Day 4.1.3 Flashcards
1
Q
How does lymph travel in nodes?
A
Subcapsular sinus through cortical sinus and into superficial cortex and paracortex
2
Q
What kind of tissue is cortical tissue in lymph nodes?
A
Phagocytic - reticular tissue
3
Q
What divides lymph nodes?
A
Specialised bands of connective tissue - trabeculae
4
Q
What are the two ways in which lymph can travel in lymph nodes?
A
From afferents to subcapsular sinus through cortical sinus into superficial cortex and paracortex
OR
Directly from cortical sinus to medullary sinus
5
Q
Where is lymphh cleansed?
A
In cortices and medullary sinuses by macrophages, and antigens are presented and processed by lymphocytes and plasma cells
6
Q
How does filtered lymph leave the nodes?
A
Efferents
7
Q
Where do efferent lymphatic vessels emerge from?
A
hilum which is concave
8
Q
Path of lymph from node to blood
A
Efferent lymphatic vessels
Efferent collecting vessels
Lymph trunks
9
Q
How many major lymph trunks in the body?
A
5
10
Q
What parts of the body does the thoracic duct receive lymph from?
A
3 out of the 4 quadrants - both lower and upper left quadrant
11
Q
Where does the upper right quadrant of the body drain its lymph?
A
Right lymphatic duct
12
Q
Where do the afferent lymphatic vessels enter the node?
A
Convex surface
13
Q
Which are more abundant - afferent or efferent lymphatic vessels?
A
Afferent
14
Q
Which lymphatic tissues have more afferent lymphatics entering them?
A
Lymph nodes as opposed to spleen, thymus, palatine and pharyngeal tonsils
15
Q
What kinds of cells are dominantly present in the paracortex?
A
T cells
16
Q
What part of lymphatic tissue do you find T cells in?
A
Paracortex
17
Q
What are the subdivisions of the lymphoid parenchyma?
A
Cortex
Paracortex
Medulla
18
Q
What are the most prominient structures in the cortex of a lymph node?
A
Lymphoid follicles
19
Q
What vessels in the body have valves?
A
Lymphatics and veins
20
Q
Primary lymphatic organs
A
Thymus
Bone marrow
21
Q
What are the primary lymphatic organs responsible for?
A
Generation and selection of lymphocytes
22
Q
Secondary lymphatic organs
A
Tonsils
spleen
lymph nodes
appendix
23
Q
What are secondary lymphatic organs responsible for?
A
Filtering lymph
24
Q
Are there areas of lymphatic tissue other than the primary and secondary lymphatic organs?
A
Yes - diffuse lymphoid tissue
25
Name the areas of diffuse lymphatic tissue
BALT
GALT
MALT
26
MALT
Mucosa associated lymphoid tissue
27
GALT
Gut associated lymphatic tissue
28
What does GALT include?
Tonsils
| Peyer's patches
29
BALT
Bronchus associated lymphoid tissue
30
What is the common component to all lymphatic tissues
Presence of lymphocytes
31
Functions of the lymphatic system
- Returns tissue fluid to the bloodstream
- Transports absorbed fats
- Provides immunological defenses against disease-causing agents
32
What is the difference between tissue fluid and lymph?
When tissue fluid enters lymph capillaries, it is called lymph
33
How is lymph returned to the bloodstream?
It is returned to the venous system via two large lymph ducts - thoracic duct and right lymphatic duct
34
What are lymph capillaries in the intestines called?
Lacteals
35
What role does the lymphatic system play in fat metabolism?
lacteals in the small intestine transport the products of fat absorption away from the GI tract and eventually into the circulatory system through the thoracic duct
36
Where are lacteals present?
In the villi of the small intestine
37
What do lymph nodes do to provide immunological defence?
Lymph filters through the nodes, filtering out bacteria and foreign substances and even trap cancerous cells in the body
38
What are the components of lymph?
1. Liquid portion
2. White blood cells
3. A few red blood cells
39
What does the liquid portion of the lymph contain?
It resembles blood plasma
40
What kind of WBCs are most abundant in lymph?
Lymphocytes
41
How is lymph absorbed?
By lymphatic capillaries
42
What are lymphatic capillaries?
A system of closed tubes that absorbs lymph from tissue spaces
43
Where is lymph absorbed from into the lymphatic system?
Tissue spaces
44
What is a hallmark of lymphatic vessels in the upper limb?
That they follow the veins
45
How is lymph circulated throughout the body?
Contractions of skeletal muscles
Presence of valves in lymphatic vessels to prevent backflow
Breathing
Gravity
46
Where are T cells produced?
Bone marrow
47
Where do T cells mature?
Thymus
48
What is the basic appearance of thymus?
Bilobed
49
Where is the thymus positioned in adults?
Superior mediastinum
50
Where is the thymus positioned in children?
The inferior part is contained in the anterior mediastinum in children
51
What is peculiar about the thymus?
It does not contain lymph nodules or vessels?
52
What is the main function of the thymus?
To potentiate immunocompetent T cells from their immunoincompetent precursors
53
What is an additional function of the thymus?
Destruction of self-recognising T cells
54
At what age is the thymus relatively large?
In newborns
55
Till what age does the thymus grow?
Puberty
56
What happens to the thymus at puberty?
It undergoes involution and is replaced by adipose tissue.
57
Blood thymus barrier
In the adult thymus the blood supply is isolated from the parenchyma
58
At what age is the blood thymus barrier not present?
In the child
59
Parenchyma vs stroma
Parenchyma is the functioning portion of the gland
Stroma is the connective tissue
60
Where are Hassall's corpuscles found?
Medulla of the human thymus
61
What are Hassall's corpuscles formed from?
Eosinophilic type VI epithelial reticular cells arranged concentrically
62
What is the congenital disease characterised by absence or underdevelopment of thymus and parathyroid glands
Digeorge syndrome
63
What is Digeorge syndrome caused by?
A deletion on the chromosome numbered 22
64
What is a manifestation of Digeorge syndrome?
Profound immunodeficiency due to a lack of T cells
65
What immune cell populations are affected by Digeorge syndrome?
None apart from T cells
66
What kinds of tissue make up the spleen?
Reticular
| Lymphatic
67
Which is the largest lymphatic organ in the body?
Spleen
68
Where does the spleen lie?
Between the fundus of the stomach and the diaphragm
69
What is the appearance of the spleen?
Slightly oval in shape, purplish in color
70
Where is the hilum of the spleen located?
On the lower medial porder
71
How is the spleen related to the peritoneum?
Entirely covered except at the hilum
72
What is the capsule of spleen made of?
Fibroelastic
73
What is special about the trabeculae of the spleen?
They are extensions of the fibroelastic capsule but do not divide the spleen into lobes or lobules
74
What is the cellular material of the spleen called?
Splenic pulp
75
What does the splenic pulp contain?
Lymphocytes
| Macrophages
76
Where does the splenic pulp lie?
Between the trabeculae
77
What is the blood supply of the spleen?
Splenic artery, a branch of the celiac artery
78
What lymphatic organ can be considered as two organs in one?
Spleen
79
What are the major functions of the spleen?
Filtration of blood to remove abnormal cells
Making disease-fighting components of the immune system
80
What components of the immune system are manufactured in the spleen?
Antibodies
| Lymphocytes
81
What does the body of the spleen appear as?
Red and pulpy, surrounded by a tough capsule
82
What does the red pulp contain?
Blood vessels interwoven with connective tissue
83
What are the blood vessels of the red pulp known as?
Splenic sinusoids
84
What is the connective tissue of the red pulp known as?
Splenic cords
85
What is the function of the red pulp?
Filters blood and removes old and defective blood cells
86
What is peculiar about the red pulp in the fetus and infants?
Along with the liver, it is a site of erythropoiesis in infants and the fetus
87
Where is white pulp found?
Inside the red pulp
88
What does the white pulp consist of?
Little lumps of lymphoid tissue
89
What occurs in the white pulp?
Antibodies are made inside the white pulp
90
What part of the lymphatic system does the posterior 1/3 of the tongue drain into?
Deep cervical nodes
91
Where are the deep cervical lymph nodes located?
Along the length of the internal jugular vein on each side of the neck, deep to the SCM muscle
92
What is the extent of the deep cervical nodes?
From the base of the skull to the root of the neck, adjacent to the pharynx, esophagus and trachea
93
How are deep cervical nodes classified?
Superior
| Inferior
94
What is the basis of classification of the deep cervical nodes?
Their position relative to the SCM muscle
95
What drainage are the deep cervical nodes responsible for?
```
Most of the circular chain of nodes
Salivary and thyroid glands
Posterior 1/3 of tongue
Tonsils
Nose
Pharynx
Larynx
```
96
Where does lymph from scalp above the parotid and from the anterior wall of the external auditory meatus drain?
Parotid lymph nodes
97
Where are the submandibular lymph nodes located?
Between the submandibular gland and the mandible
98
What areas drain into the submandibular lymph nodes?
```
Front of scalp
Nose
Adjacent cheek
Upper lip
Lower lip
Paranasal sinuses
Teeth (all except lower incisors)
Anterior 2/3 of the tongue (except tip)
Floor of mouth and vestibule
Gingiva
```
99
What parts of the tongue, teeth and lip does not drain into the submandibular lymph nodes?
Tip of tongue
Lower incisors
Central part of lower lip
100
Where are the submental lymph nodes located?
Behind the chin and on the mylohyoid muscle
101
Where do submental lymph nodes receive lymph from?
```
tip of tongue
Floor of mouth beneath tip of tongue
Mandibular incisors
Associated gingiva
Center part of lower lip
Skin over chin
```
102
Where do efferents from submental lymph nodes drain?
Submandibular and deep cervical nodes
103
What are the contents of the pericervical collar of superficial lymph nodes?
```
Submental
Sumbandibular
Parotid
Mastoid
Occipital nodes
```
104
Where does the lymph from the tongue and oral floor ultimately drain?
Jugular lymph nodes
105
Where are the jugular lymph nodes located?
Along the internal jugular vein
106
What is the peculiarity of jugular lymph nodes?
They receive drainage from both ipsilateral and contralateral sides
107
What is the danger in the crossing over of lymphatic drainage in jugular lymph nodes?
Tumor cells may become widely disseminated in this region - eg in metastatic squamous cell carcinoma esp on the lateral border of the tongue metastasizing to the opposite side
108
What happens when antigens are recognised by a lymphocyte?
B cells are activated and migrate to the germinal center of the lymph node
109
What is the primary function of lymph nodes?
To act as filters
110
What kind of cells are the primary functional components of lymphnodes?
Macrophages
111
What does the filtration function of lymph nodes entail?
They help to remove and destroy antigens that circulate in the blood and lymph
112
What are the other functions of lymph nodes?
Lymphoid tissue in the nodes produces antibodies and stores lymphocytes
113
Where do the nodes generally occur?
In clusters along connecting lymphatic vessels -
Armpits
Groin
Lower abdomen
Sides of the neck
114
What does the cortical region of lymph nodes contain?
Primary lymphoid follicles
| Secondary follicles
115
What is the function of primary follicles wrt antigen?
They do not respond to antigen
116
How do primary lymphoid follicles stain?
Uniformly
117
What kind of cells do secondary follicles contain?
Predominantly B cells
118
How do secondary follicles stain?
Lightly
119
What do secondary follicles contain?
Germinal centers
120
Which follicles are the active follicles?
Secondary follicles
121
What are secondary follicles a source of?
Lymphocytes
122
What kind of cells dominate the paracortical region?
T cells
123
What happens to B cells that enter the node in the paracortical region?
They quickly migrate to the superficial cortex
124
How is lymphoid tissue arranged in medullary region?
Medullary cords
125
What kinds of cells are produced in the medullary region?
Plasma cells - antibodies
126
What does the medullary region of lymph nodes contain?
Medullary cords and medullary sinuses
127
How can lymph nodes be classified?
Primary
| Secondary
128
How does lymphatic drainage work? Order of nodes involved
Region -- primary (regional) -- Secondary (central)
129
Primary lymph node aka
Regional node
130
Secondary lymph node aka
Central node
131
What are germinal centers in lymph nodes?
Sites within lymph nodes (and nodules within peripheral lymph tissues) where mature B lymphocytes rapidly proliferate, differentiate and mutate their antibodies
132
What happens to B lymphocytes in germinal centers?
They rapidly proliferate, differentiate and mutate their antibodies
133
How do B lymphocytes mutate their antibodies
Somatic hypermutation
134
What do B lymphocytes do to their antibodies during a normal immune response to an infection?
Proliferate
Differentiate
Mutate
Class switch
135
What does the medullary cord of the lymph node contain?
Lymphatic tissue - it projects into the medullary sinus
136
What are the main cell types found in the medullary cords?
B cells
| Plasma cells
137
Where does the lymph from lower extremities drain?
Junction of the left internal jugular and subclavian veins
138
What is the main duct of the lymphatic system?
Thoracic duct
139
Where is the thoracic duct located?
Posterior mediastinum
140
Where does the thoracic duct begin?
In the abdomen
141
What does the thoracic duct begin as?
Cisterna chyli
142
At what level is the cisterna chyli located?
T12 Vertebra
143
Describe the course of the thoracic duct
Starts at cisterna chyli, ascends through the thoracic cavity in front of the spinal column.
144
What major blood vessels is the thoracic duct associated with in the thoracic area?
Descending thoracic aorta to its left and the azygos vein to its right
145
What is the length of the thoracic duct?
~ 40cm
146
What is the point where the right brachiocephalic vein begins?
Right venous angle - junction of the right internal jugular vein with the right subclavian vein
147
What part of the diaphragm does the thoracic duct pass through?
The aortic opening, on the right of the descending aorta
148
Where do intercostal lymphatic vessels drain?
From the left and right intercostal spaces into the thoracic duct
149
Where do mammary glands drain their lymph?
Into axillary lymph nodes
150
Where do kidneys drain lymph?
Lumbar lymph nodes
151
Where do lungs and trachea drain their lymph?
Into hylar lymph nodes (located in the hilum of the lung)
152
Does spleen form crypts that trap bacteria?
no
153
Where is the spleen located?
Left hypochondriac region
154
What is the rough size of the spleen?
A fist
155
What does the white pulp surround in the spleen?
Branches of the splenic artery
156
What cells does the red pulp consist of?
Lymphocytes
Macrophages
Plasma cells
Monocytes
157
What are monocytes
Phagocytic white blood cells
158
What are the three different tissues within the spleen
Reticuloendothelial tissue
Venous sinusoids
White pulp
159
What tissue in the spleen handles phagocytosis of erythrocytes?
Reticuloendothelial tissue
160
What is the function of reticuloendothelial tissue in spleen?
Phagocytosis of erythrocytes and cell debris from the bloodstream
161
What is the additional function of reticuloendothelial tissue?
It may produce foci of hemopoiesis when RBCs are needed
162
Function of venous sinusoids
- grants power to the spleen to contract
| - Helps expel contained blood to meet increased circulatory demands
163
What does the spleen do in conditions of increased circulatory demand?
Expels contained blood within the venous sinusoids
164
What is the white pulp composed of?
Nodules containing malphigian corpuscles
165
What is the function of the white pulp of the spleen?
Provides lymphocytes and a source of plasma cells and hence antibodies for the cellular and humoral specific immune response
166
What kind of immune response does the spleen assist in?
Both cellular and humoral
167
How does blood enter the spleen?
Splenic artery, through its hilum
168
What is the venous drainage of the spleen?
Splenic vein
169
How is the hepatic portal vein formed?
The connection of the splenic vein with the Superior mesenteric vein
170
Where are the nerves to the spleen derived from?
Celiac plexus
171
What is unique about the spleen and the thymus?
They both contain only efferent lymphatic vessels
172
Where does the spleen develop from?
Mesenchymal cells of the mesentery attached to the primitive stomach
173
How is the developmental origin of the spleen different from the rest of the abdomen?
The lungs, liver, pancreas, gallbladder, stomach, esophagus and intestines all develop from the PRIMITIVE GUT - spleen develops from mesenchymal cells of the mesentery
174
What happens to the spleen in infectious mononucleosis?
It is enlarged
175
What is the absence of normal spleen function called?
Asplenia
176
What is asplenia associated with?
- Serious infection risks
- Encapsulated bacteria
= Strep pneumoniae
= Haemophilus influenzae
= Neisseria meningitidis
177
Which tonsils are covered by nonkeratinised stratified squamous epithelium?
Palatine and Lingual
178
What are tonsils?
Lymphatic organs that lie under the surface lining of the mouth and throat
179
What part of the immune system are tonsils a part of?
The secondary immune system
180
Where are tonsils located?
IN the respiratory and alimentary tracts in position to be xposed to inspired or ingested antigens from air or food
181
When do tonsils get activated?
When sufficient antigen is present, this stimulates the B cells in the germinal zone to differentiate and produce antibodies
182
What is the major kind of defence system tonsils are associated with?
Secretory IgA - which is transported to the surface and provides local immune protection
183
How many sets of tonsils exist?
3 -
Adenoids
Palatine tonsils
Lingual tonsils
184
Adenoids aka
pharyngeal tonsil
185
Location of adenoids
Posterior wall of nasopharynx
186
When are adenoids at the peak of their development?
Childhood
187
What are adenoids surrounded by?
Partly connective tissue
| Partly ciliated pseudostratified columnar epithelium
188
What kind of epithelium surrounds adenoids?
Respiratory epithelium
189
What kind of tonsils contain crypts?
Lingua and palatine
190
What kind of tonsils don't contain crypts?
Adenoids
191
Where are palatine tonsils located?
Posterolateral walls of throat - one on each side
192
When do palatine tonsils reach their maximum size?
Early childhood
193
What happens to the size of palatine tonsils after puberty?
They diminish considerably in size
194
Which tonsils are considerably enlarged when a person has a sore throat?
Palatine tonsils
195
What are the contents of palatine tonsils?
Many crypts
Lymphoid follicles
No sinuses
196
What is peculiarly absent from palatine tonsils?
Sinuses
197
What are palatine tonsils surrounded by?
Connective tissue and non-keratinized stratified squamous epithelium
198
What is the best way to distinguish the palatine from the pharyngeal tonsil histologically?
Type of associated epithelium
199
What are lingual tonsils
Collection of lymphoid follicles on the posterior portion of the dorsum of the tongue
200
What is peculiar about lingual tonsils as compared to pharyngeal and palatine tonsils?
They are smaller and more numerous
201
What composes each lingual tonsil?
A single crypt and lymphoid follicle
202
What is the name given to the three groups of tonsils?
Waldeyer's ring
203
Intestinal tonsils
Peyer's patches
204
Where are the Peyer's patches located?
Small intestine (ileum)
205
What is the function of Peyer's patches?
To destroy the abundant bacteria
206
What kind of lymphoid tissue are Peyer's patches and tonsils considered?
Subepithelial and non-encapsulated lymphoid tissues
207
Tonsillectomy
A surgical procedure in which the tonsils are removed from either side of the tonsillar fossa
208
When is tonsillectomy performed?
Repeated occurrence of acute tonsillitis or adenoiditis
Obstructive sleep apnea
Nasal airway obstruction
Diphtheria carrier state
Snoring
Peritonsillar abscess
209
What is done during tonsillectomy in children?
Adenoidectomy at the same time
210
How are the anterior and posterior parts of the dorsum of the tongue separated?
Terminal sulcus and foramen cecum
211
Where is yellow marrow found?
Hollow center of the diaphysis
212
Medullary cavity
The hollow center of the diaphysis (the long shaft of the bone)
213
What parts of bones contain red bone marrow?
Cavities in the cranial bones, vertebrae, ribs, sternum, and ends of long bones
214
What kind of bone marrow do you find in the cavities in vertebrae?
Red bone marrow
215
What tissues contribute to hemopoiesis before birth?
Yolk sac
liver
spleen
lymph nodes
216
What are the precursor cells that give rise to all the formed elements of the blood?
Hemocytoblasts
217
Where do you find hemocytoblasts?
red bone marrow
218
What are hemocytoblasts
Multipotent stem cells
219
What do hemocytoblasts give rise to?
Various committed progenitor cells
220
What are the progenitor cells for erythroblasts?
Proerythroblasts
221
What cells do platelets develop from?
Megakaryocytes
222
When does yellow marrow begin to appear?
When a child is 7 years of age
223
Where does yellow marrow appear first?
distal bones of the limbs
224
What kind of marrow does a person have at birth?
Only Red marrow
225
Where is red marrow present at the time when a person becomes an adult
```
Skull
Vertebral column
Thoracic cage
Girdle bones
Head of the humerus and femur
```
226
What is the average no of erythrocytes in the blood?
5 mn/cu mm
227
How many platelets in the blood?
150,000 to 300,000 per cu mm
228
How many leukocytes in the blood?
10,000 per cu mm
229
What are the most abundant leukocytes in blood?
Neutrophils
230
What are the most abundant agranulocytes in blood?
Lymphocytes
231
Which WBC has a kidney shaped nucleus?
Monocytes
232
What kind of WBC have ruffled membranes?
Macrophages
233
What kind of WBC has an obscure nucleus?
Basophils
234
What kind of WBCs are active against parasites?
Eosinophils
235
What do basophils release?
Histamine
Heparin
Serotonin
236
What kind of WBCs produce antibodies?
Lymphocytes
237
What kind of WBCs destroy specific target cells?
Lymphocytes
238
What kind of WBCs are part of the immune system?
Neutrophils
239
At what absolute neutrophil count does a risk of infection dramatically increase?
Less than 500 per cubic mm
240
What kind of metabolism do erythrocytes rely on?
Anaerobic
241
What is the average lifespan of RBCs?
120 days
242
What is the hormone that stimulates erythropoiesis?
Erythropoietin
243
What organ produces erythropoietin primarily?
Kidneys
244
What is the hematocrit for females?
40%
245
What is the precursor cell for all formed elements of the blood?
Hematocytoblast
246
what do hematocytoblasts give rise to?
Multipotent progenitor cells
247
What type of cells are hematocytoblasts?
Pluripotent stem cells
248
Multipotent progenitor cells aka
Colony forming cells
249
What do CFCs give rise to?
Different types of formed elements
250
What is the hormone that stimulates precursor cells to differentiate into WBCs?
Granulocyte Colony stimulating factor (G-CSF)
251
What kind of disease is sickle cell anemia?
Autosomal recessive genetic blood disorder
252
What is the shape of cells in sickle cell anemia?
Sickles or crescent
253
What is the relative life span of sickle cells as compared to normal RBCs?
Smaller
254
What do sickle cells cause in the blood stream?
- get stuck in blood vessels blocking blood flow, causing pain and organ damage
255
What is mutation?
A hydrophilic glutamic acid substitution with a hydrophobic amino acid valine
256
What does G6PD deficiency cause?
Severe hemolytic crisis in affected individuals
257
G6PD
Glucose 6 phosphate dehydrogenase
258
What is the cause of hemolytic crisis in individuals affected by G6PD deficiency?
Decreased NADPH and the inability of RBCs to maintain membrane integrity
259
What is G6PD deficiency induced by?
Sulfa drugs
Oxidants
Fava beans
260
What is the pH of blood?
7.35 - 7.45
261
What is the relative proportions of all types of leukocytes in blood?
Never Let Monkeys Eat Bananas
```
Neutrophils
Lymphocytes
Monocytes
Eosinophils
Basophils
```
262
Out of plasma and serum, which one contains clotting proteins?
Plasma
263
What % of plasma is water?
91%
264
What is the most abundant protein in human plasma?
serum albumin
265
What are the functions of albumin in blood?
```
Transports hormones
Transports fatty acids
Transports other componds
Buffers pH
Maintains osmotic pressure
```
266
Which word describes platelets better - megakaryocytes or cytoplasmic fragments?
Cytoplasmic fragments
267
What is the lifespan of platelets?
7-10 days
268
Where are platelets removed from the blood
Spleen
| liver
269
What is the stimulating factor for platelet formation?
Thrombopoietin
270
What triggers platelet plug formation?
Exposure of platelets to a rough surface
271
How do platelets gain access to materials that promote clotting?
They contain secretory vesicles
272
What do the chemicals from the platelets' secretory vesicles do?
Cause the surface of the platelets to become sticky
273
What happens when platelets become activated?
They produce Thromboxane A2 that has prothrombotic properties stimulating activation of new platelets as well as increasing platelet aggregation
274
What is the chemical that counteracts Thromboxane A2?
Prostacyclin (PGI2)
275
Actions of prostacyclin
Decreases platelet aggregation
| Causes vasodilatation
276
What are most articular disks covered by?
Hyaline cartilage
277
What are freely movable joints called?
Diarthroidal
278
What is the movement of synovial joints limited by?
Joint surfaces
Ligaments
Tendons
279
Characteristic features of synovial joints
Articular cartilage
Joint cavity
Articular capsule
Synovial membrane
280
Which synovial joint does not contain hyaline cartilage as articular cartilage?
TMJ
281
What cartilage does TMJ contain?
Fibrocartilage
282
What kind of blood vessels and nerves does the articular cartilage of synovial joints contain?
None
283
What is the joint cavity in synovial joints?
Small fluid-filled space separating the ends of adjoining bones
284
What is a synovial joint enclosed in?
Articular capsule - fibrous connective tissue
285
Where is synovial membrane found in the synovial joint?
Bursa and articular cartilage
286
What produces synovial fluid in the synovial joint?
Synovial membrane
287
How is the position of bones maintained in synovial joints?
Supporting ligaments
288
How many kinds of supporting ligaments are found with synovial joints?
three -
capsular
intracapsular
extracapsular
289
Meniscus
A washer-like structure between bone ends
290
How many synovial joints have a meniscus?
~10%
291
What is the purpose of the meniscus?
- Absorb shock
- Stabilize the joint
- Spread synovial fluid
292
What is the meniscus made out of?
Fibrocartilage
293
What is the blood supply of a meniscus?
No blood, nerve or lymphatic supply
294
How fast does the meniscus heal itself?
It can't.
295
What is the most famous and most injured meniscus of the body?
Knee
296
Bursa
Fluid-sac that is lined with a synovial membrane
297
What is the function of a bursa?
Reduce friction
298
What is a sample location of a bursa
Between a tendon and a bone to reduce friction
299
Bursitis
Inflammation of the lining of a bursa
300
Types of joints based on amount of motion
Synarthrosis
Amphiarthrosis
Diarthrosis
301
What are immovable joints known as
Synarthrosis
302
Examples of synarthroses?
Sutures between the flat bones of skull
| Gomphosis
303
How are synarthroses joined?
They are fibrous joints
304
What are slightly movable joints called?
Amphiarthrosis
305
Amphiarthrosis aka
Cartilaginous joint
306
What kind of joint is symphysis pubis
Amphiarthrosis
307
Which bones are involved in symphysis pubis?
The two os coxa bones join anteriorly in symphysis pubis
308
Classify joints based on type of associated connective tissue
Fibrous
Cartilaginous
Synovial
309
Types of fibrous joints
Sutures
| Syndesmoses
310
What is the joint between radius and ulna called
Syndesmosis
311
Types of cartilaginous joints
Synchondroses
| Symphyses
312
What are cartilaginous joints joined by?
Fibrocartilage
| Hyaline cartilage
313
What are joints that are joined by hyaline cartilage called?
Synchondroses
314
What kind of joints are epiphyseal plates within long bones
Synchondroses
315
What are joints that are joined by a plate of fibrocartilage called?
Symphyses
316
What type of joints are spheno-occipital joint and epiphyseal cartilage plates classified as?
Synchondrosis
317
Types of sutures
Coronal
Sagittal
Lambdoid
318
What is the suture between the frontal and parietal bones called?
Coronal suture
319
What is the suture between the two parietal bones called?
Sagittal suture
320
Where is the lambdoid suture situated?
Between parietal and occipital bones
321
Bregma
Site of intersection of coronal and sagittal sutures
322
What does the anterior fontanelle turn into in the adult?
Bregma
323
What is the point of intersection of the sagittal and lambdoid sutures called?
Lambda
324
What does the lambda succeed?
Posterior fontanelle
325
What kind of joint is the tympanostapedial joint?
Syndesmosis
326
What kind of joint is the inferior tibiofibular joint?
Syndesmosis
327
Primary cartilaginous joints
Synchondrosis
328
Secondary cartilaginous joints
Symphyses
329
Which kind of cartilaginous joints is movable?
Symphyses - slightly
330
Which kind of cartilaginous joints is not movable
Synchondrosis
331
What kind of cartilage is in synchondrosis
Hyaline
332
What kind of joints are intervertebral discs
Symphyses
333
What is peculiar about synchondroses?
They permit no movement but they allow growth in length of bone
334
What kind of a joint is the joint between the first rib and sternum?
Synchondrosis
335
What kind of joints permit a great degree of movement?
Synovial
336
What are synovial joints classified according to?
Axis of movement
337
Types of synovial joints
```
Gliding
Hinge
Pivot
Ellipsoidal
Saddle
Ball and socket
```
338
What are gliding joints also known as
Plane joints
339
What are ball and socket joints also known as
Universal
340
What type of joints are the ones found in the carpal bones of the wrist?
Gliding joints
341
What kind of joints are knee joints?
Hinge
342
What kind of joint is the one found between atlas and axis?
Pivot
343
What are ellipsoid joints aka
Condyloid joints
344
What kind of joints are the ones found in the tarsal bones of the ankle
Gliding
345
What is the joint where the metacarpal of the thumb meets the trapezium of the carpus (wrist) called?
Saddle
346
Example of ball and socket joint
Shoulder or hip
347
Example of ellipsoidal joint
Joint between the distal surfaces of the forearm bones and adjacent carpal bones
348
NO joint
Atlantoaxial joint
349
YES joint
Atlanto-occipital joint
350
Atlantoaxial joint
The synovial articulation between the inferior articulating facets of the atlas ant he superior articulating facets of the axis
351
First cervical vertebra
Atlas
352
Second cervical vertebra
Axis
353
What is peculiar about atlas and axis?
Absence of intervertebral disc or foramen between them
354
What is peculiar about C1?
It has no vertebral body - only two lateral masses
355
Howm any joints are formed between C1 and C2?
3
356
Atlanto-occipital joint
The synovial articulation between the superior articulating facets of the atlas and the occipital condyles of the skull
357
Rotation of the forearm with palm turning outward
Supination
358
Folding forward is an example of what kind of movement?
Flexion (of the spine)
359
Crossing one leg in front of the other is a form of what kind of movement?
Adduction
360
Crescent stretch
Dropping one hand down same side of body - it is an example of lateral flexion
361
What kind of movement is described by emptying a can of soda?
Pronation
362
When you stand with weight on inner edge of the foot, what kind of movement are you performing?
Eversion
363
Eversion
Turning the foot laterally resulting in the sole moving outward
364
Protraction
Movement of rounding shoulders forward "spreading" back
365
Squeezing shoulder blades together is known as
Retraction
366
Which part of the kidney is connected to the bladder by the ureter?
Renal pelvis
367
Where are the kidneys located?
Back of the abdomen - on each side of the spine, at the level of the lower ribs
368
Functions performed by the kidneys
- Form urine
- Maintain homeostasis
- Secrete hormones
369
What hormones are formed in the kidneys?
Renin
| Erythropoietin
370
At what level of the spine are kidneys located?
Lumbar spine
371
What is the relation of the kidneys to the peritoneum?
They are retroperitoneally located
372
What is the relation of the kidneys to muscles attached to the vertebral column
They lie in front of the muscles
373
What is the colour of the renal cortex
Light brown
374
What is the outer layer of kidney called
Cortex
375
What components of the nephron does the cortex contain?
PCT, DCT, glomeruli
376
What is the renal cortex the site of?
Blood filtration
377
What is the color of the medulla of kidney?
Dark kidney
378
What structures does the renal medulla contain?
Cone like structures called renal pyramids
379
What are renal pyramids separated by?
Renal columns
380
What are renal columns
Extensions of renal cortex
381
What is the hallow inner structure that joins with the ureters?
Renal pelvis
382
Where does the pelvis receive urine from?
Calyces
383
What is the apex of the renal pyramids?
Renal papilla
384
What happens microscopically in renal papilla?
Collecting ducts pour into minor calyces
385
What is the extension of the renal pelvis called
Renal calyx
386
Which kidney lies higher?
Left kidney
387
Why is the right kidney lower?
Due to the large size of the right lobe of the liver
388
What is the capsule of each kidney made of?
Fibre
389
What is the supportive capsule of each kidney made of?
Adipose
390
Where is the hilum of each kidney located?
Medial border
391
What are the contents of the hilum?
Ureters
Renal vessels
Nerves
392
Blood supply of kidneys
Renal artery, a branch of the abdominal aorta
393
List nephronal structures in order from b.lood to urine
```
Glomerulus
Bowman's capsule
PCT
Loop of henle
DCT
collecting duct
```
394
Nephron
Subunit of a kidney that purifies blood and maintains a safe balance of solutes and water
395
Functional unit of the human excretory system
nephron
396
How many open ends does the nephron contain?
One
397
What is the closed end of the nephron called?
bowman's capsule
398
what does the renal corpuscle normally produce?
protein free and cell free filtrate
399
what does the renal corpuscle consist of
bowman's capsule
| glomerulus
400
how many regions does the tubular portion of the nephron have?
4
401
what are the 4 regions of the tubular portion of the nephron?
pct
loop of henle
dct
collecting duct
402
where is glucose reabsorbed in nephron?
pct
403
where is sodium reabsorbed in nephron?
dct
404
what causes sodium reabsorption in nephron?
aldosterone
405
how is the filtrate treated in the loop of henle
it is concentrated through electrolyte exchange and reabsorption
406
what is the osmolarity of the fluid that exits the loop of henle
hyperosmolar
407
where in the nephron are metabolites reabsorbed
pct
408
where in the nephron is the filtrate finally filtered?
collecting duct
409
where in the nephron does reabsorption of amino acids and electrolytes occur?
pct
410
what kinds of processes do the fluid in the tubules of the nephron go through?
filtration
tubular reabsorption
tubular secretion
411
what happens to the blood that is not filtered
it passes to the efferent vessels and peritubular capillaries
412
what substances are returned to the peritubular capillaries by reabsorption?
water
glucose
sodium
413
at what rates are water, glucose and sodium returned to peritubular capillaries?
fast
414
macula densa
an area of closely packed specialized cells lining the wall of the distal tubule
415
where is macula densa found
lining the wall of the distal tubule
416
what are the cells of macula densa most affected by?
concentration of sodium chloride in the distal convoluted tubule
417
what does a decrease in NaCl concentration do to the macula densa?
decreases resistance to blood flow in afferent arterioles
increases renin release from juxtaglomerular cells
418
what does the decreased resistance to blood flow in afferent arterioles do?
it increases glomerular hydrostatic pressure and helps return GFR toward normal
419
what are the major storage sites for renin?
juxtaglomerular cells of afferent and efferent arterioles
420
distal straight tubule aka
thick ascending limb of the loop of henle
421
where is the collecting duct that the collecting tubule empties into lie?
within the medullary ray
422
what do collecting ducts converge to form
large diameter ducts in the papillae called papillary ducts or ducts of Bellini
423
area cribrosa
ducts of Bellini open into the calyces at the tips of the papillae, and the concentration of the openings produces a sieve-like surface appearance to the papillary tip called the area cribrosa
424
what is the most immature form of kidney
pronephros
425
what is the most developed form of kidney
metanephros
426
what are the stages of development of kidney
pronephros
mesonephros
metanephros
427
what stage of development of kidney persists as adult kidney
metanephros
428
ureters structure
long
slender
fibromuscular
429
function of ureters
transport urine from pelvis of kidney to base of bladder
430
which ureter is longer
left
431
what is the narrowest part of ureters
where they originate
432
what is the point of origin of ureters called
ureteropelvic junction
433
what does filling of the bladder do to ureters
constricts them at the ureterovesical junction
434
what is the ureterovesical junction
the point where ureters enter the bladder
435
how does urine move through ureters
peristaltic waves
436
how often do ureteric peristaltic waves occur
one to five times a minute
437
how do the ureters descend in the female
posterior to the ovary and into the base broad ligament passing under the uterine artery - water under the bridge
438
where is the bladder located
pelvic cavity posterior to symphysis pubis
439
in whom is bladder lower
females
440
what kind of epithelium is found in bladder?
transitional
441
what is special about transitional epithelium
they change shape in response to pressure - empty bladder - cuboidal; filled bladder - compressed and flattened
442
urethra
fibromuscular tube
443
membranous urethra
in males, the portion of the urethra that passes through the urogenital diaphragm
444
membranous urethra
in males, the portion of the urethra that passes through the urogenital diaphragm
445
What structures pass through optic canal
optic nerve
| ophthalmic artery
446
What happens to optic canal in McCune Albright syndrome?
bony fibrous dysplasia of the anterior cranial base leading to the encasement and narrowing of the optic canal
447
which bone is optic canal located in
sphenoid
448
which part of the sphenoid is optic canal located in
posterior part of lesser wing
449
what part of the cranium does the optic canal communicate with
middle cranial fossa
450
where do olfactory nerves emerge from
cribriform plate in ethmoid
451
which cranial nerve is olfactory
i
452
which bone is hypoglossal canal in
occipital
453
what structures does the hypoglossal canal house
hypoglossal nerve
454
which cranial nerve is the hypoglossal nerve
cn xii
455
which bone does the internal carotid artery enter the skull from
temporal
456
what is the opening that internal carotid enters
carotid canal
457
which bone is lacrimal canal associated with
lacrimal and maxilla
458
what are the contents of the lacrimal canal
nasolacrimal duct
459
nasolacrimal duct aka
tear duct
460
what are the contents of the inferior orbital fissure
- infraorbital and zygomatic branches of maxillary nerve
- infraorbital artery
- part of inferior ophthalmic vein
461
what does infraorbital artery pass through
inferior orbital fissure
462
what bones does the inferior orbital fissure involve
sphenoid
| maxilla
463
which of the orbital fissures involves the maxilla
inferior
464
which of the orbital fissures involves the sphenoid exclusively
superior
465
which orbital fissure transmits (branches of or full) 4 cranial nerves
superior
466
which cranial nerves pass through superior orbital fissure
iii (occulomotor),
iv (trochlear),
vi (abducens) and
v1 (nasociliary branches of ophthalmic)
467
does the superior orbital fissure transmit any nervous fibers ther than the cranial nerves
sympathetic fibers from cavernous plexus
468
what blood supply passes through superior orbital fissure
superior and inferior divisions of ophthalmic vein
469
which bone houses the optic canal and foramen
sphenoid
470
what bone is the stylomastoid foramen located in
temporal
471
what nerve passes through stylomastoid foramen
facial (cn vii)
472
what foramen does the facial nerve pass through
stylomastoid foramen
473
what bone is internal acoustic meatus part of
posterior surface of petrous part of temporal bone
474
what structures does the internal acoustic meatus transmit
```
facial nerve (vii)
vestibulocochlear nerve (viii)
```
475
where does the vestibulocochlear nerve travel after entering the internal acoustic meatus
it stays within the temporal bone
476
what does the vestibulocochlear nerve supply
cochlear duct (hearing)
semicircular ducts
maculae (balance)
477
where does the facial nerve go after entering the internal acoustic meatus
it goes in the facial canal of temporal bone and emerges from the stylomastoid foramen
478
where does the stylomastoid foramen lie
between the styloid and mastoid processes of the temporal bone
479
what does the facial nerve do after entering the internal acoustic meatus
gives rise to the chorda tympani branch
480
what is the function of the chorda tympani branch of facial nerve
parasympathetic innervation to submandibular and sublingual gland
sensory taste fibers to anterior 2/3 of tongue
481
what part of the facial nerve exits from the stylomastoid foramen
main trunk
482
what happens to the facial nerve after it exits stylomastoid foramen
it gives off 5 branches after entering parotid gland substance
483
facial nerve branches mnemonic
```
The - temporal
Zebra - zygomatic
Bit - buccal
My - mandibular
Cow - cervical
```
