| Flap 1 |
Flap 2 |
| Circulatory System Function | Distribution of nutrients/hormones; Transport of waste to excretory organs |
| Lymphatic Circulatory System | Lymph capillaries-closed-ended tubules; Lymph vessels; Empty to large vv. of circulatory system |
| Blood Circulatory System | Heart-pump; Arteries-blood away from heart, get smaller away; Capillaries-more numerous, thin-walled, exchange b/t blood and tissue; Veins-blood to heart, progressively larger |
| Heart | 4 Chambers-R and L atria-thinner-walled, receive blood from system(R) or lungs (L); Ventricles-thicker walled, distribute blood to lungs(R) or system(L); Valves maintain unidirectional flow, AV valves, pulmonary valve, aortic valve |
| Circulations | Pulmonary-R side of heart, sends deoxygenated blood from heart to lungs; Systemic-L side, sends oxygenated blood to all tissues |
| Cardiac Skeleton | Central region of heart surrounding valves, Dense CT, may calcify in older adults, provides support for valves and great vessels; Anchors cardiac m.; Annuli fibrosae surround valves; Trigona fibrosae-masses b/t annuli; Septum membranceum-part of IV septum |
| Heart wall | 3 layers-Endocardium-inner, lined with endothelium, subendothelium is loose CT, subendocardial-CT, nn., Purkinje fibers; Myocardium-middle, thickest layer, muscle, fibrous; Epicardium-outer, serous layer, mesothelium, Loose CT, vv, nn,ANS ganglia, adipose |
| Generation and conduction of impulse for heartbeat | Modified cardiac m. cells; SA node-wall of R atrium near SVC, cells spontaneously depolarize and initiate impulse, internodal tracts connect SA and AV nodes, IV bundle of His-Purkinje cells, L and R bundle branches-Purkinjes-conduct to apex and contracts |
| Blood vessels | Tunica Intima-inner; Tunica Media-middle; Tunica Adventitia-outer |
| Tunica Intima | Inner layer, endothelium lined, subendothelial CT, internal elastic lamina (in aa.) |
| Tunica Media | Middle layer-concentric layers of smooth m., elastic fibers, reticular fibers, proteoglycans, external elastic lamina (larger aa.) |
| Tunica Adventitia | Longitudinally arranged type I collagen, elastic fibers, continuous with CT of surrounding organs |
| Vasa Vasorum | In walls of larger vessels, provide nutrition for outer layers (media/adventitia) of large vessels, more frequently in vv. |
| Capillaries | 7 to 9 microns diameter, single layer of endothelial cells resting on basal lamina, cells held by tight junctions, pericytes-in capillaries adn post-capillary venules, outside endothelial layer, after tissue injury can proliferate to rebuild vessels |
| Continuous capillaries | Widespread in m., lung, CT, exocrine glands, n. tissue; no pores (fenestrae); pinocytic vesicles involved in transcellular transport |
| Fenestrated capillaries | Endothelial cells with fenestrae (pores) and continuous basal lamina; where rapid exchange occurs; kidney, intestine, endocrine glands |
| Sinusoidal capillaries | much larger diamerer, discontinuous endothelial wall with fenestrae, macrophages in gaps b/t endothelial cells, in liver, bone marrow, spleen |
| Anastomosing networks | Connects arterioles and venules, flow through network regulated by metarteriole, precapillary sphincter |
| Portal systems | 2 capillary buds separated by v. or a.; hepatic portal system-capillaries of gut drain to hepatic portal v. then empty to liver capillaries; kidney-glomerulus (capillary bed) drains to efferent arteriole then to peritubular capillaries |
| Aa. | Wall thicker than vv.; transport blood from heart to tissue, resist changes in BP in larger aa.; regulate bood flow in arterioles, large aa, medium and small arterioles |
| Large aa. | Elastic or conducting aa.; thick tunica intima, thick media-fenestrated elastic lamina, many layers of smooth m.; adventitia relatively thin |
| Medium aa. | Distributing aa., muscular aa., media has more smooth m., less elastin, prominent internal and external elastic lamina |
| Small aa. and arterioles | Tunica media 5 to 10 layers smooth m. in small aa., 2 to 4 layers in arterioles; adventitia-thin, blends in with surrounding CT |
| Vv. | Returns blood from tissue to heart, lower BP than aa.; thinner walls and larger lumens than corresponding a.; endothelial lined valves for 1-way flow; venules-sm, med, and lg vv.; postcapillary venules-similar to capillaries, larger lumen |
| Large vv. | Well-developed intima, thin media, thick adventitia-in vv. inferior to heart contains longitudinally arranged in bundles of smooth m. |
| Small and medium vv. | thin media, well-developed adventitia, valves |
| Lymphoid system functions | Return interstitial fluid to blood, filtration of lymph, filtration of blood, defense of body from invasion and damage by microorganisms and foreign substances |
| Lymphoid system components | Lymph vascular system, lymph, lymphatic tissue, lymphatic organs-primary-bone marrow-origin of lymphocytes, thymus-maturation of T-lymphocytes; secondary-lymph nodes, spleen, tonsils |
| Lymph vascular system | Lymph capillaries-closed-ended, lymph vessels-interrupted by lymph nodes, lymph trunks-empty into subclavian vv. |
| Lymphatic tissues | Reticular cells, lymphocytes, Lymph nodules, Unencapsulated lymphoid tissue |
| Reticular cells | Thymus-from endoderm, called epithelial-reticular cells, don't produce reticular fibers, participate in T-lymph maturation; Reticular cells of other lymph tissues-mesenchyme-mostly mesoderm, produce reticular fibers (Type III collagen) |
| Lymphocytes | B cells-humoral immunity, differentiate into plasma cells which make antibodies, form nodules; T cells-cellular immunity, multiple subclasses-helper, suppressor, cytotoxic, memory, etc.; don't form nodules |
| Lymph nodules | Unencapsulated aggregates of mostly B cells, primary nodules-uniformly dense staining, cells haven't been exposed to antigen; Secondary nodules-contain lightly stained central region (germinal center), cells responding to antigen, prolif into plasma cells |
| Unencapsulated lymphoid tissue | Diffuse lymphoid tissue-B and T cells, lamina propria under mucosa-digestive, respiratory and urinary tracts; Peyer's patches-aggregates of unencapsulated nodules in ileum; appendix-numerous nodules |
| Tonsils | Incomplete encapsulation in contact with epithelium; Waldeyer's ring in prox GI tract-palatine-paired-lat wall of oral pharynx, epithelium-strat squamous, non-keratinized with crypts; pharyngeal-single-sup, post pharynx-PCCE, hypertrophy produces adenoids |
| Lingual tonsils | Numerous-base of tongue-epithelium is strat squam, non-keratinized |
| Lymph nodes | In-line filters of lymph, afferent/efferent lymphatics, stroma, parenchyma, lymph circ., blood circ. |
| Lymph node stroma | Hilum-aa. and nn. enter, vv. and lymphatics exit; Capsule and trabeculae of CT, subcapsular sinus and peritrabecular sinuses, reticular cells and fibers |
| Lymph node parenchyma | Cortex-nodules of B cells, paracortex-accumulations of T cells; medulla-cellular cords and sinuses-cords mostly B cells with some plasma cells, sinuses partly lined with macrophages and reticular cells |
| Lymph node lymph circulation | Afferent lymphatics, subcapsular sinus, peritrabecular sinuses, medullary sinuses, efferent lymphatics |
| Lymph node blood circulation | Aa. enter at hilum, branch into stroma, capillaries in cortex, post-capillary venules in paracortex-lymphocytes exit blood to reside in node, vv. exit at hilum |
| Thymus | Lobulated, size varies with age, capsule with trabeculae delineates lobules, each lobule has medulla/cortex, stroma; parenchyma, medulla, vascularization |
| Thymus stroma | epithelial, reticular cells, no reticular fibers, cellular processes produce frameowrk supporting lymphocytes, secrete thymosin-for T cell differentiation |
| Thymus parenchyma | Cortex-thymocytes-immature T cells-not immunocompetent, macrophages eat thymocytes (many) |
| Thymus medulla | High concentration epithelial-reticular cells, larger lymphocytes, Hassall's corpuscles-unknown function, only in thymus |
| Thymus vascularization | capillaries in cortex (sheath of epi-ret cells), blood-thymus barrier |
| Spleen | Largest lymphoid organ, filters blood, destroys old RBCs, Produce activated lymphocytes in response to blood-borne antigens |
| Spleen stroma | Capsule of dense CT, trabeculae carry nn. and aa. from hilum to splenic pulp; carries vv. and efferent lymphatics from pulp to hilum; Reticular CT |
| Spleen parenchyma | Splenic pulp-white-around central aa., PALS-T cells, splenic nodules-B cells; red-splenic cords-cords of Bilroth, sinusoids, marginal zone-b/t red and white pulp |
| Cords of Bilroth | reticular cells and fibers, macrophages, lymphocytes, blood cells |
| PALS | Peri-arterial Lymph sheath-T cells |
| Red pulp sinusoids | elongated endothelial cells, transversely arranged reticular fibers, macrophages b/t endothelial cells, incomplete basal lamina |
| Marginal zone | B/t red and white pulp, lymphocytes-mostly B cells, macrophages act as antigen presenting cells, lymphocytes exit blood and enter white pulp |
| Spleen blood supply | Trabecular aa., central aa-surrounded by lymphocytes, penicillar aa (arterioles), arterial capillaries, closed circ-arterial capillaries empty into red pulp sinusoids, open circ-end in splenic cords and blood must pass into sinusoid wall |
| Spleen blood supply con't | Old RBCs lose flexibility and can't squeeze past endothelial cells; sinusoids, red pulp vv, trabecular vv. and splenic vv. |
| Immunity | Ability of organism to respond to and repel invasion by foreign substances, innate and acquired |
| Innate immunity | nonspecific, phys barriers, secretions with anti-microbial activity |
| Acquired immunity | Immune response, specific-direct to specific agent, cells require presentation of foreign substance to responder, responder that produces antibodies, responder that destroys cells |
| Antigens | Molecules recognized by imm cells, soluble or attached to cell, may be protein, polysaccharide, or lipid; epitope-specific portion of antigen recognized, usually 5 to 10 amino acids or sugar residues, antigen may have multi epitopes |
| Antibody characteristics | Produced by plasma cells, glycoproteins of Ig family, soluble or attached to lymphocytes, recognize and bid to specific epitope |
| Antibody structure | Multimeric protein-2 light chains and 2 heavy chains; Fc region; Fab region-antigen binding, hypervariable, 2 per molecule |
| Antbody classes | IgM, IgG, IgE, IgA, IgD |
| IgM | 1st antibody produced in initial immunity response, bound to B lymphocyte, stimulates clonal expansion and differentiation of plasma cells |
| IgG | Most abundant antibody in blood, produced in late primary and secondary response, facilitates destruction of bacteria and viruses |
| IgE | Fc region binds to receptor on mast cells and basophils, low levels in blood, antibody-mast cell coplex stimualtes release of histamine and other molecules |
| IgA | In secretions-saliva, tears, etc.; enzyme resistant, active against bacteria and viruses |
| IgD | Very low concentration, mostly bound to B lymphocytes |
| Lymphocyte Characteristics | Multiple subpopulations, distributed by membrane proteins-cluster differentiation (CD) markers, many are receptors |
| T lymphocytes | All have TCR (T cell receptors) on cell surface, only recognize epitopes bound to receptor (MHC) molecules on other cells, subpopulations distinguished by CD markers |
| CD4 | Helper T cells-central to immune response |
| CD8 | Cytotoxic T cells-cell-mediated response; T suppressor cells turn off response |
| B Lymphocytes | IgM bound to surface with Fab fragment exposed, active when bound to recognized epitope, clonal expansion-prolif of active B cells, differentiated into plasma cells and memory B cells, anamnestic response-powerful response to secondary exposure |
| MHC | Integral membrane proteins, combined with peptides from viruses or other foreign substances, display foreign antigens on cell surface, MHC I, MHC II |
| MHC I | on all cell surfaces, present antigen to cytotoxic T cells |
| MHC II | found on antigen presenting cells-macrophages, dendritic cells, activated T cell, etc.; presentation to helper T cell is central to coordination of immune response |
| Antigen processing | Macrophage-ingestion/partial digestion of foreign substance, presentation of foreign material on surface by MHC II, T cell-recognizes MHC II-antigen complex, binds to macrophage, activates cytotoxic T Cells, activates B cell to create plasma/antibodies |
| Phagocytosis | Cells-neutrophils, macrophages, Langerhan's, dendritic cells; remove bacteria by neutrophils, margination-attration of circulating neutrophils-endothelial cells secrete attractant molecules, neutrophils slow and adhere to endothelium |
| Diapedesis | movement of neutrophils b/t endothelial cells into CT |
| Digestive System Functions | Ingest, digest, absorb food |
| Digestive system components | Oral cavity, pharynx, esophagus, stomach, small and large intestines, rectum, anus |
| Associated digestive glands | Salivary glands, liver, pancreas |
| General Structure | Tueb with 4 layered wall-mucosa, submucosa, muscularis externa, serosa/adventita |
| Mucosa | Selective barrier, secretion/absorption, epithelium, lamina propria-loose CT, muscularis mucosa-smooth m. |
| Submucosa | Loose CT, blood and lymphatic vessels, Meissner's plexus-part of ANS, glands in esophagus and duodenum |
| Muscularis externa | Usually 2 layers smooth m. Auerbach's plexus-part of ANS |
| Serosa/Adventitia | Adventitia in areas where organ is embedded in other tissue; Serosa with mesothelium where there is a free surface |
| Esophagus | Transports food from mouth to stomach; mucosa-strat squam nonker; submucosal glands make mucus; muscularis externa-upper 1/3 skeletal, mid 1/3 both; lower 1/3 smooth m.; adventitia above diaphragm; serosa below diaphragm |
| Stomach functions | Convert ingested food to acidic chyme; exocrine-secretes pepsin, endocrine-secrete hormones |
| Stomach regions | Cardia, fundus/body-histologically identical, pylorus |
| Rugae | Longitudinal folds of mucosa/submucosa, non permanent-disappear when stomach fills |
| Stomach mucosa | Pits/glands; cells-stem cells-in neck region, mucous neck cells, parietal cells-HCl and intrinsic factor, chief cells-zymogenic granules contain pepsinogen and gastric lipase, enteroendocrine cells |
| Stomach muscularis externa | 3 layers-inner oblique, middle circular, outer longitudinal |
| Small intestine functions | Final digestion, absorption, endocrine secretion |
| 3 segments of small intestine | Duodenum, jejunum, ileum |
| Small intestine mucosa | Structures to increase surface area-plicae circularis-perm folds of mucosa/submucosa, villi, microvilli; crypts of Lieberkuhn; cells of mucosa; Peyer's patches in lamina propria of ileum |
| Small intestine cells of mucosa | Intestinal absorptive cells-enterocytes; columnar epi with microvilli; Goblet cells-protect/lubricate, increases in # as approach ileum; Paneth cells-base of crypts, secrete lysozyme; Enteroendocrine cells-CCK-stim pancreas/gallbladder(secretin-stim panc) |
| Small intestine submucosa | Brunner's glands in duodenum secrete alkaline mucus |
| Large intestine functions | Absorb H2O, produce mucus, form feces |
| Large intestine components | Cecum, Ascending colon, descending colon, transverse colon, sigmoid colon, rectum |
| Large intestine mucosa | No villi, glands of lieberkuhn (absorptive cells, goblet cells), extensive diffuse lymphoid tissue in lamina propria |
| Large intestine muscularis externa | Outer longitudinal layer-3 bands called tenaie coli |
| Rectoanal junction | Mucosa-epithelium changes abruptly from simple columnar to strat squam nonker, muscular mucosa disappears; submucosa-hemorrhoidal vv.; muscularis externa-inner circular layer forms internal anal sphincter |
| Salivary glands | Parotid, submandibular, sublingual |
| Saliva | Lubricates food, initiates digestion of carbs, immune function-secretes IgA and lysozyme |
| Salivary gland structure | CT capsule, lobules, serous acini, mucous, acini, myoepithelial cells-highly branches contractile cells within basal lamina |
| Salivary gland ducts | Intercalatedo-initial segs, simple cuboidal; striated-intralobular-cub to columnar, excretory-interlobular-strat cub to strat col; main duct empties to oral cavity-strat squam nonker. |
| Salivary gland innervation | By ANS, parasympathetic stimulates large amount of watery secretion, low protein; sympathetic stimulates small amount viscous saliva rich in organic material |
| Parotid gland | Largest gland, compound acinar, serous only-granules high in amylase; plasma cells in CT add IgA |
| Submandibular gland | Compund tubuloacinar gland, mucous and serous cells, serous demilune secrete lysozyme |
| Sublingual gland | Compund tubuloacinar gland, serous and mucous cells, serous cells only in demilunes |
| Pancreatic structure | Thin CT capsule with septa (divides into lobules), regionally divided into endo and exocrine glands, endocrine-islets of Langerhans (2% of total gland), exocrine-compound acinar gland |
| Pancreas-exocrine portion | Serous secretory units- digestion enzymes, duct system, secretions, hormonal control |
| Exocrine duct system | centroacinar cells-penetrate acinus, intercalated ducts secrete HCO3 to neutralize chyme in intestine, main excretory duct-duct of Wirsung; accessory duct-duct of Santorini |
| Exocrine secretions | Trypsinogen, carboxypeptidase, chymotrypsin, amylase, lipases, ribonuclease, deoxyribonuclease |
| Exocrine hormonal control | Chyme in duodenum stimulates enteroendocrine cells to release secretin and CCK-secretin-duct cells make HCO3, CCK-acinar cells-make digestive enzymes |
| Endocrine-Islets of Langerhans | Alpha cells make glucagon to increase blood glucose levels; Beta cells make insulin to decrease blood glucose levels; Delta cells make somatostatin, inhibits secretion of glucagon and insulin; PP cells (F cells) block CCK, decrease enzymes |
| Liver Stroma | Thin CT capsule (Glisson's capsule), hilum-portal v. and hepatic a enter, hepatic ducts and lymphatics exit; reticular CT |
| Liver functional units | Classic liver lobule, liver acinus, portal lobule |
| Classic liver lobule | Central v, portal areas at periphery-portal v, hepatic a, bile duct; hexagonal; dual blood supply-hepatic portal v (80%), nutrient rich from intestinal tract, blood from spleen, hepatic a (20%)-branch from celiac trunk, well-oxygenated blood |
| Liver sinusoids | Specialized large capillary, discontinuous fenestrated endothelial cells, Kupffer cells-macrophages; Space of Disse-b/t endothelial cells and hepatocytes |
| Hepatocytes | Functional units of liver, plates of cells, polyhedral, apical surface open to sinusoids, basolateral surfaces attach to other hepatocytes |
| Bile ducts | Drain bile from hepatocytes, bile canaliculus, Hering's canal, bile ducts of portal triads, L and R hepatic ducts, common hepatic duct, cystic duct, common bile duct |
| Liver function | Endocrine-plasma proteins, exocrine-bile production, metobolite storage-lipids as triglycerides, carbs as glycogens, vitamins-especially Vit. A; produces urea from deamination of amino acids, detox and inactivation of drugs |
| Gall bladder function | Concentrate bile, store bile |
| Gall bladder structure | Mucosa-simple columnar, no submucosa, CT binds to surface of liver, free surface covered with serosa |
| Integument function | Mechanical protection, protection from fluid loss, physical barrier, thermoregulation, receptor organ |
| Integument Structure | Epidermis-from surface endoderm, strat squam ker epithelium; Dermis-mostly mesoderm, dense irregular CT; hypodermis-not truly skin-loose CT, forms superficial fascia |
| Epidermis | 2 types, 5 layers, 3 cell types, pigmentation |
| Epidermis types | Thick-glabrous, smooth, nonhairy; Thin-hairy |
| Stratum basale | 1 layer thick, rests on basal lamina, highly mitotic, cuboidal to columnar cells |
| Stratum spinosum | Cuboidal cells, extensive desmosomes-"prickle cells", tonofilaments-keratin |
| Stratum granulosum | Keratohyalin granules-protein-no membrane, lamellar bodies-lipid, membrane-bound, sealant effect-waterproof, cells above die |
| Stratum Lucidum | Only in thick skin |
| Stratum Corneum | Dead cells, no organelles, high molecular weight keratin tonofilaments |
| Epidermal cell types | Keratinocytes-predominate; Langerhan's-originate in bone marrow, antigen-presenting cells; Melanocytes-from neural crest, make melanin, transfer melanin to cells of stratum basale and stratum spinosum |
| Epidermal pigmentation | Blood, carotene, melanin |
| Dermis Structure | Dense irregular CT, variable thickness, type I collagen and elastic fibers-provide strength/elasticity; fibroblasts/macrophages; Ground substance-high in hyaluronic acid, dermatan sulfate and chondroitin sulfate |
| Dermal layers | Papillary dermis, reticular dermis |
| Dermal blood supply | Arterial and venous plexuses b/t papillary and reticular dermis and b/t reticular dermis and hypodermis; Arteriovenous shunts can bypass superficial capillaries to conserve heat and increase BP |
| Dermal n. endings | Encapsulated-Meissner's corpuscles-in papillary dermis, touch; Pacinian corpuscles-depp dermis and hypodermis; deep pressure and vibration; Free-fine touch, temp; abundant around hair follicles |
| Sweat glands | Eccrine, wide distribution, simple, coiled tubular glands, secretory cells-simple cuboidal; duct-strat cuboidal, merocrine secretion |
| Hair | In thin skin, hair follicle-epidermal region; sebaceous gland-outgrowth of hair follicel, secretes sebum into follicle, holocrine secretion |
| Arrector pili m. | Smooth m. innervated by sympathetic division of ANS, contraction causes hair to stand up |
| Respiratory system functions | Conducts air for gas exchange, conditioning of air-clean, moisten, warm; respiration-gas exchange b/t air/blood |
| Respiratory General Structure | Tubes leading to lung, Lungs |
| Conducting passages | Conduct air only, nasal cavity, nasopharynx, oropharynx, larynx, trachea, extrapulmonary/intrapulmonary brochi, bronchioles, terminal bronchioles |
| Respiratory passages | Respiratory can take place, respiratory bronchioles, alveolar ducts, alveolar sacs, Alveoli |
| Larynx Function | Conduct air to trachea, generate speech |
| Larynx structure | Cartilages-hyaline and elastic, PCCE, epiglottis, vocal folds |
| Epiglottis | Separates larynx/pharynx, prevents food from entering trachea, elastic cartilage, strat squam nonker epi on lingual surface, PCCE on laryngeal surface |
| False vocal cords | PCCE, numerous glands in lamina propria |
| True vocal cords | Strat squam nonker epi, no glands, vocalis m. (skeletal) and vocal ligament |
| Trachea | Larynx to midthorax, mucosa-PCCE w/ goblet cells, prominent basement membrane; submucosa-combined w/ lamina propria, serous glands; Hyaline cartilage-16 to 20 C rings open posteriorly, ends connected by trachealis m. (smooth)/fibroelastic lig, adventitia |
| Bronchi | Extrapulmonary-1 to each lung, enter lung at hilum; Intrapulmonary-inside lung, multiple divisions; same structure as trachea, within lung-cartilage in plates, PCCE, smooth m. |
| Bronchioles | PCCE with goblet cells, no cartilage or glands, smooth m. |
| Terminal bronchioles | Simple columnar ciliated epithelium, no goblet cells, Clara cells-non-ciliated, secretory; smooth m. and elastic fibers |
| Respiratory bronchioles | Alveoli interspersed in walls, cuboidal ciliated epithelium, Clara cells, smooth m. and elastic fibers |
| Alveolar ducts | Smooth m., b/t adjacent alveoli |
| Alveolar sacs | Clusters of alveoli at end of alveolar ducts |
| Type I cells | Very thin squamous epithelium, majority of alveolus wall |
| Type II cells | In corners of alveoli, secrete surfactant |
| Alveolar septum | Wall b/t adjacent alveoli, alveolar epithelium, basal lamina, capilalries, CT cells-fibroblasts/mast cells, reticular fibers, macrophages-"dust cells", also in alveolar spaces |
| Alveolar pores | B/t adjacent alveoli, equalize air pressure |
| Blood-air barrier | Alveolar epithelium (Type I cells), capillary endothelium, fused basal lamina |
| Blood supply | Dual-nutrition of lung, oxygenation of blood; Pulmonary circulation-oxygenation of blood, pulmonary aa. to capillaries around each alveolus to pulmonary vv.; Bronchial circulation-typical systemic circulation, extends to resp. bronchioles, anastomoses |
