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119 Cards in this Set

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what's in the carotid sheath
"VAN"

V=Internal Jugular "V"ein (lateral)
A=Common Carotid "A"rtery (medial)
N=Vagus "N"erve (posterior)
which A supplies the anterior interventricular septum?
LAD (Left Anterior Descending), which originiated from LCA (Left Coronary A)
which A supplies the post interventriuclar septum
80% of the time=PD (Posterior Descending), which originated from RCA (Right Coronary A)

*=Right-dominant heart
which A supplies left ventricle
PD (Posterior Descending=Posterior Interventricular A) supplies left ventricle (posterior part of heart).

*80% of the time, PD originates from RCA (Right Coronary A) = "Right dominant heart"
which A supplies SA and AV node
RCA
"right-dominant heart" means what?
that the PD (Posterior Descending=Posterior Interventricular) arises from the RCA (Right Coronary Artery).

80% ppl have right-dominant heart
enlargement of which part of the heart can cause dysphagia?
enlargement of LA can cause dysphagia b/c LA=most posterior part of heart, closest to esophagus.
when do coronary arteries fill?
during diastole
Aortic area of heart
-located where?
-murmur here suggests what?
-located in right 2nd intercostal space
-SYSTOLIC murmur here suggests AS or flow murmur (flow murmur=nl flow thru stenotic valve OR incr flow thru nl valve, i.e. pregnancy)
Pulmonic area of heart
-located where?
-murmur here suggests what?
-located in left 2nd intercostal space
-SYSTOLIC murmur here suggests PS (Pulmonic Stenosis) or flow murmur (flow murmur=nl flow thru stenotic valve OR incr flow thru nl valve, i.e. pregnancy)
Tricuspid area of heart
-located where?
-murmur here suggests what?
-5th intercostal space over sternum
-SYSTOLIC murmur here suggests:
*TR (Tricuspid Regurg)
*VSD (Ventricular Septal Defect)

-DIASTOLIC murmur suggests
*TS (Tricuspid Sten)
*ASD (Atrial Septal Defect)
Mitral area of heart
-located where?
-murmur here suggests what?
-located at 5th intercostal space, over cardiac apex

-SYSTOLIC murmur here suggests
*MR

-DIASTOLIC murmur here suggests
*MS
MC sites of coronary artery occlusion?
LAD > RCA > LCA

(LAD supplies ant interventricular septum)
MC adrenal medulla tumor?
-does it cause HTN?
Adults=pheochromocytoma
*==>HTN

Kids=Neuroblastoma
*does not cause HTN
adrenal gland drainage
left adrenal gland
==>left adrenal V (AKA suprarenal V)
==>left renal V
==>IVC

right adrenal gland
==>right adrenal vein (AKA suprarenal)
==>IVC
neurohypophysis
-other name
-derived what which embryologic layer?
-desc
AKA Post Pit

-derived from neural ectoderm (thus "neuro"hypophysis)
-secretes oxytocin & ADH
(these are produced in hypothalamus and shipped to neurohypophysis via hypothalamic stalk; thus if hypothalamic stalk is severed (i.e. car accident)==>no secretion of oxytocin & ADH)
post pit
-other name
-derived what which embryologic layer?
-desc
AKA Neurohypophysis

-derived from neural ectoderm (thus "neuro"hypophysis)
-secretes oxytocin & ADH
(these are produced in hypothalamus and shipped to neurohypophysis via hypothalamic stalk; thus if hypothalamic stalk is severed (i.e. car accident)==>no secretion of oxytocin & ADH)
adenohypophysis
-other name
-derived what which embryologic layer?
-desc
AKA ant pit
-derived from oral ectoderm (weird, i guess the ant pit is sort of near the motuh)
-secretes FLAT PIG + MSH:
FSH
LH
ACTH
TSH
ProlactIn
GH

and MSH (Melanotropin)

has 2 subunits:
1. alpha subunit: common subunit to TSH, LH, FSH, & hCG

[mneum: "FL-α-T hCG]

2. Beta subunit: determines hormone specificty
islets of Langerhans
-desc
-where most numerous
-arise from what
-islets of Langerhans= collection of α, β, & δ cells
-most numerous in tail of pancreas
-arise from pancreatic buds:
*α=peripheral
*β=central,
*δ=interspersed

*α=glucagon
*β=insulin
*δ=somatostatin
retroperitoneal structures
1. Duod-parts 2,3,4
2. pancreas-except tail
3. ascending colon
4. descending colon
5. kidney
6. adrenal gland
7. rectum
8. Ao
9. IVC
foregut
-supplied by what artery
-consists of what structures
-celiac a

Consists of:
-stomach==>proximal duod
-liver, GB, pancreas
midgut
-supplied by what artery
-consists of what structures
-SMA

Consists of:
-proximal duod==>2/3 of transverse colon
hindgut
-supplied by what artery
-consists of what structures
-IMA

Consists of:
-2/3 transverse colon==>upper portion of rectum
what supplies blood to the stomach?
celiac trunk:
1. left gastric

2. splenic, gives off:
--short gastrics
--splenic branches
--L gastroepiploic

3. common hepatic, gives off:
--3a. rt gastric
--3b. gastroduodenal
-----3b1. R gastroepiploic
--3c. proper hepatic
-----3c1. left and rt hepatic
-----3c2. cystic (to GB)
where are the strong anastomoses in the stomach?
-b/w L & R gastroepiploics

-b/w L & R gastrics
what happens if block splenic A
poor anastomoses b/w short gastrics
reasoning behind portal-systemic anastomoses

-veins involved in anastomoses?
-site of anastomoses?
-clinical sign?
In portal HTN, the goal is to avoid the liver. Thus, veins that usually drain to portal V (to supply blood to liver) instead drain into systemic veins (which are leaving the liver and about to drain into IVC). This decreases blood flow thru the liver (goal).

1. Left gastric vein usually drains into portal vein (goes from stomach to liver), but in portal HTN, it bypasses the liver & instead drains into esophageal vein (==>IVC)
==>incr blood flow thru esophageal vein
==>esophageal varices

*site of anastomoses=esophagus

2. Paraumbilical vein usually drains into portal vein (goes from umbilicus to liver), but in portal HTN, it bypasses the liver & instead drains into superior and inferior epigastric veins (==>IVC)
==>incr blood flow through epigastric veins
==>caput medusa

*site of anastomoses=umbilicus

3. Superior rectal usually drains into portal vein (goes from rectum to liver), but in portal HTN, it bypasses the liver & instead drains into middle and inferior rectal vein (==>IVC)
==>incr blood flow in inferior rectal vein
==>hemorrhoids

*site of anastomoses=rectum


SUMMARY:
Portal <==> Systemic Anastomoses:

1. L gastric V <==>Esophageal V (site of anastomoses=esophagus)
==>esophageal varices

2. Paraumbilical V <==> Sup & inf Epigastric V (site of anastomoses=umbilicus)
==>caput medusae

3. sup rectal V <==> middle & inf rectal V (site of anastomoses=rectum)
==>hemorrhoids
if Abdominal Aorta blocked b/w the origins of SMA & IMA, what collateral circulation arises?
1. middle colic A [SMA] <==> left colic A [IMA]

2. marginal A (connects Ao above SMA's origin with Ao below IMA's origin
==>thus bypasses block b/w SMA & IMA
if Abdominal Aorta blocked, what collateral circulation arises?
A. If Abdominal Aorta blocked:
-b/w origins of subclavian/internal thoracic,
-b/w origins of internal thoracic/external iliac, or
-b/w origins of subclavian/external iliac==>

*internal thoracic/mammary [subclavian] <==> superior epigastric [internal thoracic] <==> inferior epigastric [external iliac]


B. If Abdominal Ao blocked:
-b/w origins of celiac trunk & SMA==>
*superior pancreaticoduodenal A [celiac trunk] <==> inferior pancreaticoduodenal A[SMA]

C. If Abdominal Aorta blocked b/w origins of SMA & IMA==>

1. middle colic A [SMA] <==> left colic A [IMA]

2. marginal A (connects Ao above SMA's origin with Ao below IMA's origin
==>thus bypasses block b/w SMA & IMA

D. If Abdominal Aorta blocked b/w origins of IMA & internal iliac==>

*superior rectal [IMA] <==> middle rectal [int iliac]
at what vertebral level is the celiac trunk?
T12
falciform ligament
-connects what?
-contains what structures?
-connects liver & ant abdominal wall
-contains ligamentum teres (umbilical V remnant)
hepatoduodenal
-connects what?
-contains what structures?
-connects liver & duodenum
-contains portal triad:
portal vein (duod==>liver)
hepatic artery (to liver)
common bile duct (liver==>duod)

*to control bleeding, can compress hepatoduodenal ligmanet b/w thumb and index finger placed in epiploic foramen of winslow
gastrohepatic ligament
-connects what?
-contains what structures?
-connects lesser curvature of stomach & liver
-contains gastric arteries (makes sense b/c both L and R gastric arteries supply lesser curvature of stomach:
-L gastric artery comes directly off celiac trunk;
=R gastric artery comes off common hepatic A, which came off celiac trunk)
gastrosplenic ligament
-connects what?
-contains what structures?
-connects greater curvature of stomach & spleen
-contains no vessels

*separats greater and lesser sacs of liver
gastrocolic ligament
-connects what?
-contains what structures?
-connects greater curvature of stomach & transverse colon
-contains gastroepiploic arteries

*part of greater omentum
splenorenal ligament
-connects what?
-contains what structures?
-connects spleen to posterior abdominal wall
-contains splenic A and V
Layers of gut wall
Layers of gut wall (inside==>outside): "MSMS"

1. "M"=MUCOSA

1a. epithelium (absorption)
1b. lamina propria (support)
1c. muscularis MUCOSA (motility)

2. "S"=SUBMUCOSA
*contains "S"ubmucosal nerve plexus (Meissner's), which regulates "S"ecretions, BF, & absorption

3. "M"=MUSCULARIS EXTERNA
*inner circular, outer longitudinal SmM layers
*contains "M"yenteric plexus (Auerbach's), which regulates "M"otility along entire gut wall
[Myenteric plexus is located b/w inner circular and outer longitudinal layers]

4. "S"=Serosa/Adventitia
frequencies of basal electric rhythm of:
-stomach
-duod
-ileum
basal electrical rhythm ~ rate of peristalsis

-stomach: 3 Hz
-duod: 12 Hz
-ileum: 8-9 Hz
Meissner's plexus
[Meisseners AKA "S"ubmucosal nerve plexus]

-located in "S"ubmucosa
-regulates "S"ecretions, BF, & absorption
-contains cell bodies of some parasympathetic terminal effector neurons (these regulate secretion)
Auerbach's plexus
-Auerbach's AKA "M"yenteric Plexis

-located in "M"uscularis Externa b/w inner circular and outer longitudinal layers
-regulates "M"otility along entire gut wall
-contains cell bodies of some parasympathetic terminal effector neurons (these regulate motility)
abdominal layers-from skin to peritoneum
external to internal==>

Skin
Superficial fascia
External oblique
Internal oblique
Transversus abdominis
Transversalis fascia
Extraperitoneal tissue
Peritoneum
Brunner's glands
-located in submucosa of duodenum (the only GI submucosal glands)
-secretes alkaline mucus to neutralize acidic contents entering the duodenum from the stomach

-hypertrophy of Brunnner's glands in PUD (makes sense; in PUD, incr acid, so need more alkaline mucous to neutralize)
Peyer's Patches
*unencapsulated lymphoid tissue in lamina propria & submucosa of sm int, usu ileum

*contain M cells, which sample the intraluminal contents (contents of the gut lumen)
==>if there is an antigen, M cells deliver antigen to APC's (B cells)
==>stimulates B cells to leave Peyer's Patch
==>go to mesenteric lymph nodes, where the B cells differntiate into IgA-secreting plasma cells
==>IgA receives protective secretory component and is then transported across epithelium into gut lumen to kill pathogen

mneum: "IgA"= "I"ntra-"g"ut "A"ntibody (remember that IgA is the Ig associated with mucosa)
sinusoids of liver
(pic BRS Histo p. 244)

-deliver blood from portal vessels==>central vein

-irregular "capillaries" w/
*fenestrated epithelium
(pores= 100-200 nm diameter)
*no BM
==>allows plasma macromolecules full access to basal surface of hepatocytes thru perisinusoidal space (=space of Disse=subendothelial space b/w hepatocytes and sinusoids; thus hepatocytes do not directly contact the bloodstream)
pectinate line
-formed by what?
-importance?
-associated A & V
-types of cancer
(FA pic p. 278 shows venous drainage)

-formed where hindgut (supplied by IMA) meets ectoderm

ABOVE PECTINATE LINE:
-internal hemorrhoids
-not painful b/c visceral innervation
-adenocarcinoma
-supplied by Superior Rectal Artery (branch of IMA)
-drains to Superior Rectal V
==>IMV
==>portal system

BELOW PECTINATE LINE
-external hemorrhoids
-painful b/c somatic innervation
-sq cell CA
-supplied by inferior rectal artery (branch of internal pudendal A)
-drains to inferior rectal vein
==>internal pudendal V
==>internal iliac V
==>IVC
femoral region
-contains what
Femoral Region: N-(AVEL)

N=femoral N
A=femoral A
V=femoral V
E=Empty space
L=Lymphatics (deep inguinal lymph nodes)

Femoral Triangle= NAV

Femoral Sheath=
(AVEL)
[not N!]
femoral triangle contains what
NAV:

N=femoral N
A=femoral A
V=femoral V
femoral sheath contains what
(AVEL)
[not N!]

A=femoral A
V=femoral V
E=Empty space
L=Lymphatics (deep inguinal lymph nodes)
hesselbach's triangle
=site of protrusion of direct inguinal hernia

consists of:
1. inferior epigastric A
2. inguinal ligament
3. lateral side of rectus abdominis
direct inguinal hernia
-site of protrusion
-covered by what?
-population who gets this
-site of protrusion=abdominal wall
-bulges "directly" thru abdominal wall medial to inferior epigastric A
-penetrates external/superficial inguinal ring only (not internal/deep inguinal ring)
-covered only by transversalis fascia
-usu in older men
indirect inguinal hernia
-site of protrusion
-covered by what?
-population that gets this?
-etiology?
"IN"direct inguinal hernia:

-follows path of embryologic descent of spermatic cord
==>passes thru "IN"ternal/deep inguinal ring==>thru external/superficial inguinal ring==>"IN"to scrotum
-site of protrusion=internal/deep inguinal ring

-enters internal inguinal ring lateral to inferior epigastric A
-covered by all 3 layers of spermaticord (external spermatic fascia, cremasteric muscle & fascia, internal spermatic fascia)
-d/t failure of processus vaginals to close==>found in "IN"fants
femoral hernia
-female>male
-protrudes thru femoral canal below and lateral to pubic tubercle
*leading cause of bowel obstruction
what is a leading cause of bowel obstruction
femoral hernia
diaphragmatic hernia
-describe
-et
=abdominal structuers enter thorax
-can occur in infants d/t defective development of pleuroperitoneal membrane

SLIDING HIATAL HERNIA:
*MC
-G-E jxn slides upward above esophageal hiatus of diaphragm
==>stomach herniates upward thru esophageal hiatus

DIAPHRAGMATIC HERNIA
-cardia of stomach moves into thorax
-G-E jxn nl
hernia more common in women?
femoral
hernia more common in young boys?
indirect inguinal hernia
hernia more common in older men?
direct inguinal hernia
erythrocyte
-desc
-source of energy
-anucleate (no nucleus)
-biconcave
-source of energy=glucose
*90% degraded (anaerobically) to lactate
*10% degraded via PPP (generates NADPH)

-"Physiologic Chloride Shift": RBC membrane contains Cl-bicarb antiport

==>allows RBC to transport CO2 from periphery==>lung for excretion

(BRS Phys p.144: pump Cl- in so that can ship HCO3- out (then HCO3- goes to lungs to be converted to CO2 for expiration)
anisocytosis
varying sizes of RBC's
poikilocytosis
varying shapes of RBC's

mneum: "P"oikilocytosis=varying shaPes

(vs. ani"S"ocytosis=varing "S"izes)
basophils
-desc
-contains what?
-basophilic stippling?
~mast cell structurally and functionally

dark blue color ("basophilic")
mediates allergic rxn
bilobate nucleus

contains:
-heparin (anticoagulant)
-histamine (vd)
-leukotrienes (LTD-4)


basophilic stippling=
*dark blue granules (=ribosomes) in RBC's;
*seen in "TAIL" (note-these are all the microcytic anemias):
T=Thalassemias
A=Anemia of chronic dz
I=Iron deficiency anemia
L=Lead poisoning (==>sideroblastic anemia)
basophilic stippling
*dark blue granules (=ribosomes) in RBC's;
*seen in "TAIL" (note-these are all the microcytic anemias):
T=Thalassemias
A=Anemia of chronic dz
I=Iron deficiency anemia
L=Lead poisoning (==>sideroblastic anemia)
which cells mediate allergic rxn
basophil
mast cell
mast cell
~basophils structurally and functionally

-mediates allergic rxn
-mast cell membrane can bind IgE
-Type I hypersensitivity rxn
-degranulation==>release chemotactic factors for histamine, heparin, & eosinophils

*Cromolyn sodium prevents mast cell degranuation (Tx asthma)
eosinophil
-Eosinophil's Major Basic Protein defends against helminthic and protozoan infxns
-highly phagocytic for Ag-Ig complexes
-produces histaminase and arylsulfatase

Causes of eosinophilia= "NAACP":
-Neoplasm
-Allergic rxn
-Asthma
-Collagen vascular dz
-Parasites
neutrophil
-acute inflammatory response
-phagocytic
-large azurophilic (blue) primary granules ("lysosomes") contain:
*myeloperoxidase
*lysozyme
*lactoferritin
monocyte
Goljan=hallmark of chronic inflamm
-kidney-shaped nucleus
macrophage
-activated by gamma-IFN
-can fxn as APC via MHCII
lymphocyte
B lymphocytes
*produce Ig

T lymphocytes
*cellular immune response
*regulate B lymphocytes & macrophages
plasma cell neoplasm?
Multiple Myeloma
B lymphocyte
-desc
-CD markers?

-arises from?
-matures where?
-after matures, where does it migrate?
*has CD19 & CD20

*humoral immune response (Ig)
-arises from "B"one marrow stem cells
==>matures in marrow
==>migrates to peripheral lymphoid tissue (LN follicles, white pulp of spleen, unencapsulated lymphoid tissue)

-when B lymphocyte encounters Ag, it differentiates into plasma cell to produce Ig
-has memory
-can fxn as APC via MHCII
plasma cell
-when B lymphocyte encounters Ag, it differentiates into plasma cell to produce Ig
-off-center nucleus
-clock-face chromatin distribution
-abundant RER
-well-developed Golgi (b/c plasma cell produces lots proteins [Ig], and proteins are modified processed in Golgi]
T lymphocyte
-desc
-CD markers?

-arises from?
-matures where?

-types of T cells
*Th has CD3 and CD4
*Tc has CD3 and CD8

[mneum: MHC x CD = 8;
MHC 2 x CD 4 = 8 (Th)
MHC 1 x CD 8 = 8 (Tc))

*cellular immune response
-arise from BM stem cells, but matures in "T"hymus
-T lymphocytes differentiate into:
*cytotoxic T cells (MHC 1, CD8)
*helper T cells (MHC 2, CD4)
*suppressor T cells
dendritic cells
*professional APC's
==>thus have MHC II

-main inducer of primary antibody response
-have Fc-receptors (so they can bind Fc part of Ig)
-called "Langerhans cells" in the skin
epidermis layers
"Californias Like Girls in String Bikinis"

C= stratum Corneum
L= stratum Lucidum
G= stratum Granulosum
S= stratum Spinosum
B= stratum Basalis
Epithelial cell jxns
-desc
-what structures contained
"Junctional Complex" (for cell-to-cell attachment of columnar epithelial cells):

1. Zona Occludens (Tight junctions)
-closest to lumen (vs. basal layer)
-proteins of epithelial cells attach directly to one another==>seals off intercellular space (the space b/w adjacent epi cells)
==>no diffusion of substances from lumen into intercellular space


2. Zona Adherens (Intermediate Jxns)
-surrounds perimenter of epithelial cells just below zona occludens (which is closest to lumen, vs. basal layer)
-adheres adjacent epithelial cells to one another
*contains E-cadherin & actin filaments (E-CADHERIN promotoes ADHESION)

3. Desmosome (AKA Macula Adherens)
-small, discrete sites of attachment
-adheres adjacent epi cells to each other
*contains desmoplakin & keratin

NOT part of Junctional Complex:

4. Gap Jxns
-metabolic & electrical communication b/w adjacent epi cells

5. Hemidesmosomes
-attaches epithelial cell to underlying ECM
*contains INTEGRIn (which maintains INTEGRIty of BM)
Zona Occludens
-desc
-what structures contained
*part of Junctional Complex (for cell-to-cell attachment of columnar epithelial cells):


1. Zona Occludens (Tight junctions)
-closest to lumen (vs. basal layer)
-prevent mvmt of substances from lumen into intercellular space
-proteins of epithelial cells attach directly to one another==>seals off intercellular space (the space b/w adjacent epi cells)
==>no diffusion of substances from lumen into intercellular space
Zona Adherens
-desc
-what structures contained
*part of Junctional Complex (for cell-to-cell attachment of columnar epithelial cells):

2. Zona Adherens (Intermediate Jxns)
-surrounds perimenter of epithelial cells just below zona occludens (which is closest to lumen, vs. basal layer)
-adheres adjacent epithelial cells to one another
*contains E-cadherin & actin filaments (E-CADHERIN promotoes ADHESION)
Macula Adherens
-desc
-what structures contained
*part of Junctional Complex (for cell-to-cell attachment of columnar epithelial cells):

3. Desmosome (AKA Macula Adherens)
-small, discrete sites of attachment
-adheres adjacent epi cells to each other
*contains desmoplakin & keratin
gap jxn
NOT part of Junctional Complex
(for cell-to-cell attachment of columnar epi cells)

Gap Jxns
-metabolic & electrical communication b/w adjacent epi cells

*has CONNEXON with central channel
hemidesmosomes
*not part of Junctional complex (for cell-to-cell attachment of columnar epi cells)

-attaches epithelial cell to underlying ECM
*contains INTEGRIn (which maintains INTEGRIty of BM)
unhappy triad
-football injury

-hit on lateral side==>damage:
1. medial meniscus
2. MCL (Medial Collateral Ligament)
3. ACL (Anterior Cruciate ligament)
(+) anterior drawer sign indicates
torn ACL
abnl passive abduction of leg indicates
torn MCL
rotator cuff muscles
"SItS":

Supraspinatus
(superior)==>thus abducts arm (helps deltoid)

Infraspinatus
(posterior)==>thus laterally rotates arm

teres minor
(posterior)==>thus laterally rotates
(inferior)==>thus adducts

Subscapularis
(inferior)==>thus adducts
(anterior)==>thus medially rotates
which kidney taken during transplantation?
L kidney b/c longer renal V on left (on left, gonadal and adrenal V's dump into left renal vein, which crosses over vertebral bodies to dump into IVC, which lies on right side of vertebral bodies

vs. right renal vein-shorter b/c close to IVC b/c IVC lies on right side on vertebral bodies)
course of ureters
"water under the bridge"

water (ureters) go under the bridge (ovarian artery, ductus deferens)
venous drainage of ovary/testes
L ovary/testis
==>left gonadal vein
==>left renal vein
==>IVC

R ovary/testis
==>right gonadal vein
==>IVC
lymphatic drainage of ovary/testes
para-aortic LN
suspensory ligament of ovaries:
contents?
it's a uterine ligament (AKA ovarian ligament of uterus)

ovarian vessels
what does transverse cervical ligament contain?
AKA cardinal ligament (uterus)

-contains uterine vessels
contents of cardical ligament?
AKA transverse cervical ligament

-contains uterine vessesl
contents of round ligament?
-does not contian any important strucutres

=remnant of gubernaculum
conents of broad ligament?
mneum: "Broad" ligament so covers "broad" (big) area & thus contains many structures.

It actually contains all other uterine ligament and their contents!

1. suspensory ligament of ovaries AKA ovarian ligament of uterus
-contain ovarian vessels

2. transverse cervical (AKA cardinal) ligament
-contain uterine vessels

3. round ligament of uterus
-no important structures
-remnant of gubernaculum
-erection is mediated by what?
PSNS
emission (male sex response) is mediated by what?
SNS
ejaculation is mediated by what nerves?
visceral AND somatic nerves
derivation of sperm parts
-acrosome dervied from Golgi
-flagellum (tail) derived from one of the centrioles
which part of sperm has mitochondria?
"M"iddle part contains "M"itochondria
what is food supply for sperm?
fructose
respiratory tree:
-conducting zone vs. respiratory zone
*contain which structures
*fxns

Which zone (conducting/respiratory) contains anatomic dead space?
CONDUCTING ZONE contains everything from nose==>terminal bronchioes:
*nose
*pharynx
*trachea
*bronchi
*bronchioles
*terminal broncholies

-fxn of conducting zone is to warm and humidify the air
-CONDUCTING ZONE contains anatomic dead space

RESPIRATORY ZONE contains:
*respiratory bronchioles
*alveolar ducts
*alveoli

-fxn of resp zone=gas exchange
-to where do pseudocolumnar ciliated cells extend?
respitatory bronchioles
to where do goblet cells extend in the respiratory tree?
only to the terminal bronchioes (vs pseudocolumnar ciliated cells, which extend to respitatory bronchioles)
which cells line the alveoli?
Type I cells (97% of alveolar surfaces)
pulmonary surfactant
-AKA
-secreted by what?
-AKA dipalmitoyl phosphatidylcholine
-secreted by Type II pneumocytes
dipalmitoyl phosphatidylcholine
=pulmonary surfactant
Type II pneumocytes
-secrete pulmonary surfactant
-precursors of Type I and II pneumocytes
==>thus, Type II pneumocytes proliferate during lung damage
what indicates fetal lung maturity?
lecithin:sphingomyelin ratio of >2.0
why is lecithin:sphingomyelin ratio important?
>2 ==>fetal lung maturity
bronchopulmonary segment
-each bronchopulmonary segment has

*tertiary (segmental) bronchus [center]
*2 arteries: bronchial & pulmonary [center]
*veins [periphery]
*lymphatics [periphery]

mneum: "A"rteries run with "A"irways
MC site for inhaled foreign body?
R lung (b/c R bronchus is shorter & straighter)
how many lobes in lung?
-Right lung has 3 lobes

-"L"eft lung has 2 lobes + "L"ingula
relation of pulm A and bronchus at each lung hilus
rel'n of pulm A to bronchus at each hilus is "RALS":

Right Anterior;
Left Superior
structures perforating the diaphragm
"I 8 10 EGGS AT 12"

"I 8": 8th vertebrae==>
I=IVC

"10 EGGs": 10th vetebrae==>
EG=EsophaGus
G=vaGus

"AT 12": 12th vertebrae==>
A=Ao, Azygous
T=Thoracic duct
muscles of respiration
QUIET BREATHING:
-Inspiration: diaphragm
-Expiration: passive

EXERCISE:
-Inspiration:
*ext intercostals (the only abdominal muscle used during inspiration)
*scalene (neck muscle)
*sternocleidomastoid (neck muscle)

-Expiration (all abdominal muscles):
*rectus abdominis
*ext oblique
*int oblique
*transversus abdominis
*internal intercostal
what allows anterograde mvmt of cilia
kinesin
what allows retrograde mvmt of cilia
dynein
dynein
-Dynein=
*ATPase that links peripheral 9 doublets
==>causes doublets to slide
==>bend cilium (cilia; dynein is part of the cilia)
==>allows retrograde mvmt
defective cilia
-what causes
-effects
Defective cilia (d/t defective dynein arm)==>
*male/female infertility (sperm have no cilia)
*bronchiectasis
*recurrent sinusitis (no cilia in bronchioles to sweep away pathogens)