ANATOMY – REVIEW NOTES

1. The most distal bone of the upper limbs - C

a. clavicle c. phalanges
b. radius d. carpal bones

Proximal – refers to a structure located near the root of the limb

Distal – refers to a structure located away from the root of the limb

2. The glenoid fossa of the scapula articulates with which structure of the humerus - C
a. surgical neck c. head
b. anatomical neck d. acromion

3. The muscle used for forceful expiration is - B
a. intercostal muscle
b. rectus abdominis
SCAPULA
 Shoulder blade; a triangular bone that forms the
pectoral (shoulder) girdle
 Articulates --
o laterqlly with the humerus (glenohumeral
joint)
o anterolaterally with the
clavicle(acromioclavicular joint)
 Parts:
o POSTERIOR SURFACE
 SPINE – divides the posterior aspect
into
 SUPRASPINOUS FOSSA –
above the spine
 INFRASPINOUS FOSSA –
below the spine
 ACROMION PROCESS
 the lateral projection of
the spine of the scapula
 articulates with the
clavicle anteriorly
o ANTERIOR SURFACE
 SUBSCAPULAR FOSSA
 CORACOID PROCESS
o LATERAL ASPECT
 GLENOID FOSSA (Depression that
receives the head of the humerus)
c. serratus anterior
d. latissimus dorsi
QUIET SCALENE MUSCLES INC. AP DIAMETER
INSPIRATION INTERCOSTALS RIBS PULLED
DIAPHRAGM UPWARD
Levatores costarum
Serratus posterior superior

FORCED Muscles of quiet inspiration

INSPIRATION Serratus anterior
Pectoralis muscles

QUIET EXPIRATION Relaxation of the MUSCLES FOR QUIET INSPIRATION DECREASE AP

**Serratus posterior INFERIOR DIAMETER
RIBS PULLED
DOWNWARD
FORCED MUSCLES OF THE ANTERIOR ABDOMINAL WALL
EXPIRATION

4. The stomach is located in what region -B

a. Right upper quadrant c. Left lower quadrant
b. Left upper quadrant d. Right lower quadrant
5. The pulmonary veins are ____ in number? - C
a. 3 c. 4
b. 2 d. 1

PULMONARY ARTERIES
 Two main branches of the pulmonary trunk
 Carries DEOXYGENATED BLOOD from the right
ventricle to the lungs
PULMONARY VEINS
 Four in number
 Carries OXYGENATED BLOOD from the lungs into
the left atrium

6. One example of pivot joint: - A

a. atlantoaxial joint c. patella
b. sternoclavicular joint d. none

PLANE JOINT Sliding movement Sternoclavicular joint

Acromioclavicular joint

HINGE JOINT Flexion Elbow

Extension Knee
ankle

PIVOT JOINT Rotation Atlantoaxial joint

CONDYLOID JOINT Flexion Adduction Knuckle joints

Extension Abduction
**little rotation

ELLIPSOID JOINT Flexion Adduction Wrist joint

Extension Abduction
**NO ROTATION

SADDLE JOINT Flexion Adduction Carpometacarpal joint of thumb

Extension Abduction
Rotation
BALL & SOCKET JOINT Flexion Adduction Shoulder joint
Extension Abduction Hip joint
Rotation (medial and lateral)
Circumduction

7. The posterior boundary of the thoracic inlet is the - A

a. 12th thoracic vertebra c. sternum
b. 1st thoracic vertebra d. none

THORACIC OUTLET
 A space between the first rib and the clavicle through which the
brachial plexus and subclavian vessels pass from the neck
THORACIC INLET


8. The primer of the conducting system, and is also called the pacemaker of the heart - A
a. SA Node c. Purkinje fibers
b. AV Node d. Bundle branch

SINOATRIAL (SA) NODE (located at the R atrium)

↓
ATRIOVENTRICULAR (AV) NODE (lies in the interatrial septum)
↓
AV BUNDLE OF HIS (runs along the membranous part of the
interventricular septum)
↓
BUNDLE BRANCHES (runs along the muscular part of the interventricular
septum)
↓
PURKINJE FIBERS (terminal conducting fibers)

The conducting system of the heart is composed of modified

specialized cardiac MUSCLE CELLS that lie immediately beneath
the endocardium.
9. A muscle tissue of long spindle-shaped cells arranged in bundles or sheets and are involuntary * - A
a. smooth muscle c. cardiac muscle
b. skeletal muscle d. none

CARDIAC SKELETAL SMOOTH

striated striated No striation
branched unbranched Spindle
shaped
Periphery Periphery Central
INVOLUNTARY VOLUNTARY INVOLUNTARY

10. Divides the scapula into supra- and infraspinatus fossae - D

a. glenoid fossa c. acromion
b. suprascapular fossa d. spine of the scapula

11. The total number of spinal nerves in the nervous system - A

a. 31 c. 33
b. 30 d. 32

There are 31 pairs

8 cervical
12 thoracic
5 lumbar
5 sacral
1 coccygeal
Each spinal nerve is a MIXED NERVE (comprising of dorsal and ventral roots having sensory and motor
fibers)

12. The bifurcation of the trachea is at the level of the - D

a. sternal angle c. between T4 and T5 vertebrae
b. transverse ridge d. all of the above

The sternal angle is also referred to as the transverse ridge. It lies opposite the level of T4 and T5 vertebrae
posteriorly.

13. The blood vessel that carries oxygenated blood - C

a. aorta c. both
b. pulmonary vein d. neither

AORTA
 the the largest artery in the body
 divided into
o ASCENDING AORTA
 Gives off the R and L coronary artery
o ARCH OF THE AORTA
  3 MAIN BRANCHES (BLL)
 BRACHIOCEPHALIC ARTERY
 LEFT COMMON CAROTID ARTERY
 LEFT SUBCLAVIAN ARTERY
o DESCENDING
 Thoracic
 Abdominal branches (pupunta si CELIA sa SM IMus)
 CELIAC ARTERY
 SUPERIOR MESENTERIC ARTERY
 INFERIOR MESENTERIC ARTERY
Again, the PULMONARY VEINS CARRY OXYGENATED BLOOD from the lungs to the left atrium.
14. The organs located in the umbilical area include - D
a. liver c. pancreas
b. appendix d. intestines

R hypochondriac epigastric L hypochondriac

R lumbar umbilical L lumbar

R iliac hypogastric L iliac

15. The action produced when the thumb and the little finger come in contact - B
a. apposition c. lateral rotation
b. opposition d. medial rotation
16. Medial rotation of the foot - A
a. inversion c. dorsiflexion
b. eversion d. plantar flexion

17. The
direction of the movement of muscle during contraction - A
a. towards inserted portion c. either
b. towards the origin d. neither

MUSCLE ATTACHMENTS
ORIGIN – the part that moves less
INSERTION – the part that moves more
Therefore, the direction of the contraction is TOWARDS THE ORIGIN

18. The brachial plexus is composed of -B

a. C5 to C8 spinal nerves c. C6 to C8 spinal nerves
b. C5 to C8 and T1 spinal nerves d. none
 ROOTS LARGEST BRANCH
CERVICAL PLEXUS C1-C4
BRACHIAL PLEXUS C5-T1
LUMBAR PLEXUS L1-L4 FEMORAL n.
SACRAL PLEXUS L4-S4 SCIATIC n.

19. Axillary artery is the continuation of which blood vessel - C

a. brachiocephalic c. subclavian
b. common carotid d. jugular vein

20. Rotator cuff muscles include - D

 a. subscapularis c. teres minor
b. supraspinatus d. all

ROTATOR CUFF MUSCLES (SItS)

 SUPRASPINATUS
 INFRASPINATUS
 Teres minor
 SUBSCAPULARIS

The rotator cuff is composed of the

tendons of the four muscles above. It
stabilizes the shoulder joint.

21. The right lung has the following characteristics - D

a. it has 3 lobes c. it has 2 fissures
b. it has a cardiac notch d. A and C only

22. This anatomical plane divides the body in anterior and posterior halves - C
a. saggital c. coronal
b. frontal d. B and C only

SAGITTAL
PLANE

CORONAL PLANE

TRANSVERSE
PLANE

23. Flexors of the upper arm - D

a. brachialis c. biceps brachii
b. coracobrachialis d. all

FLEXION – when the angle between two bones decreases.

EXTENSION – when the angle between two bones increases.

ALL THE MUSCLE OF THE ANTERIOR COMPARTMENT OF THE ARM ARE FLEXORS.
ALL THE MUSCLES OF THE POSTERIOR COMPARTMENT OF THE ARM ARE EXTENSORS.
24. Above the trochlea anteriorly is what structure? This structure receives the coronoid process. - B
a. olecranon fossa c. acrominon
b. coronoid fossa d. coracoid process

On the distal part of the humerus:

ANTERIOR SURFACE
 Trochlea (pulley like projection)
 Capitulum (circular projection)
o When you see the trochlea and the
capitulum together, you are looking at the
anterior aspect of the humerus
 CORONOID FOSSA – located above the trochlea and
capituluml; receives the CORONOID PROCESS of the
ulna
POSTERIOR SURFACE
 You only see the trochlea (no capitulum)
 OLECRANON FOSSA – located above the trochlea;
receives the OLECRANON PROCESS of the ulna

25. The ulna is described as - C

a. more medial compared the radius c. both
b. has an olecranon process d. neither

On the anatomical position, with the palms facing forward, THE RADIUS IS LATERAL TO THE ULNA.

26. The proximal row of carpal bones consists of the following EXCEPT - B
a. lunate c. scaphoid
b. capitate d. triquetral

27. The most lateral of the distal carpal bones - C

a. hamate c. trapezium
b. trapezoid d. capitate
CARPALS
• Proximal row of carpals from lateral to medial
– scaphoid (3)
– lunate (4)
– triquetral (5)
– pisiform (6)
• Distal row of carpals from lateral to medial
– trapezium (7)
– trapezoid (8)
– capitate (9)
– hamate (10)

SHE LOOKS TOO PRETTY. TRY TO CATCH HER.

28. These are muscles connecting the upper limb to the vertebral column EXCEPT - D
a. trapezius muscle c. rhomboid muscle
b. levator scapulae muscle d. Serratus anterior muscle

Trapezius, Levator scapulae and rhomboid muscles are all muscles of the posterior thoracic wall. They all originate
from the vertebral column and they insert into the scapula.
The serratus anterior originates from the upper 8 ribs and inserts into the scapula.

29. The following structures drain into the right atrium EXCEPT - D
a. superior vena cava c. inferior vena cava
b. coronary sinus d. right pulmonary veins

The pulmonary veins drain into the LEFT ATRIUM.

30. The right main bronchus is described as - D

a. wider c. more vertical
b. shorter d. all

This is the reason why most foreign objects aspirated into the respiratory tract lodge into the RIGHT BRONCHUS.

31. The right bronchus has - C

a. superior and inferior lobar branch c. A and B
b. middle lobar branch d. none
32. The first heart sound is produced by contraction of the ventricles and the closure of _____ valves. - B
a. mitral and aortic c. tricuspid and pulmonic
b. mitral and tricuspid d. aortic and pulmonic

HEART SOUNDS

S1 (FIRST HEART SOUND) – LUB (low-pitched)

-produced by the closure of the
 MITRAL VALVE (guards LV from LA)
 TRICUSPID VALVE (guards RV from RA)

S2 (SECOND HEART SOUND)-DUB (high-pitched)

- produced by the closure of the semilunar valves
 AORTIC VALVE
 PULMONIC VALVE

33. The following are branches of the arch of the

aorta EXCEPT - D
a. brachiocephalic artery c. left subclavian
artery
b. left common carotid artery d. right
subclavian artery
34. The esophagus has constrictions at the following levels EXCEPT - B
a. where it crosses the (L) bronchus c. where it begins
b. where it crosses the (R) bronchus d. where it pierces the diaphragm

THREE CONSTRICTIONS OF THE ESOPHAGUS

1. WHERE IT BEGINS (level of 6th cervical vertebrae)
2. WHERE IT CROSSES THE LEFT MAIN BRONCHUS
3. WHERE IT PIERCES THE DIAPHRAGM (level of 10th thoracic vertebrae)

Remember that from the oral cavity, the esophagus continues to the stomach which is located on the LUQ.
Therefore, it is easy to assume that the direction is deviated to the left, hence it will cross the left main bronchus.

35. A structure is a flattened, bilobed organ, found lying between the sternum and pericardium. - B
a. thoracic duct c. thyroid gland
b. thymus d. tonsils

36. Mitral valve is located between - C

a. right and left ventricles c. left atrium and left ventricle
b. right atrium and right ventricle d. right and left atria

37. Blood from the right ventricle goes to the - C

a. left atrium c. lungs
b. heart d. aorta

38. The heart is directed _____. - B

a. downward and backward c. downward only
b. downward and forward d. upward

That is why you feel the APEX BEAT on the anterior chest -- at thelevel of FIFTH LEFT INTERCOSTAL SPACE (5LICS)

39. Blood from the lungs are directed back into the heart via - A
a. pulmonary vein c. aorta
b. pulmonary artery d. coronary sinus
** 40. The coronary sinus drains into the - B
a. superior vena cava c. pulmonary artery
b. inferior vena cava d. pulmonary vein

The right atrium is the supposed to be the best answer for this question.

41. The body of the lumbar vertebrae is described as - C

a. small c. kidney-shaped
b. heart-shaped d. wedge-shaped

VERTEBRAL BODY
Cervical – SMALL BODY
Thoracic – HEART-SHAPED
Lumbar – KIDNEY-SHAPED

42. The anterior border of the pelvic outlet is - D

a. sacrum c. symphysis pubis
b. ileopectineal line d. pubic arch

The sacrum is located posteriorly. It cannot be the answer. It actually is the posterior boundary of the PELVIC INLET.
The ileopectineal is the lateral boundary of the inlet; and the symphysis pubis is its anterior border.

43. The posterior end of the labia minora is termed - C

a. prepuce c. fourchette
b. frenulum d. none

LABIA MINORA
Anterior end – frenulum  clitoris
Posterior end - fourchette
44. The following are parts of the uterus EXCEPT - D
a. fundus c. cervix
b. body d. vagina

45. The shortest and least dilatable portion of the male urethra - B
a. prostatic urethrae c. penile urethrae
b. membranous urethrae d. external meatus
PROSTATIC URETHRA – widest
PENILE URETHRA – longest

46. The muscular coat of the urinary bladder wall is called - C

a. dartos muscle c. detrusor muscle
b. pelvic diaphragm d. none

47. The nerve supply to the penis -B

a. genitofemoral nerve c. genital branch
b. pudendal nerve d. femoral branch

48. The approximate length of the female urethra - B

a. 2 inches c. 1.5 cm
b. 1.5 inches d. 1.5 meters

49. The true pelvis is the area _______. - B

a. above the pelvic brim c. of the pelvic brim
b. below the pelvic brim d. none of the above

The true pelvis is the cylindrical space between the pelvic inlet and the pelvic outlet.
The pelvic inlet is also termed as the pelvic brim.

50. The levator ani muscle is composed of the following muscles - D

a. iliococcygeus muscle c. pubococcygeus muscle
b. puborectalis muscle d. all of the above
51. The boundaries of the pelvic inlet includes the following EXCEPT - C
a. sacral promontory c. coccyx
b. symphysis pubis d. ileopectineal line

52. Heart shaped vertebral body is characteristic of which of the following - C

a. sacral vertebrae c. thoracic vertebrae
b. lumbar vertebrae d. cervical vertebrae

53. Which of the following is incorrect - A

a. 8 cervical vertebrae c. 5 lumbar vertebrae
b. 12 thoracic vertebrae d. 5 sacral vertebrae

54. The first cervical vertebra is also called _____. - A

a. atlas c. dens
b. axis d. none of the above

C1 – ATLAS
C2 – AXIS
Dens is the vertical cephalad projection of the axis that articulates with the atlas to form the atlantoaxial joint.

55. The narrowest portion of the uterine tube is the _____. - B

a. infundibulum c. ampulla
b. isthmus d. fimbriae

INFAMIST (FROM LATERAL TO MEDIAL) Infundibulum  Ampulla  Isthmus

AMPULLA is the widest portion. It is where fertilization takes place most often.

56. The body of the vertebra is _____ to the spinous process. - A

a. anterior c. inferior
b. posterior d. superior

57. The analog of the scrotum in the female - C

a. labia minora c. labia majora
b. mons pubis d. vestibule

58. The structure found in between the vertebrae are called - B

a. hyaline cartilage c. fat pad
b. intervetebral disc d. none of the above

**59. These 2 important ligaments found in the pelvis divide the sciatic notches - C
a. pubococcygeus and pubotuberous c. pubotuberous and pubospinous
b. pubococcygeus and pubospinous d. none of the above

There are two important ligaments attached from the sacrum to two projections from the pelvis that divide the
sciatic notch:
SACROTUBEROUS LIGAMENT – sacrum to ischial tuberosity
SACROSPINOUS LIGAMENT – sacrum to Iliac spine
60. Foramen transversarium is present in which of the following vertebrae - A
a. cervical c. lumbar
b. thoracic d. sacral

61. What structure passes thru the vertebral foramen? - B

a. artery c. medulla oblongata
b. spinal cord d. lymphatic vessel

62. Which of the following is not present in the 7th cervical vertebrae
a. spinous process c. body
b. bifid spine d. lamina

The cervical vertebrae have a bifid spine except for the atypical vertebrae:
Atypical cervical vertebra:
ATLAS – no body/ very small body
AXIS – has a dens
C7 – no bifid spine; has the longest spinous process

63. The area in the vertebral column that does not have intervertebral disc - C
a. between C1 and C2 d. B and C
b. between C7 and T1 e. A and C
c. between S1-S5

The sacrum is a fused bone of 5 primitive bones.

64. Testes is the homologue of the ____ in the female - C

a. clitoris c. ovary
b. penis d. fallopian tube

65. The roots of the sciatic nerve would come from the following - A
a. L4-S3 c. L5-S3
b. L4-S2 d. L5-S2
66. Structure that attaches the hypophysis to the hypothalamus - A
a. infundibulum c. neural stalk
b. isthmus d. all of the above

67. This is referred to as the master endocrine gland - B

a. hypothalamus c. both
b. hypophysis d. neither

The hypophysis is also known as the pituitary gland.

68. The microscopic blind end sac of the lungs -B

a. bronchioles c. bronchi
b. alveolus d. alveolar duct

69. How many cranial nerves have only sensory innervations? - C

a. 6 c. 3
b. 7 d. 4

70. How many cranial nerves have only motor innervations - C

 a. 3 c. 5
b. 4 d. 6

71. Cranial nerves that pass the jugular foramen, EXCEPT - D

a. CN 8 c. CN 10
b. CN 9 d. CN 11

OLFACTORY Oh 1 Sensory

OPTIC Oh 2 Sensory

OCULOMOTOR Oh 3 Motor

TROCHLEAR To 4 Motor

TRIGEMINAL Touch 5 Both

ABDUCENS And 6 Motor

FACIAL Feel 7 Both

VESTIBULOCOCHLEAR Very 8 Sensory

GLOSSOPHARYNGEAL Good 9 Both

VAGUS Velvet 10 Both

ACCESSORY Ah 11 Motor

HYPOGLOSSAL Heaven 12 Motor

72. Olfactory cortex is located in what part of the brain - B

a. parietal c. both A and B
b. frontal d. neither A or B

73. The following muscles are supplied by the oculomotor nerve, EXCEPT - A
a. lateral rectus c. medial rectus
b. superior rectus d. inferior oblique

LR6 SO4 R3
LATERAL RECTUS is supplied by CN 6
SUPERIOR OBLIQUE is supplied by CN 4

The rest is supplied by CN 3

74. The following are innervated by spinal nerves - C
a. sternocleidomastoid muscle c. both
b. trapezius muscle d. neither

75. Cranial nerves that enter the superior orbital fissure EXCEPT - B
a. oculomotor c. ophthalmic
b. optic d. trochlear

76. This cranial nerve supplies sensory innervations to the skin, face and scalp - A
a. trigeminal c. facial
b. vagus d. abducens

Face motor: FACIAL

Face sensory: TRIGEMINAL

77. Opening of the parotid gland to the mouth is near the - B

a. 1st molar c. 1st premolar
b. 2nd molar d. 2nd premolar

78. Sensory nerve supply to the oral cavity - A

a. CN5 c. CN6
b. CN7 d. all of the above

79. A general part of the brain for higher nervous functions like perception, emotion and cognition - D
a. thalamus c. pons
b. cerebellum d. cerebrum

80. The C-shaped duodenum accomodates which structure - C

a. liver c. head of the pancreas
b. stomach d. tail of the pancreas
81. These are four small bodies embedded in the thyroid tissue - B
a. pineal glands c. prostate
b. parathyroid glands d. larynx

82. The main function of this organ is the storage of bile - B

a. liver c. spleen
b. gall bladder d. urinary bladder

Liver produces bile. Gall bladder stores it.

The spleen is a lymphoid tissue for immune responses.

83. A pouch of skin that holds the testicle - B

a. fats c. urethra
b. scrotum d. seminal vesicle

84. A gland found below the urinary bladder which secretes the seminal fluid - A
a. prostate gland c. bulbourethral gland
b. seminal vesicle d. thyroid gland

The prostate gland is directly inferior to the urinary bladder.

85. The largest of the salivary glands - C

a. sublingual c. parotid
b. submaxillary d. submandibular

86. The type of epithelium lining the respiratory passages - B

a. pseudostratified squamous c. stratified squamous
b. pseudostratified columnar ciliated d. cuboidal ciliated

87. The nerve that increases gastrointestinal motility - A

a. 10th CN c. 11th CN
b. 9th CN d. 5th CN

88. The following are direct branches of the abdominal aorta EXCEPT - B
a. celiac artery c. superior mesenteric artery
b. splenic artery d. inferior mesenteric artery

89. The main duct of the pancreas opens into the ___ part of the duodenum - B
a. 1st c. 3rd
b. 2nd d. 4th

90. The mucous membrane of the stomach is thrown into folds termed - B
a. villi c. chyme
b. ruggae d. none of the above

91. The most superficial of the muscles of the posterior compartment of the leg - A
a. gastrocnemius muscle c. soleus muscle
b. gracilis muscle d. tibialis muscle

92. The kidneys are - B

 a. intraperitoneal c. both
b. retroperitoneal d. neither

RETROPERITONEAL STRUCTURES
• DUODENUM (2nd, 3rd and 4th parts)
• DESCENDING COLON
• ASCENDING COLON
• RECTUM
• KIDNEYS
• ADRENAL GLANDS
• URETERS
• PANCREAS (except tail)
• AORTA
• INFERIOR VENA CAVA

93. The parasympathetic autonomic nervous system is known as

a. Thoracolumbar ANS c. both
b. Craniosacral ANS d. neither

Sympathetic ANS – thoracolumbar

Parasympathetic – craniosacral

94. Contraction of the pectoralis major muscles causes - A

a. adduction of the arm c. both
b. abduction of the arm d. neither

ADDUCTION – movement of the limbs toward the midline

ABDUCTION – movement of the limbs away from the midline.
Pectoralis muscle originates from the sternum and the ribs. It inserts into the coracoid process of the scapula.
Contraction of this muscle leads to ADDUCTION.

95. The femoral artery is a branch of the - C

a. popliteal artery c. external iliac artery
b. peroneal artery d. internal iliac artery

96. Contraction of the muscles of the anterior compartment of the leg leads to - C
a. extension of the ankle c. both
b. dorsiflexion d. neither

Dorsiflexion is also known as extension of the ankle.

97. The largest branch of the lumbar plexus - C

a. Sciatic nerve c. Femoral nerve
b. Obturator nerve d. Ilioinguinal nerve

98. The temporomandibular joint is a ______ joint. - D

a. fibrous c. cartilagenous (fibrocartilage)
b. cartilagenous (hyaline) d. synovial

Fibrous joint allows no movement.

Cartilagenous joint allows minimal or no movement.
Synovial joints allow great degree of movements.

99. Aggregations of lymphoid tissue (Peyer’s patches) are present in the mucous membrane of the - A
a. ileum c. both
b. jejunum d. neither

100. The cricoid cartilage is _______ to the thyroid cartilage - B

a. superior c. lateral
b. inferior d. medial

ADDITIONAL QUESTION AND ANSWERS

BARTHOLIN’S GLAND AND SKENE’S GLAND HOMOLOGY

The Bartholin’s gland in the female, also known as the greater vestibular gland, functions to promote lubrication in
the female during intercourse. IT IS HOMOLOGOUS TO THE COWPER’S (BULBOURETHRAL) GLAND IN THE MALE.

Skene’s gland in the female, also known as the lesser vestibular gland, IS HOMOLOGOUS TO THE PROSTATE GLAND
IN THE MALE.

HYALINE CARTILAGE IN THE RESPIRATORY TRACT

Bronchioles are the terminal segments of the conductive portion. At the transition from bronchi to bronchioles the
epithelium changes to a ciliated columnar epithelium, but most of the cell types found in the epithelium of other
parts of the conductive portion are still present. GLANDS AND CARTILAGE ARE ABSENT IN THE BRONCHIOLES. The
layer of smooth muscle is relatively thicker than in the bronchi.

SINOATRIAL NODE AS PACEMAKER OF THE HEART

Because of the high sodium ion concentration in the extracellular fluid outside the nodal fiber, as well as a
moderate number of already open sodium channels, positive sodium ions from outside the fibers normally tend to
leak to the inside.

The discharge rate of the sinus node is considerably faster than the natural self-excitatory discharge rate of either
the A-V node or the Purkinje fibers. Each time the sinus node discharges, its impulse is conducted into both the A-V
node and the Purkinje fibers, also discharging their excitable membranes. But the sinus node discharges again
before either the A-V node or the Purkinje fibers can reach their own thresholds for self-excitation.