RUSM Mini 2

List palpable structurs of the back

- Vertebra prominens (C7) - T4 Scapular Spine - Acromion - Greater Tuberosity - Medial border - T7/T8 Inferior angle - 6th-12th ribs - L4 Iliac crest - Posterior Superior Iliac Spine - Anterior Superior Iliac Spine - Sacrum - Greater Trochanter - Ischial Tuberosity

Exceptions to X inactivation

- XIST (stays on - ACTIVE) - several genes necessary for normal reproduction (ones that must stay active so cell becomes female) - pseudoautosomal regions (PAR) - some other genes randomly distributed within the inactive area (diff. among women)

Loose (areolar) CT is characterized by

1) Loose arrangement of fibers (collagen, elastic, reticular) thin and sparse fibers 2) Lots of ground substance: gel-like consistency, very important for diffusion of gases, nutrients, and waste products 3) large number of cells of various types embedded in an abundant gel-like ground substance with loosely arranged fibers

the perichondrium consists of two layers

1) fibrous layer (mainly fibroblasts) 2) chondrogenic layer (between fibrous layer and cartilage tissue proper- it contains chondroblasts which later surround themselves with cartilage matrix and become chondrocytes and increase thickness of cartilage by appositional growth

Dermacentor species (ticks)

- Two main families of ticks- hard (ixodid) and soft (argasid) - soft ticks attach form less than 1 hr, red macule once they drop off * HARD TICKS more common CAN BE VECTORS hard ticks attach and feed <1 week - at bits, small area of induration , often purpuric surrounded by erythematous rim - transmitted from grass and bushes

Describe Simple Squamous Epithelium and its functions

Are flat, plate-like cells - nuclei are plump Fxs: Sites for fluid, metabolite, or gas exchange - thinness of the cells favors this

_____ recive >75% of lymph from the breast, largely from the lateral quadrants (superior lateral & inferior lateral)

Axillary Lymph Nodes

passes electrical signals to dendrites of another cell or to an effector cell

Axon

In the intrinsic palmar muscles- DEEP layer what can be found

3 Palmar interossei 4 Dorsal Interossei

The vast majority of synapses are

AXODENDRITIC - the axon terminal ends on a dendrite spine (other ones include: axosecretory, axoaxonic, axoextracellular, axosomatic, axosynaptic)

Which muscle of the thenar compartment ABducts the thumb

Abductor Pollicis Brevis

Which muscles are in the THENAR compartment of the palm (palmar)

Abductor Pollicis Brevis Flexor Pollicis Brevis Opponens Pollicis ** ALL I: recurrent branch of MEDIAN nerve

What occurs if there is an injury to the Deep Fibular Nerve (branch of the common fibular nerve L4-S2)

Abnormal motor and sensation - weakness or inability to dorsiflex ankle (i.e. FOOTDROP) or extend toes - Diminished or loss of skin sensation between 1st and 2nd toe

Concave depression (socket) on lateral surface of hip bone

Acetabulum

Hip dislocation due to high-impact trauma (ex. MVA) is refered to as

Acquired dislocation of hip joint * the affected limb appears shorter and medially rotated

Brachialis M. (anterior compartment of arm)

Action: flexes forearm in ALL positions Innervation: Musculocutaneous N and some contribution from RADIAL NERVE

The two necks of the humerus include

Anatomical Neck Surgical Neck

Which artery is found superficially over the tarsal bone, near the tendon of the extensor hallucis longus

Dorsalis Pedis Artery * can check pulse here

S-Cdk

Cyclian A/Cdk2 and cdk1

Space between the vertebral canal and dura mater; contains fat

Epidural Space

The fusion of what forms the basement membrane

Fusion of the Basal lamina with the reticular lamina ** the basement membrane can be seen by the light microscope

Which muscle does primary extension at metacarpophalangeal joint digit 5 and secondary extension at interphalangeal joint for digit 5

Extensor digiti minimi I: radial nerve (via the deep branch of the radial nerve)

Which artery supplies the ENTIRE LOWER LIMB

Femoral Artery ** one of its branches include the deep artery of the thigh (main artery supply to thigh region)

Limb muscles and muscle of abd and thoracic wall are from

Hypomere origin ex. Pronator teres and Rectus femoris, external oblique and internal intercostal

The glenohumeral joint is weakest

INFERIORLY

Humeral Shaft Fracture (radial groove) of humerus

Can be transverse or spiral Transverse: proximal fragment pulled laterally (by deltoid) * this one is straight across Spiral: may result in shortening (due to one end overriding the other) - Injury to RADIAL N. in radial groove & DEEP ARTERY OF ARM (Profunda brachii); (triangular interval)

The fibrous intercellular network surrounding cells of the CNS may superficially resemble collagen with light microscopy..but what is it actully?

It is actually the Network of cellular processes emerging from neurons and glial cells ** such processes are collectively called the NEUROPIL *** Neurons and glial cells secrete GAGs which form- groun substance gel

What can cause an axillary nerve (C5-C6) injury

It may be compressed due to anteroinferior shoulder dislocation sx's: -inability to abduct arm to or above horizontal (deltoid muscle is compromised) -sensory loss on superolateral aspect of the arm (skin overlying the deltoid muscle)

What functions to conduct the "artery to head of femur" (branch of obturator artery)

Ligament of Head of Femur (aka ligamentum teres femoris or round ligament of the femur)

An older person has an increase number of

Lipofuscin Granules

Attachment site for myosin in the sarcomere

M line

Axillary nerve which branches from the

Posterior Chord in brachial plexus - innervates the deltoid and teres minor muscles

What is the proximal and distal attachments of the Piriformis Muscle

Proximal: sacrum Distal: superior part of greater trochanter of femur

Lateral Decubitus (recumbent)

Pt lying on their side if lying on R= right lateral decubitus if lying on L= left lateral decubitus

Which muscle of the thigh has ONLY the function of lateral rotation

Quadratus Femoris

As the sclerotome surrounds the neural tube and notochord it goes throguh

Resegmentation ** the sclerotome is divided into a cranial portion and a caudal portion by VON EBNER'S FISSURE - then the cranial portion joins the caudal portion of the sclerotome above (therefore each vertebrae is composed of the caudal half of one somite and the cranial half of its neighbor)

Cancer that begins in the connective or supportive tissues such as bone, cartilage, fat, muscle, or blood vessels

Sarcoma - Rhabsosarcoma: cancer of muscle - Osteosarcoma: bone cancer * remember carcinoma was from epithelial cells

Ankle joint is aka

Talocrural joint - Distal tibia and distal fibula form a malleolar mortise (wedge-shape) that articulates with trochlea of talus - it is a uniaxial, diarthrosis, hinge type of synovial joint - stability comes from ligaments - movements: plantarflexion and dorsiflexion

Superficial Cubital Fossa

The contents overlying the cubital fossa- "roof' - Median Cubital vein, lateral cutaneous nerve of forearm, medial cutaneous nerve of forearm ** Boundaries: - Brachioradialis Muscle - Pronator Teres Muscle - Medial and lateral epicondyles of humers

What two notches join to make the intervertebral (IV) foramen

The superior vertebral notch and the Inferior vertebral notch join to form the Intervertebral (IV) Foramen- this is through which the spinal nerves pass

Do smooth muscles have a discrete neuromuscular juntion like skeletal muscle fibers do

No! they posses a different, less complex innervation ** regulation of smooth muscle activity often occurs via the autonomic nervous system, whereby axonal varicosities containing synaptic vesicles come into close contact with the sarcolemma of a smooth muscle cell

In what area of an axon is there ABSENCE of myelin

Node of Ranvier - this is the only place that ions can flow ion

In brain grey matter is on the

OUTSIDE - in spinal cord, grey matter is on inside

Your phalanges have what three parts

P: proximal (closer to body) I: intermediate D: distal (tips of finger)

From the medial quadrants, lymph passes mostly to the _____; from here lymph can travel to the contralateral breast

Parasternal lymph nodes

After the adductor hiatus the femoral artery becomes the

Popliteal artery

Can you describe Intervertebral (IV) discs

They comprise 20% of the vertebral column length - they are composed of Anulus Fibrosus (concentric rings of fibrocartilage that connect adjacent vertebral bodies) & the nucleus polpusus (a semi-gelatinous mass that acts as a shock absorber) Fxs: - strong attachment between vertebrae; forms cartilaginous joint - weight bearing, shock absorption

The largest known protein, MW 2,500,000 daltons

Titin! - it is an accessory protein in the sarcomere - one titan molecule spans half the sarcomere Fxs: - stabilize thick myosin filament - center it between the thin actin filaments - prevent overstretching of the sarcomere - acts as a SPRING to recoil the sarcomere after it is stretched ** it also attaches to the Z-disc like actin

Mesenchymally derived cells express

Vimentin intermediate filaments ** muscle cells express vimentin + desmin (muscle specific) ** remmeber epithelial cells expressed keratin

Flexor carpi radialis and extensor carpi radialis longus and brevis function in

abduction

Pes Planus (flat foot)

absence of normal supportive arch of foot "fallen arches" * can be do to weight gain

Early closure of the coronal suture

acrocephaly (tower skull)

Axons have

actin, intermediate filaments, and microtubules

Cross-bridge formation in relaxed state

actin-myosin binding is physically inhibited by troponin-tropomyosin complex: no cross-bridges formed

In stratified epithelial, the dividing cells are the

basal cells (i.e. the cells on the bottom- basal lamina side- of epithelial layers) * simple (NOT stratified) epithelia usually have stem cells in this layer

The basal surface faces the

basal lamina, and usually connective tissue below that

The actin filaments of microvilli

anchor into the terminal web/adhesion belt- a filamentous structure composed of ACTIN microfilaments found ONLY at the apical surface of polarized epithelial cells that posses microvilli * this terminal web plugs into the zonula adherens

Anterior and Posterior surface of Hand

anterior: palmar posterior: dorsal

Term for the EXACT middle

median

Rotation of the vertebral column occurs mostly in the

cervical and thoracic region - rotation of head and neck - rotation of upper trunk, neck, and head

Increased mechnical stress in osteocyte activates

molecular mechanisms similar to those found in the matrix-producing osteoblasts (why weight-bearing exercise increases bone density) ** the the osteocytes are responsible for reversible remodeling of their pericanalicular and perilacunar bone matrix this is called OSTEOCYTIC REMODELING

During contraction Z discs of adjacent sarcomeres

move closer together during contraction as sarcomere shortens

The axons of neurons in the PNS form

nerves * many of these nerves form interconnected plexii, such as: - cervical, brachial, lumbar, sacral plexus

What is the difference between a nicotinic receptor, ligand gated, and nonspecific cation channels

nothing!! they are all the same thing

Nucleus Pulposus is derived from the

notochord

Neuronal cell bodies in the CNS are called

nuclei - and are scattered throughout the cortex and brainstem levels

Principal functions of periosteum and endosteum

nutrition repair growth of bone

Rates of drug overdose are higher in

older populations 30-60 yrs old

Of the two daughter cells produced when a stem cell divides

one daughter remains a stem cell and the other daughter goes on to terminally differentiate * this keeps an available population of stem cells always

The mesenchyme

consists of gel-like ground substance containing undifferentiated mesenchymal cells and a few fibers * Mesenchyme/ mesenchymal cells develop into all types of CT/ CT cells (and some others) of the adult

Deep fascia of the leg

crural fascia

Which bone articulates with the anterior (distal) calcaneous

cuboid

If the medial ankle mortise is widened and there is no fracture of the distal tibia or medial talus what ligament must be disrupted

deltoid ligament

The information receiving end of a neuron

dendrites

Smooth muscle has

dense bodies

"intercellular bridges" are associated with

desmosomes (maculae adherens) linking the processes of adjacent cells in the stratum spinosum

What layer of the embryo does the mesenchyme develop from

develops mainly from the middle layer of the embryo, the mesoderm

Different shapes of epithelia relate to their

different functions

distal

farther from the origin of the body part or point of attachment of the limb to trunk

What secretes the reticular lamina

fibroblasts in CT

The Acromioclavicular Joint

is a plane-type synovial joint-- gliding movement it connects the clavicle and scapula * covered by acromioclavicular ligament

The femoral triangle can be used clinically to

locate and palpate the femoral artery pulse (just distal to midpoint of inguinal ligament- between the anterior superior iliac spine and pubic tubercle) * Note: the femoral neurovascular structures within the triangle are superficial and vulnerable to injury - Potential occurence of Femoral Hernia in this area= a protrusion of abdominal contents via femoral canal within the femoral traingle

In anatomical position where does the scapula sit

it sits on the posterios aspect of the thorax of ribs 2-7, lateral to the vertebral column

Permethrin is a drug used to treat

lice and scabies infestation *** would be able to treat a Pthirus Pubis (crab/pubic louse) infestation

The apical surface faces the

lumen

Eccrine Sweat glands are

simple coiled tubular glands that have a duct lined by a stratified cuboidal epithelium - found in thick and thin skin - classified as merocrine galnds: they release ONLY their secretory product which does not include cells or portions of cells

Most serous membranes are what type of epithelium

simple squamous epithelium that secrete serous fluid, which is a lubricating fluid that allows organs to move with frictionles ease

what type of stain do you need to show elastic fibers on stained tissue sections

special elastin stain

Isotretinoin is a

systemic retinoid that is administered orally - used to treat moderate to severe acne ** physicians must ensure women with child bearing potential DO NOT become pregnant because of the high risks of birth defects

Recurrence risk

the risk that a disease will strike again. In medical genetics, the risk that an inherited disease that is present in a family will recur in that family, affects another person or persons

the limb buds first appear at

week 4

your first digit is your

thumb

Reason for the latent perion in the development of tension during one muscle twitch

time required for ca2+ release and binding to Troponin C

tropomyosin brifs to

troponin

T or false NE stimulates contraction of GI blood vessels

true!!

in the hypertrophic zone of endochondral ossification blood vessels are attracted by secreting

vascular endothelial growth factor

Motor neurons are from the

ventral horn of the spinal cord

Pre-ganglionic parasympathetic axons that will form Pelvic Splanchnic Neves leve the

ventral root before the spinal nerve is formed, hence there are NO parasympathetic fibers in any spinal nerve * the GVE axons then travel to the hypogastric plexi and on the the target organ

C7 has an extra long spinous process called the

vertebra prominens *this is the big bump you feel at the bottom of your neck

Striated muscle (aka skeletal muscle) is derived from

paraxial mesoderm

3 palmar interossei originate at

palmar surfaces of 2nd, 4th, and 5th metacarpals Insert: 2nd, 4th, and 5th proximal phalanges and extensor expansions Action: ADduction of these digits and flexion of the metacarpophalangeal joint (PAD)

Papule

palpable, raised lesions less than 1 cm - caused by a proliferation of cells in dermis or superficial dermis EX: - moluscum contagiosum - verrucae - nevus - fibroepithelioma - dermatosis papulosa nigra

Myenteric plexus

part of the enteric nervous system (ENS) that regulates GI tract motility

Total tension=

passive + active tension - at shortened length: active contraction dominates force generation - just beyond resting length: passive tension begins to contribute and active tension is compromised - at more elongated lengths: passive tension accounts for most of the total force

your 5th digit is your

pinky

What fibers are found in bone? what is found in ground substance of bone?

primarily collagen type 1 the ground substance of bone is mineralized- hydroxyapatite (increases calcium and phosphate concentration)

which is larger at the wrist- radius or ulna

radius ** articulates with the scaphoid and lunate carpal bones at the RADIOCARPAL JOINT - condyloid joint, synovial - no participation by ulna - ligaments strengthem capsule anterior and posteriorly - movements: flexion/extension, abduction/adduction, circumduction ** the scaphoid and lunate fit into the distal end of the radius and this allows for high range of motion

Surgical Neck Fracture of the humerus

*common in elderly because they have lower bone density - Injury to AXILLARY N. and/or POSTERIOR CIRCUMFLEX HUMERAL A. (quadrangular space)

The myelin sheath is produced by

- oligodendrocytes in CNS - schwann cells in PNS ** theses are also incharge of electrical insulation

Patellofemoral Syndrome (AKA patellofemoral pain syndrome or "runners knee" )

- Pain/inflammation deep to patella due to abnormal gliding of patella over surface of femur * abnormal alignment of patella Causes: excessive downhill running, direct trauma to patella, osteoarthritis, weakness of vastus medialis

Benign Tumors from Squamous, Columnar and urothelium epithelia

- Papilloma (from squamous epithelium) - Adenoma (from columnar epithelium) - Urothelial papilloma (from urothelium)

What are the characteristic features that can be found in macrophage ultrastructure

- prominent nucleus and nucleolus - numerous secondary lysosomes

How many pairs of Spinal Nerves are there?

31 Pairs! - they arise from the spinal cord and form part of the PNS 8 Cervical * 12 Thoracic 5 Lumbar 5 Sacral 1 Coccygeal *

The Coccygeal Vertebrae is

4 fused segments ** this fuses after the age of 30

The 6 types of glial cells in nervous tissue

4 in CNS: -Oligodendrocyte -Astrocyte -Ependymal cells -Microglia 2 in PNS: - Schwann cell - Satellite cells

Skeletal muscle constitutes

40-50% of body weight - it is mostly attached to the skeleton - each skeletal muscle fiber is a single cylindrical muscle cell (muscle may be made of thousands of muscle fibers) - an individual skeletal muscle may be made up of hundreds, or even thousands of muscle fibers bundled together and wrapped in a CT covering

The Sacrum is

5 fused segments

The networks of nerves that supply the lower limbs

Lumbar and Sacral Plexuses Lumbar plexus= ventral rami of spinal nerves L1-L4 Sacral Plexus= ventral rami of spinal nerves L4-S4 *Lumbosacral trunk (L4,L5) contributes to the sacral plexus

The communicating channels of Gap Junctions are formed by abutting pairs of particles called

CONNEXONS - these are composed of protein subunits that span the lipid bilayer- these can open and close *** note gap junctions can be different sizes

For muscle relaxation to occur

Ca2+ concentrations in the cytosol must decrease. When cytosolic calcium decreases, Ca2+ unbinds from troponin. In the absence of Ca2+ troponin allows tropomysosin to return to its resting position, covering actins myosin-binding sites

In the Triangular Spcae you can find the

Circumflex Scapular artery

Disease of palmar fascia and aponeurosis

Dupuytren Contracture - typically in >50 yr old men * seems to be genetic what occurs: Fascial thickening (fascia replaced with scar tissue) causes shortening on the medial side of the hand - flexion at metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints

Which muscle of the deep group of the posterior leg compartment distally attaches to the 1st digit (hallux)

Flexor Hallucis Longus I: Tibial Nerve Action: flex the hallux (big tow)

Which muscle of the THENAR compartment flexes the thumb

Flexor Pollicis Brevis

Which muscle of the Superficial Anterior Compartment of the forearm is NOT innervated by the median nerve

Flexor carpi ulnaris!!! it is innervated by the ulnar nerve ** flexor digitorum profundus is also ulnar nerve- but it is in the DEEP anterior compartment

Which muscle flexes the distal interphalangeal joints of digits 2-5

Flexor digitorum profundus ** this is the only muscle that does this

Which inserts at the bases of the distal phalanx of digits 2-5: flexor digitorum profundus OR flexor pollicis longus

Flexor digitorum profundus!!!! (this is only one to act on distal interphalangeal joints) *flexor pollicis longus inserts at base of distal phalanx of digit 1! (pollex- or thumb)

Which muscle flexes the pollex (thumb)

Flexor pollicis longus

Vesicle

Fluid-filled papules (small blisters) - a large (>1cm) blister= a BULLA ex. -steven johnson synfrome -varicella -tinea pedis -herpes zoster -herpes labialis

Which infraclavicular branches of the brachial plexus only have cutaneous branches

Medial Brachial Cutaneous (C8, T1) - Medial Brachial Cutaneous Nerve (to arm) Medial Antebrachial Cutaneous (C8, T1) - Medial Antebrachial Cutaneous Nerve (to forearm)

What is the main blood suply to the hip joint

Medial Circumflex Femoral Artery (it is a branch of the Deep Artery of the thigh) * note the lateral circumflex femoral artery goes more laterally and wraps more around the greater trochanter of the femur

The tibial nerve innervates the intrinsic muscle of the sole of the foot via its two branches:

Medial Plantar Nerve and Lateral Plantar nerve

The Abductor Hallucis and the flexor digitorum brevis of the First layer of sole of the foot are innervated by the

Medial Plantar nerve

Which ligament is torn in a medial ankle sprain

Medial ligament of the ankle injure when foot forcefully everted

Macrophages derive from

Monocytes which are produced in the bone marrow and then circulate in the blood - monocytes cross the wall of the venules and capillaries to penetrate the CT, where they mature and acquire the morphologic features of macrophages

Osteoporosis

More bone material gets reabsorbed than built up, resulting in loss of bone mass - decreased density * the spine is MOST affected by degenerative diseases of the skeleton, such as osteoporosis sxs: - compression fractures and resulting back pain

An Autoimmune disease which results from antibodies that BLOCK or destroy ACh receptors at the neuromuscular junction * common symptom is dropping of one or both eyelids (ptosis)

Myasthenia Gravis - it is characterized by weakness and rapid fatigue of any skeletal muscles - it prevents nerve impulses from tiggering muscle contractions ** ACh releases but it cannot bind to receptors to cause contraction

An axon is covered by

Myelin

What occurs in a rotator cuff tear

One or more tendons may be torn, but SUPRASPINATUS is the most common sxs include: pain when arm is overhead and weakness * drop arm test( mainly for supraspinatus) abduct arm fully, lower arm slowly with control; after 90 degrees, the arm will drop more quickly than the unaffected side if there is a tear

Which muscles distally attach to the calcaneus via the calcaneal tendon

Ones found in the Superficial Group of the Posterior Leg compartment - Gastrocnemius - Soleus - Plantaris

Two types of disc herniation in the lumbar spine

Posterior hernation - In the MRI, a conspicously herniated disk at the level of L3-L4 protrudes posteriorly (transligamentous herniation). The dural sac is deeply indented at that level; *CSF Posterolateral Hernation - may spare the nerve at that level but impact nerves at inferior levels

What provides sensory to skin of the medial part of palm and dorsum

Palmar and dorsal cutaneous branches * not affected by carpal tunnel

Palmar interossei do ____ while the dorsal interossei do___

Palmar: ADDUCTION (PAD) Dorsal: ABduction (DAB)

Which ligament prevents HYPERFLEXION of the knee joint

Posterior Cruciate Ligament (PCL) - attaches to the tibia posteriorly (attaches from posterior intercondylar area of tibia and inserts on medial condyle of femur) Functions: - prevents posterior sliding of tibia under femur - taut when knee is flexed - prevents hyperflexion of knee joint *strong ligament * in a weight-bearing flexed knee, PCL is the main stabilizing ligament for the femur (ex. when walking down hill)

Sensory (Cutaneous) innervation of skin of the posterior thigh and posterior knee is done by the

Posterior Cutaneous Nerve of the thigh (S1-S3)

In the Triangular Interval (between Lateral and long head of triceps) you can find

Radial Nerve Deep artery of the arm

What dislocation may injury the Sciatic Nerve

Posterior Dislocation of the Hip joint ** this is a type of acquired hip joint dislocation - strong force pushes femoral head posteriorly out of the normal position with the acetabulum - joint capsule/ligaments rupture

Intrinsic Muscles of the back are innervated by

Posterior Ramic of Spinal Nerves - intrinsic muscles are only associated with axial skeleton & act on the vertebral column to control movements and maintain posture

Fibular arety is a branch of the

Posterior Tibial artery (it descends in posterior compartment adjacent to posterior intermuscular septum) - gives blood to the lateral part of the leg

Hypomere --> limb bud --> posterior condensation-->

Posterior condensation forms - Upper limb: Extensor and supinator muscles - Lower limb: Extensor and ABductor muscles

The Sternoclavicular Joint

a saddle-type synovial joint - functions as ball & socket to accomodate movements of the scapula - it connects the scapula to the thorax via clavicle ** covered by anterior sternoclavicular ligament

What is the "Rule of 2s" in the Autonomic Nervous System

There are 2 divisions: sympathetic and parasympathetic Each division arises from 2 regions of CNS - sympathetic= thoracolumbar - parasympathetic= craniosacral and Each system has a 2 neuron chain from either the spinal cord or cranial nerve nuclei

Sliding filament mechanism

Thin filaments on each side of the sarcomere slide inward over the thick filaments towards the center of the A band (the M line). As they slide inward, the thin filament pull the Z lines closer together, so the sarcomere shortens *** remember neither the thick or thin filaments decrease in length to shortern the sarcomere

What adipose tissue is the predominant type in adults

White (unilocular) tissue - it has a signet-ring feature with a single fat droplet that is not membrane bound - it is squeezed nucleus and scant cytoplasm form a thin rim at cell priphery ** lipid droplet surrounded by a phospholipid monomer Adipose tissue functions in: - insulation - padding of vital organs

In the Anterior and Medial Thigh lymph drains into which lymph node first

Superficial Inguinal Lymph Node first! Then to deep inguinal lymph nodes --> external iliac lymph nodes --> lumbar or aortic lymph nodes

What are the borders of the Femoral Triangle

Superior: Inguinal Ligament Lateral: Sartorius M. Medial: Adductor Longus M. Floor: Iliopsoas and Pectineus M.

What is indicated by the absence of basal/external lamina (located in the endomysium)

a problem with the muscle cell Ex: Duchennes muscular dystrophy (mutation in dystrophin- which leads to lack of its shock absorber capabilites)- leads to micro ruptures of cell membrane eventullary killing the muscle fiber/ cell

Osteocytes respond to reduced mechanical stress by secreting

matrix metalloproteinases (MMPs) which destroy bone through a rapid, transient (relative to osteoclasts) mechanism called osteocytic osteolysis ** empty space surround osteocytes= result of enzymatic degradation of bone matrix by MMPs

The posterior tibial artery ( a branch of the popliteal artery) divides into the

medial and lateral plantar arteries

Which meniscus is attached to the tibial collateral ligament

medial meniscus ** move commonly damaged

Both the pectoralis minor and major are innervated by the

medial pectoral nerve (C8,T1) - branch of Medial cord of brachial plexus (pectoralis major also is innervated by the lateral pectoral nerve)

Medial vs lateral rotation

medial: rotation toward the midline Lateral: rotation away from midline

PNS is composed of

nerves and ganglia

In Pseudostratified Columnar Epithelium all cells touch the

basal lamina but NOT all cells reach the surface ** it is called pseudostratified bc the nuclei appear to lie at two or more layers - the cells are crowded with varying shapes (multiple cell types)

Subclavian artery arises from the

brachiocephalic trunk

CNS is composed of

brain and spinal cord

A cutaneous nerve is gernerally _____ than an area supplied by only a single spinal (dermatome) nerve

broader & wider ** cutaneous nerves supply an area of skin that is related to a peripheral nerve

When transitional epithelium is relaxed if has a more

bulbar shape

calsequestrin is a

calcium binding protein in the sarcoplasmic reticulum which facilitates calcium storgae and sequsters it into the sarcoplasmic reticulum

bone is a specialized type of

connective tissue

Muscle tissue

contracts to produce movement

The big toe has

distal and proximal phalanges

when is there no net flux of a molecule across a membrane

electrical force = concentration force

elevation vs depression

elevation: movement in superior direction depression: movement in inferior direction

The Dorsal Scapular Nerve (C5)

emerges between the anterior and middle scalenes (neck muscle) before tracking posteriorly, deep to levator scapulae and the rhomboids It innervated - Rhombiod Major and Minor - Levator Scapulae via separate branch

Ca2+ is found mostly

extracellularly (1,8mM)

Depth is added to the Glenohumeral joint via the

fibrocartilaginous glenoid labrum

A joint capsule is an encapsulating sleeve for joints; composed externally of _____ and internally by synovial membrane

fibrous CT layer

ACh binding to muscle membrane ACh receptors triggers

opening of nonspecific cation channels, leading to a relatively large amount of Na+ into the cell compared to smaller K+ movement outward (into the synapse)

Most fatal drug overdose can be attributed to

opiod analgesics - exceding the rate of overdose from cocaine and heroine combined

Neuronal cell bodies in the PNS are in the

ganglia - dorsal root ganglia - cranial nerve ganglia - autonomic ganglia

Action potential spread through cardiac muscle through

gap junctions in intercalated discs

Afferent/ Sensory

goes to DORSAL ROOT

How does calcitonin lower high blood calcium

it is released by the thyroid gland and binds to the calcitonin receptor on OSTEOCLASTS and reduces the activity of their bone resorbing function

Autonomic ganglia of both the parasympathetic and sympathetic branches of the ANS have

nicotinic ACH receptors (Nn)

Cancer of the lactiferous ducts causes

nipple retraction and deviation

Binding of Acetylcholine (ACh) to the ACh receptors (AChR) in the motor end plate triggers the opening of

ligand-gated ion channels - after this a change in membrane potential to threshold causes opening of voltage-gated Na+ and K+ chaneels in the muscle cell membrane (sarcolemma) adjacent to the motor end plate

Unmineralized osteod stains

lighter on H&E than mineralized bone

Loss or disruption of HOX genes can result in the

loss of certain limb elements ex. radius, ulna, most of humerus

Malignant tumors (cancers)

malignant: dangerous to health (from Latin: "malignus" wicked, bad- natured)

Extracellular matrix is made of

many types of molecules secreted by cells that can form complex structures once outside of the cells - collagen fibrils - proteoglycans - ground substance - etc..

UVA light

wavelength 320-400 nm - reaches dermis - wrinkles, skin texture changes, freckles, and discoloration "A" is for aging **** Chemical agents: Avobenzone and Oxybenzone block this

If someone with an alcohol use disorder wakes up after a long night of binge drinking and immediately drinks alcohol to avoid "hangover symptoms" this is an example of

withdrawal

compact bone is remodeled ___ an osteon

within - osteoclasts hollow out the center, then osteoblasts lay back new bone - the new bone is likely to be at a slightly different angle than in old osteons, eventually forms interstitial lamellae

carpals refer to your

wrist

The brachial artery splits into the

radial and ulnar arteries (Ulnar has a branch to common interosseous- this splits into posterior and anterior- the posterior interosseous goes on to become the recurrent interosseous) *** both the radial and ulnar arteries continue past the wrist to form the superificial and deep palmar arches

attachment of the biceps brachii

radial tuberosity

___ is the principal way a resting human body loses heat in still air that is cooler than skin temperature

radiation

In epithelia- a single surface is usually lined by a

single type of epithelia * it is named according to the shape of the apical cell layer

Epigenetics means

the DNA sequence is unchanged, but methylation of the DNA and changes to proteins attached to the DNA leads to inactivation of the gene --> lack of transcription

Spinal Accessory N. (Cranial Nerve XI)

travels from the cranium through the neck and back deep to the trapezius - it is a relatively superficial nerve and it can be injured: penetrating injury, blunt injury (sport-induced injury)

Before contraction can occur,

tropomyosin must be shifted to a position that uncovers actins myosin binding sites

true or false: an EPP is usually large enough to bring the membrane potential of the muscle cell membrane above the threshold for producing a postsynaptic action potential

true!

true or false the permeability of the plasma membrane differs for different ion species in resting conditions

true! - the resting permeability of ions can be modified by membrane voltage, ligands or mechanical stimuli * membrane permeability to ions also depends on individual cell types and the state of activity of the cells

The superficial palmar arch of the hand is formed mainly by continuation of the

ulnar artery into the hand. It anastomoses with the superficial branch of the radial a. and gives off 3 common palmar digital arteries(adjacent to digits 2-5) these then branch (each branching into 2)= Proper palmar digital arteries

Dermatomes are

unilateral area of skin innervated by the sensory (GSA) fibers of a SINGLE spinal nerve - these are useful in neurology for finding the site of damage to the spine; identifying where a lesion has occured * 8 cervical, 12 thoracic, 5 lumbar, 5 sacral

Back Strain

"(s) train a muscle" - injury invovled some degree of stretching or microscopic tearing of muscle fibers - common sports injury - results from overly strong muscle contraction - ERECTOR SPINAE muscles are often involved - muscle spasms may be response to inflammation

Movements of the toes include

- Flexion - Extension - Abduction - Adduction

Common interosseous artery

- gives off the interosseous recurrent artery, part of the elbow anastomosis

How is bone similar to reinforced concrete

-Has "steel rods" and "cement": provide strenght and resiliency to withstand some rocking motion while maintianing strength *** flexible fibers embedded in rigid ground substance - steel bars= collagen type I (33%): without this bone is too brittle and will break - cement= hydroxyapatite: without this bone is too bendable ** you need both to bend bone

The straitations in skeletal muscle are caused by alteranating

A (dark) and I (light bands)

Which muscle of posterior compartment ABducts thumb and extends it at carpometacarpal joint

ABductor Pollicis Longus Insertion: base of 1st metacarpal I: radial nerve (via posterior interossesous nerve, a continuation of the deep branch of the radial nerve)

Most mobile region of vertebrae

Cervical Region

What are some parts of a neuron

Dendrites (information receiving end) Nucleus Cell Body Axon Schwann cell Node of Ranvier Axon terminals (synaptic end- information transfer)

What tethers the spinal cord to coccyx

Filum Terminale - it continues from the conus medullaris (~L2) to coccyx; tethers spinal cord to coccyx

____ are 5-10 times more abundant in brain than neurons

Glial Cells

Choristoma

Heterotopic rest of normally organized mature cells Ex. a piece of histologically nromal pancreas in the duodenal wall ** it is not where it is supposed to be!!

If action potential generation in the muscle ceases what occurs to the concentration of calcium

It rapidly decreases and the fiber relaxes - this is because ca2+ is actively removed from the cytoplasm ( it may be extruded across the plasma membrane or sequestered within intracellular components) Mechanisms for Ca2+ removal from the cytoplasm: 1. Use of Ca2+ ATPases (or "calcium pumps") or plasma membrane Na2+-Ca2+ exchangers: extrude calcium into the ECF- eventually will deplete cell of calcium 2. Ca2+ ATPases in the sarcoplasmic reticulum membranes continuously remove Ca2+ from the sarcoplasm and pump it into the sarcoplasmic reticulum (SR) - once returned into the SR, the resequestered Ca2+ is moved along the longitudinal elements to storage sites in the terminal cisternae. Ca2+ binding proteins within the SR lumen (calsequestrin and calreticuin) facilitate Ca2+ uptake and sequestration in the SR

Where would you insert for spinal anesthesia

It would be inserted at the same place lumbar punctures (usually L4 level) - this gives complete anesthesia below the waist *it risks leakage of CSF

Partial absence of a limb (ex. later of partial loss of FGF signaling)

Meromelia

What drugs are ectoparsiticides

Permethrin Malathion

What test can be used to test for injuries at dermatome level in lower limb

Pinprick (pinwheel) to test for sensory deficit related to suspected nerve injry at a vertebral level ** remember dermatome is related to a SINGLE spinal nerve root

Which small lateral rotator muscle of the thigh is located inferior to the gluteus medius/minimus muscles

Piriformis Muscle

Acromioclavicular Joint

Plane-type joint - connects the clavicle and scapula * acromioclavicular ligament

Receptor on the sarcoplasmic reticulum membrane which acts as ca2+ release channels

Ryanodine Receptors (RYR) ** is mechanically coupled with DHPR

Pericardium

Serous membrane covering the heart and lining the mediastinum

Do osteoblasts only secrete in one direction

YES! they are polarized cells - they secrete towards th ebone, makes it grow larger

brachial refers to the

arm

Deep veins accompany the

arteries

What forms an effective epidermal water barrier

cell and lipid envelopes ** in addition to keratohyalin granules, keratinocytes in stratum spinosum and granulosum produce small membrane-bounded granules called lamellar bodies- contain hydrophobic barrier lipids- forms lipid envelope cell envelope is made by a thick layer of insoluble protein that is deposited on the inner surface of the keratinocyte plasma membrane

The dorsal root ganglia contain the

cell bodies of sensory neurons (afferent) * note the satellite cells

Cartilage consists of

cells (chondroblasts and chondrocytes)- 3% of total cartilage volume and Extracellular matrix (95%, mostly H2O) ** chondrocytes are surrounded by ECM that they secrete and remove

Myoepithelial cells are

contractile cells that help propel sweat into the excretory duct for transport to the surface of the skin

Cancer of the suspensory ligaments causes

dimple on another surface area of the breast

Langerhan cells and Merkel cells are found in the

epidermis

Toe movement include

flexion extension abduction adduction inversion of foot eversion of foot

what is the most common fracture of the foot

fracutre of the base of the 5th metatarsal (Jones fracture)

The stimulus for contraction is provided by

free calcium ions (Ca2+)

Adipose cells are connected to each other by

gap junctions

Injury to sciatic nerve branches to the

hamstrings (semitendinosus, semimembranosus, and biceps femoris) results in paralysis of these muscles --> leads to imparment of thigh extension and leg flexion

Nervous tissue

initiates and transmits nerve impulses that coordinate body activities

Even through the epithelium is avascular (contains NO blood vessels) it is still

innervated (supplied by nerve fibers)

turning the sole of foot inward

inversion of foot

Hydrolysis of ATP by the Na+/K+ ATPase in the sarcolemma

maintains Na+ and K+ gradients, necessary for AP generation and propagation

Keratinocytes in the stratum basale can contain___ in their lyososomes

melanin ** melanocytes make melanion, transfer it to keratinocytes who phagocytose it, then immediately begin degrading it in their lyososomes

A carrier of a balanced translocation will have

most cells inactivating the normal X ** if she has a disease causing allele on the translocation chromosome, then she will express the disease

Cutaneous Nerves transmit GSA (general sensory afferent) axons to

multiple spinal levels

Acne vulgaris is a chronic inflammation within

obstructed sebaceous glands

Anterior Branch of the Obturator Artery supplies

obturator externus, pectineus, adductors of thigh, and gracilis ( posterior branch supplies muscle attached to the ischial tuberosity- **check to see what muscles these are)

most commonly found cell in mature bone tisssue

osteocytes (osteoblasts trapped in matrix they secrete) - can live as long as organism itself (half life of 25 yrs)

Collagen is a triple helix made of the reptitious AA sequence glycine-X-Y, where X and Y are frequently

proline and hydroxyproline

What gives breast their size

subcutaneous fat

In the presence of calcium, troponin

undergoes a conformational shift that exposes the myosin binding site on actin --> initiates contraction

What muscle is the main powerful ABductor of thigh at hip joint

Gluteus Medius Muscle ** you can palpate this inferior to the iliac crest as it contracts to support body weight on one leg (on the side of the supporting leg) ** it stabilizes the pelvis: prevents tilting of pelvis to opposite side when standing on one leg I: SUPERIOR gluteal nerve

Which gluteus muscles attach to the greater trochanter of the femur

Gluteus Medius and Gluteus Minimus

Appendicular skeleton comes from

lateral plate mesoderm - sternum and limb bones (include calvicle, scapula, and innominate bones)

Which Gluteus muscle is NOT innervated by the Superior Gluteal Nerve

Gluteus Maximus is innervated by the INFERIOR gluteal nerve - Medius and minimus are I: Superior Gluteal nerve

In what part of a chemical synapse are mitochondria and numerous synaptic vesicles from which a neurotransmitter is release by exocytosis found

presynaptic axon terminal

Sebaceous glands do not begin to function until

puberty and they employ holocrine secretion

Which ligament prevent overabduction (hyperabduction) of hip joint

pubofemoral ligament - connects pubic bone part of acetabulum to neck of femur, located anteriorly and inferiorly

ACh will stimulate

pupil constriction (not dilation), aqueous humor outflow (not production) and ciliary muscle contraction and lens bulging (not flattening)

The heart and lungs are mainly sympathetically innervated by

T1-T4 through the cardiopulmonary splanchnic nerves and a synapse can occur in the paravertebral ganglion ** note in more detail: efferent symp. innervation of heart and lungs can also consists of some nerves originating in the superior, middle, and inferior cervical ganglion as well as the T1-T4 segments * so the nerves from T-T4 have their own routs and may be accompanied by nerves from the cervical ganglion

Characteristic clinical sign of radial nerve injury is

"wrist-drop" - difficulty extending wrist

Genu Varum

(bow-leg) - medial angulation of tibia relative to abnormally vertical femur - weight-bearing more on medial knee (stressed medial joint cartilages, medial meniscus) and stresses fibular collateral ligament on lateral side (legs go outward <-- | --> )

Describe an elbow dislocation

* risk of ulnar nerve (most common) & median nerve injuries Mechanism: fall onto extended and abducted arm - hyperextension of elbow - direct blow to elbow You can have a: Posterior Dislocation (most common- 80-90%) - the radius and ulna dislocate posterior to humerus "Terrible Triad" injury- which includes: 1. Elbow dislocation 2. Radial head fracture 3. Coronoid process fracture

Finasteride a trichogenic drug

* treatment of androgenetic alopecia in MEN ONLY - continued treatment is necessary to sustain benegit adverse effects: decreased libido, ejaculation disorders, and erectily dysfunction ** Pregnant women should NOT be exposed by use or handling or tablet because of the risk of hypospadias (urethra not in right place) developing in male fetus

What can cause compression of the spinal nerve & vertebral artery leading to "mini-stroke"

*remember the spinal nerve and vertebral artery are very close to the uncinate process on the cervical vertebrae (spinal nerves pass through IV foramina & vertebral arteries pass through the transverse foramina) --Bony outgrowths (osteophytes) on the ucinate process (may occur from Arthritis) may compress both the nerve and vertebral artery and can lead to chronic pain in the neck * this is common in elderly patients, and results in "mini-stroke"

Overview of skeletal muscle contraction

- AP runs down myelinated axon and ends at neuromuscular junction ( a motor nerve signals a skeletal muscle to contract at the endplate) - ACh is release from the nerve- sarcolemma of skeletal muscle has Ach receptors (binding of ligand to receptor triggers intracellular events leading to contraction)- opens sodium ion channels leading to AP in sarcolemma, AP travels along the T-Tubules ***Step inhibited by BOTOX- cleaves SNARES-which are required for vesicle fusion - Leads to change in membrane potential - causes Ca2+ to be released from sarcoplasmic reticulum inside muscle fiber - This rise in intracellular calcium is what triggers muscle contraction (it connects muscle contraction to the nervous system)

A peripheral nerve is composed of

- Axons - Schwann cells (5th type of glial cell- make myelin in PNS) - CT (fibrocollagenous) containing fibroblasts - blood vessels

Ex of X-inactivation

- Calico= Tricolored Cat ** orange is caused by X-linked dominant allele at the O locus - black phenotype if there is no active O alleles (males, homozygous females, or inactive- X heterozygotes) - Heterozygot male cat with Klinefelter because in Klinefelter onve of the two X chromosomes is inactivated

Superficial Veins of the Arm

- Cephalic vein - Basilic Vein - Median Cubital Vein ** in contrast- the deep veins lie internal to the deep fascia and accompany the arters in pairs- they are names for the major arteries of the arm

What are causes of cancer

- Chemical Carcinogens (ex. Polycyclic hydrocarbons or nitrosamines) - Physical Carcinogens (ex. ionizing radiation or UV light) - Carcinogenic Microorganisms (ex. Viruses- like human papilloma virus (HPV) or Epstein-Barr virus (EBV) or Bacteria- ex. Helicobacter Pylori

What arteries supply the upper limb

- Deep artery of the arm - Subclavian artery (lateral border of 1st rib) - Axillary artery (inferior border of teres major) - Brachial Artery - Radial Artery - Ulnar Artery

The muscles of the posterior thigh ("hamstring" muscles) function to:

- Extend thigh at hip joint and - Flex leg at knee joint

Composition and Location of the Basal Lamina (laminae)

- Extracellular structures (secreted proteins) - found closely apposed to the plasma membrane on the basal surface of epithelial and endothelial cells and also surrounds muscle and fat tissues - consists of ECM proteins secreted by the epithelial cells (or muscle cells)

In the Zonula Adherens- "zone of adhesion" the adhesion is mediated

- Extracellularly: by cadherins of each cell - Intracellularly: link via actin binding proteins to actin filaments of the adhesion belt/terminal web

Malignant Tumors of proper mesenchymal tissues (connective, bone, cartilage, adipose, and muscle tissues and vasculature)

- Fibro- - Osteo- - Chondro- - Lipo- - Leio- - Rhabdomyosarcoma Hem- and lymphangiosarcoma *** add -sarcoma to the end

A mesenchymal stem cell (MSC) can differentiate into ALL connective tissue cells (also others):

- Fibroblast - Adipocyte (fat) - Osteoblast (bone) - Chondroblast (cartilage) - Myoblast (muscle) * the microenvironment determines stem cell differentiation (growth factors, oxygen levels, ECM components etc...)

Benign Tumors from Proper mesenchymal tissues (connective, bone, cartilage, adipose, and muscle tissues and vasculature)

- Fibroma - Osteoma - Chondroma - Lipoma - Leio- and Rhabdomyoma - Hem- and Lymphangioma

What occurs in supination-pronation at the elbow (movement of forearm)

- Head of radius swivels inside the annular ligament, against capitulum and radial notch of ulna * supination= holding a cup of tea

What are some joints found in the foot

- Intertarsal joints - Tarsometatarsal joints - Intermetatarsal joints - Metatarsophalangeal joints - Proximal Interphalangeal joints - Distal Interphalangeal joints

Describe Stratified Cuboidal Epithelium and where it can be found

- Multilayers (always only 2-3 layers) - it provides a more robust lining the simple cuboidal- the surface cells are cuboidal Locations: (RARE) - it can be found in the larger ducts of various glands, including the pancreas, salivary and sweat glands

What are the SMALL LATERAL rotator muscles of the thigh

- Piriformis M. - Superior Gemellus M. - Obturator Internus M. - Inferior Gemellus M. - Quadratus Femoris M.

Functions of Vertebrae

- Protect spinal cord and nerves - Supports the trunk as a rigid yet felxible axis for the body; important for posture and locomotion

Which Structures Exit the Greater Sciatic Foramen (from pelvic region to gluteal region) and Enters into the Lesser Sciatic Foramen (from gluteal region to perineum)

- Pudendal Nerve - Internal Pudendal A./V. - Nerve to Obturator Internus

Increase XIST

- RNA spreads and covers that chromosome INITIATES X INACTIVATION --> Down stream events of this include: - DNA methylation (this is initiation) - Histone modifications - Accumulation of variant histone --- these 3 above compact the DNA-- - Asynchronous replication (compacted areas replicate later in S-phase) - RNA polymerase II exclusion Once taken place, XIST expression is no longer necessary * the downstream events are similar to those happening in imprinting, and both events are examples of epigenetic changes

The Intermediate Layer of Extrinsic Muscles includes

- Serratus Posterior Superior - Serratus Posterior Inferior Actions: controls respiratory/proprioceptive movements

What are key features of Typical Vertebrae (C3-C7)

- Small overall size; small bodies - Large vertebral foramina to accomodate cervical enlargement of the spinal cord (think: innervation of the upper limbs) - Transverse foramen for vertebral artery - Uncinate process

What causes shin splints (medial tibial stress syndrome)

- Small tears in periosteum and anterior leg muscles along their attachment onto the tibial shaft ** TIBIALIS ANTERIOR MUSCLE is the most commonly invovled cause: traumatic injury or athletic overexertion of leg muscles signs/sx's: pain and inflammation in anterior compartment of the leg

Venous drainage of the Anterior and medial thigh

- Small, superficial tributary veins from anterior and medial thigh drain blood into the --> GREAT SAPHENOUS VEIN (a superficial vein)--> then enters through saphenous opening in the fasca lata to drain blood into the --> FEMORAL VEIN (a deep vein)

What are the four muscle in the Anterior Leg Compartment

- Tibialis Anterior - Extensor Digitorum Longus - Extensor Hallucis Longus - Fibularis Longus Actions: Dorsiflex ankle and extend toes I: Deep Fibular nerve (deep peroneal nerve) Blood supply: Anterior Tibial Artery/Vein

Which muscles are in the Deep group of the posterior leg compartment

- Tibialis Posterior - Flexor Hallucis longus - Flexor Digitorum Longus

The ectoparasiticide Permethrin

- Topical administration (cream, lotion, and solution) - interferes with sodium transport proteins on nerve cells of ectoparasites - is neurotoxic to ectoparasites * used to treat head and pubic LICE, as well as SCABIES ** adverse effects: transient burning, stinging, itching

Becker Muscular Dystrophy (BMD)

- Typically present in teen (or 1-2 decades later) - progress slowly (Gowers sidn in the 20's) symptoms are milder than DMD - May nerve even need wheelchair (30s or later) ** Dystrophin PRESENT but frequently abnormal size ** remmeber in DMD dystrophin was ABSENT

What are the 3 ligaments that make up the elbow joint synovial capsule

- Ulnar Collateral Ligament - Radial Collateral Ligament - Annular Ligament of Radius: "seat belt- that belts the radial head in position"

Three main players in X-inactivation

- XIC (X-inactivation center), physically overlapping XIST at Xq13.2 - XIST (X inactivation-specific transcript) a non-coding mRNA of 17kb - Its antisense transcript TSIX (only one on at a time so an increase in XIST, means there is a decrease in TSIX ) HOW? During embryonal development in an embryo with 2 X chromosomes: - the two copies of XIC transiently align - XIST and TSIX reciprocally get up- and down-regulated (up regulation on one, means deregulation on another) - On the chromosome with up-regulated XIST, the RNA spreads and covers that chromosome- this initiates X inactivation

The reticular lamina is connected to the basal lamina with

- anchoring fibrils (collagen type VII) - reticular fibrils (collagen type III)

Lymphatic System

- assists in draining surplus tissue fluid and leaked plasma proteins from bloodstream - helps remove debris from cellular breakdown and infection - regulates interstitial fluid (solution that bathes and surrounds cells) - lymph travels in vessels, through lymph nodes, following the pathways of the veins - rarely see lymphatics in lab unless pathological

RAS GTPase cycle

- cancers most frequently inacitive GTPase- RAS cannot be turned off and it is left in active state (gain of function mutation) * remember RAS+ GTP -> activates downstream proteins when bound to GTP RAS itself hydrolyzes GTP to GDP and becomes inactive

Several viruses use axonal transport to invade the nervous system, can you give examples

- herpes simples virus - rabies virus - polio virus ** these all enter the distal tips on an axon and travel to the soma by RETROGRADE transport (carried out by Dyenin (-) end directed motor)

Patellar Ligament (aka Ligamentum Patella)

- strong ligament - attaches from the apex of patella to tibial tuberosity (is a continuation of distal part of the quadriceps tendon) Fx: it maintains alignment of patella relative to femur

The brachial artery

- supplies blood to arm - it is a continuation of the axillary a. once it passes teres major - at first, medial to humerus - moves inferolaterally, overlying brachialis, accompanying the median nerve - terminated in cubital foss into radial and ulnar arteries

Deep Cubital Fossa

TAN (from lateral to medial)- tendon of biceps brachii muscle, brachial artery, MEDIAN nerve

The appendicular skeleton consists of

- upper limb (clavicles, scapulae, humeri, radii, ulnae, carpals, metacarpals, phalanges) - lower limb (pelvis, femora, tibiae, fibulae, tarsals, metatarsals, phalanges)

Give an example of epithelial transport

- uptake of GLUCOSE by intestinal absorptive cells in the small intestine problem: how do you move glucose across two diff. membranes; one way WITH and one way AGAINST the concentrations gradiaent - the solution is TIGHT JUNCTIONS: you use two diff glucose transporters and bc of the tight junctions you can insert them in different membranes (apical vs basolateral) and keep them separate

What things decrease breast density

-post-menopausal womens breast become less dense with age - obesity causes decreased breast density

Locations where covering or lining epithelia can be found

-skin - lining of closed internal cavities and blood vessels - lining of body tubes that communicate with the exterior (alimentary, respiratory, genitourinary tracts) * covering and lining epithelium forms a sheet-like covering that separates underlying or adjacent CT from: - external environment - internal cavities - fluid CT such as the blood and lymph

For a heterozygot that is not affected their risk of being a carrier is

1

Serous membranes are made of 2 layers what are they

1) a layer to line a cavity, called the parietal layer 2) a layer to cover the organ, called the visceral layer

Exocrine glands contian two parts

1) gland: the cells that secrete 2) duct: duct cells DONT secrete, they just carry the secretions of the glandular cells

Exocrine glands are classified according to

1) shape of the glandular part: tubular (like test tube) vs acinar (latin for "berry") 2) branching of the duct: can be simple or compound * Simple Duct Structures (ones that dont branch) - Simple tubular - Simple branched tubular - Simple alveolar - Simple branched alveolar * Compound Duct Structures (duct branches) - Compound tubular - Compound alveolar - Compound tubuloalveolar

Nervous tissues is divided FUNCTIONALLY into

1. A sensory component: transmits electrical impulses (signals) TO the CNS 2. A motor component - tranmists impulses FROM the CNS to various structures of the body Motor is further divided into: - Somatic: motor fibers that innervate VOLUNTARY skeletal muscle - Autonomic: motor fibers that innervary INVOLUNTARY smooth muscle, cardiac muscle, and some glands (this is further subdivided into sympathetic and parasympathetic)

Ganglia are capsulated aggregations of neuronal cell bodies (soma) located outside the CNS; they often form a swelling on a nerve fiber. There are 2 kinds, what are they

1. Autonomic Ganglia MOTOR ganglia in which axons of PREganglionic neurons synapse and POSTganglionic neurons innervate: - involuntary smooth muscle - cardiac muscle - some glands * autonomic is subdivided into sympathetic and parasympathetic *** VOLUNTARY MOTOR NEURONS DO NOT SYNAPSE IN A GANGLION (this is somatic nervous system- it just has 1 motor neuron from spinal cord to skeletal m) 2. Sensory Ganglia (ex. DRG) - these are ALWAYS pseudounipolar (no synapses?- make sure on this)

What are the two types of adipose tissue

1. Brown (multilocular) adipose tissue 2. White (unilocular) adipose tissue

In many epithelial cells, the APICAL domain exhibits special structural surface modifications to carry out specific functions * notes that bc this side faces a lumen, there is space for from these structures What are these structures?

1. Cilia: Plasma membrane processes containing bundle of MTs 2. Microvilli: plasma membrane processes containing a core of ACTIN filaments- these increase surface area, they are finger-like cytoplasmic projections on the apical surface of most epithelial cells 3. Stereocilia (stereovilli): microvilli of unusual length

What are the 3 Meninges of the Spinal Cord

1. Dura Mater ("tough mother")= outermost layer, thick, fibrous tissue 2. Arachnoid Mater= filmy layer deep to dura mater 3. Pia Mater= layer covering the spinal cord (it is indistinguishable from spinal cord

Two patterns of formation of bone in an embryo

1. Intramembranous Ossification - flat bones of the skull and mandible are formed in this way - "soft spots" that help the fetal skull pass through the birth canal later become ossified forming the skull ** bone is formed directly by condensation of mesenchyme rather than from a cartilage model this requires: - a well vascularized primitive CT - bone formation is not preceded by formation of cartilage (NO CARTILAGE MODEL) - an aggregate of mesenchymal stem cells differentiates directly into osteoid-producing osteoblasts 2. Endochondral Ossification - replacement of cartilage by bone - most bones of body are formed in this way including the long bones

What are some modifications that are found in the basal domain of ion (and fluid) transporting epithelial cells

1. Many mitochondria - to provide ATP to run pumps in membrane and 2. Infolding of basal membrane - membrane infolding provide more surface area of membrane to put in a higher concentration of pumps and aquaporins * to go with microvilli on the apical membrane ** these modificaiton are seen prominently in cells that participiate in active transport of ions across the basolaeral membrane (in either direction)

3 classes of neurons by function

1. Sensory Neurons 2. Interneurons 3. Motor Neurons ex. If a painful stimulus activates a sensory neuron this signal will be transmitted by the pain sensory neuron to the spinal cord. At spinal cord it would be transmitted to an interneuron then a motor neuron which would stimulate and effector muscle that will cause the withdrawal response

4 criteria for Impaired control in DSM-5 Diagnostic criters for substance use disorder

1. Substance is often taken in larger amounts or over a longer period than intended 2. Persistent desire or unsuccessful efforts to cut down or control use 3. A great deal of time spent in activities necessry to obtain the substance, use, or recover from its affects 4. Craving, or strong desire or urge to use substance

The processes of an Astrocytes make contact with:

1. Thousands of synapses in the CNS and 2. form end-feet on local arterioles and capillaries *** this anatomic arrangement enables an astrocyte to regulate - synaptic transmission and neurovascular coupling *** astrocytes regulate glutamate (glutamate to glutamine)

The lateral domain of epithelial cells is in close contact with opposed lateral domain of neighboring cells (it has specializations in cell-to-cell adhesion and communication). It contains 4 types of junctional complexes which are

1. Zonula Occludens (tight junctions) - extend along entire circumference of the cell and prevent material from taking paracellular route in passing from the lumen into the CT 2. Zonula Adherens - Basal to Zonula Occludens. E-Cadherins bind to eachother in the intercellular space and to actin filaments, intracellularly 3. Macula Adherens - E-cadherins are associated with the plaque; intermediate filaments form hairpin loops 4. Gap Junction - Communicating junctions for small molecules and ions to pass between cells. Couple adjacent cells metabolically and electrically

Cells have to be able to degrade ECM as well as make it, this degradation occurs normally during

1. development 2. growth 3. tissue repair 4. wound healing *** the ECM can be degraded by Matrix Metalloproteinases (MMPs; also called matrixins) - these are a family of ZINC-dependent proteases secreted as pro-enzymes (zymogens) proteolytically activated in the ECM - The activity of MMPs in the extracellular space can be specifically balanced by tissue inhibitors of MMPS (TIMPs) during tissue remodeling

What two disorders are responsible for the majority of dwarfism cases

1. growth hormone deficiency (aka pituitary dwarfism) can be treated through replacement therapy 2. Achondroplasia ("WITHOUT cartilage formation") but really affects bone more than cartilage - sporafic mutation in 80% of cases - caused by mutation in fibroblast growth receptor 3 (FGFR3) - in normal development, FGFR3 has a negative regulatory effect on bone growth * in achondroplasia: the mutated form of the receptor is constitutively active and this leads to severely shortened bones

Role of ion channels and aquaporins in fluid absorption

1. using ion transporters in basal membrane, cell pumps ions into the ECF 2. Water follows salt so the water flows into the cell from the lumen and across basal membrane (through aquaporins in apical and basal membranes)

Steps of Synaptic Vesicle Cycle in the presynaptic terminal

1. vesicles bud off the early endosome 2. vesicle is filled with neurotransmitter (acetylcholine, ACh) 3. Vesicle translocates to realese site (AKA active zone) on plasma membrane 4. vesicle docks 5. and becomes primed (dock and priming are how it attaches to plasma membrane) 6. Ca2+ triggers fusion and exocytosis of ACh into the synaptic cleft 7. Vesicle membrane is coated in clathrin which facilitates endocytosis 8. Vesicle becomes uncoated and fuses with early endosome to start the cycle again

In DMD (Duchenne Muscular Dystrophy) if a sister is shown to be a carrier. What is her apprx. probability for showing at least some symptoms?

1/10 - you would expect it to be 0% probability but what is observed 5-10% (this explanation is related to x-chromosome inactivation - or "the cause is skewed X-inactivation) ** X- chromosome inactivation is an example of epigenetics (the study of changes in gene function that are mitotically and/or meiotically heritable and that do not entail change in the DNA sequence

The Rb proteins (sometimes written pRb) contains at least

16 potential sites for phosphorylation by CDK and at least 9 have been shown to be phosphorylated in vivo. The need for phosphorylation in several of these sites to release E2F has led to the use of hypophosphrylated and hyperphosphorylated as descriptors ** remember when Rb is hyperphosphorylated --> E2F is released --> cell can progress in cell cycle

The first pair of somites form at approximately the

20th day of development and continue at a rate of 3 pairs/per day

Breast tissue typically extends transversely from the lateral border of the sternum to the midaxillary line & vertically from the

2nd to 6th ribs

Limbs develop along _____ and _____ of rotation

3 axes and 90 degrees of rotation the axes are: 1. Proximodistal: the line from the shouldr end to the finger end of the developing limb ** mediated by FGFs 2. Craniocaudal (aka preaxial to postaxial): the line from the thumb side to the little finger side of the developing limb 3. Dorsoventral: the line from the back of your hand to your palm (or dorsum of foot to sole)

What is the hip bone made out of

3 seperate bones that fuse at the acetabulum by age 25 - ilium - ischium - pubis

Developmental milestones (motor)

3-4 month: most fetal reflexes disappear 6 month: able to hold a bottle and feed 7 month: can sit unsupported 10 month: can stand 12 month: walks 18 month: walks stairs while holding hand 24 month: walks staids independently 3 years: runs well, stans on one foot 4 years: skips on one foot, broad jump ** variation among kids, these are just averages

Limb development occurs between the _____ weeks, with the lower limb growth lagging 1-2 days behind the upper limb

4th-8th weeks

If a womens life time risk of developing endometrial cancer is 60% what is the penetrance

60% ** the large majority of inherited cances have penetrance <100% (reduced penetrance). This includes the inherited form of retinoblastoma, which often is described as having 90% penetrance by with certain families having a lower penetrance. The nature of the mutation influences the level of penetrance

2 criteria for risky use in DSM-5 criteria for substance use disorders

8. Recurrent use in situations in which it is physically hazardous 9. use is continued despite knowledge of having a persistent physical or psychological problem that is likely to have been cause or exacerbated by the substance

Region where thick and thin filaments overlap

A band ** the length of the thick filament does NOT change during contraction * this A band encompasses the length of thick filament

Ankylosing Spondylitis

A form of spinal arthritic; its an inflammatory disease - affects males more often than females - causes ankylosis (fusion or fixation) of multiple vertebral and/or vertebral and sacroiliac joints - fusion makes the spine less flexible and can result in a "hunched-forward" posture

Steps of Neuronal Regeneration

A normal nerve fiber with its perikaryon and effector cell (skeletal muslce). The cell body has A LOT of Nissl Substance (well developed rER and ribosomes) 2 Weeks after injury: - when axon is injured, the nueronal nucleus moves to the cell periphery and RER is greatly reduced (less Nissl substance). The nerve fiber distal to the injury degenerate along with its myelin sheath ** debris here is removed by macrophages 3 Weeks after injury: - Schwann cells proliferate and form "schwann tube". The end of cut axons forms multiple axon "sprouts", and each of these is looking for a Schwann tube.. if one finds it, it beings elongating through the tube and the other sprouts being to degenerate. Meanwhile the muscle is atrophying 3 Months of Injury (IF SUCCESSFUL) - the axon sprout lengthens within the Schwann tube, guided and promoted by factors released from the Schwann cells, fibroblast, and macrohphases * growing at 3-4mm/day, the axon sprout reaches the postsynaptic membrane and re-esatbilishes synaptic contact

What are the Nervous System Components of the Somatic Nervous System

Voluntary Motor: (EFFERENT)- axons are called general somatic efferent (GSE) or Somatic Sensory (AFFERENT)- axons are called General Somatic Afferent (GSA)

The development of the limb bud along the dorsoventral axis is mediated by

WNT7a expression ** the presence of bone morphogenic protein (BMP) restricts WNT7a to the dorsal ectoderm of the limb bud - WNT7a which induces signals instructing the underlying mesenchyme to become dorsal in nautre. Establising dorsoventral components of the limb (ex. nails and the patella)

How is light microscopy used to study tissue in histology

A small block of tissue, harvested from an anesthetized or newly dead subject is 1. fixed 2. embedded 3. sectioned (cutt into pieces: can be oblique section, cross section, or longitudinal section) 4. stained 5. observed with a light microscope

Tension that muscle can achieve when stimulated to contract=

Active tension - depends on the length of the muscle before it contracts (tension developed by a muscle fiber when stimulated to contract represents force generated during cross-bridge cycling- this req ATP) * if muscle at resting length (optimal length, Lo)- it will achieve max tension whens timulated to contract * if muscle stretched (length >1) tension will decline * If muscle not sufficiently stretched (length (<1) max tension cannot be achieved

Absence of digits

Adactyly

Neural Regeneration in the PNS

After an injury to the PNS, the neuronal circuits MAY be reorganized by the growth of neuronal processes, forming NEW synapses to replace those lost and at least partial regain of function * injured fibers in peripheral nerves have a good capacity for regeneration and return of function

Ulnar nerve innervates

All digiti minimi muscles: - flexor digiti minimi brevis - opponens digiti minimi - abductor digiti minimi - adductor pollicis 3rd and 4th lumbrical ALL interossei muscles

Muslce contraction in skeletal muscles:

All sarcomeres within a myofibril, and also all of the myofibrils within the muscle fiber, shorten at once! - this causes the entire muscle to shorten= muscle contraction *** Note: neither the thick nor thin filaments changes their length - Contraction is the result of an increase in the amount of overlap between the filaments caused by the sliding of thin and thick filaments past one another (move towards M-line) ** Myosin myofilament stays put, slides actin myofilament towards the M band

Complete absence of a limb (ex. early loss of FGF signaling)

Amelia

What prevents "bow stringing" of muscle tendons in the forearm

Antebrachial Fascia - thickens around the wrist Anteriorly/Palmar side= Palmar carpal ligament and Flexor retinaculum Posteriorly/Dorsal side= Extensor Retinaculum (** this one is less thick) ** each has tendon sheaths passing below it

Interosseous membrane seperates the forearm into

Anterior (deep and superficial) compartments and Posterior compartment

What accounts for over 95% of the dislocations of the glenohumeral joint

Anterior Dislocation - it is caused by excessive extension & lateral rotation of the humerus OR a forceful blow to the posterior shoulder of an abducted humerus - if the joint capsule is torn, the humeral head lies inferior to the glenoid cavity and anterior to the infraglenoid tubercle ** it can result in damage to AXILLARY nerve & posterior circumflex humeral artery

Which ligament of the vertebrae prevents Hyperextension

Anterior Longitudinal Ligament - a strong, fibrous band - runs along the anterior vertebral bodies ** this would tear if you bend your back to far back

Does the anterior or posterior tibial artery pass throguh a gap in the superior part of interosseous membrane between the tibia and fibula

Anterior Tibial Artery passes through here to reach the anterior compartment - it descends through the interosseous membrane between the tibialis anterior and extensor digitorum longus

What mechanism would aid someone who is dealing with an Asthma attack

Asthma= obstruction of air flow - treatment: want to open airways to facilitate air flow * a common drug used are Beta-receptor agonist which: 1. activate Gs GPCR in bronchiolar smooth muscle 2. this then activates adenylyl cyclase 3. increases cAMP 4. then inhibits MLCK 5. leads to relaxation and permits unobstructed breathing

Most common site of metastisis from a breast cancer

Axillary lymph nodes (bc they receive most of the lymphatic drainage) - enlargement of these palpable nodes suggests the possibility of breast cancer and may be key in early detection - carcinomas of the breast are malignant tumors, usually adenocarcinomas arising from the epithelial cells of lactiferous ducts in the mammary gland lobules

Axons originate from a pyramid-shaped region of the perikaryon (Neuron cell body) called the

Axon Hillock - just beyond the axon hillock is the initial segment (IS) - UNMYELINATED ** this is where the action potential begins

Plasma cells are derived from

B lymphocytes and are responsible for the synthesiss of antibodies produced in reponse to penetration by antigens - They are variable in number in "uninfected" CT, but numerous in sites penetrated by bacteria and in inflammatory responses ** they have a large ovoid cell with basophilic cytoplasm (extensice rER) and a well developed golgi (much secretory activity) - their nucleus is spherical and acentric, alternating patches of heterochromatin and euchromatin called "clock-face" arrangement

what heals better cartilage or bone

BONE! it is very highly vascularized so it heals very well - cartilage is avascular (so grows very slow and often with incomplete regeneration- except in younf children) * cartilage that does regenerate after damage, is due to chondrogenic cells coming from the perichondrium - in extensively damaged areas and occasonally in small areas, perichondrium produces a scar of dense CT instead of forming new cartilage

Difference between the extrinsic and intrinsic muscles of the hand

BOTH have tendons that insert into the hand - main different is if the muscle belly originates outside of the hand= extrinsic - if muscle belly originates inside of the hand= Intrinsic

Benign and Malignant Tumors of Placenta (chorionic villi)

Benign- Hydatidiform mole Malignant- Choriocarcinoma

Benign and Malignant Tumors of totipotent germ cells (tumors are built of tissues from two or three germ layers)

Benign- Mature Teratoma Malignant- Malignant Teratoma

Benign and Malignant Tumors of Melanocytes

Benign- Nevus Malignant- Melanoma

The pancreas carries out

Both endocrine and exocrine secretion - Endocrine: it secretes insulin from islets of langerhans INTO blood stream - Exocrine: it secretes pancreatic enzymes (and NaHCO3) from pancreatic acinar cells into the pancreatic duct

Pectoralis Major action and innervation

Both heads: adduct and medially rotate the humerus - clavicular head: flexes humerus - sternocostal head: extends humerus from flexed position Innervation: - lateral pectoral nerve and medial pectoral nerve

Which muscle helps to flex forearm at the elbow, especially in mid-pronated position "beer drinking muscle"

Brachioradialis I: radial nerve

Which muscle can be seen from the anterior view but is actually part of the posterior compartment of the forearm

Brachioradialis! * it DOES not originate from medial epicondyle (primary flexor origin) so it is NOT in anterior compartment

Origin, innervation and cutaneous branches of Musculocutaneous Nerve

C5, C6, C7 Innervates: - Coracobrachialis (*** muculocutaneous nerve pierces right through coracobrachialis) - Biceps Brachii - Brachialis ** motor to all of the anterior compartment of arm Cutanous branches= lateral antebrachial cutaneous nerve (skin sensation to lateral forearm) ** if you have a pt who presents with no sensation to the lateral forearm- it may be something to do with lateral antebrachial cutaneous nerve

Origin and Innervation of Long Thoracic Nerve

C5, C6, C7 - Serratus Anterior

What spinal nerves are included in the brachial plexus

C5, C6, C7, C8, & T1 - provide innervation (motor and sensory) for all the muscles of the upper limb and surrounding tissues

Cancers derived from epithelial cells

Carcinomas - includes many of the most common cancers nearly all cancers developing in: - breast - prostate - lung - pancreas - colon

Main difference between cardiac and skeletal muscle contraction

Cardiac muscle has DIADS (1 T tubule + 1 terminal cisterna of the sarcoplasmic reticulum) * skeletal muscle had TRIADs (1 T tubule + 2 terminal cisternae)

"Horse's Tail"

Cauda Equina - spinal nerve roots travel from the conus medullaris down to their IV foramen exit ** Here it is just swimming in CSF so when you put in a needle they will swim away and not come into contact with needle- so here you are A-okay to put in a needle

Nodule

Caused by proliferation of cells into the mid-deep dermis ex. Lymphadenopathy and sporotrichosis

Indentations in the sarcolemma that are extremely abundant in smooth muscle

Caveolae ** can buffer mechanical tension within the plasma membrane, and thereby prevent membranes from breaking under stress forces

A superficial, subcutaneous vein of the lateral aspect of the upper limb

Cephalic vein - its travels through the deltopectoral groove & pierces the clavipectoral fascia at the deltopectoral triangle, draining into the axillary vein

In the ________ regions, when an IV disc protrudes, the spinal nerve coursing through the associated IV foramen will be compressed

Cervical & Thoracic Regions ex. - IV disc herniation between C4 and C5 will compress spinal nerve C5 (C5 spinal nerve coursing SUPERIOR to C5 vertebra) - IV disc herniation between T4 and T5 will compress the spinal nerve T4 (T4 spinal nerve coursing INFERIOR to the T4 vertebra) *****THIS DOES NOT OCCUR IN LUMBAR REGION

What are the Secondary Vertebral Curvatures

Cervical Lordosis and Lumbar Lordosis * these result from extension of the flexed fetal position; cervical lordosis develops when infants begin to hold their heads up; lumbar lordosis develops when toddlers begin standing and walking; set at puberty

Enzyme that makes Acetylcholine (ACh)

Choline Acetyltransferase (ChAT) - synthesizes ACh from Acetyl Coenzyme A and Choline

In which tissue is there ABUNDANT ECM

Connective tissue * compared to epithelium, CT has A LOT of ECM with fewer cells From Least to most abundant ECM: - Nervous tissue (has none) - Epithelial - Muscle - Connective (most abundant)

As spinal nerves "leave", the spinal cord narrows into a cone shape. This is called the

Conus Medullaris - In adults it is at L1/L2 - In neonates it is at L3/L4 This is a BIG NO for inserting a needle

What nerve is compressed or overstretched as it passes DEEP to inferior extensor retinaculum to foot and affects sensation to the middle half of hallux and middle half of digit 2

Deep Fibular Nerve - leads to pain, numbness, or loss of sensation in this area

Which artery is the main artery supply to the thigh region

Deep artery of thigh (AKA deep femoral artery or profunda femoris artery) - branch of femoral artery ** main artery supply to thigh region

What would cause "wrist drop"

Deep branch of Radial Nerve injury - deep penetrating wounds of the posterior forearm - inability to extend the thumb and fingers (MCP joint) - no loss of sensation Wrist drop: - difficulty in extension of wrist and fingers (metacarpophalangeal, PIP, DIP joint) - wrist remains partly flexed due to unopposed flexor tone and gravity - damage to radial n. usually at humerus mid-shaft (radial groove)

The intrinsic muscles on the dorsum of the foot are innervated by

Deep fibular nerve

Function of Acetylcholinesterase (AChE)

Degrade ACh to choline and acetate - choline is taken back into the presynaptic terminal on a Na+ choline transporter

Microtubules are used as tracks for ___ and ___ to transport organelles, vesicles, and macromolecules IN BOTH DIRECTIONS through a nerve cell axon

Dynein and Kinesin Dyenin (-) end directed motor: - Retrograde transport- it returns cargo for degradation and NEUROTROPIC signals to cell body Kinesin (+) end directed motor: - Anterograde transport- supplies distal axons with newly synthesized proteins anad lipids, including synaptic components required to maintain presynaptic activity Cargo includes: - mitochondria (need much ATP at nerve terminals) - cytoskeletal polymers - synaptic vesicles containing neurotransmitters

Describe mechanism of Burkitt Lymphoma

EBV infection and Malara induce a translocation t(8;14) - MYCC then contacts with IgH enhancer - MYCC overexpression - Activation of transcription - Activation of cell proliferation - Lymphoma (Burkitt Lymphoma) ** Presents as a lump- atypical lymphoid cells On FISH appears as a hybrid

The internal marrow cavity and the trabeculae of bone are lined with

Endosteum - a specialized thin CT composed of 1. monolayer of osteoprogenitor cells 2. osteoblasts

The epithelial-like cells that line the neural tube and ventricles of the brain

Ependymal Cells - some posses CILIA, aids in moving CSF around the brain ** they are joined apically by junctional complexes (tight junctions and zonula adherens)- but are NOT epithelial cells because they DO NOT sit on a basal lamina - instead the basal ends are elongated and extend into neuropil

Intrinsic Back Muscles include

Erector Spinae Group Actions: - extends vertebral column - Some rotation of vertebral column - act on vertebral column to control movements and maintain posture Paraspinous Muscles Actions: - Act on vertebral column to control moevments and maintain posture

Which intrinsic muscle on the dorsum of the foot works to extend the hallux (big toe)

Extensor Hallucis Brevis * it attaches proximally to 1st digit (Hallux) I: deep fibular nerve

True or false: smooth muscles have abundant T-tubules, troponin, and sarcoplasmic reticulum

FALSE! No t-tubules, no troponin, under-developed sarcoplasmic reticulum (SR)

An opening in the tendon of the Adductor Magnus Muscle called the ADDUCTOR HIATUS serves as a passageway for

Femoral artery and femoral vein from the anterior thigh to the posterior knee (popliteal fossa) ** at this point the femoral artery and femoral vein change names to the popliteal artery and the popliteal vein

Which cartilages do not have perichondrium

Fibrocartilage (nutrients from blood vessels in CT) and articular hyaline cartilage (gets nutrients from synovial fluid)

Which ligament supports the lateral side of the knee joint

Fibular Collateral Ligament (lateral collateral ligament) - NOT attached to the lateral meniscus - separated from by the popliteus tendon ( is passes between the lateral meniscus and ligament) - this is strong, cord-like

Which muscle of the anterior compartment of the leg is NOT found in everyone

Fibularis Tertius I: Deep Fibular Nerve Action: Dorsiflex ankle joint **when present this tends to blend into the bottom of the extensor digitorum longus ** it has a tendon to the base of the 5th metatarsal

Where is the Glial Limiting membrane/glia limitans found, what is it formed by, and what begins after it

Found below the pia mater at the external surface of CNS - it is formed by ASTROCYTE processes and it is where the nervous tissue begins

Hyaluronic Acid is a

GAG but it is non-sulfated - composed of thousands of sugars rather than hundreds - it is NOT covalently bound to protein to form proteoglycans- it is produced at the plasma membrane, NOT in golgi like proteoglycans * it has linker proteins that bind proteoglycans to hyaluronic acid thus forming proteoglycan aggregates

The intermediate filament found in astrocytes

GFAP (glial fibrillary acidic protein)

ACh receptors on smooth muscle cell membranes are

GPCRs ** there are 2 types of ACh receptors - Nicotinic (ligand gated ion channels): in NMJ and autonomic ganglia - Muscarinic (GPCRs) in target tissues like smooth muscle

Which is the only muscle in the superficial layer of large gluteal muscles the LATERALLY rotates rather than medially rotates like the rest of them

Gluteus maximus

What collects information about the degree of tension among TENDONS and relays the data to CNS, where the info is processes with that from muscles spindles to protect the myotendinous junctions and help coordinate fine muscular contractions

Golgi Tendon Organ

M3 muscarinic acetylcholine receptors primarily activate

Gq which in turn activates phospholipase C (PLC) and increases intracellular calcium

Which muscle of the medial compartment of the thigh also works to FLEX the leg at the KNEE JOINT

Gracilis Muscle - it also adducts this at hip joint I: Obturator Nerve

Lymph drainage for anterior and medial thigh follows along the path of the

Great Saphenous Vein

Which region is occupied by thick filaments only in the sarcomere

H zone -center of A band * shortens during contraction as the thin filaments slide inward

Describe Simple Cuboidal epithelium and its functions

Height and width of the cells are the same - the nucleus is spherical and centrally located Fxs: -protection, secretion, and absorption

____ is always a sign of muscle degradation and is elevated in DMD before clinical signs become obvious

High creatine kinase ** elevated in 70% of females heterozygotes for DMD

The foot is divided into

Hind foot, midfoot, forefoot

The 3 lymph nodes that form the base of the Axillary lymph nodes which drain into central lymph nodes, draining into apical lymph nodes

Humeral (lateral) Subscapular (posterior) Pectoral (anterior ** of the lymph traveling to the axillary lymph nodes from the breast, most travels FIRST to the pectoral lymph nodes

Which region of sarcomere is only thin filaments

I band - shortens during contraction as the thin filaments move inwards and overlap the thick filaments

What occurs if an injury occurs at or near the spinal nerve root vs more distally (not at the nerve root)

If an injury occurs at or near the spinal nerve root, the sensation deficit will occur in the pattern of a dermatome If an injury occurs more distally (NOT at nerve root) then the sensation deficit will occur in the pattern of the peripheral sensory cutaneous innervation

Which ligament of the hip joint limits hyperextension of hip joint while standing

Iliofemoral ligament - connects the ilium with the femur, located anteriorly and superiorly

What muscle is the MAIN flexor of the thigh at the hip joint

Iliopsoas (in the anterior compartment of thigh)

The Tensor Fasciae Latae Muscle Distally attaches to the

Iliotibial tract I: superior gluteal nerve - ABDUCTS and MEDIALLY rotates thigh

What does the deep fascia of the thigh (fascia) lata become laterally

Ilitibial tract or iliotibial band (IT band) ** this is the strong lateral portion

Which is the ONLY muscle that attaches to the LESSER trochanter of the femur

Ilopsoas

T1 spinal nerve courses _____ to the T1 vertebra

Inferior

Roots C8 and T1 join together to from the

Inferior Trunk

Innervation, Insertion, action of the Serratus Anterior

Innervation: Long thoracic nerve (C5, C6, C7) Insertion: Anterior Surface of medial border of scapula Action: - protract scapula - holds scapula against thoracic wall - superior rotation of scapula

Innervation, Insertion, Action, and Origin of Infraspinatus

Innervation: Suprascapular Nerve (from superior trunk) Insertion: Greater tuberlce of humerus Action: - Laterally rotates the arm - Stabilizes the glenohumeral joint Origin: infraspinous fossa

Innervation, Insertion, Action, and Origin of the Subscapularis

Innervation: upper (C5) & lower(C6) subscapular nerves (from posterior cord) Insertion: lesser tubercle of humerus Action: - medially rotates the arm - stabilizes the glenohumeral joint Origin: Subscapular fossa

Insertion, Innervation, Action of the Teres Major

Insertion: Medial lip of intertubercular sulcus Innervation: lower subscapular nerve (from posterior cord) Action: - Adduct & medially rotate arm

What are two types of cartilage growth and which invovles mitotic division of pre-existing chondrocytes

Interstitiatl growth and appositional growth ** INTERSTITIAL GROWTH has to do with division of pre-existing chondrocytes "in the middle" of the mass of cartilage - occurs during early phase of cartilage formation occurs at 1. epiphyseal plates of long bones (increase length of long bones) 2. articular cartilage: growth must come from within because there is NO perichondrium to add cells by appositional growth ** elsewhere in body interstitial growth becomes less pronounced after embryonic development, as matrix becomes increasingly rigid from cross-linking of matrix molecules (cartilage then only increases in girth by appositional growth)

True hamstring muscles (posterior thigh muscles) attach to the

Ischial tuberosity and is innervated by tibial division of sciatic nerve

Tension by muscle < load/force, weight cannot be moved

Isometric contraction * tension is generated, but muscle DOES NOT shorten (length remains constant) and no movement occurs work= 0, velocity= 0 ** these contractions aare allows be the elastic components (tendons) of muscles - in isometric contraction, sarcomeres shorten and tension is developed (by cross-bridge cycling) - tension is transferred to the elastic elements (tensons) which stretch - this allows the muscle length to remain constant

Tension by muscle = load/force on muscle; weight CAN be moved

Isotonic contraction * muscle contracts, shortens and creates enough tension to move the weight (tension remains constant throughout) work > 1 , Velocity > 1 *** in isotonic contraction, sarcomeres shorten and tension is developed. tension is transferred to the elastic elements which stretch, but tension developed is sufficient to overcome this stretch with the results that the entire muscle shortens

Describe Synovial Joint

Joint cavity (synovial cavity) between articulating bones - has a joint capsule made of a fibrous layer and synovial membrane which secretes synovial fluid - and articular cartilage (hyaline cartilage) covering the ends of each boen Accessory Structures that can be found in synovial joints include: (*note these are not in ALL synovial joints) - meniscus: fibrocartilage pad - labrum: rim of fibrocartilage attached to periphery of a concavity - ligament: strong cord of Dense fibrous tissue holding bones together - bursa: serous membrane sacs; cushions joint/ reduces friction - tendon sheath: tube-like bursa; wraps around the tendon to reduce friction

Anastomosis

Junction of two or more arteries or veins often the bodys way of alternative blood flow

What are the roots of the femoral nerve

L2, L3, L4

Most common kind of ankle sprain

Lateral Ankle Sprain - Lateral ligament of ankle injured when foot is forcefully inverted on plantarflexed, weight-bearing foot * Anterior Talofibular ligament component is the most commonly torn signs and symptoms: pain and swelling around lateral malleolus and dorsum of foot

Fibular fractures occur most proximally to the

Lateral Malleolus of the Fibula

Action of the Piriformis Muscle

Laterally Rotates an extended thigh; ABDUCTS a flexed thigh

Region between the knee and the ankle is referred to as the

Leg made of 2 bones: Tibia and Fibula - Tibia (shin bone): large, strong. MEDIAL and slightly anterior to fibula - it is important for weight-bearing

Carpal tunnel syndrome

Lesion: Median nerve Cause: repetitive wrist motion (swelling within the flexor retinaculum compresses the median nerve) Clinical: Writs flexion elicits pain; wrist extension relieves pain; symptoms worse at night. Ape hand; sometimes: loss of sensation on the lateral 3 1/2 digits

Claw hand

Lesion: Ulnar nerve Cause: medial elbow and wrist trauma Clinical feature: weak finger abduction and adduction; medial hand numbness; clowing of digits 4-5

Klumpke Palsy

Lesion: lower brachial plexus (C8-T1) Cause: upper limb pulled upward (trauma during delivery) Clinical Feature: Claw hand from ulnar nerve involvement; ape hand with median nerve involvement; associated with Horner Syndrome

Erb- Duchenne Palsy

Lesion: upper brachial plexus (C5-C6) Cause: separation of head and shoulder (trauma during delivery) Clinical Feature: "Waiters tip" position (shoulder medially rotated and extended and adducted; forearm pronated)

Which ligament of the vertebrae limits flexion

Ligamentum Flavum - elastic, yellow bands of tissue connecting laminae of adjacent vertebrae

If dystrophin is present and normal

Limb- Girdle MD - caused by mutations in any of the large number of genes - LGMD1 is autosomal dominant (involved with gene products like sarcoglycans and dystroglycans) - LGMD1 recessive inheritance; gene products generally interact with dystrophin - Disease can be as severe as DMD but frequently milder

What does the Serous Membrane (AKA Serosa) line

Lines cavities of body that DO NOT open directly to the external environment - lines the chest and abdnomial cavities - also covers the organs within these cavitites - covers the liver, spleen, kidneys, heart etc.

Transitional Epithelium (aka UROthelium)

Lines parts of the urinary tract: the bladder, urethra, and ureters - allows the urinary organs to expand and stretch * when filled with urine versus empty, apical cells change shape - cells flatten like simple squamous and become elongated when the bladder is filled with urine "distended" - no urine it is "collapsed"- gives a bulbar/dome shape -- this epithelium resembles both stratified squamous and stratified cuboidal-

A cytoplasmic inclusion found in neurons

Lipofuscin Granules - these are yellow-brown pigment granules that are remnants of SECONDARY LYSOSOMES- undigestible material that builds up over time - they were membrane-bound when first formed, may have lost membrane over time * they are considered to be one of the aging or "wear-and-tear" pigments * found in long lived cells like neurons, muscle cells, and cardiac muscles cells THESE ARE NEVER!!! in young ppl. ONLY IN OLD PPL

Coccydynia

Localized pain and tenderness in tailbone region - usually caused by trauma to the coccyx ex. - direct injury during contact sports - coccyx can fracture duing childbirth - repetitive straining or friction - fall onto the coccx in the seated position

Rupture of tendon of long head of biceps brachii

Location of injury: "wear and tear" over intertubercular sulcus common in males 40-60 (any extra bony growth- will not be smooth- it would be like nail sticking into the muscle) Sxs: - Audible snap/pop - Bulge in center of distal anterior arm ("Popeye Deformity") - Pain and tenderness at shoulder

___ is the initial site of inflammation and allergic (immune) responses- where leukocytes eneter when they leave bloodstream

Loose CT

Site for Lumbar Puncture and Spinal Anesthesia

Lumbar Cistern - this is an enlargement of the subarachnoid space between the conus medullaris (~L2) & end of dural sac (~S2)

An autosomal dominant disorder in which elastic tissue is weakened because of the mutation in the FIBRILLIN gene

Marfan Syndrome - this affects the ELASTIC FIBERS of the cardiovascular, ocular, and skeletal systems - individuals with this are unusually tall, with very long arms, fingers, legs, feet, and toes ** cardiovascular probles with this are life-threatening: the aorta may become enlarged (aortic dilation) or the walls of the aorta may bulge (aortic aneurysm)- note the aorta is an elastic artery and contains multiple elastic lamellae in its tunica media - a significantly enlarged aorta is at risk for tearing or rupture (aortic dissection)

The fixed cells of Connective Tissue are derived from

Mesenchymal Stem Cells these "fixed or permanent" cells are native to the tissue in which they are found..these include: - fibroblasts - adipocytes - pericytes (around blood vessels) - others..

Nearly all muscle cells (of all 3 types) are of ____ origin

Mesodermal

Unlike other glial cells that stay fixed, _______ constantly crawl through the neurophil, analyzing the tissue for damaged cells and invading microorgnaims

Microgial Cells ** these are pretty evenly distributed between the white and grey matter

___ are very important as tracks for axonal transport

Microtubules - they are also abundant in neuronal cell body and all processes * since the genetic material and nearly all of the protein synthesis machinery are localized to the cell body, a supply line needs to be maintained to provide structural and functional materials to the length of the axon (which can be more than a meter away from the cell body)

Structural classification of the Tibiofemoral joint

Modified Hinge Type of Synovial Joint - "modified" because of incongruent articular surfaces Functional classification: biaxial joint; diarthrosis

What is the normal function of the Deep Fibular Nerve (branch of Common Fibular Nerve L4-S2)

Motor and Sensory Motor: Normal Stregth and actions of ankle DORSIflexors and toe extensors (anterior leg compartment muscles) Sensory: Normal skin sensation between 1st and 2nd toe

What are the Motor and Sensory Functions of the Sciatic Nerve (L4-S3)

Motor: innervation to muscles in posterior thigh, leg, and foot Sensory: innervation (via its tibial and common fibular branches) to majory of the skin in the leg and foot

Epithelium in the Mucosa is called

Mucous membrane (mucosa) it lines the inside of cavities that open directly to the exterior environment - GI tract - Respiratory tract - Reproductive tract - Urinary tract ** this is an important defense mechanism/structure that prevents the entry of pathogens and microbes into the body ** specialized cells of mucosa (can) secrete mucus to keep the membrane moist- mucus also traps dust particles in the respiratory passageways and lubricates food as it travels through the intestinal tract ex. Goblet cells

Schwann cells (aka neurolemmocyte) forms the

Myelinated coverings over axons in PNS - can also form unmyelinate coverings ** ONE axon covered by SEVERAL schwann cells (each schwann cell covers one internode)- this difference in myelination explains why it is easier to regenerate damage myelin in PNS than in CNS ** bc in CNS one oligodendrocyte is connected to several axons- so makes CNS regeneration more difficult than PNS

is the fibula in the knee joint

NO

Does tropomyosin bind to calcium

NO troponin does ** but NOT in smooth muscle (remember in smooth calmodulin is what binds to calcium)

Describe a fibrous joint

NO synovial cavity - articulating bone held together by fibrous CT - permits little movement (amphiarthrosis) or NO movement (synarthrosis) ex. Suture in sklull, Gomphosis, and Syndesmosis (bones united by interosseous membrane or ligament)

Describe a cartilaginous Joint

NO synovial cavity - articulating bones held together by cartilage (fibrocartilage or hyaline cartilage) - permits little movement (amphiarthrosis) or no movement (synarthrosis)

Is the fibula part of the knee joint

NO!

If the dorsal scapular nerve (C5)- innervating Rhomboids and Levator Scapulae is affected would you have complete loss of shoulder movement

NO! bc Trapezius is still intact which is innervated by the Spinal Accessory Nerve (CNXI)

can skeletal muscle length be strertched in situ?

NO! in body skeletal m is held at its optimal length for active-force development (nomral working range) by the tendons that hold it in place at its origin and insertion. - event though skeletal m. active tension will change under experimental conditions when the muscle is stretched, changing the in situ muscle lenght is NOT a physiological mechanism used by the body to regulate active tension in skeletal muscle

True or False: the epithelium is very vascular

NO! The Epithelium is AVASCULAR (NO BLOOD SUPPLY) - nutrients and oxygen are delivered to epithelia by diffusion, blood vessels in underlying CT supply the oxygen and nutrients needed by diffusing them across the basal lamina

Is the plantaris muscle present in all individuals

NO!!!!!! some ppl do no thave it

Does the scapula articulate with any ribs or vertebrae

NO, it does not

Do the vertebral arteres run through the transverse foramina of C7

NOO!!!!!!!!!!! only C6-C1

Can epithelial cells crawl

NOOOOOO they do not crawl, they are polarized cells and they are "locked in place"

What determines the type of epithelium

NOT the shape of the nucleus but it IS determined by the shape of the cytoplasm ex. The endothelium lining an artery can have nuclei that are rounded but the extensions on either side are simple squamous

What is a common complication in a femoral neck fracture

Necrosis of the femoral head ( a common complication in femoral neck fractures in the elderly) *** bc a fracture, dislocation or vascular pathology that reduces blood flow of the MEDIAL circumflex femoral artery results in avascular necrosis of the femoral head *** insufficient blood supply causes tissues such as bone to die Reasons for Femoral Neck Fracture: car accident, osteoporosis, fall - affected limb shortened and laterally rotated (due to pull of lateral rotator muscles of hip joint)

Process of uncontrolled growth (not necessarily fast); accumulation of cells due to proliferation and/or evasion of apoptosis

Neoplasia

Most smooth muscle and cardiac muscle is derived from the splanchnic mesoderm, BUT the smooth msucle of the pupil is from the

Neuroectoderm

Two subtypes of Nicotinic Acetylcholine Receptors

Nn (in autonomic ganglia) and Nm (in the neuromuscular junction) - BOTH are ligand-gated NON-specific cation channels that permit passage of both Na+ and K+ on binding of ACh - permeability of the post-synaptic membrane to Na+ and K+ are essentially equal; relative movement of these ions depends on electrochemical driving forces - Net driving force for Na+ >>>> K+ * considerably more Na+ moves inward than K+ moves outward, bringing about a local depolarization in the post-synaptic membrane

Are there benign tumors of the Hemato- and Lymphopoietic Tissues (mesenchymal tissues)

No! Only malignant tumors and these are Leukemia and Lymphoma

SInce the Supraspinous Ligament only starts at C7, what ligament protects the vertebrae above it?

Nuchal Ligament - thick, fibroelastic, median band running from the external occipital protruberance and posterior border of the foramen magnum to C7 spinous process - it attaches the spinous processes of cervical vertebrae - allows for attachment of back muscles, where the spinous processes of cervical vertebrae are shorter

Does thick or thin skin has hair follicles

ONLY Thin skin has fair follicles! - they are associated with sebaceous glands and arrector pili smooth muscle bundles Thick skin lacks hair follicles

Mesenchymal tissue is found

ONLY in embryo * adults have NO mesenchymal tissues- but do have mesenchymal stem cells

Mucosal Membranes face the

OUTSIDE of the body, they need mucus to keep them moist Mucosa consist of: 1. epithelium 2. connective tissue below it 3. basemenet membrane that separates them

Collagen Fibers are

OUTSIDE the cells (**its secreted by fibroblasts) ** Type I collagen stains eosinophilc with H&E

The Suprascapular Artery goes

OVER the Superior transverse scapular ligament, while the nerve goes UNDER the ligament "Army goes over the brige; Navy goes under the bridge"

Which muscle of the HYPOthenar compartment does opposition towards digit 1

Opponens Digiti minimi

Which muscle of the THENAR compartment does opposition towards digit 5

Opponens pollicis

Sympathetic Chain Ganglia is formed by the

Paravertebral Ganglion (these are found along side the vertebral column) ** the sympathetic chain ganglia attaches to the spinal cord via the gray and white tami communicans

Median Cubital Vein of Arm

Passes obliquely in the cubital fossa, connecting cephaic and basilic veins ** this is where you extract blood from- the cubital fossa

What is the continuation of the distal part of the quadriceps tendon

Patellar Ligament **It is a strong ligament that attaches from the patella to tibial tuberosity ** LIGAMENT ATTACHES BONE TO BONE

Which muscle exits the pelvis via the greater sciatic foramen to enter the fluteal region

Piriformis Muscle ** use this muscle as landmark to understand the relationships of structures in the gluteal region (Superior gluteal nerve runs above it and inferior gluteal nerve and inferior gluteal artery run below it)

Additional digits ( up regulation of Shh in the ZPA leads to additional fingers on the ulnar side)

Polydactyly

Common variants of breast tissue

Polymastia: accessory breast Polythelia: accessory nipples (occur along mammary crest) Amastia: no breast development Gynecomastia: breast hypertrophy in males

Diamond-shaped, fat-filled area at the posterior aspect of the knee

Popliteal Fossa Muscular boundaries: - Semimembranosus and Semitendinosus - Biceps femoris - Medial head of gastrocnemius - Lateral head of gastrocnemius and Plantaris Main contents: - Tibial Nerve - Popliteal Vein - Popliteal Artery

Another name for the Deep artery of the thigh

Profunda Femoris Artery ** may arise from the femoral artery

What muscle of the Superficial Ant. compartment of the arm pronates the forearm

Pronator teres * it also helps to flex forearm at the ELBOW NOTE: - pronator quadratus: pronates the forearm; binds ulna and radius together BUT it is in the DEEP anterior compartment of the forearm

The thoracic vertebrae (n=12)

Provide attachment for the ribs (costal facets) --> leads to stability of the trunk and less injury in this region - the Transverse Costal facet of the vertebra connects with the costal tubercle of the rib - The Superior Costal facet of the vertebra connects with the Head of the rib ** thoracic vertebrae also have a wayy longer spinous process, have larger bodies than cervical vertebrae, and have a smaller vertebral foramen (when compared to cervical and lumbar vertebrae)

Langerhans cells are

antigen presenting cells ** these originate from the bone marrow ** can be found in the epidermis

Carpal tunnel syndrome

any condition that reduces the size of the tunnel - compression of the MEDIAN nerve - reptitive wrist motion causes swelling within the FLEXOR retinaculum - compresses the median nerve Symptoms: - wrist flexion elicits pain - wrist extension relieves pain - symptoms worse at night - ape hand deformity - loss of sensation on the lateral 3 1/2 digits

Which muscles attach distally to the patella via quadriceps femoris tendon; and then tibial tuberosity via the patellar ligament

Quadriceps Femoris Muscles (from Anterior Compartment of the thigh) - Rectus Femoris - Vastus Medialis - Vastus Lateralis - Vastus Intermedius

Osteocytes have reduced

RER and golgi

The presence of a modification to the apical membrane such as cilia or microvilli would indicate that the epithelium is

SIMPLE not stratified

A dermatome refers to the region of skin innervated by GSA axons from a ____ spinal nerve root

SINGLE

Cervical nerves course

SUPERIOR to their corresponding vertebra, while all others course INFERIOR to their corresponding vertebra ex. C1 spinal nerve courses SUPERIOR to C1 vertebra

Sternoclavicular Joint

Saddle-type synovial joint - functions as ball & socket to accomodate movements of the scapula - connects the scapula to the thorax via the clavicle * anterior sternoclavicular ligament * interclavicular ligament

The principal glial cells found in the PNS

Satellite Cells - these cover the surface of neuronal cell bodies in sensory and autonomic ganglia - thought to play a similar role in PNS to astrocytes in CNS - they supply nutrients to the surrounding neurons and some structural function - also provide protective, cushions cells

Most commonly fractured carpal is the

Scaphoid - pt present with pain and tenderness in the anatomical snuff box - avascular necrosis is a common complication- damage to the palmar carpal branch of the radial artery

What are the 8 carpal (wrist) bones)

Scaphoid (touches radius) Lunate Triquetrum Pisiform (pea sized- on palmar aspect) Trapezium (has a tubercle)- this one goes with thumb Trapezoid Capitate Hamate (has hook of hamate) "Some Lovers Try Positions That Thay Can't Handle"

Abnormal lateral curvature of the spine

Scoliosis

Which two muscles of the posterior thigh are located primarily on the medial aspect of the lower limb

Semitendinosus and Semimembranosus (these are hamstring muscles on the medial side of the thigh) BOTH: - Proximally attach at the ischial tuberosity - Distally attach on the tibia - I: Tibial division of sciatic nerve - Extend thigh at hip joint and flex leg at knee joint

Somatic Nervous System (Skin-sensation, bones, and skeletal muscle- if you can move it its somatic) is divided into

Sensory (AFferent) NS (sensory input) Motor (EFferent) NS (motor output)

Peritoneum

Serous membrane lining the abdominalpelvic cavity and the viscera

Pleura

Serous membrane lining the thoracic cavity and surrounding the lungs

Most frequent site of fracture of the Tibia is the

Shaft of Tibia

Connective tissue connecting periosteum to bone

Sharpey's fibers (aka bone fibers, or perforating fibers) - connective tissue consisting of bundles of strong collagenous fibers (type I) connecting periosteum to bone ** they are part of the outer fibrous layer of the periosteum

The Dorsal Venous Arch in the foot splits into the

Small Saphenous Vein (on lateral aspect) and the Great Saphenous Vein (on the medial aspect) - The small saphenous vein drains blood from the lateral foot and posterior leg into the --> popliteal vein which then goes to the femoral vein - The great saphenous vein drains blood from the medial foot and medial thigh straight into the femoral vein

Spontaenous depolarization and gap junctions are characteristic of single unit _____

Smooth muscle

Lumbar Stenosis

Stenosis (narrowing) of lumbar vertebral foramen in one or more lumbar vertebrae - may be hereditary anomaly, making a person more vulnerable to age-related degenerative changes such as IV disc bulging - surgical treatment of lumbar stenosis may consist of decompressive laminectomy

The toughest epithelium in the body

Stratified Squamous Epithelium - it lines the esophagus, mouth, and vagina Fx: it protects against abrasion- its layers are held by desmosomes and this is what allows it to withstand most friction

What two epitheliums are found in ducts

Stratified cuboidal epithelium - in sweat glands, salivary glands, and mammary glands - it is rare, but its multiple layers provide a protective tissue with more robust protection Stratified columnar epithelium - In male urethra and in ducts of some glands - rare; but its multiple layers give a more robust protection it secretes and protects

Which space contains cerebrospinal fluid (CSF)

Subarachnoid Space * it is the space between the arachnoid mater and pia mater -- the presence of CSF makes this good place to verify whether or not someone has an infection

Space between dura mater and arachnoid mater

Subdural Space * this is potential space, only seen pathologically

"Nursemaids Elbow"

Subluxation and dislocation of radius - typically in children 1-4 years old - common in Left limb - tenderness due to pinched ANNULAR LIGAMENT - radial head pinches annular ligament against capitulum

The thermoregulatory response of sweating is most likely controlled by what receptors

Sympathetic cholinergic fibers innervate sweat glands and stimulation of these glands (with ACh) leads to an increase in sweat production mediated vis muscarinic M3 receptors

Autonomic Nervous System (organs, glands, smooth muscle- things that act on its own) is divided into

Sympathetic division (arousing) Parasympathetic (calming)

What are the 2 regions of the CNS that the Sympathetic division arises from

Sympathetic= THORACOLUMBAR - pre-ganglionic cell bodies located in the lateral horn of Thoracic and Lumbar regions (T1-L2)

Ca2+ binds to vesicle protein ____, stimulating its interaction with the SNARE proteins

Synaptotagmin

Sympathetic division arises from cell bodies at level of

T1-L2

Which axons travel to sympathetically innervate the heart and lungs

T1-T4 * after they synapse in the PARAvertebral ganglion, they form cardiopulmonary splanchnic nerves

Nipple is at the level of

T4 dermatome

In CNS: the axons of neurons form

TRACTS * in PNS the axons of neurons form NERVES

True or false: only ions for which the membrane is permeable can produce a potential change and contribute to cell membrnae potential

TRUE! therefore, 2 factors: 1. concentration difference of an ion on both sides of the membrane and 2. the actual membrane permeability for that ion determine the extent to which the ion contributes to the actual membrane potential

Epithelial cells exist in the body in __ different forms

TWO diff forms 1. covering or lining epithelia (main form) 2. glands

The equivalent to carpal bones in the foot

Tarsal bones

Skeletal muscles attach to bone with

Tendons (these are made of dense, regular CT) ** tendons develop together with skeletal muscles and join muscles to the periosteum of bones ** dense collagen fibers in tendons are continuous with those in the 3 CT layers arround muscle fibers- form a strong unit that allows contraction to move other structures ** called the Muscle-tendon junction (or myotendinous junction)

Example of the gradient of Sonic hedgehog (Shh) needed for correct patterning of the craniocaudal axis

The 5th digit (little finger) requires a high concentration of Shh to form. Whereas, the 1st digit (thumb) requires NO Shh to form.

Where are the two places where you can give epidural anesthesia

The anesthetic agent can be inserted in the extradural space, either in the same position as the lumbar puncture (L4 level), or in the sacral hiatus

Moderate hypothermia

body temp 28-32 degrees celsisus, bradycardia, decreased respiration rate, eventually leading to unconsciousness while maintaining pupillary reflexes and asystole

Mild hypothermia

body temp in 32-35 degree celisius range, shivering, tachycardia, peripheral vascoconstriction, increased BP and agitated state

in the presence of oxygen what will form

bone - without oxygen; cartilage will form

What forms the three fascial compartments of the thigh

The fascia latas connection to femur by intermuscular septum makes 3 compartments: (each with similar muscle groups and nerve supply) - Anterior: Leg extensors/thigh flexors (Femoral Nerve/ except Pectineus M. also gets obturator nerve) - Medial: Thich Adductors (Octurator Nerve) - Posterior: Leg flexors/thigh extensors (Sciatic Nerve- the longest nerve in the body)

The more cross-bridges are formed

The greater the force ** when velocity of contraction increases, there is less time for cross bridges to form: increased velocity= decreased force

LEAST mobile region of vertebrae

Thoracic Region

Sun protection factor (SPF)

Time to produce erythema with sunscreen/ time to produce erythema without sunscreen ** theoretically: someone who burns after 10 min can stay outside 15 times longer before burning wearing SPF 15 ** SPF only measures protection against sunburn UVB - not UVA ***** sooo Broad Spectrum is best ! has UVA + UVB

what binds calcium

Troponin C

Inflammatory response triggered by release of histamine by mast cells

Type I hypersensitivity - stimulates IgE--> Mast cells

Medial terminal division of the brachial artery

Ulnar artery - supplies blood to 5th digit (pinky)

All four muscles of the quadriceps group receive innervation from the Femoral Nerve (L2, L3, L4) BUT which one receives innervation to it from a specific nerve branch

Vastus Medialis ** I: Femoral Nerve (specific nerve branch called nerve to vastus medialis)

Which adipose tissue is very metabolically active?

White (unilocular) Adipose tissue - it has energy reserves (triglycerides) * in fact adipose tissue is the largest repository of energy (in the form of TAGs, the neutral fats) in the body, the other organs that store energy, notably the liver and skeletal muscle do so in the form of glycogen - uptake and release of fatty acids and TAGs - release of hormones (like leptin) and other substances that regulate many different processes * nowadays, adipose tissue is considered an endocrine organ

The Cutaneous Branches of Posterior Rami provide

cutaneous sensory innervation (GSA) to the back

The cutaneous branches of posterior rami provide

cutaneous sensory innervation (GSA) to the back

Electrophoresis of X-linked markers only shows bands for

X allele ** since the X-chromosome is much larger than the Y - so X is the only thing seen ** ALSO: if two bands end on top of eachother this may or may not result in a band that is wider/heavier than if only one band is present at that location

Can genes inappropriately expressed due to a cancer inducing translocation belong to different classes

YES!

Does bone change shape?

YES! Bone is dyanmic tissue that constantly changes shape in relation to the stresses placed upon it ex. braces on your teeth reshaped your jaw bone

Which muscle flexes the proximal interphalangeal joints of digits 2-5 (NOT thumb)

flexor digitorum superficialis

Anterior Compartment of the arm contains mostly

flexors - all innervated by musculocutaneous nerve - and receiving blood supply from brachial artery

Anterior compartment (Superficial and Deep) of the forearm contains

flexors and pronators of wrist and fingers I: mostly median, some ulnar nerve innervation *** flexor retinaculum has median nerve running through! carpal tunnel *** ones innervated by ulnar nerve: flexor carpi ulnaris and 1/2 of flexor digitorum profundus (digits 4-5, pinky and ring finger)

Up to 72% of Neural Tube Defects could be prevented if all women took

folic acid as recommended

Antebrachial refers to the

forearm

Stratified Epithelium is

found where body linings have to withstand mechanical or chemical insult, such that layers can be abraded and lost without exposing subepithelial layers ** it differs from simple epithelium in that it is multilayered- not every cell touches the basal lamina ** stratified epithelium is classified according to the cell shape of its superficial layer (ex. if most superficial layer- towards apical side- is squamous, the epithelium= stratified squamous) ** even if cells resting on the basal lamina are more cuboidal- this doesnt matter.

Despite its complexity the human body is composed of only ___ types of tissue

four! - epithelial - connective - muscle - nervous

Hip (pelvic) bones, sacrum, and coccyx are held together by

gluteal ligaments: - Sacrotuberous ligament (between sacrum and ischial tuberosity) - Sacrospinous ligament (between sacrum and ischial spine) - Greater sciatic foramen: passageway for structures between the pelvis and gluteal region - Lesser sciatic foramen: passageway for structures between the gluteal region and perineum

Periodic acid- Schiff (PAS) stains both

glycogen and carbohydrate containing structures in magenta (~maroon)

Supinaton-pornation of the forearm

head of radius swivels inside the annular ligament, against capitulum and radial notch of ulna

The metatarsal bones of the foot are separated into a

head, shaft, base

Radiation

heat transfer in the form of electromagnetic waves between solid objects not in direct contact

The keratinocytes of the stratum basale contain ____ which atttach the cells to underlying basal lamina

hemidesmosomes

Transverse plane (axial, transaxial)

horizontal plane, parallel to long axis of the body/ organ imaged - divides into superior and inferior parts (can be any where in the body, does not have to be in half)

volkmann's canals carry blood

horizontally or obliquely

One peripheral nerve is made up of

hundreds or thousands of axons, parts of single cells * information is sent via SINGLE cells- they do not communicate with each other peripherally

most common type of cartialge in the adult

hyaline cartilage

the matrix of which cartilage appears glassy in living state

hyaline cartilage

Articulating bones at a symphysis are covered with

hyaline cartilage (with a perichondrium) and have a thick, fairly compressible pad of fibrocartilage between them

Many pathogens such as Staphylococcus aureus secrete

hyaluronidase - an enzyme that chopse hyaluronic acid into smaller pieces - this converts the ground substance from the GEL state into a SOL state (a colloidal suspension of very small solid particles in a continuous liquid medium) ** this results in a breakdown of the ground substance and facilitates the rapid spread of the microorganism thru the connective tissue spaces

Once ATP is bound to the myosin it is

hydrolyzed by myosin ATPase to ADP and P. This causes the mysoin head to return to its resting (cocked) state, ready to bind another actin and repeat the cycle. - The cycle will repeat if sufficient Ca2+ is present *** in absence of Ca2+, tropomyosin will cover the myosin binding sites on actin and cross-bridge cycle CANNOT proceed (resting sarcomere)

How do arteriovenous anastomoses in the skin (aka AV shunts) help to maintain a constant body temperature

in cold weather, the AV shunts open to decrease blood flow in the skin and thereby minimize heat loss - in warm weather they close to increase blood flow through capillary bed and facilitate heat loss

A carrier of a balanced translocation will have most cells

inactivating the normal X **** Cells that are missing genes from chromosome 8 ( or any of the other autosomal chromosomes (1-22) do not do well so if a normal X is inactivated it will do fine- but if an X with translocation of chromosome 8 on it these cells will not do well if they are inactivated *** the addition of a mutated DMD gene does not cahnge the inactivation pattern when a balanced translocation is present - the cell is only prepared for single copy expression of genes on X and Y

key stimulator of vesicle release

increase in pre-synaptic calcium *** entry is facilitated by steep concentration gradient which causes a rapid influx of Ca2+ into presynaptic terminal after the opening of voltage gated Ca2+ channels - with the result that the Ca2+ concentration of the cytoplasm in the terminal transiently rises to a much higher level

Flexor Digitorum Superficialis (Superficial Ant. Compartment of forearm) inserts at the

intermediate phalanx (so last joint this crosses is the proximal interphalangeal joint), digits 2-5

Serosa lines the

internal cavities Serosa consists of: 1. TWOOO layers of epithelium: Mesothelium has two layers one that covers organs (visceral layer) and one that covers the body wall (parietal layer) 2. Connective tissue below the mesothelial layers 3. Basement membrane that separates them ** mesothelium is simple squamous epithelium

The obturator artery is a branch of the

internal iliac artery - it supplies the medial group thigh muscles and small portion of head of the femur

where can fibrocartilage be found

intervertebral discs, pubic symphysis, meniscus, and certain other joints; insertions of tendons Fxs: provides cushions, tensile strength, and resistance to tearing and compression

The epimere formed from the myotome makes the

intrinsic back muscles which are innervated by the dorsal rami of spinal nerves

Neoplasia

a PROCESS of uncontrolled growth of cells (i.e. accumulation of cells due to - proliferation and/or - evasion of apoptosis

Morphogen

a chemical agent used to cause or determine structural characteristics

What can cause shoulder impingement syndrome/painful Arc Syndrome

a common cause is inflammation & calcification of the subacromial bursa (calcific scapulohumeral bursitis) - causes pain during 50-130 degrees of abduction - in this ROM, the tendon of the supraspinatus is in close association with the acromion, compressing the subacromial bursa

a break in normal (osseous) continuity of bone tisse

a fracture * must be careful because the neurovasculature near a fracture can possibly be at risk of damage

Tolerance occurs when

a higher dose is required to achieve the same affect ** this is NOT a component to the CAGE test, but it is a criterion for diagnosing substance use disorder according to DSM-5

Mallory trichome histological stain

a method especially suitable for studying CT because collagen stains green or blue * often used in histopathology to distinguish smooth muscle from collagen in tumor specimens

For skeletal and cardiac muscle. One muscle cell=

a muscle fiber and - cytoplasm of muscle cell= sarcoplasm - muscle cell membrane= sarcolemma - sER of muscle fiber= sarcoplasmic reticulum (** realses calcium to trigger a muscle contraction)

Anulus fibrosus is derived from

mesenchyme between the developing vertebrae

A Dermatome

a single spinal nerve sending sensory information from an area of skin

Although the zonula occludens involves fusion of adjoining cell membranes, their resistance to mechanical stress is limited. Therefore it is reinforced by

a strong bonding site below it called the Zonula Adherens- "Zone of Adhesion"

Synaptotagmin

a synaptic vesicle protein that binds to calcium- binding of calcium to this catalyzes fusion of synaptic vesiccles with pre synaptic membrane and neurotransmitter release

A single contaction- relaxation cycle in a skeletal muscle fiber

a twitch (AP in the axon terminal leads to an AP in the muscle fiber which then stimulates a single muscle fiber contraction and relaxation cycle) * a single AP in a muscle fiber produces a single twitch

Each quanta produces a slight depolarization in the motor end plate called a

miniature endplate potential (MEPP), which is about 0.5mV in Amplitude (this occurs spontaneously, unstimulated) - when a nerve impulse reaches the axon terminal( AP in the alpha motor neuron stimulates release of : ~100-200 quanta are released simultaneously or in rapid series causing multiple MEPPs. These summate, or combine to produce a larger depolarization in the motor end plate called an End Plate Potential (EPP) (~40mV)

In adults, fibroblasts in CT RARELY undergo division; however

mitosis can resume when the organ requires additional fibroblasts as in wound healing * fibroblasts are targets of various growth factors that influence cell growth and differentiation

Both Flexion & Extension and Lateral Flexion & Extension (bending) occur mostly in what parts of the vertebral column

mostly cervical and lumbar region

What is the normal function of the INFERIOR gluteal nerve

motor innervation to gluteus maximus muscle for hip/thigh extension Damage would lead to: - significant weakness of hip/thigh extension; weakness in hip/thigh lateral rotation ** signs of nerve damage= difficulty/weakness rising from a sitting position and/or climbing stairs

T-tubules allow

action potentials to move rapidly from the cell surface into the interior of the fiber to reach the terminal cisternae

Both beta1 and beta2 receptors act by stimulating

activate Gs --> adenylate cyclase --> increasing production of cAMP--> relaxation in smooth muscle, increased heart rate and force of contraction

What happens when ACh binds to GqGPCR on smooth muscle

activates PLC - increases IP3+ and DAG - Ca2+ is relased from sarcoplasmic reticulum - increase in intracellular calcium - increase MLCK and contraction

When a muscle is at a given length and is stimulated to contract, both

active and passive tnesion will ocntribute to TOTAL TNESION developed by that muscle * represented in a Total Tension Curve Total tension= Passive Tension + Active Tension ** the length that resting muscle is stretched to prior to contraction (preload) determines the total tension generated when stimulated to contract

the anterior cruciate ligament (ACL) restricts

anterior movement of the tibia and posterior movement of the femur. It attaches on the anterior tibial spines and on the postero-medial aspect of the lateral femoral condyle

The anterior cutaneous branch of the femoral nerve (lateral group) give cutaneous sensation to the

anterior thigh

dorsalis pedis artery comes from

anterior tibial artery

Gap junctions can occur

anywhere along the LATERAL membranes of EPITHELIAL cells, BUT are also found between cells in nearly ALL mammalian tissues ex. Heart Muscles - abundant gap junctions between cardiac muscle cells are responsible for the hearts coordinated beat

Sternal Angle (Angle of Louis)

at junction of the 2nd rib with the sternum at the levels of T4 & T5, & the second costal cartilages

Location of Mast cells

at the boundaries between tissues and the external envrionment - at mucosal surfaces of gut and lungs - in the skin - around blood vessels *** they are an extremely important part of the innate immune system

lateral

away from midline of the body

Flexor carpi radialis (Superfical Ant. compartment of forearm) inserts at

base of 2nd metacarpal

Connective tissue

binds, supports, and protects body parts - stores energy and minerals - it supports epithelial tissue

Ligaments connect

bone to bone

Inflammation of a Bursa

bursitis - causes: friction, prolonged compression at joint, direct blow or falling onto a joint * can occur at any bursa located in the body (ex. shoulder, elbow, hip, knee) - treatment method can be aspirating (draining) the bursa of extra fluid

Abduction

movement away from the midline in the hand: movement away from 3rd digit in foot: movement away from 2nd digit

circumduction

movement in a circle or ellipse

Adduction

movement toward the middline in hand: movement toward midline- 3rd digit in foot: movement toward midline- 2nd digit

Joint betweenn your carpals and metacarpals

carpometacarpal (CMC) joint - synovial joints between distal row of carpals and bases of MC, or between adjacent MC NOTE: the CMC joint of digit 1 is DIFFERENT! - it is a saddle type of synovial joint between trapezium and base of 1st MC - it has separate joint cavity Allows for movement in many planes: - Abduction - Adduction - Extension (out to the side- making an L) - Flexion (fold thumb into palm) - Opposition (meet 1-5th digit) - Reposition (relax hand to normal from opposition)

In smooth muscle the nuclei are in the

center of the cell (myocyte); NOT the periphery like skeletal

Axon fascicles in the spinal cord are part of what nervous system

central nervous system

For near vision the

ciliary muscle contracts and suspensory ligaments relax- allows the lens to bulge ** controlled by parasympathetic NS (ACh is released from the parasympathetic post-ganglionic neuron and binds to muscarinic M3 receptor in ciliary smooth muscle cells, increasing calcium levels in cell and stimulating contraction of the ciliary muscle- the suspensory ligaments relax and the lens bulges)

proximal

closer to origin of the body part/pt of attachment of a limb to the trunk

The endoneruium and perineurium are manly

collagen type III

Dense REGULAR CT is comoposed of

densely packed collagen bundles and oriented into parallel arrays of fibers and cells - few cells and sparse ground substance * LOTS OF FIBERS main types: ligaments and tendons Tendons: are cord-like, join MUSCLE TO BONE; composed of parallel bundles of collagen (type I) interspersed with fibroblasts Ligaments: A short band of tough, flexible fibrous CT which connect TWO BONES, or cartilages, or holds together a joint ** ligaments are similar to tendons in most respects, but their fibers and the organization of the fascicles tend to be less ordered

Dermomyotome gives rise to

dermis of the back and skeletal muscles of limbs and trunk

The anterior tibial artery becomes the

dorsalis pedis artery as it enters the foot ** this is the artery you can feel a pulse in (and will many times throughout your medical career) on top of the foot

which cartilage instead of chondrocytes being isolated is found usually in small isogenous groups

elastic cartilage

turning the sole of the foot outward

eversion of foot

Posterior Compartment of the arm contains mostly

extensors - all innervated by the radial nerve - and receiving blood from the deep artery of the arm

true or false: the Knee joint is so stable!!!!! Like omg nothing can shake it

false!!! it is unstable and weak- a very commonly injured joint BUT THATS OK!!! bc it has some support and stabilization by the - thigh muscles - joint capsule - ligaments - Menisci (shock absorption)

which cartilage does NOT have a perichondrium

fibrocartilage

Diarthrosis means the joint is

freely moveable ** ALL synovial joints are diarthroses

BBB develops early in the embryo by as association of

glial astrocytes and capillary endothelial cells * astrocyte foot processes wrap around the endothelial cells *** experimental evidence shows that astrocytes secrete factors that induce the capillary endothelial cells to produce these extensive tight junctions

End Plate Potentials are

graded potentials - the magnitude of EPPs decreases gradually with distance from the site of origin, eventually disappearing -EPPS= ex of excitatory post-synaptic potential EPPS are: - local, brieg changes in the end plate membrane potential (-90mV to -55mV depolarization) - EPPs result from Na+ entry (and K+ efflux) through nicotinic acetylcholine receptors - Na+ ions diffuse into the muscle from the site of origin in all directions

The Sustentaculum tali in the Talus of the foot has a

groove for the tendon of flexor hallucis longus

Cancer is improper balancing of two inputs which are

growth promotion and growth inhibition (Accelerators vs. brakes) Accelerators: - Protooncogenes= normal version - Oncogenes- have been mutated to promote cell division (increased expression and activity, resistance to inactivation)- mutation of ONE copy per cell produces effect = GAIN OF FUNCTION mutations Brakes: Tumor Suppressor Genes: - Suppress cell division - LOSS OF FUNCTION mutation (sometimes epigenetic promoter inactivation) - cell must get rid of BOTH copies before it is disregulated

What is required for bone to develop from osteogenic precursors

high oxygen ** blood vessels (bringing oxygen) must already exist in close proximity BEFORE bone will start to form

If you are looking at carrier risk of offspring for autosomal recessive go with the

high risk parent ** BUT if you are looking for probability of offspring being affected- you need to take both parents into consideration

Dystrophin Gene

huge= 2.3 million BP (largest known from human genome) - mRNA encoded is 14kb from 79 exons 1/3 of cases involve new mutations - protein is large, associated with sarcolemma, involved in linking extracellular laminin with intracellular thin filaments

costal cartilages are made of

hyaline cartilage

Where is fibrocartilage located

in areas where support and tensile strength are required * a tissue intermediate between dense CT and hyaline cartilage fibrocartilage has only a very limited distribution in the body: - annulus fibrosis of intervertebral discs - pubic symphysis - menisci of knee joint

Myoepithelial Cells are located

in between gland cells and their basal lamina - when stimulated to contract, they squeeze secretions out of gland (innervated) - they are true epithelial cells- positive for keratin intermediate filaments ** they are found in: sweat glands, mammary glands, lacrimal glands, and salivary glands

In the cross bridge cycle, ATP is needed for

muscle relaxation * ATP is needed to release thick filament from thin

Single twitch

muscle relaxes completely between stimuli

Stretch detectors found among muscle fascicles are known as

muscle spindles ** consist of CT capsule surrounding a fluid-filled space that contains a few thin, NON-striated muscle fibers densely filled with nuclei called INTRAFUSAL FIBERS (several sensory nerve axons penetrate each muscle spindle and wrap around each one of these) ** changes in length (usually stretch) of surrounding STRIATED EXTRAFUSAL fibers (the muscle fibers) caused by body movements are detected by the muscle spindles and the sensory nerves relay this information to the spinal cord

Tendon attaches

muscle to bone

Myc > MAD

increase cell proliferation!

more active cross bridges mean an

increase in force generated

Increasing frequency of motor nerve stimulation

increases tension produced by muscle fiber

K+ is found mostly

intracellularly (150mM) ** cell membrane is permeable to K+ at rest - concentration difference works to move K+ from inside the cell to its lower conc. outside (K+ moves out and makes the membran inside more negative (bc K+ leaves its negative counterpart inside the cell)- as outside becomes more positive) - a negative membrane voltage acts on the positively charged K+ with a force to move it from outside back into cell (2 forces acting on K+ in opp directions): concentration force and electrical force 1. concentration force: mediated by conc. diff of K+ that moves K+ towards outside the cell 2. electrical force: mediated by the negative voltage of the membran that moves K+ into the cell

In a slide displaying intramembrnaous ossification

irregular spicules of developing bone are visible - the vascular mesenchyme in the region is the primitive marrow

Dense IRREGUGULAR CT

is diff from regular because its fibers are arranged in bundles and are oriented in various directions rather than in parallel arrays ** this arrangement gives significant strength to withstand stresses (stretching and distension) Some locations: - dermis of skin - submmucosa of intestines - organ capsules (kidney, spleen, etc)

Which ligament stabilizes the hip joint posteriorly

ischiofemoral ligament - connects ischial part os acetabulum to neck of femur, located posteriorly

Each gland in breast tissue is drained by a

lactiferous duct, which dilates into a sinus (lactiferous sinus) & narrows again into a duct (lactiferous duct)

each chondrocyte can be found in a

lacuna

Axillary lymph node dissection has risk of damaging

long thoracic nerve and thoracodorsal nerve ** axillary lymph node dissection often needed for staging and determining appropriate treatment of cancer (ex. breast cancer)

Erosin

loss of part or all of the epidermis - may occur after a vesicle or bull dforms and the top peels off - they weep and become crusted - usually DO NOT heal with scars

Body temperature normally fluctuates over the day, as controlled by a persons circadian rhythm and activity- can you describe this

lowest levels are around 4-6am and the highest levels around 4-6pm (for a person who sleeps at night and stays awake during the day)

Lymphatic drainage of the breast is important to understanding the

metastasis of cancer cells

Another name for a genetic marker

microsatellite (a polymorphism)

Calcium and phosphorous are incorporated into the matrix- this is called

mineralization

Most epithelial cells renew continuously by

mitosis - the cells continuously wear out and are replaces by new cells ex. epidermis of skin

What is the normal function of the Superficial Fibular Nerve (branch of the common fibular nerve L4-S2)

motor and sensory Motor: normal strength and action of foot evertors (fibularis longus and brevis muscles in lateral leg) Sensory: normal skin sensation along dorsum of the foot (except skin between digits 1 and 2)

Nictotinic acetylcholine receptors are located in the

motor end plate of the muscle cell membrane

Melanocytes and Merkel cells are derived from

neural crest cells ** merkel cells act as pressure receptors *** melanocytes (in stratum basale of epidermis)- synthesize melanin pigment and transfer it to keratinocytes to protect against damage caused by UV radiation. (melanocytes sometimes give rise to a form of skin cancer called malignant melanoma)

Cleft Vertebrae (Cleft Spine/ Spina Bifida)

one of the most serious vertebral defects is the result of imperfect fusion or non-union of the vertebral arches - it may only involve the body vertebral arches, leaving the spinal cord intact (spina bifida occulta) ** remember the dorsal sclerotome will move to form the vertebral arch of the vertebrae

A Cutaneous Nerve is

one or more spinal nerves combine to form a specific named nerve that transmits sensory information from an area skin

Can you see pisiform for your palmar or dorsal aspect of hand

only seen from palmar!

across a membrane there are equal counts of

positive and negative charges

The posterior fontanelle often closes within the first ____ of age. The anterior fontanelle closes between ____ of age

posterior closes: within first 1-2 months anterior closes: between 7-19 months

Hydrolysis of ATP by Ca2+- ATPase in the SR

provides energy for active transport of Ca2+ into the SR, lowering calcium concentration and allowing relaxation

Supine

pt lying face up * supine= lying on the spine

Describe anatomical position

pt standing erect with feet flat on the floor, facing forward arms at the side with palms facing forward head, feet, and palms facing forward

Early closure of the sagittal suture

scaphocephaly (narrow and long head)

Peripheral sensory cutaneous innervation is the

sensory supply to a region of the body of a terminal branch/nerve - it can supply sensory nerves from multiple spinal nerves

Somatic translocation means a translocation that happened in a

somatic cell (ex. in a precursor cell for lymphomas) ** normal cells from the same person WILL NOT contain this translocation

Sarcoplasmic reticulum is a

specialized type of smooth ER that regulates the calcium ion concentration in the cytoplasm of straited muscle cells, forms an elaborate structure together with the sarcolemma

Complete tetanus

stimuli so close together that relaxation is not possible - tension increases to maximum tension * arises when time between successive action potentials in insufficient to return enough calcium to the SR to lower calcium concentration below a level that initiates relaxation

Pemphigus Vulgaris involves separation of

stratum basale and stratum spinosum of the epidermis

Synthesis of Vitamin D3 occurs primarily in the

stratum basale and stratum spinosum of the epidermis - the skin is the major source of Vitamin D3 : it enhances intesinal absoprtion of calcium and phosphate- essential for development of healthy bones and teeth * deficiency of vitamin D3 leads to osteomalacia in adults and rickets in children

passage through the ___ is the rate limiting step for percutaneous drug absoprtion

stratum corneum

In a full urinary bladder, the volume of urine has

stretched the lining to such a degree that the epithelium appears flattened, and more like a stratified squamous epithelium "Distended or Stretched"

What gives breast their shape

suspensory ligaments

Constriction of cutaneous blood vessels is mediated via

sympathetic (norepinephrine) stimulation of alpha-1 adrenoceptos on vascular smooth muscle cells

Brown fat thermogenesis (non-shivering thermogenesis) is mediated by

sympathetic (norepinephrine) stimulation of beta-3-adrenoceptors on BAT

As sarcomere length become increasingly shorter than the optimal length, the

tension that can develop again decreases (too much overlap in sarcomere) ** this is why normally resting muscle fiber length is held verryy close to optimal length (Lo) by firm attachments of skeletal muscle to bones (via tendons)

What makes the glenohumeral joint unique?

the tendon of the long head of biceps brachii travels through the joint-- the tendon is surrounded by a synovial membrane

Why do muscles get bigger in body building?

the trauma induced from weight lifting activates the satellite cells to proliferate at the injury site - the satellite cells fuse together as well as to other muscel fibers leading to increase in muscle fiber cross-sectional area or hypertrophy (same amount of muscle fibers they just get larger)

Stratum lucidum is only visible in

thick skin ** skin is thickest in the palm of the hand and the sole of the foot- where the skin is subject to constant abrasion ("wear and tear"

Why would gap junctions want to close?

to prevent the death of one cell from also killing every cell attached to it - so in the presence of high Ca2+ (which looks the extracellular fluid) and low pH (which looks like leakage from lysosomes) WILL STIMULATE CLOSURE OF GAP JUNCTIONS

Superficial, external

toward or at the body surface

posterior, dorsal

toward the back of the body

inferior, caudal

toward the feet

anterior, ventral

toward the front of the body

Nerves of the breast are

transmitted from the anterior & lateral cutaneous branches of the 4-6th intercostal nerves - they pierce the pectoral fascia to reach subcutaneous tissue and skin - somatic sensory fibers to skin, sympathetic to blood vessels & smooth muscles of skin and nipples

The vertebral artery passes through the

transverse foramen

when ___ molecules of ACh bind to the receptor, the channel gate opens and allows monovalent cations (Na+ and K+) to flow through. Net Na+ influx through this nonspecific cation channel dominantes K+ efflux, and the resulting increase in Na+ conductance produces a dopolarizing potential in the post-synaptic membrane

two

haversian (central) canals carry blood

vertically

Coronal plane

vertically oriented plane - divides body into anterior and posterior parts (can slide more anterior or posterior does not have to be in exact middle think: "corona" or crown

Sagittal plane

vertically oriented plane - divides the body into right and left parts - sagittal means "arrow"

your carpals refer to your

wrist

in what layer does cartilage die in endochondral ossifaction

zone of calcification * the dead of dying chondrocytes leave behind cavities that will later be invaded by bone-forming cells. Chondrocytes here die when they can no longer receive nutrients or eliminate wastes via diffusion. this is because the calcified matrix is much less hydrated than hyaline cartilage

Extracellular Matrix which makes up 95% of the total cartilage volume its composed of

- 70-80% water - 10-20% collagen (mostly type 2) - 10-15% proteoglycans (PG): composed of subunits called- glycosaminoglycans (GAGs) ** these help to soak up H2O and interact with collagen and elastic fibers ** ECM consists of an organized and dense network of thin collagen fibers embedded in a concentrated solution of proteoglycans

What muscles are found in the 1st layer of the Sole/ Plantar foot

- Abductor Hallucis: abducts and flexus hallux (1st digit- hallux/big toe) - Flexor digitorum brevis (flexes 2nd-5th toes) - Abductor digiti minimi (abducts and flexes little toe/ 5th digit) *** all 3 originate on the calcaneus and insert onto the toes

In an autosomal recessive disease if the individual has two bad alleles their probability of passing it on is

1

An affected parent in an autosomal recessive disease (like cystic fibrosis) has a risk of

1 for being affected and risk of 1 for passing on the disease causing allele

Origin and Innervation of Medial Pectoral Nerve

C8, T1 Pectoralis Major M. Pectoralis Minor M.

Ulnar Nerve

C8, T1 Innervates: - Flexor carpi ulnaris - Flexor digitorum profundus (1/2) - Palmaris brevis - Flexor digiti minimi - Abductor digiti minimi - Opponens digiti minimi - Adductor pollicia - Palmar interosseous muscles - Dorsal interosseous muslces - 3rd and 4th lumbricals Cutaneous branches: - Deep branch of ulnar nerve - Dorsal branch of ulnar nerve - Dorsal digital nerves - Common palmar digital nerves - Proper palmar digital nerves ** Sensation for ulnar nerve goes toward medial aspect of wrist and whole 5th digit and medial half of 4th digit

Part of describing lesions is noting distribution and configuration. What do each of these mean

Distribution: location on the body Configuration: how lesions are arranged or relate to each other

Supraclavicular branches of the brachial plexus

Dorsal Scapular Nerve Long Thoracic Nerve Nerve to Subclavius Suprascapular Nerve

Which are the main players of the scapular anastomoses

Dorsal scapular Suprascapular (Via Circumflex Scapular) subscapular arteries *** subscapular atery receives blood through anastomoses with suprascapular a., dorsal scapular a., & intercostal aa.

The Inferior Gemellus and Quadratus Femoris (small lateral rotators of the thigh) are innervated by

Nerve to Quadratus Femoris

Skull (the parts that are NOT dervide from the paraxial mesoderm) are derived from the

Neural Crest Cells - Viserocrainium, Frontal, Spenoid, and Sq. Temporal Bones

Number of Thoracic Vertebrae

n=12

Number of Lumbar Vertebrae

n=5

Number of Cervical Vertebrae

n=7

which bone articulates with the anterior (distal) talus

navicular

Nerves are cordlike bundles of

nerve fibers surrounded by CT sheaths - they are visible to the naked eye and usually appear whitish due to the presence of myelin (except for very thin nerves that can lack myelin) ** nerve fiber= the axon (or dendrite) of a neuron (but NOT the cell body)

The mandible, frontal, sphenoid, and maxilla are all from

neural crest cell origin

A motor neuron joins to skeletal muscle at a

neuromuscular junction

Example of Chemical Synapse

neuromuscular junction - synapse of a somatic motor neuron with a skeletal muscle fiber ** there is only one such junction per muscle fiber

During which is there work being performed: isotonic or isometric contraction

no external work is performed in isometric contraction because load is not moved - isotonic contraction, works is ALWAYS performed because the muscle shortens and load is moved

If a sympathetic nerves "job" is to innervated blood vessels or sweat glands of the skin, those axons will synapse in the

paravertebral ganglion and then travel back through the GRAY rami communicans to leave the sympathetic chain and enter the spinal nerve and from here it can go out to the periphery either through the Dorsal Primary rami or the ventral primary rami depending on where in the body the signal is going to ** one exception is the innervation of the adrenal gland -- there is no synapse in the prevertebral ganglion- the preganglionic axons synsapse directly in the adrenal medulla

The axial skeleton is developed from

paraxial mesoderm - parts of the skull, vertebral column and ribs

The parietal bone, and spinous processes of vertebrae is of

paraxial mesoderm origin

The second part of the axillary artery lies posterior to the

pectoralis minor and has 2 branches: Thoracoacromial Artery (divides into 4 branches (deep to pectoralis minor) - Clavicular artery - Acromial artery - Deltoid artery - Pectoral artery Lateral Thoracic Artery

Deep fascia of the foot

pedal fascia

The deep fascia of the foot is referred to as the

pedal fascia - it covers the dorsal and plantar surfaces of the foot

Cranial nerves III-XII are part of what nervous system

peripheral nervous system

A true hamstring muscle is defined as a

posterior thigh muscle that attaches to ischial tuberosity and is innervated by tibial division of the sciatic nerve

medial plantar artery comes from

posterior tibial artery

which portion of a chemical synapse contains receptors for neurotransmitter and ion channels or other mechnisms to initiate a new action potential

postsynaptic cell membrane

Right and Left

refers to the PATIENTS right or left, it is the patient you are examining

Activation of myosin light chain phosphatase will cause

relaxtion of vascular smooth muscle ** this dephosphorylates myosin light chains- inhibiting myosin and actin interaction and promoting relaxation

Parasympathetic preganglionic and postganglionic neurons, as well as sympathetic PRE-ganglionic neurons

release ACh ** the sympathetic POST-ganglionic neurons release NE at most target tissues

Elastic cartilage is found in structures subjected to

repeated deformation or vibration (why it needs to be elastic) found in: - external ear - epiglottis - some small cartilages of the larynx

Death of osteocytes (by trauma, senescence, or apoptosis) results in

resorption of matrix by ostoclasts

Both cardiac and smooth muscle are derived from

splanchnic mesoderm ** EXCEPT smooth m of pupil, mammary and sweat glands which are of neuroectodermal origin

osteoclasts normally have a ___ adjacent to the bony surface

striated border *usually they are found in small indentations of lacunae in the bone (howships lacunae)

Lymph passes from the nipple, areola, and lobules to the

subareaolar plexus

The vertebral artery is a branch from the

subclavian artery - it travels through the transverse foramen of C6-C1 --> passes medially along the POSTERIOR arch of C1--> passes superiorly through the foramne magnum to supply the brain ** when blood flow is reduced (ex. arteriosclerosis), prolonged turning of the head my reduce the blood flow to the brain, causing light-headedness, dizziness, and other symptoms

Describe lymph drainage of the upper limb

superficial lymphatic vessels, originating from digital lymphatic vessels of digits and lymphatic plexus of palm, drain from the palm to the DORSUM of the hand - the vessesl ascend thorugh the forearm and arm, converging toward the cephalic and basilic vv. *** Lymph following the CEPHALIC v. drains directly into the APICAL axillary lymph nodes **** Lymph from the rest of the upper limb drains into the HUMERAL (Lateral) lymph nodes before draining to the central lymph nodes

Cutaneous Nerves (Peripheral Sensory Cutaneous innervation of the back)

supplies an area of the skin that is realted to a peripheral nerve - any cutaneous nerve may contain fibers from several individual spinal nerves - cutaneous nerve areas and dermatome areas show much overlapping - a cutaneous nerve area is generally broader and wider than an area supplied by only a single spinal (dermatome) nerve

Osteoblasts are exclusively located at the

surface of bone can be: Flattened (inactive) or cuboidal to columnar (active) ** they have LOTS of rER and secretory vesicles because they synthesize and secrete the organic matrix of bone: - collagen type I - proteoglycans - GAGs - glycoproteins ** vesicles are exocytosed to form osteoid (uncalcified/unmineralized bone matrix)

Aqueous humor flow is produced under

sympathetic stimulation at the ciliary epithelium and exits under parasympathetic control at the canal of schlemm when the ciliary muscle contracts (increased parasympathetic stimulation- ACh- increases aqueous humor outflow)

Name for a 20-30nm wide intercellular space that separates the pre- and postsynaptic membrane

synaptic cleft

Somites give rist to the

sclerotome and dermamyotome

Reticular fibers (Type III collagen) commonly provides

support in the endoneurium of nerves and also in small blood vessels

Heart rate is regulated by

sympathetic and parasympathetic nervous system

Aneurysm of the axillary artery occurs in the

1st part of axillary artery - it compresses TRUNKS of brachial plexus - causes pain, anesthesia (loss of sensation)

3 criteria for Social impairment in DSM-5 Criteria for substance use disorder

5. recurrent use resulting in failure to fufill major role obligations at work, school, or home 6. continued use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance 7. important social, occupational, or recreational activities are given up or reduced because of substance use

In the ____ limb rotation occurs in opposing direction in upper and lower limbs

7th week - causes sensory dermatomes to spiral around the limb - also changes the position of the limb musculature Upper limb: flexors face anteriorly Lower limb: flexors face posteriorly

What is the one and only muscle found in the ADductor compartment of the palm

Adductor Pollicis I: deep branch of ULNAR nerve Fx: ADducts thumb towards lateral palm

which muscle of the HYPOthenar compartment does ABduction of digit 5

ABductor digiti minimi

Which muscles are in the HYPOthenar compartment of the palm

ABductor digiti minimi Flexor digiti minimi brevis Opponens Digiti Minimi ALL I: deep branch of ULNAR nerve

What occurs if there is an injury to the Femoral Nerve (L2, L3, L4)

Abnormal muscle function and sensation - Weakness or inability to extend knee, flex thigh - Decrease of loss of skin sensation along anterior thigh, anterior-medial leg, medial side of foot

Binding of ___ causesd myosin to dissociate from actin

ATP ** in absence of ATP, myosin will remain bound to actin (muscle in a state of rigor)

Energy for muscle contraction is provided by

ATP hydrolysis

What would cause sudden severe onset of pain on inside of the elbow, numbness and tingling in forearm and 4th and 5th digits, claw hand deformity

Avulsion fracture of medial epicondyle -can cause ulnar nerve irritation or injury * usually affects children 9-14 yrs old, baseball/softball pitchers or caused by a fall causing sever abduction of an extended elbow

In the Quadrangular Space you can find

Axillary Nerve (C5-C6) - travels from the anterior aspect of the scapula between the lateral border & the humerus through the quadrangular space to innervate the deltoid and teres minor Posterior Circumflex Humeral A.

Which nerves can be doung in the scapular region

Axillary Nerve (C5-C6) Posterior Cord of the Brachial Plexus Thoracodorsal Nerve (C6-C8) Upper (C5) and lower (C6) subscapular nerves: branches off the posterior cord of the brachial plexus to subscapularis and for lower subscapular, to teres major

Eosin is an ACIDIC dye so it stains

BASIC structures it stains them pink, red, or orange - Cytoplasm - Mitochondria (due to membrane proteins) - lysosomes (due to enzymes) - collagen (Type I is a big one) - Muscle * these structures are said to be acidophilic or eosinophilic

Which adipose tissue is in fetal life and the newborn

Brown (multilocular) adipose tissue - it diminishes during the 1st 10 yrs - it contains many fat droplets and many mitochondria (give it a darker color) ** it uncouples ATP production- makes heat instead

Origin and Innervation of the Dorsal Scapular Nerve

C5 - Levator Scapulae - Rhomboid Major - Rhomboid Minor

Oirgin and Innervation of Upper Subscapular Nerve

C5 ( branches off posterior cord) Subscapularis m.

Origin and Innervation of Nerve to Subclavius

C5, C6 - Subclavius

Axillary Nerve

C5, C6 Innervates: - Deltoid - Teres Minor Cutaneous branches to: Superior Lateral Brachial Cutaneous nerve (sensation to deltoid/ skin overlying superior part of arm)

Oirgin and Innervation of Lateral Pectoral Nerve

C5, C6, C7 Pectoralis Major M

If dystrophin is absent

DMD (Duchenne Muscular Dystrophy)

Injury to what nerve would cause foot drop

Deep Fibular Nerve

___ mediate adhesion between keratinocytes

Desmosomes

The process by which circulating leukocytes leave the capillaries and veins and enter CT (thus they are wandering cells in CT) is called

Diapedesis (this is just crossing the wall of the blood vessel) - the whole process= extravasation Leukocytes are very common cell types found in Loose CT - they protect the body from infection by microorganisms - most are produced in bone marrow and released into bloodstream but function OUTSIDE the bloodstream in LOOSE CT Leukocyte types: - neutrophils - lymphocytes (B,T, and natural killer) - eosinophils - basophils - monocytes/ macrophages

Structure of a typical long bone consists of

Diaphysis - shaft of long bone, consisting of a tube of compact bone enclosing the medullary cavity Epiphyses - long bones bulbous end - contians cancellous bone - forms joints with other bones Metaphysis - between dia and epiphysis - extends up to epiphyseal line - during childhood, the metaphysis consist of cartilage and is the part of bone that grows

Which proteins aid in the priming and fusion steps of the vesicle fusiing with the presynaptic membrane (remember the steps were 1. docking 2. priming 3. fusion 4. exocytosis)

During priming: - the vesicle membrane protein Synaptobrevin and presynaptic plasma membrane proteins Syntazin and SNAP-25 bind to eachother forming a SNARE COMPLEX. ** this brings the vesicle membrnae into close proximtiy with the pre-synaptic plasma membrane *** remember Botulinum Toxim cleaves SNARE proteins, eliminating vesicle exocytosis and inhibitiring neuromuscular transmission- causes muscle paralysis, weakness, and death --> BOTOX During Fusion: Calcium binds to synaptic vesicle protein SYNAPTOTAGMIN allowing it to insert into the membrane and bind with the SNARE complex- the membranes are permitted to fuse

2 ways the papilloma virus induces cancer

E6 protein - binds to p53 and induces breack down of that protein (decreases control) and E7 protein - binds to Rb-E2F complex and induce release of E2F (increases cell division) ** the "E" in these means- early (so these proteins are expressed early after the cell gets infected with the papilloma virus

The replacement of cartilage with bone

Endochondral ossification * during embryonic development, most of the skeleton is first formed of cartilage- these cells are capable of dividing UNLIKE mature bone cells, which are enclosed in solid matrix * cartilage model can grow as rapidly as fetus does ** beginning at 3rd month and through prenatal development, the cartilage is gradually replaced by bone

The posterior aspect of the pelvis comprising buttocks and hip region is referred to as the

Gluteal Region * contains muscles that ABduct and laterally rotate the thigh

What permits diffusion of gases, nutrients and waste products in the cell

Ground substance * it occupies the spaces between cells and fibers, it is a viscous clear substance with a slippery feel and high water content - it appears amorphour (shapeless, formless) and is lost in tissue preparation, shows up as an empty background in sections Consists of mainly 3 things in water 1. Glycosaminoglycans (GAGs)- ex. dermatan sulfate, keratan sulfate, hyalyronan 2. Proteoglycans- ex. aggrecan, syndecan .3 Multiadhesive glycoproteins- ex. fibronectin and laminin ***these 3 interact with each other, with fibers, and with cells

Beta-adrenoceptors activate

Gs which activate adenylate cyclase

Ulnar nerve and artery travel through

Guyons Canal - towards 5th digit- more superficial

Adductor Magnus

In medial compartment of the thigh Proximal attachment: hamstring part attaches to ischial tuberosity Distal attachment: hamstring part attaches to adductor tubercle I: Obturator Nerve and Tibial Division of Sciatic Nerve Action: Adducts thigh at hip joint

The action potential begins at the

Initial Segment (IS)- unmyelinated portion of the axon * the action potential is capable of traveling long distances along the neuronal processes, transmitting signals to - other neurons - muscles - glands ** axon becomes depolarized- this spreads down axon

Innervation, insertion, action of Teres Minor

Innervation: Axillary Nerve (terminal branch) Insertion: Greater Tubercle of humerus Action: - laterally rotates the arm - stabilizes the glenohumeral joint

Which vertebral ligament connects adjoining spinous processes

Interspinous Ligament * keeps spinous processes together

what are two ways that cartilage can grow

Interstitial Growth and appositional growth

Between all vertebrae you have

Intervertebral Discs (IV)

Connective Tissue Propers includes

Loose CT Dense CT (regular or irregular)

Vasculature of the breast includes

Lateral thoracic artery - branch of axillary artery - it gives lateral mammary branches Internal thoracic artery - branch of subclavian artery - give medial mammary branches from anterior intercostal arteries Posterior intercostal arteries - (generally) branches from thoracic aorta - gives lateral mammary branches from lateral cutaneous branches

A glial cell that is the resident macrophase of the brain and spinal cord

Micoglial Cell ** this is the first and main form of active immune defense in the CNS - these descended from monocytes (a type of WBC) and originated in bone marrow, enter the bloodstream, and crawl into tissue in the mononuclear phagocyte system

Does synaptotagmin bind calcium in the SR

NO!!! in the this occurs in the neuromuscular junction

Which cells secrete osteoid

OSTEOBLASTS! components of osteoid: - type I collagen (90% of protein in bone) which binds osteoclacin and osteonectin (calcium binding proteins) - alkaline phophatase (ALP) ALP is responsible for crystallization of CaPO4 arouns the type 1 collagen matrix *** circulating levels of ALP are used clinically as a marker of osteoblast activity

What are the 2 regions of the CNS that the Parasympathetic division arises from

Parasympathetic= CRANIOSACRAL - pre-ganglionic cell bodies associated with cranial nerves III, VII, IX, X (3,7,9,10) and in cell bodies in S2-S4 in the spinal cord Parasympathetic has LONG pre-ganglionic component and SHORT post-ganglionic component * the splanchnic nerves carrying parasympathetic axons from the sacral spinal cord levels are called "Pelvic Splanchnic Nerves"

"Cauliflower ear" is a condition that occurs when the external portion of the ear suffers a blow, BLOOD clot, or other collection of fluid under the

Perichondrium ** this separates cartilage from overlying perichondrium that supplies its nutrients, causing the cartilage cells to die and resulting in the formation of fibrous tissue (scar tissue- collagen I) in the overlying skin - the outer ear becomes permanently swollen and deformed resembling a cauliflower * most common in wrestlers, mixed martial artisits and rugby players; usually a cauliflower ear is result of repetitive injuries

Exterior of long bones is covered with CT membrane called the

Periosteum (has 2 layers) 1. outer: Dense fibrous CT, merges with ligaments and other CT 2. inner: contains osteoprogenitor cells with potential to differentiate into osteoblasts

Digits develop prematurely proximal elements of the limb absent aka flipper limb (associated with Thalidomide). Partial loss of FGF or Hox disruption

Phocomelia

The general "rule" for the autonomic nervous system (sympathetic or parasympathetic) is that the pre-ganglionic axons are ____and the post- ganglionic are ____

Pre-ganglionic are myelinated Post-ganglionic are unmyelinated

Pseudostratified Columnar Epithelium can be found in the

Respiratory Epithelium: lines a major portion of the respiratory airways "ciliated pseudostratified columnar epithelium with goblet cells" - contains 5 different cell types. ALL touch the basal lamina but not all reach apical surface- "pseudostratified"-looks stratified but isnt and Epididymis (testis)- "pseudostratified columnar epithelia with sterecilia"

The brachial plexus is broadly divided into

Roots (Anterior Rami) Trunks Divisions Cords Terminal Branches (Peripheral Nerves) " Real Texans Drink Cold Beer "

The sympathetic nervous system is said to have a _____ pre-ganglionic and ____ post-ganglionic component

Short pre-ganglionic component Long post-ganglionic component

Which muscle has striated sarcomeres and binds to troponin

Skeletal muscle

What is the reverse of a colles fracture

Smith fracture - much less common fractur of the distal radius, it occurs more frequently in younger individuals Cause: (flexion fracture) dalling onto flexed wrists; impact on dorsum of hand Presentation: - complete transverse fracture of distal radius - distal radial fragment is displaced ventrally - ulnar styloid process may be avulsed Associated injuries: - acute carpal tunnel syndrome - compressive neuropathy - ischemia

Ex of Metaplasia of Respiratory Epithelium

Squamous Metaplasia Regions of the lining of the respiratory tract of heavy smokers can undergo metaplasia - the normal lining of most of the respiratory system is ciliated pseudostratified columnar epithelium with goblet cells ( a cell type that secretes mucus) - in response to the irritation of cigarette smoke, this epithelia changes to stratified squamous epithelium (loses cilia and goblet cells) to protect itself this can lead to "smokers cough"- more debris entering lungs and fewer ciliated and mucus-secreting cells to clear it out

Superficial veins of the arm

Subclavian vein Axillary vein Cephalic vein Basilic vein

Botox inhibits

The fusion step during regulated exocytosis of the synaptic vesicles (at the neuromuscular junction) ** botox blocks the release of ACh so that the muscle CANNOT contract

A single surface is usually NOT lined by several types of epithelia, even though it may look like it...

The number of epithelial cell layers will usually be the SMALLEST number of layers visible anywhere along the surface lined by the epithelium

What is a Burst (Jefferson) fracture

This is a fracture and dislocation of the Atlas (C1) - compressive loading along the cervical spine results in the occipital condyles being driven into the lateral masses (LM) of C1 - this often occurs as a four part fracture with double fractures through the anterior and posterior arches - this occurs when diving head first into shallow water or after falling from a tall building

What would cause a Winged Sacpula

This is a pathology of the brachial plexus - A winged scapula is due to a paralyzed long thoracic nerve ** to see this you would have to ask someone to press against the wall * C5, C6, C7- wings to heaven

Which muscle of the anterior compartment of the leg Dorsiflexs the ankle joint ANDDDDD inverts the foot

Tibialis Anterior I: Deep Fibular Nerve

What drugs are retinoids

Tretinoin Isotretinoin Adapalene Tazarotene

Radial Nerve can be found in the

Triangular Interval

Two examples of autocrine stimulation in risk of cancer in genetics

Viral and Non-viral Platelet Derived Growth Factor (PDGF) Viral: - Simian (relating to monkeys) sarcoma virus expresses a protein (v-SIS) which is derived from PDGF - protein release --> stimulate PDGF receptor --> stimulate cell proliferation Non-viral: - High-grade glioma (cancer in the brain) - overexpresses PDGF (and other growth factors) - often also overexpress the receptors - Protein release --> stimulate receptor --> stimulate cell proliferation

If one copy of tumor suppressor gene fails but the second works. Can a cell resist cell division?

YES! you need to lose BOTH copies for disregulation this is the TWO HIT HYPOTHESIS - for a tumor suppressor gene: one inactivated copy will NOT change the likelihood of cell to divide ** in INHERITED cancers, the first inactive copy is inherited; only cells that inactivate copy number 2 will start the road to cancer (this happens frequently- cancer syndroms therefore usuallt show dominant inheritance but with reduced penetrance * for SPORADIC cancers, both inactivation events have to happen in the SAME cell before a cancer results (second inactivation events can be somatic mutation, inactivation by methylation, loss of heterozygosity, etc)

alpha2 receptors inhibit

adenylate cyclase and decrease cAMP levels

a spinal nerve contains

afferent and efferent axons

When asessing blood pressure you place the cuff

around the mid-arm, this compresses brachial artery against humeral shaft

The risk for having Cystic Fibrosis as a results of regular inheritance is much higher than

as a result of two new mutations

Multiple Sclerosis (MS) is an

autoimmune demyelinating disorder * the lesions (sclerae) of MS are caused by an immune response that is directed against the components of the myelin sheath in the brain and spinal cord (CNS) early sxs include - weakness - tingling - numbness - blurred vision ** the exact nature of the deficit depends on the area of the CNS affected - has a prevalance of apprx. 1/1000 persons in most of the US and Europe

Deep, internal

away from the surface of the body

The synaptic end- information transfer end of a neuron

axon terminal

immediately before an increase in calcium what is bound to myosin head and in what state are myosin and actin

before an increase in calcium ADP + P are bound to the myosin head and actin and myosin are detached

A ligament attaches

bone to bone

What does the scapula articulate with

clavicle and humerus

Path of median nerve (C6-T1; off the medial and lateral cords of brachial plexus) in forearm

enters the cubital fossa medial to brachial artery- exits the cubital fossa (TAN- biceps brachii tendon, brachial artery, median nerve) by passing between heads of pronator teres- moves through the fascial plane between flexor digitorum superficialis and flexor digitorum profundus * it runs deep to palmaris longus and into carpal tunnel EXCEPT the palmar cuaneous branch of the median nerve

Pathway of the radial nerve in the forearm

enters the forearm between brachioradialis and brachialis -branchs anterior to the lateral epicondyle into deep (motor) and superficial branches (sensory) - superficial branch descends between pronator teres and brachioradialis, joiing with the radial artery, then curves back over brachioradialis distally and divides into many superficial nerves - deep branch penetrates supinator and becomes the posterior interosseous nerve as it leaves supinator

A scar is an area of ___ that replaces normal skin after an injury

fibrous tissue - it is composed (mostly) of collagen type I - usually formed by fibroblasts - collagen and scarring are the glue by which the human body heals wounds ** this is why you get stitches to prevent a scar- you have to reform epithelial layer of keratinocytes, if you dont get stitches after a deep/wide cute, you can/will fill up the colalgen- this causes a scar

osteon=

haversian system - the functional subunity of CORTICAL bone - each osteon consists of concentric layers or lamellae, of compact bone tissue that surround a central canal, the Haversian canal * the center of the cylinder contains the neurovasculature to provide the nutrient supply to bone tissue - osteons follow a gental spiral around the long axis of the bone - 1 cm of cortical bone displays many thousands of osteons

In X-linked recessive if the father is completely normal

he does not have the disease and cannot pass it on - he would have a completely normal XY ** a healthy male is NOT a carrier in an x-linked recessive disease: he has only one X

All the gluteus muscles (maximus, medius, minimus) have a proximal attachment to the

ilium

The body is always producing heat and therefore must continuously dissipate heat and it achieves this by

increasing blood flow to the skin (increased cutaneous blood flow)

artificial hypothermia is

induced in controlled situations (ex. prior to surgary)

Subdiaphragmatic lymph nodes receive lymph typically from the

inferior quadrants

Prevertebral Ganglion are found

infront/ before the vertebral column - located on the aorta- situated around base of blood vessels. They follow the vessels to their location

Back Sprain

injury in which ONLY ligamentous tissue, or the attachment of ligament to bone, is involved, without dislocation or fracture - it results from strong contractions related to movements of the vertebral column (ex. Excessive extension or rotation) can be - Grade I sprain: stretching, small tear - Grade II sprain: larger, but incomplete tear - Grade III sprain: Complete tear

the fibrous joint that keeps radius and ulna together

interosseous membrane

all segments of extremities are present but abnormally short

micromelia

other names for the hip bone

os coxae or innominate bone or pelvic bone

Bone is 33% organic component which is

oseoid but also is 39% calcium 17% phosphate

dead cartilage is replaced by bone in the zone of

ossification osteoprogenitor cells --> osteoblasts --> matrix that becomes calcified on surface of calcified cartilage--> followed by resorption of calcified cartilage/calcified bone complex (by osteoblasts/chondroclasts)

organic component of bone is called

osteoid (before it is mineralized) ** constitutes ~50% of bone volume and ~25% of bone weight - consists of fibers and ground substance - 90-95% of fibers are collagen type I but also there are some small amounts of Type V, III, XI, XIII Ground substance serves as a - hydroxyapatite crystal nucelation site *contains: glycosaminoglycans (hyaluronan, chondroitin sulfate, keratan sulfate) and glycoproteins (osteocalcin, osteonectin, osteopontin) *** bone stains eosinophilc

an ion with an equilibrium potential closer to resting potential is much more

permeable - the further, the less permeable ** you can only change membrane potential, never equilibrium potential

Prone

pt lying face down

Oxidative fibers are divided into

slow-twitch fibers and fast-twitch fibers on the basis of their contraction speed - Slow-oxidative fibers: resistant to fatigue and can produce sustained contractions for many hours (ex. quadriceps and gluteal muscles that continually maintain posture while standing) - Fast-oxidative fibers: (an intermediate between slow-oxidative and fast glycolytic fibers) they can use aerobic or anaerobic cellular respiration to generate ATP and have high-to-moderate resistance to fatigue

Schmidt- Lanterman Clefts are

small pockets of cytoplasm left behind during the Schwann Cell Myelination process

Arrector pili muscle is made of

smooth muscle ** these cause goose-bumps ** innervated by sympathetic nerve fibers (cold and fear sitmulate them)

Mallory trichome stain is usually used to distinguish

smooth muscle from CT - collagen stains blue/green - muscle stains red/purple

Pyrogenic pathogens

stimulate release of interleukin-1 and other cytokines from immune cells which act to increase production of prostaglandins, ultimately raising the hypothalamic temperature set-point * hypothalamus now "think" that the body temp is too low (bc the core body temp is lower than the new set-point temp) and initiates mechanisms for generating heat like: - shivering - vasoconstriction - shunting blood away from venous plexus near the skin surface

Summation

stimuli closer together do not allow muscle fiber to relax fully after contraction. Twitches summate

What occurs when the knee is fully extended while standing

the Knee joint passively "locks" - due to medial rotation of femoral condyles on tibial plateau - makes lower limb solid and adapted for weight-bearing **** contraction of POPLITEUS m. UNLOCKS the knee so the knee joing can flex - popliteus tendon (attached to lateral femoral condyle) rotates femur laterally 5 degrees on tibial plateau

location for most accurate measurement of core body temp?

the anus ** temp of forehead will give an indication as to skin temperature- which is NOT a good estimate of core body temp

Tension generated by a muscle fiber is directly proportional to

the number of cross-bridges formed between the thick and thin filaments - L< Lo= too much overlap in sarcomere, tension dereases - L= Lo= optimal overlap (resting length, produces max tension) - L> Lo= barely any overlap (tension decreases)- as sarcomeres of muscle fiber stretched to a longer length, zone of overlap shortens and fewer myosin heads can make contact with actin ** note: cross-bridges can only form when thin and thick filaments overlap This is called the LENGTH-TENSION RELATIONSHIP: the length of the sarcomere has a direct influence on the force generated when the sarcomere shortens

Structure of smooth muscle

thin filaments (actin and tropomyosin) and thick filaments (myosin) NOT arranged into sarcomeres- form a diamond-shaped lattice - Dense bodies are positioned throughout cytoplasm and attached to plasma membrane by intermediate filaments- anchor actin - Myosin filaments are long with heads along the entire length -actin-myosin overlap permitted along entire length facilitating stretching and force generation

What is functionally similar to a Z-disc in smooth muscle

thin filaments attaching to dense bodies ** the sliding filament mechanism generates tension which transfers to intermediate filaments

If ACh causes pupil constriction- blocking its action would cause

pupil dilation

Neoplasm

(synonym= tumor) a MASS of cells which grow without host control

Is the teres major part of the rotator cuff?

NO! only the teres minor

What are 3 spaces that are associated with the meningeal coverings of the spinal cord

1. Epidural 2. Subdural 3. Subarachnoid

The axial skeleton consists of the

- cranium - vertebral column - ribs - Manubrium - Sternum

In autosomal recessive disease a person with genotype Aa has a carrier risk of

1

N1 nicotinic acteylcholine receptors bind to

ACh

Ryanodine receptor is a

Ca2+ channel on the SR

True or false: there are a multitude of fibroblasts and collagen in the CNS

FALSE!!! NO! there is NO fibroblasts or collagen in the CNS

_____ allow the cells in many tissues to act in a COORDINATED manner rather than as independent units

Gap Junctions

Root C7 goes on to form the

MIDDLE Trunk

In CNS: the cell bodies of neurons are called

NUCLEI * in PNS the cells bodies of neurons are called GANGLION

After passing through Adductor Canal then through adductor hiatus the Femoral artery becomes the

Popliteal artery

Venous blood flows from ___ veins then to ___ veins

Superficial veins to the deep veins

In smooth muscle calcium binds to

calmodulin

Wheel and flare bite

from mosquitors- caused by histamine release from mast cels

synovial joints between adjacent carpals

intercarpal joints

Muscles have a _____ amount of ECM

moderate

Which branch does motor to the thenar muscles

recurrent branch

Sole of foot vs top of foot

sole: plantar top: dorsal

What muscles are found in the 2nd Layer of the plantar/sole of foot

(4) Lumbricals: numbered 1st- 4th from medial to lateral and the Quadratus plantae: a quadrangular-shaped muscle. Helps Flexor digitorum longus flex toes (2nd-5th digits) ** Quadratus plantae attaches to the tendon of the flexor digitorum longus distally, while the lumbricals attach to this tendons proximally

Genu Valgum

(knock knee) - lateral angulation of tibia relative to femur - weight-bearing more on lateral knee joint (stressed lateral joint cartialges, lateral meniscus) and tibial collateral ligament (legs go inward --> | <--)

Multi-hit hypothesis

(this is different from two hit!) - Multi-hit states that going from a cell that is deregulated to a high grade cancer necessitates changes to multiple genes in the cell- and that is what is meant when using the designation multi-hit hypothesis

Which muscle of the superficial group of the posterior leg compartment plantarflexes the ankle when th eknee is extended and flexes the leg at the knee joint

- Gastrocnemius Muscle (medial and lateral head) ** it produces rapid movements during running and jumping I: tibial nerve (Soleus and Plantaris just plantar flex the ankle joint)

Does the stratum granulosum contain melanosomes

NO! but it does contain a number of dense keratohyalin granules ** stratum granulosum lies deep to stratum lucidum

The spinal cord passes through the

vertebral foramen - Vertebral Canal= a series of vertebral foramina, through which the spinal cord passes

Myosin with its bound _____ binds to actin, forming cross-bridges

ADP + P

Has thick and thin filaments

A band (dark band) of the sarcomere

true or false the Atlas (C1) has a body

FALSEEEE it has NO body it holds up the head

Lateral terminal division of the brachial artery

Radial artery - supplies blood to the thumb

what protects and supports the plantar surface of the foot

The Plantar Aponeurosis (plantar fascia) *it attaches to the calcaneus

arterioles are innervated by

sympathetic nervous system

What are 6 muscles that connect the scapula to the humerus (Scapulohumeral- intrinsic shoulder- muscles), acting on the arm at the glenohumeral joint

- Deltoid - Supraspinatus - Infraspinatus - Teres Minor - Teres Major - Subscapularis

Minoxidil a trichogenic drug

- topical (solution and foam) - enhances follicular size and results in thicker hair shaft - stimulates and prolongs the anagen phase of hair cycle (results in longer and increased number of hiars) ** treats androgenetic alopecia: cessation of treatment will result in hair loss ** percutaneous absorption of minoxidil in normal scalp is minimal (changes in blood pressure (hypotension) should be monitored in cardiac patients) ** Treats BOTH men and women, unlike Finasteride- MEN ONLY

Flexion- extension of the forearm

- trochlear notch of ulna moves against trochlea of humerus - head of radius moves against capitulum of humerus

Elbow joint capsule is made of which ligaments

- ulnar collateral ligament - radial collateral ligament - annular ligament of radius

Biting insect saliva contains

- vasodilators - anti-clotting agents - anti-platelet agents - anti-microbials - enzymes for breakdown of sugars * these induce an inflammatory response by release of histamine by mast cells - lesions and scratching can lead to secondary bacterial infections - arthropod hair, feces and saliva can lead to allergic reactions (Type I hypersensitivity)

2 criteria for the Parmacological criteria in DSM-5 Diagnostic criteria for substance use disorders

10. tolerance: as define by a) a need for markedly increased amounts of substance to achieve intoxication or desired effect or b) markedly diminished effect with continued use of the same amount of use 11. Withdrawal as the characteristic withdrawal syndrome for the substance or a substance is taken to relieve or avoid withdrawl syndromes

Huntington disease is

autosomal dominant, but symptoms appear late in life

Oligodendrocytes

A glial cell Posesses a: small, round, condensed nucleus- only a few short processes - produce the myelin sheaths around axons that provide the electrical insulation for neurons in the CNS * the myelin sheath is a greatly extended and modified plasma membrane wrapped around the nerve axon in a spiral fashion *** these are the predominant glial cell in CNS WHITE MATTER (white bc of myelin) they can also bbe found- much less abundantly in grey matter of the CNS ** have many peroxisomes

The 1st part of the axillary artery is located between the

1st rib and the medial border of the pectoralis minor - enclose within the axillary sheath - 1st section has 1 branch= superior thoracic artery

Calcaneal Tendon is AKA

Achille's Tendon or Tendocalcaneus ** strongest tendon in the body - connects gastrocnemius, soleus, and plantaris muscles to the calcaneus ** calf muscle contraction causes the calcaneal tendon to pull heel upward (i.e. plantarflexion of ankle) ** important for walking and jumping

Definition of a marker in genetics

A polymorphism (ex. microsatellite) that is used to identify a chromosomal segment; can for example be used to predict carrier status of a person ** these are pre-existing in the genome, we only detect which alleles are present in a given person How are these helpful? - helps to note if someone is forsure a carrier or not - if one of the loci has an allele that predisposes for an inherited disease AND you dont know the sequence of that gene (or ateleast not of the disease allele) you would be helped by using a lined marker to predict if a person has inherited the bad allele

the division of ____ is basis for interstitial growth of cartilage

chondrocytes

The Intrinsic muscles in the sole of the foot (plantar surface) are located in

4 layers that work together to support the foot arch

Smooth muscle cells may be interconnected via

gap junctions- allow neighboring cells to be activated

Describe Axillary Sheath and its contents

A sleeve-like extension of the cervical fascia inside axillary sheath: - axillary artery & branches - axillary vein & tributaries - brachial plexus (cords & branches) outside the axillary sheath: - axillary lymph nodes & lymphatic vessels - axillary fat

What are the borders of the anatomical snuffbox

Anterior: abudctor pollicis longus and extensor pollicis brevis tendon Posterior: extensor pollicis longus tendon Floor: scaphoid and radial artery Roof: superficial brnach of radial n. (bc posterior of arm) and cephalic v.

Examples of contractile NON-muscle cells

A. Myoepithelial cells (epithelial cells) - in certain glands they share basal laminae of secretory and duct cells - they contract to express secretory material from glandular epithelium into ducts and out of the gland - they contain actin, myosin, and IFs of KERATIN - contractions similar to that of smooth m. and occurs via a calmodulin-mediated process - in lactating mammary glands- they contract in response to oxytocin - in lacrimal glands, they contract in response to Ach B. Myofibroblasts - IFs of VIMENTIN - although they resemble fibroblasts, they possess higher amounts of actin and myosin and are capable of contraction ** they may contact during wound healing to decrease the size of the defect (wound contraction)

Bilateral vs unilateral

Bilateral: paired structures (you have L and R) Unilateral: single structures (often in the midline or structures for which you only have one)

Describe Mechanism of Chronic Myeloid Leukemia (CML)

ABL1: a gene for tyrosine kinase on chromosome 9 and BCR: a gene for serine/threonine kinase on chromosome 22 cause a translocation on t(9;22) - leads to synthesis of BCR-ABL hybrid with tyrosine kinase activity (philadelphia chromosome) - causes phosphorylation of cell cycle proteins - activation of cell proliferation - Leukemia (CML) ** Presents as immature myeloid cells in bone marrow can also be identified on FISH to confirm the translocation

Sensory neurons of the retina, olfactory mucosa, and inner ear are

Bipolar Neurons - one dendrite and one axon (other neurons include multipolar and unipolar or pseudounipolar)

Hematoxylin is a BASIC dye so it stains

ACIDIC structures it stains them blue - DNA in nulcei - RNA-rich regions of cytoplams (mRNA, rER, ribosomes) - cartilage matrix * these structures are said to be basophilic "base-loving"

What is the NT used at sympathetic post-ganglionic innervation of sweat glands

ACh ** this is the only exception to the sympathetic division primarily using NE as the signaling molecule at target tissues

Sympathetic post-ganglionic cholinergic nerves release

ACh which binds to muscarinic cholinergic (ACh) receptors at sweat glands stimulating increased sweat production

epithelial come from

ALL 3 germ layers (ectoderm, mesoderm, endoderm)

Pseudostratified Columnar Epithelium

ALWAYS has cilia/sterovilli ! - if no cili/sterovilli its a hint that it could maybe just be stratified columnar epithelium

What occurs if there is damage to the Tibial Nerve (L4-S3)

Abnormal motor and sensation - weakness or inability to plantarflex ankle or flex toes - diminished or loss of skin sensation on sole of foot

Epimere gives rise to

intrinsic back muscles ** failure to develop would affect the Erector Spinae

Hamartoma

A disorganised mass composed of mature cells indigenous to the involved site Ex. A nodule of mature hyaline cartilage in the bronchial wall ** so its basically overgrowth of cartilage but it is where it is supposed to be this is diff from Choristoma- which is a growth of cells where they are NOT supposed to be

Several axons are covered by ___ oligodendrocyte

ONE

Cl- is found mostly

extracellularly (110mM)

HSR stands for

homogeneously staining region

the acetabulum always faces out

laterally

Apocrine sweat glands have

very large lumens!!! (larger than eccrine) - like eccrine sweat glands the secretory portion is embedded in dermis and hypodermis - UNLIKE eccrine sweat glands, their ducts open into hair follicles - apocrine sweat glands are found in axillary and perineal regions of body and DO NOT develop fully till puberty

Dihydropyridine receptor is a

voltage sensor

which cartilage has dense CT with type I collagen

fibrocartilage

The radial nerve is proximal to the

lateral epicondyle (thumb side)

an increase in concentration = an increase in

equilibrium potential

Each dermomyotome is innervated by its corresponding

spinal nerve

Which quadriceps muscle has a proximall attachment to the Anterior INFERIOR iliac spine

Rectus Femoris

Diaphysis refers to

the shaft of the humerus

Both skeletal and smooth muscle

use elevation of intercellular calcium for excitation-contraction coupling - in skeletal: calcium binds to Troponin C and causes the cross-bridge cycle - in smooth: calcium binds to calmudolulin which acticated the myosin light chain kinase which phosphorylates myosin so that shortening can occur

Strategy for identifying the marker allele

use first two generation to identify the marker allele in coupling phase with the disease causing allele ** coupling phase= when looking at a pair of chromosomes, what is located on the same chromosome (Haplotype is essentially the same but not limited to two loci- i.e. a longer stretch of chromosome)

Sclerotomoe gives rise to the

vertebral column, parts of the skull and ribs

Production of extracellular fluid and lymph

water leaks out into the ECF and 90% is reabsorbed- the rest becomes lymph * hydrostatic pressure is the pressure that is exerted by a fluid at equilibrium at a given point within the fluid, due to the force of gravity. It increases in proportion to depth measured from the surface because of the increasing weight of fluis exerting downward force from above

UVB light

wavelength 290-320 nm - absorbed in epidermis - sunburn "B is for burning" ** chemical agent: para-aminobenzoic acid (PABA) blocks this

The clavicle connects the

whole upper limb to thorax

in what zone during endochonral ossification do the chondrocytes begin to secrete alkaline phosphatase

zone of maturation/hypertrophy - it is during this zone that the chondrocytes undergo hypertrophy (become enlarged) - chondrocytes contain large amounts of glycogen and begin to secrete alkaline phosphatase

during bone growth by endochondral ossification, the cartilage must grow (as the child grows) by cell division in the

zone of proliferation * chondrocytes undergo rapid mitosis, forming distinctive looking stacks

zone that contains normal resting hyaline cartilage in endochondral ossification

zone of resting cartilage (reserve zone) "resting (quiescent) zone "

A motor neuron action potential stimulates the release of

~ 100-200 synaptic vesicles, each containing ~10,000 molecules of ACh

What part of the ECM helps cartilage soak up water

~75% of wet weight of cartilage is water, which helps it to resist compression - sulfated GAGs have a negative charge, makes them absorb (mainly) Na++ ions, WATER FOLLOWS SALT ex of GAGs: - chondroitin sulfate - dermatan sulfate * responsible for high water content of cartilage

Major Components of the Basal Lamina

* all are glycoproteins secreted by epithelial cells - Type IV Collagen - Perlacan (has negatively charged side chains- gives the basal lamina a fixed, negative charge) - Laminin (membrane proteins integrins project from the epithelial cell membrane into the basal lamina, where they bind laminin, and anchor the epithelial cell to the basal lamina) - Entactin *** the basal lamina is sooo thin that it is often difficult to see with the conventional light microscopy- it is usually only clearly defined under the electron microscope

Trigger finger (flexor tendinitis)

* common among people with rheumatoid arthritis and diabetics deformity of the digits that consists of: - a finger or thumb becoming locked in a flexed position -locking occurs when one of tendons that flex the digit becomes inflamed and swollen, often with a noticeable nodule in the palm - the inflamed tendon can move out of the sheath as the finger flexes, however when the tendon is verry swollen, it cannot easily move back in as the finger extends, and therefore the digit locks - to straighten the digit, one must force the swollen area into the sheath- causing a popping sensation similar to that felt when pulling a trigger

What are the mechanisms of carcinogenesis?

- Activation/overexpression of growth-promoting protooncogenes (ex. RAS, HER-2 or MYC (MYCC) - "gain of function" mutations - Inactivation of growth-inhibiting tumor-suppressor genes- "loss of function" mutations (Rb, TP53) - Inactivation of genes that regulate apoptosis (ex. p53 or BCL-2 (cells dont go to apoptosis they accumulate) - Inactivation of DNA repair genes (ex. Lynch Syndrome) - Epigenetic Mechanisms (ex. Hypermethylation of promoter for p16INK4A )

What muscles belogn to the Medial Thigh Compartment

- Adductor Longus - Adductor Brevis - Adductor Magnus (I: Obturator Nerve AND Tibial division of Sciatic Nerve) - Gracilis - Obturator Externus Action: Adduction of thigh at hip joint I: Obturator Nerve (L2, L3, L4) Blood Supply: Obturator artery and Obturator Vein

3 compartment of the Leg

- Anterior (I: Deep Fibular Nerve) - Lateral (I: Superior Fibular Nerve) - Posterior (I: Tibial Nerve) *** the boundaries for these 3 fascial compartments of the leg are created by the deep fascia, interosseous membrane, and leg bones

What are the three fascial compartments of the thigh

- Anterior Compartment: Leg Extensors/ Thigh flexors (I: femoral nerve) - Medial Compartment: Thigh Adductors (I: obturator nerve) - Posterior Compartment: Leg Flexors/ Thigh Extensors (I: Sciatic Nerve)

Arterial Supply to the Leg Compartment

- Anterior Tibial Artery: Supplies ANTERIOR compartment of leg - Fibular Artery: Supplies LATERAL and POSTERIOR compartments of lieg - Posterior Tibial Artery: Suplpies posterior and lateral leg

Describe Simple Columnar Epithelium and its functions

- Are taller than cuboidal cells, and less wide - nucleus is ovoid - gives more height of cell to separate different transport vesicles going to apical vs basolateral membranes - also the environments are a bit harsher here than simple cuboidal, contain acid and/or digestive enzymes Fxs: - protection - secretion - absorption

Where is Loose CT found

- BENEATH EPITHELIA ( if part of the mucosa it is called the LAMINA PROPRIA: a thin vascular layer of loose CT beneath the epithelium of mucous membrane) also found - around glands - around various tubular organs (like GI and respiratory - around blood vessels

Arteries of the arm include

- Brachial Artery - Radial Artery - Ulnar artery - Common interosseous artery - Deep artery of the arm

Basic principles of topical drugs

- Concentration gradient: increasing concentration gradient increases the mass of drug transferred per unit time, increasing conc. of frug applied to skin increases amt absorbed by skin - Anatomical variation: permeability inversely prop. to thickness of stratum corneum (drug penetration higher on face, axilla, perinerium than on forearm and soles of feet) - Altered barrier fucniton in disease (if dermatological disease results in abnormal stratum corneum and barrier function compromised drug absorption is increased (drugs applited to broken skin could results in systemic toxicity) - Vehicle: A compound that facilitates applicaiton of the drug to the skin. Vehicles themselves may have therapeutic effect . Occlusion: application of a physical barrier such as a bandage to keep the vehicle in place increases efficacy) ** these vehicles include: solutions, sprays, gels, foams, creams, oils, ointments

What are ligaments of the Pectoral Girdle (This is attaching from the scapula to other regions- no longer the scapula to the humerus)

- Coracoclavicular Ligament (Trapezoid and Conoid Ligament) - Superior Transverse Scapular Ligament - Acromioclavicular Ligament

What are some ways of incresing MYC transcription

- DM (double-minutes) - MYCN (the neuro-specific subtype of MYC) ** in both cases, the copy number of the gene has risen dramatically --> increased expression --> tumorigenesis ** MYC induces transcription of cyclin, E2F, etc. (normally it is antagonized by MAD- but if this is deregulated, MYC leads to increased proliferation)

What two types of damage can cause a claw hand

- Damage to ulnar n. at WRIST and MEDIAL ELBOW At wrist: paralysis of hypothenar muscles, adductor pollicis, 3rd and 4th lumbrical and interossei - pt unable to flex metacarpophalangeal joint of digits 4 and 5 and unable to extend interphalangeal joint when trying to straighten fingers; unable to move digit 5 AT ELBOW: - medial half of flexor digitorum profunus affected in addition to muscles listed above - pt is unable to flex the distal interphalangeal joint of digits 4 and 5, making the "claw" less prominent --> ulnar paradox ** in all cases the ability to flex at the proximal interphalangeal (PIP) joint is unaffeccted (flexor digitorum superficialis- innervated by the median n.)

What movements occur at the ankle joint

- Dorsiflexion of ankle: toes and foot move up and heel moves down - Plantarflexion of ankle: toes and foot to move downward and heel moves upward

3 "I" rule for X-inactivation

- Each cell INACTIVATES one X INDEPENDENT of other cells - for that cell and all its descendants, X inactivation is IRREVERSIBLE ** exception to the rule of inactivation being irreversible: cells that become oocytes

What are possible movements of the scapula

- Elevation & Depression (shrugging) - Abduction/protraction (moves away from center of body- like punching) - Adduction/retraction (putting it back to normal from abducted position) - Superior rotation - Inferior rotation

What are the intrinsic muscles on the Dorsum of the foot

- Extensor Digitorum Brevis (EDB) - Extensor Hallucis Brevis (EHB) ** their counter parts were longer in the leg BOTH innervated by deep fibular nerve

Which muscles are found in the posterior compartment of the forearm

- Extensor carpi ulnaris - Extensor digitorum - Extensor digiti minimi - Supinator (does not cross wrist) - ABductor pollicis longus - Extensor pollicis longus - Extensor pollicis brevis - Extensor indicis - Extensor carpi radialis longus - Extensor carpi radialis brevis - Brachioradialis *** ALL innervated by the radial nerve

Arterial supply to the anterior and medial thigh includes

- Femoral Artery (main artery supply to ENTIRE lower limb) - Deep Artery of the thigh (Aka Deep femoral artery or profunda femoris artery) - MAIN artery supply to THIGH region - Obturartor Artery

What occurs in flexion-extension at the elbow (movement of forearm)

- Trochlear notch of ulna moves against trochlea of humerus - Head of radius moves against capitulum of humerus

The 3rd layer of the sole/plantar foot includes the

- Flexor Hallucis Brevis (medial and lateral heads): flexes big toe (1st digit- hallux) I: medial plantar nerve - Adductor Hallucis (transverse and oblique heads): adducts big toe (1st digit) I: Lateral plantar nerve - Flexor digiti minimi brevis (flexes little toe- 5th digit) I: lateral plantar nerve

Which muscles flex the hand at the wrist

- Flexor carpi radialis (also ABducts hand) - Palmaris longus ( also tenses palmar aponeurosis) - Flexor carpi ulnar ( also ADducts hand)

Deep Anterior Compartment of the forearm includes

- Flexor digitorum profundus (only one of these that is I: ulnar nerve NOT median nerve) - Flexor pollicis longus - Pronator quadratus (DOES NOT cross wrist)

In the sympathetic NS the splanchnic nerves (from the paravertebral ganglia) course to the prevertebral ganglia surrounding the large unpaired vessels on the abd aorta. There the signal will syanpse. But what do ganglia to the splanchnic nerves of the sympathetic NS turn into

- Greater Splanchnic --> Celiac Ganglia - Lesser Splanchnic --> Superior Mesenteric Ganglia - Least Splanchnic and Lumbar Splanchnics --> Inferior Mesenteric Ganglia - Sacral Splanchnics (originate in the sacral part of the sympathetic chain) --> network with lumbar splanchnic nerves

Joints involved in the elbow joint

- Humeroulnar Joint: hinge joint - Humeroradial Joint: gliding joint - Proximal radioulnar joint: pivot (this one allows supination and pronation) ** all 3 portions share a common synovial joint capsule, and elbow is generally referred to as a synovial hinge joint

Crusted scabies or Norwegian scabies

- Hyperinfestation with thousands of mites - immunocompromise, elderly disabled of debilitated at risk - characterized by thick crusts of skin containing large numbers of mites - very contagious - may not show usual signs and symptoms such as the rash or itching - quick and aggressive medical treatment to avoid scavies outbreak

What bands are found in the sarcomere

- I band: light area around the z-line consisting of thin actin filaments not overlapped by thick myosin filaments - A band: dark area which spans the length of the thick myosin filament - H zone: light zone in the centre of the A-band where the thick myosin filaments are not overlapped by the thin filaments - M line: within the H-zone is thin M-line formed of cross-connecting elements of the cytoskeleton - Actin filaments are bound at the Z line (or discs) ** One Sarcomere is from Z-disc to Z-disc

PseudoAutosomal Regions (PAR)

- Identical regions between X and Y - PAR1 contains about 13 genes, PAR2 about 4 * crossover in PAR1 is NECESSARY part of male meiosis - crossover may happen in PAR2

2 examples of Metaplasia

- In Airways: Pseudostratified Columnar to Squamous Epithelium (caused by cigarette smoke) - Esophagus: Squamous Epithelium --> columnar epithelium (Barretts Espophagus)- occurs from Gastro-esophageal reflux

Venous drainage of the vertebral column includes

- Internal Vertebral Venous Plexuses (epidural venous plexuses)- has anterior and posterior components - External Vertebral Venous plexuses (has anterior and posterior components) - Basivertebral Veins (which form WITHIN the vertebral bodies) ***spinal veins form plexuses along the vertebral column inside and outside the vertebral canal

Describe Scapulohumeral Rhythm (shoulder elevation)

- It involves movement at the glenohumeral joint and scapulothoracic movement - when the arm is fully elevated by abduction or flexion, 2/3 of motion occurs in glenohumeral joint and 1/3 of motion occurs between the scapula and thorax HOWEVER - the initial 30 degrees is perfomed MOSTLY by the GLENOHUMERAL JOINT; the remaining elevation occurs simultaneously between the glenohumeral and scapulothoracic joints; this coordinated movement is what is called scapulohumeral rhythm Fxs to: 1. preserve the length/tension relationship 2. prevent the humerus from impinging the acromion

Describe Pseudostratified Columnar epithelium and its functions

- It is called this bc the nuclei appear to lie at two or more layer HOWEVER, ALL cells touch the basal lamina, although some cells do not reach the surface - the cells are crowded, with varing shapes Functions: protective lining, secretion, absorption

What are the 3 articulations of the knee joint

- Lateral tibiofemoral joint= lateral tibial condyle + lateral femoral condyle - Medial tibiofemoral joint= medial tibial condyle + medial femoral condyle - Patellofemoral joint= patella and femur ** remember tibia is medial, fibula is lateral

HER2 Protein Overexpression

- Many breast cancers overexpress a structurally normal HER2 protein (human epithelial growth factor receptor- 2) - Normal circulating amount of ligand leads to abnormally high signal transduction --> cell growth

What are some branchs of the Deep Artery of the Thigh (which is the MAIN artery supply to the THIGH region) ** remember main artery supply to entire lower limb was femoral artery

- Medial Circumflex Femoral Artery (main blood supply to head and neck of femur) - Lateral Circumflex Femoral Artery - Perforating Arteries

Agents can affect neuromuscular signal transmission by blocking what steps

- Neuronal Na+ channel blockers: block depolarization and AP propagation - Neuronal K+ channel blockers: inhibit repolarization, prolonging the duration of the AP - Neuronal Ca2+ channel blockers: inhibit vesicle fusion and ACh release - Inhibition of ACh releae: cleave SNAR proteins preventing fusion of synaptic vesicles and NT exocytosis - Muscle Na+ channel blockers: inhibit muscle AP generation - AChR antagonist: blocks binding of ACh resulting in flaccid paralysis of skeletal muscle - Inhibition of AChE: accumulation of ACh in synaptic cleft, causing sustained activation of nicotinic AChR and sustained depolarization of postsynaptic membrane - prolonged depolarization inactivated voltage-gated Na+ channels. Result= muscle paralysis * reversible AChE inhibitors are used therapeutically in Myasthenia Gravis to enhanve ACh levels in the synaps and improve muscle tone

Pediculus Humanus Corporis (body louse) aka Pediculus Humanus Humanus

- Nits attached to clothing - Chronic infestation causes postinflammatory hyperpigmentation and thickening of the skin= Vagabonds disease ** NATURAL VECTORS for agents of Typhus, relapsing fever, and tranch fever *** found worldwide but limited to ppl who live under crowding and POOR HYGEINE - homeless - refugees - survivors of war or natural disasters * diagnosis from eggs and finding live lice ** improve personal hygiene ** pediculicide- medicine to kill lice may be used

How is cancer diagnosed

- Physical Examination: a lump - Imaging (x-ray, US, CT, MRI, PET) - Biopsy **** You would do a microscopic examination of biospy to identify: Tissue and cell structure abnormalities and increased mitotic activity also could do Immunohisto(cyto) chemistry of the biopsy - Fluorescent in situ hybridization (FISH)

Which structures Exit ONLY (and stay in gluteal region) from the Greater Sciatic Foramen

- Piriformis muscle - Superior Gluteal a./v./n. - Inferior Gluteal a./v./n. - Nerve to quadratus femoris - Sciatic nerve - Posterior Cutaneous Nerve of thigh

Superficial Anterior Compartment of forearm includes

- Pronator teres - Flexor carpi radialis - Palmaris longus - Flexor carpi ulnaris - Flexor digitorum superficialis (has 4 tensons) ** ALLL originate from MEDIAL EPICONDYLE (COMMON FLEXOR TENDON)

What Is allowed to pass through a gap junction

- Rapid exchange between cells of molecules with small (<1.5nM) diameters, a MW of 100-1000 WILL Pass, anything above 5000 will NOT - some molecules mediating signal transduction (cAMP, cGMP, and ions move readily though) also pass electrical charge from neuron to neuron

The Suboccipital Triangle is demarcated (Bounded) by 3 muscles. What are they? and what is contained within this triangle?

- Rectus Capitis Posterior Major (on superiormedial margin) - Obliquus Capitis Inferior (on inferolateral margin) - Obliquus Capitis Superior ( on superolateral margin) Suboccipital Triangle Contains: - Suboccipital Nerve (C1) - Vertebral Artery

In a wounded nerve fiber, it is important to distinguish changes occurring proximal to the injury from those in the distal segment

- Region proximal to the injury, has access to the cell body where alllll the new components are made - Region DISTAL to the injury is separated from the cell body- so this is the portion that degenerates

Dystrophin Associated Complex (DAPC)

- Sarcoglycans, dystroglycans, etc form a tight complex that falls apart if dystrophin is missing (Limb Girdle muscular dystrophy and others result from mutation in these proteins) - nNOS is a nitric oxide synthase necessary for exercise induced vasodilation (if missing leads to ischemia in the muslce) - in addition to ischemia, lack of physical coupling of cytoskeleton and ECM is probably involved in pathology of DMD/BMD (connected to actin in the cytoskeleton)

What muscles are found in the Anterior Thigh Compartment

- Sartorius - Iliopsoas - Pectineus - Quadriceps Femoris (Vastus Lateralis, Rectus Femoris, Vastus Intermedius, Vastus Medialis) ** these are mainly EXTENSOR of leg at knee joint; FLEXORS of thigh at hip joint I: Femoral Nerve (L2, L3, L4) for all BUT Pectineus M. also gets help from Obturator Nerve (L2, L3, L4) Blood Supply: Femoral Artery/ Vein

Glands can be characterized by what they secrete

- Serous glands: secrete watery (serous) fluid (usually contain proteins) ex. secretion from exocrine pancreas- pancreatic enzymes in watery fluid ** stain purple/blue on H&E - Mucous glands: secrete mucus ** mucus secreting cells stain grayish on H&E and are "foamy" in appearance - Mixed glands: secrete BOTH serous fluid and mucus (ex. salivary gland is mixed)

Loxosceles Species (brown recluse, violin spidder, fiddle back spider)

- Southeastern and central US plus central and south ameria Causes Locoscelism or neurotic arachnidism: - initial bite is painless - intense local pain follow the smalle blister at bite site - extent of damage correlates to amoutn of venom - necoriss - eschar formation * diagnosis observe spider- otherwise- very likely a staph aureus infection treatment: RICE and tetanus prophylaxis - debridement may be necessary

Malignant Tumors from Squamous, Columnar and urothelium epithelia

- Squamous Cell Carcinoma - Adenocarcinoma (from columnar epithelium) - Urothelial Carcinoma

Where could you find simple columnar epithelium

- Stomach (in the stomach all cells secrete, the stomach epithelia DOES have goblet cells) - Small Intestine - Gall bladder and other organs ** common in GI

Sensory (Cutaneous) innervation of the sking of the buttocks is done by

- Superior Cluneal nerves - Middle Cluneal nerves - Inferior Cluneal nerves

What is the arterial supply to the gluteal region and posterior thigh

- Superior gluteal artery and inferior gluteal artery (named in relation to their location to Piriformis muscle) - Deep artery of the thigh (Profunda femoris artery) which supplies the posterior thigh through its branches called the perforating arteries

For T5 and below, after passing through the paravertebral ganglion (no synapse), certain pre-ganglionic axons will bundle together to form splanchnic nerves

- T5-T9 axons form- Greater Splanchnic Nerve - T10-T11 form Lesser Splanchnic Nerve - T12 forms LEAST splanchnic nerve - L1-L2 forms the Lumbar Splanchnic Nerves ** sacral splanchnic nerves originate from the sympathetic chaing and netwrok with the lumbar splanchnic nerves

Which structure Exits ONLY out of the lesser sciatic foramen (from gluteal region to perineum)

- Tendon of Obturator Internus Muscle

Describe transitional epithelium, its location and function

- The form of the surface cells changes according to the degree of distension of the bladder wall - characterized by a superficial layer of domelike cells that are neither squamous not columnar Location: aka UROTHELIUM - it lines only the urinary bladder, the ureter, and the upper part of the urethra Function: expansion to hold increased volume, and these cells protect against the hypertonic and potentially cytotoxic effects of urine

What structures are injured in an Unhappy Triad Injury

- Torn anterior cruciate ligament - Torn tibial (medial) collateral ligament - Torn medial meniscus ** unhappy triad injury is a common knee injury in contact sports - mechanism of injury: hit to lateral side of extended knee or excessive lateral twisting of flexed knee

The Superficial Extrinsic Muscles of the Back include

- Trapezius - Latissimus Dorsi - Levator Scapulae - Rhomboid Minor - Rhomboid Major ** Axio-appendicular musculature: all muscles inset on the upper limb and are innervated by Anterior Rami of Spinal Nerves (EXCEPT Trapexius, CN XI)

Which muscle connect the thorax and the scapula (Scapulothoracic Muscles)

- Trapezius - Levator Scapulae - Rhomboid Minor - Rhomboid Major - Serratus Anterior

When does Herniation/Protrusion of the Intervertebral Discs Occur

- When the nucleus polposus protrudes (herniated) through the annulus fibrosis & compresses the spinal nerves exiting the IV forman [or the vertebral artery exiting the transverse foramen] * this is most common in cervical and lumbar; 95% of lumbar disc protrusions occur at L4/L5 or L5/S1 - many discs herniate- and most will resolve on their own or with physical therapy ** this typically occurs posterolaterally, where the anulus fibrosis is relatively thin and does NOT receive support from the posterior longitudinal ligament *** Note: the stress resistance of the anulus fibrosus declines with age

Eccrine Sweat glands

- are NOT found in skin of the lips and parts of the external genitalia - they are epidermal appendages that are independent of hair follicles - they are embedded in dermis and hypodermis - their excretory ducts open to the surface - they are simple, coiled tubular structures consisting of secretory and excretory portion - their secretory epithelium consists of clear cells (on basal lamina and store abundant glycogen- secrete most of water and electrolytes in sweat), dark cells( on top of clear cells-line the luminal surface- they secrete glycoproteins), and myoepithelial cells

what are 3 things that cartilage always lacks

- blood vessels (but it is usually, but not always surrounded by a dense CT perichondrium that is vascularized) - lymphatics - nerves

A joint is a union or a junction between a

- bone and bone - bone and cartilage - bone and tooth Joint= an articulation they can be classified structurally (anatomical characteristics) and functionally (type of movement permitted)

In cross-section the nuclei of cardiac and skeletal muscle are arranged differently

- cardiac muscles cells have one large nucleus in the middle of the cell - skeletal muscle have the nuclei on outside of the cell

Lactrodectus Species (widow spinders; hourglass spiders)

- cause latrodectism (neuromyopathic araneism) - generalized pain, dizziness, disturbed speech, difficulty breathing etc. - severity correlates with amount of venom injected (alpha-latrotoxin ** painful abd and leg cramps, profuse sweating, lacrymation and spasms of the jaw muscles in severs cases - Cases fatality <5% Diagnosis: observe spider- otehr wise very likely a staph aureus infection ** antivenom is available, controversial Treatment: RICE (rest ice compression elevation), tetanus prophylaxis

Activation of the parasympathetic (rest and digest) would stimulate

- contraction of the ciliary muscle allowing accommodation for near vision - CONSTRICT bronchiolar smooth muscle - increase GI tract secretions - stimulate penile endothelial cells to secrete NO which then causes relaxation of penile smooth muscle and vasodilation leading to erection - contraction of the sphincter pupillae causing pupil constriction

What ligaments can be found around the glenohumeral (GH) joint

- coracoacromial ligament - coracohumeral ligament - transverse humeral ligament (keeps long head of the biceps brachii tendon in place) ** there is a synovial sheath for tendon of longe head of biceps brachii) - glenohumeral ligaments (superior, middle, inferior)

What factors can affect bone and cartilage metabolism

- deficiency of vitamin D: rickets, osteomalacia * results in newly formed bone not properly calcified/mineralized (vitamin D usually stimulates synthesis of bone glycoproteins osteocalcin and osteopontin, which bind hydrocylapatite to collagen type 1 and integrins on bone cells. The vitamin D receptor is also a transcription factor for proteins required to import calcium from intestines (in children this results in rickets, in adults results in osteomalacia- adult rickets) ** major problem in pregnant women because a fetus req. vitamin D - insufficient growth hormone: dwarfism - excessive growth hormone: gigantism, acromegaly - sex hormones: promote bone formation; stimulate ossification of epiphyseal plate (ex. osteoporosis)

Retinoids

- derivatives of Vitamin A (retinol) Topical: - tretinoin - adapalene - tazarotene ** creams, gels ,lotion, and foam ** creams for dry skin, gel for oily skin Systemic: Isotretinoin (oral administration) **** retinoids activated the retinoic acid receptor (RAR) and the retinoid X receptor (RXR) * the activated RAR/RXR dimer binds to target DNA sequences and modulates (can increase or decrease) gene transcription * proteins from the target genes mediate the signaling that result in epidermal cell turnover ***** RETINOIDS --> GENE TRANSCRIPTION --> EPIDERMAL CELL TURNOVER --> CLEAR SKIN ** work by decreasing adhesion between epidermal cells and increasing the epidermal cell turnove- reduce P. acnes , reduce inflammation - mild to moderate acne: topical agents - moderate to secere recalcitrant acne: isotretinoin (oral/systemic)

Adverse side affects of topical retinoids

- erythema (redness) and dryness - Tretinoin and Adapalene- pregnancy category C (fine if mother wants to take risk) - Tazarotene- preg category x (NEVER use in preg!!)- a neg preg test should be obtained within 2 weeks prior to treatmen and treatment should begin during normal menstrual period

Describe Mast cell and the Immediate Hypersensitivity Reaction

- excessive, undesirable reaction produced by normal immune system 1. molecules of IgE antibody produced in an initial response to an allergen such as pollen or bee venom are bound to surface receptors for IgE, of which 300,000 are present per mast cell 2. when second exposure to allergen occurs, IgE molecules bind this antigen and a few IgE receptors very rapidly become cross-linked 3. This activates adenylate cyclase, leading to phosphorylation of specific proteins .4. Activation of Adenylate cyclase also leads to entry of Ca2+ and rapid exocytosis of some granules 5. In addition, phospholipases act on specific membrane phospholipids, leading to production and release of leukotrienes. The components released from granules, as well as leukotrienes, are immediately active in the local microenvironment and promote a variety of controlled local reactions which together normally comprise part of the inflammatory process called the immediate hypersensitivity reaction

Sympathetic Nervous System works to

- fight or flight - increase heart rate and contractility of cardiac cells, increase blood flow to skeletal muscles/vasodilator for coronary vessels - dilates bronchioles of lung, allows for greater alveolar oxygen exchange - dialtes pupils and relaxes the ciliary muscle to the lens - inhibits digestions by diverting blood flow away from GI tract, inhibits peristalsis - constricts intestinal spincters and urinary sphincter - promotes ejaculation/orgasm

What are six movements of the hip joint

- flexion - extension - medial rotation - lateral rotation - abduction - adduction ** circumduction of hip joint is combination of all 6 movements

Cimex Lectularis (bed bugs)

- found where poeple sleep (emerge at night for a blood meal) * reaction to proteins in salive results in pruritic wheal * NOT a vector - identified by fidning exoskeletons after molting, live buds in mattress or sheets, or rusty-colored spots from blood filled fecal material ** increase risk with freq of travel and sharing sleeping space where others have previously slept - calamine lotion to treat - antihistamine if needed - professional pest control company to treat infestation

7 types of proteins in cell growth regulation

- growth factors - growth factor receptos - signal transduction proteins - transcription factors (lead to cell division) --- all these above are usually protooncogenes-- - pro- and anti-apoptosis proteins - cell cycle control proteins - DNA repair proteins --- these above usually are tumor suppressor genes (DNA repair proteins frequently included)

3 major forms of cartilage

- hyaline - elastic - fibrocartilage * their different structures reflect different functions in different areas of the body

Smooth muscle is controlled by various stimuli like

- intrinsic innervation (ex. GI tract) - extrinsic innervation (ex. ANS) - chemicals and hormones (Ex. ACh, norepinephrine, epinephrine, NO, oxytocin) ** the response of the SM cells to stimuli depends on the function of the tissue, the degree of innervation and the expression of receptors for chemicals and hormones

Where can simple cuboidal epithelium be found

- kidney tubules - covering of ovary - ducts of glands

Lateral plate mesoderm (Somatic/Parietal layers) forms

- limb bones (including scapula, calvicle, and innominate) - dermis of the ventrolateral trunk and limbs - sternum

Where can simple squamous epithelium be found

- lining of blood and lymphatic vessels (called- ENDOTHELIAL cells) - lining of certain body cavities (called-MESOTHELIAL cells) - lining of the alveoli in the lung (does gas exchange) - parietal layer of Bowmans capsule in the kidney

The smooth muscle in the gut wall has two layers of smooth muscle that are arranged into sheets of opposing fibers what are they

- longitudianl - circular ** contraction of these opposing layers of muscle leads to rhythmic for of contraction called: PERISTALSIS, which propels substances through the organs

Cancer is malignant because

- more rapid growth rate - invades and destroys the adjacent tissue (with secondary necrosis, ulceration, bleeding, compression, inflammation etc. - seeds and grows at distant siets (metastasizes) ** metastases have the same malignant abilities as the primary cancer - fatal in most cases if left untreated

Connective tissue is the

- most abundant - most widespread - most varied of all four tissue types * it is also the one with the widest variety of functions Type of Connective tissue: - Loose CT (Areolar) - Adipose tissue - Dense CT - Cartilage - Bone - Blood

In a spinal cord section- luxol fast blue/cresyl violet stains

- myelin blue and nissl substance and nuclei purple

Acetylcholine is the neurotransmitter for

- myoneural junctions - preganglionic sympathetic - preganglionic and postganglionic PARAsympathic synapses

Examples of skin appendages

- nails - hair follicles - sweat glands - sebaceous glands

Examples of excitable cells

- nerve cells (neurons) - muscle cells (skeletal, hear, smooth)

A ganglion is composed of

- neuronal cell bodies - axons - loose fibrocollagenous support tissue (contains cell types of CT) - support cells: satellite cells (around neuronal cell body) and schwann cells (surround axons with myelin)

Phthirus Pubis (crab louse, pubic louse) aka Phthirus pubis

- nits attached to pubic hair (less freq axillary or facial hair including eyelases) - blueish macules apprx 3mm in diametes - blepharitis (inflammation of eyelid) accompanies infestation of eye - NOT A VECTOR * transmitted by sexual contat or close nonsexual contact * diagnose from finding eggs and live lice * pubic lice treated similar to head liev - Eyebrow/ eyelash treatment: remove with fingernails or nit comb

What is located inside the Neuronal Cell body (aka perikaryon aka soma)?

- nucles - rER and sER (individual cisternae of sER can extend into processes) - most free ribosomes - the golgi (never in processes) - other organelles that are found in BOTH the cell body and processes are (mitochondria, lyosomes, and peroxisomes)

Cells found in bone

- osteoprogenitor cell (stem cell): differentiate into osteoblasts - osteoblast (matrix-synthesizing cell responsible for bone growth) - osteocyte (mature bone cell maintains bone matrix): theses are when osteoblasts become quiescent and= osteocytes, occupy space called lacunae - osteoclast (bone-resorbing and remodeling cell): HUGE multinucleated cells derived from fused bone marrow precursors (monocytes)

Functions of Macrophages

- phagocytosis and endocytosis (have alot of lysosomes) - constantly crawling around in CT "eating" cell debris etc. (eosinophilic cytoplasm= many lysosomes) - resistance to infection: destroys microorganims (bacteria and viruses) that have been opsonized - secrete cytokines and act and antigen-presenting cells (APCs) - some macrophages that have to eliminate larger substances fuse with each other to be able to perform their duties; examples are osteoclasts and foreign body giant cells

What are the 6 subtypes of a synovial joint

- plane (ex. between navicular and second and third cunieforms in the foot) - Hinge (tochlea of humerus and trochlear notch of elbow) - Pivot (Head of radius and radial notch of ulna, also the axis and atlas) - Condyloid (between radius and scaphois and lunate bones of carpus) - Saddle (between trapezium or carpus (wrist) and metacarpal of thumb - Ball-and-socket (head of femur and acetabulum of hip bone)

Functions of muscles

- produce movement by acting on bones of skeleton, pumping blood, or propelling substances throughout hollow organ systems - aid in maintaining posture by adjusting position of body with respect to gravity - stabilizes joints by exerting tension around the joint - generate heat as a function of their cellular metabolic processes

Functions of bone

- protection of internal organs (brain, heart, lung, bladder, and reproductive organs) - supporting framework for body (long bones for limbs or facial skeleton for face) - body movement in conjunction with muscles and nervous system - blood cell production (hematopoiesis) within meduallary cavity of long bones and cancellous bone - calcium and phosphorous reserve for body - detoxification by storing heavy metals in bone tissues - sound transduction in middle ear via the ossicles: malleus, incus, stapes

What are the normal actions of ACh

- pupil constriction - reduces heart rate - contraction of bronchiolar smooth muscle - contraction of GI smooth muscle - erection SOOO blocking ACH would cause: - pupil dilation - increased HR - bronchodilation - relaxation of GI smooth muscle - inhibit erection

The "fight or flight" response causes activation of the sympathetic nervous system which does

- relaxation of GI wall smooth muscle - relaxes bronchiolar smooth muscle (decreasing airway resistance) - relax ciliary muscles to the lens -increase force of contraction of the heart - increase heart rate - stimulate aqueous humor production - contraction of the dilator pupillae muscle, causing pupil dilation and thus increase pupil diameter

Pediculus Humanus Capitis (head louse) aka Pediculus Capitis

- req several blood meals/day - saliva causes pruritis (itching): pruritic morbilliform (measles-like) or utricarial rash (hives like) - NOT a natural vector for pathogens but severe scrating may lead to secondary infection with Staph aureus or streptococcus pyogenes (impetigo, pyoderma, rarely septicemia) * nits (eggs) are cements to hair: after 10 days a nymph hatches- empty nits may remain attached for months- NOT related to hygiene. MOST often spreac by head to head contact * diganoded best by discovery of the live louse * treatment only warranted if live lice are discovered Over the counter: - Pyrethrins - Permethrin lotions

Parasympathetic NS works to

- rest and digest - can decrease heart rate and blood pressure - can constrict the bronchiolar diameter when the need for oxygen decreases - constricts the pupil and contracts the ciliary muscle of the lens, allowing for accomodation - increases digestions by dilating blood vessels of the GI tract, increasing blood flow/enhances peristalsis and stimulates salivary gland secretion - promotes erection of genital and sexual arousal

Main features of smooth muscle

- slow, sustained contractions - spindle shaped cells with one central nucleus - NON- voluntary control - have actin and myosin but NO sarcomeres Found in - wall of GI tract - walls of arteries and veins - around glands ** their nucleus when contracted appears "corck screwed" *** normally it is "cigar shaped"

Gluteal Region Muscles are organized into two layers

- superficial layer of large gluteal muscles and tensor fasciae latae muscle - deep layer of smaller muscles (covered by gluteus maximus muscle): piriformis, obturator internus, superior and inferior gemelli, and quadratus femoris

functions of cartialge

- support of soft tissues - as a shock absorber - free-gliding surface for joints - as a template for growth of long bones (the embryonic skeleton froms first as cartilage, then parts of it are transformed into bone

What are different types of junctions that cause a synapse

- synapse with another neuron - neuromuscular junctions - neuroglandular synapses *** there are two types of synapses: electrical and chemical

Deep artery of the arm (AKA profunda brachii)

- the first and largest branch from brachial artery (supply blood to arm) ** it passes posterior to the humerus with the radial nerve in the radial groove

Joints are classified structurally by

- the presence or absence of synovial cavity and - type of CT binding the joint 3 structural joint types: fibrous (no synovial cavity, fibrous CT) cartilaginous (no synovial caivty, fibrocartilage and hyaline) synovial

Can you give a description of the Rami (Ramus)

- the spinal nerve emerges laterally from the IV foramen - it then divides into 2 major branches: the anterior (ventral) and posterior (dorsal) primary rami; ramus (singular) --Posterior (dorsal) rami go to back- intrinsic back muscles (gives general sensation of back) --Anterior (ventral) rami go to the body walls and limbs (extrinsic back muscles)

The ectoparasiticide Malathion

- topical (lotion) - inhibits acetylcholinesterase - causes paralysis and death in lice and their ova ** used to treat head lice ** use when there is resistance to permethrin ** may be used to treat pubic lice in adults only Adverse effects: local irritation ** treats LICE ONLY

Paraxial mesoderm forms

- vertebral columns and ribs - dermis of the back - skeletal muscle - parts of the skull

What occurs with damage to musculocutaneous nerve (C5-C7)

- weak flexion at glenohumeral joint - weak flexion and supination at elbow joint - loss of sensation in lateral aspect of the forearm

What four muscles make up the rotator cuff- (SITS muscles)

-Supraspinatus -Infraspinatus -Teres MINOR -Subscapularis ** it is called a "cuff" because they form a musculotendinous cuff around the glenohumeral joint fx: stabilize the glenohumeral joint; supraspinatus additionally provides the first 15 degress of arm abduction

Duchenne Muscular Dystrophy (DMD)

-X-linked recessive - genetic lethal in males (an affected male will die or be disabled enought to NOT have offspring) - this is due to lack of the dystrophin protein onset of symptoms is before age 5 relatively commmon: 1/4000-1/6000 males ** a milder version= Becker Muscular Dystrophy (BMD)- where the dystrophin protein IS present

Most bones have a basic architecture composed of

1. An outer cortical or compact zone - forms rigid outer shell that resists deformation 2. An inner trabecular or spongy zone (cancellous/spongy bone) - provides strength by acting as a complex system of internal struts - in bones with substantial weight-beaing function, the trabecular pattern is arranged to provide max resistance to physical stresses to which that bone is normal subjected ** spaces between the trabecular meshwork are occupied by bone marrow

The 3 Domains of Epithelial Cells are Structurally and Functionally Diff. what are they

1. Basal Domain: rests on the basal lamina and anchors the cell to underlying CT that contains the blood supply 2. Lateral Domain: Communicates with adjacent cells- characterized by specialized attachment areas (junctions) 3. Apical Domain: Usually faces a lumen it can have microvilli, cilia

Some possible reasons for UNSUCCESSFUL nerve regeneration

1. Blockage of the Schwann tube by scar tissue 2. In an injured MIXED nerve, if regenerating SENSORY fibers grow into columns connected to MOTOR end plates, the function will NOT be restored *** if unsuccesful, the postsynaptic cell also atrophies and degenerates, indicating that the neuron exerts a TROPHIC incluence on the cell with which it synapses

Two structures that are strongly positive with PAS are

1. Brush Border (microvilli coated with glycocalyx) 2. Basement membranes (secreted glycoproteins) **the BM is thicker in kidney tubule than in the intestine and that is why it stains darker ** note that PAS stains things high in carbs like glycogen, glycoproteins, proteoglycans typically found in CT, mucus, and basement membranes

Steps that produce contraction in smooth muscle

1. Calcium enters cell from ECFthrough a number of mechanisms (depolarization of sarcolemmal membrane, which opens voltage-gated Ca2+ channels, opening of ligand-gated calcium channels) 2. increased intracellular calcium concentration 3. calcium-induced calcium release from SR 4. binding of Ca2+ to calmodulin 5. increased myosin light chain kinase 6. phosphorylation of myosin 7. binding of myosin to actin 8. cross bridge cycling which produces contraction

Blood calcium is usually wuite stable because of constant interchange between blood calcium and bone calcium. Give example of machanism for raising blood calcium

1. Calcium ions are mobilized from hydroxlapatite crystals to interstitial fluid- happens mainly in cancellous bone: easier to release calcium from younger, more lightly calcified lamellae (that exsist even in adult bone) regulated by - Parathyroid hormone (PTH): raises low blood clacium - Calcitonin: lowers high blood calcium

What are some clinical presentations of breast cancer

1. Cancer interference with lymph drainage - Lymphadema (excess fluid in subcutaneous tissue)--> deviation of the nipple, leather-like appearance of the skin - Peau d'orange sign (orange peel appearance): prominent/puffy skin between dimples - dimples caused by shortening of suspensory ligaments 2. Cancer invades glandular tissue - large dimples (fingertip size of larger) - dimples caused by shortening or traction placed on suspensory ligaments 3. Cancer invades retromammary space, pectoral fascia, or interpectoral lymph nodes - breast elevated when muscle contracts- pt places hands on hips and is asked to contact pectoral mm. - sign of advanced breast cancer - invasion of pectoral fascia characteristic of rock-hard, fixed nodule 4. Subareolar Breast Cancer - retraction & deviation of nipple caused by shortening of lactiferous ducts

3 parts of a neuron

1. Cell body 2. Multiple Dendrites (info receiving end) 3. a single axon

Principal structures of the CNS

1. Cerebrum (cortex) - largest part of the human brain, associated with higher brain function such as though and action 2. Cerebellum - counts for apprx. 10% of brains volume BUT it contains OVER 50% of the total number of neurons in the brain- it controls balance and posture, and other functions 3. Spinal cord ** these 3 contain virtually NO CT ***** nerves contain the bulk of connective tissue in the nervous tissue

What are the 3 types of fibers in CT (**NOTE: all are mostly secreted by fibroblasts)

1. Collagenous Fibers - thick, and composed of collagen (mainly collagen type 1) - these have great tensile strength in tendons and ligaments, they are abundant in dense CT, and they hold structures together 2. Reticular Fibers - very THIN collagenous fibers (collagen type 3), highly branched and forms supportive networks 3. Elastic Fibers - NOT collagen - they are bundls of microfibrils embedded in elastin, the fibers branch, elastic, its found in vocal cords, air passages, and aorta

The paraxial mesoderm segments itself into somited which differentiate into sclerotome and dermomyotome. What do the dermomyotomes differentiate into?

1. Dermatome (dorsally): the dermatomal tissue migrates to the ectoderm and with a contribution from the lateral plate mesoderm forms the dermis of the back and limbs 2. Myotome (ventrally) ** Myotome differentiates into 2 components - Dorsally: epimere - Ventrally: hypomere

Smooth muscle cells can be attached to each other via

1. Desmosomes linked to cadherins and IFs intracellularly 2. Gap junctions

Structure of a nerve bundle

1. Endoneurium: a sparse layer of loose CT that surround INDIVIDUAL nerve fibers- it merged with the external/basal lamina of schwann cells 2. Perineurium: surrounds each FASCICLE (which is a small bundle of nerve fibers)- a sleeve of specialized CT formed by layers of flattened fibroblasts ** hundreds to thousands of axons can be contained in a fascicle and severeal fascicles can create a peripheral nerve *** Endoneurium and Perineurium are mainly Collagen Type III 3. Epinerurium: MOST EXTERNAL - Dense Irregular fibrous CT (fascia) that forms the external coat of nerves. It fontinues downward to fill spaces between bundles- this is mainly composed of Collagen Type I

What muscles are part of the lateral leg compartment

1. Fibularis (peroneus) longus 2. Fibularis (peroneus) brevis Actions: Eversion of foot I: Superficial fibular nerve Blood supply: Perforationg branches of fibular artery/vein

ATP is the only energy source that can be used in muscles so they have a few metabolic pathways for making ATP. What are they?

1. Free Sarcoplasmic ATP 2. Transfer of high energy phosphate from creatine phosphate to ADP, creating creatine and ATP (this is only sufficient fo maximal muscle contraction for only 5-8 seconds ex. hitting a ball with a bat) 3. Anaerobic glycolytic conversion of glucose (from blood or glycogen) to lactic acid (accumulation of glycolytic end-products limit its ability to sustain maximum muscle contraction after ~1minute (ex. sprinting 100m) 4. Aerobic metabolism of pyruvate and fatty acids via oxidative phosphorylation (for contractions >30 sec this dominates)

3 main components of CT

1. Ground Substance 2. Fibers 3. Cells ** the ground substance + fibers= ECM (to hold cells in place in CT, INTEGRIN on cell plasma membranes bind ECM components) * the composition of these 3 elements vary tremendously from one organ to the other (this offers great diversity in the types of CT)

3 examples of immediate hypersensitivity reactions

1. Hay fever attacks: caused by effects of HISTAMINE released from mast cells of nasal mucosa. - results in swelling of mucosa due to edema caused by increased permeability of localized capillaries 2. Asthma Attacks: caused by LEUKOTRIENES released from mast cells of lungs - results in difficulty breathing as result of bronchiospasm 3. Anaphylatic Shock - marked by swelling, hives, lowered BP, and dilated blood vessels. The most severe and life-threatening symptoms are difficulty breathing and loss of consciousness due to dangerously low blood pressure - in hyperallergic persons, can cause death within a few hours if left untreated

Steps in Endochondral Ossification

1. Hyaline cartilage forms by condensation of mesenchyme 2. bony collage forms around part of cartilage- blocks oxygen flow to underlying cartilage 3. cartilage calcifies and starts to die under bone collar 4. As cartilage deteriorates in this region and is removed, which opens spaces, blood vessels invade the now empty spaces bringing oxygen and osteogenic cells, now can form bone * note that mature osteoclasts can also resorb cartilage (some sources call them chondroclasts here) and they do it here 5. bone starts to form on calcified cartilage, forms "primary ossification center" later a secondary ossification center is formed on both sides of the bone and the epiphyseal growth plate becomes the epiphyseal line= end of growth ** all epiphyseal cartilage is replaced by bone except the articular surface

Functions of the Basal Lamina (laminae)

1. It attaches epithelia (or muscle or endothelial cell etc..) to underlying connective tissue 2. Act as a selective filter (ex. kidney glomerulus) 3. Acts as a scaffolding along which regenerating epithelial cells can migrate after injury

What are three different ways in which EXOCRINE glands release their products into ducts

1. Merocrine (MOST COMMON): Simple exocytosis of vesicles. In a gland, merocrine is usually regulated secreation (needs Ca2+ signal) rather than being constitutive (ex. pancreatic acinar cell) 2. Apocrine: APical portion of the membrane goes also (ex. lactating mammary gland) 3. Holocrine: wHOLe cell blows up (and dies). Cellular debris is mixed with secretory product. Need quickly dividing replacement cells (ex. Sebaceous Glands)

3 major components of the neuromuscular junction

1. Motor neuron presynaptic terminal - contains mitochondria (that supply ATP for synthesis of excitatory neurtransmitter Ach) and Ach synaptic vesicles - pre-synaptic membrnae lined with voltage gated Na+, K+ and Ca2+ channels and proteins involved with veisicle fusion this is the ACTIVE ZONE 2. Synaptic Cleft - filled with fibrous matrix which contains acetylcholine (ACh) deactivating enzyme acetylcholinesterase (AChE) 3. Postsynaptic membrane of the skeletal muscle fiber - aka Motor End Plate - folded membrane (sarcolemma) lined with acetylcholine (ACh) receptors - voltage gated Na+ and K+ channels in the adjacent (neighboring) membrane

Mechanisms for de-regulating E2F in cancer

1. Mutate Rb to be non-functional 2. Mutate or regulate through epigenetics so Rb is not expressed 3. Increased phosphorylated of Rb so that E2F is released - mutate p16 (usually inhibits CDK-Cyclin complex) to be non-functional/not expressed - mutate cyclin/CDK to be overexpressed

Two Kinds of Cells in both the CNS and PNS

1. Neuron - the functional and structural unit of the Nervous system - specialized to accept impulses, integrate them, then send them on - can communicate with other neurons and excite tissues like muscle 2. Glial cells - 6 diff kinds (4 in CNS, 2 in PNS) - short processes - Many diff fxs: nutrition, support, protection of neurons

Describe pathay of Musculocutaneous Nerve (C5-C7) through the Anterior Compartment of the arm

1. Pierces coracobrachialis muscle 2. Travels distally between biceps brachii and brachialis 3. Emerges lateral to biceps as the lateral cutaneous nerve of the forearm (sensory to lateral forearm)

what are two varieites of bone

1. Primary (immature, woven) bone - 1st bone tissue to appear in embryonic development and bone repair - woven bone is produced when osteoblasts produce osteoid rapidly: abundant osteocytes, haphazard organization of collagen fibers (weak bone) - low mineral content * this bone is remodeled and replaced by: secondary bone (EXCEPTT: in tooth sockets, suture line in skull, and insertion sites of tendons) 2. Secondary (mature, lamellar) bone: replaces primary bone - found in adults - has an organized lamellar disposition of collagen: composed of parallel or concentric lamellae of collagen ** matrix is CALCIFIED (strong bone)

Issues that can affect the Sciatic Nerve

1. Sciatica: radiating pain anywhere along the course of the sciatic nerve. Caused by disc protrusion/herniation, external source compressing the nerve, or hypertrophy/spasms of piriformis muscle 2. Wound or surgery to medial buttock 3. Trauma to posterior thigh 4. Posteiror hip joint dislocation (femoral head moves posteriorly and impinges the sciatic nerve)

Somites (below or caudal to the occiput) from the paraxial mesoderm differentiate into two parts

1. Sclerotome: forms vertebral column, parts of skull and ribs 2. Dermomyotome: forms the dermis of the back and skeletal muscles of the limbs and trunk

A given epithelium may serve one or more functions, depending on the activity of the cell types that are present. What are some fx's that can occur

1. Secretion: like in the columnar epithelium of stomach and gastric glands 2. Absorption: like in the columnar epithelium of the intestines and PCT in the kidneys 3. Transportation: as in transport of materials or cells along the surface of an epithelium propelled by motile cilia (transport of dust particles in the bronchial tree) or in the transport of material across an epithelium (pinocytosis or endocytosis) to and form the CT 4. Mechanical protection: as in the stratified squamous epithelium of the skin (epidermis) and the transitional epithelium of the urinary bladder 5. receptor function: to receive and transduce external stimuli as in the taste buds of the tongue, olfactory epithelium of the nasal mucosa, and the retina of the eye

Functions of Tight Junctions (AKA Zonula Occludens)

1. Separate and maintain the apical domain from the basolateral domain 2. Composed of a branching network of sealing strands, each strand acts independently from the other (proteins called claudins and occludins form the strands that seal the plasma membrane of two adjacent cells together) 3. The strands of the zonula occludens/tight junction form a belt allll the way around the epithelial cell- this allows the cell sheets to serve as barriers to solute diffusion

Epithelium appearance can be classified by

1. Shape of Cells - squamous (cells wider than they are tall/flat- squame "scale" in latin - cuboidal (height and width are the same) - columnar (cells taller than they are wide) 2. Number of Cell layers - Simple: single layer ( ALL cells touch the basal lamina) - Stratified: more than one layer (contains cells that DO NOT touch the basal lamina)

3 types of muscle

1. Skeletal muscle (most common)- voluntary 2. Cardiac muscle- involuntary 3. Smooth muscle- involuntary Fx of smooth m: - peristalsis in gut - narrowing the walls of blood vessels - emptying of urinary bladder - pupillary contraction - childbirth (partuition) by contraction of the uterus

Tissue layers of the Leg

1. Skin 2. Superficial Fascia (subcutaneous tissue) 3. Deep fascia of leg (crural fascia) protective covering around muscles, nerve, blood vessels 4. Interosseous membrane 5. Intermuscular septum 6. Artery, nerve, vein *** compartment syndrome can also occur in the leg: fix with fasciotomy

3 skeletal muscle fiber types

1. Slow-Oxidative (type I) fibers 2. Fast-Oxidative (type IIa) fibers 3. Fast-Glycolytic (type IIb) fibers Oxidative or Glycolytic refers to the enzymatic machinery used for ATP formation ** oxidative fibers: oxidative phosphorylation, abundant mitochondria (generate ATP by aerobic respiration), richly supplied with capillaries, high myoglobin content (darker in color) *** Fast-glycolytic fibers: high content of glycolytic enzymes, few mitochondria (ATP is generated mainly by glycolysis) , few capillaries, little myoglobin, have high amounts of stored glycogen- these fibers contract strongly and quickly and are adapted for intense anaerobic movements of short duration (responsible for quick short muscle movement such as those involved with jumping and blinking of the eyes- although they contract rapidly and powerfully, they faitgue easily (their endurance is limited)

Functions of CT

1. Support- to epithelium (ex. lamina propria) 2. Strength- provides tensile to mechanical stress (ex. dermis of skin, ligament) 3. Storage- fat cells store fat while ground substance stores water, ions and inorganic material 4. Transport- water, ions, and inorganic material are transported from blood to various tissues of body through CT matrix 5. Packing- they fill spaces (ex. loose CT and adipose tissue) 6. Repair- helps in wound healing 7. Defense- cells help in defense action ex. plasma cells, macrophages, lymphocytes, monocyts, eosinophils

What are 3 things that the Mucous Membrane (mucosa) ALWAYS consists of

1. Surface epithelium 2. A supporting CT called the lamina propria (loose CT) 3. A basal lamina/basement membrane separating the epithelium from the lamina propria and SOMETIMES It also contains 4. a layer of smooth muscle called the muscularis mucosae as the deepest layer

What are the 3 principal characteristics of the cells that make up an epithelium

1. They are closely apposed and adhere to one another by means of specific cell-to-cell adhesion molecules that form specialized cell junctions 2. They are POLARIZED (diff fx are associated with 3 distinct morphological surface domains) - apical: usually faces a lumen - lateral: communicated with adjacent cells and is characterized by specialized attachment areas - basal: rests on basal lamina, anchoring the cell to underlying CT * the properties of each domain are determined by specific lipids and integral membrane proteins 3. Their basal surface is attached to an underlying BASAL LAMINA, a noncellular, protein-polysaccharide rich layer secreted by epithelial cells

The different types of CT differ in their

1. Types and number of cells: they can be fixed (ex. fibroblasts) or wandering (ex. wbc) 2. Types of fibers: can be collagen, reticular, elastic 3. Type of ground substance: the "gel" between the cells and fibers, contains many macromolecules including lots of water

Bone fracture and bone healing process

1. a heamatoma causes lack of oxygen to osteocytes leading to necrosis, then an inflammatory response 2. (4 days-3 weeks) then you have a soft callus (fibrocartilage and granulation tissue) [granulation tissue= new CT and microscopic blood vessels that form on surfaces of a wound during healing process]- mineralization of wooven bone 3. turns into hard callus with fibrocartilage and spongy bone (a hard callus forms as osteoblast cells create new bone, adding minerals to make it hard. Thise begins at about 2 weeks after the break, and ends somewhere between 6th-12th) 4. Remodeling phase: this hard callus turns into new compact bone (around 6 months)

Bone remodeling (or bone metabolism) is a lifelong process where:

1. bone resorption: mature bone tissue is removed from the skeleton 2. Ossification or new bone tissue formation ** remodeling responds to functional demands of mechanical loading - these processes also ocntrol the reshaping or replacement of bone following injuried like fractures but also micro-damage, which occurs during normal activity ** in first yr of life, almost 100% of the skeleton is replaced ** in adults: remodeling proceeds at about 10% per year ** an imbalance in the regulation of bone remodeling two subprocesses (bone resorption and bone formation), results in many metabolic bone disease, such as osteoporosis [absorbing > making= osteoporosis ]

The path of the radial nerve in the posterior compartment of the arm

1. enters arm posterior to the brachial artery, medial to the humerus, and anterior to the long head of the triceps 2. Descends inferolaterally with the deep artery of the arm in the radial groove, between the lateral and medial heads of the triceps 3. When it is lateral to the humerus, it pierces the lateral intermuscular septum as it moves into the forearm anterior to the lateral epicondyle, between the brachialis and brachioradialis

2/3 carrier risk (not showing they are affected,but may be caring it) for sibling of an affected applies if

1. inheritance pattern is autosomal recessive (none of the others) 2. both parents are unaffected (in case of autosomal recessive- both parents must be heterozygote carriers if they passed on the disease but are not showing it) ** the siblings risk of passing on the bad allele is 1/2- so her composite risk of passing on an 'a' allele is 1/2 x 2/3 = 1/3 ** if someone of this kind incestously marries a person WITH the disease (whose chance of passing it on would be 1) - the risk of having a child with a disease (ex. albino) would be 1/3 (from carrier) x 1 (from affected) = 1/3 (this is the product of the risk that BOTH parents pass on a bad allele)

Steps of signal transmission at a chemical synapse

1. neurotransmitter is synthesized and stored in vesicles 2. AP arrives at the pre-synaptic terminal 3. Depolarization of presynaptic terminal causes the opening of voltage-gated calcium channels 4. Influx of calcium through the channels 5. Ca2+ causes vesicle fusion with the presynaptic membrnae 6. Neurotransmitter is released into synaptic cleft by exocytosis 7. NT diffuses across the synaptic cleft and binds to receptors on the postsynaptic membrane (these are ligand-gated ion channels (NT causes their opening/sometimes their closing) 8. Opening or closing of the post-synaptic channels 9. Change in post-synaptic membrane potential (depolarization or hyperpolarization) changes the excitability of the post synaptic cell 10. NT is removed from cleft (ending signal) by enzymatic breakdown and taken back up into the presynaptic terminal 11. Retrieval of vesical membrane from the plasma membrane

What are the tissue layers of the thigh

1. skin 2. superficial fascia (subcutaneous tissue: fat, cutaneous nerves, superficial veins, lymphatic vessels) 3. deep fascia of the thigh (fascia lata): protective covering around muscles, nerves, blood vessels 4. intermuscular septum (extensions of deep fascia)- aids in stability, attaches bone 5. Muscle 6. Artery, vein, nerve 7. Bone

For autosomal recessive cases when looking at markers what is the strategy

1. start with the affected child (they should be aa) 2. look at parents (whichever allele of parents matches with affected child is an a- if the parent is unaffected they must be Aa) 3. Then go to the siblings- see which alleles (one from mom, one from dad) they acquired ** ALWAYS go in this order

In skeletal muscle physiology the speed with which a muscle contracts dependes on 2 things:

1. the type of muscle fiber (fast-twitch or slow-twitch, ATPase activity) and 2. on the load that is being moved (i.e the force required to move the load)

how do osteoclasts function

1. they release hydrogen ions through the action of carbonic anhydrase through the ruffled border into the resorptive cavity, acidifiying and aiding dissolution of the mineralized bone matrix 2. several hydrolytic enxymes (cathepsins and matrix metalloproteases- MMP), are released by lysosomes to digest the organic components of the matrix ** a trench (howships lacunae) is formed on the bone surface as the osteoclast crawls along

In autosomal recessive when looking at a possible heterozygote passing on a bas allele you multiply by

1/2 for every generation going down - remember someone with Aa has a carrier risk of 1

What occurs if there is an injury to the Superficial Fibular Nerve (branch of the common fibular nerve (L4-S2)

Abnormal motor and sensory function - weakness or inabitiy to evert foot by fibularis longus and brevis - diminished/ loss of skin sensation over dorsum of foot (except skin between digits 1 and 2)

What would occur due to an injury to the Obturator Nerve (L2, L3, L4)

Abnormal muscle and sensation function - weakness or inability to ADDUCT thigh - diminished or loss of skin sensation on medial aspect of thigh

rim of fibrocartilage attached to margin of acetabulum. It deepens the socket of acetabulum for greater fit for femur head

Acetabular Labrum

Enzyme that degrades ACh in the synaptic cleft

Acetylcholinesterase (AChE) - hydrolyzes ACh to choline and acetate *** Acetylcholinesterase Inhibitors prolong ACh action (ex. neostigmine)

Thin filament is composed of

Actin - synthesized as a globular protein (G-actin), each with myosin binding site. Polymerized into chains; 2 chains twist together (F-actin) Contains two tightly associated regulatory proteins: - tropomyosin: "gate-keeper" regulates actin-myosin binding & troponin: - Troponin T: binds to Tropomyosin - Troponin C: binds to calcium - Troponin I: binds acting and INHIBITS contraction

The ____ cytoskeleton contributes directly or indirectly to nearly every aspect of neuronal development and function

Actin Actin functions in neurons include: - growth, guidance and branching of neurons - morphogenesis of dendrites and dendritic spines - synapse formation and stability - axon and dendrite retraction

Subclavius Action and Innervation

Action: - anchors & depresses clavicle Innervation: - nerve to subclavius (C5, C6) - branch off the superior trunk

Serratus Anterior action, innervation, insertion

Action: - protracts scapula - holds scapula against thoracic wall - superior rotation of the scapula Innervation: - long thoracic nerve (from roots) Insertion: - Anterior surface of medial border of scapula

Pectoralis Minor action, innervation, insertion

Action: - stabilizes scapula by drawing it inferiorly & anteriorly against the thoracic wall Innervation: - medial pectoral nerve (C8, T1) branch of the medial cord Insertion: - coracoid process

Anconeus Muscle (Posterior Compartment of Arm)

Actions: - Assists in forearm extension - Stabilizes elbow Innervation: radial nerve

Triceps Brachii (Posterior Compartment of the arm)

Actions: - Extends forearm - Long head: resists inferior dislocation of humerus during adduction - Long head: adduct and extends arm Innervation: - Radial Nerve Insertion: Olecranon Process *** Triceps Brachii has a Lateral head, Long head, and Medial Head

Biceps Brachii (Anterior Compartment)

Actions: - Supinates forearm - Flexes supine forearm "barbels" - Helps hold humeral head in glenoid fodda Innervation: Musculocutaneous Nerve Origin: - Short head: Coracoid Process - Long head: Supraglenoid tubercle Insertion: - Radial tuberosity and forearm fascia via bicipital aponeurosis

Coracobrachialis (anterior compartment of arm)

Actions: Adducts humerus and Flexes arm Innervation: Musculocutaneous nerve (* pierces into coracobrachialis- it is part of brachial plexus) Origin: Coracoid Process

The sympathetic nervous system releases norepinephrine which

Activates: -Beta 1 adrenoceptors: increases heart rate - Alpha 1 adrenoreceptors: cause pupil dilation

Fibroblasts can either be

Active or Inactive (aka Quiescent or fibrocytes) Active Fibroblasts: - large cells with large euchromatic nuclei - basophilic cytoplasm - lots of rER and prominent golgi (lots of secretory activity) Inactive Fibroblasts (fibrocytes) - smaller - less prominent, heterochromatic nuclei

A fascial compartment located posterior to the sartorius muscle

Adductor Canal (a passageway for four neurovasculature structures); - Nerve to Vastus Medialis (motor nerve branch of femoral nerve that I: Vastus Medialis Muscle) - Saphenous Nerve (sensory nerve branch of femoral nerve that transmits sensation from skin of anteromedial leg and medial side of foot) - Femoral Artery - Femoral Vein

Which muscle of the medial compartment of the thigh has DUAL innervation

Adductor Magnus * because it is an Adductor Muscle (obturator nerve L2, L3, L4) and also a hamstring part as a posterior thigh muscle (tibial division of sciatic nerve)

Which muscle has an opening in its tendon called the Adductor Hiatus

Adductor Magnus * for passage of blood vessels to the POSTERIOR aspect of the lower limb

The 4 Dorsal Interossei originate at

Adjacent surfaces of metacarpals (1st dorsal interossei has origins on the 1st and 2 metacarpal) Inserts: digits 2-4, bases of proximal phalanges and extensor expansion Action: ABduction of digits 2-4 and flexion at the metacarpophalangeal joint

Describe the infectious path of rabies

An animal is bitten by a rabid animal (rabies virus from the infected saliva enters the wound) - it travels through the nerves to the spinal cord and brain- this process can last approximately 3-12 weeks. The animal has no signs of illness during this time * when it reachs the brain the virus multiplies rapidly and passes to the salivary glands. The animal begins to show sings of the disease- infected animal usually dies within 7 days of becoming sick *** note that replication of the virus occurs within Ventral Horn Neurons and Dorsal Root Ganglia

Which ligament prevents anterior sliding of the tibia under the femur

Anterior Cruciate Ligament (ACL)- it attaches to tibia anteriorly at the anterior intercondylar area to the lateral femoral condyle Functions: - prevents anterior sliding of tibia under femur - taut when knee is extended - prevents hyperextension of knee joint ** it is weaker than posterior cruciate ligament; more commonly damaged

Extrinsic Muscles of back are innervated by

Anterior Rami of Spinal Nerves (1 exception: CN XI- Spinal Accessory Nerve) * The Extrinsic Muscles Consist of: - Superficial Layer: connects the axial skeleton with the superior appendicular skeleton; controls the upper limb - Intermediate Layer: ONLY associated with axial skeleton; controls the respiratory/proprioceptive movements; Serratus Posterior Muscles

The Superior, Medial and Inferior Trunks each have a

Anterior and Posterior Division - All three posterior divisions come together - Anterior of superior and medial trunks come together - inferior trunks anterior division continues on alone

The deep fibular (peroneal) nerve (L5-S2) supplies the

Anterior compartment of the leg - Tibialis Anterior - Extensor Hallucis Longus - Extensor Digitorum Longus - Fibularis (peroneus) tertius

Hypomere--> Limb bud --> Anterior condensation--->

Anterior condensation forms - Upper limb: flexor and pronator muscles - Lower limb: flexor and adductor muscles

What is the innervation of the piriformis muscle

Anterior rami of S1-S2 (also called Nerve to Piriformis)

BCL2

Anti-apoptotic member of the BCL2 gene family (apoptosis is part of the normal defense against uncontrolled cell growth) - B lymphocytes: BCL2 not expressed - Follicular lymphoma: BCL2 expressed How? Through SOMATIC RECIPROCAL TRANSLOCATION (common in many Follicular Lymphomas) t (14;18) (q32;q21) - translocation in B lymphocyte - this cell normally expresses IgH (immunoglobulin heavy chain) but NOT BCL2 After translocation: - BCL2 under control of IgH enhancer IS expressed ** this translocation is in most follicular lymphomas

Damage of MEDIAN nerve at the wrist can cause

Ape Hand deformity from Paralysis of thenar muscles and lateral two lumbricals: - retain: flexor digitorum superficialis and flexor digitorum profundus, flexor pollicis longus - lose: adbuctor pollicis brevis, flexor pollicis brevis, opponens pollicis and lateral two lumbricals - result: loss of opposition from digit 1 and weakened digit 1 flexion and abduction --> "ape hand deformity" * common in suicide attempts

Which cartilage growth results from differentiation of perichondrial cells

Appositional growth "occurs at the edge" of cartilage mass chondrogenic cells in inner layer of perichondrium synthesize matrix --> chondroblasts intrapped in lacuna --> becomes chondrocytes * these chondrocytes can divide a couple of more times when they do= interstitial growth

Keratinized Stratified Squamous Epithelium

As cells move up from the basal lamina, they differentiate and die - in most apical layers (exterior) ekin cells are dead and have lost their nuclei and other organells, NO nuclei in keratinized cell - Left in these dead cells are KERATIN intermediate filaments, and not much else- this helps to waterproof skin ***Keratinized Stratified Squamous Epithelium is found on the Epidermis of the skin

Basilic Vein of the arm

Ascends from the anteromedial forearm into the arm - at approximately the middle of the arm, it pierces the brachial fascia to run with the brachial artery

Characteristic star-shaped glial cells in the brain and spinal cord (in CNS ONLY, not PNS)

Astrocytes - form a 3D web suppoting neurons - LARGEST of glial cells - MOST numerous in CNS - they have many processes * a tumor of astrocytes= astrocytoma

Steps of cartilage formation during embryonic development

At the site of chondrogenesis: Mesenchymal cells --> chondroblasts (secrete matrix- trapping themselves in --> lacunae (further separation of more matrix --> chondrocytes ** at the same time, mesenchymal cells of periphery condense to form a fibrous sheath around the newly formed cartilage- this is the Perichondrium

The joint that connects the Axis and Atlas is referred to as the

Atlanto-Axial Joint **it allows head movement (specifically rotation- it allows you to shake your head no) ** uses deep posterior neck muscles: Movement to right: sternocleidomastois and semispinalis capitis Movement to the left: - Obliquus Capitis Inferior - Rectus Capitis Posterior, Major and Minor - Longissimus Capitis - Splenius Capitis

Which joint allows for head lateral flexion and extension- to nod your head yes

Atlanto-Occipital Joint (a synovial joint) (C1 and the skull) ** uses the Deep posterior neck muscles: - Rectus capitis posterior major - Rectus capitis posterior minor - Obliquus capitis superior

What does the Quadriceps Femoris Tendon attach to

Attaches from muscle to patella ** it is a strong tendon made of combination of 3 muscle tendons of quadriceps femoris ** TENDON ATTACHES MUSCLE TO BONE

Peripheral Nervous System is divided into

Autonomic nervous system (communicates with internal organs and glands) and Somatic Nervous system (communicates with sense organs and voluntary muscles)

The terminal branches of brachial plexus include

Axillary Nerve Radial Nerve Musculocutaneous Nerve Median Nerve Ulnar Nerve

Union of the brachial vein and basilic vein

Axillary Vein - changes name at the lateral border of 1st rib to subclavian vein (same as subclavian & axillary artery) - contains 3 parts (corresponds to 3 parts of axillary artery)

Axillary artery becomes the _____ at the ___

Axillary artery becomes the brachial artery at the inferior border of teres major

Subclavian Artery becomes the

Axillary artery which then changes name to the brachial artery then it separates into the radial artery and ulnar artery

What feature of the blood brain barrier (BBB) limits transport across capillaries in the brain (nothing bigger than 500 daltons):

BBB is created primarily by very extensive TIGHT JUNCTIONS between capillary endothelial cells ** these TIGHT JUNCTIONS by EM resemble the "tight" tight junctions of epithelial cells, not the loose tight junctions found between endothelial cells in most capillaries (many strands of occludin)

Metaplastic replacement of the normal squamous epithelium of the lower esophagus by columnar epithelium with mucus-secreting goblet cells is a characteristic of

Barrett's Esophagus - is an acquired condition that results from chronic gastro-esophageal reflux (reflux of acidic stomach contents) - this change of epithelium is called intestinal metaplasia; it protects the esophagus epithelium from the acid - normally, this columnar epithelium is found in stomach but does not extend into the esophagus

The sarcolemma (muscle cell membrane) of all three types of muscle are surrounded by a

Basal lamina (like epithelial cells)- but in muscle cells this is usually called the EXTERNAL LAMINA In muscle, the components of the external lamina are secreted by muscle cells: - Collagen Type IV - Laminin - Perlecan ** in epithelia, these 3 glycoproteins are secreted by epithelial cells

If dystrophin is present but abnormal

Becker MD - caused by other mutation in DMD gene; milder symptoms, later onset

Deep Tendon Reflexes included:

Biceps Brachii Reflex (C5-C6) - tests integrity of the musculocutaneous nerve Triceps Brachii Reflex (C7-C8) - tests integrity of the radial nerve ** Diminished reflex= lesion at lower motor neuron affecting peripheral nerves ** Brisk reflex= lesion at upper motor neuron which is in CNS

Which hamstring muscles are found on the LATERAL side of the thigh

Biceps Femoris Muscle - Long Head (which is a true hamstring muscle) I: Tibial Division of the Sciatic Nerve - Short Head I: Common Fibular Division of the Sciatic Nerve

A special type of CAPILLARY is found in the brain that forms the

Blood-Brain Barrier (BBB) ** first description of this was provided when vital dyes injected into bloodstream could penetrate and stain nearly all organs except the brain - lets essential metabolites such as oxygen and glucose pass from the blood to the brain and CNS BUT blocks most molecules that are bigger than about 500 daltons ** means that everything from hormones and neurotransmitters to viruses and bacteria are refused access to the brain by the BBB *** also many drugs which would otherwise be capable of treating disorders of the CNS are also denied access to the very regions where they would be effective

Plantar aspect of foot=

Bottom (sole) of foot - feels "fleshy" - Many muscles, thick fascia

Deformity of digits that consists of flexion of the proximal interphalangeal (PIP) joints and hyperextension of the distal interphalangeal (DIP) joints

Boutonniere Deformity

Veins accompanying the brachial artery

Brachial Veins

Where does C8 spinal nerve course through

C8 spinal nerve courses INFERIOR to C7 vertebra but SUPERIOR to the T1 vertebra

In skeletal muscle what is the purpose of a T-tubule

Brings ions deep into the cell which allows all myofibrils to be stimulated to contract together - A T-tubule is formed by an invagination of the sarcolemma of striated muscle they are arranged in a TRIAD= 1 T tubule + 2 Terminal cisternae of the sarcoplasmic reticulum (one cisternae on either side of the T tubule) ** depolarization of the T tubule membrane initiates the release of calcium ions from the sarcoplasmic reticulum and eventually triggers muscle contraction

Origin and Innervation of Suprascapular Nerve

C5, C6- branch of the superior trunk of the spinal cord - Supraspinatus - Infraspinatus

Radial Nerve

C5- T1- terminal branch of brachial plexus from the posterior cord Innervates: (Posterior Compartment of Arm and Forearm) - Brachialis (contribution) - Triceps brachii - Anconeus - Supinator - Brachioradialis - Extensor carpi radialis longus - Externsor carpi radialis brevis - Extensor digitorum - Extensor digiti minimi - Extensor carpi ulnaris - Extensor pollicis longus - Extensor pollicia brevis - Extensor indicis - Abductor pollicis longus Cutaneous Branches: - Inferior lateral brachial cutaneous - Posterior brachial cutaneous nerve - Posterior antebrachial cutaneous nerve - Superficial branch of radial nerve ** If pt presents with loss of sensation to posterior arm/forearm= Radial Nerve Problem

Example of superior (upper trunk) brachial plexus injuries

C5-C6 injuries - usually results from an excessive increase in the angle between the neck and shoulder - muscles paralyzed depend on location of injury (root vs. trunk) - loss of sensation on lateral arm and forearm Ex; Erb-Duchenne Palsy ("Waiter's Tip") - often result of labor dystocia, where excessive stretching of the neck occurs during delivery - deltoid, biceps, and brachialis are paralyzed - upper limb is adducted - arm is medially rotated - elbow is extended ** affects musculocutaneous and axillary nerve - musculocutaneous (muscles of anterior arm/flexors of forearm) - Axillary nerve (shoulder muscles)

Limb buds are innervated by branches of the primary rami of spinal nerves ___ upper limb and ___ lower limb

C5-T1: upper limb L2-L3: lower limb ** as the limb bud forms the ventral primary ramus from each spinal nerve grows into the limb bud as anterior and posterior branches- as the musculature starts to differentiate the branches unite to form large dorsal and ventral nerves

Origin and Innervation of the Lower subscapular nerve

C6 Teres Major M. Subscapularis M.

Origin and Innervation of Thoracodorsal Nerve

C6, C7, C8 Latissimus dorsi m.

Inferior ("lower trunk") brachial plexus injury

C8-T1 injuries - May occur when upper limb is suddenly pulled superiorly (ex. when grasping something to break a fall) - it is less common than superior brachial plexus injuries Ex; Klumpke Paralysis: - Most commonly results from difficulties in child birth - "claw hand" deformity (when making a fist), because the muscles of the forearm and heand are involved (injury of ulnar nerve comes with C8-T1) - potential for horners syndrome; if present; there is miosis (constriction of pupils) ** Affects ulnar nerve (musscle of medial forearm and hand/flexors of hand and digits)

A specific and sensitive test to screen people for an alcohol use disorder is the

CAGE - a positive answer to any of the 4 questions indicates an alcohol use disorder ( a person has to answer affirmitively - YES- to only 1 question on CAGE to be at risk for a substance use disorder CAGE questions: - Have you ever felt that you should cut down on your drinking? - Have people annoyed you by criticizing your drinking? - Have you ever felt bad or guilty about your drinking? - Have you ever taken a drink first thing in the morning to steady your nerves or get rid of a hangover? (eye opener)

Which binds to OSTEOCLASTS: parathyroid hormone (PTH) or calcitonin

CALCITONIN BINDS TO OSTEOCLASTS!!!!!!!! - reduces there activity to decrease high blood calcium

Large, Negatively charged substances ______ cross the basal lamina

CANNOT ** this is important in kidney filtration

G1-Cdk equals

CDK4 and CDK6 which are activated by Cyclin D ** overexpression of Cyclin D1 is common in Mantle cell lymphoma

The spinal cord + brain forms the

CNS

Neural tube forms most of the

CNS ex. - pyramidal cells - ventral horn cells - astrocytes - oligodendrocytes ** Neural tube comes from the neuroectoderm

Afferent nerves conduct signals from sensory neurons to the

CNS ex. from the mechanoreceptors in skin

In contrast to the PNS, in which injured axons RAPIDLY regenerate, axons severed in the

CNS usually CANNOT regenerate due to... 1. The inability of oligodendrocytes and microglia cells to phagocytose myeling debris quickly and 2. The restiction of large numbers of migrating macrophages by the blood-brain barrier (BBB) ** sooo debris is not cleared and this myelin debris- contains several inhibitors of axon regeneration * you get gliosis

Main differences between cardiac and skeletal muscle

Cardiac muscle only has a single nucleus and its action is INVOLUNTARY ** but they are similar in that they both have striations and similar contration (both have sarcomeres)

Do skeletal or cardiac muscle contain more mitochondria

Cardiac!!! Mitochondria occupy up to 40% of the cell volume, higher than in skeletal muscle fibers, which allows them to produce ATP quickly making them highly resistant to fatigue

Trombiculid Mites (larvae called Chiggers)

Cause chigger dermatitis or trombicuolosis - feed on variety of animals with humans being an accidental host - reside in low vegitation - larva secrete saliva with proteolytic enzymes that secrete tube-like invagination or stylosome (allows mite to imbibe tissue fluids) - saliva highle antigenis - causes extremely pruritic papular , papulovesicular or papulourticarial lesiosn (often around ankles) * scratching destroys the body of a mite (itching can persist for weeks ) - true diganosis reliles on confirmations of the mites identitiy or elicitation to the mites source - oral antihistamies CAN BE VECTOR SCRATCHING CAN LEAD TO SECONDARY INFECTION

Dermatobia hominis (human botfly) aka Tórsalo

Causes myiasis (D. Hominis is bot fly that freq parasitizes humans) * myiasis is an infestation of the skin - it will capture another arthropod and deposit eggs on the abd - when the arthropod feeds on human the egg hatches and larvae enter the skin through the bite site, hair follicles, soft folds in skin, moist areas of skin * occurs in tropical and subtropical areas - pt may be affected while on vacation * A furuncular lesion (boil like pocket develops): larva develops from 5-10 weeks but can be up to 3 months- once larva mature it exits the body - if it dies prior to pupation, an abscess forms * upward pointing spinds hold larva in place, thus surgical removal is necessary - wound cleaned and antibiotics given * secondary infections with Staph aureus and streptococuus pyrogenes possibel

As the limb bud develops, cells from the ___ migrate into the developing limb buds (upper limb: C5-T1/ lower limb: L2-S3) this then divides into a

Cell from HYPOMERE migrate into developing limb buds - divides into an ANTERIOR and POSTERIOR condensation on either side of the developing limb bones

How do ion channels and aquaporing aid in fluid secretion

Cells lining the ducts of exocrine glands (ex. pancreas, liver, sweat, and salivary glands) secrete large volumes of body fluids HOW? - Ion pumps and channels situated in the basolateral and apical plasma membrane move ions (mostly Na+ and Cl-) into the ductal lumen, creating an osmotic gradient between the surrounding tissue and the duct - Water follows salt so the water molecules rapidly follow the osmotic gradient through aquaporins that are present in high concentrations in both the apical and basolateral membranes *** many times, the duct cells will reabsorb ions, BUT NOT WATER (these duct cells dont have aquaporins- so you will take up the salt but not the H2O and this will just flow out of the surface of the cell)

Nervous System is separated into

Central nervous system (brain and spinal cord) and Peripheral Nervous system

Where are the two enlargements of the spinal cord located?

Cervical and Lumbar * where there are more nerves for innervation of the limbs

What drugs are sunscreens

Chemical agents - avobenzone - oxybenzone - para-aminobenzoic acid Physical agents - titanium dioxide - zinc oxide

Which receptor stimulates release of epinephrine from the adrenal medulla

Cholinergic nicotinic receptors *** ACh stimualates release of epinephrine (and norepinephrine) from the chromaffin cells (also called pheochromocytes). The adrenal medulla- a modified ganglion. ** ACh released here binds to nicotinic ACh receptors, opening sodium channels and causing depolarization in chromaffin cells - this opens voltage-gated calcium channels in the chromaffin cell membrane - intracellular calcium levels increase stimulatig the movement of vesicles containg NE and E to the cell membrane * the vesicles fuse with the cell membrane and empty their contents (by exocytosis) into the blood stream

Primary protein involved in the recycling of synaptic vesicles

Clathrin * once the contents of the vesicles have been released, the vesicles must be reformed in a process involving endocytic budding of vesicles from plasma membrane. *Clathrin= primary protein involved in this - coated-pits are pinched off and separated from plasma membrane by a protein called: dynamin - clathrin-coated vesicles are released in the cytosol - the coated vesicles are disassembled and the recycled vesicles fuse with each other form an endosome - a newly recycled vesicle buds off the endosome and is filled with ACh

The most abundant protein in the human body

Collagen - 30% of its dry weight - there are more than 20 types of collagen that have been identifies. These are produced by several cell types and are distinguishable by their molecular compostions, morphologic characteristics, distribution, functions, and pathologies * Collagen I and II are Fibril forming - 1 is most abundant and III is in reticular fibers * Collagen IV is network-forming it is the collagen in basal lamina- secreted by epithelial cells

Reticular fibers are made up of

Collagen Type III (which is heavily glycosylated) - produced by fibroblast. DO NOT form bundles but will form fibrils and fibers - with silver staining are argyrophilic ("silver-loving") - they are arranged in a delicate mesh-like network and provide support for tissues and organ * they form a supporting framework in soft tissues like the liver, adrenal glands, bone marrow, and spleen Found around: - nerves - small blood vessels - muscle cells

What is the significance of scapular anastomoses

Collateral Circulation - when ligation of subclavian or axillary arteries is necessary, blood can still get to distal part of the axillary artery (and upper limb) 3 Main pathways: 1. Direct: subclavian --> axillary a. 2. Subclavian --> Thyrocervical trunk --> Suprascapular a. --> circumflex scapular a. --> Subscapular a. --> axillary artery 3. Subclavian --> Dorsal scapular a. --> Circumflex scapular a. --> subscapular a. --> Axillary a.

Which nerve is vulnerable to injury (ex. by fracture of fibular head/neck or excessive impact)

Common Fibular Nerve (L4-S2) * injury results in impairment of foot eversion, ankle dorsiflexion, and extension of the toes (muscles of anterior and lateral leg compartments will be affected); also sensory loss on the dorsum of the foot *** the common fibular nerve branches into the deep and superficial fibular nerves just distal to the head of the fibula **** the commmon fibular nerve has a SUPERFICIAL relationship to head and neck of the fibula- it winds laterally around the head/neck of the fibula and this is why a fracture of this area can lead to its impairment

The sciatic nerve (L4-S3) splites into the

Common fibular nerve (L4-S2) and the Tibial nerve (L4-S3) * the Common Fibular Nerve (L4-S2) splits into the superficial fibular nerve and the deep fibular nerve

Increased pressue in fascial compartment that restricts blood flow and compresses nerves can lead to

Compartment Syndrome (can occur in thigh) Cause: fracture, contusion/compression to thigh compartment --> leads to tisse swelling or blood leaking into tissues Signs/Sxs: pain, pressure, pulslessness, pale skin, paralysis, burning MAJOR PROBLEM!! - the deep fascia covering compartment is UNABLE to expand as this pressure bulds- if UNTREATED= tissue necrosis MUST AMPUTATE LIMB SOO NEED TO TREAT FAST! How? With Fasciotomy: deep fascia surgically cut to relieve pressure on blood vessels/nerves

Tarsal Tunnel Syndrome involves

Compression of the tibial nerve (or medial plantar nerve branch) within the tarsal tunnel ** this is the equivalent to carpal tunnel causes: scar tissue, varicose veins, bone spurs, repetitive foot eversion, etc. signs and symptoms: - pain/numbness at sole of foot - weakness of intrinsic foot muscles supplied by tibial nerve

The Hip Joint is also referred to as the

Coxal Joint or Acetabulofemoral Joint - Head of femur (ball) and acetabulum (socket) of hip bone articulate - this is a multi-axial, ball and socket type of synovial joint * it is very strong and very stable due to joint capsule, attachments of muscles and ligaments * it is very moveable allows for flexion, extension, abduction, adduction, medial/lateral rotaion; circumduction - the blood and nerve supply to the joint is the same as the muscles and skin surrounding the joint

G1/S-cdk

Cyclin E/Cdk2

MYC leads to trancsription of

Cyclins and E2F ** it may seem counterintuitive by MYC is also among the most robust agents of programmed cell death (apoptosis)- BUT only high levels of MYC induce robust apoptosis ** unchecked MYC expression is among the most prominent hallmaekrs of the hyperproliferation associated with most forms of cancer

About 10% of patients with DMD/BMD like symptoms ____ have mutation in dystrophin

DO NOT ** but a number of muscular dystrophies result from mutations in dystrophin and members of the DAPC

Sebaceous glands

DO NOT begin to function until puberty - and they produce sebum, an oily material and release it into the upper shaft of the hair follicle by holocrine secretion (product and cell debris are BOTH released from the gland)

Mature adipocytes _____ divide

DO NOT divide. They live ~10 yrs and are then replaced by adult mesenchymal stem cells - although fat cells CAN differentiate from adult mesenchymal stem cells throughout life, adult-onset obesity is generally believed to involved largerly increased size or hypertrophy in EXSISTING adipocytes (hypertrophic obesity) ** childhood obestiy can involve both increased adipocyte size and formation of new adipocytes by differentiation and hyperplasia of preadipocytes from mesenchymal cells - this early increas in number of adipocytes may predispose an individual to hyperplastic obesity in later life *& this is why it is important that children not become obese

Clubfoot (Talipes Equinovarus)

Deformity of the foot "foot twisted out of position" - ankle plantarflexed - foot inverted - forefoot adducted * CONGENITAL CONDITION (can be bilateral and it is MORE COMMON IN BOYS) - walking painful due to bearing weight on lateral surface of foot Treartment: series of casts/braces or surgery

Describe the Faciae of the Pectoral Region

Deltoid Fascia - Descends from clavicle, acromion, and scapular spine - continuous with the pectoral fascia anteriorly, infraspinous fascia posteriorly Pectoral Fascia - Descends from clavicle & sternum, investing pectoralis major - Becomes the axillary fascia laterally Clavipectoral Fascia - Descends from clavicle - Encloses the subclavius & pectoralis minor - Continuous with axillary fascia Axillary fascia - continuation of pectoral fascia - forms the floor of the axilla

One typical neuron in the CNS has many thousand

Dendrites - the dendritic processes may branch extensively - unlike axons, which maintain a nearly constant diameter- dendrites become much thinner as they subdivide * they receive the bulk of nervous signals from other neurons via connections called Synapses

What are the projections that often cover dendrites

Dendritic Spine - provide a tremendous increase in the surface area available for synaptic contacts ** each is a site of a synapse with another neuron - morphology of these spines depends on Actin Filaments and can be highly plastic ** These are of KEY importance in the constant changes of the neural plasticity underlying adaptation, learning, and memory - the number of DS decreases with age and poor nutrition- they have also showed altered configurations in Trisomy 21 and Trisomy 13 (have less DS)

What is prescribed for treatment of osteoporosis

Denosumab - a monoclonal antibody to RANKL. It functions like osteoprotegerin and decreases osteoclastogenesis * RANKL binds to osteoclast RANK receptor and commits the cell to osteoclastogenesis - the mononucleated monocyte becomes a multinucleated osteoclast precursor, which still cannot reabsorb bone *** blocked by osteoprotegerin (it regulates population of osteoclasts)- blocks RANKL binding to its receptor RANK

Which ligament anchors the spinal cord to the dura mater

Denticulate ligament * it is found at the midpoint between two spinal nerves

Describe the Mononuclear phagocyte system

Depending on which type of CT blood monocytes crawl into, they differentiate into diff named cells types, ALL with the basic properites of a macrophage * also includes microglia, osteoclasts, fibroblasts, and other APCs

How is Ca2+ released from the SR into the sarcoplasm ?

Depolarization of the T-tubule causes a conformational change in voltage-sensitive dihydropyridine receptors (on T-tubule membrane). This conformational change opens the Ryanodine Receptors (Ca2+ release channels) in the sarcoplasmic reticulum into the muscle cell cytoplasm (sarcoplasm) this calcium then goes and binds to Troponin C, inducing a conformational change in the troponin-tropomyosin complex, uncovering the myosin binding site on actin * actin- myosin cross-bridge binding occurs

t (8;14)

Deregulation in C-MYC (transcription factor) - involves IgH gene also Can lead to --> Burkitt Lymphoma ** NOTE: C-MYC is a different member of the gene family compared to the N-MYC shown in the slide about homogenously staining regions and double minutes

t (11;14)

Deregulation in Cyclin D1 (cyclin) - involves IgH also Can lead to --> Mantle cell lymphoma ** note for mantle cell lymphoma a large majority have cyclin D activated but the translocation is involved in a minority of them

t (9;22)

Deregulation of ABL (receptor tyrosine kinase) - involves BCR also Can lead to --> Chronic Myelogenous Leukemia and other

t (14;18)

Deregulation of BCL2 (anti-apoptosis gene) - involves IgH gene also Can lead to --> Follicular Lymphoma, etc.

A tuft of vascularized loose CT that is invaginated into the base of a hair bulb

Dermal papilla ** this is composed of CT whose primary function is to provide the vascular supply to the growing hair follicle

____ are very important for holding tissue layers together

Desmosomes! & these are found in the macula adherens/ desmosomes- "spot adhesions" - it is a major anchoring cell-to-cell junction that provides a particularly strong attachment - Desmosomes are NOT continuous around the cell like zonula adherens..they are isolated spots only - "spot-welds" are located on the LATERAL domains of the cell

which digits are I: Ulnar nerve with connections to flexor digitorum profundus

Digits 4-5: ULNAR NERVE 2-3: Median nerve, via branch, anterior interosseous n. (just like flexor pollicis longus and pronator quadratus)

What type of receptors can be found on the T-tubule membrane

Dihydropyridine receptors (DHPR): voltage-sensitive proteins (these are voltage-sensitive proteins present on the sarcolemma in the region of the triads) ** this is mechanically coupled with the RYR on sarcoplasmic reticulum membrane

The Paraxial Mesoderm segments itself in somites which then diff into Sclerotome and Dermomyotome. The Sclerotomal tissue is in three parts which are

Dorsal, Ventral, And Lateral ** the tissue moves to surround the notochord and neural tube - Dorsal Sclerotome: moves to form the VERTEBRAL ARCH of vertebrae - Ventral Sclerotome: will surround notochord and become the VERTEBRAL BODY

The popliteal artery branches into the Anterior Tibial Artery and after the ankle joint this becomes the

Dorsalis Pedis Artery (Dorsal artery of the foot) this branchs into an Arcuate artery and a deep plantar artery the Deep plantar artery makes an anastomosis with the deep plantar arch ** this deep plantar arch was a branch from the lateral plantar artery which came from the posterior tibial artery which has split into the lateral and medial arteries ** posterior tibial artery come through the tarsal tunnel

Top of the foot=

Dorsum of the foot - feels "bony" - has few muscles, thin fascia

A genetic disorder characterized by progressive muscle degeneration and weakness

Duchenne Muscular Dystrophy (DMD) - X-linked recessive, Affects mainly boys * cause by mutation in gene that encodes for protein Dystrophin (on X chromosome) DYSTROPHIN usualy links actin to the multiprotein sarcoglycan complex in plasma membrane (which link to basal/external lamina (containing laminin)- which in turn links to the collagen fibers of the endomysium [its helical nature allows it to act like a spring or shock absorber during muscle contraction] --> impairment leads to microruptures of cell membrane, eventually killing the muscle fiber/cell Sxs: - muscle weakness - delayed motor development in children - wheelchiar dependence by adolesence - enlargment and weakening of the heart - premature death

Gowes Sign (inability to properly get up) and Pseudohypertrophy of the calves is common in

Duchenne's Muscular Dystrophy (DMD) ** NOTE Gowers sign is not specific to DMD, it occurs in al disease with severe muscle weakness

Hyperabduction Syndrome aka "Saturday Night Palsy"

Due to prolonged shoulder HYPERabduction while sleeping, or overhead painting - causes compression of neurovascular structures as they pass under the coracoid process and pectoralis minor tendon sx's: - extremity numbness & parasthesia (tingling) * usually radial nerve most affected

Dura Mater that covers the Cauda Equina is known as

Dural Sac - it ends at S2, forming a "sac"

Neuronal nuclei is mainly what kind of chromatin

EUCHROMATIN! - reflects the intense synthetic activity of this cell type (it is pale staining- but the nucleuolus is still heterochromatin but veryyy small amt.) ** nucleus of neuron is spherical, unusually large, euchromatic (pale-staining), and has a prominent nucleolus

Thermoregulation is a primary function of which epidermal appendage

Eccrine Sweat glands - they produce as much as 10L of sweat per day -evaporation of sweat from the body surface serves to cool the skin - sweating is a physical response to elevated boy temp during exercise or feve and high ambient temperature

Lobster claw deformity (an abnormal cleft between the 2nd and 4th digital areas; (variatn of adactyly- middle digit is lost)) Most common cause mutation in chromosome 7

Ectrodactyly

Example of Collagenopathies

Ehlers-Danlos Syndrome (type 3 specifically) - group of rare genetic disorders affecting humans caused by defective collagen synthesis -sxs cary widely based on type of EDS pt has- in each case the sxs are ultimately due to faulty or reduced amounts of collagen, the most common of which include unstable joints that are easily dislocated and hypermobile because of overstretchable ligaments that are composed of defective collagen - some forms affect the skin and others affect walls of blood vessels - the severity of the syndromes of this incurable disease cna vary from mild to life-threatening TYPE 3: Defect in TYPE 3 COLLAGEN - lease severe form of EDS - sxs: hypermobility of all joints, dislocations, deformity of finger joints, and early onset of osteoarthritis

If water needs to be moved across an epithelium what two actions can take place

Either absorption or secretion Absorption (ex. kidney tubules during reabsorption from ultrafiltrate) - alot of H2O must be moved by the epithelial cells from the apical side, across the cell and out the basal side, and from there across the basal lamina to be taken up by the blood vessels in the CT * lumen to blood vessel Secretion (ex. Sweat glands during sweating) - the reverse; a lot of water must be moved from the CT, across the basal lamind, acroos the basal end of the epithelial cell, through it and out the apical membrane to the lumen * Interstitial fluid to lumen

Which ECM fiber can stretch up to 1.5x their length, and snap back to their original length when relaxed

Elastic Fibers (** add resiliency to CT) - not made of collagen- composed of an ELASTIN core and a sheath of FIBRILLIN microfibrils - they are produced from fibroblasts, also by smooth muscle cells in arteries and veins Elastic fibers are found in: - skin - lungs - areteries and veins - connective tissue proper - elastic cartilage - periodontal ligament - fetal tissue - & other structures ** these stain with Hematoxylin and Orcein

What drugs are antipruritic agents

Emollients

Pruritis (itching) is fixed by

Emollients ("Moisturizers")- repair of berrier function. Topical formulations used to moisturize skin ** pruritoceptive: itch originating in the skin due to inflammation or other cutaneous disease

CT coverings of skeletal muscle include

Endomysium - Surrounds each muscle fiber (single muscle cell) - Small diameter blood vessels and finest neuronal branches - Type I and III collagen** Perimysium - Surrounds GROUP of muscle fibers (bundles of fascicles) - Larger blood vessels and nerves - Type I collagen Epimysium - Dense CT sheath surrounding a collection of fascicles - MAJOR vascular and nerve supply - Type I collagen

The intrinsic nervous system of the GI is referred to as

Enteric Nervous System Contains two neural plexus - Submucosal (meissner's) plexus- deeper, reg. GI blood flow and epithelial funcition - Myenteric (auerbachs) plexus- more superficial- aids in contraction and relaxation of smooth muscle

MMPs are useful in development and functioning of organism but they can also cause damge. How?

Excessive degradation of the ECM by MMPs is observed in several pathologic conditions - Rheymatoid Arthritis - Osteoarthritis - Chronic Tissue Ulcer - Cancer ** tumor invasion, metastisis, and tumor angiogenesis require the participation of MMPs whose expression increases in association with tumorgenesis - Bc MMPs are secreted by invasive (migrating) cancer cells, reasearchers are investigating synthetic therapeutic agents that inhibit the activity of MMPs to control the spread of cancer cells

What can lead to a sway or hollow back

Excessive lumbar lordosis * term shortened clinicially to lordosis ** remember that Lumbar curvature was a secondary curvature along with cervical

What can lead to a "hunch back" appearance

Excessive thoracic kyphosis * term shortened clinically to kyphosis ** remember thoracic curvature was a primary curvature with sacral

The second form of epithelial cells is glands what are two types of glands discussed

Exocrine Gland - if it retains its connecting stalk - APICAL side secretion- secretes into a lumen (ex. sweat glands) Endocrine Gland - if gland LOSES its stalk - its produce is secreted across a BASAL lamina, picked up by blood vessels in the CT, and enters the blood stream *** both endocrine and exocrine are formed during embryonic development by down-growth of epithelium

Which muscles extends and ADDUCTS the hand at the wrist

Extensor Capri Ulnaris - Inserts at the base of 5th metacarpal - I: radial nerve (via the deep branch of the radial nerve)

which muscles extend and ABducts the hand at the wrist

Extensor Carpi Radialis Longus (ALSO active during clenching) Extensor Carpi Radialis Brevis I: radial nerve

Which intrinsic muscle on the dorsum of the foot works to extend 2nd-4th digits

Extensor Digitorum Brevis * it attaches proximally to 2nd-4th digits I: deep fibular nerve

Which muscle of the anterior compartment of the leg has a distal attachment to the 2nd-5th digits (toes)

Extensor Digitorum Longus I: Deep Fibular Nerve Action: Dorsiflex ankle joint just like all muscles in anterior compartment of leg BUT ALSO extends 2nd-5th toes

Which muscle of the anterior compartment of the leg also extends the hallux (big toe) in addition to dorsiflexion of ankle

Extensor Hallucis Longus * it distally attaches to the distal phalanx of hallux (1st digit, big toe) I: Deep fibular nerve

Which muscle extends proximal phalanx of digit 2; and extends hand at wrist

Extensor Indicis insertion: extensor expansion of digit 2 I: radial n. (via posterior interosseous nerve, a continuation of the deep branch of the radial nerve)

Which muscle does primary estension at metacarpophalangeal joint digits 2-5 and secondary extension at interphalangeal joints (distal, middle, and proximal phalanges)

Extensor digitorum ** same fx to the thumb are done by extensor digiti minimi

Which muscle extends proximal phalanx of thumb at the metacarpophalangeal joint; also extends carpometacarpal joint

Extensor pollicis brevis Insertion: base of PROXIMAL phalanx of digit 1 I: radial nerve (via post. interosseous nerve, a continuation of the deep branch of the radial n)

Which muscle extends distal phalanx of thumb at interphalangeal joint; extends carpometacarpal and metacarpophalangel joint

Extensor pollicis longus Insertion: base of DISTAL phalanx of digit 1 I: radial n (via post. interosseous nerve, a continuation of the deep branch of the radial nerve)

The Femoral artery is a continuation of the

External Iliac Artery distal to the inguinal ligament - it descends through femoral triangle --> enters the adductor canal --> exits the adductor hiatus to become the popliteal artery behind the knee

Adhesion in the Macula Adherens/Desmosome layer is mediated

Extracellularly by cadherins of each cell Intracellularly by anchoring sites for intermediate filaments (note that epithelial cells contain keratin sub-class of IFs)

Adhesion of HEMIdesmosomes is mediated by

Extracellularly by the INTEGRINS of the cell (cell to ECM) [ integrins= the cell adhesion molecule] Intracellurarly link to intermediate filaments *** this is in contracts to desmosomes where intermediate filaments link to cadherins

At birth all the bones of the skull are formed

FALSE - this allows head to change shape and aid its passage through the birth canal * in infant: space where 2 sutures join forms a membrane covered "soft spot" called a fontanelle * fontanelles allow the brain and skull to grow in the infants first year

True or False: skeletal muscle is highly avascular

FALSE! Skeletal muscle is HIGHLY vascularized (they have high O2 consumption and energy requirements) ** arteries supplying and vein draining blood usually enter the muscle with the nerves= a neurovascular bundle

True or false: muscarinic and nicotinic receptors are adrenergic

FALSE!!! they are cholinergic

True or False the Suboccipital Nerve (C1) is Motor and Sensory

FALSE!!!! it is MOTOR only - it supplies motor to 4 muscles of the suboccipital region

true or false: do chondroclasts only have a single nucleus

FALSE!!!! they are multinucleated (identical to osteoclasts)

True or false: bone type changes its composition

FALSE: regardless of bone type, they ALL have same composition!

Which retinaculum ( Extensor or flexor) is involved in carpal tunnel

FLEXOR!!! ** remember this one is on the anterior/palmar side - The flexor retinaculum converts the concavity formed by the carpal bones into the carpal tunnel Conents: (9 tendons, 1 nerve travel through) - Median Nerve - 4 tendons of flexor digitorum superficialis - 1 tendon of Flexor pollicis longus (thumb) - 4 tendons of flexor digitorum profundus ( digits 2-5) Fx: Prevents bowstringing of tendons

Athletes genetically endowed with a higher percentage of ____ are good condidated for power and sprint events, whereas those with greater proportion of ___ are more likely to succed in endurance activities, such as marathons

Fast-glycolytic fibers (in sprinters) Slow-oxidative fibers (marathon runners)

Major fuel of the heart

Fatty acids ** stored as triglycerids in small lipid droplets

The Patellar Reflex (" Knee Jerk Reflex") tests the integrity of what nerve

Femoral Nerve (L2, L3, L4 spinal cord segments) Procedure: Have patient sit with legs dangling, give firm tap on patellar ligament with reflex hammer Normal response: - quadriceps femoris muscle contracts as a reflex response to the tap (stretch)--> leg extends at knee joint

An anatomical space; a triangular depression in anteriorsuperior aspect of the thigh

Femoral Triangle

Development of the limb bud along the proximodistal axis is mediated by a morphogens called

Fibroblast growth factors (FGFs) - Lateral plate mesodermal cells induce the formation of the apical ectodermal ridge (AER)- this is the distal thickening of the ectoderm over the top of the limb bud - AER produces FGF8 and FGF4 which maintains a cluster or rapidly proliferating mesodermal cells, called the progress zone (stays near the AER) * growth along this axis occurs as cells leave the progress zone and undergo differentiation. Therefore, the more proximal structures form first

Most common cells in CT are

Fibroblasts - these originate locally from undifferentiated mesenchymal cells and spend all their life in CT Structure: spindle-shaped cell with tapering eosinophic cytoplasmic extensions - Fibroblasts synthesize most components of the CT ECM

Which cell synthesizes most components of the CT ECM

Fibroblasts - they synthesize proteins, such as collagen and elastin, which upon secretion form collagen, reticular and elastic fibers and - glycosaminoglycans, proteoglycans, and glycoproteins of the ground substance

How can you tests for cruciate ligament tear

Flex knee and pull anteriorly on tibia to test ACL (Anterior Drawer Test) Pusch posteriorly on tibia to test PCL (Posterior Drawer Test) ** the ligament sould normal be intact and the tibia does not move - Anterior Movement of Tibia= Positive Anterior Drawer Sign= ruptured ACL - Posterior Movement of Tibia= Positive Posterior Drawer Sign= ruptured PCL

Knee joint movements

Flexion and extension - note: the knee joint can rotate slightly medial and laterally but only when the knee is flexed

Which muscle of the HYPOthenar compartment flexes proximal phalanx of digit 5

Flexor Digiti Minimi brevis

Which muscle of the deep group of the posterior leg compartment flexes 2nd-5th digits in addition to plantarflexing the ankle

Flexor Digitorum Longus distally attaches to: 2nd-5th digits (toes) I: tibial nerve

Simple Squamous Epithelium

Found in air sacs of lungs and the lining of the heart, blood vessels, and lymphatic vessels Fx: allows materials to pass through by diffusion and filtration and secreted lubricating substance (thinness of cells favors rapid exchange)

Simple Cuboidal Epithlium

Found in ducts and secretory portions of small glands and in kidney tubules Fx: it secretes and absorbs (it transports alot of water, more fluid inside cell than squamous)

The PNS is composed of

Ganglia and Nerves 1. Ganglia: - encapsulated aggregations of neuronal cell bodies (soma) located outside the CNS ** in PNS- cell bodies are all from Sensory and Autonomic 2. Nerves: - cordlike bundles of nerve fibers (mainly axons) surrounded by CT sheaths

Junctions that connect the cytoplasm of two cells and allow various molecules, ions and electrical impulses to directly pass through a regulated gate between cells

Gap Junctions! - specialized intercellular connection between a multitude of animal cell-types

The Autonomic (Visceral) Motor Pathway axons are called

General Visceral Efferent (GVE) these can split into Sympathetic, Parasympathetic or Enteric ** the Autonomic (visceral) motor pathways have a 2-neuron chain from the spinal cord, starting in the lateral horn of the spinal cord - From the cell body in the LATERAL horn, a preganglionic axon will travel to a ganglia (group of cell bodies in the PNS) where a synsapse will occur - From the post-ganglionic cell bodies, a post-ganglionic axon will then travel to the target organ- a visceral/autonomic structure

What is the Genicular Anastomosis

Genicular branches of the popliteal artery form anastomosis around the knee joint (other arteries also contribute) *** important because it provides collateral circulation to maintain blood flow in the area - it compensates for possible narrowing of popliteal artery or other vascular occlusion

M2 and M4 muscarinic acetylcholine receptors (mACHRs) and alpha2 adrenoceptors activate

Gi - which inhibit adenylate cyclase and decrease cAMP production

A nonspecific reactive change of glial cells in response to damage to the CNS

Gliosis - when CNS is damaged, glial cells proliferate to form cellular scar tissue, which often interfere with neuronal regeneration ** mainly Astrocytes proliferate but also microglia and oligodendrocytes Gliosis is a prominent feature of many diseases of the CNS including: - multiple sclerosis - stroke (after a stroke neruons die and disappear with replacement gliosis)

Which gluteal muscle functions in extending thigh at hip joint and assists thigh in LATERAL rotation

Gluteus Maximus

What muscle is the main powerful thigh EXTENSOR at the hip joint

Gluteus Maximus Muscle * it is active during stair climbing, rising from seated position, running, walking uphill * it receives dual blood supply from superior and inferior gluteal arteries I: inferior gluteal nerve

Which gluteus muscles function in ABducting thigh at hip joint, MEDIALLY rotating the thigh, and keeping the pelvis leveled when ipsilateral limb is weight-bearing

Gluteus Medius and Gluteus Minimus

Which muscle is more powerful the gluteus medius or minimus

Gluteus Medius is more powerful * the Gluteus minimus is a hip abductor also but not the main powerful abductor of thigh at hip joint like the gluteus medius *** the gluteus minimus assistes the gluteus medius in supporting body weight when stainding on one leg and stabilizing the pelvis to prevent it sagging to the opposite side ** it is small and found just deep to the gluteus medius muscle I: SUPERIOR gluteal nerve

Glycoprotein vs Proteoglycan

Glycoprotein - proteins conjugated to saccharides LACKING a serial repeat unit (protein >> carbohydrate) Proteoglycans - proteins conjugated to polysaccharides WITH serial repeat units (carbohydrate >> protein) ** glycosaminoglycans= repeat unit

long straight chain polysaccharides made up of repeating disaccharide units that are a major component of ground substance

Glycosaminoglycans (GAGs) - the sugars of GAGs are usually sulfated (except hyaluronic acid) and have carboxyl groups- hence they are negatively charged ** the high negative charge allows GAGs to stain with basic dyes and to attract cations (Na+) which attract water molecules (water follows salt) *** thuse the gel becomes hydrated and can resist compressive forces ** GAG can be made in lumen of golgi and hooked to proteins coming out of secretory pathway ex of GAG: Heparan sulfate or hyaluronic acid

In the CNS, the tissue types found are

Grey Matter and White Matter - Most neuronal cell bodies are in the GRAY MATTER ** grey matter OUTSIDE the cerebral cortex consists of neuronal cell bodies and glial cells - Axons are concentrated in the WHITE MATTER (myelin gives a white color) ** white matter INSIDE the cerebral cortex contains A LOT of myelinated axons *** in brain: grey matter is on the OUTSIDE *** in spinal cord: grey matter is on the INSIDE

Which cells represent the proliferative (germanitive) layer of the hair follicle, comparable to the stratum basale of the epidermis

Hair matrix cells ** the bulge region (external root sheath) of hair follicle is believed to serce as an epidermal stem cell niche (these help in regenerating skin lesions)

Other than scaphoid, which carpal is commonly fractured

Hamate - the ulnar nerve runs through a canal (guyons canl) under the ligament between the hamat and pisiform (guyons canal syndrome) - a hamate fracture can compress the ulnar nerve, leading to loss of sensation in the medial half of digit 4 and whole digit 5

The thigh extensors in the Posterior Compartment of the thigh include the

Hamstrings Muscles: - Biceps femoris (long head) - Semitendinosus - Semimembranosus All I: Tibial Division of Sciatic Nerve ** these are powerful knee flexors, as well as hip extensors ( BUT remember that the main muscle to extend the hip= gluteus maximus) - these are also very important furing running and walking

Classic sign of hand osteoarthritis

Heberdens and Bouchards nodes Heberdens Nodes: bony enlargement at the distal interphalangeal (DIP) joint Bouchards Nodes: bony enlargement at the PROXIMAL interphalangeal (PIP) joint

All wandering cells of the connective tissue develop from the

Hematopoietic stem cell these "wandering or transient" cells are immigrant cells usually from blood or bone marrow, some retain their original characteristics and may take up permanent residence there Ex. in acute inflammation, WBCs enter the CT from the blood Wandering cells of CT include: - mast cells - monocytes/macrophages - plasma cells - lymphocytes - neutrophils - eosinophils - basophils *** note that all wanderin cells in CT are WBCs (or their close relatives) that are involved in immunologic defense of the body

Most common stain used in histology for medical diagnosis

Hematoxylin and Eosin (H&E) - Hematoxylin stains blue: the nucleus, acidic regions of cytoplasm, and cartilage matrix - Eosin stains pink: basic regions of cytoplasm and collagen fibers

In embryological endochondral ossification, ____ forms the template for bone formation

Hyaline cartilage *** BUT in healing of a bone fracture- fibrocartilage forms then bone

Simple Columnar Epithelium

If ciliated it is found in bronchi, uterine tubes, uterus. If NONciliated it is found in GI- like the small intestines, and the bladder Fx: it absorbs, and it also secretes mucous and enzymes (more height aids separation of functions in apical and basolateral membranes)

Why would you want loci very close together on a lined marker

If close together on the same chromosome: you would have linkage (ex. 1a and 2a would be together 100% of the time) - if they are that close together they are not separated by recombination

Sartorius Muscle

In Ant Compartment of Thich Proximally attaches to: Anterior Superior Iliac Spine (ASIS) I: Femoral Nerve (L2, L3, L4) Actions: - Flex, abduct and laterally rotate thigh at hip joint - Flex leg at knee joint ** this muscle produces cross-legged sitting position

Pectineus Muscle

In Anterior Compartment of Thigh (but it is a little more medial) I: Femoral AND Obturator Nerve (L2, L3, L4) Action: - Flex AND adduct thigh at hip joint(because it is more medial and the medial compartment is ADDUCTORS)

Quadriceps Femoris Muscle

In Anterior Compartment of the Thigh Made of 4 muscles: - Rectus Femoris (RF) - Vastus medialis (VM) - Vastus intermedius (located deep to RF) - Vastus Laterlis (VL) I: Femoral Nerve (L2, L3, L4) Action: - EXTENDS leg at knee joint (flexion of thigh at hip joint via rectus femoris muscle) ** Powerful knee extensor used in climbing, running, jumping, and rising from a seated position

Iliopsoas M.

In Anterior Compartment of the thigh Made of 2 Muscles that fuse into one below the Inguinal Ligament: - Iliacus (I: Femoral Nerve**only this part of iliopsoas is) - Psoas Major Which BOTH distally attach to the Lesser Trochanter of the Femur THIS IS THE MAIN FLEXOR OF THIGH AT HIP JOINT

How long bones grow in length vs in width

In length: endochondral ossification * the epiphyseal cartilage with epiphyseal plates is responsible for the growth in length of bone and disappears at adulthood, causing bone growth to cease. In adults, who have stopped growing the plate is replaced by an epiphyseal line - epiphyseal closure occurs at diff time in different bones and is complete in all bones by about age 20 - in forensics or through x-ray examination of the growing skeleton, it is possible to determine the "bone age" of a young person, noting which epiphyses are open and which are closed In width: appositional growth (osteoblasts from the periosteum lay down new bone around the outside)

Adductor Longus and Adductor Brevis

In medial compartment of thigh I: Obturator Nerve - Adducts thigh at hip joint

Compartment syndrome

Increased pressure in the muscle compartment - can lead to muscle, nerve damage, and ischemia

2 examples of injury to radial nerve in the arm

Injury superior to the origin of triceps brachii branches (near axilla) - paralysis of ALL muscles supplied by the radial nerve (ex. triceps, brachioradialis, supinator, and extensors of the wrist and fingers) - sensory loss ** WRIST DROP Injury in the radial groove (around midshaft of humerus) - Paralysis of the MEDIAL head of triceps and all posterior muscles of the forearm distal to the site of nerve lesion - Lateral and long heads of triceps NOT affected, meaning elbow extension is weakened but not lost - Sensory loss

Innervation, Insertion, Action of Trapezius

Innervated: CN XI: Spinal Accessory Nerve Insertion: Acromion & spine of the scapula Actions: - Descending: elevation of the scapula - MIddle: retracts scapula - Ascending: depresses scapula - Descending + Ascending: superior rotation of scapula

Innervation and Actions of Rhomboid Minor and Major

Innervation: Dorsal Scapular Nerve (branch of the brachial plexus) Actions: - Retract scapule - Inferior rotation of scapula - Fix scapula to thoracic wall

Innervation, Insertion, Action of Levator Scapulae

Innnervation: Dorsal Scapular Nerve (branch of Brachial Plexus) Insertion: Medial border of scapula, superior to root of scapular spine Actions: - elevates scapula - rotates glenoid cavity inferiorly

Insertion, Innervation, Action of the Deltoid (anterior, middle, and posterior parts)

Insertion: Deltoid Tuberosity of the humerus Innervation: Axillary Nerve (C5-C6- branch of posterior cord of the brachial plexus) Action: - all 3 parts: abduct the humerus at the glenohumeral joint. AFTER THE FIRST 15 degress to horizontal - All 3 parts also stabilize the shoulder - the anterior part: flexion & medial rotation of the arm - posterior part: extension & lateral roation of the arm

Insertion, innervation, action and origin of Supraspinatus

Insertion: Greater Tubercle of Humerus Innervation: Suprascapular nerve (from superior trunk) Action: - Abducts the arm for THE FIRST 15 DEGREES - stabilizes the glenohumeral joint Origin: supraspinous fossa

Distal Humerus Fracture

Intercondylar vs Supracondylar - Injury to Median N. and Brachial A. ** rember acronym: ARM - Axillary, Radial, Median Nerves (from Surfical neck --> Distal humeus fracture- these are nerves affected)

___ are abundant in the cell body and all processes of the neurons

Intermediate Filaments ** neurons express the cell-type specific IF NEUROFILAMENTS ** Glial cells (some subtypes) express IFs in the VIMENTIN subclass called glial fibrillary acidic proteins

The 4th layer of the sole/plantar foot contains the

Interosseous Muscles: located between the metatarsals (I: lateral plantar nerve) On plantar surface: 3 plantar interossei (ADducts toes 3-5th digits - PAD), weakly flex metatarsophalangeal joints On dorsal surface: 4 dorsal interossei (ABducts toe 2-4 digits- DAB) ** these muscles can cause clawing of the foot *** BOTH dorsal and palmar interossei are innervated by the lateral plantar nerve

Joints found within the phalanges

Interphalangeal (Proximal interphalangeal and Distal interphalangeal joints) - synovial joints, hinge type - flexion/extension is the only movement - each enclosed by a single joint capsule - strengthened by medial and lateral collateral ligaments *** digits 2-5 should have proximal and distal

what is the difference between interterritorial matrix and territorial matrix in cartilage

Interterritorial matrix consists of abundant collagenous fibers embedded in a matrix of ground substance Territorial matrix- adjacent to the lacuna is rich in glycosaminoglycans (GAG) with acidic properities and therefore stains more deeply with base blue stains

Ipsilateral vs Contralateral

Ipsilateral: structures on same side of body Contralateral: structures on opposite sides of the body

Adverse side affects with oral/systemic retinoid

Isotretinoin - Dryness and itching of skin and mucous membranes (resembles Hypervitaminosis A) PREGNANCY CATEGORY X! - black box warnign!!! extremely high risk for birth defect - need to intial neg preg test and monthly preg tests during treatment and use of 2 effective forms of brith control one must be surgical or hormonal for 1 month before therapy, thoughout therpay and after threapy

What are some unique features of the C1 (atlas)

It has No Body - It does have an Anterior Arch and Posterior Arch, as well as a facet for the dens of C2 in the Anterior Arch - there is also a groove for the passage of the Vertebral Artery

Describe key features of the C2 (axis)

It has a Dens (odontoid process)- which acts as the body of C1 - Also has a Posterior Articular Facet for the transverse ligament of the Atlas (helps hold two in place) - And an Anterior Articular Facet (which articulates with C1) - Bifid Spinous Process

Describe the Sacrum (5 fused segments)

It has a sacral canal which allows for the continuation of the vertebral canal- it ends on other side with sacral hiatur - it has both anterior and posterior sacral foramina - a Superior articular facet - AND an Auricular Surface which articulates with the pelvis forming the sacroiliac joint

What does the Femoral Nerve (L2, L3, L4) usually function in

It has both motor and sensory function Motor: Normal Muscle strenght and function of the anterior thigh compartment muscles (sartorius, pectineus, quadriceps femoris, iliopsoas muscle) Sensory: Normal skin sensation along the Anterior thigh, Anterior- MEDIAL leg, and MEDIAL side of foot

Shoulder Separation

It is an injury which causes separation of the Acromioclavicular Joint (AC joint separation or AC separation) - NOTTTT dislocation of glenohumeral joint ** Acromioclavicular separation occurs as a result of a downward force being appled to the superior part of the acromion -Type I: Torn AC ligament - Type II: Torn AC ligament with separation - Type III: Torn AC, coracoclavicular ligament (trapezoid & conoid ligaments) with separation

How is electron microscopy used to study a tissue in histology

It is fixed, embedded, and sectioned like for light microscopy BUT then the sections are coated with metal (OSMIUM) so they can withstand the electron beam followed by observation under the electron microscope

Pseudostratified Columnar Epithelium

It is found in - "respiratory epithelium" lining many parts of respiratory systems including the trachea - Epididymis (testis ** can only know its pseudostratified by knowing location- cant tell by looking Fx: it secretes mucus, ciliated tissue moves mucus (it looks stratified but it rlly isnt- it is multiple cell types with different heights)

Inflammation of a joint

Joint Arthritis * can occur at any joint in body - osteoarthritis: bone ends rub together (thinned cartilage) - rheumatoid arthritis: swollen inflamed synovial membrane (bone erosion)

Articulating bones forced from normal joint positioning

Joint Dislocation * ligamentous damage can likely occur as a result - visual observation, palpation and medical imaging useful to check alignment of bones * neurovasculature at risk of injury with dislocation

The resting membrane potential of a typical cell (-70mV) is less negative than Ek+ and far away from ENa+, therefore

K+ leaks out of the cell by the force of its electrochemical gradient (concentration force is higher than electrical force and drives K+ out of cell) and Na+ leaks into the cell due to its electrochemical gradient (both concentration and electrical forces drive Na+ into cell) despite a very low Na+ permeability of the membrane ** without compensatory mechanisma- conc. diff cannot be maintained over time --> membrane voltage and excitability of cell will disappear ** BUT the primary active Na+/K+ pump counter balances leaks by transporting 3Na+ out of cell and 2K+ into the cell (as a result the concentrations of these ions on both sides of membrane remains constant) (like H2O coming into boat will sink if you dont have bucket- Na+/K+ pump works as bucket, 2/3 of energy is consumed in this pump.

In resting conditions, the cell membrane is much more permeable to

K+, than it is to Na+ and therefore the resting membrane potential (-70mV) is very close to K+ equilibrium potential (-90mV) *** however, Na+ permeability at rest is NOT zero so that resting membrane potential moves slightly away from Ek+ towards Ena+ and is less negative than EK+

Which cells are abundant in areas of wound healing where they function in wound contraction (and also other places)

Myofibroblasts

What is the common extensor origin of the arm

LATERAL epicondyle (EXTENSOR ORIGIN) Muscles that originate here: - Extensor Carpi Radialis Brevis - Extensor Digitorum - Extensor digiti minimi - Extensor Carpi Ulnaris (it has 2 heads- one head originates here) - Supinator (also originates in other regions)

Name two repetitive stress injuries of the elbow

LATERAL epicondylitis (extensor)- "tennis elbow" MEDIAL epicondylitis (flexor)- "golfers elbow"

What is found in the central compartment of the palm

LUMBRICALS Origin: tendons of flexor digitorum profundus I: Lumbrical 1&2: MEDIAN N. (medial and lateral branches). Lumbrical 3&4: deep branch of ulnar nerve Actions: - flex metacarophalangeal joint, extend interphalangeal joints of digits 2-5 "bye-bye"

Infraclavicular branches of the brachial plexus

Lacteral Pectoral Upper subscapular Thoracodorsal Lower subscapular Medial pectoral Medial Cutaneous (arm) Medial Cutaneous (forearm) Musculocutaneous Axillary Radial Median Ulnar

Median Nerve

Lateral Cord: C6, C7 Medial Cord: C8, T1 Innervates: - Pronator teres - Pronator quadratus - Palmaris longus - Flexor carpi radialis - Flexor pollicis longus - Flexor digitorum profundus (1/2) - Flexor digitorum superficialis - Abductor pollicis brevis - Opponens Pollicis - Flexor pollicis brevis - 1st and 2nd lumbricals Cutaneous Branches: - Recurrent (palmar) branch of median nerve - Common palmar digital nerves - Proper palmar digital nerves *** Median Nerve sensation is almost all in the hand/lateral aspect of the wrist- it does half of the 4th digit

Nerves of Pectoral Region include

Lateral Pectoral Nerve (C5-C7) Medial Pectoral Nerve (C8-T1) ** the medial & lateral pectoral nerves are named for where they come off the brachial plexus, NOT their anatomical position at the pectoral muscles - medial pectoral nerve pierces pectoralis minor to reach pectoralis major Nerve to subclavius (C5-C6) Long thoracic nerve (C5-C7)

The Abductor Digiti minimi from the first layer of the sole of the foot is innervated by

Lateral Plantar Nerve

What are two branches of the median nerve

Lateral branch of median nerve - motor to 1st lumbircal - sensory to palmar and dorsal aspect of digit 1 Medial branches of median nerve - motor to 2nd lumbrical - sensory to palmar and dorsal digits 2,3, and 1/2 4

The superficial fibular (peroneal) nerve (L4-S1) supplies the

Lateral compartment of leg - fibularis longus - fibularis brevis

Hallux Valgus

Lateral deviation (valgus) deformity of big toe (hallux) ** deformity occurs at 1st metatarsophalangeal joint possible causes: - degenerative joint disease at 1st metatarsophalangel joint - wearing pointed-toed shoes

Which ligament stabilizes the ankle joint during foot inversion

Lateral ligament of ankle (aka lateral collateral ligament of ankle) - 3 ligaments reinforce lateral aspect of ankle join: anterior talo-fibular, calcaneo-fibular, and posterior talo-fibular ligaments ** this ligament is frequently injured

What are the contents of the femoral triangle which is located in the anterosuperior aspect of the thigh

Lateral to medial (N-A-V-E-L) - Femoral Nerve (most lateral) - Femoral Atery - Femoral Vein (most medial) - Empty Space with lymphatics - Lacunar Ligament

The Broadest Muscle of the Back

Latissimus Dorsi Innervation: Thoracodorsal Nerve (C6-C8; comes off Posterior Cord) Insertion: Intertubercular sulcus of humerus Actions: - Extends, adducts and medially rotates the humerus at the glenohumeral joint - Raises body toward arms during climbing

Surgical neck fracture of humerus

Lesion: axillary nerve Cause: A fall landing on the shoulder Clinical: Loss of innervation to deltoid; palpable depression under acromion; sensory loss of skin over deltoid

Winged Scapula

Lesion: long thoracic nerve Cause: surgery (mastectomy) and trauma to lateral chest Clinical: serratus anterior paralysis; medial scapula protrudes if pt pushes against a wall

Radial Nerve Palsy

Lesion: radial nerve Cause: freactur of midhumerus at radial groove; trauma to lateral elbow Clinical: Wrist drop; inabilitiy to extend wrist; loss of sensation from dorsum of thumb

Non-Keratinized Squamous Epithelium is found in the

Linings of the esophagus, mouth, vagina, urethra, and anus * unlike keratinized, these contain nuclei up to the top layers - this is needed to be kept moist somehow- not waterproof like keratinized - either the tissue contains glands, or lubricant/moisture comes from other tissues

which head of the biceps femoris attaches at the ischial tuberosity

Long head of Biceps Femoris *** and both the long head and short head distally attach at the head of the fibula ** both long head and short head also extend thigh at hip joint and flex the leg at the knee joint

Types of Breast Cancer Surgery

Lumpectomy (aka Partial Mastectomy)- usually followed by radition therapy Mastectomy (breast excisions it tumor is >5cm) - simple/total: only removes breast tissue - modified radical: breast tissue and lymph nodes removed - radical: breast tissue, lymph nodes, and muscles removed

Median nerve innervates

MOST pollicis muscles: - flexor pollicis brevis - opponens pollicis - abductor pollicis brevis 1st and 2nd lumbricals

Desmin is a

MUSCLE- specific intermediate filament

Long-lived tissue-resident cells with an important rols in many inflammatory settings including host defense to parasitic infection and allergic reactions

Mast Cells - derived from bone marrow (NOT mesenchymal) stem cell by live several months in CT- usually classed as wandering cell of CT Apperance: cytoplasm has large basophilic membrane-bound granules that contain histamine and heparin Fx: - mast cells function as sentinels in tissues, where they recognize microbial products and respond by producing cytokines and other mediators that induce inflammation - they can be activated by many different antigens including allergens, pathogens, and physiological mediators ** they are also storage of chemical mediators of inflammatory responses (histamine, heparin, leukotrienes etc..)- involved in pain, edema, and allergic rx.

Which artery is the MAIN blood supply to the head and neck of the femur

Medial Circumflex Femoral Artery - which is a branch of the deep artery of the thigh ** a fracture of the neck of the femur can lead to avascular necrosis of the femoral head

Which ankle joint stabilizes the ankle joint during foot eversion

Medial Ligament of ankle (aka Deltoid ligament or medial collateral ligament of ankle) * Strong; four ligaments reinforce the medial aspect of the ankle joint: - posterior tibiotalar, tibiocalcaneal, anteriortibiotalar, and tibionavicular ligament

Venipuncture target

Median Cubital Vein (In superficial cubital fossa) ** the bicipital aponeurosis protects brachial artery and median nerve, which are deep to the aponeurosis

What functions to deepen articular surface between the tibia and the femur and function in shock absorption

Meniscus - crescent- shaped fibrocartilage pad

Embryonic connective tissue is referred to as

Mesenchyme * mostly in umbilical cord ** mesenchyme is primarily in the embryo; adults have mesenchymal STEM cells but NO mesenchymal tissue

Joints found between metacarpal and phalanges

Metacarpophalangeal (MCP) joints - allow for "bye bye motion" - synovial joints, condyloid type - allow for flexion/extension, abduction/adduction and circumduction

The brachial plexus branches out between the

Middle and Anterior Scalene Muscle

What drugs are trichogenic agents

Minoxidil Finasteride

Duplication of the ulna and duplication of the ulnar halves of the carpals, metacarpals, and phalanges

Mirror Hand Syndrome (Ulnar Dimelia)

CSF is a clear fluid produced by

Modified Ependymal Cells - it circulates, bathes, and nourishes brain and spinal cord * acts as shock absorbing cushion

In the Intestinal Epithelia what is the order in which junctions appear from the Apical Plasma membrane to the basal lamina

Most Apical= tight junctions (in zonula occludens) - Adherens junctions (cadherins) (in Zonula Adherens) - Desmosomes (Macula adherens)

The Superior Gemellus and Obturator Internus (small lateral rotators of the thigh) are innervated by

Nerve to Obturator Internus

Colles Fracture "dinner fork deformity"

Most common forearm fracture of distal radius Cause: extension fracture- forced dorsiflexion of the wrist while the forearm and hand are pronated (breaking a fall) present as "dinner fork deformity" - complete transverse fracture of distal radiu - distal radial fragment is displaced dorsally - ulnar styloid process may be avulsed Associated injuries: - median and ulnar nerve injury - carpal fractures - dislocation of radioulnar joint

The basic unit of contraction is a

Motor Unit - composed of a single motorneuron and the muscle fiber it innervates ** the number of muscle fibers in a motor unit varies: - Small motor units (3-5 fibers): fine motor activities (ex: extraocular muscles) - Large motor units (>1000 fibers): gross muscular activits (ex. gastrocnemius muscle) * each muscle fiber is innervated by a single neuron

What is the normal function of the Tibial Nerve (L4-S3)

Motor and Sensory Motor: normal muscle strength and action of ankle PLANTARflexors and toe flexors (posterior leg compartment muscles) Sensory : Normal skin sensation along sole of the foot

What is the normal function of the Obturator Nerve (L2, L3, L4)

Motor and Sensory Function Motor: Normal muscle strength and function of the MEDIAL thigh muscles (adductor group, gracilis, obturator externus) Sensory: Normal cutaneous sensation on medial aspect of thigh

What is the normal function of the superior gluteal nerve

Motor innervation to gluteus medius, gluteus minimus, tensor fascia latae muscle for hip/thigh abduction and stabilixing the pelvis Injury to Superior Gluteal Nerve would cause: - weakness of hip/thigh abduction and inability to stabilize the pelvis (because the above muscles are weak and paralyzed)= Positive Trendelenburg Sign

Mucous vs Mucus

Mucus is a noun, MUCOUS is an adj. Mucus is secreted by MUCOUS glands

Two examples of multi-adhesive glycoproteins

Multiadhesive Glycoproteins contain protein moiety with carbohydrates, they play a major role in the adhesion of cells to their substrate 2 major ones: 1. Fibronectin: the product of fibroblasts and epithelial cells - has sites to bind cells, collagen, and GAGs- the interactions help to mediate normal cell adhesion and migration 2. Laminin (basal lamina of epithelial cells and external lamina of muscle cells, adipocyts, and schwann cells) - participates in the adhesion of epithelial cells to basal lamina **** integrins are transmembrane proteins on the plasma membrane that bind indirectly to multiadhesive protein that bind fibronectin and laminin (attaches cells to the ECM)

Intercalated discs in cardiac muscle contain

Multiple: - gap junctions (allows syncytium) - desmosomes - fascia adherens (stabilizes non-epithelial tissue) * like zonula adheres in epithelial cells ** anchor actin ** together these serve to bind cardiac cells firmly to prevent their pulling apart under constant contractile activity

Most neurons are

Multipolar neurons - one axon and two or more dendrites * Most neurons including all motor neurons and CNS interneurons (other neurons include Bipolar and unipolar or pseudounipolar)

The smallest contractile unit of skeletal muscle is a multinucleated, elongated cell called a

Muscle fiber * each fiber is surrounded by an invaginated sarcolemma, contains numerous mitochondria, abundant sarcoplasmic reticulum (SR) and Myofibrils

What can occur as a result of ischemia of elbow and forearm

Muscles and nerves can tolerate up to 6 hours of ischemia - after this point, fibrous scar tissue replaces necrotic tissue and causes the involved muscles to shorten permanently, producing a flexion deformity, ischemic compartment syndrome or VOLKMANN CONTRACTURE mechanism: - sudden brachial artery occlusion or laceration - collateral pathways only help in gradual and partial occlusion

A lipoprotein material organized into a sheath that insulates and protects SOME axons

Myelin **NOTE: not all axons are myelinated, some are unmyelinated - the main purpose of a myelin layer (or sheath) is to increase the speed at which impulases propagate along the myelinated fiber ** in unmyelinated fibers, impulses move continuously as waves, but in myelinated fibers they hope or "propagate SALTATORY CONDUCTION

Example of a modified fibroblast

Myofibroblast * has features of both fibroblasts and smooth muscle cells - fibroblasts and myofibroblasts express VIMENTIN intermediate filaments (DONT confuse with the myoepithelial cells that express keratin intermediate filaments)

In skeletal muscle thick filaments are made of

Myosin composed of 2 heavy chains with - head: ATPase activity and actin-binding sites - neck/hinge: allows head to pivot - tail: anchors the protein The light chains associate with each head - essential: stabilizes myosin - regulatory: modulates muscle function ** myosin attaches to the actin thin filament, pulling on it, causing it to slide past the thick filament

Which autonomic recepter mediates an increase in heart rate

NE on Adrenergic B1 receptors on the SA node increase heart rate (Beta 1,2,3 activate Gs --> Adenylate cyclase--> Increases cAMP --> relaxation of smooth muscle --> increases HR and force of contraction)

Does the head have sympathetic cell bodies

NO! there are no sympathetic cell bodies in the brain stem ** so the cell bodies in the thoracic levels will send their axons to the cervical ganglion It does this by: the Lateral horn cell bodies in the thoracic region send their pre-ganglionic axons to cervical ganglia. Post-ganglionic axons then travel on blood vessels to reach their target organ in the head

Are mast cells only bad for the body?

NO! they are important immune effectors and modulatory cells that help link innate and adaptive immunity in the fight against pathogens

Do multinucleated cells have a high capactiy for regeneration?

NO! they cannot divide - In Skeletal muscle, the multinucleated the cells CANNOT undergo mitosis- but the tissue still displays limited regeneration through the satellite cells ** still the regenerative capacity of skeletal muscle is LIMITED, occuring less well after major muscle trauma

Do cardiac muscle cells have satellite cells

NO! they have very little regenerative capacity beyond early childhood * defects or damage (ex. infarts) to heart muscle are generally replaced by proliferating fibroblasts and growth of CT - cardiomyocytes in damaged region will die by necrosis from lack of oxygen and there will be a collagenous scar tissue formed in place of cardiac myocytes (these areas cannot contract and it weakens the heart) ** collagen produced by fibroblasts

Do osteocytes divide

NO!! although they have reduceed synthetic activity (like osteoblasts) are NOT capable of mitotic division ** they ARE actively involved in the routine turnover of bony matrix, through various mechanosensory mechanisms

Do smooth muscles have troponin?

NO!!!!! calmodulin is what binds the Ca2+ to initiate contraction --> activated myosin kinase (which phosphorylates mysoin molecules)--> cross-briding occurs ** relaxation is caused by MYOSIN PHOSPHATASE

does articular hyaline cartilage have a perichondrium

NO!!!!! - it lacks a perichondrium and receives its oxygen and nutrients from the synovial fluid that bathes it * articular cartilage is a hyaline cartilage absent of perichondrium and covers the end of long bones to form synovial joints- it has changing orientations of lacunae and isogenous groups at diff depth in cartilage, which reflect the orientations of the collagen fibers in the matrix

Do inversion and eversion occur at the ankle joint

NO!!!!!!!! these occur at the foot joint (SUBTALAR JOINT) Subtalar joint: - articulation between talus and calcaneus (aka talocalcaneal joint) ** inversion and eversion of the foot occur at subtalar joint Movements of foot include: inversion and eversion

Is metaplasia cancer

NO, but it can lead to cancer - usually metaplasia is reversible- once the stimulus that caused it is removed, the tissues return to their normal pattern of differentiation BUT if the abnormal stimuli persists for a long time the metaplastic cells may transform into carcinoma cells

True or false: Dendrites are sheathed in myelin

NOOO FALSE! - Dendrites are NOT sheathed in myelin ** some axons ARE shethed in an insulating fatty protein- myelin ** dendrites are short whereas axons are long- sometimes as long as a meter or more - axons also have a constant diameter and branch less profusely unlike dendrites

Meninges

NOT nervous tissue but they are the 3 CT coverings of the brain and spinal cord ** a tumor of the meninges= meningioma 1. Dura Mater: "tough mother"- outer layer, dense CT (blood vessels, fibroblasts, collagen) 2. Arachnoid: "cobweb"- middle layer 3. Pia Mater: "tender mother"- innermost layer

What reflects high synthetic activity in a neuron

Nissl Bodies (aka Nissl Substance) - amount will vary depending on activity of the neuron - These are aggregations of many: rER tubules and free ribosomes ** they have a prominent cell body cytoplasmic structures seen in light micrographs of most neruons- they stain basophilic with H&E

Which muscle is part of the medial compartment of the thigh but DOES NOT adduct thigh at hip

Obturator Externus it LATERALLY rotates the thigh I: obturator nerve (L2,L3,L4)

What aids in increasing drug penetration

Occlusion - it increases the temperature and hydration of the stratum corneum which increases druge penetration

Ointments are better vehicles than

Ointment > cream > lotion> gel ** the ability of the vehicle to retard water evaporation of the skin (occlusivity) decreses in the list above (OINTMENTS ARE MOST OCCLUSIVE) ** oinments and creams are best for xerosis (dry) and scaling skin ** gel is best for oily skin

What is the most common glial cell in WHITE MATTER

Oligodendrocytes BUTTTT the most common glial cell in the CNS as a whole is ASTROCYTES

In skeletal muscle fibers - the tension developed when stimulated to contract is maximal at

Optimal Length (Lo)= the normal RESTING length of muscle fiber in situ (in the body) - if skeletal muscle fiber is stretched beyong Lo BEFORE being stimulated to contract, tension developed is LESS than max tension - when a muscle fiber is NOT sufficiently stretched to Lo before being stimulated to contract, tension developed is less than max tension also

The thigh extensor (hamstring muscles) all have a common origin on the _____ and are innervated by the _____

Origin: Ischial Tuberosity I: Tibial Division of Sciatic Nerve ****NOTE the short head of the biceps femoris is innervated by the common fibular division of the sciatic nerve

Most common type of arthritis

Osteoarthritis * arthritis is an inflammation of the joints, it can affet one joint or multiple joints - there are more than 100 diff types of arthritis, with diff causes and treatment methods * osteoarthritis is mose common (aka degenerative joint disease or "wear and tear" arthritis): it can lead to severe loss of integrity, the loss of articular cartilage and multifocal decrease in cells with invasion of arteries and nerves - results from breakdown of joint cartilage and underlying bone Causes: - previous joint injury - abnormal joint or limb development - inherited factors Risk is greater in those who are: - overweight - have one leg of diff length - have jobs that result in high levels of joint stress

rate of bone resorption > rate of bone formation

Osteoporosis - loss of bone mass= loss of strength making bones brittle and weak causes: - drop of estrogen in women after menopause and drop in testosterone in men - women over age 50 and men over age 70 have higher risk ** osteoclasts are inhibited by sex hormones

Mesenchymal cells (MSC) of bone and bone marrow make

Osteoprogenitor cells * quiesecent when new bone not req. - they are flat and inconspicous with pale staining oval nucleus and sparse cytoplams - bone-lining cells resemble fibroblasts ** osteoprogenitor cells are activated (become osteoblasts) followng fracture, growth or in various disorder of bone *Located in periosteum and endosteum

Crossover (recombinant event) in ____ is a mandartory part of male meiosis. The meiosis fails if no crossover gets established

PAR1

Neaural crest cells form most of the

PNS ex. sensory neurons of the cranial ganglia Ganglia - sensory: pseudounipolar neurons - autonomic- postganglionic neurons - schwann cells (PNS myelin)

Which has more CT and collagen the CNS or the PNS?

PNS has more around the nerves! --Except around the larger blood vessels, the CNS has only a very small amount of CT and collagen

Because the cell is ____ you can put different types of glucose transporters in apical versus basolateral membranes

POLARIZED! so for glucose uptake in the intestinal epithelial cells In the apical membrane: - Na+ driven glucose sympothers, ACTIVE transport, work WITH the NA+ concentrationg gradianet In basolateral membrane: - glucose carriers, PASSIVE transport, work with the GLUCOSE concentration ** remember this is possible bc of the tight junctions that allow flow in both directions

What harbors the vascular supply for avascular cartilage

Perichondrium ( a fibrous sheet of dense CT that covers cartilage) It is rich in: - fibroblasts (OUTER CELLS) - undifferentiated mesenchymal stem cells (chondrogenic precursor cells) (** the close layers to cartilage are chondroblasts) - blood vessels - nerves - lymphatic vessels

What organelles would oligodendrocytes have many of

Peroxisomes which make plasmalogens which make myelin *** Zellweger syndrome: absence or reduction of functional peroxisomes or Adrenoleukodystrophy: accumulation of VLCFA but normal plasmalogens- characterized by breakdown or loss of myelin

What could cause a calcaneal (heel) spur

Plantar Fasciitis - inflammation of plantar fascia (i.e. plantar aponeurosis) near attachment onto calcaneus causes: high impact foot activities and weaing inappropriate footwear Signs and sxs: - pain on sole of foot and heel - formation of calcaneal (heel) spur

Continuation of the femoral artery at the adductor hiatus in adductor magnus

Popliteal artery (this divids into the anterior and posterior tibial arteries a the lower broder of the popliteus muscle)

Lymph drainage from the LATERAL side of the foot and POSTERIOR leg (follows the small saphenous vein) and goes first to the

Popliteal lymph nodes --> deep inguinal lymph nodes --> external iliac lymph nodes

Which muscle is responsible for UNLOCKING the knee joint

Popliteus Muscle Proximal attachment: LATERAL condyle of femur Distal attachement: Tibia

The clinical test to diagnose Superior Gluteal Nerve Injury

Positive Trendelenburg Sign * you ask pt to stand on one leg. If the pelvis on the unsupported leg side descends or "drops" it indicates weakness or paralysis of gluteus medius muscle on the supported side (oppositie side) ex. if you have a weak right gluteus medius; the pelvis sags on the left

Which muscles are supplies by the Tibial Nerve

Posterior Compartment of the Leg: - Gastrocnemius - Popliteus - Flexor Digitorum Longus - Plantaris - Soleus - Tibialis posterior - Flexor hallucis longus

Which ligament of the vertebrae prevent Hyperflexion

Posterior Longitudinal Ligament - narrowers, somewhat weaker than the anterior longitudinal ligament - runs within the vertebral canal along the posterior aspect of vertebral bodies and IV discs

Axillary and radial nerve are branches of the

Posterior cord of the brachial plexus ** radial nerve goes doen posterior aspect of arm, forearm and have

Which aretery could be used to check the pulse by inverting the foot, palpating the artery posteriorinferior to medial malleolus in tarsal tunnel

Posterior tibial artery

Which quadriceps muscle has an extra function other than just extending the leg at the knee joint?

Rectus Femoris It Extends the leg at the knee joint AND flexes the thigh at the hip joint

Thickening of the deep fascia of the foot (pedal fascia) that creates bands

Retinaculum * this holds tendons in place ex. Superior and Inferior Extensor Retinacula

____ plays a major role in neurotrophic (relating to the growth, differentiation, and survival of the neuron) and injury response signaling

Retrograde axonal transport ** carried out by Dynein (-) end directed motor

Space where you are most likely to place breast implants

Retromammary Space - the space between the breast and pectoral fascia

The stiffening of the body after death because of the loss of ATP from the bodys muscles

Rigor Mortis ** importent in forensic pathology to determine approximate time of death. Rigor starts from head to toe from 1hr after death and reachs maximum at 12 hrs (depending on temp)

The Calcaneal Tendon Reflex (AKA Achilles' Reflex or ankle jerk reflex) tests the integrity of the

S1-S2 nerve root of the TIbial Nerve (*NOTE: Tibial Nerve is L4-S3- BUT this reflex ONLY tests for the integrity of its S1-S2 nerve root components) Procedure: - place foot in slight dorsiflexion and tap calcaneal tendon with reflex hammer Normal response= ankle plantaflexion due to contraction of gastrocenemius and soleus muscle *** A partial or complete tear of the calcaneal tendon= a calcaneal tendon rupture A patient with a COMPLETE thenon rupture shows: - significant weakness in PLANTAR flexion - inability to stand on tiptoes (heel raise) on affected side - Bulge in post. leg due to muscle shortening - Palpable gap where tendon has ruptured

Primary stem cells of skeletal muscle

Satellite Cells - serve as population of reserve stem cell or resting myoblasts that liw within the external lamina of each mature muscle fiber either for normal postnatal growth or for repair and regeneration of damage segments of the skeletal muscle fiber after injury ** in undamaged muscle- they are mostly quiescent ** become activated in response to mechanical strain- these intially proliferate as skeletal myoblasts before undergoing myogenic differentiation - they proliferate a fuse to form new skeletal muscle fibers (HYPERTROPHY AND HYPERPLASA)

What is the largest nerve in the body

Sciatic Nerve (L4-S3) ** has a tibial and common fibular nerve division (tibial supplies long head of biceps femors, common fibular supplies the short head) - The Sciatic Nerve enters the lower limb via the greater sciatic foramen and inferior to piriformis muscle --> travels through the middle of posterior thigh --> typically divides into its two nerve divisions in the region posterior to the knee (popliteal fossa)

Acne Vulgaris

Sebum overproduction related to androgenic hormones and genetics - abnormal desquamation of the follicular epithelium - propionibacterium acnes proliferation *** - follicular obstruction, which can lead to inflammation and follicular disruption *** clogged pores= comedones open comedones= black head closed comedones= white heads

In breasts what is the first node to drain the affected area, NO MATTER where it is located

Sentinel Lymph Node ** in breasts most of these are located in the pectoral chaing * if the tumor is in the medial breast the sentinel node amy be within the sternal (internal mammary chain)

In blood vessels (arteries and veins) what contracts to narrow the lumen, thus raising blood pressure

Smooth muscle in the wall (TUNICA MEDIA) ** when relaxed the diameter of this widens, decreasing the blood pressure

Describe sentinel node imaging

Sentinel lymph node= first node to drain an affected area - in the breasts, most often the sentinel lymph nodes are located in the pectoral chain (bc the pectoral lymph nodes drain >75% of breast lymph) - if tumor is in the medial breast, sentinel node may be within the sternal (internal mammary) chain * imaging does NOT tell us if the sentinel node has cancer it only tells us where it is located - biopsy of the node is required to determine cancer - radioactive particles are injected around the tumor bed at least 3-4 hrs prior to surgry - a mark may be placed on the skin over the sentinel node to help guide surgeon in its removel - the surgeon may also use radiation pobe in the OR to localize the sentinel node

Describe Stratified Columnar Epithelium; its functions and locations

Several cell layers - basal cells usually cuboidal BUT superficial cells are elongated and columnar Functions: protection & secretion Locations (RARE): small amounts in male urethra and in large ducts of some glands

What can cause "Whiplash" Injury

Severe hyperextension of the neck - the anterior longitudinal ligament is severely stretched and may be torn - can be accompanied by hyperflexion injury of the vertebral column, as head "rebounds" after the hyperextension * Hangman's Fracture is one severe example "the C2 vertebrae breaks" ** this is also a common result of MVA (motor vehicle accidents)

Example of a pseudo-dominant disease

Sickle cell - because at times just looking at portions of the pedigress the disease appears to be dominant but it is known to be autosomal recessive

Two types of smooth muscles that require different forms of contraction

Single-unit smooth muscle (aka visceral muscle) ** MOST COMMON: it is found in uterus, gastro-intestinal tract, and the bladder - it contracts rhythmically as a unit, it is electrically coupled by gap junctions, and exhibits spontaneous ACTION potentials Multi-unit smooth muscle - located in large airways to the lungs, large arteries, erector pilli muscles in hari follicles, and the iris of the eye - it consists of cells that are structurally INDEPENDENT of eachother, has motor units, and is capable of GRADED contractions

Do women have equal or skewed inactivation?

Skewed (may be local(regionally) or body-wide) - can be caused by just luck of the draw or by some specific mechanisms (i.e. mutation in XIC) Consequences of this? For a woman heterozygote for X-linked disease allele: - inactivating the X carrying the good allele in the majority of cells would lead to EXPRESSION of the disease - Inactivating the X carrying the bad allele in majority of cells --> NO disease even if allele is dominant --> REDUCED PENETRANCE Real life example: Skewed X-Chromosome Inactivation leads to expression of hemophilia A in 3 heterozygous females in an Atlantic Candian kindered * heterozygote females have about 5% risk of expressing disease in most X linked recessive diseases

Which vein and nerve travel superficially just underneath the skin and in between the two heads of the gastrocnemius (Medial and Lateral head)

Small Saphenous Vein and Sural Nerve

Sensory innervation of skin of the foot (cutaneous innervation) is done by

Sole/Plantar surface: - Medial Plantar N.: digit 1-half of 4 - Lateral Plantar N: Digit 5- half of 4 - Medial calcaneal N: to the heel - Saphenous n.: medial side - Sural n.: lateral side Dorsum: - Superficial Fibular nerve: most of the top of the foot - Deep fibular nerve (in between half of 1st and half of 2nd digit) - Saphenous nerve: medial side - Sural nerve: lateral side

Which muscles of the superficial group of the posterior leg compartment ONLY function in plantarflexion of the ankle joint

Soleus and Plantaris I: Tibial Nerve Distal attachment: Clacaneus via calcaneal tendon

By the start of the 3rd week, the Paraxial mesoderm begins to segment itself into

Somitomeres/ Somites (42-44 pairs) - somitomeres are above or cranial to the occiput - somites are below or caudal to the occiput *** segmentation occurs in CRANIAL to CAUDAL direction

The development of the limb bud along the craniocaudal axis is mediated by the morphogen

Sonic hedgehog (Shh) * it is release by a group of cells called the zone of polarizing activity (ZPA), at the caudal border of the limb bud. Shh then diffuses across the limb bud ** it is the gradient of Shh which causes correct patterning of the craniocaudal axis

Two cases of spina bifida

Spina Bifida Occulta - Birth defect where neural arches fail to develop normally (ex. spinous process or laminae not fully formed) - defect is present in up to 24% of population; most have no sx's- the defect is concealed by overlying skin, but its location is often indicated by a tuft of hair Spina Bifida Cystica - More sever form, where one or more vertebral araches fail to develop completely - result from neural tube defects, such as the defective closure of the neural tube during the 4th week of embryonic development - associated with herniation of the meninges (MENINGOCELE- a spina bifida associated with meningeal cyst) and/or the spinal cord (MENINGOMYELOCELE) - neurological sx's usually present in severe cases of Meningomyelocele (ex. paralysis of the limbs and disturbances in bladder and bowel control)

Injury to ligaments

Sprain *ligaments are stressed beyond normal capacity - overstretching - tear (incomplete or complete, rupture) - examine patient for ligament laxity and instability at joint ** any ligament in lower limb can rupture if enough force is applied (falls, contact sports, trauma causing excessive movement, etc) ** Anterior Cruciate Ligament (ACL) tear is a common knee injury: a mechanism of injury to ACL can be internal rotation trauma of knee with foot fixed on ground

LONG cytoplasmic projections, much longer than microvilli

Stereovilli - they are made of actin (like microvilli) and NOT MT's like true cilia - they increase the surface area for increased secretion and absorption (in testis) - they are NON-MOTILE, can exhibit passive mechanical movement like in ear

Stretched or partially torn muscle/tendon

Strain - occurs when muscle contracts suddenly and powerfully

Crush/Compression Fractures

Sudden forceful flexion (as in MVA or severe blows) results in the fracture of the body of one or more vertebrae - can also be accompanied by dislocation and fracture of the articular facets between two vertebrae, with rupture of the interpspinous ligaments

What nerve is compressed or overstretch as it passes SUPERFICIAL to the inferior extensor retinaculum to foot and affects sensation of dorsum of foot EXCEPT for the middle half of hallux and middle half of digit 2

Superficial Fibular Nerve - leads to pain, numbness, or loss of sensation

Lymph drainage from the MEDIAL side of the foot and anteromedial leg (follows the great saphenous vein) and empties into the

Superficial Inguinal Lymph node first --> deep inguinal lymph node--> external iliac lymph nodes

The posteiror leg compartment is seperated into a

Superficial and Deep Group Superficial Group: - Gastrocnemius - Soleus - Plantaris Deep Group: - Flexor Digitorum Longus - Flexor Hallucis Longus - Tibialis Posterior Actions: Plantarflexion of ankle joint I: Tibial Nerve (L4-S3) Blood supply: MAINLY the posterior tibial artery/ vien

Ulnar nerve banches into a superficial and deep branch what does each do

Superficial: sensory to medial 1 1/2 digits (palmar and dorsal surface) Deep branch: motor to all remaining muscles of hand (so not thenar muscles of lateral 2 lumbricals

Which small lateral rotators of the thigh laterally rotate the thigh AND abduct thigh at hip joint

Superior Gemellus Obturator Internus Inferior Gemellus

Roots C5 and C6 join together to form the

Superior Trunk

Which muscle in the posterior compartment supinatres the forearm

Supinator I: radial nerve (via the deep branch of the radial nerve)

Both the infraspinatus and supraspinatus muscle are innervated by the

Suprascapular Nerve (from superior trunk) AND they both insert at the greater tubercle of humerus (teres minor also inserts at greater tubercle)

Which vertebral ligament runs along the tips of spinous processes and at which vertebrae does it begin

Supraspinous Ligament - from C7 to sacrum

Deformity of digits that consists of hyperextension of the proximal interphalangeal (PIP) joints and flexion of the distal interphalangeal (DIP) joints

Swan Neck Deformity

Structure that permits a neuron to pass an electrical or chemical signal to another neuron

Synapse (there are 2 types) 1. Chemical (MOST COMMON) - electrical activity in the presynaptic neuron is converted (via the activation of voltage gated calcium channels) into the release of neurotransmitter that binds to receptors located in the plasma membrane of the postsynaptic cell 2. Electrical synapse (FASTEST) - the presynaptic and postsynaptic cell membranes are connected by GAP JUNCTIONS that are capable of passing an electric current, causing voltage changes in the presynaptic cell to induce voltage changes in the postsynaptic cell - often found where the fastest possible response is required, such as defensive reflexes

Fused digits (absence of interdigital cell death BMP or Shh disruption)

Syndactyly

what type of joint is covered with a layer of hyaline cartilage of fibrocartilage

Synovial joint - a joint in which the opposing bony surfaces are covered with a layer of hyaline cartilage or fibrocartilage * this articular hyaline cartilage is bathed in synovial fluid produced by the synovial membrane that lines the walls of the cavity

Zygapophysial (Facet) Joint are

Synovial, plane joint - it is the articulation of the inferior articular facet of one vertebra with the superior articular facet of the next vertebra in sequence ** this is in close proximity to the intervertebral foramen (& spinal nerves)

Passageway for tendons and neruvasculatrue to travel from leg to foot

Tarsal Tunnel * An anatomical space formed by the medial malleolus, calcaneus, and flexor retinaculum Contents (Posterior to Medial Malleolus)- "Tom Dick And Very Nervous Harry" - Tibialis Posterior Tendon - Flexor Digitorum Longus Tendon - Posterior Tibial Artery - Posterior Tibial Vein - Tibial Nerve - Flexor Hallucis Longus Tendon

What prevents superior displacement of the humerus

The Coracoacromial Arch - it is formed by the coracoid process, coracoacromial ligament, & acromion process

At the level of the L colic (splenic) flexure which nerve takes over innervation

The Vagus Nerve

What is a reason for X-Inactivation?

The X-chromosome contains about 2000 genes not found in the Y - for most of these, males and females need the same amount of product - the easiest fix is to inactivate all X chromosomes beyond one ** In humans this occurs at the late blastula (2000-10000 cells) stage of embryo development ** in other organisms such as mice, this is a progressive process: not all cells inactivate at exactly the same time, some are a few days earlier than others

How fo synapses and musculoskeletal junctions form

The axonal growth cone extends from the neuron (has lamellipodium which is pushed forward by ACTIN polymerization), this follows + and - signals to find its target to synapse with - the Filopodia (actin containing "spikes") contain receptors for these + and - signal molecules *** note the number of nerve cell death matches the number of nerve cells to number of target cells- bc there is a survival factor that is released by target cells

How does the cell manage to secrete such a large thing as a collagen fibril?

The cell secretes collagen subunits that assemble extracellularly *** this requires Vitamine C in the step of Hydroxylation of specific prolyl and lysl residues in the endoplasmic reticulum ** characteristic collagen AA= hydroxyproline and hydroxylysine

What occurs during an Avulsion Fracture of the Greater Tubercle

The small part of the greater tubercle of the humerus is torn away (avulsed) - often due to a fall onto the acromion OR fall on the hand when arm is abducted - the arm is pulled medially by muscles still attached (subscapularis)

Describe the Neurovasculature of a Synovial Joint

There is Extensive nerve and blood supply for a joint located in a joint capsule * nerves convey information about pain, joint movement/position, and degree of stretch at a joint - articular nerves: arise from nerve supplying muscle that cross and move each joint - articular arteries: arise from vessels around joint and often form anastomoses (articular veins accompany arteries)

Describe the Coccyx (4 fused segments)

These can very it can be from 3-5 fused segments this is referred to as the "tail bone" it is given the notation "Co" NOT "C" -this is for cervical vertebrae

Describe the Lumbar Vertebrae (n=5)

These have the LARGEST vertebral bodies bc they bare the MOST weight - The orientation of articular facets permints flexion and extension and lateral flexion, while rotation is PROHIBITED - the vertebral foramen is large to accomodate lumbar enlargment of the spinal cord

Smooth muscles contain

Thick (MTs), Thin (actin), and Intermediate Filaments (Desmin and Vimentin)

What is a Hangmans Fracture

This is a fracture & dislocation of the Axis (C2) - The pedicles are fractured posterior to superior articular facets due to abrupt hyperextension; fracture at pars interarticularis - this is a common result of falls and motor vehicle accidents (hitting chin on steering wheel) - Also a common injury the would occur in judicial hangings, hence the colloquial name

What are the Primary Vertebral Curvatures

Thoracic Kyphosis and Sacral Kyphosis * these develop during the fetal period- a newborn spine is kyphotic

Which is medial the TIbia or the Fibula

Tibia is medial - fibula is lateral

Which ligament supports the medial side of the knee joint

Tibial Collateral ligament (aka Medial Collateral Ligament) - it is firmly attached to the medial meniscus- this makes this weaker and more commonly damage than the fibular/lateral collateral ligament which is not attached to the lateral meniscus

ALL muscles of the posterior leg compartment but superficial and deep groups are innervated by

Tibial Nerve

The Plantar Reflex tests the function of the

Tibial Nerve (L4-S2 nerve roots) procedure: stroke plantar surface of foot with blunt object (from lateral to medial, from heel to hallux) normal response= flexion of all toes Anormal response= BABINSKI SIGN (indicated brain injury or cerebral disease)--> fanning of lateral 4 toes and extension of big toe *** babinski sign is normal in infants and children up to 4 years old

Which muscle is most common in shin splints

Tibialis Anterior Muscle (in anterior compartment of the leg)

Which muscle of the deep group of the posterior leg compartment plantarflexes the ankle and inverts the foot

Tibialis POSTERIOR I: Tibial Nerve

The knee joint is also known as the

Tibiofemoral Joint - The distal femur, patella, and proximal tibia are what articulate - The joint is biaxial, (modified) hinge type of synovial joint ** this joint is unstable but it is supported by many ligaments Movements: flexion and extension, but also slight rotation

Targeting signals and Tight Junctions/ Zonula Occludens

Tight junctions also BLOCK diffusion of membrane proteins between domains - In polarized epithelial cells, secretory and membrane proteins can posses additional targeting signals that specify whether they ONLY go to the apical or basolateral membrane from the transgolgi ** thuss, tight junctions allow the cell to put DIFFERENT sets of membrane proteins in APICAL and BASOLATERAL domains ** this is important for the polarized functions of epithelial cells

How does organization of blood vessels differ in trabecular bone vs compact bone

Trabecular bone: - blood vessels run through bone marrow spaces, supply oxygen etc. that pass into canaliculi and feed osteocyte in lacunar inside trabeculae Compact bone: - haversian systems are more specialized delivery system that are required to meet the metabolic needs of osteocytes trapped in compact bone

what ligament crosses over the acetabular notch

Transverse acetabular ligament

Trapezius Palsy

Trapezius Muscle weakness and wasting is usually the result of injury to the nerve that innervates it (Spinal Accessory Nerve- CN XI) - leads to "droopy shoulder"; weakness of superior rotation of the shoulder (glenohumeral joint) * this can be treated surgically with muscle transfers (usually of levator scapulae and the rhomboids)= Eden Lange Procedure

Do inherited cancers usually involved tumor suppressor genes or mutated oncogenes?

Tumor suppressor genes !! - because mutated oncogenes are usually NOT inherited (in inherited active oncogene could be hypothesized to result in a spontaneous abortion or a teratoma)

which collagen is MOST abundant in cartilage

Type II collagen makes up 80% of the collagen in cartilage

Dermatomes

Unilateral area of skin innervated by the sensory (GSA) fibers of a single spinal nerve - useful in neurology for finding the site of damage to the spine; identifying where a lesion has occurred 30 total dermatomes: - 7 Cervical (C2-C8, C1 is MOTOR ONLY) - 12 Thoracic (T1-T12) - 5 Lumbar (L1-L5) - 5 Sacral (S1-5) - 1 Coccygeal

Which neuron is found in spinal ganglia (like the sensory ganglia found in the spinal nerves) and most cranial ganglia

Unipolar or Pseudounipolar Neurons - these have a single process that bifurcates close to the cell body, with the longer branch extending to a peripheral endings and the other toward the CNS

The Sympathetic Division (ANS) has cell bodies from T1-L2 spinal cord regions (lateral horn grey matter) the axons originating in these cell bodies are diff than voluntary axons because they are

VISCERAL!!! - need to travel internally to synapse on ganglia and ultimately a visceral structure these axons= General Visceral Efferent (GVE) axon * they have diff path that general somatic efferent (GSE) type axons

Which veins in the vertebral column could potentially lead to metastasis

Valveless Veins (in the internal vertebral venous plexuses- epidural venous plexuses) - these are a potential path for cancer metastasis (from breasts, lungs, and prostate gland to the brain * veins of the internal vertebral plexus connect with veins in the body cavities and are continuous with the cranial dural venous sinuses through the foramen magnum

Branches of the subclavian artery

Vertebral Artery Internal Thoracic Artery Thyrocervical trunk - transverse cervical artery - suprascapular artery Costocervical trunk Dorsal Scapular Artery "Vit D"

What are the Nervous system components of the Autonomic Nervous system

Visceral Motor: (EFFERENT)- axons are called General Visceral Efferent (GVE)- these can be sympathetic, Parasympathetic, or enteric or Visceral Sensory: (AFFERENT)- axons are called general visceral Afferent (GVA)

Musculoskeletal developmental timeline

Week 3: - Somitomeres/someits begin to form - Day 20: 1st somite forms Week 4: - Sclerotome forms and surrouns neural tube and notochord - limb bud starts to appear Week 6: - Hand and foot plates appear Week 7: - musculature begins to form - rotation of the limbs - cell death in apical ectodermal ridge for digit formation Week 8: - Day 52: hands are formed - Day 54: feet are formed

During _____ hand and foot plates are formed

Week 6 * Fingers and toes are formed when areas of the AER undergo apoptosis (programmed cell death) splitting it into 5 segments. Allowing the digits to grow - cell death in interdigital areas are controlled by BMP BMP causes the AER to decreases production of FGF8 and 4. Therefore, inhibiting growth of these areas

In Autonomic Pathway: Pre-ganglionic (GVE) axons leave the lateral horn, travel in the ventral root, then exit the spinal nerve in the____

White communicans to reach a paravertebral ganglion (sympathetic chain) * from here the pre-ganglionic (GVE) axons then travel on the spanchnic nerves to reach another ganglia (prevertebral) where they synapse. - post-ganglionic axons then leave the prevertebral ganglion and travel to their target visceral organ *** THIS IS THE SYMPATHETIC INNERVATION PATHWAY OF VISCERAL ORGANS IN THORAX, ABD, PELVIS (NOT the heart and lungs)

Are all tissues used for staining in Histo dead?

YES During tissue staining in histo the cells are DEAD (from fixation) and all pH and ion gradients have been destroyed by PERMEABILIZATION. ex. of a fixed permeabilized cell= lysosomal interior is not low pH anymore

Is smooth muscle capable of a more active regeneration?

YES! it is composed of simpler, smaller, mononucleated cells - after injury, viable smooth muscle cells undergo mitosis and replace the damaged tissue - contracticle PERICYTES from the walls of small blood vessels participate in the repair of vascular smooth muscle

Can you see brachial plexus variations in your patients

YES! - Prefixed brachial plexus: C4-C8 from roots - Postfixed: C6-T2 from roots: inferior trunk compression by 1st rib

Are lipofuscin granules (the brown "wear and tear" pigment from lysosomes) often seen in long-lived cells observed frequently near the nuclei of cardiac muscle cells?

YES! - humans are born with a set number of heart muscle cells called cardiomyocytes- which increase in size (hypertrophy) as heart grows larger during childhood development ** cardiomyocytes are slowly turned over as we age, BUT less than 50% of then ones we are born with are replaced during a normal life span

Can a single epithelium contain more than a single cell type

YES! the type of epithelium refers to how the cells are arranged, but it can contain more than a single cell type - Simple= when ALL cells (and cell types) in epithelia touch the basal lamina - Stratified= when ALL cells DO NOT touch the basal lamina

Can the enteric nervous system of the GI work autonomosly apart from CNS

YES!! it can but usually it communicates extensively with ANS it is a "mini-brain" and it has - Sensory Neurons (GVA): respond to mechanical, thermal, osmotic, and chemical stimuli - Interneurons - Motor Neurons (GVE): control motility, secretion, and absorption by acting on smooth muscle and secretory cells

Can a person be born with the femoral head not properly located in the acetabulum

Yes this is called Congenital Dislocation of the Hip Joint - it can be bilateral; limbs shortened, inability to abduct thigh

How would you perform a lumbar puncture (spinal tap)

You would enter into the lumbar cistern through L4 level- you MUST avoid termination of the spinal cord proper ** this is typically done to collect CSF for evaluations infections of the CNS (ex. Meningitis)

Intracellular Adhesion in the Zonula Adherens vs the Macula Adherens

Zonula Adherens it is linked by ACTIN binding proteins to actin filaments of the adhesion belt/ terminal web Macula Adherens is done by anchoring sites for INTERMEDIATE FILMANETS (note that epithelial cells contain the keratin sub-class of IFs)

Typical presentation of a pt with Duchennes Muscular Dystrophy (DMD)

a boy between 2 1/2 and 4 yrs of age, is or has become more clumsy than normal (ex. dropping things, stumbling or falling) will often show difficulty in jumping or climbing stairs - muscle weakness progresses from proximal to distal, involves lower limbs earlier than upper * history usually shows developmental milestones reached normally until about 2, though mental development might be a little behind -- Gowers sign is typically aroung age 5-6 - inability to walk at 10-12 years of age - death at late teens to twenties (the heart is also a muscle as are the muscles that keep the lungs going) - scoliosis frequent as are contractures of tendons

Goblet Cells

a cell type found lining internal organs- especially common in intestinal and respiratory systems - they produce mucus: it protects organs like the stomach from chemical stresses like gastric acid and it traps microorganisms in bronchial tubes to prevent infection and keeps other particles out (mucociliary elevator)

Scurvy is caused by

a deficiency of Vitamin C which is needed for production of collagen - characterized by swollen bleeding gums and the opening of previously healed wounds & cork screw hair - sxs of scurvy only appear after at least one month of severe or total vitamin C deficiency - presents with hemorrhage, hyperkeratosis, and hematological abnormalities ** scurvy can also develop after 60-90 days of a diet free of ascorbic acid

Genetic mechanisms of cancer are so important because

a good diagnosis can lead to a good cure *ex: child with Burkitt Lymphoma already better after a 6-day treatment *ex: CML in the US in 2018: 8,430 new cases and 1090 deaths - treatment: introduction of Gleevec (imatinib mesylate) in 1990s in CML treatment increased the 5 yr suvival rate from 0-90% - mechanism: blocks tyrosine kinase activity of BCR-ABL hybrid-> inhibition of cell proliferation --> remission

A sun tan results from

a response to UV exposure that increase melanocytes in number (hyperplasia) and accelerate their production of melanin ** increased pigmentation protects the skin against harmful effects of sunlight

Evaporation of fluid from the surface of the skin requires

a water vapor pressure gradient * evaporation rate becomes negligible at ambient humidity >75%

Motor Unit Recruitment

activation of more motor units= increase number of contracting fibers = increase tension (CNS can control muscle force by determining number of individual muscle fibers that it stimulates at a given time) - tension developed in a muscle can be increased by increasing number of motor units active at one time ** each muscle fiber is innervated by one one motor neuron motor unit= group of muscle fibers in a muscle innervated by a single motor neuron

Tick paralysis

acute ascending flaccid paralysis that resembles Guillain- Barre syndrome - caused by toxins in salive that block neuromuscular transmission and decrease nerve conduction - followed bites of more than 60 types of ticks but usually DERMACENTOR species - weekness begins less than or at day 6 after attachmetn - may culminate in complete paralysis of extremities and cranial nerves * Diagnosis: live tick or history of tick bites ** Removal of tick leads to recovery ** Death is possible

Flexor carpi ulnar and extensor carpi ulnaris function in

adduction

Malignant tumors derived from glandular epithelial tissue are called

adenocarcinomas

Relaxation of smooth muscle cells can be induced by activation of

adenylate cyclase or guanylate cyclase - activation of cAMP-PKA: inhibits myosin light chain kinase- promotes relaxation ** in contrast: decreased K+ permeability or increase Na+ permeability results in membrane depolarization and contraction and Ca2+ ATPase inhibition favors muscle contraction

Mixed nerves (MOST COMMON) contain both

afferent and efferent axons, and thus conduct both incoming and sensory information and outgoing muscle commands in the same bundle

Acetylcholine (ACh) is the NT at

all ANS preganglionic synapses, target tissues of the parasympathetic division and is the primary NT released by somatic motor neurons at the neuromuscular junction

Efferent nerves conduct signals from the CNS

along motor neurons to their target muscles and glands

Pustule

an accumulation of pus in the skin - pus is made up of leukocytes and a thin fluid called liquor puris ("pus liquid") - a furuncle is a pustule that forms deep in a hair follicle - a carbuncle= collection or cluster of furuncles * abscess is a generic term for an accumulation of pus anywhere in the body

the inguinal ligament attaches from the

anterior superior iliace spine (ASIS) to the pubic tubercle of the pubis

Intra-cranial tumors

are much more common than tumors of the CNS for BRAIN TUMORS - about half to 3 quarters are primary tumors, and the rest are metastatic - unlike most other parts of the body, a benign tumor of the brain can still be lethal if it presses on a critical area of the brain ** Gliomas are the most common group of brain tumors, includes: - astrocytomas: most common gliomas (from astrocytes) - oligodendrogliomas (from oligodendrocytes) - ependymomas (from ependymal cells) Neuronal tumors (from neurons) are rare but they do exist (they are rare bc neurons are not dividing)

The Cephalic Vein of the arm

ascends from the anterolateral forearm into the arm, communicating with the median cubital vein, moving up the arm through the DELTOPECTORAL GROOVE, before diving deep to the clavicle to join the axillary vein

Ulcer

associated with complete loss of the epidermis in addition to part of the dermis - often heal with scarring - can be of any size

Why is ATP use lower in smooth m than in skeletal

bc smooth muscle myosin completes cross-bridge cycling more SLOWLY than skeletal muscle myosin * 2 moleculres of ATP are required to initiate contaction, one for phosphorylation of myosin light chains and one to pivot myosin cross-bridge ** smooth muscle is still efficient bc rate of myosin cross-bridge cycling is slow (slower cycling means an increase in the percentage of cross bridges that are active at any point in time) ** so because it is slower- smooth muscle requires less energy to maintain a contraction compared to skeletal muslce (myosin takes longer to attach to actin- but also remains attached longer (prolonged muscle contration)

For x-linked recessive diseases why do you multiply the final carrier risk by an additional 1/2?

because among offspring that receive the disease-causing allele, female offpsing are CARRIERS (NOT affected) but the MALE offpspring are AFFECTED * so this 1/2 is basically splitting into boys and girls and thats probability that the offspring will be - AN AFFECTED MALE

Neuromuscular junction

before it terminates in SKELETAL muscle, each motor neuron forms many branches, each of which forms a synapse with a muscle fiber

In what locations would you NOT find IV discs

between the atlanto-occipital joint, atlanto-axial joint, sacral segments, and coccygeal segments

Describe a dislocation of foot bones

bone will be moved out of normal position in relation to other bones - usually involves ligamentous disruption * common causes are falls from a height or motor vehicle accident

The third part of the axillary artery come from the lateral

border of the pectoralis minor to the inferior border of the teres major It has 3 branches: Subscapular artery which divides into - Circumflex Scapular Artery - Thoracodorsal Artery Anterior Circumflex Humeral Artery Posterior Circumflex Humeral Artery (this one travels with the axillary nerve)

Term bone refers to

both a tissue and an organ * bones are organs largely composed of bone tissue that also contains other tissues: - bone marrow - arteries - veins - lymphatics - nerves - fibrous tissue

How can you tell the difference between stratified cuboidal and transitional

by the number of cell layers - stratified cuboidal is always only 2-3 layers - transitional always has ~5 layers when in empty state

which proteins allow SR to have calcium and decrease the free calcium in the SR

calsequestrin and calreticulin

Describe Stratified Squamous Epithelium and its function

can be keratinized or non-keratinized - Thick membrane composed of several cell layers - Basal cells are cuboidal or columnar and metabolically active - Surface cells are flattened (squamous) - Cells are attached to eachother by DESMOSOMES Fx: Protects underlying tissues in areas subjected to abrasion

Radiating from the lacuna (in which osteocytes are entrapped) are

canaliculi (tunnel-like spaces) that house cytoplasmic processes of osteocytes (called filopodia) ** gap junctions form between ends of processes allowing movement of ions and small molecules *** extracellular fluid (nutrient and metabolites) are found within canaliculi- huge contribution to body ECF: 1.3L of 5-6L total

When tumor suppressor genes are inactive as a result of epigenetics it can lead to

cancer

Serous Demilune is a

cap in the shape of a half-moon of serous cells on mucous glands of some salivary glands

arteries

carry blood AWAY from the heart - usually carry oxygen rich blood - begin at the heart and finish in capillary bed - larger arteries BRANCH into smaller arteries - thick walled, have a lumen

veins

carry blood TOWARD the heart - usually carry oxygen depleted blood - veins start in capillary bed and end in heart - smaller veins are TRIBUTARIES, which drain to larger veins - thin walled, NO LUMEN

A tough resilient type of connective tissue

cartilage

Sarcoptes Scabiei Var. hominis (human itch mite)

causes scabies - intense pruritus and pimple like rash from reaction to secretions and excretions * worse at night or after a long shower * transmission is by direct, prolonged skin to skin contact (sexually acquired or shared items) NOT A KNOWN VECTOR * scratching may lead to secondary infection ** mite burrows into upper layers of skin where it lives and lays eggs - diagnosis customary appearance of rash and burrows - confirmed by microscopic examination of skin scraping for mite, eggs or fecal matter - generally 10-15 mites on a person - first exposure 2-6 weeks for symptoms - re-exposure, rapix reaction

DNA damage causes

cell cycle arrest *Damage results in a cascade of events - binding and activation of the ATM/ATR kinases - they in turn activate Chk1/Chk2 kinase - activity of Chk1/Chk2 kinase results in phosphorylation of p53, which kicks off Mdm2 from p53 - this release prevents p53 degradation *posphorylated p53 acts as a transcription regulator and increased production of p21, a Cdk Inhibitor protein (p21 is a CKI protein) - G1/S-Cdk and S-Cdk are inactivated and the cell cycle is arrested in G1 ****** this is NORMAL p53 function p53 is very commonly mutated (inactivated) in cancer- the cell can continue cell division in spite of DNA damage - one effect of this= genomic instability in cancer cells (other mutations leading to greater malignancy can accumulate)

Tissues are made of two interacting components

cells (there are about 200 types in the human body- usually they are tissue-specific cell types) and extracellular matrix (the two are in different proportion in different tissue types - Nervous tissue has cells with intertwining elongated processes, but NO ECM - Epithelial tissue is mainly aggregated polyhedral cells and only a small amount of ECM - Muscles have elongated contractile cells and a moderate amount of ECM - Connective tissue has several types of fixed and wandering cells- it has ABUNDANT ECM

For far vision the

ciliary muscle relaxes, the suspensory ligaments are stretched and pulled tight- the lens flattens ** controlled by sympathetic NS. NE released from sympathetic post-ganglionic neurons binds to beta-adrenergic receptors on ciliary muscle cells, increasing intracellular cAMP leading to ciliary muscle relaxation, stretching of the suspensory ligaments and flattening of the lens

An isogenous group is a

cluster of chondrocytes originating from ONE single progenitor cell - territorial matrix ( a thin rim surrounds lacunae) * more basophilic which indicates a high concentration of newly synthesized GAGs - interterritorial matrix: appears more eosinophilic

Efferent/ MOTOR

comes out of VENTRAL ROOT

"Power Stroke"

conformation change in myosin causes release of ADP + P and pivoting of the myosin head- this pivoting = "power stroke" which pulls the actin containing thin filaments toward the middle of the sarcomere, reducing sarcomere length and producing muscle shortening

Keratinocytes in the stratum granulosum

contain keratohyalin granules and would be actively engaged in secreting lamellar bodies to waterproof the skin

Striated muscles and myotendinous junctions contain____ that are encapsulated _____

contain sensory receptors that are encapsulated propriorceptors

Muscle tissue is composed of cells differentiated for optimal use of the cell property termed

contractility - generated by actin and myosin

Epithelial tissue

covers body and organ surfaces, lines body cavities, and forms glands. It is involved with protection, absorption, excretion, secretion, diffusion and filtration - it also covers GI tubes, skin, etc

In an empty urinary bladder, the superficial cells are

cuboidal with a dome-shaped surface "Collapsed or Relaxed"

both the dorsal and palmar interossei are innervated by the

deep branch of ulnar nerve

Impinging on a SPINAL ROOT can give numbess or pain in a

dermatomal distribution ** whereas damage to a more peripheral nerve can cause a problem in the sensory distribution of that peripheral nerve Ex. of Peripheral Nerve Damage: - Anterior Dislocation of Humerus: axillary nerve compression which will affect deltoid region (axillary n. cutaneous innervation; includes C5 & C6 dermatomes) Ex. of Dermatome Damage: - Herpes Zoster (Shingles): infection in sensory ganglia (in this case, DRG). The infected neurons of that DRG will have the virus travel to its axons to infect the area innervated by that axon --> Its dermatome ~T2 level

In adjacent lamellae, the collagen fibers are oriented in

different directions * the presence of large number of lamellae with differing fiber orientations provides the bone with great strength, despite its light weight

Binding of ATP to myosin

dissociates cross-bridges bound to actin at the end of the powerstroke, allowing the bridges to repeat their cycle of activity

the knee joint is made from the

distal femur proximal tibia and patella

Molecular basis of elasticity in elastic cartilage

each ELASTIN molecule in the network has multiple random-coil domains which expand and contract; this allows the entire network to stretch and recoil like a rubber band

Elastic cartilage is essentially similar to hyaline cartilage plus

elastic fibers (these provide greater flexibility to this type of cartilage): contains type II collagen and perichondrion * elastic fibers have a yellowish tint to them, so in fresh tissue elastic cartilage will appear somewhat yellow while hyaline cartilage willl appear clear or bluish-white

positive and negative charges are equal across a membrane/compartment making a cell

electrically neutral (rule of electro-neutrality) * BUT the ION compositions of ICF and ECF are different and this allows for concentrations differences for certain ion species

Epidermis is derived from

embryonic ectoderm - epidermis is most superficial layer- composed of keratinized, stratified squamous epithelium- with the basal cell layer anchored to the underlying basement membrane

Interstitial growth of cartilage is very active during

endochondral ossification

Hydrolysis of ATP by myosin ATPase

energizes the cross-bridges, providing energy for force generation

Obesity (excessive formation of adipose tissue) occurs when

energy intake exceeds energy expenditure

Osteoclast (Bone-Resorbing cells) lie within

enzymatically etched depressions in the matrix known as HOWSHIPS LACUNAE (areas of bone undergoing resorption) * osteoclasts are very large cells in macrophage family that are multinucleated with 5-50 nuclei Monocytes fuse together --> osteoclasts They are very vigorous motile cells with acidophilic cytoplasm: - have lots of lysosomes - lots of mitochondris - well developed rER and golgi

Changes to expression that are inherited by progenitor cells but which do not include changes to the DNA sequence

epigenetics ** heritable phenotype changes that do not involve alterations in DNA sequence - most often involved changes that affect gene activity and expression (but can be used to describe any heritable phenotypic change

The basal lamina is secreted by

epithelial cells

Endothelium is the

epithelial lining of the blood and lymphatic vessels * it is ALWAYS simple squamous epithelium lining blood vessels

What occurs in an Intervertebral disc protrusion & spinal nerve compression int the LUMBAR region

ex. The L4 spinal nerve EXITS between L4 and L5, BUT sneaks by against the body of the L4 vertebra; instead the L5 spinal nerve is COMPRESSED by a protrusion of the IV disc at L4/L5 ** in lumbar region, there is a difference in where a spinal nerve EXITS & where it is COMPRESSED

Overproduction of pituitary growth hormone (GH) aka somatotrophin causes

excessive growth at epiphyseal plate - in children= Gigantism - adults= after growth plates have closed= Acromegaly * children develop great stature * adults develop deformed bones but do NOT grow taller

Posterior compartment of the forearm contains

extensors and supinators of the wrist and fingers I: radial nerve to all

Flexion of extremities vs flexion of spine

extermities: any movement that decreases the angle between two body parts spine: forward bending

where can elastic cartialge be found

external ear, external acoustic meatus, auditory tube; epiglottis and certain other laryngeal cartilages fxs: provides flexible shape and support of soft tissues

Na+ is found mostly

extracellularly (150mM)

Extension of extremities vs for spine

extremities: movement that increases the angle between two body parts spine: bending backwards

Patch

falt (NOT palpable and do NOT cast a shadow) but larger macules - if its flat and larger than 1cm, it is a patch ex. - scar - becker nevus - cafe au lait spots - melasma - seborrheic dermatitis

A peripheral nerve is made up of

fascicles which are made up of axons * hundreds of thousands of axons can be contained in a fascicle and several fascicles can create a peripheral nerve

Area between pelvis/hip and knee

femoral (thigh) region - has one bone: the femur (thigh bone) which is large and strong and important for weight-bearing, movement and muscle attachment

Collagen Type I is a

fibril-forming collagen (MOST abundant) ** fibrillar collagens are the major fibrous proteins in the ECM (extracellular matrix) of CT - it occurs in tissues as structures that are clasically designated as collagen fibers forming structures such as tendons, organ capsules, and dermis

In collagen types I, II, and III collagen molecules aggregate and become packed together to form

fibrils - multiple collagen fibrils form into collagen fibers - multiple fibers can form a bundle

which cartilage instead of having chondrocytes and chondroblasts has chondrocytes and fibroblasts

fibrocartilage

the strongest of cartilages

fibrocartilage - blends strength of Dense Regular CT (Type I collagen with blood vessels) with that of Hyaline cartilage (Type II collagen) *NO PERICHONDRIUM (bc blood vessels in CT)

Keratohyaline granules contain two major IF associated proteins which are

filaggrin and trichohyalin

Macule

flat; it is not "palpable" - if you can feel it, then it is NOT a macule * size up to 1 cm in diameter ex. - Lentigo - Cafe au lait spot - Lentigo Senilis - Petechiae - Tinea Versicolor

if more pressure is put on a bone than it can stand, it will split or break, a break of any size is called a

fracture common causes: - fall from hieght - MVA - direct blow - child abuse - repetitive forces, such as those caused by running, can cause stress fractures of the foot, ankle, tibia, or hip *** typically treated by restoring the fractured pieced of bone to their natural positions while the bone heals

In electrical synapses the pre and post synaptic neurons are linked together by

gap junctions ** allows for very fast transmission - transmission can occur without the delay that is characteristic of chemical synapses - for electrical synapses an action potential in the presynaptic neuron causes the postsynaptic neuron to be depolarized within a fraction of a millisecond

in living tissue, osteocytic processes connected via

gap junctions are persent in successive canaliculi, making cells in all the lamellae in communication iwth blood vessels in the central canal ** in a section of dried, ground bone: one complete osteon can be seen with lacunae situated between concentric lamellae and interconnected by fine canaliculi

Astrocytes are connected to eachother by

gap junctions- forming a 3D network through which information can flow * this adds additional network to neuronal network ** a study shoed that astrocytes have responses that are almost as quick as those of neuorns. This argue the reasearches- means that the astrocytes may also play a part in thinking and feeling

Submucosal plexus regulates

gastrointestinal blood flow

Muscular Dystrophy (MD)

general term to describe 9 types of inherited disorders characterized by progressive weakness and wasting of the muscles ** most common and sever= Duchennes MD (problems with skeletal and cardiac muscle)

Skeletal muscle contraction is ALWAYS

inititated by nerve innervation. Smooth muscle CAN BE initiated by nerve innervation BUT isnt always *** in vascular smooth muscle, contraction is usually triggered by a nerve impuls. In other tissues, contraction can be triggered by stretch, hormones, and other things

The Thoracodorsal Nerve (C6, C7, C8)

innervates the latissimus dorsi m.

Main clue that you are looking at cardiac muscle

intercalated discs

The Glenohumeral Joint

is a ball and socket joint, synovial joint - the convex humeral head (the ball) fits into the concave glenoid fossa (the socket) of the scapula Movements allowed: (the joint is HIGHLY mobile & therefore unstable) - abduction - adduction - flexion (moving upper limb forward) - lateral rotation - medial rotation

Topical tretinoin

is a retinoid used to treat mild to moderate acne

Finasteride

is used to treat androgenetic alopecia and works by inhibiting 5alpha-reductase (which would usually convert testosterone to dihydrotestosterone) ** dihydrotestosterone is responsible for hair loss (androgenetic alopecia) in genetically predisposed men ** Minoxidil is also used to treat androgenetic alopecia but it is NOT a 5alpha-reductase inhibitor

What does a bursa do

it acts like a cushion pad between skin, bone, tendons during joint movements ex. Suprapatellar bursa, prepatellar bursa, infrapatellar bursa

Where is one place where adipose tissue is found

it is found underlying skin - provides insulation, fat storage, and cushioning

How does parathyroid hormone (PTH) increase low blood calcium

it is released by the parathyroid glands, binds to the PTH receptor on OSTEOBLASTS and they stop production of osteoid and instead secrete factors that promotes osteoclastic resorption of bone, raising calcium

What is the Brush Border/ Striated Border (Microvilli)

it is very thick microvilli that are found in fluid-transporting epithelial of the intestine and kidney tubules * they form a distinctive border of vertical striations at the apical surface of the cell and this is why it is called the brush border or striated (brush) border ** this stains strongly with PAS due to the Glycocalyx (secreted proteins that have been glycosylated in the secretory pathway) ** remember PAS is used for staining structures containing high concentration of Carbs

In a histology slide the axon appears in what seems like a clear white circle with a tiny axon to the periphery because

it is where the myelin sheath was before - in tissue processing the alcohol dissolved the lipid- so where there would have been myelin just leaves what seems like clear space

What is the path of the ulnar nerve in the arm

it passes posterior to the medial epicondyle - enters and descends in forearm by passing between flexor carpi ulnaris and flexor digitorum profundus - DOES NOTTTT pass through the carpal tunnel into the hand * it passes through a band of tissue called the ulanar canal (or guyons canal)- most vulnerable MORE superficial- can be affected in suicides

Which portion of the obturator internus muscle is more visible in the gluteal region

its tendon is more visibile than its muscle belly

Malathion is a drug used to

kill lice. The drug works by blocking acetylcholinesterase. This results in increased ACh, which can bind to ACh receptors; nicotinic receptors and muscarinic receptors

The hypomere formed from the myotome makes the

lateral and ventral muscles of the thorax and abdomen, and limb muscle which are innervated by the ventral rami of spinal nerves

Subclavian artery becomes the axillary artery at the

lateral border of the 1st rib

The quadratus plantae of the second layer of the sole of the foot is innervated by the

lateral plantar nerve

The patella most commonly dislocates

laterally - due to normal angulation of femur and angle of lateral pull of quadriceps femoris muscle ** if vastus MEDIALIS m. is weak, then the vastus LATERALIS m. will pull patella laterally *** NORMALLY there is a natural tendency towards lateral pull on patella, but it is counterbalance by medial pull of the stronger vastus medialis muscle

Desmosomes link cell to cell while hemidesmosomes

link cell to the basal lamina/basement membrane - an adhesive junction located along the basal layer of cells - occur in epithelia that require strong, stable adhesion to the CT - ONLY half a demosome is present- one cell to the basement membrane

Ectrodactyly

lobster claw deformity - an abnoraml cleft between the 2nd and 4th digits * this is a variation of adactyly in which the middle digit is lost ** most common cause of mutation is in chromosome 7

What occurs in mallet finger "baseball finger"

long extensor tendon avulsion presents: - hyperflexion at the distal interphalangeal joint (DIP) - inability to extend DIP

Lymph (fluis from tissue spaces) is transported by

lymphatic vessels, filtered by lymph nodes, then returned back to the venous system

Cancer causing back up of lymphatics

lymphedema; peau d'orange sign

where can hyaline cartialge be found

many components of the upper respiratory tract, articular ends and epiphyseal plates of long bones; fetal skeleton fxs: proves smooth, low friction surfaces in joints; structural support for respiratory tract

The goblet cells owe their gobletlike shape to the the

mass of secretory vesicles containing mucus that distends their apical region, the narrow base contacts the basal lamina

The posterior tibial artery bifurcates in the plantar aspect of the foot and becomes the

medial and lateral plantar arteries

The cutaneous branch of the obturator nerve gives cutaneous sensation to the

medial aspect of the thigh

The ulnar nerve is proximal to the

medial epicondyle (pinky side)

In the lumbricals of the foot the 1st lumbrical is innervated by

medial plantar nerve - whiled the 2nd-4th lumbrical are innervated by the lateral plantar nerve

Brachial Artery Pulse is taken

medial to biceps brachii tendon (in cubital fossa) TAN (lateral to medial) - T= tendon of biceps brachii - A= Brachial artery - N= Median nerve

which term is given to the imaginary line that divides the body into equal left and right parts

median

What injury can lead to a "Hand of Benediction"

median nerve damage (motor and sensory loss) after s supracondylar fracture of the humerus - hand of benediction appears when trying to make a fist Other reasons for supracondylar fracture of humerus - fall onto outstretched hand implies: - distal shaft fragment displaced (posteriorly) --> limb shortening - risk of brachial artery laceration --> ischmeic contracture (Volkmanns contracture) - LOSE: long flexors in anterior compartment of the arm (except medial half of flexor digitorum profundus and flexor carpi ulnaris) and lateral two lumbricals *** if patient asked to make a fist they will be able to flex digits 4 and 5 but patient will NOT be able to flex digits 2 and 3

Newborn babies and infants cannot shiver to maintain body temperature, therefore they rely on

non-shivering thermogenesis- which is facilitated by a greater amount of brown adipose tissue * when cold-stressed, norepinephrin binds to Beta-adrenergic receptors in brown fat stimulating heat production

The sympathetic division primarily uses

norepinephrine as the signaling molecule at target tissues (NE is primary NT released from sympathetic postganglionic neurons innervating smooth muscle cells) ** only exception to this rule= sympathetic post-ganglionic innervation of sweat glands, where ACh is the NT (sympathetic cholinergic neurons)

Histology teaches the

normal pathology teaches the abnormal

The nucleus pulposus is derviced from

notochord ** the anulus fibrosis comes from mesenchyme

1 skeletal muscle cell/fiber has many

nuclei as a result of fusion during development Mesenchymal cells --> Myoblasts --> Line up in rowrs to form Myotubes --> fuse to form multinucleated muscle fibers * the long oval nuclei are usually found at periphery of the cell- this is different from cardiac and smooth muscle cells whose nuclei are in center of cell * at birth you will have ALL skeletal M. you will have it just increases in size

In a Hematoxylin and Eosin (H&E) stain the nuclei will be ____ and the cytoplasm will be ____

nuclei blue cytoplasm pink ** if a cell had a blue cytoplasm it would be because it had alot of rER, ribosomes, or mRNA

The efficiency of a tight junction in preventing ion passage increases exponentially with the

number of strands - Intestinal epithelial cells: have lots of strands and are very tight- efficient - Capillary endothelial cells: have fewer strands and are leakier (so WBCs can migrate OUT of the bloodstream)

Lynch Syndrome

occurs from problems with genes of mismatch repair - can lead to colon cancer, endometrial cancers and others ** lifetime risk in single gene cases= penetrance - if a woman who has inherited the gene for lynch syndrome has a 60% risk of dveloping Endometrial Cancer, then the penetrance is 60%

What does it mean that wound-healing is a self-limited response

once there is enough matrix (collagen mostly) has accumulated in the injured area, the fibroblasts either 1) revert to the resting stage or 2) undergo apoptosis

are there more gap junctions in osteoblasts or osteocytes

osteocytes!!!! (osteoblasts begin to form gap junctions with other osteoblasts) butttt you need gap junctions to transfer oxygen and ions through osteocytes ** can transfer through a chain of ~10 cells

When all cancers are considered what is probably the most frequently mutated protein

p53 ** because BOTH copies of p53 is inactived in these cancers, p53 is classified as a tumor suppressor gene

your metacarpals are in your

palm!! they are not your fingers yet, your phalanges are your fingers

Palmaris longus (Superficial Ant. compartment of forearm) inserts at the

palmar aponeurosis (apex) and flexor retinaculum ** ANTERIOR COMPARTMENT= FLEXORS

The dermis is divided into the

papillary and reticular dermis ** dermis is derived from embryonic mesoderm - Papillary dermis composed of: loos CT, Type I and III collagen fibers and elastic fibers (more cellular layer than the reticular dermis- contain blood vessels, lymphatics, and sensory nerve endings- has finger like projections into epidermis (dermal papillae) - Reticular layer: dense irregular CT- less cellular, has abundant Type I collagen and elastic fibers

Dermal papillae and Meissners corpuscles are found in the

papillary layer of the dermis ** Meissner corpuscles are in the dermal papillae (part of the papillary layer of the dermis) ** they function as receptors for fine touch

Substances can move across epithelial sheets in 2 ways. This is either paracellular (which is between the cells) or transcellular (which is through the cells). The principal function of a tight junction/ zonula occludens is to form a seal that prevents the flow of material in the

paracellular pathway (which is flow between the cells) ***tight junctions prevent this

Metaplasia:

potentially reversible change from a fully differentiate cell type to another (one type of epithelia to another), which implies adaptation to environmental stimuli - epithelial changes itself to better withstand "irritating" stimuli

What things increase breast density

pregnancy and nursing will almost ALWAYS increase breast density * breast density on mammogram cannot be predicted by palpation * patient age cannot be predicted on breast density alone

Prepreg / prenatal counseling of female carriers of DMD

purpose is to 1. go through with pregnancy informed or 2. avoid giving birth to child with DMD *** it is not always possible to test for presence/absence of the mutation (if possible it will usually be late in the pregnancy) BUT it is possible to test for sex of fetus very early- termination of pregnancy with male fetus is one way to ensure not giving birth to child with DMD should include: - explanation of DMD (keep neutral) - risks and options of not having child - parent has right to opt out of counseling at any time - parent/mother makes the final decision

Control of thermoregulatory behavior include

putting on extra clothes and moving around more when cold, switching on fan etc. - this involves higher brain centers

The amount of ACh in one vesicle is called a

quanta - and the number of ACh molecules in a quanta had been estimated to be ~10,000

The deep palmar arch is formed by continuation of the

radial artery past the wrist, posterior to metacarpal 1, anastomosing with the deep palmar branch of the ulnar a.

Amelia

rare congenital upper limb deformity affecting growth along the proximodistal axis *** normal limb pattering along this axis is mediated by Fibroblast growth factors

Striations are actin and myosin assembled in

sarcomeres (unit of contraction) * smooth muscle also uses actin and myosin for contraction; but they are not organized into sarcomeres

Bones that are encased with tendons are

sesamoid bones ** they may occur in several places within the body and are seen beneath the head of the 5th metatarsal in most people ** incidentally the largest sesamoid bone in the body is the patella

Most common cause of both DMD and BMD are deletions of Dystrophin that include

several exons (72% DMD, 85% BMD) - in DMD these disrupt the reading frame (framshift) - in BMD conserves reading frame (other mutation types include point mutations, partial duplications, protein)

Pupil as an abnormal white reflex (leukocoria)

sign of Retinoblastoma (child cancer in the eyes) * Active Rb= HYPOphosphorylated --> inhibits E2F ** Hyperphosphorylated Rb --> releases E2F and hthe cell can progress in the cell cycle ** Rb protein is shown to be mutated in retinoblastome tumors which is why the gene/protein got its name

In fibrocartilage chondrocytes are dispersed

singly, in rows and in isogenous groups surrounded by scant amount of ground substance * the chondrocytes line up with collagen type I fibers along the stress axis

Which of the 3 types of muscles is voluntary

skeletal muscle (it is the most common)

Action potential in alpha motor neuron is transmitted via a chemical synapse (NMJ) to the

skeletal muscle fiber

what serves as the calcium reservoir of the body

skeleton (contains 99% of bodys calcium in crystals of hydroxyapatite)

Benign (innocent) tumors are

slow-growing and innocuous

Oral rehydration therapy

sodium transport and glucose transport are coupled in the small intestine, so that glucose accelerates the absorption of solute and water * Acuter diarrheal diseases are among the leading causes of mortality in infants and young children in many developing countries- in most cases, the death is caused by dehydration - During diarrhea, there is an increases loss of water and electrolytes (sodium, chloride, potassium, and bicarbonate) in the liquid stool. - Dehyrdration occurs when these losses are NOT replaced adequately and a deficit of water and electrolytes develops. **** oral-rehydration therapy works to treat this by giving pts by mouth an adequate glucose-electrolyte solution (Oral Rehydration Salts, ORS) - in case of rehydration you also want Na+ take up so you also give glucose to help with the take up of Na+ ** this works bc you need glucose to take up sodium and hence water by the intestines (symporter on the apical surface of the intestinal epithelial cells needs glucose to import Na+ (Na+ is exchanged for K+ by Na+/K+ ATPase on the basal membrane)

fibroblasts begin to lay down tissue called granulation tissue between 4-10 days after the fracture occurs. The granulation tissue forms a "scaffold" between two fragments, from which formation of a ____ can begin

soft callus

Describe the organization of somatic (voluntary) motor systems

somatic motor pathways have a 2- neuron chain from the cortex (primary motor cortex) - the upper motor neurons (UMN) in the primary motor cortex in the brain, send signals along the somatic motor axons-- general somatic efferent (GSE type) to the ventral horn of the spinal cord - the ventral horn contains the lower motor neurons (LMN) which will then send a signal out along axons in the ventral roots and into the peripheral (spinal) nerve) which goes on to reach the target organ (voluntary muscle fibers)

In isolated isometric muscle contraction: as skeletal muscle fibers are stretched beyond Lo ...

tension develops * this tension is NOT due to cross-bridge formation and cycling but due to the resistance of CT and muscle proteins to stretch (ex. rubber band) ** tension developed in this manner does NOT req. ATP hydrolysis= PASSIVE TENSION * passive tension development increases steadily with stretching of muscle beyond Lo

The functional commponent of breast tissue are

the 15-20 lobules of the mammary gland which constitute the parenchyma - these come from the lactiferous ducts at puberty

The limb buds are visible by the end of

the 4th week * visible as outpouchins from the ventrolateral body wall. Produced by a core of lateral plate mesoderm covered by ectoderm

The Lateral, Posterior, and Medial Cords of Brachial Plexus are named according to their position in relation to

the axillary artery

Cancers are often described by

the body part that they originated in (ex. breast cancer) - but some/most body parts contain multiple types of tissue, so cancers are additionally classified by the type of cell that the tumor cells originated from (one way to tell the cell type is by the type of Intermediate filament in the tumor cell)

Trabecular bone is remodeled on

the bone surface, in contrast to cortical bone remodeling which occurs in an osteon - 2-4 weeks osteoclasts create a resorption space limited by a cement line - 4-6 months osteoblasts start to deposit osteoid until new bone closes the resorption space *** as with compact bone, the exact direction of bone formation depends on the stresses applied to the bone while it is forming

There is a slight delay in the time it takes a chemical synapse to make an action potential vs an electrical because

the chemical synapse has to wait for the neurotransmitter to get across (delayed about 0.5ms- this time required for release and diffusion of neurotransmitter and the response of the postsynaptic cell to it ** in electrical synapse there is a direct connection between the two cells so that ions can pass directly from one cell to the next - if one cell is depolarized in an electrical synapse- the joined cell also depolarizes because the ions pass between the cells

Appositional growth of cartilage is due to

the deepest fibroblast-like cells changing their properties and helping to form the special matrix of cartilage

in long bones, growth in length occurs in the region between the primary and secondary centers of ossification which is

the epiphyseal line

Skin color differences between races is related to

the fate of melanin - darker skin: degradation of melanin in lysosomes is slower than in lighter skinnes ** allows melanosomes to be more widely distributed in epidermis of dark skinned individuals ** while melanosomes are sparse in upper layers of light skinned

alpha1 adrenergic receptors produce physiologic actions by stimulating

the formation of IP3 and causing a susequent increas in intracellular calcium concentration

During the rising phase of fever

the hypothalamic temperature set point (Tset) is greater than the body temperature (Tb)- makes hypothalmaus think that Tb is too low and stimulates thermoregulatory mechanisms to elevate Tb like: - cutaneous vascoconstriction - decreased skin blood flow - decreased heat loss - decreased sweating and increased shivering

Speed of muscle contraction (velocity of shortening, V) depends on

the load that is being moved - Vmax: when it contracts with NO load * as load increases- velocity of contraction progressively decreaes- inverse relationship - Fmax: load > or = the maximum force that the muscle can exert- the muscle is unable to move the load and the velocity of shortening= 0 (isometric contraction- E) ** isometic bc load can NOT be move ***** the velocity of shortening reflects speed of cross-bridge cycling (determined by rate of energy utilization and thus, by myosin ATPase activity ) Fast muscle- fast ATPase activity - High Vmax (peak twitch tension in 14-40msec) Slow muscle- slow ATPase activity- Low Vmax (peak twitch tension 50-100msec)

in risk calculations in genetics who do you start with first

the nearest affected - from the affected, going on step at a time, calculate the risk through the SHORTEST path to the unknown person * if you have affected offspring you need to know about the parent to know about the siblings

UVA and UVB light are blocked by

the physical agents: - Titanium dioxide and Zinc Oxide

Pacinian Corpuscles are located in

the reticular layer of the dermis or even lower in the hypodermis ** they are unlikely to be injured in a second degree burn

Population carrier risk

the risk that a random, healthy person from the population is carrying a disease causing allele ** this is population specific so there is no need for you to memorize these- if needed it will be given in question stem

Where is the safe area for an intragluteal injection?

the safe area to preform an intramuscular injection is at the superior lateral quadrant of the gluteal region into the gluteus medius muscle --> in order to avoid injuring sciatic nerve, gluteal nerves, and blood vessels during administration of injection

Cardiac muscle is developed from

the splancnic mesoderm cells of the primitive heart tube - which align into chainlike arrays and rather than fusing into multinucleated cells (like skeletal muscle), the cardiac muscle cells form complex junctions between extended processes called intercalated discs

The more K+ ions are moving out of the cell due to concentration force..

the stronger becomes the electrical force moving K+ towards inside * equilibrium is achieved as both forces become equal and membrane potential is called K+ equilibrium potential * the equilibrium potential for K+ (or any other ion) depends only on its concentrations on both side of membrane

Describe the path of the voluntary motor axons, or general somatic efferent (GSE) type axons

these are descending from the cortex (brain), synapse in the spinal cord and then will travel out the ventral root to enter the spinal nerve and peripheral nerve to ultimately innervate voluntary musculature

Describe the path of sensory axons, or General Somatic Afferent (GSA) type axons

these are traveling in the spinal nerve to then enter the dorsal root and subsequently will become a tract within the spinal cord to reach the cortex of the brain

Adipose Tissue is a specialized type of connective tissue in which adipocytes or fat cells predominate. What are adipocytes?

they are CT cells that have become specialized for stoages of neutral fats or for the production of heat * they arise from embryonic mesenchyme cells

Where can stereovilli be found

they have limited distribution. Can be found in - epididymis: where they have absorptive function during sperm maturation - sensory hair cells in ear: where they function as mechanoreceptors ** you can only really recognize sterocilia by location; they look like regular cilia on sections- what you would see it sperm in epididymis... this would signal that you are looking at stereocilia

What are the capsular ligaments of the hip joint

thickened parts of the joint capsule form 3 ligaments of the hip joint - Iliofemoral ligament - Pubofemoral ligament - Ischiofemoral ligament ** these ligaments wind around and move (screw) femoral head tightly into acetabulum

Describe a fracture of the clavicle

this is one of the most frequently fractured boned (especially at the junction of middle & lateral 1/3) Can be caused by: - direct fall onto shoulder - indirect due to transmission of force from arm & forearm to shoulder during a fall on an outstretched hand Presents as - medial fragment is ELEVATED (due to sternocleidomastoid) - lateral fragment is DEPRESSED (due to weight of the arm) ** most likeley injured vessel= subclavian vein --> internal bleeding

If EPP depolarization is sufficient to raise the membrane protential from -90mV to

threshold (-55mV), voltage-gated channels in the adjacent sarcolemma open * voltage-gated Na+ channels open more quickly, resuling in Na+ influx and depolarization. Voltage gated K+ channels open slowly resulting in K+ efflux and repolarization * once initiated the action potential propagates alond the sarcolemma and T-tubules

Superior, cranial, cephalic

toward the head

medial

toward the midline of body

Veins drain

towards the heart, they drain proximal

Cancellous/ spongy bone is made of

trabeculae ** anastomosing bony spicules in cancellous bone which form a meshwork of intercommunicating spaces that are filled with bone marrow - spicule= a slender, pointed usually hard body

The axons of neurons in the CNS form

tracts

Conduction

transfer of heat between objects which are in direct contact

Convection

transfer of heat resulting from the movement of a liquid or a gas Ex: when the body is immersed in water and the body is moving (treading water), nearly all heat is lost by convestion

Importance of CT (endo-, peri-, epimysium) in skeletal muscle

transmit the mechanical forces generated by the contracting muscle cells/fibers, because individual muscle cells seldom extend from one end of a muscle to the other

In skeletal muscles Action potentials propagate along the sarcolemma and penetrate into the cell interior via

transverse tubules (T-tubules) - there are flanked by terminal cisternae of the sarcoplasmic reticulum 1 T-tubule + 2 Terminal Cisternae= triad

Most organs are formed by an orderly combination of at least

two tissues but the small intestine contains ALL four - epithelium - connective - muscle - nervous

Gene and marker are inherited as a

unit