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1426 Cards in this Set
- Front
- Back
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Where does the trachea extend to?
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Down to the sternal angle (bifurcates below this)
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2 clinical manifestations of Tetralogy of Fallot
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Slight heart murmor, boot-shaped heart in radiological findings
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99% of the defect is where?
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Distal to subclavian artery
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__ __ is where gaseous exchange occurs at alveoli
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capillary bed
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__ is a membrane on the upper side edge of what used to be the foramen ovalis
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Limbus
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A defect in atrial septation is known as what?
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Classic post-natal patent foramen ovale
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A rich supply of the innervation goes to the __ __, which starts the information flow by th emyocardium to the atria on both sides
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SA node
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A single __ __ artery passes __ to respiratory passage
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right bronchial, posterior
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About 2/3 of the way down from the hilum to the outer surface of the lung tissue, what occurs?
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Cartilage becomes smooth muscle and elastic fibers
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After 9-11 months of serious VSD, describe the clinical manifestion?
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Pulmonary hypertension arises from an overload in pulmonary circuit damaging intima, which damages intimal growth, which causes hypertension
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After initial formation the mesoderm subdivides into 3 masses. Name them.
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Paraxial, intermediate, lateral / lateral plate
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Along the smooth wall posterior portion of the atrium there is a?
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Sinus venarum
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Anterior chest wall has doubling of __ __ __.
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Internal thoracic veins
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Anterior papillary muscles
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Largest papillary muscles come from anterior surface of chamber
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Anterior thoracic blood supply derives from what?
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Internal thoracic artery
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Aortic arch has 3 branches, name them.
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Left subclavian artery, left common carotid artery, brachiocephalic trunk
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Aortic valve has __, __, and __ cusps
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right, left, posterior
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Arch of aorta has how many important structures, and what are they?
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3 structures, brachiocephalic trunk, left common carotid artery, left subclavian artery
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Are chambers continuous externally, or are there moments of disconcert?
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They have groove between the chambers, sulcus
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Are lymph nodes localized in any certain region of the lung?
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Located along entire respiratory passages
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Are the ascending aorta and aortic arch present in the area of superior mediastinum?
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Yes
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Are the branches of the bronchial arteries large or small?
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Small
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Are the components of the coronary sinus surrounded by mesocardium?
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Mesocardium is only around the 3 great vessels
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Are the cusps of the pulmonary trunk and aortic valve similar or disimilar? How-so?
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Similar. Both are passive and are affected by blood flow via fluid dynamics
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Are the valves ont he same side or different sides of the sternum?
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Same side
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Are there any other ducts nearby?
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Smaller duct exists, smaller right lymphatic duct
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Are thoracic nerves segmentally organized?
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Yes
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Arteries carry blood __
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away
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As the respiratory passage gets smaller, what happens to the C rings?
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They become plates
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As the sections ascend, we dont see much of the chamber of the __ ventricle, only the thick muscle wall.
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Left
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As the sections descend, one can no longer see something, what is it?
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Left atrium
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As the sections descend, you will have lungs and 4 chambers, but as you get to a certain level what do you cease to see?
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Left atrium
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As we get to the top of the right atruim it gets __ and begins to transition into __ __ __.
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Smaller, superior vena cava
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As you ascent higher, does the aorta become more or less well developed?
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More well developed
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At the completion of what mechanism do the right and left heart tubes fuse at the midline to form one single heart tube?
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Lateral body folding
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At the end of the cardiac notch in the superior lobe you have the __, which is an extension around the heart
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lingual
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Atria have __, which are earlike extensions / appendages
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auricles
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Azygous vein is formed by what 3 things?
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Ascending lumbar vein, subcostal vein below 12th rib, minor contribution from inferior vena cava
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Below the diaphragm, what does the aorta become?
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Abdominal aorta
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Between the atria and ventricles lay?
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Coronary sulcus
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Between the ventricles, the sulcus is known as what?
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Interventricular sulcus
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Blood from the left ventricle goes into the __ __, then through the __ __ and into the __ __ __ for systemic circulation
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ascending aorta, aortic arch, descending thoracic aorta
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Blood is ejected via the __ __ to the ascending __ and __ __ aorta and out of heart systemic circulation
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aortic valve, arch, descending thoracic
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Bony skeleton served as a conduit for structures from the __ and __ to the __
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head, neck, abdomen
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Boundary of thorax - anterior
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Sternum, costal cartilages attachment of 12 pairs of ribs
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Boundary of thorax - inferior thoracic aperture
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Diaphragm
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Boundary of thorax - posterior
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thoracic vertebra
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Boundary of thorax - superior thoracic aperture (4 things)
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Upper portion of sternum, part of clavicle, 1st rib, thoracic vertebrae I (TVI)
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Bronchial arteries come from __ __ __, deep to __ passage
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descending thoracic aorta, respiratory
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Bronchial vein is the return system for what type of blood?
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Venous blood from lung tissue itself
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Bronchiole veins do not make it to __ __ because they are thin and fragile
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visceral fluid
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By what time period has blood flow circulation begun?
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21-22 days
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Cervical pleura serves as a reminder for what?
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That the viscera can extend above the superior thoracic apperture
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Chordae tendineae extend from where to terminate where?
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Extend from one papillary muscle to two cusps of the tricuspid valve
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Clinically, what occurs if this space between the pleura is pierced?
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Space can fill with air causing pressure preventing lung from inflating
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Combining the brachiocephalic veins forms what?
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Superior vena cava
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Conduction system of the heart is important to do what 2 things?
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sequencing contractions and affecting rate and force of contraction
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Deoxygenated blood goes under arch of aorta through what?
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Pulmonary artery
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Describe blood flow, pressure, cyanosis (or non-cyanosis), and causes of ASD
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Flow is shunted left to right, high left atrial pressure, low right atrial pressure, non-cyanotic because blood recycles through pulmonary circuit again, 2 causes - excessive absorption of septum primum or underdeveloped septum secondum
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Describe elements of turbelence and efficiency for the cusp.
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Acts to minimize turbelence and maximize efficiency
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Describe how pressure changes alter the septum primum and ultimately the foramen ovale
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Primum is pushed to right by increased pressure in left atrium, and this closes foramen ovale. Septum primum fuses with septum secundum to form interatrial septum
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Describe how the interventricular septum grows?
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It grows superiorly, inferior is muscular and superior is membranous
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Describe how the pressure differential is altered as a result of birth. Mention changes in umbilical flow, pulmonary flow, right atrium pressure, and left atrium pressure
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Umbilical flow is shut off at birth, so pressure in right atrium is lowered because umbilical flow has ceased, pulmonary flow opens up, which helps lower pressure in right atrium as well because blood can now flow out of the right atrium more easily. Left atrial pressure increases as a result of both of these
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Describe how these layers extend?
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They extend to vessels into and out of heart
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Describe in general terms how the coronary artery arises from the valve
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Blood flows passed aortic valves, walls basically collapse towards sides leaving opening so blood rushes out, blood tries to rush back in when force is dropped, blood fills in middle pouch and closes valve so no backflow occurs.
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Describe the azygos system of veins pertaining to venous return.
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Two longitudinal channels bringing blood to the vena cava, as well as fragile thinned walls
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Describe the body of the manubrium and what it provides attachments for. Also name the joint between the body of the sternum and the xiphoid process
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It has a flattened concave structure, provides attachments for ribs 3-7, and its lower portion is the xiphosternal joint
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Describe the components (2) of the internal thoracic vein and at what point they arise
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Single vein until the 7th intercostal spaces where it becomes 2 veins - musculophrenic veins and superior epigastric veins
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Describe the curvature of the body/shaft of the rib, as well as where it ends
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Curves laterally and anteriorly ending in costal cartilage
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Describe the edges of lung tissue, and why this is the case?
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Edges are thin and sharp, lets lungs slide during inspiration
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Describe the external intercostal muscles and their function
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Most superficial, fibers pass in directions of "hands in pockets". Does upward and forward movement of anterior thoracic wall during inspiration
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Describe the final position of the arterial and venous systems after contortions.
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Arterial systems end up ventral, venous systems end up dorsal
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Describe the finality of the second step of separation of common atrium into right and left atria, including a describe of what it starts to separate, what its formation depends on, and what it forms.
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Starts to separate the atrial chambers from ventricular chambers, formation depends on neural crest cells as a signal, forms atrioventricular canals on its left and right as well as helping to form atrioventricular valves
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Describe the foramen ovale
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Opening formed by a rigid septum secundum and flexible septum primum
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Describe the function of the C shaped tracheal cartilaginous rings with openings facing the esophagus
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Provide support for trachea while providing room for bolus passing through esophagus without interfering with position of trachea or obstructing it
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Describe the internal intercostal muscles (origination, insertion, membranous conclusion, relationship to external intercostals)
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They are perpendicular to external intercostals, located in intercostal space from lateral edge of sternum to angle of the rib, with a membrane extending from angle of rib to tubercle
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Describe the location of the neurovascular bundle of the thoracic wall as well as its contents
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Vein, Artery, Nerve superior to inferior arrangement running in the costal groove
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Describe the location of the sinus venosus, and what it does.
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Most caudal end, venous inflow from embryo's body occurs here
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Describe the location of the truncus arteriosus, and what it does.
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Most cranial end, arterial outlow to developing aorta system and aortic arch system
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Describe the looping effect of the outer fibers to twist to the apex during heavy exercise
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The twisting motion of fibers, you feel the apex hit against posterior portion of sternum within the pericardial sac
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Describe the manubrium, including where it is located in relation to the other parts of the sternum, and how many components it has (name them as well)
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Upper most portion, four sided with multiple facets - upper facet, lateral facet, sternal angle, and jugular notch
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Describe the path and location of the aorta
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Begins in thorax continuing to abdominal region
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Describe the path of blood from the mom to the aortic arch
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Mom --> Umbilical vein --> Ductus venosus --> Inferior venar cava --> Valve of inferior venae cava --> right atrium --> Foramen ovale --> left atrium --> left ventricle --> aortic arch
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Describe the path of blood in the right and left "hearts" for a sufferer of TotGA?
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RIght heart pumps low oxygenated blood into systemic circulation, left heart only pumps blood into pulmonary circuit
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Describe the path of the left vagus nerve?
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Over arch of aorta, sends a branch under arch of aorta and posterior to ligamentum arteriosum and runs up to larynx.
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Describe the pressure differential before birth regarding the right and left atriums.
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High pressure right atrium, low pressure in left atrium
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Describe the process of expiration
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Decrease thoracic cage volume, which increases pressure inside compared to the outside of the thoracic space; pressure equalized when air is pushed out
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Describe the process of inspiration
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Increase thoracic cage volume, which reduces pressure inside compared to outside of the thoracic space, allowing air to rush in to equalize the pressure
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Describe the relationship between the neural crest cells and endocardial cushion?
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Neural crest cells allow it to develop
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Describe the relationship between the neural crest cells and truncus arteriosus?
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Neural crest cells allow truncus arteriosus to divide into aorta and pulmonary trunk
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Describe the structure of passive and active cusp structures during systole.
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Passive cusps are open, active cusps are closed
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Describe the structure of passive and active cusp structures during systole.
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Passive valves are open, active valves are closed
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Describe the venous system around the esophagus in a clinically neutral individual?
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Blood flows through hepatic portal vein and veins located on esophagus towards heart
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Do any nerves run lateral to aorta?
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Two sympathetic chains of ganglia
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Do the aortic supply and internal thoracic arterial supply ever connect?
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They anastomose within the intercostals spaces
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Do the innermost intercostal muscles form a continuous layer?
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They do not
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Do the left and right branches run with anything else, if so, what?
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They run in a single sheath with the internal carotid artery and jugular vein
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Do the structures at the root of the lung differ from right to left side?
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Yes
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Do things pass between mediastinum regions?
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Some travel through multiple regions
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Does anything else innervate the pericardium besides phrenic nerve?
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Vagus and sympathetic nerves regulate conditions
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Does anything separate the visceral and parietal pleura?
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space with serous fluid for lubrication between two layers
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Does blood recycle through the pulmonary circuit in VSD's?
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Yes
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Does closing the primum and opening the secundum change the route of blood flow?
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No, blood still flows from right to left atria
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Does symmetry exist between right and left lungs?
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No
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Does the angle of the rib have the (broadest / sharpest) angle, (tightest / widest) curvature?
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Sharpest, tightest
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Does the coronary sulcus not encircle the heart anywhere?
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At the area where the pulmonary trunk leaves on the anterior surface
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Does the cusp when closed cut off blood flow?
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No
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Does the heart take up its final position in the thorax by the end of head-to-fail folding?
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Yes
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Does the heart's position move?
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Due to attachments it does move
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Does the left ventricle have a moderator band, septal papillary muscle, or trabeculae carnae?
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No moderator band or septal papillary muscles but has trabeculae carnae
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Does the sinus venosus fuse with the 4 heart segments?
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No, it has right and left horns
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Does the transverse pericardial sinus provide anything hematically?
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It provides easy access for blood flow to and from heart
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Draw a cross section of the heart, using the typical foot to head view, and include the right and left ventricles, right and left atria, visceral serous pericardium, fibrous pericardium, parietal serous pericardium, and esophagus. Label Right, Left, Anterior, Posterior
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-
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Draw a picture of the 3 endodermic divisions post gastrulation, and note ectoderm, endoderm, and mesoderm, as well as the subdivisions of mesoderm paraxial intermediate and lateral's outer somatic and inner splanchnic
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Draw a picture of the heart, from the front. Include the following: Right atrium, right ventricle, left ventricle, left atrium, pulmonary trunk, aortic arch, superior and inferior vena cava, xiphosternal joint, and sternal angle
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-
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During folding in the cervical region, the heart tube gains connection with what system?
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Autonomic nervous system
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Each papillary muscle gives off 2 sets of __ __ which attach to each of the two cusps.
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Chordae tendinae
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Early embryonic heart folds __ and under overlying __.
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inward, ectoderm
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Endocardium is continuous into the __ __
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blood vessels
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Epicardium is?
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Transparent layer fused with myocardium (considered part of heart)
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Esophagus is attached to what?
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Posterior side of trachea
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False ribs handle what?
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Bucket handle action
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Fetal circulation relies heavily on what 6 things?
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1 umbilical vein, 2 umbilical arteries, ductus venosus, foramen ovale, and ductus arteriosus
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Follow the path of blood flow on the right side of the heart.
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To right atrium from SVC, IVC, coronary sinus. Blood ejected through tricuspid valve, contraction of ventricle squeezes blood up through conus arteriosus out to pulmonary trunk, pulmonary trunk into right and left pulmonary arteries
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Follow the path of blue blood (low oxygenation) from the head and neck to the right atrium
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Right ventricle --> pulmonary artery --> ductus arteriosus --> aorta
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For relative locations of chambers, what lies anteriorly?
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Sternocostal surface / right ventricles
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For relative locations of chambers, what lies at the base?
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Posterior view is marked by entrance of pulmonary vein, split of pulmonary trunk, left atrium
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For relative locations of chambers, what lies at the tip?
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Apex, narrowest part of cone shape
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For relative locations of chambers, what lies inferiorly?
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Diaphragmatic - left ventricle and some right ventricle
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For relative locations of chambers, what lies left?
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Left ventricle and some left atrium (posterior surface)
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For relative locations of chambers, what lies right?
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Primarily right atrium
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For the entire nine months of development, is it important for atrial septation to complete or not complete in order to prevent serious circulatory problems from occuring
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Atrial septation cannot be completed or a serious circulatory problem will occur
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Fossa ovalis is the remains of the __ __.
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Foramen ovalis
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From the front, the right ventricle is?
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The chamber that occupies a large part of the trunk seen from the front
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From what do the upper 1 or 2 posterior intercostal spaces receive blood supply?
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Costocervical trunk branching from the subclavian artery
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General definition of the 4 chambers include what 2 things and what 2 things?
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2 ventricles, 2 atria
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What is the ligamentum arteriosum used as a landmark for?
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Vagus nerve
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High atrial pressure in fetus is due to 2 things. Name them
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Bolus of umbilical flow into atrium and pulmonary resistance because pulmonary circulation is shut down
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How do the common atrium and ventricles divide?
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By movements of mesoderm mostly in weeks 5-6
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How do the false ribs function as bucket handle action?
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Most of the action is increasing lateral dimensions, with some minor elevation of ribs
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How do the muscle fibers of transversus thoracis run?
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Multiple directions attaching to the xiphoid process and costal cartilages of several ribs with finger like projections from a hand
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How do the true ribs function as pump handle action?
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Small action at joint, large action laterally.
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How does a VSD impact the left ventricle?
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Membranous part is right up against aortic vestibule with its outflow of the aorta. IAbuts against the valve cusp down the left side
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How does a VSD impact the right side?
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Close to septal papillary and chords
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How does blood shunt in a VSD?
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Blood shunts left to right
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How does the aorta pass in relation to the trachea, and why?
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Aorta is forced over to left side of body because trachea is located on midline
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How does the foramen primum close?
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The septum primum eventually fuses to the endocardial cushion
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How does the foramen secundum open?
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Apoptosis in septum primum allows it to open
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How does the heart supply itself?
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Via myocardial vasculature, with venous return into coronary sinus which lies in coronary sulcusNWhat
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How does the pericardiacophrnic ligament attach?
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Inferior portion of pericardium to diaphragm superior fascia and central tendon of diaphragm
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How does the phrenic nerve relate to the diaphragm?
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Draped laterally on both sides down to diaphragm
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How does the phrenic nerve, draping laterally on both sides down the diaphragm innervate the pericardium?
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Sends off sensory twigs to pericardium
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How does the right atrial chamber of the embryo attain almost 100% volume of blood?
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From materal circulation through umbilical vein
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How does the septum secundum grow?
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It grows downward to the right of the septum primum such that the lower margin of the septum secundum overlaps the upper margin of the septum primum
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How is it possible someone below 50% blockage can still die soonafter a stress test?
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Plaque can bubble off of a vessel and travel down stream to a smaller space and cause a blockage
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How is the fossa ovalis itself oriented in regard to the interatrial wall?
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It is in the right atrium opposed on the interatrial wall to what was the septum primum
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How is the upper part of the body profused versus the lower part of the body?
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Upper part - hyperprofusion. Lower part - hypoprofusion
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How many arches develop, and which are important?
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6 develop, and 3rd, 4th, and 6th are important, 1,2,5 are not
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How many atriums are there at this point?
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1 common atrium at this point
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How many brachiocephalic veins are there, and what are they comprised of?
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Each (Lookup how many!) brachiocephalic vein is comprised of the joined internal jugular and subclavian veins
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How many branches does the vagus nerve have, and what is its roman number?
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X, left and right branches
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How many bronchopulmonary segments are there on the right versus the left?
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10 on right, 8 on left
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How many cusps do the left atrioventricular / bicuspid / mitral valves possess?
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2 cusp valve anterior and posterior
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How many different sections does the heart have initially?
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2 separate segments
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How many lymphatic plexi are there around the lung, and what are they called?
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Superior and deep lymphatic plexi
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How many pairs of ribs are there?
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12 pairs total
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How many parts are there of the aorta? Name them.
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3 parts. Ascending (from the heart), arch, descending
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How many parts are there of the phrenic nerve? What does it innervate? Where does it run?
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Left and right pairs, innervates diaphragm, runs into middle mediastinum, attaches to pericardium and continues to diaphragm.
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How many pulmonary veins are there, and how many pulmonary arteries?
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2 veins, 1 artery
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How many regions comprise the inferior mediastinum, and what are they?
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3 regions, middle mediastinum, anterior mediastinum, posterior mediastinum
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How many sets of papillary muscles are in bicuspid / mitral valves, and which side is larger?
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2 sets, anterior is larger than posterior
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How many types of coarctation of aorta are there, and describe each
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Preductal coarctation is natal type, occurs before ductus arteriosus, therefore ductus remains open and allows for blood flow to the systemic circulation. Postductal coarctation occurs distal to dusctus arteriosus, ductus becomes ligamentary, blood floows through subclavian --> internal thoracic artery --> intercostal arteries
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How many ventricles are at this point?
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1 common ventricle
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If a shunt is from the left atrium to the right atrium, the defect is (cyanotic / non-cyanotic).
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Non-cyanotic
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If a shunt is from the right atrium to the left atrium, then the defect is (cyanotic / non-cyanotic)
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Cyanotic
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If gurgling is heart, what does this insenuate?
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Valvular problem
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If left bundle is cut, what will happen?
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Left ventricle will not contract (bad news)
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If someone suffers from esophageal verices, what occurs?
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BLockages in liver tdue to cancer, cirrhosis occludes blood flow to hepatic portal vein somewhat
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If the ductus arteriosus doesn't close you have what?
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Persistent ductus arteriosus or PDA
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If the septum primum or secundum fail to form, what does the fetus develop?
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Classic secundum type atrial septal defect (ASD)
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if there is a large opening to the fossa ovale, what does it cause?
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Very large mixing of oxygenated and deoxygenated blood
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If there is an opening to the fossa ovale, what does it create?
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Heart murmur
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In an X-ray, what can be seen?
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Enlargement of arteries in costal groove
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In ASD, is the septum secondum abnormal?
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No, it is normal
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In fully ejecting blood out of the ventricles, the myocardium contracts. What do the inner fibers do versus the outer fibers to accomplish this?
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Inner fibers squeeze ventricle, outer fibers ring inner fibers to fully reduce blood flow
|
|
|
In lung tissue, the primary bronchi become what?
|
Secondary lobar bronchi
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|
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In older adults, glandular thymus tissue gives way to __ __.
|
fatty tissue
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In the 3rd week something forms which gives off the cells which form the notochord. Name this formation, and describe what the notochord then forms.
|
Primitive streak, notochord initiates formation of the nervous system by stimulatin overlying ectoderm to differentiate into neuroectoderm
|
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In the adult heart how to the venous and arterial portions angle?
|
The venous systems of the adult heart are dorsal, and the arterial systems of the adult heart are ventral
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In the embryo, the heart and its precursors are very far in which direction of the embryo?
|
cranial
|
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In the flat trilaminar embryo, the earliest development of the heart is cranial to all of the developing nervous system, even to the __ / __ __ of the __ __.
|
forebrain, cranial end, neural tube
|
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In the left lung how does the position of the pulmonary artery to primary bronchus different than in right lung?
|
Pulmonary artery is superior to primary bronchus
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In the left lung, name the 4 grooves
|
Aorta and arch, left brachiocephalic vein, area for trachea and esophagus, cardiac impression
|
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In the mid axillary line, the lung ends at which intercostal space?
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8th
|
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In the midclavicular line, the lung goes to which intercostal space?
|
6th
|
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In the posterior region, the lung ends at which intercostal space?
|
10th
|
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In the right ventricle, equate the force of contraction to the distance and resistance of blood.
|
Force of contraction = distance and resistance to get blood through
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|
In the venous system, the left bronchial vein goes to what?
|
Accessory hemiazygous vein
|
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In the venous system, the right bronchial vein runs to what?
|
Azygous vein
|
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In upper crosses of the heart, the left atrium is located?
|
Posteriorly
|
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In upper crosses of the heart, the left ventricle is?
|
Noticeably thicker walled with only a small projection on the anterior surface
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In upper crosses of the heart, the right atrium is located hwere?
|
Farthest to the right side of the subject or a structure associated with it
|
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In upper crosses of the heart, the right ventricle is?
|
The most anterior structure
|
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Inferior mediastinum is located where?
|
Below imaginary line between sternal angle and T4 vertebrae, superior to diaphragm
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Inferior vena cava and the opening of the coronary sinus share what?
|
Single cusp to its valve
|
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Inspiration and expiration are facilitated by what?
|
Changes in dimension of the thoracic cage
|
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Inspiration and expiration involve changes in several things, name them. (5 things)
|
Anterior, posterior, cranial / caudal dimensions, gas pressure
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Interestingly, the heart doesn't stay flat. Describe what it does from the arterial end and venous end.
|
It begins to twist, turn, and rotate. Arterial end rotates downward and to the left. Venous end rotates upward and to the right
|
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Is aortic blood flow directed more towards the right from the ascending aorta to the arch to the descending aorta or to the left?
|
Right
|
|
|
Is ASD major, and what are its clinical manifestations?
|
Not major crticial event, slight heart murmur, surgery necessary if ASD is extremely large
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Is lung tissue active or passive?
|
Passive tissue
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Is the amount of fat deep to the visceral pericardium static or does it differ much from person to person?
|
Variable condition
|
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|
Is the AV visible to the naked eye?
|
No
|
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Is the pericardium analogous to anything?
|
Analogous to two layers of pleural sac with an additional layer
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Is the pulmonary artery anterior or posterior to the primary bronchus?
|
Anterior
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Is the right ventricle thicker or thinner than the left ventricle?
|
Thinner
|
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Is the SA node visible?
|
No, so you use vessels to trace to it
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Is the thoracic duct large?
|
Largest in body
|
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Is the vagus nerve sympathetic or parasympathetic?
|
parasympathetic
|
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|
is TotGA a death sentence?
|
Usually within the first year
|
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Is venous return of the heart more or less variable than arterial vasculature?
|
More variable
|
|
|
Is VSD common?
|
It is the most common heart defect
|
|
|
Is VSD cyanotic?
|
Non-cyanotic in early stages
|
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|
It is important to understand the relationship between __ muscles, __ tendinae, and cusps
|
papillary, chordae
|
|
|
Locationally, where does the septum secundum form in relation to the septum primum?
|
It forms to the right of the septum primum
|
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|
Lowest splanchnic nerve is formed by what? Terminate where?
|
Fibers of ganglia 12, terminates into renal plexus
|
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Lungs are inside what?
|
Pleural sacs
|
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Lungs slide into spaces called what?
|
recesses
|
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Majority of venous return from heart muscle is by way of?
|
Coronary sinus
|
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Myocardium is the __ for the heart. It gives it its __.
|
skeleton, structure
|
|
|
Myocardium is?
|
Seen through transparent visceral pericardium, heart muscle fibers
|
|
|
Name 3 main findings of Tetralogy of Fallot
|
Pulmonary stenosis, ventricular septal defect, hypertrophied right ventricle
|
|
|
Name 2 larger lymphatic channels of the lungs.
|
Thoracic duct on left side, right lymphatic duct on right side
|
|
|
Name 2 recesses that the lungs slide into?
|
Mediastinal and costociaphragmatic recess
|
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Name 3 functions of the sternum
|
Strength, protection, rib attachment
|
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|
Name 3 lymph nodes of the lungs?
|
Pulmonary, tracheobronchial, and tracheal lymph nodes
|
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|
Name 3 parts of the sternum
|
Manubrium, body, xiphoid process
|
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Name 5 points concerning innervation of the heart, including activity, physicality, origins, insertions, and alterations
|
Regulates pumping activity, spider like membranous fibers with plexus from vagus nerve, sympathetic fibers from chain ganglia, nerves run around coronary arteries, alter rate and force of heart by traveling into heart tissue with blood vessels
|
|
|
Name 6 derivatives of the mesoderm
|
Muscular systems, most bones, ligaments, tendons, faschia, cardiovascular system
|
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|
Name and describe the 2 recesses derived from the parietal pleura.
|
Costodiaphragmatic recess formed by junction of costal pleura and diaphragmatic pleura (larger), costomediastinal recess is smaller and forms at midline region.
|
|
|
Name the 2 places where neural crest cells are critical in heart development?
|
Truncus arteriosus, endocardial cushion
|
|
|
Name the 3 coronary sinuses.
|
Anterior interventricular sulcus, posterior interventricular sulcus, and small cardiac vein
|
|
|
Name the 3 things which are cyanotic
|
Tetralogy, transposition, persistent truncus arteriosus
|
|
|
Name the 4 lymph nodes in the thoracic wall?
|
Parasternal, diaphragm, mammary, and axillary
|
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|
Name the 5 basic segments
|
Truncus arteriosus, bulbus cordis, embryonic ventricle, embryonic atrium, sinus venosus
|
|
|
Name the 5 grooves of the right lung?
|
Superior venae cava, azygous vein and arch, esophagus, trachea area and esophagus area, cardiac impression
|
|
|
Name the 7 structures at the root of the lung?
|
Bronchus, pulmonary artery, pulmonary vein, bronchiole artery, bronchiole vein, lymphatics, nerve fibers
|
|
|
Name the four regions of the parietal pleura.
|
Cervical, costal, diaphragmatic, mediastinal pleura
|
|
|
Name the structures that pass through the diaphragm (3).
|
Inferior vena cava, esophagus, aorta
|
|
|
Name the two segments of the heart tube?
|
Right and left heart tubes
|
|
|
New testing may look at types of cholesterol present in the body. Describe the two goals of these tests.
|
How plaque is handled in the body and how the heart may respond to stints
|
|
|
Obviously all 3 layers give rise to adult structures in the adult, but which of the 3 is especially important, and why?
|
Mesoderm, it gives rise to so many adult structures
|
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|
Of the right ventricle, the tricuspid or right atrioventricular valve does what?
|
Guards the opening between the right atrium and right ventricle
|
|
|
Of the true, false, and floating ribs, which are the most easily fractured?
|
Floating ribs
|
|
|
Of the two ends, which grows specifically fast?
|
Anterior end of the neural tube grows especially fast
|
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|
On both sides of the root of the lung, the __ artery and __ passage are going to divide together
|
pulmonary, respiratory
|
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|
On the "Bare Area," no __ over left atrium - posterior region. Myocardium makes direct contact with __ __ __.
|
epicardium, parietal serous pericardium
|
|
|
On the anterior surface of the heart, there are small veins that empty into what?
|
Nearest chamber of heart
|
|
|
On the left side, the vagus nerve branches to go where in relation to the ligamentum arteriosum?
|
Posterior to ligamentum arteriosum
|
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|
On the right atrium, the pectinate muscles also contribue to __ in addition to auricle?
|
Wall
|
|
|
On the right side as you descend, you begin to see __ instead of lung.
|
Liver
|
|
|
Once pressure has decrease, what happens to blood past the cusp, and what does this do to the cusp?
|
Blood flows backward due to gravity after pressure drops, and fills the cusps, closing valves
|
|
|
Once you get above the heart, where is the aorta visible?
|
On all sides
|
|
|
Onthe sternocostal surface of the heart, what 3 things are found?
|
Ventricles
|
|
|
Oxygen entering through the umbilical vein enters the heart how?
|
It is shunted to the left atrium and eventually to systemic circulation
|
|
|
Parietal serous layer allows what?
|
Space for serous fluid (lubricant for cardiac structures)
|
|
|
Pertaining to blood flow through the left side of the heart, blood comes off the left atrium to the __ __.
|
Left ventricle
|
|
|
Posterior papillary muscles
|
Smaller papillary muscles comes from posterior surface of chamber
|
|
|
Posterior space there is a double system in terms of __ __
|
venous return
|
|
|
Pulmonary artery
|
For oxygenation of blood
|
|
|
Pulmonary artery carries what?
|
Deoxygenated blood
|
|
|
Pulmonary blood flow is on the __ side of the sternum and ascends cranially and splits when?
|
Left, splits as trunk splits to right and left
|
|
|
Pulmonary valve has a __, __, and __ cusps
|
right, left, anterior
|
|
|
Pulmonary valve is __ to the aortic valve
|
anterior
|
|
|
Pulmonary vein
|
For oxygenation of blood
|
|
|
Septal papillary muscles
|
Variable in size, muscles may not always be seen but in chordae tendineae are seen arising from septal wall
|
|
|
Sinus is a place where what occurs?
|
Blood pools
|
|
|
Sinus venarum is the venous pooling area of the __ __.
|
Right atrium
|
|
|
So do the false ribs actually attach to the sternum?
|
Indirectly, yes they do
|
|
|
So what do the internal intercostals actually do to the ribs?
|
They do downward movement of ribs
|
|
|
State 5 points on Persistent Truncus Arteriosus concerning septum, flow of blood, correllation with other heart defects, shunting, cyanosis, and surgery.
|
No spiral septum present, common outflow of blood, always present with VSD, right to left shunting, cyanotic, corrective surgery has poor results
|
|
|
Sternocostal tributaries from the __ __ __ __ and the __ __ __ overlaps and forms what?
|
left anterior descending artery, right coronary artery, anastomoses which are important to backup blood supply for active heart
|
|
|
The 2 openings are flapped (towards / against) for the single cusp of the valve of inferior vena cava and opening of coronary sinus
|
Towards
|
|
|
The __ __ __ appears under the auricle.
|
Right coronary artery
|
|
|
The __ __ is a slight indentation where the heart lies on the __ lung
|
cardiac notch, left
|
|
|
The __ __ is the groove on the inner inferior surface of the rib
|
Costal groove
|
|
|
The __ __ separates superior and middle lobes of the __ lung
|
horizontal fissure, right
|
|
|
The __ __ separates the inferior lobe from the superior and middle lobes of the __ lung
|
oblique fissure, right
|
|
|
The __ __ sepearates into superior and inferior lobes of the __ lung
|
Oblique fissure, left
|
|
|
The __ __splits under the arch of the aorta into the __ and __ __ arteries that take blood to the lungs for oxygenation
|
pulmonary trunk, right, left pulmonary
|
|
|
The aorta is guarded by what 3 things?
|
Left cusp - left coronary artery, right cusp - right coronary artery, posterior cusp
|
|
|
The aorta is located at which thoracic vertebrae?
|
12th thoracic vertebrae
|
|
|
The aorta originates from the left ventricle as what?
|
Ascending aorta
|
|
|
The ascending aorta is known as the _- __ as soon as we go above the __ __ in the superior mediastinum.
|
aortic arch, sternal angle
|
|
|
The auricle is larger or smaller than the right atrium?
|
Smaller
|
|
|
The AV node is a bundle of nerve that passes info to the lower ventricular chambers by doing what?
|
Splitting into right and left bundle branches and travels to most distal portion of ventricles
|
|
|
The azygous vein ascends and terminates into what?
|
Superior vena cava
|
|
|
The azygous vein receives __ intercostals veins and __ intercostals vein from upper __ spaces
|
posterior, posterior, anterior
|
|
|
The azygous vein typically travels along which side of the vertebral column?
|
Right side of vertebral column
|
|
|
The blood leaves the __ ventricle and goes to the body for __ __.
|
left, systemic circulation
|
|
|
The brachiocephalic trunk splits into two structures, what are they?
|
Right common carotid artery to head, right subclavian artery horizontally
|
|
|
The bronchopulmonary segments are contained within what?
|
Connective tissue boundaries
|
|
|
The chamber opening in the right ventricle is (smaller / larger) than the chamber opening in the left ventricle
|
Right
|
|
|
The coronary sinus has how many channels, and what does the sinus do?
|
3 channels, deposits blood into right atrium
|
|
|
The custps of the aortic valve provide what?
|
Blood to the heart muscle
|
|
|
The descending aorta sits where on the subject, and what does this provide?
|
It sits slighty on the left side of the subject, and it provides the correct orientation landmark of the section
|
|
|
The developing heart tube then migrates through which region before terminating into the __?
|
Cervical region, mediastinum
|
|
|
THe ductus arteriosus shut down in a few days to become what?
|
Ligamentum arteriosum
|
|
|
The esophagus extends from the __ in __ mediastinum to the __ region
|
pharynx, superior, abdominal
|
|
|
The esophagus has what type of blood supply?
|
Regional (multiple) blood supply
|
|
|
The esophagus is located at which thoracic vertebrae, and passes through which hiatus?
|
10th thoracic vertebrae, esophageal hiatus
|
|
|
The esophagus starts midline, curves toward __ into abdominal region. In contrast, the aorta starts __ and shifts __.
|
left, left, right
|
|
|
The external heart has how many vessels and chambers?
|
3 vessels, 4 chambers
|
|
|
The fiberous rings around the 4 valves of the heart serve as attachment points for what?
|
Various myocardial fibers
|
|
|
The fibers of the sympathetic chain ganglia of the mediastinum extend where?
|
Inferiorly through the diaphragm
|
|
|
The fossa ovale is on the same side or other side of the depression of the fossa ovalis?
|
Other side
|
|
|
The gray rami of the sympathetic chain ganglia of the mediastinum are located where? White rami?
|
Medially positioned, white are laterally positioned
|
|
|
The great splanchnic nerve is formed by what?
|
Fibers of ganglia 5-9 that proceed anteriorly
|
|
|
The heart and its precursors develop from the __ __ layer of __ .
|
inner splanchnic, mesoderm
|
|
|
The heart extends to the site of the __ __ at rest or at the point of __ __.
|
xiphisternal joint, quiet expiration
|
|
|
The hemiazygous vein eventually crosses the midline and terminates into what?
|
azygous vein
|
|
|
The hemiazygous vein is formed by what 3 things?
|
Ascending lumbar vein, subcostal vein, minor contribution from left renal vein
|
|
|
The hemiazygous vein typically travels along the __ __ of the vertebral column.
|
Left side
|
|
|
The inferior vena cava is located at which thoracic vertebrae, and passes through what hiatus?
|
8th thoracic vertebrae, caval hiatus
|
|
|
The intercostal space is numbered by rib (below / above)?
|
Above
|
|
|
The intermediate mesoderm is located where in relation to the other 2 mesodermic formations, and what does it form?
|
Central to others, forms urinary / genital regions
|
|
|
The lateral body folding gives the embryo which formation?
|
Cylindrical formation
|
|
|
The lateral mesoderm is located where in relation to the other 2 mesodermic formations, and divides into what 2 things?
|
Lateral to others, forms outer somatic mesoderm and inner splanchnic mesoderm
|
|
|
The left atrioventricular / bicuspid / mitral valves are involved in?
|
Ejection of the blood from the left atrium to the left ventricle
|
|
|
The left atrium has a very intimate relationship to the esophagus. Describe the clinical significance of this.
|
If a child swallows a sharp object it may be able to pierce the esophageal wall and pierce the left atrium. This will cause blood to leak into the pericardial space and can lead to cardiac tamponade
|
|
|
THe left lung has how many lobes?
|
2 lobes, superior and inferior
|
|
|
The left vagus rotates 90 deg. to become the __ __ __, which innnervates the __ __ __.
|
anterior vagal trunk, major anterior structures
|
|
|
The lesser splanchnic nerve is formed by what? Terminates where?
|
Fibers of ganglia 10-11, terminates into aorticorenal plexus
|
|
|
The lining of all te chambers and the formation of the valves of the right atruim are formed by?
|
Endocardium
|
|
|
THe lobes of the left lung are divided by how many fisures? Name them.
|
1 fissure, oblique
|
|
|
The mitral valve is more __ and 2-3 cm to the __ of the tricuspid valve
|
distal, left
|
|
|
The neural groove with its folds gives rise to what?
|
Neural tube and neural crest cells
|
|
|
The oblique pericardial sinus is what again?
|
The framed U shaped entrance of the inferior vena cava and 4 pulmonary veins
|
|
|
The paraxial mesoderm is located where in relation to the other 2 mesodermic formations, and also name something that arises from it
|
Medial to others, forms somites
|
|
|
The pectinate muscles function to do what?
|
Delineate sinus venarum from the atrium
|
|
|
The pectinate muscles squeeze blood how?
|
Into the right ventricle during contraction of the heart
|
|
|
The posterior atrium is the most __ chamber of the heart in adult.
|
dorsal
|
|
|
The pulmonary trunk lies (anterior / posterior) to the aorta
|
Anterior
|
|
|
The recess in the posterior region goes to where?
|
12th intercostal space
|
|
|
The recess near the mid claviular line goes to which intercostal space?
|
8th
|
|
|
The recess of the mid axillary line goes to where?
|
10th intercostal space
|
|
|
The right lung has how many lobes?
|
3 lobes, superior middle inferior
|
|
|
The right lung's lobes are divided by how many fissures? Name them.
|
2 fissures, oblique and horizontal
|
|
|
The right lymphatic duct is the __ largest lymphatic channel
|
2nd
|
|
|
The right margin of the heart is __ and is formed by structures that are associated with the __ __ __.
|
Vertical, two vena cava
|
|
|
The right vagus rotates 90 deg to become ?
|
Posterior trunk
|
|
|
The right ventricle bifurcates into what?
|
Right and left pulmonary artery
|
|
|
The right ventricle feeds into what?
|
Pulmonary trunk
|
|
|
The right ventricle is near the (sternocostal / diaphragmatic) surface, and the left ventricle is on the inferior (sternocostal / diaphragmatic) surface
|
sternocostal, diaphragmatic
|
|
|
The SA node is in the junction of the __ vena cava and the __ __ of the terminal crest.
|
superior, cranial portion
|
|
|
The single cusp serves to do what?
|
Directs blood flow towards the valve that separates the atrium from the ventricle
|
|
|
The sinus venarum region of the left atrium has two sets of what entering?
|
Veins
|
|
|
The splanchnic nerves effect what?
|
Abdominal viscera
|
|
|
The superficial passages communicate directly with what?
|
Deep lymphatics
|
|
|
The sympathetic chain ganglia is covered by what of the parietal pleura?
|
Medial extension
|
|
|
The tertiary division of bronchial passage supplies what?
|
Bronchopulmonary segments
|
|
|
The thickness of the left ventricle is how many times the thickness of the right ventricle?
|
3 times as thick
|
|
|
The trachea banches into what?
|
Right and left primary bronchus
|
|
|
The trachea have cartilagenous rings have open ends facing which direction?
|
Posteriorly
|
|
|
The tricuspid valve has 3 cusps, name them.
|
Anterior, posterior, septal
|
|
|
The tricuspid valve is closer or farther from the sternum?
|
Closer to sternum
|
|
|
The vagus and chain ganglia form what?
|
A plexus around vessels going into root of lung and respiratory passages
|
|
|
There also is a __ marginal branch of the right coronary artery
|
right
|
|
|
There are 3 pairs of splanchnic nerves, name them.
|
Greater splanchnic, lesser splanchnic, lowest splanchnic
|
|
|
There are different layers of myocardium, name them and describe each.
|
Outer layer has fibers that run obliquely and in looping pattern, inner layer has fibers that run in circular pattern
|
|
|
There are ways to remove fluid filling the costodiaphragmatic recess. How is this accomplished?
|
Sit patient up so gravity drains fluid into recess
|
|
|
There is a region somewhere in the heart where there is no venous return into the coronary sinus, describe the location as well as how this works?
|
On small region on anterior portion of heart, small veins dump blood back into nearest chamber causing a mixture of venous blood into oxygenated blood in certain regions
|
|
|
This neural plate gives rise to what?
|
Neural groove w/ neural folds
|
|
|
This newly formed neuroectoderm gives rise to what?
|
Neural plate
|
|
|
Thoracic aorta gives rise to what?
|
Intercostals arteries
|
|
|
Trachea is in what?
|
Superior mediastinum
|
|
|
Transverse pericardial sinus is related to __ and __ mesocardium
|
Arterial, venous
|
|
|
True ribs handle what?
|
Pump handle action
|
|
|
Two nerves travel through the mediastinum, what are they?
|
Vagus nerve, phrenic nerve
|
|
|
Typical lymphatic channels are useful for filtering what?
|
Foreign particles
|
|
|
Typically, there are how many bronchial arteries to the left lung?
|
2 bronchial arteries
|
|
|
Veins carry blood __
|
toward
|
|
|
Veins contributing to the sinus venarum are? (4)
|
Superior vena cava, inferior vena cava, coronary sinus, anterior cardiac veins
|
|
|
Venous flow from lower body arrives by
|
Inferior vena cava
|
|
|
Venous flow from upper body arrives by
|
Superior vena cava
|
|
|
Visceral serous layer allows what?
|
Intimate attachment into and out of heart structures
|
|
|
What are the 2 complications of ventricular septation?
|
Primitive interventricular septum, endocardial cushion
|
|
|
What are the 3 sets of papillary muscles?
|
Anterior, Posterior Septal
|
|
|
What are the 4 major players in atrial separation?
|
2 septi form, 2 foramina form
|
|
|
What are the 4 things important for vascular development of a fetus?
|
Vitelline artery, umbilical artery, aortic sac, aortic arch
|
|
|
What are the 4 veins entering the sinus venarum?
|
Right, left, superior, and inferior pulmonary veins
|
|
|
What are the 5 osteological points of interest for a rib?
|
Head, neck, tubercle, body/shaft of rib, and costal groove
|
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What are the differences between the pulmonary trunk and aortic valves?
|
Pulmonary trunk has a right left and anterior cusp, aortic valve has a right left and posterior cusp
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What are the functions of the conus arteriosus (3)?
|
Reduces turbulence, maximizes efficiency, gets ejected blood out of heart
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What are the intervening tissues between the esophagus and left atrium?
|
Fibrous pericardium and visceral and parietal serous pericardium
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What are the layers of pericardium?
|
Parietal and visceral make serous layer, fibrous layer
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What are the names of the 2 bronchial arteries, and where do they run?
|
Superior and inferior, running with respiratory passages
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What are the pectinate muscles?
|
Series of muscle ridges that extend from the posterior region out into the anterior auricle with a backbone called the terminal crest
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What are the splanchnic nerves a collection of?
|
Fibers from chain ganglia
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What are trabeculae carnae muscles involved in?
|
Conduction phase of the heart
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What bone is not produced by the mesoderm?
|
Skull
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What can cause the PDA to close?
|
Prostaglandin inhibitors, as a drop in prostaglandins causes ductus arteriosus to close
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What can occur as a result of injury in the neck region to the lobes?
|
The superior lobe extension during inspiration can be affected
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What can occur as a result of surgical correction of VSD?
|
Damage to conduction system can result
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What cardiac layer is over the oblique pericardial sinus?
|
Pericardium, but no mesocardium
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What did the fossa ovale used to be?
|
Foramen ovale
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What do stress tests do?
|
Test for blockage of coronary blood vessels
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What do the chordae tendinaeae appear as?
|
Stringlike structures
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What do the cusps, chordae tendineae, and papillary muscles prevent?
|
Prevent valve from leaking during the high pressure create during ventricular contraction
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What do the sternopericardial ligaments accomplish?
|
They anchor the fibrous layer to the sternum anteriorly
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What do the superficial passages look like, and what are they relatively close to?
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Like black spots, lie close to visceral pleura
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What do the transverse pericardial sinus provide in bypass surgery?
|
It allows the insertion of tubes without damaging other tissue
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What do these 2 folding events help to form, and what two systemic developments are they also important to?
|
Cylindrical trunk of the embryo, important to gastrointestinal and cardiovascular development
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What do these veins carry?
|
Just oxygenated blood into the heart
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What do you see in intersegmental tissue?
|
Pulmonary veins that carry oxygenated blood back into the left atrium of the heart
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What does a defect in the 3rd arch result in?
|
Coarctation of Aorta
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What does a defect of neural crest cells moving into truncus arteriosus lead to?
|
Outflow problems with aorta and pulmonary trunk
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What does an opening in the atrial wall provide?
|
It provides a mechanism for exchange of blood between the 2 developing atrial chambers
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What does arterial mesocardium cover?
|
Aorta, pulmonary trunk
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What does bronchiole artery do, and how does its size compare to pulmonary artery?
|
Supplies blood to lung tissue itself, much smaller than pulmonary artery
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What does bronchiole vein do, and how does its size compare to pulmonary vein?
|
Removes blood from lung tissue itself, much smaller than pulmonary vein
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What does coarctation of aorta result in?
|
Stenosis
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What does esophageal verices present as?
|
Upped flow through distal, inferior region of esophageal veins, may result in venous rupture
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What does pulmonary hypertension cause if not fixed within a year?
|
Reversal of pressure
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What does segmental innervation of thoracic nerves provide?
|
Determination of location of possible vertebral damage through sensation patterns at the corresponding dermatomes
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What does the 3rd arch form?
|
Common carotid and internal carotid arteries
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What does the 4th arch form?
|
Middle segment of arch of aorta, right subclavian artery
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What does the 6th arch form?
|
Pulmonary arch, consisting of right and left pulmonary artery and ductus arteriosus
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What does the auricle segregate?
|
It segregates smooth wall portion of atrium from muscular portion
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|
What does the bronchial vein drain into?
|
Pulmonary veins, left atrium, azygous, superior intercostal vein, hemiazygous vein
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|
What does the circumflex branch do, and where does it terminate?
|
Gives off many branches, and terminates posteriorly
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WHat does the ductus arteriosus form in adults?
|
Ligamentum arteriosum in adults
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What does the ductus venosus shut down in a few days post natal to become?
|
Ligamentum venosum
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What does the emptying of small veins on the anterior surface of the heart result in?
|
Very small mixing of oxygenated and deoxygenated blood
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What does the esophageal plexus innervate?
|
Respiratory passage, innervates heart via coronary plexus
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What does the foramen ovale become at birth?
|
Fossa ovale
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What does the foramen primum provide?
|
It provides the initial opening for blood flow from right to left atria
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|
What does the internal thoracic artery terminate into, and where does this occur?
|
7th intercostal space, musculophrenic artery, superior epigastric artery
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What does the lateral facet of the manubrium articulate with?
|
1st rib
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What does the lumbus of the fossa ovalis represent in the right atrium?
|
It represents what was the lower margin of the septum secundum
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What does the mediastinal pleura contain?
|
Hilum (root of lung)
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What does the musculophrenic artery supply?
|
Lower intercostals
|
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|
What does the pressure differential atrially facilitate before birth?
|
Blood is able to flow from right atrium to left atrium in utero
|
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|
What does the pulmonary ligament allow?
|
Allows structures at root of lung to enter space upon inspiration, prevents constriction by expanding lung
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What does the septum primum grow towards during the first step of separation of common atrium into right and left atria?
|
It grows toward the endocardial cushion
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|
What does the superior epigastric artery supply?
|
Runs to rectus abdominus
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What does the trachea become after carina, and where is it located in relation to the sternal angle?
|
Left and right primary bronchus after carina, and deep to sternal angle
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|
What does the upper facet of the manubrium articulate with?
|
Clavicle
|
|
|
What does this movement provide?
|
Amplifies the action pushing sternum up and outward
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|
What does Transposition of the great arteries result in?
|
Two independent closed circulations
|
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|
What does venous mesocardium cover?
|
Superior vena cava
|
|
|
What else can a VSD have an impact on, and why?
|
Right atrium, septum has right and left side and projection on right atrium
|
|
|
What else to the fibrous rings do pertaining to electrical insulation?
|
They provide insulation of the atrium from the ventricles for sequencing of heart contractions
|
|
|
What forms in between where the margins of secundum and primum connect?
|
A little oblique channel, known as the foramen ovale
|
|
|
What happens to blood in Tetralogy of Fallot?
|
Blood from left and right ventricles flows into aorta
|
|
|
What happens to the 4 heart segments above the sinus venosus?
|
They fuse in the midline from cranial to caudal direction
|
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|
What happens to the distal end of the 6th arch?
|
It gets reabsorbed on the right
|
|
|
What happens to the superior lobes during inspiration?
|
They extend into cervical region, deep to cervical pleura
|
|
|
What has the thorax been approached as supporting previously?
|
Upper extremity
|
|
|
What initiates cranio-caudal folding?
|
Rapid growth of nervous system
|
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|
What innervates lymphatics of the lungs?
|
Vagus nerve and sympathetic chain ganglia
|
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|
What innervates pericardium?
|
Phrenic nerve
|
|
|
What innervates the esophagus?
|
Vagus nerve
|
|
|
What is a defect of the ventricular septum called?
|
Classic ventricular septal defect (VSD)
|
|
|
What is an exception to the rule of the direction the innermost intercostals muscles point?
|
Transversus thoracis muscles
|
|
|
What is formed by the parietal pleura to give lungs room to expand upon inspiration?
|
Two recesses
|
|
|
What is important to note about thoracic viscera and their extent past the 1st rib?
|
They extend past the 1st rib, so any trauma occuring in the lower neck region can affect pleura which can affect lung function presenting as difficulty breathing
|
|
|
What is interesting clinically about these bronchopulmonary segments?
|
Smallest units dealable with surgically
|
|
|
What is it called when fluid builds up in serous pericardium area?
|
Cardiac tamponade
|
|
|
What is knuckling effect?
|
When vessels may extend into esophagus, causes internal bleeding
|
|
|
What is mediastinum defined as?
|
Cranial / caudal limit between the pleural sacks and is a space, not a structure
|
|
|
What is mesocardium?
|
Pericardium only onto 3 great vessels, extensiosn of visceral serous pericardium and fibrous pericardium
|
|
|
What is necessary for survival in a sufferer of TotGA?
|
ASD and VSD, which allows some exchange between left and right sides of heart
|
|
|
What is PDA's commonality, flow pattern, level of cyanosis
|
Common in premis, flow is left to right, therefore non-cyanotic
|
|
|
What is responsible for the spiraling of truncus?
|
Neural crest
|
|
|
What is something to always look for that is unilateral?
|
Descending aorta
|
|
|
What is the adult derivative of the bulbus arteriosus?
|
Just becomes the general region where outflow of 2 ventricles occurs
|
|
|
What is the adult derivative of the left horn of the sinus venosus?
|
Coronary sinus and oblique vein of left atrium
|
|
|
What is the adult derivative of the primitive atrium?
|
Pectinate muscles around auricles in adult right and left atria
|
|
|
What is the adult derivative of the primitive ventricle?
|
Gives rise to trabeculae carnae, papillary muscles
|
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|
What is the adult derivative of the right horn of the sinus venosus?
|
Sinus venarum (smooth part) of right atrium, posterior lateral wall of right atrium
|
|
|
What is the adult derivative of the truncus arteriosus?
|
It becomes the main arterial outflow of the heart via pulmonary trunk, ascending aorta, and the semilunar valves
|
|
|
What is the anterior interventricular branch also known as?
|
Left anterior descending
|
|
|
What is the anterior interventricular sulcus also known as, where is it located, and where does it terminate?
|
Also known as great cardiac vein, adjacent to anterior interventricular artery, then courses with circumflex coronary artery, and terminates in left side of coronary sinus
|
|
|
What is the bifurcation of the trachea known as?
|
Carina
|
|
|
What is the bottom line for Truncus arteriosus septation?
|
Truncus arteriosus spirals
|
|
|
What is the clinical manifestation of emphyzema?
|
People take short breaths because they cannot expel large amounts of air
|
|
|
What is the composition of the fibrous layer?
|
Thick, tough, protection, stabilizes position in thorax
|
|
|
What is the conus arteriosus also known as, and what is it an additional portion of?
|
Infundibulum, additional portion on posterior wall
|
|
|
What is the costal groove a landmark for?
|
Neurovascular bundle running between the ribs to be avoided during clinical measures
|
|
|
What is the diaphragm, and what does contraction of it do?
|
It is a dome shaped muscle closing the inferior aperture of the thorax, contraction causes domes to lower, increasing cranial / caudal dimensions of the thorax
|
|
|
What is the difference between bony thorax and thoracic viscera?
|
Thoracic viscera are contained within and can exceed the bony thorax
|
|
|
What is the end result of gastrulation?
|
Flat, trilaminar embryonic disk
|
|
|
WHat is the endocardial cushion?
|
Mesodermic tissue mass that develops in center of heart
|
|
|
What is the fibrous layer fused with?
|
Outer, parietal, serous pericardium
|
|
|
What is the first folding called?
|
cranio-caudal folding
|
|
|
What is the first step in separation of common atrium into right and left atria?
|
Septum primum (mesodermal tissue) grows downward from roof of common atrium
|
|
|
What is the foramen ovalis?
|
Opening of embryo heart that allowed blood to flow from right to left side of heart
|
|
|
What is the foramen primum?
|
It is a gap that develops between the septum primum and endocardial cushion as the septum primum grows downward toward endocardial cushion
|
|
|
What is the fossa ovalis?
|
Depression or opening on wall of right atruim from left side
|
|
|
What is the function of the auricle?
|
Creates a smaller profile of heart by only filling and releasing blood at the end of the cycle so it saves surface area
|
|
|
What is the function of the endocardial cushion?
|
It helps divide atria and ventricles
|
|
|
What is the function of the innermost intercostals muscles?
|
They hold neurovascular bundles in place between itself and the internal intercostals
|
|
|
What is the function of the internal intercostal muscles?
|
Opposing orientations strengthen the intercostal space and keep it taut during changing pressures of inspiration and expiration
|
|
|
What is the hilum or root of lung?
|
Area where structures go into the lung
|
|
|
What is the internal thoracic artery a branch of?
|
Subclavian artery
|
|
|
What is the internal thoracic artery also known as?
|
Internal mammary artery
|
|
|
What is the jugular notch?
|
The midline curvature at the top
|
|
|
What is the lateral continuation of the hemiazygous vein you may or may not see?
|
Accessory hemiazygous
|
|
|
What is the left vagus nerve known as? Why?
|
Left recurrent laryngeal nerve, runs back where it began alongside larynx
|
|
|
What is the ligamentum arteriosum?
|
Thickened back of tissue between inferior side aortic arch and pulmonary trunk
|
|
|
What is the major attchment of the fibrous layer?
|
Pericardiacophrnic ligament
|
|
|
What is the membranous portion of the interventricular septum from?
|
Endocardial cushion which is made up of neural crest
|
|
|
What is the moderator band for?
|
Important conduit for nerves involved in the conduction system of the heart
|
|
|
What is the most anterior structure of the superior mediastinum?
|
Two lobes of thymus gland
|
|
|
What is the most inferior structure of the neurovascular bundle of the thoracic wall?
|
Thoracic nerves
|
|
|
What is the most vulnerable portion of the heart to blockage of coronary supply?
|
Apex
|
|
|
What is the oblique pericardial sinus as viewed from the posterior side of heart?
|
U shaped region (can be palpated)
|
|
|
What is the oblique pericardial sinus formed by?
|
Inferior vena cava, pulmonary veins - 2 right 2 left
|
|
|
What is the partietal pleura attached to?
|
Inner surface of thoracic wall
|
|
|
What is the path of blood from vena cavae to the aorta?
|
Right atrium by venae cava, pulmonary trunk, pulmonary arteries, pulmonary vein, left atrium, left ventricle, aorta
|
|
|
What is the pleural sac?
|
A double walled membrane (sack) that contains the lung tissue inside
|
|
|
What is the point of pericardiac innervation?
|
Sense conditions like cardiac tamponade
|
|
|
What is the posterior interventricular sulcus also known as, where is it located, and where does it terminate?
|
Also known as middle cardiac vein, adjacent to right primary artery and posterior interventricular artery, terminates in right side of coronary sinus
|
|
|
What is the primary function of transversus thoracis muscles?
|
Hold longitudinal blood vessels in place
|
|
|
What is the pulmonary ligament?
|
An expansion of the transition zone of visceral and parietal pleura
|
|
|
What is the result for a child with ToF?
|
They can live, but cannot be active because their blood is not as oxygenated as a normal child's
|
|
|
What is the result of a reveral of pressure resulting from VSD?
|
Blood shunts right to left, and called late cyanosis or Eisenmeger complex
|
|
|
What is the result of cardiac tamponade, what do you use for a landmark, and what is the therapy for it?
|
It squeezes heart, use sternum as landmark to heart position, pericardiocentesis is using a needle to drain excess fluid
|
|
|
What is the result of right to left atrial shunting?
|
Blood skips the lungs, so you see cyanosis (blue color in finger tips) because low oxygenated blood is being pumped through systemic circulation
|
|
|
What is the result of truncus arteriosus septation?
|
Pulmonary trunk goes left, aorta ends up going right
|
|
|
What is the right atrium drained into by?
|
Superior and inferior vena cava
|
|
|
What is the right side of the heart occupied by?
|
Right atrium
|
|
|
What is the role of lymphatics in clinical pathology?
|
Disease spread via metastasis of cancer, due to interconnectedness of system
|
|
|
What is the second step in separation of common atrium into right and left atria?
|
Endocardial cushion (mesodermal tissue) develops in central area of heart
|
|
|
What is the shape of the conus arteriosus, where is it located?
|
C shaped chamber, on smooth wall portion of RV and approaces valve of pulmonary trunk. Located in cranial arterial region of right ventricle
|
|
|
What is the sinus venarum?
|
It is the location where superior and inferior vena cava merge with the right atrium
|
|
|
What is the space between the esophagus and left atrium?
|
Oblique pericardial sinus
|
|
|
What is the sternal angle also known as, and describe its location, attachments, and significance clinically.
|
Angle of Louis, Located at junction between manubrium and body, attachment of 2nd rib, prominent palpable landmark whose plane intersects with TV4
|
|
|
What is the superior mediastinum space?
|
Central region in thoracic space
|
|
|
What is the technical name for the terminal crest?
|
Crista terminales
|
|
|
What is the thymus important for? When is its size relative to the body largest, and does it increase in size ever?
|
Immune system, At age 2, does increase in size after 2 years of age
|
|
|
What is the transition that occurs at the hilum?
|
Parietal pleura becomes visceral pleura
|
|
|
What is the tremendous network of sympathetic & parasympathetic nerve fibers draping from neck onto heart in the mediastinum?
|
Cardiac plexus
|
|
|
What is the tubercle, and what is it a landmark for?
|
Extension of the bony region containing articular facet for the articular process of vertebrae, and is a landmark for muscle attachment
|
|
|
What is the vagus nerve responsible for in lymphatics of the lungs?
|
Parasympathetic innervation
|
|
|
What is the xiphoid process?
|
The irregularly shaped bottom portion of the manubrium, which is different from person to person
|
|
|
What is transposition of the great arteries a result of?
|
Defect of truncus in which septum develops but doesn't spiral
|
|
|
What is used as the best mode of pinpointing the SA node?
|
Cranial end of terminal crest
|
|
|
What keeps blood out of the lungs before birth?
|
High pulmonary pressure / resistance keeps blood out of lungs
|
|
|
What layer of the blastocyst produces the 3 distinct germ layers?
|
Epiblast
|
|
|
What occurs at the end of the 3rd / 4th week to the flat, trilaminar embryo?
|
It has 2 important folding events
|
|
|
What occurs at the hilum or root of lung pertaining to the pleura?
|
The pleura folds back upon itself to create two layers
|
|
|
What occurs to the intercostal arteries are a result of postductal coarctation?
|
The intercostals enlarge over time and become important for collateral circulation to distal part of body.
|
|
|
What opens as the foramen primum closes off?
|
Foramen secundum
|
|
|
What percentage of blockage do stress tests pickup?
|
> 50556
|
|
|
What process occurs in the third week of embryonic development that produces 3 distinct germ layers, and what are the germ layers
|
Gastrulation, ectoderm, mesoderm, endoderm
|
|
|
What receives innervation first, and what is the purpose of this area's reception and eventual contraction?
|
Apex receives to contract to force all blood toward valvular opening an deject out of pulmonary and aortic trunks
|
|
|
What results from the breakdown of these elastic fibers?
|
Emphyzema
|
|
|
What ribs are the false ribs, and where do they attach and how do they attach?
|
Ribs 8-10, attached to upper ribs above via costal cartilages
|
|
|
What ribs are the true ribs, and where do they attach, as well as how do they attach
|
Ribs 1-7, attached to sternum directly via costal cartilages
|
|
|
What separates the 2 sides of the heart?
|
Interatrial septum
|
|
|
What separates the right and left sides of the heart?
|
Interventricular septum
|
|
|
What sound does diastole make?
|
Dub
|
|
|
What sound does systole make?
|
Lub
|
|
|
What supplies blood to the posterior side of the thoracic wall?
|
Aorta
|
|
|
What supplies the lung tissue?
|
Bronchial arteries
|
|
|
What triggers the final formation of interatrial septum?
|
Birth
|
|
|
What type of nerves run along the heart, and what do they run with?
|
Autonomic sympathetic and parasympathetic nerves run with coronary blood vessels
|
|
|
What types and numbers of nerves run with the thoracic wall?
|
The ventral rami of T1-T11 thoracic nerves run in the intercostals space in between the internal intercostals and innermost intercostals
|
|
|
What types of innervations does the heart take with it to its final location in the __ mediastinum?
|
Sympathetic, parasympathetic, middle
|
|
|
What valves are opposite to the pulmonary and aortic trunk valves
|
Two atrioventricular valves
|
|
|
What valves does the endocardial cushion also form?
|
Tricuspid and bicuspid valves
|
|
|
When blood comes towards the valves, how do they interact with the cusps?
|
Blood pushes cusps towards walls which opens valves
|
|
|
When the cusps come away from the wall, there is an opening of the __ and __ __ __ so the blood then flows out to the heart
|
right, left coronary
|
|
|
Where are the trabeculae carnae muscles located, and what do they give rise to?
|
Located in muscle wall of right ventricle, give rise to sets of muscle that extend into space of trabeculae carnae, papillary muscles
|
|
|
Where are the transversus thoracis muscles located?
|
Deep surface of the anterior chest wall
|
|
|
Where are tracheobronchial lymph nodes located?
|
Transition between trachea and bronchi
|
|
|
Where do paired structures exist related to the sympathetic chain ganglia of the mediastinum?
|
At every level
|
|
|
Where do pulmonary arteries run in relation to the bronchioles?
|
They run with the bronchioles
|
|
|
Where do the 4 lymph nodes in the thoracic wall input from?
|
Mammary and cranial nodes
|
|
|
Where do the external intercostal muscles begin?
|
Begin posteriorly where the tubercle of the rib is located, forming a membranous sheet which terminate at lateral part of sternum while muscle fibers end in costochondral junctions
|
|
|
Where do the left and right vagus nerve travel in relation to the esophagus, and what do they form after this?
|
Travel down the esophagus and form esophageal plexus
|
|
|
Where do the thoracic nerves terminate?
|
Gives off a branch laterally and continue anteriorly. Both branches anastomose somewhere in the thoracic space
|
|
|
Where do these ribs attach on the vertebral column?
|
transverse process
|
|
|
Where does one place the stethoscope in order to hear the sounds of blood flowing through aorta or pulmonary trunk
|
3rd intercostals space
|
|
|
Where does the aorta lie in relation to the pulmonary trunk?
|
It lies deep to the pulmonary trunk
|
|
|
Where does the arch of azygos vein terminate?
|
Posterior side of vena cava
|
|
|
Where does the atrioventricular node lie in relation to the ventricular region in the septal wall?
|
It lies just above the ventricular region of the septal wall
|
|
|
Where does the bifurcation to right and left primary bronchus occur in relation to the root of the lung?
|
Occurs prior to entry into root of lung
|
|
|
Where does the carina end? What is this location the intersection of?
|
Sternal angel at intersection of second rib at manubrium and sternum
|
|
|
Where does the coronary sinus lie in relation to the coronary sulcus?
|
The sinus vessel is laying in the sulcus, so if you move the coronary sinus you will be looking at the coronary sulcus
|
|
|
Where does the early branch of the right coronary artery ascend to?
|
Sinuatrial node
|
|
|
Where does the esophagus begin?
|
Inferior end of pharynx
|
|
|
Where does the esophagus pass through?
|
Through superior mediastinum, inferior mediastinum, diaphragm, to stomach
|
|
|
Where does the esophagus pass in relation to the trachea?
|
Deep to trachea
|
|
|
Where does the great splanchnic nerve terminate?
|
Celiac plexus
|
|
|
Where does the left atrium arise?
|
It develops as an absorption / incorporation of pulmonary veins
|
|
|
Where does the left common carotid artery run?
|
Toward head
|
|
|
Where does the left coronary artery originate, and what does it split into?
|
Originates from left cusp, and splits into anterior interventricular branch and circumflex branch, and posterior interventricular artery
|
|
|
Where does the left recurrent laryngeal nerve lay?
|
Gets caught under left arch and becomes part of mediastinum
|
|
|
Where does the left subclavian artery run?
|
Horizontally
|
|
|
Where does the parietal side of pleura touch, and what depth is it from a layered perspective?
|
Body wall, outermost layer
|
|
|
Where does the posterior interventricular artery derive from usually, and what is a secondary possible origin?
|
Common is right coronary artery, less common is circumflex coronary artery
|
|
|
Where does the right lymphatic duct terminate?
|
Right internal jugular and right subclavian
|
|
|
Where does the right recurrent laryngeal nerve lay?
|
Gets caught under subclavian because distal end of 6th arch gets reabsorbed on the right
|
|
|
Where does the sympathetic chain ganglia of the mediastinum extend through?
|
Through the thorax
|
|
|
Where does the sympathetic chain ganglia of the mediastinum start?
|
Neck region
|
|
|
Where does the thoracic duct ascend and terminate into?
|
Junction of internal jugular and subclavian veins on left side
|
|
|
Where does the thoracic duct empty into?
|
Intersection of left internal jugular and left subclavian vein
|
|
|
Where does the trachea begin?
|
In the neck, inferior to the larynx
|
|
|
Where does the trachea end?
|
Inferior border of superior mediastinum
|
|
|
Where does the vagus nerve start, and what is it aiming for?
|
Starts in neck region, and aims for esophagus
|
|
|
Where is the anterior mediastinum?
|
Anterior to middle mediastinum and deep to sternum
|
|
|
Where is the atrioventricular nodal branch of the right coronary artery, and what does it dive into?
|
Posterior andmiddle of heart, dives into heart tissue mass
|
|
|
Where is the descending thoracic aorta located?
|
Inferior mediastinum
|
|
|
Where is the heart located in relation to manubriosternal joint and xiphisternal joint?
|
In the middle of mediastinum between the two joints
|
|
|
Where is the middle mediastinum?
|
Pericardardium and anything stuck to it
|
|
|
Where is the moderator band found?
|
Right ventricle as an extension of the trabeculae carnae from distal portion of the septal wall, and runs to the base of the anterior papillary muscle
|
|
|
Where is the phrenic nerve located in relation to the Vagus nerve?
|
Phrenics are more lateral and anterior than vagus nerve
|
|
|
Where is the posterior mediastinum?
|
Posterior to middle mediastinum and anterior to spinal column
|
|
|
Where is the pulmonary ligament located?
|
Inferior to hilum
|
|
|
Where is the right recurrent laryngeal nerve located?
|
Outside superior mediastinum and outside thorax
|
|
|
Where is the SA node located?
|
Junction between cranial end of terminal crest and superior vena cava
|
|
|
Where is the small cardiac vein located, and where does it terminate?
|
Runs adjacent to right marginal artery and right coronary artery, and temrinates in right side of coronary sinus
|
|
|
Where is the superior mediastinum located?
|
It is the area above imaginary line between sternal angle and T4 vertebrae
|
|
|
Where is the transverse pericardial sinus located?
|
Deep to 3 great vessels
|
|
|
Where is the visceral side of pleura touching, and what depth is it from a layered perspective?
|
intimately attached to lung tissue, innermost layer
|
|
|
Where is this single heart tube located?
|
Thoracic pericardial cavity
|
|
|
Which aortic arch structures are located to the left, and which to the right?
|
Brachiocephalic trunk is on the right, left common carotid and left subclavian arteries are on the left side
|
|
|
Which direction do the pulmonary veins enter into the adult heart?
|
Enter into posterior atrium
|
|
|
Which direction does blood flow in the heart tube?
|
Caudal to cranial direction
|
|
|
Which direction do innermost intercostals muscles point?
|
They generally are in the same direction as the internal intercostals with a few exceptions
|
|
|
Which end is thicker for the ribs, cranial or caudal end?
|
Cranial (superior) end is thicker and rounder while the caudal (inferior) end is thinner and sharper
|
|
|
Which end of the heart tube is the arterial end?
|
Cranial (head) end
|
|
|
Which end of the heart tube is the venous end of the heart tube?
|
Caudal (tail) end
|
|
|
Which is the larger end of the rib which articulates with vertebral bodies?
|
Head of rib
|
|
|
Which is the narrower region where ligaments attach connecting ribs and vertebral columns?
|
Neck
|
|
|
Which lobes conform to the contour of the diaphragm
|
Inferior lobes
|
|
|
Which lung is smaller, and why?
|
Left lung smaller because position of heart
|
|
|
Which lymphatic of the htorax is the largest lymph channel, starts __ to the diaphragm, progresses __ through the diaphragm along with the aorta, and terminates at junction of __ jugular and __ subclavian?
|
Thoracic duct, inferior,longitudinally, internal, left
|
|
|
Which lymphatic plexus is closer to the root of the lung?
|
Deep lymphatic plexus
|
|
|
Which of the ribs is the largest?
|
7th rib
|
|
|
Which of the ribs is the shortest, thickest, curved, and most atypical?
|
1st rib
|
|
|
Which of the two connections, primum or secundum acts as a valve?
|
Septum primum acts like a valve over the foramen ovale, allowing blood flow from right to left atria
|
|
|
Which of the two lung recesses is larger?
|
Costodiaphragmatic recess
|
|
|
Which ribs are the floating ribs, and where do they attach, and also note their location
|
Ribs 11-12, they do not attach to sternum at all, they end in the musculature of the body wall
|
|
|
Why are active valves closed in diastole?
|
To prevent backflow of blood back into heart
|
|
|
Why are passive valves open in diastole?
|
Open to get new set of venous blood into chambers in prep for oxygenation or systemic circulation
|
|
|
Why can a damage to conduction system result in fixing VSD?
|
Left bundle as it leaves AV node crosses just to the immediate left of membranous septum
|
|
|
Why do active cusp structure have closed valves in systole?
|
Pulled shut by muscular control
|
|
|
Why doesn't the superior vena cava need a valve?
|
Gravity prevents backflow
|
|
|
Why is it alright to have a hole in the common atrial wall?
|
Lungs are not functional in utero; therefore, there is no need for blood from right atrium to go to lungs
|
|
|
Why is it important to have cartilage becoming smooth muscle and elastic fibers?
|
During exhalation pressure decreases in lungs and alveoli shrink due to smooth muscle and elastic fibers
|
|
|
Why is it named lobar bronchus?
|
Lobar arrangement of lung tissue
|
|
|
Why is it necessary to get such rich blood supply to the SA node?
|
Conduction system needs rich blood supply
|
|
|
Why is left to right shunting non-cyanotic?
|
Left atrial blood has high oxygen content coming from the lungs, so it will enter the right atrium and go through pulmonary circulation again to become super oxygenated
|
|
|
Why is the apex most vulnerable on the heart to blockage?
|
Farthest from major branches of coronary artery, limited geographically in how many vessels get to that region, apex is frequently damaged region when pathology exists
|
|
|
Why is the costodiaphragmatic recess important clinically?
|
For removing excess fluid that sometimes fills these recesses
|
|
|
Why is the thickness less for the right ventricle?
|
It pushes blood to the lungs, not to systemic circulation like the left ventricle does
|
|
|
With a quiet exhalation where does the heart lay?
|
Heart in sternal area
|
|
|
With a quiet inhalation where does the heart lay?
|
Heart below sternum
|
|
|
Name the three main types of signal transduction?
|
endocrine, paracrine, autocrine
|
|
|
What type of messenger are endocrines, and how do they work?
|
First messenger, travels in blood stream has its effect at level of cell
|
|
|
What type of messenger are paracrines, and how do they work?
|
First messenger, secreted from one cell and has its effect on adjacent cell
|
|
|
What type of messengers are autocrines?
|
First messengers, secreted from same cell that will be targeted for response
|
|
|
What is the general concept behind signal transduction?
|
Stimulus-response coupling involves alternating messengers and receptors
|
|
|
Where is the second messenger always?
|
Inside cell
|
|
|
How are hormones classified?
|
Based on location of receptor
|
|
|
Name 5 types of hormones with receptors outside cell?
|
Peptide, prepro, amino acid derivatives, nucleosides, nucleotides
|
|
|
Basically, hormones with receptors outside the cell are what?
|
lipophobic
|
|
|
Name 5 types of hormones with receptors inside cell?
|
Thyroids, steroids, gaseous hormones, sterol, isoprenyl derivatives
|
|
|
Basically, hormones with receptors inside the cell are what?
|
lipophilic
|
|
|
How many different receptors does epinephrine have?
|
At least 5 distinct receptors
|
|
|
Acetylcholine has how many receptors?
|
6 receptors
|
|
|
Nicotinic has __ receptors and muscarinic has __ receptors
|
1, 5
|
|
|
Receptors exhibit __ and __
|
specificity, affinity
|
|
|
What can be used to determine receptor affinity for a hormone?
|
Hormone receptor binding assays
|
|
|
What type of plot shows how many high affinity sites there are for a specific hormone on a receptor?
|
Scatchard plot
|
|
|
IN a langmuir isotherm, describe receptor hormone interactions
|
As hormone ups, more is bound and ratio of B/Bmax approaches 1, or complete saturation
|
|
|
Describe receptor hormone interactions in a scatchard plot
|
As concentration of free ligand increases, more becomes bound until it reaches saturation
|
|
|
What is the X intercept of a scatchard plot?
|
Number of binding sites
|
|
|
What can the slope of a scatchard plot be used to determine?
|
Affinity of receptor for hormone
|
|
|
In measuring hormones with radioimmunoassays, a __ amount of antibody is incubated with a __ amount of radioactively labeled hormone, and some __ of radioactive hormone binds to antibody
|
constant, fixed, fraction
|
|
|
What does unlabeled hormone do if present in radioimmunoassays?
|
Competes for binding site on antibody
|
|
|
What is a measure of the amount of unlabeled hormone in a sample of blood or tissue extract?
|
Degree labeled hormone is displaced from antibody
|
|
|
In radioimmunoassays, graphs show what on y-axis as a function of log [__]
|
ratio of bound to free, hormone
|
|
|
How is the graph of radioimmunoassays determined?
|
Known amounts of hormone to provide standard to determine unknown amounts
|
|
|
Why is RIA not the best test?
|
Expensive, training, waste management
|
|
|
Proteins in the sample of an ELISA are adsorbed to what?
|
Inert surface, usually 96-well polystyrene plate
|
|
|
What is washed away in an ELISA test? What is added?
|
Unbound antibody is washed away and antibodies against primary antibody are added
|
|
|
|
|
|
|
These secondary antibodies have been linked to what?
|
Enzyme that catalyzes reaction that forms colored product
|
|
|
After unbound secondary antibody is washed away, what is added?
|
Substrate of antibody-linked enzyme
|
|
|
What is an indicator of protein concentration?
|
Product formation (or color intensity)
|
|
|
Which test is used, ELISA or Radioimmunoassay is used to determine hCG in the urine?
|
ELISA
|
|
|
Do hormones have short or long lifespans?
|
Short
|
|
|
Name 5 steroids formed from cholesterol precursors?
|
Estrogen-C18, Androgen-C19, mineralocorticoids, glucocorticoids, and progesterone-C21
|
|
|
Name 2 thyroid hormones
|
Triiodothyronine (T3), Thyroxine (T4)
|
|
|
T4 exists in how many forms? Which is not made in the body
|
Two forms, reversible T3 is not made in body
|
|
|
Steroids and thyroid hormones are (lipophobic / lipohilic), and affect what?
|
Lipophilic, transcription
|
|
|
__ for steroids and thyroid hormones are transcription factors
|
receptors
|
|
|
3 steps of transcription factoring for hormones?
|
Hromone binds receptor, complex binds DNA and causes transcription into mRNA, mRNA produces protein
|
|
|
How does the enabling of transcription actually occur? Name the polymerase that is involved
|
Sequences of DNA bind complex, allows RNA pol II to bind
|
|
|
Hormone-receptor complex has __ __ that locate and bind the element on the DNA sequence
|
zinc fingers
|
|
|
Name 6 effectors that work from outside the cell
|
Glucagons, epinephrine, norepinephrine, dopamine, morphine, acetylcholine
|
|
|
Effectors working from outside the cell have how many helical segments?
|
7 transmembrane helical segments
|
|
|
How do effectors working outside the cell work?
|
Through G-proteins inside the cell
|
|
|
G proteins have how many subunits?
|
3 subunits
|
|
|
|
|
|
|
G-protein linked receptors are __ __ __ factors
|
guanine nucleotide exhange
|
|
|
G-protein linked receptors cause G-protein to do what?
|
exchange GDP for GTP activating the G-protein
|
|
|
G-protein linked receptors are receptors for?
|
Glucagon, epinephrine, norepinephrine, dopamine, morphine, acetylcholine
|
|
|
G-protein linked receptors work indirectly through what in order to regulate what?
|
Geterotrimeric G proteins to regulate activity of separate plasma membrane bound target protein
|
|
|
When talking about G-proteins, the __ binds the __.
|
receptors, effector
|
|
|
The receptore undergoes conformation change and activates what?
|
G-protein
|
|
|
A heterotrimeric G protein consists of how many subunits? Name them
|
3 subunits, alpha, beta, and gamma
|
|
|
|
|
|
|
The alpha subunit is associated with GTP or GDP, and when its associated with GTP, what occurs?
|
The subunit dissociates from beta and gamma subunits
|
|
|
Which subunits are always associated with each other?
|
beta and gamma subunits
|
|
|
What two subunits can activate a target protein?
|
Alpha, and the beta-gamma subunit
|
|
|
Gs does what?
|
Stimulates target protein
|
|
|
Gi does what?
|
Inhibits target protein
|
|
|
G proteins are also __, and thus slowly hydrolyze GTP to return to the inactive GDP bound state.
|
GTPases
|
|
|
After being activated, the g protein interacts with what?
|
It's plasma-membrane bound target protein
|
|
|
When G protein interacts with its plasma membrane bound target protein, it affects production of what? Which does what?
|
Second messenger, continues chain of signaling events until altering target proteins further down cascade modifies behavior of cell
|
|
|
In the B2 adrenergic receptor example, B2 adrenergic receptor binds what?
|
Epinephrine
|
|
|
B2 adrenergic receptor activates what?
|
Gs
|
|
|
Gs stimulates __ __ to upregulate production of second messenger __
|
Adenylate cyclase, cAMP
|
|
|
A2 adrenergic receptor binds what?
|
Norepinephrine
|
|
|
A2 adrenergic receptor activates what?
|
Gi
|
|
|
Gi inhibits __ __ and so downregulates production of the second messenger __
|
adenylate cyclase, cAMP
|
|
|
A1 adrenergic receptor binds what?
|
Norepinephrine or Ach
|
|
|
A1 adrenergic receptor activates G protein __
|
Gq
|
|
|
Gq activates __ __ __, which produces two second messengers: __ and __
|
Phospholipase C Beta, DAG, IP3
|
|
|
Forskolin toxin directly activates __ __ bypassing the __ __ __ receptor pathway
|
adenylate cyclase, g-protein linked
|
|
|
Cholera toxin inhibits __ of __
|
GTPase of Gs
|
|
|
|
|
|
|
Does cholera toxin increase or decrease cAMP?
|
increase
|
|
|
Cholera toxin produced in gut increases __ in lumen cells of the gut, which then causes them to stop the uptake of water. Increased diahrea produces excessive __ and possible death
|
cAMP
|
|
|
Pertussin toxin is also known as?
|
Whooping cough
|
|
|
What does pertussis toxin prevent?
|
Exchange of GDP for GTP in Gi
|
|
|
What does pertussis toxin prevent activation of?
|
Gi
|
|
|
With Gi being inactivated in pertussis toxin, what does one see?
|
Increase in cAMP
|
|
|
cAMP is broken down by what?
|
Phosphodiesterase (PDE) into AMP
|
|
|
What two things inhibit Phosphodiesterase?
|
Caffeine and theophylline
|
|
|
What is the only thing cAMP binds?
|
Protein Kinase A
|
|
|
PK-A phosphorylates over 30 known enzymes on __ or __ __
|
Serine, Threonine hydroxyl
|
|
|
Phosphorylation can __ or __ enzyme
|
activate, inhibit
|
|
|
IP3 triggers __ release from __ by binding the __ release channel
|
Ca2+, ER, Ca2+
|
|
|
What is the receptor in muscle tissue that mediates IP3 triggering Ca2+ release from ER?
|
Ryanodine receptor
|
|
|
Ca2+ is a __ which is increased by the action of __, __, or __ __ __ channels, __ receptor, and __ receptor
|
second messenger, Ip3, voltage, chemically gated ion, glutamate, ACh
|
|
|
There is a large group of enzymes activated by __ bound to __
|
Ca2+ calmodulin
|
|
|
Phosphorylase b kinase regulates what? Activated by what?
|
Glycogen metabolism, calmodulin-Ca2+
|
|
|
Myosin light chain kinase phosphorylates __ of the __ myosin light chains and __ the strength of skeletal muscle contraction and __ contraction in smooth muscle
|
2, 4, increases, controls
|
|
|
Myosin light chain kinase is activated by what?
|
Calmodulin-Ca2+
|
|
|
CaM kinase II phosphorylates a large number of enzymes and is activated by ?
|
Calmodulin-Ca2+
|
|
|
CaM kinase II can phosphorylate itself. What is this known as?
|
Autophosphorylation
|
|
|
CaM kinase II has a regulatory region on which terminus end?
|
C terminus end
|
|
|
Calmodulin binds to the __ domain
|
inhibitory
|
|
|
CaM Kinase II has a persistence of activity even after __ disappears and __ dissociates
|
Ca2+, calmodulin
|
|
|
Calmodulin is __ shaped and binds __ Ca2+ at each end
|
dumbbell, 2
|
|
|
Tyrosine kinase receptors are what type of helix?
|
Single transmembrane helices
|
|
|
Tyrosine kinase receptors are a hormone binding domain where?
|
outside of cell
|
|
|
Protein tyrosine kinase domain is where?
|
inside of cell
|
|
|
Tyrosine kinase receptors examples include receptors for?
|
Insulin, EGF, and nerve growth factor
|
|
|
Protein kinases phosphorylate?
|
proteins
|
|
|
Protein phosphatases do what?
|
Reverse phosphorylation by removing phosphate
|
|
|
Tyrosine kinase receptors form __ after binding of a hormone.
|
dimers
|
|
|
If a dimer of Tyrosine kinase receptors already exists, what do es binding form?
|
New conformation
|
|
|
Kinase of one subunit phosphorylates?
|
Other subunit
|
|
|
When one subunit phosphorylates it does what?
|
Activates receptor kinase activity and recruits proteins with SH2 domains
|
|
|
Tyrosine kinase phosphorylation occurs on __ of target proteins and makes an enzyme more or less active
|
Tyrosine
|
|
|
SH stands for?
|
SRC homology
|
|
|
Are SH2 and SH3 domains found in few or many proteins?
|
Many proteins
|
|
|
When SRC is recruited to tyrosine kinase receptors where it is bound at the SH2 domain, what occurs?
|
SRC is disrupting binding to itself, and is autophosphorylated to become active
|
|
|
Once SRC is active, it can go around doing what to other things in the cell?
|
Phosphorylating other things
|
|
|
Once SRC is turned on, what happens to the cell?
|
The cell divides
|
|
|
SH2 domain has its N and C terminus near or far away from eachother, and why?
|
Near eachother so it can insert easily into sequences without much disruption
|
|
|
SH2 domain binds what residues, and what does this imply about specificity?
|
It binds Tyrosine and 4 others, so it has some specificity
|
|
|
SH3 domains binds what?
|
Poly-proline sequences
|
|
|
Name some of the different SH2 domain proteins that can be attracted and autophosphorylated by a single tyrosine kinase receptor.
|
GAP, P1 3-kinase, and phospholipase C gamma
|
|
|
Some proteins serve as adapters containing only SH2 and SH3 domains. These proteins bind to what? Allow other protein to bind via what?
|
Proteins bind to receptor's SH2 domain, allow other proteins to bind via different SH2 domains or SH3 domains located on the adaptor protein
|
|
|
Phosphotyrosine binding domain works how?
|
Similar to SH2
|
|
|
WW recognize and bind what?
|
Pro rich sequences similar to SH3
|
|
|
PDZ bind to what?
|
C-terminus at many differnt ion channels
|
|
|
PH bind to?
|
Phosphatidyl inositides
|
|
|
|
|
|
|
MAP Kinase is in what receptor family? What does it often regulate by triggering MAP kinase pathway?
|
Tyrosine kinase receptor family, regulates cell prliferation
|
|
|
MKKK phosphorylates what? Which then phosphorylates Threonine / Tyrosine on MK's
|
MKK's
|
|
|
MAP kinase stands for?
|
Mitogen activated protein kinase
|
|
|
Mitogen is anything which?
|
Causes cell proliferation
|
|
|
What leads to Ras activation and the activation of Raf, MEK, and family MAP kinase?
|
Ability of tyrosine kinase receptor family to recruit SH2 and SH3 domain proteins, including SOS
|
|
|
What are two examples of oncogenes?
|
Jun and ERB-1
|
|
|
MAP kinase __ transcription!
|
increases
|
|
|
MAP kinases phosphorylate what? To do what?
|
Transcription factors elk, myc, jun, to increase mRNA's needed during cell division
|
|
|
MAP Kinase phosphorylates what?
|
eIF-4E
|
|
|
What does phosphorylation of eIF-4E cause?
|
Increases mRNA binding to ribosome, increasing translation
|
|
|
MK phosphorylates __ __ __ __ which phosphorylates ribosome S6 protein and increases rate of protein synthesis
|
S6 protein kinase II
|
|
|
S6 protein kinase II phosphorylates what? What does this increase?
|
Ribosome S6 protein, ups protein synthesis
|
|
|
4 types of basic tissues. Name them
|
Epithelium, connective tissue, neural tissue, muscle
|
|
|
connective tissue is closely or widely separated?
|
widely separated
|
|
|
neural tissue is __ active
|
electrically
|
|
|
3 muscle tissues, name them
|
skeletal, cardiac, smooth
|
|
|
which muscle tissue is striated?
|
skeletal and cardiac
|
|
|
muscle is connected to bones by?
|
tendons
|
|
|
tendons are __ tissue
|
connective
|
|
|
3 types of muscle. Name them
|
epimyseum, perimyseum, endomyseym
|
|
|
which muscle type is a sheet of dense irregular connective tissue surrounding entire muslce?
|
epimyseum
|
|
|
which muscle type extends inward and is dense connective tissue divided into partitions called fascicles?
|
Perimyseym
|
|
|
Which muscle type surrounds individual cells, is delicate loose connective tissue, and contains capillaries and nerve fibers?
|
endomyseym
|
|
|
describe muscle fibers shape?
|
long and cylindrical
|
|
|
Muscle fibers are arranged in __ cross-sections, with only part being seen
|
longitudinal
|
|
|
Sarco is greek for?
|
flesh
|
|
|
Plasma membrane is called?
|
sarcollema
|
|
|
Cytoplasm is called ?
|
sarcoplasm
|
|
|
Where are nuclei in muscle fibers?
|
peripherally located, multinucleated myonuclei
|
|
|
What are myonuclei derived from in muscle fibers?
|
Dividing uni-nucleated myoblasts which fused
|
|
|
Can nuclei of muscle fibers divide?
|
No
|
|
|
Satellite cells are located where in relation to skeletal muscle fibers? Can they regenerate?
|
Adjacent, some regenerative capacity
|
|
|
Each muscle fiber and associated satellite cells is surrounded by?
|
Basal lamina
|
|
|
The sarcoplasm is comprised mostly of?
|
Myofibrils
|
|
|
The sarcoplasm runs where in relation to the fiber?
|
Runs length of fiber
|
|
|
What is the appearance of sarcoplasm?
|
Gristly appearance
|
|
|
In longitudinal section, sarcoplasmic areas look what in relation to each other?
|
Very close together
|
|
|
Sarcoplasm exhibit what which can be see (visual duality)
|
alternating light/ dark band striations
|
|
|
Muscle fibers contain many __ which run the length of the cell and have 50 to 100 in a given cell
|
myofibrils
|
|
|
Myofibrils consist of chains of __ arranged end-to-end
|
sarcomeres
|
|
|
The ends of myofibrils are marked by?
|
Z-line
|
|
|
Myofibrils act as what?
|
Functional unit of skeletal muscle fiber
|
|
|
Two kinds of myofibril filaments. What are they?
|
Thin, thick
|
|
|
Thin filaments insert where and extend to where?
|
Insert on Z-line, extend to center of sarcomere
|
|
|
Thick filaments lie where?
|
In center of sarcomere
|
|
|
Muscle fibers have several regions. Name them
|
Dark, light, center of sarcomere, center of H-zone
|
|
|
The Dark region has what 4 things?
|
A-band, center of sarcomere, most filamentous material, thick filaments
|
|
|
Light has what 3 things?
|
I-band, less filamentous material, thin filaments here are not overlapping with thick
|
|
|
Center of sarcomere has what two things?
|
H-zone, thick filaments not overlapped by thin
|
|
|
Center of H zone has what one thing?
|
M-line
|
|
|
Do dark and light bands span the entire width of the fiber?
|
Yes
|
|
|
Each myofibril is surrounded by sarcoplasm which contains?
|
Mitochondria, glycogen granules, sarcoplasmic reticulum
|
|
|
Is the myofibril bound by a membrane?
|
No, bound by sarcoplasm
|
|
|
Thin consists of strands of filamentous?
|
Actin
|
|
|
Thick consists of many __ molecules
|
myosin
|
|
|
How many myosin molecules are in thick area, how are they arranged? array arranged?
|
250 or so, bilaterally symmetrical, staggered array
|
|
|
The globular heads of myosin face what?
|
Center of sarcomere
|
|
|
The thick area is surrounded by six thin?
|
Filaments
|
|
|
Overall, there are how many thin filaments for each thick filament?
|
2 thin filaments
|
|
|
Myosin heads bind?
|
ATP
|
|
|
When ATP is hydrolized what occurs?
|
Heads bind tightly to actin, resulting in conformational change
|
|
|
What is this conformational change also known as?
|
Power stroke
|
|
|
What does the power stroke cause?
|
Causes thin filament to slide past thick filament, toward center of sarcomere
|
|
|
Each of 500 myosin heads in each thick filament act __
|
independently
|
|
|
How often is the power stroke repeated?
|
Several times per second
|
|
|
This cycle causes what contraction?
|
Sarcomere contraction
|
|
|
Do the filaments change shape? What does if they don't?
|
No, distance between I-lines do
|
|
|
I band gets?
|
Shorter
|
|
|
H zone gets?
|
Shorter
|
|
|
M line?
|
Does not change in length
|
|
|
A band does?
|
Not get shorter
|
|
|
Is sliding filament theory spontaneous?
|
No, voluntary
|
|
|
The sliding filament is a result of __ __ in the __ nerve
|
Electrical activation, presynaptic
|
|
|
What is released in electrical activation in presynaptic nerve?
|
aCh
|
|
|
T tubules are invaginations of?
|
Sarcolemma which encircle myofibrils
|
|
|
Where are T tubules located?
|
In A-I junction
|
|
|
AP travels down the __
|
Sarcollema
|
|
|
How does the AP reach deep muscle?
|
Via T-tubule conduction
|
|
|
Sarcoplasmic reticulum is what type of ER?
|
Smooth ER
|
|
|
Sarcoplasmic reticulum is an internal system of?
|
Tubercles
|
|
|
Is the sarcoplasmic reticulum connected to T-tubules?
|
No
|
|
|
The SR encircles each __
|
myofibril
|
|
|
What are the dilated parts of SR called, and where do they lie related to T-tubules?
|
Called terminal cisternae, adjacent to T-tubules
|
|
|
What is the Triad?
|
T-tubule and two flanking terminal cisternae
|
|
|
AP causes SR to release?
|
Ca2+
|
|
|
More Ca binds to what? What does this allow?
|
Binds to troponin on myofibrils, allows head to bind actin
|
|
|
What happens to Ca when muscle is no longer innervated by mother neuron?
|
Ca pumped back into sarcoplasmic reticulum, and muscle relaxes
|
|
|
Rate of Ca diffuse puts limits on?
|
Diaemeter of myofibril
|
|
|
If the myofibril is too fat?
|
Poor diffusion = poor conduction
|
|
|
What is the diameter of myofibril as a result?
|
2 microns is usually the diameter
|
|
|
How do myofibrils get longer?
|
By adding sarcomeres at the ends
|
|
|
Length is limited of myofibrils by?
|
Characteristics of actin / myosin
|
|
|
What is alpha-actinin?
|
Protein that attaches actin to Z-line
|
|
|
What is an example of a protein that links myofilaments to the sarcolemma?
|
Dystrophin
|
|
|
How does dystrophin work?
|
Links actin to complex of proteins
|
|
|
What is the complex of proteins that dystrophin links to actin called?
|
dystroglycan
|
|
|
What is the common name for the disease resulting from mutation of dystrophin?
|
Muscular Dystrophy or Duchenne's MD
|
|
|
MD is a mutation of?
|
Dystrophin gene
|
|
|
What happens to the attachment ability and muscle fibers with MD?
|
Attachment fails, and muscle fibers die
|
|
|
Sarcolemma attachment is essential for __ and __ of muscle
|
Contraction, health
|
|
|
|
|
|
|
Cardiac muscle cells are noted to be __, and consist of __ and __ bands
|
striated, dark, white
|
|
|
Are cardiac muscle cells visible in cross section of cardiac muscle?
|
May or may not be visible
|
|
|
Do cardiac muscle cells have something that gives them a gristly appearance?
|
Yes, myofibrils
|
|
|
Cardiac muscle cells are __, __ cells arranged end to end to form __ chains
|
short, cylindrical, branched
|
|
|
Branched chains are known as?
|
Branched fibers
|
|
|
Each cardiac muscle cell in branched fiber is joined by?
|
Intercalated discs
|
|
|
Intercalated discs appear as what in cross sections?
|
Dark lines
|
|
|
Name the 3 things composed of intercalated disks?
|
Macula adherens, gap junctions, faschia adherens
|
|
|
The functional unit of macula adherens is the?
|
Desmosome
|
|
|
The desmosome is a very __ bond and does or does not allow separation between cells?
|
Strong, does not allow separation
|
|
|
The functional unit of gap junctions is?
|
Connexon protein
|
|
|
Gap junctions allow neighboring proteins to do what?
|
Share ions and thus allow coordination of muscle fiber contraction here
|
|
|
Fascia adherens look like?
|
Zonula adherens
|
|
|
What is the difference between fascia adherens and zonula adherens?
|
Fascia contain cytoplasmic dense bodies to which thin filaments attach along an alpha-actinin binding site
|
|
|
Intercalated discs observed as dark lines running __ to striated pattern of cardiac muscle
|
perpendicular
|
|
|
Cardiac muscle cells have how many nuclei?
|
Mononucleate or binucleate
|
|
|
In cardiac muscle, fascia adherens takes place of ?
|
Z-line
|
|
|
Fascia adherens contain __ __ bodies to which __ filaments attach along an __ binding site
|
cytoplasmic dense, thin, alpha-actinin
|
|
|
Where is the nuclei (are the nuclei) located?
|
Centrally located
|
|
|
Can cardiac muscle cells divide?
|
No division
|
|
|
Do cardiac muscle cells have satellite cells?
|
No satellite cells
|
|
|
Having no satellite cells means no __ capacity, making injury very __
|
regenerative, problematic
|
|
|
Are T-tubules in cardiac muscle cells small or wide?
|
Wide
|
|
|
Do cardiac muscle cells have a sarcoplasmic reticulum?
|
Some, but not as well developed
|
|
|
What does cardiac muscular SR lack?
|
large terminal cisternae
|
|
|
How does the size of T-tubules relate in cardiac muscle cells to skeletal muscle t-tubules, and where are t-tubules located in cardiac muscle cells?
|
Larger T-tubules, located at Z-lines
|
|
|
What is the profile type of T-tubules at Z-lines in cardiac muscle cells?
|
Diads
|
|
|
Mitochondria within cardiac muscle are very __ and are required to produce what?
|
Very large, a lot of energy
|
|
|
What is cardiac muscle controlled by?
|
ANS
|
|
|
Visceral smooth muscle is located where?
|
Blood vessels, hollow viscera
|
|
|
Smooth muscle undergoes what three types of contractions?
|
Sustained, partial, and rhythmic contractions
|
|
|
Sustained and partial contractions are when pertaining to blood vessels?
|
Blood vessels constrict
|
|
|
Rhythmic contractions are what pertaining to the large intestine?
|
Peristalsis in small intestine
|
|
|
Are smooth muscles striated?
|
No
|
|
|
Do smooth muscles have myofibrils?
|
No
|
|
|
Not having myofibrils in smooth muscle cells insenuates what when thinking analytically or histologically?
|
Won't see bristles in analysis
|
|
|
Do smooth muscles have light and dark bands?
|
No
|
|
|
Do smooth muscles have sarcomeres?
|
No
|
|
|
What is the shape of smooth muscles?
|
Elongated like skeletal, spindle shaped
|
|
|
How nucleated is smooth muscle cells? Where is the nucleus in smooth muscle cells?
|
Single, centrally located nucleus
|
|
|
What do smooth muscles secrete?
|
Extracellular matrix materials
|
|
|
Cells that secrete extracellular matrix materials are most prominant where?
|
In cells that line blood vessels
|
|
|
What is frequently released by these cells into extracellular matrix?
|
Collagen and elastin
|
|
|
Do smooth muscle cells have satellite cells?
|
No
|
|
|
Do smooth muscle cells have T-tubules?
|
No
|
|
|
How developed is the SR of smooth muscle cells?
|
Poorly developed
|
|
|
How is calcium influx handled in smooth muscle cells?
|
Pinocytotic vesicles
|
|
|
|
|
|
|
What is the rate of contraction of smooth muscle regulated by?
|
ANS
|
|
|
__ __ electrically couple adjacent cells and allow contraction to be coordinated
|
Gap junctions
|
|
|
Instead of myofibrils, smooth muscle cells have?
|
Anastomosing network of dense bodies throughout cytoplasm comprised of thin and thick filaments
|
|
|
Dense bodies contain?
|
Alpha actinin
|
|
|
Thin filaments and occasional interspersed thick filament bind to __ along surface of dense bodies
|
Alpha actinin
|
|
|
Thin filaments bound to alpha actinin of dense bodies form?
|
Woven network
|
|
|
Contraction of thin filaments in woven network does what?
|
Shortens and widens cell
|
|
|
When cell is scrunched, nuclei become?
|
Passively folded and pleated, which is a hallmark of contracted smooth muscle cells
|
|
|
|
|
|
|
Motor unit is?
|
1 motor neuron + all muscle fibers it innervates
|
|
|
Motor neuron originates where?
|
Ventral horn of spinal cord
|
|
|
One motor neuron can branch and innervate __ muscle fibers, but each muscle fiber receives innervation from?
|
multiple, only one motor neuron
|
|
|
When a motor neuron sends an AP, it goes __ to all muscle fibers that it innervates
|
equally
|
|
|
Where are excitatory and inhibitory signals integrated?
|
Axon hillock of neuron
|
|
|
If depolarization is above threshold, then what will occur?
|
AP
|
|
|
In healthy motor unit, once an axon hillock is depolarized above its threshold, there is no way to prevent what?
|
AP from causing a contraction of muscle fibers in motor unit
|
|
|
The axon hillock is referred to as?
|
Final common pathway of motor unit
|
|
|
Slow motor units consist of?
|
Motor neurons with small diameters
|
|
|
Do slow motor units innervate more or fewer muscle fibers than fast motor units?
|
Fewer fibers
|
|
|
Are slow motor units recruited first or last type of unit to be recruited to contract in a muscle?
|
First
|
|
|
Why are slow motor units the first type of unit to be contracted?
|
Easier to get spatial and temporal summation to occur over smaller space
|
|
|
Slow motor units are associated with which type of contraction?
|
Ones that act for extended periods of time, such as maintenance of posture
|
|
|
Fast motor units have motor neurons with __ diameters
|
larger
|
|
|
Fast motor units innervate __ number of muscle fibers than slow motor units
|
greater
|
|
|
Fast motor units are associated with contractions with?
|
Greater velocity but shorter duration, such as running cheetah
|
|
|
The excitation of a motor neuron is coupled with contraction of group of muscle fibers it innervates, what is this known as?
|
Excitation - Contraction coupling
|
|
|
Where does EC coupling occur?
|
Motor end-plate
|
|
|
After a motor neuron has reached threshold at its axon hillock, it generates an AP which travels down the axon and undergoes a series of events leading to release of?
|
Neurotransmitter
|
|
|
In skeletal muscle, the neurotransmitter is always?
|
Acetylcholine
|
|
|
Ach binds to?
|
Nicotinic receptors on the motor end plate
|
|
|
Nicotinic receptors are what kind of channel?
|
Ligand gated channels
|
|
|
Increased ion permeability caused by opening of Nicotinic channel leads to what?
|
depolarization of membrane
|
|
|
Are there voltage gated Na+ channels in the end plate?
|
No
|
|
|
Without Na+ channels in the end plate, what cannot be initiated?
|
AP
|
|
|
There must be enough receptors activated in the end plate that the depolarization spreads to surrounding membrane where what exists?
|
Voltage gated Na+ channels
|
|
|
What does having voltage gated Na+ channels only outside the neuromuscular junction act as?
|
Safety mechanism
|
|
|
How does it act as a safety mechanism?
|
Avoids noise from causing unwanted muscle contraction
|
|
|
The AP spreads the length of the muscle and encounters the __ system
|
T-tubule
|
|
|
T-tubules allow for?
|
Simulatenous depolarization of membrane throughout muscle fiber
|
|
|
|
|
|
|
|
|
|
|
Once AP travels down T-tubules, it reaches voltage gated proteins called?
|
Dihydropyridine Receptors (DHPR)
|
|
|
DHPR mechanically pulls on __ receptors.
|
Ryanodine
|
|
|
Ca2+ channels exist at the terminal cisternae, causing Ca2+ to be released from?
|
sarcoplasmic reticulum
|
|
|
Release of Ca2+ leads to activation of the __ cycling
|
cross-bridge
|
|
|
In the sarcomere, the main component of thin filaments is?
|
Actin
|
|
|
How does G-actin associate to create filaments?
|
End to end
|
|
|
Two filaments are twisted together how?
|
Helical arrangement
|
|
|
Tropomyosin is?
|
Filamentous protein that forms an alpha helix
|
|
|
Where does tropomyosin lie?
|
In the groove of the actin helix
|
|
|
There are three types of troponins in a complex, name them
|
TnC, TnI, TnT
|
|
|
What does TnC bind?
|
Ca2+
|
|
|
What does TnI serve as?
|
Inhibitor via complexing in a way that forces tropomyosin to block site where myosin head binds actin
|
|
|
What does TnI act as?
|
Inhibitor of myosin binding and contraction
|
|
|
TnT binds?
|
Troponin complex to Tropomyosin
|
|
|
The region in which the thin filaments are found is the ?
|
Isotropic region (I-band)
|
|
|
Thick filaments are a region of __ __? (What kind of fibers)
|
myosin fibers
|
|
|
Myosin is composed of how many heavy chains and how many light chains?
|
2 heavy chains, 4 light chains
|
|
|
Where are head groups found on thick filaments?
|
On heavy chains
|
|
|
Head groups have __ __ and therefore can store energy by hydrolysis of ATP
|
ATPase activity
|
|
|
When there is __ Ca2+, the myosin head is charged with energy from hydrolysis of ATP into ADP and Pi, but it cannot bind actin because of the placement of __
|
no, tropomyosin
|
|
|
Thick filaments are __ with head groups on both sides of the filament pointed in __ directions
|
bipolar, opposite
|
|
|
The region where the thick filaments are found is the ?
|
anisotropic region (A-band)
|
|
|
The thick and thin filaments are? This allows for?
|
Interdigitated, allows for binding
|
|
|
If a muscle is contracted, the length of the __ decreases or increases accordingly
|
sarcomere
|
|
|
If the thick and thin filaments have length changes (if possible), what occurs between them?
|
The filaments move relative to each other
|
|
|
Does the width of the A band change?
|
No
|
|
|
Does the width of the I band change?
|
Yes
|
|
|
When Ca2+ is released from the sarcoplasmic reticulum it binds ?
|
TnC
|
|
|
When TnC is bound to Ca2+, it changes conformation, and since TnC is complexed with __, __ also shifts, moving __ away from myosin binding site on actin
|
TnI, TnI, tropomyosin
|
|
|
After TnI moves tropomyosin away from myosin binding site, myosin now binds what?
|
Actin with high affinity
|
|
|
When Ca2+ is pumped back into the sarcoplasmic reticulum, Ca2+ dissociates from TnC and the complex shifts?
|
Back so that tropomyosin is covering myosin binding site on actin
|
|
|
The structural changes that occur during muscle contraction cause the __ filaments in a sarcomere to slide relative to the __ filaments
|
thin, thick
|
|
|
Since myosin heads extend toward both Z lines of the sarcomere, during contraction the __ filaments are pulled from both sides toward the center producing tension on the __ lines and shortening the sarcomere length
|
thin, Z lines
|
|
|
Myosin heads store energy in the form of __ + __
|
ADP, Pi
|
|
|
After myosin binds actin with high affinity, it undergoes a conformational change releasing the energy it derived from ATP hydrolysis. Because the tight association between actin and myosin, thin filament is forced to move relative to the thick filament. What is this referred to as?
|
Power stroke
|
|
|
After conformational change, ADP has low affinity for ?
|
Myosin head
|
|
|
ATP binding decreases affinity of myosin for __, and so it dissociates from the __
|
actin, actin
|
|
|
What hydrolizes the newly bound ATP so it can repeat the process by binding another actin site?
|
Myosin head
|
|
|
What inhibits the site from binding another actin site?
|
Tropomyosin in low concentrations of Ca2+
|
|
|
During a typical twitch contraction, how many cycles will occur?
|
2-4 cycles
|
|
|
Does normal live muscle run out of ATP, and if does, what does it do to replenish its supplies?
|
Never runs out
|
|
|
What is it called when there is no ATP in the dead, so nothing displaces ADP when myosin is bound to actin?
|
Rigor mortis
|
|
|
Rigor mortis continus until __ __ cleave proteins associating muscle filaments
|
proteolytic enzymes
|
|
|
|
|
|
|
Suprasternal notch is at the __ __ of the __ sterni in the __ midline
|
superior surface, manubrium, superior
|
|
|
|
|
|
|
How does insulin relate to protein synthesis?
|
Also a mitogen, triggers same pathways as MAP kinase
|
|
|
Diabetes affects __ % of the population
|
10
|
|
|
Insulin-dependent, Type I, juvenile onset, insulin is?
|
Inadequate
|
|
|
What does Type 1 diabetes result from?
|
Destruction of islets of langerhans
|
|
|
Where are islets of Langerhans, and what do they do?
|
Pancreas, make insulin
|
|
|
Insuline-independent, Type II, adult onset, insulin is?
|
Normal or elevated
|
|
|
Receptor in Type II diabetes is ?
|
Down-regulated or defective
|
|
|
What is type II diabetes associated with?
|
Obesity
|
|
|
Insulin receptor is a __ kinase receptor
|
tyrosine
|
|
|
How does insulin receptor act as a tyrosine kinase receptor? Mention glucose transporter, cell proliferation and metabolism, and MAP kinase.
|
Glucose transporter increases hugely, cell proliferation and metabolism are altered via protein kinases and phosphatases like MAP kinase
|
|
|
Insulin does what 3 things?
|
Increases glucose uptake and storage in glycogen, increase fatty acid synthesis and storage as triglycerides, increase amino acid uptake and protein synthesis
|
|
|
When insulin binds to cell it favors cell?
|
Division
|
|
|
Insulin receptor exists as a __ in the cell membrane
|
dimer
|
|
|
When insulin binds to the __ subunits, the __ subunits autophosphorylates __ residues
|
alpha, beta, tyrosine
|
|
|
Autophosphorylation in insulin results in recruitment of what proteins, and what does this activate?
|
SH2 proteins like PI-3 kinase, grb, syp, activates MAP kinase pathway
|
|
|
The last step in signalling of insulin receptor is phosphorylation of what?
|
Insulin Receptor Substrate 1 (IRS-1)
|
|
|
Signalling through insulin receptor results in increased glucose uptake by __ fold in a few __
|
30, minutes
|
|
|
Liver has how much extra glucose transporters stored in __ __?
|
30 fold increase, intracellular vesicles
|
|
|
PI-3 kinase produces what? Which increases what?
|
Phosphatidyl-3,4,5-triphosphate, increase vesicle fusion with plasma membrane
|
|
|
Signalling through insulin receptor also results in increase of __ storage
|
glucose
|
|
|
MAP Kinase activates insulin __ __ kinase
|
sensitive protein
|
|
|
What two amino acids are involved in the MAP kinase activating insulin sensitive protein kinase?
|
Serine, Threonine
|
|
|
Protein phosphatase 1 (__), then inactivates __ phosphorylase B kinase and activates __ synthase kinase
|
glycogen, glycogen, glycogen
|
|
|
Citrate lyase and pyruvate dehydrogenase complex both become __ and more active in response to __
|
phosphorylated, insulin
|
|
|
Pyruvate dehydrogenase breaks down pyruvate into __ __, which is the starting material for fat synthesis
|
Acetyl CoA
|
|
|
Triglyceride synthesis also __
|
increases
|
|
|
When you eat a candy bar, blood glucose doesn't rise much at all, it is taken up quickly to make __, __, and energy
|
glycogen, fat
|
|
|
Tyrosine kinase receptors have __ transmembrane spanning helices
|
1
|
|
|
Are these in the proper order? Receptor, grb2, sos, ras, raf, mek, MAP kinase, Jun transcription
|
Yes
|
|
|
Does MEK phosphorylate Ser?
|
No
|
|
|
Ras is activated by?
|
SOS
|
|
|
Vesicle fusion results from direct action of?
|
PI3 kinase
|
|
|
|
|
|
|
Structures from right to left of cornea
|
Epithelial layer, stroma, endothelial layer
|
|
|
Stroma is?
|
Collagenous, strong layer
|
|
|
What is the main refracting structure of the eye?
|
Cornea
|
|
|
In order to do its job, the cornea must be what? It must transmit what? It must bend what?
|
Transparent, light, light
|
|
|
Does the cornea maintain its shape? What does it require to do so?
|
Yes, strength
|
|
|
What is the corneal stroma made of?
|
Collagen layers cemented together with "muchopolysaccharides"
|
|
|
Does the cornea stay dry? What does this allow?
|
Yes, allows transparency
|
|
|
What do the structures in the cornea tend to do with water?
|
Soak up water
|
|
|
Endothelial layer uses energy to do what?
|
Pump water out of stroma
|
|
|
When cornea soaks up water it becomes?
|
Opaque
|
|
|
The anterior chamber of the eye is filled with what?
|
Aqueous humour at the angle of the eye
|
|
|
What does the anterior chamber of the eye lack?
|
Proteins
|
|
|
Where does the cornea receive nutrients from
|
Aqueous humour
|
|
|
The eye is an __-poor area, so many of these structures depend on __ rather than __ metabolism
|
oxygen, glycolysis, aerobic
|
|
|
The __ (in the middle) is the densest part of the eye
|
nucleus
|
|
|
Is there congruity between the nucleus of the eye and the nucleus of a cell?
|
No
|
|
|
The lens is surrounded by?
|
collagenous capsule
|
|
|
There is a single layer of __ __ on the surface which continue to __ throughout life. As they divide, they reach through the __. As they reach this, they go through an extreme differentiation process and turn into __ __ __. These reach frm __ pole to __ pole of the lens and can be 1 cm long
|
epithelial cells, equator, equator, long fiber cells, anterior, posterior
|
|
|
How does one's eye get rid of old cells?
|
They are pushed toward the center
|
|
|
The interior of the lens has cells from the __ __ of the patient
|
entire life
|
|
|
What does the lens have that increases over the lifespan of an individual?
|
protein concentration
|
|
|
What does the increase in protein concentration contribute to pathologically?
|
cataracts
|
|
|
In a cross section of the lens, one will see fibrous cells with what type of arrangement? What shape?
|
regular arrangement, long cells
|
|
|
Special proteins made in the lens that give it a high protein concentration and therefore a high refractory index?
|
Crystallines
|
|
|
What are the 3 labels for crystallines?
|
alpha, beta, gamma
|
|
|
Crystallines are formed from what process?
|
Differentiation process
|
|
|
As an age-related change in human lens proteins, one sees an increase in?
|
pigmentation
|
|
|
|
|
|
|
Anything that contributes to a change in clarity causes?
|
cataracts
|
|
|
What does the removal of cataracts involve replacing the lens with?
|
piece of plastic or silicon
|
|
|
Will everyone develop cataracts if they live long enough?
|
Yes
|
|
|
Are sugar cataracts rare?
|
Very rare
|
|
|
What does a sufferer of sugar cataract show a high concentration of?
|
monosaccharide
|
|
|
What is this increases monosaccharide concentration due to?
|
galactocemia or diabetes increasing glucose or galactose concentrations
|
|
|
__ __ reduces sugars to sugar alcohols
|
aldose reductase
|
|
|
Sugar alcohols produced by aldose reducase build up in the lens because there is no way to get them out. They cause what which causes cataracts?
|
osmotic imbalance
|
|
|
In a mouse retina, one sees light coming from where the __ __ is located (clear space)
|
vitreous humour
|
|
|
Light pierces through the inner layer of __ cells first, then outer segments of __ cells are reached where __ is absorbed
|
photoreceptor, photoreceptor, light
|
|
|
Choroid is?
|
vascular layer in eye below retina
|
|
|
Rod cells are?
|
more light sensitive
|
|
|
cone cells?
|
see color
|
|
|
in rod cells, discs are separated from the?
|
plasma membrane
|
|
|
in cone cells, the discs are?
|
continuous with the cell membrane
|
|
|
__ __ at superior end sends signal to synapses
|
synaptic body
|
|
|
Inside the Rod cell, we see a __ which makes mRNA
|
nucleus
|
|
|
Are rod cells energy efficient?
|
No
|
|
|
From a sensitivity standpoint, are rod cells efficient?
|
Very
|
|
|
In the rod cell, at the junction between inner and outer segments, the cell membrane starts to do what?
|
Invaginate
|
|
|
These invaginations are pinched off to form what?
|
Form discs which are separate from the cell membrane
|
|
|
What is found within these special discs?
|
Rhodopsin and visual pathway
|
|
|
Discs are constantly being __ and being __ __
|
made, pushed up
|
|
|
At the top, pigmented epithelial cells __ these discs
|
phagocytose
|
|
|
Discs pinch off in the lower part to become __ __ __
|
flat little discs
|
|
|
When discs pinch off the lower part to become flat little discs, the outer surface of the discs is the surface that always faces what?
|
Cytoplasm
|
|
|
The inner part of the disc is the part that faces?
|
Environment
|
|
|
The extracellular surface of the cell membrane becomes?
|
Inner surface of disc
|
|
|
In an electron microscopic view of the disc, its important to note the discs really are __ from the plasma membrane
|
separate
|
|
|
There are two sides to the discs, name them.
|
Cytosolic side, intradiscal side
|
|
|
The intradiscal side is the side that was originally part of the __ __
|
extracellular membrane
|
|
|
The intradiscal side has a __ and __
|
bilayer and proteins
|
|
|
The protein in the intradiscal side is?
|
Rhodopsin
|
|
|
Describe the receptor molecule and what is links to for Rhodopsin?
|
7 transmembrane helical receptor linked to G-protein
|
|
|
Rhodopsin has its own __ in the helical region that __ the membrane
|
chromophore, penetrates
|
|
|
The chromophore in rhodopsin is?
|
11-cis retinaldehyde
|
|
|
11-cis retinaldehyde is also known as?
|
11-cis retinal
|
|
|
Rhodopsin has sites for what?
|
Phosphorylation
|
|
|
11-cis retinaldehyde is a form of?
|
vitamin A
|
|
|
Vitamin A can have 3 forms. Name them.
|
Acid, aldehyde, alcohol
|
|
|
Which form of vitamin A is in rhodopsin?
|
Aldehyde (11-cis retinaldehyde)
|
|
|
Rhodopsin is a combination of __ __ bound to __
|
11-cis retinaldehyde, rhodopsin
|
|
|
What is the simple way to keep track of what is going on in signaling mechanisms?
|
Something is turned on, it does something, must be turned off, recycle proteins and receptors so another signal can be received
|
|
|
In vision, we start in the __ state and end in the __ state
|
dark, dark
|
|
|
Rhodopsin absorbs light and causes __ __ to isomerize to the all __ isomer
|
11-cis retinaldehyde, trans
|
|
|
|
|
|
|
The suprasternal notch is also known as the?
|
jugular notch
|
|
|
What is it important to note on both sides of the manubrium sterni?
|
Sternal articulations of clavicles and attachments of sternocleidomastoid muscles
|
|
|
5 cm inferior to the suprasternal notch is a ridge where the manubrium sterni articulates with the ?
|
Body of the sternum
|
|
|
What is the transverse ridge where the manubrium sterni articulates with the body of the sternum called?
|
Sternal angle or Angle of Louis
|
|
|
What does the sternal angle act as clinically?
|
Excellent landmark of anterior chest wall
|
|
|
The sternal angle demarcates what concerning a costal cartilage.
|
Level of articulation of second costal cartilage with the sternum
|
|
|
Inferior from the sternal angle, the remaining __ can be counted.
|
ribs
|
|
|
Which ribs are difficult to identify?
|
11th and 12th ribs
|
|
|
Why can the first ribs not be palpated?
|
Deep to clavicles
|
|
|
At the inferior end of the sternum are two things. Name them.
|
Cartilaginous xiphoid process and the xiphosternal junction
|
|
|
The xiphosternal junction indicates what? (3 things)
|
anterior surface projection of the inferior border of heart, superior surface of liver, and anterior midline attachment of diaphragm
|
|
|
The nipples are usually located in which intercostal space?
|
4th
|
|
|
Why are nipples in women not always reliable landmarks?
|
Variable amount of fatty tissue and size of breasts
|
|
|
What are the bony elements that make up the thoracic wall?
|
Ribs, sternum, thoracic vertebrae
|
|
|
The external intercostal muscles lie on the __ aspect of one or two representative intercostal spaces on each side of the body.
|
anterior
|
|
|
How do the external intercostal muscles run?
|
Obliquely in the intercostal spaces
|
|
|
Which are the most superficial muscle layer in the intercostal spaces?
|
External intercostal muscles
|
|
|
How many pairs of external intercostal muscles are there?
|
11 pairs
|
|
|
The external intercostal muscles extend from the __ of the ribs __ to the __ articulations anteriorly
|
tubercles, anteriorly, costochondral articulations
|
|
|
From the anterior limit of the external intercostal muscles, what extends to the antesternal margin?
|
External intercostal membrane
|
|
|
Reflecting the external intercostal muscles from several intercostal spaces exposes the deeper what?
|
Internal intercostal muscles
|
|
|
How many pairs of internal intercostal muscles are there?
|
11 pairs
|
|
|
The internal intercostal muscles extend __ from the __ margin of the sternum to the __ of the ribs __
|
posteriorly, lateral, angle, posteriorly
|
|
|
How do the internal intercostal muscles course in relation to the external intercostal muscles?
|
Right angles to the fiber direction
|
|
|
Posteriorly at the angle of the ribs, there is a what?
|
Internal intercostal membrane
|
|
|
The internal intercostal membrane begins at the angle of the ribs and continues medially to?
|
Tubercle of the rib
|
|
|
The internal thoracic arteries and veins course on the __ __ of the chest wall at the __ margins of the sternum
|
deep aspect, lateral
|
|
|
The endothoracic fascia is fused to what?
|
Inner aspect of the rib cage
|
|
|
|
|
|
|
The transversus thoracis muscle is attached to what part of the chest wall?
|
Inner surface of chest wall
|
|
|
The transversus thoracis binds what against the inner surfaces of the costal cartilages?
|
Internal thoracic vessels
|
|
|
After removing the anterior chest wall, what artery can be seen on the inner aspect of the anterior thoracic wall?
|
internal thoracic artery
|
|
|
The internal thoracic artery lies deep to what costal cartilages?
|
Upper five costal cartilages
|
|
|
Where do the internal thoracic arteries originate?
|
Right and left subclavian arteries in the root of the neck
|
|
|
Where do the internal thoracic arteries enter the thorax in relation to the sternoclavicular joint?
|
Just posterior to the sternoclavicular joints
|
|
|
At the inferior end of the sternum, the internal thoracic artery is separated from the pleura by what muscles?
|
Transversus thoracis muscles
|
|
|
Deep to the sixth costal cartilage, the internal thoracic artery divides into?
|
Superior epigastric and musculophrenic arteries
|
|
|
The superior epigastric artery, after arising from the internal thoracic artery cotinues a vertical course and enters what?
|
Rectus sheath of the abdominal wall
|
|
|
Musculophrenic artery follows the contour of the?
|
Costal margin of the rib cage
|
|
|
The musculophrenic artery gives rise to the ?
|
Lower anterior intercostal arteries and branches
|
|
|
Where do the lower anterior intercostal arteries and branches supply?
|
Diaphragm
|
|
|
The internal thoracic artery is accompanied by?
|
Two internal thoracic veins
|
|
|
The internal thoracic veins drain superiorly into ?
|
The brachiocephalic veins
|
|
|
The transversus thoracis muscle arises from?
|
Inner surface of the sternum
|
|
|
The fibers of the transversus thoracis pass upward and laterally and attach to?
|
Inner surfaces of the second to sixth costal cartilages
|
|
|
How visible are the anterior intercostal arteries and veins?
|
Small and difficult to locate
|
|
|
How many anterior intercostal arteries are usually in each costal space?
|
Two
|
|
|
The anterior intercostal arteries branch from the internal thoracic artery in the upper __ spaces or from the __ arteries in the lower __ or __ spaces
|
five spaces, musculophrenic, five, six
|
|
|
How do the anterior intercostal arteries course through the intercostal spaces?
|
Laterally
|
|
|
What do the anterior intercostal arteries do once reaching the most lateral edges of the thoracic wall?
|
Anastomose with posterior intercostal arteries
|
|
|
What does the anastomosis form between the anterior and posterior intercostal spaces?
|
Important collateral blood supply between internal thoracic artery and descending aorta
|
|
|
The anterior intercostal veins accompany what?
|
Intercostal arteries
|
|
|
The anterior intercostal veins are important because they connect?
|
Internal thoracic and musculophrenic veins anteriorly to the azygous system of veins posteriorly
|
|
|
The intercostal nerves provide?
|
Somatic and motor innervation for muscles and skin of chest wall and for abdominal wall for intercostal nerves 7 through 11
|
|
|
In the costal groove of the ribs, describe how the artery, vein, and nerves run?
|
VAN (Superior to Inferior)
|
|
|
Anterior cutaneous branches lay?
|
Sides of the sternum
|
|
|
Lateral cutaneous branches of intercostal nerves lay?
|
In midaxillary line
|
|
|
The thoracic cavity contains?
|
Two lungs, mediastinum centrally
|
|
|
How many compartments does the mediastinum have?
|
Superior, anterior, middle, posterior
|
|
|
The mediastinum contains most of the __ viscera
|
thoracic
|
|
|
The mediastinum is limited by the __ anteriorly, the __ __ __ __ posteriorly, and the __ pleura laterally
|
sternum, 12 thoracic vertebral bodies, parietal
|
|
|
Are the lungs and pleura in the mediastinum?
|
No
|
|
|
Where are the lungs and pleura located?
|
lateral aspects of the thoracic cavity
|
|
|
The thracic cavity communicates superiorly with the neck through the?
|
Superior thoracic aperture
|
|
|
The thoracic cavity is separated inferiorly from the abdomen by the?
|
Diaphragm
|
|
|
The diaphragm acts to close the?
|
Inferior thoracic aperture
|
|
|
What is the serous membrane that surrounds each lung and is composed of two layers
|
pleura
|
|
|
The two pleural layers are continuous with each other where?
|
Root of the lung (hilum)
|
|
|
The inner pleural layer is the?
|
Visceral pleura
|
|
|
The outer pleural layer is the?
|
Parietal pleura
|
|
|
The visceral pleura is directly adherent to?
|
Surfaces of the lung
|
|
|
The parietal pleura follows the?
|
contour of the thoracic wall and the lateral boundary of the mediastinum
|
|
|
The potential space between the two pleura layers is? Contains what? Which does what?
|
Pleural cavity, serous fluid, facilitates movement of layers against each other during respiration
|
|
|
The parietal pleura is divided into four regions. What are they?
|
Mediastinal, diaphragmatic, cervical, costal
|
|
|
The mediastinal and costal parietal pleura continue over?
|
The apices of the lungs to form the cupula of the pleura
|
|
|
What lies in the fascia between the mediastinal pleura and lateral side of the pericardium?
|
Phrenic nerve, pericardiacophrenic vessels
|
|
|
Are the two pleural cavities separate or joined?
|
Separate from each other
|
|
|
The superior limit of the cervical pleura is?
|
Neck of the first rib
|
|
|
Where are the parietal and visceral pluera continuous?
|
Roots of the lung
|
|
|
|
|
|
|
The costodiaphragmatic recess is found?
|
Inferiorly of the lung and laterally at the diaphragm
|
|
|
What pleural regions are continuous at the costodiaphragmatic recess?
|
Costal and diaphragmatic pleura
|
|
|
How are the two pleural regions of the costodiaphragmatic recess oriented to one another?
|
Opposed to each other in quiet respiration
|
|
|
The costomediastinal recess is located?
|
Anteriorly to the lung, deep to the sternum
|
|
|
What pleural regions are continuous at the costomediastinal recess?
|
Costal and mediastinal pleura
|
|
|
The two recess are important clinically because?
|
Excess pleural fluid can be withdrawn without damaging the lungs
|
|
|
The superior mediastinum is the portion of the mediastinal space?
|
Superior to the horizontal plane of the sternal angle
|
|
|
Where does the mediastinal space extend upward to?
|
Upward to the superior thoracic aperture
|
|
|
What does the superior mediastinum contain?
|
Structures that course between the thorax and the neck and between the thorax and the upper limb
|
|
|
The most anterior structure in the superior mediastinum is?
|
thymus gland
|
|
|
In the adult, most of the glandular elements of the thymus's two lobes have been replaced by?
|
Fat and areolar tissue
|
|
|
The remnants of the thymus lobes lie directly posterior to the?
|
Manubrium sterni
|
|
|
The remnants of the thymus lobes lie anteriorly to the?
|
Brachiocephalic veins and superior vena cava
|
|
|
Thymic veins are often seen terminating in the?
|
Left brachiocephalic vein
|
|
|
The pericardium terminates at the level of the?
|
sternal angle
|
|
|
When the pericardium terminates at the level of the sternal angle, it becomes continuous with the?
|
Adventitial layer of the great vessels
|
|
|
What are the great vessels?
|
Ascending aorta, superior vena cava, and pulmonary trunk and veins
|
|
|
The brachiocephalic veins begin?
|
On each side of the neck deep to the sternal ends of the clavicles by the junction of the internal jugular and subclavian veins
|
|
|
What usually terminates into the brachiocephalic veins?
|
Internal thoracic, inferior thyroid, vertebral, and first posterior intercostal veins
|
|
|
|
|
|
|
The left superior intercostal vein is a tributary of?
|
Left brachiocephalic vein
|
|
|
Left superior intercostal vein is the?
|
Superior continuation of the accessory hemizygous vein
|
|
|
The left superior intercostal vein separates the __ __ and __ __ at the __ surface of the aortic arch
|
left vagus, phrenic nerves, left
|
|
|
The right brachiocephalic vein descends how and in what way to the clavicle along the __ border of the sternum
|
vertically and deep to clavicle, right
|
|
|
The left brachiocephalic vein passes __ and __ across the __ mediastinum, __ to the __ and ventral to the __ branches of the __ arch to join the __ brachiocephalic vein __ to the __ first costal cartilage
|
obliquely, inferiorly, superior, deep, manubrium, arterial, aortic, right, deep, right
|
|
|
What is formed at the junction of left and right brachiocephalic vein?
|
Superior vena cava
|
|
|
The superior vena cava descends from the superior mediastinum and pierces what at the level of the sternal angle?
|
Pericardium
|
|
|
Where does the superior vena cava terminate?
|
In the middle mediastinum in the right atrium
|
|
|
Where does the arch of the azygos vein terminate?
|
Right aspect of the superior vena cava just before it pierces the pericardium
|
|
|
Immediately inferior and deep to the left brachiocephalic vein are the __ __ and its branches
|
aortic arch
|
|
|
The aortic arch begins as a continuation of?
|
Ascending aorta at sternal angle
|
|
|
The aortic arch arches superiorly, posteriorly, and to the left, __ to the lower half of the __ sterni
|
deep, manubrium
|
|
|
Where does the aortic arch lie (which mediastinum?)
|
Superior mediastinum
|
|
|
The posterior course of the aortic arch brings it into direct contact with?
|
Anterior and left sides of the trachea
|
|
|
The aortic arch ends where in relation to the body and the thoracic vertebrae?
|
Left side of the body and disc of the fourth thoracic vertebra
|
|
|
After the aoritc arch ends, what does it continue as?
|
Descending aorta
|
|
|
Where is the descending aorta (which mediastinum?)
|
posterior mediastinum
|
|
|
What is the first and largest branch of the aortic arch?
|
Brachiocephalic trunk
|
|
|
Where does the brachiocephalic trunk arise in relation to the manubrium sterni?
|
Posterior to manubrium sterni
|
|
|
The brachiocephalic trunk followed superiorly will be deep to the __ joint
|
sternoclavicular
|
|
|
Second branch of the aortic arch is the __ __ __ __
|
left common carotid artery
|
|
|
The left common carotid artery arises from the?
|
highest aspect of the aortic arch to the left and posterior to the brachiocephalic trunk
|
|
|
Where does the left common carotid artery travel to?
|
The head
|
|
|
Distal to the left common carotid artery is the?
|
Left subclavian artery
|
|
|
The left subclavian artery lies where in relation to the trachea?
|
Left to it
|
|
|
The left subclavian artery enters the axilla as the?
|
Axillary artery at the outer border of the first rib
|
|
|
The ligamentum arteriosum lies where in relation to the aortic arch?
|
Inferior surface opposite origin of left subclavian artery
|
|
|
The ligamentum arteriosum is a remnant of the?
|
Fetal ductus arteriosus
|
|
|
The ligamentum ateriosum attaches to?
|
Left pulmonary artery in the middle mediastinum
|
|
|
The right and left vagus nerves enter the superior mediastinum as?
|
They cross the anterior surface of the subclavian arteries at the root of the neck
|
|
|
The right vagus nerve descends between the?
|
RIght brachiocephalic vein and the brachiocephalic arterial trunk
|
|
|
After descending past the right brachiocephalic vein and brachiocephalic trunk, the right vagus nerve courses how in relation to the trachea and the enters what?
|
On lateral surface of trachea and enters posterior mediastinum
|
|
|
How does the right vagus nerve enter the posterior mediastinum?
|
Passes deep to the root of the lung
|
|
|
The left vagus nerve descends between what?
|
Left common carotid artery and left subclavian artery
|
|
|
The left vagus nerve passes how in relation to the brachiocephalic vein?
|
Left vagus nerve
|
|
|
After passing between the left common carotid and left subclavian arteries, the left vagus nerve crosses the lateral surface of the?
|
Aortic arch
|
|
|
The left vagus nerve is bound to the aortic arch by the?
|
Left superior intercostal vein
|
|
|
The left phrenic nerve lies how in relation to the left superior intercostal vein?
|
Lateral
|
|
|
The left vagus nerve passes how to the ligamentum arteriosum?
|
Left
|
|
|
When does the left vagus nerve pass to the left of the ligamentum arteriosum?
|
Inferior surface of the aortic arch
|
|
|
When the left vagus nerve pass to the left of the ligamentum arteriosum, a nameshift occurs. What does the left vagus nerve become?
|
Left recurrent laryngeal nerve
|
|
|
The left recurrent laryngeal nerve courses how to the ligamentum arteriosum?
|
Deep and posterior
|
|
|
The thoracic cardiac nerves bracnh from?
|
Vagus nerves and sympathetic trunks in the neck
|
|
|
The thoracic cardiac nerves course how through the superior thoracic aperture and in what relation to the aortic arch?
|
Inferiorly through superior thoracic aperture, superficial and deep surfaces of the aortic arch
|
|
|
The thoracic cardiac nerves form the?
|
Cardiac plexus
|
|
|
The phrenic nerves enter the mediastinum by coursing between the?
|
Subclavian arteries and veins
|
|
|
The left phrenic nerve courses between the __ __ __ and __ __ arteries
|
left common carotid, left subclavian
|
|
|
The left phrenic nerve crosses the aortic arch in what relation to the vagus nerve?
|
Lateral to the vagus nerve
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The right phrenic nerve descends in what manner to the right brachiocephalic vein?
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Lateral
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The right phrenic nerve descends in what manner to the superior vena cava?
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Lateral
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Both right and left phrenic nerves cross the __ __ of the roots of the lungs to enter the __ mediastinum
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ventral surface, middle
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What do the right and left phrenic nerves enter the middle mediastinum by coursing through?
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Medistinal pleura and fibrous pericardium
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The trachea and esophagus run how to the structures just mentioned?
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Deep
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the sheath of dense irregular connective tissue that surrounds an entire muscle
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epimysium
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partitions of dense irregular CT extending inward from the epimysium and dividing the muscle into fascicles (bundles)
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perimysium
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the delicate loose CT that surrounds each muscle cell and contains capillaries and nerve fibers
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endomysium
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Skeletal muscle cells are long and cylindrical and so they are called
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muscle fibers
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the plasma membrane of the muscle fiber is the ?
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sarcolemma
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the cytoplasm of the muscle fiber is the ?
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sarcoplasm
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a ? fiber might have 50-100 nuclei because they are formed by uninucleated myoblasts that fuse together but then lose their capacity to divide
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muscle
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Multi-nucleated; myonuclei are ? located
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peripherally
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muscle fibers ? from dividing uni-nucleated myoblasts; these fuse together but then lose their capacity to divide
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originate
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? cells lie adjacent to skeletal muscle fibers; have some regenerative capacity
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Satellite
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Each muscle fiber (and associated satellite cells) is surrounded by a ? lamina
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basal
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The ? is comprised mostly of myofibrils, which are cylindrical units that run the length of the muscle fiber
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sarcoplasm
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In longitudinal sections skeletal muscle fibers are characterized by cross-striations alternating ? and ? bands
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light dark
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A ? consists of a chain of sarcomeres
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myofibril
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A ? is the basic functional unit of a skeletal muscle fiber
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sarcomere
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? lines form the boundaries of each sarcomere
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Z
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Sarcomeres in adjacent myofibrils are lined up in register so that dark and light bands span the width of the? muscle fiber
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entire
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Each myofibril is surrounded by ? containing mitochondria glycogen granules and the sarcoplasmic reticulum
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sarcoplasm
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? filaments insert into Z line; ? filaments occupy the center of the sarcomere
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thin thick
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? filaments lie parallel, interdigitated with, and partly overlapping thin filaments
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thick
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? band = dArk band = region where thick filaments are located
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A
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? band is the region where thick filaments are located
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A
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? band = LIght band
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I
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? band is the region where only thin filaments are located; spans two adjacent sarcomeres
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I
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? zone is the central part of dark band where there are thick filaments but not thin filaments
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H
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? line is the dark line in the middle of sarcomere
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M
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A thin filament consists of a strand of ?
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F-actin
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A thick filament consists of ~250 ? molecules arranged in a bilaterally symmetric staggered array with their globular heads facing the center of the sarcomere
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myosin
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Each ? filament is surrounded by 6 thin filaments
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thick
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Overall there are ? thin filaments for each thick filament
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2
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Myosin heads bind ?, hydrolyze it, bind tightly to actin, and undergo a conformational change that creates a power stroke
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ATP
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The power stroke of the myosin head causes the ? filament to slide past the ? filament toward the center of the sarcomere.
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thin thick
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Each of the ~? myosin heads in each thick filament acts independently repeating the power stroke several times in a second thereby causing the sarcomere to shorten.
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500
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When a motoneuron is activated an action potential is conducted along its ? to the synaptic terminal.
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axon
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Depolarization of the terminal causes the release of ?. Binding of acetylcholine (ACh) to its receptor on the muscle fiber results in the influx of ? and ultimately the generation of an action potential in the muscle.
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ACh Na
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That action potential is conducted up and down the muscle fiber along the sarcolemma and into the body of the muscle fiber along the ?-tubules (transverse tubules).
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t
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?-tubules = invaginations of the sarcolemma; encircle myofibrils located at the A-I junction
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T
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? reticulum (slide 12 muscle2006.pdf) is the highly elaborated smooth ER found in skeletal muscle; encircles each myofibril not continuous with the T-tubule system or the sarcolemma
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Sarcoplasmic
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? cisternae = enlarged portion of the sarcoplasmic reticulum adjacent to the T-tubules
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Terminal
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? is the T-tubule plus the 2 flanking terminal cisternae
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triad
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Action potential conducted along ?- tubules causes the release of calcium from SR. Calcium binds to ? and this in turn allows myosin heads to bind to actin
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T troponin
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When muscle is no longer electrically active ? is pumped back into the SR and the muscle relaxes
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Ca
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The rate of ? diffusion puts limits on the diameter of myofibrils. Muscles grow by adding a filaments in the myofibrils.
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Ca
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During development myofibrils get longer by adding ? at their ends
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sarcomeres
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? - attaches actin filaments to the Z line (an example of the numerous proteins serve to maintain the arrangement of myofilament)
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actinin
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? - links actin to dystroglycan (an example of Other proteins link myofilaments to the sarcolemma)
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dystrophin
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? cells are striated short and cylindrical; arranged end-to-end to form branched fibers; joined by intercalcated discs
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cardiac
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cardiac cell can ? in relation to other cardiac cells
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branch
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cardiac muscle cells cannot ?; no satellite cells; no ? capacity
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divide regenerative
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the cardiac muscle have wide ?-tubules some sarcoplasmic reticulum diads at Z lines
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T
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the cardiac muscle is under involuntary control; rate of contraction regulated by ? innervation
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autonomic
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? discs joining adjacent cardiac muscle cells consist of: Macula adherens = desmosomes, Gap junctions, Fascia adherens
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Intercalcated
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? ? are analogous to zonula adherens; thin filaments insert into the associated cytoplasmic plaque
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Fascia adherens
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? ? coordinate the contraction of the cardiac muscles cells through their communication
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gap junctions
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Cardiac muscle ?-tubules are large and located at ?-lines; major site of the calcium influx associated with muscle contraction
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T Z
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The cardiac ? reticulum not as well-developed as in skeletal muscle lacking the large terminal cisternae
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sarcoplasmic
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Diads in the cardiac muscle (profile of T-tubule + SR) present at ?-lines
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Z
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? smooth muscle are found in blood vessels and the “hollow viscera” undergoes sustained partial contractions or rhythmic contractions (e.g. peristalsis)
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visceral
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? muscles are not striated; have no myofibrils dark & light bands or sarcomeres
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smooth
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? muscle cells are elongated and spindle-shaped; centrally-located nucleus
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smooth
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? muscle cells secrete ECM molecules such as collagen and elastin
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smooth
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? muscle cells have no satellite cells; smooth muscle cells can hypertrophy and divide
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smooth
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? muscle cells have no T-tubules poorly developed sarcoplasmic reticulum; calcium influx through pinocytotic vesicles
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smooth
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visceral ? muscle is under involuntary control
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smooth
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The rate of contraction of ? muscle cells are regulated by autonomic innervation
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smooth
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? junctions serve to electrically couple adjacent smooth muscle cells
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Gap
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? and ? filaments are present in smooth muscle although they are not arranged in sarcomeres; there are many more thin filaments than thick filaments
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thin thick
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? filaments of the smooth muscle insert into dense bodies; attach to -actinin
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thin
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In smooth muscles ? bodies form an anastomosing network throughout the cytoplasm
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dense
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The spatial arrangement in smooth muscle of ? bodies and ? filaments allow smooth muscle cells to shorten; nuclei become passively pleated
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dense thin
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? vesicles provide a major route for calcium influx in smooth vessels
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pinocytotic
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? ? in smooth muscle serve to electrically couple adjacent cells and thereby coordinate their contraction
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gap junctions
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? ? is the process by which a cell converts one type of signal or stimulus
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signal transduction
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signal transduction is the way that information is relayed from the ? of a cell to the ?
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outside inside
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signal transduction involves a series of biochemical reactions carried out by enzymes and linked through ? ?
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secondary messengers
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the ? ? is measured in milliseconds or seconds
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time scale
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? ? - natural extracellular ligands that bind and activate receptors
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first messengers
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? ? - result from actions of first messengers (e.g. cAMP, ions, lipids)
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second messanger
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? messanger binds to and activates a receptor which in turns generates a ? messanger initiating a cellular response
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first second
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second messengers are know as ? signaling proteins
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intracellular
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intracellular signaling proteins ? proteins
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target
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target proteins can be ? enzymes ? ? proteins ? proteins
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metabolic gene regulatory cytoskeletal
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signals have a ? ?
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short lifetime
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signals have a effetive ? concentration
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low
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? feedback is common for signal transduction
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negative
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most hormones function at ? molar to ? molar concentration
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nano pico
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signals are releaseed when needed (have a ? ?) then either taken back up or degraded-allows for modulation of signal
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short lifetime
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there are 4 different types of signaling ? ? ? and ?
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public local long distance intimate
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each cell responds to a ? number of signals
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limited
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each cell as an organism is exposed to hundreds of different ? from the environment and only reponds to the signal if it expresses a receptor specific for that cue
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cues
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the endocrine system is an example of the ? signalling system
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public
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the paracrine system is an example of the ? signaling system
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local
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the neuronal system is an example of the ? ? signaling system
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long distance
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the contact-dependent system is an example of the ? signaling system
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intimate
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multiple ? activate signaling pathways which can act together
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receptors
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a ? generated outside the cell (say a hormone or neurotranmitters) encounters a target molecule on another cell surface-Receptor
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signal
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therapeutics are a very large class of receptor ?
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ligands
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two broad distinction of receptors \n a) cell-? receptors\n b) ? receptors
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surface intracellular
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the first step in signal transduction is the binding of an extracellular isgnaling molecule to a receptor ? ?
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first messanger
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a receptor protein is activated by the extracellular ? molecule
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signaling
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T or F - there is a difference between affinity and efficacy
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t
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? is how good the receptor at generating a response in a target cell
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efficacy
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Receptors exist in families of highly related ? which often share very similar but not identical pharmacology
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proteins
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? can bind to at least five distinct receptors called _1 _2 _1 _2 and _3 adrenergic receptors
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epinephrine, alpha, alpha, beta, beta, beta
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? can bind to the one nicotinic type receptor and the five muscarinic type receptors
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acetylcholine
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? - defined as a drug that binds to a physiological receptor and mimics the regulatory effect of the endogenous signaling compound
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agonist
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-
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partial agonist
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? - defined as a drug that binds to a physiological receptor without the regulatory effect, and blocks the binding of the agonist
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antagonist
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? - a molecule that binds to a specific site on a receptor - this is a generic terms which could refer to an agonist or antagonist
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ligand
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norepinephrine (epinephrine w/o -CH3) is a _-adrenergic receptor ?
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agonistic
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propranolol is a _-adrenergic receptors ?
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antagonist
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? theory originated from the work of Paul Erhlich based on the hypothesis that the parasite was more susceptible to toxic substances than the human host due to a higher metabolic rate
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Receptor
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Paul Erhlich was the first to determine the relationship between ? of a small molecule and function
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binding
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J. N. Langley (1852-1926) Early studies on the chemical basis for autonomic transmission focused on understanding the basis of the poison ?.
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curare
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? is an neuromuscular blocking agent which acts at the nicotinic acetylcholine receptor
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curare
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J.N. Langley discovered that curare and nicotine were “mutually ?” when studying frog muscle contraction i.e.-high concentrations of nicotine could block the effects of curare and high concentrations of curare could block the effects of nicotine
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antagonistic
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2. Rate of combination was dependent on the ? of the drug used
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mass action, saturable, concentration
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this interaction of drugs and receptors obeyed the law of ? ?
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concentration mass action
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-rate of ? =k2 [R-H]
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association, dissociation
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[?]= concentration of occupied receptor complex (should be equal to the concentration of H bound to R)
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H,R, H-R
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[?][?] / [?] = k2/k1= molar units
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H, R, H-R
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[?] / [?][?]= k1/k2= units of molar-1
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H-R, H, R
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• a number of drugs could not give ? response even at heroic concentrations
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steeper maximal
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Stephenson hypothesized that a maximal cellular response could be produced by an agonist when occupying only a small portion of receptors leaving many ? receptors.
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spare
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The spare receptors are the reason that the response of a tissue is not ? proportional (in the law of mass action) to the number of receptors occupied.
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linearly
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different drugs may have varying capacities to initiate a response and consequently occupy different proportions of the receptors when producing equal responses and is known as the ? of the drugs
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efficacy
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The spare receptor hypothosis was proven by blocking ?% of the histamine receptors on a cell and still getting a response with the rest of the receptors.
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99
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Drugs binding to receptors is governed by ? (i.e. one drug reaches Vmax faster then the other)
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affinity
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Drugs eliciting a response in the target cell is governed by ? (i.e. one drug has a higher Vmax then the other)
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efficacy
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Ligand-Receptor Binding Assays are generally done by combining Cells + Radiolabeled ligand and then using a ? or centrifuge to separate the bound and unbound ligands. (Repeating for several concentrations of agonist or antagonist)
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filter
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? is the affinity of a ligand for a receptor
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Kd
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Kd or affinity of a ligand for a receptor is normally determined using a radiolabeled ?, which is usually an ?
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ligand antagonist
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Specific Binding = ? binding - non-specific binding
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specific total
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In a saturation binding assay the non-specific binding (a linear plot) is usually defined by addition of a 20-100X Kd concentration of cold ?
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ligand
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In a saturation binding plot Kd is ? Vmax and is often converted to a scatchard plot used to determine the number of ? ?
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1/2, binding site
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A hallmark of any ? is its ability to discriminate among closely related compounds
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receptor
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Using competition binding assays one can determine the potency of various drugs in competition for binding to the receptor (because of the receptors ability to discriminate) and from assay results determine the? of the drug for a receptor.
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affinity
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A receptor binding specificity assay is performed with a fixed concentration of radiolabeled ligand (usually antagonist) and increasing concentrations of an unlabeled drug. The radiolabel is in competition with the cold ligand and will be displaced from the receptor. The competition curve can be analyzed to determine the ? of the unlabeled drug for the receptor.
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affinity
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Use ? assays to define a receptor’s pharmacology; is ? and is a ‘fingerprint’ of a receptor
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unique
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The intercept on the x axis when y is 1/2 y max is the ? in a competition binding plot
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EC50
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When plotting various radiolabeled ligands on a competition plot the ligand with the lowest EC50 is the most ? because it competes with the radiolabeled ligand at a lower EC50
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potent
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If the order of EC50 of three competition binding curves x, y, z is x < y < z then the order of potency is ? > ? > ?
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x, y, z
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