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Cardio Flashcards

1
Q

What is the pericardium?

A

Outermost layer of the heart

Layer of mesothelial cells resting on thin layer fibrous connective tissue

Visceral and parietal

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2
Q

What is the epicardium like?

A

Sometimes used interchangeably with pericardium

Strictly it is the underlying adipose connective tissue, vessels and nerves

Between pericardium and myocardium

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3
Q

What is myocardium like?

A

Thickest layer of the heart
Specialised cardiac muscle
Striated
Central nuclei
Branching
Intercalated discs

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4
Q

What are intercalated discs like?

A

Connect adjacent cardiac myocytes
Contain:
Gap junctions
Adhering junctions
Desmosomes

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5
Q

What is endomysium like?

A

Loose fibrous connective tissue between the muscle fibres (endomysium)

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6
Q

What does myocardium like?

A

Atrial myocytes are small than those in the ventricles

Contain perinuclear neuroendocrine granules (atrial natriuretic peptide)

The heart is an endocrine organ!

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7
Q

What is in the conducting system?

A

Sinoatrial node
Atrioventricular node
Bundle of His
Purkinje fibres
Subendocardial
Large vacuolated muscle cells

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8
Q

What is the endocardium composed of?

A

Innermost layer of heart

Thin layer of fibrous connective tissue

Endothelial cells

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9
Q

What are valves like?

A

Covered by endothelium
Attach to central fibrous body

Endothelial cells on either side

Fibrosa (dense fibrous CT)
Spongiosa (loose fibrous CT)
Ventricularis (collagen & elastin)
Interstitial cells inside like smooth muscle cells, fibroblasts and myofibroblasts

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10
Q

What are the layers of the heart?

A

Pericardium
Epicardium
Myocardium
Endocardium

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11
Q

What does myocardium comprise?

A

Myocardium comprises a specialised form of involuntary striated muscle known as cardiac muscle

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12
Q

What are valves?

A

Valves are specialised extensions of endocardium

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13
Q

What is plasma?

A

Plasma is blood minus the cells and comprises:
water
salts & minerals
plasma proteins (albumins, globulins, fibrinogen)
hormones, signal molecules
other clotting factors etc.

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14
Q

What is serum?

A

Serum is plasma minus clotting factors

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15
Q

What are erythrocytes like?

A

4-6million per mL blood
Lifespan of 4 months
Produces in liver (fetus) and bone marrow
Enucleate, biconcave discs - 6/5-8.5 micrometer in diameter (end to end about 180km)
Major protein is haemoglobin
Destroyed in the liver and spleen
Cell membrane has important endoskeleton attached (major protein -spectrin)

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16
Q

What are the white cell series (leucocytes)?

A

Granulocytes (contain visible granules)
40-75% Neutrophils
~ 5% Eosinophils
~ 0.5% Basophils

Agranulocytes (no visible granules)
20-50% Lymphocytes
1-5% Monocytes

Platelets (cell fragments)

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17
Q

What are neutrophils?

A
  • Polymorphonuclear leucocytes

Commonest WBC
Commonest granulocyte

Multi-lobed nucleus, granular cytoplasm (12-14micrometer) in diameter

Phagocytic - engulf and destroy bacteria and other foreign macromolecules

Circulate in blood and invade tissue spaces

Contain myeloperoxidase

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18
Q

What does neutrophils contain?

A

Polymorphonuclear leucocytes

Contains 3 types of cytoplasmic granule

Primary granules
Lyzosomes - myeloperoxidase acid hydrolases

Secondary granules
Specific granules - secrete substances that mobilizer inflammatory mediators

Tertiary granules
Gelatinases and adhesion molecules

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19
Q

What are eosinophils?

A

1% of total number of white cells
Numbers increase in parasitic infections
12-17 μm in diameter
Bi-lobed nucleus
Distinctive large red cytoplasmic granules with crystalline inclusions

Antagonistic in action to basophils

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20
Q

What do eosinophils do?

A

Characteristic lozenge-shaped granules with crystalline cores
Phagocytic with particular affinity for antigen/ antibody complexes
Receptors for IgE
Inhibit Mast cell secretion
Neutralise histamine – thereby restricting inflammatory responses

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21
Q

What are basophils?

A

0.5% of white cell series,

14-16 μm in diameter

Bi-lobed nucleus and prominent dark blue-staining cytoplasmic granules

Granules contain histamine.

Involved in inflammatory reactions and act to prevent coagulation and agglutination

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22
Q

What do basophils do?

A

Circulating form of the tissue Mast Cell

Receptors for IgE

Release histamine and other vaso-active agents in response to allergens
Results in immediate hypersensitivity reaction

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23
Q

What are they two functional subtypes of lymphocytes?

A

Two functional subtypes

B Cells - become plasma cells and secrete antibodies

T Cells - are involved in cell-mediated immunity

Very few cytoplasmic inclusions and hence have a clear blue/grey cytoplasm

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24
Q

What are they two functional subtypes of lymphocytes?

A

Two functional subtypes

B Cells - become plasma cells and secrete antibodies

T Cells - are involved in cell-mediated immunity

Very few cytoplasmic inclusions and hence have a clear blue/grey cytoplasm

25
What are the cells of lymphocytes?
B Cells – produce antibodies T Helper (TH) Cells – help B cells and activate macrophages T Cytotoxic (TC) Cells – kill previously marked target cells T Suppressor (TS) Cells – suppress TH cells and hence suppress the immune response Natural Killer (NK) Cells – mainly kill virus infected cells ALL look the same in histological sections on H+E
26
What are monocytes?
Immature cells, circulate briefly in blood Characteristic reniform nucleus 15-20 μm in diameter Differentiate into one of several cell types within tissue Major phagocytic and defensive role Some become antigen presenting cells, passing antigen fragments to lymphocytes
27
What do monocytes differentiate into?
Small cytoplasmic granules (despite classification!), mostly lysosomes Differentiate into Tissue macrophages - everywhere Kupffer cells – liver Osteoclasts – bone Antigen presenting cells - everywhere Alveolar macrophages – lung
28
What are platelets?
Fragments of cells derived from large multi-nucleated Megakaryocytes in the bone marrow 1 to 3 μm in diameter, surrounded by cell membrane and containing vesicles with coagulation factors Responsible for clotting of blood, notably when the endothelium lining all blood vessels is breached
29
What occurs in hematopoiesis?
All blood cells form in the haematopoeitic bone marrow in adults (liver in the fetus) Myelon series lies next to bone and gives rise to white blood cells Erythron series lies in between bony trabeculae and gives rise to erythrocytes Megakaryocytes lie in between bony trabeculae and give rise to platelets
30
What is erythropoeisis?
Reducing cell size •Haemoglobin production •Reduction and loss of organelles •Basophilia in early precursors changes to eosinophilia in late precursors •Loss of nucleus •Mediated by erythropoeitin (EPO)
31
What is granulopoeisis?
Morphology similar for neutrophils, eosinophils and basophils •Increasing number of granules •Increasingly complex shape of the nucleus •Large pool of stored mature neutrophils in marrow
32
Where are blood cells formed?
Blood cells are formed in haematopoeitic bone marrow, ultimately from a single precursor
33
What occurs in the formation of blood cells
There are multiple precursors in the formation of blood cells. You are not expected to be able to identify the precursor cells, but you should know where different elements of haematopoiesis occur.
34
What is the most common cell and leucocyte?
Erythrocytes most common cell •Neutrophils most common leucocyte
35
What if imp to remember?
Function dictates form! For: Filtration Humidification Warming Olfaction (and taste) Gas transport Speech Protection against infection Gas exchange
36
What is respiratory epithelium like?
Lines the tubular portion of the respiratory Pseudostratified - all cells contact b.m Ciliates epithelial cells Interspersed goblet cells
37
What occurs in the noses?
Filtration Humidification Warming Olfaction
38
What is found in the nose?
Keratinising and non-keratinising squamous epithelium Respiratory epithelium Richly vascular laminated proprietary containing seromucinous glands
39
What is found in the nose?
Keratinising and non-keratinising squamous epithelium Respiratory epithelium Richly vascular laminated proprietary containing seromucinous glands
40
What occurs in olfaction?
Roof of the nasal cavity, extending down septum and lateral wall Pseudostratified columnar epithelium of olfactory receptor cells with supporting sustentacular cells and basal cells Serous glands of Bowman
41
What cells are found in olfaction?
Olfactory receptor cells - Bipolar neurons – dendrite extends to surface to become club-shaped ciliated olfactory vesicle
42
What occurs at the nasopharynx?
Gas transport Humidification Warming Olfaction Lined by Resp epithelium
43
What are the nasal sinuses?
Frontal Ethmoid Maxillary
44
What do nasal sinuses do?
Lower the weight of the skull Add resonance to the voice Humidify and warm inspired air Lined by respiratory epithelium
45
What is the larynx like?
Cartilaginous box Voice production Respiratory epithelium Loose fibrocollagenous stroma with seromucinous glands Lymphatics and blood vessels common
46
What are the vocal cords like?
Voice production Stratified squamous epithelium overlying loose irregular fibrous tissue (Reinke’s space) Almost no lymphatics
47
What is the trachea like?
Conducts air into and from the lungs Respiratory epithelium Seromucinous glands in submucosa Tracheal is muscle posteriorly C-shaped cartilaginous rings
48
What is teh composition of bronchi and bronchioles?
Main bronchi -> lobar bronchi -> segmental bronchi -> bronchioles Smooth muscle Partial cartilaginous rings Respiratory epithelium Ciliates columnar epithelium Some basal neuroendocrine cells Seromucinous glands and goblet cells Few goblet cells Clara cells Order? Which is which!!!1
49
What ate Clara cells?
Most numerous in terminal bronchioles, Mitochondria, Smooth ER, Secretory granules No cilia; vesicular cytoplasm Precise function uncertain… but believed: Oxidise inhaled toxins? Antiprotease function? Surfactant production / elimination? Stem cell? ??
50
What are respiratory bronchioles like?
First part of distal respiratory tract Gas exchange as well as transport Link terminal bronchioles and alveolar ducts Cuboidal ciliated epithelium Spirally-arranged smooth muscle
51
What is alveoli?
150-400 million/lung 250 µm in diameter GAS EXCHANGE
52
What are teh types of alveoli?
Type 1 pneumocytes 40% cell population 90% SA Flattened cells, flattened nucleus, few organelles Type 2 pneumocytes 60% cell population 5-10% SA Rounded cells, round nucleus, rich in mitochondria, smooth and rough ER, spherical bodies Produce surfactant
53
What are alveolar macrophages?
Alveoli – cell types Alveolar macrophages Luminal cells, also present in the interstitium Phagocytose particulates including dusts and bacteria Enter lymphatics or leave via mucociliary escalator
54
What is the BBB like?
blood-air barrier Type 1 pneumocyte Fused basement membrane of pneumocyte and capillary Vascular endothelial cell 200-800nm thick! How linked to alveoli?
55
What is the interstitium of the alveoli?
Where endothelial cells are not in direct contact with Pneumocytes Collagen and elastin fibres Fibroblasts Macrophages (Pores of Kohn)
56
What is the visceral pleura like?
visceral pleura Flat mesothelial cells Loose fibrocollagenous connective tissue Irregular external elastic layer Interstitial fibrocollagenous layer Irregular internal elastic layer
57
What are the conducting parts of the airways lined by?
Ciliated epithelium which becomes flatter more distally
58
What are the walls for alveoli like?
The alveoli - very thin walls
59
What does alveolar interstitium contain?
Blood vessels, lymphatics, collagen and elastin and some macrophages

Histology (5 decks)

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