8. Breathing and Circulation (HT) Flashcards

Question

Describe the structure of the common iliac arteries and veinsand what is flows to/from.

Answer 1

* Bifurcation of the aorta and inferior vena cava, respectively * External arteries/veins go to lower limb * Internal arteries/veins go to pelvis, buttock and perineum

Answer 2

* It is the point where the common carotid artery divides into the internal and external carotid arteries * This usually occurs at the upper border of the thyroid cartilage, at around the level of the C4.

Answer 3

* Flows from the right atrium * Splits into the right and left pulmonary artery

Answer 4

4 -\> There are 2 from each lung that drain into the left atrium

Answer 5

* A ligament that is between the top of the left pulmonary artery and the proximal descending aorta * It is a remanant of the ductus arteriosus, which is a blood vessel in the developing fetus connecting the trunk of the pulmonary artery to the proximal descending aorta. It allows most of the blood from the right ventricle to bypass the fetus's fluid-filled non-functioning lungs. Upon closure at birth, it becomes the ligamentum arteriosum.

Answer 6

In atria: * Pectinate muscles (musculi pectinati) In ventricles: * Papillary muscles * Trabeculae carnae

Answer 7

* Small parallel ridges on the wall of the right atrium (and to a lesser extent in the left atrium) * Do not extent into the vena cava

Answer 8

The smooth border that divides the right atrium into the rough anterior (pectinate muscles) and smooth posterior (fossa ovalis and coronary sinus). It is where the pectinate muscles attach.

Answer 9

* The papillary muscles are muscles located in the ventricles of the heart. * They attach to the cusps of the atrioventricular valves (also known as the mitral and tricuspid valves) via the chordae tendineae and contract to prevent inversion or prolapse of these valves on systole (or ventricular contraction).

Answer 10

Rounded or irregular muscular columns which project from the inner surface of the right and left ventricle of the heart.

Answer 11

* A depression in the right atrium of the heart, at the level of the interatrial septum, the wall between right and left atrium. * The fossa ovalis is the remnant of a thin fibrous sheet that covered the foramen ovale during fetal development.

Answer 12

* Atrioventricular valves: * Tricuspid -\> Right AV valve * Bicuspid/Mitral -\> Left AV valve * Outflow valves: * Pulmonary -\> Right SL valve * Aortic -\> Left SL valve

Answer 13

* Mitral (bicuspid) valve * Between left atrium and ventricle * Has two leaflets (or "cusps") * Connected to papillary muscles via cordae tendinae * Tricuspid valve * Between right atrium and ventricle * Has three leaflets (or "cusps") * Connected to papillary muscles via cordae tendinae

Answer 14

* Pulmonary valve * Between the right ventricle and the pulmonary artery * Has three semilunar cusps * Aortic valve * Between the left ventricle and the aorta * HAs three semilunar cusps

Answer 15

Coronary arteries

Answer 16

Aortic sinuses just above the aortic valve.

Answer 17

Right coronary artery and the left coronary artery pass around the atrioventricular groove, forming an incomplete arterial ‘ring’. Branches arise from these towards the apex. * Left coronary artery * Left anterior descending artery -\> Between the ventricles on the anterior side * Left circumflex artery + Left marginal artery -\> Supply left side of heart * Posterior descending artery (only sometimes, usually supplied by the right coronary artery) * Right coronary artery * Right marginal artery -\> Supplies right side of heart * Posterior descending artery (usually, unless supplied by left CA)

Answer 18

No, they are functional end arteries.

Answer 19

The flow in the arteries occurs mainly during diastole because, during systole, contraction of ventricular muscle compresses the capillaries.

Answer 20

* Chest pain or pressure, usually due to not enough blood flow to the heart muscle. * Angina is usually due to obstruction or spasm of the coronary arteries. Other causes include anemia, abnormal heart rhythms and heart failure. * The main mechanism of coronary artery obstruction is atherosclerosis as part of coronary artery disease.

Answer 21

Angina is the symptom that arises due to myocardial ischaemia.

Answer 22

* Coronary sinus drains blood back into the right atrium * A small amount of the venous blood drains directly into the right atrium via venae cordis minimae

Answer 23

* In the right atrium wall * Positioned just above the crista terminalis, near the opening of the superior vena cava

Answer 24

Lower back section of the interatrial septum near the opening of the coronary sinus,

Answer 25

It is the atrioventricular bundle of His.

Answer 26

* A cardiac plexus which receives nerves from both the sympathetic and parasympathetic (vagus) systems is located beneath the arch of the aorta * Sympathetic fibres innervate both the SAN and AVN, and also the cardiac muscle. Sympathetic activation causes an increase in heart rate and force of contraction. * (Parasympathetic) Vagal fibres end primarily on the SAN and cause slowing of the heart.

Answer 27

Pain perceived at a location other than the site of the painful stimulus.

Answer 28

* Central chest * Neck * Left arm (male)

Answer 29

Shoulder (C4)

Answer 30

* The central compartment of the thoracic cavity surrounded by loose connective tissue. * The mediastinum contains: * Heart and its vessels * Oesophagus * Trachea * Phrenic and cardiac nerves * Thoracic duct * Thymus * Lymph nodes of the central chest

Answer 31

* Mediastinum is divided into the superior and inferior region * Inferior region is then subdivided into the anterior, middle (heart) and posterior compartments

Answer 32

Middle mediastinum

Answer 33

* Oesophagus * Trachea * Major great vessels supplying the head and neck: brachiocephalic arteries, carotid and subclavian arteries. * Vagus nerve * Left recurrent laryngeal nerve

Answer 34

Inferior anterior mediastinum: * Lymph nodes Inferior middle mediastinum: * Heart (in pericardium) * Major vessels: Ascending aorta, superior vena cava and pulmonary trunk * Phrenic nerves (on outside of pericardium) The inferior posterior mediastinum: * Descending aorta, hemi-azygos veins, azygos veins * Thoracic duct * Oesophagus * Vagus nerve * Sympathetic trunks

Answer 35

Sternal angle (at the T4 level)

Answer 36

The diaphragm.

Answer 37

* It is the side of the lung where the nerves, vessels and bronchii enter the lungs. * Lymph nodes are at the hilum of the lungs.

Answer 38

* The largest lymph duct in the body, originating from about the T12 level. * Drains into the left subclavian vein.

Answer 39

* Blood vascular system (cardiovascular system) * Lymphatic vascular system

Answer 40

Collects lymph (excess extracellular tissue fluid) and delivers it back to the cardiovascular system.

Answer 41

* Hepatic portal system * Hypothalamic-pituitary portal

Answer 42

* Macrovasculature * Vessels \> 0.1 mm in diameter * Arteries * Veins * Microvasculature * Vessels \< 0.1 mm * Arterioles * Capillaries * Venules

Answer 43

* Tunica intima -\> Endothelium * Tunica media -\> Muscle or elastic * Tunica adventitia -\> Connective tissue

Answer 44

* Tunica intima (innermost): * Single layer of flattened squamous epithelial cells & basal lamina * Sub-endothelial connective tissue * Internal elastic lamina * Tunica media: * Smooth muscle cells orientated concentrically around lumen * Replaced by elastic in elastic arteries (larger vessels) * External elastic lamina in large vessels * Tunica adventitia: * Fibroelastic connective tissue arranged longitudinally with adipose tissue

Answer 45

* Basal lamina -\> In tunica intima, just outside the epithelial layer * Internal elastic lamina -\> In tunica intima, thin band of elastic fibres just inside the smooth muscle layer * External elastic lamina -\> In tunica media, band of elastic fibres just outside the smooth muscle layer (i.e. the elastic lamina tend to sandwich the smooth muscle layer)

Answer 46

* Internal elastic lamina is well-developed * External elastic lamina is not distinguishable in all arteries

Answer 47

Structure: * Simple squamous endothelium * Loose connective tissue * Internal elastic lamina Function: * Endothelium regulates blood clotting and vascular tone and flow by secreting various substances

Answer 48

* Secretes: * Collagens -\> strength * Lamin -\> attachment * Endothelin -\> vasoconstrictor * Nitric oxide -\> vasodilator * Von Willebrand factor -\> clotting protein * Also possess membrane bound enzymes: * In lung, angitoensin converting enzyme (ACE) -\> Converts Angiotensin I to Angiotensin II Vasoconstrictor

Answer 49

* Clotting factor produced by the endothelium * Genetic disease where VWF is not produced -\> Problems with blood clotting. Binds FVIII, gets degraded in absence.

Answer 50

* Angiotensin-converting-enzyme inhibitors are a class of medication used primarily for the treatment of high blood pressure and heart failure. * They work by causing relaxation of blood vessels as well as a decrease in blood volume, which leads to lower blood pressure and decreased oxygen demand from the heart.

Answer 51

Structure: * Concentric cell layers comprise helically arranged smooth muscle cells (elastic in elastic arteries) * Elastic fibres * Type III collagen * Proteoglycans interspersed within layers * Larger arteries have external elastic lamina Function: * Collagen -\> Provides restraint * General protective role (NOTE: Capillaries and post-capillary venules do not have tunica media)

Answer 52

* Ehlers-Danlos syndrome (EDS) Type IV (vascular type) * Mutation in COL3A1 gene -\> Coding for Type III collagen * Autosomal dominant * Increases the chance of aneurysm

Answer 53

Structure: * Fibroblasts * Type I collagen fibers * Elastic fibers * Small blood vessels * Adipose tissue Function: * Blends into surrounding connective tissue

Answer 54

* "Vessels of vessels" * These are small arteries that supply the walls (tunica media and adventitia) of large veins and arteries

Answer 55

From largest to smallest: * Elastic (Conducting) * Muscular (distributing) * Arterioles

Answer 56

* In elastic arteries concentric layers of elastic occupy most of tunica media * Muscular arteries have thick tunica media composed mostly of smooth muscle

Answer 57

* Larger arteries (e.g. aorta) are elastic, while smaller arteries are non-elastic * Tunica intima is thinner and internal elastic lamina is more prominent in non-elastic arteries

Answer 58

* Smooth muscle cells (discontinuous) -\> Surround arterioles and small veins * Pericytes -\> support vessels, but can differentiate into: * Fibroblasts * Smooth muscle cells * Macrophages

Answer 59

* Wound healing -\> By differentiating into fibroblasts, smooth muscle cells, macrophages and other cell populations * Angiogenesis (formation of new blood vessels)

Answer 60

Sympathetic nerves

Answer 61

* A ring of muscle surrounding a blood vessel at the junction between an arteriole and capillary (pre-capillary sphincter) * Dilation & constriction of resistance vessels (arterioles) * Controlled by factors which reflect tissue metabolism

Answer 62

* Length = Approx. 50 micrometers * Diameter = Approx. 8-10 micrometers

Answer 63

* Fenestrated * Continuous * Sinusoidal

Answer 64

Veins are classified on the basis of their diameter and wall thickness: * Small * Medium * Large

Answer 65

* Same 3 layers as arteries but muscular and elastic layers not as well developed * Connective tissue components more pronounced than arteries * Boundary between tunica intima and tunica media not clear * Medium size veins have valves to assist blood flow

Answer 66

* Varicose veins * Deep vein thrombosis (DVT) * Vasculitis

Answer 67

* Blood Brain barrier * Blood air barrier * Kidney filtration barrier

Answer 68

* Plain films * CT * Ultrasound * Angiography * MRI

Answer 69

* X-rays are produced by bombarding a tungsten anode with electrons at high voltage. * The anode beam is directed so that the x-rays pass through the patient. * Emerging radiation is then detected by the digital detector plate. * The degree of exposure corresponds to how much of the beam has passed through the patient and how much has been absorbed by the different tissues of the body. * Air is radiolucent (black) and bone and metal are radiopaque (white)

Answer 70

* Aortic knuckle or knob -\> May be enlarged in pathology such as thoracic aortic aneurysm; or may be reversed in dextrocardia. * Right heart border -\> Made up predominantly by the right atrium * Left heart border -\> Made up of the left ventricle. * Superior vena cava -\> Only major venous structure drianing into heart that is seen on plain x-ray. * Pulmonary arteries + Thoracic aorta * Lymph nodes drain to the hilar and mediastinal nodes -\> May become enlarged in infection or tumour. * Relationship of the subclavian artery to the clavicle, which may be damaged in trauma. * Relationship of the subclavian vein to the first rib, which may be compressed, causing venous thrombosis.

Answer 71

* Air: -1000 HU * Fat: -100 HU * Water: 0 HU * Soft tissue: 30 HU * Bone: 700 HU

Answer 72

* When we are looking at blood vessels on CT, the absorption is the same as for many other soft tissues. * To highlight vessels on CT imaging, we falsely increase the absorption of vessels compared to soft tissue by injecting an intravenous contrast agent. * This is an iodine-based contrast agent, with a high atomic number. * The contrast agent is injected intravenously, passes through the system veins to the right side of the heart, then to the pulmonary circulation, and finally to the left side of the heart and the systemic circulation.

Answer 73

* The timing of the taking of the CT scanrelative to when the contrast is injected * This is critical to ensure the contrast is in the vessel of interest (for example, in acquiring a CT of the pulmonary arteries, the radiographer will commence the scan earlier than for a CT of the aortic arch).

Answer 74

* Estimation of flow rates in the carotid arteries -\> Used to assess risk of stroke * Estimation of flow in peripheral veins, both in the deep venous system for diagnosing deep vein thrombosis, and the superficial venous system for assessing patients with varicose veins. * Because ultrasound imaging is real-time imaging, this allows the radiologist to perform image guided treatments and biopsies, using the ultrasound to guide placement of the needle.

Answer 75

* Goal is to produce images of contrast-filled vessels in isolation from other tissues, whilst using the minimum amount of contrast agent. * Images of the same region are taken in rapid succession (2-6 frames per second), before and after direct injection of contrast medium into the vessel, minimizing patient movement. * The image without contrast (from just before injection) is then subtracted digitally from the post contrast images, to give an image of the vessel alone (bone and soft tissue removed). * DSA is used for imaging the peripheral venous and arterial systems as well as abdominal vessels and cerebral vessels, but cannot be used for cardiac imaging due to cardiac motion. Instead, higher frame rates are used (up to 10 frames per second), and non-subtracted angiograms are acquired.

Answer 76

* Relies on the fact that blood is fast flowing. * A radiofrequency current is applied to a single slice of the patient, which flips the spins in the protons in the slice selected. The RF current is then turned off. * When the slice is imaged a fraction of time later, fresh blood has passed into the vessels, and the protons in the fresh blood have not been exposed to the radiofrequency current. * So they emit a different signal from the tissues in the original slice and can therefore be detected. * Gadolinium is used as a contrast agent. The gadolinium itself is not actually visualised on the MRI but it alters the magnetic properties of the adjacent tissues, so that they emit different signals. This eliminates the need to rely on blood flow to create an image of a vessel and allows imaging in any plane. This is particularly useful for cerebral imaging where the vessels are very small and tortuous.

Answer 77

A connection between two blood vessels, such as between arteries (arterio-arterial anastomosis), between veins (veno-venous anastomosis) or between an artery and a vein (arterio-venous anastomosis).

Answer 78

* Nearly all small arteries form anastomoses with neighbouring vessels. * Around all joints small arterial branches form anastomoses which link the major vessels above and below a joint. These are particularly important in the lower limb. * The degree of anastomosis is very variable.

Answer 79

* An anatomical end artery is one that is the only supply of oxygenated blood to a portion of tissue. Arteries which do not anastomose with their neighbors are called end arteries. * Functional end arteries occur when the degree of anastomosis is insufficient, particularly as we age.

Answer 80

* In the limbs veins form two important groups, lying superficial and deep to the deep fascia. * Understanding this is critical in the lower limb.

Answer 81

* No, they are not typically visible in DR * They have many anastamoses * We study them due to their importance in cancer spread

Answer 82

* Ateries -\> Post-ganglionic sympathetic fibres control arterial flow and pressure, especially through the diameter of arterioles and alpha receptors * Veins -\> Constriction increases venous return to the heart (and therefore pre-load).

Answer 83

THORACIC AORTA: * Ascending aorta gives off: * Right and left coronary arteries, which go to the heart * Aortic arch gives off: * The brachiocephalic artery, which gives off: * Right subclavian artery (to head) and right common carotid artery (to upper limbs, neck and thorax) * Left common carotid artery * Left subclavian artery Subclavian arteries each give off a thoracic artery that gives off anterior inctercostal arteries. They also give off the vertebral arteries, that are the major arteries of the neck. * Descending thoracic aorta * Bronchial + Oesophagal arteries * Posterior intercostal arteries (to body wall) Anastomoses between anterior and posterior intercostal arteries in chest wall. ABDOMINAL AORTA: * Midline branches to gastrointestinal tract and derivatives * T12: Coeliac artery to foregut (oesophagus to mid duodenum) * L1: Superior mesenteric artery to midgut (mid-duodenum to colon splenic flexure * L3: Inferior mesenteric to hindgut (splenic flexure to recto-anal junction) * Paired branches to paired organs: * Musculophrenic arteries * Adrenal/Suprarenal arteries * Renal arteries (L1) * Gonadal arteries (L2) * Paired lumbar arteries (to posterior abdominal wall) COMMON ILIAC ARTERIES: * External iliac arteries (to lower limbs via femoral artery) * Internal iliac arteries (to pelvic organs and gluteal region) Anastamoses: Trochanteric anastomosis (supplies the head of the femur), Cruciate anastomosis in thigh, anastomoses for knee, ankle, foot

Answer 84

It passes BEHIND the crura of the diaphragm at T12.

Answer 85

The paired arteries are in descending order: * The musculophrenic to supply the diaphragm * The suprarenal to the adrenal glands * The renal to the kidney * The gonadal to the ovary or testes (note that relatively cranial postion at which the gondal arteries arise reflects their embryonic origins) The unpaired arteries are: * The coeliac trunk that supplies the foregut, which includes the stomach, liver, and upper parts of duodenum and pancreas * The superior mesenteric artery which supplies the midgut, which includes the lower parts of the duodenum and pancreas, the entire small bowel (jejunum and ileum) the caecum, ascending colon and transverse colon. * The inferior mesenteric artery which supplies the hindgut, including the descending colon, the sigmoid colon, and upper parts of the rectum. The abdominal aorta divides into the common iliac arteries which in turn divide into the external and internal iliac arteries.

Answer 86

Arterial: * Each common carotid artery splits (at the carotid sinus) into: * Internal carotid artery * Supplies brain, eyes and forehead through the carotid canal in the skull * External carotid artery * Supplies areas of the head and neck that are exterior to the cranium * Gives off 6 branches: Superior thyroid artery, Lingual artery, Facial artery, Ascending pharyngeal artery, Occipital artery, Posterior auricular artery * Each subclavian artery gives off a vertebral artery that converge and supply the brain Venous: * Internal jugular veins * Drain the brain and parts of the face * Drain INTO the subclavian veins, forming brachiocephalic veins * External jugular veins * Drain the superficial tissues of the skull and the posterior and deep parts of the face * Drain INTO the subclavian veins (before they join with the internal jugular veins) * Anterior jugular veins * Drain the neck * Drain INTO the external jugular vein just before they enter the subclavian veins

Answer 87

A dilated area at the base of the internal carotid artery just superior to the bifurcation of the internal carotid and external carotid at the level of the superior border of thyroid cartilage.

Answer 88

At the thyroid cartilage.

Answer 89

* Superior vena cava: * Confluence of right and left brachiocephalic veins, which are confluences of: * Internal jugular veins (drain head) and subclavian veins (drain external jugular veins and upper limb) * Drain the azygos vein just before the SVC enters the right atrium * Intercostal veins drain into the azygos vein on the right and the hemi-azygos veins on the left side of the thorax. The hemi-azygous veins drain into the azygous vein. * Coronary sinus drains heart * Inferior vena cava: * Drains the hepatic portal vein, which drains liver and alimentary tract (indirectly, via the hepatic portal veins) * Drains the adrenals, kidneys, gonads, pelvic organs (corresponding veins to arteries) * Drains the common iliac veins

Answer 90

Veins below the level of the heart and outside the thorax and abdomen (extra-abdominal).

Answer 91

* Veins are more variable and have more anastomoses than arteries * Important anastomoses connect the superficial and deep veins of the lower limb

Answer 92

The large veins are also innervated by postganglionic sympathetic nerves which control their capacity.

Answer 93

* Lymph returns to blood vascular system at the junction of the subclavian and jugular veins (differences on R and L sides) * Lymphatics that drain directly into the venous confluence: * Head (jugular lymph trunks) * Upper limb (subclavian lymph trunks) * Bronchi & mediastinum (broncho-mediastinal lymph trunks) join venous confluence. * Lymphatics that drain into the cisterna chyli, which is emptied into the confluence of the left internal jugular and subclavian veins by the thoracic duct: * Lower limb & pelvis (external and internal iliac lymph trunks) * Posterior abdominal wall (via para-aortic nodes to cisterna chyli) * G-I tract (via midline pre-aortic nodes to cistern)

Answer 94

* More valves than veins * Not innervated * Intrinsic contractile properties + compressed by arterial pulsations

Answer 95

* Vena cava - T8 (8 letters) * Oesophagus - T10 (10 letters) * Aorta - T12

Answer 96

No, the artery winds laterally around the wrist, passing through the anatomical snuff box and between the heads of the first dorsal interosseous muscle.

Answer 97

* Deep veins run deep, and tend to run alongside an artery of the same name * Superficial veins run close to the skin * These two types are joined by communicating veins

Answer 98

Deep: * Brachial * Ulnar * Radial Superficial: * Basilic * Cephalic * Median cubital

Answer 99

From superficial to deep

Answer 100

In the limbs, lymphatic drainage follows venous drainage.

Answer 101

* Lymphatics run along veins * Superficial nodes drain to deep nodes * Drainage occurs via progressively more central nodes

Answer 102

* Breast (important in sentinel node biopsy) * Upper limb

Answer 103

Note: The popliteal is on the posterior side, which is because the femoral winds medially from the anterior to the posterior side as is gets more distal.

Answer 104

At the inguinal ligament.

Answer 105

Passes through a hiatus in the largest adductor muscle (adductor magnus).

Answer 106

Deep femoral (profunda femoris)

Answer 107

* Arteries run deep to the deep fascia * This can constrict the blood supply if there is swelling in the compartment, for example as a result of a fracture and bleeding. This constricts the venous return which makes the problem worse and leads to a ‘compartment syndrome’.

Answer 108

A blood vessel of the lower limb that carries oxygenated blood to the dorsal surface of the foot.

Answer 109

Around joints

Answer 110

* Femoral circumflex artery wraps around the head of the femur * It is at risk in fractured neck of femur as it runs along the neck of the femur from the trochanteric anastomosis.

Answer 111

Superficial veins: * Great saphenous vein * Drains blood from dorsal arch of the foot * Along medial side of leg, passing anterior to medial malleolus but posterior to medial condyle at the knee * Drains into the femoral artery, just inferior of the inguinal ligament * Small saphenous vein * Drains blood from dorsal arch of the foot and dorsal vein of little toe * Along posterior side of the leg, passing posterior to the lateral malleolus and along the calcaneal tendon. Passes between the two heads of the gastrocnemius muscle. * Then empties into the popliteal vein in the popliteal fossa. Deep veins (run along arteries): * Posterior tibial + Fibular vein * Arise from the plantar veins (lateral and medial) * Popliteal vein * Anterior tibial vein * Femoral vein * Profunda femoris * External iliac vein Communicating veins drain the superficial veins into the deep veins.

Answer 112

Perforating veins

Answer 113

* Deep veins -\> Deep vein thrombosis * Superficial veins -\> Varicose veins

Answer 114

* Buldging and twisting veins, just deep to the skin (i.e. affects superficial veins) * Occur due to the pooling of blood in superficial veins, which is commonly a result of reduced venous retunr to the heart * Example causes: * Pregnancy, obesity and abdominal straining may place pressure on the abdomen * Incompetent valves can allow backflow * Symptoms: Pain, inability to stand for long periods, ulcers, severe bleeding upon trauma, skin conditions and clotting * Treatment is typically conservative (e.g. elevating legs and using medicine), but surgical approaches may also be used

Answer 115

* The formation of a blood clot inside deep veins of the lower limb * 3 major risk factors: * Slow blood flow * High coaguability of blood * Damage to endothelium * Symptoms: * Pain * Swelling * Discolouration * Cyanosis * Serious risk of pulmonary embolism * Treatments include use of anticoagulants, compression socks and removal of the clot

Answer 116

Swelling of the lower limbs caused by filarial parasites blocking the superficial lymphatics.

Answer 117

* A skeletal-muscle pump is a collection of skeletal muscles that aid the heart in the circulation of blood. * It is especially important in increasing venous return to the heart.

Answer 118

* Plain Film/x-ray * Ultrasound * Nuclear Medicine * MRI * CT * PET/CTMRI

Answer 119

* Anteroposterior * Posteroanterior (The direction refers to the direction of travel of the x-rays, etc.)

Answer 120

* Film-Focus Distance 2m * Scapulae rotated away from lungs

Answer 121

* Film-Focus distance 1m * Scapulae projected over lungs * Low kV only * Suboptimal inspiration * Often semi-erect

Answer 122

Plain film x-ray

Answer 123

Pros: * Quick * Cheap * Readily available * Fast to interpret by non-specialists COns: * Radiation (some) * Poor sensitivity * Poor tissue characterisation * 3D structure on 2D image

Answer 124

Ultrasound

Answer 125

Pros: * Quick * Cheap (ish) * High sensitivity * No radiation - safe Cons: * Cannot look through air or bones * Very user-dependent – most useful in hands of specialists * Needs bed-site clinician

Answer 126

Nuclear medicine

Answer 127

Pros: * Physiological test * High sensitivity and specificity Cons: * Radiation (to patient and environment) * Need for radio-isotopes * More limited clinical use (answer ‘one question’)

Answer 128

Pros: * No radiation * Very good tissue characterisation * Very high sensitivity * Cross-sectional imaging technique Cons: * Strong magnets * Heating effects * Long time in the scanner * Needs specialist to interpret * Expensive, not readily available

Answer 129

Pros: * Quick – ideal for emergencies * Cheap(ish) – readily available around the clock * Extremely good images of most tissues, high sensitivity/specificity Cons: * High radiation dose * Often need for IV contrast * Needs specialist to interpret

Answer 130

Pros: * Physiological test – biologic activity * High sensitivity Cons: * Relatively low specificity * Radiation (to patient and environment) * Need for radio-isotopes * Very expensive

Answer 131

* Pleural biopsy * Lung biopsy * Drain insertion * Tumour ablation

Answer 132

Pleaural biopsy

Answer 133

Lung biopsy

Answer 134

Drain insertion

Answer 135

Tumour ablation

Answer 136

From superior to inferior: * Manubrium * Body of sternum * Xiphoid process

Answer 137

* The plane that passes through the sternal angle * It is at the level of the T4 vertebra * It marks the bifurcation of trachea

Answer 138

* 1-7 -\> Attach to sternum via a costal cartilage (vertebrosternal) * 8-10 -\> Attach to the costal cartilage above (vertebrocostal) * 11-12 -\> No anterior attachment (floating)

Answer 139

There are two points of attachment.

Answer 140

* Central tendon * Crura

Answer 141

Contraction during inspiration increases thoracic cavity volume.

Answer 142

* Right crura: L1, 2, 3 vertebrae * Left crura: L1 & 2 vertebrae

Answer 143

* Vena cava -\> T8 -\> There are 8 letters in vena cava * Aorta -\> T12 -\> Idk good luck * Vagus nerve -\> T10 -\> There are 10 letters in vagus nerve and it is the 10th cranial nerve * Oesophagus -\> T10 -\> There are 10 letters in oesophagus

Answer 144

Read up on this.

Answer 145

* Motor and sensory -\> Phrenic nerve * Sensory -\> Intercostal nerves

Answer 146

* Right shoulder (phrenic n.) * Right hypochondrium (intercostal n.) (Hypochondrium = Just below the rib cage)

Answer 147

C3, C4, C5 keep the diaphragm alive.

Answer 148

Function: Inspiration

Answer 149

Function: Expiration

Answer 150

Assist the internal intercostal muscles.

Answer 151

* The main neurovascular bundles lie in the costal groove of the costal groove above this * Chest drain insertion in lower part of the intercostal space: Avoid damage to the main neurovascular bundle

Answer 152

Flail chest -\> The rib cage moves upon breathing.

Answer 153

* Each **subclavian arteries** give off the **internal thoracic arteries** that run down the anterior side of the thorax * The **internal thoracic arteries** give off the **anterior intercostal arteries** * The **descending aorta** gives off the **posterior intercostal arteries**

Answer 154

Bronchial arteries

Answer 155

* **Posterior intercostal veins** drain into the **azygos**, **hemiazygos** and **accessory hemiazygos veins** * The hemiazygos and accessory hemiazygos veins drain into the azygos veins * The azygos vein drains into the **superior vena cava**

Answer 156

* Parietal pleura -\> Outer membrane which is attached to the inner surface of the thoracic cavity. It also separates the pleural cavity from the mediastinum. * Visceral pleura -\> Inner membrane that covers the surface of each lung.

Answer 157

* Thoracic cage (costal pleura) * Mediastinum * Part of cervical region * Diaphragm

Answer 158

The space in the thorax between the pleural and visceral membranes.

Answer 159

* It is a recess formed by the parietal pleura into which the lung can expand into during deep inspiration * Region for potential fluid accumulation: pleural effusion

Answer 160

Below the 12th rib.

Answer 161

* A pneumothorax is a collapsed lung. * It occurs when air leaks into the space between your lung and chest wall. * This air pushes on the outside of your lung and makes it collapse.

Answer 162

It is a special case of penumothorax where the pressure of the air trapped in the pleural cavity continues to increase due to a one way valve in the chest wall. It is more dangerous.

Answer 163

* Main (primary) bronchi * Lobar (secondary) bronchi * Segmental (tertiary) bronchi i.e. The main bronchi divide into lobar bronchi, which divide into segmental bronchi.

Answer 164

* Rght main bronchus * Due to its wider lumen & more vertical orientation

Answer 165

3 lobes: * Upper lobe * Middle lobe * Lower lobe

Answer 166

2 lobes: * Upper lobe * Lower lobe

Answer 167

* Upper lobe -\> 3 BP segments (1-3) * Middle lobe -\> 2 BP segments (4-5) * Lower lobe -\> 5 BP segemnts (6-10)

Answer 168

* Upper lobe -\> 5 BP segments (1-5) * Lower lobe -\> 5 BP segments (6-10)

Answer 169

The cardiac notch is the lateral deflection of the anterior border of the left lung. It is produced to accommodate the space taken up by the heart.

Answer 170

The most superior point on each lung.

Answer 171

Right lung: * Horizontal fissure * Oblique fissure Left lung: * Oblique fissure

Answer 172

* Apical segment of the lower lobe * This is important because any fluid will drain there when lying down

Answer 173

* Pulmonary arteries -\> Supply exchange parts of the lungs * Bronchial arteries -\> Supply non-exchange parts of the lungs (e.g. bronchi)

Answer 174

2 -\> A left and a right one.

Answer 175

* Pulmonary veins drain the lungs -\> Drain into the left atrium of the heart. * Bronchial veins drain the larger bronchi and structures at the roots of the lungs -\> The right side drains into the azygos vein, while the left side drains into the left superior intercostal vein or the accessory hemiazygos vein.

Answer 176

4 -\> A superior and inferior on each side.

Answer 177

Note: The posterior is in the middle, the anterior is to the sides.

Answer 178

* On the right -\> The main bronchus & pulmonary arteries typically divide BEFORE entering the lung * On the left -\> The main bronchus & pulmonary arteries typically divide AFTER entering the lung

Answer 179

A fold of pleural membrane reflected at the junction between the parietal and visceral pleura, at the bottom of the hilum.

Answer 180

* Lymphatic drainage from lungs follows the tracheobronchial tree * Majority of lymphatic drainage is to right lymphatic duct / subclavian vein except left upper lobe

Answer 181

It is about 2cm above the clavicle.

Answer 182

Note: You definitely don't need to know the surface markings of the fissures. Nothing else is mentioned in the spec, apart from the apex, but it might be worth knowing the lower boundaries of the lungs.

Answer 183

If the sound is dull, you may be tapping the: * Heart * Liver * Other liquid-filled cavities If the sound is resonant, you may be tapping: * Gas-filled cavity (e.g. lungs or gas in stomach)

Answer 184

The action of listening to sounds from the heart, lungs, or other organs, typically with a stethoscope, as a part of medical diagnosis.

Answer 185

Note that the numbers show the position of the actual valves, while the crosses show where it is best to listen for that valve.

Answer 186

Medial right 2nd intercostal space.

Answer 187

Medial left 2nd intercostal space

Answer 188

Medial left 4th/5th intercostal space

Answer 189

Left 5th intercostal space, close to the midclavicular line

Answer 190

* The areas of the lungs that can be listened to using a stethoscope. * These are the posterior, lateral, and anterior lung fields.

Answer 191

Do it, whatever that means.

Answer 192

Skull: * Frontal * Parietal * Occipital * Sphenoid * Temporal * Ethmoid Facial skeleton: * Maxilla * Mandible * Zygomatic * Nasal * Vomer

Answer 193

* Cranial -\> 8 * Facial -\> 14 [Check this!]

Answer 194

The orbit is the bony protective socket for the eye and is formed by the surrounding frontal, sphenoid, maxilla and zygomatic bones.

Answer 195

* Upper jaw -\> Maxilla * Lower jaw -\> Mandible

Answer 196

* The cheekbone * Formed by the zygomatic process of the temporal bone and the temporal process of the zygomatic bone

Answer 197

The temporal bone at the temporo-mandibular joint.

Answer 198

* Greater wings -\> These are the bits that can be seen on the lateral skull wall * Lesser wings * Pterygoid plates * Pituitary fossa (in the body) -\> Where the pituitary gland is found * Sphenoid sinuses (in the body)

Answer 199

* Zygomatic bone * Note that the part of it that forms the zygomatic arch is called the temporal process

Answer 200

* Nasal bones * Lateral nasal cartilages * Greater alar cartilages

Answer 201

* Perpendicular plate of the ethmoid * Vomer * Septal cartilage

Answer 202

* Olfaction * Warming, cleaning and humidifying inspired air

Answer 203

Conchae: * Bony ridges in the nasal passage. * Act to increase the surface area of the nasal passages -\> For warming, cleaning and humidifying inspired air. Meati: * The spaces created by the conchae through which air can flow.

Answer 204

3 Conchae: * Inferior concha * Middle concha * Superior concha 4 Meati: * Inferior meatus –\> Between the inferior concha and floor of the nasal cavity. * Middle meatus -\> Between the inferior and middle concha. * Superior meatus -\> Between the middle and superior concha. * Spheno-ethmoidal recess -\> Superiorly and posteriorly to the superior concha.

Answer 205

The middle and upper conchae are part of the ethmoid bone, whilst the inferior concha is a separate bone.

Answer 206

Mucus-secreting cells and rich blood supply.

Answer 207

Originating from the internal and external carotid supply: * Maxillary artery * Facial artery * Branches of the ophthalmic artery

Answer 208

The alternating blood supply to the two nostrils, meaning that only one nostril can be blocked at a time during a cold.

Answer 209

Specialised sensory epithelium which allows us to sense odours (olfaction).

Answer 210

* Olfactory Nerve (I) -\> Smell * Trigeminal Nerve (V) -\> General sensory * Facial Nerve (VII) -\> Parasympathetic supply (of mucosa)

Answer 211

Air-filled spaces are lined with mucus membrane and have openings into the nasal passage, behind the conchae.

Answer 212

* Lightening the weight of the head * Humidifying and heating inhaled air * Increasing the resonance of speech * Serving as a crumple zone to protect vital structures in the event of facial trauma

Answer 213

There are 2 copies of each of these 4 types: * Maxillary * Ethmoid * Sphenoid * Frontal

Answer 214

From the eye to below the inferior concha.

Answer 215

Trigeminal nerve (V)

Answer 216

In each quarter of the mouth: * 2 Incisors -\> Cutting * 1 Canine -\> Gripping * 2 Premolars -\> Grinding * 3 Molars -\> Grinding

Answer 217

Trigeminal Nerve (V)

Answer 218

Head of the mandible articulates with the temporal bone forming a synovial joint at the mandibular fossa.

Answer 219

* Temporalis and masseter -\> Jaw-closing muscles. * Medial and lateral pterygoid muscles -\> Allow protrusion of the lower jaw and sideways movements involved in chewing.

Answer 220

Mandibular branch of the trigeminal nerve (V)

Answer 221

* Intrinsic * Extrinsic

Answer 222

They all end in glossus.

Answer 223

Motor: * Hypoglossal nerve (XII) -\> All muscles (except palatoglossus X) Sensory: * Trigeminal nerve (V) -\> General sensation of anterior 2/3rds of tongue * Facial nerve (VII) -\> Taste sensation of anterior 2/3rds of tongue * Glossopharyngeal nerve (IX) -\> Both general and taste sensation of posterior 1/3rd

Answer 224

Parotid gland: * Glossopharyngeal nerve (IX) via the otic ganglia Sub-mandibular and sublingual salivary glands: * Facial nerve (VII) via the sub-mandibular ganglion

Answer 225

* It is essentially the throat -\> It is a common passage for solid food, liquid and air * It is the muscular tube behind the mouth and nasal cavity, and above the esophagus and larynx of the trachea (the tubes going down to the stomach and the lungs).

Answer 226

* Nasopharynx * Oropharynx * Laryngopharynx

Answer 227

The enters the start of the oesophagus, but not the trachea.

Answer 228

The nasopharynx and oropharynx are separated during swallowing by the elevation of the soft palate.

Answer 229

Opening of the pharyngo-tympanic tube.

Answer 230

The superior, middle and inferior pharyngeal constrictor muscles.

Answer 231

The muscles are fused posteriorly as a “raphe”.

Answer 232

Hyoid bone

Answer 233

* Lies in the upper part of the neck * Suspended by muscles and the stylohyoid ligament

Answer 234

* Superior constrictor -\> Medial pterygoid plate of sphenoid * Middle constrictor -\> Hyoid bone * Inferior constrictor -\> Thyroid cartilage and the cricoid cartilage (parts of the larynx)

Answer 235

Pharyngeal plexus

Answer 236

Cricopharyngeus

Answer 237

They are the two parts of the roof of the mouth. The hard palate is the bony part at the front of the mouth, while the soft palate is the soft part at the back.

Answer 238

* Palatine process of the maxilla * Paired palatine bones

Answer 239

Facilitates speech, breathing and swallowing by making sure that the proper communication channels between the oral, pharyngeal and nasal cavities are open or closed during each of these processes.

Answer 240

* Commonly called the voice box * It is an organ in the top of the trache * Involved in breathing, producing sound and protecting the trachea against food aspiration. * The larynx houses the vocal folds, and manipulates pitch and volume, which is essential for phonation.

Answer 241

The larynx is the voice box at the top of the trachea, while the pharynx is the throat behind the mouth and nose. The pharynx essentially ends at the larynx, but goes a bit further into the oesophagus.

Answer 242

* Cartilages * Membranes

Answer 243

* Epiglottis -\> Leaf-like cartilage which covers the opening of the larynx during swallowing * Thyroid cartilage -\> Major cartilage of the larynx and is larger in males (Adams apple) * Cricoid cartilage -\> Like a signet ring and lies at the top of the trachea. * Arytenoid cartilages -\> Within the thyroid cartilage.

Answer 244

The leaf-shaped covering at the top of the larynx that covers the opening during swallowing.

Answer 245

Thyroid cartilage

Answer 246

In the larynx.

Answer 247

* Posteriorly -\> Arytenoid cartilages * Anteriorly -\> Thyroid cartilage

Answer 248

* The cricoid cartilage * This means that the can move freely and rotate and slide on the cricoid cartilage -\> This is controlled by the vocal muscles

Answer 249

Note: The vocal cords are attached posteriorly to the arytenoid cartilages (on the cricoid cartilage), and anteriorly to the thyroid cartilage. Volume control: * Moving the arytenoids controls the separation of the cords and therefore the volume Pitch control: * The cricothyroid muscle pulls the thyroid cartilage down tensing the vocal cords -\> Increases pitch * The thyroarytenoid muscles run in parallel with the vocal cords so slacken the cords -\> Decrease pitch [Don't need to know named muscles]

Answer 250

Epiglottis (of the larynx)

Answer 251

* The teeth break down the food, and the tongue mixes the food with salivary secretions to form a paste-like bolus. * The tip of the tongue is elevated against the hard palate and the posterior part of the tongue depressed, so the bolus moves to the oro-pharynx. * The sensory receptors on the posterior part of the tongue (glossopharyngeal) initiate a swallowing reflex. * The soft palate is tensed and elevated, sealing the nasal part of the pharynx. * The hyoid bone is elevated as the bolus passes to the pharynx, where the pharyngeal constrictors force the bolus down toward the oesophagus. * The elevation of the hyoid causes the epiglottis to cover the opening of the larynx, protecting the airway. * The bolus passes over the epiglottis down into the pharynx and, once past the cricopharyngeus muscle, the hyoid descends and the epiglottis flips back to reopen the airway.

Answer 252

Branches of the vagus nerve: * Recurrent laryngeal nerve -\> Sensory innervation of the infraglottis, and motor innervation to all the internal muscles of larynx (except the cricothyroid). * Superior laryngeal nerve -\> Internal branch provides sensory innervation to the supraglottis, and external branch provides motor innervation to the cricothyroid muscle.

Answer 253

Pulmonary plexus: * Recurrent laryngeal nerves (branches of the vagus) -\> Parasympathetic supply * Sympathetic trunks -\> Sympathetic supply

Answer 254

* Gas exchange -\> O₂and CO₂ * Synthesis -\> e.g. Collagen, elastin etc * Metabolism -\> ATP production * Secretion -\> e.g Mucus, surfactant * Defence -\> Non-specific, specific

Answer 255

Conducting portion: * Nasal cavity * Nasopharynx * Larynx * Trachea * Bronchi * Bronchioles * Terminal bronchioles Respiratory portion: * Respiratory bronchioles * Alveolar ducts * Alveoli

Answer 256

Patency of conducting airways maintained by: * Rigid structural support -\> Bone and cartilage * Flexibility and extensibility -\> Elastic and collahen fibres, and smooth muscle For protective and secretory functions: * A lining of epithelial cells with glands

Answer 257

* Thin walled pouches where gaseous exchange can take place * Rich capillary network and thin cellular membranes

Answer 258

Mucous membrane (mucosa)

Answer 259

They consist of two layers: * Epithelial cells * Layer of connective tissue Beneath the mucous membrane there is usually a submucosa and adventitia, plus maybe other layers.

Answer 260

* It is just another name for a mucous membrane * It is found lining many places, including in the respiratory system, digestive system, and reproductive systems * Mucous membranes can contain or secrete mucus, having a protective function

Answer 261

* Mucous membrane (mucosa) is: * Respiratory epithelium * Lamina propria * Submucosa and adventitia found beneath mucosa

Answer 262

* Covers and protects * Secretory and absorptive functions

Answer 263

All body cavities that are in continuity with the external surface.

Answer 264

Ciliated pseudostratified columnar epithelium

Answer 265

1. Ciliated columnar cells 2. Mucous goblet cells 3. Basal (short) cells [EXTRA] 4. Small granule cells (Kulchitsky or K cells) [EXTRA] 5. Brush cells [EXTRA]

Answer 266

* Ciliated columnar cells -\> 30% * Mucous goblet cells -\> 30% * Basal (short) cells -\> 30% * Small granule cells (Kulchitsky or K cells) -\> 3-4% * Brush cells -\> 3%

Answer 267

1000-1500 beats per minute

Answer 268

Axoneme core: * 2 central microtubules * 9 pairs of microtubules around the outside of each cilia Motor protein: * Dynein -\> Enables movement

Answer 269

* Microtubules arranged longitudinally along the cilia glide past each other by ATP hydrolysis * Dynein (motor protein) provides the force for bending -\> This is controlled by Ca²⁺ flux through gap junctions

Answer 270

Produce mucus to trap particulate matter and pollutants.

Answer 271

Relative contributions from goblet cells and seromucus glands.

Answer 272

* Co-ordinated beating of cilia * Maintained by Ca²⁺ flux via gap junctions -\> Visualised using Ca²⁺ sensitive dye

Answer 273

* The pseudostratified columnar epithelium that covers most of the upper respiratory tract. * It is a structural classification, not a functional one.

Answer 274

Mucous membrane = Respiratory epithelium + Lamina Propria

Answer 275

* Autosomal recessive disorder * Caused by a mutation in the CFTR protein (cystic fibrosis transmembrane conductance regulator) -\> This is a Cl^- channel * Affects most critically: * Lungs * Pancreas, liver, and intestine * Mechanism: * Disrupts epithelial ion transport * Results in defective transport of Cl^- and water by the submucosal glands * Lack of chloride transport leads to decreased water movement by osmosis * Cells take up extra Na⁺ * Mucus becomes thick and traps bacteria * The thick mucus leads to lung infections

Answer 276

* The respiratory epithelium is most susceptible to damage from pollutants * Smoking transforms respiratory epithelium into stratified squamous epithelium -\> This is the first step in differentiation into a tumour

Answer 277

Connective tissue with: * Mucous glands * Serous glands It is beneath the respiratory epithelium and supports it. Together the two make up the mucosa (mucous membrane).

Answer 278

* Elastic connective tissue * Has glands: * Mucous glands * Serous glands * Has MALT for defence: * Lymphocytes * Plasma cells * Macrophages * Neutrophils * Eosinophils * Rich blood supply

Answer 279

* Mucous glands * Serous glands

Answer 280

* Mucous glands * Produce a mucus that supplements that produced by goblet cells * It is viscous * Serous glands * Produce a watery secretion that dilutes mucus * Lysosyme, lactoferrin and protease inhibitors -\> Protection against bacteria

Answer 281

* Submucosa -\> Larger glands * Cartilage * Muscle * Collagenous and elastic connective tissue fibres

Answer 282

Elastic lamina

Answer 283

There are 3 types of epithelium: * Respiratory epithelium (ciliated pseudostratified columnar epithelium) * Stratified squamous epithelium * Olfactory epithelium

Answer 284

* Very plentiful blood supply (for warming air) * Vibrissae (for filtering out dust particles) * Higher goblet : ciliated cell ratio (than lower airways)

Answer 285

It covers the roof of the nasal cavity.

Answer 286

Respiratory epithelium

Answer 287

* Mucosa * Sub-mucosa * Adventitia with cartliage

Answer 288

* 10-12 C-shaped cartilage rings * Open on the posterior side, where the gap is bridged by smooth muscle * Collagenous and elastic connective tissue fibres link individual rings

Answer 289

It is very similar to the tracheal mucosa (i.e. the archetypal respiratory epithelium, with abundant mucous and serous glands), but the underlying cartilages are more irregular and there is a criss-crossing muscle layer.

Answer 290

They have muscle, but no cartilage.

Answer 291

* Decrease in glands and goblet cells * Epithelial cells become more cuboidal

Answer 292

Not typical respiratory epithelium -\> Lined with ciliated cuboidal cells and Club (Clara) cells

Answer 293

Increase in smooth muscle and elastic tissue (relative to wall)

Answer 294

Muscle contracts at end of expiration and relaxes during inspiration

Answer 295

Between the terminal and respiratory bronchioles.

Answer 296

* Mucosa similar to terminal bronchioles except walls interrupted by saclike alveoli which increase in number * Smooth muscle and elastic connective tissue * 80% of cells are Club cells

Answer 297

Alveolar ducts are tiny ducts that connect the respiratory bronchioles to alveolar sacs, each of which contains a collection of alveoli (small mucus-lined pouches made of flattened epithelial cells).

Answer 298

* Simple squamous epithelium * Alveolar ducts do not have walls of their own

Answer 299

Sphincter-like smooth muscle cells

Answer 300

* A rich matrix of elastic (expansion) and reticular fibres provides the only support of the alveolar duct and alveoli * A loss of elasticity and breakdown of elastic fibres gives rise to emphysema

Answer 301

* Between the two squamous epithelia lie capillaries, elastic and reticular fibres and connective tissue matrix and cells (i.e. the interstitium) * Richest capillary network in body * Pores of Kohn allow communication between alveoli

Answer 302

* Type I pneumocytes * Type II pneumocytes * Macrophages

Answer 303

* Type I -\> 90% of alveolar surfaces * Type II -\> More numerous than Type I cells but only occupy 10% of alveolar surface * Alveolar macrophages -\> 10% of alveolar surface

Answer 304

* Squamous epithelial cells * Form gas exchange surface

Answer 305

Adapted to gas exchange: * Organelles grouped round nucleus leaving cell with minimal thickness * Form occluding junctions with each other preventing seepage of extracellular fluid into alveolar lumen

Answer 306

1. Cytoplasm of alveolar cells 2. Cytoplasm of endothelial cells 3. Fused basal laminae of closely apposed alveolar and endothelial cells

Answer 307

It occurs by passive diffusion, which is driven by pressure difference of gases within blood and alveolar lamina.

Answer 308

* Cuboidal epithelial cells found in groups * They produce sufactant and can also replace both type I and II pneumocytes by mitosis

Answer 309

Thery are cuboidal and found in groups. They are interspersed with type I cells.

Answer 310

Type II cells have occluding and desmosomal junctions with type I cells.

Answer 311

Type II pneumocytes divide by mitosis to replace their own population and also the type I population.

Answer 312

A protein lipid complex which lowers alveolar surface tension.

Answer 313

* Lamellar bodies synthesize (and recycle) phospholipids, glycosaminoglycans and proteins that comprise surfactant * Released at apical surface of cell where it forms a broad lattice-like network known as tubular myelin

Answer 314

Phagocytes

Answer 315

* Phagocytose particulate matter (dust and bacteria) in lumen of alveoli maintaining sterile environment within lungs * Produce proteolytic and lysosomal enzymes * Also kill bacteria through peroxide-producing oxidative mechanisms * Also assist type II cells in the uptake of surfactant * Has many psuedopods and microvilli

Answer 316

* Common cold * Influenza * Croup * Diptheria * Whooping cough (pertussis) * Pneumonia * Pleurisy * TB * Sinusitis

Answer 317

* Filtration * Sneeze and cough reflexes * Mucus - 'mucociliary escalator' moves particles up to the mouth, where they can be swallowed * Lysozme, lactoferrin, transferrin involved in bacterial defence * Opsonins, such as immunoglobulins and complement * Phagocytic cells, such as alveolar macrophages and neutrophils * Pulmonary surfactant proteins * Nitric Oxide – inflammatory mediator

Answer 318

* Mucosal immune system * Aggregates of immune tissue * Adenoids * Bronchus-associated lymphoid tissue (BALT) -\> Nodules containing T and B lymphocytes * NALT – in nose

Answer 319

* The posteriorinferior margin of the diaphragm is the T12 vertebra. * The anteroinferior margin is the costal margin.

Answer 320

Pulmonary branches of the vagus nerve (X).

Answer 321

A series of anastomosing arterial arches between the arterial branches of the jejunum and ileum.

Answer 322

Sympathetic

8. Breathing and Circulation (HT) Flashcards

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