PHCY 411 Final
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
0
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
1%
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
15
How long do panic attacks typically last?
15-30 min
brain tumors account for ___(%) of cancer deaths
2
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
20
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
80
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?
90
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
A
Decreasing the activity of the enzyme- prothrombin activator- will __________ formation of fibrin threads. A. Decrease B. No effect C. Increase
A
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
A
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
A
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
A
_______ is an anti-rheumatoid arthritis therapy that stabilizes lysomomes to slow immune cell-mediated damage A. Hydroxychloroquine B. Entanercept C. Adalimumab D. Methotrexate
A
_________ cells actively produce and secrete the organic portion of th bone matrix. A. Osteoblasts B. Osteoclasts C. Osteoprogenitors D. Osteocytes
A
__________ inhibits calcium release from bone by inhibiting osteoclast activity A. Calcitonin B. Ergocalciferol C. Parathyroid hormone D. Cholecalciferol
A
__________ is a term used to describe the formation of uric acid crystals (tophi) in joints. A. Gout B. Osteomalacia C. Osteoarthritis D. Rheumatic arthritis
A
___________ 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
A
diffusion area
A
c
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.
c
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
A
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
B
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
B
During intestinal absorption ________ or vitamin D2 is converted to Vitamin D3 A. Calcitonin B. Ergocalciferol C. Parathyroid hormone D. Cholecalciferol
B
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
B
Increasing the amount of GTP hydrolysis would ____________ the dynamic instability of the microtubule cytoskeletal network. A. No effect B. Increase C. Decrease
B
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
B
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***
B
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
B
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
B
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
B
_________ 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
B
__________ 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
B
___________ 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
B
_____________ is a term used to describe a dwindling yet not dangerous bone density A. Osteoporosis B. Osteopenia C. Scoliosi D. Osteogenesis imperfecta
B
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.
B
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
B
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
C
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. Serum B. Plasma C. Buffy Coat D. Hematocrit
C
Loss of thrombocytes would result in a _________ in the body's ability to form blood clots A. Not effect B. Increase C. Decrease
C
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
C
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
C
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
C
_________ cells secrete hydrocholoric acid during osteolysis for bone resorption. A. Osteocytes B. Osteoprogenitors C. Osteoclasts D. Osteoblasts
C
__________ 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
C
__________ is an anti-rheumatiod arthritis therapy that interferes with purine metabolism to reduce inflammation A. NSAIDs B. Etanercept C. Methotrexate D. Hydroxychloroquine
C
______ 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
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. Buffy Coat B. Serum C. Hematocrit D. Plasma
D
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
D
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
D
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
D
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
D
__________ 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
D
__________ cells actively maintain bone A. Osteoprogenitors B. Osteoblasts C. Osteoclasts D. Osteocytes
D
__________ is a term used to describe the critical loss of bone density. A. Scoliosis B. Osteogenesis imperfecta C. Osteopenia D. Osteoporosis
D
__________ is an anti-osteoarthritis therapy that selectively inhibits cyclo-oxogenase-2. A. Methotrexate B. Etanercept C. NSAIDs D. Celecoxib
D
__________ 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
D
____________ 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
D
_______________ 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
D
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
E
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
E
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)
D
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
C
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
SA
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?
NO
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
B
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
c
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.
E
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
D
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
c
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
c
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
b
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
a
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
b
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
d
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
B
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
b
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
b
_____ cells secrete hydrochloric acid during osteolysis for bone resorption. a. osteoprogenitors b. osteoclasts c. osteoblasts d. osteocytes
b
_____ 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
b
______ 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
c
______ 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
c
______ is an anti-osteoarthritis therapy that selectively inhibits cyclo-oxogenase 2. a. etanercept b. NSAIDs c. celecoxib d. methotrexate
d
______ 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
d
______ 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
B
_______ is an anti-rheumatiod arthritis therapy that interferes with purine metabolism to reduce inflammation a. NSAIDs b. methotrexate c. hydroxychloroquine d. etanercept
C
_______ 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
A
_________ cells actively maintain bone. A. Osteocytes B. Osteoprogenitors C. Osteoblasts D. Osteoclasts
D
__________ 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
C
__________ 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
D
__________ 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
D
__________ is a term used to describe the critical loss of bone density. A. Scoliosis B. Osteogenesis imperfecta C. Osteopenia D.Osteoporosis
C
__________ 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
A
____________ cells actively produce and secrete the organic portion of the bone matrix A. Osteoblasts B. Osteocytes C. Osteoprogenitors D. Osteoclasts
C
____________ 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
A
________________ 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
C
___________________ inhibits calcium release from bone and by inhibiting osteoclast activity A. Parathyroid Hormone B. Cholecalciferol C. Calcitonin D. Ergocalciferol
B
___________________ 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
a
18. Delusions are a positive symptom of schizophrenia. a. True b. False
a
21. The Na+/K+-ATPase pump will _______ the number of intracellular K+ ions. a. Increase b. Decrease c. Not affect
a
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
a
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
a
28. An excitatory postsynaptic potential will cause a _____ event on the postsynaptic cell. a. Depolarizing b. Hyperpolarizing c. Repolarizing
a
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
a
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
a
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
a
47. Repeated use of 'goof balls' by this patient would be classified as substance abuse. a. True b. False
a
49. _________ is a solution that exerts a similar osmotic pressure than the cell contents. a. Isotonic solution b. Hypertonic solution c. Hypotonic solution
a
5. The Na+/K+-ATPase pump will ___________ the number of extracellular K+ ions? a. Decrease b. Not effect c. Increase
a
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
b
10. Activating nociceptors in the liver would classify as __________ pain. a. Somatic b. Visceral c. Neuropathic d. Cutaneous
b
13. This neurotransmitter plays a critical role in appetite, sleep, mood, pain, and vomiting. a. Acetylcholine b. Serotonin c. GABA d. Norepinephrine
b
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
b
17. Vaccinations are available for the pathogens that induce viral meningitis. a. True b. False
b
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
b
22. _____ is a solution that exerts a similar osmotic pressure than the cells contents. a. Hypotonic b. Isotonic c. Hypertonic
b
24. Delusions are a negative symptom of Schizophrenia. a. True b. False
b
26. The Na+/K+-ATPase pump will ______ the number of intracellular Na+ ions. a. Increase b. Decrease c. Not effect
b
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
b
30. An antagonist binding to its receptor will ________ the receptor's activity. a. Not effect b. Decrease c. Increase
b
31. ________ is a solution that exerts a greater osmotic pressure than the cell contents. a. Hypotonic solution b. Hypertonic solution c. Isotonic solution
b
36. We should feel embarrassed and ashamed if we suffer from a mental disorder a. True b. False
b
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
b
4. ____________ is a solution that exerts a lower osmotic pressure than the cell contents. a. Isotonic solution b. Hypotonic solution c. Hypertonic solution
b
42. High levels of NMDA receptor activation leads to ________. a. Cerebral edema b. Excitotoxicity c. Hyperpolarization d. Neuronal viability e. Tau
b
44. Increased GABA transmission is associated with depression, pain, and seizures. a. True b. False
b
51. A hypotonic solution would ______ the intracellular fluid volume of a blood cell. a. Decrease b. Increase c. Not change
b
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
b
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
c
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
c
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
c
29. A hypertonic solution would ______ the intracellular fluid volume of a blood cell. a. Increase b. Not change c. Decrease
c
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
c
35. According to Fick's Law, adding a semipermeable membrane would _____ the net flux of diffusion. a. Not Effect b. Increase c. Decrease
c
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
c
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
c
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.
c
50. An agonist binding to its receptor will _____ the receptor's activity. a. Not effect b. Decrease c. Increase
c
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
c
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
d
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
d
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
d
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
d
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
d
7. Vasospasms are a life-threatening complication of which brain disorder? a. Ventricular hemorrhage b. Multiple sclerosis c. Concussion d. Aneurysmal hemorrhage
d
9. Plaques and tangles are hallmarks of which neurological disease? a. Depression b. Stroke c. Epilepsy d. Alzheimer's Disease
d
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
e
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
Ds
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
c
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
c
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