Section 1
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Glycoprotein hormones are composed of...
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Last updated
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Date created
Mar 1, 2020
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Section 1
(50 cards)
Glycoprotein hormones are composed of...
two chains alpha (92 aa) and beta (110 aa) which contain carbohydrate moieties; beta chains are the distinguishing chains`
TSH is inhibited by...
high blood levels of thyroid in a negative feedback system loop
MSH
stimulates melanocytes; may increase mental alertness
PTH
increases blood calcium levels by stimulating osteoclast activity; decreases kidney calcium secretion; activates vitamin D, which stimulates uptake of calcium from intestines
Renin
signals adrenal cortex to secrete aldosterone
Epinephrine/adrenaline
hormone as well as neurotransmitter; crucial aspect in fight or flight mechanism; produced in some neurons in the central nervous system and in the chromaffin cells in the medulla; catecholamines
TRH
Turns on TSH
gamma cells
secrete somatostatin which inhibits glucagon
Cortisol (main glucocorticoid) helps
the body deal with stressful situations within minutes
Calcitonin
decreases blood calcium levels by inhibiting osteoclasts; increase calcium secretion by kidney (THYROID)
PRL
stimulates mammary glands in breast to make milk
Aldosterone (main mineralcorticoid) is secreted in response to...
decline in blood volume or blood pressure (severe hemorrhage)
Erythropoietin
A hormone produced and released by the kidney that stimulates the production of red blood cells by the bone marrow.
Placenta
estrogen and progesterone hPL HCG
Anterior Pituitary
FLAT PEG
Epinephrine physiological responses...
1. increased heart rate 2. increased respiratory rate 3. increased glycogenolysis 4. Trigger Lipolysis 5. muscle contraction 6. vasoconstriction or vasodilation
PIF
Turns off prolactin
chief cells of parathyroid gland
secrete PTH
Posterior Pituitary
ADH and oxytocin
TSH
stimulates thyroid gland
Heart: ANP
stimulate kidney to secrete more salt thus decreasing excess blood volume, high BP, and high blood sodium concentration
Adrenal cortex
1. mineralcorticoids-aldosterone 2. Glucocorticoids-cortisol
Gonads
Testes and ovaries
norepinephrine
1. as a stress hormone affects part of the brain such as the amygdala where attention and responses are controlled 2. Increased heart rate 3. Triggering release of glucose from energy stores 4. Increase blood flow to skeletal muscle 5. Increase oxygen flow to the brain
Oxytocin (posterior pituitary)
contraction of smooth muscle in reproductive tracts, initiating labor and ejection of milk from breasts
TSH binds to...
G protein receptor on the follicular cell on the thyroid that activates Protein kinase A.
acinar cells of pancreas
secrete digestive enzymes (most cells of pancreas) exocrine
Islet cells of langerhans
endocrine fuction
ADH (posterior pituitary/neurohypophysis)
stimulates the kidney to reclaim more water from the urine, raises blood pressure
GHIH
turns off growth hormone (GH)
LH in women stimulates...
steroidogenesis in ovarian follicle, induces ovulation, maintain secretory function in corpus luteum
GHRH
Turns on GH
alpha cells
secrete glucagon to raise blood glucose
FSH in men stimulates...
spermatogenesis in sertoli cells, secretion of inhibin, production of sex-hormone-binding globulin
Cortisol regulates or supports
a lot of different important cardiovascular, immunologic, and homeostatic functions including water balance
ACTH
stimulates adrenal cortex to produce corticosteroids; aldosterone and cortisol
Kidney
Renin and erythropoietin
GnRH (LHRH)
Turns on FSH & LH
Adrenal medulla
epinephrine and norepinephrine
Testes
Interstitial cells secrete androgens (Testosterone) Maintains secondary sex characteristics Spermatogenesis
Thyroxin
1. increases MBR 2. affects many target cells; protein synthesis, bone growth, neuronal maturation, cell differentiation (THYROID)
Thyroid hormone
thyroxin and calcitonin
beta cells
secrete insulin to lower blood glucose
Aldosterone prompts
distal and collecting tubules in kidney to reabsorb more sodium which increases blood volume levels and BLOOD PRESSURE
Oxytocin is regulated by
physical stimulation of nipples, vaginal stimulation, stress can inhibit, fall of progesterone and increase in estrogen production
Glycoprotein hormone
TSH and gonadotrophic (LH and FSH)
Ovaries
androgens (estrogen and progesterone) secreted by thecal folliculi
Pineal gland ( conarium)
secretes melatonin which regulates the circadian rhythm
FSH in women stimulates...
development of ovarian follicles, secretion of estradiol, secretion of inhibin
skin
modified cholesterol with UV exposure is the precursor to Vit D
Section 2
(50 cards)
Myxedema
hypothyroidism
Senile kyphosis
geriatic degeneration of thoracic E.g. Intrinsic muscle weakness, disc aging, osteoporosis MOST COMMON IN ELDERLY any age group can get it
Cretinism
extreme form of hypothyroidism
Windowing (CT scan)
putting together all slices to construct an image of particular interest
acromegaly
overproduction of GH
Stratum lucidum
cells contain eleidin which is a mixture that is derived from immature keratin and keratohyaline granules
Apocrine duct portion...
-empties into hair follicle -less coiled, lined by simple to stratified cubiodal epithelial
GVE (general visceral efferent)
motor controls involuntary muscle multi-synaptic neuron lateral horn
stomach
gastrin
Attenuation
Loss of amplitude of beam as it passes through the tissue
Anulus Fibrosus
14 concentric layers (lamellae) of fibrocartilage, arranged in alternating, perpendicular angulations
MRI artifacts
metal in body causes image to be black
Vitamin D
necessary for calcium metabolism; signals intestines to absorb calcium
Langerhans cells
derived from bone marrow antigen presenting
GVA
sensation from visceral
Herniated disc
-abnormal displacement of nucleus pulposus causing abnormal bulging of disc as a whole
dwarfism
too little GH
Diabetes insipidus
kidneys fail to absorp water; hyposecretion of ADH; excessive urination
Acoustic shadowing
blocking images behind they hyperechoic object (ULTRASOUND)
GSE (general somatic efferent)
innervates skeletal muscle w/one neuron anterior horn
Apocrine Sweat Glands
mainly in pubic, axilla, areola of breast and anal regions
Accessory ribs in cervical region can cause...
problems with branchial plexus, subclavian artery
radiopaque
calcium in bone absorbs much of beam, appears white
Addison's disease
adrenal gland fails to produce enough corticosteroids -skin hyperpigmentation
Acoustic enhancing
enhance views of structures around anechoic objects (ULTRASOUND)
Hyperechoic
appears white; bone, air, diaphragm, gall stone
Stratum granulosum
cells basophilic due to the presence of keratohyaline granules containing filaggrin
Primary curves
Thoracic + Sacrococcygeal
Hypoechoic
shades of grey; liver, kidney, spleen, skeletal muscle
radioluscent
beam passes through air w/little of beam absorbed
Accessory ribs
outgrowths typically on C7 and L1
Gain
adjusting contrast
Costal processes
rib formation
X rays can be used in...
Herniated disc is more likely to occur...
on C4,5 and L4,5
Gigantism
hyper secretion of growth hormone
Cushing's syndrome
a condition caused by prolonged exposure to high levels of cortisol
GSA
discriminates touch, proprioception, pain and temperature from the skin, joints and muscle
Anechoic
no echos (appears black); full bladder, gall bladder, lumen of vessels
Kyphosis
hunchback; thoracic abnormal curve
Apocrine secretory portion...
-deep in reticular dermis -larger with wider lumens -cuboidal to columnar cells -2 layers -release by apocrine (viscous odorless secretion degraded by bacteria to produce distinct smell)
Lordosis
abnormal lumbar curve
Herniated discs pushes...
-posterior but forces lateral protrusion w/high chance of impeding on nerves through foramen (spinal nerves) against ROOTS
Melanocytes
derived from neural crest lack attachment to keratinocytes attached to basal lamina by hemidesmosomes
Sciolosis
lateral abnormality (MAINLY THORACIC) more common in female
Nucleus pulposus
inner gelatinous nucleus that gives the disc its elasticity and compressibility; mucopolysaccaride gel w/high water content -derived from notochord -normal loss of water with age
Goiter
enlargement of thyroid gland due to iodine deficiency
Dorsal outgrowths
pedicals & lamina -neural arch (vertebral arch)
Grave's disease
hyperthyroidism; IgG attch to TSH receptor causing it to produce too much thyroid hormone
Disease-based kyphosis
degeneration & collapse of vertebral bodies, resulting in exaggerated thoracic curvature e.g. osteoporosis, tuberculosis of vertebral bodies
Section 3
(50 cards)
Laminar flow
parallel flow of layers of the fluid from an area of high pressure to an area of low pressure
Cranial nerve X
Vagus nerve; innervates only the atria of heart (SA and AV node)
Turbulent flow
flow of fluid layers are erratic and don't follow any direction
Trabeculae carnae
muscular ridges and columns on inside walls of ventricles
Spina bifida cystica
open vertebral canal usually associated w/cyst-like sac; maybe accompanied w/neural tube defects -strong association w/alpha-fetoprotein -Folic acid in first part of pregnancy reduces chances of spina bifida
Meningocele
outer (dura-arachnoid) displaced dorsally [fluid-filled]
Lub
closing of AV valves (systole)
Anterior Intraventricular artery
separates the left and right ventricle
Cranial nerve IX
Glossopharyngeal, salivary gland
Bruit
turbulent blood flow in vessel
Serous pericardium layers
parietal and visceral pericardium
M2 and M4
decreased cAMP, Ca2+ increased potassium -agonist Ach relaxation or inhibition
Murmur
turbulent blood flow in the heart
Cranial nerve VII
facial muscles, lacrimal and salivary glands
Ejection fraction
(EDV-ESV)/EDV
pectinate muscles
prominent muscular ridges along the inner surface of the auricle and across the adjacent anterior atrial wall
Stroke Volume
SV = EDV - ESV
Eccrine
occurs in all skin type except glans penis, glans clitoris, and lips -most abundant in thick skin -simple coiled glands
Parasympathetic pathway uses...
both nicotinic and muscarinic receptors use Ach
Compliance
C= Volume/ Pressure -higher in veins, holds larger volume at lower pressure -lower in artery, holds less volume at higher pressure
Atropine
competitive muscarinic antagonist
Non-genomic steroids
the steroid hormone engages cell-surface receptors to activate conventional signalling pathways
Semilunar valves
pulmonary valve and aortic valve
Myelocele (rachischisis, myeloschisis)
failure in neurulation "open book" -Always severe neurological deficits -neurolation doesn't occur and neural tube doesn't form -most of deaths come from complications
Septomarginal trabecula
(moderator band): right branch of A-V bundle passes through.
Genes that are regulated by steroid hormones possess binding regions in the sequence called...
hormone regulated elements (HRE's)
decreased blood pressure..
decreased baroreceptor firing
Rachis
vertebrae
increased blood pressure...
increased baroreceptor firing
M1, M3, M5 muscarinic receptors
work through IP3 and DAG system, increases Ca2+, CNS excitation -agonist Ach
Spina bifida occulta
small defect only; normal neural tube asymptomatic 10-15% L5/S1
Eccrine duct portion...
empties onto surface -less coiled, lined from simple to stratified cuboidal
Pouiseuille's equationC
Flow (F)= P (pressure) x r (radius)^4
G-protein alpha subunit
always GTPase (hydrolyzes GTP to GDP)
Meth mouth
the decaying of teeth due to decreased saliva production in methamphetamine users -causes acidosis because the loss of buffer
Cranial nerve III
oculomotor, innervation of pupil and lens
Sympathetic pathway uses..
Nicotinic-Ach alpha 1 beta 1 NE
Eccrine secretory portion...
-deep in reticular dermis layer -surrounded by myoepithelial cells - stratified cuboidal -release merocrine -increased activity in sympathetic
Sympathetic sweat glands uses...
Nico-Ach musc-Ach
Ohm's Law
blood pressure= caridiac output (CO) x Total peripheral resistance (TPR)
Dub
closure of semilunar valves
Pericardial cavity
between visceral and parietal layers and contain serous fluid
S2,3,4
provides parasympathetic innervation to the Sigmoid-Descending colon & the Rectum (genital erection)
G protein 12
regulate ion channels
Meningomyelocele
spinal chord/ spinal nerve roots displaced -defects below level of presentation (urinary, rectal functions)
Sebaceous glands
occur in all thin skin -most enter through ducts in to follicular canals of hair -acinar secretory portions contain abundant lipid filled cells -holocrine
Some sympathetic uses...
Nico-Ach alpha 1 beta 1 beta 2 Epi
G protein q
stimulate the enzyme phospholipase C
V=F/A
Velocity=Flow/ Area -left side (the capillaries increase cross-sectional area which slow down velocity so blood can exit into tissue)
Peptide hormones
synthesized as pre-pro forms which are inactive; have to be cleaved to become active
Section 4
(50 cards)
r-fng
Dorsoventral -inhibited by En1 from ventral ectoderm in dorsal ectoderm expressing Wnt7a
polydactyly
extra digits
Generalized gangliosidosis
GM1-Beta-galactosidase -mental retardation, liver enlargement, skeletal deformation
Right Pulmonary surface
right atrium
Left border
left ventricle and a little of left auricle
Left pulmonary surface
left ventricle
MAO and COMT
degrades EPI, NE, DA
Beta 1 receptors
increase the heart rate and contractive force of the heart (ventricles)
Sonic Hedgehog (Shh)
-Anteroposterior, posterior mesenchyme -induces FGF-4 secretion by AER -induces Hoxd expression
Polymastia
extra breast mast
Ach decreases ...
calcium conductance & increase K+ conductance to decrease HR
Retinoic acid (RA)
Low concentration mimics ZPA, induces Shh & Hox -Increased concentration shuts down AER and PZ -stops outgrowthic n
Right Border
formed by right atrium
Pericarditis
inflammation of pericardium; -chest pain -cause infection, metabolic & cardiovascular disorder -cardiac tamponade (compression)
En1
Dorsoventral, ventral ectoderm -inhibits r-fng & Wnt7a -specifies AER -ventral signal
Tay-sachs disease (TSD)
Hexosaminidase A -mental retardation, blindness, muscular weakness
FGF-10
progress zone maintains AER structure & function
Beta 2 receptors
vasodilation of skeletal muscles/ branchial vasodilation
Base
primarily by left atrium
pectinate muscle
rough muscle in atria
Inferior border
Right and left ventricle
Sympathetic reactions increases....
PNMT synthesis (precursor to adrenaline and ne)
Limb bud development begins
somatic layer of the lateral plate mesoderm (week 4)
FGF-4
posterior AER, maintains proliferation & inhibits differentiation in progress zone induced by Shh
Superior border
Right and left atria
FGF-8
maintains proliferation & inhibits differentiation in profress zone maintained by FGF-10
Amelia
missing whole limbs
Progress zone (PZ)
-induced by AER -secretes FGF-10 -rapid cell division -inhibited cell differentiation
Anteroposterior
digit specification
Apical Ectodermal Ridge (AER)
induced by underlying mesenchyme -Secretes FGF-4 and 8 -Maintains Progress zone -Required for limb outgrowth
Fabrys disease
alpha-Galactosidase -rash, kidney failure (only in male) -X linked recessive
Wnt7a
Dorsoventral, dorsal ectoderm -induces Lmx1 in dorsal mesoderm -dorsal signal
Anterior surface of heart
primarily right ventricle
HoxD
proximodistal& anterposterior induced by Shh & FGF-4
En1 located
restricted to ventral ectoderm
Proximodistal
limb outgrowth
En1 inhibits
r-fng in dorsal ectoderm expressing Wnt7a
syndactyly
fused digits
polymelia
extra limbs
Lmx1
dorsoventral -dorsal mesoderm -induced by Wnt7a -specifies dorsal structure
Polythelia
extra nipples
Wnt7a location...
restricted to dorsal ectoderm
Wnt7a induces
Lmx1 in dermal mesoderm
Inferior surface of heart
primarily LV and right ventricle
NE & Epi increase...
calcium conductance & decrease K+ conductance to increase HR
Dorsoventral
AER position and muscle pattern
Trabeculae carnae
rough wall of ventricle
Meromelia
missing part of limb
Ectoderm forms
forms epidermis and der iatives
Fibrous lobar septa
gland system in breast -divide breast into 15-20 sections -attach to pectoralis
Section 5
(50 cards)
Phospholipase A2
cleaves C2 -releases arachnidonic acid from PL; inhibited by glucocorticoids
Leukotriene C4, D4, E4 (LTC4, LTD4, LTE4)
vasoconstriction bronchoconstriction major player involved in asthma
Acidic glycosphingolipids
gangliosides and sulfatides
Gangliosides
ceramide linked to an oligosaccharide Located in ganglion cells/ nerve endings
Dentriculate ligament
-comes off the pia mater -helps anchor the spinal cord
Niemann-Pick Disease Type A
SMPD1 gene mutation, infantile form -less than 1% enzymatic activity -Hepatosplenomegaly
Phosphoglycerides (Glycerophospholipids)
major class -located in plasma membrane/organelle membranes
Niemann-pick disease C
NPC1 & NPC2 gene mutation -adult onset -protein transport of lipids
NSAIDs
inhibit COX-1 and COX-2 -side effects: GI discomfort
COX-2
-inducible enzyme during inflammatory response -inhibited by NSAIDs, -celbrex, bextra, vioxx -Alzheimer's Disease and specific cancers
niemann-pick disease B
usually life to adulthood -Hepatosplenomegaly
DPCC (Dipalmitoylphospatidylcholine)
primary component in extracellular fluid lining alveoli -Produced and secreted by Type 2 pneuocytes
Sphingophospholipid
ER->golgi->plasma membrane/exocytosis -precursors: Palmitoyl-CoA and serine
Farber's disease
Ceramidase -hoarseness, dermatitis, skeletal deformation, mental retardation; fatal in early life
Prostacyclin (PGI2)
-produced by endothelial cells -inhibits platelet aggregation -vasodilation
Leukotriene B4 (LTB4_)
promotes adhesion of WBCs -stimulates release of lysosomal enzymes
Metachromatic leukodystrophy
Arylsulfatase A -mental retardation and psychologic disturbances in adults; demyelination
Phospholipase C
cleaves phosphate and PIP2->DAG, IP3
Leukotriene A4 (LTA4)
Produced in leukocytes, mast cells, platelets
Thromboxane A2 (TXA2)
-produced by activated platelets -promotes platelet aggregation and formation of blood clots -vasoconstriction
Ceramide
sphingosine + fatty acid
Prostaglandin F2 alpha (PGF2alpha)
-Produced by most tissues -Vasoconstriction -smooth muscle contraction
3 Specialized types phosphoglycerides
Cardiolipin, plasmalogens, platelet-activating factor (RAF)
Niemann-Pick disease
Spingomyelinase -Enlarged liver and spleen, mental retardation, fatal in early life
Sphingomyelin
Ceramide + choline myelin sheath
Anterior (Pectoral) node
anterior chest wall (lateral breast sections)
Leukotrienes
arachidonic acid is the precursor -Lipooxygenases catalyze reactions -inflammatory responses, smooth muscle contraction
Prostaglandin E2 (PGE2)
-produced by hepatocytes, also in most tissues -vasodilation -smooth muscle relaxation
COX-1
Constitutively expressed in all tissues -involved in cell maintenance
5 types of phosphoglycerides
Phosphatidylserine (PS), Phosphatidylinositol(Pl), Phosphatidylethanolamine (PE), Phosphatidylcholine (PC), and Phosphatidylglycerol (PG)
Eicosanoids are located...
in all tissues, and participates in paracrine signaling
Celebrex, Bextra, Vioxx
treatment of arthritis -side effects: stroke and heart attack
Non-membrane phosphoglycerides
-component of lung surfactant -major component of bile
Sulfatides
cerebrosides that contain sulfated galactoses found in nerve and kidney -major in brain
Phospholipase A1
cleaves C1
Glycosphingolipids/ glycolipids
ceramide + carbohydrate -role in ABO blood group antigens -located primarily in nerve tissues, all tissues, exterior of plasma membrane (touch w/ECM)
Eicosanoids
precursors are unsaturated FAs -mediated via G-proteins -Inflammatory responses associated with injury & disease -Regulation of smooth muscle contraction, promotion of blood clotting process, hypersensitivity
Neutral Glycosphingolipids
GALACTOCEREBROSIDE and glucocerebroside O-glycosidic bond
Gaucher's disease
Beta-Glucosidase -enlarged liver and spleen, erosion of long bones, mental retardation in infants
Epidural fat
moves and changes pressure points
respiratory distress syndrome
lecithin/sphingomyelin levels predict the disease -Treated by administration of antenatal corticosteroids/exogenous surfactant--> assisted ventilation 2.0 or more= lung maturity 1.5-1.9= RDS risk 40% less than 1.5=75% diabetic parents need fetus to have 3.4
Cyclooxygenase (COX) Enzyme
Function: Creates the 5-membered ring structure of PCG -Requires O2
Phospholipid synthesis
SER->Golgi->plasma membrane/exocytosis -located in ALL cells/ liver: depending on need 1. Phosphatidic acid pathway (Pl, PG, and cardiolipin) 2. Salvage pathway ( PC, PE, and PS)
Lateral (humoral) lymph node
upper limb
Phospholipase D
cleaves phosphate (in plant tissues)
Posterior (subcapsular) node
back
Internal thoracic lymph node
most of median section of breast drain into this secondary lymph node
Membrane phosphoglycerides
anchors cell -participates in intracellular signaling
Vertebral foramen
canal through which spinal cord passes
Glycosphingolipids regulate...
cell growth, development, and cell-cell interaction
Section 6
(50 cards)
Ventral primary ramus
1. simple segmentation 2. nerve plexus
Hypomere
Lateral/ventral to vertebral column (ventral primary ramus) -Superficial and Intermediate back muscles
Vertebral regions
C7, T12, L5, S5, Coccyx:2-4/5
Accessory ribs
Abnormal costal process L1: most common (ASYMPTOMATIC) cervical rib: most problematic C7
Myogenic mechanism
explains autoregulation -smooth muscle contracts back and pulls walls of blood vessels vasoconstricts which increases resistance and decreases flow
Spinal muscle atrophy
motor neuropathy "floppy baby"
peripheral thermoreceptors
skin
Which arteries are best at autoregulation?
cerebral arteries
Trapezius innervated by
spinal accessory nerve (CN XI)
Shivering
posterior hypothalamus
Autoregulation
how blood flow stays constant even after dilation
dorsal rhizotomy
Surgical severance of selected dorsal roots. Purpose is to decrease pain or to decrease hyperflexia.
Metabolites
waste products of metabolism cause vasodilation which increase Cardiac output
Annulus fibrosus function...
to support anulus against tension due to the strength of the alternating weaving of the layers
central thermoreceptors
located in the hypothalamus and monitor internal temperature
ligamentum flavum
connects lamina to lamina -limits flexion
Skin circulation
-Vessels have dense sympathetic innervation to control blood flow -Low metabolic level -Principal function is regulation of body temperature
Pulmonary circulation
controlled by O2 -hypoxia induces vasoconstriction -Shunts blood from poorly ventilated areas towards well-ventilated areas where gas exchange can occur
Shingles
sensory neuropathy
Somites differentiate into
sclerotome, myotome, dermatome
Coronary blood flow
70% during diastole 30% during systole -myocardial O2 demand
Sympathetic innervation of coronary blood flow
is low -resting heart: SNS plays minor role -exerting heart: SNS vasoconstriction is overridden due to increased myocardial O2 demand
Thermogenic
Actions in target tissue result in heat production ↑ O2 consumption ↑ Metabolic rate Stimulation of Na+-K+ ATPase
Reactive hyperemia
if blood supply cut off then restored, flow increases above normal
myocardial O2 demand
-HR -Contractility -LV wall Stress: Pressure X Radus/ Wall thickness (preload and afterload)
Extrinsic
Sympathetic nervous system, hormones, and other external factors
Sclerotome forms
Occipital bone vertebrae annulus fibrosus of intervertebral disc
Intrinsic
autoregulation, active hyperemia, and reactive hyperemia
Paraxial mesoderm forms
somites
Skin during exercise...
Body temperature increases → inhibition of sympathetic centers that control skin blood flow → vasodilation → warm blood from body cores shunted to skin surface for dissipation of heat
Blood flow is matched...
to airflow so there is very little air or blood wasted in the lung.
Intermediate Layer of Back
1. Serratus posterior superior 2. Serratus posterior inferior
The heart uses...
ATP as energy source -adenosine (metabolite) acts as vasodilator along with Hypoxia
5 Components of Epidural space
1. fat 2. Internal vertebral venous plexus 3. internal Vertebral Arterial Plexus 4. Spinal & vertebral nerves 5. Lymphatics
Pyrogens
-(fever-producing substances) -Increase the hypothalamic set point temperature -Normal core temperature is sensed as too low -Anterior hypothalamus activates heat-generating mechanisms (e.g. shivering) to raise body temperature to the new set point
Aspirin
COX inhibitor -disrupts prostanglandin synthesis -activates mechanism for heat dissipation
Coronary artery
An artery that supplies blood to the heart itself -controlled by oxygen
Deep layer of back
movement of vertebrae, ribs, and skull 1. Splenius capitis 2. Splenius cervicis 3. Erector spinae
Metabolism mechanism
explains autoregulation, active & reactive hyperemia
Proprioceptors
Sensory receptors, located in the muscles and joints, that provide information about body position and movement.
Lateral outgrowths
costal processes
Epimere
dorsal to developing vertebral column (dorsal primary ramus) -deep back muscle layer
Thyroid hormone effects body temperature by...
raising body temp
Superficial back muscles
1. Trapezius 2. Latissmus dorsi 3. Rhomboids 4. Levator scapulae
Exteroreceptors
skin ( external stimuli: pain, temp, touch, and pressure)
Epiphysis
the end part of a long bone, initially growing separately from the shaft.
Mechanism of pyrogens...
-Increased production of interleukin-1 (IL-1) in phagocytic cells -IL-1 acts on the anterior hypothalamus to increase local production of prostaglandins -Increase set-point temperature
CSF fills...
the central lumen and subarachnoid space
Active hyperemia
increased blood flow through a tissue associated with increased metabolic activity
Myotome forms
Epimere, hypomere
Section 7
(50 cards)
Ulnar nerve innervates 1.5 muscles in the antebrachium
flexor carpi ulnaris (1) and flexor digitorum profundus (.5)
Lateral intermuscular septum
separate brachial anterior and posterior section
Posterior Brachial region innervated by...
radial nerve
Capillary Oncotic pressure
force opposing filtration -tends to draw water into capillary -Effective osmotic pressure due to presence of plasma proteins Determined by blood protein concentration -Increase = decrease filtration -Decrease = increase filtration
3 main components of the primordial cardiovascular system
1. heart primordium 2. neural crest 3. angioblasts
Water-soluble substances
H20, ions, glucose, amino acids -diffusion limited to the aqueous clefts between endothelial cells -smaller surface area for diffusion
filtration
net fluid movement out of capillary into interstitial fluid
2 motor nerves in hand
ulnar and median
Anterior Brachial region innervated by...
musculocutaneous nerve
Capillary hydrostatic pressure
-Increased due to arteriolar dilation and venous constriction -Decreased due to arteriolar constriction (e.g. hemorrhage)
Capillary oncotic pressure
-Increased due to loss of fluid but not protein (e.g. dehydration or diarrhea) -Decreased due to less concentrated plasma protein (e.g. liver disease- reduced synthesis of plasma proteins and renal disease- excessive loss of plasma protein in the urine)
Interstitial-fluid hydrostatic pressure (P*i)
-negative -
Capillary sphincters closed...
blood flows through metarteriole thoroughfare channel and bypasses capillaries
Interstitial oncotic fluid
-force favoring filtration -Determined by interstitial protein concentration -Normally quite low due to little loss of proteins from capillaries
Sinus Venosus
develops right and left horn
Interstitial Hydrostatic Pressure
Force opposing filtration -tends to draw water into capillary -normally is zero or slightly negative
Capillary sphincters open...
blood flows through true capillaries
Posterior antebrachial
Extension, Supination
Lesion of upper trunk of brachial plexus?
Nerve defects in Suprascapular nerve, musculocutaneous nerve, and Axillary nerve
Musculocutaneous nerve innervates...
coracobrachialis, biceps brachii, brachialis
Lower trunk lesion
primarily ulnar nerve -
Ductus arteriosus
shunt between pulmonary trunk and aorta -allows most of the blood from the right ventricle to aorta, bypassing the lungs
Capillary Hydrostatic Pressure
-Force favoring filtration out of capillary -more affected by changes in venous pressure -declines along the length of the capillary due to filtration -highest at the arteriolar end and lowest at venous end
Foramen ovale
shunt between right and left atria -shunts oxygenated placental blood from vena cava through the right atrium into the left atrium.
Lungs inflate...
decreased pressure of pulmonary trunk
Increased Interstitial oncotic pressure...
due to impaired lymphatic system (e.g. tumor in the lymph node) or increase capillary permeability (e.g. burns)
Nerve that innervates the anterior section of antebrachium
median nerve
Increased filtration...
-Caused by increases in capillary hydrostatic pressure due to increased arterial or venous pressure -Caused by decreases in capillary oncotic pressure due to dilution of plasma protein concentration
Nerve that innervates the posterior section of the antebrachium
Deep radial nerve
Osmotic force due to plasma protein concentration (pi * i)
-negative -
Lipid soluble substances
gases such as O2 and CO2 -diffusion driven by partial pressure gradient for the particular gas -greater number of capillaries=greater surface area for diffusion
Umbilical artery are clamped
pressure of systemic circulation increase
Edema
Increase in interstitial fluid volume
Umbilical vein
Ligumentum teres hepatis
As a result of the head folding, the heart and pericardial cavity lie...
ventral to the foregut -caudal to the oropharyngeal membrane
5 divisions of primitive heart
1. truncus arteriosus 2. bulbus cordis 3. atrium 4. ventricle 5. sinus venosus
Bulboventricular Loop
U-shaped loop formed when the bulbus cordis and ventricle grow faster than other regions causing the heart to bend upon itself -adult shaped -Day 23-complete Day 28
Upper trunk lesion contraction effect...
waiter's tip (Erb-Duschenne's palsy)
Fluid exchange across capillaries...
driven by hydrostatic and osmotic pressure -proteins contribute the most to osmotic pressure (impermeable)
Capillary hydrostatic pressure (Pc)
positive value -
Proteins in capillary transport...
-too big to cross -in fenestrated capillaries, limited amounts cross (kidney and intestines) -may cross in pinocytosis vesicles
Anterior antebrachial
flexion and pronation
Musculocutaneous nerves innervates...
cor. branch, biceps, branchialis
Umbilical arteries
medial umbilical ligaments
Ductus Venosus
shunt between IVC and umbilical vein -brings oxygenated blood from placenta to inferior vena cava, bypassing the liver
Osmotic force (pi*c)
positive value -
absorption
net fluid movement from the interstitium into the capillary
axillary nerve innervates
deltoid and teres minor
Umbilical vein is clamped at birth...
blood flow decreased from IVC -pressure on the right side is lower than the left
Suprascapular nerve innervates
supraspinatus and infraspinatus
Section 8
(50 cards)
Norwood Operation
Cut out the atrial septal defect and insert an artificial PDA from aorta and RPA
ST Segment
Beginning of ventricle repolarization -should be flat
The fetus requires an increasing oxygen supply as it grows. How are these increased oxygen needs met?
-Increased maternal blood supply to the placenta (Uterine flow increases 20-fold during pregnancy) -Plenty of fetal blood supply to the placenta (50% of cardiac output) -Higher hemoglobin concentration in the fetus (17-18g/dl) than in adult (12g/dl) -Fetal hemoglobin (HbF, α2γ2) has a higher oxygen affinity than maternal/adult hemoglobin (HbA, α2β2) -The Double Bohr Effect
T wave (ECG)
repolarization of the ventricular muscles
Ventricular Septal Defect (VSD)
most common shunt lesion
R wave (ECG)
bulk of the muscle of both ventricles gets activated with the endocardial surface being activated before the epicardial surface
P wave (ECG)
SA impulse spread through the right atrium to AV node
Features of fetal circulation
-Low resistant placenta receives 50% of the total fetal cardiac output -High resistant pulmonary circulation due to low pO2 and compressed alveoli -Relatively low resistant systemic circulation due to low pO2 -interestingly, the smooth muscle of the pulmonary arterioles responds to pO2 in an opposite manner to the smooth muscle of the systemic arterioles does. The mechanism for this response is unknown yet.
Sinus Venosus receives...
IVC and SVC -becomes smooth wall of atrium
6th pair (aortic arches)
left: left pulmonary artery, ductus arteriosus right: right pulmonary artery
obstructive shock
due to obstruction of blood flow -tension pneumo, pericardial tamponade
septic, anaphylactic, or neurogenic shock (DISTRIBUTIVE)
peripheral vasodilation -TPR (afterload) decreased -PWP and CVP decreased
Left-to-right shunt lesions
more oxygenated blood re-enters pulmonary artery -'step up' saturations in the pulm. artery
At the first breath the cardiovascular...
-Pressure in the right side of the heart decreases -Pressure in the left side of the heart increases as more blood is returned from lungs -Foramen ovale closes -Ductus arteriosis constricts (mainly due to higher pO2) -Systemic BP increase (due to higher pO2)
Aortic arches
6 aortic arches develop from aortic sac
Obstructive lesions (CHD)
valve stenosis
Primordial blood flow
Sinus Venosus --> Atrium --> Ventricle --> Bulbus Cordis --> Truncus Arteriosus
patent ductus arteriosus (PDA)
passageway (ductus arteriosus) between the aorta and the pulmonary artery remains open (patent) after birth -derived from 6th branchial arch vessel -arteries and veins are dorsal; heart is ventral -to get blood from the ventral heart to the dorsal aorta; initially bilaterally symmetric -neural crest cells help to direct aortic arch development; neural crest ablation results in aberrant aortic arch development
1st-3rd pair (aortic arches)
arteries of head and neck
shock
acute circulatory failure leading to inadequate tissue perfusion that results in generalized organ hypoxia -hypotension, low cardiac output, tachycardia, oliguria
Left umbilical vein
definitive umbilical vein
PR interval (ECG)
isoelectic portion that corresponds to AV node conduction
S wave (ECG)
small areas of the ventricles are activated at a rather late stage
Clinical consequences to VSDs...
-tachypnea, feeding difficulties, failure to thrive -cardiomegaly w/left ventricular and left atrial dilation -murmur -no cyanosis (unless w/right to left shunt)
hypovolemic shock
intravascular volume deficit -preload is decreased -CO, CVP (Central Venous Pressure) and PWP also decreased (Pulmonary Wedge Pressure) -most common
Fontan Operation
take all the venous blood and put into the lungs (5/6 yrs old) -change the saturations
At the first breath the lungs...
-Expansion of the pulmonary alveoli and pulmonary vessels -Pulmonary circulation: Low resistance (also due to higher pO2) and more bloodflow
Atrial partitioning
1. septum primum (containing foramen primum) grows from superior surface downward toward endocardial cushions 2. foramen secundum appears in septum primum; foramen primum disappears 3. septum secundum grows (containing foramen ovale) downward to endocardial cushions 4. septae fuse with endocardial cushions -afterward, left with non-overlapping foramen secundum and foramen ovale
Right vitelline vein
hepatic portal system -hepatic veins
Shunt lesions
loci where red and blue blood mix
The most common form of congestive heart failure (CHD) is...
Bicuspid aortic valve defect -can evolve into aortic stenosis
Treatment of Hypoplastic Left Heart Syndrome
Norwood Operation, Bidirectional Glenn Operation, Fontan Operation
5th pair (aortic arches)
degenerate
Ventricle partitioning
1. interventricular septum begins to grow from inferior surface upward toward endocardial cushions (but does not fuse with cushions) 2. spiral septum grows obliquely down toward endocardial cushions to separate truncus arteriosus into aorta and pulmonary trunk 3. IV septum, spiral septum, and endocardial cushions fuse to form membranous interventricular septum
Hypoplastic Left Heart Syndrome
-left side of heart is underdeveloped -need patent ductus arteriosus -need ascending aorta because only way to get blood to coronary arteries -could have so much pulmonary blood flow that it steals from systemic blood flow -e.g atrial septal defect, slit-like left ventricle, hypoplastic aorta
cardiogenic shock
myocardial pump failure -pump function decreased (CO, SV, EF-?l) -CO just decreased
ST wave (ECG)
isoelectric portion that correlates with the plateau of the ventricular action potential
At the end of placental circulation...
-Umbilical vein and ductus venosus close due to the loss of placental bloodflow -Umbilical arteries constrict due to the end of the placental bloodflow and higher pO2
Q wave (ECG)
The first area of the ventricular muscle to be activated is the IV septum, which activates from left to right
Bidirectional Glenn Operation
connect SVC to pulmonary artery (6 months)
Eisenmenger's Syndrome
severe pulmonary vascular disease from a longstanding unrestrictive shunt -when pulmonary v. resistance > Systemic V. resistance *clinical cyanosis, polycythemia, clubbing
Regurgitant lesions (CHD)
valvar insufficiencies
Anterior Cardinal Veins
left branchiocephalic veins -Superior vena cava
4th pair (aortic arches)
Left: arch of aorta Right: right subclavian artery
Fetal blood pressure...
created by the fetal heart -the fetal blood pressure decreases when passing through the placenta
Cardiomyopathies (CHD)
dilated, hypertrophic, restrictive, arrhythmic
Pulmonary Vascular Disease
-worst consequence of increased pulmonary blood flow -permanent, progressive, lethal changes in pulmonary arteriolar structure -at systemic pressures, risks begin at 6 months -at normal PA pressures, risk begin to increase in early to late teenage
PR interval
delay of AV node to allow filling of ventricles
QRS Complex
Depolarizion of ventricles, triggers main pumping contractions
Surgery required to fix VSDs when...
-VSD is unrestrictive -left-to-right shunt is 2:1 or greater -aortic valve distortion results in aortic insuffiency
Section 9
(50 cards)
osmoreceptor compensation
water retention, vasoconstriction, thirst
Inferior dislocation
Could impenge on quadruple. Space (axillary n and blood vessels)
Short term regulation of MAP is achieved through
neural and hormonal (epinephrine+) control of cardiovascular function -baroreceptor also short term
Dorsal Compartment of hand...
only tendons, no nerves b/c no intrinsic muscles
Carotid sinus
responds to increase/decrease in arterial pressure -branch of the glossopharyngeal nerve -traveling to brain
MAP prevents
the risk of vascular damage/rupture
Carotid sinus and Aortic nerve
synapse in the nucleus tractus solitarius (NTS)
Low pressure recptors respond to changes (increase) in blood volume...
-increase secretion of ANF (atrial natriuretic factor) -Decrease secretion of ADH -Cause renal vasodilation -Increased heart rate
acromioclavicular ligament
connects acromion to clavicle -capsular ligament
Mnemonic for carpal bones
Some Lovers Try Positions (Proximal) That They Can't Handle (Distal)
Upper limb rotates
90 degrees laterally (away from the body) during embryogenesis
Central Chemoreceptor is located...
medulla
Umbilical
T10 dermatome
Baroreceptor compensation
Sympatho-adrenal Response -sodium and water retention -increased heart rate -increased cardiac output -blood pressure normalizes -vasoconstriction
In the Renin-Ang II-Aldo system, Angiotensin II increases...
1. adrenal cortex (aldosterone)->kidney (Na+ reabsorption) 2. kidney (Na+/H+ exchange)->Na+ reabsorption 3. brain (thirst) 4. Arteriolar SMC (vasoconstriction), TPR
intervertebral foramen
-Opening formed by the inferior and superior notches on the pedicles of adjacent vertebrae. Allows passage of spinal nerves and vessels. -spinal nerve and dorsal ganglion run through
neural mechanisms
extrinsic regulatory mechanisms work to keep MAP at a constant level -MAP drops: bring back to normal -MAP rises: bring back down -controlled by negative feedback control
Components of Baroreceptor Reflex
1. Sensors (Receptor)= baroreceptors a. Stretch receptors in the walls of large arteries that monitor blood pressure 2. Afferent (Sensory) Neuron -Transmits impulse to CNS 3. Integration center = cardiovascular control center in brainstem -output from the center is the net effect of total afferent inputs -Set point that constitutes the set point is compared to a signal received from a recptor and if the regulated variable (MAP) is not the set point level 4. Efferents = autonomic nervous system (carries error signal information away fropm the CNS to the effector that controls the regulated variable) 5. Effectors = heart and arterioles -modifies activity to give a response to initial stimulus
renin-angiotensin-aldosterone system
Primarily affects blood volume -slow response time (gene transcription and protein synthesis required) -activated in response to a decrease in MAP
Hypothenar
1. Flexor digiti minimi 2. Abductor digiti minimi 3. Opponens digiti minimi
intertransverse ligament
between transverse processes -resists rotation
Ligamentum nuchae
helps keep the head erect -resists head flexion
Thenar is innervated by...
recurrent branch of the median nerve
juxta aglomerular apparatus (compensation)
vasoconstriction, salt retention
NTS
efferent to SNS, PNS -role is decipher how to respond to baroreceptors stimuli
Proximal row (carpal)
Scaphoid, Lunate, triquetrum, pisiform
Peripheral Chemoreceptor Reflex
Sense chemical composition of blood: O2, CO2, and pH -determine amount of ventilation needed -primarily regulate respiration *Decrease BP, Decrease Blood Flow, and Decrease PO2/ Increase PCO2
Sensitivity of Baroreceptors
Absolute level of pressure -changes in pressure -Can be altered by disease *Chronic hypertension-can increase set point (elevated blood pressure not seen as abnormal)
In the hand...
Ulnar is the major nerve; median is minor
Renin-Ang II-Aldo system response to decreased MAP
-sensed by barorecptors in afferent arterioles of the kidney->Renin->Angiotensin I->Angiotensin II
Renin-angiotensin-aldosterone mechanism (compensatory)
-all components lead to vasoconstriction -aldosterone leads to water conservation
Mean Arterial Pressure (MAP)
pressure exerted by circulating blood within the walls of the systemic blood vessels -Propels blood to rest of the tissues -provides for O2 and nutrient delivery -removal of waste products -pressure maintained throughout entire artery
aortic arch
responds to increase in arterial pressure -aortic nerve which then combines to vagus nerve -make sure its enough blood to perfuse to all tissues
coracoclavicular ligament
connects coracoid process to clavicle -extracapaular ligament -if torn=winged scapula
distal row of carpals
Trapezium, Trapezoid, Capitate, Hamate
Lumbricals are innervated by?
1st two-median last two-deep ulnar
MAP equation
MAP=COxTPR MAP= SV x HR x TPR
anterior longitudinal ligament
prevents hyperextension of spine
posterior longitudinal ligament
limits flexion of the spine
Peripheral Chemoreceptor located in...
Aortic Body or Carotid Body
Increased MAP
-response to increased CO -response to increased TPR
Lumbricals
attached to tendions of the profundus
MAP ensures
sufficient driving pressure for adequate tissue blood flow -keep from fainting
Thenar
1. Flexor pollicis brevis 2. Abductor pollicis brevis 3. Opponens pollicis
Arterial baroreceptors
negative feedback control of MAP -(mechanoreceptor-sensitive to presssure/stretch)
Angiotensin II
Activates AT1 receptor -Type 1 GPCR
Central Chemoreceptor Reflex Cushing Reaction
-maintain cerebral blood flow via cerebral chemoreceptors -Causes: increase intracranial pressure->compression of cerebral arteries->decrease blood perfusion->increase PCO2 and decrease pH -Effects: increase sympathetic outflow to blood vessels->vasoconstriction (redirect blood to the brain) and a dramatic increase in MAP
Long term control of MAP is achieved through regulation of blood volume through...
the renin-angiontensin-aldosterone system, which involves the kidney
Losartan
inhibits Angiotensin II
Nipple
T4 dermatome
Section 10
(50 cards)
Grade V shoulder
includes muscle damage (pain, loss of mobility, tenderness)
Common AV Canal
-Endocardial Cushion defect -Defiencies in atrial and ventricular septa -Left-to-right shunt between atria and ventricles -Clinical Findings (Enlarged right atrium and right ventricle) TREATMENT- surgical correction of complete common AV canal within the first year of life
V2 receptors (ADH)
-present in principal cells of renal collecting ducts -involved in water reabsorption in collecting ducts -maintains body fluid osmolarity
muscular Type of VSD
Excessive cavitation of the muscular wall
Cardiac accelerator center
Cardiac center that is part of the SNS -Increases SA node firing to increase hR; Increase AV node conduction velocity; increase ventricular contractility
shoulder dislocation
glenohumeral joint
Orthostatic Hypotension
dizzy or light-headedness upon standing up too fast -gravity pulls blood down and reduces SV and CO
Radical masectomy
removal of entire breast, all subcutaneous tissues, the lymph nodes, pectoralis major and minor; goes down to chest wall and remove deep fascia before other muscles
medial epicondyle fracture and repair
degenerative joint disease, elbow dislocation, occupational elbow disorders, Ulnar sulcus syndrome & cubital tunnel syndrome
persistent truncus arteriosus
-failure of conotruncal (bulbar and truncal) ridge develop -one vessel provides systemic, pulmonary, and coronary circulation -VSD is normally also present -Cyanosis is present at birth -Requires surgical repair to close associated VSD and to separate vessels
most common shoulder dislocation
inferior (muscle reacts and the humoral head ends up anterior to glenoid)
Ulnar Tunnel Syndrome
Compression of ulnar nerve at anterior wrist
Carotid sinus (location)
at bifurcation of internal and external carotid -responsive to increases in arterial pressure with blood moving to brain
The Carotid sinus nerve and the aortic nerve synapse...
in the nucleus tractus solitarius (NTS)
Osseeo-fascial compartment
anatomical area housing a group of muscles having a similar major action and a common innervation
Ventricular Septal Defects
-one of the most common CHD in live births
V1 receptors (ADH)
-present on vascular smooth muscle -cause vasoconstrictionof arterioles and increase total peripheral resistance
Sensitivity of Arterial Baroreceptors
-Absolute level of pressure -Changes in pressure -Rate of change of pressure (strongest stimulus is rapid change) -Altered by disease (such as hypertension-increase set point b/c elevated bp not seen as abnormal / decrease sensitivity to increase in arterial pressure)
Elbow dislocation...
olecranon sticking out
Dextrocardia
-The future apex of the heart is displaced to thre right side rather than the left side -Normally occurs with other cardiac anomalies -can occur with Situs Inversus
Upper limb compartments
9 compartments, 4 nerves, 2 brachial compartments
The higher the point of the lesion of the ulnar nerve...
the broader the outcome
Small VSD
-may be no symptoms -many close spontaneously by 4 years of age
Lower limbs rotate
medially
SA nodes (Autonomic inputs)
increase HR
Occupational elbow disorders
chronic, high frequency flexion/extension -ulnar nerve constantly stretched and extended
anterior interosseous nerve
innervation of pronator quadratus, flexor digitorum profundus of digits 2 and 3
Ventricular myocardium (Autonomics input)
increase contractility and SV
Membranous Type of VSD
Failure of development of membranous portion of IV septum
Latissimus Dorsi Flap (breast reconstruction)
LD muscle is cut from origin line on back and a flap is rotated around underneath the skin, and wrap around the implant on the chest wall and use it with its skin to rebuild the breast -unilateral procedure -sacrifice area for function for latissimus dorsi -nipple tattoo
Veins (Autonomic input)
venoconstrict and decrease unstressed volume (VRS)
TRAM flap (breast reconstruction)
Transverse rectus abdominis musculocutaneous flap -most widely used -contralateral (opposite side)
Cardiovascular Control Centers reside...
primarily in medulla and pons within brainstem
Upper limbs rotate
90 degrees laterally
modified radical masectomy
removal of lymph nodes, breast, pectoralis muscle lining, tries to keep pectoralis muscle
Atrial Septal Defects
Defect in the development of the atrial septum -incidence of 6.4/10,000 -Ostium secundum defects are the most common ASD, can be non-symptomatic into adulthood -associated with higher risk of stroke -present in 25% of individuals -Treatment only necessary if symptoms present
Extended radical mastectomy
more radical, go into chest cavity and remove nodal groups in chest wall (b/c of accessory drainage)
Aortic arch is innervated by
aortic nerve, which then combines with the vagus nerve (CNX)
Vasoconstrictor center
vasomotor center that is part of the SNS -produces vasoconstriction in arterioles and venules
Carotid sinus innervated by
carotid sinus nerve -branch of glossopharyngeal nerve (CN9)
MAP is measured at approximately...
100 mmHg
Aortic arch (location)
Primarily responsive to increases in arterial pressure
Ulnar Sulcus Syndrome & Cubital Tunnel Syndrome
Treat with Surgical release & anterior transposition of nerve
Tetralogy of Fallot (TOF)
-most common cause of cyanosis at birth -Pulmonary Stenosis: narrowing of pulmonary trunk -Ventricular Septal Defect: Bulbar ridges do not properly fuse -Overriding Aorta -hypertrophy of Right ventricle: needs to pump harder -"Tet" (cyanotic episodes) spell can occur after extertion -TREATMENT: prostoglandins may be given to keep ductus arteriosus patent; surgery
Arterioles (Autonomic inputs)
vasoconstrict to increase TPR
Septation of Bulbus Cordis and Truncus Arteriosus
-Migration of neural crest cells form the conotruncal (bulbar & truncal) ridges -Form spiral aorticopulmonary septum -Separates aorta from pulmonary trunk (outflow tract)
Anterior side of upper limb except biceps
flexion and pronation
Large VSD
-initial left to right shunt, which increases blood flowing through the pulmonary arteries leading to pulmonary hypertension and dyspnea -Pulmonary resistance can reverse the direction of blood flow (right to left) and lead to cyanosis
ligamentum arteriosum
This structure is a remnant of a fetal vessel that connected the pulmonary trunk and the aorta.
Cardiac decelerator center
cardiac centrer that is a part of the PNS. Decreases SA node firing rate to decrease HR
Section 11
(13 cards)