature, and the body's
senses.
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LUNGS
ANATOMY:
● The lungs are the principal organs of
respiration. Each lung is cone-shaped, with
its base resting on the diaphragm and its
apex extending superiorly to a point about
2.5 cm above the clavicle.
● The right lung has three lobes:
(1) the superior lobe - located at the top of the
lung and is part of the right lung. Its primary function
is to help in the exchange of oxygen and carbon
dioxide between the air we breathe and the
bloodstream. It also assists in the overall process
of respiration, which is crucial for maintaining life.
(2) the middle lobe - lobe is situated between
the superior lobe and the inferior lobe on the right
lung. Like the other lobes, its primary function is to
facilitate gas exchange and contribute to the overall
respiratory process. It also helps in the distribution
of air within the lungs.
(3) the inferior lobe - lobe is located at the bottom of the left lung. It too plays a crucial role in gas exchange
and respiration. Its position allows it to work efficiently with the diaphragm, a muscle responsible for inhaling and
exhaling air.
The left lung has two lobes, called the superior lobe and the inferior lobe.
● The lobes of the lungs are separated by deep, prominent fissures on the lung surface.
● Each lobe is divided into bronchopulmonary segments separated from one another by connective tissue
septa, but these separations are not visible as surface fissures. Because major blood vessels and bronchi
do not cross the septa, individual diseased bronchopulmonary segments can be surgically removed,
leaving the rest of the lung relatively intact.
● Each main bronchus divides into lobar bronchi (or secondary bronchi), as they enter their respective
lungs.
● The lobar bronchi conducts air to each lung lobe. The lobar bronchi in turn divide into segmental bronchi
(or tertiary bronchi), which lead to the bronchopulmonary segments of the lungs.
● The bronchi continue to branch many times, finally giving rise to bronchioles.
● The bronchioles also subdivide numerous times to give rise to terminal bronchioles, which then subdivide
into respiratory bronchioles. Each respiratory bronchiole subdivides to form alveolar ducts, long,
branching ducts with many openings into alveoli.
● Alveoli are small air-filled chambers where the air and the blood come into close contact with each other.
The alveoli become so numerous that the alveolar duct wall is little more than a succession of alveoli.
The alveolar ducts end as two or three alveolar sacs, which are chambers connected to two or more
alveoli. There are about 300 million alveoli in the lungs. As the air passageways of the lungs become
smaller, the structure of their walls changes.
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● The respiratory membrane of the lungs is where gas exchange between the air and blood takes place. It
is formed mainly by the walls of the alveoli and the surrounding capillaries. To facilitate the diffusion of
gases, the respiratory membrane is very thin; it is thinner than a sheet of tissue paper.
PHYSIOLOGY:
● The cells of the body use O2 and produce CO2. Thus, blood returning from tissues and entering the
lungs has a lower Po2 and a higher Pco2 compared to alveolar air. Oxygen diffuses from the alveoli into
the pulmonary capillaries because the Po2 in the alveoli is greater than that in the pulmonary capillaries.
In contrast, CO2 diffuses from the pulmonary capillaries into the alveoli because the Pco2 is greater in
the pulmonary capillaries than in the alveoli. When blood enters a pulmonary capillary, the Po2 and Pco2
in the capillary are different from the Po2 and Pco2 in the alveolus.
● By the time blood flows through the first third of the pulmonary capillary, an equilibrium is achieved, and
the Po2 and Pco2 in the capillary are the same as in the alveolus. Thus, in the lungs, the blood gains O2
and loses CO2. During breathing, atmospheric air mixes with alveolar air. The air entering and leaving
the alveoli keeps the Po2 higher in the alveoli than in the pulmonary capillaries. Increasing the breathing
rate makes the Po2 even higher in the alveoli than it is during slow breathing. During labored breathing,
the rate of O2 diffusion into the pulmonary capillaries increases because the difference in partial pressure
between the alveoli and the pulmonary capillaries has increased. There is a slight decrease in Po2 in the
pulmonary veins due to mixing with deoxygenated blood from veins draining the bronchi and bronchioles;
however, the Po2 in the blood is still higher than that in the tissues.
KIDNEYS
ANATOMY:
Location and External Anatomy of the Kidneys:
• The kidneys are behind the peritoneum, or
retroperitoneal and are located on each side of the
vertebral column.
• They are bean-shaped organs, each about the size
of a tightly clenched fist.
• Structures that are behind the peritoneum are said
to be retroperitoneal.
• A layer of connective tissue called the renal capsule
surrounds each kidney.
• Around the renal capsule is a thick layer of adipose
tissue, which protects the kidney from mechanical
shock.
• On the medial side of each kidney is the hilum,
where the renal artery and nerves enter and where the renal vein, ureter, and lymphatic vessels exit the
kidney. The hilum opens into a cavity called the renal sinus, which contains blood vessels, part of the
system for collecting urine, and adipose tissue.
PHYSIOLOGY:
1. Excretion. The kidneys remove waste products from the blood. Most of the waste products are metabolic
by-products of cell metabolism. Other waste products are substances absorbed from the intestine. Many
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waste products are toxic. Organs such as the skin, liver, lungs, and intestines eliminate some of these
waste products. However, if the kidneys fail to function, these organs cannot remove sufficient wastes to
maintain homeostasis.
2. Regulation of blood volume and pressure. The kidneys play a major role in controlling the extracellular
fluid volume in the body. The kidneys can produce either a large volume of dilute urine or a small volume
of concentrated urine, depending on the hydration level of the body. Through urine production, the
kidneys regulate blood volume and blood pressure.
3. Regulation of the concentration of solutes in the blood. The kidneys help regulate the concentration
of the major molecules and ions, such as glucose, Na+, Cl−, K+, Ca2+, HCO3 −, and HPO4 2−.
4. Regulation of extracellular fluid pH. The kidneys excrete variable amounts of H+ to help regulate
extracellular fluid pH.
5. Regulation of red blood cell synthesis. The kidneys secrete a hormone, erythropoietin, which
regulates the synthesis of red blood cells in bone marrow (see chapter 11).
6. Regulation of vitamin D synthesis. The kidneys play an important role in controlling blood levels of
Ca2+ by regulating the synthesis of vitamin D.
PERITONEUM
ANATOMY:
• The peritoneum is a serous membrane which

lines the walls of the abdominal cavity and lies on
abdominal and pelvic organs. Between its two
layers – parietal and visceral – is the peritoneal
cavity. The peritoneum functions to support and
protect abdominopelvic organs.
• The peritoneum consists of two layers:
1. Parietal peritoneum – an outer layer
which adheres to the anterior and
posterior abdominal walls.
2. Visceral peritoneum – an inner layer
which lines the abdominal organs. It's
made when parietal peritoneum reflects
from the abdominal wall to the viscera.
• The peritoneal cavity is a potential space found
between the parietal and visceral layers of the peritoneum. The cavity is filled with a small amount of
serous peritoneal fluid secreted by the mesothelial cells which line the peritoneum. Peritoneal fluid
enables the peritoneal layers to slide against each other with little friction while following the subtle
movements of the abdominopelvic organs.
PHYSIOLOGY:
• The peritoneum has several functions, it provides:
➢ Insulation - Layers of the peritoneum contain fat that warms and protects your organs.
➢ Lubrication - Peritoneal fluid lubricates your organs inside of your peritoneal cavity (the ones that
move).
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➢ Structure - Ligaments in your peritoneum connect your organs to each other and attach your
intestines to your back abdominal wall.
➢ Blood, lymph and nerve supply - Nerves and vessels run through the layers of your peritoneum.
➢ Immunity - Your peritoneum serves as a barrier to injury and pathogens in your abdominal cavity.
It recognizes invasive particles and sends in white blood cells to target them. It filters fluids in your
peritoneal cavity and drains waste products away. The tissue also has rapid healing properties to
repair its own injuries. Researchers are still exploring these properties.
HEMATOLOGIC SYSTEM
ANATOMY:
● The hematologic system consists of the blood and the sites where blood is produced, including the bone
marrow and the reticuloendothelial system (RES). Blood is a specialized organ that differs from other
organs in that it exists in a fluid state. Blood is composed of plasma and various types of cells which
account for 7% to 9% of total blood volume (Jouria, 2018). Plasma is the fluid portion of blood; it contains
various proteins, such as albumin, globulin, fibrinogen, and other factors necessary for clotting, as well
as electrolytes, waste products, and nutrients. About 55% of whole blood volume is plasma.
PHYSIOLOGY:
● Hematopoiesis and stromal stem cell differentiation. Uncommitted (pluripotent) stem cells can
differentiate into myeloid or lymphoid stem cells. These stem cells then undergo a complex process of
differentiation and maturation into normal cells that are released into the circulation. The myeloid stem
cell is responsible not only for all nonlymphoid white blood cells but also for the production of red blood
cells (RBCs) and platelets. Each step of the differentiation process depends in part on the presence of
specific growth factors for each cell type. When the stem cells are dysfunctional, they may respond
inadequately to the need for more cells, or they may respond excessively, and sometimes uncontrollably,
as in leukemia.
➢ Bone Marrow
The bone marrow is the site of hematopoiesis, or blood cell formation. In adults, blood cell formation
is usually limited to the pelvis, ribs, vertebrae, and sternum. Marrow is one of the largest organs of
the body, making up 4% to 5% of total body weight. It consists of islands of cellular components (red
marrow) separated by fat (yellow marrow). The marrow is vascular. Within it are primitive cells called
stem cells. The stem cells have the ability to self-replicate, thereby ensuring a continuous supply of
stem cells throughout the life cycle. When stimulated to do so, stem cells can begin a process called
differentiation, and develop into either myeloid or lymphoid stem cells. Lymphoid stem cells produce
either T or B lymphocytes, cells that have specific immune functions. Myeloid stem cells differentiate
into three broad cell types: erythrocytes, leukocytes, and platelets. Thus, with the exception of
lymphocytes, all blood cells are derived from myeloid stem cells.
➢ Blood
The cellular component of blood consists of three primary cell types : erythrocytes (red blood cells
[RBCs], red cells), leukocytes (white blood cells [WBCs]), and thrombocytes (platelets). These cellular
components of blood normally make up 40% to 45% of the blood volume. The primary site for
hematopoiesis is the bone marrow. Under normal conditions, the adult bone marrow produces about
175 billion erythrocytes, 70 billion neutrophils (a mature type of WBC), and 175 billion platelets each
day. When the body needs more blood cells, as in infection (when neutrophils are needed to fight the
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invading pathogen) or in bleeding (when more RBCs are required), the marrow increases its
production of the cells required. Blood makes up approximately 7% to 9% of the normal body weight
and amounts to 5 to 6 L of volume for men and 4 to 5 L of volume for women. Circulating through the
vascular system and serving as a link between body organs, blood carries oxygen absorbed from the
lungs and nutrients absorbed from the gastrointestinal (GI) tract to the body cells for cellular
metabolism. Blood also carries hormones, antibodies, and other substances to their sites of action or
use. In addition, blood carries waste products produced by cellular metabolism to the lungs, skin,
liver, and kidneys, where they are transformed and eliminated from the body.
➢ Reticuloendothelial System (RES)
composed of special tissue macrophages. When released from the marrow, monocytes spend
a short time in the circulation (about 24 hours) and then enter the body tissues. Within the
tissues, the monocytes continue to differentiate into macrophages, which can survive for
months or years. Macrophages have a variety of important functions. They defend the body
against foreign invaders (i.e., bacteria and other pathogens) via phagocytosis. They remove
old or damaged cells from the circulation. They stimulate the inflammatory process and
present antigens to the immune system (Banaski, 2019). Macrophages give rise to tissue
histiocytes, phagocytic cells that are present in loose connective tissue. These include Kupffer
cells of the liver, peritoneal macrophages, alveolar macrophages, and other components of
the RES. Thus, the RES is a component of many other organs within the body, particularly
the spleen, lymph nodes, lungs, and liver.
IMMUNE SYSTEM
ANATOMY:
• The immune system is composed of an integrated collection of various cell types, each with a designated
function in defending against infection and invasion by other organisms. Supporting this system are
molecules that are responsible for the interactions, modulations, and regulation of the system. These
molecules and cells participate in specific interactions with immunogenic epitopes (antigenic
determinants) present on foreign materials, initiating a series of actions in a host, including the
inflammatory response, the lysis of microbial agents, and the disposal of foreign toxins. The major
components of the immune system include central and peripheral organs, tissues, and cells.
➢ BONE MARROW
The white blood cells (WBCs) involved in immunity are produced in the bone marrow. Like other blood
cells, lymphocytes are generated from stem cells (undifferentiated cells). There are two types of
lymphocytes—B cells, also called B lymphocytes, and T cells, also called T lymphocytes.
➢ LYMPHOID TISSUES
The spleen, composed of red and white pulp, acts somewhat like a filter. The red pulp is the site
where old and injured red blood cells (RBCs) are destroyed. The white pulp contains concentrations
of lymphocytes. The lymph nodes, which are connected by lymph channels and capillaries, are
distributed throughout the body. They remove foreign material from the lymph system before it enters
the bloodstream. The lymph nodes also serve as centers for immune cell proliferation. The remaining
lymphoid tissues contain immune cells that defend the body’s mucosal surfaces against
microorganisms.
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➢ PARTS OF THE IMMUNE SYSTEM

Thymus - is a bilobed gland roughly triangular in shape. The thymus is the site for maturation of a class
of lymphocytes called T cells.
Lymph Nodes - are rounded structures varying from the size of a small seed. They are found throughout
the body. Lymph flows through the lymph nodes and filters it and is activated once pathogens are
detected through the action of macrophages.
1. Mesenteric lymph nodes - is the “first pass” organ for nutrients and microbial substances
entering the lymph fluid in the intestinal lamina propria. As such, it serves as a key site for
tolerance induction to food particles but at the same time acts as a firewall to prevent systemic
spread of microorganisms.
Spleen - is roughly the size of a clenched fist and is located in the left, superior corner of the abdominal
cavity. It fights any invading germs in the blood.
White Pulp - is lymphatic tissue surrounding the arteries within the spleen and plays a role in the normal
immune response to infection.
Red Pulp - Removes of old, damaged and dead red blood cells along with antigens and microorganisms.
Storage of red blood cells in case of hypovolemia, these can then be released following an injury resulting
in blood loss.
Tonsils - include the pharyngeal, palatine and lingual tonsils. They formed a protective ring of lymphatic
tissue that protect against pathogens entering from the nose and mouth.
Bone Marrow - produces T cells and B cells but the T cells mature in the thymus while B cells stay and
mature in the bone marrow.
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B Lymphocytes - These B lymphocytes develop plasma (coming from the plasma of the blood) and
memory cells it explains why when an invasion occurs, the body already knows the specific antigen to
attack.
T Lymphocytes - They mature in the thymus gland and would enter the lymph nodes, spleen, etc.
White Blood Cells - It is concerned with the body's defense against pathogens, removal of toxins and
wastes, and attacks abnormal cells.
a) Neutrophils - are first to respond to an infection.
b) Eosinophils - plays a role in allergic reactions and parasitic infections.
c) Lymphocytes - fights infections by producing antibodies.
d) Monocytes - cleans up dead cells.
➢ CYTOKINES
Interleukin-1 (IL-1): Wide variety of biologic effects; activates endothelium in inflammation; induces fever
and acute-phase response; stimulates neutrophil production
Interleukin-2 (IL-2): Growth factor for activated T cells; induces synthesis of other cytokines; activates
cytotoxic T lymphocytes and NK cells
Interleukin-3 (IL-3): Growth factor for progenitor hematopoietic cells
Interleukin-4 (IL-4): Promotes growth and survival of T, B, and mast cells;
causes Ty2 cell differentiation; activates B cells and eosinophils and induces IgE-type responses
Interleukin-5 (IL-5): Induces eosinophil growth and development
Interleukin-6 (IL-6): Stimulates the liver to produce mediators of acute-phase inflammatory response;
also induces proliferation of antibody-producing cells by the adaptive immune system
Interleukin-7 (IL-7): Primary function in adaptive immunity; stimulates pre- B cells and thymocyte
development and proliferation
Interleukin-8 (IL-8): Primary function in adaptive immunity; chemo attracts neutrophils and T
lymphocytes; regulates lymphocyte homing and neutrophil infiltration.
Interleukin-10 (IL-10): Inhibitor of activated macrophages and dendritic cells; decreases inflammation
by inhibiting TH1 cells and release of interleukin-12 from macrophages.
Interleukin-12 (IL-12): Enhances NK cell cytotoxicity in innate immunity; induces Tyl cell differentiation
in adaptive immunity
Type I interferons (IFN-a, IFN-B): Inhibit viral replication, activate NK cells, and increase expression of
MHC-I molecules on virus-infected cells
Interferon-y (IFN-Y): Activates macrophages in both innate immune responses and adaptive cell-
mediated immune responses; increases expression of MHC I and II and antigen processing and
presentation
Tumor necrosis factor a (TNF-a): Induces inflammation, fever, and acute-phase
response; activates neutrophils and endothelial cells; kills cells through apoptosis
Chemokines: Large family of structurally similar cytokines that stimulate leukocyte movement and
regulate the migration of leukocytes from the blood to the tissues.
Granulocyte-monocyte CSF (GM-CSF): Promotes neutrophil, eosinophil, and monocyte maturation and
growth; activates mature granulocytes
Granulocyte CSF (G-CSF): Promotes growth and maturation of neutrophils consumed in inflammatory
reactions
Monocyte CSF - (M-CSF): Promotes growth and maturation of mononuclear phagocytes.
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• LYMPHOCYTES INVOLVING IMMUNE RESPONSE

Humoral:
1. B lymphocyte - Produces antibodies or immunoglobulins (IgA, IgD, 1gE, IgG, IgM)
Cellular: T lymphocyte
1. Helper T - Attacks foreign invaders (antigens) directly; Initiates and augments inflammatory
response
2. Helper T1 - Increases activated cytotoxic T cells
3. Helper T2 - Increases B-cell (BG8) antibody production
4. Suppressor T - Suppresses the immune response
5. Memory T - Remembers contact with an antigen and on subsequent exposures mounts an
immune response
6. Cytotoxic T (killer T) - Lyses cells infected with virus; plays a role in graft rejection
Nonspecific:
1. Non-T or non-B-lymphocyte null cell - Destroys antigens already coated with antibody.
2. Natural killer cell (granular lymphocyte) - Defends against microorganisms and some types of
malignant cells; produces cytokines.
PHYSIOLOGY:
• The basic function of the immune system is to remove foreign antigens such as viruses and bacteria
to maintain homeostasis. There are two general types of immunity: natural (innate) and acquired
(adaptive). Natural immunity or nonspecific immunity is present at birth. Acquired or specific immunity
develops after birth. Each type of immunity has a distinct role in defending the body against harmful
invaders, but the various components are usually interdependent.
➢ NATURAL IMMUNITY
Natural immunity, which is nonspecific, provides a broad spectrum of defense against and resistance to
infection. It is considered the first line of host defense following antigen exposure, because it protects the
host without remembering prior contact with an infectious agent. Responses to a foreign invader are very
similar from one encounter to the next, regardless of the number of times the invader is encountered.
Natural (innate) immunity coordinates the initial response to pathogens through the production of
cytokines and other effector molecules, which either activate cells for control of the pathogen (by
elimination) or promote the development of the acquired immune response. The cells involved in this
response are monocytes, macrophages, dendritic cells, natural killer (NK) cells, basophils, eosinophils,
and granulocytes. The early events in this process are critical in determining the nature of the adaptive
immune response. Natural immune mechanisms can be divided into two stages: immediate (generally
occurring within minutes) and delayed (occurring within several days after exposure).
➢ RESPONSE TO INVASION
When the body is invaded or attacked by bacteria, viruses, or other pathogens, it has three means of
defense:
COLLEGE OF NURSING
The phagocytic immune response - The first line of defense, primarily involves the WBCs (granulocytes
and macrophages), which ingest foreign particles and destroy the invading agent; eosinophils are only
weakly phagocytic. Phagocytes also remove the body’s own dying or dead cells. Cells in necrotic tissue
that are dying release substances that trigger an inflammatory response.
Apoptosis, or programmed cell death, is the body’s way of destroying worn-out cells such as blood or
skin cells or cells that need to be renewed.
The humoral or antibody immune response - A second protective response (antibody response),
begins with the B lymphocytes, which can transform themselves into plasma cells that manufacture
antibodies.
An antibody is a protein substance developed by the body, transported in the bloodstream, and attempts
to disable invaders.
The cellular immune response - The third mechanism of defense, involves the T lymphocytes, which
can turn into special cytotoxic (or killer) T cells that can attack the pathogens.
The structural part of the invading or attacking organism that is responsible for stimulating antibody
production is called an antigen (or an immunogen). Not all antigens are naturally immunogenic; some
must be coupled to other molecules to stimulate the immune response. A single bacterium or large
molecule, may have several antigens, or markers, on its surface, thus inducing the body to produce many
different antibodies. Once produced, an antibody is released into the bloodstream and carried to the
attacking organism. There are four well-defined stages in an immune response: recognition, proliferation,
response, and effector.
Recognition Stage
Recognition of antigens as foreign, or non-self, by the immune system is the initiating event in any
immune response. Recognition involves the use of lymph nodes and lymphocytes for surveillance. Lymph
nodes are widely distributed internally throughout the body and in the circulating blood, as well as
externally near the body’s surfaces. They continuously discharge small lymphocytes into the
bloodstream. These lymphocytes patrol the tissues and vessels that drain the areas served by that node.
Lymphocytes recirculate from the blood to lymph nodes and from the lymph nodes back into the
bloodstream in a continuous circuit. Lymphocytes and other cells have “microbial sensors” that identify
molecules on microbes and other microorganisms. The interaction of these sensors with the offending
agent sets off a cascade aimed at destroying the microbe. Invading organisms have pathogen-associated
molecular patterns (PAMPs) contained in their cell membranes that are recognized by the immune
system cells. Once the receptors on the immune cells reach the PAMPs, the immune response is
triggered. Both macrophages and neutrophils have receptors for antibodies and complement; as a result,
they coat microorganisms with antibodies, complement, or both, thereby enhancing phagocytosis (Norris,
2019).
Proliferation Stage
The circulating lymphocytes containing the antigenic message return to the nearest lymph node. Once
in the node, these sensitized lymphocytes stimulate some of the resident T and B lymphocytes to enlarge,
divide, and proliferate. T lymphocytes differentiate into cytotoxic (or killer) T cells, whereas B lymphocytes
produce and release antibodies.
COLLEGE OF NURSING
Response Stage
In the response stage, the differentiated lymphocytes function in either a humoral or a cellular capacity.
This stage begins with the production of antibodies by the B lymphocytes in response to a specific
antigen. The cellular response stimulates the resident lymphocytes to become cells that attack microbes
directly rather than through the action of antibodies. These transformed lymphocytes are known as
cytotoxic (killer) T cells.
Viral antigens induce a cellular response. This response is manifested by the increasing number of T
lymphocytes (lymphocytosis). Most immune responses to antigens involve both humoral and cellular
responses, although one usually predominates.
Effector Stage
In the effector stage, either the antibody of the humoral response or the cytotoxic (killer) T cell of the
cellular response reaches and connects with the antigen on the surface of the foreign invader. This action
initiates activities involving an interplay of antibodies, complement, and action by the cytotoxic T cells.
➢ THE IMMUNE RESPONSE

The immune response is the bodies action plan to combat invading microorganism or
substances. The immune complex (antigen + antibody = immune complex) is the one
that is deposited into the different parts of the body which will later on caused destruction on the parts
because it will be attacked further by an antibody or other defenses of the body causing an autoimmune
disorder.

Anatomy and Physiology Final

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DOÑA TRINIDAD ROMUALDEZ MEDICAL FOUNDATION

CALANIPAWAN ROAD, TACLOBAN CITY, LEYTE

CENTRAL NERVOUS SYSTEM

• The peritoneum is a serous membrane which

➢ PARTS OF THE IMMUNE SYSTEM

• LYMPHOCYTES INVOLVING IMMUNE RESPONSE

➢ THE IMMUNE RESPONSE

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