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Questions and Answers
Which type of hypersensitivity reaction is associated with IgE and mast cell activation?
Which type of hypersensitivity reaction is associated with IgE and mast cell activation?
What is the effector mechanism associated with Type III hypersensitivity reaction?
What is the effector mechanism associated with Type III hypersensitivity reaction?
Which immunoglobulin class is associated with chronic urticaria?
Which immunoglobulin class is associated with chronic urticaria?
What is the size of IgM in kilodaltons (kDa)?
What is the size of IgM in kilodaltons (kDa)?
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What is the normal serum level of IgA in milligrams per milliliter (mg/ml)?
What is the normal serum level of IgA in milligrams per milliliter (mg/ml)?
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What is the main effect of helminth infection, according to the text?
What is the main effect of helminth infection, according to the text?
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Which genetic factor is mentioned to affect levels of IL-4 secretion?
Which genetic factor is mentioned to affect levels of IL-4 secretion?
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What is the role of mast cells in allergic reactions?
What is the role of mast cells in allergic reactions?
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What is the main result of allergic reactions?
What is the main result of allergic reactions?
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How do epigenetic influences modify gene behavior?
How do epigenetic influences modify gene behavior?
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What causes allergic rhinitis and allergic asthma?
What causes allergic rhinitis and allergic asthma?
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Where is IgE produced in the body?
Where is IgE produced in the body?
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What is the suggested treatment for severe anaphylaxis?
What is the suggested treatment for severe anaphylaxis?
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What does the Hygiene Hypothesis propose regarding early childhood exposure to pathogens?
What does the Hygiene Hypothesis propose regarding early childhood exposure to pathogens?
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What effect does the presence of helminth have on allergies and asthma?
What effect does the presence of helminth have on allergies and asthma?
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During which stage of development does implantation occur?
During which stage of development does implantation occur?
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Which layers form from the inner cell mass during implantation?
Which layers form from the inner cell mass during implantation?
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What process gives rise to the three germ layers - ectoderm, mesoderm, and endoderm?
What process gives rise to the three germ layers - ectoderm, mesoderm, and endoderm?
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What is the main outcome of the three germ layers formed during gastrulation?
What is the main outcome of the three germ layers formed during gastrulation?
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Which book is mentioned as a recommended reading source for further study on the development of the respiratory system?
Which book is mentioned as a recommended reading source for further study on the development of the respiratory system?
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Which structure is replaced by non-functional cystic tissue in congenital pulmonary airway malformation?
Which structure is replaced by non-functional cystic tissue in congenital pulmonary airway malformation?
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What is the most common type of congenital diaphragmatic hernia?
What is the most common type of congenital diaphragmatic hernia?
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What is the incidence of oesophageal atresia and tracheoesophageal fistula in births?
What is the incidence of oesophageal atresia and tracheoesophageal fistula in births?
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What is the primary cause of respiratory distress syndrome in newborns?
What is the primary cause of respiratory distress syndrome in newborns?
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Which of the following is a component of VACTERL association?
Which of the following is a component of VACTERL association?
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During embryonic development, the fusion of which specific embryonic structures forms the central tendon of the diaphragm?
During embryonic development, the fusion of which specific embryonic structures forms the central tendon of the diaphragm?
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Which phase of lung development is characterized by the formation of primitive airway structures and vascularization?
Which phase of lung development is characterized by the formation of primitive airway structures and vascularization?
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What is the origin of the respiratory diverticulum (lung bud) during embryonic development?
What is the origin of the respiratory diverticulum (lung bud) during embryonic development?
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Which pharyngeal arches contribute to the development of the larynx in embryos?
Which pharyngeal arches contribute to the development of the larynx in embryos?
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What causes congenital diaphragmatic hernia, a condition occurring in 1 in 2000 births?
What causes congenital diaphragmatic hernia, a condition occurring in 1 in 2000 births?
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Which intercostal space is the midaxillary line located at?
Which intercostal space is the midaxillary line located at?
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At which level does the oblique fissure posteriorly lie?
At which level does the oblique fissure posteriorly lie?
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In the context of pneumothorax, what causes the lungs to tend towards a collapsed state?
In the context of pneumothorax, what causes the lungs to tend towards a collapsed state?
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Where is the safety triangle for chest drain placement located?
Where is the safety triangle for chest drain placement located?
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How many ribs need to be fractured to diagnose flail chest?
How many ribs need to be fractured to diagnose flail chest?
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Which of the following describes the boundaries of the “triangle of safety” for chest tube insertion?
Which of the following describes the boundaries of the “triangle of safety” for chest tube insertion?
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Which vertebral levels do the structures passing through the diaphragm typically correspond to?
Which vertebral levels do the structures passing through the diaphragm typically correspond to?
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What is the clinical significance of understanding the surface projections of the pleura and lungs?
What is the clinical significance of understanding the surface projections of the pleura and lungs?
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What happens during a pneumothorax?
What happens during a pneumothorax?
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What movements occur during respiration?
What movements occur during respiration?
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Which nerve innervates the diaphragm?
Which nerve innervates the diaphragm?
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At which vertebral level is the caval opening located?
At which vertebral level is the caval opening located?
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What is the primary role of the diaphragm in breathing?
What is the primary role of the diaphragm in breathing?
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Which vessels supply arterial blood to the diaphragm?
Which vessels supply arterial blood to the diaphragm?
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During forced inspiration, which muscles aid in increasing thoracic volume?
During forced inspiration, which muscles aid in increasing thoracic volume?
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Which type of hypersensitivity reaction is associated with Th1 cells and Th2 cells?
Which type of hypersensitivity reaction is associated with Th1 cells and Th2 cells?
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In Type II hypersensitivity reactions, antibodies usually bind to components of:
In Type II hypersensitivity reactions, antibodies usually bind to components of:
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Which condition is caused by antibodies binding to basement membrane collagen type IV, resulting in glomerulonephritis and pulmonary hemorrhage?
Which condition is caused by antibodies binding to basement membrane collagen type IV, resulting in glomerulonephritis and pulmonary hemorrhage?
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Type III hypersensitivity reactions are caused by antibodies directed to:
Type III hypersensitivity reactions are caused by antibodies directed to:
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What is the effector mechanism associated with Type I hypersensitivity reaction?
What is the effector mechanism associated with Type I hypersensitivity reaction?
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Type II hypersensitivity reactions are the result of antibodies, usually IgG, binding to components of:
Type II hypersensitivity reactions are the result of antibodies, usually IgG, binding to components of:
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Which type of hypersensitivity reaction is caused by antibody-antigen complexes?
Which type of hypersensitivity reaction is caused by antibody-antigen complexes?
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Which type of hypersensitivity reaction is entirely cell-mediated and does not involve complement?
Which type of hypersensitivity reaction is entirely cell-mediated and does not involve complement?
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In which autoimmune disease does the immune complex deposition lead to glomerulonephritis and pulmonary hemorrhage?
In which autoimmune disease does the immune complex deposition lead to glomerulonephritis and pulmonary hemorrhage?
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Which autoimmune disease is associated with the destruction of red blood cells and anemia?
Which autoimmune disease is associated with the destruction of red blood cells and anemia?
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Which site is NOT a common site for immune complex deposition?
Which site is NOT a common site for immune complex deposition?
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Which type of hypersensitivity reaction is associated with antibody-mediated immune complex formation to soluble antigens?
Which type of hypersensitivity reaction is associated with antibody-mediated immune complex formation to soluble antigens?
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Which autoimmune disease is characterized by the formation of granulomas in response to DTH reactions?
Which autoimmune disease is characterized by the formation of granulomas in response to DTH reactions?
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Which autoimmune disease is associated with the abnormal bleeding and thrombocytopenia?
Which autoimmune disease is associated with the abnormal bleeding and thrombocytopenia?
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In which autoimmune disease does the immune complex deposition lead to systemic vasculitis and rash?
In which autoimmune disease does the immune complex deposition lead to systemic vasculitis and rash?
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What is the main function of the larynx?
What is the main function of the larynx?
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Where is the laryngeal inlet located?
Where is the laryngeal inlet located?
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What is the primary composition of the larynx?
What is the primary composition of the larynx?
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At what vertebral level is the trachea located?
At what vertebral level is the trachea located?
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When is the laryngeal prominence most mobile?
When is the laryngeal prominence most mobile?
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Which of the following laryngeal cartilages is composed of elastic cartilage?
Which of the following laryngeal cartilages is composed of elastic cartilage?
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What is the most likely cause of a hoarse voice after thyroid surgery?
What is the most likely cause of a hoarse voice after thyroid surgery?
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In cricothyroidotomy, where is the vertical incision made to avoid the anterior jugular veins?
In cricothyroidotomy, where is the vertical incision made to avoid the anterior jugular veins?
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What is the primary cause of laryngospasm?
What is the primary cause of laryngospasm?
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What is the consequence of unilateral recurrent laryngeal nerve damage?
What is the consequence of unilateral recurrent laryngeal nerve damage?
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Which nerve innervates the larynx, except for the cricothyroid muscle?
Which nerve innervates the larynx, except for the cricothyroid muscle?
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Which arteries supply arterial blood to the larynx?
Which arteries supply arterial blood to the larynx?
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Where does venous drainage from the larynx occur?
Where does venous drainage from the larynx occur?
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To which lymph nodes does lymphatic drainage from the larynx occur?
To which lymph nodes does lymphatic drainage from the larynx occur?
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What are the clinical considerations related to the larynx?
What are the clinical considerations related to the larynx?
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Study Notes
Allergies and Their Treatment
- Allergy occurs when IgE triggers Mast cell degranulation
- IgE is produced by plasma B cells in lymph nodes or locally at the site of inflammation
- Certain antigens and routes of delivery favor IgE production
- Inhaled allergens can cause allergic rhinitis and allergic asthma
- Allergens entering through the skin cause rashes and other symptoms
- Ingested allergens can lead to symptoms such as diarrhea, vomiting, and hives
- Chemical mediators of allergic responses include lipids, toxic mediators, cytokines, and enzymes
- Treatment of allergies includes desensitization, blockade of effector pathways, and potential future therapies involving recombinant allergens and DNA vaccines
- Severe anaphylaxis should be treated with epinephrine injection
- The Hygiene Hypothesis suggests that early childhood exposure to Th1-inducing pathogens may prevent bias towards Th2 responses later
- Environmental pollution may not necessarily increase allergic asthma
- Allergies and asthma are lower in areas with high helminth burdens, and the presence of helminth may suppress allergy.
Development of Body Cavities, Lungs, and Larynx in Embryos
- Mesoderm develops into paraxial, intermediate, and lateral plate mesoderm, divided into parietal and visceral layers by intraembryonic coelom
- Lateral folding of the embryonic disc causes the entrapment of intraembryonic coelom into a closed body cavity, lined by somatic and visceral lateral plate mesoderm
- The embryonic disc folds in two planes, leading to the movement of the developing heart and septum transversum
- Primitive body cavities undergo partitioning, forming pleural cavities and pleuropericardial folds that form fibrous pericardium
- The diaphragm separates thoracic and abdominopelvic cavities, formed by the fusion of pleuroperitoneal membranes, mesentery of oesophagus, and myoblasts
- The central tendon of the diaphragm and its peripheral scaffold are formed by the fusion of specific embryonic structures
- The respiratory diverticulum (lung bud) develops from the foregut, with tracheoesophageal ridges fusing to form the tracheoesophageal septum, separating the trachea and esophagus
- Pharyngeal arches 4 and 6 contribute to larynx development, with associated cranial nerves
- Laryngeal muscles and cartilages come from the fusing of mesenchyme from arches 4 and 6
- Lung development involves generational divisions to create the bronchial tree, with four distinct phases from prenatal to childhood
- The four phases of lung development include pseudoglandular, canalicular, saccular, and alveolar periods, each characterized by specific changes in lung structure and function
- Congenital diaphragmatic hernia, occurring in 1 in 2000 births, can lead to abdominal organs entering the thoracic cavity, potentially requiring intervention such as fetoscopic endoluminal tracheal occlusion.
Anatomy and Mechanics of the Diaphragm
- The diaphragm is a musculotendinous sheet that separates the thoracic and abdominal cavity, with a central tendon surrounded by muscle.
- It has attachments to the margins of the inferior thoracic aperture, including the sternal part (xiphoid process, T8/9 vertebral level) and costal part (costal cartilages 7-10, ribs 11, 12).
- The diaphragm also has lumbar attachments, including the right and left crura, median arcuate ligament, medial arcuate ligaments, and lateral arcuate ligaments.
- The diaphragm has three major openings: caval opening (level of T8), oesophageal hiatus (level of T10), and aortic hiatus (level of T12).
- It is crossed by various structures, including the phrenic nerve, sympathetic trunks, splanchnic nerves, intercostal nerves, and vessels such as the superior epigastric vessels and musculophrenic vessels.
- The diaphragm's arterial supply includes superior phrenic, musculophrenic, and pericardiophrenic arteries, while its venous drainage mirrors the arteries.
- It is innervated by the phrenic nerve (C3, C4, C5) and receives additional peripheral sensory innervation from intercostal and subcostal nerves.
- The diaphragm plays a key role in the mechanics of breathing, primarily driving inspiration at rest by increasing thoracic volume and drawing air into the lungs.
- During inspiration, the diaphragm contracts, causing the domes to descend, while external intercostals act to move ribs superiorly and laterally, increasing thoracic volume and drawing in air.
- Forced inspiration involves the diaphragm aiding in increasing thoracic volume by raising ribs when anchored via the pericardium, with accessory muscles such as the SCM, scalenes, trapezius, pectoralis major, and minor, among others, aiding in the process.
- The surface anatomy of the lungs and pleurae includes the apex of the lungs being 3cm superior to the mid clavicle, and the midclavicular line being at the 6th rib for the lungs and the 8th rib for the pleurae, among other details.
- The lungs and pleurae have specific anatomical landmarks, such as the apex of the lungs, midclavicular line, midaxillary line, and scapular line, with corresponding levels for the pleurae.
Larynx Anatomy and Function Overview
- Larynx located inferior to the hyoid bone, connected to the thyroid and cricoid cartilages
- Composed of three large unpaired cartilages, four pairs of smaller cartilages, and membranes
- Various ligaments and membranes cover the cartilages, divided into vestibule, ventricle, and infraglottic space
- Intrinsic and extrinsic muscles control the airway, vocal cord tension, and diameter of rima glottidis
- The larynx is innervated by the recurrent laryngeal nerve, except for the cricothyroid muscle
- Muscle functions include protection/closure of airway, controlling the size of rima glottidis, and altering vocal ligament tension
- The larynx has a complex subconscious process for airway protection involving muscle coordination
- Innervation of the larynx is via the vagus nerve, with specific branches serving sensory and motor functions
- Arterial supply to the larynx comes from the superior and inferior laryngeal arteries
- Venous drainage occurs through superior and inferior laryngeal veins, draining into the internal jugular and brachiocephalic veins
- Lymphatic drainage from the larynx occurs to the deep cervical and pre/paratracheal nodes
- Clinical considerations include choking, anaphylaxis, laryngospasm, aspiration pneumonia, cricothyroidotomy, and recurrent laryngeal nerve damage
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Description
Test your knowledge of allergies and their treatment with this quiz. Explore the causes and symptoms of allergies, the role of IgE, and the various routes of allergen entry. Learn about the chemical mediators of allergic responses and the potential future therapies for treating allergies. Find out how severe anaphylaxis should be treated and discover the impact of early childhood exposure and environmental factors on allergies.
