NUR 606 Week 5 Week 5 Discussion 1: Question-Based Discussion—Team B (Normal Skin/Lymph)

NUR 606 Week 5 Week 5 Discussion 1: Question-Based Discussion—Team B (Normal Skin/Lymph)

Describe the normal functions of the lymph nodes, the thymus gland, the tonsils, and the spleen. What happens when each does not function normally and moves away from homeostasis?

Lymph nodes and lymphoid tissue act as our defense system that protects us by removing foreign or unwanted pathogens from the lymph fluid before it goes into general circulation. Structures that are made up of lymphoid tissue include the thymus gland, tonsils, and spleen. The tonsils are made up of the palatine and pharyngeal tonsils, as well as the adenoids. This ring of lymphatic tissue surrounds the opening to the throat and nasal cavity to protect us against bacterial infections entering our respiratory system. Tonsils are known to be the first line of defense to the invasion of external organisms. During an active infection, such as tonsilitis, lymph nodes become enlarged, swollen, and tender. It is controversial about removing the tonsils surgically after repeat infections because of the important role they play for our immune system. (Hubert & VanMeter, 2018)

Personally, after many cases of strep throat when I was younger, I was close to getting my tonsils out but fortunately did not have to. Who got their tonsils removed?

The thymus is located below where a necklace would sit on our chest. It consists of two lobes and is in the mediastinum, lying in front of the top half of the heart, and extends up the neck to the bottom of the thyroid gland. It plays an active role in immunity during the neonatal and pre-adolescent periods. Prior to birth, it is the final site of lymphocyte development and the secretion of hormones after birth, which allows lymphocytes to then develop into mature T cells. T cells have an important role in attacking abnormal cells and regulate immune function. After these periods, the thymus atrophies and gets replaced by fat after puberty. Thymic output is essential during early life to establish immune competence and homeostasis but is dispensable thereafter (Thapa & Farber, 2019).

The spleen is another lymphoid organ that is located in the left upper quadrant of the abdomen. It is about the size of a fist and acts as a filter for blood that passes through and macrophages remove microorganisms from the blood. During hematopoiesis, monocytes, and lymphocytes mature and become activated in the spleen (Hubert & VanMeter, 2018). Defective spleen function related to autoimmune GI disorders like inflammatory bowel disease can result in increased susceptibility to severe bacterial infection (Giufrida et al., 2020). The spleen does not only serve a large role in our immunity but also acts as a blood reservoir during cases of anemia. The spleen withholds a large amount of blood that can be returned to the circulatory system if needed during a trauma. However, damage to the spleen can result in a serious problem quickly that could lead to death. Recently, I was called into work for a ruptured spleen and we had to initiate the mass blood transfusion protocol. Luckily, our patient did well and recovered in the OR.

Have a great week everyone!

References:

Giuffrida, P., Aronico, N., Rosselli, M., Lenti, M. V., Cococcia, S., Roccarina, D., Saffioti, F., Delliponti, M., Thorburn, D., Miceli, E., Corazza, G. R., Pinzani, M., & Di Sabatino, A. (2020). Defective spleen function in autoimmune gastrointestinal disorders. Internal and Emergency Medicine, 15(2), 225–229.

Osmosis. (2017). Introduction to the lymphatic system [Video]. YouTube. Retrieved September 27, 2021, from

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Week 5 Discussion 1: Question-Based Discussion—Team B (Normal Skin/Lymph)

1. B-1: Describe the basic path of the lymphatic circulation. You may use a visual aid to assist you.
2. B-2: Describe the normal functions of the lymph nodes, the thymus gland, the tonsils, and the spleen. What happens when each does not function normally and moves away from homeostasis?
3. B-3: Explain three ways the skin acts as a defense mechanism. For each of these, identify one condition that develops when this defense mechanism fails.
4. B-4: Where are resident or normal skin flora located related to the skin and its appendages? Identify three normal skin flora and discuss their importance to homeostasis.
5. B-5: It is well known that handwashing is critical to preventing the spread of infection. Explain how excessive handwashing may in some cases increase the potential for a bacterial skin infection. Give two examples where this might occur.
6. B-6: Describe the role of sebaceous glands and eccrine glands in maintaining homeostasis within the dermatologic system. For each of these, identify one condition that develops when homeostasis is not maintained.
7. B-7: Describe the structure of a hair follicle, including any gland associated with it. How do these glands promote homeostasis? What conditions can develop when homeostasis is not maintained.

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Hey Amanda,

I got my tonsils removed…at 19! Just like you highlighted on, my pediatrician was very hesitant to remove them because she saw them as an important player in my immune response against inhaled or ingested pathogens (Hubert & VanMeter, 2018). But, I have to say, they were definitely more of a hazard than a defender.

Expanding on your discussion, tonsils are composed of lymphatic tissue and when compromised by a bacteria or virus can become inflamed known as tonsillitis. It is important to differentiate between bacterial and viral tonsillitis for course of treatment to prevent overuse of antibiotics. Viral causes include the common cold, rhinovirus, coronavirus, Epstein-Barr, rubella, HIV, and so on (Georgalas et al., 2014). Bacterial sources that trigger inflammation include examples like  “Group A Streptococcus, Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenza” (Anderson & Paterek, 2021). This is also commonly called “strep throat.” Expected signs of tonsillitis include enlarged neck lymph nodes, red and swollen tonsils in the back of the throat, white spots on the tonsils, and a possible fever. Symptoms include pain with swallowing and other cold like symptoms such as runny nose, cough, and body aches (Anderson & Paterek, 2021).

For most patients, tonsillitis is caused by a virus and will run its course with at home treatment of rest, hydration, and NSAIDs for relief. In possible bacterial cases, a culture will be obtained to determine the course of antibiotics. In cases like mine, recurrent acute tonsillitis “generally identified as five or more tonsillitis episodes in one year” (Anderson & Paterek, 2021). In my senior of high school into my freshman year of college, I had six occurrences of tonsillitis. Even when they were not inflamed, my tonsils were large at baseline. After finally removing them, the surgeon told my mom that I had some of the most scarred tonsils he had ever seen. While the recovery was one of the worst experiences I have ever had, I definitely do not get sick nearly as often!

Resources:

Anderson, J., & Paterek, E. (2021, August 11). Tonsillitis. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK544342/

Georgalas, C. C., Tolley, N. S., & Narula, P. A. (2014). Tonsillitis. BMJ Clinical Evidence. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106232/

Hubert, R. J., & VanMeter, K. C. (2018). Gould’s pathophysiology for the health professions. (6th ed.). Elsevier Saunders