Cardiorespiratory Flashcards
Tunica intima structure
Endothelium layer
Loose CT
Internal elastic lamina
Tunica intima structure
Endothelium layer
Loose CT
Internal elastic lamina
Tunica media structure
Circularly arranged smooth muscle
Supporting ECM with collagen and elastic fibres
External elastic lamina
Tunica adventitia
Loose CT
Vaso vasorum
Endocardium structure
Inner endothelium lining
Supporting highly elastic fibrocollagenous CT
Myocardium structure
Cardiac myocytes linked by intercalated discs
Supporting fibrocollagenous CT
Epicardium structure
Outer fibrocollagenous tissue
Large amounts of adipose tissue
Outer mesothelium - visceral pericardium
Elastic arteries
Predominance of elastin and little smooth muscle in tunica media
Found in large arteries just downstream of the heart
Function to smooth out large pressure fluctuations
Muscular arteries
Medium to small sized arteries
Have the basic arterial structure
Which types of cells form foam cells
Macrophages and smooth muscle cells
What does the fibrous cap consist of?
Smooth muscle cells with an ECM with dense collagen, elastic fibres and proteoglycans
Upper respiratory tract
Mouth –> larynx
Lower respiratory tract
Trachea –> terminal bronchioles
Classic respiratory epithelium
Pseudostratified columnar, ciliated epithelium with mucous secreting goblet cells
How does the epithelium change throughout the lungs?
Gradual transition from pseudostratified to columnar to cuboidal epithelium
Gradual decrease in number of goblet cells
Epithelium in the pharynx
Stratified squamous
Immune properties of the respiratory tract
Mucociliary escalator
MALT
Trachea layers
Respiratory epithelium Lamina propria - with elastin and lymphoid tissue Submucosa - with many glands C shaped rings of hyaline cartilage Adventita
Bronchi structure
Shorter epithelial cells Lamina propria contains more elastic tissue Muscularis mucosae begins to form Fewer submucosal glands Cartilage in plates rather than rings
Tertiary bronchi structure
Simple columnar epithelium
Prominent muscularis mucosae
Few cartilage plates
Few mucous glands
Bronchiole structure
Ciliated columnar epitehlium Few goblet cells Clara cells Prominent muscularis mucosae No cartilage No mucous glands
Respiratory bronchiole structure
Occasional alveoli in their walls
Ciliated cuboidal epithelium
Smooth muscle in their walls
Alveolar cell types
Type I pneumocyte - simple squamous lining cell
Type II pneumocyte - cuboidal cells that produce surfactant
Pulmonary macrophages - immune surveillance
Blood-air barrier
Type I pneumocyte
Basement membrane
Capillary endothelium
Functions of platelet factors
Promote aggregation with other platelets
Alter local blood flow
Initiate coagulation cascade
Encourage vascular repair
Neutrophils
60-70% of blood WBCs
First line of defence against pathogens
Highly phagocytic
Role in inflammation
Eosinophils
1-4% of blood WBCs
Defence against parasites and helminths
Increased levels in allergic responses
Basophils
Monocytes
2-6% of blood WBCs
Mature into macrophages when they enter the tissues
Main roles in phagocytosis, antigen presentation and cytokine production
Lymphocytes
20-40% of blood WBCs
B cells and T cells
Can form memory cells - longest WBC lifespan
CCBs
Amlodipine, dilatiazem
Blocks calcium entry into smooth muscle cells
Vasodilators and reduce heart rate and contractility
May worsen heart failure
CCBs
Amlodipine
Tunica media structure
Circularly arranged smooth muscle
Supporting ECM with collagen and elastic fibres
External elastic lamina
Tunica adventitia
Loose CT
Vaso vasorum
Endocardium structure
Inner endothelium lining
Supporting highly elastic fibrocollagenous CT
Myocardium structure
Cardiac myocytes linked by intercalated discs
Supporting fibrocollagenous CT
Epicardium structure
Outer fibrocollagenous tissue
Large amounts of adipose tissue
Outer mesothelium - visceral pericardium
Elastic arteries
Predominance of elastin and little smooth muscle in tunica media
Found in large arteries just downstream of the heart
Function to smooth out large pressure fluctuations
Muscular arteries
Medium to small sized arteries
Have the basic arterial structure
Which types of cells form foam cells
Macrophages and smooth muscle cells
What does the fibrous cap consist of?
Smooth muscle cells with an ECM with dense collagen, elastic fibres and proteoglycans
Upper respiratory tract
Mouth –> larynx
Lower respiratory tract
Trachea –> terminal bronchioles
Classic respiratory epithelium
Pseudostratified columnar, ciliated epithelium with mucous secreting goblet cells
How does the epithelium change throughout the lungs?
Gradual transition from pseudostratified to columnar to cuboidal epithelium
Gradual decrease in number of goblet cells
Epithelium in the pharynx
Stratified squamous
Immune properties of the respiratory tract
Mucociliary escalator
MALT
Trachea layers
Respiratory epithelium Lamina propria - with elastin and lymphoid tissue Submucosa - with many glands C shaped rings of hyaline cartilage Adventita
Bronchi structure
Shorter epithelial cells Lamina propria contains more elastic tissue Muscularis mucosae begins to form Fewer submucosal glands Cartilage in plates rather than rings
Tertiary bronchi structure
Simple columnar epithelium
Prominent muscularis mucosae
Few cartilage plates
Few mucous glands
Bronchiole structure
Ciliated columnar epitehlium Few goblet cells Clara cells Prominent muscularis mucosae No cartilage No mucous glands
Respiratory bronchiole structure
Occasional alveoli in their walls
Ciliated cuboidal epithelium
Smooth muscle in their walls
Alveolar cell types
Type I pneumocyte - simple squamous lining cell
Type II pneumocyte - cuboidal cells that produce surfactant
Pulmonary macrophages - immune surveillance
Blood-air barrier
Type I pneumocyte
Basement membrane
Capillary endothelium
Functions of platelet factors
Promote aggregation with other platelets
Alter local blood flow
Initiate coagulation cascade
Encourage vascular repair
Neutrophils
60-70% of blood WBCs
First line of defence against pathogens
Highly phagocytic
Role in inflammation
Eosinophils
1-4% of blood WBCs
Defence against parasites and helminths
Increased levels in allergic responses
Basophils
Monocytes
2-6% of blood WBCs
Mature into macrophages when they enter the tissues
Main roles in phagocytosis, antigen presentation and cytokine production
Lymphocytes
20-40% of blood WBCs
B cells and T cells
Can form memory cells - longest WBC lifespan
ACEIs
Ramipril, captopril
Lower blood pressure
Used after MIs in diabetics
Side effects = K+ retention, cough
CCBs
Amlodipine
Thiazide diuretic
Bendoflumethiazide
Loop diuretic
Furosemide
Beta blockers
Propanolol, atenolol
Reduce sympathetic tone
Used in heart failure and after MI
Aldosterone blockers
Spironolactone
Used in heart failure
Angiotensin II receptor antagonists
Losartan
Digoxin mechanism of action
Inhibits Na/K ATPase in cardiac myocytes Myocyte Na+ rises Increased IC calcium Improved contractility Slows heart rate at AV node
Hypertension treatments
ACEI, CCBs, diuretics
Heart failure treatments
Reduce preload and afterload Diuretics ACEIs Beta blockers Digoxin
Angina treatments
Nitrates
Beta blockers
CCBs
Short term beta2 agonist
Salbutamol Receptor activates adenylyl cyclase ATP --> cAMP Lowers IC calcium Relaxes smooth muscle
Long term beta2 agonist
Salmeterol, formoterol
Anti-muscarinic
Ipratropium = short term
Tiotropium = long term
Mainly act on M3 receptors
Superior mediastinum contents
Thymus Large veins Large arteries Trachea Oesophagus Thoracic duct Sympathetic trunks
Path of the right vagus nerve
Enters lateral to the right common carotid and passes Anterior to the subclavian artery
Here it gives of the right recurrent laryngeal
Passes posterior to subclavian vein and SVC
Joins course of oesopahgus
Path of left vagus nerve
Enters lateral to the left common carotid
Anterior to the subclavian artery and posterior to brachiocephalic vein
Passes over the aortic arch and gives off left recurrent laryngeal
Passes posterior to the lung root and gives off branches to the pulmonary and cardiac plexuses
How do the phrenic nerves enter the mediastinum?
Between the subclavian artery and vein
Where does the right phrenic nerve travel?
Over pericardium and right atrium
Anterior to the lung root
Where does the left phrenic nerve travel
Over the aortic arch and left atrium and ventricle
Anterior to the lung root
Trachea length and spinal levels it extends from and to
13cm
C6–> T4
Where does the thoracic duct cross the midline?
T4/5
Azygous vs hemiazygous
Azygous drains right side
Hemiazygous drains left side
Where does the hemiazygous vein cross and empty into the azygous vein?
T7-8
Where does the azygous vein empty into?
SVC just before it enters the right atrium
Left coronary arteries
LAD
Circumflex
Left marginal
Right coronary arteries
Right marginal
Posterior descending
Where does the great cardiac vein run?
Anterior IV sulcus
Where does the middle cardiac vein run?
Posterior IV sulcus
Where does the small cardiac vein run?
With the right marginal artery
What divides the pectinate and smooth muscle of the atria?
Cristae terminalis
Where is the moderator band found?
Right ventricle
What happens when the papillary muscles contract/
Chordae tendinae pulled taut
Valve cusps close
Blood supply to thoracic wall
Anterior intercostals from internal thoracic artery
Posterior intercostals from thoracic aorta
Venous drainage of thoracic wall
Anterior intercostals drain into the internal thoracic vein
Posterior intercostals drain to the azygous and hemiazygous veins
Where is the intercostal bundle found?
Inferior to the superior rib
Between innermost and internal intercostals
External intercostal fibre direction
Inferomedially
Internal and innermost intercostal fibre direction
Inferolaterally
What passes through the diaphragm at T8?
Interior vena cava
What passes through the diaphragm at T10?
Oesophagus
Vagus nerve
What passes through the diaphragm at T12?
Aorta
Azygous vein
Thoracic duct
Site of referred pain from mediastinal and diaphragmatic parietal pleura
Neck and shoulders
C3,4,5
What forms the nasal septum?
Ethmoid bone
Vomer
Hyaline nasal cartilage
What forms the floor of the nasal cavity?
Palatine process of maxilla
Horizontal process of palatine bone
Paranasal sinus functions
Decrease weight of skull Increase vocal resonance Humidifying air Regulation of gas pressure Immunological defence
Intrinsic laryngeal muscles
Cricothyroid
Crico-arytenoids
Vocalis
Membranes of the larynx
Cricothyroid membrane
Vocal fold
Vestibular fold
Thyrohyoid membrane
Internal laryngeal nerve
Sensory to the larynx above the vocal fold
External laryngeal
Motor to cricothyroid to provide tone to the voice
Recurrent laryngeal
Sensory to larynx below the vocal fold
Motor to all muscles of the larynx except the cricothyroid