Basic Human Needs Safety and Protective Environment

1. Basic Human NeedsSafety and Protective Environment Body Defense Mechanisms: Inflammation, Immunity and the Stress Response

2. IMMUNITY • Purpose of inflammation and immunity • Neutralize, eliminate or destroy organisms that invade internal environment • Healthy self cells are distinguished from non-self cells by immune system cells

4. SELF AND NON-SELF CELLS • Body can only defend against an invader if it is able to distinguish between its own cells (self) and those of an invader (non-self) • Each cell in the body carries on its surface the same distinct marker for selfness

5. SELF AND NON-SELF CELLS • Tissue introduced into a person (i.e. transplant) will be recognized as non-self • Key feature of the immune system is its ability to recognize self against non-self cells (Self-tolerance). If this does not occur can lead to autoimmune disorders where the immune system attacks self cells

6. HUMAN LEUKOCYTE ANTIGENS • Universal Product Code—proteins found on the surface of all body cells of an individual • Human Leukocyte Antigens (HLAs) are proteins responsible for each individual’s universal product code. Their function is to transport antigens from within the cell to the cell surface

7. HLAs • Immune System uses the HLAs to differentiate between self and non-self cells. Any cells displaying that person’s HLA type belongs to that person (and is not an invader) • HLAs is dependent on which genes are inherited by parents

8. Self -Tolerance—Ability to recognize self vs. non-self cells. Necessary to prevent healthy body cells from being destroyed along with invaders • Antigen (antibody generation) is a specific foreign protein that prompts the generation of antibodies. Antigens specify tissue type of person

9. FACTORS AFFECTING IMMUNE SYSTEM FUNCTION • Nutritional Status • Environmental Conditions • Therapeutic Agents • Presence of Disease • Age • Genetics • Certain viruses

10. Organization of the Immune System • Stem Cells • Maturation • Leukocytes (refer to Ignatavicius Table 19-1, pg. 309) • Actions • Recognize self vs. non-self • Phagocytic destruction • Production of cytokines • Production of antibodies • Production of cytokines

11. THE THREE PROCESSES OF HUMAN PROTECTION THROUGH IMMUNITY • INFLAMMATION • ANTIBODY- MEDIATED IMMUNITY • CELL- MEDIATED IMMUNITY

13. INFLAMMATION • Process by which the body utilizes WBCs and chemicals to provide immediate protection from infection and foreign substances • Nonspecific immune response • Can rid body of harmful organisms • Tissue damage may result from chronic inflammation

14. INFLAMMATION • WHAT DISEASES ARE ASSOCIATED WITH INFLAMMATION? • WHAT ARE THE SYMPTOMS OF INFLAMMATION? • WHAT CAUSES THE SYMPTOMS OF INFLAMMATION? • WHAT MEDICATIONS ARE USED TO TREAT INFLAMMATION?

15. TYPES OF CELLS INVOLVED IN INFLAMMATION • NEUTROPHILS • SEGS, BANDS AND LEFT SHIFT • MACROPHAGES • EOSINOPHILS • BASOPHILS

16. PROGRESSIOM FROM BAND TO SEG

18. PHAGOCYTOSIS • Key process of inflammation • Cellular process of engulfing solid particles such as bacteria and cell debris and removing them • Rids the body of debris after tissue injury • Neutrophils and macrophages

19. PHAGOCYTOSIS—SEVEN STEPS • EXPOSURE AND INVASION • ATTRACTION • ADHERENCE • RECOGNITION • CELLULAR INGESTION • PHAGOSOME FORMATION • DEGRADATION

21. INFLAMMATORY RESPONSE SEQUENCE • Stage I- Vascular (change in blood vessel) • Phase I rapid blood vessel constriction • Phase II hyperemia, edema • Stage II- Cellular Exudate increase in circulating neutrophils, formation of pus • Stage III- Tissue Repair and Replacement

24. ANTIBODY-MEDIATED IMMUNITY • Antibody—a protein (gammaglobulin) that forms to defend the body from a specific antigen (foreign substance), such as chemical agents, virus particles, and bacterial toxins • All antibodies are gammaglobulins (also called immunoglobulins) • Globulin is a protein in a globular shape • Globular proteins provide immunity • Resulting term is immumoglobulin

25. ANTIBODY-MEDIATED IMMUNITY • Antigen-Antibody Reactions • Destroy, eliminate, neutralize foreign proteins • Long lasting immune reaction • Entire immune system must function adequately for optimal AMI

26. ANTIBODY-MEDIATED IMMUNITY • CELLS INVOLVED IN AMI • B-cells • Macrophages • T-Lymphocytes • B-Cells • Start as stem cells from bone marrow • Produce antibodies to specific foreign protein • Develop in lymphocytic tissue • Produce antibodies

27. ANTIBODY-MEDIATED IMMUNITY

28. ANTIGEN-ANTIBODY INTERACTIONS • EXPOSURE • ANTIGEN RECOGNITION • LYMPHOCYTIC SENSITIVATION • ANTIBODY PRODUCTION AND RELEASE • ANTIGEN-ANTIBODY BINDING • ANTIBODY BINDING ACTIONS • SUSTAINED IMMUNITY: MEMORY

29. ANTIBODY TYPES • IMMUNOGLOBULINS ARE CLASSIFIED BY SIZE, TIMING, AND ASSOCIATION • IgA • IgD • IgE • IgM

30. ACQUIRED ANTIBODY MEDIATED IMMUNITY • Innate-native Immunity • Adaptive Immunity • Active Immunity

31. ACQUIRED ANTIBODY MEDIATED IMMUNITY • Nature Active Immunity • Artificial Active Immunity • Passive Immunity

32. CELL MEDIATED IMMUNITY • Provided by mature lymphocyte stem cells • Helps protect the body by differentiating self from non-self cells. Cells most easily recognized by CMI are cancer cells and those cells inflicted by organisms that live in the host cell

33. CELL MEDIATED IMMUNITY • T-lymphocytes (T-cells) • Helper-Inducer T- Cells • Suppressor T-cells • Cytotoxic/Cytolytic T-Cells • Natural Killer Cells

34. CYTOKINES • Small, secreted proteins which regulate immunity, inflammation, and hematopoiesis • Act by binding to specific membrane receptors, which then signal the cell to alter its behavior, causing a change in function of the target cell. • Many different types of cells can produce the same cytokine, and a single cytokine may act on a variety of target cells

35. CYTOKINES

36. TRANSPLANT REJECTION • Hyperacute Rejection • Acute Graft Rejection • Chronic Rejection

37. TREATMENT OF TRANSPLANT REJECTION • Medication • Maintenance • Rescue Therapy

38. Stress & Coping

39. Scientific Knowledge Base • Fight or flight response to a stressor • Stimulation of sympathetic nervous system • Medulla Oblongata • Reticular Formation • Pituitary Gland

40. General Adaptation Syndrome • Alarm Reaction • Resistance Stage • Exhaustion Stage

42. Response to Stress • Physiological Responses- LAS, GAS • Local Adaptation Syndrome-1.) Reflex Pain Response 2.)Inflammatory Response • General Adaptation Response- 1.)Alarm Reaction (Flight or Fight) 2.) Resistance Stage 3.) Exhaustion Phase

46. Types of Stress • Eustress • Distress • Post Traumatic Stress Disorder (PSTD)

47. Understanding Stress Response • Psychological response- Coping Mechanism, Ego-Defense Mechanism • Situational Factors • Developmental/Maturational Factors • Intellectual Factors • Emotional, Behavioral Issues • Family Factors • Lifestyle Factors • Sociocultural, Spiritual Factors

48. Assessing Stress • Physiological Indicators • Stress Situations • Psychological Indicators • Developmental Indicators • Emotional Behavioral Indicators • Intellectual Indicators • Family Indicators

49. Implementation • Stress Management • Time Management • Medications • Alternative Therapies • Regular Exercise • Good Nutrition and Diet • Rest • Support Systems • Crisis Intervention

50. Restorative Care • Humor • Enhancing Self-esteem • Relaxation Techniques • Spirituality • Stress Management