Salivary Glands - Peyer’s patch

- serous cell o Appendix

o intercellular canaliculi o Tonsils
o microvilli o Ileum
o spherical N - Pancreas
- mucous cell o No mucus acini – purely serous  digestive enzymes
o no intercellular canaliculi o No striated ducts
o no microvilli o Pancreatic islet (Langer)
o long N o Intercalated ducts
- intercalated duct  Cub
o cub o Intra/interlobular duct
o microvilli  Low columnar
- striated duct  Goblet
o column o Main pancreatic duct
o no microvilli  Column
o handles majority of saliva modification  Goblet
- excretory duct o B cell most abundant  insulin  G into cells
o tuft cells - Liver
o microvilli o blood  liver (into)
- salivary gland parasymp bile  liver (out of)
o superior salivatory nuclei  CN7  Sub-Mn/l o Classic lobule (blood)
o inferior salivatory nuclei  CN9  parotid  PA  CV
Portal lobule (bile)
GI tract  3 CV  PA
- unique features: Portal acinar  distributing artery
o MM 3rd layer in mucosa  Zone 3: least O2/toxin
o ME: inner circle, outer long o Hepatocyte  bile
 Stomach: inner oblique Canaliculi
- GI tract parasymp Cholangioles
o Ganglion found in wall of GI organ itself Canals
o From vagus or pelvic splanchnic Interlobular bile duct
o Auer myenteric (ME) Hepatic duct
o Meiss submucosal (SubM)
- GI tract symp
o From thoracic or sacral splanchnic
- Stomach
o Parietal
 IntrAcellular canaliculi
 Tubulovesicular system
o Chief
 Zymogenic
 Pepsinogen
o Inner oblique
PAW - RAAS
- Psoas o Liver  Ang-sinogen
o L1-L4 o Ang II  adrenal cortex  aldosterone
o Flex/adduct (thigh/hip, column, trunk) o Aldosterone  DT (R Na)  inc BP
o Medial arc l. o ADH  CT (principal) (R H2O)
o Genitofemoral n. overlays - CT principle cells have distinct lateral membranes
o Femoral n. lateral
- R crus Pelvis
o Esophageal hiatus - inlet sep false (greater)/true (lesser)
o Esophagus and vagus n. - diaphragm sep pelvis/perineum
- Ab aorta - pelvic l.
o Median arc l. o sacro-Spinous
o T12-l4  pudendal n. overlays
o Aorta and thoracic duct o sacro-Tuberous
o Gonadal a. directly  pudendal n. under
o L renal v. crosses over aorta, under SMA o Obturator
- Quad lumb - Pudendal n.
o Lateral arc l. o Over sacro-Spinous l.
- Central t. o Under sacro-Tuberous l.
o IVC foramen o Next to ischial spine
o IVC and phrenic n.  Causes perineal compression
- IVC - nn. that stay in pelvis and don’t go to gluteal region:
o T8-L5 o piriformis (M)
o Shift R (overlay suprarenal) o perforating cutaneous nn. (S)
o Longer L renal than R renal - Obturator n.
- Greater spl  celiac  T6-9  referred epigastric (abdominal pain) o Only n. from lumbar plexus supplying pelvis (the rest are from
Lesser spl  SMA  T10/11  umbilicus the sacral plexus)
Least spl  IMA  T12-L1/2 - Sciatic foramen communicate w gluteal region
o Greater sciatic foramen from pelvic region
Kidney o Lesser sciatic foramen from perineal region
- Kidney  peri  renal  para capsules - Internal pudendal a.
- R lower at T12 o Bleeds out if injured penis
- Hilum A  P: AVU - Ejac d. = SV + VD
- Ureter under vss - Vesical uterine space  bladder & uterus/vagina
- Stones at ureteropelvic jcn Recto uterine space  uterus/vagina & rectum
- Renal lobe = cortex cap + medulla pyramid
- CT  Papillary duct of Bellini  minor calyx Reproductive
- Podocyte pedicel over BL in renal corpuscle - seminiferous tubule
(Myo-ET cells under BL in salivary glands) o ET – germinal
- Juxtamedullary apparatus LP (tunica propria)- CT
o DT + afferent + extraglomerular o Surrounded by interstitial (Leydig) testosterone
md + JG + mg - Sertoli
o JG  renin o Col
 Modified sm in TM of afferent o Apex at lumen
o Linked by tight jcns  BTB
o
 - SpermATO Foramen of head
o Gonia  primary (reduction) - jugular – carotid sheath, CN 9/10/11
o Primary  secondary (equational) - carotid – common carotid a.
- sermIO - lacerum – internal carotid
o Secondary  tid (transformation) - stylomastoid – facial n. & stylomastoid a.
- supraorbital – supraorbital VAN
Osteology - infraorbital – infraorbital br. of Mx n. (2nd division of CN5 trigeminal
- zygomatic arch bones - mental – mental nerve (previously called internal alveolar n,) & inferior
o Frontal alveolar a.
o Temporal - infratemporal fossa on side of head - Mx vein
o Zygomatic
o Mx Triangles
- Orbit margins - C3 – hyoid
o T: Frontal C45 – thyroid
o B: Zygomatic & Mx C6 – cricoid, trachea transition
o M: Frontal, Mx, Lacrimal - Subtriangles
o L: Zygomatic o Occipital
- Optic canal o Omoclavicular/subclavian
o In sphenoid bone - Facial CN7
- Nasal conchae o Stylomastoid foramen
o Inferior – 1 bone o Platysma
o Middle and superior – ethmoid bone o Suprf’l fascia
- Pterion - Glossopharyngeal CN9
o H shape o Bw int/ext carotid aa.
o Frontal o Provides sensory to carotid body (chemoR) and sinus (baroR)
o Parietal - Vagus CN10
o Temporal o Carotid sheath
o Sphenoid (greater) o Thru esophageal hiatus
- Infratemporal fossa o Pharyngeal n.
o Foramen ovale and spinosum opens into it  Bw int/ext carotid aa.
- Anterior cranial fossa o Recurrent laryngeal n.
o A: frontal  R: around subclavian
o P: sphenoid (lesser) bw esoph and trach
- Middle cranial fossa  L: around arch
o A: sphenoid (greater)  Assoc inf thyroid a. of subclavian’s thyrocervical
o P: dorsum sellae and petrous temporal ridge trunk
- Posterior cranial fossa  Compromise  GOITER
o A: occipital clivus and petrous temporal o Sup laryngeal n.
o P: occipital  Deep to int/ext carotid aa.
 Internal
 External
 Runs with sup thyroid a. of ext carotid
- Accessory CN11 - Cervical plexus
o Jugular foramen o Motor:
o SCM (key to triangle), trapezius  C1
 Ansa cervicalis
o C1-5
 phrenic
o Investing fascia o Sensory:
o Pops out posteriorly  Great auricular
- Hypoglossal CN12  Transverse cervicalis
o Supf’l to int/ext carotid aa.  Supraclavicular
o Wraps around occipital a. of ext carotid a.  Lesser occipital
- Sympathetic chain - Brachial plexus
o Prevertebral o Bw ant and middle scalene
- Anterior scalene
o Deep to carotid sheath
o Sep subclavian a/v
o Extends from base of skull o Divides subclavian a. into thirds
- Phrenic n. o Phrenic n. overlays
o Mixed - Midline vss
o Cervical plexus o Inferior thyroid v.
o Prevertebral o Thyroid ima a.
o Ant to ant scalene m. - Thyroid membrane
o Thru IVC foramen o Pierced by sup laryngeal a. of sup thyroid a. (ext carotid)
- Supf’l to int/ext carotid aa.
- Ansa cervicalis
o Digastric *key to carotid triangle
o Motor o Stylohyoid
o Cervical plexus o Hypoglossal CN12
o Plastered on but not a content of carotid sheath o Thoracic duct
o Wraps internal jugular v. - Bw int/ext carotid aa.
o Omo/sternohyoid, sternothyroid o Stylopharyngeaus m.
- C1 o Glossopharyngeal CN9
o Motor o Vagus (pharyngeal n)
- Deep to int/ext carotid aa.
o Cervical plexus
o Vagus (sup laryngeal n.)
o Thyro/geniohyoid - Danger space
- Suprf’l fascia o In: pterygoid (infratemoral fossa)
o Distinguishing feature: fat o Out: cavernus (mid cranial fossa)
o Sensory and motor nn opthalamic (orbit)
 M: facial - Pulse point (ext carotid a. br.)
 S: great auricular, transverse cervical, supraclavicular o Facial a.
- Investing fascia  Masseter
o Supf’l temporal a.
o Accessory CN11
 Ant ear
o SCM (key to triangle), trapezius  Found in parotid along with Mx a.
o Pierced by ext. jugular - Ascending pharyngeal a.
o Parotid o Off ext carotid a. at bifurcation
- Prevertebral fascia - Lingual a.
o Phrenic n. o Off ext carotid a.
o Sympathetic chain o Assoc hyoid (greater horn)
o Scalene mm. - Occipital a.
o Off ext carotid a.
- Arch and ant jugular v.
o Wrapper by hypoglossal CN12
o Bw supf’l and deep fascia - Thoracic duct
- Internal jugular v. o Supf’l to arteriole plane
o Carotid sheath o Internal jug and subclavian vv.
o Jugular foramen
o Wrapped by ansa cervicalis Parotid
- Mx & supf’l temporal aa. in parotid