Ventricular escape beat reaching the ventricles (normally initiated by the heart's sinoatrial node (SA node), transmitted to the atrioventricular node (AV node), and then further transmitted to the ventricles) falls below the base rate determined by the rate of Phase 4 spontaneous depolarisation of ventricular pacemaker cells. An escape beat usually occurs 2–3 seconds after an electrical impulse has failed to reach the ventricles. This phenomenon can be caused by the sinoatrial node (SA node) failing to initiate a beat, by a failure of the conductivity from the SA node to the atrioventricular node (AV node), or by atrioventricular block (especially third degree
Lymph node and fixed macrophages. The subcapsular sinus has clinical importance as it is the most likely location where the earliest manifestations of a metastatic carcinoma in a lymph node would be found. The cortex of the lymph node is the outer portion of the node, underneath the capsule and the subcapsular sinus. It has an outer superficial part and a deeper part known as the paracortex. The subcapsular sinus drains to the trabecular sinuses, and then the lymph flows into the medullary sinuses. The outer cortex consists mainly of the B cells arranged as follicles, which may develop a germinal center