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1426 Cards in this Set

  • Front
  • Back
Where does the trachea extend to?
Down to the sternal angle (bifurcates below this)
2 clinical manifestations of Tetralogy of Fallot
Slight heart murmor, boot-shaped heart in radiological findings
99% of the defect is where?
Distal to subclavian artery
__ __ is where gaseous exchange occurs at alveoli
capillary bed
__ is a membrane on the upper side edge of what used to be the foramen ovalis
A defect in atrial septation is known as what?
Classic post-natal patent foramen ovale
A rich supply of the innervation goes to the __ __, which starts the information flow by th emyocardium to the atria on both sides
SA node
A single __ __ artery passes __ to respiratory passage
right bronchial, posterior
About 2/3 of the way down from the hilum to the outer surface of the lung tissue, what occurs?
Cartilage becomes smooth muscle and elastic fibers
After 9-11 months of serious VSD, describe the clinical manifestion?
Pulmonary hypertension arises from an overload in pulmonary circuit damaging intima, which damages intimal growth, which causes hypertension
After initial formation the mesoderm subdivides into 3 masses. Name them.
Paraxial, intermediate, lateral / lateral plate
Along the smooth wall posterior portion of the atrium there is a?
Sinus venarum
Anterior chest wall has doubling of __ __ __.
Internal thoracic veins
Anterior papillary muscles
Largest papillary muscles come from anterior surface of chamber
Anterior thoracic blood supply derives from what?
Internal thoracic artery
Aortic arch has 3 branches, name them.
Left subclavian artery, left common carotid artery, brachiocephalic trunk
Aortic valve has __, __, and __ cusps
right, left, posterior
Arch of aorta has how many important structures, and what are they?
3 structures, brachiocephalic trunk, left common carotid artery, left subclavian artery
Are chambers continuous externally, or are there moments of disconcert?
They have groove between the chambers, sulcus
Are lymph nodes localized in any certain region of the lung?
Located along entire respiratory passages
Are the ascending aorta and aortic arch present in the area of superior mediastinum?
Are the branches of the bronchial arteries large or small?
Are the components of the coronary sinus surrounded by mesocardium?
Mesocardium is only around the 3 great vessels
Are the cusps of the pulmonary trunk and aortic valve similar or disimilar? How-so?
Similar. Both are passive and are affected by blood flow via fluid dynamics
Are the valves ont he same side or different sides of the sternum?
Same side
Are there any other ducts nearby?
Smaller duct exists, smaller right lymphatic duct
Are thoracic nerves segmentally organized?
Arteries carry blood __
As the respiratory passage gets smaller, what happens to the C rings?
They become plates
As the sections ascend, we dont see much of the chamber of the __ ventricle, only the thick muscle wall.
As the sections descend, one can no longer see something, what is it?
Left atrium
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?
Left atrium
As we get to the top of the right atruim it gets __ and begins to transition into __ __ __.
Smaller, superior vena cava
As you ascent higher, does the aorta become more or less well developed?
More well developed
At the completion of what mechanism do the right and left heart tubes fuse at the midline to form one single heart tube?
Lateral body folding
At the end of the cardiac notch in the superior lobe you have the __, which is an extension around the heart
Atria have __, which are earlike extensions / appendages
Azygous vein is formed by what 3 things?
Ascending lumbar vein, subcostal vein below 12th rib, minor contribution from inferior vena cava
Below the diaphragm, what does the aorta become?
Abdominal aorta
Between the atria and ventricles lay?
Coronary sulcus
Between the ventricles, the sulcus is known as what?
Interventricular sulcus
Blood from the left ventricle goes into the __ __, then through the __ __ and into the __ __ __ for systemic circulation
ascending aorta, aortic arch, descending thoracic aorta
Blood is ejected via the __ __ to the ascending __ and __ __ aorta and out of heart systemic circulation
aortic valve, arch, descending thoracic
Bony skeleton served as a conduit for structures from the __ and __ to the __
head, neck, abdomen
Boundary of thorax - anterior
Sternum, costal cartilages attachment of 12 pairs of ribs
Boundary of thorax - inferior thoracic aperture
Boundary of thorax - posterior
thoracic vertebra
Boundary of thorax - superior thoracic aperture (4 things)
Upper portion of sternum, part of clavicle, 1st rib, thoracic vertebrae I (TVI)
Bronchial arteries come from __ __ __, deep to __ passage
descending thoracic aorta, respiratory
Bronchial vein is the return system for what type of blood?
Venous blood from lung tissue itself
Bronchiole veins do not make it to __ __ because they are thin and fragile
visceral fluid
By what time period has blood flow circulation begun?
21-22 days
Cervical pleura serves as a reminder for what?
That the viscera can extend above the superior thoracic apperture
Chordae tendineae extend from where to terminate where?
Extend from one papillary muscle to two cusps of the tricuspid valve
Clinically, what occurs if this space between the pleura is pierced?
Space can fill with air causing pressure preventing lung from inflating
Combining the brachiocephalic veins forms what?
Superior vena cava
Conduction system of the heart is important to do what 2 things?
sequencing contractions and affecting rate and force of contraction
Deoxygenated blood goes under arch of aorta through what?
Pulmonary artery
Describe blood flow, pressure, cyanosis (or non-cyanosis), and causes of ASD
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
Describe elements of turbelence and efficiency for the cusp.
Acts to minimize turbelence and maximize efficiency
Describe how pressure changes alter the septum primum and ultimately the foramen ovale
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
Describe how the interventricular septum grows?
It grows superiorly, inferior is muscular and superior is membranous
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
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
Describe how these layers extend?
They extend to vessels into and out of heart
Describe in general terms how the coronary artery arises from the valve
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.
Describe the azygos system of veins pertaining to venous return.
Two longitudinal channels bringing blood to the vena cava, as well as fragile thinned walls
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
It has a flattened concave structure, provides attachments for ribs 3-7, and its lower portion is the xiphosternal joint
Describe the components (2) of the internal thoracic vein and at what point they arise
Single vein until the 7th intercostal spaces where it becomes 2 veins - musculophrenic veins and superior epigastric veins
Describe the curvature of the body/shaft of the rib, as well as where it ends
Curves laterally and anteriorly ending in costal cartilage
Describe the edges of lung tissue, and why this is the case?
Edges are thin and sharp, lets lungs slide during inspiration
Describe the external intercostal muscles and their function
Most superficial, fibers pass in directions of "hands in pockets". Does upward and forward movement of anterior thoracic wall during inspiration
Describe the final position of the arterial and venous systems after contortions.
Arterial systems end up ventral, venous systems end up dorsal
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.
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
Describe the foramen ovale
Opening formed by a rigid septum secundum and flexible septum primum
Describe the function of the C shaped tracheal cartilaginous rings with openings facing the esophagus
Provide support for trachea while providing room for bolus passing through esophagus without interfering with position of trachea or obstructing it
Describe the internal intercostal muscles (origination, insertion, membranous conclusion, relationship to external intercostals)
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
Describe the location of the neurovascular bundle of the thoracic wall as well as its contents
Vein, Artery, Nerve superior to inferior arrangement running in the costal groove
Describe the location of the sinus venosus, and what it does.
Most caudal end, venous inflow from embryo's body occurs here
Describe the location of the truncus arteriosus, and what it does.
Most cranial end, arterial outlow to developing aorta system and aortic arch system
Describe the looping effect of the outer fibers to twist to the apex during heavy exercise
The twisting motion of fibers, you feel the apex hit against posterior portion of sternum within the pericardial sac
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)
Upper most portion, four sided with multiple facets - upper facet, lateral facet, sternal angle, and jugular notch
Describe the path and location of the aorta
Begins in thorax continuing to abdominal region
Describe the path of blood from the mom to the aortic arch
Mom --> Umbilical vein --> Ductus venosus --> Inferior venar cava --> Valve of inferior venae cava --> right atrium --> Foramen ovale --> left atrium --> left ventricle --> aortic arch
Describe the path of blood in the right and left "hearts" for a sufferer of TotGA?
RIght heart pumps low oxygenated blood into systemic circulation, left heart only pumps blood into pulmonary circuit
Describe the path of the left vagus nerve?
Over arch of aorta, sends a branch under arch of aorta and posterior to ligamentum arteriosum and runs up to larynx.
Describe the pressure differential before birth regarding the right and left atriums.
High pressure right atrium, low pressure in left atrium
Describe the process of expiration
Decrease thoracic cage volume, which increases pressure inside compared to the outside of the thoracic space; pressure equalized when air is pushed out
Describe the process of inspiration
Increase thoracic cage volume, which reduces pressure inside compared to outside of the thoracic space, allowing air to rush in to equalize the pressure
Describe the relationship between the neural crest cells and endocardial cushion?
Neural crest cells allow it to develop
Describe the relationship between the neural crest cells and truncus arteriosus?
Neural crest cells allow truncus arteriosus to divide into aorta and pulmonary trunk
Describe the structure of passive and active cusp structures during systole.
Passive cusps are open, active cusps are closed
Describe the structure of passive and active cusp structures during systole.
Passive valves are open, active valves are closed
Describe the venous system around the esophagus in a clinically neutral individual?
Blood flows through hepatic portal vein and veins located on esophagus towards heart
Do any nerves run lateral to aorta?
Two sympathetic chains of ganglia
Do the aortic supply and internal thoracic arterial supply ever connect?
They anastomose within the intercostals spaces
Do the innermost intercostal muscles form a continuous layer?
They do not
Do the left and right branches run with anything else, if so, what?
They run in a single sheath with the internal carotid artery and jugular vein
Do the structures at the root of the lung differ from right to left side?
Do things pass between mediastinum regions?
Some travel through multiple regions
Does anything else innervate the pericardium besides phrenic nerve?
Vagus and sympathetic nerves regulate conditions
Does anything separate the visceral and parietal pleura?
space with serous fluid for lubrication between two layers
Does blood recycle through the pulmonary circuit in VSD's?
Does closing the primum and opening the secundum change the route of blood flow?
No, blood still flows from right to left atria
Does symmetry exist between right and left lungs?
Does the angle of the rib have the (broadest / sharpest) angle, (tightest / widest) curvature?
Sharpest, tightest
Does the coronary sulcus not encircle the heart anywhere?
At the area where the pulmonary trunk leaves on the anterior surface
Does the cusp when closed cut off blood flow?
Does the heart take up its final position in the thorax by the end of head-to-fail folding?
Does the heart's position move?
Due to attachments it does move
Does the left ventricle have a moderator band, septal papillary muscle, or trabeculae carnae?
No moderator band or septal papillary muscles but has trabeculae carnae
Does the sinus venosus fuse with the 4 heart segments?
No, it has right and left horns
Does the transverse pericardial sinus provide anything hematically?
It provides easy access for blood flow to and from heart
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
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
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
During folding in the cervical region, the heart tube gains connection with what system?
Autonomic nervous system
Each papillary muscle gives off 2 sets of __ __ which attach to each of the two cusps.
Chordae tendinae
Early embryonic heart folds __ and under overlying __.
inward, ectoderm
Endocardium is continuous into the __ __
blood vessels
Epicardium is?
Transparent layer fused with myocardium (considered part of heart)
Esophagus is attached to what?
Posterior side of trachea
False ribs handle what?
Bucket handle action
Fetal circulation relies heavily on what 6 things?
1 umbilical vein, 2 umbilical arteries, ductus venosus, foramen ovale, and ductus arteriosus
Follow the path of blood flow on the right side of the heart.
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
Follow the path of blue blood (low oxygenation) from the head and neck to the right atrium
Right ventricle --> pulmonary artery --> ductus arteriosus --> aorta
For relative locations of chambers, what lies anteriorly?
Sternocostal surface / right ventricles
For relative locations of chambers, what lies at the base?
Posterior view is marked by entrance of pulmonary vein, split of pulmonary trunk, left atrium
For relative locations of chambers, what lies at the tip?
Apex, narrowest part of cone shape
For relative locations of chambers, what lies inferiorly?
Diaphragmatic - left ventricle and some right ventricle
For relative locations of chambers, what lies left?
Left ventricle and some left atrium (posterior surface)
For relative locations of chambers, what lies right?
Primarily right atrium
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
Atrial septation cannot be completed or a serious circulatory problem will occur
Fossa ovalis is the remains of the __ __.
Foramen ovalis
From the front, the right ventricle is?
The chamber that occupies a large part of the trunk seen from the front
From what do the upper 1 or 2 posterior intercostal spaces receive blood supply?
Costocervical trunk branching from the subclavian artery
General definition of the 4 chambers include what 2 things and what 2 things?
2 ventricles, 2 atria
What is the ligamentum arteriosum used as a landmark for?
Vagus nerve
High atrial pressure in fetus is due to 2 things. Name them
Bolus of umbilical flow into atrium and pulmonary resistance because pulmonary circulation is shut down
How do the common atrium and ventricles divide?
By movements of mesoderm mostly in weeks 5-6
How do the false ribs function as bucket handle action?
Most of the action is increasing lateral dimensions, with some minor elevation of ribs
How do the muscle fibers of transversus thoracis run?
Multiple directions attaching to the xiphoid process and costal cartilages of several ribs with finger like projections from a hand
How do the true ribs function as pump handle action?
Small action at joint, large action laterally.
How does a VSD impact the left ventricle?
Membranous part is right up against aortic vestibule with its outflow of the aorta. IAbuts against the valve cusp down the left side
How does a VSD impact the right side?
Close to septal papillary and chords
How does blood shunt in a VSD?
Blood shunts left to right
How does the aorta pass in relation to the trachea, and why?
Aorta is forced over to left side of body because trachea is located on midline
How does the foramen primum close?
The septum primum eventually fuses to the endocardial cushion
How does the foramen secundum open?
Apoptosis in septum primum allows it to open
How does the heart supply itself?
Via myocardial vasculature, with venous return into coronary sinus which lies in coronary sulcusNWhat
How does the pericardiacophrnic ligament attach?
Inferior portion of pericardium to diaphragm superior fascia and central tendon of diaphragm
How does the phrenic nerve relate to the diaphragm?
Draped laterally on both sides down to diaphragm
How does the phrenic nerve, draping laterally on both sides down the diaphragm innervate the pericardium?
Sends off sensory twigs to pericardium
How does the right atrial chamber of the embryo attain almost 100% volume of blood?
From materal circulation through umbilical vein
How does the septum secundum grow?
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
How is it possible someone below 50% blockage can still die soonafter a stress test?
Plaque can bubble off of a vessel and travel down stream to a smaller space and cause a blockage
How is the fossa ovalis itself oriented in regard to the interatrial wall?
It is in the right atrium opposed on the interatrial wall to what was the septum primum
How is the upper part of the body profused versus the lower part of the body?
Upper part - hyperprofusion. Lower part - hypoprofusion
How many arches develop, and which are important?
6 develop, and 3rd, 4th, and 6th are important, 1,2,5 are not
How many atriums are there at this point?
1 common atrium at this point
How many brachiocephalic veins are there, and what are they comprised of?
Each (Lookup how many!) brachiocephalic vein is comprised of the joined internal jugular and subclavian veins
How many branches does the vagus nerve have, and what is its roman number?
X, left and right branches
How many bronchopulmonary segments are there on the right versus the left?
10 on right, 8 on left
How many cusps do the left atrioventricular / bicuspid / mitral valves possess?
2 cusp valve anterior and posterior
How many different sections does the heart have initially?
2 separate segments
How many lymphatic plexi are there around the lung, and what are they called?
Superior and deep lymphatic plexi
How many pairs of ribs are there?
12 pairs total
How many parts are there of the aorta? Name them.
3 parts. Ascending (from the heart), arch, descending
How many parts are there of the phrenic nerve? What does it innervate? Where does it run?
Left and right pairs, innervates diaphragm, runs into middle mediastinum, attaches to pericardium and continues to diaphragm.
How many pulmonary veins are there, and how many pulmonary arteries?
2 veins, 1 artery
How many regions comprise the inferior mediastinum, and what are they?
3 regions, middle mediastinum, anterior mediastinum, posterior mediastinum
How many sets of papillary muscles are in bicuspid / mitral valves, and which side is larger?
2 sets, anterior is larger than posterior
How many types of coarctation of aorta are there, and describe each
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
How many ventricles are at this point?
1 common ventricle
If a shunt is from the left atrium to the right atrium, the defect is (cyanotic / non-cyanotic).
If a shunt is from the right atrium to the left atrium, then the defect is (cyanotic / non-cyanotic)
If gurgling is heart, what does this insenuate?
Valvular problem
If left bundle is cut, what will happen?
Left ventricle will not contract (bad news)
If someone suffers from esophageal verices, what occurs?
BLockages in liver tdue to cancer, cirrhosis occludes blood flow to hepatic portal vein somewhat
If the ductus arteriosus doesn't close you have what?
Persistent ductus arteriosus or PDA
If the septum primum or secundum fail to form, what does the fetus develop?
Classic secundum type atrial septal defect (ASD)
if there is a large opening to the fossa ovale, what does it cause?
Very large mixing of oxygenated and deoxygenated blood
If there is an opening to the fossa ovale, what does it create?
Heart murmur
In an X-ray, what can be seen?
Enlargement of arteries in costal groove
In ASD, is the septum secondum abnormal?
No, it is normal
In fully ejecting blood out of the ventricles, the myocardium contracts. What do the inner fibers do versus the outer fibers to accomplish this?
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
In older adults, glandular thymus tissue gives way to __ __.
fatty tissue
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
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
In the embryo, the heart and its precursors are very far in which direction of the embryo?
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
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
In the left lung, name the 4 grooves
Aorta and arch, left brachiocephalic vein, area for trachea and esophagus, cardiac impression
In the mid axillary line, the lung ends at which intercostal space?
In the midclavicular line, the lung goes to which intercostal space?
In the posterior region, the lung ends at which intercostal space?
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
In the venous system, the left bronchial vein goes to what?
Accessory hemiazygous vein
In the venous system, the right bronchial vein runs to what?
Azygous vein
In upper crosses of the heart, the left atrium is located?
In upper crosses of the heart, the left ventricle is?
Noticeably thicker walled with only a small projection on the anterior surface
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
In upper crosses of the heart, the right ventricle is?
The most anterior structure
Inferior mediastinum is located where?
Below imaginary line between sternal angle and T4 vertebrae, superior to diaphragm
Inferior vena cava and the opening of the coronary sinus share what?
Single cusp to its valve
Inspiration and expiration are facilitated by what?
Changes in dimension of the thoracic cage
Inspiration and expiration involve changes in several things, name them. (5 things)
Anterior, posterior, cranial / caudal dimensions, gas pressure
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
Is aortic blood flow directed more towards the right from the ascending aorta to the arch to the descending aorta or to the left?
Is ASD major, and what are its clinical manifestations?
Not major crticial event, slight heart murmur, surgery necessary if ASD is extremely large
Is lung tissue active or passive?
Passive tissue
Is the amount of fat deep to the visceral pericardium static or does it differ much from person to person?
Variable condition
Is the AV visible to the naked eye?
Is the pericardium analogous to anything?
Analogous to two layers of pleural sac with an additional layer
Is the pulmonary artery anterior or posterior to the primary bronchus?
Is the right ventricle thicker or thinner than the left ventricle?
Is the SA node visible?
No, so you use vessels to trace to it
Is the thoracic duct large?
Largest in body
Is the vagus nerve sympathetic or parasympathetic?
is TotGA a death sentence?
Usually within the first year
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
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
Lowest splanchnic nerve is formed by what? Terminate where?
Fibers of ganglia 12, terminates into renal plexus
Lungs are inside what?
Pleural sacs
Lungs slide into spaces called what?
Majority of venous return from heart muscle is by way of?
Coronary sinus
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
Name 3 functions of the sternum
Strength, protection, rib attachment
Name 3 lymph nodes of the lungs?
Pulmonary, tracheobronchial, and tracheal lymph nodes
Name 3 parts of the sternum
Manubrium, body, xiphoid process
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
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
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
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
On both sides of the root of the lung, the __ artery and __ passage are going to divide together
pulmonary, respiratory
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
On the right atrium, the pectinate muscles also contribue to __ in addition to auricle?
On the right side as you descend, you begin to see __ instead of lung.
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?
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
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
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?
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
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)?
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?
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.
The pulmonary trunk lies (anterior / posterior) to the aorta
The recess in the posterior region goes to where?
12th intercostal space
The recess near the mid claviular line goes to which intercostal space?
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
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?
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?
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
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 __
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
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
What are the functions of the conus arteriosus (3)?
Reduces turbulence, maximizes efficiency, gets ejected blood out of heart
What are the intervening tissues between the esophagus and left atrium?
Fibrous pericardium and visceral and parietal serous pericardium
What are the layers of pericardium?
Parietal and visceral make serous layer, fibrous layer
What are the names of the 2 bronchial arteries, and where do they run?
Superior and inferior, running with respiratory passages
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
What are the splanchnic nerves a collection of?
Fibers from chain ganglia
What are trabeculae carnae muscles involved in?
Conduction phase of the heart
What bone is not produced by the mesoderm?
What can cause the PDA to close?
Prostaglandin inhibitors, as a drop in prostaglandins causes ductus arteriosus to close
What can occur as a result of injury in the neck region to the lobes?
The superior lobe extension during inspiration can be affected
What can occur as a result of surgical correction of VSD?
Damage to conduction system can result
What cardiac layer is over the oblique pericardial sinus?
Pericardium, but no mesocardium
What did the fossa ovale used to be?
Foramen ovale
What do stress tests do?
Test for blockage of coronary blood vessels
What do the chordae tendinaeae appear as?
Stringlike structures
What do the cusps, chordae tendineae, and papillary muscles prevent?
Prevent valve from leaking during the high pressure create during ventricular contraction
What do the sternopericardial ligaments accomplish?
They anchor the fibrous layer to the sternum anteriorly
What do the superficial passages look like, and what are they relatively close to?
Like black spots, lie close to visceral pleura
What do the transverse pericardial sinus provide in bypass surgery?
It allows the insertion of tubes without damaging other tissue
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
What do these veins carry?
Just oxygenated blood into the heart
What do you see in intersegmental tissue?
Pulmonary veins that carry oxygenated blood back into the left atrium of the heart
What does a defect in the 3rd arch result in?
Coarctation of Aorta
What does a defect of neural crest cells moving into truncus arteriosus lead to?
Outflow problems with aorta and pulmonary trunk
What does an opening in the atrial wall provide?
It provides a mechanism for exchange of blood between the 2 developing atrial chambers
What does arterial mesocardium cover?
Aorta, pulmonary trunk
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
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
What does coarctation of aorta result in?
What does esophageal verices present as?
Upped flow through distal, inferior region of esophageal veins, may result in venous rupture
What does pulmonary hypertension cause if not fixed within a year?
Reversal of pressure
What does segmental innervation of thoracic nerves provide?
Determination of location of possible vertebral damage through sensation patterns at the corresponding dermatomes
What does the 3rd arch form?
Common carotid and internal carotid arteries
What does the 4th arch form?
Middle segment of arch of aorta, right subclavian artery
What does the 6th arch form?
Pulmonary arch, consisting of right and left pulmonary artery and ductus arteriosus
What does the auricle segregate?
It segregates smooth wall portion of atrium from muscular portion
What does the bronchial vein drain into?
Pulmonary veins, left atrium, azygous, superior intercostal vein, hemiazygous vein
What does the circumflex branch do, and where does it terminate?
Gives off many branches, and terminates posteriorly
WHat does the ductus arteriosus form in adults?
Ligamentum arteriosum in adults
What does the ductus venosus shut down in a few days post natal to become?
Ligamentum venosum
What does the emptying of small veins on the anterior surface of the heart result in?
Very small mixing of oxygenated and deoxygenated blood
What does the esophageal plexus innervate?
Respiratory passage, innervates heart via coronary plexus
What does the foramen ovale become at birth?
Fossa ovale
What does the foramen primum provide?
It provides the initial opening for blood flow from right to left atria
What does the internal thoracic artery terminate into, and where does this occur?
7th intercostal space, musculophrenic artery, superior epigastric artery
What does the lateral facet of the manubrium articulate with?
1st rib
What does the lumbus of the fossa ovalis represent in the right atrium?
It represents what was the lower margin of the septum secundum
What does the mediastinal pleura contain?
Hilum (root of lung)
What does the musculophrenic artery supply?
Lower intercostals
What does the pressure differential atrially facilitate before birth?
Blood is able to flow from right atrium to left atrium in utero
What does the pulmonary ligament allow?
Allows structures at root of lung to enter space upon inspiration, prevents constriction by expanding lung
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
What does the superior epigastric artery supply?
Runs to rectus abdominus
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
What does the upper facet of the manubrium articulate with?
What does this movement provide?
Amplifies the action pushing sternum up and outward
What does Transposition of the great arteries result in?
Two independent closed circulations
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
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
What innervates lymphatics of the lungs?
Vagus nerve and sympathetic chain ganglia
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
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?
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?
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?
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?
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?
What sound does systole make?
What supplies blood to the posterior side of the thoracic wall?
What supplies the lung tissue?
Bronchial arteries
What triggers the final formation of interatrial septum?
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?
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?
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?
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?
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?
Do hormones have short or long lifespans?
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
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?
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.
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?
B2 adrenergic receptor activates what?
Gs stimulates __ __ to upregulate production of second messenger __
Adenylate cyclase, cAMP
A2 adrenergic receptor binds what?
A2 adrenergic receptor activates what?
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 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?
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
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?
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?
CaM kinase II phosphorylates a large number of enzymes and is activated by ?
CaM kinase II can phosphorylate itself. What is this known as?
CaM kinase II has a regulatory region on which terminus end?
C terminus end
Calmodulin binds to the __ domain
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?
Protein phosphatases do what?
Reverse phosphorylation by removing phosphate
Tyrosine kinase receptors form __ after binding of a hormone.
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
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
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!
MAP kinases phosphorylate what? To do what?
Transcription factors elk, myc, jun, to increase mRNA's needed during cell division
MAP Kinase phosphorylates what?
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
3 muscle tissues, name them
skeletal, cardiac, smooth
which muscle tissue is striated?
skeletal and cardiac
muscle is connected to bones by?
tendons are __ tissue
3 types of muscle. Name them
epimyseum, perimyseum, endomyseym
which muscle type is a sheet of dense irregular connective tissue surrounding entire muslce?
which muscle type extends inward and is dense connective tissue divided into partitions called fascicles?
Which muscle type surrounds individual cells, is delicate loose connective tissue, and contains capillaries and nerve fibers?
describe muscle fibers shape?
long and cylindrical
Muscle fibers are arranged in __ cross-sections, with only part being seen
Sarco is greek for?
Plasma membrane is called?
Cytoplasm is called ?
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?
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?
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 consist of chains of __ arranged end-to-end
The ends of myofibrils are marked by?
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?
Do dark and light bands span the entire width of the fiber?
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?
Thick consists of many __ molecules
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?
Overall, there are how many thin filaments for each thick filament?
2 thin filaments
Myosin heads bind?
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 __
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?
H zone gets?
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?
T tubules are invaginations of?
Sarcolemma which encircle myofibrils
Where are T tubules located?
In A-I junction
AP travels down the __
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?
Is the sarcoplasmic reticulum connected to T-tubules?
The SR encircles each __
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?
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?
How does dystrophin work?
Links actin to complex of proteins
What is the complex of proteins that dystrophin links to actin called?
What is the common name for the disease resulting from mutation of dystrophin?