Day 4.1.3 Flashcards
How does lymph travel in nodes?
Subcapsular sinus through cortical sinus and into superficial cortex and paracortex
What kind of tissue is cortical tissue in lymph nodes?
Phagocytic - reticular tissue
What divides lymph nodes?
Specialised bands of connective tissue - trabeculae
What are the two ways in which lymph can travel in lymph nodes?
From afferents to subcapsular sinus through cortical sinus into superficial cortex and paracortex
OR
Directly from cortical sinus to medullary sinus
Where is lymphh cleansed?
In cortices and medullary sinuses by macrophages, and antigens are presented and processed by lymphocytes and plasma cells
How does filtered lymph leave the nodes?
Efferents
Where do efferent lymphatic vessels emerge from?
hilum which is concave
Path of lymph from node to blood
Efferent lymphatic vessels
Efferent collecting vessels
Lymph trunks
How many major lymph trunks in the body?
5
What parts of the body does the thoracic duct receive lymph from?
3 out of the 4 quadrants - both lower and upper left quadrant
Where does the upper right quadrant of the body drain its lymph?
Right lymphatic duct
Where do the afferent lymphatic vessels enter the node?
Convex surface
Which are more abundant - afferent or efferent lymphatic vessels?
Afferent
Which lymphatic tissues have more afferent lymphatics entering them?
Lymph nodes as opposed to spleen, thymus, palatine and pharyngeal tonsils
What kinds of cells are dominantly present in the paracortex?
T cells
What part of lymphatic tissue do you find T cells in?
Paracortex
What are the subdivisions of the lymphoid parenchyma?
Cortex
Paracortex
Medulla
What are the most prominient structures in the cortex of a lymph node?
Lymphoid follicles
What vessels in the body have valves?
Lymphatics and veins
Primary lymphatic organs
Thymus
Bone marrow
What are the primary lymphatic organs responsible for?
Generation and selection of lymphocytes
Secondary lymphatic organs
Tonsils
spleen
lymph nodes
appendix
What are secondary lymphatic organs responsible for?
Filtering lymph
Are there areas of lymphatic tissue other than the primary and secondary lymphatic organs?
Yes - diffuse lymphoid tissue
Name the areas of diffuse lymphatic tissue
BALT
GALT
MALT
MALT
Mucosa associated lymphoid tissue
GALT
Gut associated lymphatic tissue
What does GALT include?
Tonsils
Peyer’s patches
BALT
Bronchus associated lymphoid tissue
What is the common component to all lymphatic tissues
Presence of lymphocytes
Functions of the lymphatic system
- Returns tissue fluid to the bloodstream
- Transports absorbed fats
- Provides immunological defenses against disease-causing agents
What is the difference between tissue fluid and lymph?
When tissue fluid enters lymph capillaries, it is called lymph
How is lymph returned to the bloodstream?
It is returned to the venous system via two large lymph ducts - thoracic duct and right lymphatic duct
What are lymph capillaries in the intestines called?
Lacteals
What role does the lymphatic system play in fat metabolism?
lacteals in the small intestine transport the products of fat absorption away from the GI tract and eventually into the circulatory system through the thoracic duct
Where are lacteals present?
In the villi of the small intestine
What do lymph nodes do to provide immunological defence?
Lymph filters through the nodes, filtering out bacteria and foreign substances and even trap cancerous cells in the body
What are the components of lymph?
- Liquid portion
- White blood cells
- A few red blood cells
What does the liquid portion of the lymph contain?
It resembles blood plasma
What kind of WBCs are most abundant in lymph?
Lymphocytes
How is lymph absorbed?
By lymphatic capillaries
What are lymphatic capillaries?
A system of closed tubes that absorbs lymph from tissue spaces
Where is lymph absorbed from into the lymphatic system?
Tissue spaces
What is a hallmark of lymphatic vessels in the upper limb?
That they follow the veins
How is lymph circulated throughout the body?
Contractions of skeletal muscles
Presence of valves in lymphatic vessels to prevent backflow
Breathing
Gravity
Where are T cells produced?
Bone marrow
Where do T cells mature?
Thymus
What is the basic appearance of thymus?
Bilobed
Where is the thymus positioned in adults?
Superior mediastinum
Where is the thymus positioned in children?
The inferior part is contained in the anterior mediastinum in children
What is peculiar about the thymus?
It does not contain lymph nodules or vessels?
What is the main function of the thymus?
To potentiate immunocompetent T cells from their immunoincompetent precursors
What is an additional function of the thymus?
Destruction of self-recognising T cells
At what age is the thymus relatively large?
In newborns
Till what age does the thymus grow?
Puberty
What happens to the thymus at puberty?
It undergoes involution and is replaced by adipose tissue.
Blood thymus barrier
In the adult thymus the blood supply is isolated from the parenchyma
At what age is the blood thymus barrier not present?
In the child
Parenchyma vs stroma
Parenchyma is the functioning portion of the gland
Stroma is the connective tissue
Where are Hassall’s corpuscles found?
Medulla of the human thymus
What are Hassall’s corpuscles formed from?
Eosinophilic type VI epithelial reticular cells arranged concentrically
What is the congenital disease characterised by absence or underdevelopment of thymus and parathyroid glands
Digeorge syndrome
What is Digeorge syndrome caused by?
A deletion on the chromosome numbered 22
What is a manifestation of Digeorge syndrome?
Profound immunodeficiency due to a lack of T cells
What immune cell populations are affected by Digeorge syndrome?
None apart from T cells
What kinds of tissue make up the spleen?
Reticular
Lymphatic
Which is the largest lymphatic organ in the body?
Spleen
Where does the spleen lie?
Between the fundus of the stomach and the diaphragm
What is the appearance of the spleen?
Slightly oval in shape, purplish in color
Where is the hilum of the spleen located?
On the lower medial porder
How is the spleen related to the peritoneum?
Entirely covered except at the hilum
What is the capsule of spleen made of?
Fibroelastic
What is special about the trabeculae of the spleen?
They are extensions of the fibroelastic capsule but do not divide the spleen into lobes or lobules
What is the cellular material of the spleen called?
Splenic pulp
What does the splenic pulp contain?
Lymphocytes
Macrophages
Where does the splenic pulp lie?
Between the trabeculae
What is the blood supply of the spleen?
Splenic artery, a branch of the celiac artery
What lymphatic organ can be considered as two organs in one?
Spleen
What are the major functions of the spleen?
Filtration of blood to remove abnormal cells
Making disease-fighting components of the immune system
What components of the immune system are manufactured in the spleen?
Antibodies
Lymphocytes
What does the body of the spleen appear as?
Red and pulpy, surrounded by a tough capsule
What does the red pulp contain?
Blood vessels interwoven with connective tissue
What are the blood vessels of the red pulp known as?
Splenic sinusoids
What is the connective tissue of the red pulp known as?
Splenic cords
What is the function of the red pulp?
Filters blood and removes old and defective blood cells
What is peculiar about the red pulp in the fetus and infants?
Along with the liver, it is a site of erythropoiesis in infants and the fetus
Where is white pulp found?
Inside the red pulp
What does the white pulp consist of?
Little lumps of lymphoid tissue
What occurs in the white pulp?
Antibodies are made inside the white pulp
What part of the lymphatic system does the posterior 1/3 of the tongue drain into?
Deep cervical nodes
Where are the deep cervical lymph nodes located?
Along the length of the internal jugular vein on each side of the neck, deep to the SCM muscle
What is the extent of the deep cervical nodes?
From the base of the skull to the root of the neck, adjacent to the pharynx, esophagus and trachea
How are deep cervical nodes classified?
Superior
Inferior
What is the basis of classification of the deep cervical nodes?
Their position relative to the SCM muscle
What drainage are the deep cervical nodes responsible for?
Most of the circular chain of nodes Salivary and thyroid glands Posterior 1/3 of tongue Tonsils Nose Pharynx Larynx
Where does lymph from scalp above the parotid and from the anterior wall of the external auditory meatus drain?
Parotid lymph nodes
Where are the submandibular lymph nodes located?
Between the submandibular gland and the mandible
What areas drain into the submandibular lymph nodes?
Front of scalp Nose Adjacent cheek Upper lip Lower lip Paranasal sinuses Teeth (all except lower incisors) Anterior 2/3 of the tongue (except tip) Floor of mouth and vestibule Gingiva
What parts of the tongue, teeth and lip does not drain into the submandibular lymph nodes?
Tip of tongue
Lower incisors
Central part of lower lip
Where are the submental lymph nodes located?
Behind the chin and on the mylohyoid muscle
Where do submental lymph nodes receive lymph from?
tip of tongue Floor of mouth beneath tip of tongue Mandibular incisors Associated gingiva Center part of lower lip Skin over chin
Where do efferents from submental lymph nodes drain?
Submandibular and deep cervical nodes
What are the contents of the pericervical collar of superficial lymph nodes?
Submental Sumbandibular Parotid Mastoid Occipital nodes
Where does the lymph from the tongue and oral floor ultimately drain?
Jugular lymph nodes
Where are the jugular lymph nodes located?
Along the internal jugular vein
What is the peculiarity of jugular lymph nodes?
They receive drainage from both ipsilateral and contralateral sides
What is the danger in the crossing over of lymphatic drainage in jugular lymph nodes?
Tumor cells may become widely disseminated in this region - eg in metastatic squamous cell carcinoma esp on the lateral border of the tongue metastasizing to the opposite side
What happens when antigens are recognised by a lymphocyte?
B cells are activated and migrate to the germinal center of the lymph node
What is the primary function of lymph nodes?
To act as filters
What kind of cells are the primary functional components of lymphnodes?
Macrophages
What does the filtration function of lymph nodes entail?
They help to remove and destroy antigens that circulate in the blood and lymph
What are the other functions of lymph nodes?
Lymphoid tissue in the nodes produces antibodies and stores lymphocytes
Where do the nodes generally occur?
In clusters along connecting lymphatic vessels -
Armpits
Groin
Lower abdomen
Sides of the neck
What does the cortical region of lymph nodes contain?
Primary lymphoid follicles
Secondary follicles
What is the function of primary follicles wrt antigen?
They do not respond to antigen
How do primary lymphoid follicles stain?
Uniformly
What kind of cells do secondary follicles contain?
Predominantly B cells
How do secondary follicles stain?
Lightly
What do secondary follicles contain?
Germinal centers
Which follicles are the active follicles?
Secondary follicles
What are secondary follicles a source of?
Lymphocytes
What kind of cells dominate the paracortical region?
T cells
What happens to B cells that enter the node in the paracortical region?
They quickly migrate to the superficial cortex
How is lymphoid tissue arranged in medullary region?
Medullary cords
What kinds of cells are produced in the medullary region?
Plasma cells - antibodies
What does the medullary region of lymph nodes contain?
Medullary cords and medullary sinuses
How can lymph nodes be classified?
Primary
Secondary
How does lymphatic drainage work? Order of nodes involved
Region – primary (regional) – Secondary (central)
Primary lymph node aka
Regional node
Secondary lymph node aka
Central node
What are germinal centers in lymph nodes?
Sites within lymph nodes (and nodules within peripheral lymph tissues) where mature B lymphocytes rapidly proliferate, differentiate and mutate their antibodies
What happens to B lymphocytes in germinal centers?
They rapidly proliferate, differentiate and mutate their antibodies
How do B lymphocytes mutate their antibodies
Somatic hypermutation
What do B lymphocytes do to their antibodies during a normal immune response to an infection?
Proliferate
Differentiate
Mutate
Class switch
What does the medullary cord of the lymph node contain?
Lymphatic tissue - it projects into the medullary sinus
What are the main cell types found in the medullary cords?
B cells
Plasma cells
Where does the lymph from lower extremities drain?
Junction of the left internal jugular and subclavian veins
What is the main duct of the lymphatic system?
Thoracic duct
Where is the thoracic duct located?
Posterior mediastinum
Where does the thoracic duct begin?
In the abdomen
What does the thoracic duct begin as?
Cisterna chyli
At what level is the cisterna chyli located?
T12 Vertebra
Describe the course of the thoracic duct
Starts at cisterna chyli, ascends through the thoracic cavity in front of the spinal column.
What major blood vessels is the thoracic duct associated with in the thoracic area?
Descending thoracic aorta to its left and the azygos vein to its right
What is the length of the thoracic duct?
~ 40cm
What is the point where the right brachiocephalic vein begins?
Right venous angle - junction of the right internal jugular vein with the right subclavian vein
What part of the diaphragm does the thoracic duct pass through?
The aortic opening, on the right of the descending aorta
Where do intercostal lymphatic vessels drain?
From the left and right intercostal spaces into the thoracic duct
Where do mammary glands drain their lymph?
Into axillary lymph nodes
Where do kidneys drain lymph?
Lumbar lymph nodes
Where do lungs and trachea drain their lymph?
Into hylar lymph nodes (located in the hilum of the lung)
Does spleen form crypts that trap bacteria?
no
Where is the spleen located?
Left hypochondriac region
What is the rough size of the spleen?
A fist
What does the white pulp surround in the spleen?
Branches of the splenic artery
What cells does the red pulp consist of?
Lymphocytes
Macrophages
Plasma cells
Monocytes
What are monocytes
Phagocytic white blood cells
What are the three different tissues within the spleen
Reticuloendothelial tissue
Venous sinusoids
White pulp
What tissue in the spleen handles phagocytosis of erythrocytes?
Reticuloendothelial tissue
What is the function of reticuloendothelial tissue in spleen?
Phagocytosis of erythrocytes and cell debris from the bloodstream
What is the additional function of reticuloendothelial tissue?
It may produce foci of hemopoiesis when RBCs are needed
Function of venous sinusoids
- grants power to the spleen to contract
- Helps expel contained blood to meet increased circulatory demands
What does the spleen do in conditions of increased circulatory demand?
Expels contained blood within the venous sinusoids
What is the white pulp composed of?
Nodules containing malphigian corpuscles
What is the function of the white pulp of the spleen?
Provides lymphocytes and a source of plasma cells and hence antibodies for the cellular and humoral specific immune response
What kind of immune response does the spleen assist in?
Both cellular and humoral
How does blood enter the spleen?
Splenic artery, through its hilum
What is the venous drainage of the spleen?
Splenic vein
How is the hepatic portal vein formed?
The connection of the splenic vein with the Superior mesenteric vein
Where are the nerves to the spleen derived from?
Celiac plexus
What is unique about the spleen and the thymus?
They both contain only efferent lymphatic vessels
Where does the spleen develop from?
Mesenchymal cells of the mesentery attached to the primitive stomach
How is the developmental origin of the spleen different from the rest of the abdomen?
The lungs, liver, pancreas, gallbladder, stomach, esophagus and intestines all develop from the PRIMITIVE GUT - spleen develops from mesenchymal cells of the mesentery
What happens to the spleen in infectious mononucleosis?
It is enlarged
What is the absence of normal spleen function called?
Asplenia
What is asplenia associated with?
- Serious infection risks
- Encapsulated bacteria
= Strep pneumoniae
= Haemophilus influenzae
= Neisseria meningitidis
Which tonsils are covered by nonkeratinised stratified squamous epithelium?
Palatine and Lingual
What are tonsils?
Lymphatic organs that lie under the surface lining of the mouth and throat
What part of the immune system are tonsils a part of?
The secondary immune system
Where are tonsils located?
IN the respiratory and alimentary tracts in position to be xposed to inspired or ingested antigens from air or food
When do tonsils get activated?
When sufficient antigen is present, this stimulates the B cells in the germinal zone to differentiate and produce antibodies
What is the major kind of defence system tonsils are associated with?
Secretory IgA - which is transported to the surface and provides local immune protection
How many sets of tonsils exist?
3 -
Adenoids
Palatine tonsils
Lingual tonsils
Adenoids aka
pharyngeal tonsil
Location of adenoids
Posterior wall of nasopharynx
When are adenoids at the peak of their development?
Childhood
What are adenoids surrounded by?
Partly connective tissue
Partly ciliated pseudostratified columnar epithelium
What kind of epithelium surrounds adenoids?
Respiratory epithelium
What kind of tonsils contain crypts?
Lingua and palatine
What kind of tonsils don’t contain crypts?
Adenoids
Where are palatine tonsils located?
Posterolateral walls of throat - one on each side
When do palatine tonsils reach their maximum size?
Early childhood
What happens to the size of palatine tonsils after puberty?
They diminish considerably in size
Which tonsils are considerably enlarged when a person has a sore throat?
Palatine tonsils
What are the contents of palatine tonsils?
Many crypts
Lymphoid follicles
No sinuses
What is peculiarly absent from palatine tonsils?
Sinuses
What are palatine tonsils surrounded by?
Connective tissue and non-keratinized stratified squamous epithelium
What is the best way to distinguish the palatine from the pharyngeal tonsil histologically?
Type of associated epithelium
What are lingual tonsils
Collection of lymphoid follicles on the posterior portion of the dorsum of the tongue
What is peculiar about lingual tonsils as compared to pharyngeal and palatine tonsils?
They are smaller and more numerous
What composes each lingual tonsil?
A single crypt and lymphoid follicle
What is the name given to the three groups of tonsils?
Waldeyer’s ring
Intestinal tonsils
Peyer’s patches
Where are the Peyer’s patches located?
Small intestine (ileum)
What is the function of Peyer’s patches?
To destroy the abundant bacteria
What kind of lymphoid tissue are Peyer’s patches and tonsils considered?
Subepithelial and non-encapsulated lymphoid tissues
Tonsillectomy
A surgical procedure in which the tonsils are removed from either side of the tonsillar fossa
When is tonsillectomy performed?
Repeated occurrence of acute tonsillitis or adenoiditis
Obstructive sleep apnea
Nasal airway obstruction
Diphtheria carrier state
Snoring
Peritonsillar abscess
What is done during tonsillectomy in children?
Adenoidectomy at the same time
How are the anterior and posterior parts of the dorsum of the tongue separated?
Terminal sulcus and foramen cecum
Where is yellow marrow found?
Hollow center of the diaphysis
Medullary cavity
The hollow center of the diaphysis (the long shaft of the bone)
What parts of bones contain red bone marrow?
Cavities in the cranial bones, vertebrae, ribs, sternum, and ends of long bones
What kind of bone marrow do you find in the cavities in vertebrae?
Red bone marrow
What tissues contribute to hemopoiesis before birth?
Yolk sac
liver
spleen
lymph nodes
What are the precursor cells that give rise to all the formed elements of the blood?
Hemocytoblasts
Where do you find hemocytoblasts?
red bone marrow
What are hemocytoblasts
Multipotent stem cells
What do hemocytoblasts give rise to?
Various committed progenitor cells
What are the progenitor cells for erythroblasts?
Proerythroblasts
What cells do platelets develop from?
Megakaryocytes
When does yellow marrow begin to appear?
When a child is 7 years of age
Where does yellow marrow appear first?
distal bones of the limbs
What kind of marrow does a person have at birth?
Only Red marrow
Where is red marrow present at the time when a person becomes an adult
Skull Vertebral column Thoracic cage Girdle bones Head of the humerus and femur
What is the average no of erythrocytes in the blood?
5 mn/cu mm
How many platelets in the blood?
150,000 to 300,000 per cu mm
How many leukocytes in the blood?
10,000 per cu mm
What are the most abundant leukocytes in blood?
Neutrophils
What are the most abundant agranulocytes in blood?
Lymphocytes
Which WBC has a kidney shaped nucleus?
Monocytes
What kind of WBC have ruffled membranes?
Macrophages
What kind of WBC has an obscure nucleus?
Basophils
What kind of WBCs are active against parasites?
Eosinophils
What do basophils release?
Histamine
Heparin
Serotonin
What kind of WBCs produce antibodies?
Lymphocytes
What kind of WBCs destroy specific target cells?
Lymphocytes
What kind of WBCs are part of the immune system?
Neutrophils
At what absolute neutrophil count does a risk of infection dramatically increase?
Less than 500 per cubic mm
What kind of metabolism do erythrocytes rely on?
Anaerobic
What is the average lifespan of RBCs?
120 days
What is the hormone that stimulates erythropoiesis?
Erythropoietin
What organ produces erythropoietin primarily?
Kidneys
What is the hematocrit for females?
40%
What is the precursor cell for all formed elements of the blood?
Hematocytoblast
what do hematocytoblasts give rise to?
Multipotent progenitor cells
What type of cells are hematocytoblasts?
Pluripotent stem cells
Multipotent progenitor cells aka
Colony forming cells
What do CFCs give rise to?
Different types of formed elements
What is the hormone that stimulates precursor cells to differentiate into WBCs?
Granulocyte Colony stimulating factor (G-CSF)
What kind of disease is sickle cell anemia?
Autosomal recessive genetic blood disorder
What is the shape of cells in sickle cell anemia?
Sickles or crescent
What is the relative life span of sickle cells as compared to normal RBCs?
Smaller
What do sickle cells cause in the blood stream?
- get stuck in blood vessels blocking blood flow, causing pain and organ damage
What is mutation?
A hydrophilic glutamic acid substitution with a hydrophobic amino acid valine
What does G6PD deficiency cause?
Severe hemolytic crisis in affected individuals
G6PD
Glucose 6 phosphate dehydrogenase
What is the cause of hemolytic crisis in individuals affected by G6PD deficiency?
Decreased NADPH and the inability of RBCs to maintain membrane integrity
What is G6PD deficiency induced by?
Sulfa drugs
Oxidants
Fava beans
What is the pH of blood?
7.35 - 7.45
What is the relative proportions of all types of leukocytes in blood?
Never Let Monkeys Eat Bananas
Neutrophils Lymphocytes Monocytes Eosinophils Basophils
Out of plasma and serum, which one contains clotting proteins?
Plasma
What % of plasma is water?
91%
What is the most abundant protein in human plasma?
serum albumin
What are the functions of albumin in blood?
Transports hormones Transports fatty acids Transports other componds Buffers pH Maintains osmotic pressure
Which word describes platelets better - megakaryocytes or cytoplasmic fragments?
Cytoplasmic fragments
What is the lifespan of platelets?
7-10 days
Where are platelets removed from the blood
Spleen
liver
What is the stimulating factor for platelet formation?
Thrombopoietin
What triggers platelet plug formation?
Exposure of platelets to a rough surface
How do platelets gain access to materials that promote clotting?
They contain secretory vesicles
What do the chemicals from the platelets’ secretory vesicles do?
Cause the surface of the platelets to become sticky
What happens when platelets become activated?
They produce Thromboxane A2 that has prothrombotic properties stimulating activation of new platelets as well as increasing platelet aggregation
What is the chemical that counteracts Thromboxane A2?
Prostacyclin (PGI2)
Actions of prostacyclin
Decreases platelet aggregation
Causes vasodilatation
What are most articular disks covered by?
Hyaline cartilage
What are freely movable joints called?
Diarthroidal
What is the movement of synovial joints limited by?
Joint surfaces
Ligaments
Tendons
Characteristic features of synovial joints
Articular cartilage
Joint cavity
Articular capsule
Synovial membrane
Which synovial joint does not contain hyaline cartilage as articular cartilage?
TMJ
What cartilage does TMJ contain?
Fibrocartilage
What kind of blood vessels and nerves does the articular cartilage of synovial joints contain?
None
What is the joint cavity in synovial joints?
Small fluid-filled space separating the ends of adjoining bones
What is a synovial joint enclosed in?
Articular capsule - fibrous connective tissue
Where is synovial membrane found in the synovial joint?
Bursa and articular cartilage
What produces synovial fluid in the synovial joint?
Synovial membrane
How is the position of bones maintained in synovial joints?
Supporting ligaments
How many kinds of supporting ligaments are found with synovial joints?
three -
capsular
intracapsular
extracapsular
Meniscus
A washer-like structure between bone ends
How many synovial joints have a meniscus?
~10%
What is the purpose of the meniscus?
- Absorb shock
- Stabilize the joint
- Spread synovial fluid
What is the meniscus made out of?
Fibrocartilage
What is the blood supply of a meniscus?
No blood, nerve or lymphatic supply
How fast does the meniscus heal itself?
It can’t.
What is the most famous and most injured meniscus of the body?
Knee
Bursa
Fluid-sac that is lined with a synovial membrane
What is the function of a bursa?
Reduce friction
What is a sample location of a bursa
Between a tendon and a bone to reduce friction
Bursitis
Inflammation of the lining of a bursa
Types of joints based on amount of motion
Synarthrosis
Amphiarthrosis
Diarthrosis
What are immovable joints known as
Synarthrosis
Examples of synarthroses?
Sutures between the flat bones of skull
Gomphosis
How are synarthroses joined?
They are fibrous joints
What are slightly movable joints called?
Amphiarthrosis
Amphiarthrosis aka
Cartilaginous joint
What kind of joint is symphysis pubis
Amphiarthrosis
Which bones are involved in symphysis pubis?
The two os coxa bones join anteriorly in symphysis pubis
Classify joints based on type of associated connective tissue
Fibrous
Cartilaginous
Synovial
Types of fibrous joints
Sutures
Syndesmoses
What is the joint between radius and ulna called
Syndesmosis
Types of cartilaginous joints
Synchondroses
Symphyses
What are cartilaginous joints joined by?
Fibrocartilage
Hyaline cartilage
What are joints that are joined by hyaline cartilage called?
Synchondroses
What kind of joints are epiphyseal plates within long bones
Synchondroses
What are joints that are joined by a plate of fibrocartilage called?
Symphyses
What type of joints are spheno-occipital joint and epiphyseal cartilage plates classified as?
Synchondrosis
Types of sutures
Coronal
Sagittal
Lambdoid
What is the suture between the frontal and parietal bones called?
Coronal suture
What is the suture between the two parietal bones called?
Sagittal suture
Where is the lambdoid suture situated?
Between parietal and occipital bones
Bregma
Site of intersection of coronal and sagittal sutures
What does the anterior fontanelle turn into in the adult?
Bregma
What is the point of intersection of the sagittal and lambdoid sutures called?
Lambda
What does the lambda succeed?
Posterior fontanelle
What kind of joint is the tympanostapedial joint?
Syndesmosis
What kind of joint is the inferior tibiofibular joint?
Syndesmosis
Primary cartilaginous joints
Synchondrosis
Secondary cartilaginous joints
Symphyses
Which kind of cartilaginous joints is movable?
Symphyses - slightly
Which kind of cartilaginous joints is not movable
Synchondrosis
What kind of cartilage is in synchondrosis
Hyaline
What kind of joints are intervertebral discs
Symphyses
What is peculiar about synchondroses?
They permit no movement but they allow growth in length of bone
What kind of a joint is the joint between the first rib and sternum?
Synchondrosis
What kind of joints permit a great degree of movement?
Synovial
What are synovial joints classified according to?
Axis of movement
Types of synovial joints
Gliding Hinge Pivot Ellipsoidal Saddle Ball and socket
What are gliding joints also known as
Plane joints
What are ball and socket joints also known as
Universal
What type of joints are the ones found in the carpal bones of the wrist?
Gliding joints
What kind of joints are knee joints?
Hinge
What kind of joint is the one found between atlas and axis?
Pivot
What are ellipsoid joints aka
Condyloid joints
What kind of joints are the ones found in the tarsal bones of the ankle
Gliding
What is the joint where the metacarpal of the thumb meets the trapezium of the carpus (wrist) called?
Saddle
Example of ball and socket joint
Shoulder or hip
Example of ellipsoidal joint
Joint between the distal surfaces of the forearm bones and adjacent carpal bones
NO joint
Atlantoaxial joint
YES joint
Atlanto-occipital joint
Atlantoaxial joint
The synovial articulation between the inferior articulating facets of the atlas ant he superior articulating facets of the axis
First cervical vertebra
Atlas
Second cervical vertebra
Axis
What is peculiar about atlas and axis?
Absence of intervertebral disc or foramen between them
What is peculiar about C1?
It has no vertebral body - only two lateral masses
Howm any joints are formed between C1 and C2?
3
Atlanto-occipital joint
The synovial articulation between the superior articulating facets of the atlas and the occipital condyles of the skull
Rotation of the forearm with palm turning outward
Supination
Folding forward is an example of what kind of movement?
Flexion (of the spine)
Crossing one leg in front of the other is a form of what kind of movement?
Adduction
Crescent stretch
Dropping one hand down same side of body - it is an example of lateral flexion
What kind of movement is described by emptying a can of soda?
Pronation
When you stand with weight on inner edge of the foot, what kind of movement are you performing?
Eversion
Eversion
Turning the foot laterally resulting in the sole moving outward
Protraction
Movement of rounding shoulders forward “spreading” back
Squeezing shoulder blades together is known as
Retraction
Which part of the kidney is connected to the bladder by the ureter?
Renal pelvis
Where are the kidneys located?
Back of the abdomen - on each side of the spine, at the level of the lower ribs
Functions performed by the kidneys
- Form urine
- Maintain homeostasis
- Secrete hormones
What hormones are formed in the kidneys?
Renin
Erythropoietin
At what level of the spine are kidneys located?
Lumbar spine
What is the relation of the kidneys to the peritoneum?
They are retroperitoneally located
What is the relation of the kidneys to muscles attached to the vertebral column
They lie in front of the muscles
What is the colour of the renal cortex
Light brown
What is the outer layer of kidney called
Cortex
What components of the nephron does the cortex contain?
PCT, DCT, glomeruli
What is the renal cortex the site of?
Blood filtration
What is the color of the medulla of kidney?
Dark kidney
What structures does the renal medulla contain?
Cone like structures called renal pyramids
What are renal pyramids separated by?
Renal columns
What are renal columns
Extensions of renal cortex
What is the hallow inner structure that joins with the ureters?
Renal pelvis
Where does the pelvis receive urine from?
Calyces
What is the apex of the renal pyramids?
Renal papilla
What happens microscopically in renal papilla?
Collecting ducts pour into minor calyces
What is the extension of the renal pelvis called
Renal calyx
Which kidney lies higher?
Left kidney
Why is the right kidney lower?
Due to the large size of the right lobe of the liver
What is the capsule of each kidney made of?
Fibre
What is the supportive capsule of each kidney made of?
Adipose
Where is the hilum of each kidney located?
Medial border
What are the contents of the hilum?
Ureters
Renal vessels
Nerves
Blood supply of kidneys
Renal artery, a branch of the abdominal aorta
List nephronal structures in order from b.lood to urine
Glomerulus Bowman's capsule PCT Loop of henle DCT collecting duct
Nephron
Subunit of a kidney that purifies blood and maintains a safe balance of solutes and water
Functional unit of the human excretory system
nephron
How many open ends does the nephron contain?
One
What is the closed end of the nephron called?
bowman’s capsule
what does the renal corpuscle normally produce?
protein free and cell free filtrate
what does the renal corpuscle consist of
bowman’s capsule
glomerulus
how many regions does the tubular portion of the nephron have?
4
what are the 4 regions of the tubular portion of the nephron?
pct
loop of henle
dct
collecting duct
where is glucose reabsorbed in nephron?
pct
where is sodium reabsorbed in nephron?
dct
what causes sodium reabsorption in nephron?
aldosterone
how is the filtrate treated in the loop of henle
it is concentrated through electrolyte exchange and reabsorption
what is the osmolarity of the fluid that exits the loop of henle
hyperosmolar
where in the nephron are metabolites reabsorbed
pct
where in the nephron is the filtrate finally filtered?
collecting duct
where in the nephron does reabsorption of amino acids and electrolytes occur?
pct
what kinds of processes do the fluid in the tubules of the nephron go through?
filtration
tubular reabsorption
tubular secretion
what happens to the blood that is not filtered
it passes to the efferent vessels and peritubular capillaries
what substances are returned to the peritubular capillaries by reabsorption?
water
glucose
sodium
at what rates are water, glucose and sodium returned to peritubular capillaries?
fast
macula densa
an area of closely packed specialized cells lining the wall of the distal tubule
where is macula densa found
lining the wall of the distal tubule
what are the cells of macula densa most affected by?
concentration of sodium chloride in the distal convoluted tubule
what does a decrease in NaCl concentration do to the macula densa?
decreases resistance to blood flow in afferent arterioles
increases renin release from juxtaglomerular cells
what does the decreased resistance to blood flow in afferent arterioles do?
it increases glomerular hydrostatic pressure and helps return GFR toward normal
what are the major storage sites for renin?
juxtaglomerular cells of afferent and efferent arterioles
distal straight tubule aka
thick ascending limb of the loop of henle
where is the collecting duct that the collecting tubule empties into lie?
within the medullary ray
what do collecting ducts converge to form
large diameter ducts in the papillae called papillary ducts or ducts of Bellini
area cribrosa
ducts of Bellini open into the calyces at the tips of the papillae, and the concentration of the openings produces a sieve-like surface appearance to the papillary tip called the area cribrosa
what is the most immature form of kidney
pronephros
what is the most developed form of kidney
metanephros
what are the stages of development of kidney
pronephros
mesonephros
metanephros
what stage of development of kidney persists as adult kidney
metanephros
ureters structure
long
slender
fibromuscular
function of ureters
transport urine from pelvis of kidney to base of bladder
which ureter is longer
left
what is the narrowest part of ureters
where they originate
what is the point of origin of ureters called
ureteropelvic junction
what does filling of the bladder do to ureters
constricts them at the ureterovesical junction
what is the ureterovesical junction
the point where ureters enter the bladder
how does urine move through ureters
peristaltic waves
how often do ureteric peristaltic waves occur
one to five times a minute
how do the ureters descend in the female
posterior to the ovary and into the base broad ligament passing under the uterine artery - water under the bridge
where is the bladder located
pelvic cavity posterior to symphysis pubis
in whom is bladder lower
females
what kind of epithelium is found in bladder?
transitional
what is special about transitional epithelium
they change shape in response to pressure - empty bladder - cuboidal; filled bladder - compressed and flattened
urethra
fibromuscular tube
membranous urethra
in males, the portion of the urethra that passes through the urogenital diaphragm
membranous urethra
in males, the portion of the urethra that passes through the urogenital diaphragm
What structures pass through optic canal
optic nerve
ophthalmic artery
What happens to optic canal in McCune Albright syndrome?
bony fibrous dysplasia of the anterior cranial base leading to the encasement and narrowing of the optic canal
which bone is optic canal located in
sphenoid
which part of the sphenoid is optic canal located in
posterior part of lesser wing
what part of the cranium does the optic canal communicate with
middle cranial fossa
where do olfactory nerves emerge from
cribriform plate in ethmoid
which cranial nerve is olfactory
i
which bone is hypoglossal canal in
occipital
what structures does the hypoglossal canal house
hypoglossal nerve
which cranial nerve is the hypoglossal nerve
cn xii
which bone does the internal carotid artery enter the skull from
temporal
what is the opening that internal carotid enters
carotid canal
which bone is lacrimal canal associated with
lacrimal and maxilla
what are the contents of the lacrimal canal
nasolacrimal duct
nasolacrimal duct aka
tear duct
what are the contents of the inferior orbital fissure
- infraorbital and zygomatic branches of maxillary nerve
- infraorbital artery
- part of inferior ophthalmic vein
what does infraorbital artery pass through
inferior orbital fissure
what bones does the inferior orbital fissure involve
sphenoid
maxilla
which of the orbital fissures involves the maxilla
inferior
which of the orbital fissures involves the sphenoid exclusively
superior
which orbital fissure transmits (branches of or full) 4 cranial nerves
superior
which cranial nerves pass through superior orbital fissure
iii (occulomotor),
iv (trochlear),
vi (abducens) and
v1 (nasociliary branches of ophthalmic)
does the superior orbital fissure transmit any nervous fibers ther than the cranial nerves
sympathetic fibers from cavernous plexus
what blood supply passes through superior orbital fissure
superior and inferior divisions of ophthalmic vein
which bone houses the optic canal and foramen
sphenoid
what bone is the stylomastoid foramen located in
temporal
what nerve passes through stylomastoid foramen
facial (cn vii)
what foramen does the facial nerve pass through
stylomastoid foramen
what bone is internal acoustic meatus part of
posterior surface of petrous part of temporal bone
what structures does the internal acoustic meatus transmit
facial nerve (vii) vestibulocochlear nerve (viii)
where does the vestibulocochlear nerve travel after entering the internal acoustic meatus
it stays within the temporal bone
what does the vestibulocochlear nerve supply
cochlear duct (hearing)
semicircular ducts
maculae (balance)
where does the facial nerve go after entering the internal acoustic meatus
it goes in the facial canal of temporal bone and emerges from the stylomastoid foramen
where does the stylomastoid foramen lie
between the styloid and mastoid processes of the temporal bone
what does the facial nerve do after entering the internal acoustic meatus
gives rise to the chorda tympani branch
what is the function of the chorda tympani branch of facial nerve
parasympathetic innervation to submandibular and sublingual gland
sensory taste fibers to anterior 2/3 of tongue
what part of the facial nerve exits from the stylomastoid foramen
main trunk
what happens to the facial nerve after it exits stylomastoid foramen
it gives off 5 branches after entering parotid gland substance
facial nerve branches mnemonic
The - temporal Zebra - zygomatic Bit - buccal My - mandibular Cow - cervical
