Cardiopulmonary Practical I
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Contents I. Respiratory Histology ................................ 2 II. Vascular Histology ..................................... 3 III. Cardiac Histology ....................................... 3 IV. Radiology ................................................... 4 V. Cross‐Sectional Anatomy .......................... 4 VI. Lung Dissection ........................................ 4 VII. Heart Dissection ....................................... 5 VIII. Coronary Vessels ...................................... 5 IX. Mediastinal Dissection ............................. 5 This is not exactly a candidate for VH1’s “Best Week Ever.”
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Cardiopulmonary Practical anatomy test
Transcript of Cardiopulmonary Practical I
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Contents
I.RespiratoryHistology................................2 II.VascularHistology.....................................3 III.CardiacHistology.......................................3 IV.Radiology...................................................4 V.CrossSectionalAnatomy..........................4
VI.LungDissection ........................................4 VII.HeartDissection.......................................5VIII.CoronaryVessels......................................5 IX.MediastinalDissection.............................5
ThisisnotexactlyacandidateforVH1sBestWeekEver.
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TableI RespiratoryHistologyTissue Images Description Components Function
Respiratoryepithelium
Linerespiratorytractfromnasopharynxtoterminalbronchioles
PCCE(ciliatedcolumnar) Epitheliallining,sweepoutparticles
Gobletcells Containmucusdroplets&granules
Brushcells Numerousmicrovilli,sensoryreceptors
Basalcells Lieonbasallamina,mitotic
Smallgranulecells Neuroendocrine
Olfactoryepithelium
Notelackofcleargobletcells
LinessuperiornasalconchaLackgobletcells
PCCE(ciliatedcolumnar) Epitheliallining,sweepoutparticles
Olfactorycells Bipolarneurons,ciliaassmellreceptors
Bowmansglands Inlaminapropria,seroussecretions
Swellbodies(venousplexi) Engorgeevery30m,recoverfromdesiccation
Sustentacularcells Supportsurroundingcells
Larynx
ConnectspharynxtotracheaHyalinecartilage
Falsevocalfolds(VF)Upperpair,linedbyrespiratoryepithelium(Limage)
Truevocalfolds(VoF)Lowerpair,linedbysquamousepithelium,containvocalism.(VM,Rimage)
Trachea
10cmlongSplitsintobronchiatcarina(levelofsternalangle)
Cartilagerings 1620,hyalinecartilage
Fibroelasticligament Preventsoverdistensionoftracheallumen
Trachealism. Allowsforregulationoflumen
Bronchi
Rbronchusisshorter,wider,moreverticalthanLSecondary:3R,2L
PCCE Moregobletcells
Smoothmuscle Becomesmoreprominentinsmallerbronchi
Cartilage Becomeirregularplatesinsecondarybronchi
Terminalbronchioles
Lackglandsandcartilage
Simplecuboidalepithelium Ciliated,fewtonogobletcells
Claracells Secreteglycosaminoglycansfordetoxification
Smoothmuscle TargetofANSstimulation
Respiratorybronchioles
TransitionbetweenconductingandrespiratoryportionsAlveoliinwalls
SimplecuboidalepitheliumCiliated,fewtonogobletcells,transitionstosimplesquamousatalveolaropenings
Claracells Secrateglycosaminoglycansfordetoxification
Alveolarducts
Aroundrespiratorybronchiolewherealveolaropeningsareevident
Simplesquamousepithelium Nociliaorgobletcells
Alveolarsac Communicatebtw.ductandalveoliviaatrium
Elasticfibers Allowexpansionandcontraction
Reticularfibers Preventoverdistension
Alveoli
TypeIcellsandcapillarylumen TypeII;notegranules
Functionalunitofrespiration
Simplesquamousepithelium Nociliaorgobletcells
TypeIalveolarcells(97%) Siteofgasexchange,desmosomes&tightjcts
TypeIIalveolarcells(3%) Cuboid,secretesurfactant,lamellarbodies
Surfactant Dipalmitoylphosphatidylserine,surfacetension
Interalveolarseptum
Barrieracrosswhichgasexchangetakeplace0.20.5mthick
Basementmembrane FusionofcapillaryendotheliumandtypeIcell
Fibroblasts,reticularfibers Stabilizestructure
Macrophages Eliminatesmallparticlesnottrappedbycilia
Alveolarpores Connectadjacentalveoli,equalizepressure
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TableII VascularHistologyArtery Image Description Vein Image Description
Arterioles
Lackofsubendotheliallayer;theinternalelasticlimitingmembraneisnotapparentwiththelightmicroscope.
Oneortwolayersofsmoothmusclecellsinthemedia.
Poorlydevelopedorabsentadventitiaandnoexternalelasticlimitingmembrane.
Functionascontrolvalvesoncapillarybedsautonomicnervousinnervationandassistsincontrolofbloodpressure.
Venules
Characterizedbyanendotheliallining,anabsentmediaandadelicatecollagenousadventitia.
Functionsincellandfluidegress,i.e.releasedhistaminecausestheendothelialcellstoseparateexposingthebasallamina.Neutrophilsattachandcrossthebasementmembranetoentertheconnectivetissue.Histaminealsocausesarteriolecontraction,therebyincreasingvenousbloodpressureandsoincreasingfluidsmovingintotheconnectivetissue.
Smallarteries
Morethantwolayersofsmoothmusclecells.
Mayhaveaninternalelasticlimitingmembrane.
Assistinthecontrolofbloodpressure.
Smallveins
Similartovenulesbutlargerwithmediaandadventitia
Medium(muscular)arteries
Allcoatswelldefined. Mediaisprominentwithupto40
smoothmusclelayers. Bothinternalandexternalelasticlimiting
membranespresent.
Mediumveins
Circularlyarrangedsmoothmuscleintheirmediaandlongitudinallyarrangedsmoothmuscleintheiradventitia.
Themediaofmediumveinsismuchthickerrelativetothesizeofthelumenthanisthemediaofthelargevein.
Valvesmaybepresent.
Large(elastic)arteries
Intimacomposedofendothelium,athinconnectivetissuelayerandaprominentinternalelasticlimitingmembrane.
Thickmediawithabundantelasticfibersarrangedinfenestratedlaminae.
Theadventitiaiscomposedofelasticconnectivetissueandiswellvascularizedwithsmallarteriesandveins;vasavasorum.
Largeveins
Adventitiaismostprominentandcontainsnumerouslongitudinallyarrangedbundlesofsmoothmuscle.
Circularlyarrangedsmoothmuscleinnarrowmedia. Vasavasorumpresentinadventitia. Valvesgenerallypresent
Capillary Locations Description
Continuous muscle,connectivetissue,CNS,gonads,skinandformthebloodbrainbarrierSinglelayer ofendotheliumrolledbackuponitselftoform atubeCelljunctionsandabasallaminaarepresent.
Fenestrated gastrointestinaltract,endocrineglandsandinrenalglomeruliPores orfenestraeintheendothelialcellwallSometimescoveredbyathindiaphragm
Discontinuous spleen,bonemarrowandliverDiscontinuityorgapintheendothelialcellliningBasallaminaisincompleteormissing
TableIII CardiacHistologyTissue Images Description
Endocardium
Composedofanendotheliallining,basallaminaandsubendocardiallayerofconnectivetissueVeins,nerves,andtheimpulseconductingsystemarepresentinthesubendocardialregionCoverscuspsofheartvalvesPurkinjecellsaregenerally,largerthancardiacmusclecells,andcontainhighlevelsofglycogen
Myocardium Cardiacmusclefibers
Epicardium Serouscoveringofmesotheliumandalooseconnectivetissuesubepicardiallayer
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TableIV Radiology
TableV CrossSectionalAnatomy
TableVI LungDissectionLung MedialImage LateralImage Landmark Description
Left
Bronchus Inbetweenpulmonaryvessels
Pulmonaryartery Mostsuperiorhilaropening
Pulmonaryvein Mostinferiorhilaropening
Hilus Areaofattachmenttolungroot,containsbronchus&pulmonaryvessels
Cardiacimpression Onmedialsurface
Cardiacnotch Atanteromedialedge
Lingula Mostinferiorprocessoflung
ObliqueFissure Separatessuperiorandinferiorlobes
Grooveforaorticarch Apparentonmedialaspect
Right
Bronchus Eparterial:mostsuperiorofhilaropenings
Pulmonaryartery Inbetweenbronchusandpulmonaryvein
Pulmonaryvein Mostinferiorhilaropening
Obliquefissure Separatesinferiorfrommiddleandsuperiorlobes
Horizontalfissure Separatessuperiorfrommiddlelobe,endsatobliquefissure
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TableVII HeartDissectionChamber Images Landmarks Description
Rightatrium
Coronarysinus Emptiescoronaryvv.intoRA
SinoatrialnodePacemaker,locatedposteriorlynearopeningforsuperiorvenacava
AtrioventricularnodeMedialtofossaovalis,conductsimpulsestotheventricles
FossaovalisRemnantofforamenovale,onwallbetweenRAandLA
Rightauricle earshapedpouchPectinatemm. Parallelmusclesonauriclewall
CristaterminalisTerminalconnectorofpectinatemm.,unionofauricleandatrium
Rightventricle
Papillarymm. ControlclosingoftricuspidvalveChordatetendineae Connectvalveflapstopapillarymm.Moderatorband Muscular,preventsoverdistension
TrabeculaecarnaeIrregularmuscularcolumnsinventricularwall
Tricuspidvalve Rightatrioventricularvalve,3leaves
ConusarteriosusConicalpouchfromwhichpulmonaryarteryarises,lackstrabecularcarnae
Pulmonicvalve ValvefromRVtopulmonarya.
Leftheart Theleftsideisbrilliantlysimple:leftauricle,pectinatemm.,fossaovalis,openingsofpulmonaryvv.,mitralvalveAorta:openingsofLandRcoronaryaa.behindtherightandleftsemilunarcuspsoftheaorticvalve
TableVIII CoronaryVesselsVessel Location Supply/DrainageRcoronarya. OverRatrium RatriumPosteriordescendinga. Posteriorinterventriculargroove PosteriormuscleLcoronarya.circumflexbranch Inferiortopulmonaryvv. PosterolateralLventricle,anterolateralpapillarym.Lanteriordescendinga. Anteriorinterventriculargroove Anterolateralmuscle,apex,septumCoronarysinus Inferiortopulmonaryvv. Drainscardiacvv,emptiesintoRatriumGreatcardiacv. Anteriorinterventriculargroove Anterolateralmuscle,apex,septumMiddlecardiacv. Posteriorinterventricularsulcus PosterolateralLventricleSmallcardiacv. Rightcoronarysulcus Ratrium,Rventricle
TableIX MediastinalDissectionStructure Location Function ImagesThoracicduct Lower,posterior EmptieslymphintosuperiorVCAzygosv. AlongRspine,overlungroot DrainsRposteriorintercostalvv.Accessoryhemiazygosv. MiddleLposteriormediastinum Drainsmiddlepost.intercostalvv.Hemiazygosv. InferiorLposteriormediastinum Drainsinferiorpost.intercostalvv.Brachiocephalicvv. Superiormediastinum DrainintosuperiorvenacavaSuperiorintercostalvv. Inbetween1stand2ndribs DrainuppertwointercostalspacesSympathetictrunk Posteriormediastinum Sympatheticfibers
Splanchnicnn.GreaterT59,LesserT1011,LeastT12offsympathetictrunk
Greater adrenalmedulla,Lesserceliac,Leastrenal
Vagusn.(CNX) Posteromedialmediastinum ParasympatheticfibersPhrenicn.(C35) Anteromedialmediastinum InnervatesdiaphragmLrecurrentlaryngealn. Beneathligamentumarteriosum InnervateslarynxAorticarch Obvious! Carriesblooddirectlyfromheart
Brachiocephalictrunk Firstbranchoffaorta(BCS)BranchesintoRcommoncarotida.andRsubclaviana.
Lcommoncarotida. Secondbranchoffaorta(BCS) SuppliesneckandheadL.subclaviana. Thirdbranchoffaorta(BCS) SuppliesLarmCavalopening Diaphragm,Rofspine AllowspassageofinferiorVCAortichiatus Diaphragm,posteromedial Allowspassage ofaortaEsophagealhiatus Diaphragm,anteromedial Allowspassageofesophagus
