FIRST AID for the Basic Sciences: Organ Systems

Official Updates, Corrections, and Clarifications

Updated November 2009
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The Basic Sciences Team
Chapter age ! Correction"Clarification
Cardiovascular p. In !igure "#", the septum premium in the fourth image $bottom left% should
show the ostium secundum, as depicted in the third image $top right%.
Cardiovascular p. & The second row in Table "#' should also include (Stapedial artery and
hyoid artery.)
Cardiovascular p. "" The last bulleted point under (*ericardium) should read, (The visceral
layer, also +nown as the epicardium, is the thin innermost layer of the
pericardium.)
Cardiovascular p. ", The Clinical Correlation of aortic stenosis should read, (-ortic stenosis
$-S% causes a crescendo#decrescendo systolic e.ection murmur. The
murmur is best heard at the right second intercostal space and typically
radiates toward the carotid arteries and/or the cardiac ape0.)
Cardiovascular p. ", In Table "#1, in the (-ortic) row in the (Site of -uscultation) column, the
te0t should read, (2ight second intercostal space3.) In the second row of
the (Site of -uscultation) column, the te0t should read, (4eft second IS at
the SB).
Cardiovascular p. 5 In Table "#"', in the (S) row of the (Significance) column, the te0t should
read, (-t the beginning of the rapid ventricular filling.)
Cardiovascular p. ' The first bullet listed under (6aneuvers that affect baroreceptor refle0)
should read, (Increased S7S $sympathetic nervous system% output,
decreased *7S $peripheral nervous system% output8 leads to increase
in B*.) (Carotid occlusion, cutting afferents, orthostasis/lying to
standing, and fluid loss) should appear as a second#level bullet.
The second bullet listed under (6aneuvers that affect baroreceptor refle0)
should read, (Turning *7S on, turning S7S off decreased *7S will
dramatically decrease blood pressure.) Carotid massage, volume
loading, and weightlessness) should appear as a second#level bullet.
Cardiovascular p. 9 The sentence under (7et !iltration *ressure $*7:T%) should read, (Sum of
the Starling forces. 7ote that the force is positive if entering the capillary
$arteriolar end% and negative if leaving the capillary $venular end%.)
Cardiovascular p. & The second row of the first ;ey !act should read, (Septal $anterior% < =">
='> -nterior < =, =?> 4ateral < =,.)
Cardiovascular p.?? The fifth bullet under (Secondary @ypertension) should read,
(-ldosterone#producing tumor causes triad of hypertension, hypo+alemia,
and metabolic al+alosis.)
Cardiovascular p. ,5 The first !lash Bac+ should read, (=itamin B" deficiency also leads to
beriberi.)
Cardiovascular p. ,5 In Table "#', in the (Dilated) column of the (Clinical presentation) row,
the te0t should read, (Decreased :! and A=D 3)
Cardiovascular p. ,B The sentence in the third bullet point under (*resentation) (-ortic
Stenosis) should read, (Cea+ and delayed pulse at the carotid artery due to
stenosis $pulsus parvus et tardus%.)
Cardiovascular p. ,B In !igure "#,", S" should appear even to lower relative to S'.
Cardiovascular p. 15 The first sentence under (Diagnosis) of (=SD) should read, (The =SD
murmur 3best heard at the left sternal border.)
*age " of 1
Cardiovascular p. 1" In !igure "#,?, S" should appear even relative to S' $S' is usually not
changed relative to S"%.
Cardiovascular p. 1' The fifth bullet point under (*resentation) of (-ortic =alve 2egurgitation
$-2%) should read, (S and an early diastolic decrescendo murmur heard
best at the right intercostal space3.)
Cardiovascular p. 99 The Clinical Correlation should read, (-t 9#"5 days there is an increased
chance of rupture of the papillary wall due to the central softening.)
Cardiovascular p. 9B The sentence in the si0th bullet point under (Cardiac 2upture) should read,
(3often, #9 days after an 6I....)
Cardiovascular p. &, In Table "#,, there should be a downward pointing arrow depicting
decreased Ca
DD
e0cretion with use of ThiaEide diuretics.
Cardiovascular p. &B The first sentence under (6echanism of -C: Inhibitors) should read, (3
conversion of angiotensin I to angiotensin II.)
Cardiovascular p. B? In Table "#?", under (6echanism) of (7iacin $7icotinic -cid%) the te0t
should read, (In the liver8 2educes secretion of =4D4 resulting in less
formation of 4D4) and (In the adipose tissue8 Inhibits the lipolysis of
triglycerides by hormone#sensitive lipase, which reduces transport of free
fatty acids to the liver thereby decreasing hepatic triglyceride synthesis.)
Cardiovascular p. BB The row (Internal elastic lamina) under (=asa vasorum) should be deleted.
:ndocrine p. "' The last sentence in the !lash !orward should read, (It is a component of
the multiple endocrine neoplasia $6:7% syndrome types ' and $formerly
'- and 'B%.)
:ndocrine "& The fifth bullet point under (*resentation) of (@ypothyroidism) should
read, (Diastolic @ypertension.)
:ndocrine p. "?B The first ;ey !act should read, (*atients with hyperthyroidism may develop
osteitis fibrosa cystica, characteriEed by bony lesions and cystic
demineraliEation. The condition occurs when the boneFs normal cellular
and marrow elements are replaced by fibrous tissues.)
:ndocrine ", The third bullet point under (Synthetic *athways) for (Steroid @ormone
Synthesis) should read, ("9#G#@ydro0ilase converts pregnenolone and
progesterone into androstenedione and D@:-, both precursors of adrenal
androgens.)
:ndocrine p. ",9 In the second row of Table '#, in the second row under (Disorders) should
read, (*ituitary -CT@ hypersecretion $CushingHs disease%.)
In the third row, the arrow under (Cortisol) should point down $decreased%
and not up.
In the fourth row, both arrows should point down $decreased cortisol and
-CT@%.
:ndocrine ",B In the third row of Table '#'?, the arrow under (-CT@) should point up
$increased% and not down.
Iastrointestinal p."&, In the Treatment section of (Intestinal 6alrotation) (44J) should read
(24J) instead.
Iastrointestinal p. "B1 The clinical correlation should read (3occlusion of the left renal vein.)
Iastrointestinal p. "B1 In the !igure #B, the following corrections should be made8
4eaving the spleen8 (b) and not (c) represents vasa brevia.)
Derived from vena cava inferior8 (- < portal vein> B < splenic vein> C <
indicates the superior mesenteric vein.)
Iastrointestinal p. "B9 The first sentence under (4ymphatic Drainage of the II Tract) should read,
(3which in turn empties into the venous system at the .unction of the left
internal .ugular vein and the left subclavian vein.)
Iastrointestinal p. '5" The fourth bulleted point under (@istologic and !unctional Characteristics)
should read, (*arietal cells, which secrete hydrochloric acid and intrinsic
factor $I!%.)
The fifth bulleted point under (@istologic and !unctional Characteristics)
should read, (Chief cells, which secrete pepsinogen.)
Iastrointestinal p. '5B In the !lash Bac+, the correct spelling is (chyme.)
*age ' of 1
Iastrointestinal p. ',? In Table #",, the third bullet point under (Inherited hepatocellular
diseases) should read (IilbertHs syndrome8 Transient decrease in activity of
KD* glucuronyl transferase, which causes asymptomatic rise in indirect
bilirubin, associated with stress> common, affecting about ,L of the
population.)
Iastrointestinal p. ',, In *art B of !igure #,", the bo0 that appears at the top should read
(6ostly uncon.ugated hyperbilirubinemias.)
@ematology and
Mncology
p. 5 The fifth sentence of the second bullet point under (4ymphocytes) should
read, (...helper T cells $6@C II, CD ?, and CD %...)
@ematology and
Mncology
p.5 The first ;ey !act should read, (B lymphocytes e0press CD'" receptors,
which :B= uses for entry into the cell.)
@ematology and
Mncology
p. " The first sentence under (Cold -gglutinin Immune @emolytic -nemia
should read, (Ig6 autoantibodies $pathologic cold agglutinins% occur at
high titers and react at '&#" NC, and sometimes at 9 NC.)
@ematology and
Mncology
p. ", In the ;ey !act regarding iron deficiency anemia, the arrow before TIBC
should point up $increased%.
@ematology and
Mncology
p. '' In Table ?#,, *T for (@emophilia - and B) and (=on CillebrandFs disease)
should be () and *TT should be (.)
@ematology and
Mncology
p. ,5 The first sentence under (*aro0ysmal 7octurnal @emoglobinuria $*7@%
should read, (2are, acOuired clonal hematologic disorder that arises from a
mutation in the PIGA gene, which is essential for the synthesis of the
glycosylphosphatidylinositol $I*I% anchors used for surface protein
attachment. -s a result, 2BCs are more sensitive to complement#induced
lysis.)
@ematology and
Mncology
p. ,' The fourth bullet point under (G#Thalassemia) should read, (@b Bart8
:0cess P#globin chains form stable tetramers.)
@ematology and
Mncology
p. &9 The last paragraph and bulleted list should be replaced with the te0t that
follows below.
(The lateral compartment of the leg contains the an+le evertors and is
innervated by the superficial fibular nerve8
*eroneus longus8 :verts and plantar fle0es the an+le
*eroneus brevis8 :verts and plantar fle0es the an+le.)
7eurology p. ?1? In the first bullet point under (*resentation) of (-rnold#Chiari), the
sentence should read, (Type I may not show neurologic symptoms until
adolescence or adult life.)
7eurology p. ?11 In !igure 1#&, the fourth bullet under Type ', -rnold Chiari syndrome
should read, (*sychomotor retardation and developmental delays are
freOuently observed.)
7eurology p. ?11 In the bo0 within !igure 1#&, the third bullet under (Type I) reading,
(6eningomyelocele is common) should be deleted from Type I and placed
under Type II.
7eurology p. ?19 The first sentence under (@ydrocephalus) should read, (@ydrocephalus is
defined as an abnormal accumulation of cerebrospinal fluid $CS!% in the
ventricles, which in turn may lead to an increased intracranial pressure
$IC*%.)
7eurology p. ?1B The sentence under the first bullet point (Subarachnoid space) should read,
(4ies between the pia and the arachnoid and contains CS!. It is relatively
narrow space over the surface of the cerebral hemisphere, but it becomes
much wider in areas at the base of the brain. It terminates at the S'
vertebra.)
7eurology p. ?1B Correction within the bo0 in !igure 1#"58 The third bullet under
(Subarachnoid @emorrhage) should read, (-dult *olycystic ;idney
Disease3.)
7eurology p. ?95 In the first bullet of the ;ey !act, the correct spelling is (fle0ed.)
7eurology p. ?95 The second sentence under (:pidural @emorrhage) should read, (Imaging
shows a biconve0, lens#shaped enhancement with smooth borders.)
*age of 1
7eurology p. ?9" The first sentence under (=entricular System) should read, (@ydrocephalus
develops as a result of an e0cess accumulation of CS! in the ventricles,
which in turn causes ventricular dilation.)
7eurology p. ?9, The second sentence of the second paragraph under (MrganiEation) should
read, (...The Sylvian fissure $lateral fissure% divides the temporal lobes from
the frontal and parietal lobes.)
7eurology p. ?&, The first two bullets below the (Divisions) heading should be replaced with
the following te0t8
(-nterior limb8 2elatively little clinical significance.
*osterior limb8 Corticobulbar, corticospinal, and somatosensory.)
7eurology p. ?&9 In the eighth row of Table ,#9, the correct spelling is (amnesia.)
7eurology p. ?&B The second bullet point under (6a.or *athways) should read, (The *ur+in.e
cells pro.ect ipsilaterally to the deep cerebellar nuclei, especially the dentate
nucleus at which point they form inhibitory synapses.)
7eurology p. ?B? In !igure 1#', the middle set of eyes depicted for a lesion in the left 64!
should show the eye on the right#hand side loo+ing straight ahead.
7eurology p. ,'" The sentence under (4ambert#:aton syndrome) should read, (4ambert#
:aton syndrome is an autoimmune disease in which antibodies attac+ the
voltage#gated calcium channels on the pre#synaptic membrane of the
neuromuscular .unction.)
7eurology p. ,'' The second sentence of the third ;ey !act should read, (@igh hCI coupled
with low levels of estriol and G#fetoprotein indicate3)
7eurology p. ,'1 In the second to last paragraph, the first sentence should end with a period
and not a comma.
7eurology p. ,' In Table 1#',, the third row under presentation for epidural hemorrhage
should read, (CT is diagnostic and shows biconve0 disc3)
In the second row under presentation for subarachnoid hemorrhage, should
read, (...at the .unction of the *C- and posterior communicating
artery.)
7eurology p. ,? In !igure 1#1"8 *anels (B) and (D) represent parenchymal hemorrhage,
while panel (C) represents subarachnoid hemorrhage.
7eurology p. ,& The second sentence under (6ultiple Sclerosis) should read, (3increased
prevalence in people who lived at higher latitudes north of the :Ouator3)
7eurology p. ,?" In Table 1#'B, the sentence under (*athology for CilsonHs disease) should
read, (:0cessive copper accumulation occurs predominantly in8 $"% The
liver, leading to broad range of hepatic changes> $'% the basal ganglia,
leading to to0ic in.ury, and $% the eyes, ;ayser#!leischer rings.)
7eurology p. ,?' The fourth sentence in the paragraph under Diagnosis for 6S should read,
(The acute lesion shows perivenular cuffing with activated T cells $mainly
CD?D, some CD&D%, and macrophages.)
7eurology p. ,15 In !igure 1#1B, item " in the legend should read (subfalcine $cingulate%
herniation.) Item ? in the legend should read (transtentorial herniation.) In
the figure, the arrow labeled (?) should be moved so that it curves down
toward the center of the figure.
7eurology p. ,95 The first sentence under (6echanism) of Buspirone) should read,
(Buspirone is a partial agonist to the serotonin "- $@T#"-% receptors in the
brain.)
7eurology p. ,9& Knder (6echanism) the figure reference should be !igure 1#99.
*sychiatry p. 1', The first sentence under the presentation for alcohol should read, (3which
is caused by vitamin B" deficiency.)
2enal p. 1,' In the first row Table &#", (metanephric mesoderm) should be replaced
with (ureteric bud.)
2enal p. 1,1 The first sentence (;idney) should read, (The +idney is covered by a
capsule of fibrous tissue. Beneath this capsule are the corte0 and medulla,
which contain the functional components of the +idney.)
*age ? of 1
2enal p. 1,B In the figure legend for !igure &#1, delete (B < capillary, glomerular.)
2enal p. 119 The second sentence of the ;ey !act should read, (:C! volume changes to
maintain this balance.)
2enal p. 195 The first sentence under (Ilomerular !iltration Barrier) should read, (3
that separates the blood from BowmanHs space and is composed of two main
layers.)
2enal p. 19? Below the first eOuation, the e0isting te0t should be replaced with, (where
K*-@ is the urine concentration of *-@, = is the urine flow rate, **-@ is the
plasma concentration of *-@, and C*-@ is the clearance rate of *-@.)
2enal p. 19, The (*-S) label in !igure &#"B should read (*BS.) -lso, QBS should appear
below QIC.
The te0t that begins above !igure &#"B, should be changed to read (where
;f is the filtration coefficient, *IC is the glomerular capillary
hydrostatic pressure, *BS is the bowmanHs space hydrostatic pressure,
QIC is the glomerular capillary plasma colloid osmotic pressure, QBS
is the bowmanHs space interstitial colloid osmotic pressure....)
2enal p. 11& In !igure &#",, the correct captions for the clinical implications are as
follows8
Diarrhea8 IC! 7C, :C! decreased, Msm 7C
Cater deprivation8 IC! decreased, :C! decreased, osm increased
-drenal insufficiency8 IC! increased, :C! decreased, Msm decreased
Infusion of isotonic 7aCl8 IC! 7C, :C! increased, Msm 7C
@igh 7aCl inta+e8 IC! decreased, :C! increased, Msm increased
SI-D@8 IC! increased, :C! increased, Msm decreased
2enal 1&B The second bullet point under (-cid#Base @omeostasis8 The 4ungs) should
read, (3promoting retention of CM' and a decrease in p@.)
The third bullet point listed under (-cid#Base @omeostasis8 The 4ungs)
should read, (3increased respiratory rate, decreased CM' and an
increase in p@.)
2enal p. 1B' In !igure &#'B, under (6etabolic -l+alosis), the compensation should
indicate, (*CM' arrow up by 5.1#5.9 and up arrow for @CM
#
.)
2enal p. 9'" The first sentence under *resentation of @ypercalcemia should read, (3may
produce :CI changes $shortening of the JT interval3%.)
2enal p.9'? In Table &#'", the first bullet under (:lectrolyte changes) for (4oop
Diuretics) should read, (@ypo+alemic 6etabolic -l+alosis.)
2eproductive p. 99, In Table B#"", the te0t in the (Cardiovascular) row is misaligned and should
read as follows below.
(@eart rate8 Iradually increases '5L
Blood pressure8 Iradually decreases "5L by ? wee+s, then increases
to prepregnancy values
Stro+e volume8 Increases to ma0imum at "B wee+s, then plateaus
Cardiac output8 2ises rapidly by '5L, then gradually increases an
additional "5L by '& wee+s
*eripheral venous distention8 *rogressive increase to term
*eripheral vascular resistance8 *rogressive decrease to term)
2eproductive p. &", The ;ey !act should read, (!ifty percent of choriocarcinomas are derived
from complete moles, ''L from full#term pregnancies, and ',L from
spontaneous abortions or ectopic pregnancies.)
2eproductive p. &'B The last sentence in the paragraph describing (@igh#ris+ @*=) should
read, (@*= types "1 and "& integrate in 3and inactivate the tumor
suppressor functions of p, and 2b...)
2espiratory p. &?9 In the last ;ey !act, the figure number listed should be !igure "5#"".
2espiratory p. &1? In the fourth bullet point below (Distribution of *ulmonary Blood !low,)
(=/J < &) should be replaced with (=/J < R.)
2espiratory p. &19 In the second bullet point from the bottom, (=/J < &) should be replaced
with (=/J < R.)
*age , of 1
2espiratory p. &1B The second to last sentence under (Mbstructive 4ung Diseases) should read,
(3all lead to a mar+ed decrease in forced e0piratory volume in " second
$!:="%, a normal to decreased forced vital capacity $!=C%3)
2espiratory p. &9" In the figure legend for !igure "5#'9, ($red arrow%) should read .ust
($arrow%.)
2espiratory p.&9" The fifth bullet under (Spontaneous *neumothora0) should read, (In cases
of tension pneumothora0, a tracheal deviation away from the lesion may
occur.)
2espiratory p. &9? The figure legend for !igure "5#'& should read (The inflammation in
asthma leads to airway wall thic+ening, edema, and mucus secretion. This
leads to an obstructive pattern on spirometry.)
2espiratory p. &B5 In Table "5#"5, in the (Characteristics) column, Haemophilus influenzae,
Klebsiella pneumoniae, and Pseudomonas aeruginosa should all be
identified as being gram negative.
2espiratory p. &B1 The first sentence on the page should read (*revents bronchoconstriction by
competitively bloc+ing muscarinic acetylcholine 6", 6', and 6
receptors, thus preventing the effects of acetylcholine by bloc+ing its
binding to muscarinic cholinergic receptors at various neuroeffector sites
$e.g., on smooth muscle, cardiac muscle, gland cells, etc.%)
*age 1 of 1