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

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