Nbde Part 1 Lymphbloodarteriesveins

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The paracortex is dominated by T-cells. Lacteals :lymph capillaries in the small intestine. Active follicles in cortical region are a source of T Cells. Inner medullary region is a source of plasma cells . Primary node drains into secondary node or central.node. Thoracic duct begins at level of T12 vertebra, 40cm long. Ascending aortic opening. Right lymphatic duct is approximately 1 cm long. Splenic vein and superior mesenteric vein form hepatic portal vein . Like thymus spleen posses only efferent lymphatic vessels Spleen develop from mesenchymal cells of the mesentery attached to the primitive stomach. Peyer's patches located in small intestine especially the illum. Pharyngeal tonsils no crypts has sinuses. Palatine tonsil many crypts no sinuses Lingual tonsils single crypts. Lymph node are the only lymphatic structure with efferent and afferent vessels. Inner Medulla of thymus(hassall's) corpuscle contains epithelioreticular cells. Red pulp in spleen contains rbc macrophage and lymphocytes White pulp :B Cells and periarterial lymphatic sheath(PALS) contains T Cells. Before birth formed elements produced also in yolk sac ,liver ,spleen,lymph nodes.

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Carbon dioxide binds to the amine group in the polypeptide chains of the hemoglobin. Single rbc contains up to 300 million hemoglobin molecules. Maximum capacity is eight oxygen atoms per hemoglobin molecule. Hemoglobin values Men:13-18/women:12-16/newborn:14-20. Albumin regulate vascular osmotic pressure Globulin :immunoglobulins Fibrinogen clotting factors hemostasis. Serum=blood-fibrinogen and clotting factors.

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Low hemoglobin :anemia,hyperthyroidism ,cirrhosis. High hgb:polycythemia,COPD,congestive heart failure. All plasma proteins are glycoproteins except Albumin. Albumins is extremely versatile (multi binding site for thyroxine,cortisol,heme,bilirubin...etc. Calcium =1-1.5kg in the body Liver syntheses only factor II,VII,IX,X.

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Iron=4-5 gram in the body. Iron stored in form Ferritin and hemosiderin,absorbed in upper small intestine,primarily in the duodenum. Iron combines with beta globulin apotransferrin to form transferrin,60% of excess iron stored in the liver. Iron can only be absorbed isns bivalent form (f2) reducing agent such as acrobat(vitmC) promote iron uptake. Hemochromatosis is iron storage disease deposition of iron in peripheral tissues. Bilirubin is a product of heme degradation. Increase in carbon dioxide and blood temperature and 2-3-bisphosphoglycerate (BPG) cause dissociation curve to shift to the right where the affinity of hgb to o2 is decreased.

Hemoglobin a is the normal hemoglobin Rbc has large quantity of carbonic anhydrase.

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The pulmonary and umbilical arteries are the only arteries that contain deoxygenated blood. The pulmonary and umbilical veins are the only veins that contains oxygenated blood. Alpha 1 adrenergic receptors found in arterioles of skin and splanchnic circulation,beta 2 adrenergic found on arterioles of skeletal muscles. Vascular compliance= increase in volume/increase in pressure. Compliance decrease with higher pressure. Sympathetic activation decreased venous compliance and return more blood back to the heart.

Most pressure drop occurs in arterioles. Blood flow =pressure gradient/resistance . The pressure is highest in the aorta and lowest in the venae cavae . The pulse pressure =systolic pressure-diastolic pressure.

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Stretch receptors in the atria of pulmonary circulations are stimulated by an expansion of blood volume ,they don't directly respond to changes in systemic arterial blood pressure. Tunica adventitia in veins is more prominent than tunica media,reverse in arteries .

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Carotid artery bifurcate at superior border of the thyroid cartilage. The right common carotid arise from brachiocephalic trunk while the left arise directly from Aortic arch. Internal carotid artery divided into middle cranial fossa into anterior and middle cerebral artery supply anterior three fifth of the cerebrum,vertebrobasilar artery supply posterior two fifth. Vertebral arteries are branch of subclavian artery. Carotid sinus body,innervated by glossopharyngeal nerve and vagus nerve,carotid sinus is stretch receptor or baroreceptor change in pressure while carotid body is a chemoreceptor change in co pressure. Middle cerebral artery is largest branch of ICA supply portion of frontal lobe lateral surface of temporal and parietal lobe primary motor sensory areas of the face throat hand and arm areas for speech . Lenticulostriate arteries=arteries of stroke,are thin walled and can be rupture.

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Atherosclerosis is the emergence of plaque between the basement of membrane and the endothelial cells of the tunica intima. Vasa vasorum(vasa vasora)=vessels of the vessels for nourishe the more external tissue of the blood vessel wall. The velocity is slowest in capillaries Capillaries have no tunica media nor adventitia . Common hepatic is a branch of the celiac trunk. Any artery its diameter is less than 5 mm is arterioles Facial artery branches cervical(tonsillar,ascending palatine,submental glandular) Facial artery branches facial(inferior superior labial,lateral nasal,angular) Between ramus and medial pterygoid muscle found lingual nerve and inferior alveolar nerve artery and vein. Lingual artery branch of ECA opposite the site of the greater cornu of the hyoid bone. Hypoglossal nerve cross the lingual artery. Tongue supplied by lingual artery , tonsillar branch of facial artery,ascending pharyngeal artery. Lingual veins drains into internal jugular vein. Celiac trunk originate at the of T12 Celiac has three terminal :left gastric ,common hepatic ,splenic. Splenic has three branches:pancreatic,left gastroepiploic ,short gastric . Left gastric give esophageal branches,it anastomoses with the right gastric artery. Common hepatic artery give three branches: right gastric, gastroduodenal,proper hepatic artery. Descending or thoracic aorta start at T4 Epistaxis =nosebleed. Maxillary artery divided into three branches by the lateral pterygoid muscle. Renal artery is a branch of abdominal aorta Nasal cavity supply is mainly from sphenopalatine branch of maxillary,anterior ethmoidal branch of ophthalmic and septal branch of superior labial branch of facial(maxillary artery,ophthalmic,facial artery)