Lecture 1 + 2

Question 1

The three layers of the vessels and characteristics

Answer 1

Epicardium (tunica adventitia)
visceral layer of the serous pericardium
contains BV and N
fibroelastic CT

endocardium (tunica intima)
has purkinje fibers
loose connective tissue

myocardium (tunica media)
muscle
largest of the three layers

Question 2

The three layers of valves and characteristics

Answer 2

Atrialis: DCT with organized collagen and elastic fibers
allow extension and recoil

spongiosa: core of the valve
LCT with loosely arranged collagen and elastic fibers
shock absorber
flexibility and plasticity of cusps

Fibrosa: DICT with collagen and elastic fibers
covered in endothelial cells
provides tensile stiffness
continues into chordae tendineae

Question 3

Types of arteries and characteristics

Answer 3

Elastic arteries: aorta
large # of elastic fibers in the tunica media
arranged like shingles on a roof (imbricated)
have fenestrations (permit diffusion)

Muscular arteries: most abundant
external elastic laminae is see between tunica media and adventitia

Question 4

Types of capillaries and characteristics

Answer 4

1. continuous/somatic capillary (control over diffusion)
continuous basal lamina 
uninterrupted endothelium 
tight junctions present 
seen in nervous tissue 

2. Fenestrated/Visceral capillary
   continuous basal lamina
   tight junctions present
   peptide-secreting organs, ciliary processes, kidney

 3. Discontinuous/Sinusoidal
discontinuous basal lamina
no tight junctions
large fenestrations
liver, spleen, bone

Question 5

Veins

Answer 5

Thick tunica adventitia

folds of the tunica intima make valves to prevent backflow of blood

Question 6

Hypertension

What is it? what does it do? what changes occur?

Answer 6

leads to damage to blood vessels
arterioles are the major contributor to BP

leads to:

1. symmetrical hypertrophy
2. reduplication of the internal elastic lamina
3. fibrotic thickening of the tunica intima

Question 7

Atherosclerosis

Answer 7

Shrinkage of a vessel lumen

compression of the tunica media and narrowing of the lumen

Question 8

Aneurysm

Answer 8

Blood accumulation within the tunica media
will normally burst into the tunica adventitia

usually due to weakening of the vascular walls

Question 9

lymphedema

Answer 9

accumulation of lymph

due to: 
trauma
post-surgical 
post-radiation 
inflammation
parasitic or other obstruction

Question 10

Plane of ludwig

Answer 10

horizontal plane across the thorax

anterior boundary:
angle of luis
2nd costal cartilage

posterior boundary: T4/5

Question 11

Structures at the plane of ludwig

Answer 11

SVC
arch of the aorta
trachea bifurcation
pulmonary trunk bifurcation

Question 12

boundaries of the superior mediastinum

Answer 12

Superior: 1st rib, T1, and jugular notch

inferior: transthoracic plane
posterior: T1-T4
anterior: manubrium

Question 13

Contents of the superior mediastinum

Answer 13

esophagus 
thoracic duct
thymus 
trachea 
SVC
aortic arch 
left and right brachiocephalic veins

nerves: phrenic, recurrent laryngeal, and vagus

Question 14

three branches of the aortic arch

Answer 14

brachiocephalic trunk

left common carotid

left subclavian

Question 15

boundaries of the inferior mediastinum

Answer 15

superior: transthoracic plane
inferior: diaphragm
anterior: body of the sternum
posterior: T5-T12

anterior, posterior, and middle sections

Question 16

Anterior mediastinum borders and contents

Answer 16

anterior: sternum
posterior: pericardium

thymus, lymph nodes, CT

Question 17

Middle mediastinum contents

Answer 17

heart and main bronchi

Question 18

Posterior mediastinum borders and contents

Answer 18

anterior: pericardium
posterior: T5-T12

contents:
sympathetics 
esophagus 
azygos system 
thoracic duct 
descending thoracic aorta 
esophageal plexus

Question 19

The constrictions of the esophagus

Answer 19

1. junction with the pharynx (C6)
2. where crossed by the arch of the aorta
3. where crossed by the left main bronchus T4/5
4. esophageal hiatus (T10)

Question 20

Thoracic outlet syndrome

Answer 20

caused by:
extra rib attaching to 7th vertebra and rib 1 \
muscular abnormalities
trauma

compression of subclavian A/V: thrombosis/ embolization
nerves C8-T1

symptoms:
pain, paresthesia, paresis, paralysis
pallor, pulselessness, cold, edemic