The Lymphatic System (pp.755-764)

1. Functions of the lymphatic system
   1.   Absorption of excess interstitial fluid
   2.   Protection against pathogens
   3.   Transport of dietary lipids
2. Lymph and the lymphatic vessels
   1.   Composition of lymph
   2.   Origin of lymph
   • Structure of lymphatic capillaries
   • Mechanism of fluid uptake
   3.   Lymphatic vessels
   • Collecting vessels
   • Lymphatic trunks
   • Collecting ducts
   4.   Flow of lymph
   • Contractions of lymphatic vessels
   • Skeletal muscle pump
   • Pulsation of adjacent arteries
   • Thoracic pump
3. Lymphatic tissue
   1.   Diffuse lymphatic tissue
   2.   Lymphatic nodules (follicles)
4. Lymph nodes
   1.   Locations
   2.   Structure
   • Size and shape
   • Capsule and trabeculae
   • Stroma and parenchyma
   • Cortex and medulla
   • Lymphatic nodules
   • Medullary sinuses
   • Afferent and efferent vessels
   3.   Function
5. Tonsils
   1.   Histology
   2.   Three major sets
6. Thymus
   1.   Location
   2.   Age-related changes
   3.   Histology
   4.   Relationship to T cell development
7. Spleen
   1.   Location
   2.   Red and white pulp
   3.   Role in erythrocyte production, storage, and disposal
   4.   Roles in defense and immunity

Nonspecific Resistance (pp. 764-770)

1. Physical barriers
   1.   Skin
   2.   Mucous membranes
   3.   Connective tissue gel
2. Chemical barriers
   1.   Acids
   2.   Lysozyme
3. Leukocytes and macrophages
   1.   Leukocyte functions
   2.   Macrophages
4. Inflammation
   1.   Cardinal signs
   2.   Causes of pain and functional impairment
   3.   Causes of hyperemia, swelling, redness, and heat
   4.   Leukocyte deployment
   • Margination, diapedesis, and chemotaxis
   • Leukocytosis-promoting factor
   • Involvement of basophils, eosinophils, and monocytes
   5.   Tissue repair
5. Antimicrobial proteins
   1.   Interferons
   2.   Complement system
   • Classical pathway
   • Alternate pathway
   • Actions of complement proteins
     • Enhanced inflammation
     • Opsonization
     • Cytolysis
6. Fever
   1.   Beneficial effects
   2.   Role of pyrogens and hypothalamus
   3.   Stages
   4.   Dangers

General Aspects of Specific Immunity (pp.770-774)

1. General characteristics
   1.   Specificity and memory
   2.   Humoral and cellular immunity
2. Antigens
   1.   Types of antigenic molecules
   2.   Recognition of self and nonself
   3.   Antigenic determinants
   4.   Haptens
3. Antibodies
   1.   Chemical nature and location
   2.   Structure of antibody monomer
   • Heavy and light chains
   • Variable and constant regions
   • Antigen-binding sites
   3.   Five antibody classes
   4. Passive and active immunity
4. Lymphocytes
   1.   T lymphocytes (T cells)
   • Development in thymus
   • Receptors and immunocompetence
   • Virgin lymphocyte pool
   • Clonal deletion and self-tolerance
   2.   B lymphocytes (B cells)
   • Development in bursa equivalents
   • Receptors and immunocompetence
   • B cell diversity
   • Distribution in body
   3. Antigen-presenting cells (APCs)
5. Interleukins
   1.   Lymphokines
   2.   Monokines

Humoral Immunity (pp.775-779)

1. Recognition phase
   1.   Capping of receptors
   2.   Endocytosis of antigen
   3.   Display of processed antigen
   • Role of MHC protein
   • Binding of helper T cell
   • Secretion of helper factors
   4.   Clonal selection
   5.   Plasma cell differentiation
   • Antibody synthesis
   6.   Somatic recombination and antibody diversity
2. Attack phase
   1.   Neutralization
   2.   Complement fixation
   3.   Agglutination
   4.   Precipitation
3. Memory phase
   1.   Primary and secondary responses
   2.   Memory B cells

Cellular Immunity (pp.779-784)

1. Lymphocytes involved
   1.   Helper (CD4 or T₄) cells
   2.   CD8 (T₈) cells
   • Cytotoxic (killer) T cells
   • Suppressor T cells
   3.   Memory T cells
2. Recognition phase
   1.   Antigen presentation
   • Antigen-presenting cells
   • MHC-I proteins and cytotoxic T cells
   • MHC-II proteins and helper T cells
   • MHC restriction
   2.   T cell activation
   • CD4 and CD8 cell adhesion molecules
   • Role of protein kinase
   • Costimulation by Il-1 and Il-2
   • Clonal selection
3. Attack phase
   1.   Role of helper T cells
   • Recognition of presented antigen
   • Secretion of lymphokines
   • Role of macrophage-activating factor
   2.   Role of cytotoxic T cells
   • Docking and lethal hit
   • Other actions
     • Lymphotoxin
     • Tumor necrosis factor
     • Interferon
     • Macrophage-activating factor
     • Migration-inhibiting factor
   3.   Role of suppressor T cells
4. Memory phase
   1.   Memory T cells
   2.   Primary response and T cell recall response

Immune System Disorders (pp.784-787)

1. Hypersensitivity (allergy)
   1.   Type I (acute) reaction
   • Anaphylaxis
   • Asthma
   • Anaphylactic shock
   2.   Type II (antibody-dependent cytotoxic) hypersensitivity
   3.   Type III (immune complex) hypersensitivity
   4.   Type IV (delayed) hypersensitivity
2. Autoimmune diseases
   1.   Causes
   • Antigen cross-reactivity
   • Abnormal exposure of self-antigens
   • Changes in structure of self-antigens
   2.   Examples
   • Rheumatic fever
   • Sterility from autoimmunity
   • Type I diabetes
3. Immunodeficiency diseases
   1.   Severe combined immunodeficiency disease (SCID)
   2.   Acquired immunodeficiency syndrome (AIDS)

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