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  <head>
    <title>084-01 Cardiovascular and respiratory histology from vessel wall to alveolar barrier</title>
    <ownerName>Integrated Medical Foundations</ownerName>
  </head>
  <body>
    <outline text="Cardiovascular and respiratory histology">
      <outline text="Organising principles">
        <outline text="Endothelium on walls adapted to function"/>
        <outline text="Airway conducts, then exchanges gas"/>
        <outline text="Structure changes along the pathway"/>
      </outline>
      <outline text="Heart wall">
        <outline text="Endocardium continuous with vascular intima">
          <outline text="Subendocardium: vessels, nerves, Purkinje fibres"/>
        </outline>
        <outline text="Myocardium of branching cardiomyocytes">
          <outline text="Atria thinner, some with natriuretic granules"/>
          <outline text="Left ventricle thickest: systemic pressure"/>
          <outline text="Mitochondria and dense capillaries">
            <outline text="Ischaemia rapidly impairs contraction"/>
          </outline>
        </outline>
        <outline text="Epicardium: visceral serous pericardium"/>
      </outline>
      <outline text="Fibrous skeleton, valves, conduction">
        <outline text="Dense tissue around valve orifices">
          <outline text="Anchors cusps, limits dilation"/>
          <outline text="Insulates atria from ventricles"/>
        </outline>
        <outline text="Valve layers: collagen, proteoglycan, elastic"/>
        <outline text="Nodes: small cells, few myofibrils"/>
        <outline text="Purkinje fibres: large, pale, glycogen-rich">
          <outline text="Rapid subendocardial conduction"/>
        </outline>
        <outline text="Fibrosis or ischaemia: block, re-entry"/>
      </outline>
      <outline text="Arterial wall">
        <outline text="Intima, media, adventitia">
          <outline text="Large vessels need vasa vasorum"/>
        </outline>
        <outline text="Elastic arteries buffer pulsatile output">
          <outline text="Systolic stretch stores energy">
            <outline text="Recoil sustains diastolic flow"/>
          </outline>
          <outline text="Internal elastic lamina indistinct"/>
        </outline>
        <outline text="Muscular arteries distribute to organs">
          <outline text="Prominent wavy internal elastic lamina"/>
          <outline text="Atherosclerosis arises in intima"/>
        </outline>
        <outline text="Arterioles set resistance, capillary pressure">
          <outline text="Hyaline: hypertension, diabetes"/>
          <outline text="Hyperplastic: severe hypertension">
            <outline text="Chronic downstream ischaemia"/>
          </outline>
        </outline>
      </outline>
      <outline text="Capillaries, venules, veins, lymphatics">
        <outline text="Continuous: muscle, lung, nervous tissue"/>
        <outline text="Fenestrated: endocrine, gut, kidney"/>
        <outline text="Sinusoidal: liver, spleen, marrow"/>
        <outline text="Pericytes stabilise vessels, regulate flow"/>
        <outline text="Postcapillary venules: leukocyte exit"/>
        <outline text="Veins: thin media, thick adventitia">
          <outline text="High compliance stores blood"/>
        </outline>
        <outline text="Judge wall-to-lumen ratio, not shape"/>
        <outline text="Lymphatics: overlapping cells, no erythrocytes"/>
      </outline>
      <outline text="Upper airway and trachea">
        <outline text="Pseudostratified ciliated columnar mucosa">
          <outline text="Vascular lamina propria warms air"/>
          <outline text="Seromucous glands humidify, trap particles"/>
        </outline>
        <outline text="Olfactory mucosa with bipolar neurons"/>
        <outline text="True folds: stratified squamous, few glands"/>
        <outline text="False folds keep respiratory epithelium"/>
        <outline text="Trachea: C-shaped hyaline rings">
          <outline text="Trachealis spans the open ends"/>
          <outline text="Irritation causes squamous metaplasia"/>
        </outline>
      </outline>
      <outline text="Bronchi and bronchioles">
        <outline text="Cartilage becomes discontinuous plates"/>
        <outline text="Smooth muscle proportionally prominent"/>
        <outline text="Arteries follow bronchi, veins in septa"/>
        <outline text="Bronchioles lack cartilage and glands">
          <outline text="Terminal bronchiole: last conducting airway"/>
          <outline text="Club cells: secretion, detoxification, renewal"/>
        </outline>
      </outline>
      <outline text="Gas exchange region">
        <outline text="Respiratory bronchioles interrupted by alveoli"/>
        <outline text="Elastic recoil drives passive expiration">
          <outline text="Elastic loss: emphysema, expiratory collapse"/>
        </outline>
        <outline text="Type one pneumocytes cover most surface"/>
        <outline text="Type two cells secrete surfactant">
          <outline text="Replace both types after injury"/>
        </outline>
        <outline text="Surfactant lowers surface tension">
          <outline text="Deficiency promotes collapse"/>
        </outline>
        <outline text="Barrier: surfactant, epithelium, lamina, endothelium">
          <outline text="Oedema and fibrosis thicken barrier"/>
          <outline text="Emphysema reduces surface area"/>
        </outline>
      </outline>
      <outline text="Defence, pleura, interpretation">
        <outline text="Alveolar macrophages clear particles"/>
        <outline text="Interalveolar pores can spread infection"/>
        <outline text="Pleural lymphatics drain via parietal stomata"/>
        <outline text="Air or fluid separates pleural layers"/>
        <outline text="Ask which compartment is abnormal"/>
      </outline>
    </outline>
  </body>
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