Exam 3 Flashcards
1
Q
What is the lining surrounding the heart called?
A
Pericardium
2
Q
What is the general location of the heart?
A
It is located in the thorax between the lungs.
3
Q
What direction do arteries travel?
A
Away/Out of the heart
4
Q
Where are the arteries traveling out of the heart to?
A
Ascending aorta and pulmonary trunk
5
Q
What direction do veins travel?
A
Towards/into the heart
6
Q
What are the main veins traveling into the heart?
A
Superior and inferior vena cava
7
Q
What is the main purpose of the circulatory system?
A
To pump blood, which contains O2, CO2, nutrients, H20, and waste.
8
Q
What are 3 things that the circulatory system has a role in?
A
1) Respiration - Oxygen and carbon dioxide exhange
2) Waste elimination of H20, nitrogenous waste, and salts
3) Lymphatic system with interstitial fluid (water balance)
9
Q
What makes up the pulmonary circuit?
A
Right heart chambers and deoxygenated blood
10
Q
What makes up the systemic circuit?
A
Left heart chambers and oxygenated blood
11
Q
How many chambers does the heart have? Name them.
A
4 chambers
Right and left atrium. Right and left ventricle.
12
Q
What protects the heart in the thorax?
A
The thoracic cage
13
Q
What is the sternal angle?
A
This is the place in the sternum where the manubrium meets the body.
14
Q
What rib attaches at the sternal angle?
A
2nd rib
15
Q
What do the muscles within the thoracic cage allow for?
A
Expansion of the lungs for breathing
16
Q
Label the sternal notch, sternal angle, and 2nd rib.
A
17
Q
What is the purpose of the pulmonary circuit?
A
The right side receives deoxygenated blood and pumps it to the lungs to become oxygenated.
18
Q
What is the purpose of the systematic circuit?
A
The left side receives oxygenated blood and pumps it throughout the body.
19
Q
What do the pulmonary arteries do?
A
Carry deoxygenated blood to the lungs.
20
Q
What are two examples of important arteries in the heart?
A
The aortic artery and the pulmonary arteries.
21
Q
What branches to pulmonary arteries?
A
Pulmonary trunk
22
Q
What do the pulmonary veins do?
A
Return oxygenated blood to the heart.
23
Q
What are examples of important veins in the heart?
A
Superior and inferior vena cava. Pulmonary veins.
24
Q
T/F: The heart is a midline structure.
A
False! The heart is situated obliquely, about 2/3 to the left, and 1/3 to the right.
25
Where is the base of the heart located?
At the sternal angle
26
Where is the apex of the heart located?
In the 5th intercostal space on the left side
27
What is the transverse thoracic plane?
This is a surface landmark for the heart and is a transverse plane at the sternal angle.
28
Where do we travel along the clavicle then down to reach the heart?
Midclavicularly
29
Where is the apex of the heart directed?
Anteriorly and left
30
What chamber is at the anterior border of the heart?
Right ventricle
31
What chamber is at the left or lateral border of the heart?
Left ventricle
32
What chamber(s) are located at the superior border of the heart?
Right and left atria
33
What does each atrium have that translates to "ear" in latin?
Each atrium has an Auricle.
34
What exits the heart from the base?
Pulmonary trunk and aorta
35
What is the Coronary Sulcus?
A depression between the Atria and Ventricles.
36
What is the Interventricular Sulcus?
A depression between the right and left Ventricles.
37
What is situs inversus? Why is this bad?
The vital organs in the chest and abdomen are on the opposite side of the body from the normal location.
Can be complications with breathing and more prone to infections due to non-functioning cilia.
38
What is this picture showing?
The individual has a heart that is located on the right side instead of the usual, left side.
39
What is the pericardium?
A serous membrane surrounding the heart.
40
What is a serous membrane?
An epithelium + connective tissue that produces serous fluid.
41
What is the inner layer of the pericardium?
The visceral pericardium or epicardium
42
What is the outer layer of the pericardium?
The parietal pericardium
43
What is the Fibrous pericardium?
The layer outside of the parietal pericardium.
44
T/F: There is a potential space between the parietal and fibrous pericardium.
False. There is no potential space between the parietal and fibrous pericardium. They are kind of sealed together.
45
What is the Pericardial Space/Cavity?
A serous fluid-filled space between Visceral and Parietal Pericardium.
46
What is Cardiac Tamponade?
This is when fluid accumulates in the pericardial space between the visceral and parietal pericardium. This prevents the heart chambers from expanding and filling and causes compression of the heart (TRAGIC).
47
What does Cardiac Tamponade literally mean?
Heart Plug
48
What layer of the pericardium is directly touching the heart?
Visceral pericardium or epicardium
49
What is the purpose of serous fluid in the pericardial space?
It acts as a lubricant so the layers of the pericardium do not stick or get damaged from friction.
50
How does the pericardium develop around the heart?
It develops as one continuous layer. Think of the fist in the balloon. The developing heart grows in the cavity of the pericardium (which remains the same size).
51
What is the Fibrous pericardium?
A fascia that is adhered to the parietal pericardium.
52
What secretes serous fluid?
Parietal pericardium
53
Clinically, what is the fibrous pericardium?
The parietal and fibrous pericardium.
54
How many layers does each chamber wall of the heart consist of? Name them.
The walls of each chamber consist of 3 layers:
-Endocardium, myocardium, and epicardium.
55
What is the endocardium?
Endothelial lining consisting of epithelium + subendothelial connective tissue
56
What is the myocardium?
A THICK layer of cardiac muscle
57
What is the histological appearance of cardiac muscle?
Striated, branching, with single, central nuclei
58
How do cardiac muscle cells communicate?
Through a cell junction called a Gap junction or Intercalated discs.
59
What is the epicardium?
The visceral pericardium.
60
Surrounding the heart is a layer consisting of two parts. Name those parts.
Parietal pericardium and Fibrous pericardium
61
Where is the pericardial space located?
Between the epicardium/visceral pericardium and parietal pericardium.
62
How does the heart develop?
Similar to the neural tube, it starts as a linear tube then bends and folds giving us atria and ventricles.
63
What serves as the filling chambers?
Atria
64
What serves as the pumping chambers?
Ventricles
65
Describe what the right atrium is receiving and from what.
Receives deoxygenated blood from the superior and inferior Vena cava
66
Describe what the left atrium is receiving and from what.
Receives oxygenated blood from the Pulmonary veins
67
What separates the right and left atrium?
Interatrial Septum
68
Describe the right ventricle.
Pumps blood through the pulmonary arteries to the lungs
69
Describe the left ventricle.
Pumps blood through the Aorta to the body.
70
Which ventricle has a thicker myocardium? Why?
The left ventricle is much thicker than the right because it is pumping blood to the whole body.
71
What separates the right and left ventricles?
The interventricular septum
72
What is the posterior half of the right atrium called? What is it called during embryonic development?
Sinus venarum
During embryonic development, sinus venosus
73
What is the posterior half of the right atrium composed of?
A smooth texture composed of endocardium and myocardium.
74
What do the superior and inferior vena cava lead into?
Right atrium
75
Where are the SinoAtrial (SA) node and AtrioVentricular (Av) node located?
Right atrium
76
Where are the coronary sinus, opening to the coronary sinus, and fossa ovalis found?
Right atrium
77
What type of texture covers the anterior half of the right atrium?
A texture called Pectinate muscle
78
What separates the smooth wall from the pectinate muscle?
Crista Terminalis
79
What is another name for the Right Auricle? What type of texture does it have?
The right auricle is also called the atrial appendage.
It has Pectinate muscle.
80
Where does the right ventricle pump blood to?
To the pulmonary trunk and then into the lungs.
81
What are Trabeculae Carnae?
These are the texture of the ventricle walls which look like beams of meat.
82
What is the purpose of Trabeculae Carnae?
It provides support and structure of the ventricular walls.
83
What is the Conus Arteriosis/Infundibulum?
A cone-shaped ventricle which conducts blood out of the right ventricle into the pulmonary trunk.
84
Name the papillary muscles of the right ventricle. What are these composed of?
Anterior, posterior, and septal (papilla = "nipple").
These are composed of myocardium.
85
What occurs when papillary muscles of the right ventricle contract?
They tighten the cusps of the valves.
86
What are Chordae Tendinae ("tendinous cords")?
They connect the papillary muscles to the cusps of the valves.
87
Describe the location of the moderator band.
Extends from the interventricular septum to the anterior papillary muscle.
88
What does the moderator band contain and do?
Contains nerve fibers ("Purkinje" fibers) which carry electrical impulses for contraction of the heart from the interventricular septum to the anterior papillary muscle.
89
What is the definition of a trunk in the heart?
An artery that branches into two other arteries.
90
What does the trachea do?
Carries oxygen towards the lungs and carbon dioxide away.
91
What is systole?
This is when the ventricles are contracting and valves close.
92
In terms of the apex and artery, in what direction does contraction occur?
From the apex up into the artery.
93
What describes contraction action?
Muscle fiber arrangement describes contraction action.
94
What serves as an overflow space for extra blood in the right atrium?
The right auricle (pectinate)
95
Which produces a stronger contraction: smooth or pectinate?
Both make up the atrial wall but Pectinate is stronger
96
What does the opening of the coronary sinus allow for?
Allows for deoxygenated blood to be returned to the right atrium.
97
Describe the left atrium.
A smooth-walled chamber that receives the four Pulmonary veins traveling from the lungs.
98
T/F: From inside the left atrium, it is NOT possible to see the left side of the Fossa Ovale.
False! From the inside of the left atrium, it is possible to see the left side of the Fossa Ovale.
99
What is another name for the Left Auricle? What is it lined by?
Left atrial appendage, which is lined by Pectinate muscle.
100
What chamber has the thickest myocardium? What does this mean then?
Left ventricle, which means it can pump the strongest then.
101
What papillary muscles are located in the left atrium?
Anterior and posterior
102
T/F: Trabeculae carnae and chordae tendinae are structures within the left ventricle.
True!
103
What valve separates the right atrium and right ventricle?
Tricuspid Valve
104
What valve separates the left atrium and left ventricle?
Bicuspid or Mitral Valve
105
What do atrioventricular valves separate?
Atrium from ventricles
106
What do semilunar valves separate?
Ventricles from aorta or pulmonary trunk.
107
What separates the left ventricle from the aorta?
Aortic Semilunar valve
108
What separates the right ventricle from the pulmonary trunk?
Pulmonary Semilunar valve
109
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110
Label the visceral and parietal pericardium
111
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113
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117
Does the fetus require oxygenated blood in its lungs? Why?
No! This is because the fetus receives oxygenated blood from the mother, so it does not require oxygenated blood in its lungs.
118
What does the umbilical vein do?
Carries oxygenated blood from placenta to heart.
119
What does the umbilical artery do?
Carries deoxygenated blood from heart to placenta.
120
How do we avoid oxygenated blood from entering the placenta and going to the lungs?
The foramen ovale and ductus arteriosus help to divert oxygenated blood from going to the lungs.
121
What is Foramen ovale?
A hole to enable blood to travel directly from the right to left atrium.
122
After birth, what happens to foramen ovale?
This hole closes shortly after birth to become fossa ovalis.
123
What is Ductus arteriosus?
A duct which carries blood from the left pulmonary artery to the aorta.
124
What does Ductus arteriosus do?
This duct functions to divert oxygenated blood out of the left pulmonary artery to the aorta and tissues of the body.
125
What is Atrial Septal Defect (ASD), also known as Patent Foramen Ovale?
In rare cases, a malformed Foramen Ovale remains patent/open after birth.
126
Are individuals with Atrial Septal Defect (ASD) initially symptomatic?
Initially, individuals are non-symptomatic for many decades.
127
What causes individuals with Atrial Septal Defect (ASD) to become symptomatic?
After decades of growth, the right atrium is able to generate more pressure than the left atrium. This then becomes symptomatic.
128
Describe how Atrial Septal Defect (ASD) leads to Hypoxia.
Deoxygenated blood will flow from the right atrium into the left atrium. This deoxygenated blood flows into the aorta and to all tissues of the body, leading to decreased blood oxygen concentration. Individuals will be constantly tired.
129
During embryonic development, what separates the right and left ventricles?
A septum/wall called the Interventricular Septum. This septum grows from the myocardium to form a wall between the ventricles.
130
What is Ventricular Septal Defect (VSD)? What is this condition sometimes called?
In rare cases, the interventricular septum is not a complete wall separating the ventricles.
This defect is sometimes called an infant born with a hole in the heart.
131
What can aid with Ventricular Septal Defect (VSD)?
There are Amplatzer closure devices that can help to close and separate the ventricles.
132
Generally speaking, what is a stroke?
This is when parts of the brain are not getting enough Oxygen.
133
What is a thrombus?
A blood clot
134
What is the blood supply to the myocardium?
Coronary Arteries are the blood supply to the myocardium.
135
Where are the openings in the coronary arteries?
In the Aorta, just distal to the Aortic Semilunar valve.
136
When and where does blood enter the Coronary Arteries from?
Blood enters the Coronary Arteries from the Aorta when the aortic semilunar valves are closed and the left ventricle is relaxing (diastole) and filling.
137
What does the Left coronary artery branch into?
Anterior Interventricular Artery, Circumflex artery, and the Left marginal arteries (branches of the Circumflex artery).
138
What is another name for the Anterior Interventricular Artery?
Left Anterior Descending artery (LAD).
139
What does the Right coronary artery branch into?
Right Marginal Artery and Posterior Interventricular Artery.
140
What is Arteriosclerosis?
This is the hardening of the arteries in which plaques form in the arterial wall.
141
What is Occlusion?
Blockage of Coronary Arteries
142
What leads to the formation of a thrombus?
Rupture or damage of the endothelium.
143
What can a thrombus cause?
Coronary artery occlusion, blockage, and heart attack.
144
What is Myocardial Infarction?
This is heart muscle cell-death, also known as a heart attack.
145
What do cardiac veins do?
These are the vessels that return deoxygenated blood from the myocardium to the Right Atrium.
146
What are the 3 systems that get blood from the myocardium to the right atrium?
1) Drain from the right ventricle directly into the right atrium (Anterior Cardiac Veins)
2) Veins that travel with the Coronary Arteries (Cardiac veins and the Coronary sinus)
3) The Microscopic or Smallest cardiac veins
147
What do Anterior Cardiac veins do?
Drain from right ventricle into the right atrium.
148
What do the cardiac veins do? What are the names of them?
Cardiac veins course with the Coronary arteries and then empty into the coronary sinus.
These are called the Great, Middle, and Small cardiac veins.
149
What does the Great Cardiac Vein become?
It becomes the Coronary sinus, which empties into the Right Atrium.
150
Where do the Middle and Small Cardiac Veins empty into?
The Coronary Sinus.
151
What cardiac veins do not empty into the coronary sinus?
Only the anterior cardiac and smallest or microscopic cardiac veins do not empty into the coronary sinus.
152
What do the Microscopic or Smallest cardiac veins do?
They carry deoxygenated deoxygenated blood from the myocardium directly into the Lumen of the Chambers of the Heart.
153
What are the Lumen Chambers of the Heart?
The right atrium and right ventricle.
154
What are Running Mates?
Arteries and veins that run together.
155
Who is the Great Cardiac Vein's running mate?
It runs alongside the Anterior Interventricular artery
156
Who is the Middle Cardiac Vein's running mate?
It runs alongside the Posterior Interventricular artery.
157
What is the Cardiac Skeleton?
A dense connective tissue that encircles the 4 valves (atrioventricular + semilunar).
158
List 3 functions of the Cardiac Skeleton.
1) Anchor the myocardium together
2) Support and reinforce the valves of the heart
3) Block impulses from traveling from the atria to ventricles
159
What are the importance of Intercalated discs (a type of gap junction)?
They spread the impulse for contraction from one myocardial cell to another.
160
Where is the Sinoatrial (SA) node located?
In the roof of the right atrium
161
Where is the Atrioventricular node (AV) located?
Base of the right atrium
162
Describe impulse pathway starting at SA node and ending at AV node.
Impulses for contraction of the heart are spread from SA node through the atrial myocardium and into the AV node.
163
What prevents the spread of impulse from traveling between the AV node to the Ventricles?
Cardiac Skeleton
164
Describe impulse pathway from AV node to apex of the ventricles.
Impulses for contraction are spread from AV node to bundle branches to the apex of the ventricles.
165
Where are bundle branches located?
In the Interventricular Septum
166
What do Purkinje fibers do?
They carry impulses from bundle branches in the septum to the papillary muscles and then to the ventricular myocardium.
167
What is the right marginal?
Contains arteries to the right side of the heart.
168
What is the left marginal?
Contains arteries to the left side of the heart.
169
What do we mean when we say circumflex?
Flexes around the heart.
170
Coronary arteries are ____-epicardial. What does this mean?
Coronary arteries are sub-epicardial, meaning they are covered by epicardium.
171
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173
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176
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177
During the cardiac cycle, the heart functions as a ______.
pump
178
What is the purpose of the two atria contracting together?
This pushes blood into the ventricles.
179
After the atria contract, what is the purpose of the two ventricles contracting?
This pushes blood into the pulmonary veins and pulmonary arteries.
180
Define systole.
Contraction of myocardium (chamber pumps).
181
Define diastole.
Relaxation of myocardium (chamber fills).
182
"Leaky bundle of nerves that depolarizes on its own rate."
What is this?
SA node
183
What is the "LUB" sound?
Systole causes the AV valves to slam shut to prevent backflow of blood from the ventricles back into the atria.
184
What is the "DUB" sound?
Diastole causes the Semilunar valves to shut to prevent the backflow from the arteries back into the ventricles.
185
Describe what would happen if we had occlusion of the Anterior Interventricular artery.
There is now a loss of blood flow to Bundle branches (Interventricular septum), which leads to infarction. This means there is then a loss of impulses to the ventricular myocardium.
Impulse for contraction cannot travel from AV node to the Ventricular myocardium.
186
How does a Pacemaker work?
The pacemaker generates the impulse for contraction. It is delivered by an electrode to the Ventricular myocardium.
187
What node provides "pacemaker" activity?
SinoAtrial (SA) node
188
In addition to the SA node "pacemaker" activity, what other innervation is there?
The heart has neuronal innervation from the brain
189
Autonomic Nervous System Autonomic innervation of the heart passes mainly through the ___________ ____________.
cardiac plexus
190
Why is a defibrillator used? What can it not do?
Stops electrical activity, then starts electrical activity so there is normal sized rhythm. This allows the heart to go back to normal.
It cannot restart a stopped heart. We can only defibrillate a fibrillating heart.
191
Where are sympathetic nerves derived from?
Thoracic and Lumbar spinal cord segments.
192
In regards to the heart, what do the sympathetic nerves (T1-L2) do?
Increase heart-rate (rate of contractions). SA and AV node depolarize faster.
193
Where are parasympathetic nerves derived from?
Cranial and Sacral spinal cord segments.
194
In regards to the heart, what do the parasympathetic nerves do?
Decrease the heart rate (i.e. the Vagus nerve). SA and AV node depolarize slower.
195
What is the Cardiac Plexus?
All sympathetic and parasympathetic (autonomic) nerves to the Heart.
196
Describe the sequence of events for Sympathetic "fight or flight" response.
1) Receptors detect low blood pressure and/or high carbon dioxide concentrations.
2) Centers in medulla oblongata send signals via sympathetic nerves to the SA and AV nodes in the heart.
3) The SA and AV nodes create impulses that are faster and stronger to increase heart rate.
197
Describe the sequence of events for Parasympathetic "rest and digest" response.
1) Receptors detect high blood pressure and/or low carbon dioxide concentrations.
2) Centers in medulla oblongata send signals via parasympathetic nerve (Vagus) to the SA and AV nodes in the heart.
3) The SA and AV nodes create impulses that are slower and weaker to decrease heart rate.
198
What effect does vasoconstriction have on blood pressure?
Increases
199
What effect does vasodilation have on blood pressure?
Decreases
200
"Ventricular contraction (atrial relaxation), pump blood to lungs, exchange carbon dioxide for oxygen."
What is this?
Systole
201
"Ventricular relaxation (atrial contraction) and return of oxygen to the heart."
What is this?
Diastole
202
Where does the heart pump blood through?
Through vessels
203
Describe the pressure in arteries versus capillaries and veins.
Arteries: High pressure
Capillaries and Veins: Low pressure
204
Arterioles serve to ______________ pressure.
reduce
205
When is pressure high?
During systole
206
When is pressure low?
During diastole
207
How many layers make up blood vessel walls?
There are 3 layers or Tunics of tissue that make up the tubule walls.
208
Name the 3 Tunics of tissue.
Tunica intima (innermost), Tunica media (middle), and Tunica externa or adventitia (outermost).
209
What is Tunica intima?
This is the innermost layer comprised of a simple squamous (endothelium) layer continuous with the lining of the heart.
210
What does the internal elastic lamina do?
Provides ability to expand and recoil at the innermost layer.
211
What is the Tunica media?
This is the middle layer which is smooth muscle under autonomic innervation.
212
What is the Tunica externa or adventitia?
This is the outermost layer of connective tissue.
213
What does the external elastic lamina do?
Provides ability to expand and recoil at the outermost layer.
214
A capillary has the diameter of a single ______ ____________ _____.
Red Blood Cell
215
What is the structural definition of an artery?
A capillary (endothelium + sub-endothelial) with 2 or more layers. Thus, 3 tunics around a lumen make up an artery.
216
Structurally, how is a capillary different from an artery?
A capillary consists of only endothelium (simple squamous epithelia + sub-endothelial).
217
What are the 3 types of capillaries?
Continuous, fenestrated, and sinusoidal.
218
Describe Continuous Capillaries.
Permeable to gases (oxygen and carbon dioxide) and water.
219
Describe Fenestrated Capillaries.
Permeable to molecules and peptides (i.e. hormones).
220
Describe Sinusoidal Capillaries.
Permeable to proteins and cells, found in liver and spleen.
221
Name the first, second, and third segment of the aortic artery or aorta.
Ascending aorta is the first segment.
Arch is the second segment.
Descending aorta is the third segment.
222
After exiting the thorax, what does the descending aorta become?
The abdominal aorta
223
There are __ branches off of the Arch of the aorta. Name them.
3
Braciocephalic trunk, left common carotid artery, and left subclavian artery.
224
A _______ is an artery before it branches.
trunk
225
What does the brachiocephalic trunk branch into?
The right subclavian artery and the right common carotid artery, which supplies the head.
226
When we describe an artery as "common", what does this mean?
It means that the artery will bifuracte.
227
Abdominal Aorta will bifurcate to form _____ & ______ ____________ __________ ______________
left & right Common iliac arteries.
228
A Common iliac artery will bifurcate to form the __________ & ___________ _________.
internal & external iliac.
229
Once the subclavian artery passes the first rib, what does it become?
Axillary (armpit) artery
230
Once the axillary artery passes the Teres major muscle, what does it become?
Brachial artery
231
When does the subclavian artery become the axillary artery?
Once it passes the first rib
232
When does the axillary artery become the brachial artery?
Once it passes the Teres major muscle
233
The ________ brachial artery is a branch off of the brachial artery. Describe its location and role.
The DEEP brachial artery is a branch off of the brachial artery.
It runs deep or posterior to the Humerus to supply Triceps Brachii muscles.
234
What does the brachial artery split to become?
Radial and ulnar arteries
235
What is the common interosseous artery?
A branch off of the ulnar artery.
236
What forms the Palmar Arches (arch-shaped arteries)?
They are formed from the radial and ulnar arteries which anastomose to form collateral circulation of forearm and hand.
237
Arteries branching from the brachial artery are called _____________ arteries.
collateral
238
What are recurrent arteries?
Arteries branching from the radial or ulnar arteries.
239
What forms collateral circulation?
Collateral and recurrent arteries that anastomose.
240
What would happen if we had an occlusion of the brachial artery in the elbow?
Collateral circulation around the elbow can be achieved and blood will continue to reach the forearm.
241
What does the Common Carotid artery bifurcate to form?
Internal and External carotid arteries.
242
T/F: The External Carotid has a single branch to supply the external head.
False! The External Carotid has many branches to supply the external head.
243
Where does the Internal Carotid go and why?
Enters the cranium to supply the anterior and middle of cerebral hemispheres.
244
"A branch off of the subclavian artery"
What is this?
The Vertebral Artery
245
What does the Vertebral Artery do?
Supplies the posterior cerebral hemisphere.
246
Where does the Vertebral Artery travel through?
Travels through transverse foramina of cervical vertebrae.
247
What is the main arterial flow of the Circle of Willis (Cerebral Arterial Circle)?
Internal carotid artery and Vertebral artery.
248
Describe the pathway of the internal carotid artery. What does it do at the end?
Carotid canal --> foramen lacerum --> middle cranial fossa.
Arteries supply the anterior and middle cerebral hemispheres.
249
Describe the pathway of the Vertebral Artery. What does it do at the end?
Transverse foramina --> Foramen magnum --> posterior cranial fossa.
Artery supplies posterior cerebral hemisphere.
250
Describe the pathway of the Right and Left Vertebral arteries.
Basilar artery --> R & L posterior cerebral arteries
251
Describe the pathway of the Anterior Cerebral artery
Anterior Cerebral --> Anterior Communicating --> Anterior Cerebral
252
Describe the pathway of the Middle Cerebral artery.
Middle Cerebral --> Posterior Communicating --> Posterior Cerebral
253
What is the purpose of a Cerebral circle?
So that there is collateral circulation.
This means that there is alternate blood flow in the case of an occluded artery.
254
What would happen in the case of an occluded Internal Carotid Artery?
Blood flow through Posterior Cerebral and Posterior Communicating Arteries
and/or
Anterior Cerebral and Anterior Communicating Arteries.
255
What would happen in the event of an occluded Basilar Artery?
Blood flow through Middle Cerebral and Posterior Communicating Arteries.
256
Complete the sequence:
Arch of Aorta --> ____________ --> Right Common Carotid Artery
Arch of Aorta --> brachioencephalic trunk --> Right Common Carotid Artery
257
Complete the sequence:
Vertebral artery --> ___________________ --> Posterior cerebral artery
Basilar artery
258
What does the Abdominal Aorta bifurcate into?
Forms the right and left Common Iliac arteries
259
What do the Common Iliac arteries bifurcate into?
Bifurcate in the pelvis to form the internal and external iliac arteries.
260
What does the External iliac artery become and at where?
It passes under the Inguinal Ligament to become the Femoral artery.
261
What does the femoral artery give off a branch to? Where does this travel and why?
It branches off to form the Deep femoral artery.
This travels deep or posterior to the femur to supply the hamstring muscles.
262
What does the Femoral artery become?
Popliteal artery (behind the knee).
263
Where is the Popliteal artery location?
It passes from anterior to posterior side of the thigh through Adductor Hiatus (hole in the adductor muscle).
264
In the case of an occlusion of the Popliteal artery, can blood still reach the leg?
Yes, collateral circulation around the knee can be achieved and blood will continue to reach the leg.
265
What do the Genicular (knee) arteries do?
They provide collateral circulation between the Femoral artery and Anterior and Posterior Tibial arteries.
266
What does the Popliteal artery bifurcate to form?
Anterior and Posterior Tibial arteries.
267
What does the Posterior Tibial artery supply?
Supplies the posterior compartment of the leg (flexor muscles of the foot).
268
What does the Posterior Tibial artery branch off into?
Fibular artery and Plantar arteries
269
What does the Fibular artery supply?
Supplies the lateral compartment of the leg (Fibularis longus and brevis muscles).
270
What do the Plantar arteries supply?
Supplies the plantar muscles of the foot.
271
What does the Anterior Tibial artery supply?
Supples the anterior compartment of the leg (extensor muscles of the foot).
272
What does the Anterior Tibial become? Where does it become this?
Becomes the Dorsalis Pedis artery to supply the dorsum of the foot.
It becomes this at an imaginary line passing from medial to lateral malleolus.
273
What does the Dorsalis Pedis artery terminate as?
The Arcuate artery
274
T/F: Dorsal pedis is super deep in the foot.
False! It is superficial and we can get a pedal pulse here.
275
What would happen if we had an occlusion of the Anterior or Posterior tibial artery? Can blood still reach the foot?
Collateral circulation around the ankle and food can be achieved. The Arcuate artery of the Anterior tibial artery cross-connecting with the Plantar arteries of the Posterior Tibial artery can provide collateral supply to the foot.
276
How does the external iliac artery become the femoral artery?
Passes under the inguinal ligament.
277
If I took a pedal pulse, what artery do I need to find?
Dorsal pedis artery
278
What is the aorta in the thorax called?
Descending/Thoracic aorta
279
What does the thoracic aorta give off?
Posterior intercostal arteries
280
T/F: Internal thoracic arteries are present on each side of the sternum.
True!
281
What do internal thoracic arteries branch off of?
Subclavian arteries
282
What do internal thoracic arteries supply?
Supplies the respiratory diaphragm.
283
What do internal thoracic arteries give off?
Anterior intercostal arteries
284
What do Anterior and Posterior intercostal arteries supply?
Intercostal muscles
285
What would happen if we had an occlusion of the Anterior or Posterior Intercostal artery?
Collateral circulation to intercostal muscles can be achieved because the Anterior and Posterior intercostal arteries anastomose (cross-connect).
286
What is the aorta in the abdomen called?
Abdominal Aorta
287
What does the Abdominal Aorta bifurcate to form?
Left and Right Common iliac arteries
288
There are __ major branches off of the ___________ aorta to organs of digestion.
Are these arteries paired?
3, abdominal
These are arteries are unpaired!
289
Name the 3 major branches off of the abdominal aorta to organs of digestion.
Celiac trunk - to liver, stomach and spleen
Superior mesenteric artery - to small and first part of large intestine
Inferior mesenteric artery - to second part of colon and rectum
290
What acts as the arterial supply to the kidneys?
RENAL ARTERIES WOOOOOOHOOOOOOO
291
What supplies the gonads (ovaries and testicles)?
Gonadal arteries
292
T/F: The renal and gonadal arteries branch off of the aorta in pairs.
Very true!
293
What do the Common iliac arteries bifurcate to form?
External and internal iliac arteries
294
Where does the external iliac artery pass under and what does it then become?
Passes under the inguinal ligament and becomes the femoral artery
295
Name the organs in the pelvis that the internal iliac artery supplies.
Bladder, uterus, vagina, rectum, and gluteal muscles
296
What does the internal iliac artery give off branches to produce?
Superior and inferior gluteal arteries.
297
Where do the names for Superior and Inferior gluteal arteries come from?
Their position relative to the Piriformis muscle.
298
What do the Superior and Inferior Gluteal arteries run with?
Run with the Superior and Inferior Gluteal nerves.
299
What does the Superior Gluteal artery supply?
Supplies the Gluteus Medius, Minimus, and Tensor Fascia Lata muscles
300
What does the Inferior Gluteal artery supply?
Supplies the Gluteus Maximus muscle
301
T/F: The Superior and Inferior Gluteal arteries and nerves follow the same patterns.
True!
302
Muscles superior to the Piriformis muscle are supplied by __________ ___________ ____________ and muscles inferior are supplied by _____________ _______________ ____________.
Superior Gluteal artery, Inferior Gluteal artery.
303
Brachiocephalic --> _________________ --> axillary artery
subclavian
304
Vertebral artery --> _________________ --> posterior cerebral artery
Basilar
305
Left subclavian artery --> _______________ --> brachial artery
Left axillary
306
Internal carotid artery --> _________________ --> anterior communicating artery
Anterior cerebal
307
Abdominal aorta --> _________________ --> external iliac artery
Common iliac
308
Femoral artery --> _________________ --> anterior tibial artery
Popliteal
309
External iliac artery --> _________________ --> popliteal artery
Femoral
310
Popliteal artery --> _________________ --> fibular artery
Posterior tibial
311
Brachiocephalic --> _________________ --> internal carotid artery
Right common carotid
312
What is the primary arterial supply to the external head?
External carotid artery
313
What is the primary arterial supply to the anterior and middle cerebral hemispheres?
Internal carotid artery
314
What is the primary arterial supply to the posterior cerebral hemisphere?
Vertebral artery
315
What is the primary arterial supply to the Triceps Brachii muscle?
Deep brachial artery
316
What is the primary arterial supply to the muscles of the posterior compartment of the thigh?
Deep femoral artery
317
What is the primary arterial supply to the fibularis longus and brevis?
Fibular artery
318
What is the primary arterial supply to the plantar foot?
Plantar arteries
319
What is the primary arterial supply to the dorsum of the foot?
Dorsalis Pedis and Arcuate arteries
320
What is the primary arterial supply to the anterior compartment of the leg?
Anterior Tibial artery
321
What is the primary arterial supply to the Intercostal muscles?
Anterior and Posterior intercostal arteries
322
What is the primary arterial supply to the respiratory diaphragm?
Internal thoracic artery
323
What is the primary arterial supply to the bladder, uterus, vagina, and rectum?
Internal iliac artery
324
What is the primary arterial supply to the Gluteus Medius, Minimus, and Tensor Fascia Lata?
Superior Gluteal artery
325
What is the primary arterial supply to the Gluteus Maximus?
Inferior Gluteal artery
326
Generally speaking, where does a vein begin and as what?
A vein begins distal to a capillary as a venule.
327
Generally speaking, what do veins do?
Return blood from tissues and organs back to the heart.
328
T/F: The venous return is a High Pressure system.
False! It is a low pressure system.
329
Veins carry blood from ____________ towards the __________.
capillaries, heart
330
How many layers are veins composed of? Name them.
3:
Tunica Intima
Tunica Media
Tunica Externa
331
Which do veins have: internal or external elastic lamina?
NEITHER
332
T/F: Veins have a thick tunica media and a thin tunica externa.
False! Veins have a very thin tunica media and a thick tunica externa.
333
What is the purpose of valves in veins?
They prevent the backflow of blood due to low pressure in the vessel.
334
When the veins are moving blood towards the heart, what force are they working against?
GRAVITY!
335
_____________ muscles pump blood through __________.
Skeletal, veins
336
What do deep veins travel with? Where do they get their name?
Travel with arteries and have the same name.
337
Where do superficial veins travel? What accompanies them?
Travel in hypodermis.
They are losers (too surface-level) and have no accompanying arteries.
338
What comes together at the confluence of sinuses?
Superior and inferior sagittal sinus, straight sinus, and occipital sinus form the confluence of sinuses.
339
What drains the confluence of sinuses?
Transverse sinus
340
What does the transverse sinus become?
Becomes the sigmoid sinus, which exits the cranium through the jugular foramen.
341
What does the sigmoid sinus pass through the jugular foramen to become?
Becomes the internal jugular vein
342
What forms the Brachiocephalic vein?
Internal Jugular vein + Subclavian vein
343
The Right and Left Brachiocephalic veins join together to become what?
The Superior Vena Cava (SVC).
344
T/F: Similar to arteries, there are both deep and superficial veins.
False! Arteries are just deep. Veins are both deep and superficial.
345
Where do external veins reside?
In the Superficial fascia or Hypodermis
346
T/F: The External Jugular Vein is Deep.
False! It is superficial and in the Hypodermis.
347
A surgeon needs to insert a pacemaker into the heart. She makes an incision under the clavicle and introduced the lead into the subclavian veins. Describe the pathway to get to the heart.
Subclavian vein --> brachiocephalic vein --> superior vena cava --> right atrium
348
The _____ veins in the extremities run with the ___________ and have the ______ name.
deep, arteries, same.
349
The deep veins in the extremities run with the arteries and have the same name. Trace the palmar arches back to the subclavian.
Palmar arches --> Radial & Ulnar --> Brachial --> Axillary --> Subclavian
350
What drains the muscles of the posterior compartment of the arm?
Deep Brachial vein
351
What does the Basilic vein empty into?
The brachial vein
352
What forms the axillary vein?
The Basilic + Brachial vein
353
What does the Cephalic vein empty into?
The axillary vein
354
What are the superficial veins of the upper extremity?
Basilic and Cephalic
355
What are the deep veins in the lower extremity?
Dorsalis pedis, Anterior Tibial, Plantar , Posterior Tibial, Fibular, and Deep Femoral.
356
What drains the dorsum of the foot?
Dorsalis pedis vein
357
What drains the anterior compartment of the leg?
Anterior Tibial vein
358
What drains the plantar foot?
Plantar veins
359
What drains the posterior compartments of the leg?
Posterior tibial veins
360
What drains the lateral compartment of the leg?
Fibular veins
361
What drains the posterior compartment of the thigh?
Deep femoral vein
362
Describe the pathway of the Great Saphenous vein.
Begins superior to the medial malleolus, ascends the medial side of the leg and thigh and empties into the Femoral vein.
363
Describe the pathway of the Small Saphenous vein.
Beings inferior to the lateral malleolus, ascends up into the posterior side of the leg and empties into the Popliteal vein.
364
What drains the arm and head into the heart?
Superior Vena Cava
365
What drains the abdomen and lower extremity into the heart?
Inferior Vena Cava
366
Where does deoxygenated blood from the anterior intercostal muscles get drained into?
Into the anterior intercostal veins.
367
Where does deoxygenated blood from the respiratory diaphragm drain into?
Into the internal thoracic vein.
368
Where do anterior intercostal veins drain into?
The internal thoracic vein.
369
Where does the internal thoracic vein drain into?
Into the subclavian vein
370
Where is deoxygenated blood from the intercostal muscles of the posterior thoracic wall drained into?
Into the Posterior Intercostal veins
371
What do the Posterior Intercostal veins drain into?
Into the Azygos system of veins.
372
What does the Azygos system of veins do?
Carries deoxygenated blood from the intercostal veins into the Superior Vena Cava.
373
What is on the right side of the Azygos system of veins? What about the left side?
Right side = Azygos vein
Left side = Accessor Hemiazygos and Hemiazygos veins
374
What does the Femoral vein of the thigh become? Where is this located?
Becomes the External iliac vein in the pelvis.
375
What do the internal and external iliac veins from the pelvis form?
The Common iliac veins
376
What do the Common Iliac Veins combine to form?
The Inferior Vena Cava
377
What does the Renal vein do?
Carries deoxygenated blood from the kidney and empties into the IVC.
378
Which renal vein is longer: left or right? Why?
The Left Renal Vein is much longer than the Right because it travels over the Abdominal Aorta.
Right Renal Vein is short.
379
What do the Gonadal veins do?
Carry deoxygenated blood from the gonads (ovaries and testicles).
380
Describe the pathway of veins of the digestive system.
Digestive organs --> Hepatic Portal Vein --> Liver
381
Why is the venous blood from the digestive organs important?
It carries nutrients that must go to the liver via the Hepatic Portal Vein for metabolism and storage.
382
T/F: The veins of the Digestive organs empty into the inferior vena cava.
False! They do NOT empty into the inferior vena cava.
383
The _____ draining the organs of digestion share the same names as the _________________.
veins, arteries
384
Where do the Superior and Inferior Mesenteric veins drain into?
The intestines
385
What does the Splenic vein do?
Drains the spleen
386
Veins that drain into the Inferior Vena Cava are part of the __________ _________ _______________.
Caval Venous Drainage
387
What are some examples veins drain into the Inferior Vena Cava?
Renal veins, Gonadal veins, and Internal Iliac veins.
388
Veins that drain organs of digestion and empty into the Hepatic Portal vein are part of the ___________ _____________ _____________.
Portal Venous Drainage.
389
What are some examples of veins that drain organs of digestion and empty into the Hepatic Portal vein?
Intestines, Spleen, and Stomach.
390
What does the word "Portal" refer to?
An atypical circulatory pathway (NOT artery - capillary - vein).
391
Insert the vein that completes the sequence:
Posterior tibial --> ________________ --> femoral.
Popliteal
392
Insert the vein that completes the sequence:
Popliteal --> ________________ --> external iliac.
Femoral
393
Insert the vein that completes the sequence:
Inferior mesenteric --> ________________ --> liver.
Hepatic portal
394
Insert the vein that completes the sequence:
Radial --> ________________ --> axillary.
Brachial
395
Insert the vein that completes the sequence:
Cephalic --> ________________ --> subclavian.
Axillary
396
Insert the vein that completes the sequence:
Internal Jugular --> ________________ --> Superior Vena Cava.
Brachiocephalic
397
Insert the vein that completes the sequence:
Great saphenous --> ________________ --> external iliac.
Femoral
398
Insert the vein that completes the sequence:
Hemiazygos --> ________________ --> Superior Vena Cava.
Azygos
399
Insert the vein that completes the sequence:
Sigmoid Sinus --> ________________ --> Subclavian.
Internal Jugular
400
What provides the primary drainage of the Dural Sinuses?
Internal Jugular Vein
401
What provides the primary drainage of the External cranium and face?
External jugular vein
402
What provides the primary drainage of the Right posterior intercostal veins?
Azygos vein
403
What provides the primary drainage of the Triceps Brachii muscle?
Deep brachial vein
404
What provides the primary drainage of the muscles of the posterior compartment of the thigh?
Deep femoral vein
405
What provides the primary drainage of the Fibularis longus and brevis?
Fibular vein
406
What provides the primary drainage of the Plantar foot?
Plantar veins
407
What provides the primary drainage of the Dorsum of the foot?
Dorsal Pedis and Arcuate veins
408
What provides the primary drainage of the Anterior compartment of the leg?
Anterior Tibial vein
409
What provides the primary drainage of the stomach, small intestine, and large intestine?
Hepatic portal vein
410
What provides the primary drainage of the Respiratory Diaphragm?
Internal Thoracic vein
411
What provides the primary drainage of the bladder, uterus, vagina, and rectum?
Internal Iliac vein
412
What provides the primary drainage of the Gluteus Medius, Minimus, and Tensor Fascia Lata?
Superior Gluteal vein
413
What provides the primary drainage of the kidney?
Renal vein
414
What are apertures?
Openings that allow for structures to move in.
415
Name the apertures (openings) in and out of the thorax.
Superior thoracic aperture & Inferior thoracic aperture
416
What is the inferior thoracic aperture covered by?
Covered completely by the diaphragm for protection purposes.
417
Describe the contents of the pleural cavity.
The pleural cavity contains the lungs. In between the pleural cavities, there is the mediastinum, which contains the heart and surrounding pericardium.
418
What are the 5 functions of the respiratory system?
GASOD:
1) Gas Exchange
2) Air Conditioning (humidifies air)
3) Sound Production
4) Olfaction (brings molecules to olfactory nerve)
5) Defense (against foreign particles)
419
What is the sole function of the upper respiratory tract?
Air conduction
420
What type(s) of passageways are in the upper respiratory tract?
Air and food passageways
421
What structures make up the upper respiratory tract?
Nose, nasal cavity, paranasal sinuses, and pharynx (throat).
422
What are the functions of the lower respiratory tract?
Air conduction and gas exchange
423
What type(s) of passageways are in the lower respiratory tract?
Air ONLY
424
What structures make up the lower respiratory tract?
Larynx, Trachea, Bronchi, and Lungs.
425
From the larynx to the lungs, there is a change in _______________.
epithelium
426
What are the differences between the upper and lower respiratory tract?
The function of the upper respiratory tract is air conduction and is made up of air and food passageways.
The function of the lower respiratory tract is air conduction and gas exchange and is made up of air passageways ONLY.
There are also different structures that make up each.
427
What type of epithelium makes up shared passageways (air and food passageways)? Why?
Stratified squamous epithelium, which aids in protection
428
What tract are considered shared passageways: upper or lower respiratory tract?
Upper respiratory tract
429
What type of membrane is evident in air ONLY passageways? What tract is this considered: upper or lower respiratory tract?
Mucus membrane
Lower respiratory tract
430
Name the 3 layers of the mucus membrane.
Respiratory epithelium
Characteristically thick basement membrane
Lamina propria containing seromucus glands
431
What type of epithelium is the respiratory epithelium in the mucus membrane? What does this do?
Pseudostratified columnar, which produces mucous.
432
What is the purpose of the characteristically thick basement membrane in the mucus membrane?
It protects against penetration of viruses and bacteria.
433
In the mucus membrane, what do the Lamina propria containing seromucus glands do?
They produce serous fluid and mucus. Mucus helps to trap stuff and serous fluid destroys shit!
434
Where is the nasal vestibule located?
This is within the external nares (nostrils).
435
What two structures are important in the nasal vestibule? What do they do?
Vibrissae, which are nose hairs that filter the air we bring in.
And mucus, which lines the nose hairs to trap debris that gets into our nose.
436
With which type of epithelium would the nasal vestibule most likely be lined by? Why?
EVERYBODY PICKS THEIR NOSE WAHAHAHAHHAH.
Thus, we need stratified squamous epithelium for protection.
437
What protects the nasal cavity?
Craniofacial bones on all sides
438
What divides the nasal cavity into R and L bones?
Nasal septum
439
What two bones make up the nasal septum? What connects these bones?
Perpendicular plate of ethmoid bone and vomer bone.
They are connected by septal cartilage.
440
T/F: The Nasal Conchae are unpaired bones.
False! They are paired bones, meaning they are bilateral bones.
441
Name the 3 Nasal Conchae.
Superior, middle, and inferior nasal conchae
442
Which nasal conchae should we identify first? Why is this?
Inferior nasal conchae, then work your way up.
This is because the superior nasal conchae can sometimes be tricky to visualize.
443
Where are the nasal conchae found?
The superior and middle conchae are part of the ethmoid bone. The inferior conchae is a separate bone.
444
What are Meatuses? Name the 3.
Spaces under nasal conchae.
Superior, middle, and inferior meatus.
445
What is the function of the nasal conchae and meatuses?
Slow down the flow of air so it can be conditioned (warmed up & hydrated).
446
Name the 4 paranasal sinuses.
Frontal, ethmoid 'air cells', sphenoid, and maxillary.
447
What is a sinus?
A space within bone.
448
What is the MAIN function of the paranasal sinuses?
To produce mucus to maintain moisture in the nasal cavity.
449
What is the Ethmoid Bulla?
These are the largest air cells that project/push into the middle meatus.
450
What is the semilunar hiatus?
It is a gap that resides under and is formed by the ethmoid bulla.
451
What is the semilunar hiatus's relationship with the maxillary sinus?
Maxillary and frontal sinus drain into the semilunar hiatus.
452
How do the paranasal sinuses serve in protection?
Paranasal sinuses provide a "crumple zone" to protect the orbit, optic nerve, and brain
453
Studies show when trauma is inflicted on the face, the __________ ____________ fractures, leaving the _________ intact.
orbital floor, globe
454
When scientists obliterated/filled the sinuses with cement, what would happen upon trauma inflicted on the face?
Globe rupture was inevitable
455
How does the size of the sinus contribute to risk of injury?
Smaller frontal sinus contribute to greater risk of cerebral injury following craniofacial trauma.
456
What are the internal nares?
This is the area between the concha and beginning of pharynx (throat)
457
How is the pharynx subdivided?
1. Nasopharynx
2. Oropharynx
3. Laryngopharanx
458
Describe the area that the Nasopharynx covers.
Extends from the internal nares to the uvula of the soft palate.
459
What is the sole function of the Nasopharynx? What epithelium comprises this?
Air ONLY.
It has a Respiratory Epithelium, which produces mucous for the air entering the nasal cavity.
460
What 3 structures does the Nasopharynx contain?
Pharyngeal tonsil, Pharyngotympanic (Eustachian) tubes, and the Uvula.
461
What is the Pharyngeal tonsil made up of and what is its function?
It is made up of Lymphatic tissue and it surveys the air we breathe in for pathogens.
462
What is the function of the Pharyngotympanic tube?
Think of flying on an airplane and getting ear bubbles.
It stabilizes the air pressure in the inner ear versus the external ear pressure. It also releases fluid from the inner ear.
463
The Uvula forms a loose seal between _____ and ____________.
naso- and oropharynx
464
Where does the Oropharynx extend from and to?
From the uvula to the hyoid bone
465
What type of passageway is the Oropharynx? What does this mean?
It is a shared passageway, meaning it is used for both air and foot
466
What type of epithelium does the Oropharynx have? Why?
It has a stratified squamous epithelium, which helps with protection.
467
What is the function of the epiglottis? What section of the pharynx is it located in?
Prevents food from getting into the larynx and then down into the trachea.
Most of the epiglottis is located in the Oropharynx, but some is in the Laryngopharynx.
468
What is the function of the Palatine and Lingual tonsils? What section of the pharynx are these located in?
Monitors the food we swallow for pathogens before hitting the Oropharynx.
Located in the Oropharynx.
469
Describe the area that the Laryngopharynx covers?
Extends from the hyoid to the cricoid cartilage.
470
What type of passageway is the Laryngopharynx? What does this mean?
It is a shared passageway, meaning it includes both air and food
471
What type of epithelium does the Laryngopharynx contain? Why?
Stratified squamous for protection
472
What structures does the Laryngopharynx contain?
Contains the opening into the larynx and the epiglottis.
473
What is the dedicated pathway to the lungs?
Lower Respiratory Tract
474
What 3 things make up the Hyo-Laryngeal Complex?
Hyoid bone, Thyroid cartilage, and Cricoid cartilage.
475
Describe 3 functions of the Hyo-Laryngeal complex.
1) Protection of Larynx ("Voice Box")
2) Insertion for intrinsic laryngeal muscles
3) Insertion site for vocal cords
476
Fracture of the hyolaryngeal complex are only present in __% of the suspected cases of neck trauma.
When fractures do occur, the ___________ _______________ contains a higher percentage of fracture than does the ___________ ____________.
20
thyroid cartilage, hyoid bone
477
During strangulation, what is most likely to fracture in the hyo-laryngeal complex?
Superior horn thyroid
478
Describe 3 things about the Thyroid Cartilage.
C-shaped
Lateral halves form the laryngeal prominence (Adam's Apple)
Origin of vocal cords
479
Describe 2 things about the Cricoid Cartilage.
Ring-shaped cartilage which encircles the larynx
Expands as it covers the posterior larynx
480
What serves as the origin for muscles that move the vocal cords?
Posterior larynx
481
What does the Epiglottis cover and when?
Covers the larynx during swallowing
482
What does the Cricoid cartilage cover?
Covers the anterior and posterior side of the larynx
483
What does the Arytenoid cartilage articulate with?
Articulates with the cricoid cartilage
484
What does the anterior Arytenoid cartilage serve as?
Vocal process; insertion of vocal cords
485
What does the posterior Arytenoid cartilage serve as?
Muscular process; insertion of laryngeal muscles
486
Name the 2 muscles of the Larynx.
Posterior Cricoarytenoid muscles & Arytenoid muscles
487
What is the origin and insertion of the Posterior Cricoarytenoid muscles?
Origin: Cricoid cartilage
Insertion: Arytenoid cartilage
488
What action do the Posterior Cricoarytenoid muscles perform?
ABDUCT vocal cords
489
What is the origin and insertion of the Arytenoid muscles?
Origin and Insertion: Arytenoid cartilage
490
What action do the Arytenoid muscles perform?
ADDUCT vocal cords
491
What type of pitch does abduction of the vocal cords create?
Deeper pitch voice
492
What type of pitch does adduction of the vocal cords create?
Higher pitch voice
493
Where do vocal cords originate and insert?
Vocal cords originate on thyroid cartilage and insert of arytenoid cartilage.
494
What forms the Rima Glottidis?
The conus elasticus covers and stretches from the vocal cord to the cricoid cartilage, forming the rima glottidis.
495
How does the Rima Glottidis change shape?
Muscles of the larynx change the shape of the rima glottidis by adducting abducting the vocal cords.
496
How are different sounds produced?
Different sounds are produced as air flows through the rima glottidis and vibrates the vocal cords.
497
"Change in shape = Change in tone."
What structure is this true of regarding sound?
Rima Glottidis
498
"Wraps around the vocal cords and manipulates air to force it between the vocal cords."
What structure is this true of?
Conus elasticus
499
What is the False Vocal Fold?
It protects the true vocal fold.
500
Where does the False vocal fold lie in comparison to the True vocal fold?
The False vocal fold is superior to the True vocal fold.
501
T/F: Vocal fold and vocal cord are separate structures.
False! Vocal fold is just another term for vocal cord.
502
Air _______ the larynx and __________ the trachea.
exits, enters
503
Describe the area that the Trachea covers.
Begins inferior to the cricoid cartilage and extends to the manubriosternal angle/2nd rib.
504
What structures support the trachea?
There are C-shaped cartilaginous rings that support the anterior and lateral trachea to keep it in an open position.
There is also smooth muscle located between the cartilaginous rings.
505
The posterior side of the trachea is covered by the ___________ ______________.
trachealis muscle
506
What does the Trachealis Muscle do?
It allows the esophagus to slightly bulge into the lumen of the trachea when swallowing. This gives the esophagus more room to breathe while we are eating.
507
What does the Trachea bifurcate into?
Primary bronchi
508
Both the __________ and _____________ _________ are supported by C-shaped cartilaginous rings.
trachea, primary bronchi
509
What is the Carina? How is it formed?
It serves as the last line of defense against aspiration.
The Carina is formed by the last cartilaginous ring of the trachea.
510
T/F: The bronchi bifurcate into two even tunnels.
False! The bronchi bifurcate unevenly.
511
If we were to aspirate food into the bronchi, is it more likely to go into the Right or Left Bronchi? Why?
More likely to travel into the Right Bronchi, because of the angle to get into the Left Bronchi and also because the Right Bronchi is bigger.
512
Why does the trachea bifurcate asymmetrically?
We have to note the displacement of the left primary bronchi around the growing and developing heart.
513
Each primary bronchus divides into?
Secondary bronchi, tertiary bronchi, several more bronchi, and then bronchioles.
514
T/F: The bronchioles have cartilage.
False! There is no cartilage in the bronchioles, because they are too tiny.
515
What helps to hold the bronchioles open?
Smooth muscle
516
____________ ____________ designate the end of the conducting zone & transition into the respiratory zone.
Terminal bronchioles
517
How big is the diameter of bronchioles?
<1 mm diameter
518
In the Trachea and Primary Bronchi, what cartilage is present?
Supported by C-shaped cartilaginous rings
519
In the bronchi, what provides support?
Supported by cartilaginous plates.
520
What is the difference between a bronchus and a bronchiole?
Bronchi are supported by cartilaginous plates and continue branching.
Bronchioles are supported by smooth muscle and terminal bronchioles mark the end of the conducting zone.
521
Why is there smooth muscle in the airway?
Smooth muscle controls the size of the airway, dictating how much oxygen gets in and out.
522
What type of innervation controls the smooth muscle in the airway?
Autonomic innervation
523
What does sympathetic control of the smooth muscle in the airway cause?
Bronchodilation, which increases the amount of oxygen in the lungs.
524
What does para-sympathetic control of the smooth muscle in the airway cause?
Bronchoconstriction, which reduces the amount of oxygen in the lungs.
525
_____________ __________ branch from terminal bronchioles.
Respiratory bronchiole
526
What type of epithelium makes up the Respiratory bronchiole? Why is this good?
Simple squamous epithelium, which is good for fast diffusion of Oxygen and Carbon Dioxide.
527
Respiratory bronchioles lead to ____________ _______.
respiratory ducts
528
The distal end of the respiratory ducts dilate into an ____________ _____.
alveolar sac
529
What are the three structures that make up the respiratory zone?
Respiratory bronchiole, respiratory ducts, and alveolar sac.
530
Respiratory bronchioles, alveolar ducts, and alveolar sacs are all made of ____________________.
Alveoli (singular alveolus).
531
What are Alveoli?
They serve as the final termination of the airway and where gas exchange takes place.
532
What type of epithelium is in the Alveoli? Why is this?
Lined mostly with simple squamous epithelium, which is important, because very thin walls will help to facilitate gas exchange.
533
What is the function of the simple squamous epithelium in the alveoli?
Allows for quick diffusion of Oxygen and Carbon Dioxide with the capillaries.
534
What are two important functions of Alveolar pores?
Communication and Collateral Ventilation
535
What is the function of Collateral Ventilation?
Allows for air to still fill the alveoli/lungs even if an area collapses.
536
What 3 cell types are present in the Alveoli?
Type I pneumocyte, Dust cell, and Type II pneumocyte.
537
What epithelium do Type I pneumocytes have? What are these cells the location of?
Simple squamous cells, because this is where gas exchange takes place.
538
Describe Dust Cells.
They can be fixed in tissue or migratory. They are alveolar Macrophages that seek out pathogens to destroy.
539
What shape are Type II pneumocytes?
Dome-shaped cells
540
What do Type II pneumocytes produce? What does it do?
Surfactant, which is a lipid that repels other type II pneumocytes so the alveoli stay open instead of collapsing.
541
What do Type II pneumocytes function as?
Function as stem cells by replacing dead Type I pneumocytes.
542
What cells produce Surfactant?
Type II pneumocytes.
543
What 3 things surround the Alveolar sac?
Smooth muscles, elastic fibers, and capillaries.
544
What is the function of smooth muscle in the Alveolar sac?
Controls the size of the airway and maintains patency/openness.
545
What is the function of elastic fibers in the Alveolar sac?
Suspend and support the alveolar sacs.
546
What is the function of Capillaries in the Alveolar sac?
Exchange of gasses between blood and alveoli.
547
Why is there asymmetry of the lungs?
Asymmetry of the lungs is due to development of the heart on the left side.
548
What is the Cardiac Impression?
Mediastinal surface of BOTH lungs.
549
What is the Cardiac Notch?
Indentation on the anterior border of the left lung's superior lobe.
550
What is the Lingula (little tongue)? Where is it located?
It is a remnant of what would have been the middle lobe.
Extends from the cardiac notch and the oblique fissure.
551
The cardiac impression is found on both lungs, but on which lung would the impression be more obvious? Why?
Left lung, because this is where the heart sits.
552
What is the Hilum?
The physical part of the lung where structures enter or exit.
553
What does "root of the lung" mean? Name examples.
Root of the lung refers to the structures that are entering and exiting.
Bronchi, pulmonary arteries, and pulmonary veins.
554
What structures are entering or exiting the Left Lung?
Pulmonary artery, Hypoarterial (below the artery) bronchus, and Pulmonary vein
555
What structures are entering or exiting the Right Lung?
Eparterial (above the artery) bronchus, Pulmonary artery, and Pulmonary vein.
556
Describe the 3 steps of development of the pleural cavity.
1) Lung bud is developing into the fluid-filled space of the intraembryonic cavity.
2) Lung bud is covered with visceral lining as it develops into the membrane.
3) Visceral and parietal lining are separated by pleural space.
557
What is the intraembryonic cavity surrounded by? What is this adhered to?
The intraembryonic cavity is surrounded by a serous membrane which is adhered to the thoracic wall.
558
In the lung bud, where does the parietal lining stay attached to?
The thoracic wall
559
Visceral and parietal lining are separated by pleural space. What fills this space?
Serous fluid fills this space and separates the linings.
560
Which layer of the pleural cavity maintains an attachment with the thoracic wall?
Parietal lining of the serous membrane
561
Which layer of the serous membrane covers the developing lung bud?
Lung bud is covered with visceral lining.
562
What are the 2 main functions of the serous fluid in the pleural cavity?
1) Lubrication of the pleural cavity
2) Creation of tension between the visceral and parietal pleural layers that sticks the two layers of pleura together. This indirectly attaches the lungs to the thoracic wall.
563
What does indirect attachment of the lungs to the thoracic wall in terms of contraction and expansion?
As the thoracic wall expands/contracts, the lungs will also expand/contract because they are attached to the thoracic wall.
564
How is the Parietal Pleura named?
Named for the regions of the thoracic that it touches.
565
Name the 3 regions of the thoracic cavity that the Parietal Pleura touches.
Costal = touches ribs
Mediastinal = touches mediastinum
Diaphragmatic = touches diaphragm
566
What is a Pneumothorax? What is this caused by?
In the case of trauma or illness, air can enter the space from the lung, causing a pneumothorax.
Air creates excessive pressure on the lung causing the lung to collapse.
567
Besides a Pneumothorax, what else can the pleural space be filled with?
Blood (hemothorax) or fluid (pleural effusion).
568
How do we treat a Pneumothorax?
Treatment involves needle aspiration of air.
569
What is the Pleural Cavity normally filled with?
Lubricating serous fluid
570
What type of muscles expand and contract the thoracic cavity: skeletal, cardiac, or smooth?
Skeletal muscles expand and contract the thoracic cavity.
571
At rest, what is the main muscle of respiration? What does it increase?
What muscle also assists in respiration at rest? What does it increase?
Main muscle of respiration is the diaphragm. It increases vertical dimensions.
External Intercostal muscles also aid in respiration. They increase the lateral dimensions.
572
What type of muscles aid with forced inhalation? Name the 3 and what they increase.
Muscles SUPERIOR to the thoracic cavity help with forced inhalation.
Pectoralis Minor, Serratus posterior superior, and Sternocleidomastoid.
They help to increase lateral dimensions.
573
What type of muscles aid with forced exhalation? Name the 3 and what they increase.
Muscles INFERIOR to the thoracic cavity help with forced exhalation.
Abdominals, Serratus posterior inferior, and Internal intercostal mm.
They help to decrease vertical dimensions.
574
Which nerve innervates the diaphragm? From what spinal cord segments do these come from?
The Phrenic Nerve innervates the diaphragm (cervical spinal cord segments 3, 4, and 5).
575
Where do the Intercostal nerves from T1-T11 run?
Run in the inferior border of each rib with the intercostal vein and artery.
576
Which nerves innervate the intercostal muscles?
Intercostal nerves innervate the intercostal muscles.
577
Where does neural control of the respiratory system come from?
Medulla oblongata
578
In the respiratory center, what do nuclei do?
Set a baseline rate of ventilation
579
What does the respiratory center do?
Gathers information from stretch receptors in the lungs and chemoreceptors in the arteries.
580
From which structures does the respiratory center gather information?
Stretch receptors in the lungs and chemoreceptors in the arteries.
581
Where are stretch receptors (mechanoreceptors) located? What do they do?
Located in the lungs.
They respond to excessive stretching in the lungs (prolonged inhalation) and trigger exhalation.
582
Where are chemoreceptors located? What do they do?
Located in the aortic and carotid bodies.
They sense changes in blood oxygen/carbon dioxide levels and changes in pH. They also trigger inhalation.
583
Why is it good that the chemoreceptors are located where they are?
The aortic and carotid bodies are the first places where oxygenated blood will travel. This is a good place for our body to sense if it has good oxygen and pH levels before it reaches the rest of the body.
584
In regards to chemoreceptors, what do cranial nerves do?
Cranial nerves bring information regarding chemoreception to the brain.
585
Which cranial nerves sense/receive information from the carotid bodies?
Glossopharyngeal Nerve (CN IX)
586
Which cranial nerves sense/receive information from the aortic bodies?
Vagus Nerve (CN X)
587
What are the 3 functions of blood?
Transportation, regulation, and protection.
588
What are some examples of what the blood transports?
Oxygen, Carbon Dioxide, Immune cells, nutrients, hormones, and waste products.
589
What are some examples of things the blood is regulating?
pH (between 7.35 - 7.45), body temperature, and normal fluid levels.
590
What are some examples of how the blood provides protection?
Immunity and clotting
591
Blood cells perform specific _________________ based on their ______________.
functions, structure
592
What do we mean by "whole blood"? When would we see whole blood?
All parts of the blood are distributed homogenously.
We can see this when we do a blood draw.
593
What does centrifugation of blood allow for?
Whole blood can be separated into liquid and formed elements.
594
What are the Formed Elements of blood?
Red blood cells, white blood cells, and platelets.
595
Components of blood separate during centrifugation to reveal what 3 things?
Plasma, buffy coat, and erythrocytes.
596
During centrifugation, why are RBCs at the bottom of the tube?
They contain lots of metals, such as Iron, which makes it heavy.
597
What is found in plasma?
Water, proteins, nutrients, hormones, etc.
598
What is found in the buffy coat?
White blood cells and platelets
599
What is Hematocrit?
Hematocrit determines the percent of RBCs in your entire blood volume.
600
What is normal Hematocrit?
37 - 47% RBCs in the entire blood volume
601
What does a depressed or elevated hematocrit level tell us?
Depressed and elevated Hematocrits are symptoms of underlying conditions.
602
What is Anemia? What can it indicate?
Anemia is a depressed Hematocrit %, which may indicate bleeding, low iron, autoimmune diseases, infection, etc.
603
T/F: Anemia is a disease.
False! Anemia is a symptom of underlying disease.
604
What is Polycythemia? What are 3 reasons for why someone might have this?
Elevated hematocrit %.
Living at higher altitudes, dehydration, and doping (increasing RBCs) can make your hematocrit % elevated.
605
What are the 3 components of blood? Name the percentages for each.
Plasma ~55%
Buffy Coat <1%
Erythrocytes (RBCs) ~44%
606
What are the 3 major types of plasma proteins? Name the percentages of each.
Albumin (60%), Globulins (35%), and Fibrinogens (4%).
607
What does Albumin do in the plasma?
Maintains osmotic pressure within blood vessels. Helps keep fluid from leaking out of blood and into other tissues. Also carry hormones, vitamins, and enzymes through the body.
608
What do Globulins do in the plasma?
Immunoglobulins (antibodies) are another type of globulin that are produced by the immune system that protect the body from antigens.
609
Where are antibodies found circulating?
In the blood plasma
610
What do Fibrinogens do?
They are released by platelets and undergo a reaction that results in blood clotting.
611
How can we examine formed elements?
We can perform a blood smear to stain and examine the formed elements.
612
Describe the 2 components of a blood smear and stain.
Smear distributes the elements of the blood. Staining allows visualization of cellular components.
613
Why would a blood smear be performed?
Helps to identify or narrow down a diagnosis.
614
T/F: Erythrocytes are defined as cells.
False! Erythrocytes are not actual cells, because they do not contain a nucleus or organelles.
615
What does the cytoplasm of erythrocytes contain?
Hemoglobin, no nucleus or organelles.
616
What do erythrocytes do?
Transport oxygen to tissues and carbon dioxide (lesser extent) to the lungs.
617
What is the shape of erythrocytes? Why is this good?
Biconcave disc shape.
The shape allows it to get into tiny spaces and perform gas exchange. It can fold at the center of the erythrocyte to get through capillaries 4 mm wide.
618
Describe the dimensions of erythrocytes.
Width = 7.8 micrometers
Height = 2.6 micrometers
Middle Heigh = 0.8 micrometers
619
How does RBC shape assist in their function?
They are able to squeeze through narrowest capillaries. Additionally, they make tons of contact, which increases surface area and allows for rapid diffusion of gases.
620
How many globin chains and heme units does each hemoglobin molecule contain?
4 globin chains and 4 heme units per 1 hemoglobin molecule.
621
Each heme unit contains __ iron and each iron binds __ O2 molecule
1, 1
622
How many Oxygen atoms are there per 1 hemoglobin molecule?
4 heme units per 1 hemoglobin each binding 1 O2 molecule. O2 molecule has 2 O atoms
8 Oxygen per 1 hemoglobin molecule
623
Each blood cell contains ____ _______________ heme units, which transport ____ ______________ oxygen molecules per RBC.
300 million, 1.2 billion
624
What does iron bind?
Iron will bind O2 and CO2 during gas exchange in the tissue or the lungs.
625
How does shape of RBC facilitate gas exchage?
The concavity is closer to the surface to better diffuse. If it was a sphere, then the large diameter makes it difficult to diffuse.
626
What causes Sickle Cell Anemia?
A rare genetic disorder that involves a homozygous recessive (hh) hemoglobin gene resulting in sickle cell anemia.
627
How do we diagnose Sickle Cell Anemia?
Affected red blood cells appear sickle-shaped.
628
What are the symptoms of Sickle Cell Anemia?
Shortness of breath, pain joints, chest, abdomen, fatigue, and dizziness.
629
How do we treat Sickle Cell Anemia?
Blood transfusions and bone marrow transplants.
630
In regards to Sickle Cell Anemia, what would an Hh gene indicate? Why has this gene persisted throughout evolution?
This person would be non-symptomatic with just a few cells being sickle-shaped.
This has persisted through evolution because it provides protection against Malaria.
631
What is Hematopoiesis?
Production of formed elements.
632
Hematopoietic stem cells are referred to as ______________________.
hematocytoblasts
633
Which types of cells do Hematocytoblasts produce?
Lymphoid and myeloid cells
634
What formed elements do Myeloid cells produce?
Erythrocytes, megakaryocytes, and all leukocytes, except lymphocytes.
635
What formed elements do Lymphoid cells produce?
ONLY lymphocytes
636
Where does Erythropoiesis take place? What is it stimulated by?
Only in red bone marrow including midline bones and the proximal ends of proximal long bones.
Stimulated by erythropoietin.
637
What are the midline bones in which Erythropoiesis takes place?
Skull, sternum, ribs, vertebrae, scapula, and pelvis.
638
What are the proximal end of proximal long bones in which Erythropoiesis takes place?
Humerus and Femur
639
What is a bone marrow transplant?
A procedure that infuses healthy blood-forming stem cells into your body.
640
What are some reasons for a bone marrow transplant?
Cancers of the blood, sickle cell anemia, and certain autoimmune disorders.
641
For bone marrow transplants, what does pretreatment involve?
Pretreatment involves chemotherapy or radiation to destroy foreign cells and prepare the bone marrow for transplant in the recipient of the bone marrow transplant.
642
What does bone marrow transplant involve?
Involves the introduction of healthy bone marrow stem cells that will divide and produce healthy cells that will populate the blood and function properly.
643
Erythropoiesis is stimulated by _______________.
erythropoietin, which is a hormone.
644
How long do Erythrocytes circulate for?
120 days
645
In the liver and spleen, what happens to aged erythrocytes? What happens to the heme components of the blood?
They are phagocytized/decomposed.
The heme components, Hemoglobin and Iron, are recycled and stored in the bone marrow for new red blood cell production.
646
Where is Bilirubin from the heme unit stored?
Stored in the liver for bile production
647
Why do RBCs only last for 120 days?
They don't have a nucleus or organelles so they just die.
648
What determines your blood type?
The presence and/or absence of the cell surface antigens (A & B type).
649
All red blood cells maintain the __ type antigen. Why is this?
O type
Protects against certain infectious diseases.
650
What cell surface antigens are Type O blood?
Neither A nor B surface antigens
651
What cell surface antigens are Type A blood?
Surface antigen A
652
What cell surface antigens are Type B blood?
Surface antigen B
653
What cell surface antigens are Type AB blood?
Surface antigens A and B.
654
How do we know what type of antibodies white blood cells will produce against red blood cells?
White blood cells produce antibodies against surface antigens not found on OWN red blood cells.
655
Where do antibodies circulate?
In the blood plasma
656
What antibodies are present with Type A blood?
Anti-B antibodies
657
What antibodies are present with Type B blood?
Anti-A antibodies
658
What antibodies are present with Type AB blood?
Neither anti-A nor anti-B antibodies
659
What antibodies are present with Type O blood?
Both anti-A and anti-B antibodies
660
When we do a blood transfusion, what is transfused into the recipient?
ONLY RBCs are transfused into the recipient, not the plasma (so only worry about what antibodies the RECIPIENT has).
661
What would happen if we gave a type A individual a type B blood transfusion?
The recipient has anti-B antibodies which will bind to the type B cells, resulting in agglutination and hemolysis (death will occur within minutes).
662
How do antibodies protect against foreign blood cells?
Antibodies will agglutinate (form complexes) withforeign blood cells and cause hemolysis (death of foreign cells).
663
Describe Rapid Agglutination Tests.
A drop of blood is placed on a card containing antibodies against the A and B. Whichever one we see agglutination with is the blood type.
For example: Dots on anti-A = blood type A.
664
If someone has anti-A and anti-B antibodies, which blood type can they be transfused?
Only type O
665
If someone has anti-A antibodies, which blood type can they be transfused?
Type B and Type O
666
If someone has anti-B antibodies, which blood type can they be transfused?
Type A and Type O
667
If someone has no antibodies, which blood type can they be transfused?
Type A, Type B, Type AB, and Type O.
668
Which blood type is the Universal recipient? Which blood type is the Universal donor?
Universal recipient = Blood type AB
Universal donor = Blood type O
669
If we didn't know the blood type of an individual, what blood type should we transfuse to this patient?
Type O- because it is the universal donor
670
Rh is present = ____
Rh+
671
Rh antigen is absent = _____
Rh-
672
T/F: Anyone is Rh- naturally produces the Rh antibody.
False! Antibodies against the Rh antigen are only produced if someone is Rh- and has been previously exposed to the Rh antigen.
673
Describe a situation in which a Rh- mother would produce Rh antibody.
A Rh- mother during her first pregnancy could have a Rh+ baby. After the 1st pregnancy, the Rh- mother will produce anti-Rh antibodies. If the mother has a second pregnancy with a Rh+ fetus, the anti-Rh antibody from the mother will attack the Rh antigen and kill the fetus.
674
Describe structural characteristics of Leukocytes (WBCs).
Contain nuclei
Larger than red blood cells
Motile and can leave the bloodstream
675
__________________ are classified as either granular or agranular.
Leukocytes
676
_________ initiate immune response.
Leukocytes
677
How do we classify a Leukocyte as granular?
-Contain visible cytoplasmic granules
-Nuclei are divided into 2-5 lobes
678
Name 3 granular Leukocytes.
Neutrophils, eosinophils, basophils.
679
What are Granules?
Digestive enzymes that destroy bacteria.
680
How do we classify a Leukocyte as agranular?
-Cytoplasmic granules are NOT visible with staining techniques
-Single lobed, thick nucleus
681
Name 2 agranular Leukocytes.
Monocytes and Lymphocytes
682
How do Neutrophils initiate an immune response?
They are the first immune cells to reach the infection site, leaving the bloodstream and entering the infected tissues.
683
What is pus?
Accumulation of dead tissue, cells, and bacteria.
Basically, accumulation of dead neutrophils.
684
What type of WBC has a nucleus with 2-6 connected lobes and makes up 60-70% of leukocytes?
Neutrophils
685
______________ are also referred to as polymorphonuclear (PMN).
Neutrophils
686
How do eosinophils initiate an immune response?
They attack parasites or worms.
687
Describe the appearance of eosinophils.
Nucleus with 2 connected lobes, granules stain dark red
Old-fashioned "telephone" or "earmuff" shape
688
Name the characteristics of basophils.
Nucleus with 2 connected lobes
"U" or "S" shaped nucleus
Granules stain dark blue/purple
689
How do basophils help with the immune response?
They release Histamine and Heparin during allergic or inflammatory reactions. They also assist in vasodilation and inhibition of blood clotting.
690
Name the characteristics of Monocytes.
Nucleus is 3x the size of an RBC
Horseshoe-shaped nucleus
691
When in the blood, what are monocytes called? What about when they exit the bloodstream and enter bodily tissues?
When in blood = monocyte
When in tissue = macrophage
692
What are the 3 types of Lymphocytes?
B cells, T cells, and Natural Killer (NK) cells.
693
Describe Lymphocytes.
Nucleus almost fills the entire cell
Reside in lymphatic structures and organs
Major component of the immune system
694
How are platelets formed?
Megakaryocytes extend processes into blood vessels. The force of the blood flow breaks off pieces, creating platelets.
695
How do platelets function in blood clotting?
Platelets convert fibrinogen into fibrin. Fibrin will bind erythrocytes and platelets to form a clot.
696
697
what type of epithelium?
stratified squamous epithelium
698
699
700
701
702
703
704
705
706
707
708
709
710
711
what cell is normal and what is abnormal?
left is normal, right is sickle cell
712
what blood type is this person?
type A
713
714
715
what is this
Neutrophil
716
what is this
eosinophil
717
what is this
Basophil
718
what is this
Monocyte
719
what is on the right? And label
Lymphocyte
720
What is Hypovolemia? What does it lead to?
It is low blood volume. This leads to lack of oxygen to bodily tissues and organs.
721
What is Edema?
Build up of fluid in the interstitial spaces around the tissues, usually in the extremities.
722
What are the results of having fluid build up in the interstitial spaces?
This leads to Hypovolemia, in which there is low blood volume (more RBCs than plasma).
722
How do we fix Edema?
Fix this with movement, so that the fluid doesn't pool
723
What size substances can Lymphatic vessels transport?
Lymphatic vessels can transport larger substances
724
What are the 3 main functions of the Lymphatic System?
1) Regulate blood-fluid volume
2) Transport large nutrients, lipids, hormones, and waste
3) Immunity
725
Explain how the Lymphatic System regulates blood-fluid volume.
Blood pressure pushes fluid from vessels. Blood capillaries are able to pick up about 85% of this fluid, so Lymphatic capillaries will reabsorb the rest. The fluid is then filtered and returned to the circulatory system to maintain blood-volume levels.
726
When Lymphatic capillaries reabsorb fluid from vessels, where are they returned to? Why?
The fluid is reabsorbed, filtered, and returned to the circulatory system to maintain blood-volume levels.
727
What are Lacteals and what do they do?
Lacteals are specific lymphatic vessels that absorb larger lipids and lipid-soluble vitamins.
728
What part of the Lymphatic System is SPECIFIC to the villi of the small intestine?
Lacteals are specific to the small intestine which is where super large solutes are.
729
How does the Lymphatic System defend the body?
The Lymphatic System surveys blood and lymph fluid for antigens. When it finds them, the antigens initiate an immune response. The Lymphatic System will then produce cells that kill antigens.
730
Blood pressure forces fluid from the _____________ ________________ into _____________ ______________.
arterial capillaries into interstitial spaces
731
How is the fluid found in the interstitial spaces reabsorbed?
85% of the fluid is reabsorbed by venous capillaries. The remaining interstitial fluid is absorbed by Lymphatic capillaries.
732
Once interstitial fluid is reabsorbed into the Lymphatic capillaries, what do we refer to the "fluid" as?
Lymph
733
What is the function of Lymphatic Capillaries?
Absorbs the remaining interstitial fluid that is not reabsorbed by venous capillaries.
734
Explain the structure of a lymphatic vessel.
-Large diameter
-Overlapping endothelial cells migrate into the vessel to create one-way valves. These cells are also leaky and allow fluid to flow into the vessel.
735
How does lymphatic fluid move through the vessels?
Lymph is forced through the vessels via muscular contraction so that fluid flows back to the circulatory system.
Standing around without moving (resting) encourages pooling of fluid in the vessels
736
What do all lymphatic vessels enter and why?
All lymphatic vessels enter lymph nodes to be filtered and surveyed for antigens.
737
What is the difference between the afferent and efferent vessels?
Afferent vessels will ENTER lymph nodes. Efferent vessels will EXIT lymph nodes.
738
Lymphatic vessels merge to form ___________.
trunks
739
What 5 major regions of the body do lymphatic trunks drain?
Jugular, Subclavian, Bronchomediastinal, Intestinal, and Lumbar
740
Trunks merge into __ ________.
2 ducts
741
Where does the Right Lymphatic duct drain lymph into?
Right subclavian vein
742
Where does the Thoracic duct drain lymph into?
Left subclavian vein
743
What is the Cisterna Chyli and where does it drain?
It receives lymph (specific type called chyli) from intestinal nodes. It is continuous with the thoracic duct (transitions into the thoracic duct) and drains into the left subclavian vein.
744
Blockage of the jugular lymphatic trunk would result in a build up of lymphatic fluid in what region?
Head and neck
745
What is Lymphatic filariasis (elephantiasis)?
Buildup of interstitial fluid in the extremities resulting from a parasitic nematode blocking the lymphatic capillaries.
746
For an individual with Lymphatic filariasis (elephantiasis), what white blood cell would you expect to be elevated?
Eosinophils
747
Where are antigens found? Where are antibodies found?
Antigens = cell surface
Antibodies = blood plasma
748
What stimulates an immune response?
Antigens
749
What is produced in response to antigens?
Antibodies
750
What are the 2 classes of Antigen Presenting Cells (APCs)?
Macrophages and Dendritic Cells
751
How do APCs present antigens?
1) Enemy cell is ingested.
2) Enemy cell is broken down.
3) Fragments of antigen 'presented' on surface of APC.
4) Circulate within lymphoid tissues where lymphocytes are established for cells to recognize the antigen.
752
What are Macrophages?
Monocytes that have migrated from the blood to the tissues.
753
Where are Dendritic Cells found?
Found in epithelial tissues of respiratory and GI system.
754
What do Dendritic Cells do?
They are 'Professional APCs' who enforce tolerance of 'self' and harmless antigens. This means that they make sure macrophages don't destroy own cells with antigens (ex: RBCs).
755
What is the most abundant cell in the lymphatic system?
Lymphocytes
756
Name the 3 types of Lymphocytes.
T-lymphocytes, B-lymphocytes, and Natural Killer Cells
757
What do T-Lymphocytes (T-cells) do?
They recognize ONE particular antigen. They are able to travel to sites of infection and directly kill the antigen.
758
What are the 4 types of T-Cells?
1. Helper
2. Cytotoxic
3. Regulatory cells (Treg)
4. Memory Cells
759
T/F: T-Lymphocytes are part of CELL-MEDIATED IMMUNITY.
True! This means that actual cell itself kills the antigen
760
How do Helper T-cells initiate an immune response?
Each Helper T-cell is activated by one specific antigen. The cell will then act as an APC as well as release cytokines to activate other lymphatic cells, such as B cells.
761
What is the function of cytotoxic T-cells?
They are activated by Helper T-cells and are antigen-specific. They will DIRECTLY cause cell death.
762
What is the function of a regulatory T-cell?
It regulates the immune response by inhibiting cell activity / cytokines to slow down the immune response. It is thus good at suppressing autoimmunity.
763
Which T-cells are inactive and long-living?
Memory T-cells
764
What is the function of Memory T-cells?
They remember antigens that have previously been encountered so that they can elicit a quicker immune response with more cells being produced upon future encounters.
765
When do autoimmune disorders occur?
When lymphatic cells mistake healthy cells of the body as foreign.
766
___________ cells are activated to decrease macrophage activity.
Regulatory T-cells
767
What cells does treatment of autoimmune disorders rely on? What do they do?
Regulatory T-cells are used to help decrease macrophage activity.
768
Where do B-cells reside? Are they mobile?
Reside in lymphatic tissues of the body. They are NOT mobile.
769
B-cells contain surface receptors for how many antigens?
ONLY ONE antigen
770
T/F: B-cells are a part of cell-mediated immunity.
False! They are a part of HUMORAL MEDIATED immunity, meaning there is indirect cell death via the production of antibodies.
771
Explain how B-cells kill antigens indirectly.
B-cells are activated by APCs and Cytokines. B-cells will then proliferate into plasma and memory cells. Plasma cells will produce antibodies to kill the antigen.
772
What do Plasma cells do?
Produce antibodies (immunoglobulins)
773
Generally speaking, what do Memory B-cells do?
They remember the antigen for future encounters. If it recognizes an antigen, it immediately produces plasma cells, meaning NO activation is needed from other processes.
774
T/F: B-cells are mobile whereas antibodies are immobile.
False! B-cells are immobile whereas the antibodies are mobile.
775
T/F: B-cells themselves are able to kill antigens directly.
False! They kill indirectly via the production of antibodies.
776
What are Natural Killer (NK) cells and what do they do?
They are large granular lymphocytes that can kill a wide variety of infected cells and some cancerous cells.
777
What type of cells are used in immunotherapy against cancer cells?
Natural Killer (NK) cells
778
What kind of cells do NK cells attack?
They are not specific to any type of antigen, a wide variety of infected cells and some cancerous cells.
779
What type of tissue is Lymphatic tissue?
A connective tissue made with reticular fibers.
780
Capillaries are abundant within Lymphatic tissue. What do they do?
They bring Lymphocytes into the tissue.
781
How do we identify Lymphoid tissues?
They are identifiable by areas of densely packed B-cells called Nodules.
782
What are Nodules?
B-cells that are densely packed and reside in the tissue.
783
What are the 2 types of Nodules that B-cells form?
Primary and Secondary Nodules
784
What are Primary Nodules?
Areas of inactivated B-lymphocytes.
785
What are Secondary Nodules? How are they characterized?
The site of lymphocyte activation.
They are characterized by the dark outer ring surrounding the GERMINAL CENTER.
786
What type of tissue is this?
Lymphatic tissue
787
Classify the nodules
Left is Secondary Nodule with Germinal center.
Right is Primary Nodule.
788
Where are the 2 types of Lymphatic Tissues found?
1) Found in all lymphatic organs
2) Found in mucosa-associated lymph tissue (MALT)
789
Define GALT, BALT, and Peyer's Patches.
Gut-Associated Lymph Tissue
Bronchiole-Associated Lymph Tissue
Ileum of small intestine.
790
What are tonsils and how are they arranged?
Tonsils are swellings of the mucus membrane lining the pharynx. They are arranged in a circle around the pharynx.
791
The lamina propria contains abundant ___________.
MALT (mucosa-associated lymph tissue)
792
How are Crypts formed and what do they do?
Crypts are created by the overlying epithelium. They trap antigens and activate nodules.
793
What is Lymphopoiesis?
The process of lymphocyte production and maturation.
794
What 3 things do Lymphoid stem cells differentiate into?
B-cells, T-cells, and NK cells.
795
What is Immunocompetence?
Process of maturation in which a lymphoid cell is fully capable of participating in the immune response.
796
What cells mature in the bone marrow?
B-cells and NK cells
797
Where do T-cells migrate to and why?
T-cells migrate to the thymus for maturation.
798
What is the site of T-cell maturation and immunocompetence?
Thymus
799
How is the Thymus divided?
Divided into lobules, with each lobule containing an outer cortex and inner medulla.
800
When is the Thymus most active?
During childhood
801
T/F: The thymus is considered a central lymphatic organ.
True!
802
Where is the Bilobate organ located?
In the superior mediastinum
803
The cortex in the thymus contains 3 cell types. Name them.
1) Macrophages
2) Developing T-cells
3) Epithelial Reticular Cells (ER Cells)
804
What do Epithelial Reticular (ER) cells do?
They form the Blood-Thymic Barrier and secrete hormones that train and test T-cells for immunocompetence.
805
What 3 things make up the Blood-Thymus Barrier?
Epithelium of ER cells, Endothelium of capillary, and Fused basement membrane
806
What does the Blood-Thymus Barrier do? What are T-cells protected from?
Blood-Thymus Barrier isolates T-cells from the blood.
T-cells are protected from entering the bloodstream before they are immunocompetent as well as antigens in the bloodstream.
807
T-cells are screened to ensure ___________________ ________________.
immunological tolerance
808
What are self-antigens?
Any cell in the host organism's body that the immune system tolerates.
809
How do we classify a T-cell as Positive Selection?
T-cells must recognize foreign antigens.
810
How do we classify a T-cell as Negative Selection?
T-cells must NOT recognize 'self-antigen'.
811
What does the Medulla of the thymus contain?
Numerous blood capillaries and thymic corpuscles.
812
Where do immunocompetent T-cells migrate to?
Migrate to the medulla and enter the blood vessels.
813
What are Thymic corpuscles? How do we recognize them? What are they used to ID histologically?
They are degenerated ER cells.
They have a rosy appearance and are used to ID the thymus histologically.
814
What is the largest lymphoid organ? Where is it located?
The spleen is the largest lymphoid organ and it is located in the upper left quadrant of the abdoment
815
What does the spleen do?
Filters the blood by:
-Removing antigens from the blood
-Removing defective/old RBCs
-Storage of blood
-Fetal hematopoiesis
816
What enters the spleen at the hilum (concave edge)?
Splenic artery
817
Spleen is an __________ and maintains a _________ connective tissue capsule.
organ, dense
818
How are trabeculae in the spleen formed and what do they do?
The dense connective tissue capsule invaginates into the spleen forming trabeculae.
The trabeculae create pathways for blood vessels.
819
How is the spleen broken down into lobules?
Trabeculae divide the spleen into lobes. Each lobe contains areas of red pulp (RBCs) and white pulp (WBCs).
820
Describe the blood flow through the spleen.
Blood flow begins with the splenic artery. Splenic artery divides into trabecular arteries. Central arteries enter the inner tissue of the spleen, where they become coated with Peri-arterial Lymphatic Sheaths (PALS).
821
What do Peri-arterial Lymphatic Sheaths (PALS) do? What are they made of?
White blood cells in the PALS monitor blood entering the spleen for antigens.
Made of clusters of T-cells, B-cells, and macrophages.
822
Blood flows from central arteries to ___________ ______________.
splenic sinusoids
823
What are splenic sinusoids?
Open areas where blood flows freely (open circulation).
824
What types of cell would you find in the red pulp?
Macrophages inspect and destroy old/defective RBCs. RBCs are also stored in the reticular fibers of the splenic cords.
825
What is the function of the lymph nodes? Where are they located?
Filter lymph fluid
Nodes are scattered in groups along lymphatic vessels, typically surrounding joints.
826
Describe the structure of the Lymph Nodes.
Surrounded by a connective tissue capsule. The capsule forms trabeculae. Trabeculae form sinuses through which fluid will flow.
827
Lymph Nodes:
Afferent vessels enter all along _________ ______________. Efferent vessels exit at the _________.
convex border, hilum
828
What 3 regions are the lymphatic nodes divided into?
Outer cortex, paracortex, and inner medulla.
829
What does the outer cortex of the lymph nodes contain?
Primary and secondary nodules make of resident B-cells
830
What cells are present in the Paracortex of the lymph nodes?
T-cells entering the lymph node from the blood
831
What does the inner medulla of the lymph nodes contain?
Sinuses and cords made of reticular fibers.
832
What happens as lymph fluid flows through the cortex?
Afferent vessels release lymph into the subcapsular sinus. The sinus is lined with APCs that present the antigen to B-cells, which then become activated. Primary nodules turn into secondary nodules.
833
Which lymphocytes are in the paracortex? What do they do?
T-cells are attracted to the paracortex when cytokines are released from APCs. T-cells scan the lymphatic fluid for antigens.
834
What types of cells are present in the cords of the lymph node medulla?
Cords contain plasma cells, macrophages, and B-cells.
835
Antibodies from plasma cell exit through ___________ _______________. Lymph exit through _____________ _____________.
blood vessels, efferent vessel
836
T/F: T helper cells are required for only cell mediated response.
False! T helper cells are required for BOTH cell and humoral mediated response.
837
Describe T- cells cell mediated immune response.
Begins with antigen recognition. T helper cells release cytokines. Cytokines stimulate produce of cytotoxic T-cells, T-regs, and memory cells. Also attract T-cells to the site of infection.
838
Describe Opsonization.
An indirect method of defense in which antibody forms a complex with antigen, which attracts macrophages to come ingest the entire complex.
839
What is the difference between primary and secondary immune response?
In the secondary immune response, there will be a much higher concentration of antibodies.
840
What are Lymphatic Vessels?
A bunch of merged lymphatic capillaries.
841
What keeps valves in the Lymphatic Vessels closed?
The pressure of fluid pressed up against the valve keeps it closed after it passes through.
842
T/F: The structure of the Lymphatic vessels allows for fluid to leak in and out easily.
False! Fluid can get in but it CANNOT get out.
843
What does the jugular trunk drain?
Head & neck
844
What does the subclavian trunk drain?
Upper extremities
845
What does the bronchomediastinal trunk drain?
Chest
846
What does the intestinal trunk drain?
Lacteals from intestine (abdomen)
847
What does the lumbar trunk drain?
Lower extremities into the intestinal trunks
848
What drains each color of the body?
Dark green = Drained by lymphatic duct
Light green = Drained by thoracic duct
849
T/F: Not only do helper T-cells help to initiate the cell response, but they also keep the cell response going.
True!
