2. Anatomy I p70-75
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- ANATOMY - CELL TYPE
- Cell Type - Blood Cell Differentiation
- True/False: Myeloblast --> Promyelocyte --> Metamyelocyte --> Myelocyte --> Stab cell --> Neutrophil, Eosinophil or Basophil
- False, Metamyelocyte is after myelocyte (Greek tip - 'meta' means after)
- A megakaryoblast becomes a ------------- then ----------------
- Megakaryocyte then platelet
- A reticulocyte is an immature -------------
- erythrocyte
- Monoblasts are progenitors of
- monocytes
- What is the progenitor of plasma cells and active T cells?
- Lymphoblasts
- Erythrocyte
- p. 70
- Describe the shape of rbc's
- Anucleate, biconcave, large SA:V ratio
- What is the rbc's source of energy?
- C2
- Why purpose does the large SA:V ratio serve in an rbc?
- easy gas exchange of O2 and CO2
- Define erythrocytosis
- Increased number of red cells
- Define poikilocytosis
- Varying shapes
- How is glucose metabolized in an rbc?
- 90% anaerobic and 10% HMP shunt
- What is the lifetime of the rbc?
- 120 days
- Importance of "physiologic chloride shift"?
- Membrane contains chloride-bicarbonate antiport which allows rbc to transport CO2 from the periphery to the lungs for elimination
- Leukocyte
- p. 70
- Name three types of granulocytes
- Neutrophils, eosinophils, basophils
- Name two mononuclear cells
- lymphocytes and monocytes
- Purpose of leukocytes?
- Defense against infections
- Normal levels of leukocytes?
- 4.000 - 10,000/ul
- Basophil
- p. 70
- What % of all leukocytes do basophils comprise?
- <1%
- True/False: Nucleus of basophil is trilobed
- False, bilobed
- Granules of a basophil are ------------ and stain with -------------- stains
- basophilic, basic (wow, tough one)
- Granules of a basophil contain
- heparin (anticoagulant), histamine (vasodilator), other vasoactive amines and SRS-A
- Mast Cell
- p. 70
- Function of mast cell?
- Mediates allergic reactions
- Upon degranulation, mast cells release
- histamine, heparin, and eosinophil chemotactic factors
- Mast cells bind which class of globulin
- IgE
- True/False: Mast cells are the same cell type as basophils
- False, they are the same structurally and functionally, but are not the same cell type
- Mast cells are involved in which type of hypersensitivity reactions?
- Type 1
- Which pharmacologic agent is used to prevent mast cell degranulation and what is it used to treat?
- Cromolyn sodium/asthma
- Eosinophil
- p. 71
- What % of all leukocytes do eosinophils comprise?
- 1-6%
- The nucleus of an eosinophil is ------------
- bilobed
- Function of an eosinophil?
- Defend against helminthic and protozoan infections
- Eosinophils are highly phagocytic for ---------------
- Antigen-antibody complexes
- What are the causes of eosinophilia?
- Neoplastic, Asthma, Allergic Processes, Collagen Vascular Diseases, Parasites (NAACP = mnemonic)
- What substances do eosinophils produce?
- histaminase and arylsulfate
- Neutrophil
- p. 71
- Function of neutrophil?
- Acute inflammatory response cell, phagocytosis
- What percentage of WBC's do neutrophils comprise?
- 40-75%
- Nucleus of a neutrophil is ----------------
- multilobed
- Primary granules in a neutrophil are called -------------
- lysosomes
- Describe primary granules of a neutrophil.
- Large, spherical, azurophilic
- Primary granules in a neutrophil contain --------------
- hydrolytic enzymes, lysozyme, myeloperoxidase and lactoferrin
- In what pathologic conditions do you see hypersegmented neutrophils?
- B12/folate deficiency
- Monocyte
- p. 71
- Shape of monocyte nucleus
- kidney shaped
- Cytoplasm of monocyte looks like --------------
- "frosted glass"
- In the tissues, monocytes differentiate into --------------
- macrophages
- Monocytes comprise what percent of all leukocytes?
- 2-10%
- Lymphocyte
- p. 71
- Describe nucleus of lymphocyte
- small, round, densely staining
- True/False: A lymphocyte has a large amount of dark cytoplasm
- False, small amount of pale cytoplasm
- What to B lymphocytes produce?
- antibodies
- Function of T lymphocytes?
- Cellular immune response and regulation of B lymphocytes and macrophages
- B Lymphocyte
- p. 71
- B lymphocytes are part of the -------------- immune response.
- humoral
- Where do B lymphocytes mature?
- Bone marrow (B = Bone marrow)
- What markers are present on B lymphocytes?
- CD19 and CD20
- B lymphocytes migrate to
- peripheral lymphoid tissue (follicles of lymph nodes, white pulp of spleen, unencapsulated lymphoid tissue)
- When B cells encounter antigen, they differentiate into --------- and produce ---------
- plasma cells/antibodies
- B cells function as antigen presenting cells (APC) via ------------
- MHC II
- Plasma Cell
- p. 71
- Nucleus of plasma cell is ----------- and has a -------------- chromatin distribution
- off-center/clock-face
- True/False: Plasma cells have abundant RER and well-developed Golgi apparatus
- TRUE
- Plasma cell neoplasm
- multiple myeloma
- Plama cells differentiate from --------- to produce large amounts of ---------- specific to a particular antigen
- B cells/antibody
- T Lymphocyte
- p. 72
- Function of T cells?
- Mediate cellular immune response
- T cells mature in the -------------
- Thymus
- What does CD stand for?
- Cluster of Differentiation
- Name four types of cells that T cells differentiate into?
- cytotoxic, helper, suppressor, delayed hypersensitivity
- Markers present on T helper cells?
- CD3, CD4
- Markers present on cytotoxic T cells?
- CD3, CD8
- Class ----- MHC molecules present antigen to CD--- positive T helper cells
- 2, 4
- Class ----- MHC molecules present antigen to CD--- positive cytotoxic T cells
- 1, 8
- Macrophage
- p. 72
- Function of macrophages
- phagocytize bacteria, cell debris and senescent red cells, and scavenges damaged cells and tissues
- Macrophages differentiate from circulating ---------------
- monocytes
- Macrophages are activated by
- gamma interferon
- Macrophages function as APC via ------------
- MHC II
- Airway cells
- p. 72
- Ciliated cells extend to -------------------
- respiratory bronchioles
- Goblet cells extend to ------------------
- terminal bronchioles
- Type ----- cells line the alveoli and take up what % of the alveolar surface?
- Type 1, 97%
- Type ----- cells secrete pulmonary surfactant and take up what % of the alveolar surface?
- Type 2, 3%
- Pulmonary surfactant is made up of ----------------
- dipalmitoylphosphatidylcholine
- What is the purpose of pulmonary surfactant?
- Decrease alveolar surface tension
- Which type of cells serve as precursors to both type 1 and type 2 cells?
- Type 2
- In amniotic fluid, what ratio is indicative of fetal lung maturity?
- lecithin:sphingomyelin ratio >2.0
- Function of ciliated cells?
- To sweep mucus secretions out of the lungs toward the mouth
- Microglia
- p. 72
- Microglia are CNS --------------
- phagocytes
- Embryonic origin of microglia?
- mesodermal
- True/False: Microglia are readily seen with Nissl stain
- FALSE
- Describe nucleus and cytoplasm of microglia
- small irregular nuclei, little cytoplasm
- In response to tissue damage, microglia transform into ------------
- large, ameboid phagocytic cells
- HIV-infected microglia form ----------------------- in the CNS
- multinucleated giant cells
- Oligodendroglia
- p. 72
- Function of oligodendroglia?
- To myelinate multiple CNS axons
- In Nissl stain, oligodendroglia appear as -------------
- small nuclei with dark chromatin and relatively little cytoplasm
- Oligodendroglia are the predominant type of glial cell in --------- matter
- white
- Oligodendroglia are destroyed in --------------------
- Multiple sclerosis
- Schwann Cells
- p. 72
- Each Schwann cell functions to myelinate how many PNS axons?
- One
- What is the function of Schwann cells?
- To promote axonal regeneration
- Name an example of a schwannoma
- acoustic neuroma
- Location of acoustic neuroma commonly associated with what anatomical landmark?
- internal acoustic meatus (CN VII and CN VIII)
- Gas Exchange Barrier
- p. 73
- See p. 73 for Gas exchange barrier diagram
- ANATOMY - EMBRYOLOGY
- p. 73
- Fetal landmarks
- p. 73
- Implantation of blastocyst is present in which week?
- 1
- The bilaminar disk is formed within which week?
- 2
- Gastrulation, primitive streak, notochord, neural plate begin to form
- Within week 3
- Neural tube formed, organogenesis, extremely susceptible to teratogens
- Weeks 3-8
- Heart begins to beat, Upper and lower limb buds begin to form
- Week 4
- When do genitalia begin to have male/female characteristics?
- Week 10
- From day 0 to implantation at end of week 1, name stages of embryogenesis
- Fertilization (day 0), zygote (day 2), morula (day 3), blastocyst (day 5), implantation (day 6)
- Teratogens
- p. 74
- Example
- Effect on fetus
- ACE Inhibitors
- Renal damage
- Cocaine
- Abnormal fetal development, fetal addiction
- DES
- vaginal clear cell adenocarcinoma
- Iodide
- congenital goiter or hypothyroidism
- 13-cis-retinoic acid
- extremely high risk for birth defects
- thalidomide
- limb defects ("flipper" limbs)
- warfarin, x-rays
- multiple anomalies
- fetal infections
- congenital malformations
- Umbilical cord
- p. 74
- how many umbilical arteries?
- 2
- what kind of blood do the umbilical arteries carry?
- deoxygenated blood from fetus
- how many umbilical veins?
- 1
- what kind of blood is carried by umbilical vein?
- supplies oxygenated blood from placenta to the fetus
- a single umbilical artery is associated with what anomalies?
- congenital and chromosomal
- Embryologic derivatives
- p. 74
- surface ectoderm
- adenohypophysis, lens of eye, epithelial linings, epidermis
- neuroectoderm
- neurohypophysis, CNS neurons, oligodendrocytes, astrocytes, pineal gland
- neural crest
- ANS, dorsal root ganglia, melanocytes, chromaffin cells of adrenal medulla, enterochromaffin cells, pia, celiac ganglion, Schwann cells, odontoblasts, parafollicular - C cells of thyroid, laryngeal cartilage
- mesoderm
- dura connective tissue, muscle, bone, cardiovascular structures, lymphatics, blood urogenital structures, serous linings of body cavities (peritoneal), spleen, adrenal cortex
- endoderm
- gut tube epithelium and derivatives (lungs, liver, pancreas, thymus, thyroud, parathyroid)
- what induces ectoderm to form neuroectoderm (neural plate)?
- notochord
- what is the postnatal derivative of the notochord?
- nucleus pulposus of the intervertebral disk
- Early Develpoment
- p. 75
- Name the precursor for the ectoderm and its purpose
- epiblast, invaginates to form primitive streak
- Cells from the primitive streak give rise to
- intraembryonic mesoderm and endoderm
- How many germ layers in second week and what are they?
- 2, epiblast and hypoblast (remember rule of 2's for second week)
- How many cavities in second week and what are they?
- 2, amniotic cavity and yolk sac (remember rule of 2's for second week)
- How many components to placenta in second week and what are they?
- 2, cytotrophoblast and syncytiotrophoblast (remember rule of 2's for second week)
- How many germ layers in third week and what are they?
- 3, (gastrula): ectoderm, mesoderm, endoderm (Rule of 3's for third week)
- Fetal Erythropoiesis
- p. 75
- In the 3-8th weeks, fetal erythropoiesis occurs in
- Yolk sac
- In the 6-30th weeks, fetal erythropoiesis occurs in
- Liver
- In the 9-28th weeks, fetal erythropoiesis occurs in
- Spleen
- Erythropoiesis occurs in the Bone marrow from the ---- week onward
- 28th
- Mnemonic for remembering fetal erythropoiesis?
- Young Liver Synthesizes Blood
- Heart Embryology
- p. 75
- Embryonic structure
- Gives rise to
- Truncus arteriosus
- Ascending aorta and pulmonary trunk
- Bulbus cordis
- Smooth parts of left and right ventricle
- Primitive ventricle
- trabeculated parts of left and right ventricle
- Primitive atria
- trabeculated left and right atrium
- Left horn of sinus venosus (SV)
- coronary sinus
- Right horn of sinus venosus (SV)
- smooth part of right atrium
- Right common cardinal vein and right anterior cardinal vein
- SVC
- Twinning
- p.75
- Monozygotic twins have ---- amniotic sacs, ----- placentas, ---- chorions
- 2,1,1
- Dizygotic (fraternal) twins have ---- amniotic sacs, ----- placentas, ---- chorions
- 2,2,2