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NBDE 1 > Day 4.1.3 > Flashcards

Day 4.1.3 Flashcards

1
Q

How does lymph travel in nodes?

A

Subcapsular sinus through cortical sinus and into superficial cortex and paracortex

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2
Q

What kind of tissue is cortical tissue in lymph nodes?

A

Phagocytic - reticular tissue

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3
Q

What divides lymph nodes?

A

Specialised bands of connective tissue - trabeculae

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4
Q

What are the two ways in which lymph can travel in lymph nodes?

A

From afferents to subcapsular sinus through cortical sinus into superficial cortex and paracortex

OR

Directly from cortical sinus to medullary sinus

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5
Q

Where is lymphh cleansed?

A

In cortices and medullary sinuses by macrophages, and antigens are presented and processed by lymphocytes and plasma cells

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6
Q

How does filtered lymph leave the nodes?

A

Efferents

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7
Q

Where do efferent lymphatic vessels emerge from?

A

hilum which is concave

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8
Q

Path of lymph from node to blood

A

Efferent lymphatic vessels
Efferent collecting vessels
Lymph trunks

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9
Q

How many major lymph trunks in the body?

A

5

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10
Q

What parts of the body does the thoracic duct receive lymph from?

A

3 out of the 4 quadrants - both lower and upper left quadrant

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11
Q

Where does the upper right quadrant of the body drain its lymph?

A

Right lymphatic duct

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12
Q

Where do the afferent lymphatic vessels enter the node?

A

Convex surface

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13
Q

Which are more abundant - afferent or efferent lymphatic vessels?

A

Afferent

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14
Q

Which lymphatic tissues have more afferent lymphatics entering them?

A

Lymph nodes as opposed to spleen, thymus, palatine and pharyngeal tonsils

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15
Q

What kinds of cells are dominantly present in the paracortex?

A

T cells

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16
Q

What part of lymphatic tissue do you find T cells in?

A

Paracortex

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17
Q

What are the subdivisions of the lymphoid parenchyma?

A

Cortex
Paracortex
Medulla

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18
Q

What are the most prominient structures in the cortex of a lymph node?

A

Lymphoid follicles

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19
Q

What vessels in the body have valves?

A

Lymphatics and veins

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20
Q

Primary lymphatic organs

A

Thymus

Bone marrow

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21
Q

What are the primary lymphatic organs responsible for?

A

Generation and selection of lymphocytes

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22
Q

Secondary lymphatic organs

A

Tonsils
spleen
lymph nodes
appendix

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23
Q

What are secondary lymphatic organs responsible for?

A

Filtering lymph

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24
Q

Are there areas of lymphatic tissue other than the primary and secondary lymphatic organs?

A

Yes - diffuse lymphoid tissue

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25
Q

Name the areas of diffuse lymphatic tissue

A

BALT
GALT
MALT

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26
Q

MALT

A

Mucosa associated lymphoid tissue

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27
Q

GALT

A

Gut associated lymphatic tissue

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28
Q

What does GALT include?

A

Tonsils

Peyer’s patches

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29
Q

BALT

A

Bronchus associated lymphoid tissue

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30
Q

What is the common component to all lymphatic tissues

A

Presence of lymphocytes

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31
Q

Functions of the lymphatic system

A
  • Returns tissue fluid to the bloodstream
  • Transports absorbed fats
  • Provides immunological defenses against disease-causing agents
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32
Q

What is the difference between tissue fluid and lymph?

A

When tissue fluid enters lymph capillaries, it is called lymph

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33
Q

How is lymph returned to the bloodstream?

A

It is returned to the venous system via two large lymph ducts - thoracic duct and right lymphatic duct

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34
Q

What are lymph capillaries in the intestines called?

A

Lacteals

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35
Q

What role does the lymphatic system play in fat metabolism?

A

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

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36
Q

Where are lacteals present?

A

In the villi of the small intestine

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37
Q

What do lymph nodes do to provide immunological defence?

A

Lymph filters through the nodes, filtering out bacteria and foreign substances and even trap cancerous cells in the body

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38
Q

What are the components of lymph?

A
  1. Liquid portion
  2. White blood cells
  3. A few red blood cells
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39
Q

What does the liquid portion of the lymph contain?

A

It resembles blood plasma

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40
Q

What kind of WBCs are most abundant in lymph?

A

Lymphocytes

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41
Q

How is lymph absorbed?

A

By lymphatic capillaries

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42
Q

What are lymphatic capillaries?

A

A system of closed tubes that absorbs lymph from tissue spaces

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43
Q

Where is lymph absorbed from into the lymphatic system?

A

Tissue spaces

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44
Q

What is a hallmark of lymphatic vessels in the upper limb?

A

That they follow the veins

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45
Q

How is lymph circulated throughout the body?

A

Contractions of skeletal muscles
Presence of valves in lymphatic vessels to prevent backflow
Breathing
Gravity

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46
Q

Where are T cells produced?

A

Bone marrow

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47
Q

Where do T cells mature?

A

Thymus

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48
Q

What is the basic appearance of thymus?

A

Bilobed

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49
Q

Where is the thymus positioned in adults?

A

Superior mediastinum

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50
Q

Where is the thymus positioned in children?

A

The inferior part is contained in the anterior mediastinum in children

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51
Q

What is peculiar about the thymus?

A

It does not contain lymph nodules or vessels?

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52
Q

What is the main function of the thymus?

A

To potentiate immunocompetent T cells from their immunoincompetent precursors

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53
Q

What is an additional function of the thymus?

A

Destruction of self-recognising T cells

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54
Q

At what age is the thymus relatively large?

A

In newborns

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55
Q

Till what age does the thymus grow?

A

Puberty

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56
Q

What happens to the thymus at puberty?

A

It undergoes involution and is replaced by adipose tissue.

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57
Q

Blood thymus barrier

A

In the adult thymus the blood supply is isolated from the parenchyma

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58
Q

At what age is the blood thymus barrier not present?

A

In the child

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59
Q

Parenchyma vs stroma

A

Parenchyma is the functioning portion of the gland

Stroma is the connective tissue

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60
Q

Where are Hassall’s corpuscles found?

A

Medulla of the human thymus

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61
Q

What are Hassall’s corpuscles formed from?

A

Eosinophilic type VI epithelial reticular cells arranged concentrically

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62
Q

What is the congenital disease characterised by absence or underdevelopment of thymus and parathyroid glands

A

Digeorge syndrome

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63
Q

What is Digeorge syndrome caused by?

A

A deletion on the chromosome numbered 22

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64
Q

What is a manifestation of Digeorge syndrome?

A

Profound immunodeficiency due to a lack of T cells

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65
Q

What immune cell populations are affected by Digeorge syndrome?

A

None apart from T cells

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66
Q

What kinds of tissue make up the spleen?

A

Reticular

Lymphatic

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67
Q

Which is the largest lymphatic organ in the body?

A

Spleen

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68
Q

Where does the spleen lie?

A

Between the fundus of the stomach and the diaphragm

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69
Q

What is the appearance of the spleen?

A

Slightly oval in shape, purplish in color

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70
Q

Where is the hilum of the spleen located?

A

On the lower medial porder

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71
Q

How is the spleen related to the peritoneum?

A

Entirely covered except at the hilum

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72
Q

What is the capsule of spleen made of?

A

Fibroelastic

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73
Q

What is special about the trabeculae of the spleen?

A

They are extensions of the fibroelastic capsule but do not divide the spleen into lobes or lobules

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74
Q

What is the cellular material of the spleen called?

A

Splenic pulp

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75
Q

What does the splenic pulp contain?

A

Lymphocytes

Macrophages

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76
Q

Where does the splenic pulp lie?

A

Between the trabeculae

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77
Q

What is the blood supply of the spleen?

A

Splenic artery, a branch of the celiac artery

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78
Q

What lymphatic organ can be considered as two organs in one?

A

Spleen

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79
Q

What are the major functions of the spleen?

A

Filtration of blood to remove abnormal cells

Making disease-fighting components of the immune system

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80
Q

What components of the immune system are manufactured in the spleen?

A

Antibodies

Lymphocytes

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81
Q

What does the body of the spleen appear as?

A

Red and pulpy, surrounded by a tough capsule

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82
Q

What does the red pulp contain?

A

Blood vessels interwoven with connective tissue

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83
Q

What are the blood vessels of the red pulp known as?

A

Splenic sinusoids

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84
Q

What is the connective tissue of the red pulp known as?

A

Splenic cords

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85
Q

What is the function of the red pulp?

A

Filters blood and removes old and defective blood cells

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86
Q

What is peculiar about the red pulp in the fetus and infants?

A

Along with the liver, it is a site of erythropoiesis in infants and the fetus

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87
Q

Where is white pulp found?

A

Inside the red pulp

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88
Q

What does the white pulp consist of?

A

Little lumps of lymphoid tissue

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89
Q

What occurs in the white pulp?

A

Antibodies are made inside the white pulp

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90
Q

What part of the lymphatic system does the posterior 1/3 of the tongue drain into?

A

Deep cervical nodes

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91
Q

Where are the deep cervical lymph nodes located?

A

Along the length of the internal jugular vein on each side of the neck, deep to the SCM muscle

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92
Q

What is the extent of the deep cervical nodes?

A

From the base of the skull to the root of the neck, adjacent to the pharynx, esophagus and trachea

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93
Q

How are deep cervical nodes classified?

A

Superior

Inferior

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94
Q

What is the basis of classification of the deep cervical nodes?

A

Their position relative to the SCM muscle

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95
Q

What drainage are the deep cervical nodes responsible for?

A 
Most of the circular chain of nodes
Salivary and thyroid glands
Posterior 1/3 of tongue
Tonsils
Nose
Pharynx
Larynx
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96
Q

Where does lymph from scalp above the parotid and from the anterior wall of the external auditory meatus drain?

A

Parotid lymph nodes

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97
Q

Where are the submandibular lymph nodes located?

A

Between the submandibular gland and the mandible

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98
Q

What areas drain into the submandibular lymph nodes?

A 
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
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99
Q

What parts of the tongue, teeth and lip does not drain into the submandibular lymph nodes?

A

Tip of tongue
Lower incisors
Central part of lower lip

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100
Q

Where are the submental lymph nodes located?

A

Behind the chin and on the mylohyoid muscle

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101
Q

Where do submental lymph nodes receive lymph from?

A 
tip of tongue
Floor of mouth beneath tip of tongue
Mandibular incisors
Associated gingiva
Center part of lower lip
Skin over chin
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102
Q

Where do efferents from submental lymph nodes drain?

A

Submandibular and deep cervical nodes

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103
Q

What are the contents of the pericervical collar of superficial lymph nodes?

A 
Submental
Sumbandibular
Parotid
Mastoid
Occipital nodes
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104
Q

Where does the lymph from the tongue and oral floor ultimately drain?

A

Jugular lymph nodes

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105
Q

Where are the jugular lymph nodes located?

A

Along the internal jugular vein

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106
Q

What is the peculiarity of jugular lymph nodes?

A

They receive drainage from both ipsilateral and contralateral sides

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107
Q

What is the danger in the crossing over of lymphatic drainage in jugular lymph nodes?

A

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

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108
Q

What happens when antigens are recognised by a lymphocyte?

A

B cells are activated and migrate to the germinal center of the lymph node

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109
Q

What is the primary function of lymph nodes?

A

To act as filters

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110
Q

What kind of cells are the primary functional components of lymphnodes?

A

Macrophages

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111
Q

What does the filtration function of lymph nodes entail?

A

They help to remove and destroy antigens that circulate in the blood and lymph

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112
Q

What are the other functions of lymph nodes?

A

Lymphoid tissue in the nodes produces antibodies and stores lymphocytes

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113
Q

Where do the nodes generally occur?

A

In clusters along connecting lymphatic vessels -

Armpits
Groin
Lower abdomen
Sides of the neck

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114
Q

What does the cortical region of lymph nodes contain?

A

Primary lymphoid follicles

Secondary follicles

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115
Q

What is the function of primary follicles wrt antigen?

A

They do not respond to antigen

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116
Q

How do primary lymphoid follicles stain?

A

Uniformly

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117
Q

What kind of cells do secondary follicles contain?

A

Predominantly B cells

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118
Q

How do secondary follicles stain?

A

Lightly

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119
Q

What do secondary follicles contain?

A

Germinal centers

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120
Q

Which follicles are the active follicles?

A

Secondary follicles

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121
Q

What are secondary follicles a source of?

A

Lymphocytes

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122
Q

What kind of cells dominate the paracortical region?

A

T cells

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123
Q

What happens to B cells that enter the node in the paracortical region?

A

They quickly migrate to the superficial cortex

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124
Q

How is lymphoid tissue arranged in medullary region?

A

Medullary cords

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125
Q

What kinds of cells are produced in the medullary region?

A

Plasma cells - antibodies

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126
Q

What does the medullary region of lymph nodes contain?

A

Medullary cords and medullary sinuses

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127
Q

How can lymph nodes be classified?

A

Primary

Secondary

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128
Q

How does lymphatic drainage work? Order of nodes involved

A

Region – primary (regional) – Secondary (central)

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129
Q

Primary lymph node aka

A

Regional node

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130
Q

Secondary lymph node aka

A

Central node

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131
Q

What are germinal centers in lymph nodes?

A

Sites within lymph nodes (and nodules within peripheral lymph tissues) where mature B lymphocytes rapidly proliferate, differentiate and mutate their antibodies

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132
Q

What happens to B lymphocytes in germinal centers?

A

They rapidly proliferate, differentiate and mutate their antibodies

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133
Q

How do B lymphocytes mutate their antibodies

A

Somatic hypermutation

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134
Q

What do B lymphocytes do to their antibodies during a normal immune response to an infection?

A

Proliferate
Differentiate
Mutate
Class switch

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135
Q

What does the medullary cord of the lymph node contain?

A

Lymphatic tissue - it projects into the medullary sinus

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136
Q

What are the main cell types found in the medullary cords?

A

B cells

Plasma cells

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137
Q

Where does the lymph from lower extremities drain?

A

Junction of the left internal jugular and subclavian veins

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138
Q

What is the main duct of the lymphatic system?

A

Thoracic duct

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139
Q

Where is the thoracic duct located?

A

Posterior mediastinum

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140
Q

Where does the thoracic duct begin?

A

In the abdomen

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141
Q

What does the thoracic duct begin as?

A

Cisterna chyli

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142
Q

At what level is the cisterna chyli located?

A

T12 Vertebra

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143
Q

Describe the course of the thoracic duct

A

Starts at cisterna chyli, ascends through the thoracic cavity in front of the spinal column.

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144
Q

What major blood vessels is the thoracic duct associated with in the thoracic area?

A

Descending thoracic aorta to its left and the azygos vein to its right

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145
Q

What is the length of the thoracic duct?

A

~ 40cm

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146
Q

What is the point where the right brachiocephalic vein begins?

A

Right venous angle - junction of the right internal jugular vein with the right subclavian vein

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147
Q

What part of the diaphragm does the thoracic duct pass through?

A

The aortic opening, on the right of the descending aorta

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148
Q

Where do intercostal lymphatic vessels drain?

A

From the left and right intercostal spaces into the thoracic duct

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149
Q

Where do mammary glands drain their lymph?

A

Into axillary lymph nodes

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150
Q

Where do kidneys drain lymph?

A

Lumbar lymph nodes

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151
Q

Where do lungs and trachea drain their lymph?

A

Into hylar lymph nodes (located in the hilum of the lung)

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152
Q

Does spleen form crypts that trap bacteria?

A

no

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153
Q

Where is the spleen located?

A

Left hypochondriac region

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154
Q

What is the rough size of the spleen?

A

A fist

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155
Q

What does the white pulp surround in the spleen?

A

Branches of the splenic artery

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156
Q

What cells does the red pulp consist of?

A

Lymphocytes
Macrophages
Plasma cells
Monocytes

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157
Q

What are monocytes

A

Phagocytic white blood cells

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158
Q

What are the three different tissues within the spleen

A

Reticuloendothelial tissue
Venous sinusoids
White pulp

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159
Q

What tissue in the spleen handles phagocytosis of erythrocytes?

A

Reticuloendothelial tissue

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160
Q

What is the function of reticuloendothelial tissue in spleen?

A

Phagocytosis of erythrocytes and cell debris from the bloodstream

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161
Q

What is the additional function of reticuloendothelial tissue?

A

It may produce foci of hemopoiesis when RBCs are needed

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162
Q

Function of venous sinusoids

A
  • grants power to the spleen to contract

- Helps expel contained blood to meet increased circulatory demands

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163
Q

What does the spleen do in conditions of increased circulatory demand?

A

Expels contained blood within the venous sinusoids

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164
Q

What is the white pulp composed of?

A

Nodules containing malphigian corpuscles

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165
Q

What is the function of the white pulp of the spleen?

A

Provides lymphocytes and a source of plasma cells and hence antibodies for the cellular and humoral specific immune response

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166
Q

What kind of immune response does the spleen assist in?

A

Both cellular and humoral

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167
Q

How does blood enter the spleen?

A

Splenic artery, through its hilum

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168
Q

What is the venous drainage of the spleen?

A

Splenic vein

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169
Q

How is the hepatic portal vein formed?

A

The connection of the splenic vein with the Superior mesenteric vein

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170
Q

Where are the nerves to the spleen derived from?

A

Celiac plexus

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171
Q

What is unique about the spleen and the thymus?

A

They both contain only efferent lymphatic vessels

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172
Q

Where does the spleen develop from?

A

Mesenchymal cells of the mesentery attached to the primitive stomach

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173
Q

How is the developmental origin of the spleen different from the rest of the abdomen?

A

The lungs, liver, pancreas, gallbladder, stomach, esophagus and intestines all develop from the PRIMITIVE GUT - spleen develops from mesenchymal cells of the mesentery

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174
Q

What happens to the spleen in infectious mononucleosis?

A

It is enlarged

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175
Q

What is the absence of normal spleen function called?

A

Asplenia

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176
Q

What is asplenia associated with?

A
  • Serious infection risks
  • Encapsulated bacteria
    = Strep pneumoniae
    = Haemophilus influenzae
    = Neisseria meningitidis
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177
Q

Which tonsils are covered by nonkeratinised stratified squamous epithelium?

A

Palatine and Lingual

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178
Q

What are tonsils?

A

Lymphatic organs that lie under the surface lining of the mouth and throat

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179
Q

What part of the immune system are tonsils a part of?

A

The secondary immune system

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180
Q

Where are tonsils located?

A

IN the respiratory and alimentary tracts in position to be xposed to inspired or ingested antigens from air or food

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181
Q

When do tonsils get activated?

A

When sufficient antigen is present, this stimulates the B cells in the germinal zone to differentiate and produce antibodies

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182
Q

What is the major kind of defence system tonsils are associated with?

A

Secretory IgA - which is transported to the surface and provides local immune protection

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183
Q

How many sets of tonsils exist?

A

3 -
Adenoids
Palatine tonsils
Lingual tonsils

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184
Q

Adenoids aka

A

pharyngeal tonsil

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185
Q

Location of adenoids

A

Posterior wall of nasopharynx

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186
Q

When are adenoids at the peak of their development?

A

Childhood

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187
Q

What are adenoids surrounded by?

A

Partly connective tissue

Partly ciliated pseudostratified columnar epithelium

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188
Q

What kind of epithelium surrounds adenoids?

A

Respiratory epithelium

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189
Q

What kind of tonsils contain crypts?

A

Lingua and palatine

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190
Q

What kind of tonsils don’t contain crypts?

A

Adenoids

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191
Q

Where are palatine tonsils located?

A

Posterolateral walls of throat - one on each side

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192
Q

When do palatine tonsils reach their maximum size?

A

Early childhood

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193
Q

What happens to the size of palatine tonsils after puberty?

A

They diminish considerably in size

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194
Q

Which tonsils are considerably enlarged when a person has a sore throat?

A

Palatine tonsils

195
Q

What are the contents of palatine tonsils?

A

Many crypts
Lymphoid follicles
No sinuses

196
Q

What is peculiarly absent from palatine tonsils?

A

Sinuses

197
Q

What are palatine tonsils surrounded by?

A

Connective tissue and non-keratinized stratified squamous epithelium

198
Q

What is the best way to distinguish the palatine from the pharyngeal tonsil histologically?

A

Type of associated epithelium

199
Q

What are lingual tonsils

A

Collection of lymphoid follicles on the posterior portion of the dorsum of the tongue

200
Q

What is peculiar about lingual tonsils as compared to pharyngeal and palatine tonsils?

A

They are smaller and more numerous

201
Q

What composes each lingual tonsil?

A

A single crypt and lymphoid follicle

202
Q

What is the name given to the three groups of tonsils?

A

Waldeyer’s ring

203
Q

Intestinal tonsils

A

Peyer’s patches

204
Q

Where are the Peyer’s patches located?

A

Small intestine (ileum)

205
Q

What is the function of Peyer’s patches?

A

To destroy the abundant bacteria

206
Q

What kind of lymphoid tissue are Peyer’s patches and tonsils considered?

A

Subepithelial and non-encapsulated lymphoid tissues

207
Q

Tonsillectomy

A

A surgical procedure in which the tonsils are removed from either side of the tonsillar fossa

208
Q

When is tonsillectomy performed?

A

Repeated occurrence of acute tonsillitis or adenoiditis

Obstructive sleep apnea

Nasal airway obstruction

Diphtheria carrier state

Snoring

Peritonsillar abscess

209
Q

What is done during tonsillectomy in children?

A

Adenoidectomy at the same time

210
Q

How are the anterior and posterior parts of the dorsum of the tongue separated?

A

Terminal sulcus and foramen cecum

211
Q

Where is yellow marrow found?

A

Hollow center of the diaphysis

212
Q

Medullary cavity

A

The hollow center of the diaphysis (the long shaft of the bone)

213
Q

What parts of bones contain red bone marrow?

A

Cavities in the cranial bones, vertebrae, ribs, sternum, and ends of long bones

214
Q

What kind of bone marrow do you find in the cavities in vertebrae?

A

Red bone marrow

215
Q

What tissues contribute to hemopoiesis before birth?

A

Yolk sac
liver
spleen
lymph nodes

216
Q

What are the precursor cells that give rise to all the formed elements of the blood?

A

Hemocytoblasts

217
Q

Where do you find hemocytoblasts?

A

red bone marrow

218
Q

What are hemocytoblasts

A

Multipotent stem cells

219
Q

What do hemocytoblasts give rise to?

A

Various committed progenitor cells

220
Q

What are the progenitor cells for erythroblasts?

A

Proerythroblasts

221
Q

What cells do platelets develop from?

A

Megakaryocytes

222
Q

When does yellow marrow begin to appear?

A

When a child is 7 years of age

223
Q

Where does yellow marrow appear first?

A

distal bones of the limbs

224
Q

What kind of marrow does a person have at birth?

A

Only Red marrow

225
Q

Where is red marrow present at the time when a person becomes an adult

A 
Skull
Vertebral column
Thoracic cage
Girdle bones
Head of the humerus and femur
226
Q

What is the average no of erythrocytes in the blood?

A

5 mn/cu mm

227
Q

How many platelets in the blood?

A

150,000 to 300,000 per cu mm

228
Q

How many leukocytes in the blood?

A

10,000 per cu mm

229
Q

What are the most abundant leukocytes in blood?

A

Neutrophils

230
Q

What are the most abundant agranulocytes in blood?

A

Lymphocytes

231
Q

Which WBC has a kidney shaped nucleus?

A

Monocytes

232
Q

What kind of WBC have ruffled membranes?

A

Macrophages

233
Q

What kind of WBC has an obscure nucleus?

A

Basophils

234
Q

What kind of WBCs are active against parasites?

A

Eosinophils

235
Q

What do basophils release?

A

Histamine
Heparin
Serotonin

236
Q

What kind of WBCs produce antibodies?

A

Lymphocytes

237
Q

What kind of WBCs destroy specific target cells?

A

Lymphocytes

238
Q

What kind of WBCs are part of the immune system?

A

Neutrophils

239
Q

At what absolute neutrophil count does a risk of infection dramatically increase?

A

Less than 500 per cubic mm

240
Q

What kind of metabolism do erythrocytes rely on?

A

Anaerobic

241
Q

What is the average lifespan of RBCs?

A

120 days

242
Q

What is the hormone that stimulates erythropoiesis?

A

Erythropoietin

243
Q

What organ produces erythropoietin primarily?

A

Kidneys

244
Q

What is the hematocrit for females?

A

40%

245
Q

What is the precursor cell for all formed elements of the blood?

A

Hematocytoblast

246
Q

what do hematocytoblasts give rise to?

A

Multipotent progenitor cells

247
Q

What type of cells are hematocytoblasts?

A

Pluripotent stem cells

248
Q

Multipotent progenitor cells aka

A

Colony forming cells

249
Q

What do CFCs give rise to?

A

Different types of formed elements

250
Q

What is the hormone that stimulates precursor cells to differentiate into WBCs?

A

Granulocyte Colony stimulating factor (G-CSF)

251
Q

What kind of disease is sickle cell anemia?

A

Autosomal recessive genetic blood disorder

252
Q

What is the shape of cells in sickle cell anemia?

A

Sickles or crescent

253
Q

What is the relative life span of sickle cells as compared to normal RBCs?

A

Smaller

254
Q

What do sickle cells cause in the blood stream?

A
  • get stuck in blood vessels blocking blood flow, causing pain and organ damage
255
Q

What is mutation?

A

A hydrophilic glutamic acid substitution with a hydrophobic amino acid valine

256
Q

What does G6PD deficiency cause?

A

Severe hemolytic crisis in affected individuals

257
Q

G6PD

A

Glucose 6 phosphate dehydrogenase

258
Q

What is the cause of hemolytic crisis in individuals affected by G6PD deficiency?

A

Decreased NADPH and the inability of RBCs to maintain membrane integrity

259
Q

What is G6PD deficiency induced by?

A

Sulfa drugs
Oxidants
Fava beans

260
Q

What is the pH of blood?

A

7.35 - 7.45

261
Q

What is the relative proportions of all types of leukocytes in blood?

A

Never Let Monkeys Eat Bananas

Neutrophils
Lymphocytes
Monocytes
Eosinophils
Basophils
262
Q

Out of plasma and serum, which one contains clotting proteins?

A

Plasma

263
Q

What % of plasma is water?

A

91%

264
Q

What is the most abundant protein in human plasma?

A

serum albumin

265
Q

What are the functions of albumin in blood?

A 
Transports hormones
Transports fatty acids
Transports other componds
Buffers pH
Maintains osmotic pressure
266
Q

Which word describes platelets better - megakaryocytes or cytoplasmic fragments?

A

Cytoplasmic fragments

267
Q

What is the lifespan of platelets?

A

7-10 days

268
Q

Where are platelets removed from the blood

A

Spleen

liver

269
Q

What is the stimulating factor for platelet formation?

A

Thrombopoietin

270
Q

What triggers platelet plug formation?

A

Exposure of platelets to a rough surface

271
Q

How do platelets gain access to materials that promote clotting?

A

They contain secretory vesicles

272
Q

What do the chemicals from the platelets’ secretory vesicles do?

A

Cause the surface of the platelets to become sticky

273
Q

What happens when platelets become activated?

A

They produce Thromboxane A2 that has prothrombotic properties stimulating activation of new platelets as well as increasing platelet aggregation

274
Q

What is the chemical that counteracts Thromboxane A2?

A

Prostacyclin (PGI2)

275
Q

Actions of prostacyclin

A

Decreases platelet aggregation

Causes vasodilatation

276
Q

What are most articular disks covered by?

A

Hyaline cartilage

277
Q

What are freely movable joints called?

A

Diarthroidal

278
Q

What is the movement of synovial joints limited by?

A

Joint surfaces
Ligaments
Tendons

279
Q

Characteristic features of synovial joints

A

Articular cartilage
Joint cavity
Articular capsule
Synovial membrane

280
Q

Which synovial joint does not contain hyaline cartilage as articular cartilage?

A

TMJ

281
Q

What cartilage does TMJ contain?

A

Fibrocartilage

282
Q

What kind of blood vessels and nerves does the articular cartilage of synovial joints contain?

A

None

283
Q

What is the joint cavity in synovial joints?

A

Small fluid-filled space separating the ends of adjoining bones

284
Q

What is a synovial joint enclosed in?

A

Articular capsule - fibrous connective tissue

285
Q

Where is synovial membrane found in the synovial joint?

A

Bursa and articular cartilage

286
Q

What produces synovial fluid in the synovial joint?

A

Synovial membrane

287
Q

How is the position of bones maintained in synovial joints?

A

Supporting ligaments

288
Q

How many kinds of supporting ligaments are found with synovial joints?

A

three -
capsular
intracapsular
extracapsular

289
Q

Meniscus

A

A washer-like structure between bone ends

290
Q

How many synovial joints have a meniscus?

A

~10%

291
Q

What is the purpose of the meniscus?

A
  • Absorb shock
  • Stabilize the joint
  • Spread synovial fluid
292
Q

What is the meniscus made out of?

A

Fibrocartilage

293
Q

What is the blood supply of a meniscus?

A

No blood, nerve or lymphatic supply

294
Q

How fast does the meniscus heal itself?

A

It can’t.

295
Q

What is the most famous and most injured meniscus of the body?

A

Knee

296
Q

Bursa

A

Fluid-sac that is lined with a synovial membrane

297
Q

What is the function of a bursa?

A

Reduce friction

298
Q

What is a sample location of a bursa

A

Between a tendon and a bone to reduce friction

299
Q

Bursitis

A

Inflammation of the lining of a bursa

300
Q

Types of joints based on amount of motion

A

Synarthrosis
Amphiarthrosis
Diarthrosis

301
Q

What are immovable joints known as

A

Synarthrosis

302
Q

Examples of synarthroses?

A

Sutures between the flat bones of skull

Gomphosis

303
Q

How are synarthroses joined?

A

They are fibrous joints

304
Q

What are slightly movable joints called?

A

Amphiarthrosis

305
Q

Amphiarthrosis aka

A

Cartilaginous joint

306
Q

What kind of joint is symphysis pubis

A

Amphiarthrosis

307
Q

Which bones are involved in symphysis pubis?

A

The two os coxa bones join anteriorly in symphysis pubis

308
Q

Classify joints based on type of associated connective tissue

A

Fibrous
Cartilaginous
Synovial

309
Q

Types of fibrous joints

A

Sutures

Syndesmoses

310
Q

What is the joint between radius and ulna called

A

Syndesmosis

311
Q

Types of cartilaginous joints

A

Synchondroses

Symphyses

312
Q

What are cartilaginous joints joined by?

A

Fibrocartilage

Hyaline cartilage

313
Q

What are joints that are joined by hyaline cartilage called?

A

Synchondroses

314
Q

What kind of joints are epiphyseal plates within long bones

A

Synchondroses

315
Q

What are joints that are joined by a plate of fibrocartilage called?

A

Symphyses

316
Q

What type of joints are spheno-occipital joint and epiphyseal cartilage plates classified as?

A

Synchondrosis

317
Q

Types of sutures

A

Coronal
Sagittal
Lambdoid

318
Q

What is the suture between the frontal and parietal bones called?

A

Coronal suture

319
Q

What is the suture between the two parietal bones called?

A

Sagittal suture

320
Q

Where is the lambdoid suture situated?

A

Between parietal and occipital bones

321
Q

Bregma

A

Site of intersection of coronal and sagittal sutures

322
Q

What does the anterior fontanelle turn into in the adult?

A

Bregma

323
Q

What is the point of intersection of the sagittal and lambdoid sutures called?

A

Lambda

324
Q

What does the lambda succeed?

A

Posterior fontanelle

325
Q

What kind of joint is the tympanostapedial joint?

A

Syndesmosis

326
Q

What kind of joint is the inferior tibiofibular joint?

A

Syndesmosis

327
Q

Primary cartilaginous joints

A

Synchondrosis

328
Q

Secondary cartilaginous joints

A

Symphyses

329
Q

Which kind of cartilaginous joints is movable?

A

Symphyses - slightly

330
Q

Which kind of cartilaginous joints is not movable

A

Synchondrosis

331
Q

What kind of cartilage is in synchondrosis

A

Hyaline

332
Q

What kind of joints are intervertebral discs

A

Symphyses

333
Q

What is peculiar about synchondroses?

A

They permit no movement but they allow growth in length of bone

334
Q

What kind of a joint is the joint between the first rib and sternum?

A

Synchondrosis

335
Q

What kind of joints permit a great degree of movement?

A

Synovial

336
Q

What are synovial joints classified according to?

A

Axis of movement

337
Q

Types of synovial joints

A 
Gliding
Hinge
Pivot
Ellipsoidal
Saddle
Ball and socket
338
Q

What are gliding joints also known as

A

Plane joints

339
Q

What are ball and socket joints also known as

A

Universal

340
Q

What type of joints are the ones found in the carpal bones of the wrist?

A

Gliding joints

341
Q

What kind of joints are knee joints?

A

Hinge

342
Q

What kind of joint is the one found between atlas and axis?

A

Pivot

343
Q

What are ellipsoid joints aka

A

Condyloid joints

344
Q

What kind of joints are the ones found in the tarsal bones of the ankle

A

Gliding

345
Q

What is the joint where the metacarpal of the thumb meets the trapezium of the carpus (wrist) called?

A

Saddle

346
Q

Example of ball and socket joint

A

Shoulder or hip

347
Q

Example of ellipsoidal joint

A

Joint between the distal surfaces of the forearm bones and adjacent carpal bones

348
Q

NO joint

A

Atlantoaxial joint

349
Q

YES joint

A

Atlanto-occipital joint

350
Q

Atlantoaxial joint

A

The synovial articulation between the inferior articulating facets of the atlas ant he superior articulating facets of the axis

351
Q

First cervical vertebra

A

Atlas

352
Q

Second cervical vertebra

A

Axis

353
Q

What is peculiar about atlas and axis?

A

Absence of intervertebral disc or foramen between them

354
Q

What is peculiar about C1?

A

It has no vertebral body - only two lateral masses

355
Q

Howm any joints are formed between C1 and C2?

A

3

356
Q

Atlanto-occipital joint

A

The synovial articulation between the superior articulating facets of the atlas and the occipital condyles of the skull

357
Q

Rotation of the forearm with palm turning outward

A

Supination

358
Q

Folding forward is an example of what kind of movement?

A

Flexion (of the spine)

359
Q

Crossing one leg in front of the other is a form of what kind of movement?

A

Adduction

360
Q

Crescent stretch

A

Dropping one hand down same side of body - it is an example of lateral flexion

361
Q

What kind of movement is described by emptying a can of soda?

A

Pronation

362
Q

When you stand with weight on inner edge of the foot, what kind of movement are you performing?

A

Eversion

363
Q

Eversion

A

Turning the foot laterally resulting in the sole moving outward

364
Q

Protraction

A

Movement of rounding shoulders forward “spreading” back

365
Q

Squeezing shoulder blades together is known as

A

Retraction

366
Q

Which part of the kidney is connected to the bladder by the ureter?

A

Renal pelvis

367
Q

Where are the kidneys located?

A

Back of the abdomen - on each side of the spine, at the level of the lower ribs

368
Q

Functions performed by the kidneys

A
  • Form urine
  • Maintain homeostasis
  • Secrete hormones
369
Q

What hormones are formed in the kidneys?

A

Renin

Erythropoietin

370
Q

At what level of the spine are kidneys located?

A

Lumbar spine

371
Q

What is the relation of the kidneys to the peritoneum?

A

They are retroperitoneally located

372
Q

What is the relation of the kidneys to muscles attached to the vertebral column

A

They lie in front of the muscles

373
Q

What is the colour of the renal cortex

A

Light brown

374
Q

What is the outer layer of kidney called

A

Cortex

375
Q

What components of the nephron does the cortex contain?

A

PCT, DCT, glomeruli

376
Q

What is the renal cortex the site of?

A

Blood filtration

377
Q

What is the color of the medulla of kidney?

A

Dark kidney

378
Q

What structures does the renal medulla contain?

A

Cone like structures called renal pyramids

379
Q

What are renal pyramids separated by?

A

Renal columns

380
Q

What are renal columns

A

Extensions of renal cortex

381
Q

What is the hallow inner structure that joins with the ureters?

A

Renal pelvis

382
Q

Where does the pelvis receive urine from?

A

Calyces

383
Q

What is the apex of the renal pyramids?

A

Renal papilla

384
Q

What happens microscopically in renal papilla?

A

Collecting ducts pour into minor calyces

385
Q

What is the extension of the renal pelvis called

A

Renal calyx

386
Q

Which kidney lies higher?

A

Left kidney

387
Q

Why is the right kidney lower?

A

Due to the large size of the right lobe of the liver

388
Q

What is the capsule of each kidney made of?

A

Fibre

389
Q

What is the supportive capsule of each kidney made of?

A

Adipose

390
Q

Where is the hilum of each kidney located?

A

Medial border

391
Q

What are the contents of the hilum?

A

Ureters
Renal vessels
Nerves

392
Q

Blood supply of kidneys

A

Renal artery, a branch of the abdominal aorta

393
Q

List nephronal structures in order from b.lood to urine

A 
Glomerulus
Bowman's capsule
PCT
Loop of henle
DCT
collecting duct
394
Q

Nephron

A

Subunit of a kidney that purifies blood and maintains a safe balance of solutes and water

395
Q

Functional unit of the human excretory system

A

nephron

396
Q

How many open ends does the nephron contain?

A

One

397
Q

What is the closed end of the nephron called?

A

bowman’s capsule

398
Q

what does the renal corpuscle normally produce?

A

protein free and cell free filtrate

399
Q

what does the renal corpuscle consist of

A

bowman’s capsule

glomerulus

400
Q

how many regions does the tubular portion of the nephron have?

A

4

401
Q

what are the 4 regions of the tubular portion of the nephron?

A

pct
loop of henle
dct
collecting duct

402
Q

where is glucose reabsorbed in nephron?

A

pct

403
Q

where is sodium reabsorbed in nephron?

A

dct

404
Q

what causes sodium reabsorption in nephron?

A

aldosterone

405
Q

how is the filtrate treated in the loop of henle

A

it is concentrated through electrolyte exchange and reabsorption

406
Q

what is the osmolarity of the fluid that exits the loop of henle

A

hyperosmolar

407
Q

where in the nephron are metabolites reabsorbed

A

pct

408
Q

where in the nephron is the filtrate finally filtered?

A

collecting duct

409
Q

where in the nephron does reabsorption of amino acids and electrolytes occur?

A

pct

410
Q

what kinds of processes do the fluid in the tubules of the nephron go through?

A

filtration
tubular reabsorption
tubular secretion

411
Q

what happens to the blood that is not filtered

A

it passes to the efferent vessels and peritubular capillaries

412
Q

what substances are returned to the peritubular capillaries by reabsorption?

A

water
glucose
sodium

413
Q

at what rates are water, glucose and sodium returned to peritubular capillaries?

A

fast

414
Q

macula densa

A

an area of closely packed specialized cells lining the wall of the distal tubule

415
Q

where is macula densa found

A

lining the wall of the distal tubule

416
Q

what are the cells of macula densa most affected by?

A

concentration of sodium chloride in the distal convoluted tubule

417
Q

what does a decrease in NaCl concentration do to the macula densa?

A

decreases resistance to blood flow in afferent arterioles

increases renin release from juxtaglomerular cells

418
Q

what does the decreased resistance to blood flow in afferent arterioles do?

A

it increases glomerular hydrostatic pressure and helps return GFR toward normal

419
Q

what are the major storage sites for renin?

A

juxtaglomerular cells of afferent and efferent arterioles

420
Q

distal straight tubule aka

A

thick ascending limb of the loop of henle

421
Q

where is the collecting duct that the collecting tubule empties into lie?

A

within the medullary ray

422
Q

what do collecting ducts converge to form

A

large diameter ducts in the papillae called papillary ducts or ducts of Bellini

423
Q

area cribrosa

A

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

424
Q

what is the most immature form of kidney

A

pronephros

425
Q

what is the most developed form of kidney

A

metanephros

426
Q

what are the stages of development of kidney

A

pronephros
mesonephros
metanephros

427
Q

what stage of development of kidney persists as adult kidney

A

metanephros

428
Q

ureters structure

A

long
slender
fibromuscular

429
Q

function of ureters

A

transport urine from pelvis of kidney to base of bladder

430
Q

which ureter is longer

A

left

431
Q

what is the narrowest part of ureters

A

where they originate

432
Q

what is the point of origin of ureters called

A

ureteropelvic junction

433
Q

what does filling of the bladder do to ureters

A

constricts them at the ureterovesical junction

434
Q

what is the ureterovesical junction

A

the point where ureters enter the bladder

435
Q

how does urine move through ureters

A

peristaltic waves

436
Q

how often do ureteric peristaltic waves occur

A

one to five times a minute

437
Q

how do the ureters descend in the female

A

posterior to the ovary and into the base broad ligament passing under the uterine artery - water under the bridge

438
Q

where is the bladder located

A

pelvic cavity posterior to symphysis pubis

439
Q

in whom is bladder lower

A

females

440
Q

what kind of epithelium is found in bladder?

A

transitional

441
Q

what is special about transitional epithelium

A

they change shape in response to pressure - empty bladder - cuboidal; filled bladder - compressed and flattened

442
Q

urethra

A

fibromuscular tube

443
Q

membranous urethra

A

in males, the portion of the urethra that passes through the urogenital diaphragm

444
Q

membranous urethra

A

in males, the portion of the urethra that passes through the urogenital diaphragm

445
Q

What structures pass through optic canal

A

optic nerve

ophthalmic artery

446
Q

What happens to optic canal in McCune Albright syndrome?

A

bony fibrous dysplasia of the anterior cranial base leading to the encasement and narrowing of the optic canal

447
Q

which bone is optic canal located in

A

sphenoid

448
Q

which part of the sphenoid is optic canal located in

A

posterior part of lesser wing

449
Q

what part of the cranium does the optic canal communicate with

A

middle cranial fossa

450
Q

where do olfactory nerves emerge from

A

cribriform plate in ethmoid

451
Q

which cranial nerve is olfactory

A

i

452
Q

which bone is hypoglossal canal in

A

occipital

453
Q

what structures does the hypoglossal canal house

A

hypoglossal nerve

454
Q

which cranial nerve is the hypoglossal nerve

A

cn xii

455
Q

which bone does the internal carotid artery enter the skull from

A

temporal

456
Q

what is the opening that internal carotid enters

A

carotid canal

457
Q

which bone is lacrimal canal associated with

A

lacrimal and maxilla

458
Q

what are the contents of the lacrimal canal

A

nasolacrimal duct

459
Q

nasolacrimal duct aka

A

tear duct

460
Q

what are the contents of the inferior orbital fissure

A
  • infraorbital and zygomatic branches of maxillary nerve
  • infraorbital artery
  • part of inferior ophthalmic vein
461
Q

what does infraorbital artery pass through

A

inferior orbital fissure

462
Q

what bones does the inferior orbital fissure involve

A

sphenoid

maxilla

463
Q

which of the orbital fissures involves the maxilla

A

inferior

464
Q

which of the orbital fissures involves the sphenoid exclusively

A

superior

465
Q

which orbital fissure transmits (branches of or full) 4 cranial nerves

A

superior

466
Q

which cranial nerves pass through superior orbital fissure

A

iii (occulomotor),
iv (trochlear),
vi (abducens) and
v1 (nasociliary branches of ophthalmic)

467
Q

does the superior orbital fissure transmit any nervous fibers ther than the cranial nerves

A

sympathetic fibers from cavernous plexus

468
Q

what blood supply passes through superior orbital fissure

A

superior and inferior divisions of ophthalmic vein

469
Q

which bone houses the optic canal and foramen

A

sphenoid

470
Q

what bone is the stylomastoid foramen located in

A

temporal

471
Q

what nerve passes through stylomastoid foramen

A

facial (cn vii)

472
Q

what foramen does the facial nerve pass through

A

stylomastoid foramen

473
Q

what bone is internal acoustic meatus part of

A

posterior surface of petrous part of temporal bone

474
Q

what structures does the internal acoustic meatus transmit

A 
facial nerve (vii)
vestibulocochlear nerve (viii)
475
Q

where does the vestibulocochlear nerve travel after entering the internal acoustic meatus

A

it stays within the temporal bone

476
Q

what does the vestibulocochlear nerve supply

A

cochlear duct (hearing)
semicircular ducts
maculae (balance)

477
Q

where does the facial nerve go after entering the internal acoustic meatus

A

it goes in the facial canal of temporal bone and emerges from the stylomastoid foramen

478
Q

where does the stylomastoid foramen lie

A

between the styloid and mastoid processes of the temporal bone

479
Q

what does the facial nerve do after entering the internal acoustic meatus

A

gives rise to the chorda tympani branch

480
Q

what is the function of the chorda tympani branch of facial nerve

A

parasympathetic innervation to submandibular and sublingual gland

sensory taste fibers to anterior 2/3 of tongue

481
Q

what part of the facial nerve exits from the stylomastoid foramen

A

main trunk

482
Q

what happens to the facial nerve after it exits stylomastoid foramen

A

it gives off 5 branches after entering parotid gland substance

483
Q

facial nerve branches mnemonic

A 
The - temporal
Zebra - zygomatic
Bit - buccal
My - mandibular
Cow - cervical

NBDE 1 (4 decks)

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