AP Module 4 Course Manual

Anatomy & Physiology Diploma
Module 4
2012 Essentially Holistic

Not for reproduction in any form without prior permission of Essentially Holistic
Contents
Contents ....................................................................................................... 2
Course Outline ............................................................................................. 3
Aims & Objectives of the course: ............................................................... 3
Course literature .......................................................................................... 3
Structure of the Course:.............................................................................. 4
Section 1 - The Lymphatic System ............................................................. 6
a. The structure and function of the lymphatic system ............................ 6
b. Lymph nodes and lymph flow ................................................................ 7
c. The role of the Lymphatic system in the body .................................... 11
d. Common Disorders of the Lymphatic System .................................... 13
Section 2 - The Immune System ............................................................... 14
a. The Immune system .............................................................................. 15
b. Non-specific defence mechanisms ...................................................... 15
c. Immunity and immune responses ........................................................ 19
d. Allergic responses ................................................................................ 23
e. Common Disorders of the Immune System ......................................... 24
Section 3 - The Respiratory System ......................................................... 25
a.
The structure and function of the respiratory system ................... 26
b. Respiration and breathing .................................................................... 27

c. Common Disorders of the Respiratory System ................................... 30
Further Reading ......................................................................................... 32

Course Outline
The Human Body is an amazing and very complex machine which we all take
for granted! To be a successful therapist it is crucial that you understand how
the body functions normally and what happens when it becomes out of
balance and diseased. Throughout this course you will be introduced to each
body function, given information on how it works, what happens when it
doesnt work and common problems and diseases that can affect it. To
ensure you are assimilating the knowledge there will be regular tests. These
can take the format of multiple choice questions, short answer questions,
longer questions and diagrams to label.
Aims & Objectives of the course:
By the end of the course you will be able:
To provide an introduction to the workings of the human body
To provide an understanding of the anatomical terms associated with
describing the human body
To develop an awareness of the chemistry underlying the functioning of
the human body
To develop an understanding of the organisation of the human body from
cells to systems
To provide a thorough understanding of the normal physiology of the
human body
To develop an awareness of what constitutes a deviation from normal
functioning
To describe symptoms and signs of these deviations
To develop an awareness of how the human body responds to stress
To provide an understanding of the mechanisms by which repair may be
affected
Course literature
In order to complete the course you will need a copy of:
Ross and Wilson Anatomy & Physiology in Health and Illness (11th Edition)
by Anne Waugh & Alison Grant
ISBN: 978-0-7020-3227-1
We will use this for reference purposes during the modules and you may wish
to use it to read more about topics that interest you. I will refer to the book at
the end of each section if there is any further reading required.
There is a list of books that you may want to use for further reading at the end
of each module.

Structure of the Course:

The course is presented in five modules:
Module 1
Aims & Objectives of the course
Introduction to the Human Body
The Chemistry of Life
Cells
Tissues
Module 2
The Integumentary System
The Skeletal System
The Muscular System
Module 3
The Nervous System
The Endocrine System
The Cardiovascular System
Module 4
The Lymphatic System
The Immune System
The Respiratory System
Module 5
The Digestive System
The Urinary System
The Reproductive System
The Effects of Stress on the System

Throughout the course notes you will find the following images:
Image
This gives details of a diagram, image or chart in the Ross &
Wilson book that you need to look at.
Additional Work
This gives details of extra reading you need to undertake in order
to complete the tests and assignments
Media
This gives information about films, slideshows or images you
may find useful
Additional Work
This gives ideas of work to supplement your studies
Have some fun!

This gives details of things you may find fun but will help with your
learning.

Module 4 -
The Lymphatic System

The Immune System
The Respiratory System
Section 1 - The Lymphatic System

By the end of this section you will be able to:
1. Describe the functions of the lymphatic system
2. Identify the main structures of the lymphatic system (tonsils, spleen, thymus,
lymph nodes and vessels)
3. Describe the structure of a lymph capillary and its relation to the blood
capillaries
4. Explain the composition, circulation and functions of lymph
5. Locate the major groups of lymph nodes and lymphatic tissue throughout
the body and describe their structure
6. Describe the formation of lymph and the mechanisms responsible for lymph
flow
7. Describe the structure of a lymph node
8. Describe the role of the lymphatic system in the inflammatory process
9. Explain the role of the lymphatic system in fighting infection
10. Name & describe briefly common disorders/diseases of the lymphatic
system including:
Oedema
Enlarged Lymph Nodes
Hodgkins disease
Non-Hodgkins lymphatic disease
Lymphoedema
Tonsillitis
a. The structure and function of the lymphatic system

The lymphatic system is a subsystem of the circulatory system.
Its three principal functions are: To collect and return interstitial fluid, including plasma protein to the blood,
and thus help maintain fluid balance,
To defend the body against disease by producing lymphocytes,
To absorb lipids from the intestine and transport them to the blood
Image
A diagram showing the major parts of the lymphatic system can
be found in Ross & Wilson page 128, Figure 6.1
Media
This video gives an overview of the lymph system
http://www.youtube.com/watch?v=lGRceUoQRVw&feature=related
Lymph is a transparent, straw coloured fluid with the consistency of honey. It

is derived from plasma (the liquid part of the blood) and therefore its
composition is similar but not identical. Lymph contains fewer nutrients, more
waste products, no red cells and relatively more white cells.
The Lymphatic system has to have a high intra-vascular pressure if the blood
is to be adequately transported. This results in fluid seepage from the
capillaries and it is thought that the lymphatic system originally evolved to
combat this problem. Lymphatic tissue is a type of connective tissue
characterised by large numbers of lymphocytes. The stroma (framework) of
lymphatic tissue is a network of reticular fibres. Connective tissue cells
including fibroblasts and macrophages are present.
Lymphatic tissue is organised in 3 different ways:
Diffuse lymphatic tissue
Lymph nodules
Lymph nodes
Small amounts of diffuse lymphatic tissue are found in virtually every organ of
the body.
b. Lymph nodes and lymph flow

The lymphatic system has neither a heart nor arteries. Its microscopic deadend capillaries extend into most tissues, paralleling the blood capillaries.
The lymphatic circulation is a drainage system. Its job in maintaining fluid
balance is to:
Collect excess interstitial fluid and return it to the blood (approximately 3
litres daily).
Return plasma proteins to the blood

Once interstitial fluid enters a lymph capillary, it is referred to as lymph.
The three main types of lymphatic vessels are lymph capillaries, lymphatics,
and lymph ducts.
Lymph capillaries are microscopic tubes located between cells. Lymph
capillaries resemble blood capillaries somewhat, but differ in important ways.
Whereas a blood capillary has an arterial and a venous end, lymph capillary
has no arterial end. Instead, each lymph capillary originates as a closed tube.
Lymph capillaries also have a larger and more irregular lumen (inner space)
than blood capillaries and are more permeable.
The wall of a lymph capillary is constructed of endothelial cells that overlap
one another.

When fluid outside the capillary pushes against the overlapping cells, they
swing slightly inward, like a swinging door that moves in only one direction.
Fluid inside the capillary cannot flow out through these openings.
This diagram showing a section through a lymph capillary shows how the
interstitial fluid surrounding the capillary enters through the overlapping cells.
The arrows represent the direction of flow of the lymph.
Note the internal valve, which allows the lymph to flow in one direction only.
Media
This video gives an overview of the formation of lymph
http://www.youtube.com/watch?v=1rVsonBiBHk
Lymph capillaries branch and interconnect freely and extend into almost all
tissues of the body except the CNS (Central Nervous System) and the
avascular tissues such as the epidermis and the cartilage.
Lymph capillaries join to form larger vessels called lymphatics or lymph veins.
These resemble blood-conducting veins but have thinner walls and relatively
larger lumen, and they have more valves. In the skin, lymphatics are located
in subcutaneous tissue and follow the same paths as veins. In the viscera,
lymphatics generally follow arteries and form plexuses (networks) around
them.
At certain locations lymphatics enter lymph nodes. These are structures that
consist of lymphatic tissue.
As the lymph flows slowly through the lymph sinuses within the tissue of the
lymph node, it is filtered. Macrophages remove bacteria and other foreign
matter as well as debris.
Lymphocytes are added to the lymph as it flows through the sinuses of a

lymph node. Thus the lymph leaving the node is both cleaner of debris and
richer in lymphocytes. Lymphatics leaving lymph nodes are called efferent
lymph vessels and conduct lymph toward the shoulder region. Large
lymphatics that drain groups of lymph nodes are often called lymph trunks.
Lymphatics from the lower portion of the body converge to form a dilated
lymph vessel, the cysterna chyli, in the lumbar region of the abdominal cavity.
The cysterna chyli extends for about 6 centimetres just to the right of the
abdominal aorta. At the level of the twelfth thoracic vertebra, the cysterna
chyli narrows and becomes the thoracic duct.
Lymphatic vessels from all over the body, except the upper right quadrant,
drain into the thoracic duct. This vessel delivers the lymph into the base of the
left subclavian vein at the junction of the left subclavian and internal jugular
veins. In this way lymph is continuously emptied into the blood where it mixes
with the plasma. At the junction of the thoracic duct and the venous system, a
valve prevents blood from flowing backward into the duct.
Image
A diagram showing the major parts of the lymphatic system can
be found in Ross & Wilson page 128, Figure 6.1
Only about 1 centimetre in length, the right lymphatic duct receives lymph
from the lymphatic vessels in the upper right quadrant of the body. The right
lymphatic duct empties lymph into the base of the right subclavian vein (at the
point where it unites with the internal jugular vein to form the brachiocephalic)
An example of the pattern of lymph circulation is:
Lymph capillaries
cysterna chyli
lymphatic
thoracic duct
lymph node
lymphatic
Lymphatic vessels and lymph nodes can be visualised by the process of

lymphangiography. A radiopaque (not transparent to x-rays) contrast material
is injected into the lymphatic vessel. This will show up the vessel and its
connections to other lymph vessels. The fluid is left in the system for 24 hours
and X-rays can then observe the lymph nodes. This technique is quite
important in the treatment of neoplasms and other disorders of the lymphatic
system. The technique is also used to locate lymph nodes for radiation
therapy or for surgical removal.
Lymph Nodes
All the small and medium-sized lymph vessels open into lymph nodes, which
are situated in strategic positions throughout the body. The lymph drains
through a number of nodes, usually 8 to 10, before returning to the blood.

These nodes vary considerably in size: some are as small as a pinhead and
the largest are about the size of an almond.
Image
A diagram showing the structure of a lymph node can be found in
Ross & Wilson page 130, Figure 6.4
Lymph nodes have a surrounding capsule of fibrous tissue, which dips down
into the node substance forming partitions, or trabeculae. The main
substance of the node consists of reticular and lymphatic tissue containing
many lymphocytes and macrophages. As many as four or five afferent lymph
vessels may enter a lymph node while only one efferent vessel carries lymph
away from the node. Each node has a concave surface called the hylum
where an artery enters the vein and the efferent lymph vessel leaves. There
are large numbers of lymph nodes situated in strategic positions throughout
the body in deep and superficial groups.
Lymph from the head and neck passes through deep and superficial cervical
nodes. Lymph from the upper limbs pass through nodes situated in the elbow
region then through the deep and superficial axillary nodes. Lymph from
organs and tissues in the thoracic cavity drains through groups of nodes,
including:
parasternal,
intercostal,
brachiocephalic,
mediastinalis,
tracheobronchial, bronchopulmonary and oesophageal nodes.
Most of the lymph from the breast passes through the axillary nodes. Lymph
from the pelvic and abdominal cavities passes through many lymph nodes
before entering the cysterna chyli. The abdominal and pelvic nodes are
situated mainly in association with the blood vessels supplying the organs
and close to the main arteries, i.e. the aorta and the external and internal iliac
arteries. The lymph from the lower limbs drains through deep and superficial
nodes including popliteal nodes and inguinal nodes.
Functions of lymph nodes
Filtering and phagocytosis
Lymph is filtered by the reticular and lymphoid tissue as it passes through
lymph nodes. Particulate matter may include microbes, dead and live
phagocytes containing ingested microbes, cells from malignant tumours, worn
out and damaged tissue cells, and inhaled particles. Organic material is
destroyed in the lymph nodes by macrophages and antibodies. Some
inorganic inhaled particles cannot be destroyed by phagocytosis. These
remain inside the macrophage either causing no damage or destroying it.
Material not filtered off and dealt with in one lymph node passes on to the
next and so on. Thus by the time the lymph reaches the blood it has usually
been cleaned of all impurities such as cell debris and foreign bodies. In some
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instances where phagocytation is incomplete the node may swell. Swelling of

lymph nodes is often an indication of an infection. You may well have
experienced swollen cervical lymph nodes. These often accompany a sore
throat due to streptococcal infection. Infections in almost any part of the body
may result in swelling and tenderness of the lymph nodes associated with
that part of the body.
c. The role of the Lymphatic system in the body

The role of the lymphatic system in the inflammatory process
Within us all there is a silent system working to keep us healthy- the lymph
system. Without it our bodies would swell up like balloons, swamping our
cells with stagnant fluid. The lymph system's impact is so far reaching that
many don't even realize that minor aches and pains, low energy or
susceptibility to colds and flu may be due to a sluggish lymph system and a
compromised immune system.
Lymph vessels make an intimate meshwork that covers every inch of your
skin, and surrounds each organ in great detail. The lymph vessels start very
small in what are called the initial lymphatic. Over 70% of the initial
lymphatics are in and just under the skin. The initial lymphatic is a very
delicate structure, one cell thick. These cells are supported within the
connective tissue by collagen and elastin fibres that help to anchor them in
place. When the pressure within the interstitial space increases due to a build
up of fluid (known as lymph obligatory load LOL), or when the skin is slightly
stretched, the filaments deform the wall of the initial lymphatic, opening it up.
Then the interstitial fluid flows in and starts to move along the channel. At this
point we start calling it lymph. Although only 2-3 litres of lymph are filtered
through the lymph system per day, it is vital because it helps to remove
proteins that are too large to get back through the capillary wall. The spaces
that open in the initial lymphatic are 4 to 6 times bigger than the spaces in the
capillaries. Removal of protein is essential because they draw water to
themselves, so excess protein in the interstitial spaces causes swelling or
oedema. The lymph vessels also collect dead cells, waste products, bacteria,
viruses, inorganic substances, water and fats.
Each cell is nourished by the nutrients, oxygen and proteins that flow across
the walls of capillaries into the interstitial fluid. There is a dynamic balance
between the forces that help those nutrients to first exit the capillaries, and
then get reabsorbed back into the blood stream. Proteins play a big part in
this transfer because they have a tendency to draw water to themselves. This
means that the proper amounts of protein on both sides of the capillary wall
are vital to keep the tissues balanced. If there are too many proteins within
the interstitial spaces, fluid will start to accumulate, causing oedema. The
lymph systems role of removing proteins is vital to keeping oedema down. If
the lymph system becomes sluggish, or is damaged by surgical removal of
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lymph nodes, oedema can develop. This type of oedema is called

lymphostatic oedema- or a high protein oedema.
Other causes of oedema can be a chemical imbalance in the body caused by
liver disease, diabetes, or a variety of other ailments. This type of oedema is
called lymphodynamic oedema, and requires other forms of therapy due to
the fact that it is a chemical imbalance.
Additional Work
Research the role of the lymphatic system in the inflammatory
process using books and the internet
The role of the lymphatic system in immunity
Lymph nodules are small masses of lymph tissue (up to a millimetre or so in
diameter) in which lymphocytes are produced. Lymph nodules are scattered
throughout loose connective tissue, especially beneath moist epithelial
membranes such as those that line the upper respiratory tract, intestine, and
urinary tract. Lymph nodules appear to be strategically distributed to defend
the body against disease organisms that penetrate the lining of passageways
that communicate with the outside of the body. A lymph nodule consists
mainly of large numbers of lymphocytes enmeshed within reticular fibres.
Lymph nodules do not have vessels bringing lymph to them. The periphery of
the nodule is not sharply defined. Some lymph nodules develop germinal
centres, central areas filled with immature lymphocytes. Here new
lymphocytes proliferate from stem cells that originate in the bone marrow.
The lighter-staining germinal centre is surrounded by a darker-staining region
called the cortex.
Most lymphatic nodules are small and solitary. However, some are found in
large clusters. For example large aggregates of lymph nodules occur in the
wall of the lower portion (ileum) of the small intestine. These large masses of
lymph nodules are known as Peyer's patches. Tonsils are also aggregates of
lymph nodules. They are located strategically to defend against invading
bacteria. The tonsils produce lymphocytes. They are located under the
epithelial lining of the oral cavity and pharynx. The lingual tonsils are located
at the base of the tongue. The single pharyngeal tonsil is located in the
posterior wall of the nasal portion of the pharynx above the soft palate and is
often referred to as the adenoids.
So to summarise lymph nodules comprise:
Palatine and lingual tonsils--between the mouth and the oral part of the
pharynx.
Pharyngeal tonsil--on the wall of the nasal part of the pharynx
Solitary lymphatic follicles

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Aggregated lymphatic follicles (Peyer's patches)--in the wall of the small

intestine
Vermiform appendix--an outgrowth from the caecum (first part of the

large intestine).
Collectively this tissue is referred to as mucosa associated lymph tissue
(MALT) and along with the spleen and thymus it is involved in the
development of immunity. However, unlike lymph nodes, MALT has no
afferent lymph vessels and therefore does not filter lymph. MALT is
strategically positioned to protect the respiratory and gastrointestinal tracts
from microbes and other foreign material which has entered.
Additional Work
Research the role of the lymphatic system in fighting infection
using books and the internet
d. Common Disorders of the Lymphatic System

Disorders of the lymphatic system can vary from fairly mild with few
symptoms to major conditions that can impair function and affect everyday life
The list below gives many of the well known disorders:
Oedema
Enlarged Lymph Nodes
Hodgkins disease
Non-Hodgkins lymphatic disease
Lymphoedema
Tonsillitis
Auditory disturbances i.e.: deafness, tinnitus, vertigo, and otitis media
Additional Work
Further information on the disorders of the lymphatic system can
be found in Ross & Wilson pages 134 136
Additional Work
Research the disorders of the lymphatic system using textbooks
and the internet

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Section 2 - The Immune System

1. Distinguish between specific immunity and non-specific defence
mechanisms
2. Identify non-specific defence mechanisms such as skin, stomach acid,
respiratory passageways and explain how they protect against infection.
3. Relate the physiological changes and clinical symptoms associated with
inflammation to its role in the defence of the body.
4. Describe the process of phagocytosis
5. Compare the types of T and B lymphocytes with respect to life cycle and
function and identify other cells such as macrophages that function in
immune responses.
6. Define the terms antigen and antibody and describe how antigens
stimulate the immune response
7. Describe the mechanisms of antibody mediated immunity
8. Describe the mechanisms of cell-mediated immunity, including the
development of memory cells
9. Define active and passive immunity/ define inborn immunity and compare
it with naturally and artificially acquired immunity
10. Describe the allergic response both local and general
11. Differentiate between the allergic response and sensitivity
12. Name & briefly describe common disorders/diseases of the immune
system, including:
Allergies
Auto immune diseases
e.g. ankylosing spondylitis, colitis, psoriasis
SLE, RA, Graves
Immunodeficiency diseases e.g. AIDS
Immuno-suppression
e.g. after organ transplant
Chronic fatigue syndrome

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a. The Immune system

Our bodies are under constant threat from the environment in which we live. It
begins as we are forming from a foetus in our mothers womb and only
ceases upon our death. The immune system protects us from bacteria,
viruses, cancer cells, parasites and foreign cells to name but a few! The
immune system can be divided into two distinct categories:
Specific Defence mechanisms
These are generally grouped under the term immunity. The resistance
developed is to only one specific type of invader. Immunological memory
develops as part of the immune process giving long term protection against
the invader i.e. mumps. Alongside this antigens stimulate immune responses
in the body.
Non-specific defence mechanisms
These protect against a myriad of possible threats to the immune system.
Media
This video gives an overview of the immune system
http://www.youtube.com/watch?v=Cv_zt9eOB-A&feature=related
b. Non-specific defence mechanisms

They act as the first line of defence, preventing entry into the system or
reducing the amount of microbes or foreign materials that pass into the
system. There are 5 main non-specific defence mechanisms:
Defence at the body surfaces
Phagocytosis
Naturally occurring antimicrobial substances
Inflammatory processes
Immunological monitoring
Defence at the Body surfaces
These take the form of:
1. Skin and mucous membranes providing these are intact and healthy
they provide a barrier against invading microbes. The outer layer of skin
is only able to be penetrated by a few microbes. Antibacterial and
antifungal substances are contained in both the sebum and sweat
secreted by the skin. Mucous membranes secrete mucous which helps
trap foreign matter and microbes on its sticky surface.
2. Hairs in the nose acts as the first filtration device with the cilia and
mucous membranes in the respiratory tract carrying on the process.
Any matter needing to be expelled is either coughed up or swallowed.
3. Stomach acid helps to eradicate any bacteria or foreign matter entering
the digestive system.
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4. The one-way flow from the kidneys to the bladder also helps reduce the
risk of microbes being transported by the urethras to the bladder.
The inflammatory process
This is the bodys response to tissue damage. Inflammation has a set of
characteristics which occur locally to the damage. It usually takes place when
microbes have passed through the non-specific defence mechanism. The
purpose of inflammation is protective. It achieves this by:
Isolating and inactivating the area
Removing the cause and any damaged tissue
These processes allow healing to take place in the area.
The causes of inflammation are many and varied. Generally it is caused by:
Microbes bacteria, funguses, protozoa and viruses
Physical agents heat, cold, injury and ultraviolet
Chemical agents these can be organic (microbial toxins or organic
poisons) or inorganic (acids and alkalis)
Episodes of inflammation usually are short in duration lasting from a few
hours to a few weeks. They can range in severity from minor to very severe.
Indicators of inflammation include:
Heat
Pain
Redness
Swelling
Loss of function
Most of the processes involved in the inflammatory process are beneficial to
the body for the fact that they remove the harmful agent and set in place the
process required for healing to occur.
The following steps are a normal part of the inflammatory process:
Increased Blood Flow
When injury occurs both the arterioles and capillaries supplying blood to the
site dilate causing an increased blood flow. This occurs as a result of
chemical mediators being released locally from the damaged cells i.e.
serotonin and histamine. Oxygen and nutrients are supplied in increased
quantities to the area to provide for the increased cellular activity which
occurs as part of the inflammatory process. This increase in blood flow
causes increased reddening and temperature in the area, also contributing to
oedema and swelling.

16
Increase tissue fluid formation

One of the main signs of inflammation is the swelling of the tissues involved.
This is a result of fluid leaving the localised blood vessels and seeping into
the interstitial spaces. This is partly as a result of histamine, prostaglandins
and serotonin increasing the permeability of the capillaries and also due to
increased pressure inside the vessels as a result of the elevated blood flow
within the area. The excess fluid drains into the lymphatic system taking with
it the damaged tissue and toxins.
Plasma proteins which are normally only present in the bloodstream escape
through the capillary walls, increasing osmotic pressure and thus drawing out
more fluid from the blood. The proteins include antibodies, which help combat
infection and fibrinogens which acts as a clotting agent. Fibrinogen in the
tissues is converted by thromboplastin to fibrin. This forms an insoluble mesh
in the interstitial spaces, closing off the affected area and helping prevent the
spread of infection in the body. Some pathogens (usually present in throat
and skin infections) contain substances that can break down this network and
release infection into the surrounding areas.
When swelling occurs in the mouth or respiratory passages it can be fatal so
medical assistance should be sought immediately. Most swelling results in
pain. Swelling can however cushion joints and restrain movement of the area
thus allowing healing to take place faster.
Leukocyte migration
As a result of fluid being lost from the blood it becomes thicker, slowing the
flow and allowing white blood cells (normally fast-flowing) to adhere to the
vessel walls. In the most acute phase a leukocyte known as neutrophil enters
the tissues to carry out is function in the Phagocytosis of antigens.
Raised temperatures that are associated with inflammation (both localised
and systemic) promote phagocyte activity. After 24 hours, the most
predominant cell type at the site of the inflammation is macrophages. They
continue to be present in the tissues if the problem has not been resolved
resulting in chronic inflammation.
Chemotaxis this is the process of chemical attraction as a result of
inflammation that brings leukocytes including neutrophils and macrophages to
the area.
Increased core temperature
A rise in body temperature (pyrexia) may be part of the inflammatory process
if there is a significant infection present. Pyrexia causes an increase in the
metabolic rate of the cells in the affected area thus, requiring an increase
supply of oxygen and nutrients. Increased temperature in the inflamed and
17
damaged tissues has the effect of inhibiting the growth and division of
microbes, whilst encouraging the activity of phagocytes.
Pain
Pain associated with inflammation is caused by the swelling compressing the
sensory nerve endings. Chemical mediators that are part of the inflammatory
process may cause the pain to be more acute which increase sensitivity of
the sensory nerve ending to pain stimuli. Pain can help promote healing as it
encourages reduced movement and thus protection of the affected area.
Pus formation (suppuration)
Pus contains dead phagocytes, cells and debris, fibrin, exudates from the
inflammatory process along with living and dead cells. These are contained in
a membrane of new blood capillaries, fibroblasts and phagocytes. Small
amounts of pus result in boils whereas larges amounts result in abscesses
being formed. Pus formation can result in:
Rupturing and discharge of pus followed by healing
Partial rupture followed by the formation of a chronic abscess
Rupture and discharge into adjacent organs
Removal of pus by the phagocytes
Enclosure of the pus by fibrous tissue, creating a source for further
infection
Formation of fibrous adhesions
Inflammation is normally resolved resulting in the area healing with new
healthy tissues with or without the formation of a scar. Occasionally the
inflammation is not resolved and a chronic inflammation results. This can lead
to deep seated abscesses, wound and possibly bone infections.
Media
This video gives an overview of the inflammatory process
http://www.youtube.com/watch?v=7r94q8Z3CH0&feature=related
Additional Work
Further information on the inflammatory process can be found in
Ross & Wilson pages 367 - 369
Phagocytosis
This is the process when phagocytic defence cells (macrophages and
neutrophils) travel to areas of infection or inflammation. They are attracted by
the chemoattractants released by neutrophils and invading microbes. They
18
then trap particles by either engulfing them with their body mass or extending
long pseudopodia towards them and reeling them in. They have the ability to
bind, engulf and digest all foreign particles and cells.
Macrophages form an important link between the non-specific and specific
defence mechanisms. After they have ingested an antigen they take on the
role of antigen-presenting cells. They display their antigen on their cell
surface, stimulating T-lymphocytes and activating the immune response.
Media
This video gives an overview of phagocytosis
http://www.youtube.com/watch?v=7VQU28itVVw
c. Immunity and immune responses

The cell which controls the immunity in our bodies is the lymphocyte. It is a
white blood cell manufactured in the bone marrow. Once it is present in the
blood stream further processing occurs which results in two distinct types of
lymphocytes being formed:
T-lymphocytes
These are processed by the thymus gland. Thymosin, a hormone released by
this gland causes the lymphocytes to be processed resulting in mature,
specialised, functioning T-lymphocytes. These are only able to recognise one
type of antigen. It reacts to no other form of antigen it may meet during its
passage through the body. T-lymphocytes provide the body with cellmediated immunity.
B-lymphocytes
These are produced and processed in the bone marrow. Their role is in the
production of antibodies (immunoglobulins), these are proteins designed to
bind and destroy antigens. As with T-lymphocytes they react to only one
specific type of antigen. B-lymphocytes provide antibody-mediated immunity.
As you may gather from the above descriptions the body contains millions of
different types of T and B-lymphocytes which need to be produced and
present in the body during its lifetime
Antigens & Antibodies
Antibodies
These are also known as immunoglobins. They are types of protein
manufactured by the body in the response to foreign substances (antigens)
which can enter the body. The antibodies inactivate the antigen by binding or
attaching themselves to it.
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A healthy adults body contains thousands of different types of antibodies.

They have a characteristic Y shape with a binding site on each arm of the Y.
These sites each have a specific shape relating to the antigen they are
designed to inactivate.
Antigens
These are substances that stimulate the immune system to produce
antibodies. They can take many forms including viruses, fungi and bacteria.
They can also be allergens which cause an allergic reaction to take place in
the body. Allergens include food, dust, pollen and stings. Blood transfusions
can also result in antibodies being produced if the antigens in the transfused
blood are incompatible with the bodys own blood.
When foreign substances enter the body for the first time the body immune
system needs time to produce antibodies to fight. This results in symptoms
being present. However, when subsequent attacks take place the body is
prepared and there may be no symptoms. This shows that the body has
developed immunity to the antigen.
Media
This video shows antibodies and antigens
http://www.youtube.com/watch?v=KpNFAEbLcvk&feature=related
Cell-mediated immunity
T-lymphocytes which have been formed by the thymus are free to circulate
within the body. When they encounter an antigen for the first time they
become sensitised to it. If the cell is of a foreign origin it needs to be
presented to the T-lymphocyte. This is done on the surface of the antigenpresenting cell. Macrophages are one of the main types of antigen-presenting
cells. They are apart of the non-specific defences as they engulf, and digest
antigens of any type, as well as taking part in immune responses. In order to
complete this task they first ingest the antigen transporting the most antigenic
fragment in its own cell membrane, displaying it on the surface until it meets
the T-lymphocyte specifically manufactured to deal with the antigen.
If the antigen is classified as an abnormal cell (cancer cell) it also displays
foreign material on its surface which will also stimulate T-lymphocyte activity.
When the antigen is finally present to the T-lymphocyte it stimulates clonal
expansion (division and proliferation). Four main types of T-lymphocyte are
produced against the original antigen:
1. Memory T-cells
These are long living cells which remain in the body long after the initial
episode has ended. They provide cell-mediated immunity which can respond
rapidly to further encounter with the same antigen.
20
2. Cytotoxic T-cells
These inactivate any cells carrying antigens by attaching themselves to the
target cell and releasing powerful toxins. Their main role is to destroy
abnormal body cells.
3. Helper T-cells
These are essential for the correct functioning of both cell-mediated and
antibody-mediated immunity. When this type of cells number are diminished
the whole immune system enters a compromised state. Their main functions
include:
The production of cytokines which support and promote cytotoxic Tlymphocytes and macrophages
Producing antibodies in cooperation with B-lymphocytes.
4. Suppressor T-cells
These cells cause a cessation in the production of T- and B- lymphocyte
cells. These prevent potential harm to the immune system.
Media
This video explains cell-mediated immunity
http://www.youtube.com/watch?v=1tBOmG0QMbA
Antibody mediated immunity

T lymphocytes vary from B-lymphocytes as they circulate freely around the
body with the ability to recognise and bind antigen cells without needing the
assistance of an antigen-presenting cell. B-lymphocytes are fixed in lymphoid
tissue. When they are presented with an antigen they begin to enlarge and
divide (clonal expansion). As a result of this process the following cells are
formed:
1. Plasma cells
These secrete immunoglobins (antibodies) into the blood. These are then
carried throughout the tissues of the body. They live no longer than 24 hours
producing just one type of antibody targeting only the antigen same as the
one originally bound to the b-lymphocyte. These cells:
Bind to the antigens, making them visible so other defence cells
(macrophages and cytotoxic T-lymphocytes)
Binding and neutralising bacterial toxins
Activates complement reactions
2. Memory B-cells
These act in a similar way to memory T-cells. They remain in the body long
term and after the initial episode they are quick to react to another encounter
with the same antigen by producing antibody secreting plasma cells.
21
There is a fine balance in the bodies immune system which does not
normally allow the body to develop immune reactions to its own cells. When
this occurs autoimmune diseases result.
Media
This video explains antibody-mediated immunity
http://www.youtube.com/watch?v=hQmaPwP0KRI
Acquired Immunity
After an antigen has been detected for the first time a primary response
follows. This normally lasts for around 2 weeks. During this time a low level of
antibodies can be detected in the blood. Normally this is sufficient to deal with
the antigen and after this time the levels of antibodies in the blood will fall
unless the antigen is encountered again in the system. A secondary response
occurs when the antigen is encountered again. This elicits a rapid response
by the memory B-cells and a marked increase in the production of antibodies.
Further increases are generally as a result of further encounters until a
maximum is reached. This is the principle used when active immunisation is
used against infectious diseases.
Immunity can be acquired either naturally or artificially with both forms having
an active and passive mechanism. Active immunity results when the body
has been exposed and has reacted to an antigen by producing its own
antibodies resulting in the formation of a long lasting resistance. In passive
immunity the antibodies are provided by a third party. This type of immunity
does not normally result in long tem protection.
Active naturally acquired immunity
The body may be stimulated to form its own antibodies in the following ways:
Being exposed to the disease infection during the time of infection the
body develops B-lymphocytes to overcome the infection
Having a sub-clinical infection this is when the body is exposed to the
antigen but it does not develop into full blown symptoms. This may
however result in the body developing immunity to the antigens
Active artificially acquired immunity
This type of immunity is developed when the body is exposed to either dead,
artificially weakened microbes or deactivated toxins. These can take the form
of vaccines or toxoids which are able to stimulate the development of
immunity in the system but are not able to develop into the full blown disease.
Many infectious diseases can be prevented by artificial immunisation

22
Passive naturally acquired immunity

This type of immunity is acquired before birth by the passage of antibodies
from the mother across the placenta to the foetus and also through the breast
milk. This type is very dependant on the strength of the mothers immune
system and is only short lived.
Passive artificially acquired immunity
This is a result of ready-made antibodies in the form of serum being injected
into the recipient. They can be administered either before the disease
develops to provide immunity or when disease is present to help accelerate
the immune function of the body.
Additional Work
Further information on immunity can be found in Ross & Wilson
pages 369 373
d. Allergic responses
An allergy is the term used to describe a powerful immune response which
occurs in the body due to an antigen. The allergen is usually harmless in
nature i.e. dust, pollen or dander. It is the body which causes the damage to
itself and not the allergen. When initial exposure occurs the body becomes
sensitised. When further exposure to the antigen occurs the body creates a
response which is out of proportion to the danger posed by exposure to the
antigen. These reactions can range from runny eyes, swelling and itching
through to anaphylactic shock which can in extreme cases result in death.
Hypersensitivity is classified into 4 categories:
1. Type I anaphylactic hypersensitivity
This generally occurs in individuals who have inherited elevated levels of
immunoglobins E. When exposure to antigens occurs the body reacts by
releasing large levels of mast cells and basophils. Histamine is also released
causing constricture in some smooth tissue. This can lead to
bronchoconstriction and shock. This type of reaction can result in death if not
treated quickly.
2. Type II cytotoxic hypersensitivity
When an antibody and antigen (i.e. bacteria) react together on the surface of
a cell the result is normally that the cell is marked for destruction. This occurs
by one of several processes. However, if the anti-bodies are directed at the
self antigens it results in the destruction of body tissues (auto-immune
disorders). This type of reaction can occur when transfusion or organ
transplants are performed.
23
3. Type III immune-complex-mediated hypersensitivity

Phagocytosis normally occurs within the body to clear antibody-antigen
complexes, however if this process fails or excessive amounts of the immune
responses are manufactured they can be deposited in the tissues (kidneys,
skin, joints and eyes) where they set up an inflammatory reaction. When this
occurs in the kidneys it can impair kidney function but in other areas of the
body it can create rashes, joint pains and occasionally haematuria.
**Sensitivity to penicillin is classified as a type III reaction**
4. Type IV delayed type hypersensitivity
This type of hypersensitivity is due to an over reaction of T-lymphocytes to an
antigen. When memory T-lymphocytes detect an antigen they create clonal
expansion resulting in cytotoxic T-lymphocytes being released to eliminate
the antigen. If this response is not in proportion it can result in damage to the
body tissues. An example of this is contact dermatitis.
Additional Work
Further information on allergic responses can be found in Ross &
Wilson pages 374 375
Media
This video briefly summarises allergic reactions
http://www.youtube.com/watch?v=nudFAzJsTog&feature=related
e. Common Disorders of the Immune System

Disorders of the immune system can vary from fairly mild with few symptoms
(sneezing, running eyes, itching) to major reactions that can result in death
Allergies
Auto immune diseases
e.g. ankylosing spondylitis, colitis, psoriasis
SLE, RA, Graves
Immunodeficiency diseases e.g. AIDS
Immuno-suppression
e.g. after organ transplant
Chronic fatigue syndrome
Additional Work
Further information on the disorders of the immune system can
be found in Ross & Wilson pages 374 - 377

24
Additional Work
Research the disorders of the immune system using textbooks
and the internet. You could also talk to people who suffer
various immune reactions and disorders.
Section 3 - The Respiratory System

1. Identify the major structures of the respiratory system and their relative
positions:
Nose, nasal cavity, pharynx, epiglottis, larynx, bronchi, bronchioles,
alveoli, pleura, sinuses
2. Describe the structure and function of the lungs
3. Define and differentiate between pulmonary ventilation, external respiration
and internal respiration
4. Describe the mechanism and regulation of breathing including internal and
external respiration, inspiration, expiration and exchange of gases
5. Recognise the ways in which oxygen and carbon dioxide are transported in
the blood
6. Name & briefly describe common disorders/disease of the Respiratory
system, including:
Acute
Tuberculosis
Pleurisy
Bronchitis
Pneumonia
Seasonal rhinitis (hayfever)
Sinusitis
Coryza (common cold)
Influenza
Laryngitis
25
Chronic
Chronic obstructive pulmonary disease (COPD)
Asthma
Lung cancer
Emphysema
Rhinitis
a. The structure and function of the respiratory system

The structures involved in the process of respiration are divided into two main
parts, they are firstly the air passages and secondly the lungs. The air
passages filter, moisten and warm the air as it enters the body and the lungs
provide the location for the exchange of gases into and from the body.
The first structure in the respiratory system is the nose. There are right and
left nasal cavities which are divided by a structure called a septum. These
cavities are lined with mucous membrane, which secretes a sticky fluid called
mucus. Mucus helps to moisten the air on its way to the lungs. On the surface
of the membrane are cilia, which help to move inhaled dust and bacteria
away from the lungs. The sinuses communicate with the nasal cavities,
explaining why the sinuses are so susceptible to infection. The roof of the
nasal cavity is formed by the ethmoid bone, which holds the olfactory bulb
giving access to the olfactory lobe in the brain.
Behind the nose is the nasopharynx, which is connected to the middle ear via
the eustachian tube. Just below the nasopharynx lies the pharynx. It provides
a passage for both air on its way to the lungs and for food on its way to the
stomach, but cannot be used for both at the same time. When swallowing,
food is prevented from going up to the nasal cavity by the uvula (soft palate)
and from entering the lower respiratory tract, by the epiglottis, which closes
the entrance to the trachea. This prevents us choking or suffocating because
of food.
The next part of the upper respiratory tract is the larynx (voice box). The
larynx is supported by hyaline cartilage to the front, which prevents the airway
from collapsing. The vocal cords are also situated in the larynx.
The trachea is a continuation of the larynx. It is approximately 10 centimetres
long and at its lower end divides into the two bronchi. The trachea is kept
permanently open by means of rings of cartilage joined together by muscle
tissue at the back. This arrangement allows the trachea to be flexible but at
the same time the cartilage prevents it from collapsing, so allowing it to
remain permanently open. The trachea is lined with mucous membrane to
moisten and filter the air on its way to the lungs.
The bronchi start where the trachea divides into two. Each bronchus passes
to either the left or right lung. These two short tubes are built on a similar
26
structure to the trachea so that there is no obstruction to the airway. From

each main bronchus, numerous smaller bronchi branch off and these divide
even further into very fine bronchioles. The bronchioles are formed from
muscular tissue and there are no hoops of cartilage, meaning that they may
collapse. Each bronchiole ends in an irregularly shaped sac called an
alveolus. These minute circular chambers grouped together are known as
alveoli; they are lined with very thin flattened epithelial tissue and are
surrounded by numerous blood capillaries. The exchange of gases takes
place through the thin walls of both these structures.
The lungs are the organs of respiration and they lie in the thoracic cavity.
The right and left lungs are separated in the middle by the heart and the great
vessels, the aorta and vena cava.
The lungs occupy the whole of the thoracic cavity, except for the structures in
the mediastinum, the heart & its vessels. The lungs are composed of bronchi,
bronchioles and alveoli. A thin double layer of serous membrane called the
pleura covers each lung. The outer (visceral) layer lines the thoracic cavity.
The inner (parietal) layer lines the lung surface. These layers are lubricated
by serous fluid, which prevents friction when breathing. Between these two
layers is a space called the pleural cavity where the pressure is slightly below
atmospheric pressure, which helps to draw the air into the lungs.
Image
A diagram showing the structure of the respiratory can be found in
Ross & Wilson page 234, Figure 10.1
Additional Work
Further information on the respiratory system can be found in
Ross & Wilson pages 234 246
Media
This video briefly shows the respiratory system during respiration
http://www.youtube.com/watch?v=HiT621PrrO0
b. Respiration and breathing

The mechanism of breathing
The structures involved in the physical process of respiration are the muscles
of respiration, the thoracic cage and the pleura. When we breathe there is a
series of events taking place known as the respiratory cycle. There are three
phases to this cycle inspiration (breathing in), expiration (breathing out),
followed by a pause. The cycle occurs approximately 16 times a minute.
During inspiration the rib cage expands by swinging upwards and outwards
and the volume of the thorax is increased so taking in air. In expiration the
27
ribs swing down and reduce the volume of the thorax and air is expelled.
Before the cycle begins again there is a slight pause. During this phase, the
air begins to pour into the lungs, which is due to the atmospheric pressure
being greater than the pressure within the lungs. Pressure within the pleural
cavity is lower than atmospheric pressure so the air will flow from higher to
lower pressure, filling the lungs.
The muscles used in respiration are the diaphragm and the intercostals. The
diaphragm, the main muscle of inspiration, is domed-shaped and it separates
the thoracic cavity from the abdominal cavity. During inspiration the
diaphragm descends and flattens. In expiration the diaphragm relaxes to
return to its dome shape. The intercostal muscles lie within the spaces
between each rib. There are two layers of these muscles called the external
and internal intercostals and their muscle fibres run at right angles to each
other. They are antagonistic, so when the external intercostals are
contracted, the internal intercostals are relaxed and vice versa. The external
layer of muscles contracts with the diaphragm during inspiration. The internal
layer contracts during expiration. As one or other of the layers is always
contracted, the rib cage is prevented from collapsing. The muscles mentioned
above are the ones used during quiet, normal breathing. There are several
other muscles, know as accessory muscles that are used in forced
respiration, for example when you are out of breath. These include the
pectorals, sternocleidomastoid, platysma and the abdominal muscles.
Pulmonary Ventilation
Pulmonary ventilation or breathing is the exchange of gases that occurs
between the lungs and the external environment. This mechanical process is
dependant on the difference of atmospheric air pressure and pressure in the
alveoli. On inhalation increased internal volume occurs along with a reduction
in internal pressure. The diaphragm and intercostals are the muscles
responsible for this process. During this action the diaphragm contracts and
moves downwards, flattening its dome shape and increasing the size of the
chest cavity and reducing the pressure on the lungs. The intercostals also
contract causing the ribs to move upwards and outwards. This action also
lowers the pressure on the lungs whilst increasing the size of the chest cavity.
When the diaphragm and intercostals muscles contract internal pressure is
reduced relative to the atmospheric pressure, thereby causing air to rush into
the lungs. When the diaphragm relaxes, its domed shape returns along with
the intercostals relaxing to bring the ribs down and inwards. This action
results in the size of the chest cavity being reduced causing increased
pressure in the lungs, thus forcing out the air.
Diffusion of gasses
When there is a difference in pressure across a semi-permeable membrane
an exchange of gases will occur. Gases move by a process of diffusion from
28
a place of higher to an area of lower concentration until a state of equilibrium

is achieved. The pressure of atmospheric nitrogen which is present during
this process remains unchanged at all times.
Pulmonary Circulation (External Respiration)
Pulmonary circulation is the circulation of blood between the heart and the
lungs, where the pulmonary artery carries the deoxygenated blood away from
the heart towards the lungs. A branch of the artery passes to each lung where
it divides into smaller and smaller branches forming a vast capillary network
around all the alveoli. Once this exchange has taken place, the pulmonary
veins carry oxygenated blood back to the heart. The function of the lungs is to
allow a free exchange of gases to take place between the alveoli and the
capillary network around them. This process is known as external respiration.
Internal Respiration
This term is used to define the process of diffusion between blood in the
capillaries and the cells of the body. There is no gaseous exchange in the
walls of the arteries carrying blood from the heart to the tissue as their walls
are too thick. Blood carried to the tissues of the body has been cleansed of
any carbon dioxide and saturated with oxygen during its journey through the
lungs. This concentration gradient ensures that gaseous exchange occurs
diffusing oxygen from the bloodstream into the tissues via the capillary wall
and returning carbon dioxide through the intracellular fluid out into the
bloodstream.
Image
A diagram showing internal and external respiration can be found in
Ross & Wilson page 251, Figure 10.24 and 10.25
Transport of gases
The transport of both oxygen and carbon dioxide in the blood is essential for
internal respiration to occur.
Oxygen is carried in the following ways by the blood:
In chemical combination with the haemoglobin as oxyhaemoglobin
As a solution in plasma water
These are in ratio of 98.5% to 1.5%
Carbon dioxide is a waste product produced during metabolism which is
excreted by the lungs. It is carried in the following ways:
As a bicarbonate in the plasma
In the erythrocytes in a combination with haemoglobin as
carbaminohaemoglobin
Dissolved in the plasma
29
This ratio is 70% to 23% to 7%

Control of respiration
The control of respiration is normally involuntary however voluntary control
can be exerted. Factors that affect the control of respiration can include:
Exercise and strenuous activity
Speech
Singing
Emotional factors crying, laughing or fear
Drugs sedatives and alcohol
Sleep
Additional Work
Further information on the control of respiration can be found in
Ross & Wilson pages 252 253
c. Common Disorders of the Respiratory System
We all encounter disorders of the immune system from a common cold
through to some of the chronic respiratory conditions. Chronic breathing
conditions can limit our ability to carry out everyday task sometimes resulting
in the need for oxygen and breathing aids.
Acute
Tuberculosis
Pleurisy
Bronchitis
Pneumonia
Seasonal rhinitis (hayfever)
Sinusitis
Coryza (common cold)
Influenza
Laryngitis
Chronic
Chronic obstructive pulmonary disease (COPD)
Asthma
Lung cancer
Emphysema
Rhinitis
Additional Work
Further information on the disorders of the respiratory system can
be found in Ross & Wilson pages 254 264
30
Additional Work
Research the disorders of the respiratory system using
textbooks and the internet. You could also talk to people who
suffer various respiratory system disorders.

31
Further Reading
Anderson P D. 2004
Human Anatomy and Physiology

Colouring Workbook and Study Guide
Jones and Bartlett Publishers, Inc;
Ball J. 2005
Understanding Disease: A Health

Practitioner's Handbook
Vermilion
Blandine C G. 2004
Anatomy of Movement
Eastland Press
Blakey P. 2008
The Muscle Book

Himalayan Institute Press
Bowden B & J. 2002
An Illustrated atlas of the skeletal muscles,

Morton publishing, USA
Cash M 1999
The Pocket Atlas of the Moving Body

Ebury Press
Cohen BJ. 2008
Memmler's the Human Body in Health

and Disease
Lippincott, Williams & Wilkins
Crawley J L. 2002
Photographic Atlas for Anatomy and

Physiology
Morton publishing, USA
Jarmey C. 2008
The Concise Book of Muscles

Lotus Publishing
Kapit W & Elson L. 2001
Anatomy Colouring Book

Benjamin Cummings
Kapit W, Macey RI
& Meisami E. 1999
Physiology Colouring Book

Benjamin Cummings
Martin E. 2007
Concise Medical Dictionary

OUP Oxford
Parker S & Medi-mation 2007
The Human Body Book: The Ultimate

Visual Guide to Anatomy, Systems and
Disorders
Dorling Kindersely
Thibodeau GA &
Patton KT. 2009
The Human Body in Health and Disease,

Mosby
Tortora GJ &
Grabowski SR. 2008:
Principles of Anatomy and Physiology

with Atlas and Registration Card
John Wiley
Waugh A & Grant A. 2006
Ross and Wilson's Anatomy and

Physiology Colouring and Workbook
Churchill Livingstone
Werner R. 2009
A massage therapists guide to Pathology

Lippincott Williams & Wilkins,
DVDs
Anatomy for Beginners Dr Gunther von Hagens
This was originally shown on Channel 4 television and shows an autopsy
taking place. Interesting but not for the squeamish!!
***The Books & DVDs Highlighted in Red are particularly recommended***

33

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Anatomy & Physiology Diploma

2012 Essentially Holistic

The structure and function of the respiratory system ................... 26

b. Respiration and breathing .................................................................... 27

2012 Essentially Holistic

2012 Essentially Holistic

Structure of the Course:

2012 Essentially Holistic

Have some fun!

2012 Essentially Holistic

The Lymphatic System

Section 1 - The Lymphatic System

a. The structure and function of the lymphatic system

Lymph is a transparent, straw coloured fluid with the consistency of honey. It

b. Lymph nodes and lymph flow

Return plasma proteins to the blood

2012 Essentially Holistic

Lymphocytes are added to the lymph as it flows through the sinuses of a

Lymphatic vessels and lymph nodes can be visualised by the process of

through a number of nodes, usually 8 to 10, before returning to the blood.

instances where phagocytation is incomplete the node may swell. Swelling of

c. The role of the Lymphatic system in the body

lymph nodes, oedema can develop. This type of oedema is called

Pharyngeal tonsil--on the wall of the nasal part of the pharynx

Solitary lymphatic follicles

Aggregated lymphatic follicles (Peyer's patches)--in the wall of the small

Vermiform appendix--an outgrowth from the caecum (first part of the

d. Common Disorders of the Lymphatic System

2012 Essentially Holistic

Section 2 - The Immune System

2012 Essentially Holistic

a. The Immune system

b. Non-specific defence mechanisms

2012 Essentially Holistic

Increase tissue fluid formation

c. Immunity and immune responses

A healthy adults body contains thousands of different types of antibodies.

Antibody mediated immunity

2012 Essentially Holistic

Passive naturally acquired immunity

3. Type III immune-complex-mediated hypersensitivity

e. Common Disorders of the Immune System

2012 Essentially Holistic

Section 3 - The Respiratory System

a. The structure and function of the respiratory system

structure to the trachea so that there is no obstruction to the airway. From

b. Respiration and breathing

a place of higher to an area of lower concentration until a state of equilibrium

This ratio is 70% to 23% to 7%

2012 Essentially Holistic

Human Anatomy and Physiology

Understanding Disease: A Health

The Muscle Book

Bowden B & J. 2002

An Illustrated atlas of the skeletal muscles,

The Pocket Atlas of the Moving Body

Cohen BJ. 2008

Memmler's the Human Body in Health

Photographic Atlas for Anatomy and

The Concise Book of Muscles

Kapit W & Elson L. 2001

Anatomy Colouring Book

Physiology Colouring Book

Concise Medical Dictionary