Pacemaker activity sinoatrial node. Medical search. Frequent questions

Selected contribution: axial stretch increases spontaneous pacemaker activity in rabbit isolated sinoatrial node cells. (ox.ac.uk)
These immunocytochemical data, together with morphological and electrophysiological data, obtained from the intact sinoatrial node and isolated sinoatrial node cells support the gradient model of the cellular organisation of the SA node. (ox.ac.uk)

Pacemakers are used to treat arrhythmias. (universityhealthcenter.in)
iii) it helps protect the sinoatrial node from reentrant arrhythmias. (ox.ac.uk)
We will test whether SAN function and atrial fibrillation susceptibility share a common genetic architecture due to overlapping molecular regulatory mechanisms in PCs and PVMS, a result that will have important implications for developing novel drug targets for sinus node dysfunction and atrial fibrillation, the most commonly encountered clinical arrhythmias. (yale.edu)
Some inherited arrhythmias are caused by a malfunction of proteins that are related to the initiation or propagation of electrical activity. (medscape.com)
Electrical artifacts - or measured cardiac potentials that are not related to electrical activity of the heart - can mimic a wide range of arrhythmias and are seen in 100% of patients on telemetry. (broadcastmed.net)

In a healthy heart, the SA node continuously produces action potentials, setting the rhythm of the heart (sinus rhythm), and so is known as the heart's natural pacemaker. (wikipedia.org)
Parasympathetic influence on heart rate often acts to dampen sympathetic influence via innervation of the vagus nerve, which acts as a brake on the activity of the heart's natural pacemaker, the sympathetically driven sinoatrial node. (frontiersin.org)
Your heartbeat is determined by the signals sent by the sinoatrial (SA) node, which is located in the right atrium of the heart and acts as the heart's natural pacemaker. (liquidimageco.com)
Most often, mutations in the ANK2 gene lead to abnormalities of the heart's natural pacemaker (the sinoatrial node), a heart rate that is slower than normal (bradycardia), a disruption in the rhythm of the heart (arrhythmia), and an increased risk of fainting (syncope) and sudden death. (medlineplus.gov)
A pacemaker (or artificial pacemaker , so as not to be confused with the heart 's natural pacemaker ) is a medical device which uses electrical impulses, delivered by electrodes contracting the heart muscles, to regulate the beating of the heart . (universityhealthcenter.in)
The primary purpose of a pacemaker is to maintain an adequate heart rate , either because the heart's natural pacemaker is not fast enough, or because there is a block in the heart's electrical conduction system . (universityhealthcenter.in)
Your heart has a natural pacemaker called the sinoatrial (SA) node, which is in the upper right atria. (naplesheartrhythm.com)
This natural pacemaker is hardwired with a backup system. (wisc-online.com)
It normally regulated by the sinoatrial node ( SA node) known as the heart natural pacemaker, which is located in the posterior wall of the right atrium. (bartleby.com)

Isolated, spontaneously beating rabbit sinoatrial node cells were subjected to longitudinal stretch, using carbon fibers attached to both ends of the cell. (ox.ac.uk)
This review focuses on the cellular organisation of the rabbit sinoatrial node in terms of the expression of connexin (Cx40, Cx43 and Cx45), L-type Ca2+ channel and Na+ -Ca2+ exchanger proteins. (ox.ac.uk)

The SA node is located in the wall (epicardium) of the right atrium, laterally to the entrance of the superior vena cava in a region called the sinus venarum (hence sino- + atrial). (wikipedia.org)
The connective tissue, along with the paranodal cells, insulate the SA node from the rest of the atrium, preventing the electrical activity of the atrial cells from affecting the SA node cells. (wikipedia.org)
The SA node cells are smaller and paler than the surrounding atrial cells, with the average cell being around 8 micrometers in diameter and 20-30 micrometers in length (1 micrometer= 0.000001 meter). (wikipedia.org)
Unlike the atrial cells, SA node cells contain fewer mitochondria and myofibers, as well as a smaller sarcoplasmic reticulum. (wikipedia.org)
This means that the SA node cells are less equipped to contract compared to the atrial and ventricular cells. (wikipedia.org)
This is again important in insulating the SA node from the surrounding atrial cells. (wikipedia.org)
These findings strongly implicate rs6817105 minor allele in sinus node dysfunction and left atrial enlargement. (nature.com)
Sinoatrial node (SAN) and pulmonary veins (PVs) are closely related atrial dysrhythmia. (tmu.edu.tw)
Conclusion GJ dysfunction modulates SAN and PV electrical activity, which may contribute to atrial arrhythmogenesis. (tmu.edu.tw)
Complete heart block, also known as complete atrioventricular (AV) block, is a condition in which the electrical impulses generated by the sino-atrial node in the atria of the heart are not conducted to the ventricles. (pediatriconcall.com)
The ECG shows a complete dissociation between the P-waves (representing the atrial rhythm) and the QRS complexes (representing the ventricular activity). (pediatriconcall.com)
Contribution of small conductance K + channels to sinoatrial node pacemaker activity: insights from atrial-specific Na + /Ca 2+ exchange knockout mice. (bvsalud.org)
The SA node may be insulated from the surrounding atrial myocytes except at a limited number of preferential exit sites. (medilib.ir)
In the mosaic model, there is a variable mix of atrial and sinoatrial node cells from the centre to the periphery. (ox.ac.uk)
In particular, although it is well established that bradycardia is associated with the development of atrial fibrillation (AF), it is not known whether common genetic mechanisms lead to both AF and sinus node dysfunction. (yale.edu)
In this study, we identify a non-coding regulatory element that affects both sinus node function and atrial fibrillation susceptibility. (yale.edu)
We first used Assay for Transposase Accessible Chromatin (ATAC-seq) in mouse pacemaker cells (PCs) and right-atrial cardiomyocytes (RACMs) to identify differentially accessible regions within the SAN. (yale.edu)
Raised extracellular potassium attenuates the sympathetic modulation of sino-atrial node pacemaking in the isolated guinea-pig atria. (ox.ac.uk)
Since changes in [K(+)](o) modulate membrane currents involved in sino-atrial node pacemaking, in particular the voltage-sensitive hyperpolarization-activated current (I(f)), we investigated whether raised [K(+)](o) (from 4 mM to 8 or 12 mM) could directly affect the heart rate response to cardiac sympathetic nerve stimulation (SNS). (ox.ac.uk)
The SA node is located less than 1 mm from the epicardial surface, laterally in the right atrial sulcus terminalis at the junction of the anteromedial aspect of the superior vena cava (SVC) and the right atrium (RA). (medscape.com)
The human SA node contains a more than 3-fold greater density of beta-adrenergic and muscarinic cholinergic receptors than the adjacent atrial tissue. (medscape.com)

Similarly, SAN-specific CRISPR/Cas9-mediated gene silencing of ACI results in sinus node dysfunction. (ox.ac.uk)
Sinus node dysfunction (SND), also historically referred to as sick sinus syndrome, is the term used to describe the inability of the SA node to generate a heart rate that meets the physiologic needs of an individual. (medilib.ir)
See "Sinus node dysfunction: Clinical manifestations, diagnosis, and evaluation" and "Sinus node dysfunction: Treatment" . (medilib.ir)

Verkerk AO, van Ginneken AC, Wilders R. Pacemaker activity of the human sinoatrial node: Role of the hyperpolarization-activated current, I(f). (edu.pl)
Identification of a gene encoding a hyperpolarization-activated pacemaker channel of brain. (nature.com)
Molecular and functional heterogeneity of hyperpolarization-activated pacemaker channels in the mouse CNS. (nature.com)

The sinoatrial node (also known as the sinuatrial node, SA node or sinus node) is an oval shaped region of special cardiac muscle in the upper back wall of the right atrium made up of cells known as pacemaker cells. (wikipedia.org)

The normal cardiac impulse of the vertebrate heart originates in the pacemaker cells of the sinoatrial node, located in the right atrium. (medscape.com)

Each heartbeat begins with an impulse from the heart's pacemaker (sinus or sinoatrial node). (merckmanuals.com)
The surgery takes just a few hours, but you'll stay in the hospital overnight so your health care team can check your heartbeat and make sure your pacemaker is working properly. (universityhealthcenter.in)
The SA node fires the electrical signals that begin each heartbeat. (naplesheartrhythm.com)
The human sinoatrial node (SAN) regulates our heartbeat. (wisc-online.com)

The main role of a sinoatrial node cell is to initiate action potentials of the heart that can pass through cardiac muscle cells and cause contraction. (wikipedia.org)
The SCN5A gene encodes specific voltage-dependent Na+ channels abundant in cardiac muscle that open and close at specific stages of cardiac activity in response to voltage change, thereby controlling the magnitude and timecourse of voltage-dependent Na+ currents (iNa) in cardiac muscle cells. (ox.ac.uk)
The rhythmic contraction of cardiac muscle is regulated by the sinoatrial node, the heart's pacemaker. (britannica.com)

The cells of the SA node are spread out within a mesh of connective tissue, containing nerves, blood vessels, collagen and fat. (wikipedia.org)
Immediately surrounding the SA node cells are paranodal cells. (wikipedia.org)
These cells have structures intermediate between that of the SA node cells and the rest of the atrium. (wikipedia.org)
Pacemaker cells, however, do not have a resting potential. (wikipedia.org)
Instead, immediately after repolarization, the membrane potential of these cells begins to depolarise again automatically, a phenomenon known as the pacemaker potential. (wikipedia.org)
Sinoatrial node (SAN) cells are the heart's primary pacemaker. (ox.ac.uk)
Although iNa has been recorded from sinoatrial (SA) node pacemaker cells, its precise role in SA node pacemaker function remains uncertain. (ox.ac.uk)
Originally described in 1907 as a subepicardial structure located at the junction of the right atrium and superior vena cava, the SA node represents the integrated activity of pacemaker cells in a compact region of the right atrium that depolarize and produce action potentials almost synchronously [ 1-3 ]. (medilib.ir)
While the location of the primary pacemaker may move among groups of cells within the region of the SA node, only about 1 percent of the cells in the SA node act as the leading pacemaker [ 4 ]. (medilib.ir)
The second mechanism thought to be critical in SA node activity initiation is spontaneous sarcoplasmic reticulum calcium release within the SA nodal cells [ 5 ]. (medilib.ir)
According to the gradient model there is a gradual transition in morphology and electrical properties of SA node cells from the centre to the periphery of the SA node. (ox.ac.uk)
Although the transcriptome of SAN pacemaker cells (PCs) has been defined, and it is well established that SAN function and arrhythmia susceptibility are heritable traits, the mechanisms whereby variation in non-coding regulatory elements influences cardiac conduction and arrhythmia susceptibility remain poorly studied. (yale.edu)
Furthermore, our preliminary studies using hybridization chain reaction fluorescent in-situ hybridization (HCR RNA-FISH) on myocardial sections from Rgs6enh/enh adult mice and WT littermates revealed a qualitative decrease in RGS6 expression specifically within SAN pacemaker cells, with studies ongoing to assess expression in the PVMS and atria. (yale.edu)
The innervation of muscle cells, or fibres, permits an animal to carry out the normal activities of life. (britannica.com)
Takaki M, Suzuki H, Nakayama S. Recent advances in studies of spontaneous activity in smooth muscle: Ubiquitous pacemaker cells. (edu.pl)
With severe ischemia, pacemaker cells cannot transport the ions necessary to affect the transmembrane action potential. (medscape.com)
The sinoatrial (SA) node is a spindle-shaped structure composed of a fibrous tissue matrix with closely packed cells. (medscape.com)

The sinus node is approximately 15 mm long, 3 mm wide, and 1 mm thick, located directly below and to the side of the superior vena cava. (wikipedia.org)

We may have to reduce the influence of a certain form of nerve activity on the hearts of sick sinus patients. (sca-aware.org)
A nerve impulse is a wave of electrical activity that passes from one end of nerve cell to another. (wisc-online.com)
Simulated vagal nerve activity, including the actions of acetylcholine in the model, amplified the effects of ischemia, leading to possible SAN arrest and/or conduction exit block, which are major features of the sick sinus syndrome. (bris.ac.uk)
These nerve fibers converge at a few key places in the heart, into nodes. (aliciavance.com)
Intense exercise or myocardial ischaemia can significantly increase both the concentration of extracellular potassium ([K(+)](o)) and cardiac sympathetic nerve activity. (ox.ac.uk)
The SA node is densely innervated with postganglionic adrenergic and cholinergic nerve terminals. (medscape.com)

We also hypothesized that the enhancer might have activity in the pulmonary vein myocardial sleeves (PVMS), thereby affecting triggered activity and refractoriness of the PVMS (known to trigger AF). (yale.edu)

Cellular physiology - Pacemaking activity that originates from the sinoatrial (SA) node is incompletely understood. (medilib.ir)
HCN-encoded pacemaker channels: From physiology and biophysics to bioengineering. (edu.pl)

The stippled area adjacent to the central fibrous body is the approximate site of the compact atrioventricular node. (medscape.com)

Mapping of sinus node activation indicates that at faster rates, the SA impulse originates in the superior portion of the SA node, or extranodally, while at slower rates, it arises from the inferior portion of the node or, once again, extranodally [ 7 ]. (medilib.ir)

Instances of patients surviving up to the fourth to six decades of life without pacemaker implantation have been recorded. (pediatriconcall.com)
Treatment of SND is directed at symptoms and typically involves the implantation of a permanent pacemaker. (medilib.ir)
Medicare will not cover pacemaker implantation for either post MI patients with asymptomatic bradycardia who otherwise would be precluded from beta-blocker long-term drug therapy or post MI patients who are treated with beta-blockers and later develop asymptomatic bradycardia as a result of the treatment. (cms.gov)
Medicare will continue to cover pacemaker implantation in patients with symptomatic bradycardia whether iatrogenic or induced by required pharmacologic therapy. (cms.gov)
It is essential to document an association between symptoms and the dysrhythmia before pacemaker implantation because symptoms may be non-specific, such as dizziness or lightheadedness. (cms.gov)
Less than 2% of patients suffer from complications due to pacemaker implantation. (cms.gov)

But groundbreaking research by Professor Henggui Zhang at The University of Manchester shows how gene mutation and activity of the nervous system can combine to seriously disrupt the heart's normal rhythm. (sca-aware.org)
Due to this, the intrinsic electric rhythm of the ventricular muscle takes over the pacemaker role for the ventricles. (pediatriconcall.com)
First, sinus bradycardia occurred when the SA node is generating a slower than 60 beats per minute rhythm. (bartleby.com)

Some combine a pacemaker and defibrillator in a single implantable device. (universityhealthcenter.in)
Implantable pacemaker failure may also be a cause of primary asystole. (medscape.com)
An implantable pacemaker is usually required for these conditions. (medscape.com)

Heptanol (10 μM) also reduced the spontaneous beating rates in single SAN cardiomyocyte, but not PV cardiomyocyte, with a decreased pacemaker current. (tmu.edu.tw)
As the slope of the increase in resting membrane potential steepens, the rate of spontaneous sinus node activity increases. (medilib.ir)

Adenylyl cyclase isoform 1 contributes to sinoatrial node automaticity via functional microdomains. (ox.ac.uk)

Ischemia in the heart impairs function of the cardiac pacemaker, the sinoatrial node (SAN). (bris.ac.uk)
This may result from ischemia or from degeneration (ie, sclerosis) of the sinoatrial (SA) node or atrioventricular (AV) conducting system. (medscape.com)
Proximal occlusion of the right coronary artery can cause ischemia or infarction of both the sinoatrial (SA) and the atrioventricular (AV) nodes. (medscape.com)

The sinoatrial node receives its blood supply from the sinoatrial nodal artery. (wikipedia.org)
For example, in most humans, this is a single artery, although in some cases there have been either 2 or 3 sinoatrial node arteries supplying the SA node. (wikipedia.org)
Bradycardia also can be caused by sick sinus syndrome (SSS) which is a malfunctioning sinoatrial (SA node) , mainly due to aging and coronary artery disease. (bartleby.com)
The artery supplying the sinus node branches from the right coronary artery in 55-60% of hearts or the left circumflex artery in 40-45% of hearts. (medscape.com)
The artery approaches the node from a clockwise or counterclockwise direction around the SVC-RA junction. (medscape.com)

The rate of the steady increase of the resting membrane potential can be modulated by other ionic currents as well as beta-adrenergic activity. (medilib.ir)
In neurons, TASK channels carrying hyperpolarizing K + leak currents, and the pacemaker channel HCN2, carrying depolarizing I h , stabilize the membrane potential by a mutual functional interaction. (biomedcentral.com)

You develop a supraventricular tachycardia when the signal begins somewhere in the atria other than the SA node. (naplesheartrhythm.com)

Thereby, the acidified milieu after arterial occlusion most probably influences the activity of acid-sensing ion channels as well as the cell membrane potential. (biomedcentral.com)
In addition, ankyrin-B helps ensure that signaling molecules that regulate the activity of ion channels and ion transporters are in the proper location. (medlineplus.gov)

This study evaluated whether GJ modifications modulate SAN and PVs electrical activities. (tmu.edu.tw)
Neurotransmitters modulate the SA node discharge rate by stimulation of beta-adrenergic and muscarinic receptors. (medscape.com)

The approach to the therapy of CAVB can be classified into pharmacological and pacemaker therapy. (pediatriconcall.com)
what happens to the HPV when given a pharmacological blocker of cardiac PNS activity? (brainscape.com)

A pacemaker consists of a battery, a computerized generator, and wires with sensors called electrodes on one end. (universityhealthcenter.in)
The sinoatrial node (SAN) consists of specialized pacemaker cardiomyocytes (PCs) that collectively function as the leading pacemaker of the heart. (yale.edu)

Node of specialized tissue lying near the bottom of the right atrium that fires an electrical impulse across the ventricles, causing them to contract. (encyclopedia.com)
ginates, and it sets the pace for the electrical impulse as it travels to several other nodes and bundles of conducting fibers. (aliciavance.com)

This rate is affected by a variety of factors, including physical activity, stress, and even certain medications. (liquidimageco.com)
Heart rate could be influenced by several factors as in some activity that can provoke change such as stress, sleep, and some drug. (bartleby.com)
There are several factors that affect the metabolism of a person, such as the amount of muscle tissue, the frequency of the meals one consumes, genetics, stress levels, personal diet and activity levels. (rakshakfoundation.org)

Continuous Ambulatory Electrocardiography A standard electrocardiograph (ECG) records the heart's electrical activity for only a few seconds. (merckmanuals.com)
The electrodes detect your heart's electrical activity and send data through the wires to the computer in the generator. (universityhealthcenter.in)

Using experimental measurements from the sinoatrial node together with detailed computer models, Professor Zhang, from the University's School of Physics and Astronomy, has been able to simulate the electrical activity in cardiac tissue. (sca-aware.org)
The sinoatrial (SA) node is a complex and inhomogeneous tissue in terms of cell morphology and electrical activity. (ox.ac.uk)
Ivabradine (30 μM, 60 μM or 90 μM) was added to the tissue bath either prior to or after the application of the agonist, and the resulting contractile activity was compared to the preceding contractile activity. (edu.pl)
Metabolism slows done due to the following: loss of muscle because of not enough physical activity, the tendency of the body to cannibalize its own tissue because Order Actonel no rx UK there is not enough food energy to sustain it, and the decrease of physical activity that comes naturally with old age. (rakshakfoundation.org)

PCs have a distinct gene expression program that allows for automatic electrical activity and, importantly, coupling to the autonomic nervous system. (yale.edu)

iii) Experimental and computational evaluations of the functional roles of iNa in SA node pacemaker function. (ox.ac.uk)

Pacemakers can relieve some arrhythmia symptoms, such as fatigue ( tiredness ) and fainting . (universityhealthcenter.in)
Before recommending a pacemaker, your doctor will consider any arrhythmia symptoms you have, such as dizziness , unexplained fainting , or shortness of breath . (universityhealthcenter.in)
Pacemakers are generally implanted to alleviate symptoms of decreased cardiac output related to rate or arrhythmia. (cms.gov)

Complications from pacemaker surgery are rare. (universityhealthcenter.in)
Examples of complications include pneumothorax, perforation of the atrium or ventricle, lead dislodgement, infection and erosion of the pacemaker pocket. (cms.gov)

You also need to avoid certain medical procedures that can disrupt your pacemaker. (universityhealthcenter.in)

however, they do so at a slower rate and therefore, if the SA node is functioning properly, its action potentials usually override those that would be produced by other tissues. (wikipedia.org)

The form of sick sinus syndrome investigated is not connected with structural heart disease, but with genetic mutations that alter a protein called SCN5A that is involved in generation of electrical activity in the heart. (sca-aware.org)
But in sick sinus syndrome patients, it may entirely prevent electrical activity spreading across the heart, thereby compromising cardiac function leading to heart arrest. (sca-aware.org)

These effects are significant during both short, high intensity exercise as well as with prolonged strenuous exercise such as done in endurance sports like marathons, ultramarathons, and road bicycle racing.In exercise, the liver generates extra glucose, while increased cardiovascular activity by the heart, and respiration by the lungs, provides an increased supply of oxygen. (bladeresearchinc.com)

By contrast, at a cellular "global" level PKA plays a major role downstream β1AR and results in an increase in LTCC current.Conclusions:Regulation of the LTCC activity by proximity coupling mechanisms occurs only via β2AR, but not β1AR. (imperial.ac.uk)

Once the pacemaker potential reaches a set value, the threshold potential, it produces an action potential. (wikipedia.org)
Once the resting membrane reaches the depolarization threshold of the cell, an action potential is generated, and electrical activity ensues. (medilib.ir)

SCN5A and sinoatrial node pacemaker function. (ox.ac.uk)
Taken together, these new observations suggest strong correlations between SCN5A-encoded Na+ channel and SA node pacemaker function. (ox.ac.uk)

The research has been made possible by developing models of cardiac electrical activity over 13 years and has now been published in the leading journal Circulation Research . (sca-aware.org)
Each tracing shows the electrical activity of the heart from different angles. (merckmanuals.com)
A whole-cell patch clamp was used to record the electrical activities before and after heptanol in single SAN and PV cardiomyocytes. (tmu.edu.tw)
Once you have a pacemaker, you have to avoid close or prolonged contact with electrical devices or devices that have strong magnetic fields. (universityhealthcenter.in)
And second, they're caused by abnormal electrical activity that begins above the ventricles (supraventricular), which are the two lower chambers of your heart. (naplesheartrhythm.com)
An ECG is measuring the electrical activity of the heart and can indicate damage to the SA node and the accompanying nodes and conducting neurons. (aliciavance.com)
Pulseless electrical activity (PEA) is the term applied to a heterogeneous group of dysrhythmias unaccompanied by a detectable pulse. (medscape.com)
When discussing pulseless electrical activity, ventricular fibrillation (VF) (see the following image) and ventricular tachycardia (VT) are excluded. (medscape.com)

We are currently testing for enhancer activity differences between the major and minor alleles of rs17180489 iPSC-derived human pacemaker cardiomyocytes. (yale.edu)

Newer pacemakers also can monitor your blood temperature, breathing , and other factors and adjust your heart rate to changes in your activity. (universityhealthcenter.in)

Pacemakers are generally used for persistent, symptomatic second- or third-degree AV block and symptomatic sinus bradycardia. (cms.gov)

There are two models of the cellular organisation of the sinoatrial node: the gradient and mosaic models. (ox.ac.uk)

The middle internodal tract begins at the superior and posterior margins of the sinus node, travels behind the SVC to the crest of the interatrial septum, and descends in the interatrial septum to the superior margin of the AV node. (medscape.com)
The posterior internodal tract starts at the posterior margin of the sinus node and travels posteriorly around the SVC and along the crista terminalis to the eustachian ridge and then into the interatrial septum above the coronary sinus, where it joins the posterior portion of the AV node. (medscape.com)

Anatomy24

Organisms8

Diseases13

Chemicals and Drugs36

Analytical, Diagnostic and Therapeutic Techniques and Equipment12

Phenomena and Processes15

Disciplines and Occupations1

Information Science1

Isolated sinoatrial node cells2

Arrhythmias5

Natural pacemaker9

Rabbit sinoatrial node2

Atrial21

Sinus Node Dysfunction3

Hyperpolarization-activated3

Known as pacemaker1

Located in the right atrium1

Heartbeat4

Cardiac muscle3

Cells17

Superior vena1

Nerve6

Pulmonary vein1

Physiology2

Atrioventricular node1

Originates1

Implantation6

Rhythm3

Implantable3

Spontaneous2

Automaticity1

Ischemia3

Artery5

Currents2

Atria1

Channels2

Modulate2

Pharmacological2

Consists2

Impulse2

Stress3

Heart's electrical activity2

Tissue4

Gene1

Functional1

Symptoms3

Complications2

Disrupt1

Slower1

Sick sinus sy2

Cardiovascular1

Mechanisms1

Action2

SCN5A2

Electrical8

Human1

Heart rate1

Bradycardia1

Cellular1

Posterior2