Exam 1 Flashcards
What does a lusitropic effect impact?
Rate of muscular relaxation
What layer of the trachea has the BALT
Epithelia
What receptor is associated with splanchnic sympathetics?
A-1 Adrenergic (constriction)
What step of lung developement fucks up to cause unilateral agenesis?
Respiratory bud failing to split into R/L bronchial buds
Where would you find mucigen granules?
Goblet cells’ apical cytoplasm
You see lipofuscin granules around the nucleus of a cell. What type do you think it is?
Cardiac Muscle
What structure causes tail folding?
Growth of the distal neural tube (SC primordium)
What is the sequence of heart structures for electrical conduction?
SA Node, AV Node, AV Bundle, Bundle Branches, Purkinje
What cells secrete lipoprotein for preventing lumenal adhesion?
Club Cells
What kind of tissue is the endocardium?
Areolar CT with Endothelium
What does SREBP do to cholesterol?
Transcription of LDL receptor (cholesterol Endocytosis)
Where does the primordial of the tracheobronchial tree develop?
Caudal to the 4th Pharyngeal Pouches
When can you find Definitive Hematopoietic cells in the AGM?
Day 27 - Day 40
What wave is represented by ventricular depolarization?
QRS Complex
What is the ST segment associated with?
Phase 2 (the plateau) - Calcium influx
What rib has an insertion point for the Serratus Anterior m?
2nd Rib
Where do the Vagus fibers arrive for lung innervation?
Nucleus Ambiguus
What ions do cardiac glycosides act on?
Na (increased)
Ca (increased)
What does the medial mammary A come off of?
Internal Thoracic A
What is the origin of the celiac ganglion?
T5 - T9
What are dense bodies made from
Desmin and Vimentin
What is the target of ANF?
Kidneys
What kind of mesoderm is the parietal wall derived from?
Somatic Mesoderm
A fetus has oligohydramnios. What is the hallmark of this?
Insufficient amniotic fluid production to counteract pressure on fetus
What is the function of internal intercostals?
Exhaling
What rib has a groove for subclavian A and V?
1st Rib
What do you take to prevent CoQ10 deplete?
Squalene Synthesis Inhibitors
What is the formula of the Fick Principle of O2 Consumption?
[O2]pv - (CO x [O2]pa)
What endoderm part forms the hind-gut (descending colon / rectum)?
From the caudal eminence projecting over the cloacal membrane
Which intercostal nerves are atypical?
1 and 2
7-11
What type of joints are between vertebral bodies?
Symphysis
What type of joint is the Manubriosternal joint?
Symphesis
What type of target tissue has varicosities to bind neurotransmitters?
Smooth muscle
What type of joint is the costochondral joint?
Synchondrosis
What channels does calcium enter smooth muscle on the sarcolemma?
L-Type Voltage Gated
Receptor activated
What are the only tissues found in alveoli?
Epithelium, smooth muscle, elastic fibers.
What causes happens to SREBP when you take a statin?
Translocates SREBP-SCAP complex to Golgi
What wave represents the pressure created as blood goes back to the heart but cant enter the ventricle?
V-Wave
What is at increased risk if a mother has a Rubella infection early on in pregnancy?
Patent Ductus Arteriosus
What secretes Renin?
Justaglomerular Apparatus
What do peaked T-waves represent?
Hyperkalemia
What does the Ductus Venosus become after birth?
Ligamentum Venosum
Where do you find fenestrated capillaries?
Gallbladder, Kidney
What wave would you expect to be affected by cardiac tissue injury?
ST segment (shift)
What day does hematopoiesis and bv formation start?
Day 17
What are the sympathetics to the Coronary Arteries?
A1
What are the paired lateral visceral branches of the thoracic aorta?
Bronchial As
What is the cloaca?
Rudiment of urinary bladder / rectum
What three pairs of vessels do blood inflow to the primitive heart?
Vitelline Veins
Umbilical Veins
Common Cardinal Veins
What do the cartilages of the larynx come from?
Mesenchyme of PA 4 and 6
NCC derived
What type of joint is the costovertebral joint?
Synovial Planar
What layer has the glands of the trachea?
Submucosa
What supplies blood to the tunica adventitia?
Vasa Vasorum
What significantly increases risk for pulmonary hypoplasia?
Oligoihydramnios under 26 weeks
What makes up bronchopulmonary segments?
Segmental bronchi and mesenchyme
When the laryngotracheal groove evaginates, what does it form?
Laryngtracheal Diverticulum (long bud)
What effect type do cardiac glycosides have on the heart?
Positive Inotropic Effect
What forms the ct, cartilage, smooth muscles surrounding the foregut?
Splanchnic Mesoderm (from lateral plate)
What is the orientation of external intercostals?
Down and In
What is the positive staircase effect?
Increased heart rate increases contractility
Can lead to Post-Extrasystolic potentiation
What do you get with an obliterated Right and Left AA IV?
Interrupted Aortic Arch
What does the tracheoesophageal septum divide the cranial foregut into dorsally?
Primordial Oropharynx, Esophagus
What type of receptor is the sympathetic SA / AV innervation?
B1-Adrenergic
What is the embryonic derivative of tracheal epithelium and glands?
Endoderm
What is the building block of all isoprenoid synthesis?
IPP
Which rib has a tuberosity for the serrates anterior?
2
What does calcium use to exit smooth muscle?
SERCA
3Na Antiporter
Ca ATPase
What epithelium is alveolar stuff
Simple squamous
What is the end result of Renin Secretion?
Increased blood volume
What is the main difference in the Phase 0 of Fast vs Slow Action Potentials?
Slow APs depolarize mainly by calcium influx rather than Na
What do Statins Primarily Act On?
Competitively Inhibit HMG CoA Reductase
What does the C-Wave represent?
Pressure from Isovolumetric Contraction in the Ventricles
bulging of wall back into the atria
What is the timeline of canalicular lung development?
16 - 25 weeks (overlaps with pseudo glandular)
What forms the epithelium and glands of the larynx / trachea / bronchi?
Endoderm of the Laryngotracheal groove
A Patient has Cyanosis, Breathlessness, murmur with poor weight gain later on. What is the cause of the disease?
Not enough AV Septum shift or Cardiac Looping
double outlet right ventricle
Lead I is Positive, AVF is negative. What is this?
LAD
What is the excitatory effect of b-AR activation?
Phosphorylation of Phospholamban
What divides the lateral mesoderm into Somatic and Splanchnic (parietal and visceral) Layers?
Intraembryonic Coelom
What anastomosis forms the Left Brachiocephalic V?
Right and Left Anterior Cardinal Veins
What is the role of Nodal cardiocytes?
Initiate and relay electrical signals
What effect does the latch mechanism have on smooth muscle?
Increases time of contraction
what is the timeline of pseudo glandular lung development?
5 - 17 weeks
Pt has a failure of conotruncal ridges to spiral. What is this?
Transposition of great vessels
Cyanotic, needs surgery
What does visceroatrial heterotaxia look like?
Right heart / Normal GI
Left heart / Right GI
What makes the third heart sound?
Blood rushing into the ventricle during the rapid filling phase
What heart defect has and overriding aorta, pulmonary stenosis, a ventricular septal defect, and right ventricular hypertrophy?
Tetrology of Fallot
What does the lateral mammary A come off of?
Lateral Thoracic A
What innervates the Aortic sinus?
Vagus N
Aortic N
What makes the first heart sound?
Mitral and Tricuspid (AVs) valve Closure (ejection)
Blood entering atria hits the closed valves
What are the skeletal muscle sympathetic receptors?
A1
B2
Why might the Superior Vena Cava drain into the heart via the Coronary Sinus?
Abnormal Anterior Cardinal Vein Development
What does ACAT do?
Esterifies Cholesterol
What layer of the trachea is the trachealis m.?
Adventitia
What do you think when you see a PR interval greater than 0.2 seconds?
AV Block (prolonged SA to AV conduction)
What does the dorsal mesocardium become in the adult?
Transverse Sinus
Proepicardial organ
In which heart defect does blood from the aorta get sucked into the pulmonary artery?
Patent Ductus Arteriosis
Where can you find definitive hematopoietic cells?
Aortic Gonadal Mesonephric (AGM) Region
What ions are affected by a negative inotropic effect of the atria?
Ca++ decreased inward
K+ increased outward by Ach
What do laryngeal muscles develop from?
PA 4 and 6
What two things are missing in the case of Abetalipoproteinemia?
ApoB-48
ApoB-100
Where is the defect in an infant with protruding viscera?
Gastroschisis: Right of the umbilical cord
What are the cerebral and coronary sympathetic receptors?
A-1 Adrenergic (protective constriction)
What lung element has not formed in the pseudoglandular stage of lung development?
Those involved with gas exchange (fetus cannot survive)
ex. Primitive alveoli, sacs, bronchioles
What causes Gastroschisis?
Improper merging of lateral folds
Causes protrusion of viscera
What kind of epithelium is the Epicardium (visceral serous pericardium)?
Simple Squamous with Areolar CT and Fat
What pressure value can be thought of as Afterload?
Pressure required to open the aortic valve
What is the typical cardiac output?
5 L/min
What veins do the vitelline veins contribute to?
Portal Vein
Mesenterics
Splenic
Lead I and AVF are both positive. What does this mean?
Normal Mean Electrical Axis
What Leads area is supplied by the Anterior Interventricular artery?
Anterior wall
What produces surfactant for the lungs?
Type II alveolar cells
What provides ANS innervation to the tunica adventitia?
Nervi Vasorum
How do you treat laryngeal atresia?
Endoscopic dilation of laryngeal web
What is a deficiency in Apo-C II or Capillary lipoprotein lipase?
Type I Hyperlipoproteinemia
aka Familial Hyperchylomicronemia
What is the number that indicates transition from laminar to turbulent flow?
2000
What does the respiratory bud come from?
Distal end of the laryngotracheal diverticulum
What three conditions are a L-R shunt?
ASD, VSD, PDA
What makes the fourth heart sound?
Little bit of blood squeezed into the ventricle during atrial contraction
What leads are asssociated with the Inferior wall?
II, III, AVF
V3R - V6R
What do visceral and parietal pleura come from?
Splanchnic (visceral pleura) lateral plate mesoderm
Somatic (parietal Pleura) lateral plate mesoderm
What is the main difference in the Phase 1 of Fast vs Slow Action Potentials?
Slow don’t even have a phase 1 or 2 lol
What is the origin of sympathetic innervation to the lower airways?
T1 - T5
What are the paired segmental parietal branches of the thoracic aorta?
Posterior Intercostal A
Subcostal A
What is the origin of upper airway parasympathetics?
Trigeminal nerve
Sphenopalatine Ganglion
What does the aorticopulmonary septum divide?
Truncus Arteriosus into Aorta and Pulmonary Arteries
What leads are associated with anterior wall infarction?
V1 - V7
What is becks triad indicative of?
Cardiac Tamponade
In what stage are type I and II pneumocystis found in the lung?
Terminal Sac (24 weeks-birth)
What is the goal of ANF?
Decrease Na+ and H2O retention
Which ribs are false?
8-10
What do the Pleurocardial folds develop into?
Primitive Mediastinum
Fibrous Pericardium
A patient has Down’s Syndrome, Exercise Intolerance, and Pulmonary Hypertension. What could be causing this disease?
Failure of AV Septum fusion (Persistent AV Canal)
What are the sympathetic receptors of the veins?
A-1 Adrenergic (constriction)
A-2 Adrenergic (relaxation)
B-1 Adrenergic (relaxation)
What type of receptor is the parasympathetic cardiac innervation?
Cholinergic Muscarinic (M2/M3)
What foramen form the flutter valve of the atria before birth?
Foramen Secondum on Septum Primum
Foramen ovale on Septum Secundum
What is the defining characteristic of alicyclic compounds?
Hydroxyl at C3
How does a negative chronotropic or dromotropic effect hyper-polarize the SA node?
Effluxes K+ via special Ach channels
What forms the hepatic sinusoids?
Vitelline Veins
What is the origin of the last splanchnic nerve?
T12
When does the respiratory bud form the laryngotracheal diverticulum?
Week 4
What is the cardiac output formula?
(Pa - Pv) / TPR
What regulates the branching pattern of the lung?
Splanchnic Mesenchyme
What do the superior and lateral costotransverse ligaments connect?
Lateral: Tubercle of the rib to the transverse process
Superior: Neck of rib to transverse process one up
What wave represents Ventricular Repolarization?
T wave
What causes looping defects like heterotaxia?
Failure of splanchnic mesoderm to proliferate at the ends of the rupturing dorsal mesocardium (lengthening) for the second heart field.
What does ApoA-I do?
Activates enzyme that esterifies cholesterol
Its on HDLs
When do the pericardial cavity and pleural cavities separate?
Week 7
When does the Yolk Sac Mesoderm do hematopoiesis?
Day 17 - 60
What is the origin of coronary artery sympathetics?
T1 - T5
A Patient has elevated cTnT, what disease could mislead you to thinking its a MI?
Renal Failure
What are the sympathetics to the pulmonary arteries?
A1
B1
B2
What brain stem region does Parasympathetic stuff with baroreceptors?
dorsal motor Vagus
nucleus Ambiguus
What is the hypo pharyngeal eminence derived from?
Mesenchyme of PA 3 and 4
What structure allows blood to bypass the sinusoidal plexus of the liver?
Ductus Venosus
What is the rate limiting enzyme of cholesterol biosynthesis?
HMG CoA Reductase
What type of joint is the zygopophyseal joint?
Planar Synovial
What is special about the endocardium in the ventricles?
Has Subendocardial layer
What does the tracheoesophageal septum divide the cranial foregut into ventrally?
Laryngotracheal tube
What is the inhibitory effect of b-AR activation?
Phosphorylation of troponin I
What does an Inotropic effect impact?
Strength of muscular contraction
Where would you expect to find pericytes?
Tunica intimate of Post-Capillary Venules
What is the the embryonic derivative of tracheal cartilages, CT, and muscle?
Splanchnic mesenchyme
What are the sympathetic receptors in the ventricular myocytes?
B1 (always)
B2 sometimes
What embryological structure is the start of the respiratory system?
Laryngo-treacheal Groove
Which part of the rib separates and which part dislocates?
Dislocates on the sternum / cartilage part
Separates on the rib / cartilage part
What costal cartilages form the boundary of the inferior thoracic aperture?
7 - 10
What are the unpaired visceral branches of the thoracic aorta?
Mediastinal A
Esophageal A
Pericardial A
What is the origin of splanchnic sympathetic innervation?
T5 - L2 (celiac and both mesentery ganglia)
What type of tissue is the cardiac skeleton?
Dense Irregular CT in endocardium
What stage of the respiratory tract discontinues the cartilage plates?
Bronchioles
A patient has a L. posterolateral defect, with viscera bulging into the pleural cavity. What do we think?
CDH: Congenital Diaphragmatic Hernia
Slight increase in amniotic fluid
What is the embryological origin of the Left Subclavian A?
7th Intersegental A
Where does the articular facet of a typical rib’s tubercle articulate?
Transverse Costal Facets on the thoracic vertebrae
A pt has elevated troponin, CK, CK/MB. No ST elevation. What do we think?
NSTEMI
Lead I is negative and AVF is Positive. What is this?
Rad
What do you call it when you use a balloon to flatten a plaque in the coronary artery?
Coronary Angioplasty
What is the orientation of internal intercostals?
Down and Out
What ligaments are associated with the sternocostal joint?
Anterior and posterior Radiate Sternocostal L. (2-7)
What is the origin of the greater splanchnic nerve?
T5 - T9
What is at increased risk in patients with turners syndrome?
Coarctation of the Aorta
Wen does embryonic head folding start?
Week 4 / Day 22
What classification is the interchondral joint?
Planar synovial from ribs 6-9
Fibrous between 9-10
Where does the external carotid artery come from (embryologically)?
Sprouts from Aortic Arch III
What sets of ribs are atypical?
1 - 2
10 - 12
A newborn cannot swallow, is drooling, regurgitates food. What do we think?
Tracheoesophageal Fistula
What forms upon recanalization of the larynx?
Laryngeal Ventricles, bounded by vocal and vestibular folds (or if it doesn’t, you get laryngeal atresia.)
What muscles tug on the chordae tendonae of the tricuspid valve?
Ant / Post / Septal Papillary m.
What is the ligamentum arteriosum?
Remnant of Ductus Arteriosus
What is the formula for minute work?
CO x aortic pressure
What CAMs are found in the transverse (perpendicular) region of cardiocytes?
Fascia Adherens
Desmosomes
What brain stem region coordinates peripheral signals associated with baroreceptors?
Nucleus Solitarius
How are congenital lung cysts formed?
Dilation of terminal bronchi
What causes Tangier Disease?
Mutation in ABCA1 leading to deficient Cholesterol transport by HDL
What forms when myoblasts grow into the dorsal mesentery?
the Crura of the Diaphragm
What does the Foramen Ovalis do?
In infants, it allows blood to flow from R atrium to L atrium
What are the two main Embryo components of the Right Subclavian Artery?
AA IV (Proximally) R 7th Dorsal Intersegmental A (distally)
An infant has CHAOS syndrome, dilated airways, ascites, and enlarged lungs. What is the Dx?
Laryngeal Atresia
A newborn has a tracheoesophageal fistula. How did this happen?
Foregut endoderm didn’t proliferate fast enough compared to the rest of the embryo
What embryonic structure houses the Cardinal Veins, Future Phrenic N, and myoblasts destined to become diaphragm?
Pleuropericardial Membranes
What is typical stroke volume?
70mL
What is the timeline of the Terminal Sac stage of lung maturation?
24 weeks - birth
What do the Pleuroperitoneal Membranes become?
Primordial Diaphragm
What is the typical ejection fraction?
55%
A baby has an Ostium I Defect / Low Atrial Septal Defect. What has caused this?
Failure of AV cushion tissue to grow upward
Failure of DMP to fill in foramen primum
What is Area does the RCA supply?
Inferior wall
What wave would you expect to be affected by ischemia?
T Wave (inverted)
Which folds are superior and inferior to the developing lungs?
Pleuropericardial folds are superior to lungs
Pleuroperitoneal folds are inferior to lungs
What type of joint is the 1st Sternocostal joint?
Synchondrosis
What shapes are type I and II pneumocytes?
I: Squamous
II: Cuboidal / Rounded
What do you call a right-sided left ventricle?
Ventricular Inversion
reverse cardiac looping
When does the tracheoesophageal septum form?
Week 5
What is the formula of stroke work (of L. Ventricle)?
Stroke Volume x Aortic Pressure
Between the pleuropericardial and pleuroperotineal folds, which is cranial and which is caudal?
PleuroperiCardial is Cranial
PleuroPeritoneal is Caudal
What effect does stimulation during the SNP have on an AP?
Weaker
What produces the dicrotic notch?
Closing of the Aortic Valve
What conducts impulses to the papillary muscles?
Moderator Band (trabecular carnae)
What cells contain dense bodies?
Smooth Muscle
What is at increased risk with DiGeorge patients?
Interrupted Aortic Arch. It can kill you.
When is the laryngeal lumen re-Canalized, following occlusion by epithelium?
Week 10
What separates the respiratory and digestive tracts in a neonate?
Epiglottis
What innervates the carotid sinus?
Glossopharyngeal N
Sinus N of Hering
What does A-2 Adrenergic receptor do?
Veinous relaxation
What does a Dromotropic effect impact?
Speed of conduction
Phase 0 of Depolarization Slope
What is the epiglottis derived from?
Hypopharyngeal Eminence
What is the formula for flow?
Pressure gradient divided by resistance
What receptors allow calcium entry into smooth muscle on the SR?
InsP3
Ryanodine
What type of joint is the Xiphisternal joint?
Synchondrosis
What does surfactant do in the lungs?
Reduces surface tension in alveoli
Prevents collapse during respiration
Where are the transverse thoracic m.?
Pulling the costal cartilages down toward the sternum and xiphoid
When do the secondary bronchial buds form into tertiary?
Week 5
What combines to form the first heart field?
Endothelial Precursor Cells
Intraembryonic splanchnic mesoderm
When do the first rhythmic contractions of the heart begin?
Day 22 (blood flow at day 24)
What receptor is directly associated with the juxtaglomerular apparatus?
B1
What nucleus does the baroreceptor reflex work through?
Nucleus Tractus Solitarius
What type of epithelium is atop the true vocal cords?
non-keratinized strat squamous
What does a Chronotropic Effect impact?
HR
Phase 4 of Depolarization
What kind of tissue are the cartilaginous tracheal rings?
Hyaline cartilage
What valves are closed during ejection?
Mitral and Tricuspid
Excessive amniotic fluid because it cant enter the stomach / guts for absorption, nor be transferred for disposal by placenta. What is this.
Polyhydraminos
What is the origin of the lesser splanchnic nerve?
T10 - T11
What happens when SCAP binds to INSIG?
SREBP is retained in the ER membrane
What is the fate of Aortic Arch I?
Contributes to Maxillary A
What is the embryonic origin of the central tendon of the diaphragm?
Septum Transversum
What is the key difference between gastroschisis and an umbilical hernia?
Bowel is uncovered and floating in the amniotic fluid with Gastroschisis
What layer of heart histo contains coronary arteries?
Epicardium
What myocytes receive sympathetic innervation?
Ventricular (not atrial)
When does the alveolar stage of lung development take over?
32 weeks
What are the only tissues found in bronchioles?
Epithelium, Ciliated Cells, Smooth Muscle, Elastic Fibers
What structure allows surgeons to access the area posterior to the aorta / pulmonary trunk to clamp or insert the tubes of a bypass machine into them?
Transverse Pericardial Sinus
What is respiratory epithelium
Pseudostratified ciliated columnar with goblet cells
What does Aortic Arch III become?
Common and Internal Carotid A
What is the role of ApoB - 48?
Facilitates chylomicron transport
What are basal cells
Mitotically active stem cells
What is the purpose of Ductus Venosum in the fetus?
Circulation bypasses the liver
What stage of lung development introduces the alveolocapillary membrane?
Alveolar Stage (32 weeks - 8 years)
What do you call a partial reversal of the heart?
Situs ambiguous
What joint forms the boundary of the inferior thoracic aperture?
Xiphisternal
What chylomicron and VLDL component activates capillary LPL?
ApoC - II
What does the A-Wave represent?
Pressure from Atrial Contraction
What is the formula for Velocity of blood flow?
Flow (q) divided by area
What is the Splanchnic (visceral) Layer of the lateral mesoderm continuous with?
Extraembryonic mesoderm cowering Umbilical Vesicle
What are the components of the blood air barrier?
Type I pneumocytes, their basal lamina
capillary endothelial cells
What protein is increased by statins?
SREBP
What wave is represented by atrial depolarization?
P Wave
What is the formula of the Fick Principle of Cardiac Output?
O2 Consumption / ([O2]pv - [O2]pa)
What causes Statin-Mediated Myopathy?
Depletion of CoQ10
What happens if the Ductus Arteriosus bursts its aneurism?
Hits L Recurrent Laryngeal N and Vagus N
What embryonic structure(s) form the embryonic gut?
Splanchnopleure (splanchnic mesoderm and endoderm)
What do the primary bronchial buds grow laterally into?
Pericardioperitoneal canals
What kind of mesoderm is the visceral wall derived from?
Splanchnic Mesoderm
What is the embryonic origin of the ligament teres hepatis?
Left Umbilical Vein
What effect is produced by b-AR activation?
Positive inotropic effect (sympathetic)
If an action potential is observed in smooth muscle, what type must it be?
Unitary
What are the three blood supplies to the breast?
Posterior Intercostal A
Internal Thoracic A
Lateral Thoracic A
There is no P-wave on the ECG. What does this mean?
Atrial Fibrillation
What are the components of becks triad?
Distant Heart Sounds
Jugular Distension
Hypotension
What is the origin of parasympathetic innervation to the lower airways?
Vagus N
What component is responsible for chylomicrons and VLDL uptake into the liver?
ApoE
What can a bicuspid aortic valve lead to over time?
Left ventricular hypertrophy
Aortic aneurism
What is normal pulmonary pressure?
25 / 15
What is the origin of cardiac sympathetics and parasympathetics respectively?
T1 - T5
Vagus N
What might a supernumerary rib affect?
Brachial Plexus and Subclavian A (thoracic outlet syndrome)
How would you treat a Patent Ductus Arteriosus?
Give Prostaglandin Inhibitors (indomethacin)
Where are club cells found?
Terminal Bronchioles
What type of joint are Sternocostals 2-7?
Planar Synovial
Why does an aberrant origin of R Subclavian A cause Dysphagia and Dyspnea?
It now has to cross over from the left to reach the arm, strangling the esophagus and trachea on its way
Permanent enlargement of the airspaces accompanied by destruction of alveolar walls. What is this?
Emphysema
What comes together to form the Ductus Venosus?
Left Umbilical Vein
Right Hepatocardiac Channel
What suspends the caudal foregut, midgut, and hind gut?
the Dorsal Mesentery
What embryonic structure(s) form the body wall?
Somatopleure (somatic mesoderm and ectoderm)
What does pulmonary hypoplasia lead to?
Restriction of fetal thorax from uterine pressure
Which rib has a scalene tubercle?
1
When will you see hematopoiesis in the bone marrow?
10.5 weeks
What ligaments are associated with the costovertebral joint?
Radiate L (head of the rib to the vertebral body) Intraarticular L (Head of rib to Intervertebral disc) Articular Capsule
What is normal aortic pressure?
120 / 70
What is formed when the connection between the umbilical vesicle and midgut is reduced during lateral folding?
Omphaloenteric Duct
What are the sympathetics to the skin?
A1
Where does the L Posterior Intercostal V dump?
Upper Drains into the Accessory Hemiazygous V
Lower into the Hemiazygos V
What is the function of external intercostals?
Inhaling
What is the formula for Mean Arterial Pressure?
CO x TPR
What are the stimulatory neurotransmitters of smooth muscle?
Angiotensin II
Vasopressin
Endothelin
What receptor types are associated with the pulmonary vasculature?
A-1 Adrenergic (constriction)
B-1 and B-2 (dilation)
What are the only tissues found in bronchioles?
Epithelium, Ciliated Cells, Smooth Muscle, Elastic Fibers
What structure do the vena cava and coronary sinus empty into?
Sinus Venarum (in the R. Atrium)
What rib has an insertion point for the Anterior Scalene M.?
1st Rib
What is the order of branching in the bronchi?
Main Lobar Segmental Conducting (bronchioles) Terminal Respiratory Alveolar
When do you see Definitive Hematopoietic cells seeding the liver?
Day 30
This is where they’re first programmed, btw
When does the Right Recurrent Laryngeal Never get wrapped around the R subclavian A?
When AAVI loses its connection
What is our formula for Resistance to blood flow?
(8 x length x viscosity) / (pi x radius^4)
ST segment is elevated in two+ leads. What do you think?
STEMI
What are the sympathetic receptors to skeletal muscle blood sources?
A-1 Adrenergic (constriction)
B-2 Adrenergic (dilation)
What does ApoB-100 do?
Uptake of LDL / HDL / VLDL into cells
When do new alveoli stop being added?
8 years
What happens when you get a blockage of the coronary artery?
Myocardial infarction
What tissue type are heart valves?
Fibroelastic CT core (lamina fibrosa) with endothelium
What principle prevents the AV node or bundle branches from generating their own APs?
Overdrive Suppression
What disease is the LDL receptor completely or partially defective?
Type IIa and IIb Hyperlipoproteinemia
aka Familial Hypercholesterolemia
What kind of tissue is the Epicardium?
Dense Fibrocollagenous CT with Elastic Fibers and Mesothelium
What Aortic Arch does the Ligamentum Arteriosum come from?
VI
What comes from the Yolk Sac Mesoderm?
Early RBCs and Macrophages
Which layer of the serous pericardium is innermost?
Visceral (epicardium)
Parietal layer is inner part of fibrous pericardium
What tissue type surrounds the parietal and visceral pleura?
Mesothelium
What is the formula for cardiac output?
Stroke Volume x HR
What overgrowth pushes the septum transversum, heart, and pericardial cavity ventrally and caudally?
Neural Folds projecting dorsally to overgrow the oropharyngeal membrane
What effect does the Sympathetic and Parasympathetic NS have on baroreceptor firing rate?
Sympathetic Decreases it
Parasympathetic Increases it
What are the sympathetics and parasympathetics for for the upper respiratory system?
Facial N (sympathetic) Trigeminal N (parasympathetic)
Where is the site of parasympathetic negative inotropic effect on cardiac output?
Atria
What is the origin of upper airway sympathetics?
Cervical Ganglia via the Facial Nerve
In what region of cardiocytes are gap (nexus) junctions found?
Longitudinal (parallel)
What cells do you find ANF in?
Myoendocrine Cardiocytes
What rib and thoracic vertebra level is the diaphragm?
12th Vertebra
11th and 12th Ribs
What separates the pleural cavities from the peritoneal cavity?
PleuroPeritoneal Folds
What is the Somatic (parietal) Layer of the lateral mesoderm continuous with?
Extraembryonic mesoderm covering Amnion
Where can you find HMG CoA Reductase?
ER membrane
Catalytic Domain in Cytosol
When do bronchopulmonary segments form?
Week 7
What is the biochemical “site” of atherosclerosis?
ApoB-100 failing to bind LDL receptors in the liver and muscle
What does the laryngotracheal diverticulum become?
Trachea and Primary Bronchial Buds (2)
Which lung has the cardiac notch?
Left
What part of the heart does all the work to make up for a hypo plastic left ventricle?
Right Ventricle
What does the PR interval mean?
Time it takes for the depolarization to pass from the ventricles to the atria via the AV node
What structure electrically insulates the atria from ventricles?
Fibrous Skeleton of heart
What is the role of sympathetic and parasympathetic fibers terminating in the heart nodes?
MODIFY rate of intrinsic contraction
What brain stem region does Sympathetic stuff with baroreceptors?
Rostral Ventrolateral Medulla
What forms the primary bronchial buds?
Respiratory Bud
Where does the Conus Arteriosus lead?
From the right ventricle to the pulmonary trunk
Both Lead I and AVF are Negative. What is this?
EXTREME RAD
Where does the primitive streak transition to after tail folding?
From cranial to cloacal membrane to caudal to cloacal membrane
How much IPP goes into a steroid backbone?
6
In hyperchylomicronemia, which deficiency manifests when?
LPL deficiency in infancty
ApoC-II after adolescence
What leads are associated with the posterior wall?
V1 - V3
What can severe and chronic oligohydramnios cause?
Retarded lung development
Where is the Laryngotreacheal groove?
Inferior to the 4th Pharyngeal Arches
What heart defect pulls blood from both atria into the aorta and pulmonary artery simultaneously?
Persistant Truncus Arteriosus
What is associated with oligohydramnios?
Renal agenesis or failure
What is the fate of Aortic Arch II?
Contributes to Stapedial A
What valves are open during ejection?
Aortic and Pulmonic
What two neurotransmitters act to relax smooth muscle?
NO
Adenosine
What are the sympathetic lower airway receptors?
B-2 (bronchial dilation)
When do early hematopoietic cells populate the developing liver?
Day 23
Where do you find discontinuous capillaries?
Marrow
Liver
Spleen
When the great vessels are transposed, how is gas exchanged?
Through ductus arteriosis
What cells make the “pacemaker” function of the heart?
Purkinje
What makes the second heart sound?
Aortic and Pulmonary valve Closure (diastole)
Blood in the aorta and pulmonary A. hit the closed valves
What are cardiac cells like in the Supranormal Period?
More excitable
What does parasympathetic innervation of the lungs produce?
NO for relaxing already-constricted blood vessels
What structure becomes the anus?
Cloacal Membrane
What is the hepatocardiac channel formed from, and what does it contribute to?
From Right Vitelline Vein
Contributes to Inferior Vena Cava
When the pericardioperitoneal canals expand and split the mesenchyme into inner and outer layers, what do each of them become?
Inner becomes Fibrous Pericardium (outer layer of sac)
Outer becomes Thoracic Wall
What does the Dorsal Mesentery become?
Median portion of the diaphragm
When are intra and extra embryonic coeloms in communication?
After head folding
What wave would you expect to be affected by an infarction?
Q Wave
Where are you most likely to find myoendocrine cardiocytes?
Right Atrium
What is the formula for ejection fraction?
Stroke Volume divided by End Diastolic Volume
What forms the cloaca?
Terminal hind-gut dilation
handout formed from caudal eminence projecting over cloacal membrane
What does the right common cardinal vein become?
Superior Vena Cava
What kind of Coarcation of the Aorta is worse, and why?
Preductal is way worse. It cannot establish collateral circulation like post-ductal can
What is ApoE not on?
LDLs
What layers of the heart is a cardiac tamponade?
Between the Serous Layers
What type of capillaries do endocrine glands have?
Fenestrated
What type of capillaries do exocrine glands have?
Continuous
What dx do you think of with a deviated mediastinum?
Tension pneumothorax
What dx do you think with a pulmonary meniscus sign?
Pleural Effusion
What do thrombocytes come from?
Megakaryocytes
What controls clotting?
TPO (thrombopoietin)
What does Aspirin act on?
Inhibits cyclooxygenase
What does cyclooxygenase do?
Generates Thromboxane A2 from Arachidonic Acid
How does Clopidogrel (Plavix) work?
Inhibits P2Y12 Receptors so theres no more platelet activation / aggregation
What is responsible for fibrin clot lysis?
Plasmin
What does Protein C do?
Shuts off t-PA inhibitor, so Plasmin can form
What effect would taking Fibrin have?
Inhibition of thrombin (anti-Coagulant)
What anti-coagulant is made by endothelial cells during vasodilation?
Prostacyclin (PGI2)
What mast cell product increases anti-thrombin efficacy?
Heparin
