PHCY 411 Final

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muscular distributing arteries

-distal to elastic arteries; deliver blood to body organs -have thick tunica media with more smooth muscle and less elastic tissue -active in vasoconstriction

epithelial transport involves ...

-molecules entering or leaving the body - molecules moving between compartments - molecules must cross a layer(s) of polarized epithelial cells

magnitude of diffusion

-same as direction of diffusion -estimate of net flux

focal seizures

-simple partial; consciousness not impaired, -complex (impaired consciousness), -impairment of consciousness at onset, -partial seizures evolving into generalized seizures

Early afterdepolarization

-↑AP duration, Na channels return to resting state, membrane still depolarized, get Na+ current; phase 3 repolarization is interrupted, and membrane potential oscillates (long Q-T interval with slow repolarization and prolonged AP due to delayed "rectifier K current" repolarization

systemic pressure is _______ mmHg in the right atrium

occurrence of hip dysplasia

1 in 100 infants have instability ; 1 in 1000 complete dislocation

how common is Parkinson's?

1 in 100 people over 65

how common is ALS?

1 in 100,000; 2x more common in men

how common are psychiatric disorders in the US?

1 in 4

________ of the world population has disordered, positive, and negative symptoms of schizophrenia

cardiac muscle - cell characteristics

1)Branching, chains of cells 2)Single or binucleated 3)Striations 4)Connected by *intercalated discs*

skeletal muscle tissue - cell characteristics

1)Long and cylindrical, in bundles 2)Multinucleate 3)Obvious Striations

smooth muscle - cell charactersitics

1)Single cells, uninucleated 2)No striations

in the liver/kidney, hydroxylates Vitamin D3 to __________

1,25-dihydrovitamin D3

bipolar depression occurs in _____% of adults

1-3

functions that exocytosis performs for cells

1. Provides a way to replace portions of the plasma membrane that endocytosis has removed 2. Adds new membrane components to the membrane 3. Provides a route by which membrane-impermeable molecules (such as protein hormones) the cell synthesizes can be secreted into the extracellular fluid

3 general ways that cells use cytoskeleton elements to move

1. Roadway 2. Active Reorganization of Cytoskeletal Network 3. Motor proteins pull on cytoskeletal rope

3 major areas of sarcomere

1. Z line 2. Thin (actin) filaments 3. Thick (myosin) filaments

what 2 ways can cartilage grow?

1. appositional 2. interstitial

steps of the local inflammatory response

1. chemical signals released by activated macrophages and mast cells at the injury site cause nearby capillaries to widen and become more permeable. 2. Fluid, antimicrobial proteins, and clotting elements move from blood to the site; clotting begins. 3. Chemokines released by various kinds of cells attract more phagocytic cells form the blood to the injury site 4. Neutrophils and macrophages phagocytose pathogens and cell debris at the site and the tissue heals.

causes of thrombocytopenia?

1. decreased production - loss of marrow (aplastic anemia - radiation therapy - HIV infection - antimalarial drugs - quinine and quinidine - sulfa-containing antibiotics 2. increased destruction - increase sequestration of platelets in spleen --> hypersplenic thrombocytopenia 3. impaired function - decrease platelet survival --> anti-platelet antibodies

Categories of antihypertensive drugs

1. diuretics 2. sympathoplegics 3. direct vasodilators 4. blocking production or actions of angiotensin

What are the 4 important arrhythmia mechanisms?

1. enhanced or ectopic pacemaker activity 2. after depolarizations 3. impulse fractionation 4. Re-entry

pacemaker action potential of auto rhythmic myocardium cells

1. f-channel sodium channels cause a slow depolarization due to sodium influx 2. once membrane depolarizes to a threshold voltage, voltage-gated fast calcium channels open to initiate the depolarization and AP (f channels close during this) 3. At AP, Ca channels close and votlage-gated K+ channels open to repolarize the membrane (f-channels open back up) 4. no true hyperpolarization

Damaged tissues are repaired in 2 ways

1. first intention (regeneration) 2. second intention (fibrosis)

three general types of endocytosis:

1. fluid endocytosis (pinocytosis) 2. phagocytosis 3. receptor-mediated endocytosis

5 principles of electricity

1. human body is electrically neutral 2. opposite charges are attracted to eachother 3. like charges repel eachother 4. separating (+) and (-) charges requires ATP 5. when separate charges can freely move toward each other through a conductor (water)

forms of hypercoagulability forming thrombus

1. increased platelet function - thrombocytosis 2. increased coagulation activity --> primary --> secondary

4 classes of antiarrhythmic drugs

1. membrane stabilizers (sodium channel blockers) 2. antiadrenergics (beta blockers) 3. potassium channel blockers 4. calcium channel blockers

categories of A fib

1. paroxysmal A fib 2. persistent A fib 3. permanent A fib

transcellular transport of glucose involves what 3 transport systems?

1. sodium-glucose cotransporter 2. GLUT transporter 3. Sodium-Potassium ATPase pump

steps of neurotransmission

1. synthesis 2. storage 3. release 4. neurotransmitter binds to post-synaptic receptor 5. transmission = terminated

transcellular transport must cross TWO membranes, so it is. a TWO step process. What are the steps?

1. uphill = energy required 2. downhill = NO energy required

stages of hemostasis

1. vascular constriction 2. formation of platelet plug 3. blood coagulation 4. clot retraction 5. clot dissolution

steps of the cardiac cycle

1. ventricular diastole (higher pressure in atria, AV valves open and fill ventricles) 2. atrial systole (contraction forces additional blood into ventricle) 3. ventricular systole (pushes AV valves close and increases ventricular pressure) 4. ven. systole (ejection; increased pressure forces SL valves open and blood is ejected) 5. ven. diastole (pressure in arteries is greater to close SL valves)

3 wound healing stages

1.) inflammatory phase 2.) proliferative phase 3.) remodeling phase

steps of microtubule growth

1.Alpha and beta combine to form tubulin (dimer) 2.Polarity occurs on each dimer; alpha tubulin bound GTP and beta tubulin bound GTP bound 3.Added end to end; line of magnets where the negative alpha (GTP) end attracts the positive beta (GDP) end 4.Chain (protofilament) grows until it reaches a critical length 5.Protofilaments will then line up side by side to form a sheet that eventually rolls into a tube to form the microtubule

effects of anemia

1.Compensatory responses to impaired oxygen transport 2.Reduction in RBC indices and hemoglobin levels 3.Signs and symptoms associated with pathology causing anemia

what are the causes of anemia?

1.Excessive RBC loss - Volume loss 2.Chronic RBC loss - Hemoglobin loss 3.Destruction of RBC (Hemolytic anemia) 4.Deficient RBC production due to nutritional deficiencies or bone marrow failure

diagnosis (4 categories) of rheumatoid arthirtis

1.Joint involvement - Swelling, tenderness, warmth in joint(s) 2.Serology - RF+ and anti-citrulinated protein autoantibody (ACPA)+ 3.Acute phase reactants - Nonspecific inflammation markers (increased erythrocyte sedimentation rate and C-reactive peptide) 4.Duration of symptoms

types of neoplastic disorders

1.Non-Hodgkin Lymphomas •Follicular Lymphomas •Diffuse Large B-cell Lymphomas •Burkitt Lymphoma 2.Hodgkin Lymphomas 3.Leukemia

Explain the action potential

1.Resting membrane potential is ~70mV 2.Depolarization Na+ channels open; rapid reduction in membrane production 3.Voltage-sensitive Ca2+ channels open, allow the influx of Ca2+ into the cell from the extracellular space 4.After a period, Na+ channels and Ca2+ channels begin to close and voltage-sensitive K+ channels open, causing the cell to repolarize 5.Reestablishment of resting membrane potential by Na+/K+ ATPase pump

steps of neurotransmission

1.Synthesis (limited as to what type) 2. Storage (loaded into synaptic vesicles) 3. Release (AP travels down axon and causes a calcium influx. Ca binds the vesicles and releases) 4. binding receptor (induces effect) 5. termination (degraded, diffuses away, or is taken up by transporters)

2 main ways that muscles are able to ensure the entire sarcolemma is depolarized uniformly in space and time

1.through multiple innervations 2. through invaginations of the sarcolemma (t-tubules)

What percentage of intracranial space does CSF take up?

10%

What percentage of the intracranial space does blood take up?

10%

diuretics lower BP by ________ mmHG

10-15

diffusion rates through membranes are (slower/faster) than diffusion rates of SAME molecules through water by how much?

10^3-10^6 SLOWER

normal blood pressure

120 systolic/80 diastolic

metastasis to brain occurs in approx. ____% of cancer patients

How long do panic attacks typically last?

15-30 min

brain tumors account for ___(%) of cancer deaths

What percent of cancer deaths are from a brain tumor?

2% but metastasis to brain happens in 15%

_______% of iron is stored in bone marrow, liver, spleen, and other organs

the brain consumes _______% of the body's oxygen and ________% of cardiac output

20, 15-20

atrial flutter is characterized by a heart rate of?

240-450 bpm

Na/K ATPase

3 Na out, 2 K in; pumps sodium out of the cell to keep intracellular fluid sodium concentrations low

ventricular tachycardia

3-4+ ventricular extra systoles, including V-fib •Ectopic beats, EADs or DADs, or re-entry circuits

ventricular tachycardia

3-4+ ventricular extra systoles, including V-fib (ectopic beats, EADs or DADs, or reentry circuits); COMPLETE BEATS

hemolysis is a ___________ life span

4 month

Eye opening response

4 spontaneously 3 to speech 2 to pain 1 no response

blood volume in femalse

4-5 liters

normal cardiac output

4.9-5 L/min

what is normal cardiac output?

4.9-5.0 L/min

normal hematocrit for females

42 +- 5%

normal hematocrit value for newborns

42 - 68%

normal hematocrit for males

47 +- 5%

approximately how many WBCs are there?

4800 - 11,000 / cubic mL

blood volume in males

5-6 L

Which neurotransmitter is associated with depression, anxiety, and ADHD

5-HT

known polymorphisms in the __________ lead to increased risk of depression and suicide, and depressed patients show altered monoamine function

5-HT transport gene (SERT)

about how many lymph nodes in the body?

500

orthostatic hypotension is characterized by a shift of _________ mL of blood to lower extremeties

500-700 mL

Motor response

6 obeys commands 5 localizes to pain 4 withdraws from pain 3 flexion to pain 2 extension to pain 1 none

regular heart rate

60-80 bpm

_________% of iron is complexed to hemoglobin , myoglobin, cytochromes, and iron-containing enzymes

What percentage of the intracranial space does brain tissue take up?

80%

Astrocytic glial tumor

80% of primary brain tumors, contains most lethal type of brain tumor

approx. what percentage of blood plasma is water?

normal MAP

93 mmHg

normal mean arterial pressure

93 mmHg

A bacterial or viral infection would result in a(n) _____________ in the number of leukocytes. A. Increase B. Decrease C. Not effect

Decreasing the activity of the enzyme- prothrombin activator- will __________ formation of fibrin threads. A. Decrease B. No effect C. Increase

Living at high altitudes may cause ________ or an increase in red blood cells which would ________ your oxygen carrying ability in blood A. Polycythemia; increase B. Anemia; decrease C. Polycythemia; decrease D. Anemia; increase

Which of the following medications could cause crystal-induced arthropathy? A. All of the above medications can cause crystal-induced arthropathy B. Beta blockers C. Diuretics D. Angiotensin converting enzymes (ACE) inhibitors

Which of the following medications would inhibit leukocyte migration and phagocytosis to reduce inflammation in crystal-induced arthropathy? A. Colchicine B. Corticosteroids C. Allopurinol D. NSAIDs

_______ is an anti-rheumatoid arthritis therapy that stabilizes lysomomes to slow immune cell-mediated damage A. Hydroxychloroquine B. Entanercept C. Adalimumab D. Methotrexate

_________ cells actively produce and secrete the organic portion of th bone matrix. A. Osteoblasts B. Osteoclasts C. Osteoprogenitors D. Osteocytes

__________ inhibits calcium release from bone by inhibiting osteoclast activity A. Calcitonin B. Ergocalciferol C. Parathyroid hormone D. Cholecalciferol

__________ is a term used to describe the formation of uric acid crystals (tophi) in joints. A. Gout B. Osteomalacia C. Osteoarthritis D. Rheumatic arthritis

___________ is a systemic autoimmune and inflammatory disease that clinically manifests in progressive joint destruction A. Rheumatoid arthritis B. Osteoarthritis C. Psoriatic arthritis D. Paget's disease

diffusion area

A bacterial or viral infection would result in a(n) ____ in the number of leukocytes. a. decrease b. not effect c. increase

dark areas in sarcomere

A bands

___ bands & ___ bands create banding appearance

A bands and I bands

pons

A brain structure that relays information from the cerebellum to the rest of the brain

antiporter

A carrier protein that transports two molecules acrss the plasma membrane in opposite directions.

What are the primary pain fibers?

A delta and C

amygdala

A limbic system structure involved in memory and emotion, particularly fear and aggression.

A loss of red blood cells or _______ would cause a _______ your oxygen carrying ability in blood. a. anemia; increase b. polycythemia; decrease c. anemia; decrease d. polycythemia; increase

glutamate

A major excitatory neurotransmitter; causes depolarization

bipolar disorder

A mood disorder in which the person alternates between the hopelessness and lethargy of depression and the overexcited state of mania.

hippocampus

A neural center located in the limbic system that helps process explicit memories for storage.

ligand-gated ion channel

A transmembrane protein containing a pore that opens or closes as it changes shape in response to a signaling molecule (ligand), allowing or blocking the flow of specific ions; also called an ionotropic receptor.

Phagocytosis

A type of endocytosis in which a cell engulfs large particles or whole cells

Pinocytosis

A type of endocytosis in which the cell ingests extracellular fluid and its dissolved solutes.

classification of DRG neurons by fiber type include which fibers?

A, B , and C fibers

_________ is centrally acting hypertension used to depress brainstem vasomotor centers. A.) Clonidine B.) Atenolol C.) Propanolol D.) Metopropolol

A.) Clonidine

To return elevated wall stress to normal ________ will decrease (LaPlace Law Sigma=Pr/w) A.) Pressure B.) Vessel Radius C.) Wall Thickness

A.) Pressure B.) Vessel Radius

The QRS complex represents _____________. A.) Ventricular Depolarization B.) Atrial Repolarization C.) Ventricular Repolarization D.) Atrial Depolarization

A.) Ventricular Depolarization

The T Wave represents _________________ A.) Ventricular Repolarization B.) Atrial Repolarization C.) Atrial Depolarization D.) Ventricular Depolarization

A.) Ventricular Repolarization

potassium channel blockers

APD wideners prolong repolarization (usually phase 3) by blocking rectifier K current; slows down repolarization and hyperpolarization

structural changes in motor protein are ________ _____________ dependent

ATP hydrolysis

what is the head of myosin responsible for ?

ATPase activity

what happens during re-entry ?

Abnormal circuit from tissue damage (ischemia or MI) •Leads to repetitive action such as: 1.Micro-reentry circuit- daughter impulses 2.Circus movement •Can fix by altering conduction (slowing or accelerating impulses)

Seizure

Abnormal discharge of neurons; classified by symptoms

Which neurotransmitter is associated with psychosis with neurodegenerative diseases?

Acetylcholine (ACh)

primary active transport

Active transport that relies directly on the hydrolysis of ATP; includes Na/K ATPase, Ca ATPase, H+ ATPase, H+/K+ ATPase

Relapsing-remitting MS

Acute episodes with recovery and relapse

treatment for venous thrombosis

Ambulation, compression stockings, pneumatic compression devices, anticoagulant therapy (heparin, warfarin), surgery

Proteins that are abnormal in Alzheimer's

Amyloid B (makes plaques) and tau (forms tangles)

resting membrane potential

An electrical potential established across the plasma membrane of all cells by the Na+/K+ ATPase and the K+ leak channels. IN most cells, the resting membrane potential is approximately -70 mV with respect to the outside of the cell.; STEADY state chemical gradient

describe appositional growth

"growth from outside" -Chondroblasts in surrounding perichondrium produces new cartilage by actively secreting matrix; Bone thickening

describe interstitial growth

"growth from within" -Chondrocytes within cartilage divide and secrete new matrix; Bone lengthening •Cartilage stops growing in late teens when the skeleton stops growing. •Chondrocytes stop dividing; regenerates poorly in adults.

sinoatrial node (SA node)

"pacemaker"; found in right atrium and is responsible for initiating the heartbeat by sending excitatory impulses to cause atria to contract; keeps heart beat regular

which 3 neurons are required to successfully transmit pain?

(first, third, and second order): 1. afferent neuron that transmits info from periphery to CNS (often spinal cord) 2. neuron that travels up the spinal cord to the thalamus. (also communicates with interneurons in the spinal cord) 3. neuron that relays information from thalamus to cord

therapeutic strategies for Parkinson's

*Increase Synthesis* --> administering the dopamine precursor L-DOPA --> increasing dopamine synthesis machinery *Prevent Termination* --> decreasing dopamine reuptake --> preventing dopamine degradation *Bind post-synaptic receptor* --> mimic dopamine by agonizing the dopamine receptors

For microtubules: At high concentrations, more dimers will be added and grow at the ________ end At low concentrations, dimers will be lost and shrink at the _______ end

+ ; -

myogenic muscle

- "beginning in the muscle" - contract spontaneously

What is LDL?

- 'bad' cholesterol - low density lipoprotein - main carrier of cholesterol

what is HDL?

- 'good' cholesterol - high density lipoprotein - composed of 50% protein

rate of movement of motor proteins is determined by :

- ATPase domain of the proteins - Regulatory proteins that associate with the motor proteins

3 classes of cytoskeletal filaments

- Actin filaments (also called microfilaments) - Intermediate filaments and. - Microtubules.

clinical manifestation of preeclampisa

- BP > 140/90 - proteinuria

treatment of paget disease

- Bisphosphonates and calcitonin - pain treatment

MOA of verapamil and diltiazem

- Blocks activated and non-activated L-type calcium channels - A reduction in contractility throughout the heart - A decrease in sinus node pacemaker rate - A decrease in atrioventricular node conduction velocity

MOA of lidocaine

- Blocks activated and non-activated sodium channels with rapid kinetics - Effect on inactive cells makes it more effective against cells with longer AP such as Purkinje fibers or ventricular cells vs atrial cells - Low incidence of adverse events and overall good anti-arrhythmia efficacy

MOA of amiodarone

- Blocks potassium channels and prevents repolarization - Significantly blocks inactivated sodium channels preventing new AP

MOA of procainamide

- Blocks sodium channels - slows AP upstroke, slows conduction, prolongs QRS - Suppresses abnormal ectopic pacemaker activity - Blocks depolarized cell sodium channels. - Directly depresses SA and AV nodes

functions of microtubules

- Cell division - radiate from centrosome for chromosome separation - Motility - cilia cores - *Protein trafficking*

what is involved in calcium regulation and release?

- Complicated- involves transporters and cellular compartments - Most muscles respond to sarcolemma depolarization by opening voltage-dependent Ca2+ channels to allow Ca2+ to rush into the cell - Several types of Ca2+ channels named for how long they remain open.

genetic predisposition of psoriatic arthritis

- HLA-B27 (Human Leukocyte Antigen - B27 isotype) is an MHC (major histocompatibility complex) cell surface receptor - Autoimmune response to psoriasis

sympathoplegics

- Interfere with the sympathetic nervous system •Decrease peripheral vascular resistance (PR) •Decrease cardiac function (HR) •Increase venous pooling in capacitance vessels

epilepsy treatments

- MANY anti-epileptic drugs - cannabidiol = finally approved - surgery - pacemaker for nerves - ketogenic diet?

mechanism(s) of ALS

- Motor neurons in spinal cord die, then brain stem motor nuclei, then cortical control of motor neurons - Cause still not understood

MOA of vernakalant

- Multichannel blocker (potassium, sodium, etc.) - Prolongs atrial effective refractory period; Used for atrial fibrillation - Slows AV node conduction - No change in ventricular refractory period

pharmacological treatment of gout

- NSAIDs - colchicine - corticosteroids - allopurinol

treatment of rheumatoid arthritis pharmacological

- NSAIDs - disease modifying anti-rheumatic drugs (DMARDs) conventional and biologics - corticosteroids

explain what happens in the spinoreticular tract

- Neuron dessucates and travels up contralateral side - Synapses in *reticular formation* in brain stem - Third-order neurons then travel to thalamus and hypothalamus - Fourth-order neurons then travel to cortex, amygdala, and many other regions to induce emotional aspects of pain

conditions associated with DIC

- Obstetric conditions - Cancers - Infections - Shock - Trauma or surgery - Hematologic conditions

disease states of MS

- Relapsing-remitting: acute episodes with recovery and relapse - Secondary progressive: gradual deterioration - Primary progressive: continuous deterioration - Progressive relapsing: gradual deterioration with relapse

MOA of propafenone

- Slow dissociative sodium channel blocker - Supraventricular arrhythmias

arterioles

- Smallest arteries - Lead to capillary beds - Control flow into capillary beds via vasodilation and vasoconstriction

tunica media

- Smooth muscle and elastic fiber layer, regulated by sympathetic nervous system - Controls vasoconstriction/vasodilation of vessels

what is the staining of blood cells called? acidic dye vs. basic dye

- Wright's stain - acidic dye - eosin; stains pink - basic dye - methylene blue; stains blue and purple

neurotransmitters include:

- acetylcholine - amino acid based chemicals - glutamate, glycine, and GABA - monoamine based chemicals - dopamine, norepinephrine, *epinephrine - neuropeptides, substance p, CGRP

red marrow function

- actively generate new blood cells - contain immature erythrocytes - trabeculae of spongy bone of axial skeleton and girdles; proximal epiphyses of humerus and femur

alpha platelet granules are released in the formation of platelet plug in hemostasis; what does this contain?

- adhesive factors (P-selectin, von Willebrand factor, fibrinogen) - growth factors (TGF, PDGF) for vessel repair

risk factors for stroke

- age - hypertension - smoking - hypercholesteremia - cardiovascular disease - sex (women)

etiology of orthostatic hypotension

- aging - reduced blood volume - bed rest - antihypertensive & psychotropic drugs - autonomic nervous system disorders

causes of the hangover headache

- alcohol - alcohol is a diuretic which leads to dehydration; alters vasopressin (hormone that regulates water balance) - robust vasodilation - inflammation

negative symptoms of schizophrenia

- alogia (marked poverty of speech and content of speech) - affective flattening (reduced emotional responsiveness) - anhedonia (inability to feel pleasure) - asocialiy (inability to feel intimacy, initiate or maintain social contacts - avolition/apathy - attentional impairment

name the corresponding receptor: epinephrine (Epi)

- alpha adrenergic receptors (a-AR) - beta adrenergic receptors (b-AR)

name the corresponding receptor: norepinephrine (NE)

- alpha adrenergic receptors (a-AR) - beta adrenergic receptors (b-AR)

function of globulins

- alpha globulin transports bilirubin and steroids - beta globulin transports iron and copper - gamma globulin makes up antibodies

thrombolytic drugs

- alteplase - reteplase - tenecteplase - urokinase - streptokinase

transporters in secondary active transport have two binding sites:

- an ion - transported molecule

What are the two statins we discussed in class?

- atorvastatin (LIPITOR) - rosuvastatin (CRESTOR)

primary cause of acquired neutropenia

- autoimmune - bone marrow disease

explain the inflammatory phase of wound healing

- begins when the wound develops, lasts 4-6 days - marked by edema, erythema, inflammation and pain - healing process triggered - immune system works to prevent microbial colonisation

what types of tissue are contained in bones?

- bone connective - blood, dense connective, cartilage - nervous - vascular - epithelial

explain the remodeling phase of wound healing

- can last 21 days to 2 years - length of time depends on patient - filled in wound is covered and strengthened - scar tissue forms

examples of ACE inhibitors

- captopril - enalapril (hint: look at ending -pril drugs)

major functions of blood

- carries respiratory gases, nutrients, and hormones - conveys immune cells to sites of infection - helps body regulate temperature

symathoplegics are classified based on site of impairment. name the two classifications

- centrally acting (CNS) - B-adrenoreceptor antagonists

MOA of Na+ channel blockers

- change the slope of phase 0 ; - can abolish tachyarrhythmia caused by reentry circuit

what is meant by increased intercranial pressure?

- changes in amount of blood, brain tissue, and CSF leads to obstructed blood flow, neuron death, and displaced tissue

drugs causing neutropenia

- chemotherapy - radiation - antipsychotics (clozapine - apoptosis) - B-lactam antibiotics - cephalosporins - inhibits maturation

drugs to treat thrombocytosis

- clopidogrel - aspirin - heparin

different forms of pain management

- cognitive-behavioral interventions - heat/cold - stimulus induced analgesis - TENS units - pharmacological treatment

direction and magnitude of ion fluxes depends on

- concentration differences - electrical differences

risk factors for osteoporosis:

- congenital factors (age, family history, chronic disease, caucasian race, female gender) - acquired factors (visual impairment, dementia, low body weight, recurrent falls, early menopause, hypo and hyper thyroidism) - lifestyle (low calcium, alcoholism, vitamin D deficiency, inactivity, smoker) - iatrogenic factors (glucocorticoids, cyclosporine, anticonvulsant, thyroxin, aluminum, gnRH agonist, lithium, aromatase inhibitor)

clinical manifestations of thrombocytopenia

- cutaneous bleeding - pinpoint hemorrhages (petechiae) and purple-pink bruising (purpura) - mucous membrane bleeding --> nose, mouth, GI tract, uterine cavity - intracranial vessels

MOA of beta blockers

- decrease heart rate and conduction velocity ; - can indirectly alter K and Ca conductance

most common signs of osteoporosis

- decrease in height over time - hunched or stooped posture - back pain (esp. lower back) - easier than usual bone facturing

treatment for aneurysms

- decrease tension with beta-adrenergic antagonists - surgical grafts

MOA of diuretics

- decrease water retention - used in wide array of patients with varying renal and cardiac function - overall, toxicity related to potassium depletion

what is the monoamine hypothesis?

- deficit in amount or function of the monoamine transmitters, especially 5-HT, NE and DA in the cortical and limbic systems

What is Parkinson's disease?

- degeneration of dopaminergic neurons in the substantia nigra of the basal ganglia (region that helps control voluntary movement by regulating motor cortex)

describe the structure of neurons and their function(s)

- dendrites - receive info - soma - integrates info/cell body - axon - sends info

symptoms of the depressive phase of bipolar depression

- depressed mood - sleep disturbance - anxiety - at times psychosis

intercalated discs anchor cardiac cells together and have 2 parts:

- desmosomes = cell connections - gap junctions = allow free passage of ions for spread of depolarization

Active transport is defined by the use of two types of energy sources:

- direct use of ATP in primary active transport - use of electrochemical gradient across a membrane to drive the process in secondary active transport

How can you categorize neurons?

- direction of information flow (afferent vs. efferent) - type of information released (neurotransmitter) - size, shape, and location of the neuron

what is blood used to screen for?

- disease - substance abuse - nutritional status - pregnancy

difference in Raynaud's disease vs. phenomenon

- disease = primary type; no known cause - phenomenon = secondary type; associated with other disease states or known causes of vasospasms

treatment of scoliosis

- early diagnosis - milwaukee to wilmington braces - surgery

secondary osteoporosis is associated with multiple conditions:

- endocrine disroders - alcohol - long term corticosteroid use - prolonged use of medications that increase calcium secretion (anticonvulsants, aluminum containing antacids)

treatment for osteoporosis in women

- estrogen replacement therapy - SERMs (selective estrogen receptor modulators)

primary thrombocytosis

- excess unbound thrombopoietin - stimulates megakaryocyte

symptoms of the manic phase of bipolar depression

- excitement - hyperactivity - impulsivity - dis-inhibition - aggression - no need for sleep - at times psychosis

primary hypercholesterolemia

- familial - LDL receptor deficiency/dysfunction with marked elevated levels

What does the reticular activating system do?

- filter of information that regulates emotional and behavioral responses to sensory information

what are sarcomeres?

- functional units of skeletal muscle tissue - responsible for contraction

causes of Paget disease

- genetics : 1st degree family member with disease - paramyxovirus particles in osteoclasts

mesenchymal stem cells

- give rise to fat cells, osteoblasts, chondrocytes, fibroblasts, and muscle cells - extracted and used to regenerate all types of tissue for organ replacement

positive symptoms of schizophrenia

- hallucinations - delusions - incoherence of speech - passivity phenomena - thought insertion, withdrawal and broadcast - incongruity of emotion (affect)

describe A fibers of DRG neurons

- highly myelinated - proprioception, fine touch cool

what brings on migraines?

- hormonal changes - food chemicals - physical exertion

ions passing through channels depends on

- how often channel opens - how long it stays open

vasodilator drugs

- hydralazine - minoxidil - sodium nitroprusside

what is typically involved in inflammation?

- immune cells, blood vessels, and molecular mediators - removes initial cause of injury, clears out necrotic cells & tissue - initiates tissue repair - mechanism of innate immunity

how do the cardiac and skeletal muscles differ?

- in shape of action potential - in duration of action potential - in refractory periods

causes of preeclampsia

- increase RAS - increase catecholamines - diabetes, obesity, metabolic syndrome

MOA of K+ channel blockers

- increase action potential duration (APD) or effective refractory period (ERP) - delay repolarization - inhibit reentry tachycardia

what is cerebral edema?

- increase in water and sodium content

classification of scoliosis

- infantile; 0-3 years; rare - juvenile; 4-9 years; uncommon - adolescent; >10 years; 80% of all cases

stimuli that activate pain receptors on DRG neurons include:

- inflammatory signals - acid - histamine

what is the function of inorganic components of bone tissue?

- invade matrix and crystalize around collagen fibrils in extracellular matrix - contributes to hardness and resistance to compression

name the corresponding receptor: GABA

- ionotropic GABA receptor (GABAa) - metabotropic GABA receptor (GABAb)

name the corresponding receptor: Glutamate (Glu or E)

- ionotropic glutamate receptors (AMPA-R, KA-R, NMDA-R) - metabotropic glutamate receptors (mGluR)

what are the common mechanisms underlying brain damage with injury?

- ischemia - excitotoxicity - cerebral edema - increased intracranial pressure

explain the proliferative phase of wound healing

- lasts 4-24 days - granulation tissue fills in the wound - fibroblasts lay collagen in the wound bed, strengthening new granulation tissue - wound edges begin to connect - epithelial cells migrate from the wound margins

sympathoplegic CNS drugs

- less common in practice - overall MOA: decrease adrenergic activation by inhibiting outflow FROM vasomotor center of brainstem

what happens in the cellular phase of acute inflammation?

- leukocytes adhere and transmigrate from blood vessel into the injured tissues extravascular space - immune cells become activated and phagocytosis

treatment for atherosclerosis

- lifestyle changes - surgery

treatment for hypertension

- lifestyle modifications - pharmacologic treatment

treatment for hyperlipidemia

- lifestyle: increased physical exercise, diet, reduce LDL and increase HDL, weight reduction, smoking cessation - drugs: - HMG CoA reductase inhibitors (statins) - bile acid-binding resins - cholesterol absorption inhibitor agents - niacin - fibrates

key principle establishing membrane potential

- like charges repel - opposite charges attract - (-) intracellular charges repel (-) ions - (-) intracellular charges attract (+) ions

paget disease (osteitis deformans)

- local areas of excessive bone turnover lesions with increased osteoblastic deposition of bone - chaotic in fashion; causes bone deformities - 2nd most common bone disease

myofibrils

- long rods within cytoplasm - make up 80% of sarcoplasm - are specialized contractile organelles found in muscle tissue

examples of ARBs

- losartan - candesartan (hint: look at ending -artan drugs)

risk factors for bleeding

- lumbar puncture/epidural/spinal anesthesia within previous 4 hours - concurrent use of anticoagulants known to increase bleeding - untreated inherited bleeding disorders - thrombocytopenia - active bleeding - acquired bleeding disorders (such as acute liver failure) - lumber puncture/epidural/spinal anesthesia in the next 12 hours - uncontrolled systolic hypertension (230/120 mmHg or higher) - acute stroke

short-term controls of blood pressure

- mediated by the nervous system and bloodborne chemicals; -counteract moment-to-moment fluctuations in blood pressure by altering peripheral resistance; - hydrostatic pressure changes-orthostatic hypotension

examples of centrally acting sympathoplegic drugs

- methyldopa - clonidine

example of selective B-adrenoreceptor blocking agent (beta blocker)

- metoprolol - atenolol

primary headaches

- migraine - tension - cluster - chronic daily headache

Type IV osteogenesis imperfecta

- milder, usually normal life expectancy - osteoporosis - skeletal deformity, more severe than type I - fractures before puberty - triangular shaped face

Type I Osteogenesis Imperfecta

- mildest and most common ; collagen production reduced by 50% - mild to moderate bone fragility - no deformity - fractures occurs before puberty - hearing loss - easy bruising - normal stature

what are the inorganic components of bone tissue?

- mineral salts (inorganic hydroxyapatites) - primarily calcium phosphate

describe B fibers of DRG neurons

- moderately myelinated - mechanical sensation

type III osteogenesis imperfecta

- moderately severe - in utero fractures - bone deformity, bowing, osteoporosis, scoliosis - progressive deformity, extremely short stature - triangular shaped face - WC dependent teenage years

what happens in transcytosis?

- molecule brought into cell by receptor-mediated endocytosis to form vesicle - vesicles cross cell with help from microtubules of cytoskeleton-vesicular transport - vesicle contents are released into interstitial fluid exocytosis

type II osteogenesis imperfecta

- most severe and perinatal lethal - in utero fractures and growth retardation - severe bone deformity - large, soft cranium - connective tissue fragility

common pathologies involving oligodendroytes and Schwann cells

- multiple sclerosis - Guillain-Barre syndrom -encephalomyelitis

symptoms of generalized anxiety disorder

- muscle tension - autonomic hyperactivity - exaggerated startle response, inability to concentrate

explain what happens in the spinothalamic tract

- neuron decussates and travels up contralateral side - synapses in *thalamus* - third order neuron then travels to sensory cortex to localize pain and periaqueductal gray

sum up what happens physiologically in a headache

- neurons in brain NOT responsible for sensing pain (blood vessels, meninges, and cranial nerves transmit pain) - vasodilation and meningeal stress cause activation of trigeminal nerve (acts as first-order neuron) --> can also cause trigeminal nerve pain (TMJ) - relay of pain = initiated

name the corresponding receptor: Acetylcholine (ACh)

- nicotinic acetylcholine receptor (nAChR) - muscarinic acetylcholine receptor (mAChR)

drugs for treatment of Raynaud's

- nifedipine and diltiazem = calcium channel blockers - prazosin = alpha-adrenergic receptor blocker

unusual features of erythrocytes and platelets

- not true cells --> RBC lack nuclei and organelles, and platelets are cell fragments - Cannot divide and survive in the bloodstream for only a short time (few hours to months) before being replaced by new cells or broken down and recycled

secondary hypercholesterolemia

- obesity, high calorie intake, diabetes mellitus - LDL leves exceed receptor efficiency

osteogenesis imperfecta

- occurrence: 20,000 - 50,000 US cases - defective synthesis of collagen I alpha chains on chromosomes 17 and 7 - thin, poorly developed bones - short limbs - prone to multiple fractures - hearing loss due to osteosclerosis - stillborn prevention ad treatment of fractures

explain second intention healing

- occurs when there is a large defect, wound edges are far apart, and the healing tissue is exposed - example: gaping wounds and serious burns - take longer to heal bc greater tissue proliferation required - each stage of healing is prolonged

explain first intention healing

- occurs when there is minimal tissue damage and the wound edges closely approximate each other - an example would be surgical incision course of events: 1. immediate - clot formation 2. day 0-3 - acute inflammation 3. day 3-7 - granulation tissue, epithelialization 4. week 2-6 - scar formation 5. week 6+ - remodeling

referred pain

- often visceral in origin but FEELS like it's coming rom a somatic structure nearby i.e. heart attack feels like pain in left arm, neck, and chest wall - somatic and visceral sensory neurons synapse on SAME cells in dorsal horn which causes signals to get crossed - embryonic development of neurons will set pattern of referred pain

which two neural cells are myelinated?

- oligodendrocytes - Schwann cells

differentiate between oligodendrocytes and schwann cells

- oligodenrocytes = CNS - Schwann cells = PNS

different ways pain is classified

- onset, duration, autonomic responses, physiological component, other types of response - acute vs chronic

visceral pain

- origin is an organ - nociceptors are much more spread out in organs - travel unique tracts up to the brain

difference in osteopenia and osteoporosis

- osteopenia - bone density has begun to dwindle, but is not yet considered dangerous - osteoporosis - bone density levels become critical and frequent fractures are likely

types metabolic bone disorders

- osteoporosis - osteomalacia - malignancies - endocrine disorders: hyperparathyroidism and hyperthyroidism

myogenic cells possess an unusual ion channel, funny channel or F channel. describe it

- permeable to Na+ - when open, Na+ influx - slow depolarization

torsades de pointes is characterized by ...

- polymorphic ventricular tachycardia - rapid, asynchronous complexes with undulating baseline - long QT interval - Often seen as cardiac toxicity with many antiarrhythymic drugs and electrolyte disturbances - Repolarization of the cardiomyocytes occurs in phases 1-3, and is caused predominantly by the outward movement of potassium ions

factors effecting cardiac output:

- preload - afterload - cardiac contractility - heart rate

treatment for osteoporosis

- prevention and early detection - increased exercise - biphosphonates: analogs of endogenous inorganic pyrophosphates - *calcitonin* - endogenous peptide that inhibits osteoclastic activity

examples of B-adrenorecepto antagonists (beta blockers)

- propranolol - metoprolol - atenolol

what is the result of a cardiac arrhythmia?

- pulse = too fast (tachycardia) - pulse = too slow (bradycardia) - asynchronous

5 classes of inflammation

- redness (rubor) - swelling (tumor) - heat (calor) - pain (dolor) - loss of function (function laeso)

what is ischemia?

- reduced blood flow which results in less ATP and Less oxygen - occurs with stroke, myocardial infarction

stroke penumbra

- region of tissue radiating out from stroke - damage continues over time - accounts for deterioration in function after stroke

What is the function of microtubule-associated proteins?

- regulate microtubule dynamics - bind to surface of microtubules to stabilize or destabilize the structures

humoral mechanisms

- renin-angiotensin-aldosterone system - angiotensin II (short term) vasoconstriction - angiotensin II (long term): --> reduces sodium excretion by increasing sodium reabsorption to increase water reabsorption --> stimulate aldosterone release by adrenal gland; increases sodium and water reabsorption

astrocytes are implicated in some neuropathologies, but are rarely the root cause. Give 2 examples of this

- scar formation in TBI, stroke, Azheimers - astrocytom-glioblastoma multiforme (most aggressive brain cancer)

what is membrane potential?

- separation of electrical charges that exists across plasma membrane - provides an electrical force that influences the movement of ions across the membrane

rate of diffusion depends on

- size of concentration gradient (dC/dX) - size of molecule used to calculate diffusion coefficient (Ds) - diffusion area (A)

MOA of Ca++ channel blockers

- slowing the rate of rise in phase 4 of SA node - decrease conduction velocity in SA and AV node

genetic cause of gout

- solute carrier family 2, facilitated glucose transporter members (SLC2A9, SLC22A12) and ATP-binding cassette sub-family G member 2 (ABCG2) genes

rate of transport in mediated-transport systems is dependent on...

- solute concentration - affinity - rate of conformational change

2 key roles of the PNS :

- somatic - voluntary control of muscles - autonomic - involuntary functions --> sympathetic - fight or flight --> parasympathetic - rest and digest

describe bone connective tissue

- specialized cells - extracellular matrix protein fibers and ground substance - deposited calcium salts

2 ascending pathways the second order neurons follow:

- spinothalamic tract - spinoreticular tract

function of bones

- structural support - movement leverage - protection - mineral storage - blood-cell formation - energy storage

function(s) of astrocytes

- support neuronal function - couple blood flow from vessels to neurons - produce growth factors - buffer toxins

secondary cause of acquired neutropenia

- systemic lupus - infection (HIV, TB)

Locations of synovial joints with articular discs

- temporomandibular joint - sternoclavicular joint - knee joint

osteopenia

- term used to describe lack of bone mass greater than expected based on age, race, or sex - NOT a diagnosis - includes all metabolic bone diseases

treatment for osteoporosis in men

- testosterone: stimulates osteoblast and inhibits osteoclast - contraindicated in men with prostate cancer

treatment for hip dysplasia

- therapy - harnesses - hip casts - surgery

what do capping proteins do?

- they bind and stabilize the (-) end, preventing it from disassembling - increases the length of myofilaments - more G-actin is added than lost

diuretic drugs

- thiazides - loop diuretics - potassium-sparing diuretics

clinical manifestations of thrombocytosis

- thrombosis (deep vein thrombosis, and pulmonary embolism) - erythromelagia

how does the accumulation of LDL occur?

- through decreases in LDL receptors - through increases in LDL over receptor denisty

what is the blood-brain barrier?

- tight junctions between endothelial cells - feet of astrocytes - pericytes

secondary thrombocytosis

- tissue damage due to major surgery - chronic inflammation - cancer and myeloproliferative disorders (leukemia)

What is excitotoxicity?

- too much excitatory amino acids like glutamate get released and over-excite neurons to death

receptors that are activated on DRG neurons

- transient receptor potential channels (TRP) TRPV1 - heat and acid TRPM8 - cold - acid sensing ion channels (ASIC)

atherosclerosis

- type of arteriosclerosis - hardening of arteries - formation of fibrous fatty lesions in intimal layer of medium-large arteries

the BBB is not a good barrier against:

- uncharged and lipid soluble molecules - alcohol, nicotine, and various drugs

hangover headache mechanism

- unclear but byproducts of alcohol DEFINITELY contribute (acetaldehyde and acetic acid) - congers also contribute

diagnosis of scoliosis

- uneven shoulders or iliac crest - prominent scapula - malalignment of spinous process - asymmetrical rib cage - rib hump or paraspinal muscle prominence

complex regional pain syndrome

- unique form of chronic pain that may or may not be neuropathic - pain is WAY out of proportion to initial injury, often in arm or leg

describe C fibers of DRG neurons

- unmyelinated - primary pain fibers, warmth, burning, itch chemicals, extreme cold

secondary active transport

- uses electrochemical gradient across a plasma membrane as energy source

what happens in the vascular phase of acute inflammation?

- vasodilation results in increased blood flow (redness and heat) - increased vascular permeability --> resulting in protein rich exudate leaving capillary into interstitial space; swelling - flow slows and clotting occurs to localize spread of infection

examples of calcium channel blockers

- verapamil - diltiazem

symptoms of a brain hemorrhage

- vomiting - pain/headache - loss of consciousness

genetic disorders causing thrombocytopathia

- von willebrand disease - hemophilia A - X-linked recessive disorder - Hemophilia B - Factor IX deficiency

mediated-transport system

- when solutes are either too large and/or charged, cannot get into cell

neurogenic muscle

-"beginning of the nerve" - stimulated by action of neurons

treatment for osteoarthritis

-* Pharmacological* - •Non-steroidal anti-inflammatory drugs (NSAIDs) •COX-2 selective inhibitors (celecoxib) - NSAID •Glucocorticoid injections -Surgery - Joint replacement -Alternative medicines - Benefits are unclear •Glucosamine and chondroitin - Chondroprotective •Hyaluronate injections - Viscosupplementation

manifestation of sickle cell

-Acute pain in bones -Hypoxia -Acute chest syndrome - Atypical pneumonia -Damaged spleen

function of joints

-Articulation of bones -Allow movement by skeletal muscle contraction

clinical manifestations of leukemia

-Bone pain, anemia, fevers, chills, night sweats, weight loss

function of lymphatic vessels

-Carry fluid to great veins in the neck -Fluid flows only toward the heart -Once tissue fluid is within lymphatic vessels it is termed lymph

functions of actin filaments

-Cell shape -Mobility -Cell division -Muscle cell contraction

describe how motor proteins pull on cytoskeletal rope

-Cells organize the cytoskeleton in a way that translates tugging action into movement -Cells regulate this movement by controlling the activity of the motor proteins

pathogenesis of sickle cell

-Chronic hemolytic anemia -Blood vessel occlusion

precapillary sphincters

-Cuff of smooth muscle that surrounds each true capillary -Regulates blood flow into the capillary

2 classes of dyneins:

-Cytoplasmic- intracellular movement -Axonemal- driving force cilia and flagella movements

describe the active reorganization of cytoskeletal network

-Cytoskeletal fibers act like bulldozers pushing cellular contents forward (like amoeboid movement) -Regulated controlling rate and direction of growth of cytoskeletal fibers

medications that can cause gout

-Diuretics, ACE inhibitors, ANGII receptor blockers, beta blockers

phase 2 of cardiac muscle action potential

-Fast K+ channels close decreasing K+ permeability -L-type Ca2+ channels are fully open to increase Ca2+ permeability and flatten AP

functions of synovial joints with articular discs

-Fills in gaps to improve fit -Distributes load evenly -Minimizes wear and damage

weeping lubrication

-Fluid is squeezed out as opposing cartilages touch -Cartilages ride on the slippery film; not each other -When pressure ceases, fluid rushes back in (sponge) and ready for next load.

Causes of thrombocytopenia

-Genetic adhesion disorders •Von Willebrand disease •Hemophilia A - X-linked recessive disorder causing factor VIII deficiency in males •Hemophilia B - Factor IX deficiency -Acquired disorders •Liver disease affecting synthesis of coagulation factors V, VII, IX, X, XI, and XII, prothrombin, and fibrinogen •Vitamin K deficiency -Surgeries requiring extracorporeal circulation - Cardiac bypass -NSAIDs and aspirin use - Acetylation of platelet COX activity and

dynein structure:

-Globular head -Neck -Tail

clinical manifestations of polycythemia

-Increase in blood viscosity -Cardiac dysfunction; Hypertension -Vascular obstruction -Hypoxia

clinical course for mononucleosis

-Incubation period - 4-8 weeks -Prodromal period - Malaise, anorexia, chills -Infectious period - High fever, pharyngitis, lymphadenopathy

clinical manifestations of non-hodgkin lymphomas

-Indolent (slow-growing) lymphoma - Painless spreading with painless lymphadenopathy •Course of disease may fluctuate over years; Eventually transforming into aggressive forms -Aggressive (fast-growing) lymphoma - Pain, fever, night sweats, weight loss, susceptible to infections

dynein function:

-Larger than kinesin and moves about 5x faster. - Moves in (-) direction; to MTOC -Does not attach directly to cargo; large multiprotein accessory complexes link dynein to cargo -Provides layer of regulation of microtubule movement

kinesin structure:

-Long neck -Fan-like tail- attaches to cargo -Globular head has ATPase activity; attaches to the microtubule

diagnosis and treatment for non-hodgkin lymphomas

-Lymph node biopsy and histology -Early stage - Localized and adjuvant radiation, chemotherapy

secondary lymphoid organs

-Lymph nodes -Spleen -Tonsils -Aggregated lymphoid nodules -Appendix

medical causes of gout related to conditions

-Metabolic syndrome, hyperlipidemia, obesity, hypertension, diabetes, traumas, surgeries

phase 1 of cardiac muscle action potential

-Na+ channels close -Fast K+ channels open increasing K+ permeability for rapid repolarization

phase 0 of cardiac muscle action potential

-Na+ channels open -Voltage-sensitive L-type Ca2+ channels slowly open for CICR

properties of cartilage

-No nerves or blood vessels -Surrounded by dense irregular CT- perichondrium- acts as a girdle to prevent outward expansion; growth and repair. -Consists primarily of water -Resilient tissue—it springs back to original shape

etiology of osteomalacia and rickets

-Nutritional deficits -Malabsorptive syndromes (celiac diseases and cystic fibrosis) -Medications: Anticonvulsants, antacids -Insufficient calcium absorption due to lack of dietary calcium -Deficiency or resistance to vitamin D -Phosphate deficiency caused by renal losses or decreased intestinal absorption

Principles of Electricity

-Opposite charges attract each other -Energy is required to separate opposite charges across a membrane -Energy is liberated when the charges move toward one another -like charges repel eachother - the human body is electrically

long term controls of blood pressure

-Organ system(s) will change maintain blood pressure -Changing blood volume -Changing peripheral resistance -CO = SV x HR -BP = CO x PR

clinical manifestations of osteoarthritis

-Pain, crepitus, stiffness, redness, swollen -Bony outgrowths (osteophytes), nodes, bunions

clinical manifestations of hodgkin lymphomas

-Painless enlargement and involves lymph nodes above diaphragm -Chest discomfort with cough or dyspnea (difficulty breathing) -Fevers, chills, night sweats, weight loss

treatment of psoriatic arthritis

-Pharmacological - •Non-steroidal anti-inflammatory drugs (NSAIDs) •Disease-modifying anti-rheumatic drugs (DMARDs) - Conventional and biologics •Corticosteroids -Surgery - Joint replacement

etiology of sickle cell

-Point mutation in β-chain of hemoglobin molecule -Valine for glutamic acid -Deoxygenated hemoglobin aggregates and polymerizes in cytoplasm to change and deform cell

etiology of osteoarthritis

-Primary variants - Intrinsic defects in articular cartilage from wear and tear -Secondary variants - Congenital defects, trauma, infection, crystal deposits, metabolic disorders, inflammatory diseases

clinical manifestations of psoriatic arthritis

-Progressive joint destruction and joint deformities -May progress to arthritis mutilans

clinical manifestations of rheumatoid arthritis

-Progressive joint destruction leading to subluxation and joint deformities -Systemic disease - Fatigue, anorexia, anemia, low-grade fever

clinical manifestations of gout

-Recurrent attacks of a red, tender, hot, and swollen joint -Pain typically comes on rapidly, reaching maximal intensity in less than 12 hours -Base of the big toe is affected in about half of cases; Temperature sensitive

diagnostic marker for Hodgkin Lymphomas

-Reed-Sternberg cell presence - Large, atypical, mononuclear tumor cells

functions of secondary lymph organs

-Removal of blood-borne antigens -Removal and destruction of old or defective blood cells

treatment of rheumatoid arthritis personal

-Rest, weight loss, exercise, physical therapy, hot-cold modalities

phase 3 of cardiac muscle action potential

-Slow K+ channels open increasing K+ permeability to repolarize the membrane

pathogenesis of mononucleosis

-Spread through oral secretions -EBV can incorporate into B cell genome causing B cells to produce heterophil antibodies (diagnostic test) -Asymptomatic carriers account for spread of mononucleosis

lifestyle cause of gout

-Strongly associated with alcohol consumption, soft drinks, red meat, seafood

conducting (elastic ) arteries

-Thick-walled arteries near the heart; aorta and its major branches -Large lumen allow low-resistance conduction of blood -Contain elastin fibers in all three tunics -Withstand and smooth out large BP fluctuations allowing blood flow fairly continuously throughout the body

high permeability of lymphatic system allows for the entrance of ___________

-Tissue fluid and protein molecules -Bacteria, viruses, and cancer cells -Fight disease

manifestations of anemia

-Tissue hypoxia -Fatigue and weakness -Headache and faintness -Pallor -Tachycardia and palpitations -Bone pain/tenderness due to accelerated erythropoiesis

functions of inflammation

-To mobilize and attract immune components to the site of injury -remove initial cause of injury, clear dead tissues and cells, and initiate tissue repair; INNATE IMMUNITY

What do changes in MAPs phosphorylation do?

-alter its subcellular location - change its ability to bind a microtubule - alter its functional properties

absolute secondary polycythemia

Increase in erythropoietin as a compensation to hypoxia

Cerebral edema

Increase in water and sodium content; cytotoxic = swelling of cells with fluid, vasogenic = swelling of interstitial space with fluid

Primary CNS lymphoma

Increasing prevalence, common in immunocompromised individuals

Increasing the amount of GTP hydrolysis would ____ the dynamic instability of the microtubule cytoskeletal network. a. increase b. decrease c. no effect

What are the common mechanisms behind brain injury?

Ischemia, exicitotoxicity, cerebral edema, increases intracranial pressure

What affect does a membrane have on diffusion?

It makes it 10^3-10^6 times slower than just in water. It ultimately affects the diffusion coefficient.

which ion is the major intracellular ion?

K+

negative schizophrenia symptoms

LOSS OF NORMAL FUNCTION; alogia, affective flattening, anhedonia, asocialty, avolition/apathy, attentional impaitments

etiology of leukemia

Largely unknown etiology; high incidence in persons with high levels of radiation, benzene & some anti-tumor drug exposures High incidence in some congenital disorders (Down's syndrome) Some cases occur within the same family

etiology and pathogenesis of hodgkin lymphomas

Largely unknown, but exposure to carcinogens, viruses, genetic causes have been proposed

Cause of seizures

Largely unknown, damage, infection or epilepsy; may be connected to sodium channel and GABA signal mutations

Caused of Parkinson's disease

Largely unknown, some genetics, certain chemicals, heavy metals

Epilepsy treatments

Anti-epileptic drugs, cannabidiol, surgery (respective, corpus collostomy, and in severe hemispherectomy, and subpial transaction), keto diet, modulate GABA

dermatome

Area of skin supplied by a single spinal nerve/ganglia

Glial tumor

Astocytic and oligodendroglial

3 parts of consciousness

Awake, alert (controlled by reticulum), and consciousness (controlled by the cerebral cortex)

Blood looks homogenous to the naked eye, but it actually contains both cellular and liquid components. What is the name of the component that contains the erythrocyte component? A. Thrombocytic B. Hematocrit C. Buffy Coat D. Plasma

Developmental hip dysplasia is more prevalent in _________ because of exposure to high levels of hormones like _________ while in utero. A. Females; Testosterone B. Females; Estrogen C. Males; Testosterone D. Males; Estrogen

During intestinal absorption ________ or vitamin D2 is converted to Vitamin D3 A. Calcitonin B. Ergocalciferol C. Parathyroid hormone D. Cholecalciferol

If the concentration of ATP was decreased in the cell due to hypoxia, which of the following phases of microfilament formation would be most affected? A. Nucleation B. None of the above phases would be affected by decreases in ATP C. All of the above phases would be affected by decreases in ATP D. Elongation E. Microfilament growth

Increasing the amount of GTP hydrolysis would ____________ the dynamic instability of the microtubule cytoskeletal network. A. No effect B. Increase C. Decrease

These agranulocytes account for 20-25% of WBCs; they have large, dark-purple, circular nuclei with a thin rim of blue cytoplasm; and they are found enmeshed in lymphoid tissue? (Examples are B-cells and T-cells) A. Basophils B. Lymphocytes C. Neutrophils D. Eosinophils E. Macrophages

Transverse-tubules (T-tubules) are responsible for which of the following skeletal muscle responses? Choose the statement that most accurately describes the role of the t-tubules. A. Propagating the action potential into the muscle by carrying it parallel to the skeletal muscle fibers B. Propagating the action potential into the muscle by carrying it perpendicular to the skeletal muscle fibers***

When muscles contract, which of the following does NOT happen to the sarcomere? A. The sarcomere shortens due to the actin motor proteins pulling the myosin microfilaments inward B. The sarcomere shorterns due to the pivoting of the actin heads C. The sarcomere shortens due to the inward movement of the Z-disc

Which of the following medications would inhibit xanthine oxidase activity to prevent uric acid formation in crystal-induced arthropathy? A. NSAIDS B. Allopurinol C. Corticosteroids D. Colchicine

Which of the following receptors is directly responsible for the release of the greatest amounts of intracellular calcium and is located on the terminal cisternae of the sarcoplasmic reticulum? A. Dihydropyridine (DHP) receptors B. Ryanodine receptors (RyRs) C. Rhinoplasty receptors (RyRs) D. None of the above choices are correct

_________ will directly increase intestinal absorption of calcium and promote actions of parathyroid hormone A. Ergocalciferol B. 1,25-dihydrovitamin D3 C. Cholecaliferol D. 7-dehydrocholesterol

__________ is diagnosed by 5 cardinal signs, such as uneven shoulders, prominent scapula, malaligned spinous process, assymetrical rib cage, and rib hump. A. Osteoporosis B. Scoliosis C. Osteogenesis imperfecta D. Osteopenia

___________ condition(s) are associated with secondary osteoporosis A. Hyperparathyroidism B. All of the above are conditions associated with secondary osteoporosis C. Alcohol D. Long-term corticosteroid use

_____________ is a term used to describe a dwindling yet not dangerous bone density A. Osteoporosis B. Osteopenia C. Scoliosi D. Osteogenesis imperfecta

Autorhythmicity in myogenic cells is caused by ____________. A.) Na+/K+ ATPase Pump B.) "Funny" Channels C.) Leaky Ca2+ Channels D.) Leaky Na+ Channels

B.) "Funny" Channels D.) Leaky Na+ Channels

Vasoconstriction or Vasodilation will result in ________ changing. A.) Stroke Volume (SV) B.) Peripheral Resistance (PR) C.) Blood Pressure (BP)

B.) Peripheral Resistance (PR) C.)Blood Pressure (BP)

Changes blood volume exiting the heart with each beat will result in __________ alterations. A.) Blood Pressure (BP) B.) Stroke Volume (SV) C.) Peripheral Resistance (PR)

B.) Stroke Volume (SV)

Bedrest will cause stagnant blood flow thru _____ to result in ________. A.) Veins; Embolism B.) Veins; Thrombosis C.) Arteries; Embolism D.) Arteries; Thrombosis

B.) Veins; Thrombosis

nutritional deficiencies causing neutropenia?

B12 , folate, anorexia

signs of a stroke

BE FAST B - loss of balance E - vision disturbance (eyesight) F - facial drooping A - arm weakness S - speech difficult T - time to call 911

What is physiologically happening during a headache?

BRAIN NEURONS ARE NOT RESPONSIBLE. Vasodilation and meningeal stress cause activation of trigeminal nerve (acts on first-order neuron); can also activate trigeminal nerve pain

cerebellum

Balance and coordination

Aneurysm

Ballooning of an artery

subarachnoid hemorrhage

Bleeding into the subarachnoid space, where the cerebrospinal fluid circulates.

Blood looks homogenous to the naked eye, but it actually contains both cellular and liquid components. What is the name of the component that contains the leukocyte component? A. Hematocrit B. Buffy Coat C. Serum D. Plasma

Blood looks homogenous to the naked eye, but it actually contains both cellular and liquid components. What is the name of the fluid component that suspends the cellular component? A. Hematocrit B. Plasma C. Serum D. Buffy Coat

sick sinus syndrome

Bradycardia-tachycardia syndrome; Result of partial-total SA node destruction and SA/AV node junctional arrhythmias

A loss of red blood cells or _______ would cause a ______ in your oxygen carrying ability in blood A. Anemia; increase B. Polycythemia; decrease C. Anemia; decrease D. Polycythemia; increase

Loss of thrombocytes would result in a _________ in the body's ability to form blood clots A. Not effect B. Increase C. Decrease

Osteogenesis imperfecta is thought to be caused by defective synthesis of __________. A. Collagen II alpha B. Collagen IV alpha C. Collagen I alpha D. Collagen VIII alpha

Paget disease (osteitis deformans) is characterized by _____________. A. Lesions of excessive bone turnover B. Localized areas of osteoblastic deposition of bone C. All of the above answers are correct choices D. None of the above answers are correct choices

The Na+/Ca2+ exchanger is used to pump Na+ _______ the cell and Ca2+ ___________ during muscle relaxation A. Out of; Into B. Out of; Out of C. Into; Out of D. Into; Into E. None of the above choices are correct

_________ cells secrete hydrocholoric acid during osteolysis for bone resorption. A. Osteocytes B. Osteoprogenitors C. Osteoclasts D. Osteoblasts

__________ cytokine(s) will stimulate osteoclast precursors to cause loss of mineralized bone mass causing osteoporosis A. Tumor necrosis factor (TNF) B. Interleukin-1 (IL-2) C. Interleukin-6 (IL-6) D. All of the above cytokines are associated with increased osteoblastic activity

__________ is an anti-rheumatiod arthritis therapy that interferes with purine metabolism to reduce inflammation A. NSAIDs B. Etanercept C. Methotrexate D. Hydroxychloroquine

______ is a potent _______ to increase PR A.) Angiotensin II; Vasodilator B.) Angiotensin I; Vasoconstrictor C.) Angiotensin II; Vasoconstrictor D.)Aldosterone; Vasodilator

C.) Angiotensin II; Vasoconstrictor

Increasing the relative refractory time will _____ the chances of arrhythmias A.) Increase B.) Not Effect C.) Decrease

C.) Decrease

Vasoconstriction will _______ blood flow (Q=P/R) A.) Not effect B.) Increase C.) decrease

C.) Decrease

Vasopressin will _______ BP by _______. A.) Increase; Decreasing SV B.) Decrease; Decreasing SV C.) Increase; Increasing SV D.) Decrease; Increasing SV

C.) Increase; Increasing SV

cardiac output equation

CO = HR x SV

BP =

CO x PR

contractile myocardium cells

Cardiac muscle cell AP and CICR contraction

Bacterial Meningitis

Caused by Lysis of bacteria and release of endotoxins that lead to inflammation

what is tachycardia typically caused by?

Caused by anatomical/physiological block creating a "circus movement" (re-entrant circuit)

viral meningitis

Caused by several different viruses, less severe, great the symptoms

How are leukemias classified?

Cell type (myelocytic - ML or lymphocytic LL) Acute vs chronic

Increase intracranial pressure

Changes in amount of blood, brain tissue, and CSF that leads to obstructed blood flow, neuron death and displaced tissue

voltage-gated ion channels

Channels that open or close in response to a change in the membrane potential.

histamine

Chemical stored in mast cells that triggers dilation and increased permeability of capillaries during inflammation

What can repeated concussions lead to?

Chronic traumatic encephalopathy (causes issue with memory and controlling emotions)

Primary progressive

Continuous deterioration

seasonal affective disorder

Controversial disorder in which a person experiences depression during winter months and improved mood during spring

The ________ charge of alpha tubulin and the ________ charge of beta tubulin will be magnetically attracted to one another causing dipole formation and ultimately microtubule formation A. Positive; Negative B. Positive; Positive C. Negative; Negative D. Negative; Positive

The _________ charge of beta tubulin and the ______ charge of alpha tubulin will be magnetically attracted to one another causing dipole formation and ultimately microtubule formation A. Negative; Positive B. Negative; Negative C. Positive; Positive D. Positive; Negative

Which of the following factors will influence microtubule formation? A. Local concentrations of tubulin B. Hydrolysis of GTP C. Microtubule-associated proteins D. All of the above choices will influence microtubule formation

Which of the following is NOT characteristic of hemoglobin? A. Each hemoglobin molecule can transport four molecules of oxygen B. Hemoglobin is composed of the protein globin C. Hemoglobin has a heme group bound to an atom of iron D. Hemoglobin irreversibly binds with oxygen

__________ are recommended drug(s) for osteoporosis. A.Selective estrogen receptor modulators (SERMs) for women B. Testosterone for men C. Calcitonin D. All of the above are possible therapeutics for osteoporosis

__________ cells actively maintain bone A. Osteoprogenitors B. Osteoblasts C. Osteoclasts D. Osteocytes

__________ is a term used to describe the critical loss of bone density. A. Scoliosis B. Osteogenesis imperfecta C. Osteopenia D. Osteoporosis

__________ is an anti-osteoarthritis therapy that selectively inhibits cyclo-oxogenase-2. A. Methotrexate B. Etanercept C. NSAIDs D. Celecoxib

__________ or "growth from outside" is a term used to describe _________ in surrounding perichondrium actively secreting new cartilage. A. Interstitial growth; Chondrocytes B. Appositional growth; Chrondrocytes C. Interstitial growth; Chondroblasts D. Appositional growth; Chondroblasts

____________ is a term used to describe a slowly progressing degenerative joint disease caused by wear and tear on joints A. Osteomalacia B. Rheumatic arthritis C. Gout D. Osteoarthritis

_______________ prevents serum calcium levels from falling and serum phosphate levels from rising above normal physiological levels. A. Cholecalciferol B. Calcitonin C. Ergocalciferol D. Parathyroid hormone

The P wave represents ______________. A.) Ventricular Depolarization B.) Atrial Repolarization C.) Ventricular Repolarization D.) Atrial Depolarization

D.) Atrial Depolarization

Class I antiarrhythmic drugs will affect ___________ phase of the action potential. A.) Resting Membrane Potential B.) Hyperpolarization C.) Repolarization D.) Depolarization

D.) Depolarization

blocking production or actions of angiotensin

Dampen impact of angiotensin II (ARB's, ACEi's) to reduce PR and to some extent decrease blood volume (PR/HR)

vasodilators act by ______

Decreasing PR by relaxing smooth muscle in arterioles and veins

Parkinson's disease

Degeneration of dopaminergic neurons in the substantia nights of basal ganglia (controls voluntary movement by regulating the motor cortex)

4th leading cause of death in the US

Dementia

Multiple sclerosis

Demyelination and inflammation of white matter in the CNS; more common in men

Concussion

Diffuse brain injury caused by rotational forces, acceleration, and deceleration; no treatment

Epilepsy

Disease of having seizures

Symptoms of a concussion

Dizziness, nausea, headache, confusion, slurred speech, appearing dazed, fatigued, and amnesia

Which neurochemical is associated with schizophrenia and anxiety?

Dopamine (DA)

pericardium

Double-layered membrane surrounding the heart; provides cushioning; friction free; made of dense connective tissue and has pericardial fluid in between the layers

diffusion rate

Ds x A x dC/dX

These agranulocytes leave the circulation, enter tissue, and differentiate into highly mobile and actively phagocytic cells A. Neutrophils B. Basophil C. Eosinophils D. Lymphocytes E. Macrophages

These granulocytes account for 60-70% of WBCs; they take up both acidic and basic dyes to stain a lilac color and contain peroxidases and defensins to act as the body's bacteria slayers. A. Lymphocytes B. Eosinophils C. Basophils D. Macrophages E. Neutrophils

What do intracranial and subarachnoid hemorrhages cause?

Edema, compression of brain, and spasm of blood vessels

Transient ischemic attack

Episode of ischemia without clear infarction, stroke warning

85% of infectious mononucleosis is caused by what virus? Remainder is caused by?

Epstein-Barr ; cytomegalovirus, Hep A, rubella

psychotic depression

Expression of intensely negative mood shifts and unusual behaviors involving hallucinations, delusions, disorganized speech patterns, or loss of contact with reality.

what are the 3 main behaviors used to determine consciousness?

Eye opening, verbal and motor response (Glasgow coma scale)

TRUE OR FALSE: There are more WBCs then RBCs

FALSE

TRUE OR FALSE: Microglia are large

FALSE - small

TRUE OR FALSE: Kinesin move cargo in (-) direction to outer edges of cell

FALSE --> (+) !

TRUE OR FALSE: At least 4 neurons are required to successfully transmit pain

FALSE --> 3 neurons

TRUE OR FALSE: Schizophrenia does not have a genetic component

FALSE --> Schizophrenia has high heritability with no single gene cause

TRUE OR FALSE: the afferent neuron transmitting the signal to the spinal cord can only synapse the ascending second-order neuron

FALSE --> it can synapse MULTIPLE neurons, which may stimulate an interneuron that relays to a motor neuron to move the muscle ^^ correlation between pain & reflex

TRUE OR FALSE : cartilage is more abundant in adults than in embryos

FALSE --> vice versa

sinus pause/arrest

Failure of SA node to fire caused by digitalis toxicity, stroke, MI, myocarditis, increased vagal tone, hyper- or hypokalemia

Calcium Channel Blockers block DHP receptors to decrease contractility. True False

False

sinus tachycardia

Fast heart rate (<100 bpm) caused by fever, blood loss, anxiety, sympathetic stimulation (epinephrine)

Living at high altitudes may cause _____________ or an increase in red blood cells which would ____________ your oxygen carrying ability in blood. A. Anemia; decrease B. Polycythemia; decrease C. Anemia; increase D. Polycythemia; increase

Signs of a stroke

Loss of balance, vision disturbance, facial drooping, arm weakness, speech difficulty, time to call 911

Loss of thromboycytes would result in a _________ in the body's ability to fomr blood clots A. increase B. Not effect C. Decrease

diuretics

Lower BP by depleting Na+ to reduce blood volume (SV)

(-) ends of microtubule motor protein are arranged at ____________ (+) ends are arranged at ____________

MTOC ; outer edges of cell

foam cells

Macrophages that have consumed lipid, seen in atherosclerosis pathogenesis

Treatment of Parkinson's disease

Many drugs to restore dopamine signals, but no treatment for degeneration

alloimmune neonatal neutropenia

Maternal alloantibodies destroy infant's neutrophils

Thrombotic stroke

Most common, often occurs in large vessels

Mechanisms of ALS

Motor neurons in spinal cord die, then brain stem motor nuclei, then cortical control of motor neurons

chordae tendinae

Fibers (heart strings) attatched to the tricuspid and mitral valve which pull it closed when papillary muscles contract, preventing back flow of blood; anchor AV valves to papillary muscles

rate of diffusion obeys __________

Fick's Law : Diffusion rate = Ds * A *dC/dX

Reticular activating system

Filters info that regulates emotional and behavioral responses to sensory info, damage to RAS will impair consciousness

Stroke

Focal injury due to impaired blood flow to a region of the brain

Stroke treatment

For ischemic, bust clot and restore blood flow. Use thrombolytics (not for those with bleeding problems) or intracranial stent

What kind of protein does actin filament contain?

G-actin

what is actin composed of ?

G-actin and F-actin

Which neurotransmitter is associated with anxiety and seizures?

GABA

reduced transmission of which neurotransmitter is often thought to contribute to anxiety?

GABA

what is the pharmacological target for generalized anxiety disorders?

GABA modulation

ventricular fibrillation

Get massive uncoordinated contraction and a loss of pumping; Fatal within minutes if not reverted

what is the name of the scale that is used to assess consciousness?

Glasgow Coma Scale

Secondary Progressive MS

Gradual deterioration

Progressive relapsing

Gradual deterioration with relapse

respiratory sinus arrhythmia

Gradual lengthening and shortening of R-R intervals caused by intrathoracic pressure changes due to respiration

major medications for hyperlipidemia

HMG CoA reductase inhibitors (statins), bile acid-binding resins, cholesterol absorption inhibitor agents, niacin, and fibrates

CO =

HR x SV --> when one increases, the other decreases to keep CO about the same

kostmann syndrome

Halting of myeloid maturation due to mutations in HAX-1 gene causing neutrophil mitochondrial loss of function

F-channels:

Have unstable resting potentials that continuously let Na+ in causing slow depolarization (drift slowly up to threshold) called pacemaker potentials

cytokines

Hormone-like chemicals facilitating communication between brain and immune system (TNF and interleukins)

Who proposed the sliding filament theory?

Huxley

cause of gout

Hyperuricemia - Elevated uric acid levels that crystalize in joints in the from of monosodium urate to form deposits (tophi)

light bands in sarcomere

I bands

how many types of osteogenesis imperfecta?

I-IV

Symptoms of MS

Parathesia, optic neuritis, diplopia, abnormal gait, numbness and visual disturbances

anti-psychotic drugs often have side effects that mimic which brain disorder?

Parkinson's

________________ is a movement disorder induced by the selective death of dopaminergic neurons in the substantia nigra (a region of the midbrain)

Parkinson's disease

medulla oblongata

Part of the brainstem that controls vital life-sustaining functions such as heartbeat, breathing, blood pressure, and digestion.

periodic (cyclic) neutropenia

Periodic changes in neutrophil elastase that degrades virulent factors in bacteria

cardiac muscle action potential

Phase 0-4; depolarize quickly but take much longer to repolarize

Class III antiarrhythmics

Potassium channel blockers (increases action potential duration (APD) or effective refractory period or delay repolarization, inhibits reentry tachycardia)

Treatment for brain hemorrhage

Prevent rebleeding with vascular clips, prevent vasospasms with extra fluids, nimodipone to block calcium channel

examples of beta blockers

Propanolol, Metoprolol, Atenolol

poiseulle's equation

Q = ΔP/8Ln/pir^4 (l = length of the tube, n = viscosity of the fluid

Law of Bulk Flow

Q = ΔP/R

law of bulk flow

Q = ΔP/R

Poiseuille's equation

Q = ΔPπr4/8Lη

hemolytic anemia

RBC destruction in circulation not organs

during excitation, SR releases free calium through ______

RYR

atrial fibrillation is characterized by...

Rapid disorganized atrial activation and uncoordinated contraction of atria

Class 1 Antiarrhythmics

Sodium channel blockers (change the slope of phase 0, can abolish tachyarrhythmia cause by re-entry circuit)

mediated-transport systems

Solutes are either too large and/or charged cannot get into the cell; needs help, transporters/carriers bring them in

Treatments for MS

Some available to reduce acute attacks, slow disease and treat symptoms

2nd degree AV block

Some supraventricular complexes not conducted; dropped beats

Ischemia

Reduced blood flow, ATP, and glucose, occurs with a myocardial infarction and stroke, kills neurons and activated glial cells

Stroke penumbra

Region of tissue radiating out from stroke, damage continues over time

Disease states of MS

Relapsing-remitting, secondary progressive, primary progressive, progressive relapsing

direct vasodilators

Relax vascular smooth muscle tone allowing for dilation of resistance vessels and increased capacitance (PR)

Define inflammation

Response to eliminate harmful stimuli, such as pathogens, damaged cells, or irritants

Hemorrhagic stroke

Rupture is a cerebral blood vessel; most fatsli

Aneurysmal hemmorage

Rupture of the aneurysm

sick sinus syndrome occurs as a result of disease in the _________ node

frank-starling law

SV increases in response to an increase in blood volume in ventricles before contraction; large blood volume stretches the cardiac muscle fibers and leads to an increase in the force of contraction (increased actin-myosin binding and calcium sensitivity); CO is synchronized with venous return

status epilepticus

Seizures that do not stop

________________ are ligand-gated ion channels that allow calcium influx following glutamate stimulation

NMDA receptors

glutamate and schizophrenia

NMDA-R inhibitors exacerbate schizophrenia

Is ATP used in facilitated diffusion?

what kind of drugs could cause thrombocytopathia?

NSAIDs and aspirin use - acetylation of platelet COX activity

what kinds of pharmacological treatments are intended for pain management?

NSAIDs, opioids, anti-depressants

three transport system of glucose

Na glucose cotransporter, GLUT transporter, and the Na-K ATPase pump

Which ion is the major extracellular ion?

Na+

Which ions use specific protein channels to diffuse into and out of cells?

Na+ , K+ , Cl- , and Ca2+

absolute primary polycythemia

Neoplastic disease of pluripotent cells of bone marrow

Treatment for Alzheimer's

No effective ones, targeting amyloid B failed

3rd degree AV block

No supraventricular complexes, ventricle generates own impulse. Complete heart block

MOA of propranolol

Nonselective β receptor blocker that acts as full antagonist to decrease heart rate

Which neurotransmitter is associated with depression and PTSD?

Norepinephrine (NE)

Oligodendroglial tumlr

Not as common as astrocytic

What easily diffuses across a cell membrane?

O2, CO2, fatty acid, steroid hormones, and other nonpolar molecules [gases, fat, lipids, etc.]

premature atrial contraciton

Occur before next expected SA node impulse that is transmitted to ventricle and back to SA node

Why can glucose transport never reach an equilibrium?

Once it enters the cell it is immediately converted to G6P.

MOA of minoxidil

Opens K+ channels on smooth muscle membranes to stabilize (decrease) resting membrane potential and contraction

Osteogenesis Imperfecta is thought to be caused by defective synthesis of _______________ A. Collagen IV alpha B. Collagen I alpha C. Collagen VIII alpha D. Collagen II alpha

Risk factors for strokes

She, hypertension, smoking, diabetes, hypercholesteremia, cardiovascular disease, sex (women)

amphiarthroses

Slightly movable joints common in the axial skeleton

sinus bradycardia

Slow heart rate (<60 bpm) caused by increased vagal stimulation, medications, seen in athletes

1st degree AV block

Slowed conduction and prolonged P-R interval

what is the normal sinus rhythm?

P wave precedes QRS complex with constant R-R intervals; No alterations in SA node function

normal sinus rhythm

P wave precedes QRS complex with constant R-R intervals; no alteration in SA node function

3 waves in EKG

P wave, QRS complex, T wave

3 waves (deflections) of an EKG

P wave, QRS complex, and T wave

the outward ends of microtubules are anchored to __________________

PM integral proteins

Paget disease (osteitis deformans) is characterized by _____. a. lesions of excessive bone turnover b. localized areas of osteoblastic deposition of bone c. all of the above d. none of the above

allodynia

Pain due to a stimulus that does not normally provoke pain

TRUE OR FALSE: All available antidepressants, to date, have significant effects on the monoamine system

TRUE

TRUE OR FALSE: Blood flows from higher to lower pressures

TRUE

TRUE OR FALSE: individuals with OCD often recognize their compulsions as unreasonable

TRUE

TRUE OR FALSE: individuals with epilepsy have seizures, but not every individual who has seizures has epilepsy

TRUE

TRUE OR FALSE: microfilaments spontaneously assemble and disassemble without the investment of energy

TRUE

dissection

Tearing of the vessel wall to form a blood filled chamber and often occurs without previous evidence of dilation

Small vessel stroke

Termed lacunar, leave behind small cavities, commonly caused by hypertension and diabetes

pituitary gland

The endocrine system's most influential gland. Under the influence of the hypothalamus, the pituitary regulates growth and controls other endocrine glands.

receptor-mediated endocytosis

The movement of specific molecules into a cell by the inward budding of membranous vesicles containing proteins with receptor sites specific to the molecules being taken in; enables a cell to acquire bulk quantities of specific substances.

aortic valve

The semilunar valve separating the aorta from the left ventricle that prevents blood from flowing back into the left ventricle.

polypharmacy

The use of many different drugs concurrently in treating a patient, who often has several health problems.

These agranulocytes account for 20-25% of WBCs; they have larger dark-purple, circular nuclei with a thin rim of blue cytoplasm; and they are found enmeshed in lymphoid tissue? (examples B-cells and T-cells) a. eosinophils b. basophils c. neutrophils d. macrophages e. lymphocytes

These agranulocytes leave the circulation, enter tissue, and differentiate into highly mobile and actively phagocytic cells. A. lymphocytes B. eosinophils C. neutrophils D. macrophages E. basophils

These granulocytes account for 1-5% of WBCs; they have red, acidophilic granules that lead the body's counterattack against parasitic worms. a. basophils b. macrophages c. eosinophils d. lymphocytes e. neutrophils

These granulocytes account for 60-70% of WBCs; they take up both acidic and basic dyes to stain a lilac color and contain peroxidases and defensins to act as the body's bacteria slayers. a. macrophages b. eosinophils c. neutrophils d. lymphocytes e. basophils

Meninges

Tissue wrapping the brain that contains CSF

3 subunits of troponin

TnT, TnC, TnI

Generalized seizures

Tonic-Clonic, absence, myoclonic, clonic, tonic, atomic (all are motor other than absence)

Excitotoxicity

Too much excitatory amino acids like glutamate get released and over-excite neurons to death; NMDA receptors accept glutamate and cause a calcium influx; HALLMARK OF NEURODEGENERATIVE DISEASE

Mechanism of seizures

Too much excitatory transmission or too little inhibitory transmission

what is happening in impulse fractionation?

Too much vagal tone •Impulse generation during diastole that hits the atrium •Affects recovered cells, refractory cells, and some in-between •As a result, get asynchronous atrial stimulation and atrial fibrillation

paracellular transport

Transport of materials through the interstitial space between cells without interactions with the cytoplasm or cell membrane

Transverse tubules (T-tubules) are responsible for which of the following skeletal muscle responses? Choose the statement that most accurately describes the role of the t-tubules. a. propagating the action potential into the muscle by carrying it parallel to the skeletal muscle fibers b. propagating the action potential into the muscle by carrying it perpendicular to the skeletal muscle fibers c. propagating the action potential into the muscle to trigger voltage-sensitive RyR to open letting in extracellular calcium into the skeletal muscle fibers d. none of the above

Symptoms of Parkinson's diseade

Tremor, rigidity, bradykinesia, dysphasia and autonomic dysregulation

TRUE OR FALSE: Pain is a perception/feeling

True

TRUE OR FALSE: WBCs are usually larger than RBCs

True

Verapamil and Dilitiazem will block activated and nonactivated Ca2+ channels. True False

True

Meningiomas

Tumor in meningothelial cells

Ependymomas

Tumor in the cells that line the ventricles

Cause of MS

Unknown but oligodendrocytes die

what do voltage-gated calcium channels do?

Use calcium influx (rather than sodium) for rising phase depolarization of the action potential

antiarrhythmic drugs are classified according to ________

Vaughan William

the hypercoagulability risk factors are determined by what?

Virchow's Triad

Ergocalciferol

Vitamin D2

Cholecalciferol

Vitamin D3

through intestinal absorption, Vitamin D2 (ergocalciferol) is converted to _________

Vitamin D3 (cholecalciferol)

Symptoms of brain hemorrhage

Vomiting, pain/headache, loss of consciousness

symptoms of ALS

Weakness, stiffness, dysphagia, dysphonia, as it advances- death often involves respiratory muscle failure

Symptoms of ALS

Weakness, stiffness, dysphasia, dysphonia, then death or respiratory muscle failure after it advances

Law of Laplace

T = aPr •σ = Pr / w -σ = wall stress placed on the tube's wall -P = transmural pressure (pressure in tube vs. pressure out tube) -r = radius of the tube

lymphocytes that help fight infection

T cells and B cells

common pathologies associated with astrocytes

TBI, stroke, Alzheimer's (rarely the root cause)

arterioles

smallest arteries; lead to capillary beds, control flow into capillary beds via vasodilation and constriction; very little muscle layer if at all

What do a lot of patients with schizophrenia do?

smoke

tunica media

smooth muscle and elastic fiber layer, regulated by sympathetic nervous system; contributes to controlling blood pressure (controls vasoconstriction and vasodilation); controls lumen diameter

B2 adrenergic receptors are located in _________

smooth muscle of bronchioles, arterioles, and visceral organs

ions involved in ectopic pacemaker activity

sodium and potassium

marked phase 0 slope decrease

sodium channel blocker antiarrhythmic drugs that cause minimal APD effects; slow dissociation from Na channel

little phase 0 slope decrease

sodium channel blocker antiarrhythmic drugs that shorten the APD in some cardiac tissues; rapid dissociation from Na channel

moderate phase 0 slope decrease

sodium channel blocker antiarrhythmic drugs the prolong the action potential duration; intermediate dissociation from Na channel

certain forms of epilepsy are caused by failures of

sodium channel inactivation --> repetitive firing/failed repolarization

phase 0 of cardiac muscle action potential

sodium channels open while voltage-sensitive L-type calcium channels slowly open for CICR

pressure natriuresis

sodium excretion

electrolytes in blood

sodium, potassium, calcium, chloride, bicarbonate

What is the blood brain barrier not good at protecting against?

uncharged and lipid soluble, alcohol, nicotine and various drugs

complex regional pain syndrome

unique form of chronic pain may or may not be neuropathic; pain is WAY out of proportion to initial injury, often in an arm or a leg

cause of psoriatic arthritis

unknown

cause of rheum

unknown

cause of M.S.

unknown , but oligodendrocytes die

causes of hereditary and congenital deformities

unknown, genetic influences, exposure to external agents abnormalities of bone matrix, deficient, collagen synthesis, decreased bone mass

causes of seizures

unknown; thought to be due to damage or infection; likely due to genetic mutations in sodium channels or GABA signals

C fiber

unmyelinated, inolved in pain, warmth, burning, itching, chemicals and extreme cold

myogenic cells have a (stable / unstable) resting membrane potential

unstable

developmental hip dysplasia types

unstable, subluxated, or complete dislocated

afferent information runs (up/down) the spinal cord; what kind of info does this usually consist of? is it the (dorsal/ventral) column?

up; sensory info; dorsal

What does the rate of transport depend on?

solute concentration, affinity and rate of conformational change

2 key roles of the peripheral nervous system

somatic and autonomic

ectopic pacemaker is often a result of

some injury - ischemia, hypoxia

2nd degree AV block

some supraventricular complexes not conducted; dropped beats

aura

sometimes occurs with migraines to warn before it starts, often light disturbances

What is the two step process of transcellular transport?

uphill step that requires energy and a downhill step that does not require energy

transporter

specific for their ligand, dont move as many ions because they have to bind and go through conformational shifts; can be saturated and reach a max flux; how we move BIG THINGS

most DRG neurons synapse in _________ and release excitatory neurotransmitters -->

spinal cord; glutamate, substance P, CGRP

peripheral nervous system

spinal nerves, cranial nerves and all nerves outside CNS

what does the PNS consist of

spinal nerves, cranial nerves, all nerves outside CNS

2 main ascending pathways that second order neurons follow up to the brain

spinothalamic tract and spinoreticular tract

inflammatory phase

starts when wound develops (damaged vessels leak blood and damaged cells release histamine), lasts 4-6 days, healing process triggered (vascular and cellular phase of inflammation); clot and scab form and macrophages start cleaning up debri

HMG CoA reductase inhibitors

statins; act by competitively inhibiting HMG-CoA reductase, the rate limiting enzyme of the mevalonate pathway that produces cholesterol in the liver

what is the function of osteogenic cells?

stem cells that differentiate into osteoblasts for healing

What is hemostasis?

stoppage of bleeding

what causes premature atrial contraction?

stress, alcohol, tobacco, caffeine, MI, potassium imbalance

characteristics of cardiac muscle

striated, short, fat, branched and interconnected due to branching, centrally located nuclei

Frank Starling law

stroke volume of the heart increases in response to an increase in the volume of blood in the ventricles, before contraction

common pathologies indicated in cerebrovasculature

stroke, transient ischemic attack, aneurysm

common pathologies associated with cerebrovasculature

stroke, transient, ischemic attack, aneurysm

what kind of hemorrhage leads to accumulation of blood in the subarachnoid space?

subarachnoid hemorrhage

neuropeptides

substance p and CGRP

A delta fibers

subtype of A fibers with slightly less myelination and are responsible for acute mechanical and thermal pain (sharp pain)

cutaneous pain

superficial pain usually involving the skin or subcutaneous tissue

astrocyte

support neuronal function by controlling blood flow to neurons, producing growth factors, and buffering toxins; contribute to blood-brain barrier

voltage-gated calcium channels

use calcium influx (rather than sodium) for rising phase depolarization of the action potential; lets a puff of calcium in to induce CICR

what is cytotoxic edema?

swelling of cells with fluid

what is vasogenic edema?

swelling of interstitial space with fluid

Cause of Raynaud's Disease

sympathetic vasoconstriction causing vasospasms resulting in ischemia

etiology of Raynaud's disease/phenomenon

sympathetic vasoconstriction causing vasospasms resulting in ischemia

peripartum depression

symptoms of depression or a major depressive episode that occurs during pregnancy

site of connection between neurons and target effector cells

synapse

the ______ circuit is the left side of the heart and pushes blood through heart --> tissues --> heart

systemic

left ventricle

systemic circuit, contracts more forcefully, more pressure/resistance, and greater distance

cardiac cycle phases

systole (contraction) and diastole (relaxation)

phases of the cardiac cycle

systole (contraction) and diastole (relaxation); in order for it to start, all chambers must be relaxed. then, atria contracts while ventricles relax and vice versa

__________ pressure results from blood forced into the arteries during ventricular systole

systolic

results of arrhythmias

tachycardia, bradycardia and asynchronous heart rate; rate and/or timing of contraction is insufficient to maintain normal cardiac output

Sick sinus syndrome can cause what other syndrome?

tachycardia-bradycardia syndrome --> rate varies from fast to slow and back again

For the monoamine hypothesis, how do we test for the low levels of serotonin and norepinephrine?

take a sample of cerebrospinal fluid

pulmonary artieries

take the blood to the lung where oxygen is picked up and CO2 is left off

what do the pulmonary arteries do?

take the blood to the lung where oxygen is picked up and CO2 is left off

dissection aneurysm

tearing of the vessel wall, where the layers start to separate, form a blood filled chamber and often occurs without previous evidence of dilation

factors that influence magnitude of diffusion

temperature, mass of molecule, surface area, medium

factors that influence the magnitude of diffusion

temperature, mass of molecule, surface area, medium

most common form of primary headache

tension

In an EKG, what are the atrial repolarization and diastole records masked by?

the QRS complex but ventricular depolarization gives off very strong electrical activity

cardiac contractility

the ability of the heart to contract; the strength of the heart's contractions; ionotropic effect

What causes reflexes when pain signals are being transmitted?

the afferent neuron synapses on multiple neurons, one of which being an interneuron in the spinal cord that relays to a motor neuron to cause a muscle to move

cardiac output

the amount of blood the heart beats per unit time

what is cardiac output?

the amount of blood the heart beats per unit time (min)

what is stroke volume?

the amount of blood the heart pumps with each beat

stroke volume

the amount of blood the heart pumps within each beat

afterload

the amount of resistance to ejection of blood from the ventricle; load imposed on heart after contraction; resistance heart has to work against after contraction

What is the difference between the different degrees of heart block?

the amount of signal that gets through

heart sounds

the closure of valves and rushing of blood through the heart cause characteristic "Lub Dub" sounds that can be heard during auscultation; can change depending on where on the chest one is listening from

affect the medium has on the rate of diffusion

the denser the medium, the slower the rate of diffusion

sympathetic nervous system

the division of the autonomic nervous system that arouses the body, mobilizing its energy in stressful situations

parasympathetic nervous system

the division of the autonomic nervous system that calms the body, conserving its energy

somatic nervous system

the division of the peripheral nervous system that controls the body's skeletal muscles; voluntary

fatty streaks

the earliest lesion of atherosclerosis; thin, fatty, intimal plaques composed of macrophages and smooth muscle cells with lipids to form foam cells; attract monocytes

what is the "potential" portion of resting membrane potential?

the electrical and chemical gradient created by active ion transporters (Na/K ATPase pumps) in the membrane represent stored or potential energy

membrane potential

the electrical and chemical gradient created by active ion transporters in the membrane; represents a stored or potential energy; when opposite charges come back together energy is released to do work

objective fear

the fear was reasonable under the circumstances; triggers sympathetic response

wall stress

the force per unit area on the wall of a blood vessels created by blood leaving the heart

affect the surface area of a container has on the rate of diffusion

the greater the space available for diffusion, the faster the rate of diffusion

affects mass of molecule has on the diffusion rate

the heavier the molecule, the slower the rate of diffusion

What is the major limiting factor of diffusion across a membrane?

the hydrophobic interior of the bilayer

stimulation of periaqueductal gray (PAG) leads to neurotransmission signals that activate ______________

the interneurons inhibit the second-order ascending pain neurons

Where are a lot of aquaporins found?

the kidney and the gut

hemorrhage

the loss of a large amount of blood in a short time; can happen with atherosclerosis when the plaque builds up with blood then starts to leak some

oxygen carrying capacity

the maximum amount of oxygen that can be transported by hemoglobin

The larger the injury to the brain...

the more likely to lose consciousness or if it affects the brainstem

diffusion

the movement of molecules from one location to another across a membrane as a result of random thermal motion; eventually reaches equilibrium; NO ENERGY USED

autonomic nervous system

the part of the peripheral nervous system that controls the glands and the muscles of the internal organs (such as the heart).; involuntary functions

diastolic pressure

the pressure in the arteries during ventricular diastole; pressure in aorta after the heart relaxes

myelination

the process by which axons become coated with myelin, a fatty substance that speeds the transmission of nerve impulses from neuron to neuron; viewed as white matter in scans

Where do sensory receptors send their information to?

the sensory cortex (including touch, temp, position, pain)

Where do most DRG neurons synapse?

the spinal cord and release excitatory neurtransmitters like glutamate, substance P, and CGRP

what is the "resting" portion of resting membrane potential?

the steady state electrical gradient seen in all living cells cells are more (-) charged outside

gate control theory

theory that non painful stimuli close the gates on painful signals being transmitted interneurons in spinal cord can inhibit the ascending pathway interneurons can be activated by the faster A fibers

For every increase or decrease in resistance...

there in an inverse change in flow (Q)

For every increase or decrease in MAP...

there is a direct change in flow (Q)

For every increase or decrease in the tube radius...

there is a direct change in flow (Q)

Forever every increase or decrease in tube length (or cross-sectional area) or viscocity...

there is an inverse change in flow (Q)

how do membranes affect diffusion coefficients?

they act as barriers SLOWING diffusion of molecules across their surfaces

What plane are the heart valves in?

they are all in the same plane as the heart so they separate the heart into top and bottom halfs

pressure fluxes in arteries

they are dampened due to elasticity

What do astrocytes do when responding to an injury?

they form a scar called a gliosis or glial scar

the striated muscle cell is composed of thick and thin filaments . name them

thick : myosin thin : - tropomodulin - troponin - tropomyosin

What spinal nerves have cell bodies in the DRG?

thoracic and lumbar regions

what group of people does Paget disease typically manifest in?

those of Northern European heritage ~40 years old

symptoms of migraines

throbbing, light sensitivity, smell sensitivity, nausea & vomiting, etc

________ acts as an enzyme severing amino acid side chains from fibrinogen molecules to form fibrin threads

thrombin

platelets

thrombocytes; cell fragments in the blood that are essential for blood clotting (coagulation)

what is the most common kind of ischemic stroke?

thrombotic (occurs in large blood vessels)

what is released from platelets in vascular constriction?

thromboxane A2 (TXA2)

where are T cells matured?

thymus

What controls the amount of paracellular transport that occurs?

tight junctions

what is paracellular transport minimized by?

tight junctions of epithelium

What are parts of an EKG like the S-T segment or any of the intervals a measure of?

time

erythropoiesis is governed by ________________; and is sensed by peritubular cells of kidney to release _____________

tissue oxygen needs; erythropoietin

what is the goal of clot dissolution in hemostasis?

to activate. fibrinolysis enzymes to dissolve clot

what is the goal of treatment for thrombocytosis?

to decrease platelet activation

what is the goal of the formation of platelet plug in hemostasis?

to plug vessel and start repair

what is the goal of clot retraction in hemostasis?

to shrink clot to join edges of broken vessel

what is the goal of blood coagulation in hemostasis?

to stabilize plug and form clot

what is the goal of vascular constriction in hemostasis?

to stop blood loss

mechanism of seizures

too much excitatory transmission or too little inhibitory transmission

impulse fractionation

too much vagal tone that causes it to be slow; impulse generation during diastole that hits the atrium, affects recovered cells, refractory cells, and some in-between; get asynchronous atrial stimulation and atrial fibrillation; during relaxation period, cell is suddenly stimulated by a random pulse

base of the heart

top of the heart

where do veins carry blood?

towards the heart

what are the deep lymph nodes?

tracheobronchial, aortic, iliac

in epithelial transport, movement can occur through cells ( _____________) or around cells (____________)

transcellular, paracellular

TENS unit

transcutaneous electrical nerve stimulation

large molecules that cannot cross epithelium are transported by ____________

transcytosis

glucose transport from intestinal lumen or kidney tubule to extracellular fluid is an example of what kind of transport?

transepithelial

what is the function of the GLUT transporter

transfers glucose to ECF (extracellular fluid) by facilitated diffusion

GLUT transporters

transfers glucose to ECF by facilitated diffusion

What are the receptors for DRG neurons?

transient receptor potential channels (TRPV1 and TRPM8) and acid sensing ion channels

blood

transport medium within which material being transported are dissolved or suspended; flows from HIGHER to LOWER pressure

transcellular transport

transport of materials through the cell; requires interaction with the cytoplasm and may require transport proteins

what do the different arrangements of actin and myosin enable cells to do?

transport vesicles and organelles, change shape, and motility

Describe facilitated diffusion

transporter moves molecules down concentration gradient across cell membrane

facilitated diffusion

transporter moves molecules down concentration gradient across cell membrane, does not use energy; continues until concentrations are equal on both sides of membrane

symporter

transporter that carries two different ions or small molecules, both in the same direction

pathogenesis of Raynaud's phenomenon

trauma, occupational trauams, collagen diseases, neurological disorders, hot-cold exposures

examples of brain injuries

trauma, stroke, metabolic problems, degenerative disorders

what kinds of treatments are available for MS?

treatments to reduce acute attacks, slow the disease, and treat symptoms

4 valves of the heart

tricuspid, pulmonary, mitral, aortic

which troponin subunit? Ca2+ sensor; has 4 Ca2+ binding sites

troponin C

which troponin subunit? links troponin to actin; inhibits actin-myosin ATPase

troponin I

which troponin subunit? .tropomyosin which blocks sites on actin where myosin binds

troponin T

in muscle contraction, the calcium signal is transmitted to contractile apparatus by thin filament proteins _______ and _______

troponin and tropomyosin

When muscles contract, which of the following does NOT happen to the sarcomere? a. the sarcomere shortens due to the pivoting of the actin heads b. the sarcomere shortens due to the actin motor proteins pulling the myosin microfilaments inward c. the sarcomere shortens due to the inward movement of the Z-disc

TRUE OR FALSE: Microtubules are easily arranged

true

TRUE OR FALSE: blood has cellular and liquid component(s)

true

dystrophic calcification occurs in normal, living tissue as a result of hypercalcemia

true

Which of the following medications would inhibit leukocyte migration and phagocytosis to reduce inflammation in crystal-induced arthropathy? a. corticosteroids b. colchicine c. allopurinol d. NSAIDs

Which of the following medications would inhibit xanthine oxidase activity to prevent uric acid formation in crystal-induced arthropathy? a. corticosteroids b. colchicine c. NSAIDs d. allopurinol

Which of the following receptors is directly responsible for the release of the greatest amounts of intracellular calcium and is located on the terminal cisternae of the sarcoplasmic reticulum? A. Dihydropyridine (DHP) receptors B. Ryanodine Receptors (RyRs) C. Rhinoplasty Receptors (RyRs) D. None of the above choices are correct

Active transport

uses ATP to move molecules against the concentration gradient

perimysium

Within a muscle, muscle fibers (cells) are separated and bound into groups (fascicles) "around the muscle"

endomysium

Within each fascicle, each muscle fiber is surrounded by a fine sheath of connective tissue wrapping each muscle cell "within the muscle"

describe active transport

uses ATP to move molecules against the concentration gradient

EC coupling in skeletal muscle

uses acetylcholine to change sodium permeability to open voltage gated calcium channels

Within the skin, 7-dehydrocholesterol D3 is converted to vitamin D3 or ______. a. calcitonin b. cholecalciferol c. parathyroid hormone d. ergocalciferol

Focal seizure

Without impairment is simple partial, with impairment is complex partial

does active transport use ATP?

YES

are neurons excitable?

Yes

secondary active transport

uses electrochemical gradient across a plasma membrane as energy source, coupled to a transporter

Who does bipolar disorder present in?

usually in 30s to 40s of about 1-3% of the population

sarcomere

Z disc, A bands and I bands - arrangement of actin and myosin

_____ cells secrete hydrochloric acid during osteolysis for bone resorption. a. osteoprogenitors b. osteoclasts c. osteoblasts d. osteocytes

_____ is diagnosed by 5 cardinal signs, such as uneven shoulders, prominent scapula, malaligned spinous process, assymmetrical rib cage, and rib hump. a. osteopenia b. scoliosis c. osteoporosis d. osteogenesis imperfecta

______ are the boundaries of each sarcomere. a. I-zones b. Z-discs c. H-zones d. M-lines

c (I think this is the one where the answer just could not be D)

______ cytokines will stimulate osteoclast precursors to cause loss of mineralized bone mass causing osteoporsis. a. tumor necrosis factor (TNF) b. interleukin-1 (IL-1) c. interleukin-6 (IL-6) d. all of the above cytokines are associated with increased osteoblastic activity

______ is a term used to describe the formation of uric acid crystals (tophi) in the joints. a. osteoarthritis b. rheumatic arthritis c. gout d. osteomalacia

______ is an anti-osteoarthritis therapy that selectively inhibits cyclo-oxogenase 2. a. etanercept b. NSAIDs c. celecoxib d. methotrexate

______ is an anti-rheumatoid arthritis therapy that is soluble TNF-alpha fusion protein used to scavenge circulating and local TNF-alpha to reduce inflammatory cytokine. a. methotrexate b. hydroxychloroquine c. NSAIDs d. etanercept

______ prevents serum calcium levels from falling and serum phosphate levels from rising above normal physiological levels. a. cholecalciferol b. ergocalciferol c. calcitonin d. parathyroid hormone

_______ is an anti-rheumatiod arthritis therapy that interferes with purine metabolism to reduce inflammation a. NSAIDs b. methotrexate c. hydroxychloroquine d. etanercept

_______ will directly increase intestinal absorption of calcium and promote actions of parathyroid hormone a. cholecalciferol b. 7-dehydrocholesterol D3 c. 1,25-dihydrovitamin D3 d. ergocalciferol

_________ cells actively maintain bone. A. Osteocytes B. Osteoprogenitors C. Osteoblasts D. Osteoclasts

__________ are recommended drug(s) for osteoporosis A. Selective estrogen receptor modulators (SERMs) for women B. Testosterone for men C. Calcitonin D. All of the above are possible therapeutics for osteoporosis

__________ condition(s) are associated with secondary osteoporosis. A. Alcohol B. Long-term corticosteroid use C. All of the above conditions are associated with secondary osteoporosis D. Hyperparathyroidism

__________ is a systemic autoimmune and inflammatory disease that clinically manifests in progressive joint destruction. A. Psoriatic arthritis B. Osteoarthritis C. Paget's disease D. Rheumatoid arthritis

__________ is a term used to describe the critical loss of bone density. A. Scoliosis B. Osteogenesis imperfecta C. Osteopenia D.Osteoporosis

__________ is a term used to describe the softening of bones. A. Osteomalacia B. Rickets C. All of the above answers are correct choices D. None of the above answers are correct choices

____________ cells actively produce and secrete the organic portion of the bone matrix A. Osteoblasts B. Osteocytes C. Osteoprogenitors D. Osteoclasts

____________ or "growth from within" is a term used to describe _______________ within the cartilage dividing and secreting new cartilage matrix A. Interstitial Growth; Condroblasts B. Appositional growth; Chondroblasts C. interstitial Growth; Chondrocytes D. Appositional Growth; Chondrocytes

________________ cells are randomly distributed throughout the bone matrix and are able to differentiate to osteoblasts during the bone healing process A. Osteoprogenitors B. Osteoclasts C. Osteoblasts D. Osetocyetes

___________________ inhibits calcium release from bone and by inhibiting osteoclast activity A. Parathyroid Hormone B. Cholecalciferol C. Calcitonin D. Ergocalciferol

___________________ or "growth from outside" is a term used to describe ________________ in surrounding perichondrium actively secretng new cartilage. A. interstitial growth; Chondrocytes B. Appositional growth; Chrondroblasts C. Appositional Growth; Chrondrocytes D. Interstitial Growth; Chondroblasts

14. A person that finds it difficult to relax and enjoy themselves without a drink of alcohol is exhibiting signs of dependence. a. True b. False

18. Delusions are a positive symptom of schizophrenia. a. True b. False

21. The Na+/K+-ATPase pump will _______ the number of intracellular K+ ions. a. Increase b. Decrease c. Not affect

23. _____ is caused by a reduction in neurons that synthesize _____. a. Parkinson's Disease; Dopamine b. Bipolar Disorder; Acetylcholine c. Amyotrophic Lateral Sclerosis; GABA d. Amyotrophic Lateral Sclerosis; Glutamate

25. Which of the following cell types is most commonly the source of primary brain tumors. a. Astrocytes b. Schwann cells c. Neurons d. Microglia

28. An excitatory postsynaptic potential will cause a _____ event on the postsynaptic cell. a. Depolarizing b. Hyperpolarizing c. Repolarizing

33. High levels of this neurotransmitter is associated with chronic anxiety and some aspects of schizophrenia, while low levels are linked to depression. a. Dopamine b. Norepinephrine c. GABA d. Acetylcholine

37. A focal seizure is marked by spontaneous depolarizations and increased excitability in one localized region of the brain. Which cell type is most commonly associated with a seizure? a. Neuron b. Microglia c. Cerebrovasculature/endothelial cell d. Schwann cell

46. An unresponsive patient is brought to the ER and their friends indicate they may have overdosed on "goof-balls", a street version of pentobarbital - a powerful barbiturate. The pt scores a 6 on the Glasgow Coma Scale. The patient has likely damaged or reduced the function of their reticular activating system. (RAS - also helps us sleep) a. True b. False

47. Repeated use of 'goof balls' by this patient would be classified as substance abuse. a. True b. False

49. _________ is a solution that exerts a similar osmotic pressure than the cell contents. a. Isotonic solution b. Hypertonic solution c. Hypotonic solution

5. The Na+/K+-ATPase pump will ___________ the number of extracellular K+ ions? a. Decrease b. Not effect c. Increase

parasympathetic regulation of blood pressure

vagal stimulation of SA node, AV node, atria, very little in ventricles to slow heart rate

mitral valve

valve between the left atrium and the left ventricle; bicuspid valve

tricuspid valve

valve between the right atrium and the right ventricle

bundle of His

a bundle of modified heart muscle that transmits the cardiac impulse from the atrioventricular node to the ventricles causing them to contract; there is a pause right before this; carries signal through septum to bottom of the heart and to the outside edges

pulmonary valve

valve positioned between the right ventricle and the pulmonary artery

what does the endothelial layer cover?

valves

ion channel

a complex of protein molecules aggregated together in a cell membrane that form a subunit that create a pore through which ions can pass

What does too much cocaine use cause?

a decrease in the availability of dopamine receptors

major depression

a disorder characterized by severe negative moods or a lack of interest in normally pleasurable activities; comes on suddenly and seems to have no cause

premenstrual dysphoric disorder

a disorder marked by repeated episodes of significant depression and related symptoms during the week before menstruation

GABA

a major inhibitory neurotransmitter; causes hyperpolarization

Na/glucose symporter

a membrane transport protein that simultaneously transports glucose and sodium ions into cells, with the movement of sodium ions down their electrochemical gradient driving the transport of glucose against its concentration gradient

periaqueductal gray

a midbrain region involved in pain modulation (may involve endorphins and endogenous opioids); stimulation leads to neurotransmission of signals that activate interneurons (inhibit ascending)

ectopic pacemaker

a pacemaker other than the SA node; may arise from conduction cells, if SA node slows down too much or other conduction cells become dominant; increasing phase 4 slope, new pacemaker cells are controlling conduction (lower threshold)

what is an arrhythmia?

a problem with SA, AV, Bundle of His, or Purkinje network

arrhythmia

a problem with SA, AV, bundle of his or purkinje netowrk; can cause changes in electrical events

secondary arrhythmia

a secondary effect of a combination of other conditions

basal ganglia

a set of subcortical structures that directs intentional movements

dependence

a state in which the individual only functions normally in the presence of the drug

dependence

a state in which the individual only functions normally in the presence of the drug; cant function normally without it

orthostatic hypotension (postural hypotension)

a sudden drop in blood pressure when rising to sit or stand.

phases of acute inflammation

vascular , cellular

circulating plasminogen in clot and tissue plasminogen (TPA) in damaged cells are activated by ________________

vascular endothelium

oligodendrocyte

a type of glial cell that forms myelin in the central nervous system

Ischemic stroke

a type of stroke that occurs when the flow of blood to the brain is blocked, usually by a clot

atypical depression

a variant of major depressive disorder marked by increased sleep and appetite

gamma platelet granules contain what?

vasoconstrictors (histamine, serotonin, epinephrine)

vascular phase of acute inflammation

vasodilation results in an increase of blood flow, vascular permeability, changes in osmotic pressure that lead to swelling, and clotting starts to occur; increases movement of plasma

blood flow is regulated by __________________

vasomotor nerves and local chemical conditions, so it can either bypass or flood the capillary bed

Who created the four classes of antiarrhythmics?

vaughan william

Where is blood pressure lowest?

vena cava/ veins

Why can the heart not move blood back from the limbs?

venous blood flow is low

the Frank-Starling Mechanism allows the cardiac output to be synchronized with the

venous return

What condition leads to an occlusion in venous drainage?

venous thrombosis

example(s) of occluding venous drainage

venous thrombosis

once in the loose CT, WBCs move by ________ motion

abeoboid

Disseminated Intravascular Coagulation (DIC)

abnormal activation of the proteins involved in blood coagulation, causing small blood clots to form in vessels and cutting off the supply of oxygen to distal tissues

Re-entry arrhythmias

abnormal circuit from tissue damage (ishemia or MI); leads to repetitive action such as micro-reentry circuit-daughter impulses and circus movement

seizure

abnormal discharge of neurons

what is neoplasia?

abnormal growth of tissue

scoliosis

abnormal lateral deviation of spine

what is polycythemia?

abnormally high RBC count

what is thrombocytosis?

abnormally high platelet count

what is anemia?

abnormally low RBCs and/or low level of hemoglobin; decreased oxygen-carrying capacity

in the cardiac cycle, the atria contracts first while ________ relax

ventricles

in atrial fibrillation , the _________ response is irregular in pulse deficit

ventricular

what does the QRS complex correspond to?

ventricular depolarization

What is most common cause of sudden cardiac death?

ventricular fibrillation

most common cause of sudden cardiac death

ventricular fibrillation

what does the T wave correspond to?

ventricular repolarization followed by ventricular relaxation (diastole)

neurotransmitters include...

acetylcholine, amino acid based chemicals, monoamine based chemicals and neuropeptides

secondary increased coagulation activity

acquired, causes: chronic inflammation, venous stasis MI , oral contraceptives

How do lipid soluble substances move across capillaries?

across the cell membrane

list the cytoskeleton filaments in order from smallest to largest

actin < intermediate < microtuble

systemic manifestations of inflammation

activation of macrophages leads to the produce of TNF and IL-1 - local and systemic effects both come from this

nociception

activation of pain sensors in periphery

pump

active transport mechanism that works against electrochemical gradients

what is the function of osteoblasts?

actively produce and secrete organic portion of bone matrix or osteoid

veins are formed when ______

venules converge

acute inflammation vs. chronic inflammation

acute: - initial response to harmful stimuli - increased movement of plasma (vascular phase) - leukocytes (granulocytes) move from blood into injured tissues (cellular phase) chronic: - prolonged inflammation - shift in the type of cells present at the site of inflammation (lymphocytes, macrophages)

examples of calcium channel blockers

verapamil , diltiazem

examples of calcium channel blockers

verapamil and diltiazem

How do water soluble substances move across capillaries?

vesicle transport (transcytosis)

transcytosis

vesicle transport for large molecules that cant usually get across the membrane; brought into a vesicle via receptor- mediated endocytosis; vesicles transported by microtubules and release their content into interstitial fluid via exocytosis

therapeutic strategies for parkinson's disease

administer L-DOPA and increase dopa. synthesis (increase synthesis); decrease reuptake and prevent degradation (prevent termination); mimic dopa. by agonizing receptors (bind post-synaptic receptor)

dorsal column

afferent and carries SENSORY information

first order neuron

afferent neuron that transmits information from periphery to CNS (often through the dorsal root ganglion to the spinal cord)

Calcium-induced calcium release (CICR)

after depolarization via sodium channels, calcium enters cell via L-type channels. This activates ryanodine receptors that trigger calcium release from the SR to aid in contraction

calcium channel blockers

agents that inhibit the entry of calcium ions into heart muscle cells, causing a slowing of the heart rate and a relaxing of the smooth muscle cells of the blood vessels to cause dilation; blocks L type channel and reduces CICR

what is osteoporosis associated with?

aging, gender, genetics, activity level, nutrition

treatments for schizophrenia

aim to induce remission, prevent reoccurrence and improve behavioral function

proteins in blood

albumins, globulins, fibrinogen

other diseases that increase risk of neuropathic pain

alcoholism and hypothyroidism

what do myeloid stem cells give rise to?

all other blood cells other than lymphocytes

what do lubricating devices of synovial joints allow for?

allow for joining bones to move across one another with minimal friction

gap junctions

allow free passage of ions for spread of depolarization; cytosol to cytosol

receptors of norepinephrine

alpha adrenergic (alpha AR) and beta adrenergic (beta AR)

what are microtubules made of ?

alpha and beta tubulin

what is the neuroendocrine hypothesis?

alterations in several hormone cascades are associated with depression --> many pts show elevated cortisol and low thyroid hormone levels

neuroendocrine hypothesis

alterations in several hormone cascades are associated with depression like low cortisol and low thyroid hormone

treatment of venous thrombosis

ambulation, compression stockings, pneumatic compression devices, anticoagulant therapy (heparin and warfarin), or surgery

in the skin, UV radiation converts 7-dehydrocholesterol D3 to ______

vitamin D3

what is required to synthesize and activate the clotting cascade in hemostasis?

vitamin k and calcium

_____________________ channels in cardiac muscle stay open for a much longer time period

voltange-sensitive Ca2+

What are the precursors of monoamine based chemicals?

amino acids

example of potassium channel blockers

amiodarone and vernakalant

examples of potassium channel blockers

amiodarone, vernakalant

which region of the CNS is critical for emotional regulation?

amygdala

which proteins are abnormal in dementia?

amyloid beta - forms plaques and tau forms tangles

what is ALS?

amyotrophic lateral sclerosis (Lou Gehrig's disease)

ALS

amyotrophic lateral sclerosis; mostly in men

Are skeletal muscles voluntary or involuntary?

voluntary

___________ muscle tissue is innervated by voluntary motor nerves and is subject to conscious control

voluntary

according to Frank-starling law, as a larger volume of blood flows into the ventricle, the blood stretches the cardiac muscle fibers, leading to ___________

an increase in the force of contraction

2 binding sites of secondary active transporters

an ion and a transported molecule; ion binds causes a conformational change that opens another binding site of the transported molecule

what is the function of chordae tendineae?

anchor AV valves to papillary muscles

intercalated discs

anchors cardiac cells together; has 2 parts: desmosomes and gap junctions

ballooning of an artery =

aneurysm

What is OCD treated with?

anti-depressants

how is obsessive compulsive disorder treated?

anti-depressants

why is bipolar disorder often difficult to treat pharmacologically?

antidepressant medications often can precipitate mania

what is the most common mental health disorder?

anxiety

What does an alteration in GABA cause?

anxiety and seizures

What is the most common mental health disorder?

anxiety disorder

What is reduced GABA transmission thought to be related to?

anxiety disorders

Where do non-Hodgkin's lymphomas originate?

any lymphoid tissues

Systemic pressure is highest in the ______________

aorta

aneurysms are most common in _____

aorta

What is the pressure reservoir of the heart?

aorta; blood vessels narrow there and increase in resistance causing backing up. This exerts pressure on the walls of the aorta causing the aorta expands and stores energy.

Where are aneurysms most common?

aorta; high pressure areas

life span of RBC

approx. 120 days

osmosis is facilitated by channel proteins called ______

aquaporins

Where is blood pressure highest?

arteries

3 major types of blood vessels

arteries, capillaries, veins

the steepest change in the blood pressure occurs in the _________

arterioles

Where is the steepest change in blood pressure?

arterioles; about 60 mm Hg

how might sick sinus syndrome manifest itself?

as a syncope

circus movement

as the purkinje fibers go to spread to the outside of the heart, one side has a blockage in it. This causes the signal that went the other direction to circle around and restimulate an area that was already recently repolarizing

secondary hypercholesterolemia

associated with other health problems and behaviors; obesity, high calorie intake, diabetes, LDL levels exceed receptor efficiency (but the receptors are working unlike primary)

etiology and pathogenesis of venous thrombosis

associated with stasis of blood, increased coagulation, vessel wall injury, spinal cord injury, impaired cardiac function, long air travel, prolonged sitting, increased viscosity, hormone replacement therapy and dehydration

What is the most abundant cell type in the CNS?

astrocytes

most abundant cell type in the CNS

astrocytes

which cell type? often respond to injury forming a 'scar' termed gliosis or glial scar

astrocytes

80% of primary brain tumors are _________

astrocytic

2 forms of glial tumors

astrocytic, oligodendroglial

types of astrocytic glial tumors

astrocytoma, anaplastic astrocytoma, glioblastoma multiforme (Most lethal)

clinical manifestations of aneurysms

asymptomatic, can experience pain that one may or may not be able to pinpoint where it is originating

clinical manifestation of venous thrombosis

asymptomatic, inflammatory process symptoms including pain, swelling and tenderness; early detection needed due to increased risk for pulmonary embolism

clinical manifestations of a dissection

asymptomatic, pain may vary

what is the typical result from impulse fractionation?

asynchronous atrial stimulation and atrial fibrillation

where are ganglia found?

at each vertebral level

Examples of HMG-CoA reductase inhibitors

atorvastatin and rosuvastatin (prevent cholesterol production)

in the cardiac cycle, ventricles contract while ______ relax

atria

most chronic arrhythmia

atrial fibrillation

What is the "lub" sound?

atrioventricular (tricuspid and mitral) valves close

chemotactic factors

attract phagocytes to area of inflammation

Treatment of Raynaud's disease

avoid decongestants causing vasoconstriction , nifedepine and diltiazem (calcium channel blockers), prazosin (alpha-adrenergic receptor blocker)

Where do arteries carry blood?

away from the heart

1. According to Fick's Law, decreasing the medium density would ___________ the net flux of diffusion. a. Decrease b. Increase c. Not effect

10. Activating nociceptors in the liver would classify as __________ pain. a. Somatic b. Visceral c. Neuropathic d. Cutaneous

13. This neurotransmitter plays a critical role in appetite, sleep, mood, pain, and vomiting. a. Acetylcholine b. Serotonin c. GABA d. Norepinephrine

16. Increased swelling of astrocytes with water and sodium can be described as _________. a. Meningeal fluid flooding b. Cytotoxic edema c. Vasogenic edema d. Subarachnoid edema

17. Vaccinations are available for the pathogens that induce viral meningitis. a. True b. False

19. Which of the following is NOT a way to reduce pain transmission? a. Induce an IPSP in the second-order neurons b. Inhibit the descending pain pathway c. Stimulate the periaqueductal gray d. Activate A fibers which subsequently activate interneurons

22. _____ is a solution that exerts a similar osmotic pressure than the cells contents. a. Hypotonic b. Isotonic c. Hypertonic

24. Delusions are a negative symptom of Schizophrenia. a. True b. False

26. The Na+/K+-ATPase pump will ______ the number of intracellular Na+ ions. a. Increase b. Decrease c. Not effect

27. You take a bite of delicious deep-dish pizza and the bubbling hot cheese burns your tongue. A second-order neuron eventually releases its neurotransmitters in the thalamus. Which tract did this second-order neuron follow? a. Spinoreticular b. Spinothalamic

30. An antagonist binding to its receptor will ________ the receptor's activity. a. Not effect b. Decrease c. Increase

31. ________ is a solution that exerts a greater osmotic pressure than the cell contents. a. Hypotonic solution b. Hypertonic solution c. Isotonic solution

36. We should feel embarrassed and ashamed if we suffer from a mental disorder a. True b. False

38. A patient burns their feet on the hot road. If the patient has a mutation in the sodium channels within their DRG neurons that renders the sodium channels inactive, what effect would there be on CGRP release in the dorsal horn? a. More CGRP would be released b. Less CGRP would be released c. No change in CGRP release is expected d. CGRP isn't even associated with pain

4. ____________ is a solution that exerts a lower osmotic pressure than the cell contents. a. Isotonic solution b. Hypotonic solution c. Hypertonic solution

42. High levels of NMDA receptor activation leads to ________. a. Cerebral edema b. Excitotoxicity c. Hyperpolarization d. Neuronal viability e. Tau

44. Increased GABA transmission is associated with depression, pain, and seizures. a. True b. False

51. A hypotonic solution would ______ the intracellular fluid volume of a blood cell. a. Decrease b. Increase c. Not change

8. One of the ascending pain pathways synapses in the midbrain regions that control autonomic signaling. What behavioral/physiological effects would one expect as a result of this direct connection to the autonomic system? a. New memory formation b. Changes in heart rate c. Skeletal muscle relaxation d. Reflex activation

HDL cholesterol carries cholesterol from tissues ____________

back to liver

After CICR, where does the calcium go?

back to the SR via SERCA calcium channels

neutrophils

bacteria

aneurysm

ballooning of a weakened portion of an arterial wall; localized dilation of a blood vessel; classified based on cause and location

ambulation

walking

blood leaving the heart will create a force per unit area on the ______

wall of blood vessel

What drug reduces Vitamin K dependent coagulation factors?

warfarin

pressure diuresis

water exretion

If the TRP channels arent functioning, what happens?

we can't feel pain

Is a glial scar good or bad?

we dont really know at this point because it is trying to fix damage but it also prevents neurons from growing

in orthostatic hypotension, cardiac output and BP drop causing _______

weakness, nausea, dizziness, syncope

change in MAP and blood flow from arterial side to venous side

begins to fall as cross-sectional area and resistance increase; blood flow is slow at capillaries and even due to high resistance and total cross-sectional area

Class II antiarrhythmic drugs

beta blockers (decrease heart rate and conduction velocity, can indirectly alter K and Ca conductance)

where are the AV valves located?

between atria and ventricles

atrioventricular valves

between the atria and ventricles, prevent backflow into the atria when ventricles contract; tricuspid and mitral

semilunar valves

between the ventricles and arteries; prevent backflow of blood into the ventricle

where are the semilunar valves located?

between ventricles and arteries

heme is converted to__________ to be removed by liver

bilirubin

What kind of disease are hodgkin lymphomas?

bimodal - occur in early adulthood and in older adults

what is the tail of myosin responsible for ?

binds cargo (vesicles, organelles, PM) may also allow dimers to be formed (II and IV)

what does heparin do?

binds to antithrombin III to increase ability to inactivate thrombin and factor Xa

What brain disorder has the highest risk for suicide?

bipolar disorder

Intracerebral hemorrhage

bleeding into the brain as a result of a ruptured blood vessel within the brain; caused focal hemorrhage

when calcium is low, the troponin-tropomyosin complex sits on the thin filament in a position that ___________ actins binding site for myosin

blocks

lidocaine

blocks activate and non-activated sodium channels with rapid kinetics; effect on inactive cells makes it more effective against cell with longer AP such as purkinje fibers or ventricular cells vs. atrial cells, low incidence of adverse events and overall good anti-arrhythmia efficacy

verapamil and diltiazem

blocks activated and non-activated L-type calcium channels; a reduction in contractility through the heart, a decrease in sinus node pacemaker rate, and a decrease in AV node conduction velocity (decreases heart rate)

amiodarone

blocks potassium channels and prevents repolarization; significantly blocks inactivated sodium channels preventing new AP, slows repolarization

procainamide

blocks sodium channels - slow action potential upstroke and conduction + prolongs QRS; suppresses abnormal ectopic pacemaker activity, blocks depolarized cell sodium channels, directly depresses SA and AV nodes

thrombosis

blood clot

circulatory plan of humans

blood is carried in a closed system of vessels that begins and ends at the heart

true aneurysm

blood remains within vascular compartment and is bounded by vascular wall

true aneurysm

blood remains within vascular compartment and is bounded by vascular wall; thinning of vascular wall allowing expansion

capacitance vessles

blood reservoirs ; contain 65% of blood supply

capacitence vessels

blood reservoirs; contain 65% of the blood supply; veins are these due to the large amount of elasticity they have to allow them to expand

pulmonary veins

blood returns to the heart via four pulmonary veins that go to the left atrium

what do the pulmonary veins do?

blood returns to the heart via four pulmonary veins that go to the left atrium

pulmonary circulation consists of ______

blood vessels that take the blood to and from the lungs for the purpose of gas exchange

what kind of tissue are bones dominated by?

bone connective tissue

osteotomy

bone cutting to remove a section of bone near a damaged joint

where are WBCs produced

bone marrow

primary lymphoid organs

bone marrow and thymus

where are skeletal muscles attached?

bones , fascia , and skin

What is the Z line?

boundary of each sarcomere

sick sinus syndrome

bradycardia-tachycardia syndrome; result of partial-total SA node destruction and SA/AV node junctional arrhythmias; often asymptomatic, may have lightheadedness, syncope, dizziness; disease in the SA node; goes back and forth between fast and slow

central nervous system

brain and spinal cord

what does the CNS consist of

brain and spinal cord

neurotrophic hypothesis

brain derived neurotrophic factor is reduced in depressed patients

what is the neurotrophic hypothesis?

brain derived neurotrophic factor is reduced in depressed patients

global brain injury

brain injury causes changes that differ from focal brain injury; alterations in sensory, motor, cognitive function

what is the function of the sodium-glucose cotransporter?

brings glucose into cell against its gradient using sodium concentration gradient and kinetic energy

tension-type headache

brought on by physical or emotional stress such as muscle strain, anxiety, depression, psychological stressor, and sometimes caffeine or sleep withdrawals; symptoms include dull, diffuse pain

symptoms of neuropathic pain

burning, stabbing, shooting pain and allodynia

symptoms of neuropathic pain

burning, stabbing, shooting pain, allodynia

how is transcellular transported regulated?

by adding or removing transporters on cel membrane

How can one fix re-entry arrhythmias?

by altering conduction (slowing or accelerating impulses)

how is paracellular transport regulated?

by changing 'tightness' of junctions by junctional proteins called claudins

How does our body keep the wall stress of blood vessels balanced?

by the elasticity and transmural pressure of the vessel (allows blood to keep flowing without damaging the vessels)

How is blood flow regulated in capillary beds?

by vasomotor nerves and local chemical conditions, so it can either bypass or flood the capillary bed

________ is cell death in which bacteria causes affected area to swell and blacken

wet gangrene

how is muscle relaxation induced?

when the calcium falls to resting levels when the sarcolemma repolarizes

12. A patient presents in the emergency room with facial drooping, arm weakness, and difficulty speaking. A stroke is expected. CT scans indicate no overt signs of bleeding and a potential blockage in the large middle cerebral artery. Which type of stroke would this insult be classified as? a. Transient ischemic attack b. Intracerebral hemorrhage c. Thrombotic stroke d. Small vessel stroke

2. You recently discovered a drug that would prevent voltage gated ion channels on the axon terminus membrane from opening. Theoretically, your drug would __________ the membrane potential on the neuron to _________ neurotransmitter release. a. Decrease; Increase b. Increase; Increase c. Decrease; Decrease d. Increase; Decrease

20. What role do interneurons play in pain transmission? a. Reduce the speed of the descending pathway b. Increase the speed of the ascending pathway c. Induce an IPSP in the second-order neuron d. Induce an EPSP in the second-order neuron

29. A hypertonic solution would ______ the intracellular fluid volume of a blood cell. a. Increase b. Not change c. Decrease

3. According to Fick's Law, increasing the mass of the molecule would __________ the net flux of diffusion a. Not effect b. Increase c. Decrease

35. According to Fick's Law, adding a semipermeable membrane would _____ the net flux of diffusion. a. Not Effect b. Increase c. Decrease

40. Dopamine is a catecholamine derived from L-DOPA. If a patient with Parkinson's disease is given L-DOPA (Levodopa), which step in neurotransmission is being therapeutically targeted directly? a. Release b. Storage c. Synthesis d. Termination e. Receptor activation

43. Several antidepressants are used to treat anxiety. While these drugs can have effects throughout the CNS, which region in particular is critical for emotional regulation? a. Cerebellum i. Motor skills b. Thalamus i. Pain c. Amygdala i. emotion d. Hypothalamus i. endocrine e. Medulla oblongata i. Midbrain stem

48. While sitting in my office reading a new scientific paper. All of a sudden, I start to sweat and breathe rapidly. These changes are _______ manifestations that accompany _______ in anxiety disorders. a. Objective; calm b. Subjective; calm c. Objective; fear d. Subjective; fear e. Hallucination; delusions ● Autonomic = objective. ← ANXIETY DISORDER SECTION.

50. An agonist binding to its receptor will _____ the receptor's activity. a. Not effect b. Decrease c. Increase

6. This type of headache is self-induced and is likely associated with acetaldehyde and acetic acid build-up in the brain? a. Cluster b. Migraine c. Hangover d. Chronic daily headache

what are leukocytes?

white blood cells

what does myelination appear as in brain scans?

white matter

effective refractory period

window of insensitivity where muscle cells cannot depolarize again until the repolarization phase is complete

what major minerals do bones serve as a reservoir for?

calcium , phosphate

the ER of muscle tissue is specialized for the storage of ___________ and is called ___________

calcium ; sarcoplasmic reticulum

Class IV antiarrhythmics

calcium channel blockers (slowing the rate of rise in phase 4 of SA node, decreases conduction velocity in SA and AV node)

ions involved in delayed afterdepolarization

calcium overload; sometimes sodium or potassium

while some calcium ions are free, most are bound to a protein called _________

calsequestrin

What is a possible side affect of antiarrhythmic drugs?

can be proarrhythmic (promote arrhythmia)

oscillatory afterdepolarizations

can initiate spontaneous activity in nonpacemaker tissue; 2 types: early afterdepolarization and delayed afterdepolarization

remodeling phase

can last 21 days to 2 years (depends on patient), scar tissue forms; epithelial cells grow under the scab which falls off and allows it to grow thicker

neurons (can / can't) store oxygen

can't

what is leukemia?

cancer of white blood cells

______ are the smallest blood vessels

capillaries

venules are formed when ______

capillary beds unite

________ muscle: ACH or DHP receptors NOT used

cardiac

Because neurons can't store oxygen or glucose, they rely on a constant supply of both. if this supply is cut off, what is a possibility?

cardiac arrest --> unconscious within seconds --> death of neurons within 4-6 seconds

what type of surgery could cause thrombocytopathia

cardiac bypass

other triggers of arrhythmias

cardiac ischemia, excessive dischard or sensitivity to autonomic transmitters, exposure to toxic substances, electrolyte disturbances, drugs, trauma, irradiation, unknown etiology

arteries

carry blood away from the heart; have much higher blood pressure and thicker walls than veins

veins

carry blood toward the heart; formed when venules converge; composed of three tunics, with a thin tunica media and a thick tunica externa consisting of collagen fibers and elastic networks; much lower blood pressure and thinner walls

efferent

carry information away from CNS

afferent

carry information to the CNS

what group of people are at a higher risk for osteoporosis? why?

caucasian and asian women ; decreased estrogen with increased TNF, IL-1, IL-6 cytokines that stimulate osteoclast precursors

dissections are classified based on _______

cause and location

What do the Purkinje fibers do?

cause ventricles to contract

hangover headache

caused by alcohol; actual mechanism isnt really known but may be related to acetylaldehyde, acetic acid, and congers, or dehydration; symptoms include vasodilation and inflammation

tachycardia

caused by anatomical/physiological block creating a "circus movement"

viral meningitis

caused by several different viruses, less severe, treat symptoms

bradycardia

caused by severely depressed conduction due to parasympathetic control of AV

3 parts of a neuron

cell body, dendrites, axon

soma

cell body; integrates information

desmosomes

cell connections similar to velcro

membrane potential of a hypothetical cell

cells are electrically neutral with equal numbers of negative and positive charges, phoslipid is not permeable to ions, there is a separation of charges. After inserting an active transporter, it is used to actively move na out and k into the cell to maintain -70 mV potential.

what are the organic components of bone tissue?

cells, fibers, ground substance

H zone

center part of A band where no thin filaments occur

lumen

central blood-containing space surrounded by the tunics; innermost, radius of this plays a role in resistance and pressure

lumen

central blood-containing space surrounded by tunics

what controls cognition?

cerebral cortex

epilepsy

certain forms are caused by failures in sodium channel inactivation, therefore there is constant firing and failed repolarization

where are superficial lymph nodes located?

cervical, axillary, and inguinal regions

process of opening or closing a channel is called; and what does this result from?

channel gating; results from conformational change

______________ are integral membrane proteins

channels (pores)

panic disorder

characterized by recurrent, unexpected panic attacks often coupled with shortness of breath, or other signs and symptoms of a life-threatening disease- what causes a patient to go to the doctor; usually lasts 15-30 minutes; not related to external events

Alzheimer's disease

characterized by the death of neurons and atrophy of the brain leading to memory impairment; progressive; 4th leading cause of death in US, causes people to be at higher risk for other things, no real treatments but they think some can help slow it

what binds to calcium to prevent clot formation ?

chelators (citrate and EDTA)

neurotransmitter

chemical substances synthesized and released from pre-synaptic neurons to excite, inhibit or modify the response of its post-synaptic effector cell; released in response to an action potential

long- lived response to harmful stimuli

chronic inflammation

repeated concussions can lead to

chronic traumatic encephalopathy

diapedesis

circulating leukocytes leave the capillaries

permanent a fib

classified when all attempts to terminate a fib fail

permanent atrial fibrillation

classified when all attempts to terminate fail

Serous Inflammatory Exudate

clear, watery ex: skin blisters, pericarditis

lub

closing of AV valves

dub

closing of semilunar valves

emboli

clots that travel to and suddenly block a blood vessel

blood coagulation requires a ___________ cascade to convert _________ to _________

clotting ; fibrinogen ; fibrin

what is fibrinogen?

clotting protein in blood

Catarrhal Inflammatory Exudate

cloudy mucous ex: running nose (common cold)

which form of primary headaches are most often observed in men

cluster

in disseminated intravascular coagulation (DIC) there is widespread _______ and ________

coagulation , hemorrhage

how to manage pain

cognitive-behavioral interventions, heat/cold, stimulus-induced analgesia, pharmacological treatment

TRPM8

cold

why is cold a common form of pain management?

cold leads to vasoconstriction and reduced swelling, slows the nerve response **must be limited to prevent damage (15-20 min MAX)

tunica externa

collagen fibers that protect and reinforce vessels

deep somatic pain

comes from sources such as blood vessels, joints, tendons, muscles, and bone

Burkitt's lymphoma

common childhood cancer in central Africa; affects jaw before affecting whole body

follicular lymphomas

common in US; can affect any lymph nodes

skeletal muscle contraction contribution to venous return

common in extremities and pushes blood to the heart

neurotransmission

communication between neurons and effector cells

MOA for statins

competitively inhibit HMG-CoA reductase ( rate-limiting enzyme mevalonate pathway that produces cholesterol in the liver )

plasma proteases

complement system, coagulation factors, kinin vasoactive peptides

postcapillary venules

composed of endothelium, adds tunics as they get larger

What determines the direction and magnitude of ion influxes in and out of a cell?

concentration and electrical differences/ electrochemical gradient

facilitated diffusion continues until...

concentrations are equal on both sides of membrane

where does an ectopic pacemaker arise from?

conduction cells

What can cause the vessel weakness that leads to aneurysms?

congenital defects, trauma, infections, atherosclerosis

what causes atrial flutter?

congenital heart defects

damage to the reticular activating system (RAS) will impair _________

consciousness

systemic circulation

consists of blood vessels that extend to and from the heart; delivers oxygen and nutrients to body tissues and picks up CO2 and waste products along the way

pulmonary circulation

consists of blood vessels that take the blood to and from the lungs for the purpose of gas exchange

what do capillaries do?

contact tissue cells and directly serve cellular needs

capillaries

contact tissue cells and directly serve cellular needs; tiny and directly feed to cells; the smallest blood vessels, walls consist of thin tunica interna that is one cell thick and allow only a single RBC to pass at a time

complicated lesions

contain hemorrhage, ulceration, scar tissue

dorsal root ganglion

contains cell bodies of sensory neurons from limbs and trunk for temperature, position and touch

3 structural types of capillaries

continuous, fenestrated, sinusoids

myogenic cells

contract spontaneously without neuronal input; have an unstable resting membrane potential due to F-channels

special functional features of muscles

contractility, excitability, extensibility, elasticity

duration of the action potential is ~50% of _______ cycle

contractive

what is the function of the organic components of bone tissue?

contribute to flexibility and resisting tension

channels are regulated to ...

control the movement of ions into and out of cell

Ecamplsia

convulsions

syncytium

coordinated unit; how the heart muscle behaves

How does the brain and spinal cord create "feeling?"

coordinating sensory and motor signals

P wave

corresponds to depolarization of SA node; after P wave begins, atria contracts (systole); atria contracts while ventricles relax

QRS complex

corresponds to ventricular depolarization and precedes ventricular contraction or systole; ventricles contract while atria relax

T wave

corresponds to ventricular repolarization followed by ventricular relaxation (diastole)

_________ move molecules in the same direction

cotransporters (symporters)

________ move molecules in opposite directions

countertransporters (antiporters)

what is the function of the endosteum?

covers trabeculae of spongy bone lining medullary cavity

when myosin binds actin, it initiates ____________

crossbridges

precapillary sphincter

cuff of smooth muscle that surrounds each true capillary that regulates blood flow into the capillary; autonomic and sympathetic; vasoconstriction of these closes off a lot of the capillary bed

11. Decreased signaling of __________ is associated with anxiety and seizures because its normal role is to __________ neuronal excitability. a. Dopamine; Increase b. GABA; Increase c. Acetylcholine; Decrease d. GABA; Decrease

15. Seizure are often marked by _________ in glutamate signaling and/or ___________ in GABA signaling. a. Increases; Decreases b. Decreases; Decreases c. Decreases; Increases d. Increases; Decreases

32. While sitting on my couch with the dog, I begin to think about my schedule for tomorrow. Walk the dog, read a chapter in the textbook, do the laundry... My heart begins to beat fast and my breathing rate increases. These changes are ____ manifestations that accompany ___ in anxiety disorders. a. Objective; calm b. Subjective; fear c. Subjective; calm d. Objective; fear

34. Polymorphisms 5-HT transporters are associated with depression and suicide. This evidence supports which of the hypotheses about the mechanisms underlying depression? a. Neuroendocrine b. Neurotropic c. GABA d. Monoamine

41. Decreased signaling of _________ is associated with anxiety and seizures because its normal role is to _______ neuronal excitability. a. Dopamine; increase b. Acetylcholine; decrease c. GABA; increase d. GABA; decrease e. Acetylcholine; increase

7. Vasospasms are a life-threatening complication of which brain disorder? a. Ventricular hemorrhage b. Multiple sclerosis c. Concussion d. Aneurysmal hemorrhage

9. Plaques and tangles are hallmarks of which neurological disease? a. Depression b. Stroke c. Epilepsy d. Alzheimer's Disease

equation for MAP

dP + 1/3(sP-dP)

Mechanism of atherosclerosis

damage to endothelium results in an inflammatory response. Monocytes are recruited and differentiate into macrophages. These macrophages ingest oxidized LDL and form foam cells. These cells eventually die and further propagate the inflammatory response. Smooth muscle proliferation and migram from tunica media to the tunica intima occurs in response to the cytokines released by the damaged endothelial cells. Finally, a fibrous capsule is formed to cover the fatty streak.

what is dementia characterized by?

death of neurons and atrophy of brain leading to memory impairment

a hypertonic solution would _________ the intracellular fluid volume of a blood cell

decrease

negative inotropic

decrease contractility; interfering with ATP generation (hypoxia)

negative inotropic effect of adrenoreceptor antagonists

decrease force or speed of contraction

negative chronotropic effect of adrenoreceptor antagonists

decrease heart rate by changing the rhythm produced by the SA node

treatment for bipolar disorder

decrease in DA or NE to treat mania; antipsychotics are commonly used

What happens if LDL accumulated?

decrease in LDL receptors or an increase in LDL over receptor density

what is neutropenia?

decrease in neutrophils

treatment for aneurysm

decrease tension with beta-adrenergic antagonists, surgical grafts

the Na+/K+ will ________ intracellular Na+ ions and ________ intracellular K+ ions

decrease; increase

how do you confirm thrombocytopenia diagnosis?

decreased platelet number < 150,000 thrombocytes / microliter

increases in P will be offset by (increases/decreases) in r

decreases

what are the microglia responsible for?

defending the brain against any foreign cells clean up debris, damage, infection

monoamine hypothesis

deficit in amount or function of the monoamine transmitters, especially 5-HT, NE and DA in the cortical and limbic systems; known polymorphisms in the 5-HT transport gene leads to increased risk of depression and suicide, and depressed patients show altered monoamine function

alzheimer's is a form of

dementia

what is multiple sclerosis?

demyelination and inflammation of white matter in the CNS

structure of a dorsal route ganglion neuron

dendrites are in periphery, cell body is in ganglia, axon extends into the spinal cord

epimysium

dense regular connective tissue surrounding entire muscle "outside the muscle"

compact bone

dense, solid, outer layer of bone

muscle activity is initiated by excitation, a ____________ of sarcolemma

depolarization

delayed afterdepolarization

depolarization occurs shortly after completion of repolarization (mechanism not well understood) -> does not get to phase 4; after resting membrane potential is reached, cells get secondary impulses which may or may not be sufficient to reach threshold

what does the P wave correspond to

depolarization of SA node; after P wave begins, atria contracts (systole)

what do skeletal myofibers do?

depolarize and repolarize very quickly

pacemaker cells

depolarize and transmit electrical signals throughout the heart and cause cardiomyocytes to depolarize and contract

time course of depolarization in cardiomyocytes

depolarize quickly but take much longer to repolarize; the voltage-sensitive calcium channels stay open for a lot longer; duration of the AP is 50% of contraction cycle; prolonged effective refractory period to protect against stay APs

cardiomyocytes _______ quickly, but take much longer to ________

depolarize, repolarize

what does the second order neuron do?

depolarizes to take information up to the brain

AV block

depress conduction through AV node and Bundle of His

AV block

depress conduction through AV node and bundle of His

What do drugs for re-entrant circuit do?

depress conduction time to increase refractory time

depressive phase

depressed mood, sleep disturbance, anxiety, at times psychosis

What can too little serotonin cause?

depression

too little serotonin binding post-synaptic receptor is associated with __________

depression

most common forms of psychiatric disorders

depression , anxiety, substance abuse

What does an alteration in norepinephrine cause?

depression and PTSD

What does an alteration in serotonin cause?

depression, anxiety, ADHD

the region in which ganglia innervate

dermatome

primary hypercholesterolemia

describes elevated cholesterol levels that develop independent of other health problems or lifestyle behaviors; familial hypercholesterolemia: LDL receptor deficiency/dysfunction with marked elevated level

venous thrombosis (thrombophlebitis)

describes the presence of thrombus in vein and accompanying inflammatory response

venous thrombosis

describes the presence of thrombus in vein and accompanying inflammatory response, common in lower extremeties

Multiple Sclerosis (MS)

destruction of the myelin sheath from oligodendrocytes

baroreceptors

detect changes in blood pressure; located in aorta and carotids between heart and brain and respond to change in stretch, heart rate, contraction and vascular tone

which chronic health condition most commonly exhibits length-dependent neuropathy

diabetes --> longest axons = most vulnerable --> leads to feet problems and eventual amputation risk

shaft of the bone that forms long axis

diaphysis

______ pressure is the pressure in the arteries during ventricular diastole

diastolic

calcium initiated calcium release consists of what two receptors?

dihydropyridine (DHP) receptors ryanodine (RyRs) receptors

functions of sympathetic division

dilate pupil, inhibit salivary glands, relax bronchi, accelerate heart, inhibit digestion, stimulate glucose release from liver, prevent peeing, promote ejaculation

for every increase or decrease in MAP there is a (direct/inverse) change in flow (Q)

direct

for every increase or decrease in tube radius, there is a (direct/inverse) change in flow (Q)

direct

focal brain injury

direct blow to the head resulting from collision with an external object, a fall, or a penetrating injury

ways to categorize neurons

direction of information flow, type of information released, size, shape, and location of the neuron

hypothalamus

directs several maintenance activities (eating, drinking, body temperature), helps govern the endocrine system via the pituitary gland, and is linked to emotion and reward.

anemia is not a disease but a ____________

disease indicator

epilepsy

disease of having seizures

What can too much inflammation lead to?

diseases

false aneurysm

dissection/tear in vascular wall with formation of extravascular hematoma causing vessel enlargment and is bounded by outer layers of vessel wall

false aneurysm

dissection/tear in vascular wall with formulation of extravascular hematoma causing vessel enlargement and is bounded by outer layers of vessel wall

plasmin digests fibrin strands to __________

dissolve clot

muscular arteries

distributing arteries; distal to elastic arteries; deliver blood to body organs; have thick tunica media with more smooth muscle and less elastic tissue, active in vasoconstriction; branch of the main artery

what are the symptoms of a concussion?

dizziness, nausea, headache, confusion, slurred speech, appearing dazed, fatigued, amnesia

EC coupling in cardiac muscle

does not use acetylcholine or DHP receptors; myogenic signal triggers the AP to cause contraction, L-type calcium channels open to let a spark of calcium in that leads to RyR's CICR to cause contraction

chronic anxiety and some aspects of schizophrenia may be caused by high _______ levels

dopamine

name the corresponding receptor: Dopamine (DA)

dopamine receptors (D)

receptors of dopamine

dopamine receptors (D)

monoamine based chemicals

dopamine, norepinephrine, and epinephrine (epi. is usually made in the adrenal glands though)

limbs and trunk communicate touch, temperature, and position through neurons housed in the ________

dorsal root ganglion

efferent information runs (up/down) the spinal cord; what kind of info does this usually consist of? is it the (dorsal/ventral) column?

down; motor info; ventral

oscillatory afterdepolarizations are typically the result of _____________

drugs used to treat other cardiopathologies (digitalis, norepinephrine)

symptoms of tension headache

dull, diffuse pain

where is iron absorbed?

duodenum

metabolic bone disorders

dysfunction of bone remodeling

39. Reduced dopamine function is associated with _______ while increased dopamine function is associated with ________. a. Schizophrenia; ALS b. ALS; Parkinson's c. Parkinson's; ALS d. Schizophrenia; Parkinson's e. Parkinson's; schizophrenia

without the ____________ period , contraction of cardiomyocytes or regions of cardiomyocytes occur chaotically - arrhythmia

effective refractory period

ventral column

efferent and carries MOTOR information

sympathetic regulation of blood pressure

efferent nerves are present in atria (mainly SA node) and ventricles to increase heart rate and increase peripheral resistance

conducting arteries

elastic arteries; thick-walled arteries near the heart that includes the aorta and its major branches, large lumen allows low-resistance conduction of blood, contains elastin fibers in all three tunics; withstand and smooth out large blood pressure fluctuations by allowing blood to flow fairly continuously through the body

What are deflections like the P wave, T wave, and QRS complex measuring?

electrical activity

electrocardiogram

electrical activity generated detected and recorded by electrocardiograph to produce this; electrodes (leads) are positioned at various sites on the body

neurons communicate via

electrical impulses = action potentials

how can you confirm thrombocytosis diagnosis?

elevated platelet count > 1x10^6 thromboytes/microliter

What sets the patterns for referred pain?

embryonic development

what do the structures of joints allow for?

enabling of resistance to crushing, tearing , and other forces

other bones develop initially from hyaline cartilage and is replaced by bone

endochondral ossification

what is vascular constriction in hemostasis initiated by?

endothelial cell injury to release endothelin-1

tunica interna

endothelial layer that lines the lumen of all vessels

postcapillary venules are composed of ________

endothelium

heart valves

ensure unidirectional blood flow through the heart

which of the following cell types are responsible for the cellular phase of acute inflammation?

eosinophils

adrenoreceptor agonist drugs compete with ______

epi and norepi

What are common pathologies associated with neurons?

epilepsy, Alzheimers, depression, and many more

common pathologies involving neurons

epilpepsy, Alzheimer's, depression, many more

what is the epiphysis supplied by?

epiphyseal arteries and veins

plate seen in children and adolescents; plate of hyaline cartilage separating epiphysis and diaphysis

epiphyseal plate

ends of long bone; covered with articular cartilage

epiphysis

small blood vessel stroke

episode of ischemia without clear infarction, typically warning of stroke risk

chronic pain

episode of pain that lasts for 6 months or longer; may be intermittent or continuous; does not trigger sympathetic response

hemoglobin synthesis begins at early ___________ stage and continues until maturation

erythroblast

cellular elements of blood

erythrocytes, leukocytes, platelets

positive symptoms of schizophrenia

exaggeration!!; hallucinations, delusions, incoherence of speech, passivity phenomenona, thought insertion, withdrawal and broadcast, incongruity of emotion

hyperlipidemia

excess lipids in blood such as triglycerides, phospholipids, cholesterols; risk factor for heart attack and stroke

hyperlipidemia

excess lipids in the blood --> triglycerides, phospholipids, cholesterols (hypercholesterolemia)

hypercholesterolemia

excessive cholesterol in the blood

neuron

excitable cells; responsible for communication and controlling functions

the translation of an excitatory signal at the sarcolemma into a stimulation of contraction is called _______________

excitation-contraction coupling (EC coupling)

glutamate is classically a(n) __________ neurotransmitter

excitatory

manic phase

excitement, hyperactivity, impulsivity, dis-inhibition, aggression, no need for sleep, at times psychosis

___________ is a Hallmark of neurodegenerative disease

excitotoxicity

when free hemoglobin > bound hemoglobin, it is _____________

excreted in urine

pathogenesis of Raynaud's disease

exposure to cold, stress and strong emotions

pathogenesis of Raynaud's disease

exposure to cold, stress, strong emotions

what are the thin filaments ?

extend from Z disc toward center of the sarcomere *I band* *actin*

in regard to a DRG neuron, where is the axon?

extending to CNS (spinal cord)

sinus pause/arrest

failure of SA node to fire caused by digitalis toxicity, stroke, MI, myocarditis, increased vagal tone, hyper or hypokalamia

rickets

failure/delay in calcification of growth plate (children)

tissue function is fully restored with second intention tissue repair?

false

sinus tachycardia

fast heart rate (<100 bpm) caused by fever, blood loss, anxiety, sympathetic stimulation

3 pathogenesis of atherosclerosis

fatty streaks, fibrous atheromatous plaques, and complicated lesions

agoraphobia

fear of open spaces; closely related to panic disorder because people avoid any situation that it would be difficult to get help

which gender is most affected by scoliosis?

female

what is iron stored as in tissue?

ferritin

purkinje fibers

fibers in the ventricles that transmit impulses to the right and left ventricles, causing them to contract

______________ threads wind around platelets forming clot; RBCs get trapped within clot causing red appearance

fibrin

What forms scar tissue?

fibroblasts/ connectivee tissue

two layers of periosteum

fibrous layer and osteogenic layer

structural classifications of joints

fibrous, cartilaginous, synovial

which kind of tissue repair? - replacement of dead or damaged cells with the same cell type - restores normal function

first intention - regeneration

what is a stroke?

focal injury due to impaired blood flow to a region of the brain

brain injuries can be classified as ______ or ________

focal, global

mature B cell lymphomas

follicular, diffuse large B cell , burkitt

Absence seizure

form of seizure consisting of momentary clouding of consciousness and loss of awareness of surroundings, face goes blank

venules

formed when capillary beds units; large venules have one or two laters of smooth muscle

sinusoidal capillaries

found in liver and bone; most porous with fewer tight junction to allow passage of larger molecules

atrioventricular (AV) node

found in right atrium near the septum; stimulated by impulses from the SA node and sends out those impulses through the septum

fenestrated capillaries

found in the kidney, endocrine organs and intestine; similar to continuous but pores (fenestrations) allow passage of small molecules; filters organs

How many pulmonary veins are there?

four

what do platelets result from?

fragmentation of megakaryocytes in bone marrow

ionizing and UV radiation will cause cellular injury by producing _______

free radicals

diarthroses

freely movable joints; common in appendicular skeleton (all synovial joints)

where do hodgkin lymphomas originate?

from a single node or chain of nodes

A bands

full length of the thick filament; Includes inner end of thin filaments (dark region)

What are mediators of inflammation classified by?

function: vasoactive and smooth muscle constricting properties, plasma proteases, chemotactic factors and leukocye-derived reactive molecules and cytokines

arthrodesis

fusing together two bones

group of cell bodies

ganglia

What all neurons send their info to the sensory cortex?

general somatic afferent neurons, special somatic afferent neurons, and general visceral afferent neurons

What is the most common type of anxiety disorder?

generalized anxiety disorder

Schizophrenia

genetic disorder with high heritability, no single gene cause; lots of the genetic changes that causes it are related to neurotransmitters

primary increased coagulation activity

genetic, Leiden mutation in factor V and prothrombin gene

ventricular fibrillation

get massive uncoordinated contraction and a loss of pumping; fatal within minutes if not reverted; NOT COMPLETE BEATS

which gender is hip dysplasia more common in? why?

girls ; increased maternal hormones (estrogen)

facilitated diffusion uses what kind of transporters?

glucose

example of facilitated diffusion

glucose transport

organic nutrients in blood

glucose, carbohydrates, amino acids

amino acid based chemicals

glutamate, glycine, and GABA

what binds fibrinogen to connect platelets?

glycoproteins GPIIb/IIIa

respiratory sinus arrhythmias

gradual lengthening and shortening of R-R intervals caused by intrathoracic pressure changes due to respiration; inspiration will increase heart rate, expiration will decrease heart rate; changes in thoracic pressure

thalamus

grand central station of sensory information input

persistent atrial fibrillation

greater than 7 days and usually requires intervention

ganglia

group of cell bodies

microtubules maintain their constant length by balancing __________ and ___________ while hydrolyzing ___________

growth, shrinkage ; GTP

addiction

hard to define - primary, chronic disease of brain reward, motivation, memory and related circuitry

addiction

hard to define- primary, chronic disease of brain reward, motivation, memory and related circutry, self medication is highly prevalent

atherosclerosis

hardening of the arteries due to the formation of fibrous fatty lesions in intimal layer of medium to large arteries

migraine

has a genetic component, can be brought on by hormonal changes, food chemicals, and physical exertion, symptoms include throbbing, light sensitivity, smell sensitivity, vomiting etc.

blood-brain barrier

has tight junctions, feet of astrocytes, and pericytes; highly selective transport

hypertonic solution

have a higher concentration of nonpenetrating solutes as normal extracellular fluid

hypotonic solution

have a lower concentration of non penetrating solutes as normal extracellular fluid

What do almost all antidepressants do?

have significant effect on the monoamine system

isotonic solution

have the same concentration of nonpenetrating solutes as normal extracellular fluid; no net movement

F-channels

have unstable resting potentials that continuously let sodium in causing slow depolarization (drift slowly up to threshold); called pacemaker potentials

persistant depression disorder

having depression 2 years or more

vasodilation of blood vessels in the brain can lead to which of the following disorders?

headache

chronic daily headache characteristics

headache for 15 days a month for 3 months ; often resembles migraine or tension headache

chronic daily headache

headache that lasts 15 days a month for 3 months or more; often resembles migraine or tension headache

B1 adrenergic receptors are primarily located in ______

heart

which part of the circulatory system establishes the pressure gradient needed for blood to flow to tissues?

heart

What can atherosclerosis lead to?

heart attack or stroke, ischemia, hypoxia, and necrosis

atrial flutter (atrial tachycardia)

heart rate 240-450 bpm caused by congenital heart defects

three basic components of the circulatory system

heart, blood and blood vessels

three components of the circulatory system

heart, blood, blood vessels

5 classic signs of inflammation

heat (calor), redness (rubor) , swelling (tumor), pain (dolor), loss of function (laesa)

TRPV1

heat and acid

why is heat a common form of pain management?

heat increases blood flow and triggers release of endogenous opioid ** controversial bc in some cases, its contraindicated -> peripheral vascular disease

subjective fear

heightened awareness to thoughts of impeding disaster

pericytes

help stabilize capillary walls and control permeability

process by which blood cells are formed in red marrow

hematopoiesis

where are leukemias derived from?

hematopoietic precursor cells

what is the cytoplasm packed with?

hemoglobin

which kind of stroke is the most fatal?

hemorrhagic

what causes absolute polycythemia

high altitudes chronic heart and lung diseases

HDL

high density lipoprotein; good cholesterol; composed of 50% protein and carries cholesterol from tissues back to liver

A fibers

high myelinated, involved in proprioception, fine touch and cool

high MAP

high pressure

arterial thrombus

high shear flow and turbulent blood cause platelet aggregation due to narrowed artery

hypertonic solutions have (lower,higher,same) concentration of nonpenetrating solutes as normal extracellular fluid

higher

facilitated diffusion is _________ to ________ concentration

higher to lower

systemic pressure

highest in the aorta, declines throughout the length of the pathway, is 0 mm Hg in the right atrium

receptors of histamine

histamine receptors (H)

vasoactive and smooth muscle constricting properties

histamine, arachidonic acid metabolites (prostaglandins and leuktrienes), and platelet activating factor

Hodgkin or Nonhodgkin : associated with EBV

hodgkin

Hodgkin or Nonhodgkin : bimodal distribution - young adulthood and > 55 yo ; more common in men except for nodular sclerosing type

hodgkin

Hodgkin or Nonhodgkin : constitutional 'b' signs / symptoms : low grade fever, night sweats, weight loss

hodgkin

blood LOOKS (homogenous / heterogenous)

homogenous

spongy bone (trabecular bone)

honeycomb of small needle like flat pieces (trabeculae) form internal network of bone

action potential

how neurons communicate with eachother; lead to the release of neurotransmitters

what is the major factor limiting diffusion across a membrane?

hydrophobic interior of its lipid bilayer

risk factors for atherosclerosis

hypercholesterolemia, age, family history of heart disease, smoking, obesity, hypertension, diabetes

exaggerated form of hemostasis

hypercoagulability

Name one major risk factor for heart attack and stroke

hyperlipidemia

What diseases lead to arterial blood supply being occluded?

hyperlipidemia, atherosclerosis, Raynaud disease, aneurysms

________ is a form of cellular adaptation in which the cell number increases

hyperplasia

low MAP

hypotension

cause of scoliosis?

idiopathic or unknown

45. Place the following steps of spinoreticular pain transmission in order: 1. Neurons in the thalamus receive the information and relay it up 2. DRG neuron is activated by nociceptor signaling 3. Neurons in the reticular formation receive the information and relay it up 4. Neurons in the spinal cord receive info and relay it up i. 2,3,4 1 [is not used in this scenario] ii. 2,4,1,3 iii. 2,4,3,1 iv. 2,4,1 3 [is not used in this scenario ← spinothalamic ]

iii

day by day breakdown of first intention tissue repair

immediate: clot formation Day 0-3: acute inflammation Day 3-7: granulation tissue, epithelialization Week 2-6: scar formation Week 6+: remodeling

synarthroses

immovable joints; common in axial skeleton

what is thrombocytopathia?

impaired platelet function

What do disorders of arterial circulation cause?

impairment of blood flow

what is the AV node stimulated by ? where do they then send impulses?

impulses from SA node; send impulses thru septum (Bundle of His)

where are the cellular elements of blood formed?

in bone marrow

where are RBCs manufactured continuously?

in bone marrow of pelvis, skull, ribs, vertebrae, and ends of long bones

M line

in center of H zone; Contains tiny rods that hold thick filaments together

Z line

in center of I band.

where do synovial joints with articular discs typically occur?

in joints whose articulating bones have somewhat different shapes; fit poorly together

AV node is found _________

in right atrium near septum

in regard to a DRG neuron, where is the cell body?

in the ganglia

in regard to a DRG neuron, where are the dendrites located?

in the periphery

analgesia

inability to feel pain

osteomalacia

inadequate mineralization of bone ; softening of bones not involving bone matrix loss

difference between an infection and inflammation

includes that actual harmful stimuli and inflammation is just the response to it

Arterial side to venous side MAP and blood flow begin to fall as cross-sectional area and resistance _________

increase

a hypotonic solution would ________ the intracellular fluid volume of a blood cell

increase

in respiratory sinus arrhythmia, inspiration will (increase/decrease) and expiration will (increase/decrease) heart rate

increase ; decrease

Fibrinous Inflammatory Exudate

increased amount of fibrinogen ex: adhesions following surgery

which of the following condition(s) would cause pathologic hypertrophy?

increased resistance

hyperalgesia

increased sensitivity to pain

decreases in P will be offset by (increases/decreases) in r

increases

heat treatment of pain

increases blood flow and triggers release of endogenous opioids; controversial

how is muscle contraction induced?

increases in intracellular calcium activates actin-myosin machinery and induces contraction

function of 1,25 dihydroxyvitamin D

increases intestinal absorption of calcium, promotes PTH levels

what is the purpose of myelination?

increases the speed of the nerve impulse

Vasopressin (antidiuretic hormone, ADH)

increases water reabsorption

positive inotropic

increasing calcium

positive ionotropic effect

increasing calcium

primary CNS lymphomas

increasing prevalence, common in immunocompromised individuals

serotonin and schizophrenia

indole hallucinogens like LSD (from plant?) bind 5-HT 2a and 2creceptors and induce hallucinations

common pathologies associated with microglia

infection, Alzheimer's, MS and potentially linked to autism

-itis

inflammation

thrombophlebitis

inflammation of a vein associated with a clot formation

commonality in arthritis

inflammation of joint resulting from immune response

meningitis

inflammation of meninges - tissue wrapping the brain that contains CSF

encephalitis

inflammation of the brain

encephalomyelitis

inflammation of the brain and spinal cord

Encephalomyelitis

inflammation of the brain and spinal cord due to an infection

Encephalitis

inflammation of the brain due to an infection

Meningitis

inflammation of the meninges of the brain and spinal cord due to an infection

Guillain-Barre syndrome

inflammation of the myelin sheath of peripheral nerves (from schwann cells)

myelitis

inflammation of the spinal cord

Myelitis

inflammation of the spinal cord due to an infection

gout is a type of ________ arthritis

inflammatory

basophils

inflammatory response

damage to endothelium results in _______

inflammatory response --> monocytes then are recruited to area --> monocytes differentiate into macrophages --> ingest oxidized LDL --> turn into large "foam cells" --.> foam cells eventually die and propagate the inflammatory process --> smooth muscle proliferation and migration from tunica media to the tunica intima in response to cytokines secreted by damaged endothelial cells -- > forms fibrous capsule covering fatty streak

what are stimuli for the DRG neurons?

inflammatory signals, acid and histamine

wound healing stages

inflammatory, proliferative, remodeling phase

ARB MOA

inhibition of angII binding to receptors

ACE inhibitor MOA

inhibition of angiotensin converting enzyme

GABA is classically a(n) ___________ neurotransmitter

inhibitory

interneurons produce an _________ in second order neurons during pain transmission

inhibitory potential

what is the function of calcitonin?

inhibits calcium release from bone by inhibiting osteoclast activity

MOA of clonidine

inhibits norepi release; reduces sympathetic tone and increase parasympathetic tone in vasomoter center

phase 1 of cardiac muscle action potential

initial repolarization; sodium channels close and fast potassium channels open to allow for RAPID repolarization

acute inflammation

initial response to harmful stimuli that has two stages: vascular and cellular phase

What do autorhythmic cells myocardium cells do?

initiate action potentials to stimulate contractile myocardium AP

auto rhythmic myocardium cells

initiate action potentials to stimulate contractile myocardium action potentials; SA node AV node, bundle of His, purkinje fibers

what does the SA node do?

initiates heartbeat by sending excitatory impulses to cause atria to contract; keeps heartbeat regular

endocardium

inner lining of the heart consisting of connective and endothelial tissue (specialized epithelial tissue); covers valves and is continuous with the lining of the blood vessels; sensitive to changes in blood flow and friction

what is the endocardium?

inner surface of the the heart consisting of connective and endothelial teissue

anxiety disorders

intense fearfulness that occurs without a precipitating potentially dangerous event

Raynaud's disease and phenomenon

intense vasospasm (closing and opening of BV) of arteries and arterioles of fingers; primary type with no known cause

Raynaud's disease/phenomenon

intense vasospasm of arteries and arterioles of fingers

what kind of hemorrhage leads to focal hemotoma?

intercerebral hemorrhage

MOA of hydralazine

interferes with calcium metabolism and movement across membranes and decreases arteriole (not venous) contraction

negative ionotropic effect

interfering with ATP generation (hypoxia)

what do striations in muscle result from?

internal structure of myofibrils

second order neurons can be modulated by ________

interneurons in the spinal cord

two types of hemorrhagic strokes

intracerebral and subarachnoid

long bone ossification

intramembranous ossification

what kind of mechanism is the heart beat?

intrinsic, rhythmic

for every increase or decrease in pressure (P) there is a (direct/inverse) change in wall thickness to offset wall stress

inverse

for every increase or decrease in resistance (R), there is a (direct/inverse) change in flow (Q)

inverse

for every increase or decrease in tube length (cross-sectional area) or viscosity there is a (direct/inverse) change in flow (Q)

inverse

________ muscle tissue is innervated by the involuntary portion of the nervous system and cannot be controlled consciously.

involuntary

is cardiac muscle voluntary or involuntary?

involuntary

is smooth muscle voluntary or involuntary?

involuntary

substance abuse disorder

involves substance abuse, dependence, and/or addiction

elasticity of vessels

inward pressure

distending pressure

inward pressure, related to elasticity?

receptors of GABA

ionotropic and metabotropic

receptors of glutamate

ionotropic and metabotropic (mGluR)

what is cardiac contractility

ionotropic effect: positive and negative

treatment for leukemia

irradiation and bone marrow transplant

treatment for hodgkin lymphomas

irradiation and chemotherapy

2 types of strokes

ischemic and hemorrhagic

Types of strokes

ischemic and hemorrhagic

infarction

ischemic necrosis in an organ

infarction

ischemic necrosis in an organ; occluding arterial supply or occluding venous drainage

How does temperature affect diffusion rates?

it increases them by affecting the movement of molecules

What happens if you dont treat an aneurysm?

it may rupture

How does the heart contract?

it uses intrinsic mechanisms (contraction due to conduction system or myogenic NOT neurogenic)

spinal cord

junction for the tracts running up to the brain and out to the periphery, surrounded by vertebra, spinal nerves run out

_________ is a key player in long term pressure regulation (fluid regulation)

kidney

What organs play a large role in controlling cardiac output long term?

kidney and heart

fenestrated capillaries

kidney, endocrine and intestine; similar to continuous but pores (fenestrations) allow passage of small molecules

The 2 major motor proteins associated with microtubules:

kinesin , dynein

nonprotein nitrogenous wastes in blood

lactic acid, urea, creatinine

special adaptations that veins have to return blood to the heart

large lumen diameter (lowers resistance to flow) and valves similar to SL and AV nodes (prevent backflow and keep blood going one way)

fibrous atheromatous plaque

large, fibrous plaques with inflammation that may occlude vessel causing thrombus formation

Cause of Non Hodgkins Lymphoma

largely unknown --> -EBV infections in essentially all people with Burkitt lymphoma -Human T-cell lymphotropic virus (HTLV-1)- endemic in southwestern island of Japan; Associated with adult T-cell leukemia/lymphoma -Chronic immunosuppression- HIV, organ transplant

causes of Parkinson's

largely unknown --> some genetics, certain chemicals, heavy metals

proliferative phase

lasts 4-24 days, granulation tissue fills in the wound; fibroblasts lay collagen down and start strengthing tissue, wound edges contract, wound begins closing; new capillaries grow into the wound

persistent a fib

lasts >7 days and usually requires intervention

generalized anxiety disorder

lasts more than 6 months; excessive worry that is not easily controlled by the person, treated with GABA modulation and modulation of sympathetic signals like beta blockers

fick's law

law stating that the net diffusion rate of a gas across a fluid membrane is proportional to the difference in partial pressure, proportional to the area of the membrane, and inversely proportional to the thickness of the membrane

cold treatment of pain

leads to vasoconstriction and reduced swelling slow nerve responsel must be limited to 15-20 minutes

Which side of the heart has higher pressure?

left

which ventricle? •Systemic circuit •Contracts more forcefully •More pressure/resistance •Greater distance

left

systemic circuit

left side of the heart pushes blood through the aorta to the rest of the body and deoxygenated blood eventually returns to the left side from the veing

What part of the heart has the largest pressure fluctuations?

left ventricle

what does the wiggers diagram show?

left ventricular function or performance

in osteoporosis, osteoblastic activity occurs, but is (less / more) common than osteoclastic activity

less

acute pain

less than 6 months, triggers a sympathetic response

transporters move (more/less) molecules than channels. why?

less; because of binding and conformational shifts

most common cancer in children and adolescents; diagnosed more frequently in adults

leukemia

cellular phase of acute inflammation

leukocytes adhere and transmigrate from blood vessels to extracellular space of tissue; immune cells are activated and phagocytose

non-pharmacological treatment for gout

lifestyle change

treatment for atherosclerosis

lifestyle changes and surgery; stents

treatment of hyperlipidemia

lifestyle changes like exercise, diet, reduced LDL and increase HDL, weight reduction, stop smoking or drugs that decrease cholesterol production, absorption, or remove cholesterol from the blood stream

transporters are specific to their __________

ligand

types of gated channels

ligand gated voltage gated mechanically gated

types of gated channels

ligand gated, voltage gated, mechanically gated

What are the key principles establishing membrane potential?

like charges repel, opposite charges attract, a negative intracellular charge will repel negative ions and attract positive ones

membrane stabilizer antiarrhythmic drugs

limit sodium conductance (sodium channel blockers and local anesthetic actions) 3 types: moderate phase 0 slope decrease, little phase 0 slope decrease, and marked phase 0 slope decrease

where is smooth muscle located?

lining of hollow organs , blood vessels

steatosis is an abnormal intracellular accumulation of which macromolecule?

lipids

sinusoidal capillaries

liver and bone; most porous with fewer tight junctions to allow passage of larger molecules

what is afterload?

load imposed on heart after contraction

what is preload?

load imposed on heart before contraction begins

preload

load imposed on heart before contraction begins; volume is has to "work against" before contraction

aneurysm

localized dilation of a blood vessel

describe ryanodine receptors

located in SR ; most skeletal muscles and cardiac muscles to signal release of greater amounts of Ca2+ from intracellular stores (terminal cisternae) in SR (terminal cisternae)

chemoreceptors

located in carotid bodies at bifurcation of the two common carotids and monitor O2, CO2, H+ to regulate ventilation

describe dihydropyridine (DHP) receptors

located in sarcolemma ; typically Ca2+ delivery is too slow or too minor to induce contraction; contraction threshold not reached; is used to induce opening of ryanodine receptors

what are the thick filaments ?

located in the center of the sarcomere *A band* *myosin*

neurotransmission of the parasympathetic nervous system

long initial neuron that releases Ach to nicotinic receptors on post-synaptic; short 2nd neurons that releases Ach to muscarinic on muscle cells

osteoporosis

loss of mineralized bone mass causing porosity

what is leukopenia?

low WBC count

LDL

low density lipoprotein; bad cholesterol; main carrier of cholesterol and enter cells by receptor mediated endocytosis

What is thrombocytopenia?

low platelet count

venous thrombus

low shear flow and stasis of blood flow cause platelet aggregation and fibrin complexes to activate coagulation cascade

hypotonic solutions have (lower,higher,same) concentration of nonpenetrating solutes as normal extracellular fluid

lower

where is venous thrombosis most common ?

lower extremities

apex of the heart

lower tip of the heart

osmosis: movement of water from ______ solute conc. to _______ solute conc.

lower; higher

veins have (higher/lower) blood pressure and (thicker/thinner) walls than arteries

lower; thinner

______________ collect excess tissue fluid and proteins from loose connective tissue

lymphatic vessels

What do lymphoid stem cells give rise to?

lymphocytes

2 types of progenitor cells

lymphoid stem cells and myeloid stem cells

bacterial meningitis

lysis of bacteria and release of endotoxins initiates inflammation *vaccination* has reduced leading cause(s) of bacterial meningitis

what happens in chronic inflammation?

macrophages and lymphocytes adhere and transmigrate from blood vessel into the injured tissues extravascular space

during a cardiac arrhythmia, the rate and/or timing of contraction is insufficient to do what?

maintain normal cardiac output (CO)

function of albumins

maintain osmotic pressure and blood volume

myocardium

major portion of the heart composed largely of cardiac muscle tissue; layer of the heart that contract; contains branching cardiac muscle cells, forms a crisscrossing, interlacing laters of cells connective tissue to allow for 3D contraction

types of depression

major, persistent, seasonal affective, psychotic, peripartum, premenstrual dysphoric, and atypical

lymphoma

malignant tumor of lymph nodes and lymph tissue

dopamine and schizophrenia

many antipsychotic drugs strongly block post-synaptic D2 receptors in emotion centers, drugs that increase dopamenergic activity lead to hallucinations, and increased levels of DA-R have been seen post partum

headache

many are secondary to other disorders; primary types include migraine, tension type, cluster, and chronic daily headache

treatment of Parkinson's

many drugs on market that try to restore dopamine signals (L-Dopa) , but no treatment to stop degeneration yet

causes of oscillatory afterdepolarizations

may be the result of drugs used to treat other cardiopathologies; originates from contractile cells

what brings on cluster headaches?

maybe hypothalamic changes

activating a DRG neuron

mechanical or noxious stimuli activite the pain receptor on DRG neurons

_________ or ________ stimuli activate 'pain receptors' on DRG neurons

mechanical, noxious

short term controls of blood pressure

mediated by the nervous system and bloodborne chemicals (sympathetic and parasympathetic), counteract moment-to-moment fluctuations in blood pressure by altering peripheral resistance

treatment of bipolar disorder

medications usually only treat half of it (mania or depression) and can even make the other half worse

interior hollow cavity filled with yellow marrow

medullary cavity

_______ is defined as a separation of electrical charges that exists across cell membranes

membrane potential

4 classes of antiarrhythmic drugs

membrane stabilizers that limit sodium conductance, antiadrenergics, potassium channel blockers, and calcium channel blockers to slow CA dependent conduction

what can a decrease in growth factor cause?

memory issues

hematocrit count for men vs women in polycythemia

men: >54% hematocrit women: >47% heamtocrit

which cell type? resident immune cells of the brain

microglia

Most cells gather the ends of microtubules near the nucleus of the cell at the ______________

microtubule organizing center (MTOC)

which filament is the most rigid?

microtubules

which form(s) of primary headaches tend to be genetic?

migraine and cluster

a concussion is classified as. (mild/moderate/severe) traumatic brain injury

mild

b fibers

moderately myelinated, involved in mechanical sensation

neural mechanisms of regulating blood pressure

modulation of ANS responses

what is the function of osteocytes?

monitor and maintain protein mineral content of bone matrix

agranular leukocytes

monocytes and macrophages

cluster headache

more often observed in men, may be caused by hypothalamic changes, symptoms include rapid onset that last minutes to hours but occur multiple times over the course of weeks

Astrocytoma and glioblastoma multiforme

most aggressive form of brain cancer; associated

atrial fibrillation

most chronic arrhythmia; rapid disorganized atrial activation and uncoordinated contraction of atria; occurs when atrial cells cannot repolarize for incoming stimulus, ventricular response is irregular resulting in pulse deficit (change in heart rate compared to measurement in periphery)

continuous capillaries

most common type of capillary, found in skin and muscle; junctions between cells are not complete leaving areas for transport fluid and small molecules but are pretty tightly connected

what does cartilage form?

most of skeleton to be replaced by bone during fetal and childhood

axon terminals located in the sarcolemma region are called the __________ and has what kind of receptors?

motor end plate ; acetylcholine

in roadway movement, what acts like trucks carrying cargo over the complex cytoskeletal networks?

motor proteins `

Parkinson's disease

movement disorder induced by the selective death of dopaminergic neurons in the substantia nigra in midbrain

epithelial transport

movement of material from one side of an epithelium to the other; molecules entering or leaving the body, moving between compartments

endocytosis

movement of molecules into the cell via vesicles; 3 types: fluid endocytosis, phagocytosis, receptor-mediated endocytosis

exocytosis

movement of molecules out of the cell via vesicles

functions of muscle tissue

movement, maintenance of posture, joint stabilization, heat generation

countertransport

moves 2+ substances in opposite directions at same time; performed by protein

vernakalant

multichannel blocker (potassium, sodium, etc.) mostly potassium though; prolongs atrial effective refractory period (used for atrial fibrillation), slows AV node conduction, no change in ventricular refractory period

how many symptoms are required for a major depression diagnosis?

multiple

common pathologies associated with myelination

multiple sclerosis, Guillain-Barre syndrome, and encephalomyelitis

What does diagnosis of major depression require?

multiple symptoms

______________ cells cannot depolarize again until repolarization phase is complete

muscle

myocyte

muscle cell

what is myosin II?

muscle myosin, found in non-muscle cells

symptoms of generalized anxiety disorder

muscle tension, autonomic hyperactivity, exeggerated startle response, inability to concentrate

Deep somatic pain examples

muscles, tendons, joints

fine touch can help alleviate burning pain and itch by activating _______

myelinated A fibers

name for heart muscle

myocardium

_____________ cells contract spontaenously without neuronal input

myogenic

_______________ triggers action potential to cause cardiac muscle cell action potential and contraction

myogenic signal

what happens, according to the sliding filament theory, if no ATP is available? what would an example of this be?

myosin remains firmly attached to actin ; dead animals rigor mortis

effects of atheosclerotic plaque

narrowing of vessel, sudden vessel obstruction, plaque rupture, thrombosis and emboli formation, ischemia and infarction, aneurysm formation

examples of neuropathic pain

nerve compression, abnormal growths, infections, spinal cord injury

what is phantom limb pain associated with?

nerve damage

neuropathic pain is pain caused by _______

nerve injury or neurological disease

what is osmosis?

net diffusion of water across a membrane

osmosis

net diffusion of water across a membrane that is facilitated by aquaporins

direction of diffusion

net flux always proceeds from high to low concentration (there are still some that go backwards)

spinothalamic tract

neuron decussates and travels the contralateral side, synapses in the thalamus, then has a third order neurons that travels to the sensory cortex so that it can LOCALIZE pain (also goes to periaqueductal gray)

spinoreticular tract

neuron dessucates and travels up contralateral side, synapses in reticular formation in brain stem, third order then travels to thalamus/hypothalamus, then a fourth travels to cortex, amygdala and other regions; EMOTIONAL REACTION TO PAIN

third order neuron

neuron that relays information from thalamus to cortex

second order neuron

neuron that travels up the spinal cord to the thalamus (also communicates with interneurons in the spinal cord)

what are some pathologies microglia are implicated in?

neuronal damage - infection, Alzheimer's, MS ; possible Autism link

calcium imbalance stresses ________

neurons

What type of information is released from neurons?

neurotransmitter

ultimately, action potentials may lead to the release of _________

neurotransmitters

most numerous WBC; responsible for defense against infections

neutrophils

granular leukocytes

neutrophils, eosinophils, basophils

preeclampsia syndrome

new onset of hypertension with proteinuria after 20 weeks of pregnancy

receptors of acetylcholine

nicotinic (nAchR) and muscarinic (mAchR)

3rd degree AV block

no supraventricular complezes, ventricle generate own impulse; complete heart block

Can neurons store oxygen or glucose?

no, so they need a constant supply; associated with cardiac arrest

Can macrophages enter the brain after development?

no, thats what microglia are for

what is the word for the sensory response to pain?

nociception

Pathway of Pain Impulses

nocireceptor--> first order neuron ---> dorsal root ganglion--> through the spinal cord --> second order neuron --> thalamus --> third order neuron --> somatosensory cortex

Hodgkin or Nonhodgkin : can occur in children and adults

non hodgkin

Hodgkin or Nonhodgkin : majority involve B cells; few are of T-cell lineage

non hodgkin

Hodgkin or Nonhodgkin : may be associated with HIV and autoimmune disease

non hodgkin

Hodgkin or Nonhodgkin : may present with constitutional signs/ symptoms

non hodgkin

Hodgkin or Nonhodgkin : multiple lymph nodes involved; extranodal involvement common , noncontiguous spread

non hodgkin

dementia

non-normative cognitive decline

what is dementia?

non-normative cognitive decline (MANY types)

DHP receptor

nonconducting calcium channels in the T-tubule membranes of skeletal muscle cells, which act as voltage sensors in excitation-contraction coupling

treatment of concussion

none; acute --> rest

oscillatory afterdepolarizations can initiate spontaneous activity in ____________ tissue

nonpacemaker

gate control theory

nonpainful stimuli can close gates for painful ones because interneurons can inhibit the ascending pathway (may involve opioids inhibiting calcium) (activated by A fibers)

FACT: oxygen, carbon dioxide, fatty acids, and steroid hormones are (polar/nonpolar) molecules that diffuse readily through lipid portions of membranes

nonpolar

propanolol

nonselective B receptor blocker that acts as full antagonist to decrease heart rate; blocks the fight or flight neurotransmitters to decrease heart rate

Before being released from bone marrow, RBCs lose their ______ and synthesize __________

nucleus; hemoglobin

what is the diaphysis supplied by?

nutrient artery vein

what is an ischemic stroke?

occlusion of a blood vessel, typically a clot

premature atrial contraction

occur before next expected SA node impulse that is transmitted to ventricle and back to SA node; caused by stress, alcohol, tobacco, caffeine, MI, potassium imbalance; the cell is very primed, threshold change

cotransport

occurs when active transport of a solute indirectly drives transport of other substances in the same direction

large-diameter lumens

offer little resistance to flow

for every increase or decrease in pressure (P) the radius of the the must change to....

offset the tension or wall stress

Length dependent neuropathy

often in diabetic patients; longest axons are most vulnerable, can lead to feet problems that lead to amputation

causes of ectopic pacemaker

often result of other injury (ischemia, hypoxia)

What are causes of torsades de pointes?

often seen as cardiac toxicity with many antiarrhythmic drugs and electrolyte disturbances

where are osteoblasts found?

on inner or outer surfaces of bone

Where are sensory receptors found?

on sensory neurons

long term controls of blood presure

organ systems change to maintain it, changing blood volume, changing resistance

bone tissue consists of organic and inorganic components. What percentages do each make up respectively?

organic - 35 inorganic - 65

Verbal response

oriented = 5; confused conversation = 4; inappropriate words = 3; incomprehensible sounds = 2; none = 1

What can hydrostatic pressure changes cause?

orthostatic hypotension

bone tissue formation

ossification (osteogenesis)

slowly progressing degenerative joint disease, particularly in weight bearing joints

osteoarthritis

which bone cells are responsible for osteogenesis?

osteoblasts

what do osteoblasts secrete? what does it do?

osteocalcin - increase insulin sensitivity to increase glucose uptake for increased fat storage

osteoblasts become _______ when surrounded by bone matrix

osteocytes

what cells occupy lacunae between calcified layers of matrix (lamellae or lamella)

osteocytes

types of cells in bone

osteocytes, osteoblasts, osteoclasts, osteogenic

which bone cells are randomly dispersed through the bone matrix

osteogenic

what is contained within the osteogenic layer of periosteum?

osteoprogenitor cells - for growth and repair

epicardium

outer layer of the heart that lines the surface of the heart and is often infiltrated with fats; made of dense connective tissue

what is the epicardium?

outer visceral layer that lines the surface of the heart; often infiltrated with fats

How do arteries control pressure fluctuations?

outward force causes them to swell then shrink when that pressure goes away to keep continuous blood flow

pressure exerted on vessel walls by a volume blood entering vessels (transmural pressure)

outward pressure

Do microtubules radiate outwards or inwards?

outwards

what gives blood its red color?

oxidation of iron on the hemoglobin

hemoglobin reversibly binds with ________

oxygen

respiratory gases in blood

oxygen and carbon dioxide

what is the purpose of the pulmonary trunk

oxygen-poor blood leaves the right ventricle via the pulmonary trunk; large artery that branches to left and right pulmonary arteries

pulmonary trunk

oxygen-poor blood leaves the right ventricle via the pulmonary trunk; large artery that branches to the left and right pulmonary arteries

__ cells depolarize transmit electrical signals throughout the heart and cause cardiomyocytes to depolarize and contract

pacemaker

causes of arrhythmias

pacemaker impulse formation, contraction impulse conduction (involves f channels and contractile muscle) or a combination of things like arteriosclerosis, coronary artery spams, heart block and myocardial infarction

neuropathic pain

pain caused by nerve injury or neurological disease such as nerve compression, abnormal growths, infections and spinal cord injuries

visceral pain

pain originating in the internal organs; nociceptors are much more spread out and cause it to be difficult to pinpoint where the pain is coming from

nociception is the activation of ________

pain sensors

referred pain

pain that is felt in a location other than where the pain originates; often visceral (somatic and visceral sensory neurons both synapse at the dorsal horn)

what is erythromelagia?

painful throbbing / burning in fingers caused by occlusion

How do water, ions, and gases move across capillaries?

paracellular transport (through pores)

disseminated intravascular coagulation (DIC) is a ______ disease

paradox

eosinophils

parasitic worms

symptoms of M.S.

paresthesia, optic neuritis, diplopia, abnormal gait

_______ is caused by a reduction in neurons that synthesize dopamine

parkinson's disease

categories of atrial fibrillation

paroxysmal atrial fibrillation, persistant atrial fibrillation, permanent atrial fibrillation

prefrontal cortex

part of frontal lobe responsible for thinking, planning, and language

blood vessels

passageway through which blood is distributed from heart to all parts of the body and back to heart

Diffuse large B-cell lymphoma

peak incidence 60-70 yo ; aggressive and rapidly fatal lymphoma affecting lymph node(s) , multi-focal sites of origin and extranodal sites

hematocrit

percentage of blood volume occupied by red blood cells

which region is FULL of opioid receptors and regulates endogenous opioid signaling?

periaqueductal gray

_______________ is a pain modulating region in the brain

periaqueductal gray (region in the midbrain

osteogenic cells are most concentrated at innermost lining of _______ and _______

periosteum , endosteum

schwann cells

peripheral nervous system

the two layers opposite in orientation in smooth muscle allows for what?

peristalsis

diagnosis of gout

physical exam and x ray

diagnosis of osteoarthritis

physical exam and x ray

what are tension headaches brought on by?

physical or emotional stress

________________ is an inactive precursor of proteolytic enzyme - plasmin

plasminogen

phase 2 of cardiac muscle action potential

plateau; fast potassium channels close and L-type calcium channels fully open to bring in more calcium and flatten the action potential; at the end, L-type channels close

treatment for thrombocytopathia

platelet transfusion

treatment for thrombocytopenia

platelet transfusion

all blood cells originate from __________

pluripotent hematopoieitic stem cells

RBCs are produced by

pluripotent stem cells

What does not easily diffuse across a membrane?

polar molecules and hydrophilic, stopped at the border of the cell membrane and cannot pass through the hydrophobic region

FACT: (polar/nonpolar) and (hydrophobic/hydrophilic) molecules do NOT diffuse readily through membranes

polar, hydrophilic

torsades de pointes

polymorphic ventricular tachycardia that can lead to sudden cardiac death; rapid asynchronous complexes with undulating baseline, long QT interval; repolarization of myocytes occurs in phases 1-3, and is caused predominantly by the outward movement of potassium ions (repol. is prolonged)

what is specificity of diffusion determined by ?

pore size of channel, charge, and binding sites

What is specificity of an ion channel determined by?

pore size of the channel, charge, and binding sites

channel

pore; integral membrane proteins

ions involved in early afterdepolarization

potassium

major cause of maternal-neonatal morbitity-mortality

preeclampsia

factors affecting CO

preload, afterload, cardiac contractility, and heart rate

hemorrhagic inflammatory exudate

presence of RBCs ex: hematoma

transmural pressure

pressure exerted on the vessel walls by a volume blood entering vessels

Mean Arterial Pressure (MAP)

pressure forcing blood into tissues, averaged over cardiac cycle

the pumping action of the heart generates blood flow through the vessels along a _______ _________ always moving from higher to lower pressure areas

pressure gradient

the aorta acts as a ________

pressure reservoir

what do the AV valves do?

prevent back flow into atria when ventricles contract

purpose of valves

prevent back flow of blood

function of semilunar valves

prevent backflow into the ventricles

effective refractory period of cardiomyocytes

prevents extra AP from stimulating contraction in cardiomyocytes that are in the midst of contractile cycle; without this, contraction of them or regions of them would occur sporadically and lead to arrhythmias

what does the long effective refractory period prevent the action potential from doing?

prevents it from stimulating contraction in cardiomyocytes that are in midst of contractile cycle

what is the function of parathyroid hormone (PTH)?

prevents serum calcium levels from falling and serum phosphate levels from rising above normal physiological levels

source of iron

primarily dietary

types of high blood pressure

primary and secondary

most antiarrhythmic drugs are ___________

proarrythmic

examples of sodium channel blockers

procainamide, lidocaine, and propafenone

examples of Na+ channel blockers

procainamide, lidocaine, propafenone

channel gating

process of opening and closing ion channels that results from a conformation change; ion flow depends on how often and how long these are open

reticular cells

produce reticular fiber stroma that supports other cells in lymphoid organs

What can too little inflammation cause?

progressive tissue destruction

what controls when we are awake and alert?

projections from reticulum of brain stem to cerebrum

what defines generalized anxiety disorder?

prolonged (>6 months) excessive worry that is not easily controlled by the person

long Qt syndrome

prolonged QT interval results in polymorphic tachycardia

Long QT syndrome

prolonged QT interval results in polymorphic tachycardia; example is torsades de pointes; lengthens time between ventricular depolarization and ventricular repolarization

_______________ period is critical in action potential

prolonged effective refractory period

chronic inflammation

prolonged inflammation; shifts the type of cells present at the site of inflammation; proliferation of fibroblasts causes an alteration in tissues

example of nonselective b-adrenoreceptor blocking agent (beta blocker)

propranolol

examples of antiadrenergics (beta blockers)

propranolol

function of WBCs

protect the body from infectious microorganisms; fight infection

what regulates microtubule-associated proteins? (MAPs)

protein kinases and phosphatases

cerebrovasculature

provide glucose and oxygen because brain uses tons of these

function of cerebrovasculature

provide glucose and oxygen to neural tissue

function of the pericardium

provides cushioning; friction free

systemic inflammatory disease that may occur in patients with psoriasis

psoriatic arthritis

mental health

psychological and emotional well being; it influences how we handle stress, relate to others, out ability to work and enjoy life, and how our body functions

What does an alteration in acetylcholine cause?

psychosis with neurodegenerative diseases

the ________ circuit is the right side of the heart and pushes blood through heart --> lungs --> heart

pulmonary

What are the two functional circuits of the heart?

pulmonary and systemic

right ventricle

pulmonary circuit, contracts less forcefully, less pressure/resistance, and short distance

arterial blood pressure

pulsatile so a single value is used - Mean Arterial Pressure

what is the main function of cardiac muscles?

pump blood through vessels

What is transcellular transport dependent on?

pump, channels and receptors (regulated by adding or removing these)

blood pressure of the heart

pumping action of the heart generates blood flow through the vessels along a pressure gradient always moving from higher-to-lower-pressure area

what are the transporters involved in active transport called?

pumps

what is the function of the sodium-potassium ATPas pump?

pumps sodium out of the cell to keep intracellular fluid sodium concentration low

functions of parasympathetic division

pupil constriction, stimulate digestion salivary glands, slow heart, constrict bronchi, stimulate digestion, promote voiding of bladder, promoting sexual arousal

•Combination of physical and chemical changes within the muscle cell that (raises / lowers) the calcium concentration

raises

symptoms of cluster headaches

rapid onset of headache that lasts ~3 hours, but occur multiple times over the course of weeks .. then intermission

phase 3 of cardiac muscle action potential

rapid repolarization; slow calcium channels open to repolarize the membrane

heart rate

rate of contraction

what is the heart rate?

rate of contraction

dendrite

receive information

how does LDL enter cells?

receptor mediated endocytosis

electrocardiogram

record of the electrical activity of the heart

two types of bone marrow

red and yellow

MOA of renin-angiotensin-aldosterone system drugs

reduce impact of RAS

ischemia

reduction in blood flow to level insufficient to met tissue oxygen demands

ischemia

reduction in blood flow to levels insufficient to meet tissue oxygen demands

isovolumetric contraction

refers to the short period during ventricular systole when the ventricles are completely closed chambers

first intention tissue repair

regeneration; replacement of dead or damaged cells with the same cell type; restores normal function; wound edges are close together

What is the brain divided into?

regions with specific functions (BLS, motor control, visual cortex, emotion area, learning and memory zone)

What happens if pacemaker cells are damaged?

regular cardiomyocytes have the ability to become new pacemakers

claudins

regulate the "tightness: of junctions; a junction protein

what is the neck of myosin responsible for?

regulates activity of the myosin head directly, and also mediates the effects of proteins that associate with the neck, *myosin light chains*

in _____________ , hematocrit rises because of plasma volume loss without decrease in RBCs

relative polycythemia (gaisock syndrome)

in the cardiac cycle, all chambers _______

relax

In order for a behavior to be classified as compulsive , the behavior must be _________

repeated and repletion must not be related to any environmental condition

obsessive-compulsive disorder

repeated thoughts (obsessions) and repeated acts (compulsions), repletion must not be related to any environmental condition; time consuming and distressing

substance abuse

repeated use of drugs, resulting in functional problems

second intention tissue repair

replacement of damaged cells with scar tissue (collagen), holds organs together but is not fully functional; wound edges are further apart

MOA of methyldopa

replaces epi/norepi as neurotransmitter

functions of exocytosis

replaces portions of the plasma membrane, adds new membrane components, and provides a route for impermeable molecules to be secreted

in torsades de pointes, the _________ is prolonged

repolarization

microglia

resident immune cells of the brain; the brain is surrounded by these to protect from foreign cells; small and clean up debris

what are red blood cells dedicated to?

respiratory gas transport

mechanically gated ion channels

respond to mechanical stress; found in muscles and gut

inflammation

response to eliminate harmful stimuli, such as pathogen, damaged cells, or irritants; involves immune cells, blood vessels, and molecular mediators

what does phase 4 of cardiac muscle action potential consist of ?

resting membrane potential

phase 4 of cardiac muscle action potential

resting membrane potential is reestablished

arrhythmogenesis

result from disorders of impulse formation, conduction or both

systolic pressure

results from blood forced into the arteries during ventricular; pressure in aorta after ventricular contraction

framework of red marrow

reticular fibers form a complex network of branching series of caves

hemoglobin is released into circulation as __________

reticulocytes

main function of lymphatic system

return excess tissue fluid to blood vascular system

systemic inflammatory disease

rheumatoid arthritis

which ventricle? •Pulmonary circuit •Contracts less forcefully •Less pressure/resistance •Shorter distance

right

SA node is found in ______

right atrium

4 chambers of the heart

right atrium, right ventricle, left atrium, left ventricle

pulmonary circuit

right side of the heart pushes blood through the pulmonary arteries to the lungs then through the pulmonary veins back to the heart; blood is now oxygenated

What does preponderance of catecholamine activity increase?

risk of bipolar disorder

What is the most common way that cells can use cytoskeleton elements to move?

roadway

what are concussions brought on by?

rotational forces, acceleration, deceleration

if untreated, dissections may______

rupture

what is a hemorrhagic stroke?

rupture of a cerebral blood vessel (MOST fatal)

aneurysmal hemorrhage

rupture of. an aneurysm

What kind of protein do microtubules contain?

tubulin

symptoms of depression

sad, anxious, empty mood, hopelessness, pessimistic, irritable, feelings of guilt or worthlessness, loss of interest in hobbies, less energy, moving or talk slowly, restless, difficulty concentrating or making decisions, sleep disturbances, appetite or weight changes, suicidal ideations, aches and pains

meningiomas

tumor in meningothelial cells

ependymomas

tumor in the cells that line the ventricles

isotonic solutions have (lower,higher,same) concentration of nonpenetrating solutes as normal extracellular fluid

same

plasma membrane in muscle tissue

sarcolemma

myofibril made up of repeating segments called _________

sarcomeres

cytoplasm in muscle tissue

sarcoplasm

Where are ryanodine receptors found?

sarcoplasmic reticulum

too much dopamine binding post-synaptic receptor is associated with _________

schizophrenia

What does an alteration in dopamine cause?

schizophrenia and anxiety

What can too much dopamine cause?

schizophrenia; also might lead to parkinson's

which kind of tissue repair? - replacement of damaged cells with scar tissue (collagen) - helps hold organ together - function is not fully restored

second intention - fibrosis

Raynaud's phenomenon

secondary type; associated with other disease states or known causes of vasospasms, genetic

what do perforating fibers (Sharpey's fibers) within periosteum do?

secure periosteum; provide insertion points for tendons and ligaments

status elepticus

seizures that do not stop

paroxysmal atrial fibrillation

self terminates and laast <7 days

paroxysmal a fib

self terminates and lasts <7 days

what is the "dub" sound?

semilunar (pulmonary and aortic) valves close

axon

sends information

______ ________ throughout the body send info on touch, temperature, position, and pain to the sensory cortex

sensory receptors

membrane potentional

separation of electrical charges that exists across plasma membranes; provides an electrical force that influences the movement of ions across the membrane

neural spasms in vascular constriction is mediated by ______________

serotonin

this neurotransmitter plays a critical role in appetite, sleep, mood, pain, and vomiting

serotonin

name the corresponding receptor: serotonin (5-HT)

serotonin (5-HT) receptors

receptors of serotonin (5-HT)

serotonin receptors

What neurotransmitters are involved in schizophrenia?

serotonin, dopamine and glutamate

which neurotransmitters play a role in schizophrenia?

serotonin, dopamine, glutamate

heart

serves as a pump that establishes the pressure gradient needed for blood to flow to tissues

What kind of protein does the intermediate filament contain?

several

what is bradycardia typically caused by?

severely depressed conduction due to parasympathetic control of AV (relieved by atropine)

differences between cardiac and skeletal muscle's action potentials

shape of action potential, duration of action potential, refractory periods

neurotransmission of the sympathetic nervous system

short initial neuron that releases Ach to N receptors at ganglion; long 2nd neuron that can release Ach to M, Ne to both alpha and beta, D to D1, and Ach to N

tunica externa

tunica adventitia; collagen fibers that protect and reinforce vessels; has a large ECM and fibroblast component

the tunics of blood vessels

tunica interna, tunica media, tunica externa

tunica interna

tunica intima; endothelial later that line the lumen of all vessels, 1 cell layer thick; interface between blood and vessel

What studies were used to research schizophrenia?

twin studies -- also in bipolar disorder!

what is hemoglobin composed of?

two alpha and two beta chains bound to a heme group

I bands

two regions on either side of the A band - thin filament (light region)

Antiadrenergic Drugs

type of antiarrhythmic drugs; decrease heart rate

typical symptoms of sick sinus syndrome

typically asymptomatic however could be lightheadedness, syncope, or dizziness

inherited hemolytic anemia

sickle cell anemia

synapse

site of connection between neurons and target effector cells

size of molecule used to calculate the diffusion coefficient

dC/dX

size of the concentration gradient

________ muscle use ACH to change sodium permeability to open voltage gated calcium channels

skeletal

three types of muscle tissue

skeletal, cardiac, smooth

continuous capillaries

skin and muscle; junctions between cells are not complete leaving areas for transport fluid and small molecules

propafenone

slow dissociative sodium channel blocker that prevents supraventricular arrhythmias

sinus bradycardia

slow heart rate caused by increased vagal stimulation, medications, seen in athletes (they have a slow resting heart rate)

negative dromotropic effect of adrenoreceptor antagonists

slowed atrioventricular conduction speed

1st degree AV block

slowed conduction and prolonged PR interval

fluctuations in arteries are (larger/smaller) than those in the left ventricle

smaller

what gender does rheumatoid arthritis affect more? by how much?

women 3x greater than men

define a neuron

workhorse of nervous system responsible for communicating and controlling functions throughout the body

Purulent Inflammatory Exudate

yellow or green opaque discharge ex: abscesses, boils, cellulitis

Is cardiac muscle straited?

yes

are the blood vessels well vascularized?

yes

are WBCs complete cells?

yes --> with organelles and nuclei

how do sympathoplegic drugs work?

• Activating the sympathetic nervous system leads to an increase in CO and PR to increase BP • CO = SV x HR • BP = CO x PR • Decreasing sympathetic function- Lowers BP by decreasing HR and/or PR

treatment for orthostatic hypotension

• Alleviate cause by avoiding causative medications and situations • Mineralocorticoids can be used to reduce salt and water loss • Sympathomimetic drugs (clonidine)

clinical manifestation(s) of venous thrombosis

• Asymptomatic, inflammatory process symptoms- pain, swelling, tenderness •Early detection needed due to increased risk for pulmonary embolism

how do kinesin and dynein work?

• Both undergo conformational changes, where they stretch out to grab a tubulin dimer, then bend to pull themselves along the microtubule.

MOA of calcium channel blockers

• Inhibit Ca2+ influx into vascular smooth muscle • Decrease contractile force • Decrease PR and BP - Capable of decreasing contractility of the heart

baroreceptors

• Located in aorta and carotids between heart and brain and respond to changes in stretch • Changes heart rate, contraction, and vascular tone

chemoreceptors

• Located in carotid bodies at bifurcation of the two common carotids and monitor O2 , CO2 , H+ to regulate ventilation • Causes widespread vasoconstriction when pressure drops

neural mechanisms of blood pressure regulation

• Parasympathetic: Vagal stimulation of SA node, AV node, atria, very little in ventricles to slow heart rate • Sympathetic: Efferent nerves are present in atria (mainly SA node) and ventricles to increase heart rate and increase peripheral resistance

MOA of Sodium Nitroprusside (Nitropress)

• Vasodilates arterial and venous vessels •Activates guanylyl cyclase à More cGMP levels à Vasodilation •Increase in release of NO

effects of atherosclerotic plaque

• narrowing of vessel • Sudden vessel obstruction • Plaque rupture • Thrombosis and emboli formation • Ischemia and infarction • Aneurysm formation

what is Torsades de pointes?

•"twisting of the points" •Polymorphic ventricular tachycardia that can lead to sudden cardiac death

etiology and pathogenesis of venous thrombosis

•Associated with stasis of blood, increased coagulation, vessel wall injury, spinal cord injury, impaired cardiac function, long air travel, prolonged sitting, increased viscosity, hormone replacement therapy, dehydration

clinical manifestations of hypertension

•Asymptomatic disease •Target-organ damage- Long term effects of hypertension •Heart- LV hypertrophy, MI, coronary disorders, heart failure •Brain- Stroke, TIA, dementia, cognitive disorder •Chronic kidney disease •Peripheral vascular disease •Retinopathy

sliding filament model

•Describes the movement of myosin on an actin filament 1.Myosin head bound to actin called crossbridge 2.ATP binds causing myosin head to detach from actin 3.Myosin neck extends , moving myosin head forward 4.Myosin phosphorylates ATP to ADP releasing P energy 5.Actin is pulled forward called power stroke 6.ADP is released ; crossbridge is formed ; myosin is able to bind to a new molecule of ATP

Non-Hodgkin's Lymphoma

•Diverse group of B-cell, T-cell, and Natural killer (NK)-cell origin

what is happening in after-depolarizations

•Early (EAD) - phase 3 repolarization is interrupted, and membrane potential oscillates •See long Q-T interval with slow repolarization and prolonged AP due to delayed "rectifier K+ current" repolarization •Late (DAD) - After RMP is reached, cells get a secondary impulse which may or may not be sufficient to reach threshold •Generally from Ca2+ overload

treatment of Raynaud's

•Eliminating stressor factors •Avoid decongestants causing vasoconstriction

pacemaker action potential of autorhythmic myocardium cells

•F-channel (If) Na+ channels slow depolarization due Na+ influx •Once membrane depolarizes to a threshold voltage, voltage-gated Ca2+ channels open to initiate the depolarization and AP •F-channels close during depolarization •At AP: Ca2+ channels close and K+ channels open to repolarize membrane •No true hyperpolarization •If pacemaker cells damaged, regular cardiomyocytes have ability to become new pacemakers

Pathogenesis of atherosclerosis

•Fatty streaks- Thin, fatty, intimal plaques composed of macrophages and smooth muscle cells with lipids to form foam cells; Attracts monocytes •Fibrous atheromatous plaques- Large, fibrous plaques with inflammation that may occlude vessel causing thrombus formation •Complicated lesions- Contain hemorrhage, ulceration, scar tissue

Genetic predisposition to rheumatoid arthritis

•HLA-DRB1 (Human Leukocyte Antigen - DRB1 isotype) is an MHC (major histocompatibility complex) cell surface receptor -Ligand for the T-cell receptor (TCR) involved in several autoimmune conditions and is upregulated in infection -T-helper cell mediated response to release TNF and ILs

example(s) of occluding arterial supply

•Hyperlipidemia •Atherosclerosis •Raynaud disease •Aneurysms

secondary hypertension

•Identifiable cause •Kidney disease- Increases in salt and water retention and decreases in renal blood flow • Activates of renin-angiotensin-aldosterone mechanism •Adrenal cortical disorders- Increases in salt and water retention (hyperaldosteronism) and excess glucocorticoid levels (Cushing disease) •Pheochromocytoma- Increases in catecholamines (epinephrine, norepinephrine) •Aortic coarctation- Narrowing of aorta •Oral contraceptive drugs- Cause unknown; Thought to be sodium retention

what is happening in enhanced or ectopic pacemaker activity?

•Increasing phase 4 slope •New pacemaker cells are controlling conduction

how does allopurinol work?

•Inhibits xanthine oxidase preventing uric acid formation

acquired disorders causing thrombocytopathia

•Liver disease affecting synthesis of coagulation factors V, VII, IX, X, XI, and XII, prothrombin, and fibrinogen •Vitamin K deficiency

major components of immune system

•Lymphocytes •Lymphoid tissue •Lymphoid organs

types of depression

•Major depression •Persistent depression disorder (2 years) •Seasonal affective disorder •Psychotic depression •Peripartum depression •Premenstrual dysphoric disorder •Atypical

how does colchicine work?

•Microtubule polymerization inhibitor; Inhibits leukocyte migration and phagocytosis.

primary hypertension

•No cause can be identified •Family history •Age related changes- Systolic blood pressure increases with age •Race- More prevalent in African Americans •Insulin resistance, type 2 diabetes, hyperlipidemia, obesity- Cardiovascular risk factor cluster (metabolic syndrome) •Modifiable risk factors- High salt intake, excessive calorie intake, obesity, excessive alcohol consumption, low potassium, stress, smoking, high fat diet

treatment for sickle cell

•No treatment; Avoidance of sickling episodes (infections, cold, physical exertion, dehydration)

symptoms of panic disorder

•Often coupled with chest pain, shortness of breath, or other signs and symptoms of a life-threatening disease- what causes a patient to present at doctor

what is the cause(s) of an arrhythmia?

•Pacemaker impulse formation •Contraction impulse conduction •Combination •Arteriosclerosis •Coronary artery spasm •Heart block (mostly AV block) •Myocardial ischemia

autoimmune response of rheumatoid arthritis

•Rheumatoid factor (RF) - Autoantibody precipitates when the blood cools; Binds with IgG to form complex to contribute to disease •Pannus - Destructive vascular granulation tissue caused by inflammation •Matrix Metalloprotease-1 (MMP-1) - Destroys collagen I

what happens during the development of an ectopic pacemaker?

•SA node slows down too much other conduction cells could become dominant

treatment for brain hemorrhage. what kind of drug?

•prevent rebleeding with vascular clips, prevent vasospasms with extra fluids? (difficult to prevent, most difficult complication) - nimodipine = calcium channel blocker, may help in some cases

what are leukemias characterized by?

•replacement of normal ratio of red blood cells with white blood cells in the bone marrow

name the corresponding receptor: Histamine (H)

Histamine (H) receptors

Hodgkin or Nonhodgkin : characterized by Reed-Sternberg cells

Hodgkin

Hodgkin or Nonhodgkin : localized, single group of nodes ; contiguous spread. many patients have relatively good prognosis

Hodgkin

The Na/Ca exchanger is used to pump Na _____ the cell and Ca ____ the cell during muscle contraction. a. out; in b. out; out c. in; out d. in; in

The _______ charge of beta tubulin and the _______ charge of alpha tubulin will be magnetically attracted to one another causing dipole formation and ultimately microtubule formation. A. Positive; Positive B. Negative; Negative C. Positive; Negative D. Negative; Positive

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