oth3416: the ultimate exam 2 mega-quizlet

endocrine system

5 general functions of the _____________: 1. differentiation of reproductive system and CNS in fetus 2. stimulation of growth and development 3. coordination of the male and female reproductive systems 4. maintenance of internal environment 5. adaptation to emergency demands of the body

A. interneurons

CH14 Q1: which of the following neurons transmit impulses from neuron to neuron? A. interneurons B. motor neurons C. sensory neurons D. unipolar neurons

C. vestibulospinal

CH14 Q2: which of the following motor pathways is responsible for rapidly contracting extensor muscles? A. corticobulbar B. reticulospinal C. vestibulospinal D. lateral corticospinal

B. somatic pain

CH15 Q1: a 15 year old male hots his finger while hammering a nail. which of the following best describes the type of pain he would feel? A. visceral pain B. somatic pain C. chronic pain D. neuropathic pain

D. hypothalamus

CH15 Q2: which part of the brain is responsible for temperature regulation? A. medulla B. thalamus C. limbic system D. hypothalamus

C. intracerebral

CH16 Q1: a patient has a structural problem w/in the brain tissue that decreases the level of consciousness. which of the following terms best describes the location? A. subdural B. infratentorial C. intracerebral D. extracerebral

C. interstitial

CH16 Q2: a patient is experiences edema in the brain caused by movement of the cerebrospinal fluid (CSF) from the ventricles into the extracellular space. what type of edema does this describe? A. ischemic B. cytotoxic C. interstitial D. vasogenic

C. forward displacement of the vertebrae

CH17 Q1: a patient is told he has spondylolisthesis. which of the following best describes this condition? A. spinal stenosis B. radiculopathy C. forward displacement of the vertebrae D. degenerative process of the vertebral column

B. between the dura mater and the skull

CH17 Q2: an extradural (epidural) hematoma occurs: A. within the brain B. between the dura mater and the skull C. in the space located between the dura mater and the brain D. by opening a communication between the cranial contents and the environment

C. it is demyelinating disorder

CH17 Q3: which of the following is TRUE regarding multiple sclerosis? A. it affects gray matter B. it is an uncommon disease C. it is demyelinating disorder D. it involves the central nervous system only

D. myelomeningocele

CH18 Q1: which neural tube defect is a saclike cyst, most often in the lumbar area, containing meninges, spinal fluid, and a portion of the spinal cord with its nerves?: A. meningocele B. anencephaly C. encephalocele D. myelomeningocele

A. neuroblastoma

CH18 Q2: what type of brain tumor is an embryonic tumor of the sympathetic nervous system? A. neuroblastoma B. ependymoma C. retinoblastoma D. medulloblastoma

B. catecholamine

CH19 CASE STUDY: a 24 year old mother visits her obstetrician's office 1 week after delivering her baby. she is having trouble w/ breast-feeding and milk expression. following her appointment, as she is walking to her car, the mother becomes aware that someone is following her. her body responds with a "fight or flight" response. the "fight or flight response is regulated by the adrenal medulla's secretion of what hormone? A. cortisol B. catecholamine C. glucocorticoid D. androgen

A. oxytocin

CH19 CASE STUDY: a 24 year old mother visits her obstetrician's office 1 week after delivering her baby. she is having trouble w/ breast-feeding and milk expression. for her milk expression, the obstetrician prescribes a nasal spray that will stimulate the posterior pituitary to release which of the following hormones? A. oxytocin B. prolactin C. calcitonin D. incretin

C. TSH secretion is regulation by thyrotropin-releasing hormone

CH19 Q1: which of the following is TRUE regarding thyroid hormone and thyroid-stimulating hormone? A. TSH secretion is controlled by positive feedback B. TSH is secreted in excess when stimulated by T4 C. TSH secretion is regulation by thyrotropin-releasing hormone D. decreased anterior pituitary release of TSH stimulates thyroid hormone secretion

B. beta

CH19 Q2: insulin is secreted by the pancreas from which type of cell? A. F B. beta C. delta D. alpha

B. activation of glucose-forming pathways in the liver

CH20 CASE STUDY: a 7-year old boy id brought to the emergency department by his grandmother. she informs the staff that she is her grandson's guardian and that he is breathing heavily and smells funny. laboratory tests confirm that the child is in DKA. during DKA, insulin counterregulatory hormones, such as catecholamines ad cortisol, increase. profound insulin deficiency results in: A. dec fat mobilization B. activation of glucose-forming pathways in the liver C. increased glucose uptake D. activation of bicarbonate buffering

A. norepinephrine

CH20 CASE STUDY: while her grandson is in the hospital, the 60-year old grandmother has been drinking coffee in an attempt to stay awake at the bedside. she begins to complain of a severe headache. she informs the staff that the headache is usually an increase in her blood pressure. although she has been prescribed a medication and has been taking it regularly, she continues to have issues. she is sweating and feels her heart racing. she is transported to the emergency department. she undergoes a barrage of test and, 2 days later, her physician is ready to discuss her diagnosis of pheochromocytoma. her symptoms are caused by an excessive production of: A. norepinephrine B. cortisol C. thyroid-stimulating immunoglobulins (TSIs) D. growth hormone

A. diabetes insipidus

CH20 Q1: which of the following is a condition associated w/ polyuria and polydispia? A. diabetes insipidus B. hypoparathyroidism C. hyperthyroidism D. Graves disease

B. diabetes type 2

CH20 Q2: a 12-year-old patient develops pancreatic atrophy w/ loss of beta cells. which of the following conditions does this patient have? A. diabetes type 1 B. diabetes type 2 C. hypothyroidism D. diabetes insipidus

A, white

CH21 Q1: obesity w/ body fat distributed around the abdomen and upper body is mostly composed of what type of adipose tissue? A, white B. bone marrow C. brown D. beige

D. erythrocytes

CH22 Q1: which are the most abundant cells of the blood, responsible for tissue oxygenation? A. platelets B. leukocytes C. neutrophils D. erythrocytes

B. occurs in the bone marrow after birth

CH22 Q2: a student is explaining the process of hematopoiesis. which statement made by the student is accurate? A. involves one stage, proliferation B. occurs in the bone marrow after birth C. occurs in the liver and spleen after birth D. decreases in response to hemolytic anemia

A. chronic gastritis

CH23 CASE STUDY Q1: a 63 year old woman w/ diabetes notes that she has a general feeling of tiredness and a loss of appetite. for several months, while on her daily 2-mile walks, she has heard her heartbeat in her ears as a whooshing sound. very knowledgable about her disease and compliant w/ diet and medications, she waits until she sees her endocrinologist for her yearly examination. in the office, she explains her symptoms, and the physician collects a CBC in addition to normal diabetic laboratory tests. the results indicate an anemia, and she is referred to a hematologist. the hematologist reviews her laboratory findings and begins to explain her diagnosis of megaloblastic anemia. further testing indicated that the woman suffers from a vitamin B12 deficiency or PA. this condition is often associated with: A. chronic gastritis B. thalassemia C. excessive blood loss D. inadequate dietary intake

B. phlebotomy

CH23 CASE STUDY Q2: the woman is treated with replacement cobalamin (vitamin B12) over several weeks until the deficiency is corrected. monthly injections for the remainder of the woman's life is explained, and she acknowledges the importance of treatment. one year later, the hematologist sees the woman for follow-up laboratory testing. the woman again complains of fatigue. part of her health screening indicates that she has elevated serum iron and ferritin levels. confused, the hematologist reviews her medications. she states that she has been taking several iron supplements and a multivitamin w/ iron daily after reading online that anemia should be further treated w/ iron administration. discussion w/ her friends further convinced her that iron was the treatment of choice for anemia. the physician again explains the patient's initial diagnosis and now informs the woman that she additionally suffers from secondary iron overload. the treatment for iron overload is: A. vitamin C supplements B. phlebotomy C. aspirin D. plasmapheresis

C. presence of macrocytes

CH23 Q1: which of the following is characteristic of the megaloblastic anemias? A. small cell size B. decreased thickness C. presence of macrocytes D. caused by increased folate

C. leukocytosis

CH23 Q2: which of the following terms best describes a higher-than-normal white blood cell count? A. neutrophilia B. leukopenia C. leukocytosis D. granulocytosis

D. disseminated intravascular coagulation

CH23 Q3: thrombocytopenia commonly is seen with which condition? A. multiple myeloma B. hemolytic anemia C. non-hodgkin lymphoma D. disseminated intravascular coagulation

C. hodgkin lymphoma

CH24 Q2: painless lymphadenopathy is the most common manifestation of which hematologic disease? A. hemophilia B. sickle cell disease C. hodgkin lymphoma D. acute lymphoblastic leukemia

B. sickle cell disease

CH24 which hematologic dysfunction, seen in children, causes a change in the shape of the red blood cell (RBC), resulting in decreased oxygen to the tissues? A. hemophilia B. sickle cell disease C. acute lymphoblastic leukemia D. hemolytic disease of the newborn

C. blood flows from the right ventricle through the pulmonic semilunar valve

CH25 Q1: which of the following is an accurate statement regarding blood flow through the heart? A. blood flows from the left ventricle through the bicuspid valve B. blood flows from the right atrium through the aortic valve to the right ventricle C. blood flows from the right ventricle through the pulmonic semilunar valve D. blood flows from the left atrium through the tricuspid valve to the left ventricle

D. cardiac fibers have only one nucleus, and skeletal muscle fibers have many nuclei

CH25 Q2: which of the following is TRUE with regard to cardiac and skeletal muscle fibers? A. cardiac fibers have fewer mitochondria than skeletal muscle fibers B. cardiac fibers are parallel, and skeletal muscles are branched C. cardiac fibers have a slower transmission than skeletal muscle fibers D. cardiac fibers have only one nucleus, and skeletal muscle fibers have many nuclei

C. left ventricle will be required to pump harder

CH25 Q3: a client is diagnosed w/ inc systemic vascular resistance. what will be the effect on the heart A. left atrium will be required to pump harder B. right atrium chamber will become enlarged C. left ventricle will be required to pump harder D. right ventricle will become ineffective because of increased pressure

C. coronary artery disease

CH26 Q1: severe and chronic hypertension can lead to which of the following? A. anemia B. glaucoma C. coronary artery disease D. chronic obstructive pulmonary disease

D. atherosclerotic plaque progression

CH26 Q2: a client is complaining of having intermittent "chest pain" after exercise. this is most likely caused by which of the following A. mitral valve prolapse B. infective endocarditis C. inflammation of the pericardium D. atherosclerotic plaque progression

B. cardiogenic

CH26 Q3: a client has adequate intravascular volume but is experiencing decreased cardiac output and tissue hypoxia. which type of shock is occurring? A. neurogenic B. cardiogenic C. hypovolemic D. anaphylactic

C. patent ductus arteriosis

CH27 Q1: the nurse hears a machinery-like murmur when performing cardiac auscultation on a 2-day-old infant. this is most likely indicative of what condition? A. tetralogy of fallot B. ventricular septal defect C. patent ductus arteriosis D. atrioventricular septal defect

A. tetralogy of fallot

CH27 Q2: a pediatric client is diagnosed w/ a cyanotic heart defect. which of the following defects is classified as cyanotic? A. tetralogy of fallot B. ventricular septal defect C. patent ductus arteriosus D. atrioventricular septal defect

A. minimally conscious

EXAM 2 PRACTICE Qs: A patient has sustained a traumatic brain injury but is able to follow simple commands and can manipulate objects. The term used to describe this state is: A. minimally conscious B. vegetative C. locked-in syndrome D. coma

C. brain

EXAM 2 PRACTICE Qs: The central nervous system contains the: A. somatic nervous system B. afferent pathways C. brain D. cranial nerves

C. coarctation of the aorta

EXAM 2 PRACTICE Qs: A child has been noted to have hypertension with decreased pulses in the lower extremities. Which condition is the most likely congenital cause for this finding? A. pulmonary stenosis B. atrial septal defect C. coarctation of the aorta D. tricuspid atresia

B. fontanels

EXAM 2 PRACTICE Qs: At birth, a newborn has separations in the skull that contain unossified membranous tissue. These structures are referred to as: A. myelins B. fontanels C. sutures D. Schwann cells

B. falls

EXAM 2 PRACTICE Qs: The most common cause of TBI for children and older adults is: A. sports-related events B. falls C. violence D. motor vehicle accidents

B. stress

EXAM 2 PRACTICE Qs: Which activity has been documented to increase the levels of circulating endogenous endorphins? A. cough B. stress C. pain D. sleep

D. calcium channel blockers

EXAM 2 PRACTICE Qs: Which classification of drugs decreases the strength of cardiac contraction? A. adenosine B. aspirin C. narcotics (morphine) D. calcium channel blockers

B. very low-density lipoproteins (VLDL)--triglycerides and proteins

EXAM 2 PRACTICE Qs: Which conditions are associated with dyslipidemia? A. high-density lipoprotein (HDL)--triglycerides and fat packages B. very low-density lipoproteins (VLDL)--triglycerides and proteins C. low-density lipoproteins (LDL) --phospholipids and proteins D. chylomicrons--triglycerides and phospholipids

B. decreased erythrocytes in circulating blood

EXAM 2 PRACTICE Qs: Which description appropriately defines the term anemia? A. increased erythrocyte number in circulating blood B. decreased erythrocytes in circulating blood C. increased white blood cell size D. decreased circulating platelets

A. sickle cell thalassemia

EXAM 2 PRACTICE Qs: Which disease process occurs in patients with two hemoglobin (Hgb) abnormalities in which at least one involves the Hb gene? A. sickle cell thalassemia B. sickle cell anemia C. hereditary spherocytosis D. sickle cell trait

A. oxytocin

EXAM 2 PRACTICE Qs: Which hormone is secreted by the posterior pituitary? A. oxytocin B. parathyroid (PTH) C. calcitonin D. thyroid-stimulating (TSH)

A. musculoskeletal support

EXAM 2 PRACTICE Qs: Which is not a function of adipose tissue? A. musculoskeletal support B. hormone secretion C. immune cell function D. insulation

B. is the result of a GH-secreting pituitary adenoma

EXAM 2 PRACTICE Qs: Which is true regarding acromegaly? It: A. occurs due to excessive levels of ACTH B. is the result of a GH-secreting pituitary adenoma C. is a relatively common condition D. occurs more frequently in men

D. polycythemia

EXAM 2 PRACTICE Qs: Which term refers to an abnormally high production of red blood cells? A. hemolytic crisis B. apoferritin C. anemia D. polycythemia

4

Kawasaki disease: how many pathologic stages are in Kawasaki disease?

Kawasaki disease stage I

Kawasaki disease: this is when capillaries, venules, arterioles, and the heart become inflamed -1-12 days

Kawasaki disease stage IV

Kawasaki disease: this is when inflam wanes w/ potential scarring of vessels, calcification and stenosis -41 days and beyond

Kawasaki disease stage III

Kawasaki disease: this is when medium sized arteries begin the granulation process -26-40 days

Kawasaki disease stage II

Kawasaki disease: this is when there is inflam of larger vessels and coronary aneurysms appear -13-25 days

5

Kawasaki disease: to be diagnosed w/ Kawasaki disease, a child must exhibit _____ of 6 criteria 1. fever for 5+ days (unresponsive to antibiotics) 2. bilateral conjunctivitis w/o exudation 3. erythema of oral mucosa (strawberry tongue) 4. changes in the extremities, such as peripheral edema and erythema w/ desquamation of palms and soles 5. polymorphous rash 6. cervical lymphadenopathy

C. Landau

UNIT 4 QUIZ A 10-month-old infant presents for a well-baby visit. Which of the following reflexes should be present at this age? A. Stepping B. Sucking C. Landau D. Palmar grasp

C. Craniopharyngioma

UNIT 4 QUIZ A 10-year-old presents with headaches and seizures. CT scan reveals a tumor that is located near the pituitary gland. Which of the following is the most likely tumor type? A. Ependymoma B. Medulloblastoma C. Craniopharyngioma D. Astrocytoma

C. Escherichia coli

UNIT 4 QUIZ A 15-year old is diagnosed with an outer ear infection. Which of the following is most likely to cause this infection? A. Haemophilus B. Streptococcus pneumonia C. Escherichia coli D. Moraxella catarrhalis

B. Paratonia

UNIT 4 QUIZ A 16-year old male fell off the bed of a pickup truck and hit his forehead on the road. He now has resistance to passive movement that varies proportionately with the force applied. He is most likely suffering from: A. Spasticity B. Paratonia C. Rigidity D. Dystonia

A. Metabolically induced coma

UNIT 4 QUIZ A 16-year old's level of arousal was altered after taking a recreational drug. Physical exam revealed a negative Babinski sign, equal and reactive pupils, and roving eye movements. Which of the following diagnoses will the nurse most likely see on the chart? A. Metabolically induced coma B. Structural arousal altercation C. Structurally induced coma D. Psychogenic arousal alteration

B. Reticular activating system

UNIT 4 QUIZ A 19-year-old college student reports to his primary care provider that he cannot stay awake in class regardless of how much sleep he gets. Under-stimulation of which area of the brain is likely the site of the problem? A. Cerebellum B. Reticular activating system C. Corpora quadrigemina D. Hypothalamus

D. Brainstem

UNIT 4 QUIZ A 20 year old experiences a severe closed head injury as a result of a motor vehicle accident. Which of the following structures is most likely keeping the patient in a vegetative state (VS) 1 month after the accident? A. Cerebral cortex B. Cerebellum C. Spinal cord D. Brainstem

B. Neisseria meningitidis

UNIT 4 QUIZ A 3-year-old has been diagnosed with bacterial meningitis. What should the nurse expect to find on the lab report for the most common cause of this bacterial meningitis? A. Streptococcus pneumonia B. Neisseria meningitidis C. Escherichia coli D. Haemophilus influenzae

A. Huntington's disease

UNIT 4 QUIZ A 40-year-old male complains of uncontrolled excessive movement and progressive dysfunction of intellectual and thought processes. He is experiencing movement problems that begin in the face and arms and eventually affect the entire body. The most likely diagnosis is: A. Huntington's disease B. Tardive dyskinesia C. Alzheimer's disease D. Hypokinesia

C. Retina

UNIT 4 QUIZ A 50-year-old diabetic patient experiences visual disturbances and decides to visit his primary care provider. After examination, the primary care provider tells the patient that the cells that allow him to see are degenerated. Which of the following structures is most likely damaged? A. Pupil B. Lens C. Retina D. Cornea

D. Obstructive sleep apnea syndrome (OSAS)

UNIT 4 QUIZ A 52- year old male enters a sleep study to gather information about his sleep disturbances. He reports that his wife will not let him sleep in the bed with her until he stops snoring so loudly. He also reports feeling tired a lot throughout the day. When the nurse checks the chart, what is the most likely diagnosis? A. Insomnia B. Jet-lag syndrome C. Somnambulism D. Obstructive sleep apnea syndrome (OSAS)

B. Agnosia

UNIT 4 QUIZ A 65-year-old patient who recently suffered a cerebral vascular accident is now unable to recognize and identify objects by touch because of injury to the sensory cortex. How should the nurse document this finding? A. Hypermimesis B. Agnosia C. Dysphasia D. Echolalia

C. Chronic subdural hematoma

UNIT 4 QUIZ A 69-year-old patient with a history of alcohol abuse presents to the emergency room (ER) after a month-long episode of headaches and confusion. The patient's history and symptomology support which medical diagnosis? A. Concussion B. Subacute subdural hematoma C. Chronic subdural hematoma D. Epidural hematoma

C. Stage 3

UNIT 4 QUIZ A 70-year-old patient is being closely monitored in the neurologic critical care unit for a severe closed head injury. After 48 hours, signs of deterioration occur: pupils are small and sluggish, pulse pressure is widening, and heart rate is bradycardic. These clinical findings are evidence of what stage of intracranial hypertension? A. Stage 1 B. Stage 2 C. Stage 3 D. Stage 4

A. Macular degeneration

UNIT 4 QUIZ A 70-year-old patient presents to the primary care provider reporting loss of vision. A history that includes hypertension and cigarette smoking supports which visual diagnosis? A. Macular degeneration B. Strabismus C. Amblyopia D. Presbyopia

D. Meningeal infection

UNIT 4 QUIZ A CT scan reveals that a patient has an open basilar skull fracture. Which major complication should the nurse observe for in this patient? A. Cognitive deficits B. Increased intracranial pressure (ICP) C. Hematoma formation D. Meningeal infection

B. Dandy-Walker deformity

UNIT 4 QUIZ A baby is stillborn after 6 hours of labor. Autopsy reveals hydrocephalus caused by cystic dilation of the fourth ventricle and aqueductal compression. Which of the following is the most likely diagnosis? A. Microcephaly B. Dandy-Walker deformity C. Congenital hydrocephalus D. Macewen sign

B. Microglia

UNIT 4 QUIZ A cell was isolated from the CNS. A researcher revealed that its main function was to clear cellular debris. What type of cell is the researcher studying? A. Ependymal cell B. Microglia C. Astrocyte D. Schwann cell

B. Dystonic

UNIT 4 QUIZ A child is diagnosed with cerebral palsy, characterized by extreme difficulty in fine motor coordination and purposeful movement. Which of the following types of cerebral palsy is the child experiencing? A. Mixed B. Dystonic C. Spastic D. Ataxic

C. Night terrors

UNIT 4 QUIZ A child suffers from sudden apparent arousals in which she expresses intense fear or other emotion. Her mother reports that she seems to wake screaming, but that she is difficult to waken completely. The child most likely suffers from: A. Somnambulism B. Parasomnia C. Night terrors D. Enuresis episodes

C. Frontal

UNIT 4 QUIZ A coup injury resulting from a blow to the frontal portion of the skull would occur in which region of the brain? A. Temporal B. Occipital C. Frontal D. Parietal

D. Reticular activating system

UNIT 4 QUIZ A neurologist explains that arousal is mediated by the: A. Cerebral cortex B. Cingulate gyrus C. Medulla oblongata D. Reticular activating system

D. Spinothalamic tract

UNIT 4 QUIZ A neurologist is teaching about sensory pathways. Which information should the neurologist include? Sensory pathways in the spinal cord to the thalamus are included in the: A. Corticospinal tract B. Anterior column C. Pyramids D. Spinothalamic tract

D. Broca area

UNIT 4 QUIZ A neurologist is teaching about the region responsible for motor aspects of speech. Which area is the neurologist discussing? A. Brodmann area 4 B. Brodmann area 6 C. Wernicke area D. Broca area

C. Multipolar

UNIT 4 QUIZ A neurologist is teaching the staff about motor neurons. Which structural classification identifies motor neurons? A. Pseudounipolar B. Unipolar C. Multipolar D. Bipolar

D. Affective-motivational system

UNIT 4 QUIZ A nurse is discussing an individual's conditioned or learned approach or avoidance behavior in response to pain. Which system is the nurse describing? A. Sensory-motivational system B. Cognitive-evaluative system C. Sensory-discriminative system D. Affective-motivational system

C. Tentorium cerebelli

UNIT 4 QUIZ A nurse is discussing the membrane that separates the cerebellum from the cerebrum. Which term should the nurse use to describe this membrane? A. Temporal lobe B. Arachnoid membrane C. Tentorium cerebelli D. Faix cerebri

B. Astrocytoma

UNIT 4 QUIZ A nurse is preparing to teach about brain tumors. Which information should the nurse include? The most common type of brain tumor in children is: A. Neuroblastoma B. Astrocytoma C. Germ cell D. Meningioma

D. Hypothalamus

UNIT 4 QUIZ A nurse is preparing to teach about functions to maintain homeostasis and instinctive behavioral patterns. Which area of the brain is the nurse discussing? A. Thalamus B. Medulla C. Cerebellum D. Hypothalamus

B. Axon hillock

UNIT 4 QUIZ A nurse is preparing to teach about nerves. Which information should the nurse include? The axon leaves the cell body at the: A. Nissl body B. Axon hillock C. Myelin sheath D. Node of ranvier

A. Posterior

UNIT 4 QUIZ A nurse is preparing to teach about the most common defects of neural tube closure. Which one should the nurse discuss? A. Posterior B. Anterior C. Lateral D. Superior

A. Concussion

UNIT 4 QUIZ A nurse is preparing to teach staff about the most common type of traumatic brain injury. Which type of traumatic brain injury should the nurse discuss? A. Concussion B. Focal brain injury C. Diffuse axonal injury D. Penetrating trauma

B. Lateral horn

UNIT 4 QUIZ A nurse is teaching about the area of the spinal cord that contains cell bodies involved in the autonomic nervous system. Which of the following areas is the nurse discussing? A. Dorsal horn B. Lateral horn C. Anterior horn D. Ventral horn

B. Eustachian tube

UNIT 4 QUIZ A nurse is teaching about the structure that connects the middle ear with the pharynx. Which structure is the nurse describing? A. Organ of Corti B. Eustachian tube C. Semicircular canal D. Estuchian tube

C. Influencing and modifying spinal reflex arcs

UNIT 4 QUIZ A nurse recalls that characteristics of upper motor neurons include: A. Directly innervating muscles B. Cell bodies located in the gray matter of the spinal cord C. Influencing and modifying spinal reflex arcs D. Dendritic processes extending out of the CNS

B. Affective C. Memory and language D. Attentional

UNIT 4 QUIZ A nurse recalls that neural systems basic to cognitive functions include (select all) A. Tactile systems B. Affective C. Memory and language D. Attentional E. Sensory and motor

D. 20

UNIT 4 QUIZ A nurse remembers the brain receives approximately ___% of the cardiac output. A. 80 B. 10 C. 40 D. 20

B. 3-6 months

UNIT 4 QUIZ A nurse should document on the chart that chronic pain is occurring when the patient reports the pain has lasted longer than: A. 2-3 years B. 3-6 months C. 1 year D. 1 month

B. Adrenal medulla

UNIT 4 QUIZ A nurse wants to teach about one of the primary organs responsible for heat production. Which organ should the nurse include? A. Pancreas B. Adrenal medulla C. Heart D. Liver

C. 90

UNIT 4 QUIZ A patient asks the nurse how often REM sleep occurs. The nurse responds "About every ___ minutes" A. 30 B. 60 C. 90 D. 15

B. Skin

UNIT 4 QUIZ A patient asks the nurse where nociceptors can be found. How should the nurse respond? One location in which nociceptors can be found is the: A. Hypothalamus B. Skin C. Efferent pathways D. Spinal cord

B. A1

UNIT 4 QUIZ A patient begins taking a new drug that causes pupil dilation, vasoconstriction, decreased gastrointestinal motility, and goosebumps. Which of the following receptors are activated? A. A2 B. A1 C. B1 D. B2

B. Substance P

UNIT 4 QUIZ A patient brought to the emergency room (ER) with severe burns is requesting something for the excruciating pain and is medicated with morphine, which blocks which of the following neurotransmitters, thus reducing the pain? A. Dopamine B. Substance P C. Enkephalin D. Acetylcholine

B. Acute brain swelling

UNIT 4 QUIZ A patient diagnosed with a diffuse brain injury (DBI) is at increased risk for which complication? A. Complete loss of vision B. Acute brain swelling C. Meningitis infection D. Arrhythmia

D. Central neurogenic hyperventilation

UNIT 4 QUIZ A patient experiences a severe head injury hitting a tree while riding a motorcycle. Breathing becomes deep and rapid but with normal pattern. What term should the nerve use for this condition? A. Apneusis B. Gasping C. Ataxic breathing D. Central neurogenic hyperventilation

D. Middle cerebral artery

UNIT 4 QUIZ A patient experiences a stroke and now has difficulty writing and producing language. This condition is most likely caused by occlusion of the: A. Anterior communicating artery B. Circle of Willis C. Posterior communicating artery D. Middle cerebral artery

A. Hyperkinesia

UNIT 4 QUIZ A patient has excessive movement. What disorder will the nurse see documented on the chart? A. Hyperkinesia B. Hypokinesia C. Akinesia D. Dyskinesia

C. Glaucoma

UNIT 4 QUIZ A patient has increased intraocular pressure. Which diagnosis will the nurse observe on the chart? A. Diplopia B. Ocular degeneration C. Glaucoma D. Nystagmus

D. Retrograde amnesia

UNIT 4 QUIZ A patient has memory loss of events that occurred before a head injury. What cognitive disorder does the nurse suspect the patient is experiencing? A. Anterograde amnesia B. Executive memory deficit C. Selective memory deficit D. Retrograde amnesia

C. Paraplegia

UNIT 4 QUIZ A patient has paralysis of both legs. What type of paralysis does the patient have? A. Infraparaplegia B. Paresthesia C. Paraplegia D. Quadriplegia

D. Decerebrate posturing

UNIT 4 QUIZ A patient is admitted to the neurologic critical care unit with a severe closed head injury. All four extremities are in rigid extension, the forearms are hyper-pronated, and the legs are in plantar extension. How should the nurse chart this condition? A. Basal ganglion posturing B. Decorticate posturing C. Dystonic posturing D. Decerebrate posturing

A. Higher than normal

UNIT 4 QUIZ A patient is admitted to the neurologic critical care unit with a severe closed head injury. When an intraventricular catheter is inserted, the intracranial pressure (ICP) is recorded at 24 mmHg. How should the nurse interpret this reading? A. Higher than normal B. Lower than normal C. Normal D. Borderline

D. His sympathetic nervous system has been damaged

UNIT 4 QUIZ A patient is brought to the ER for treatment of injuries received in a motor vehicle accident. An MRI reveals spinal cord injury, and his body temperature fluctuates markedly. The most accurate explanation of this phenomenon is that: A. He has a brain injury B. He has septicemia from an unknown source C. He developed pneumonia D. His sympathetic nervous system has been damaged

C. Gyri

UNIT 4 QUIZ A patient is looking at a picture of the brain and points to the convolutions on the surface of the cerebrum. The nurse should tell the patient these are called: A. Fissures B. Reticular formations C. Gyri D. Sulci

A. REM

UNIT 4 QUIZ A patient is undergoing a sleep lab test. When the sleep lab worker notices EEG patterns with brain activity similar to the normal awake pattern, which phase of sleep is occurring? A. REM B. NREM stage III C. NREM stage I D. NREM stage II

C. Medulla oblongata

UNIT 4 QUIZ A patient presents to the ER reporting excessive vomiting. A CT scan of the brain reveals a mass in the: A. Skull fractures B. Thalamus C. Medulla oblongata D. Frontal lobe

D. Reticular Formation

UNIT 4 QUIZ A patient presents with altered respiratory patterns following head trauma. Based on the symptoms, which of the following areas does the nurse suspect is injured? A. Cerebellum B. Cerebrum C. Midbrain D. Reticular Formation

C. Increased heat production

UNIT 4 QUIZ A patient received a prescription for a weight loss pill. One effect of the pills is to increase the release of epinephrine. Which of the following would be expected to occur? A. Decreased vascular tone B. Increased skeletal muscle tone C. Increased heat production D. Decreased basal metabolic rate

B. Somatic pain

UNIT 4 QUIZ A patient scrapes both knees while playing soccer and reports sharp and well-localized pain. Which of the following should the nurse document to most accurately characterize the pain? A. Referred pain B. Somatic pain C. Visceral pain D. Chronic pain

C. Loss of sense of smell

UNIT 4 QUIZ A patient suffers from head trauma that affects cranial nerve I. Which of the following symptoms would the nurse expect? A. Visual disturbances B. Hearing disturbances C. Loss of sense of smell D. Loss of ability to taste

B. Acute confusional state

UNIT 4 QUIZ A patient with an addiction to alcohol checked into a rehabilitation center as a result of experiencing delirium, inability to concentrate, and being easily distracted. What term would be used to document this state? A. Dementia B. Acute confusional state C. Dysphagia D. Echolalia

C. Medulla oblongata

UNIT 4 QUIZ A student nurse asks the nurse what controls reflex activities concerned with heart rate and blood pressure. What is the nurse's best response? These reflex activities are controlled by the: A. Pons B. Midbrain C. Medulla oblongata D. Cerebrum

A. Stupor

UNIT 4 QUIZ A teenager sustains a severe closed head injury following an all-terrain vehicle (ATV) accident and is in a state of deep sleep that requires vigorous stimulation to elicit eye opening. How should the nurse document this in the chart? A. Stupor B. Coma C. Obtundation D. Confusion

A. Entropia

UNIT 4 QUIZ A young child presents to the ophthalmologist for visual difficulties secondary to eye deviation. One of the child's eyes deviates inward, thereby decreasing the visual field. Which of the following diagnoses is most likely? A. Entropia B. Diplopia C. Extropia D. Nystagmus

B. Moderate diffuse brain injury

UNIT 4 QUIZ After falling, a patient's Glasgow Coma Scale (GCS) was 5 initially and 7 after 1 day. The patient remained unconscious for 2 weeks but is now awake, confused, and experiencing anterograde amnesia. This history supports which medical diagnosis? A. Severe diffuse brain injury B. Moderate diffuse brain injury C. Mild diffuse brain injury D. Postconcussive syndrome

A. Prefrontal

UNIT 4 QUIZ After rehabilitation for severe brain damage following a motor vehicle accident, a patient reports that her thought processes and ability to concentrate are impaired. Which area does the nurse suspect is damaged? A. Prefrontal B. Occipital C. Thalamus D. Limbic

B. Pseudounipolar

UNIT 4 QUIZ An experiment looking at an isolated neuron revealed a sensory nerve with one process containing a dendritic portion extending away from the CNS and an axon extending toward the CNS. Which of the following classifications would this neuron fall into? A. Multipolar B. Pseudounipolar C. Interpolar D. Bipolar

B. Interstitial edema

UNIT 4 QUIZ An infant diagnosed with non-communicating hydrocephalus. What is an immediate priority concern for this patient? A. Metabolic edema B. Interstitial edema C. Vasogenic edema D. Ischemic edema

B. Cyclopia

UNIT 4 QUIZ An infant has an anterior midline defect of neural tube closure. What term will the nurse observe written on the chart? A. Myelodysplasia B. Cyclopia C. Anencephaly D. Hydrocephalus

B. Enlarged ventricles

UNIT 4 QUIZ An infant is diagnosed with congenital hydrocephalus. Which of the following characteristics would the nurse expect to find? A. Small than average head circumference B. Enlarged ventricles C. Increased reabsorption of CSF D. Decreased cerebrospinal fluid (CSF) production

C. Cerebral aqueduct

UNIT 4 QUIZ Blockage of which of the following would cause hydrocephalus? A. Red nucleus B. Inferior colliculi C. Cerebral aqueduct D. Tegmentum

C. Head

UNIT 4 QUIZ During infancy, what is the fastest growing part of the human body? A. Vertebral column B. Spinal cord C. Head D. Limb bones

C. REM sleep

UNIT 4 QUIZ During the sleep cycle, when does loss of temperature control occur? A. Delta wave sleep B. Light sleep C. REM sleep D. Non-REM sleep

B. Endotoxins

UNIT 4 QUIZ Exogenous pyrogens are: A. Corticotropin releasing factors B. Endotoxins C. Prostaglandins D. Interleukins

A. Moisture

UNIT 4 QUIZ For evaporation to function effectively as a means of dissipating excess body heat, which one of the following conditions must be present? A. Moisture B. Pyrogens C. Trauma D. Fever

C. Cessation of entire brain function

UNIT 4 QUIZ For legal purposes, brain death is defined as: A. A consistent vegetative state (VS) B. Death of the brainstem C. Cessation of entire brain function D. Lack of cortical function

C. Transfer of heat through currents of liquids or gas

UNIT 4 QUIZ Heat loss from the body via convection occurs by: A. Dilation of blood vessels bringing blood to skin surfaces B. Direct heat loss from molecule-to-molecule transfer C. Transfer of heat through currents of liquids or gas D. Evaporation of electromagnetic waves

B. Heat exhaustion

UNIT 4 QUIZ Hikers are attempting to cross the Arizona desert with a small supply of water. The temperatures cause them to sweat profusely and become dehydrated. The hikers are experiencing: A. Heat cramping B. Heat exhaustion C. Malignant hyperthermia D. Heat stroke

B. Facilitated

UNIT 4 QUIZ If a neuron's membrane potential is held close to the threshold potential by excitatory postsynaptic potentials (EPSPs), the neuron is said to be: A. Hyperpolarized B. Facilitated C. Integrated D. Inhibited

C. Extradural (epidural) hematoma

UNIT 4 QUIZ Immediately after being struck by a motor vehicle, a patient is unconscious, but the patient regains consciousness before arriving at the hospital and appears alert and oriented. The next morning the patient is confused and demonstrates impaired responsiveness. The patient's history and symptoms support which medical diagnosis? A. Subdural hematoma B. Mild concussion C. Extradural (epidural) hematoma D. Mild diffuse axonal injury

A. REM

UNIT 4 QUIZ Most memorable dreams occur during which sleep phase? A. REM B. Non-REMF C. Delta wave D. Alpha wave

D. Receptor

UNIT 4 QUIZ Neurotransmitters interact with the postsynaptic membrane by binding to which structure? A. Neurofibril B. Nissl body C. Glial Cell D. Receptor

B. Tay-Sachs disease

UNIT 4 QUIZ Parents of a 3-month-old bring the infant to the emergency room (ER) after a seizure has caused muscle rigidity. Both parents are of Jewish ancestry. For what genetic disease should this infant be screened? A. PKU B. Tay-Sachs disease C. Juvenile myoclonic epilepsy D. Congenital encephalopathy

C. Phantom limb pain

UNIT 4 QUIZ Several years after an amputation, the patient continues to sporadically feel pain in the absent hand. What type of pain should the nurse document in the chart? A. Chronic pain B. Visceral pain C. Phantom limb pain D. Neuropathic pain

C. Cessation of spinal cord function below the lesion

UNIT 4 QUIZ Spinal shock is characterized by: A. Loss of spinal cord function at the level of the lesion only B. Loss of voluntary motor function with preservation of reflexes C. Cessation of spinal cord function below the lesion D. Temporary loss of spinal cord function above the lesion

B. Cheyne-Stokes

UNIT 4 QUIZ The breathing pattern that reflects respirations based primarily on carbon dioxide levels in the blood is: A. Ataxic B. Cheyne-Stokes C. Central Neurogenic D. Normal

C. Presbycusis

UNIT 4 QUIZ The most common cause of sensorineural hearing loss in the elderly is: A. Acute otitis media B. Meniere disease C. Presbycusis D. Conductive hearing loss

C. Oculomotor

UNIT 4 QUIZ The nurse is assessing the patient with a pen light. The integrity of which cranial nerve is being evaluated? A. Vagus B. Trigeminal C. Oculomotor D. Olfactory

D. A sensation that the room is spinning

UNIT 4 QUIZ The nurse would expect the patient with an alteration in proprioception to experience vertigo, which is manifested by: A. Headache B. Loss of feeling in the lips C. Light sensitivity D. A sensation that the room is spinning

D. The blood-brain barrier is disrupted

UNIT 4 QUIZ The primary care provider states that the patient is experiencing vasogenic edema. The nurse realizes vasogenic edema is clinically important because: A. ICP is excessively high B. It usually has an infectious cause C. It always causes herniation D. The blood-brain barrier is disrupted

C. Infratentorial

UNIT 4 QUIZ The progress notes read: the cerebellar tonsil has shifted through the foramen magnum due to increased pressure within the posterior fossa. The nurse would identify this note as a description of herniation. A. Cingulated gyrus B. Central C. Infratentorial D. Supratentorial

A. An autosomal recessive gene

UNIT 4 QUIZ What is the cause of true (primary) microcephaly? A. An autosomal recessive gene B. Fetal trauma C. Hydrocephalus D. Viral infection

B. Arterial

UNIT 4 QUIZ What is the main source of bleeding in extradural hematomas? A. Venous B. Arterial C. Sinus D. Capillary

C. In the posterior fossa

UNIT 4 QUIZ What is the most common location of brain tumors in children? A. In the anterior cerebrum B. In the ventricular lining C. In the posterior fossa D. Above the cerebellum

D. Spastic

UNIT 4 QUIZ What is the most common type of cerebral palsy? A. Ataxic B. Mixed C. Dystonic D. Spastic

A. Ischemic tissue damage

UNIT 4 QUIZ What is the physiological response when the body's core temperature is altered due to prolonged exposure to a cold environment? A. Ischemic tissue damage B. Increased respirations C. Increased cellular metabolism D. CNS excitation

D. Folic Acid

UNIT 4 QUIZ What nutrient should the nurse encourage a woman in the early stages of pregnancy to consume to prevent neural tube defects?. A. Vitamin D B. Iron C. Protein D. Folic Acid

A. Craniosynostosis

UNIT 4 QUIZ What term is used to describe a premature closure of one or more of the cranial sutures during the first 18 months of life? A. Craniosynostosis B. Acrania C. Microcephaly D. Congenital hydrocephalus

B. Seizure

UNIT 4 QUIZ What term is used to describe an explosive, disorderly discharge of cortical neurons? A. Reflex B. Seizure C. Inattentiveness D. Brain death

A. Encephalocele

UNIT 4 QUIZ What term is used to document a herniation of the brain and meninges through a defect in the occipital area of the skull? A. Encephalocele B. Myelomeningocele C. Meningocele D. Craniosynostosis

A. Dura mater

UNIT 4 QUIZ What term should the nurse use when talking about the outermost membrane layer surrounding the brain? A. Dura mater B. Arachnoid mater C. Faix cerebri D. Pia mater

A. Astrocyte

UNIT 4 QUIZ What type of cell supports the forming of the blood-brain barrier (BBB)?. A. Astrocyte B. Endothelial C. Schwann D. Oligodendrocyte

B. Corpus callosum

UNIT 4 QUIZ When a nurse is teaching about the transverse fiber tract that connects the two cerebral hemispheres, what term should the nurse use? A. Peduncle B. Corpus callosum C. Pons D. Basal ganglia

B. Skeletal muscle

UNIT 4 QUIZ When a patient asks what the somatic nervous system controls, how should the nurse respond? It controls: A. The spinal cord B. Skeletal muscle C. The heart D. Smooth muscle organs

C. The body's thermostat is reset to a higher level

UNIT 4 QUIZ When a patient has a fever, which of the following thermoregulatory mechanisms is activated? A. Temperature is raised above the set point B. The body's thermostat is adjusted to a lower temperature C. The body's thermostat is reset to a higher level D. Bacteria directly stimulate peripheral thermogenesis

A. Increased gastrointestinal activity

UNIT 4 QUIZ When a patient's vagus nerve is stimulated, what does the nurse expect to observe? A. Increased gastrointestinal activity B. Increased heart rate C. Vasoconstriction D. Pupil constriction

B. Synaptic bouton

UNIT 4 QUIZ When a presynaptic neuron is stimulated in a patient's body by an electrical current, neurotransmitters are released from the: A. Synapse B. Synaptic bouton C. Synaptic cleft D. Receptor

C. Large axon

UNIT 4 QUIZ When a student asks in which region of the neuron do nerve impulses travel the fastest, how should the nurse respond? The... A. Cell body B. Dendrives C. Large axon D. Axon hillock

C. More variable

UNIT 4 QUIZ When planning care for a child in pain, which principle should the nurse remember? The pain threshold is ____ that of adults. A. Higher than B. Not related to C. More variable D. The same as

D. Spleen

UNIT 4 QUIZ When planning care for a newborn, the pediatric nurse recalls that the site of hematopoiesis in the fetus is the: A. Lymph nodes B. Bone marrow C. Kidney D. Spleen

B. Circadian rhythm

UNIT 4 QUIZ When the nurse is discussing the patient's cyclical temperature fluctuation occurring on a daily basis, what term should the nurse use? A. Thermoconductive phases B. Circadian rhythm C. Thermogenesis cycle D. Adaptive pattern

A. Hypothalamus

UNIT 4 QUIZ When the nurse is taking a patient's temperature, which principle should the nurse remember? Regulation of body temperature primarily occurs in the: A. Hypothalamus B. Cerebrum C. Brainstem D. Pituitary gland

C. Locked-in syndrome

UNIT 4 QUIZ When thought content and arousal level are intact but a patient cannot communicate and is immobile, the patient is experiencing: A. Cerebellar motor syndrome B. Dysphagia C. Locked-in syndrome D. Cerebral death

A. Occipital lobe

UNIT 4 QUIZ Where is the primary visual cortex of the brain located? A. Occipital lobe B. Frontal lobe C. Temporal lobe D. Parietal lobe

A. Increase in the strength of myocardial contraction

UNIT 4 QUIZ Which action will occur when a patient's a1-receptors are stimulated? A. Increase in the strength of myocardial contraction B. Vasoconstriction of arteries C. Dilation of the coronary arteries D. Decrease in the rate of myocardial contraction

B. A brief loss of consciousness

UNIT 4 QUIZ Which assessment finding by the nurse characterizes a mild concussion? A. Significant behavioral changes B. A brief loss of consciousness C. Permanent confusion D. Retrograde amnesia

A. Reimplantation surgery

UNIT 4 QUIZ Which condition would be treated with therapeutic hypothermia? A. Reimplantation surgery B. Malnutrition C. Parkinson disease D. Hypothroidism

B. Cerebral edema and degeneration of the CNS

UNIT 4 QUIZ Which finding indicates the patient is having complications from heat stroke? A. Mild elevation of core body temperatures B. Cerebral edema and degeneration of the CNS C. Spasmodic cramping in the abdomen and extremities D. Alterations in calcium uptake

D. Males

UNIT 4 QUIZ Which group of people is most prone to color blindness? A. Children B. Females C. Elderly persons D. Males

A. Myelinated peripheral neurons

UNIT 4 QUIZ Which neurons have the capacity for regeneration? A. Myelinated peripheral neurons B. Myelinated neurons in the spinal cord C. Postganglionic motor neurons D. Unmyelinated neurons in the brain

B. Acetylcholine

UNIT 4 QUIZ Which neurotransmitter is released when a patient's parasympathetic motor neurons are stimulated? A. Substance P B. Acetylcholine C. Epinephrine D. Serotonin

B. Phenylketonuria (PKU)

UNIT 4 QUIZ Which of the following diseases does the nurse screen for in all newborns? A. Tay-Sachs disease B. Phenylketonuria (PKU) C. Epilepsy D. Pica

B. Astrocyte C. Oligodendrocyte D. Ependymal cell

UNIT 4 QUIZ Which of the following is a neuroglial cell? (Select all that apply) A. Melanocyte B. Astrocyte C. Oligodendrocyte D. Ependymal cell E. Neuron

C. Stepping

UNIT 4 QUIZ Which reflex of infancy will disappear first? A. Moro reflex B. Palmar Grasp C. Stepping D. Rooting

B. Circle of willis

UNIT 4 QUIZ Which structure ensures collateral blood flow from blood vessels supplying the brain? A. Vertebral arteries B. Circle of willis C. Basal artery D. Carotid arteries

A. Cognitive-evaluative system

UNIT 4 QUIZ Which system modulates a patient's perception of pain? A. Cognitive-evaluative system B. Affective-motivational system C. Sensory-discriminative system D. Reticular-activating system

B. Myelomeningocele

UNIT 4 QUIZ Which term is used to document a hernial protrusion of a sac-like cyst through a defect in the posterior arch of a vertebra? A. Meningocele B. Myelomeningocele C. Encephalocele D. Craniosynostosis

B. Do not shiver C. Cannot conserve heat

UNIT 4 QUIZ While planning care for infants, which principles should the nurse remember? Infants have problems with thermoregulation because they: (Select all that apply) A. Have decreased metabolic rates B. Do not shiver C. Cannot conserve heat D. Have excess subcutaneous fat E. Rarely sweat

D. The elderly

UNIT 4 QUIZ Who is most at risk of spinal cord injury because of preexisting degenerative disorders? A. Women B. Infants C. Men D. The elderly

D. Choroid

UNIT 4 QUIZ An ophthalmologist is teaching about the structure of the eye that prevents light from scattering in the eye. What structure is the ophthalmologist describing? A. Retina B. Iris C. Pupil D. Choroid

B. Arachnoid villi

UNIT 4 QUIZ Cerebrospinal fluid (CSF) can accumulate around the brain when there is injury to the sites of CSF reabsorption, which are called the: A. Lateral apertures B. Arachnoid villi C. Epidural foramina D. Choroid plexuses

A. Rigidity in muscle tone B. Normal or slightly increased tendon reflexes C. Little or no paralysis of voluntary movement D. Presence of tremor

UNIT 4 QUIZ: The nurse is explaining clinical manifestations of alterations in the extrapyramidal system. The nurse would correctly include: A. Rigidity in muscle tone B. Normal or slightly increased tendon reflexes C. Little or no paralysis of voluntary movement D. Presence of tremor E. Positive (present) Babinksi

A. medial, lateral

UNIT 4 VB: ________ fibers of the optic nerve cross over to the opposite side of the brain, whereas _________ fibers continue on the same side A. medial, lateral B. lateral, medial C. anterior, medial D. posterior, lateral

B. more quickly than

UNIT 4 VB: a myelinated axon transmits a signal _______________ a non-myelinated axon A. more slowly than B. more quickly than C. at the same rate as D. more accurately than

B. dendrites

UNIT 4 VB: a neuron receives signals at its: A. axon terminal B. dendrites C. nucelus D. axon

A. dendrites, cell body, axon, axon terminals

UNIT 4 VB: a signal moves through the parts of a single neuron in what order? A. dendrites, cell body, axon, axon terminals B. axon terminals, axon, cell body, dendrites C. cell body, dendrites, axon, axon terminals D. axon, dendrites, axon terminals, cell body

soma, many dendrites, one axon

UNIT 4 VB: a typical neuron consists of a(n) ___________, ___________, and ____________

C. the adrenal medulla

UNIT 4 VB: acetylcholine is a widespread neurotransmitter that is found in all of the following except A. peripheral nerves B. skeletal muscles C. the adrenal medulla D. the central nervous system

A. somatic

UNIT 4 VB: all nerves involved in the voluntary control of skeletal muscles are part of the ________ system of the peripheral nervous system A. somatic B. autonomic C. sympathetic D. parasympathetic

D. skeletal muscle contractions

UNIT 4 VB: all of the following activities are controlled by the autonomic nervous system except A. heart rate B. sexual arousal C. pupillary response D. skeletal muscle contractions

B. controlling reflexes

UNIT 4 VB: all of the following are functions of the brain except A. controlling activities such as speech and movement B. controlling reflexes C. maintaining homeostasis D. integrating information to form perception and thought

A. digestion

UNIT 4 VB: all of the following are sympathetic responses, except: A. digestion B. pupil dilation C. increase of blood glucose level D. dilation of airways

A. gray matter passes information up and down the spinal cord

UNIT 4 VB: all of the following are true about gray and white matter in the spinal cord, except: A. gray matter passes information up and down the spinal cord B. regions called horns contain gray matter C. white matter is arranged in columns D. tracts consist of white matter

they perform sensory functions only

UNIT 4 VB: all of the following are true of the trigeminal nerves (V) except

D. the sciatic nerve

UNIT 4 VB: all of the following nerves innervate the shoulder and upper back except A. the thoracordorsal nerve B. the subscapular nerve C. the axillary nerve D. the sciatic nerve

D. the heart rate decreases

UNIT 4 VB: all of the following occur as part of the fight-or-flight response except A. the heart rate increases B. increase in blood pressure C. decrease of digestive secretions D. the heart rate decreases

sensory information, motor commands

UNIT 4 VB: ascending tracts of nervous system fibers in the white matter columns carry _________ up to the brain, whereas descending tracts carry _______ from the brain.

C. stomach

UNIT 4 VB: cranial nerve X innervates which body part (s)? A. ears B. trapezius muscle C. stomach D. tongue

C. sensory; into; motor; out of

UNIT 4 VB: dorsal roots carry ________ signals _________ the spinal cord, white ventral roots carry ___________ signals __________ the spinal cord A. motor; into; sensory; out of B. motor; out of; sensory; into C. sensory; into; motor; out of D. sensory; out of; motor into

D. a single pair of spinal nerves

UNIT 4 VB: each dermatome sends sensory signals through: A. a single left spinal nerve or right spinal nerve but not both B. a single nerve plexus C. a segment of the spinal cord corresponding to a plexus D. a single pair of spinal nerves

D. oligodendrocytes have processes that reach out to multiple axon segments, whereas the entire schwann cell surrounds just one axon segment

UNIT 4 VB: how do schwann cells differ from oligodendrocytes? A. schwann cells form myelin, oligodendrocytes do not B. oligodendrocytes are only found in the PNS; schwann cells are only found in the CNS C. schwann cells form sheaths around several axons, while oligodendrocytes form heaths around only one axon D. oligodendrocytes have processes that reach out to multiple axon segments, whereas the entire schwann cell surrounds just one axon segment

B. the top of the spinal cord is continuous with the brain, and it transmits signals between the brain and the rest of the body

UNIT 4 VB: how would you describe the spinal cord, in relation to the brain? A. the brain controls reflexes and sends them down the spinal cord B. the top of the spinal cord is continuous with the brain, and it transmits signals between the brain and the rest of the body C. the spinal cord is part of the peripheral nervous system, whereas the brain is part of the central nervous system D. unlike the brain, the spinal cord doesn't have any surrounding membranes

B. prior to the process, the neuron is polarized; as the signal passes along the axon, the membrane depolarizes and repolarizes again, passing positive charges in and then back out

UNIT 4 VB: how would you explain the charge changes that occur in a neuron during the messaging process? A. prior to the process, the neuron is depolarized; as the signal passes along the axon, the membrane polarizes and then depolarizes again, passing negative charges in and then back out B. prior to the process, the neuron is polarized; as the signal passes along the axon, the membrane depolarizes and repolarizes again, passing positive charges in and then back out C. prior to the process, the neuron is depolarized; as the signal passes along the axon, the membrane polarizes, passing negative charges in, and stays that way D. prior to the process, the neuron is polarized; as the signal passes along the axon, the membrane depolarizes, passing positive charges in, and stays that way

unipolar neurons are sensory neurons in which the axon splits into two branches that attach to the cell body

UNIT 4 VB: if one of your classmates asked you to explain the different types of neurons that can be classified by structure, which of the following would you include in your explanation?

the iliohypogastric, ilioinguinal, genitofemoral, femoral, obturator, and lateral femoral cutaneous nerves innervate the skin and muscles of the abdomen, hip, and pelvis

UNIT 4 VB: if one of your friends was confused about the brachial plexus and the body parts it innervates, all of the following could be apart of your discussion except _________

the lateral horn is the central component of the sympathetic division of the autonomic nervous system

UNIT 4 VB: if one of your peers asked you to explain the functions of the different types of gray matter horns, which of the following would you include in your explanation?

C. parasympathetic

UNIT 4 VB: if you are being chased by a bear, your __________ nervous system functions have likely been put on hold. A. autonomic B. sympathetic C. parasympathetic D. somatic

they pass from the nasal cavity through the cribriform plate of the ethmoid and end in the olfactory bulbs

UNIT 4 VB: if you were describing how the olfactory nerves (I) transmit impulses for smell to a friend who does not understand the process, which of the following would you most likely say?

B. proteins within the muscle tissue release acetylcholine

UNIT 4 VB: if you were explaining skeletal muscle contraction to a friend who doesn't understand the concept, your explanation should include all of the following except A. impulses from the nervous system reach the neuromuscular junction B. proteins within the muscle tissue release acetylcholine C. the muscle filaments slide across each other and the muscle shortens D. acetylcholine binds to receptor on the muscle and begins a chemical reaction within its fibers

D. its hemispheres are symmetrical in function

UNIT 4 VB: if you were explaining the cerebrum to a friend who doesn't understand its structure or function, which of the following would not be apart of your explanation? A. it has two hemispheres that each contain four lobes: the frontal lobe, the temporal lobe, the parietal lobe, and the occipital lobe B. its surface is covered by gyri separated by shallow fissures called sulci C. it is the largest part of the brain D. its hemispheres are symmetrical in function

the postcentral gyrus contains the primary somatosensory cortex and is responsible for spatial discrimination.

UNIT 4 VB: if you were giving an oral presentation on how somatic sensory signals are processed in the cerebral cortex, which of the following points would you make as part of your presentation?

C. the cochlear nerves transmit signals for hearing, whereas the vestibular nerves transmit signals for equilibrium

UNIT 4 VB: if your instructor asked you to compare the branches of the vestibulocochlear nerves (VIII), which of the following would you most likely say? A. the cochlear nerves transmit signals for equilibrium, whereas the vestibular nerves transmit signals for hearing B. the cochlear nerves transmit signals for olfaction, whereas the vestibular nerves transmit signals for taste C. the cochlear nerves transmit signals for hearing, whereas the vestibular nerves transmit signals for equilibrium D. the cochlear nerves transmit signals for taste, whereas the vestibular nerves transmit signals for olfaction

C. VIII

UNIT 4 VB: impulses for hearing and equilibrium are carried through which cranial nerve? A. VII B. IV C. VIII D. V

B. polarized

UNIT 4 VB: in resting state, the plasma membrane of a neuron is: A. depolarized B. polarized C. hyperpolarized D. imperable

D. temperature

UNIT 4 VB: meissner corpuscles can detect all of the following, except: A. touch B. pressure C. vibration D. temperature

C. stratum basale of the fingertips, lips, hands, and external genitalia

UNIT 4 VB: merkel cells are found in the A. mammary glands, pancreas, urinary bladder, and genital organs B. dermal papillae of hairless skin such as the nipples, soles, clitoris, tip of the penis, and tip of the tongue C. stratum basale of the fingertips, lips, hands, and external genitalia D. hair cells that appear on the skin on the arms, legs, head, and genitalia

D. bones

UNIT 4 VB: neurotransmitters are chemicals released at synapses that regulate the activity of all of the following except A. other neurons B. muscles C. glands D. bones

A. acetylcholine (ACh)

UNIT 4 VB: parasympathetic neurons release which neurotransmitter?: A. acetylcholine (ACh) B. norepinephrine (NE) C. epinephrine (E) D. all of the above

nuclei in the medulla oblongata

UNIT 4 VB: sensory axons of the glossopharyngeal nerve (IX) arise from all of the following except

D. a and b

UNIT 4 VB: signals are passed through the nervous system: A. electrically B. chemically C. mechanically D. a and b

automatic responses to stimuli that allow for fast reactions, before messages reach the brain

UNIT 4 VB: somatic reflexes are ______________________

A. thoracic and lumbar spinal cord

UNIT 4 VB: sympathetic nerves arise from the: A. thoracic and lumbar spinal cord B. brain stem and sacral spinal cord C. cervical and thoracic spinal cord D. cerebrum and brain stem

B. basal ganglia

UNIT 4 VB: the _______ are a group of nuclei that surround the thalamus and regulate body movements by processing sensory and motor information coming from the cerebral cortex A. cerebellar lobes B. basal ganglia C. cerebral gyri D. cerebral sulci

B. brachial

UNIT 4 VB: the axillary nerve is a major nerve of the ___________ plexus A. cervical B. brachial C. lumbar D. sacral

A. Schwann cells

UNIT 4 VB: the cells that create a myelin sheath around peripheral nerve axons are called: A. Schwann cells B. satellite cells C. oligodendrocytes D. astrocytes

A. posterior, inferior

UNIT 4 VB: the cerebellum is located ________ to the brain stem and ________ to the occipital lobe of the cerebrum A. posterior, inferior B. anterior, inferior C. anterior, superior D. posterior, superior

meningeal; endosteal

UNIT 4 VB: the cranial dura mater is composed of two layers, which are the ___________ and ___________

D. I, II, and VIII

UNIT 4 VB: the cranial nerves that are purely sensory nerves are: A. III, IV, VI, XI, and XII B. I, II, and III C. I, II, V, and VII D. I, II, and VIII

C. III, VII, IX, and X

UNIT 4 VB: the cranial nerves that have autonomic functions are: A. I, III, and X B. VII, IX, II, and XI C. III, VII, IX, and X D. I, II, VIII, and IX

D. b and c

UNIT 4 VB: the eyeball is moved by the: A. optic nerve B. oculomotor nerve C. abducens nerve D. b and c

B. medulla oblongata

UNIT 4 VB: the fibers of the vagus nerve (X) originate in the A. pons B. medulla oblongata C. brainstem D. cerebrum

suboccipital

UNIT 4 VB: the first spinal nerve, which supplies muscles of the neck is called the ________ nerve. A. oculomotor nerve B. vagus nerve C. suboccipital D. trigeminal nerve

D. a and b

UNIT 4 VB: the function of the thalamus is to: A. relay sensory information to the cerebral cortex B. maintain consciousness C. relay motor commands to the brainstem D. a and b

D. control voluntary muscle contraction

UNIT 4 VB: the hypothalamus does all of the following, except: A. regulate ANS activity B. produces hormones C. control body temperature D. control voluntary muscle contraction

B. pia mater

UNIT 4 VB: the innermost layers of the meninges of the spinal cord is the: A. dura mater B. pia mater C. arachnoid mater D. subarachnoid space

A. sciatic

UNIT 4 VB: the major nerve that passes from the level of the sacrum down the posterior log is the _________ nerve. A. sciatic B. femoral C. genitofemoral D. obturator

A. trigeminal nerve

UNIT 4 VB: the ophthalmic, maxillary, and mandibular nerves are all branches of the: A. trigeminal nerve B. facial nerve C. abducens nerve D. glossopharyngeal nerve

A. thalamus

UNIT 4 VB: the optic nerve ends in the ___________. A. thalamus B. cerebrum C. pons D. medulla oblongata

B. coordinate movement and muscle tone

UNIT 4 VB: the primary function of the cerebellum is to: A. process sensory input B. coordinate movement and muscle tone C. issue motor commands directly to muscles D. relay reflex signals

A. precentral gyrus

UNIT 4 VB: the primary motor cortex is located on which surface feature of the brain? A. precentral gyrus B. postcentral gyrus C. cingulate gyrus D. parieto-occipital sulcus

C. negative, positive

UNIT 4 VB: the resting neuron has a net ________ charge inside the cell and a net _______ charge outside it A. positive, negative B. positive, neutral C. negative, positive D. negative, neutral

B. SNS motor neurons do not synapse at ganglia

UNIT 4 VB: the somatic nervous system (SNS) is different from the autonomic nervous system in which way? A. SNS nerves carry only motor signals B. SNS motor neurons do not synapse at ganglia C. the SNS is responsible for all muscle tissue contraction in the body D. the SNS does not relay tactile sensory information

C. action potential

UNIT 4 VB: the wave of depolarization that is propagated down an axon is known as the: A. graded potential B. resting potential C. action potential D. refractory period

C. pancinian corpuscles

UNIT 4 VB: touch receptors in the skin that carry signals for vibration are known as ___________. A. baroreceptors B. chemoreceptors C. pancinian corpuscles D. free nerve endings

D. it acts as a processing center for the reflex signal

UNIT 4 VB: what function does gray matter serve in spinal reflexes? A. it transmits the reflex signal to the brain B. it receives the signal at the point of external stimulus C. it transmits a command from the spinal cord to the skeletal muscle D. it acts as a processing center for the reflex signal

D. the net charge inside the cell is negative

UNIT 4 VB: when a neuron is not transmitting a signal, which of the following is true? A. the cell membrane is depolarized B. the cell contains an action potential C. the cell cannot be stimulated by neurotransmitters D. the net charge inside the cell is negative

B. skeletal muscle contraction and gland secretion

UNIT 4 VB: when motor commands pass from the spinal cord through the ventral root of each spinal nerve and out the body to trigger an action, which of the following are the two types of such action? A. skeletal muscle contraction and digestive system activity B. skeletal muscle contraction and gland secretion C. cardiac muscle contraction and hormone production D. smooth muscle contraction and circulatory system activity

A. in the adrenal glands

UNIT 4 VB: where are norepinephrine and epinephrine produced? A. in the adrenal glands B. in the pituitary gland C. by the heart D. in the pons

B. lateral ventricles, third ventricle, fourth ventricle, central canal

UNIT 4 VB: which best describes the pathway of circulation for cerebrospinal fluid? A. lateral ventricles, third ventricle, fourth ventricle B. lateral ventricles, third ventricle, fourth ventricle, central canal C. central canal, fourth ventricle, third ventricle, lateral ventricles D. fourth ventricle, third ventricle, lateral ventricles

B. olfactory

UNIT 4 VB: which cranial nerve connects directly to the cerebrum? A. optic B. olfactory C. trigeminal D. oculomotor

B. IX

UNIT 4 VB: which nerve carries sensory signals from the taste buds? A. XI B. IX C. VIII D. VI

B. direct pathways extend from the motor area of the cerebral cortex, whereas indirect pathways originate in the brain stem

UNIT 4 VB: which of the following accurately compares the direct and indirect pathways of motor signals? A. direct pathways originate in the pons, whereas indirect pathways extend from the motor area of the cerebellum B. direct pathways extend from the motor area of the cerebral cortex, whereas indirect pathways originate in the brain stem C. direct pathways originate in the brain stem, whereas indirect pathways extend from the motor area of the cerebral cortex D. direct pathways extend from the motor area of the cerebellum, whereas indirect pathways originate in the medulla oblongata

in the diencephalon, the intraventricular foramen connects the lateral ventricles and the third ventricle

UNIT 4 VB: which of the following accurately describes how particular ventricles are connected to each other?

the motor part transmits signals that control facial expressions, whereas the sensory part transmits signals related to taste

UNIT 4 VB: which of the following accurately explains the motor and sensory functions of the facial nerve (VII)?

C. sympathetic nerves arise from the thoracic and lumbar segments of the spinal cord, whereas parasympathetic nerves originate in the brain stem and the sacral spinal cord.

UNIT 4 VB: which of the following accurately explains the origins of sympathetic and parasympathetic nerves? A. sympathetic nerves originate in the brain stem and the sacral spinal cord, whereas parasympathetic nerves arise from the thoracic and lumbar segments of the spinal cord B. both sympathetic and parasympathetic nerves originate in the brain stem and the sacral spinal cord C. sympathetic nerves arise from the thoracic and lumbar segments of the spinal cord, whereas parasympathetic nerves originate in the brain stem and the sacral spinal cord D. both sympathetic and parasympathetic nerves arise from the thoracic and lumbar segments of the spinal cord

the intermediate compartment of the jugular foramen transmits the glossopharyngeal (IX), vagus (X), and accessory (XI) nerves

UNIT 4 VB: which of the following accurately explains the role the jugular foramen plays in the transmittal of cranial nerves?

D. motor signals are transmitted mainly from the anterior cortex, whereas sensory signals are received and processed in the posterior regions of the cortex

UNIT 4 VB: which of the following accurately identifies how information is processed in the cerebral cortex A. motor signals are received and processed in the anterior cortex, whereas sensory signals are transmitted mainly from the posterior regions of the cortex B. motor signals and sensory signals are both received and processed in the posterior regions of the cortex C. motor signals are transmitted mainly from the posterior regions of the cortex, whereas sensory signals are received and processed in the anterior cortex D. motor signals are transmitted mainly from the anterior cortex, whereas sensory signals are received and processed in the posterior regions of the cortex

A. excitatory neurotransmitters encourage the transmission of an action potential, whereas inhibitory neurotransmitters inhibit transmission

UNIT 4 VB: which of the following best explains how neurotransmitters affect an action potential? A. excitatory neurotransmitters encourage the transmission of an action potential, whereas inhibitory neurotransmitters inhibit transmission B. inhibitory neurotransmitters encourage the transmission of an action potential to cease a certain cell activity, whereas excitatory neurotransmitters alert surrounding cells of what is occurring in the cell C. excitatory neurotransmitters encourage the transmission of an action potential, whereas inhibitory neurotransmitters encourage the transmission of an action potential that inhibits certain cell activities D. excitatory and inhibitory neurotransmitters both suppress the transmission of an action potential

C. skeletal muscle movement

UNIT 4 VB: which of the following body functions is controlled by the somatic nervous system?: A. heart rate B. peristalsis C. skeletal muscle movement D. respiration

cones interpret the color of light, whereas rods interpret the intensity of light

UNIT 4 VB: which of the following correctly explains the difference between the rods and cones in the retina?

B. accessory (XI)

UNIT 4 VB: which of the following cranial nerves is purely a motor nerve? A. optic nerve B. accessory (XI) C. glossopharyngeal (IX) D. facial nerve

C. all nerves involved in the voluntary control of skeletal muscles are part of the somatic system, whereas body functions that are involuntary and controlled by signals that pass from the brain to glands and organs throughout the body are part of the autonomic system

UNIT 4 VB: which of the following differentiates the somatic and autonomic systems of the peripheral nervous system from each other? A. the autonomic nervous system is responsible for our conscious perception of the environment, whereas the somatic nervous system produces motor responses to environmental stimuli B. all nerves involved in the voluntary control of skeletal muscles are part of the autonomic system, whereas body functions that are involuntary and controlled by signals that pass from the brain to glands and organs throughout the body are part of the somatic system C. all nerves involved in the voluntary control of skeletal muscles are part of the somatic system, whereas body functions that are involuntary and controlled by signals that pass from the brain to glands and organs throughout the body are part of the autonomic system D. the autonomic nervous system controls voluntary and sensory functions, including the sensation of special sensory information, whereas the somatic nervous system coordinates involuntary functions like heart rate and respiration

the right hemisphere is responsible for visual, emotional, and artistic awareness, whereas the left hemisphere is responsible for language and calculation

UNIT 4 VB: which of the following distinguishes the right and left cerebral hemispheres from each other?

D. recognizing emotions

UNIT 4 VB: which of the following functions would typically be associated with the right hemisphere of the cerebrum? A. language interpretation B. mathematical calculation C. control of muscles of the right side of the body D. recognizing emotions

B. their structures are composed of neurons and neuroglia

UNIT 4 VB: which of the following is a similarity between the central nervous system and the peripheral nervous system? A. their structures are composed of satellite and schwann cells B. their structures are composed of neurons and neuroglia C. they both consist of series of nerves that connect the brain and spinal cord with the various tissues of the body D. their structures are composed of astrocytes and oligodendrocytes

A. the internal carotid and vertebral arteries supply blood to the brain, whereas the dural venous sinuses and internal jugular vein drain the blood from the brain

UNIT 4 VB: which of the following is an accurate comparison of. the arteries and veins in the brain? A. the internal carotid and vertebral arteries supply blood to the brain, whereas the dural venous sinuses and internal jugular vein drain the blood from the brain B. the internal carotid and vertebral arteries join with the dural venous sinuses and the internal jugular vein to form the blood-brain barrier C. the internal carotid and vertebral arteries carry blood from the brain to the rest of the body, whereas the dural venous sinuses and internal jugular vein bring blood from the body into the brain D. the internal carotid and vertebral arteries drain blood from the brain, whereas the dural venous sinuses and internal jugular vein supply blood to the brain

B. anterior corticospinal

UNIT 4 VB: which of the following is not a somatic sensory pathway?: A. anterolateral (spinothalamic) B. anterior corticospinal C. posterior column-medial lemniscus D. posterior spinocerebellar

A. it controls involuntary functions of respiratory, digestive, and circulatory systems

UNIT 4 VB: which of the following is true of the medulla oblongata? A. it controls involuntary functions of respiratory, digestive, and circulatory systems B. it is divided into four symmetrical parts C. it acts as a barrier between the brain and the spinal cord D. it is the midbrain

A. pia mater, arachnoid mater, dura mater

UNIT 4 VB: which of the following lists the layers of the meninges in the correct order from innermost to outermost? A. pia mater, arachnoid mater, dura mater B. dura mater, arachnoid mater, pia mater C. arachnoid mater, dura mater, pia mater D. dura mater, pia mater, arachnoid mater

A. sacral, lumbar, brachial, cervical

UNIT 4 VB: which of the following lists the spinal nerves plexuses in the correct order from lower body to upper body? A. sacral, lumbar, brachial, cervical B. cervical, brachial, lumbar, sacral C. lumbar, sacral, cervical, brachial D. cervical, sacral, lumbar, brachial

D. hypoglossal

UNIT 4 VB: which of the following nerves has only motor functions? A. olfactory B. facial C. glossopharyngeal D. hypoglossal

C. it only circulates through the ventricles of the brain

UNIT 4 VB: which of the following statements about cerebrospinal fluid is false? A. it provides shock absorption during impact B. it passes substances between the blood and the nervous system C. it only circulates through the ventricles of the brain D. it is absorbed into venous blood

C. they innervate only the head and neck

UNIT 4 VB: which of the following statements about cranial nerves is false? A. they arise from the brain B. they are part of the peripheral nervous system C. they innervate only the head and neck D. they are numbered based in where they originate along the brain's lomg axis

B. at a neuromuscular junction, acetylcholine has inhibitory effects

UNIT 4 VB: which of the following statements about neurotransmitters is false?: A. excitatory neurotransmitters may generate an action potential in the neuron they reach B. at a neuromuscular junction, acetylcholine has inhibitory effects C. dopamine helps regulate muscle tone D. norepinephrine is found in both the central and peripheral nervous systems

C. capillary walls

UNIT 4 VB: which of the following structures in the brain forms part of the blood-brain barrier that prevents harmful substances from entering brain tissue? A. cerebrum B. hypothalamus C. capillary walls D. platelets

B. limbic system

UNIT 4 VB: which part of the brain responsible for establishing emotional states? A. thalamus B. limbic system C. cerebellum D. medulla oblongata

A. cervical

UNIT 4 VB: which plexus innervates muscles of the neck? A. cervical B. brachial C. lumbar D. sacral

B. C5-C8

UNIT 4 VB: which spinal nerve roots from the brachial plexus? A. C1-C4 B. C5-C8 C. T1-T12 D. L1-L5

A. cerebellum

UNIT 4 VB: which structure is not part of the brainstem?: A. cerebellum B. medulla oblongata C. pons D. thalamus

C. proteins

UNIT 4 VB: which substance(s) cannot usually cross the blood-brain barrier? A. glucose B. carbon dioxide C. proteins D. ions

C. microglia

UNIT 4 VB: which type of cells phagocytize debris in the central nervous system? A. ependymal cells B. astrocytes C. microglia D. oligodendrocytes

C. the signal for a spinal reflex is processed in the spinal cord rather than the cerebrum

UNIT 4 VB: why can spinal reflexes occur more quickly than premediated actions? A. reflexes utilize different motor neurons B. reflex actions do not involve the central nervous system C. the signal for a spinal reflex is processed in the spinal cord rather than the cerebrum D. sensory information travels faster during a reflex action

D. Oxytocin

UNIT 5 QUIZ A 39-year-old female is recovering from the birth of her third child. Which hormone would help prevent uterine bleeding? A. Aldosterone B. Cortisol C. Prolactin D. Oxytocin

D. Concentrated urine

UNIT 5 QUIZ A 44-year-old patient with pulmonary tuberculosis is evaluated for SIADH. Which assessment finding would support this diagnosis? A. Peripheral edema B. Tachycardia C. Low blood pressure D. Concentrated urine

A. Hyponatremia

UNIT 5 QUIZ A 54-year-old patient with pulmonary tuberculosis is evaluated for syndrome of inappropriate ADH secretion (SIADH). Which electrolyte imbalance would be expected in this patient? A. Hyponatremia B. Hyperkalemia C. Hypernatremia D. Hypokalemia

C. Inhibit calcium resorption from bones

UNIT 5 QUIZ A 70-year-old female has brittle bones secondary to osteoporosis. Her primary care provider prescribes calcitonin to: A. Activate vitamin D B. Stimulate osteoclastic activity C. Inhibit calcium resorption from bones D. Promote thyroid hormone release

C. Neurologic damage

UNIT 5 QUIZ A nurse is caring for a patient with SIADH. What severe complication should the nurse assess for? A. Stroke B. Diabetes insipidus C. Neurologic damage D. Renal failure

D. Potassium, magnesium phosphate

UNIT 5 QUIZ A nurse recalls insulin has an effect on which of the following groups of electrolytes? A. Sodium, chloride, phosphate B. Calcium, magnesium, potassium C. Hydrogen, bicarbonate, chloride D. Potassium, magnesium phosphate

C. Neural

UNIT 5 QUIZ A nurse recalls that direct stimulation of the insulin-secreting cells of the pancreas by the autonomic nervous system is an example of which type of control? A. Negative feedback B. Positive feedback C. Neural D. Substrate-level dependent

C. Hypocortisolism

UNIT 5 QUIZ A patient diagnosed with Addison disease reports weakness is easily fatigued. What is the root of these symptoms? A. Hyperkalemia B. Hypoglycemia C. Hypocortisolism D. Metabolic acidosis

B. Dehydration from polyuria

UNIT 5 QUIZ A patient is admitted to the intensive care unit with a closed head injury sustained in a motorcycle accident. The injury has caused severe damage to the posterior pituitary. Which of the following complications should the nurse anticipate? A. Dilutional hyponatremia B. Dehydration from polyuria C. Cardiac arrest from hyperkalemia D. Metabolic acidosis

B. Glucagon

UNIT 5 QUIZ A patient is diagnosed with a hormone-secreting tumor of the pancreas alpha cells. Which of the following would the nurse expect to be most likely increased in this patient? A. Amylin B. Glucagon C. Insulin D. Somatostatin

A. A pituitary adenoma

UNIT 5 QUIZ A patient presents with breast discharge, dysmenorrhea, and excessive excitability. Tests reveal that all pituitary hormones are elevated. What does the nurse suspect as the most likely cause for these assessment findings? A. A pituitary adenoma B. Hypothalamic hyposecretion C. Hypothalamic inflammation D. Pheochromocytoma

D. Decreased thyroid-stimulating hormone (TSH)

UNIT 5 QUIZ A patient who has elevated thyroxine production should be assessed for which accompanying condition? A. Increased thyroid-releasing hormones (TRH) B. Increased anterior pituitary stimulation C. Decreased T4 D. Decreased thyroid-stimulating hormone (TSH)

B. Aldosterone

UNIT 5 QUIZ A patient with one kidney underwent surgery for an adrenal tumor that removed a large portion of the zona glomerulosa. The nurse would expect a postsurgical decrease in the patient's: A. Sodium B. Aldosterone C. Potassium D. Acid

B. High plasma osmolarity sensed by osmoreceptors in the hypothalamus.

UNIT 5 QUIZ ADH release from the posterior pituitary is stimulated by which process? A. Low blood pressure sensed by baroreceptors in the kidneys. B. High plasma osmolarity sensed by osmoreceptors in the hypothalamus. C. Low osmolality sensed by osmoreceptors in the kidneys. D. High concentration of potassium sensed by chemoreceptors in the carotid body.

A. Abnormal receptor activity

UNIT 5 QUIZ Besides hyposecretion and hypersecretion, endocrine system dysfunction can result from: A. Abnormal receptor activity B. Abnormal hormone levels C. Increased synthesis of second messengers D. Extracellular electrolyte alterations

A. Polycythemia B. Increased appetite D. Decreased calcium

UNIT 5 QUIZ Elevated levels of glucocorticoids result in which of the following assessment findings? (Select all that apply) A. Polycythemia B. Increased appetite C. Weight loss D. Decreased calcium E. Increased height

A. Hypotension

UNIT 5 QUIZ For which condition is obesity NOT considered a risk factor? A. Hypotension B. Sleep apnea C. Asthma D. Reflux

A. Diffusion

UNIT 5 QUIZ How do lipid-soluble hormone receptors cross the plasma membrane?. A. Diffusion B. Osmosis C. Active transport D. Endocytosis

D. Hypophyseal portal system

UNIT 5 QUIZ How do the releasing hormones that are in the hypothalamus travel to the anterior pituitary? A. Vessels of the zona fasciculata B. Chromophils C. Median eminence D. Hypophyseal portal system

B. Epinephrine

UNIT 5 QUIZ If a patient has a problem with the adrenal medulla, which of the following hormones should the nurse monitor? A. Cortisol B. Epinephrine C. Androgens D. Estrogens

B. ADH

UNIT 5 QUIZ If a patient's posterior pituitary is removed, which hormone would the nurse expect to decrease? A. PRF B. ADH C. ACTH D. Growth hormone (GH)

A. Melatonin

UNIT 5 QUIZ If the patient has a problem with the pineal gland, which substance would the nurse monitor? A. Melatonin B. Epinephrine C. Cortisol D. Somatostatin

B. Serum glucose levels

UNIT 5 QUIZ Insulin is primarily regulated by: A. Metabolic rate B. Serum glucose levels C. Prostaglandins D. Enzyme activation

D. Diffuse thyroid enlargement

UNIT 5 QUIZ Palpation of the neck of a patient diagnosed with Graves disease would most likely reveal: A. A normal sized thyroid B. Small discrete thyroid nodule C. Multiple discrete thyroid nodules D. Diffuse thyroid enlargement

D. Stress

UNIT 5 QUIZ What can trigger ACTH to be released? A. High serum levels of cortisol B. Hypotension C. Hypoglycemia D. Stress

B. Hyperglycemia

UNIT 5 QUIZ What causes the chronic microvascular and macrovascular complications of DM? A. Pancreatic changes B. Hyperglycemia C. Ketone toxicity D. Hyperinsulinemia

B. Cancer

UNIT 5 QUIZ What is the most common cause of elevated levels of antidiuretic hormone (ADH) secretion? A. Autoimmune disease B. Cancer C. Pregnancy D. Heart failure

C. Parathyroid gland injury

UNIT 5 QUIZ What is the most common cause of hypoparathyroidism? A. Pituitary hyposecretion B. Parathyroid adenoma C. Parathyroid gland injury D. Hypothalamic inactivity

C. The renin-angiotensin system

UNIT 5 QUIZ What regulates aldosterone secretion? A. Sympathetic nervous system B. ACTH feedback C. The renin-angiotensin system D. Positive feedback

B. Location of stored fat

UNIT 5 QUIZ What should the nurse consider when educating the client on the complications of obesity? A. Estrogen levels in the teen B. Location of stored fat C. Costs of nutritious foods D. Resources to encourage exercise

C. Breast

UNIT 5 QUIZ What type of cancer does the nurse indicate as not associated with obesity? A. Liver B. Colorectal C. Breast D. Esophageal

D. Direct

UNIT 5 QUIZ What type of effect occurs when insulin binds to its receptors on muscle cells, resulting in an increase in glucose uptake by those muscle cells? A. Pharmacologic B. Permissive C. Biphasic D. Direct

B. Posterior pituitary

UNIT 5 QUIZ When a staff member asks the nurse which gland secretes ADH and oxytocin, how should the nurse respond? A. Anterior pituitary B. Posterior pituitary C. Hypothalamus D. Pineal

D. Hyperglycemia

UNIT 5 QUIZ When catecholamines are released in a patient, what should the nurse assess for? A. Nutrient absorption B. Fluid retention C. Hypotension D. Hyperglycemia

D. Uterus

UNIT 5 QUIZ Where are the target cells for oxytocin located? A. Renal tubules B. Thymus C. Liver D. Uterus

C. Adrenal cortex

UNIT 5 QUIZ Where is the main site of aldosterone synthesis? A. Liver B. Kidneys C. Adrenal cortex D. Hypothalamus

B. Abdomen

UNIT 5 QUIZ Where would the nurse expect to find visceral adipose tissue? A. Arms B. Abdomen C. Breasts D. Buttocks

D. Activation of catecholamines

UNIT 5 QUIZ Which action is known to activate nonshivering thermogenesis? A. Exposure to heat B. Activation of the parasympathetic nervous system C. Decrease in T3 levels D. Activation of catecholamines

C. Urine volume

UNIT 5 QUIZ Which assessment finding would the nurse expect to be increased in a patient with deficient ADH production? A. Blood volume B. Urine osmolality C. Urine volume D. Arterial vasoconstriction

C. Downregulation

UNIT 5 QUIZ Which control mechanism will a patient's target cells implement in order to adapt to high hormone concentrations? A. Negative feedback B. Positive feedback C. Downregulation D. Upregulation

C. Cortisol

UNIT 5 QUIZ Which is the most potent naturally occurring glucocorticoid? A. Aldosterone B. Testosterone C. Cortisol D. Prolactin

C. Iodine

UNIT 5 QUIZ Which nutrient would the nurse encourage the patient to consume for thyroid hormone synthesis? A. Zinc B. Sodium C. Iodine D. Calcium

A. Cushing syndrome

UNIT 5 QUIZ Which obesity risk factor does the nurse identify as related to metabolic abnormalities? A. Cushing syndrome B. Low nutrient C. Depression D. Obesogens

D. Epinephrine

UNIT 5 QUIZ Which of the following is a water-soluble amine? A. Growth hormone (GH) B. Luteinizing hormone (LH) C. Antidiuretic hormone (ADH) D. Epinephrine

D. Insulin

UNIT 5 QUIZ Which of the following is an example of the protein hormone? A. Thyroxine (T4) B. Aldosterone C. Testosterone D. Insulin

A. Increased serum calcium levels

UNIT 5 QUIZ Which of the following lab results would indicate a slowdown in the rate of parathyroid hormone secretion? A. Increased serum calcium levels B. Decreased serum calcium levels C. Decreased levels of TSH D. Increased levels of TSH

B. Anterior pituitary

UNIT 5 QUIZ Which organ contains prolactin-inhibiting factor's target tissue? A. Hypothalamus B. Anterior pituitary C. Mammary glands D. Posterior pituitary

A. Obese children become obese adults

UNIT 5 QUIZ Which statement is true regarding obesity among children? A. Obese children become obese adults B. Blacks have the lowest rate of obesity C. Hispanics have the highest rates of obesity D. 85% of children are currently obese

B. Nephrogenic

UNIT 5 QUIZ While planning care for a patient from general anesthesia, which principle should the nurse remember? A side effect of some general anesthetic agents is ____ diabetes insipidus. A. Neurogenic B. Nephrogenic C. Psychogenic D. Allogenic

B. Laryngeal spasms and hyperreflexia

UNIT 5 QUIZ: A 30-year-old female with Graves disease is admitted to a hospital unit for the surgical removal of her thyroid gland. During the postoperative period, the nurse notes that the patient's serum calcium is low. The nurse should observe the patient for which of the following signs/symptoms? A. Muscle weakness and constipation B. Laryngeal spasms and hyperreflexia C. Abdominal pain and fever D. Anorexia, nausea, and vomiting

C. Hypoparathyroidism caused by surgical injury to the parathyroid glands

UNIT 5 QUIZ: A 45 year old diagnosed with Graves Disease underwent surgical removal of the thyroid gland. During the postoperative period, the patients serum calcium is low. The most probable reason for her low serum calcium is: A. Hyperparathyroidism secondary to graves disease B. Myxedema secondary to surgery C. Hypoparathyroidism caused by surgical injury to the parathyroid glands D. Hypothyroidism resulting from lack of thyroid replacement.

D. Aldosterone deficiency

UNIT 5 QUIZ: The body's inability to conserve water and sodium when affected by Addison disease is explained by which of the following conditions? A. Elevated levels of cortisol B. Decreased levels of ACTH C. Hypersecretion of ADH D. Aldosterone deficiency

B. Low

UNIT 5 QUIZ: When considering hypothyroidism, the basal metabolic rate is unusually: A. High B. Low C. Steady D. Variable

B. regulation of urine output

UNIT 5 VB: all of the following are functions of human growth hormone, except: A. growth of skeletal muscles B. regulation of urine output C. lipid metabolism D. growth of skeletal tissues

B. glucagon

UNIT 5 VB: all of the following hormones are released by the kidneys except A. calcitriol B. glucagon C. erythroprotein D. renin

A. adrenal cortex

UNIT 5 VB: coticosteroids are hormones that affect the breakdown of proteins and the reabsorption of water and sodium. they are produced in the: A. adrenal cortex B. parathyroid gland C. thyroid gland D. kidneys

C. get secreted by glands through hollow ducts

UNIT 5 VB: hormones do all of the following, except: A. bind to receptors on the surface of the target cell B. pass through the cell membrane C. get secreted by glands through hollow ducts D. attach to receptors in the cytoplasm or nucleus

D. in addition to its lymphatic functions, the thymus secretes hormones that increase metabolism, glucose use, protein synthesis, and nervous system development

UNIT 5 VB: if you were doing an oral presentation on organs that have endocrine functions as well as other bodily functions, you would likely make all of the following points except A. in addition to urinary functions, the kidneys secrete hormones that increase calcium reabsorption in the body, stimulate red blood cell production, and increase blood pressure B. in addition to cardiovascular functions, the heart produces hormones that promote water loss to decrease blood volume and pressure C. in addition to its digestive functions, the pancreas secretes hormones necessary to regulate blood glucose levels D. in addition to its lymphatic functions, the thymus secretes hormones that increase metabolism, glucose use, protein synthesis, and nervous system development

C. the pineal gland is a small reddish-gray body, about 1 cm in diameter, that is attached to the infundibulum of the hypothalamus

UNIT 5 VB: if you were to do an oral presentation on the pineal gland, you would likely make all the following points except A. the pineal gland consists of follicles lined by epithelium and enveloped by connective tissue B.the pineal gland is attached to the roof of the third ventricle near its junction with the midbrain, and is located in the depression between the superior colliculi C. the pineal gland is a small reddish-gray body, about 1 cm in diameter, that is attached to the infundibulum of the hypothalamus D. the pineal gland secretes melatonin at varying levels throughout the day and night, contributing to the circadian cycle

B. lymphatic vessels

UNIT 5 VB: in addition to the endocrine glands, hormone-secreting cells occur in all of the following except A. the heart atria B. lymphatic vessels C. adipose tissue D. gastric and intestinal mucous membranes

A. glucagon

UNIT 5 VB: low blood glucose cuases alpha cells of the pancreas to release __________, which triggers the release of glucose by the liver A. glucagon B. insulin C. somatostatin D. progesterone

B. erythroprotein

UNIT 5 VB: one of the hormones released by the kidneys is: A. natriuretic peptides B. erythroprotein C. estrogen D. melatonin

C. growth

UNIT 5 VB: one type of hormone produced by the anterior lobe of the pituitary gland regulates: A. blood pressure B. urine production C. growth D. uterine contractions

B. adrenal glands

UNIT 5 VB: stress stimulates the _______ to produce hormones that ramp up body activity in the fight-or-flight response A. pancreas B. adrenal glands C. thyroid D. pineal gland

D. thyroid, thymus

UNIT 5 VB: the ___________ gland oversees metabolism and growth, while the __________ oversees immune responses A. parathyroid, thymus B. gonads, thyroid C. adrenals, thyroid D. thyroid, thymus

C. corticosteroid hormones, epinephrine, norepinephrine

UNIT 5 VB: the adrenal cortex produces __________, whereas the adrenal medulla produces _______ and _______ A. epinephrine, mineralocorticosteroids, glucocorticosteroids B. mineralocorticosteroids, glucocorticosteroids, gonadocorticoids C. corticosteroid hormones, epinephrine, norepinephrine D. norepinephrine, gonadocorticosteoids, mineralocorticosteroids

C. vertebral column

UNIT 5 VB: the adrenal glands are located superior to the kidneys on either side of the: A. liver B. stomach C. vertebral column D. thyroid gland

A. all of these are regulated by hormones

UNIT 5 VB: the following body functions are regulated by glands in the endocrine system, except: A. all of these are regulated by hormones B. sexual development and function C. metabolism and growth D. immune responses

B. anterior pituitary gland

UNIT 5 VB: the hypothalamus releases regulatory hormones into the hypophyseal portal system, a closed capillary bed around the: A. adrenal gland B. anterior pituitary gland C. hypothalamus D. thyroid

C. testosterone

UNIT 5 VB: the pancreatic islets are clusters of cells in the pancreas that secrete the following hormones, except: A. insulin B. glucagon C. testosterone D. somatostatin

C. parathyroid hormone

UNIT 5 VB: the parathyroid glands secrete ________ which increases calcium levels in the blood by stimulating bones, intestines, and kidneys. A. thyroxine (T4) B. melatonin C. parathyroid hormone D. epinephrine (E)

B. melatonin

UNIT 5 VB: the pineal gland produces the hormone ______, which protects nervous tissue and regulates sleeping patterns A. glucagon B. melatonin C. corticosteroids D. estrogen and progesterone

D. triiodothyronine (T3), thyroxine (T4), calcitonin (CT)

UNIT 5 VB: the thyroid consists of mainly spherical sacs known as thyroid follicles, which are lined by epithelial cells that make and secrete _______ and ______, and cells within or between follicles make and secrete ________. A. calcitonin (CT), thyroxine (T4), triiodothyronine (T4) B. calcitonin (CT), triiodothyronine (T3), thyroxine (T4) C. triiodothyronine (T3), thyroxine (T4), glucocorticoids D. triiodothyronine (T3), thyroxine (T4), calcitonin (CT)

A. anterior to, inferior to

UNIT 5 VB: the thyroid gland is located ___________ the trachea and _________ the larynx A. anterior to, inferior to B. inferior to, anterior to C. posterior to, inferior to D. inferior to, posterior to

D. prohibit protein synthesis

UNIT 5 VB: the thyroid gland releases the hormones thyroxine (T4) and triiodothyronine (T3), which do the following, except: A. increase metabolism B. increase nervous system development C. increase glucose use D. prohibit protein synthesis

B. hormones

UNIT 5 VB: what does the pituitary gland produce? A. sweat B. hormones C. sex cells D. blood cells

B. adrenocorticotropic hormone (ACTH)

UNIT 5 VB: which hormone causes the adrenal glands to produce steroid hormones that influence the metabolism of glucose A. melanocyte-stimulating hormone (MSH) B. adrenocorticotropic hormone (ACTH) C. oxytocin (OXT) D. luteinizing hormone (LH)

D. prolactin (PRL)

UNIT 5 VB: which hormone is responsible for milk production in a new mother? A. thyroid-stimulating hormone (TSH) B. melanocyte-stimulating hormone (MSH) C. adrenocorticotropic hormone (ACTH) D. prolactin (PRL)

A. antidiuretic hormone (ADH) and oxytocin (OXT)

UNIT 5 VB: which hormones are produced in the hypothalamus and stored in the posterior pituitary? A. antidiuretic hormone (ADH) and oxytocin (OXT) B. adrenocorticotropic hormone (ACTH) and antidiuretic hormone (ADH) C. luteinizing hormone (LH) and oxytocin (OXT) D. melanocyte-stimulating hormone (MSH) and thyroid-stimulating hormone (TSH)

A. primary endocrine organs release regulatory hormones, whereas secondary endocrine organs have other functions in addition to secreting hormones

UNIT 5 VB: which of the following accurately compares primary and secondary endocrine organs? A. primary endocrine organs release regulatory hormones, whereas secondary endocrine organs have other functions in addition to secreting hormones B. secondary endocrine organs release regulatory hormones, whereas primary endocrine organs have other functions in addition to secreting hormones C. all primary and secondary endocrine organs have endocrine and non-endocrine functions D. both primary and secondary endocrine organs function solely in the endocrine system

B. glucagon stimulates organs and tissues to release glucose, whereas insulin stimulates organs and tissues to increase their uptake of glucose

UNIT 5 VB: which of the following accurately compares the role of glucagon and insulin in regulating blood glucose levels? A. glucagon reduces blood glycose levels via glycolysis, whereas insulin increases blood glucose levels via glycogenolysis and gluconeogenesis B. glucagon stimulates organs and tissues to release glucose, whereas insulin stimulates organs and tissues to increase their uptake of glucose C. glucagon stimulates organs and tissues to increase their uptake of glucose whereas insulin stimulates organs and tissues to release glucose D. the primary function of both glucagon and insulin is to facilitate the uptake of glucose into body cells

A. both help regulate blood calcium levels

UNIT 5 VB: which of the following is a similarity between calcitonin (CT) and parathyroid hormone (PTH)? A. both help regulate blood calcium levels B. both are released in response to low blood calcium levels C. both are produced by parafollicular cells D. both are produced by the parathyroid gland

D. chief

UNIT 5 VB: parathyroid cells known as _______ cells are thought to produce most or all of the parathyroids' endocrine secretion A. oxyphil B. colloid C. follicle D. chief

C. An iron deficiency

UNIT 6 QUIZ A 1 year old female is diagnosed with anemia secondary to insufficient erythropoiesis. The most likely cause is: A. Genetic factors B. A hemoglobin abnormality C. An iron deficiency D. An erythrocyte structural abnormality

D. Iron deficiency

UNIT 6 QUIZ A 12-month-old toddler weighing 18 pounds is brought to the clinic because of weakness, slow physical growth, and developmental delays. His mother reports that the only food he will consume is cow's milk. The symptoms support a diagnosis of which form of anemia? A. Hemolytic B. Aplastic C. Pernicious D. Iron deficiency

D. Hemoglobin synthesis

UNIT 6 QUIZ A 2 year old male presented with growth and maturation retardation and splenomegaly. He died shortly after arriving at the ER. autopsy revealed thalassemia secondary to defective: A. Erythrocyte membranes B. Iron metabolism C. Stem cell formation D. Hemoglobin synthesis

D. Peripheral vasoconstriction

UNIT 6 QUIZ A 25 year old female has a heavy menses during which she loses a profuse amount of blood. Which of the following adaptations should the physician expect? A. Decreased oxygen release from hemoglobin B. Movement of fluid into the cell C. Decreased cardiac output D. Peripheral vasoconstriction

B. Peripheral vasoconstriction

UNIT 6 QUIZ A 25-year-old female has a heavy menses during which she loses a profuse amount of blood. Which of the following adaptations should the physician expect? A. Decreased cardiac output B. Peripheral vasoconstriction C. Decreased oxygen release from hemoglobin D. Movement of fluid into the cell

C. Decreased calcium reabsorption in the kidney

UNIT 6 QUIZ A 40-year-old patient undergoes surgery for a PTH-secreting tumor in which the parathyroid is removed. Which physiologic alteration would the nurse expect following surgery? A. Increased serum calcium B. Decreased bone formation C. Decreased calcium reabsorption in the kidney D. Increased calcitonin

B. Hemolytic

UNIT 6 QUIZ A 5 year old was diagnosed with normocytic-normochromic anemia. Which type of anemia does the nurse suspect the patient has? A. Iron deficiency B. Hemolytic C. Sideroblastic D. Pernicious

D. Increased rate and depth of breathing

UNIT 6 QUIZ A 60-year-old patient diagnosed with emphysema experiences a rapid and pounding heart, dizziness, and fatigue with exertion. Which respiratory assessment findings indicate the respiratory system is compensating for the increased oxygen demand? A. Activation of the renin-angiotensin response B. Bronchoconstriction C. Dyspnea D. Increased rate and depth of breathing

A. Eosinophil

UNIT 6 QUIZ A group of cells isolated in the laboratory have membrane-bound granules in their cytoplasm, and they show phagocytic activity. Which of the following cells is most similar? A. Eosinophil B. Macrophage C. Lymphocyte D. Monocyte

D. Hb S and Hb A

UNIT 6 QUIZ A mother has a child that is diagnosed with sickle cell anemia. While the mother does not have the disease, which characteristic of her genetic makeup is responsible for the child's disease? A. Hb A and Hb C B. Hb S and Hb C C. Hb S and Hb S D. Hb S and Hb A

A. Pernicious

UNIT 6 QUIZ A newborn is diagnosed with congenital intrinsic factor deficiency. Which of the following types of anemia will the nurse see documented on the chart? A. Pernicious B. Iron deficiency C. Sideroblastic D. Hemolytic

C. Able to assume various shapes

UNIT 6 QUIZ A patient's anemia is described as having erythrocytes that demonstrate poikilocytosis. The nurse would recognize the erythrocytes would be: A. Present in various sizes B. Live only a few days C. Able to assume various shapes D. Pale in color

A. Hyperdynamic circulatory state

UNIT 6 QUIZ After initial compensation, what hemodynamic change should the nurse monitor for in a patient who has a reduction in the number of circulating erythrocytes? A. Hyperdynamic circulatory state B. Altered coagulation C. Decreased cardiac output D. Increased viscosity of blood

C. Release biochemical mediators of inflammation

UNIT 6 QUIZ In addition to playing a role in hemostasis, platelets have the ability to: A. Stimulate bone marrow production of erythrocytes B. Activate a humoral response C. Release biochemical mediators of inflammation D. Undergo cell division in response to bleeding

B. Blacks

UNIT 6 QUIZ In the United States, which group of people should be assessed first for sickle cell disease?. A. Asians B. Blacks C. Whites D. Hispanics

C. Macrophages

UNIT 6 QUIZ Monocytes are blood cells that mature (differentiate) into: A. Eosinophils B. Mast cells C. Macrophages D. Neutrophils

C. Neutrophil

UNIT 6 QUIZ The predominant phagocyte of early inflammation is the: A. Lymphocyte B. Macrophage C. Neutrophil D. Eosinophil

B. hypochromic.

UNIT 6 QUIZ When a nurse is reviewing lab results and notices that the erythrocytes contain an abnormally low concentration of hemoglobin, the nurse calls these erythrocytes: A. microcytic. B. hypochromic. C. macrocytic. D. Hyperchromic.

B. Mother is Rh-negative, and fetus is Rh-positive

UNIT 6 QUIZ Which mother-fetus combination is at most risk for a maternal-fetal blood incompatibility? A. Mother has type AB blood, and fetus has type B blood B. Mother is Rh-negative, and fetus is Rh-positive C. Mother has type A blood, and fetus has type O blood D. Mother is Rh-positive, and fetus is Rh-negative

B. Valine

UNIT 6 QUIZ Which of the following amino acids is present in Hb S and not present in normal Hb? A. Histinde B. Valine C. Glutamic acid D. Proline

C. 5000-10,000 per cubic millimeter

UNIT 6 QUIZ While checking lab results, the nurse remembers that the normal leukocyte count is: A. 1000-2000 per cubic millimeter B. 4.2-6.2 million per cubic millimeter C. 5000-10,000 per cubic millimeter D. 1.2-2.2 million per cubic millimeter

B. Erythrocytes

UNIT 6 QUIZ While reviewing lab results, the PA recalls that the most abundant cells in the blood are: A. Leukocytes B. Erythrocytes C. Lymphocytes D. Thrombocytes

A. An iron deficiency

UNIT 6 QUIZ: A 1-year old female is diagnosed with anemia secondary to insufficient erythropoiesis. The most likely cause is: A. An iron deficiency B. A hemoglobin abnormality C. An erythrocyte structural abnormality D. Genetic factors

B. A few weeks

UNIT 6 QUIZ: A 15-year-old female presents with splenomegaly, hepatomegaly, and lymph nodeenlargement. She is diagnosed with infectious mononucleosis. What should the nurse tell the patient about the recovery time? A. 6 months B. A few weeks C. 3-5 days D. 72 hours

D. Bronze-colored skin

UNIT 6 QUIZ: A 50-year-old female was diagnosed with sideroblastic anemia. Which of the following assessment findings would most likely occur? A. Normochromic erythrocytes B. Aplastic bone marrow C. Decreased iron D. Bronze-colored skin

B. Their life span is shorter

UNIT 6 QUIZ: Considering anemia, what effect do vitamin B12 and folate deficiencies have on red blood cells? A. Orcarrying capacity is decreased B. Their life span is shorter C. They are unable to differentiate into erythrocytes D. They contain malformed hemoglobin molecules

D. Spleen

UNIT 6 QUIZ: Sickled cells will be removed from circulation mostly by the: A. Liver B. Kidney C. Pancreas D. Spleen

B. Reversible deformability E. Biconcavity

UNIT 6 QUIZ: When a staff member asks how erythrocytes can carry oxygen, the nurse should describe which of the following properties that allow erythrocytes to function as gas carriers? (Select all that apply.) A. Presence of many mitochondria B. Reversible deformability C. Undergoes mitotic division D. Presence of a nucleus E. Biconcavity

B. Calcium

UNIT 6 QUIZ: Which electrolyte will the nurse check to ensure normal platelet functioning? A. Sodium B. Calcium C. Magnesium D. Potassium

B. Spontaneous nosebleeds, bruising, petechiae

UNIT 6 QUIZ: Which of the following clusters of symptoms would lead the nurse to suspect a child has immune thrombocytopenic purpura (ITP)? A. Lower extremity that is warm to touch, edematous, and painful B. Spontaneous nosebleeds, bruising, petechiae C. Multiple infection; bruising; abnormal bone marrow aspiration D. Increased platelet count; recent-onset venous thrombosis

D. Vitamin B12

UNIT 6 QUIZ: Which of the following nutritional components will the nurse encourage a patient to consume as it is needed for erythropoiesis? A. Vitamin D B. Zinc C. Vitamin B1 D. Vitamin B12

D. Sequestration crisis

UNIT 6 QUIZ: Which type of sickle cell crisis occurs only in young children? A. Hyperhemolytic crisis B. Aplastic crisis C. Vaso-occlusive crisis D. Sequestration crisis

B. lymphatic system

UNIT 6 VB: B and T cells spend most of their time in the ________. A. bloodstream B. lymphatic system C. heart chambers D. capillaries

D. erythrocytes

UNIT 6 VB: all of the following are types of white blood cells except A. monocytes B. neutrophils C. lymphocytes D. erythrocytes

D. platelets

UNIT 6 VB: all of the following types are white blood cells, except: A. neutrophils B. lymphocytes C. T cells D. platelets

C. 90%, nutrients, wastes

UNIT 6 VB: although plasma is ________ percent water, it also transports _______ and _______. A. 70%, cells, proteins B. 50%, oxygen, carbon dioxide C. 90%, nutrients, wastes D. 20%, lymphocytes, bone particles

D. produce stem cells

UNIT 6 VB: blood does all of the following, except: A. destroy invading pathogens B. transport oxygen and carbon dioxide C. transport endocrine hormones D. produce stem cells

C. connective

UNIT 6 VB: blood is a(n) ________ tissue A. muscle B. epithelial C. connective D. nervous

A. oxygenated, deoxygenated

UNIT 6 VB: blood traveling from the lungs is ________, and blood traveling to the lungs is _________. A. oxygenated, deoxygenated B. deoxygenated, oxygenated C. high-pressure, low-pressure D. nitrogen-rich, nitrogen-poor

B. it is composed of water, proteins, nutrients, and hormones

UNIT 6 VB: if your friend asked you to explain the composition of blood plasma, which of the following would you most likely say? A. it is composed of white and red blood cells B. it is composed of water, proteins, nutrients, and hormones C. it is composed of white blood cells and platelets D. it is composed of red blood cells

B. this allows the cells to carry more oxygen to the tissues

UNIT 6 VB: if your instructor asked you to explain the benefit of red blood cells ejecting their nuclei, which of the following would you most likely say? A. this allows the cells to synthesize proteins B. this allows the cells to carry more oxygen to the tissues C. this allows cells to conduct aerobic respiration D. this allows cells to change their shape to squeeze through capillaries

C. plasma, red blood cells, platelets, white blood cells

UNIT 6 VB: if your instructor asked you to list the components of blood, from highest percentage of blood volume to lowest, which of the following would you most likely say? A. red blood cells, white blood cells, platelets, plasma B. platelets, plasma, white blood cells, red blood cells C. plasma, red blood cells, platelets, white blood cells D. white blood cells, red blood cells, plasma, platelets

B. phagocytize bacteria

UNIT 6 VB: neutrophils perform which of the following functions? A. produce antibodies B. phagocytize bacteria C. destroy infected body cells D. deliver carbon dioxide to the lungs

D. all of the above

UNIT 6 VB: platelets stop blood loss by: A. collecting and adhering at the site of damage B. triggering a reaction that promotes the formation of fibrin threads C. forming a platelet plug D. all of the above

A. the liver

UNIT 6 VB: the hepatic portal vein collects blood from the vessels that drain all of the following organs except A. the liver B. the intestines C. the stomach D. the spleen

A. platelets, red blood cells, plasma, white blood cells

UNIT 6 VB: the main components of blood are: A. platelets, red blood cells, plasma, white blood cells B. red blood cells, platelets C. proteins, plasma, neutrophils D. white blood cells, red blood cells, oxygen

C. platelets

UNIT 6 VB: when a blood vessel tears, ________ at the site adhere to the vessel's wall to close the tear. A. leukocytes B lymphocytes C. platelets D. erythrocytes

C. red bone marrow

UNIT 6 VB: where are red blood cells produced? A. lymphatic vessels B. heart chambers C. red bone marrow D. yellow bone marrow

C. erythropoietin

UNIT 6 VB: which hormone, produced in the kidneys and liver, stimulates red blood cell production? A. cortisol B. oxytocin C. erythropoietin D. prolactin

D. red blood cells transport oxygen to body tissues, whereas white blood cells defend the body against disease

UNIT 6 VB: which of the following accurately compares the functions of red blood cells and white blood cells? A. red blood cells defend the body against disease, whereas white blood cells transport oxygen to body tissues B. red blood cells make up 1% of circulating blood, whereas white blood cells make up 40-45% of blood volume C. red blood cells increase in number during inflammation, whereas white blood cells decrease D. red blood cells transport oxygen to body tissues, whereas white blood cells defend the body against disease

D. i, ii, iii, and iv

UNIT 6 VB: which of the following are true? i. mature red blood cells do not contain a nucleus ii. red blood cells contain hemoglobin, which binds to oxygen iii. red blood cells transport oxygen to body cells and transport some carbon dioxide from body cells iv. hemocytoblasts give rise to all types of blood cells A. i, ii,, and iii B. ii and iii only C. ii, iii, and iv D. i, ii, iii, and iv

A. they originate in red bone marrow inside the bones

UNIT 6 VB: which of the following is a similarity among red blood cells, white blood cells, and platelets? A. they originate in red bone marrow inside the bones B. they can be classified into several types C. they are part of the coagulation system D. they account for equal percentages of circulating blood

B. Ventricular hypertrophy

UNIT 7 QUIZ A 1-month-old infant visits his primary care provider for a well-baby check. Physical exam reveals decreased cardiac output, hypotension, tachycardia, and a loud murmur, suggestive of aortic stenosis. Which condition would be expected with this diagnosis? A. Atrial dilation B. Ventricular hypertrophy C. Atrial rigidity D. Decreased contractility

C. Left-to-right shunt

UNIT 7 QUIZ A 2-week-old infant who presents with poor feeding, fatigue, dyspnea, and a murmur is diagnosed with a patent ductus arteriosus (PDA). this condition results in a(n): A. Decreased pulmonary blood flow B. Right-to-left shunt C. Left-to-right shunt D. Increased systemic blood flow

C. Backward expulsion of the atrioventricular valves

UNIT 7 QUIZ A 20 year old underwent an echocardiogram to assess chest pain. Results revealed a congenital defect in the papillary muscles. Which of the following would the nurse expect to occur? A. Closure of the semilunar valve B. Closure of the atrioventricular valve C. Backward expulsion of the atrioventricular valves D. Backward expulsion of the semilunar valves

C. Skin hyperpigmentation

UNIT 7 QUIZ A 52-year-old male presents with pooling of blood in the veins of the lower extremities and edema. The diagnosis is chronic venous insufficiency, and an expected assessment finding of this disorder is: A. Deep vein thrombus formation B. Gangrene C. Skin hyperpigmentation D. Edema above the knee

D. Long periods of standing

UNIT 7 QUIZ A 75-year-old obese female presents to her primary care provider reporting edema in the lower extremities. Physical exam reveals that she has varicose veins. Upon performing the history, which of the following is a possible cause for the varicose veins? A. Trauma to the deep veins B. Ischemia C. Extreme exercise D. Long periods of standing

C. Provide a barrier against extracardial infections

UNIT 7 QUIZ A function of the pericardium is to: A. Improve blood flow through the heart B. Assist in cardiac contraction C. Provide a barrier against extracardial infections D. Play a role in cardiac conduction

D. Valve

UNIT 7 QUIZ A newborn develops a murmur and cyanosis shortly after birth. A diagnosis of pulmonic stenosis (PS) is made after an echocardiogram revealed narrowing of the pulmonary: A. Vein B. Tree C. Artery D. Valve

C. Weak or absent femoral pulses

UNIT 7 QUIZ A newborn is suspected of having coarctation of the aorta. Which of the following assessments would aid in diagnosis? A. Cool arms B. Cyanosis C. Weak or absent femoral pulses D. Bounding pedal pulses

C. Systolic pressure less than 120 mm Hg and diastolic pressure less than 80 mm Hg

UNIT 7 QUIZ A nurse takes an adult patient's blood pressure and determines it to be normal. What reading did the nurse obtain? A. Systolic pressure greater than 140 mm Hg and a diastolic pressure of 100 mm Hg B. Systolic pressure between 140 and 150 mm Hg C. Systolic pressure less than 120 mm Hg and diastolic pressure less than 80 mm Hg D. Systolic pressure less than 100 mm Hg regardless of diastolic pressure

C. Down syndrome

UNIT 7 QUIZ An 8-week-old infant presents to the pediatrician for a well-baby checkup. Physical exam reveals a murmur, and an echocardiogram confirms a ventricular septal defect. Which genetic disorder is likely to accompany this diagnosis? A. Huntington disease B. Color blindness C. Down syndrome D. Hemophilia

B. Ostium secundum

UNIT 7 QUIZ An infant undergoes an echocardiogram for a suspected heart defect. Tests reveal an opening in the middle of the atrial septum. What term would the nurse use to describe this defect? A. Ostium primum B. Ostium secundum C. Sinus venosus D. Eisenmenger syndrome

C. Right ventricle

UNIT 7 QUIZ As a result of blockage in the pulmonary artery, blood would first back up into the: A. Pulmonary veins B. Aorta C. Right ventricle D. Left ventricles

A. Ductus arteriosus

UNIT 7 QUIZ Coarctation of the aorta is the local narrowing of the aorta near the: A. Ductus arteriosus B. Bifurcation into the common iliac arteries C. Aortic valve D. Diaphragm

A. Viral infection

UNIT 7 QUIZ Intrauterine exposure to which factor could be responsible for a diagnosis of congenital heart disease? A. Viral infection B. Alcohol exposure C. Diabetes D. Dextroamphetamine

C. Primary

UNIT 7 QUIZ Most cases of combined systolic and diastolic hypertension have no known cause and are documented on the chart as _____ hypertension. A. Secondary B. Congenital C. Primary D. Acquired

C. Occlusion

UNIT 7 QUIZ Superior vena cava syndrome (SVCS), causing venous distention in the upper extremities, is a result of progressive superior vena cava: A. Inflammation B. Sclerosis C. Occlusion D. Distention

A. Endothelium

UNIT 7 QUIZ The internal lining of the cardiovascular system is formed by what tissue? A. Endothelium B. Mesothelium C. Connective D. Tunica adventitia

B. A membranous sac that encloses the heart

UNIT 7 QUIZ The pericardium is: A. The innermost layer of the heart chambers B. A membranous sac that encloses the heart C. The outer muscular layer of the heart D. The heart's muscular fibrous skeleton

A. Ductus arteriosus

UNIT 7 QUIZ What term is used to describe the patent opening between the aorta and pulmonary artery in a fetus? A. Ductus arteriosus B. Foramen ovale C. Septal defect D. Sinus venosus

C. Ductus arteriosus

UNIT 7 QUIZ What term is used to describe the patent opening between the aorta and pulmonary artery in a fetus? A. Foramen ovale B. Sinus venosus C. Ductus arteriosus D. Septal defect

D. Ischemia

UNIT 7 QUIZ When a patient is diagnosed with coronary artery disease, the nurse assesses for myocardial: A. Necrosis B. Inflammation C. Hypertrophy D. Ischemia

B. Left ventricle

UNIT 7 QUIZ Which chamber of the heart generates the highest pressure? A. Right ventricle B. Left ventricle C. Right atrium D. Left atrium

B. Chordae tendineae

UNIT 7 QUIZ Which structures act as anchors for the atrioventricular valves? A. Trabeculae carneae B. Chordae tendineae C. Coronary ostia D. Great vessels

B. Superior vena cava syndrome (SVCS)

UNIT 7 QUIZ: A 50-year-old male with a 30-year history of smoking was diagnosed with bronchogenic cancer. He developed edema and venous distention in the upper extremities and face. Which of the following diagnosis will the nurse observe on the chart? A. Thromboembolism B. Superior vena cava syndrome (SVCS) C. Chronic venous insufficiency D. Deep vein thrombosis

B. decreased oxygen supply to the muscle tissue of the heart

UNIT 7 VB: a major complication of myocardial ischemia is A. increased oxygen supply to the muscle tissue of the heart B. decreased oxygen supply to the muscle tissue of the heart C. increased nutrient supply to the muscle tissue of the heart D. decreased nutrient supply to the muscle tissue of the heart

D. ventricular, heart

UNIT 7 VB: prolonged hypertension can cause __________ hypertrophy and eventual _________ failure. A. ventricular, kidney B. renal, kidney C. renal, heart D. ventricular, heart

A. systolic

UNIT 7 VB: 120mmHg, or millimeters of mercury, is the average _______ pressure for an adult. A. systolic B. diastolic C. arterial D. cardiac

C. reduced tissue perfusion

UNIT 7 VB: all of the following are common complications when hypertension damages blood vessels except A. kidney damage B. vision trouble C. reduced tissue perfusion D. stroke

A. low cholesterol

UNIT 7 VB: all of the following are possible complications of atherosclerotic plaque formation except A. low cholesterol B. ischemia C. coronary artery disease D. stenosis

A. ischemia

UNIT 7 VB: all of the following are risk factors for atherosclerosis except A. ischemia B. advanced age C. high cholesterol D. obesity

D. valves

UNIT 7 VB: all of the following are structures arteries and veins have in common except A. tunica intima B. tunica externa C. tunica media D. valves

A. atria

UNIT 7 VB: all of the following are types of blood vessels except A. atria B. arterioles C, capillaries D. venules

B. varying activity levels

UNIT 7 VB: all of the following can cause arrhythmias except A. changes to the sinoatrial node's firing rate B. varying activity levels C. formation of reentrant circuits in the heart D. obstructions in the conduction system

B. reduced venous pressure

UNIT 7 VB: all of the following can result from cardiac tamponade except A. muffled heart sounds B. reduced venous pressure C. hypotension D. reduced stroke volume

B. cardiac tamponade

UNIT 7 VB: all of the following disorders can eventually lead to heart failure by inhibiting ventricular ejection except A. myocardial infarction B. cardiac tamponade C. hypertension D. aortic stenosis

D. it may cause blood to leak back into the ventricle

UNIT 7 VB: all of the following statements accurately describe mitral valve prolapse except A. it may cause blood to leak back into the atrium B. it prevents the mitral valve from closing properly C. it may cause a complication called mitral valve regurgitation D. it may cause blood to leak back into the ventricle

C. ischemia narrows the arteries

UNIT 7 VB: all of the following statements describe how atherosclerosis can inhibit blood flow to the heart, as part of coronary artery disease, except A. calcification restricts artery dilation B. plaques narrow the arteries C. ischemia narrows the arteries D. fibrosis restricts artery dilation

D. a and b

UNIT 7 VB: arteries are structurally different from veins in which way? A. they have thicker and stretchier walls to accommodate higher pressures B. they lack valves C. they have a tunica media D. a and b

C. thickens and stiffens

UNIT 7 VB: as an atherosclerotic plaque grows, the artery wall A. thickens and relaxes B. thins and stiffens C. thickens and stiffens D. thins and relaxes

B. superior and inferior mesenteric veins

UNIT 7 VB: deoxygenated blood from the intestines drains into the A. azygos system B. superior and inferior mesenteric veins C. common iliac veins D. superior and inferior venae cavae

C. LDL cholesterol, endothelium

UNIT 7 VB: fatty streaks appear when excess _______ in the blood invades the artery wall through the __________. A. HDL cholesterol, fibrous cap B. LDL cholesterol, fibrous cap C. LDL cholesterol, endothelium D. HDL cholesterol, endothelium

B. a plaque in coronary arteries can rupture and form a thrombus, obstructing blood flow

UNIT 7 VB: how can coronary artery disease cause myocardial infarction? A. a plaque can form in the heart chambers, blocking valves B. a plaque in coronary arteries can rupture and form a thrombus, obstructing blood flow C. a plaque in pulmonary arteries can rupture and form a thrombus, obstructing blood flow D. a plaque can form in myocardial tissue, progressing to necrosis

D. the atria and ventricles contract independently, decreasing cardiac output

UNIT 7 VB: how do some arrhythmias cause hypotension? A. bradycardia reduces the stroke volume, increasing cardiac output B. bradycardia increases the stroke volume, decreasing cardiac output C. the atria and ventricles contract independently, increasing cardiac output D. the atria and ventricles contract independently, decreasing cardiac output

B. on its way to the liver, blood passes through the right, left, and intermediate hepatic veins, which originate in the inferior vena cava

UNIT 7 VB: if you were giving an oral presentation on the hepatic system, you would most likely make all of the following points except A. the hepatic portal vein transports oxygen-depleted blood to the liver, which performs detoxification, protein synthesis, and other functions B. on its way to the liver, blood passes through the right, left, and intermediate hepatic veins, which originate in the inferior vena cava C. in the liver, the branches of the hepatic portal vein subdivide and end in smaller vessels known as sinusoids, which are permeable D. the hepatic portal vein collects blood from the vessels that drain the stomach, intestines, colon, spleen, pancreas, and gall bladder

B. pulmonary circulation moves blood between the heart and lungs, and systemic circulation moves blood between the heart and the rest of the body

UNIT 7 VB: if your friend asked you to distinguish between pulmonary and systemic circulation, which of the following would you most likely say? A. systemic circulation moves blood between the heart and lungs, and pulmonary circulation moves blood between the heart and the rest of the body B. pulmonary circulation moves blood between the heart and lungs, and systemic circulation moves blood between the heart and the rest of the body C. in pulmonary circulation, the arteries transport oxygenated blood and the veins transport deoxygenated blood, whereas in systemic circulation, the opposite is true D. systemic circulation manages the gas exchange and oxygenation of blood, and pulmonary circulation simply delivers oxygenated blood throughout the body

B. the subclavian artery is the first part of the long trunk that supplies each upper extremity, and at the axilla, it becomes the axillary artery, which ends at the lower border of the tendon of the teres major, where it becomes the brachial artery

UNIT 7 VB: if your instructor asked you to discuss the arteries of the upper limb in order, from superior to inferior, which of the following would you most likely say? A. the subclavian artery is the first part of the long trunk that supplies each upper extremity, and at the lower border of the teres major, it becomes the brachial artery, which ends in the axilla, where it becomes the axillary artery B. the subclavian artery is the first part of the long trunk that supplies each upper extremity, and at the axilla, it becomes the axillary artery, which ends at the lower border of the tendon of the teres major, where it becomes the brachial artery C. the axillary artery is the first part of the long trunk that supplies each upper extremity, and at the clavicle, it becomes the subclavian artery, which ends at the lower border of the tendon of the teres major, where it becomes the brachial artery D. the brachial artery is the first part of the long trunk that supplies each upper extremity, and at the clavicle, it becomes the subclavian artery, which ends in the lower border of the tendon of the teres major, where it becomes the axillary artery

B. calcify, decreases

UNIT 7 VB: in aortic stenosis, the leaflets of the aortic valve ___________ and normal blood flow out of the heart ________. A. stretch, increases B. calcify, decreases C. calcify, increases D. stretch, decreases

C. pericardial cavity, dilating

UNIT 7 VB: in cardiac tamponade, as fluid accumulates in the _______, it presses on the heart and prevents chambers from _______ fully. A. lungs, dilating B. lungs, contracting C. pericardial cavity, dilating D. pericardial cavity, contracting

C. arteries, veins

UNIT 7 VB: in systemic circulation, oxygenated blood is pumped from the heart into __________, which carry it to body tissues. ________ carry deoxygenated blood back to the heart. A. vessels, cells B. veins, arteries C. arteries, veins D. valves, capillaries

C. jaw or back, left arm and neck

UNIT 7 VB: in women, angina can present as pain in the ________. in men, it typically presents as chest pain that can radiate to the _________. A. left arm and neck, jaw or back B. jaw or neck, left arm and back C. jaw or back, left arm and neck D. left arm and back, jaw or neck

C. arteries, arterioles, capillaries, venules, veins

UNIT 7 VB: oxygenated blood flows from the heart through systemic circulation in which order? A. arteries, veins. capillaries, arterioles, venules B. veins, venules, capillaries, arterioles, arteries C. arteries, arterioles, capillaries, venules, veins D. capillaries, veins, venules, arterioles, arteries

D. oxygenated blood, deoxygenated blood

UNIT 7 VB: pulmonary veins carry _______, and pulmonary arteries carry ________. A. deoxygenated blood, oxygenated blood B. more blood, less blood C. nitrogenous wastes, oxygenated blood D. oxygenated blood, deoxygenated blood

D. 100, 60

UNIT 7 VB: tachycardia is a heart rate above _______ beats per minute, and bradycardia is a heart rate below ________ beats per minute. A. 60, 100 B. 40, 120 C. 120, 40 D. 100, 60

B. axillary, femoral

UNIT 7 VB: the _______ arteries supply the upper limbs, and the _______ arteries supply the lower limbs. A. radial, mesenteric B. axillary, femoral C. iliac, gastric D. aortic, popliteal

B. aorta

UNIT 7 VB: the ________ is the largest artery in the body A. pulmonary artery B. aorta C. subclavian artery D. common carotid artery

C. circle of willis

UNIT 7 VB: the __________ provides blood supply to the brain and contains alternate routes in case of blockage A. azygos system B. hepatic portal stress C. circle of willis D. venous sinuses

A. blood is pumped from the left ventricle into the aorta, blood drains from the superior and inferior venae cavae into the right atrium

UNIT 7 VB: the first and last steps of systemic circulation are: A. blood is pumped from the left ventricle into the aorta, blood drains from the superior and inferior venae cavae into the right atrium B. blood is pumped from the right atrium into the superior vena cava, blood drains from the aorta into the left ventricle C. blood drains into the venae cavae, blood leaves the aorta D. blood flows through the pulmonary valve, blood returns through the bicuspid valve

D. pelvic region

UNIT 7 VB: the iliac veins are located in which area of the body? A. upper limbs B. back C. abdominal viscera D. pelvic region

B. renal arteries

UNIT 7 VB: the kidneys are supplied by the: A. celiac trunk B. renal arteries C. tibial arteries D. pancreaticoduodenal arteries

B. jugular veins

UNIT 7 VB: the major vein draining the head are the: A. cephalic veins B. jugular veins C. brnachiocephalic veins D. facial veins

A. increasing, constricting

UNIT 7 VB: the nervous and cardiovascular systems may respond to a drop in blood flow by ________ heart rate and by _______ vessels to increase venous return. A. increasing, constricting B. increasing, dilating C. decreasing, dilating D. decreasing, constricting

D. systolic, diastolic

UNIT 7 VB: the point of highest blood pressure is _________ pressure, and the point of lowest blood pressure is _______ pressure. A. cardiac, systemic B. diastolic, systolic C. arterial, venous D. systolic, diastolic

B. ensure unidirectional blood flow

UNIT 7 VB: the purpose of valves is to: A. filter debris from the bloodstream B. ensure unidirectional blood flow C. move blood through arteries D. all of the above

C. the intestines

UNIT 7 VB: the superior and inferior mesenteric arteries primarily supply: A. the lungs B. the stomach C. the intestines D. the heart

B. increased pressure on the heart caused by fluid buildup in the pericardial cavity

UNIT 7 VB: what causes cardiac tamponade? A. decreased pressure on the heart caused by a tear in the pericardium B. increased pressure on the heart caused by fluid buildup in the pericardial cavity C. increased heart volume caused by fluid backup in the pericardial cavity D. infection in the heart wall, which prevents the chambers from dilating fully

A. decreased myocardial contractility

UNIT 7 VB: what happens when the body's compensatory responses to decreased cardiac output and perfusion of body tissues overload the myocardial muscle? A. decreased myocardial contractility B. increased cardiac output C. increased blood volume and pressure D. decreased retention of sodium and water in the kidneys

C. speeds up, slows down

UNIT 7 VB: when blood pressure increases, blood flow _________. when resistance increases, blood flow _________. A. slows down, speeds up B. stops, reverses C. speeds up, slows down D. reaches the extremities, moves into veins

C. carotid

UNIT 7 VB: which arteries supply the brain? A. subclavian B. intercostal C. carotid D. jugular

A. the unpaired visceral branches are the celiac trunk, the superior mesenteric artery, and the inferior mesenteric artery, whereas the paired visceral branches are the suprarenal, renal, and gonadal arteries

UNIT 7 VB: which of the following accurately identifies the paired and unpaired visceral branches of the abdominal aorta? A. the unpaired visceral branches are the celiac trunk, the superior mesenteric artery, and the inferior mesenteric artery, whereas the paired visceral branches are the suprarenal, renal, and gonadal arteries B. the paired visceral branches are the celiac trunk, the superior mesenteric artery, and the inferior mesenteric artery, whereas the unpaired visceral branches are the suprarenal, renal, and gonadal arteries C. the unpaired visceral branches are the suprarenal and renal arteries and the median sacral artery, whereas the paired visceral branches are the superior and inferior mesenteric arteries and the phrenic and lumbar arteries D. the paired visceral branches are the phrenic and lumbar arteries, whereas the unpaired visceral branch is the median sacral artery

D. it is caused by the blood flow generated by the heart as it pumps and the resistance that blood encounters as it moves through the enclosed vessel

UNIT 7 VB: which of the following causes blood pressure? A. it is caused by electrical impulses in the blood vessels and the resulting contractions that move blood through the vessels B. it is caused by the relaxation of the heart and the subsequent increase in blood flow through the vessels C. it is caused by the size of the blood vessels and the amount of force needed to move blood through the vessels D. it is caused by the blood flow generated by the heart as it pumps and the resistance that blood encounters as it moves through the enclosed vessel

A. loss of functional muscle tissue in the heart

UNIT 7 VB: which of the following results from myocardial infarction? A. loss of functional muscle tissue in the heart B. increased ventricular contractility C. atherosclerotic plaque rupture in the coronary arteries D. increased cardiac output

B. primary hypertension arises from genetic, dietary, and lifestyle factors that increase vessel resistance or cardiac output, whereas secondary hypertension results from another disorder, such as kidney disease

UNIT 7 VB: which of the following statements accurately compares primary and secondary hypertension A. primary hypertension affects vessels in the kidneys, heart, and other primary organs, whereas secondary hypertension affects vessels in the limbs B. primary hypertension arises from genetic, dietary, and lifestyle factors that increase vessel resistance or cardiac output, whereas secondary hypertension results from another disorder, such as kidney disease C. primary hypertension occurs intermittently, whereas secondary hypertension is chronic D. primary hypertension arises from genetic, dietary, and lifestyle factors tat decrease vessel resistance or cardiac output, whereas secondary hypertension results from another disorder, such as kidney disease

intrinsic

________ causes of circadian rhythm sleep disorder: -advanced sleep phase disorder: sleep loss if social reqs are late for sleep (early morning waking-early evening sleeping) -delayed sleep phase disorder: loss of sleep because of required early morning rising (late morning waking-late night to early morning sleeping)

extrinsic

________ causes of circadian rhythm sleep disorder: -rapid time zone change -alternating sleep schedule -changes in total sleep

neural tube defects (NTDs)

_________ are an arrest of the normal development of the brain and spinal cord during the first month of embryonic development -2 categories: anterior midline defects & posterior defects

hemolytic anemia

_________ is a premature accelerated destruction of erythrocytes, either episodically or continuously

heart failure

_________ is when the heart is not able to maintain CO at level that meets demands of the body, resulting from poor ventricular function -complication of many congenital heart defects

cerebral infarction

_________ results when an area of the brain loses blood supply due to vascular occlusion

structural malformations

__________ are responsible for 75% of fetal deaths and 40% of deaths in first year -most are defects of neural tube closure: arnold-chiari type II malformation; tethered cord syndrome

left heart failure

__________ is categorized as heart failure w/ reduced EF (systolic heart failure) or heart failure w/ preserved EF (diastolic heart failure)

brain death (total brain death)

__________ occurs when brain is damaged so completely that it can never recover and cannot maintain internal homeostasis

alterations of coagulation

___________ are caused by probs w/ clotting factors -disorders include: impaired hemostasis, consumptive thrombohemorrhagic disorders (i.e. disseminated intravascular coagulation), and thromboembolic disorders (i.e. hereditary thrombophilias, acquired hypercoagulability)

thermoregulation

___________ is achieved through precise balance of heat production, heat conservation, and heat loss -varies in response to: location, activity, environment, circadian rhythm, and gender

thrombus formation

___________ occurs when there is a blood clot that remains attached to a vessel wall -risk factors: intimal injury/inflam, obstruction of flow, pooling (stasis)

risk factors

____________ for obstructive sleep apnea syndrome: -obesity -male sex -older age -being postmenopausal

aplastic anemia

____________ is a hematopoietic failure or bone marrow aplasia with a reduced production of mature cells

increased intracranial pressure (IICP)

____________ may be caused by an increase in intracranial content, cerebral edema, excessive CSF, or hemorrhage

spinal cord tumors

____________ may be intramedullary tumors or extramedullary tumors -manifestations: compressive syndrome or irritative syndrome

acquired cardiovascular disorders

_______________ refer to heart disease processes or abnormalities that occur after birth -ex. Kawasaki disease, systemic hypertension

headache

a common neurologic disorder and is usually a benign symptom -assoc w/ serious disease, such as brain tumor, meningitis, or cerebrovascular disease

acute pain

a normal protective mechanism that alerts an indiv to a condition or experience that is immediately harmful to the body -mobilizes the indiv to take prompt action -transient -begins suddenly and relieved after pain stimulus removed

Kawasaki disease

acquired cardiovascular disorders: this is formerly known as mucocutaneous lymph node syndrome; this is an acute self-limiting systemic vasculitis that may result in cardiac sequelae -occurs in kids under 5 years of age in winter or spring -greatest incidence in Japan

systemic hypertension

acquired cardiovascular disorders: this is when systolic and diastolic BP over 95th percentile for age, gender, and height on at least 3 occasions -often has underlying disease (renal disease or coarctation of aorta) -cause is almost always found -children commonly asymptomatic

obesity

acquired cardiovascular disorders: we are seeing an increased incidence of primary hypertension in older children related to _________

causes of acquired cardiovascular diaorders

acquired cardiovascular disorders: what does this list describe? 1. infection 2. genetic disorders 3. autoimmune process/diseases 4. environmental factors

myasthenia gravis (MG)

acquired chronic autoimmune disease -defect in nerve impulse transmission at neuromuscular junction -an IgG antibody is produced against acetylcholine receptors -symptoms: weakness and fatigue of muscles of the eyes and throat causing diplopia and difficulty chewing, talking, swallowing

kernicterus

acquired disorders of erythrocytes: in erythroblastosis fetalis, if bilirubin levels exceed the liver's ability to conjugate and excrete bilirubin, it can be deposited in the brain leading to a condition known as __________, causing cell damage and eventually death if the neonate does not receive exchange transfusions

hemolytic disease of the newborn (eythroblastosis fetalis)

acquired disorders of erythrocytes: this is an alloimmune disease; maternal antibody directed against fetal antigens -ABO incompatibility: 20-25% -Rh incompatibility: less than 20% -manifestations: anemia, hyperbilirubinemia, icterus neonatorum, kernicterus

iron deficiency anemia (IDA)

acquired disorders of erythrocytes: this is the most common nutritional disorder of infancy and childhood -causes: lack of iron intake, probs w/ iron absorption, blood loss, inc iron reqs -manifestations: irritability, lack of interest in play; weakness and dec activity tolerance

icterus neonatorum

acquired disorders of erythrocytes: without exchange transfusions in which the neonate receives Rh-negative red blood cells, severe hyperbilirubinemia and ___________, or neonatal jaundice, can develop shortly after birth

antiphospholipid syndrome

acquired hypercoagulability: this is an autoimmune syndrome characterized by autoantbodies against plasma membrane phospholipids and phospholipid-binding proteins

hyperosmolar hyperglycemic nonketotic syndrome (HHNKS)

acute complications of diabetes mellitus: an uncommon but significant complication of T2DM w/ high overall mortality -occurs in more elderly indivs -manifestations: severe dehydration, loss of electrolytes, neurologic changes (i.e. stupor)

hypoglycemia

acute complications of diabetes mellitus: called insulin shock or insulin reaction; most often occurs when there is an unexpected change in caloric intake or exercise w/o appropriate modification of insulin dosing -symptoms: pallor, tremor, anxiety, tachycardia, palpitations, diaphoresis, headache, dizziness, irritability, fatigue, poor judgement, confusion, visual disturbances, hunger, seizures, coma

diabetic ketoacidosis (DKA)

acute complications of diabetes mellitus: serious complication related to deficiency of insulin and an inc in the levels of insulin counterregulatory hormones -much more common in T1DM -characteristics: hyperglycemia, acidosis, ketonuria -symptoms: Kussmaul respirations (hyperventilation in attempt to compensate for acidosis), postural dizziness, CNS depression, ketonuria, anorexia, nausea, abdominal pain, thirst, polyuria

bone marrow depression

acute leukemias: ____________ causes signs/ symptoms if fatigue, bleeding, fever, anorexia, and neurologic symptoms

acute lymphocytic leukemia (ALL)

acute leukemias: this is characterized by too many lymphoblasts -mostly occurs in kids -aggressive and fast growing

acute myelogenous leukemia (AML)

acute leukemias: this is characterized by too many myeloblasts -most common adult leukemia -aggressive and fast growing

visceral pain

acute pain: arises from internal organs and body cavity linings -poorly localized w/ aching, gnawing, throbbing, or cramping quality -often radiates or is referred

somatic pain

acute pain: arises from skin, joints, and muscles -can be sharp or dull

referred pain

acute pain: this is felt in area removed or distant from its point of origin -supplied by same spinal segment as the acute site -can be acute or chronic

adipokines

adipose tissue as an endocrine organ: these are cell-signaling proteins that function like hormones -excess WAT causes dysregulation of secretion and function -> contribute to complications of obesity

adipocytes

adipose tissue: these are fat-storing cells

zona reticularis

adrenal cortex: this is the inner layer and constitutes 7% of the cortex -secretes mineralocorticoids (aldosterone), adrenal androgens and estrogens, and glucocorticoids

zona fasciculata

adrenal cortex: this is the middle layer and constitutes 78% of the cortex -secretes the glucocorticoids cortisol, cortisone, and corticosterone

zona glomerulosa

adrenal cortex: this is the outer layer and constitutes about 15% of the cortex -primarily produces mineralocorticoid aldosterone

catecholamines

adrenal medulla: release of _________ has been characterized as fight or flight response and promote hyperglycemia

chromaffin cells

adrenal medulla: these are cells in the adrenal medulla that secrete and store catecholamines (epinephrine and norepinephrine)

lymphocyte; immune system

aging and blood: _________ function decreases w/ age, causing changes in cellular immunity, and the humoral _________ is less responsive to antigenic challenge and to vaccination

iron deficiency

aging and blood: the erythrocyte lifespan is normal but erythrocytes are replaced more slowly which is caused by ____________ -dec in total serum iron, iron-binding-capacity, and intestinal iron absorption

anemia of chronic disease

also called anemia of inflammation; this anemia results from dec erythropoiesis and impaired iron utilization in chronic disease or inflam -common in hospitalized patients -results from: dec erythrocyte life span, suppressed production or eythropoietin, ineffective bone marrow response, altered iron metabolism in macrophages -tx: treating underlying disorder

diffuse brain injury

also called diffuse axonal injury (DAI); this injury involves widespread areas of the brain; clinically defined as coma lasting 6-24 hours after TBI -acceleration/deceleration of rotational forces cause axonal damage: shearing, tearing, or stretching nerve fibers -severity: amount of shearing force applied to the brain stem

traumatic brain injury (TBI)

alteration in brain function from external force; occurs from motor vehicle accidents, falls, or unintentional blunt trauma

supratentorial

alterations in arousal: above the tentorium cerebelli; produce changes by either diffuse or localized dysfunction -diffuse: disease process affecting cerebral cortex or underlying white matter -localized: masses develop w/in brain substance

infratentorial

alterations in arousal: below tenterorim cerebelli; destruction of reticular activating system OR destruction of brainstem

structural

alterations in arousal: these are divided according to primary location of pathologic condition -causes: infection, vasc alterations, neoplasms, traumatic injury, congenital alterations, degenerative changes, polygenic traits, metabolic disorders

metabolic

alterations in arousal: these disorders produce a decline in arousal by alterations in delivery of energy -ex. hypoxia, electrolyte disturbances, hypoglycemia

psychogenic

alterations in arousal: unresponsiveness; may signal psychiatric disorders -uncommon -despite apparent unconsciousness, person is physiologically awake

sensory inattentiveness

alterations in awareness: _____________ is a form of neglect

selective attention

alterations in awareness: ability to select from available, competing environmental and internal stimuli and focus on that stimuli

anterograde amnesia

alterations in awareness: amnesia in which there is an inability to form new personal or factual memories but memories of the distant past are retained and retrieved -i.e. where a car is parked, recognizing a person one has met in the preceding minutes

retrograde amnesia

alterations in awareness: amnesia in which there is difficulty retrieving or recalling past personal history memories or past factual memories -i.e. place of birth or high school graduation; current address or phone number

selective attention deficit

alterations in awareness: can be temporary, permanent, or progressive -disorders associated: seizure activity, parietal lobe contusions, subdural hematomas, stroke, gliomas or metastatic tumor, late Alzheimer dementia, fronototemporal dementia, psychotic disorders

global amnesia

alterations in awareness: combination of anterograde and retrograde amnesia -may not be able to recall where they are, how they arrived there, where they were born, or recognize family and friends

image processing

alterations in awareness: higher level of memory function and includes the ability to integrate sensory data and language to form concepts, assign meaning, and make abstractions -alterations: inability to form concepts and generalizations or to reason

amnesia

alterations in awareness: loss of memory and can be mild or severe -two types: retrograde and anterograde

extinction

alterations in awareness: person is able to recognize indiv sensory input from dysfunctional side when asked but ignores the sensory input from dysfunctional side when stimulated from both sides

memory

alterations in awareness: recording retention, and retrieval of information

neglect syndrome

alterations in awareness: the entire complex of denial of dysfunction, loss of recognition of one's own body parts, and extinction is sometimes referred to as _________

pathophysiologic mechanisms

alterations in awareness: the primary _____________ that operate in disorders of awareness are 1) direct destruction caused by ischemia and hypoxia or indirect destruction caused by compression and 2) effects of toxins, chemicals or metabolic disorders

executive attention deficits

alterations in awareness: these include the inability to maintain sustained attention and a working memory deficit (inability to remember instructions and info needed to guide behavior) -ex. ADHD -> common and can continue through adulthood

paroxysmal dyskinesias

alterations in muscle movement: abnormal, involuntary movements that occurs as spasms -movements include dystonia, chorea, athetosis, and ballism or combo of these

loss of associated motion

alterations in muscle movement: accompanies hypokinesia; movements that provide skill, grace, and balance to voluntary movements are lost

huntington's disease

alterations in muscle movement: autosomal dominant hereditary degenerative hyperkinetic disorder; severe degeneration of basal ganglia, particularly the caudate nucleus -also known as huntington's chorea -depletion of GABA: biochemical alteration of the disease

akinesia

alterations in muscle movement: decrease in voluntary and associated movements

hyperkinesia

alterations in muscle movement: excessive, purposeless movement -Huntington's disease symptoms are hallmark of _______

tardive dyskinesia

alterations in muscle movement: involuntary movement of the face, lip, tongue, trunk, and extremities -usually occurs as side effect of prolonged antipsychotic drug therapy -common symptom: rapid, repetitive stereotypic movement such as continual chewing w/ intermittent protrusions of tongue, lip smacking, and facial grimacing

hypokinesia

alterations in muscle movement: loss of voluntary movement despite normal consciousness and peripheral nerve and muscle function -Parkinson disease symptoms are the hallmark of _______

tourette syndrome

alterations in muscle movement: presence of motor tics (sudden, rapid, repetitive nonrhythmic movements) and vocal tics

parkinson disease (PD)

alterations in muscle movement: severe degeneration of the basal ganglia w/ loss of dopamine-producing neurons -tremor, rigidity, bradykinesia -postural disturbances -autonomic and neuroendocrine symptoms -cognitive-affective symptoms

bradykinesia

alterations in muscle movement: slowness of voluntary movements -difficulty in initiating movements, continuing movements smoothly, performing synchronous and consecutive tasks

secondary parkinsonism

alterations in muscle movement: this is PD caused by disorders other than PD (i.e. head trauma, infection, neoplasm, atherclerosis, toxins, drug intoxication) -drug induced: most common of this form

primary parkinsonism

alterations in muscle movement: this is hereditary and sporadic form of PD; begins after age of 40 w/ incidence inc after 60

upper motor neuron syndromes

alterations in muscle movement: this is the result of injury to motor pathways that descend from the motor cortex -cause: trauma, stroke, tumors

hypotonia

alterations in muscle tone: decreased muscle tone -causes: cerebellar damage and pure pyramidal tract damage; nerve impulses needed for muscle tone are lost

hypertonia

alterations in muscle tone: increased muscle tone -causes: upper motor neuron damage w/ loss of inhibitory control -types: spasticity, gegenhalten (paratonia), dystonia, rigidity

movements

alterations in neuromotor function: dysfunction in nervous system areas that control ___________ can cause: -alteration in muscle tone -alterations in muscle movement -upper and lower motor neuron syndromes -motor neuron disease -amyotrophic lateral sclerosis

quantitative disorders

alterations of leukocyte function: this results from an increase or decrease in cell numbers; this is a response to infectious microorganism invasion -bone marrow disorders or premature destruction of cells

qualitative disorders

alterations of leukocyte function: this results from disruptions of leukocyte function -phagocytes or lymphocytes lose abilities

tertiary hyperparathyroidism

alterations of parathyroid function: this develops after a long period of hypocalcemia

hypoparathyroidism

alterations of parathyroid function: this is abnormally low PTH levels; usually caused by parathyroid damage in thyroid surgery -manifestations: primarily those of hypocalcemia

secondary hyperparathyroidism

alterations of parathyroid function: this is characterized by an inc in PTH secondary to chronic hypocalcemia -compensatory response of parathyroid glands to chronic hypocalcemia

primary hyperparathyroidism

alterations of parathyroid function: this is characterized by the inappropriate excess secretion of PTH from one or more parathyroid glands -one of the most common endocrine disorders

hyperparathyroidism

alterations of parathyroid function: this is inc secretion of parathyroid hormone -classified as primary, secondary, or tertiary -hallmark manifestations: hypercalcemia; hypophospatemia

bleeding time

alterations of platelet function: qualitative alterations demonstrate an increased _______________ in the presence of normal platelet count -manifestations: petechiae, purpura, bleeding in GI and GU tract, pulmonary mucosa, and gums -can be congenital acquired

congestive splenomegaly

alterations of splenic function: ___________ is accompanied by ascites, portal hypertension, and esophageal varices and is most commonly seen in those w/ hepatic cirrhosis

infiltrative splenomegaly

alterations of splenic function: ____________ is caused by engorgement by the macrophages w/ indigestible materials associated w. various "storage diseases"

hypersplenism

alterations of splenic function: this is overactivity of the spleen; causes anemia -tx: splenectomy (if indicated)

splenomegaly

alterations of splenic function: this is the enlargement of the spleen; may or may not be pathologic -classified as congestive or infiltrative

interruption of pituitary stalk

alterations of the hypothalamic-pituitary system: this is caused by destructive lesions, rupture after head injury, surgical transection or tumor -loss of hypothalamic hormones causes pituitary to release inadequate amounts of hormones

hypothyroidism

alterations of thyroid function: this is results from the deficient production of TH by the thyroid gland; most common disorder of thyroid func -manifestations: dec metabolic rate, cold intolerance, lethargy

central (secondary) hypothyroidism

alterations of thyroid function: this occurs because of failure of the pituitary to synthesize adequate TSH -causes: pituitary tumors; associated treatments

primary hypothyroidism

alterations of thyroid function: this occurs because of the loss of thyroid function -causes: autoimmune thyroiditis (hashimoto disease), loss of thyroid tissue, medications, endemic iodine deficiency

hyperthyroidism

alterations of thyroid function: form of thyrotoxicosis; this is increased TH levels from the thyroid gland -primary cause: Grave's disease, toxic multinodular goiter, and solitary toxic adenoma -central (secondary) cause: pituitary adenomas; less common

central (secondary) thyroid disorders

alterations of thyroid function: these are disorders of the pituitary gland's thyroid stimulating hormone (TSH) production

thyrotoxicosis

alterations of thyroid function: this is a condition due to any cause of inc TH levels -manifestations: inc metabolic rate, heat intolerance, tissue sensitivity

primary thyroid disorders

alterations of thyroid function: this is dysfunction or disease of the thyroid; majority of thyroid diseases -cause: inc or dec thyroid hormone (TH) -idiopathic: caused by autoimmune mechanisms

toxic adenoma

alterations of thyroid function: hyperthyroid conditions if only one node is hyperfunctioning, it is termed _____________

graves disease

alterations of thyroid function: hyperthyroid conditions this is an autoimmune disease caused by stimulation of thyroid by antibodies against TSH receptor -type II hypersensitivity -clinical manifestation: opthalmopathy and pretibial edema; pretibial myxedema (subcutaneous swelling on the anterior portions of the legs and by indurated and eythematuous skin)

thyrotoxic crisis (thyroid storm)

alterations of thyroid function: hyperthyroid conditions this is when TH levels rise dramatically, can be fatal -may develop spontaneously; usually occurs in indivs who have undiagnosed or partially treated Graves disease and those subjected to physiologic stress

toxic multinodular goiter

alterations of thyroid function: hyperthyroid conditions this occurs when there are several hyperfunctioning nodules leading to hyperthyroidism -absence of autoimmune stimulus

postpartum thyroiditis

alterations of thyroid function: hypothyroid conditions: _____________ generally occurs up to 6 months after birthing w/ a course similar to that seen in subacute thyroiditis (inflam of thyroid gland)

subacute thyroiditis (de quervain thyroiditis)

alterations of thyroid function: hypothyroid conditions: this is a rare nonbacterial inflam of the thyroid gland often preceded by a viral infection -symptoms: fever, tenderness, enlargement of thyroid gland, transient hypothyroidism

hashimoto disease

alterations of thyroid function: hypothyroid conditions: this is an autoimmune disease causing gradual destruction of thyroid tissue -most common cause of primary hypothyroidism in US

congenital hypothyroidism

alterations of thyroid function: hypothyroid conditions: this is when thyroid tissue is absent in infants -hereditary defects in TH synthesis

early

alzheimer disease (AD) ______ clinical manifestations of AD include forgetfulness and emotional upset

later

alzheimer disease (AD) _______ clinical manifestations include memory loss, disorientation, confusion, lack of concentration, decline in abstraction, problem solving, and judgement

neuritic plaques; neurofibrillary tangles

alzheimer disease (AD): pathological alterations in the brain include an accumulation of extracellular __________ containing a core of amyloid beta protein and intraneuronal _________ of tau protein

posturing

an inequality of tone in muscle groups results in __________ of limbs -four types of disorders: dystonic postures and movements, decorticate posture/response, decerebrate posture/response, basal ganglion posture

reduced oxygen-carrying capacity

anemia : the main physiologic manifestation is ______________ of the blood resulting in hypoxemia, or reduced oxygen level in the blood

microcytic-hypochromic

anemia of chronic disease: initially ACD is normocytic-normochromic, but with persistence becomes __________________

size; hemoglobin content

anemia: classifications of anemias are based on ________, which are identified on terms that end in -cytic (i.e. macrocytic, microcytic, normocytic) or __________, which are identified by terms that end in -chromic (i..e normochromic, hypochromic)

poikilocytosis

anemia: these are when red cells are present in various shapes

anisocytosis

anemia: these are when red cells present is various sizes

anemia symptoms

anemia: what does this list describe? -fatigue -weakness -dyspnea -pallor

posthemorrhagic anemia

anemias of blood loss: this is a normocytic-normochromic anemia caused by acute blood loss -effects depend on rate of hemorrhage -often due to trauma

chronic blood loss

anemias of blood loss: this occurs if loss is greater than replacement capacity of bone marrow -iron deficiency anemia can occur if iron stores are depleted

aorta

aneurysm: the ________ is most susceptible to aneurysms, especially abdominal area, due to constant stress on the vessel wall and absence of penetrating vasa vasorum in media layer -causes: atherosclerosis, hypertension -can lead to aortic dissection or rupture

false aneurysm

aneurysm: this is an extravascular hematoma that communicates w/ the intravascular space -common cause: leak b/w vascular graft and natural artery

true aneurysm

aneurysm: this is the weakening of all 3 layers of wall -most are fusiform and circumferential -less common: saccular aneurysm -> spherical in shape

undernutrition

anorexia of aging: __________ leads to adverse outcomes such as malnutrition, fralility, mitochondrial dysfunction, reduced regenerative capacity, inc oxidative stress, imbalanced hormones

orexigenic; anorexigenic

anorexia of aging: aging associated w/ dec ___________ signals and inc ___________ signals

growth hormone (GH)

anterior pituitary: _________ is essential to normal tissue growth and maturation and also impacts aging, sleep, nutritional status, stress, and reproductive hormones

thyroid-stimulating hormone (TSH)

anterior pituitary: _________ regulates the activity of the thyroid gland

prolactin

anterior pituitary: __________ primarily functions to induce milk production during pregnancy and lactation

adrenocorticotropic hormone (ACTH)

anterior pituitary: ____________ regulates the release of cortisol from the adrenal cortex

somatotropic hormones

anterior pituitary: growth hormone (GH) and prolactin are called the ___________ and have diverse effects on body tissues

tropic hormones

anterior pituitary: the anterior pituitary secretes __________ that affect the physiologic function of specific target organs

glycoprotein hormones

anterior pituitary: these include follicle-stimulating hormone (FSH), luteinizing hormone (LH), adrenocorticotropic hormone (ACTH), and thyroid-stimulating hormone

pars tuberalis

anterior pituitary: this is a thin layer of cells on the anterior and lateral portions b/w the pituitary stalk

pars distalis

anterior pituitary: this is the major component of the anterior pituitary and is source of anterior pituitary hormones

pars intermedia

anterior pituitary: this lies b/w the two other pars and secretes melanocyte-stimulating hormone in the fetus -disappears in adulthood

melanocyte-stimulating hormone (MSH)

anterior pituitary: this promotes the pituitary secretion of melanin, which darkens skin color -example of a tropic hormone

factors of anterior pituitary hormone regulation

anterior pituitary: what does this list describe? 1. secretion of hypothalamic releasing factor 2. feedback effects of hormones 3. direct effects of mediating neurotransmitters

primary immune thrombocytopenia

antibody-mediated hemorrhagic disease: this is the most common platelet consumption disorder; platelet destruction rate that exceeds production -70% w/ antecedent viral disease: cases preceded w/ viral illness -manifestations: bruising, petechial rash -prognosis excellent w/ 80-90% regaining normal platelet count w/in 6 months after onset

pancytopenia

aplastic anemia causes peripheral ______________, which is a reduction or absence of all three blood cell types

progression of atherosclerosis

atherosclerosis: what does this list describe?: 1. inflam of endothelium 2. cellular proliferation 3. macrophage migration and adherence 4. LDL oxidation (foam cell formation) -> macrophages engulf LDL 5. fatty streak -> lesion formed by foam cells 6. fibrous plaque -> what is formed when smooth muscle cells in region of endothelial cell proliferate, produce collagen and migrate over fatty streak 7. complicated plaque -> plaque that has ruptured

mixed hearing loss

auditory dysfunction: combination of conductive and sensorineural losses

Ménière's disease

auditory dysfunction: episodic disorder of the middle ear involving excessive pressure in the labyrinth

conductive hearing loss

auditory dysfunction: impaired sound conduction from outer to inner ear -causes: impacted cerumen, foreign bodies lodged in ear canal, etc -symptoms: diminished hearing and soft speaking voice

sensorineural hearing loss

auditory dysfunction: impairment of the organ of Corti or its central connections -causes: congenital and hereditary factors, noise exposure, aging, etc -ex. presbycusis

functional hearing loss

auditory dysfunction: indiv appears not to hear ad does not respond to voice -rare

presbycusis

auditory dysfunction: most common form of sensorineural hearing loss in elderly people -age related hearing loss

preganglionic

autonomic nervous system: these are myelinated; conduct impulses from the brainstem or spinal cord to an autonomic ganglion where they synapse w/ a postganglonic neuron

postganglionic

autonomic nervous system: these are unmyelinated; conduct impulses away from the ganglion to the effector

reflex arc

basic unit that responds to stimuli and provides circuitry for motor output -structures needed: receptor, afferent (sensory) neuron, efferent neuron, effector (muscle or gland)

cardiac cycle

blood flow and cardiac cycle: each ventricular contraction and the relaxation that follows it constitute one __________

pressure gradients

blood flow and cardiac cycle: four heart valves, four chambers, and the ____________ ensure that blood only flows one way through the heart

systole

blood flow and cardiac cycle: this is when ventricles contract; propels blood out of ventricles and into pulm and systemic circulatins -ventricle pressure inc -valves close to prevent backflow -semilunar valve opens when ventricle pressure higher than aortic/pulmonary pressure -blood flows out

diastole

blood flow and cardiac cycle: this is when ventricles relax; blood fills the ventricles -higher pressure in atria -lower pressure in ventricles

head injury

blood supply in the brain: because cerebral venous drainage does not parallel arterial supply, it is important when a person has a ______ to avoid turning head or letting head fall to the side or veins could become occluded

autoregulated

blood supply in the brain: cerebral blood flow is _______ to maintain stable flow w/in the CNS

no

blood supply in the brain: does cerebral venous drainage parallel arterial supply?

20

blood supply in the brain: the brain receives approximately ____% of the cardiac output, or 800 to 1000 mL of blood flow per minute

circle of willis

blood supply in the brain: this provides an alternative route for blood flow when one of the contributing arteries is obstructed

internal carotid arteries and vertebral arteries

blood supply in the brain: what are the two systems in which the brain derives its arterial supply?

CO2

blood supply in the brain: which compound is the primary regulator for CNS blood flow?

anterior; posterior

blood supply in the spinal cord: the _________ spinal artery and the paired _________ spinal artery branch from the vertebral artery at the base of the cranium and descend alongside the spinal cord

aorta

blood supply in the spinal cord: the spinal cord derives its blood supply from branches off the vertebral arteries and from branches of various regions of the ______

brain death criteria

brain death (total brain death): what does this list describe? -completion of all appropriate diagnostic and therapeutic procedures -unresponsive coma -no spontaneous respirations -no brainstem functions -flat EEG -persistence of signs for appropriate period

intracerebral abscess

brain or spinal cord abscess: arise from a vascular source

connective tissue capsule

brain or spinal cord abscess: brain abscesses progresses from localized inflammation to a necrotic core w/ the formation of a _____________, usually w/in 14 days or longer

subdural brain abscess

brain or spinal cord abscess: empyemas; arise from sinus infection or a vascular source

epidural brain abscess

brain or spinal cord abscess: empyemas; associated w. osteomyelitis in a cranial bone

daughter abscesses

brain or spinal cord abscess: existing abscesses can spread and form ___________

intramedullary

brain or spinal cord abscess: these are abscesses found w/in the spinal cord

spinal cord abscesses

brain or spinal cord abscess: these are very rare and can be classified as epidural or intramedullary

epidural spinal abscess

brain or spinal cord abscess: these usually originate as osteomyelitis in a vertebra; the infection then spreads into the epidural space

brain abscess

brain or spinal cord abscess: this is classified as epidural, subdural, or intracerebral

headache

brain or spinal cord abscess: clinical manifestations ___________ is the most common early symptom; later symptoms are associated w/ expanding mass

brain abscess

brain or spinal cord abscess: clinical manifestations ____________ manifestations include localized pain, purulent drainage from nose or ears, fever, localized tenderness, and neck stiffness

spinal cord abscess

brain or spinal cord abscess: clinical manifestations _______________ manifestations include spinal aching, severe root pain w/ back muscle spasms and ;limited vertebral movement, weakness, and paralysis

brainstem

brain: composed of the midbrain, medulla, and pons; connects the hemispheres of the brain, cerebellum and spinal cord

cerebrum

brain: largest part of the brain; contains both gray and white matter -has 3 primary structural divisions: forebrain, midbrain, and hindbrain

reticular formation

brain: network of connected nuclei in brainstem that regulate vital reflexes (i..e cardiovascular function and respiration)

reticular activating system

brain: the reticular formation together w/ the cerebral cortex is referred to as the _______________ -essential for maintaining wakefulness and attention

propogation

cardiac action potentials:

electrical impulses

cardiac action potentials: ____________ control the cardiac cycle

resting membrane potential

cardiac action potentials: a healthy myocardial cell has a ________________ of approximately ~90 mV

hyperpolarization

cardiac action potentials: if the resting membrane potential becomes more negative bc of a dec in extracellular potassium concentration, it is termed ____________

repolarization

cardiac action potentials: this is the deactivation of a cardiac action potential

automaticity

cardiac action potentials: this is the property of generating spontaneous depolarization to threshold -enables the SA and AV nodes to generate cardiac action potentials w/o any stimulus

rhythmicity

cardiac action potentials: this is the regular generation of an AP by the heart's conduction system -SA node: sets pace -if SA node damaged, AV can become heart's pacemaker

refractory period

cardiac action potentials: this is wen there is no new cardiac action potential that can be initiated by a normal stimulus -happens after depolarization

electrocardiogram

cardiac action potentials: this originates from myocardial cell electrical activity; recorded by skin electrodes -summation of all cardiac action potentials

sympathetic nerves

cardiac innervation: this inc conductivity of APs and strength of contraction -enhance myocardial performance -influence diameter of coronary vessels -> dilation

autonomic nervous system

cardiac innervation: this influences the rate of impulse generation, depolarization and repolarization and the strength of atrial and ventricular contraction

parasympathetic nerves

cardiac innervation: this slows conduction of APs and reduces strength of contraction -helps vagus nerve release acetylcholine => dec HR

ejection fraction

cardiac output: this is calculated by dividing stroke volume by end diastolic volume -def: amount ejected per beat

stroke volume

cardiac output: this is the volume of blood ejected during systole in L/ beat

factors that determine cardiac output

cardiac output: what does this list describe? 1. preload 2. afterload 3. myocardial contractility 4. heart rate

moderate TBI (moderate concussion)

categories of TBI: loss of consciousness 30 minutes to 6 hours; confusion w/ amnesia longer than 24 hours -often permanent deficits in selective attention, vigilance, detection, working memory, data processing, vision or perception, language, mood

severe TBI (severe concussion)

categories of TBI: loss of consciousness longer than 6 hours; severe cognitive system defects -some indivs remain in vegetative state or die as a result of brain injury or secondary complications

mild TBI (mild concussion)

categories of TBI: no or short loss of consciousness; confusion for several minutes, retrograde amnesia -most blunt trauma injuries cause this form of TBI

neurons

cells of the nervous system: these are the primary cell of the nervous system; electrically excitable -vary in size and structure throughout the nervous system -func: transmits and receives info

neuroglial cells

cells of the nervous system: these provide structural support, protection, and nutrition for neurons, and facilitate neurotransmission

neurons; neuroglial cells

cells of the nervous system: two different types of cells constitute nervous tissue: ___________ and supporting ___________

metastatic brain tumors

central nervous system tumors: ___________ from systemic cancers are 10 times more common than primary brain tumors, and about 20% to 40% of persons w/ cancer have metastasis to the brain

primary brain tumors

central nervous system tumors: also called gliomas; these originate from brain substance, including neuroglia, neurons, cells of blood vessels, and connective tissue -include astrocytomas, oligodendroglioma, gliobastoma multiforme, ependymomas

extracerebral tumors

central nervous system tumors: these originate outside substances of the brain and include meningiomas, acoustic nerve tumors, and tumors of the pituitary and pineal glands -include meningiomas, nerve sheath tumors (neurofibramtosis), and metastatic brain tumors

survivors

cerebral death: __________ of cerebral death: -remain in coma -emerge in persistent vegetative state -progress into a minimally conscious state -locked-in syndrome

persistant vegetative state

cerebral death: complete unawareness of the self or surrounding environment and complete loss of cognitive function

minimally conscious state (MCS)

cerebral death: in a ___________ indivs may follow simple commands, manipulate or reach for objects, gesture or give yes/no responses, have intelligible speech, and have movements such as blinking or smiling

locked in syndrome

cerebral death: there is complete paralysis of voluntary muscles w/ the exception of eye movement -indiv cannot communicate thru speech or body movement but fully conscious w/ intact cognitive function

cytotoxic edema

cerebral edema: cellular brain edema; accumulation of fluid is in the cells of the brain (neuronal, glial, and endothelial cells) rather than in the interstitial spaces -blood-brain barrier is intact -occurs w/ head injury, hypoxia, and arterial infarction

vasogenic edema

cerebral edema: caused by inc permeability of capillaries that compromise the blood-brain barrier => plasma proteins leak into extracellular spaces, draw water, and inc water content in brain interstitial spaces -clinically the most important and common type

interstitial/ hydrocephalic edema

cerebral edema: most often seen w/ noncommunicating hydrocephalus; movement of CSF from lining of the ventricles into the extracellular spaces of the brain tissues

ischemic

cerebral infarction: area pales and softens, necrosis

hemorrhagic

cerebral infarction: bleeding occurs in infarcted area

ischemic penumbra

cerebral infarction: there is a central core of irreversible irreversible ischemia and necrosis, surrounded by ___________ -prompt infusion of thrombolytic agents may restore perfusion in ______ (same word) and prevent necrosis -3 hour window of opportunity

brain abnormalities

cerebrovascular disease (CVD): ___________ induced by CVD are ischemia w/ or w/o infarction or hemorrhage

blood vessel abnormalities

cerebrovascular disease (CVD): ___________ induced by CVD are lesions, occlusions, rupture of vessel, or alterations in blood quality

epilepsy

cerebrovascular disease: _________ is diagnosed when a child has more than one unprovoked seizure

seizures

cerebrovascular disease: _________ may result from diseases that are neurologic (CNS) or systemic (affect CNS function secondarily)

childhood stroke

cerebrovascular disease: __________ may be divided into 2 categories: ischemic and hemorrhagic

hemorrhagic

cerebrovascular disease: ___________ stroke is most commonly caused by bleeding from congenital cerebral arteriovenous malformations and is rare in children younger than 19

ischemic (occlusive)

cerebrovascular disease: ____________ stroke is rare in children and may result from embolism, sinovenous thrombosis, or congenital or iatrogenic narrowing of vessels -dec flow of blood and oxygen to areas of the brain

moyamoya disease

cerebrovascular disease: rare, chronic, progressive vascular stenosis of the circle of Willis -obstruction of arterial flow to the brain -development of small basal arterial collateral vessels -means puff of smoke -> appearance of small vessels

febrile seizures

cerebrovascular disease: these are benign seizures and are the most common type of childhood seizure

perinatal stroke

cerebrovascular disease: this is a leading cause of perinatal brain injury, CP, and lifelong disability -risk: clotting abnormalities

right ventricle

chambers of the heart: the ________ is shaped like a crescent or triangle enabling a bellows-like action that efficiently ejects large volumes of blood thru the pulmonary semilunar valve into low-pressure pulmonary system

left ventricle

chambers of the heart: the __________ is shaped like a bullet, which allows it to generate enough pressure to eject blood thru a relatively larger aortic semilunar valve into high-pressure systemic circulation

ventricles

chambers of the heart: the right and left _______ have a thicker myocardial layer and constitute much of the bulk of the heart -must propel blood all the way thru pulmonary or systemic vessels

atria

chambers of the heart: the right and left _________ have smaller and thinner walls -low pressure chamber units that serve as storage units and channels for blood

right atrium, left atrium, right ventricle, left ventricle

chambers of the heart: what are the four chambers of the heart?

left ventricle

chambers of the heart: which of the ventricles has a wall that is 3 times thicker than the other because of pressure having to overcome in systemic circulation?

retinoblastoma

childhood tumors: rare congenital eye tumor of young children that originates in the retina of one or both eyes -2 forms: inherited and acquired

acquired

childhood tumors: the ________ form of retinoblastoma is most commonly diagnosed in children 2 to 3 years of age and involves unilateral disease -more common form

inherited

childhood tumors: the _________ form of retinoblastoma is generally diagnosed during the 1st year of life -least common form

embryonal tumors

childhood tumors: the most common brain tumors are __________, including medulloblastoma, atypical teratoid rhabdoid tumors, CNS primitive neuroectodermal tumors, and high-grade gliomas

neuroblastoma

childhood tumors: embryonal tumor originating from neural crest tissues of the SNS outside the CNS -most common cancer in infants of less than 1 year of age -associated w/ spontaneous remission

macular edema

chronic complications of diabetes mellitus: __________ is the leading cause of blurred vision among persons w/ diabetes

cardiovascular disease

chronic complications of diabetes mellitus: ____________ is the primary cause of death of people w/ diabetes, w/ higher risk for women -cause: usually hypertension -reduced mechanical compliance of the heart during filling w/ diastolic and eventually systolic failure

microvascular disease

chronic complications of diabetes mellitus: _____________ complications include diabetic retinopathy, diabetic neuropathy, and diabetic neuropathies

macrovascular disease

chronic complications of diabetes mellitus: _______________ complications include cardiovascular disease, stroke, and peripheral vascular disease

diabetic nephropathy

chronic complications of diabetes mellitus: diabetes is the most common cause of chronic kidney disease and end-stage kidney disease, having dearly half of indivs w/ DM developing ________________ -progressive glomerulosclerosis and dec glomerular blood flow and filtration => renal failure

peripheral vascular disease

chronic complications of diabetes mellitus: diabetes mellitus inc the incidence of ______________ -more diffuse and often involves arteries below the knee -can lead to claudication, ulcers, gangrene, and amputation -inc risk for infection

infection

chronic complications of diabetes mellitus: the indiv w/ diabetes is at an inc risk for __________ throughout the body because of impaired senses, hypoxia, pathogens, blood supply, and suppressed immune response

stroke

chronic complications of diabetes mellitus: this is 2x more common in those w/ diabetes than those who do not -accelerated atheroscleosis of vessels results from insulin resistance and hyperglycemia

diabetic retinopathy

chronic complications of diabetes mellitus: this is the leading cause of blindness worldwide and is a common complication of T2DM -causes: relative hypoxemia, damage to retinal blood vessels, RBC aggregation, hypertension

diabetic neuropathies

chronic complications of diabetes mellitus: this is the most common complication of diabetes -somatic and peripheral nerve cells show diffuse or foal damage -loss of pain, temp, and vibration sensation

chronic myelogenous leukemia (CML)

chronic leukemias: this is when there are too many blood cells made in the bone marrow -tx: chemo, biologic response modifiers, stem cell transplant

chronic lymphocytic leukemia (CLL)

chronic leukemias: this is when there are too many immature lymphocytes -most common adult leukemia in western world -tx: observation w/ symptom treatment

right heart

circulatory system: pulmonary circulation -pumps blood thru the lungs

left heart

circulatory system: systemic circulation -pumps blood thru the body

white adipose tissue (WAT)

classification of adipose tissue: derived from connective tissue and located in visceral (central) and subcutaneous (peripheral) stores, muscle, and bone marrow -single lipid droplet (or vacuole) -release free fatty acids and glycerol for energy metabolism

brown adipose tissue (BAT)

classification of adipose tissue: derived from muscle tissue and have multiple lipid droplets, rich in mitochondria -generate heat thru oxidation of fatty acids and glucose: nonshivering thermogenesis, neonatal heat generation, protects against obesity

beige adipose tissue

classification of adipose tissue: this is found in WAT, and has multiple mitochondria like BAT; emerge w/ chronic exposure to cold or exercise (beiging or browning of WAT) -diminished in obesity

bone marrow adipose tissue (MAT)

classification of adipose tissue: this is found in all bones and inc w/ obesity and age -excessive = osteoporosis and fractures

subdural hematoma

closed brain injury: bleeding b/w the dura mater and the arachnoid membrane covering the brain -cause: tearing of veins -most common cause of traumatic intracranial mass lesion -characteristics: headache, drowsiness, restlessness or agitation, slowed cognition, and confusion

epidural hematoma

closed brain injury: bleeding b/w the dura mater and the skull -most common site: temporal fossa -characteristics: losing consciousness at injury, headahe of inc severity, vomiting, drowsiness, confusion, seizure occur

intracerebral hemorrhage

closed brain injury: bleeding w/in the brain; most commonly located in front and temporal lobes -inc ICP, compress brain tissues, and causes edema -characteristics: dec level of consciousness; contralateral hemiplegia

contusions

closed brain injury: compression of the skull at the point of impact produces __________ or brain bruising from blood leaking from an injured vessel -may be evidenced by an immediate loss of consciousness, loss of reflexes, transient cessation of respiration, brief period of bradycardia, dec in BP

contrecoup

closed brain injury: describes injury opposite the site of impact -brain rebounds and hits opposite side of the skull

coup

closed brain injury: describes injury that is directly below the point of impact

closed brain injuries

closed brain injury: what does this list describe? -contusions -subdural or epidural hematoma -intracerebral hemorrhage

circadian rhythm sleep disorder

common disorders of the 24 hour sleep-wake schedule that desynchronize circadian rhythm -long term health consequences

insomnia

common dyssomnias: the inability to fall or stay asleep -accompanied by fatigue, maliase, and difficulty w/ performance while awake -mild, moderate, or severe -may be transient or chronic

posttraumatic seizures

complications of TBI: these can occur w/in days, last up to 2-5 years post injury; seizure prevention initiated early w/ moderate to severe TBI

chronic traumatic encephalopathy (CTE)

complications of TBI: this is a progressive dementing disease from repeated injury -assoc injuries: sports injuries, blast trauma, work-related head trauma -characteristics: violent behaviors, loss of control, depression, memory loss, change in cognition and motor function

postconcussion syndrome

complications of TBI: this lasts for weeks or months post mild concussion; symptomatic relief w/ observation -characteristics: headache, dizziness, fatigue, nervousness, anxiety, irritability, insomnia, depression, inability to concentrate, forgetfulness

blood clot

components of hemostasis: __________ is a meshwork of protein (fibrin) strands that stabilizes platelet plug

platelet activation

components of hemostasis: damage to vessel initiates __________ which is inc platelet adhesion to the damaged wall, activation leading to platelet degranulation, and aggregation, as adherence increases

von Willebrand factor (vWF)

components of hemostasis: endothelial cells in blood vessels contain intracellular structures that contain _________ which is released during vascular injury and activates platelets -happens when underlying subendothelial matrix is exposed

platelets

components of hemostasis: the functions of _________ are: -regulate blood flow by inducing vasoconstriction -form platelet plug to stop bleeding -activate coagulation cascade to stabilize platelet plug -initiate repair process (clot retraction, clot dissolution

clotting (coagulation) system

components of hemostasis: the strands are made of fibrin, which is produced by the _____________ -present as 2 pathways of initiation (intrinsic and extrinsic) that join in a common pathway

intrinsic pathway

components of hemostasis: this is activated when factor XII (Hageman factor) contacts subendothelial substances exposed by vascular injury

extrinsic pathway

components of hemostasis: this is activated when tissue thromboplastin is released by damaged endothelial cells and reacts w/ clotting factors

adhesion

components of hemostasis: this is when platelets become sticky t the site of endothelial damage -mostly mediated by binding of platelet surface receptor glycoprotein Ib to vWF

common pathway

components of hemostasis: this occurs through the activation of factor X proceeding to clot formation -both initiation pathways lead to this

activation

components of hemostasis: this results in reorganization of platelet cytoskeleton, leasing to dybamic changes in platelet shape from smooth spheres to those w/ spiny projections and degranulation

blood vessels

components of hemostasis: walls of these contain endothelial cells adhering to subendotehlial matrix pf connective tissue -normally produce nitric oxide (NO) and prostacyclin -regulate blood flow and prevent clotting system

leukocytes

composition of blood: also called white blood cells; these defend against infection and remove debris; act in the tissues but transported by circulation

biconcavity; reversible deformity

composition of blood: erythrocytes contain __________ which provides surface area/volume ratio that is optimal for gas diffusion, and ________ which allows it to squeeze into and out of a cell with ease

structure

composition of blood: leukocytes are classified by __________ as either granulocytes and agranulocytes

neutrophils

composition of blood: most numerous of the granulocytes; these are phagocytes in early inflam -also called PMN

globulins

composition of blood: plasma proteins that consist of carrier proteins and immunoglobulins

albumin

composition of blood: plasma proteins that function as carriers and control the plasma oncotic pressure -most abundant plasma protein

clotting factors/proteins

composition of blood: plasma proteins that promote coagulation, mainly fibrinogen (most plentiful of these plasma proteins)

6

composition of blood: the blood volume amounts to about ____ quarts in adults

91; 9

composition of blood: the composition of blood is _____% water and ____% solutes

monocytes

composition of blood: these agranulocytes are immature macrophages -once mature, these will make up the mononuclear phagocyte system (MPS)

natural killer (NK) cells

composition of blood: these agranulocytes kill some types of tumor cells and some virus-infected cells w/o prior exposure

lymphocytes

composition of blood: these agranulocytes mature to be T cells, B cells, or plasma cells -primary cells of the immune response

erythrocytes

composition of blood: these are also called red blood cells; most abundant cells in the blood that are responsible for tissue oxygenation -have a 100-120 day life cycle

platelets (thrombocytes)

composition of blood: these are irregularly-shaped cytoplasmic fragments that are essential for blood coagulation and control of bleeding

agranulocytes

composition of blood: these contain relatively fewer granules than granulocytes and include monocytes, macrophages, and lymphocytes

basophils

composition of blood: these granulocytes are structurally and functionally similar to mast cells

eosinophils

composition of blood: these granulocytes ingest antigen-antibody complexes and are induced by IgE hypersensitivity -inc in parasitic infections

granulocytes

composition of blood: these leukocytes contain membrane bound granules in their cytoplasm, which contain enzymes capable of destroying microorganisms -have inflam and immune funcs -capable of ameboid movement (diapedesis): migrate to site where their action is needed

plasma

composition of blood: this amounts to 50-55% of the blood volume; liquid portion of the blood that contains organic and inorganic elements

erythrocytes and leukocytes

composition of blood: what are the two cellular components of blood (besides platelets)?

plasma proteins

composition of blood: what does this list describe? -albumin -globulins -clotting factors/proteins

chief functions of blood

composition of blood: what does this list describe? -delivery of substances needed for cellular metabolism -removal of wastes -defense against microorganisms and injury -maintenance of acid-base balance

bundle of His (AV bundle)

conduction system of the heart: conducting fibers from the AV node converge to form the ____________ w/in the posterior border of the intraventricular septum

atrioventricular node (AV)

conduction system of the heart: each AP travels rapidly from cell to cell and thru atrial myocardium, carrying the AP onward to the ___________ as well as causing both atria to contract, beginning systole -func: conduct APs onward to ventricles -innervated by nerves from autonomic parasympathetic ganglia

sinoatrial node (SA)

conduction system of the heart: normally, electrical impulses arise in the ___________, the usual pacemaker of the heart -heavily innervated by both sympathetic and parasympathetic nerve fibers

right and left bundle branches

conduction system of the heart: the bundle of His then gives rise to the _________________

pacemakers

conduction system of the heart: these are cells that initiate signal -concentrated at two sites of the myocardium: sinoatrial node (SA) and atriovenricular node (AV)

purkinje fibers

conduction system of the heart: these are the terminal branches of the right bundle branch and the left bundle branch -extensive network of these promote rapid spread of impulse to ventricular apexes

left bundle branch

conduction system of the heart: this divides into two branches, or fassicles -somewhat protected from injury caused by wear and tear bc blood flow thru portion of left ventricle is relatively nonturbulent

right bundle branch

conduction system of the heart: this is thin and travels w/o much branching to the right ventricular apex -susceptible to interruption of impulse conduction by damage to endocardium

cyanotic heart defects; right-to-left shunt

congenital heart disease: ____________ frequently cause shunting of blood from the right side of the heart directly into the left side of the heart, also known as ____________ -tetralogy of fallot is most common ________(same 1st word)

cyanosis

congenital heart disease: a right-to-left shunt dec blood flow thru the pulmonary system, causing less-than-normal oxygen delivery to the tissues and resulting in a bluish discoloration of the skin called ___________

shunt

congenital heart disease: abnormal movement from one side of the hear to the other is termed a ________

blood flow pattern

congenital heart disease: congenital heart defects can be classified by ____________: -inc pulmonary blood flow -causing obstruction of blood flow from ventricles -dec pulmonary blood flow -causing mixed desaturated w/ saturated blood in chambers or great arteries

acyanotic heart defects

congenital heart disease: defects that cause left-to-right shunt are termed ______________, because blood continues to flow through the lungs before passing systemic circulation and does not cause decrease in tissue oxygenation

left-to-right shunt

congenital heart disease: shunting of blood flow from the left heart into the right heart is called a _____________ and occurs in conditions such as atrial septal defect and ventricular septal defect

endothelial cell surface

control of hemostatic mechanisms: spontaneous hemostasis is prevented by factors in the ______________ including antithrombin, tissue factor inhibitors, and protein C

autonomic nervous system

coordinates and maintains steady state among the visceral (internal) organs -components located in both CNS and PNS, but considered to be part of the PNS -2 antagonistic divisions: sympathetic and parasympathetic

hypertension

coronary artery disease: ___________ is responsivle for a twofold to threefold inc risk of atherosclerotic cardiovasc disease -contributes to endothelial injury

prinzmetal angina

coronary artery disease: abnormal vasospasm of coronary vessels results in unpredictable chest pain called _____________ -often occurs at rest

cigarette smoking

coronary artery disease: both direct and passive (environmental) __________ inc the risk of CAD -direct effect on endothelial cells and generation of oxygen free radicals contributing to atherogenesis

stable angina

coronary artery disease: chronic coronary obstruction results in recurrent predictable chest pain called ___________

mental stress-induced ischemia

coronary artery disease: chronic stress has been linked to an inc in the number of inflam cytokines and a hypercoagulable state that may contribute to _____________

diabetes mellitus

coronary artery disease: insulin resistance and _________ are extremel important risk factors for CAD -damage to endothelium, thickening of vessel wall, inc inflam, inc thrombosis, glycation of vasc proteins, dec production of endothelial-derived vasodilators

silent ischemia

coronary artery disease: myocardial ischemia that does not cause detectable symptoms is called _____________ -primary cause: abnormalities in autonomic innervation -> diabetes mellitus

atherogenic diet

coronary artery disease: this is a diet high in salt, fats, trans-fats, and carbohydrates

transient myocardial ischemia

coronary artery disease: this is a local, temporary deprivation of coronary blood supply

troponin I

coronary artery disease: this is a serum protein whose measurement is used as a sensitive and specific diagnostic test to help identify myocardial injury during acute coronary syndromes

acute coronary syndromes

coronary artery disease: this is the result of when there is sudden coronary obstruction caused by thrombus formation over a ruptured atherosclerotic plaque -includes unstable angina or myocardial infarction

dyslipidemia

coronary artery disease: this refers to abnormal conc of serum lipoproteins -result of combination of genetic and dietary factors -risk factor for CAD

unstable angina

coronary artery disease: this results from reversible myocardial ischemia -harbinger of impending infarction

myocardial infarction

coronary artery disease: this results when there is prolonged ischemia causing irreversible damage to the heart muscle

high density C-reactive protein

coronary artery disease: what is the most important marker of inflam attributed to an inc in CAD risk?

modifiable risk factors for CAD

coronary artery disease: what does this list describe? 1. dyslipidemia 2. hypertension 3. cigarette smoking 4. diabetes mellitus and insulin resistance 5. obesity/sedentary lifestyle 6. atherogenic diet

nonmodifiable risk factors for CAD

coronary artery disease: what does this list describe? 1. inc age 2. family history 3. male gender or female gender postmenopause

nontraditional risk factors for CAD

coronary artery disease: what does this list describe? 1. markers of inflam and thrombosis: high density C reactive protein, troponin 1 2. adipokines 3. chronic kidney disease 4. air pollution and ionizing radiation 5. certain medications 6. microbiome

coronary veins

coronary circulation: after passing thru the capillary network, blood from the coronary arteries drains into the ________ located alongside the arteries -great cardiac vein, coronary sinus, posterior vein of the left ventricle

great cardiac vein; coronary sinus

coronary circulation: after venous drainage in the visceral pericardium, the veins then feed into the _________ and _________ on the posterior surface of the heart, between the atria and ventricles, in the coronary sulcus

left coronary artery

coronary circulation: the ________ divides into the left anterior descending artery and the circumflex artery

right coronary artery

coronary circulation: the ___________ branches into the conus, right marginal branch, and posterior descending branch

coronary capillaries

coronary circulation: the heart requires an extensive ___________ network to function, as this is where oxygen and other nutrients enter the myocardoum while waste products enter the blood

collateral arteries

coronary circulation: these are connections or anastomoses, b/w branches of the same coronary artery or connections of branches of the right coronary artery w/ branches of the left

left anterior descending artery

coronary circulation: this supplies blood to portions of the left and right ventricles and much of the interventricular septum

circumflex artery

coronary circulation: this supplies blood to the left atrium and the lateral wall of the left ventricle

conus

coronary circulation: this supplies blood to the upper right ventricle

posterior descending branch

coronary circulation: this supplies smaller branches to both ventricles

right marginal branch

coronary circulation: this supplies the right ventricle to the apex

lymphatic vessels

coronary circulation: with cardiac contraction, the __________ drain fluid to lymph nodes in the anterior mediastinum that empty into the superior vena cava -important for protecting myocardium against infection and injury

plagiocephaly

craniosynostosis: this is an asymmetric shape of the skull; used to describe deformities that result from craniosynostosis or from asymmetric head posture

dementia mechanisms

data processing deficits: __________ include neuron degeneration, brain tissue compression, atherosclerosis, brain trauma, and infection and neuroinflammation

dementia

data processing deficits: an acquired deterioration and progressive failure of many cerebral functions including impairment of intellectual processes -loss of orientation, memory, language, judgement and decision making

delirium

data processing deficits: an acute disturbance in attention ans awareness, associated w/ autonomic nervous system overactivity and typically develops over 2-3 days -manifestations: restlessness, irritability, difficulty in concentrating, insomnia, tremulousness, poor appetite

aphasia

data processing deficits: defect of language comprehension or production; usually associated w/ cerebrovascular accident -types: expressive, receptive, transcortical, global dysphasia

agnosia

data processing deficits: defect of pattern recognition -can be tactile, visual, or auditory; generally one sense is affected -associated most commonly w/ cerebrovascular accidents

expressive aphasia

data processing deficits: known as Broca, motor, or nonfluent aphasia; involves loss of ability to produce spoken or written language, w/ slow or difficult speech

receptive aphasia

data processing deficits: known as Wernicke, sensory, or fluent aphasia; involves in inability to understand written or spoken language -speech is fluent but words and phrases have no meaning

global aphasia

data processing deficits: most severe aphasia; involves both expressive and receptive aphasia -indiv is nonfluent or mute; cannot read or write; has impaired comprehension, naming, reading, and writing

transcortical aphasia

data processing deficits: rare and can be motor, sensory, or mixed -involve areas of the brain that connect into the language centers

acute confusional states (ACSs)

data processing deficits: transient disorders of cognitive function, consciousness, or perception -arises from brain networks, not a discrete area of the brain -ex. delirium

hyperactive; hypoactive

data processing deficits: what are the two types of delirium?

tricuspid atresia

defects dec pulmonary blood flow: this is failure of the tricuspid valve to develop; lack of communication b/w the right atrium and right ventricle -associated defects: pulmonic stenosis; transportation of the great arteries -manifestations: in newborn -> cyanosis, tachycardia, dyspnea, poor feeding; in older child -> signs of chronic hypoxemia w/ clubbing

tetralogy of fallot

defects dec pulmonary blood flow: this syndrome is represented by 4 defects 1) large ventricular septal defect (VSD) 2) overriding aorta that straddles the VSD 3) pulmonary valve stenosis 4) right ventricle hypertrophy -manifestations: acute cyanosis at birth or gradual cyanosis; acute episodes of cyanosis and hypoxia: "tet" spells; difficulty feeding and poor growth

sinus venosus ASD

defects w/ inc pulmonary blood flow: __________ is an opening usually high in the atrial wall near the junction of the superior vena cava and may be associated w/ partial anomalous pulmonary venous connection

ostium secundum ASD

defects w/ inc pulmonary blood flow: ____________ is an opening in the middle of the atrial septum and is the most common type

ostium primum ASD

defects w/ inc pulmonary blood flow: ____________ is an opening low in the atrial septum and may be associated w/ abnormalities of the mitral valve

perimembranous VSD

defects w/ inc pulmonary blood flow: _______________ are located high in the ventricular septal wall underneath the AV valves

muscular VSD

defects w/ inc pulmonary blood flow: ________________ are located low in the septal wall

Eisenmenger syndrome

defects w/ inc pulmonary blood flow: irreversible pulmonary hypertension can result in __________, in which shunting of blood is reversed because of high pulmonary pressure and resistance (right-to-left shunt w/ cyanosis)

atrial septal defect (ASD)

defects w/ inc pulmonary blood flow: this is an abnormal opening b/w the atria; blood flows/shunts from left atria to right atria -3 major types: ostium primum, ostium secundum, sinus venosus -manifestations: asymptomatic @ early age; pulmonary symptoms on exertion at later age

ventricular septal defect (VSD)

defects w/ inc pulmonary blood flow: this is an opening b/w the ventricles; blood flows from the left ventricle to the right ventricle -most common type of congenital heart lesion -two types: perimembranous, muscular -manifestations: may be asymptomatic; inc pulmonary blood flow from left-to-right shunt; pulmonary hypertension (Eisenmenger syndrome)

patent ductus ateriosus (PDA)

defects w/ inc pulmonary blood flow: this is the failure of the ductus arteriosis to close, allowing blood to shunt from the aorta to pulmonary artery, causing left-to-right shunt -manifestations: asymptomatic or signs of pulmonary distress (i.e. dyspnea, fatigue, poor feeding); characteristic machinery-like murmur -complications: risk for bacterial endocarditis; pulmonary hypertension later in life

atrioventricular canal defect (AVC)

defects w/ inc pulmonary blood flow: this results from incomplete fusion of the endocardial cushions; demonstrates abnormalities in the atrial and ventricular septa and atrioventricular valves -manifestations: left-to-right shunt and pulmonary overcirculation; irreversible pulmonary hypertension if untreated -common cardiac defect in those w/ Down syndome

acute LBP

degenerative disorders of the spine: _______ is often associated w/ muscle or ligament strain and is more common n indivs younger than 50 yrs of age w/o history of cancer

herniated intervertebral disk

degenerative disorders of the spine: a displacement of nucleus pulposus or annulus fibrosis beyond intervertebral disk space -causes: trauma, degenerative disk disease, both -symptoms: radiculopathy, pain, paresthesia

low back pain (LBP)

degenerative disorders of the spine: affects the areas between the lower rib cage and gluteal muscles and often radiates into the thighs; most cases idiopathic or nonspecific -80% of people will experience at some time -categories: acute (include sciatica); chronic (include cauda equine syndrome)

chronic LBP

degenerative disorders of the spine: common causes of __________ include degenerative disk disease, spondylolysis, spondylolisthesis, spinal osteochrondrosis, spinal stenosis, and lumbar disk herniation

sciatica

degenerative disorders of the spine: inflammation of sciatic nerve; accompanied by neurosensory and motor deficits, such as tingling, numbness, and weakness in various parts of leg and foot -associated w/ acute LBP

degenerative disk disease (DDD)

degenerative disorders of the spine: this is a normal part pf aging plus genetic predisposition -response to continuous vertical compression of the spine

spondylolysis

degenerative disorders of the spine: this is a structural defect (degeneration, fracture, or developmental defect) in pairs interarticularis of vertebral arch (joining of vertebral body to the posterior structures) -symptoms: lower back and lower limb pain

spondylolisthesis

degenerative disorders of the spine: this is an osseous defect in pairs interarticularis -allows vertebra to slide anteriorly -management: exercise, rest, back bracing

cauda equina syndrome

degenerative disorders of the spine: this is new onset bowel or bladder incontinence or urinary retention, loss of anal sphincter tone, and saddle anesthesia -associated w/ chronic LBP

spinal stenosis

degenerative disorders of the spine: this is the narrowing of the spinal canal that puts pressure on spinal nerves or cord -can be congenital or acquired (more common) -assoc w/ trauma and arthritis

multipotent stem cells

development of blood cells: cellular differentiation results in ______________, which are an intermediate group of stem cells w/ limited abilities to differentiate into many different types of cells

red marrow

development of blood cells: referred to as active or hematopoietic; found in primarily flat bones in adults and is vascularized

yellow marrow

development of blood cells: referred to as inactive; found in other bones -may change to active bone marrow if sensed to by the body

bone marrow niches

development of blood cells: the hematopoietic marrow consists of a variety of cellular and molecular microenvironments, called _______________, which support the cells by direct cell-to-cell signaling and production of growth factors and cytokines important for retention, expansion, maintenance, and quiescence of HSCs

hematopoietic stem cells (HSCs)

development of blood cells: these develop into blood cells and contain colony stimulating factors (CSFs) -self renewing: proliferate w/o further differentiation

mensenchymal stem cells

development of blood cells: these develop into osteoclasts, fibroblasts, chrondrocytes, and adipocytes and maintain HSCs

colony stimulating factors (CSFs)

development of blood cells: these stimulate the proliferation of progenitor cells and their progeny and initiate the maturation events necessary to produce fully mature cells

erythropoietin

development of blood cells: this is a hormone produced primarily by the kidney that stimulates erythrocyte production

bone marrow

development of blood cells: this is confined to the cavities of the bone and is the primary site of residence of hematopoietic stem cells -2 types: red and yellow

mensenchymal stem cells (MSCs) and hematopoietic stem cells (HSCs)

development of blood cells: what are the two populations found in bone marrow niches?

functional; stored

development of leukocytes: granulocytes become two pools of cells: _______ and circulating in the bloodstream or _______ in blood vessel walls, often called the marginating storage pool

myelopoiesis

development of leukocytes: this is the development of granulocytes and monocytes -mature in bone marrow

lymphopoiesis

development of leukocytes: this is the development of lymphocytes -released into blood stream and mature in lymphoid organs

ectoderm

development of nervous system in children: develops from embryonic __________ in a complex sequential process -begins on about day 40 -by day 175, brain has developed all parts

head

development of nervous system in children: the ______ is the fastest growing part of the body during infancy

fontanelles

development of nervous system in children: the bones of an infant's skull are separated at the suture lines, forming two ________ or "soft spots" in the skull -allows for expansion of rapidly growing brain

hypopituitarism

diseases of the anterior pituitary: this is an absence or failure of the anterior pituitary hormones -causes: pituitary infarction, space-occupying lesions (two most common causes), traumatic brain injury (TBI), removal of destruction of gland, infections, autoimmune hypophysis -symptoms related to cortisol insufficiency

acromegaly

diseases of the anterior pituitary: this is the hypersecretion of GH (growth hormone) during adulthood

hyperpituitarism

diseases of the anterior pituitary: this is the hypersecretion of anterior pituitary hormones; commonly caused by benign slow-growing pituitary adenoma -manifestations: related to tumor growth and hormone hyper/hyposecretion

giantism

diseases of the anterior pituitary: this is the hypersecretion of growth hormone (GH) in children whose epiphyseal plates have not yet closed

prolactinoma

diseases of the anterior pituitary: this is the hypersecretion of prolactin; most common hormonally active pituitary tumors -cause: pituitary tumors that secrete prolactin -manifestations: women (amennorhea, galacactirrhea, hiruitism, osteopenia); men (gynecomastia, hypogonadism, erectile dysfunction)

panhypopituitarism

diseases of the anterior pituitary: this is when all hormones of the anterior pituitary are deficient -indiv suffers multiple complications

hypertension

diseases of the arteries: this is consistent elevation of systemic arterial blood pressure; sustained systolic BP of 130 mm Hg or greater or a diastolic pressure of 80 mmHg or greater -can be primary or secondary

atherosclerosis

diseases of the arteries: this is a form of arteriosclerosis that results in thickening and hardening caused by accumulation of lipid-laden macrophages in the arterial wall -plaque development -risk factors: diabetes, smoking, hyperlipidemia/dyslipidemia, hypertension, autoimmunity -results in inadequate perfusion, ischemia, and necrosis

aneurysm

diseases of the arteries: this is a local dilation or outpouching of a vessel wall or cardiac chamber -types: true or false

coronary artery disease

diseases of the arteries: this is any vascular disorder that narrows or occludes the coronary arteries leading to myocardial ischemia -most common cause: atherosclerosis -primary cause of heart disease in US

peripheral artery disease

diseases of the arteries: this refers to atherosclerotic disease of arteries that perfuse limbs, especially the lower extremities

nephrogenic diabetes insipidus

diseases of the posterior pituitary: DI caused by inadequate response to ADH

neurogenic diabetes insipidus

diseases of the posterior pituitary: DI caused by insufficient secretion of ADH

diabetes inspidus (DI)

diseases of the posterior pituitary: this is characterized by an insufficiency of ADH causing loss of too much water -two forms: neurogenic and nephrogenic -manifestations: polyuria, nocturia, and continuous thirst

syndrome of inappropriate antidiuretic hormone secretion (SIADH)

diseases of the posterior pituitary: this is characterized by the hypersecretion of ADH -cause: ectopic production of ADH by tumors, pulmonary, or CNS disorders, surgery, or meds -clinical manifestations: related to hyponatremia and determined by severity

thromboembolus

diseases of the veins: a detached thrombus is a ___________

venous stasis ulcers

diseases of the veins: poor circulation makes tissues vulnerable to trauma and infection resulting in the formation of _____________ and cellulitis

triad of virchow

diseases of the veins: the factors promoting thrombosis are known as the _____________, and include venous stasis (i..e immobility, age, heart failure), venous endothelial damage (i.e. trauma, surgery, IV meds), and hypercoagulable stress (i.e. inherited disorders, malignancy, pregnancy, use of oral contraceptives, HRT)

thrombus

diseases of the veins: this is a blood clot that remains attached to a vessel wall

superior vena cava syndrome

diseases of the veins: this is a progressive occlusion of the superior vena cava; leads to venous distention of upper extremities and head -oncologic emergency

varicose vein

diseases of the veins: this is a vein in which blood has pooled; distended, tortuous, and palpable veins -cause: trauma or gradual venous distention -risk factors: age, female gender, family history, obesity, pregnancy deep vein thrombosis, prior leg injury

thrombosis formation in veins

diseases of the veins: this is an obstruction of venous flow leading to inc venous pressure

chronic venous insufficiency

diseases of the veins: this is inadequate venous return over a long period of time -cause: varicose veins; valvular incompetence

other factors promoting thrombosis

diseases of the veins: what does this list describe? -cancer -orthopedic surgery/ trauma -heart failure -immobility

communication

disorders of expression involve the motor aspects of __________ and include hypermimesis, hypomimesis, and dyspraxia/apraxia

apraxia/ dyspraxia

disorders of expression: disorder of learned skilled movements w/ difficulty planning and executing coordinated motor movements -difficulty speaking, writing, using tools or utensils, playing sports, following instructions, focusing -connecting pathways b/w left and right cortical areas are interrupted

hypomimesis

disorders of expression: manifests as aprosody -> loss of emotional language -receptive aprosody: inability to understand emotion in speech and facial expression -expressive aprosody: inability to express emotion in speech and facial expression

hypermimesis

disorders of expression: this commonly manifests as pathologic laughter or crying -laughter: right hemisphere -crying: left hemisphere

frontal lobe ataxic gait

disorders of gait: assoc w/ start hesitation, gait ignition failure, a wide-based gait, body sway and falls, loss of control of truncal motion, shuffling and freezing

basal ganglion gait

disorders of gait: broad-based gait in which the person walks w/ small steps and a dec arm swing -head and body flexed; arms semiflexed and abducted -assoc w/ Parkinson's

upper motor neuron gait

disorders of gait: indiv may have footdrop, fatigue, hip and leg pain; legs swing around the body rather than being appropriately lifted and placed; foot may drag on ground and person tends to fall on the affected side

cerebellar (ataxic) gait

disorders of gait: wide-based w/ feet apart and often tuned outward or inward for greater stability -pelvis held stiff, indiv staggers when walking

decorticate posture/response

disorders of posture (stance): characterized by upper extremities flexed at the elbows and held close to the body and lower extremities that are externally rotated and extended -occurs when brainstem is not inhibited by cerebral cortex motor area

dystonia

disorders of posture (stance): maintenance of an abnormal posture through muscular contractions

basal ganglion posture

disorders of posture (stance): refers to a stooped, hyperflexed posture w/ a narrow-based, short-stepped gait -cause: basal ganglion dysfunction; loss of postural reflexes and not from defects in proprioceptive, labyrinthine, or visual function

decerebrate posture/response

disorders of posture (stance): refers to inc tone in extensor muscles and trunk muscles, w/ active tonic neck reflexes -all four limbs rigidly extended -cause: severe injury to the brain and brainstem

dystonic movements; dystonic postures

disorders of posture (stance): when muscular contractions are sustained for several seconds, they are called _________. when contractions last for longer periods, they are called ____________

hyperfunction; hypofunction

disorders of the adrenal cortex: disorders of the adrenal cortex are either related to _________ or ___________

hypercortical function

disorders of the adrenal cortex: hyperfunction that causes inc secretion of cortisol, called ______________, leads to Cushing disease or Cushing sydrome

hypocorticolism

disorders of the adrenal cortex: ______________, or low levels of cortisol secretion, develops either because of inadequate stimulation of adrenal glands by ACTH or because of primary inability of adrenals to produce and secrete the adrenocortical hormones

feminization

disorders of the adrenal cortex: hypersecretion of adrenal estrogens causes ___________, the development of female secondary sex characteristics

virilization

disorders of the adrenal cortex: hypersecretion of androgens causes ___________, the development of male secondary sex characteristics

congenital adrenal hyperplasia

disorders of the adrenal cortex: this is a deficiency in cortisol production causing inc in ACTH concentration

primary hyperaldosteronism (Conn syndrome)

disorders of the adrenal cortex: this is caused by an inc aldosterone secretion from abnormality in the adrenal cortex -manifestations: hypertension, hypokalemia, hypervolemia

secondary hyperaldosteronism

disorders of the adrenal cortex: this is caused by extra-adrenal stimulus of aldosterone secretion

hyperaldosteronism

disorders of the adrenal cortex: this is characterized by excessive adrenal secretion of aldosterone -both primary and secondary forms can occur

cushing syndrome

disorders of the adrenal cortex: hypercortical function ___________ refers to the clinical manifestations resulting from chronic excess cortisol, regardless of cause

cushing disease

disorders of the adrenal cortex: hypercortical function ___________ refers to the excess anterior pituitary secretion of ACTH

cushing disease manifestations

disorders of the adrenal cortex: hypercortical function what does this list describe? -weight gain in trunk ("truncal obesity"), facial ("moon face"), cervical areas ("buffalo hump") -glucose intolerance and protein wasting

secondary hypocortisolism

disorders of the adrenal cortex: hypocorticolism this is caused by dec ACTH leading to adrenal atrophy -results from prolonged exposure to exogenous glucocorticoids

addisonian crisis

disorders of the adrenal cortex: hypocorticolism this is hypotension leading to vascular collapse and shock -develops in indivs who have undiagnosed disease and experience physiologic stress

addison disease

disorders of the adrenal cortex: hypocorticolism this is primary adrenal insufficiency where autoimmune mechanisms destroy adrenal cortical cells

valvular dysfunctions

disorders of the endocardium: what does this list describe? 1. mitral valve prolapse syndrome 2. acute rheumatic fever and rheumatic heart disease 3. infective endocarditis

cardiomyopathies

disorders of the myocardium: these are a diverse group of diseases that affect the myocardium -can be primary or secondary -categorized as dilated, hypertrophic, or restrictive

dilated cardiomyopathy

disorders of the myocardium: this is characterized by impaired systolic function leading to increases in intracardiac volume, ventricular dilation, and heart failure w/ reduced EF -results from: ischemic heart disease, valvular disease, diabtes, renal failure, alcohol or drug toxicity, peripartum complications, or infection -genetic basis

restrictive cardiomyopathy

disorders of the myocardium: this is characterized by resistance to filling and inc diastolic pressure of either or both ventricles -myocardium becomes rigid and noncompliant

hypertrophic obstructive cardiomyopathy

disorders of the myocardium: this is characterized by thickening of the septal wall, which may cause outflow obstruction to the left ventricle outflow tract -most commonly inherited cardiac disorder -significant risk factor for serious ventricular dysrhythmias and sudden death

hypertensive (valvular) hypertrophic cardiomyopathy

disorders of the myocardium: this occurs because of inc resistance to ventricular ejection, which is commonly seen in indivs w/ hypertension or valvular stenosis -attempt to compensate for inc myocardial workload -

hypertrophic cardiomyopathy

disorders of the myocardium: this refers to two major categories of thickening of the myocardium: (1) obstructive and (2) hypertensive/ valvular

tamponade

disorders of the pericardium: if the fluid accumulates rapidly, however, even a small amount may create sufficient pressure to cause cardiac compression, a serious condition known as ___________ -mech: pressure exerted by pericardial fluid eventually equals or exceeds diastolic pressure w/in heart chambers

constrictive pericarditis

disorders of the pericardium: in ___________, fibrous scarring w/ occasional calcification of the pericardium causes the visceral and parietal pericardial layers to adhere, obliterating the pericardial cavity -lesions encase heart in rigid shell -compresses heart and eventually reduces cardiac output -develops gradually

acute pericarditis

disorders of the pericardium: this is acute inflam of the pericardium; membrane becomes roughened -most often idiopathic -other causes: viral infection, MI, trauma, neoplasm, surgery, uremia, bacterial infection, connective tissue disease, radiation therapy

pericardial effusion

disorders of the pericardium: this is the accumulation of fluid in the pericardial cavity and can occur in all forms of pericarditis -most are idiopathic -other causes: neoplasm, infection

sepsis

disseminated intravascular coagulation (DIC): _________ is the most common condition associated w/ DIC

signs and symptoms of DIC

disseminated intravascular coagulation (DIC): what does this list describe? -bleeding from veni[uncture sites or arterial lines -purpura, petechiae, and hematomas -symmetric cyanosis of fingers and toes

yes

does venous drainage parallel arterial supply?

neuropathic pain

dysfunction that causes long-term changes in pain pathway structures and abnormal processing of sensory info -there is an amplification of pain w/o stimulation by injury or inflammation -description: burning, shooting, shocklike, tingling

acute otitis media

ear infections: associated w/ ear pain, fever, irritability, inflamed tympanic membrane, fluid in middle ear

otitis media

ear infections: includes acute ________ and ________ (same word) w/ effusion

otitis externa

ear infections: most common inflammation of outer ear; commonly caused by bacterial infections -usually follows prolonged moisture exposure -> swimmer's ear

otitis media w/ effusion

ear infections: presence of fluid in the middle ear w/o symptoms of acute infection

dystonic (dyskinetic) CP

encephalopathies: CP caused by associated injury to the basal ganglia w/ extreme difficulty in fine motor coordination and purposeful movements (stiff, uncontrolled, abrupt)

extrapyramidal/nonspastic CP

encephalopathies: CP caused by damage to cells in the basal ganglia or cerebellum -less common -2 subtypes: dystonic and ataxic

ataxic CP

encephalopathies: CP caused by damage to the cerebellum, w/ alterations in coordination and movement -broad-based gait in an attempt to maintain balance -tremor common w/ intentional movements

pyramidal/spastic CP

encephalopathies: CP resulting from damage to corticospinal pathways and is associated w/ inc muscle tone, persistent primitive reflexes, hyperactive deep tendon reflexes, clonus, rigidity of extremities, scoliosis, and contractures -most common

phenylketonuria (PKU)

encephalopathies: _________ is an example of an inborn error of amino acid metabolism

amino acid

encephalopathies: defects in ____________ metabolism result because of a lack of normal protein and absence of enzymatic activity

cerebral palsy

encephalopathies: disorder of movement, muscle tone, or posture that is caused by injury or abnormal development in the immature brain, before, during, or after birth up to 1 year of age -types: pyramidal/spastic, extrapyramidal/nonspastic, dystonic (dyskinetic), ataxic

lysosomal storage disease

encephalopathies: disorders of lipid metabolism are termed ___________ because each disorder in this group can be traced to a missing lysosomal enzyme

tay-sachs disease

encephalopathies: the best known of the lysosomal storage disorders is ___________, an autosomal recessive disorder caused by a deficiency of the lysosomal enzyme HexA

static (nonprogressive) encephalopathies

encephalopathies: this is a neurologic condition caused by a fixed lesion w/o active disease -causes: brain malformations or brain injury that may occur during gestation, birth, any time during childhood

awareness

encompasses all cognitive functions -mediated by attentional systems, memory systems, language systems, and executive systems

beta cells

endocrine pancreas: these cells secrete insulin and amylin

delta cells

endocrine pancreas: these cells secrete somatostatin and gastrin

islets of langerhans

endocrine pancreas: the pancreas houses the ____________ which have 4 different types of hormone secreting cells: alpha, beta, delta, and F cells

alpha cells

endocrine pancreas: these cells secrete glucagon

F (PP) cells

endocrine pancreas: these cells secrete pancreatic polypeptide

old/ senescent erythrocytes

erythropoiesis: _____________ are increasingly fragile and lose reversible deformability

macrophages

erythropoiesis: aged red blood cells are sequestered and destroyed by _______ of the MPS primarily in the spleen or liver (if spleen is dysfunctional or absent)

erythropoietin

erythropoiesis: regulation of erythropoiesis is under control of feedback loop w/ ___________ which causes an inc in red cell production in conditions of tissue hypoxia

proteins

erythropoiesis: the nutritional requirements in terms of _______ are amino acids

vitamins

erythropoiesis: the nutritional requirements in terms of _________ are B12, B6, B2, E, and C, folic acid, pantothenic acid, and niacin -prenatals have lots of these in order for baby to create RBCs

minerals

erythropoiesis: the nutritional requirements in terms of __________ are iron and copper -make the blood red

sequence of erythropoiesis

erythropoiesis: what does this list describe? -progenitor cells, proerythroblast, erythroblast/normoblast, reticulocyte, erythrocyte -each step the quantity of hemoglobin inc and nuc dec in size

conjunctivitis

external eye disorders: this is inflammation of conjunctiva; can present as: -acute bacterial (pinkeye) -viral -allergic -trachoma (chlymidial)

cerebellar motor syndrome

extrapyramidal motor syndromes: associated w/ ataxia; primarily influence the same side of the body (damage to right side causes symptoms on right side)

basal ganglia motor syndrome

extrapyramidal motor syndromes: caused by an imbalance of dopaminergic and cholinergic activity in the corpus stratium -produces hypokinesia and hypertonia

laminar

factors affecting blood flow: blood flow thru the vessels, except where vessels split or branch is usually _________

radius; diameter

factors affecting blood flow: clinically, the most important factor determining resistance in a single vessel is the ________ or _______ of the vessel's lumen

poiseuille law

factors affecting blood flow: this indicates that resistance is directly related to tube length and blood viscosity and inversely related to the radius of the tube to the fourth power (r^4)

pressure

factors affecting blood flow: this is the force exerted on a liquid per unit area -expressed as mmHg or torr -fluid moves from an area of high to low ______

vascular compliance

factors affecting blood flow: this is the inc in volume a vessel can accommodate w/ a given inc in pressure; determines a vessel's response to pressure changes -elastic arteries > muscular arteries -veins > artery

resistance

factors affecting blood flow: this is the opposition to force; the diameter and length of blood vessels contribute to this -inc _____, leads to dec blood flow

velocity

factors affecting blood flow: this is the speed of blood -unit: cm/sec -aorta to cap: area inc and _______ dec

laminar flow

factors affecting blood flow: this is when the concentric layers of the molecules move straight ahead w/ each layer flowing at a slightly different velocity

turbulent flow

factors affecting blood flow: where flow is obstructed, the vessel turns or branches, or blood flows over rough surfaces, the flow becomes _________ w/ whorls or eddy currents that produce noise causing a murmur to be heard on auscultation

hormones; biochemicals

factors affecting cardiac output: __________ and ________ affect the arteries, arterioles, venules, capillaries, and contractility of the myocardium -ex. norepinephrine, hydrocortisone, growth hormone

heart rate

factors affecting cardiac output: the average ________ in healthy adults is 70 beats/min

intropic agents

factors affecting cardiac output: these are hormones, NTs, or meds that affect contractility -most important positive: epinephrine and norepinephrine -most important negative: acetylcholine

myocardial contractility

factors affecting cardiac output: this depends on stroke volume and preload, intropic agents, and O2 and CO2 levels

frank-starling law of the heart

factors affecting cardiac output: this indicates that the volume of blood in the heart at the end of diastole, as the volume determines the length of its muscle fibers, is directly related to the force of contraction during the next systole

baroreceptor reflexes

factors affecting cardiac output: this influences ST regulation of the vascular smooth muscle of resistance arteries, myocardial contractility, and HR -components of blood pressure control -crucial to maintain adequate tissue perfusion

cardiovascular vasomotor control center

factors affecting cardiac output: this is in the medulla and pons areas of the brainstem, w/ additional areas in the hypothalamus, cerebral cortex, and thalamus -regulate cardio responses to change in temp, reaction to emot states, HR, and BP

afterload

factors affecting cardiac output: this is resistance to ejection of blood from the left ventricle; load muscle must move after it starts to contact -determined by system vascular resistance in aorta

bainbridge reflex

factors affecting cardiac output: this is the name for the changes in the heart rate that may occur after intravenous infusions of blood or other fluid

preload

factors affecting cardiac output: this is the volume/pressure inside the ventricle at the end of diastole -left ventricular end-diastolic volume -determined by: end systolic volume and venous return

laplace law

factors affecting cardiac output: this states that wall tension generated in the wall of the ventricle (or any chamber or vessel) to produce a given intraventricular pressure depends directly on ventricular size (internal radius) and inversely on ventricular wall thickness

fever of unknown origin (FUO)

fever: a high fever of greater than 38.3 degrees C or 101 degrees F for longer tan 3 weeks that remains undiagnosed

exogenous pyrogens

fever: endotoxins produced by pathogens

endogenous pyrogens

fever: exogenous pyrogens stimulate the release of _________ from phagocytic cells -both of these pyrogens raise the thermal set point

neurologic function

five patterns of __________ are critical to the evaluation of consciousness: 1. level of consciousness (most critical) 2. pattern of breathing (rate, rhythm, pattern) 3. pupillary reaction 4. oculomotor responses (resting, spontaneous, reflexive eye movements) 5. motor responses (determines side of brain most damaged)

telencephalon

forebrain: this is made up of the cerebral cortex (largest part of the brain) and basal ganglia (composed of several nuclei; caudate nucleus, putamen, and globus pallidus)

diencephalon

forebrain: this is the interbrain; surrounded by cerebrum and sitting on top of the brainstem -4 divisions: epithalamus, thalamus, hypothalamus, subthalamus

hypothalamus

forebrain: diencephalon forms the base of the diencephalon; exerts influence through endocrine system as well as through neural pathways -func: maintain constant internal env, implement behavioral patterns

epithalamus

forebrain: diencephalon forms the roof of the third ventricle and composes the most superior portion of diencephalon

thalamus

forebrain: diencephalon major integrating center for afferent impulses to the cerebral cortex; relay center for info from basal ganglia and cerebellum to appropriate motor area

subthalamus

forebrain: diencephalon this flanks the hypothalamus laterally; serves as important basal ganglia center for motor activities

lobes

forebrain: telencephalon each hemisphere is divided into __________: frontal, parietal, occipital, temporal

limbic system

forebrain: telencephalon this consists of the amygdala, hippocampus, fornix, hypothalamus, and related autonomic nuclei -located b/w the telencephalon and diencephalon and surrounding corpus callosum

associational

functional classification of neurons: also called interneurons; transmit impulses from neuron to neuron (sensory to motor neurons) -interneurons and multipolar -solely located w/in the CNS

sensory

functional classification of neurons: transmit impulses from the peripheral sensory receptors to the CNS -afferent and mostly pseudounipolar

motor

functional classification of neurons: transmits impulses from the CNS to an effector organ (i..e skeletal muscle or organs) -efferent and multipolar

hormones

general characteristics of ____________: 1. specific rates and rhythms of secretion 2. operate w/in feedback systems 3. affect only target cells w/ appropriate receptors 4. are excreted by kidneys or deactivated by liver or cellular mechanisms

right and left pulmonary arteries

great vessels: blood exits to pulmonary circulation through the ______________

superior and inferior vena cavae

great vessels: blood is received from systemic circulation through the ____________________ which join and then enter the right atrium

aorta

great vessels: the oxygenated blood moves thru the left atrium and ventricle, out into the _______ that subsequently branches into the systemic arteries that supply the body

pulmonary veins

great vessels: these carry oxygenated blood from the lungs to the left side of the heart -4 of these: 2 from right lung and 2 from left lung

closed brain injury

grossly observable brain lesions -head strikes surface or moving object strikes head -dura remains intact; brain tissues are not exposed to the env

pericardial fluid

heart wall: the ________ is secreted by cells of the mesothelial layer of the pericardium and lubricates the membranes that line the pericardial cavity -slide smoothly over one another w/ minimal friction as heart beats

mediastinum

heart wall: the heart lies diagonally in the _________, which is the area above the diaphragm and between the lungs

pericardium

heart wall: the three layers of the heart wall- the epicardium, myocardium, and endocardium- are enclosed in a double walled membranous sac, called the __________

pericardial cavity

heart wall: the two layers of the pericardium, the parietal and visceral pericardia are separated by fluid-containing space called the ____________

pericardial sac

heart wall: this has 3 main functions 1) preventing displacement of the heart during gravitational acceleration or deceleration 2) physical barrier to protect the heart against infection and inflam coming from lungs and pleural space 3) pain receptors and mechanoreceptors cause reflex changes in BP and HR

myocardium

heart wall: this is composed of cardiac muscle -thickest layer of heart wall

endocardium

heart wall: this is the inner lining of the myocardium

epicardium

heart wall: this is the outer layer of the heart

extramedullary hematopoiesis

hematopoiesis: this is blood cell production in tissues other than the bone marrow -usually a sign of disease

heme

hemoglobin: each ______ carries one molecule of oxygen -bound to reduced ferrous iron (Fe2+)

methemoglobulin

hemoglobin: this is the nonreduced ferrous iron (Fe3+) that cannot bind to oxygen

vasoconstriction; hemostatic plug; fibrin clot; permanent

hemostasis: sequence of events 1. vascular injury causes __________ to limit blood flow at affected site 2. endothelial cell damage leads to platelet adherence and the formation of a __________ to prevent further bleeding (primary hemostasis) 3. clotting system activated to form _________ (secondary hemostasis) 4. fibrin/platelet clot contracts to form more _______ plug

myelencephalon

hindbrain: this is usually called the medulla oblongata -reflex activities, such as heart rate, respiration, vomiting, coughing, sneezing, swallowing are controlled in this area

metencephalon

hindbrain: the major structures of this are the cerebellum and pons

pons

hindbrain: metencephalon a bridge; transmits info from cerebellum to brainstem and b/w two cerebellar hemispheres

cerebellum

hindbrain: metencephalon responsible for reflexive, involuntary fine motor control, balance, and posture

adult hodgkin lymphoma

hodgkin lymphoma: _______________ can usually be cured w/ early diagnosis and treatment, including chemo, radiation, and surgery

physical findings

hodgkin lymphoma: often one of the first _________ of HL is an enlarged painless lymph node in the neck, mediastinal mass, or splenomegaly

reed-sternberg (RS) cells

hodgkin lymphoma: the presence of ______________, which are malignant transformed lymphocytes, are necessary for diagnosis of Hodgkin lymphoma, but not specific to Hodgkin lymphoma

target cells

hormone receptors: __________ have two main functions: 1. recognize and bind w/ particular hormone 2. initiate signal to intracellular effectors -these are plasma membrane or intracellular hormone receptors

down-regulation

hormone receptors: this is when high concentrations of hormones decrease the number or affinity of receptors

up-regulation

hormone receptors: this is when low concentrations of hormones inc the number or affinity of receptors

adrenal estrogens and androgens

hormones of adrenal cortex: secreted in a minimal amount -________(one of the words) are weak and are converted to peripheral tissues to stronger _______(same word) such as testosterone -peripheral conversion is enhanced by aging or obesity

mineralocorticoids

hormones of adrenal cortex: these hormones affect ion transport by epithelial cells -most potent: aldosterone -> regulated by renin-angiotensin system

glucocorticoids

hormones of adrenal cortex: these hormones have a direct effect on carbohydrate metabolism -suppress immune and inflam reactions -most potent: cortisol

insulin

hormones of endocrine pancreas: this hormone facilitates the rate of glucose uptake into the cells -synthesized from proinsulin -secretion promoted by inc blood levels of glucose, amino acids, and GI hormones -anabolic hormone: promotes synthesis of proteins, lipids, and nucleic acids

pancreatic somatostatin

hormones of endocrine pancreas: this hormone is involved in regulating alpha- and beta-cell function -checks and balances

ghlerin

hormones of endocrine pancreas: this hormone stimulates GH secretion, controls appetite, and plays a role in obesity and regulation of insulin sensitivity

gastrin

hormones of endocrine pancreas: this hormone stimulates the secretion of gastric acid

amylin

hormones of endocrine pancreas: this is a peptide hormone that is co-secreted w/ insulin -delays gastric emptying -suppresses glucagon secretion after meals

pancreatic polypeptide

hormones of endocrine pancreas: this is released by F cells in response to hypoglycemia and protein-rich meals

glucagon

hormones of endocrine pancreas: this is the opposite of insulin; release of this hormone is stimulated by dec blood glucose levels -stimulates glycogenolysis, gluconeogenesis, and lipolysis

patterns of secretion

hormones: what does this list describe? 1. diurnal 2. pulsatile and cyclic patterns 3. patterns that depend on circulating substances

communicating hydrocephalus

hydrocephalus: defective resorption of CSF from cerebral subarachnoid space; found more often in adults -cause: infection w/ inflam adhesions

normal-pressure hydrocephalus

hydrocephalus: dilation of ventricles w/o inc pressure; develops slowly and occurs more commonly in the elderly -triad of symptoms: unsteady, broad-based gait w. history of falling, incontinence, dementia

noncommunicating hydrocephalus

hydrocephalus: this can be internal or intraventricular; obstruction w/in ventricular system and is seen more often in children -cause: congenital abnormality

acute hydrocephalus

hydrocephalus: this presents w/ signs of rapidly developing IICP -deteriorate into deep coma if not promptly treated

primary hypertension

hypertension: also called essential or or idiopathic hypertension; caused by genetic or environmental factors -92-95% of cases -risk factors: family history, diet (high sodium, low potassium, calcium, magnesium), tobacco and alcohol consumption, and obesity and glucose intolerance

orthostatic (postural) hypotension

hypertension: this is a dec in both systolic and diastolic BP upon standing -lack of normal BP compensation in response to gravitational changes on the circulation -can be acute or chronic

secondary hypertension

hypertension: this is caused by a systemic disease process that raises peripheral vascular resistance or cardiac output -ex. renal vascular or parenchymal disease, adrenocortical tumors, adrenomedullary tumors, drugs

myocardial hypertrophy

hypertension: this is characterized by a myocardium that is thickened, scarred, less able to relax during diastole; leads to heart failure w/ preserved ejection fraction -one of the potential complications of complicated hypertension

complicated hypertension

hypertension: this is chronic hypertensive damage to blood vessels and tissues leading to target organ damage in the heart, kidney, brain, and eyes

hypertensive crisis

hypertension: this is rapidly progressive hypertension in which systolic pressure is >180 mmHg and/or diastolic pressure is usually >120 mmHg -life-threatening

chronic orthostatic hypotension

hypertension: this may be (1) seconary to specific disease or (2) primary (idiopathic) -caused by: endocrine disorders, metabolic disorders, or diseases of CNS or PNS

acute orthostatic hypotension

hypertension: this occurs when normal regulatory mechanisms are inadequate as result of (1) altered body chemistry, (2) drug action (e.g. antihypertensives, antidepressants), (3) prolonged immobility, (4) starvation, (5) physical exhaustion, (6) volume depletion (e.g dehydration, diuresis, potassium, or sodium depletion), or (7) any condition that results in venous pooling (e.g. pregnancy, extensive varicosities of lower extremities) -common in the elderly

therapeutic hyperthermia

hyperthermia: a form of local, regional, or whole-body hyperthermia used to destroy microorganisms or tumor cells

heat stroke

hyperthermia: failure of heat loss mechanisms at core temperatures >40 degrees C (104 degrees F), may be lethal

heat exhaustion

hyperthermia: profound vasodilation and profuse sweating resulting from prolonged high core or environmental temperatures

heat cramps

hyperthermia: spasmodic cramps in the abdomen and extremities after sweating (sodium loss)

accidental hyperthermia

hyperthermia: the forms of __________ include heat cramps, heat exhaustion, heat stroke, and malignant hyperthermia

malignant hyperthermia

hyperthermia: uncoordinated muscle contractions and inc lactic acid, complication of inherited muscular disorder

hypothalamus

hypothalamic-pituitary system (HPA): this is located at the base of the brain; contains special neurosecretory cells that synthesize and secrete the hypothalamic-releasing hormones that regulate release of hormones in anterior pituitary

pituitary gland

hypothalamic-pituitary system (HPA): this is located in the sella turcica (saddle-shaped depression of sphenoid bone at base of skull) -composed of anterior lobe and posterior lobe

accidental hypothermia

hypothermia results from immersion in cold water, prolonged exposure to cold, or altered thermoregulation

tissue hypothermia

hypothermia: slows the rate of cellular metabolism -inc blood viscosity, facilitates blood coagulation, and stimulates vasoconstriction

therapeutic hypothermia

hypothermia: used to slow metabolism and preserve ischemic tissue during surgery or limb reimplantation or cardiac arrest

liver disease

impaired hemostasis: _____________ causes the production of fewer clotting factors, as hepatic cells produce the most factors involved in hemostasis

vitamin K

impaired hemostasis: _____________ is necessary for synthesis and regulation of prothrombin, the procoagulant factors (VII, XI, and X) and proteins C and S (anticoagulants)

mitral valve prolapse syndrome

in ____________, one or both cusps of mitral valve billow upward into left atrium during systole -mitral regurgitation: if blood leaks into atrium -can be asymptomatic or have vague symptoms -most common valve disorder in US

stage 3 of IICP

increased intracranial pressure (IICP): ICP begins to approach arterial pressure; brain tissues begin to experience hypoxia and hypercapnia and condition rapidly deteriorates

reduction

increased intracranial pressure (IICP): an increase in content requires an equal ________ -CSF is displaced -cerebral blood volume and flow are altered

stage 4 IICP

increased intracranial pressure (IICP): the brain shifts (herniates) from the compartment of greater pressure to a compartment of lesser pressure

4

increased intracranial pressure (IICP): there are _____ progressive stages of IICP

stage 2 of IICP

increased intracranial pressure (IICP): there is continued expansion of intracranial contents; pressure begins to compromise neuronal oxygenation -reduce ICP and promote better clinical outcomes

stage 1 of IICP

increased intracranial pressure (IICP): this is when vasoconstriction and external compression of venous system occurs in an attempt to further decrease the intracranial pressyre

aseptic meningitis

infections of the CNS: ________ has no evidence of bacterial infection, but may be associated w/ viral infection, systemic disease, or drugs

viral encephalitis

infections of the CNS: _________ in kids is similar to ________(same word) in adults and can be difficult to distinguish from viral meningitis

viral meningitis

infections of the CNS: may result from direct infection caused by a virus, or it may be secondary to disease, such as MMR, herpes, or leukemia -mononuclear response in the CSF & presence of normal glucose levels

bacterial meningitis

infections of the CNS: one of the most serious infections to which infants and children are susceptible -often preceded by an URI or gastrointestinal infection

meningoencephalitis

infections of the CNS: term that describes when both meningitis and encephalitis are present

50; 10

infectious mononucleosis (IM): the diagnosis for IM is <_____% lymphocytes and at least ______% atypical lymphocytes, monospot qualititative test for heterophilic antibodies, and antibodies for EBV antigens

splenic rupture

infectious mononucleosis (IM): what is the most common cause of death with IM?

symptoms of IM diagnosis

infectious mononucleosis (IM): what does this list describe? -fever -fatigue -sore throat -swollen cervical lymph nodes -inc lymphocyte count -atypical (activated) lymphocytes

janeway lesions

infective endocarditis: nonpainful hemorrhagic lesions on the palms and soles; characteristic physical finding

osler nodes

infective endocarditis: painful erythematous nodules on the pads of fingers and toes; characteristic physical finding

damaged; adherence; proliferation

infective endocarditis: the pathogenesis of infective endocarditis requires at least 3 critical elements 1) ____________ endocardium: caused by trauma, congenital heart disease, valvular heart disease, and presence of prosthetic valves 2) blood-borne microorganism _________: bacteria use adhesins to stick to damaged endocardium 3) __________ of the microorganism: bacteria infiltrate the sterile thrombi and accelerate fibrin formation by activating clotting cascade

sickle cell-thalassemia disease; sickle cell-Hb C disease

inherited disorders of erythrocytes: _____________ and ____________ are compound heterozygous forms in which the child inherits Hb S from one parent and another type of abnormal hemoglobin from the other parent

beta-thalassemia major

inherited disorders of erythrocytes: also called Cooley anemia; this occurs when beta globin production is depressed severely in the homozygous form -life-threatening condition

sickle

inherited disorders of erythrocytes: in SCD, deoxygenation and dehydration cause Hb S to stretch and elongate leading red cells to assume a _________ shape

sequestration crisis

inherited disorders of erythrocytes: large amounts of blood become acutely pooled in the liver and spleen -typically seen only in kids less than 5 yrs old -1/2 kids experiencing this will have recurrent episodes

thalassemias

inherited disorders of erythrocytes: these are autosomal recessive disorders that result in slow or defective synthesis of globin chains (alpha or beta (more common)) of the Hb molecule -has a major or minor form

alpha thalassemia

inherited disorders of erythrocytes: these are caused by mutations that dec the synthesis of alpha globin chains -4 forms: trait, thalassemia minor, hemoglobin H disease, thalassemia major

beta thalassemia

inherited disorders of erythrocytes: these are caused by mutations that dec the synthesis of beta globin chains

vasoocclusive crisis

inherited disorders of erythrocytes: this crisis type begins with sickling in the microcirculation; logjam effect blocks all blood flow thru vessel -can result in stroke -extremely painful

sickle cell trait

inherited disorders of erythrocytes: this happens when a child inherits Hb S from one parent, and HbA (normal hemoglobin) from another

alpha trait

inherited disorders of erythrocytes: this happens when a single alpha chain forming gene is defective -heterozygous carrier state

alpha-thalassemia major

inherited disorders of erythrocytes: this happens when all four alpha chain forming genes are defective -fatal condition: oxygen cannot be released to the tissues

hemoglobin H disease

inherited disorders of erythrocytes: this happens when three alpha chain forming genes are defective

alpha-thalassemia minor

inherited disorders of erythrocytes: this happens when two alpha chain forming genes are defective

sickle cell disease

inherited disorders of erythrocytes: this is a group of disorders characterized by the presence of an hemoglobin S (genetic mutation in which one amino acid (valine) replaces another (glutamic acid)) -can result in: vaso-occlusive crisis (thrombotic crisis); aplastic crisis, sequestration crisis, and hyperhemolytic crisis

aplastic crisis

inherited disorders of erythrocytes: this is when the bone marrow is not able to compensate replacing cells lost thru hemolysis -happens usually after a viral infection in those w/ profound anemia

thalassemia major

inherited disorders of erythrocytes: this is when the combination of mutations causing thalassemia is homozygous

beta-thalassemia minor

inherited disorders of erythrocytes: this occurs when beta globin chain production is depressed moderately in the heterozygous form

thalassemia minor

inherited disorders of erythrocytes: this s when the combination of mutations causing thalassemia is heterozygous

hyperhemolytic crisis

inherited disorders of erythrocytes: this type of crisis may occur in assoc w/ certain drugs or infection; reported as an acute or chronic rxn following a blood transfusion

other forms of SCD

inherited disorders of erythrocytes: what does this list describe -sickle cell-thalassemia disease -sickle cell-Hb C disease

indistinguishable

inherited hemorrhagic disease: because both factors VIII and IX function together to activate factor X, hemophilia A and B are clinically _____________

hemophilias

inherited hemorrhagic disease: these are serious bleeding disorders that involve mutations in coagulation factors -1st signs by age 3-4 yrs: persistent bleeding from minor injuries

hemophilia A

inherited hemorrhagic disease: this results from a mutation in the F8 gene, which codes for factor VIII (essential cofactor for factor IX in the coagulation cascade) -most common hereditary disease assoc w/ life-threatening bleeding

hemophilia B

inherited hemorrhagic disease: this results from a mutation in the F9 gene, which codes for factor IX

types of hemophilias

inherited hemorrhagic disease: what does this list describe? -hemophilia A (factor VIII deficiency) -hemophilia B (factor IX deficiency) -hemophilia C (factor XI deficiency)

peripheral nervous system disorders

injury to the peripheral nerves and subsequent neuropathy by disease processes, inflammation, or trauma -include mononeuropathies, multiple mononeuropathies, polyneuropathy, and autonomic neuropathies

fetal neurotoxicity

intoxications of the CNS: ____________ occurs w. maternal lead exposure, particularly during the 1st trimester

lead poisoning

intoxications of the CNS: results in high blood levels of lead; untreated causes lead encephalopathy => responsible for serious and irreversible neurologic damage

saccular (berry) aneurysm

intracranial aneurysm: this may be 1) round w/ narrow stalk connecting it to the parent artery; 2) broad-based w/o a stalk; 3) cylindrical

total body iron

iron cycle: ___________ is bound to heme or stored bound to ferritin or hemosiderin or mononuclear phagocytes -less than 1 mg per day is lost in urine, sweat, bile, and epithelial cells or from skin or gut

hypoperfusion

ischemic stroke: systemic ________ decreases blood supply to the brain

lacunar strokes

ischemic stroke: these are caused by the occlusion of single, deep perforating artery or brain

embolic stroke

ischemic stroke: this involves thrombus fragments that have traveled obstructing small brain vessels

transient ischemic attacks (TIAs)

ischemic stroke: this is an ischemic event causing neurologic dysfunction lasting no more than 1 hour -12% of indivs experiencing this will have a stroke

thrombotic stroke

ischemic stroke: this is an obstruction by a thrombus in arteries supplying the brain

frontotemproal dementia

known as Pick disease; this is a rare, degenerative disease; degeneration of frontal and anterior frontal lobes -familial association -most cases involve gene mutation

alzheimer disease (AD)

leading cause of severe cognitive dysfunction in older persons -forms: nonhereditary sporadic or late onset (70-90%); early-onset familial; early onset (very rare) -exact cause is unknown -diagnosis is made by ruling out other causes of dementia

stroke volume

left heart failure: ____________ is influenced by 3 major determinants: 1) contractility 2) preload 3) afterload

systolic heart failure

left heart failure: this is defined as an ejection fraction (EF) less than 40%; inability of the heart to generate adequate cardiac output to perfuse tissues -manifestations: dyspnea, orthopnea, cough of frothy sputum, fatigue, dec urine output, and edema -examination: pulmonary edema, hypotension/hypertension, S3 gallop

diastolic heart failure

left heart failure: this is defined as pulmonary congestion despite normal stroke volume and cardiac output; results from dec compliance of the left ventricle and abnormal diastolic relaxation -major causes: hypertension-induced myocardial hypertrophy and myocardial ischemia-induced ventricular remodeling -manifestations: dyspnea on exertion, fatigue; pulmonary edema may develop over time; S4 gallop

blast cell

leukemia: _________ is the hallmark of acute leukemia -this replaces the bone marrow by 80-100% in ALL

bone marrow

leukemia: the manifestations of leukemia reflect __________ failure: -pallor -fatigue -petechiae -purpura -bleeding -fever

chronic leukemia

leukemias (lymphoid neoplasms): happens when predominant cell is mature but does not function normally -slow progression

acute leukemia

leukemias (lymphoid neoplasms): presence of undifferentiated or immature cells, usually blast cells -onset abrupt and rapid -w/o treatment => short survival time

fibrillation

lower motor neuron syndromes: isolated contraction of single muscle fiber because of metabolic changes in denervated muscle -not clinically visible

flacid paresis/paralysis

lower motor neuron syndromes: muscle that has reduced tone or hypotnia is accompanied by hyporeflexia or areflexia (loss of tendon reflexes) and ______________

fasiculations

lower motor neuron syndromes: this is muscle rippling or quivering under the skin

localized lymphadenopathy

lymphadenopathy: this is inidicated by a drainage of an inflam lesion located near the enlarged node

generalized lymphadenopathy

lymphadenopathy: this occurs in he presence of infections, autoimmune diseases, or disseminated malignancy

lymph nodes

lymphatic system: as lymph is transported toward the heart, it is filtered thru thousands of bean-shaped ________ clustered along the lymphatic vessels

afferent lymphatic vessels; efferent lymphatic vessels

lymphatic system: lymph enters the nodes thru ____________, filters thru the sinuses in the node, and leaves by way of ______________

lymphatic veins and venules

lymphatic system: once w/in the lymphatic system, lymph travels thru ________________ that drain into one of the two large ducts in the thorax: the right lymphatic duct and the thoracic duct

right lymphatic duct

lymphatic system: the __________ drains lymph from the right arm and the right side of the head and thorax -drain lymph into right subclavian vein

thoracic duct

lymphatic system: the larger __________ receives lymph from the rest of the body that the right lymphatic duct does not -drain lymph into left subclavian vein

lymph

lymphatic system: the lymphatic fluid is called _______, which consists of primarily water and small amounts of dissolved proteins, that are too large to be reabsorbed into less permeable blood capillaries

spleen

lymphoid organs: largest lymphoid organ that serves as a site of fetal hematopoiesis, cleanses blood, initiates immune response, destroys aged cells, and is a blood reservoir

lymph nodes

lymphoid organs: these are structurally part of the lymphatic system but functionally apart of the hematologic and immune systems -func: transport lymphatic fluid back to the circulation and cleanse the lymphatic fluid of microorgs and foreign particles

venous sinuses

lymphoid organs: these initiate phagocytosis of old, damaged, and dead blood cells -blood storage: 300 ml -one of the reasons why the spleen can store so much blood

splenic pulp

lymphoid organs: this is masses of lymphoid tissue containing macrophages and lymphocytes and lymphoid follicles -one of the reasons why the spleen can store so much blood

non-hodgkin lymphoma (NHL)

lymphoma: these are cancers of the immune cells -types: B-cell (burkitt and burkitt-like; burkitt leukemia); diffuse large B-cell; lymphoblastic; anaplastic large cell -manifestations specific to site involved -tx: intensive chemo

hodgkin lymphoma

lymphoma: these are lymphoid cancers in a single chain of lymph nodes; presence of Reed-Sternberg cells characteristic -EBV frequently involved -manifestations: painless lymphadenopathy w/ or w/o fever (most common symptom in children); anorexia, malaise, weight loss -tx: chemo and radiation

Burkitt lymphoma

lymphoma: what is the most common type of lymphoma in children?

folate

macrocytic anemias: humans are dependent on dietary intake of _________, which is absorbed in the upper small intestine and is not dependent on any other factor

folate deficiency anemia

macrocytic anemias: this anemia is similar to pernicious anemia except neurologic manifestations are generally not seen -tx: daily oral admin of folate until body levels are adequate

pernicious anemia (PA)

macrocytic anemias: this is caused by a lack of intrinsic factor from the gastric parietal cells which results in vitamin B12 deficiency -manifestations: early symptoms nonspecific and vague; hemoglobin at 7-8 g/dl; neurologic -tx: life-long B12 replacement

symptoms of PA

macrocytic anemias: what does this list describe? -weakness -fatigue -difficulty walking -paresthesias -loss of appetite -abdominal pain -weight loss -sore tongue

ribonucleic acid (RNA)

macrocytic anemias: although DNA synthesis is effected, __________ processes occur at a normal rate -this leads to asynchronous development => overproduction of hemoglobin

true (primary) microcephaly

malformation of brain development: _________ is usually caused by an autosomal recessive genetic or chromosomal defect

secondary (acquired) microcephaly

malformation of brain development: ___________ is associated w/ various cause, such as intrauterine infection, trauma, metabolic disorders, maternal anorexia, in utero exposure to alcohol, toxins, or certain medications, and presence of other generic syndromes

microcephaly

malformation of brain development: defect in brain growth as a whole; cranium size is significantly below average for the infant's age, gender, race, and gestation -two types: true (primary); secondary (acquired)

cortical dysplasia

malformation of brain development: defect in the brain development in which embryonic neurons migrate to the wrong places

dandy-walker malformation (DWM)

malformation of brain development: this is a congenital defect of the cerebellum that is characterized by a large posterior fossa cyst

congenital hydrocephalus

malformation of brain development: this is characterized by an increased CSF pressure and enlargement of the ventricles -cause: blockage, CSF production imbalance, or reduced reabsorption

hodgkin lymphoma or non-hodgkin lymphoma

malignant lymphomas: what are the two REAL (revised european american lymphoma) classifications of lymphomas?

autonomic hyperreflexia (dysreflexia)

manifestations of spinal cord trauma: this is a sudden, massive reflex sympathetic discharge because descending inhibition is blocked -stimulation of sensory receptors below the level of the cord lesion -may occur after spinal shock resolves

spinal shock

manifestations of spinal cord trauma: this is when normal activity of the spinal cord ceases at and below the level of injury; sites lacks continuous nervous discharges from the brain -characteristics: complete loss of reflex function, flaccid paralysis, absence of sensation, loss of bladder/rectal control, transient drop in BP, bradycardia, poor venous circulation

neurogenic shock

manifestations of spinal cord trauma: this occurs w/ injury above T6; caused by absence of sympathetic activity and unopposed parasympathetic tone -may be seen in addition to spinal shock

encephalopathy

means brain pathology; general category that includes a number of syndromes and diseases -may be acute or chronic as well as static or progressive

amounts; responses

mechanisms of hormone alterations: significantly altered hormone levels may happen due to: 1. inappropriate _________ of hormone delivered to the target cell: i.e. disorders of the endocrine glands; failure of feedback systems; dysfunctional hormones; defects in hormone delivery 2. inappropriate _______ by the target cell: i.e. abnormalities in receptors; intracellular disorders

viral meningitis

meningitis: _________ is infection thought to be limited to the meninges -cause: enteroviral viruses, arboviruses, and herpes simplex type 2 -> cross the BBB -clinical manifestations milder than bacterial but similar

bacterial meningitis

meningitis: _________ is primarily an infection of pia mater, arachnoid villi, subarachnoid space, ventricular system, and CSF -cause: meningococci and pneumococci -> cross the BBB and infect meninges -results in: infectious, meningeal, and neurologic signs -> acute infectious purpura fulminans (rare complication -rapid diagnosis and treatment to prevent morbidity and mortality

infectious meningitis

meningitis: ___________ is caused by bacteria, viruses, fungi, parasites, and toxins

fungal meningitis

meningitis: ___________ is chronic with insidious development (usually over days or weeks) -less common than bacterial or viral -produce granulomatous reaction in meninges at base of brain -manifestations: dementia or communicating hydrocephalous

progression

microcytic hypochromic anemias: ________ of iron deficiency causes: -brittle, thin, coarsely ridged, and spoon-shaped nails (koilonychia) -cheilosis (scales and fissures of the mouth), stomatitis, painful ulcerations in mouth, dysphasia (difficulty swallowing)

early symptoms of iron deficiency anemia

microcytic hypochromic anemias: what does this list describe? -fatigue -weakness -shortness of breath -pale earlobes -palms -conjunctiv

iron deficiency anemia

microcytic-hypochromic anemias: this is the most common nutritional disorder worldwide -causes: dietary deficiency, impaired absorption, increased requirement of iron, chronic blood loss, chronic diarrhea

corpora quadrigemina

midbrain: ceiling of the midbrain composed of two pairs of superior colliculi and two pairs of inferior colliculi

mesencephalon

midbrain: composed of 3 structures corpora quadrigemina (tectum), tegmentum, and basis pendunculi

tegmentum

midbrain: floor of the midbrain composed of the red nucleus, substantia nigra, and the basis penunculi

inferior colliculi

midbrain: corpora quadrigemina involve movements affecting the auditory system

superior colliculi

midbrain: corpora quadrigemina involved w/ voluntary and involuntary visual motor movements

basis pendunculi

midbrain: tegmentum made up of efferent fibers of the corticospinal, corticobulbar, and corticopontocerebellar tracts

red nucleus

midbrain: tegmentum receives ascending sensory info from the cerebellum and projects minor motor pathway to the cervical spinal cord

transportation of the great arteries

mixing defects: in this condition, the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle -results in 2 separate parallel circuits: 1) unoxygenated blood circulates continuously thru systemic circulation, 2) oxygenated blood circulates continuously thru pulmonary circulation -other defects allow mixing of circuits -manifestation: depends on size and associated defects

supracardiac TAPVC

mixing defects: this is attachment above the diaphragm, ususally to the superior vena cava -most common form

infracardiac TAPVC

mixing defects: this is attachment below the diaphragm, such as to the inferior vena cava -most severe and least common form

cardiac TAPVC

mixing defects: this is direct attachment to the heart usually the RA or coronary sinus

truncus arteriosus

mixing defects: this is the failure of the embryonic artery and the truncus arteriosus to divide into the pulmonary artery and aorta; results in a single vessel -types: I, II, and III -manifestations: asymptomatic w/ moderate heart failure, variable cyanosis, poor growth, activity intolerance; risk for brain abscess and bacterial endocarditis

hypoplastic left heart syndrome

mixing defects: this is the underdevelopment of the left side of the heart; obstruction of blood flow from the left ventricular outflow tract -underdevelopment of: left ventricle, aorta, aortic arch -can cause: mitral atresia or stenosis; coarctation of the aorta -manifestations: occur early in newborn (cyanosis, tachypnea, dec CO); fatal in early life if untreated

type I truncus arteriosus

mixing defects: this is when a single pulmonary trunk arises near the base of the truncus and divides into the left and right PAs

total anomalous pulmonary venous connection (TAPVC)

mixing defects: this is when pulmonary veins connect to the right side of the heart, directly or indirectly thru one or more systemic veins that drain into the right atrium -classified by point of attachment: supracardiac, cardiac, infracardiac -manifestations: cyanosis early in life, worsening w/ vein obstruction

type III

mixing defects: this is when the PAs arise independently and from the lateral aspect of the truncus

type II truncus arteriosus

mixing defects: this is when the left and right PAs arise seperately from the posterior aspect of the truncus

ventricular septal defect (VSD)

mixing defects: truncus arteriosus is always associated w/ ________, with mixing of systemic and arterial circulations causing some degree of cyanosis

bulbar palsy

motor neuron diseases involves cranial nerves in motor nuclei of medulla IX, X, XI, and XII

spinal muscular atrophy

motor neuron diseases: inherited autosomal recessive degenerative disease of the anterior horn cells of the spinal cord -causes weakness and atrophy of skeletal muscles

progressive bulbar palsy

motor neuron diseases: involves degeneration of glossopharyngeal, vagusm and hypoglossal cranial nerves

upper motor neurons

motor neurons: completely contained w/in the CNS; control fine motor movement and influence/ modify spinal reflex arcs -synapse w/ interneurons -destruction results in initial paralysis followed w/in days or weeks by partial recovery

neuromuscular junction

motor neurons: junction b/w axon of motor neuron and plasma membrane of the muscle cell

motor units

motor neurons: motor neurons innervate one or muscle cells, forming ___________, which consists of a neuron and the skeletal muscles it stimulates

lower motor neurons

motor neurons: their cell bodies originate in the gray matter of the spinal cord, but their axons extend into the PNS -have direct influence on muscles -destruction leads to paralysis unless peripheral nerve damage is followed by nerve regeneration and recovery

vestibulospinal tract

motor pathways: arises from a vestibular nucleus in the pons and causes the extensor muscles of the body to rapidly contract, most backward -white matter

reticulospinal tract

motor pathways: arises in the reticular formation of the medulla or pons and modulates motor movement by inhibiting and exciting spinal activity -white matter

lateral corticospinal

motor pathways: connects motor cortex w/ anterior horn cells in the spinal cord -gray matter

rubrospinal tract

motor pathways: originates in the red nucleus, decussates, and terminates in the cervical spinal cord -most important for muscle movement and fine muscle control in the upper extremities -white matter

corticobulbar tract

motor pathways: synapse on motor cranial nuclei w/in the brainstem that control muscles of the face, head, and neck -leave the tract to go to specific interneurons or motor neurons in the anterior horn -white matter

individual organ systems

multiple organ dysfunction syndrome: as MODS continues, manifestations of _________ can be seen: -renal: jaunsice, abdominal distention, liver tenderness, muscle wasting, hepatic encephalopathy -GI: sensitive to ischemic and inflam injury; hemorrhage, ileus, malabsorption, diarrhea, constipation, vomiting, anorexia, abdominal pain -cardiac: tachycardia, bounding pulse, inc CO, dec SVR, and hypotension -nervous: apprehension, confusion, disorientation, restlessness, agitation, headache, dec cognitive ability and memory, dec level of consc

manifestations of MODS

multiple organ dysfunction syndrome: what does this list describe? -fever -tachycardia -dyspnea -altered mental status -hyperdynamic/hypermetabolic stages -ARDS: tachypnea, pulmonary edema w/ crackles and diminished breath sounds, use of accessory muscles, hypoxemia

plaques

multiple sclerosis (MS): __________ disrupt nerve conduction w/ subsequent death of neurons and brain atrophy -ex. paresthesia, weakness, impaired gait, visual disturbances, or urinary incontinence

myasthenic crisis

myasthenia gravis (MG): occurs when severe muscle weakness causes extreme quadriparesis or quadriplegia, respiratory insufficiency w/ shortness of breath, and extreme difficulty in swallowing -develop as disease progresses

cholinergic crisis

myasthenia gravis (MG): this may arise from anticholinesterase drug toxicity w/ inc intestinal motility, episodes of diarrhea and complaints of intestinal cramping, bradycardia, pupillary constriction, increased salivation, and diaphoresis -in danger of respiratory arrest

absolute polycythemia

myeloproliferative RBC disorders: ___________ consists of two forms: primary and secondary

polycythemia vera

myeloproliferative RBC disorders: this is a slowly growing blood cancer in which bone marrow makes too many RBCs -WBCs and platelets are also often inc -acquired mutation in JAK2gene -uncommon and insidious -manifestations: due to inc red cell mass and hematocrit => inc blood volume and viscosity and hypercoagulopathy

secondary absolute polycythemia

myeloproliferative RBC disorders: this is an inc in eythropoietin as a normal response to chronic hypoxia or an inappropriate response to eythropoietin-secreting tumora

hereditary hemochromatosis

myeloproliferative RBC disorders: this is an iron overload disorder; autosomal recessive disorder of iron metabolism -mutations in one of several genes: HFE, HJV, HAMP, FR2, SLC40A1 -manifestations: from excessive storage of iron in liver, skin, pancreas, heart, joints, and testes => abdominal pain, weakness, weight loss, cirrhosis

polycythemia

myeloproliferative RBC disorders: this is the overproduction of red blood cells

hepcidin

myeloproliferative RBC disorders: this is the protein that governs iron regulation -mutations of this impair control of iron absorption

relative polycythemia

myeloproliferative RBC disorders: this results from the hemoconcentration of blood due to dehydration -fluid loss results in relative inc of red cell counts and Hgb and Hct values

polycythemia vera

myeloproliferative RBC disorders: what is the primary absolute polycythemia?

myocardial oxygen consumption

myocardial cells: cardiac work is expressed as ____________, which is closely correlated w/ total cardiac energy requirements -determined by: 1) amount of wall stress during systole (systolic BP), 2) duration of systolic wall tension (HR), 3) contractile state of myocardium -inc w/ exercise and dec w/ hypotension and hypothermia

intercalated disks

myocardial cells: electrical impulses are transmitted rapidly from cardiac fiber to cardiac fiber because the network of fibers connects at _____________, which are thickened portions of the sarcolemma -3 junctions: desmosomes, , fascia adherens, gap junctions

skeletal muscle cells

myocardial cells: myocardial cells are nearly identical to ________ muscle cells, but have differences important to cardiac function -branched network arrangement -fibers have only one nucleus

actin

myocardial cells: resemble beads; they are strung into two chains that wind around each other forming a thin filament

myosin

myocardial cells: resemble golf glubs w/ two large ovoid heads at one end of the shaft; bundled together w/ heads facing outward forming a single thick filament

sarcomere

myocardial cells: the area from one Z line to the next Z line defines one ___________

H band

myocardial cells: the center of the sarcomere is a less dense region called the ______ which contains only myosin molecules and no actin

sarcomeres

myocardial cells: the dark and light bands of the myofibrils create repeating longitudinal units called _________ -length determines the limit of myocardial stretch at end of diastole and the force of contraction during systole

I bands

myocardial cells: the light bands of the sarcomere, called the ________, contain only actin molecules and no myosin

M line

myocardial cells: thick filaments are held together by M-protein molecules that from a central thin, dark ________

Z line

myocardial cells: thin filaments of actin extend from each side of the __________, a dense fibrous structure at the center of each I band

troponin

myocardial cells: this a relaxing protein that associates w/ the tropomyosin molecule

tropomyosin

myocardial cells: this is a relaxing protein that lies alongside the actin molecules

A band

myocardial cells: where thick filaments overlap w/ thin filaments, a central dark band is formed, called the ____________

sarcomere

myocardial contraction and relaxation: each ________ serves as the basic contractile unit of a muscle cell

excitation-contraction coupling

myocardial contraction and relaxation: this is the process by which an AP arriving at the muscle fiber plasma membrane triggers the cycle, leading to cross-bridge formation and contraction -depends on: Ca availability, conc of Ca ions -Ca binds to troponin => tropomyosin moving troponin => uncover binding sites => myosin and actin form cross-bridges

myocardial relaxation

myocardial contraction and relaxation: this occurs when conc of Ca dops, troponin releases Ca, and the tropomyosin complex moves and blocks the active sites on the actin molecule, preventing cross-bridge formation w/ myosin heads

cross-bridge theory of muscle contraction

myocardial contraction and relaxation: this theory states that 1) myosin molecules form bridges w/ exposed actin molecules and 2) myosin pulls actin filaments toward center to shorten sarcomere and result in contraction

subendocardial MI; non-STEMI

myocardial infarction: if the thrombus disintegrates before complete distal tissue necrosis has occurred, the infarction will involve only the myocardium directly beneath the endocardium, resulting in a ____________ with the classification of ___________

transmural MI; STEMI

myocardial infarction: if the thrombus lodges permanently in the vessel, the infarction will extend thru the myocardiu all the way from endocardium to epicardium, resulting in a ____________, with the classification of ___________

hibernating myocardium

myocardial infarction: this describes tissue that is persistently ischemic and undergoes metabolic adaptation to prolong myocyte survival until perfusion can be restored

myocardial remodeling

myocardial infarction: this is a process mediated by Ang II, aldosterone, catecholamines, adenosine, and inflam cytokines that causes myocyte hypertrophy and loss of contractile func in areas of the heart distant from the site of infarction

myocardial stunning

myocardial infarction: this is a temporary loss of contractile function that persists for hours to days after perfusion has been restored -cause: alterations in electrolyte pumps and Ca homeostasis by release of toxic oxygen free radicals

structural changes after MI

myocardial infarction: what does this list describe? 1. myocardial stunning 2. hibernating myocardium 3. myocardial remodeling

electrical; chemical

nerve impulse: nerves generate and conduct ________ and _________ impulses by selectively changing the electrical potential of the plasma membrane and influencing other nearby neurons by releasing chemicals called neurotransmitters

all-or-none response

nerve impulse: refers to the fact that an action potential response occurs only when the stimulus is strong enough; if it is too weak the membrane remains unexcited

Wallerian degeneration

nerve injury and regeneration: when an axon is severed, ___________ occurs in the distal axon, the portion cut off from the cell body

factors of nerve regeneration

nerve injury and regeneration: what does this list describe? -location: closer to cell body = more chance of death -injury: crush better than cut -inflammatory response -scar tissue formation

sprouts

nerve injury and regeneration: about 7-14 days after cell injury, new terminal ______ project from the proximal segment and may enter the remaining Schwann cell pathway -reason: trying to build another arm

protein synthesis

nerve injury and regeneration: after the Nissl substance is dispersed, the cell increases in _________ and mitochondrial activity -reason: trying to survive, repair, and regenerate

Nissl substance

nerve injury and regeneration: at the proximal end of the injured axon, the cell responds to trauma by swelling and dispersal of _________

PNS

nerve injury and regeneration: the process of nerve regeneration is limited to myelinated axons and generally occurs only in the ________

swelling

nerve injury and regeneration: Wallerian degeneration 1) a characteristic ________ appears w/in portion of the axon distal to the cut

hypertrophy

nerve injury and regeneration: Wallerian degeneration 2) in response to swelling, neurofilaments ________

shrink

nerve injury and regeneration: Wallerian degeneration 3) swelling draws in fluid from the surrounding area causing the myelin sheath to ________ and disintegrate

axon

nerve injury and regeneration: Wallerian degeneration 4) if degeneration continues, the ______ portion degenerates and disappears -could lead to the potential death of a neuron

encephalocele

neural tube defects (NTDs): refers to herniation or protrusion of the brain and meninges through a defectin the skull, resulting in a saclike structure

anencephaly

neural tube defects (NTDs): anomaly in which the soft, bony component of the skull and part of the brain are missing -born stillborn or die w/in few days after birth

cyclopia

neural tube defects (NTDs): anterior midline defects may cause brain and face abnormalities w/ the most extreme being ________, in which the child has a single midline orbit and eye w/ a protruding noselike proboscis above the orbit

Chiari II malformation (Arnold-Chiari malformation)

neural tube defects (NTDs): complex malformation of the brainstem and cerebellum in which the cerebellar tonsils are displaced downward into the cervical spinal canal; hydrocephalus from pressure that blocks the flow of CSF -myelomeningoceles almost always associated w/ this

myelomeningocele

neural tube defects (NTDs): hernial protrusion of a saclike cyst (containing meninges, spinal fluid, and a portion of the spinal cord w/ its nerves) through a defect in the posterior arch of a vertebra

tethered cord syndrome

neural tube defects (NTDs): may develop after surgical correction for myelomeningocele -cord becomes abnormally attached or tethered as result of sacr tissue as cord transcends the vertebral canal w/ growth

spina bifida

neural tube defects (NTDs): most common neural tube defect; verterbrae fail to close in -defects: anencephaly, encephalocele, meningocele, myelomeningocele

meningocele

neural tube defects (NTDs): saclike cyst of meninges fillws w/ spinal fluid and is a mild form of spina bifida

spina bifida occulta

neural tube defects (NTDs): this is a vertebral defect that is not visible -no neurologic dysfunction -spinal cord and spinal nerves normal

unmyelinated c fibers

neuroanatomy of pain: poorly localized dull pain -most numerous -transmit dull, aching, or burning sensations that may be constant

nociception

neuroanatomy of pain: processing of harmful stimuli through normally functioning nervous system

nociceptors

neuroanatomy of pain: these are free nerve endings in skin, muscles, joints, arteries, and the viscera that respond to chemical, mechanical, and thermal stimuli -can detect a wide range of stimuli

a-delta myelinated fibers

neuroanatomy of pain: these are localized fast pain sensations -larger and myelinated -transmit sharp pain -> i.e. intense heat or pinprick to skin

four phases of nociception

neuroanatomy of pain: what does this list describe? 1. transduction 2. transmission 3. perception 4. modulation

transduction

neuroanatomy of pain: nociception activation of nociceptors by stimulus

perceptual dominance

neuroanatomy of pain: nociception because of _______, pain at one site may mask other painful areas

transmission

neuroanatomy of pain: nociception conduction to dorsal horn and up spinal cord

perception

neuroanatomy of pain: nociception conscious awareness of pain; occurs primarily in reticular and limbic systems and the cerebral cortex -3 systems: sensory-discriminative system, affective-motivational system, cognitive evaluative system

modulation

neuroanatomy of pain: nociception different mechanisms that increase and decrease in transmission before, during, or after perception

threshold; tolerance

neuroanatomy of pain: nociception pain _______ and __________ are subjective phenomena that influence an indiv's perception of pain -factors: genetics, sex, cultural perceptions, expectations, role socialization, physical and mental health, age

pain tolerance

neuroanatomy of pain: nociception the greatest intensity of pain that a person can endure

pain threshold

neuroanatomy of pain: nociception the lowest intensity of pain that a person can recognize

affective-motivational system

neuroanatomy of pain: nociception this determines an individual's conditioned avoidance behaviors and emotional responses to pain -mediated thru reticular formation, limbic system, and brainstem

sensory-discriminative system

neuroanatomy of pain: nociception this is mediated by the somatosensory cortex and is responsible for identifying the presence, character, location, and intensity of pain

cognitive-evaluative system

neuroanatomy of pain: nociception this overlies the indiv's learned behavior concerning the experience of pain and therefore can modulate perception of pain -mediated thru cerebral cortex

astrocytes

neuroglia: -form specialized contacts b/w neuronal surfaces and blood vessels -provide rapid transport for nutrients and metabolites -thought to form an essential component of blood brain barrier -appear to be scar-forming cells of the CNS -appear to work w/ neurons in processing info and memory storage

PNS

neuroglia: Schwann cells, nonmyelinating Schwann cells, and satellite glial cells are found in the ________

CNS

neuroglia: astrocytes, oligodendroglia, ependymal cells, and microglia are all neuroglia found in the ________

nonmyelinating Schwann cells

neuroglia: provide neuronal metabolic support and regeneration in the PNS

microglia

neuroglia: responsible for clearing cellular debris (phagocytic properties) and the key immune cell in the CNS

oligodendroglia

neuroglia: these are responsible for formation of the myelin sheath in the CNS

Schwann cells

neuroglia: these are responsible for formation of the myelin sheath in the PNS and direct axonal regrowth and recovery in the PNS

ependymal cells

neuroglia: these serve as a lining for ventricles and choroid plexuses involved in production of cerebrospinal fluid

satellite glial cells

neuroglia: these surround sensory, sympathetic, and parasympathetic nerve cell bodies and ganglia to provide protection and promote cellular communication (similar to astrocytes in CNS)

human immunodeficiency virus-associated neurocognitive disorder (HAND)

neurologic complications of AIDS: this is a mild neurocognitive disorder; includes HIV associated dementia -combined antiretroviral therapy (cART) has reduced prevalence and improved survival

ganglia

neurons: cell bodies in the PNS are found in groups called ________

dendrites

neurons: these are extensions that carry impulses towards the cell body

cell body (soma)

neurons: these are mostly located in the CNS; part of the neuron

Nissl substances

neurons: these are the endoplasmic reticulum and ribosomes; involved in protein synthesis

microfilaments

neurons: these are thought to be involved in transport of cellular products

axons

neurons: these carry nerve impulses away from the cell body

microtubules

neurons: these transport substances w/in the cell

neurofibrils

neurons: very thin supportive fibers that extend throughout teh neuron

cell body, dendrites, axon

neurons: what are the three structural components of a neuron?

cellular constituents of neurons

neurons: what does this list describe?: 1. microtubules 2. neurofibrils 3. Nissl substances 4. microfilaments

initial segment of axon

neurons: axons the first part of the axon hillock is known as the _____________ because this area has the lowest threshold for stimulation and is where action potentials begin

axon hillock

neurons: axons this is a cone shaped process where axon leaves the cell body

synaptic knobs

neurons: axons axons end w/ branches that terminate with ____________, which are used in neurotransmission

nodes of ranvier

neurons: axons the myelin sheath is interrupted at regular intervals by the _____________ -nutrient exchange can occur here

myelin sheath

neurons: axons this is a segmented layer of lipid material that wraps an axon

saltatory conduction

neurons: axons this is the flow of ions between segments of myelin rather than along the entire length of the axon -this yields increased velocity for the action potential

peripheral; central

neuropathic pain is classified as either _________ neuropathic pain and _______ neuropathic pain

central neuropathic pain

neuropathic pain: caused by a lesion or dysfunction in the brain or spinal cord

peripheral neuropathic pain

neuropathic pain: caused by peripheral nerve lesions

norepinephrine

neurotransmitters and neuroreceptors of the ANS: most postganglionic sympathetic fibers release ______________ and considered to function by adrenergic transmission

acetylcholine

neurotransmitters and neuroreceptors of the ANS: sympathetic preganglionic fibers and parasympathetic preganglionic and postpanglionic fibers release __________, which is characterized by cholinergic transmission

cannabis

neurotransmitters of pain modulation: ____________ produces a resin containing cannabinoids -analgesic in humans -drawbacks: psyhcoactive and addictive properties

endomorphins

neurotransmitters of pain modulation: bind w/ u receptors and have potent analgesic effects

endorphins

neurotransmitters of pain modulation: endogenous morphine; produced in the brain -produce great sense of exhilaration as well as substantial natural pain relief

dynorphins

neurotransmitters of pain modulation: most potent of the endogenous opioids, binding strongly w/ k receptors to impede pain signals -play role in neuropathic pain and mood disorders and drug addiction

enkephalins

neurotransmitters of pain modulation: most prevalent of natural opioids; have pharmacological actions similar to morphine -bind as direct antagonists to opioid receptors

endogenous opioids

neurotransmitters of pain modulation: these are morphine-like neuropeptides that bind w/ opioid receptors to inhibit pain impulses in the periphery, spinal cord, and brain -receptors present throughout the body -func: responsible for sensations of wellbeing and modulation of many physical processes

endocannabinoids

neurotransmitters of pain modulation: these are synthesized from phospholipids and classified as eicosanoids

inhibitory neurotransmitters

neurotransmitters of pain modulation: these include GABA, glycine, serotonin, norepinephrine -contribute to pain inhibition in the CNS but can excite peripheral nerves

excitatory neurotransmitters

neurotransmitters of pain modulation: these include glutamate, aspartate, substance P, calcitonin -reduce activation threshold, leading to inc responsiveness of nociceptors

excitatory postsynaptic potential (EPSP)

neurotransmitters: happens when the postsynaptic neuron is depolarized -if this reaches threshold potential, an action potential is initiated

inhibitory postsynaptic potential (IPSP)

neurotransmitters: happens when the postsynaptic neuron's plasma membrane may be hyperpolarized -makes the membrane less likely to reach threshold potential, meaning the action potential is inhibited

summation

neurotransmitters: number and frequency of potentials the postsynaptic nerve receives

spatial summation

neurotransmitters: spacing effect; combined effects of impulses from a number of neurons onto a single neuron at the same time -slow down; gives space b/w responses

temporal summation

neurotransmitters: time relationship; refers to the effects of successive, rapid impulses received from a single neuron at the same synapse -speed up response

clonal expansion

non-hodgkin lymphoma: NHL is a progressive __________ of B cells, T cells, and/or NK cells -oncogene activation linked to chromosome translocations -tumor-suppressor loci inactivated by deletion or mutation

risk factors for non-hodgkin lymphoma

non-hodgkin lymphoma: what does this list describe -being older, male, or white -having certain immune disorders, autoimmune disorders, or HIV/AIDS -exposure to mutagenic chemicals -infections w/ certain cancer related viruses -immune suppression related to organ transplant

leptin resistance

obesity: ___________ fails to inhibit orexigenic hypothalamic satiety signaling and promotes overeatinga nd excessive weight gain

intestinal microbiome

obesity: alterations in the _____________ may have a casual role in obesity

intake; expenditure

obesity: obesity develops when caloric ________ exceeds caloric _________ in genetically susceptible people

WAT

obesity: obesity produces a state of chronic, low-grade inflammation of _________, which contribute to the development of insulin resistance, metabolic syndrome, and other complications

ghrelin

obesity: produced by the stomach gastric mucosa -inc in response to fasting and chronic caloric restriction and dec after food intake -satiety, vasodilatory, and cardioprotective effects

hypothalamus; brainstem

obesity: signaling mediators act on the ____________ and _________ to regulate hunger and satiety

interaction

obesity: the pathophysiology of obesity is complex and involves the _________ of peripheral and central pathways and numerous adipokines, hormones, and neurotransmitters

endocannabinoids

obesity: these are arachidonic acid derivates expressed in both the brain and peripheral nerve tissues -inc appetite, enhance nutrient absorption, stimulate lipogenesis, and inc WAT accumulation -inhibit energy expenditure and thermogenesis

leptin

obesity: this is a product of the obesity gene and is expressed primarily by adipocytes -levels inc after eating, lower during fasting

retinol-binding protein 4

obesity: this is an adipokine produced both in the liver and by adipocytes -contributes to inflam and insulin resistance in liver and muscles

glucagon-like peptide 1

obesity: this is an anorexigenic hormone secreted by intestinal endocrine cells when nutrients enter the small intestine -func: dec blood glucose levels, delays gastric emptying, suppresses appetite, inc satiety, and inc energy expenditure -dec of this in obese indivs

angiotensinogen

obesity: this is produced in the liver and by adipocytes -inc in obesity -promote lipogenesis, oxidative stress, inflam, insulin resistance

adiponectin

obesity: this is produced primarily by visceral adipose tissue but also cardiomyocytes and skeletal muscle -func: inc energy expenditure; antiinflam and antiatherogenic plasma protein -cardioprotective

peptide YY

obesity: this is released from intestinal endocrine cells in response to nutrients entering the intestine -inhibits gastric motility and dec apetite -dec w/ obesity

cholecystokinin

obesity: this is secreted by proximal small intestinal cells after food intake -func: gallbladder contraction, release of pancreatic enzymes, insulin, satiation, reduced food intake -reduced in obesity

risk factors for obesity

obesity: what does this list describe? -polygenic defects -metabolic abnormalities -environmental factors -depression and mood disorders

adipokines and obesity

obesity: what does this list describe? -leptin -adiponectin -retinol-binding protein 4 -endocannabinoids -angiotensinogen -ghrelin -glucagon-like peptide 1 -peptide YY -cholecytokinin

supravalvular aortic stenosis

obstructive defects: ___________, a narrowing of the aorta just above the valve, occurs infrequently -occur as single defect or part of Williams syndrome (unusual elfin facial appearance and ID)

subvalvular aortic stenosis

obstructive defects: ____________ is a stricture caused by a fibrous ring below a normal valve or by a narrowed LV outflow tract in combination w/ a small aortic valve annulus (diameter at the base of the aortic root)

pulmonary atresia

obstructive defects: _____________ is an extreme form of PS, w/ total fusion of valve leaflets, meaning that blood cannot flow out of the lungs

valvular aortic stenosis

obstructive defects: ______________ occurs because of malformed or fused cusps, resulting in a unicuspid or bicuspid valve -obstruction tends to be progressive -rare form of congenital heart disease

coarctation of the aorta

obstructive defects: this is the localized narrowing of the lumen of the aorta that impedes blood flow -manifestations: if severe dec cardiac output, acidosis, hypertension; if undiagnosed, no manifestations until hypertension in upper extremities at older age

aortic stenosis

obstructive defects: this is the narrowing of the left ventricular outlet; causes inc workload on the left ventricle and left ventricular hypertrophy -3 types: valvular, subvalvular, supravalvular -manifestations: infant -> faint pulse, hypotension, tachycardia, poor feeding; older children -> exercise intolerance, risk for bacterial endocarditis

pulmonic stenosis

obstructive defects: this is the narrowing of the pulmonary valve causing resistance to flow from right ventricle to pulmonary artery -mod to severe: right ventricular hypertrophy -manifestations: if severe -> cyanosis from right-to-left shunt thru atrial septal defect; dec cardiac output; heart systolic murmur and ejection click

polysomnography

obstructive sleep apnea syndrome: _________ is needed to diagnose OSAS in addition to the history and physical exam

hypersomnia

obstructive sleep apnea syndrome: excessive daytime sleepiness -falling asleep during daytime activities -impaired mood and cognitive function

olfactory stimulants

olfaction: what does this list describe? -camphoraceous -musky -floral -peppermint -ethereal -pungent -putrid

parosmia

olfactory dysfunction: abnormal sense of smell

anosmia

olfactory dysfunction: complete loss of sense of smell

hyposmia

olfactory dysfunction: impaired sense of smell

olfactory hallucinations

olfactory dysfunction: smelling odors that are not really present

missile injuries

open brain injury: injuries caused by bullets, rocks, shell fragments, knives, and blunt instruments

compound skull fracture

open brain injury: opens a communication b/w the cranial contents and the env and should be investigated wenever lacerations of the scalp, tympanic membrane, sinuses, eye, or mucous membranes are present

gestational diabetes mellitus (GDM)

other types of diabetes mellitus: this is any degree of glucose intolerance w/ onset or 1st recognition during pregnancy -not clearly overt diabetes prior to gestation

maturity onset diabetes of youth (MODY)

other types of diabetes mellitus: this is when beta-cell function or insulin action is affected by autosomal dominant mutations -usually presents before 25 years of age -management similar to type 2 diabetes

central nervous system; peripheral nervous system

overview of the nervous system: structurally, the nervous system is divided into the ____________ and the _____________

peripheral nervous system (PNS)

overview of the nervous system: composed of cranial nerves and spinal nerves and their ganglia

central nervous system (CNS)

overview of the nervous system: consists of the brain and spinal cord, enclosed w/in a protective cranial vault and vertebrae

somatic nervous system; autonomic nervous system

overview of the nervous system: functionally, the PNS can be divided into the ___________ and the ___________

afferent pathways; efferent pathways

overview of the nervous system: peripheral nerve pathways are differentiated into ___________, which ascend and carry sensory impulses towards the CNS, and _____________, which descend and transmit motor impulses away from the CNS

sympathetic; parasympathetic

overview of the nervous system: the autonomic nervous system is further divided into the __________ and __________ divisions

autonomic nervous system

overview of the nervous system: this consists of pathways regulating the body's internal environment through involuntary control of organ systems (i.e. heart rate, breathing, etc)

somatic nervous system

overview of the nervous system: this consists of pathways that regulate voluntary motor control (e.g. skeletal muscle)

night terrors

parasomnias: characterized by sudden apparent arousals in which the child expresses intense fear or emotion -no memory of event

restless leg syndrome (RLS)

parasomnias: common sensorimotor disorder associated w. unpleasant sensations (pickling, tickling, crawling) and nonvolitional periodic leg movements that occurs at rest and is worse in the evening or at night

somnambulism (sleepwalking)

parasomnias: non-REM parasomnia disorder primarily of chilhood and appears to resolve w/in a few years -no memory of event on awakening

vitamin D

parathyroid glands: __________ acts as a cofactor with PTH to promote calcium and phosphate absorption -needed for PTH function

parathyroid hormone (PTH)

parathyroid glands: this hormone: 1. increases serum calcium and decreases serum phosphate 2. promotes calcium and phosphate absorption to enhance bone mineralization

inhibitory pathways

pathways of modulation: ____________ can: -activate opioid receptors -inhibit release of excitatory NTs -release inhibitory NTs -stimulate inhibitory interneurons

expectancy-related cortical activation

pathways of modulation: cognitive expectations cause physiologic effects -placebo effect

segmental inhibition of pain

pathways of modulation: occurs when A-beta fibers stimulate inhibitory interneurons and decrease pain transmission -ex. rubbing an area that has been injured to relieve pain

diffuse noxious inhibitory control (DNIC)

pathways of modulation: pain is relieved when two noxious stimuli occur at the same time from different sites -pain inhibiting pain -basis of pain relief w/ acupuncture, deep massage, or intense cold or heat

inhibits

pathways of modulation: stimulation of efferent pathways _________ pain signals

newborns

pediatrics and blood: _________ at risk for impaired phagocytosis, bacterial infections, and delayed wound healing

increase

pediatrics and blood: blood cell counts _________ above adult levels at birth due to the trauma of birth and cutting of the umbilical cord

IgG

pediatrics and blood: protection from disease provided by passive _________ antibody from mother transplacentally and in breast milk

polycythemia

pediatrics and blood: the hypoxic intrauterine environment stimulates erythropoietin production and accelerates fetal erythropoiesis, producing __________, which is excessive proliferation of erythrocyte precursors

intermittent claudication

peripheral artery disease: in most indivs, gradually inc atherosclerotic obstruction to arterial blood flow in the iliofemoral vessels can result in leg pain w/ ambulation called _______________

polyneuropathy

peripheral nervous system disorders: generalized involvement or peripheral nerves

autonomic neuropathies

peripheral nervous system disorders: involve autonomic nervous system

mononeuropathies

peripheral nervous system disorders: these affect a single nerve

multiple mononeuropathies

peripheral nervous system disorders: two or more indiv nerves

fascicles

peripheral nervous system: in the PNS, nerves are arranged in bundles called _________

tree

peripheral nervous system: spinal nerve structure is similar to a _______ -arise as rootlets, which combine into roots -roots converge into a trunk -trunk divides into rami (branches): anterior rami form plexuses and posterior rami innervate specific cutaneous areas called dermatomes

cranial nerves

peripheral nervous system: these arise from the brain and can be either sensory, motor, or mixed (mostly) -12 pairs

spinal nerves

peripheral nervous system: these arise from the spinal cord; names correlate w/ vertebral level from which they exit -31 pairs -mixed nerves (both sensory and motor neurons)

feet; hands

peripheral vascular disease: in buerger disease, over time, the thrombi become organized and fibrotic resulting in permanent occlusion of portions of small- and medium- sized arteries in ________ and _______

secondary raynaud phenomenon

peripheral vascular disease: this is RP secondary to other systemic diseases or conditions such as collagen vascular disease, pulmonary hypertension, hypothyroidism, and long term exposure to cold environment -changes in skin color and sensation

primary raynaud phenomenon

peripheral vascular disease: this is a common vasospastic disorder of unknown origin

thromboangiitis obliterans (Buerger disease)

peripheral vascular disease: this is an autoimmune disease of the peripheral arteries; characterized by the formation of thrombi filled w/ inflam and immune cells -strongly assoc w/ smoking -chief symptom: pain and tenderness in affected area -can lead to gangrenous lesions and amputations

raynaud phenomenon

peripheral vascular disease: this is an episodic vasospasm in arteries and arterioles of the fingers, less commonly the toes -can be primary or secndary

metabolically healthy obesity

phenotypes of obesity: these are indivs who are obese but have no metabolic-obesity associated w/ complications and dec risk for morbidity and mortality

normal weight obesity

phenotypes of obesity: this describes indiv w/ normal body weight and BMI w/ percent of body fat greater than 30%

peripheral obesity

phenotypes of obesity: this occurs when the distribution of body fat is extraperitoneal and distributed around the thighs and buttocks -"pear shape"

visceral obesity

phenotypes of obesity: this occurs when the distribution of body fat is localized around the abdomen and upper body -"apple shape" -assoc w/ more obesity complications than peripheral

visceral and peripheral

phenotypes of obesity: what are the two different forms of phenotypes of adipose tissue distribution?

melatonin

pineal gland: this hormone regulates circadian rhythms and reproductive systems (secretion of goandotropin-releasing hormones and onset of puberty); plays a role in immune regulation

monoclonal gammopathy of undetermined significance (MGUS)

plasma cell malignancy: multiple myeloma is often preceded by a condition known as ____________________, which is diagnosed by the presence of an M protein in the blood or urine

multiple myeloma (MM)

plasma cell malignancy: this is a malignant proliferation of plasma cells; infiltrate bone marrow and aggregate into tumor masses in skeletal system to make lytic bone lesions -manifestations: hypercalcemia, renal failure, anemia, immune abnormalities

spinal cord

portion of the CNS that lies w/in the vertebral canal, protected by the vertebral column

infundibular process

posterior pituitary: place where axons originating in the hypothalamus terminate -secrete hormones of the posterior pituitary

pituitary stalk

posterior pituitary: this contains the axons of neurons that originate in the supraoptic and paraventricular nuclei of the hypothalamus and connects w/ pituitary gland to the brain

antidiuretic hormone (ADH)

posterior pituitary: this hormone controls plasma osmolality

oxytocin

posterior pituitary: this hormone is responsible for uterine contractions and milk ejection in lactating females -may affect sperm motility in males

median eminence

posterior pituitary: this is composed largely of the nerve endings of axons from the ventral hypothalamus

antidiuretic hormone (ADH) and oxytocin

posterior pituitary: what are the two hormones that the posterior pituitary secretes?

chronic cluster headaches

primary headache syndromes: if the cluster of attacks occurs more frequently w/o sustained spontaneous remission, the condition is classified as ______________

migrane triggers

primary headache syndromes: ___________ include altered sleep patterns, skipping meals, overexertion, weather change, stress or relaxation from stress, hormonal changes (menstrual periods), excess afferent stimulation (bright lights, strong smells), chemicals (alcohol or nitrates)

diagnosis

primary headache syndromes: the ________ of migraines are unilateral head pain, throbbing, worsened by movement, moderate or severe, and one of the following: nausea and/or vomiting, photphobia and phonophobia

migraine aura

primary headache syndromes: these may last an hour and may be visual, sensory, or motor

cluster headache

primary headache syndromes: this involves the autonomic division of the trigeminal nerve; occur in clusters (min to hrs) for a period of days followed by a long period of remission -usually occur in men b/w 20-50yrs old -unilateral severe pain w/ manifestations on the same side of the body (tearing and ptosis of eye, stuffy nose)

migraine

primary headache syndromes: this is an episodic disorder characterized by headache lasting 4-72 hrs -cause: combination of genetic and environmental factors -usually women 25-55 years old -chronic: > 14 days per month

premonitory phase

primary headache syndromes: this is had hours to days before the onset of the aura or headache -symptoms: fatigue, irritability, loss of concentration, stiff neck, food cravings

tension-type headache (TTH)

primary headache syndromes: this is the most common recurrent headache; mild to moderate bilateral headache w/ sensation of a tight band or pressure around the head w/ gradual onset of pain -average onset: 2nd decade -occurs in episodes and may last for several hours or several days -chronic version occurs at least 15 days per month for at least 3 months

headache phase

primary headache syndromes: this is when headaches usually begin on one side and spreads to include the entire head -accompanied by fatigue, nausea, vomiting, dizziness; hypersensitivity to anything touching head -lasts 4-72 hours (usually a day)

recovery phase

primary headache syndromes: this may include irritability, fatigue, or depression; may take hours or days to resolve

phases of a migraine

primary headache syndromes: what does this list describe? 1. premonitory 2. aura 3. headache 4. recovery

ventricles

protective structures: cavities where the CSF circulates

cerebrospinal fluid (CSF)

protective structures: clear, colorless fluid similar to blood plasma and interstitial fluid -125-150 ml in ventricles -produced by choroid plexuses in lateral, third, and fourth ventricles -reabsorbed thru the arachnoid villi

cranium

protective structures: composed of eight bones; this encloses and protects the brain and its associated structures

meninges

protective structures: protective membranes surrounding the brain and spinal cord -3 layers: dura mater, arachnoid, pia mater

subgleal space

protective structures: space where blood can be shunted to reduce intracranial pressure -provides flexibility to adjust for intracranial pressure

intervertebral disk

protective structures: these are found in between each interspace -absorbs shocks, preventing damage to the vertebrae -common source of back problems

galea aponeurotica

protective structures: thick, fibrous band of tissue overlying the cranium between the frontal and occipital muscles, affords added protection to the skull -helmet of the cranium

vertebral column

protective structures: this is composed of 33 vertebrae: 7 cervical, 12 thoracic, 5 lumbar, 5 fused sacral, and 4 fused coccygeal

nucleus pulposus

protective structures: this is found at the center of the intervertebral disk; pulpy mass of elastic fibers

subarachnoid space

protective structures: this lies b/w the arachnoid and pia mater

subdural space

protective structures: this lies b/w the dura and the arachnoid

dura mater

protective structures: meninges composed of two layers, w/ the venous sinuses formed b/w them -literal meaning: "hard mother"

pia mater

protective structures: meninges delicate; adheres to contours of the brain and spinal cord, provides support for blood vessels serving brain tissue

arachnoid

protective structures: meninges this lies internal to the dura mater; spongy, web-like structure that loosely follows contours of cerebral structures

thrombocytopenia

quantitative disorders of platelets: this is a dec in the number of circulating platelets

thrombocythemia

quantitative disorders of platelets: this is an inc in the number of circulating platelets

granulocytopenia; agranulocytosis

quantitive alterations of granulocytes: _______________, or severe neutropenia, and ________________, or the bsence of granulocytes requires chemotherapy for treatment

shift to the left; shift to the right

quantitive alterations of granulocytes: if the need for more neutrophils increases beyond the supply, immature neutrophils are released in a phenomenon termed ______________ when the population of neutrophils returns to normal, a phenomenon termed ________ occurs

basopenia

quantitive alterations of granulocytes: this is a dec in circulating numbers of basophils -occurs in acute infections, hyperthyroidism, ovulation, pregnancy and long-term steroid therapy

eosinopenia

quantitive alterations of granulocytes: this is a dec in circulation numbers of eosinophils -main cause: migration of cells to inflam sites -other causes: Cushing syndrome, stress from surgery, shock, trauma, mental distress

basophilia

quantitive alterations of granulocytes: this is an inc in circulating basophils -response to inflam and hypersensitivity rxns -seen in myeloproliferative disorders

eosinophilia

quantitive alterations of granulocytes: this is an inc in circulating eosinophils -triggered by hypersensitivity rxns -causes: allergic disorders and parasitic invasions

granulocytosis

quantitive alterations of granulocytes: this is an increase in granulocytes -neutrophilia: evident in the 1st stages of an infection or inflammation

neutropenia

quantitive alterations of granulocytes: this is the reduction of circulating neutrophils -causes: prolonged severe infection, dec production, reduced survival, and abnormal neutrophil distribution, and sequestration

leukocytosis

quantitive alterations of leukocytes: this is a high leukocyte count; normal protective physiologic resp to physiologic stressors such as infectious microorgs

leukopenia

quantitive alterations of leukocytes: this is a low leukocyte count; not normal and not beneficial -predisposes a patient to infections

lymphocytopenia

quantitive alterations of lymphocytes: this is a dec in the number of circulating lymphocytes -causes: abnormal production due to immune deficiencies; destruction by drugs, viruses, or radiation

lymphocytosis

quantitive alterations of lymphocytes: this is an inc in number or proportion of lymphocytes -causes: acute viral infections, particularly Epstein-Barr virus (EBV)

monocytopenia

quantitive alterations of monocytes: this is a dec in circulating monocytes -very rare

monocytosis

quantitive alterations of monocytes: this is an inc in circulating monocytes -often transient and unrelated to dysfunction of monocyte production -usually occurs w/ neutropenia in later stages of infections when monocytes needed to phagocytize organisms and debris

cardiac output

regulation of blood pressure: an inc in _________ w/o a dec in peripheral resistance will cause MAP and flow rate to inc

vasoconstrictor hormones

regulation of blood pressure: the ___________ include epinephrine, norepinephrine, angiotensin II, and vasopressin

vasodilator hormones

regulation of blood pressure: the natriuretic peptides or hormones including atrial natriuretic peptide (ANP), B-type natriuretic peptide (BNP), C-type natriuretic peptide, and urodilation, function as both ___________ and regulators of Na and H2O excretion

chemoreceptors

regulation of blood pressure: these transmit impulses to the medullary cardiovascular centers that regulate BP

total peripheral resistance

regulation of blood pressure: this is a function of arteriolar diameter -includes baroreceptors and chemoreceptors

adrenomedullin

regulation of blood pressure: this is a peptide w/ powerful vasodilatory activity

nitric oxide `

regulation of blood pressure: this is an intracellular and intercellular signaling molecule produced in endothelial cells -vasodilator -inhibitor of smooth muscle proliferation -called endothelium-derived relaxing factor

arterial pressure

regulation of blood pressure: this is determined by the cardiac output multiplied by the peripheral resistance

mean arterial pressure (MAP)

regulation of blood pressure: this is the average pressure in the arteries throughout the cardiac cycle -depends on elastic properties of arterial walls and mean volume blood in arterial system

systolic blood pressure

regulation of blood pressure: this is the highest arterial BP after ventricular contraction or systole

diastolic blood pressure

regulation of blood pressure: this is the lowest arterial BP that occurs after ventricular filling or diastole

venous pressure

regulation of blood pressure: this is the volume of fluid in veins and compliance of vessel walls

factors that affect BP

regulation of blood pressure: what does this list describe -cardiac output -total peripheral resistance -hormones -other mediators: nitric oxidem adrenomedullin, endothelins, prostacyclin

autonomic regulation

regulation of coronary circulation: although coronary vessels themselves contain sympathetic and parasympathetic neural receptors, coronary blood flow during refular activity is regulated locally by the factors that cause ______________

autoregulation

regulation of coronary circulation: this enables organs to regulate blood flow by altering the resistance (diameter) in their arterioles -maintains blood flow at nearly constant rate at perfusion pressures b/w 60-140 mmHg

coronary perfusion pressure

regulation of coronary circulation: this is the difference b/w pressure in the aorta and pressure in the coronary vessels

arcuate nucleus

regulation of food intake and energy balance: ____________ in the hypothalamus balances the opposing effects of neurons

central; peripheral

regulation of food intake and energy balance: regulation of food intake and energy balance is a complex process controlled by ________ and ________ physiological signals

GI tract

regulation of food intake and energy balance: the _______________ secretes hormones that control hunger and satiety

orexigenic neurons

regulation of food intake and energy balance: these promote appetite, stimulate eating, and dec metabolism

anorexigenic neurons

regulation of food intake and energy balance: these suppress appetite, inhibit eating, and inc metabolism

feedback systems

regulation of hormone release: _____________ provide precise monitoring and control of the cellular environment -can be negative or positive

circulatory system

regulation of hormone release: hormones are released into the _______________ by endocrine glands and distributed throughout the body

adaptation; regulated

regulation of hormone release: hormones are released: -in response to an __________ in the cellular environment -to maintain a _________ level of certain substances or other hormones

negative feedback

regulation of hormone release: this happens when a response to a stimulus decreases synthesis and secretion of hormone -ex. thyroxine and triiodothyronine

positive feedback

regulation of hormone release: this happens when a response to stimulus increases synthesis and secretion of hormone -ex. thyrotropin-releasing hormone (TRH) (stimulates secretion of TSH -> synthesis and secretion or thyroid hormones)

chemical, endocrine, neural

regulation of hormone release: what are the three factors hormones are regulated by?

lysis of blood clots

retraction and lysis of blood clots: ______________ is carried out by the fibrinolytic system

plasmin; fibrin degradation products (FDPs)

retraction and lysis of blood clots: in the fibrinolytic system, plasminogen is converted to _________, which is an enzyme that dissolves clots by degrading fibrin and fibrinogen into ____________, a major one being D-dimer

clot retraction

retraction and lysis of blood clots: this is when fibrin strands shorten and become denser and stronger ti approximate the edges of the injured vessel and site of injury -process facilitated by large numbers of platelets w/in the clot

febrile illness

rheumatic fever: in its acute form, rheumatic fever is a ____________ characterized by inflam of joints, skin, nervous system, and heart

common manifestations of rheumatic fever

rheumatic fever: what does this list describe? 1. fever 2. lymphadenopathy 3. arthralgia 4. nausea/vomiting and abdominal pain 5. tachycardia 6. epistaxis

major clinical manifestations of rheumatic fever

rheumatic fever: what does this list describe? 1. carditis: murmur, chest pain, pericardial friction rub 2. polyarthritis: heat, redness, swelling, pain that migrate among large joints of extremities 3. chorea: sudden, aimless, irregular, involuntary movements 4. erythema marginatum: nonpruritic, erythematuous macules on the trunk that may fade in the center 5. subcutaneous nodules: palpable nodules over bony prominences and extensor tendons

cerebral processes

secondary brain injury: ____________ include inflammation, cerebral edema, inc ICP, dec cerebral perfusion pressure, cerebral ischemia, and brain herniation

systemic processes

secondary brain injury: _____________ include hypotension, hypoxia, anemia, hypercapnia, and hypocapnia

cervical

secondary spinal cord injury van be life-threatening if swelling occurs in the _______ region -reason: cardiovascular and respiratory control can be lost

aura

seizures: a partial seizure experiences as a peculiar sensation preceding onset of generalized seizure that may take the form of gustatory, visual, or auditory experience or a feeling of dizziness, numbness, or just a "funny feeling"

prodroma

seizures: early clinical manifestation (such as malaise, headache, a sense of depression or alterations in smell, taste, hearing or vision) that may occur a few days to hours before onset of a seizure

classified

seizures: seizures are _________ by clinical manifestations, site of origin, EEG correlates, response to therapy

generalized seizures

seizures: seizures originating in both sides of the brain simultaneously; can include tonic, atonic, clonic, myoclonic, myoclonic-atonic, clonic-tonic-clonic activity

focal seizures

seizures: seizures originating in one area of the brain; an aura is common

preictal phase

seizures: the ________ includes prodroma, which can happen hours to days before, and aura, which happens immediately before

status epilepticus

seizures: this is a state of continuous seizures -medical emergency that requires immediate intervention

ictus

seizures: this is the seizure episode w/ tonic-clonic activity

postictal state

seizures: time period immediately following cessation of seizure activity -experience headache, confusion, dysphasia, memory loss, paralysis

types of seizures

seizures: what does this list describe? -focal -generalized -epilepsy syndromes

lateral spinothalamic tract

sensory pathways: responsible for pain and temperature perception -protopathic

anterior spinothalamic tract

sensory pathways: responsible for vague touch sensation -protopathic

posterior column

sensory pathways: this carries fine-touch sensation, two-point discrimination, and proprioceptive information

oxygen

shock: in all types of shock, the cell either is not receiving an adequate amount of ________ or is unable to use _______ (same word) -cells shift from aerobic to anaerobic metabolism (less efficient)

cause

shock: shock is classified by _________

cardiogenic shock

shock: this is shock caused by heart failure; dec cardiac output and evidence of tissue hypoxia in the presence of adequate intravascular volume -most cases follow MI

anaphylactic shock

shock: this is shock caused by immunologic processes; begins w/ exposure of a sensitized indiv to an allergen -results from a widespread hypersensitivity reaction

septic shock

shock: this is shock caused by infection that progresses from bacteremia to sepsis to ____________ and finally to MODS -begins w/ bacteria entering blood stream to produce bacteremia

hypovolemic shock

shock: this is shock caused by insufficient intravascular fluid volume (large amount of blood, plasma, interstitial fluid loss) -begins to develop when intravascular volume has dec by about 15%

neurogenic shock

shock: this is shock caused by neural alterations of vascular smooth muscle tone -result of widespread and massive vasodilation resulting from imbalances b/w parasympathetic and sympathetic stim of vasc smooth musc

sleep disorders

six classifications of ________________: 1. insomnia 2. sleep related breathing disorders 3. central disorders of hypersomnolence 4. circadian rhythm sleep-wake disorders 5. parasomnias 6. sleep related movement disorders

paradoxical sleep

sleep: REM sleep is known as _______ because EEG is similar to normal awake pattern

hypothalamus

sleep: ___________ is the major sleep center

hypocretins (orexins)

sleep: these promote wakefulness and REM sleep

non-REM sleep (NREM)

sleep: this accounts for 75%-80% of sleep time; sympathetic tone decreased and parasympathetic activity inc -state of reduced activity -characteristics: dec in metabolic rate, temperature, HR, respiration, BP, muscle tone

rapid eye movement (REM) sleep

sleep: this sleep occurs 20% to 25% of sleep time; occurs every 90 minutes beginning after 1 to 2 hrs of non-REM sleep -inc parasympathetic activity and variable sympathetic activity

REM sleep; non-REM sleep

sleep: what are the two phases of sleep?

REM sleep

sleep: which phase do these characteristics describe? -rapid eye movement -muscle relaxation -loss of thermoregulation -altered heart rate. blood pressure, and respiration -memorable dreams

touch

somatosensory function: ______ receptors are present in the skin and include meissener corpuscles, pacinian corpuscles, merkel discs, and ruffini endings

meissner; pacinian

somatosensory function: _________ corpuscles sense movement across skin ________ corpuscles sense movement across vibration

ruffini endings

somatosensory function: respond to deep sustained pressure, stretch, and joint position

merkel discs

somatosensory function: sense sustained light touch

age

somatosensory function: tactile discrimination decreases w/ ______

proprioception

somatosensory function: this is the awareness of position of body and its parts -depends on inner ear and receptors in joints and ligaments -progressive loss w/ age -> inc risk for falls and injury

vestibular nystagmus

somatosensory function: vestibular dysfunction in which there constant involuntary movement of eyeball -develops when semicircular canal system is overstimulated

vertigo

somatosensory function: vestibular dysfunction of the sensation of spinning that occurs w/ inflammation of semicircular canals in ear

olfaction (smell)

special senses: cranial nerves I and IV

taste (gustation)

special senses: cranial nerves VII and IX

hearing

special senses: ears

vision

special senses: eyes

compressive syndrome

spinal cord tumors: involves both the anterior and posterior spinal tracts, and motor function and sensory function are affected as the tumor grows

irritative syndrome

spinal cord tumors: combines the clinical manifestations of a cord compression w/ radicular pain that occurs in the sensory root distribution and indicates root irrutation

extramedullary tumors

spinal cord tumors: originate from tissues outside the spinal cord; these include peripheral nerve sheath tumors and meningiomas

intrameduallary tumors

spinal cord tumors: these include gliomas (astrocytomas and ependymomas)

substantia gelatinosa

spinal cord: at the tip of the posterior horn is the _________, a structure involved in pain transmission

cauda equina

spinal cord: nerves continue from the end of the spinal cord and form a nerve bundle called the ___________

gray matter

spinal cord: the ________ of the spinal cord is divided into 3 regions: posterior horn/ dorsal horn, lateral horn, anterior horn/ ventral horn

coverings

spinal cord: the _________ of the spinal cord consist of the dura mater, arachnoid mater, and pia mater

white matter

spinal cord: this forms ascending and descending pathways called spinal tracts -has more myelin sheath so it appears more ____ to the eye

conus medullaris

spinal cord: this is the end of the spinal cord; cone shaped

spinal cord functions

spinal cord: what does this list describe? -connects the brain to the body -conducts somatic and autonomic reflexes -provides motor pattern and control centers -modulates sensory and motor function

arousal

state of awakeness -mediated by reticular activating system

consciousness

state of awareness if oneself and the environment -two components: arousal and awareness

pseudounipolar

structural classification of neurons: have one axon process and one dendrite process, but the dendrite and the axon are fused to each other near the cell body and the axon then extends into the CNS

bipolar

structural classification of neurons: have two distinct processes (one axon and one dendrite) arising directly from the cell body

multipolar

structural classification of neurons: most common; have multiple processes capable of extensive branching

unipolar

structural classification of neurons: one process, an axon which branches shortly after leaving the cell body

processes

structural classification of neurons: the structural classification of neurons is based on the number of ________, or projections, extending from the cell body

vasa vasorum

structure of blood vessels: cells of larger vessel walls are nourished by the _____________, which are small vessels located in the tunica externa

veins

structure of blood vessels: compared w/ arteries, ____________ are thin walled w/ more fibrous connective tissue and have a larger diameter; also they are more numerous

metaarterioles

structure of blood vessels: the capillary network is composed of connective channels called _________ and "true" capillaries -discontinuous smooth musc cells in tunica media

tunica intima

structure of blood vessels: the is the innermost layer of the blood vessel walls

venules

structure of blood vessels: the smallest __________ downstream from capillaries have an endothelial lining and are surrounded by connective tissue the largest ___________ (same word) have some smoot muscle fibers in their thin tunica media

capillaries

structure of blood vessels: these are composed solely of a layer of endothelial cells surrounded by a basement membrane -thin walls and structure: rapid exchange of water, small soluble molecules, some larger molecules, and cells of innate and adaptive components of the immune system

muscular arteries

structure of blood vessels: these are farther from the heart than elastic arteries; contain more muscle fibers and func to distribute blood to arterioles thru the body

arterioles

structure of blood vessels: these are mainly composed of smooth muscle and regulate the flow of blood into the capillaries by constricting or dilating to either slow or inc flow of blood into the capillaries -diameter of lumen narrows to < 0.5 mm

venous vessels

structure of blood vessels: these carry deoxygenated blood toward the heart (color coded blue) -list: veins, venules

arterial vessels

structure of blood vessels: these carry oxygenated blood away from the heart (color coded red) -can be elastic or muscular -list: arteries, arterioles, metarterioles, capillaries

elastic arteries

structure of blood vessels: these have a thick tunica media w/ more elastic fibers than smooth muscle fibers; allow vessel to absorb energy and stretch as blood is ejected from heart during systole -located close to heart -aorta and major branches and the pulm tract

endothelium

structure of blood vessels: this is the blood vessel lining made of endothelial cells -func: transport, coagulation, immune function, wound healing, vasomotion (contraction and relaxation of vessels)

lumen

structure of blood vessels: this is the internal cavity of the vessel

tunica media

structure of blood vessels: this is the middle layer of blood vessel walls

tunica externa (adventitia)

structure of blood vessels: this is the outermost, or external layer of the blood vessel walls -contains nerves and lymphatic vessels

layers of vessel walls

structure of blood vessels: what does this list describe? 1. tunica intima 2. tunica media 3. tunica externa (adventitia)

kernig sign

subarachnoid hemorrhage (SAH): this is known as straightening the knee w/ the hip and knee in a flexed position producing pain in the back and neck regions

brudzinski sign

subarachnoid hemorrhage (SAH): this is passive flexion of the neck appearing to produce neck pain and inc rigidity

seizure

sudden, transient alteration of brain function caused by abnormal excessive discharges of cortical neurons -manifestations of disease, not disease itself

postsynaptic neurons

synapses: distal to the synapse; relay impulses away from the synapse -receiving message

synaptic cleft

synapses: gap that separates the synaptic knob from the postsynaptic neuron

presynaptic neurons

synapses: proximal to the synapse; relay impulses toward the synapse -sending nerve

synaptic boutons

synapses: this is where chemicals known as neurotransmitters are stored

venules; veins

systemic circulation: blood from the capillaries then enters tiny ________ that hoin to form the larger _________, which return venous blood back to the right heart

arteries

systemic circulation: oxygenated blood leaves the left side of the heart through the aorta and flows into the systemic ___________

arterioles; capillaries

systemic circulation: these arteries branch into small ___________, which branch into the smallest vessels, the ___________, where nutrient and waste product exchange b/w the blood and tissues occurs

ageusia

taste dysfunction: absence of sense of taste

hypogeusia

taste dysfunction: decreased sense of taste

dysgeusia

taste dysfunction: perversion of sense of taste -substances possess and unpleasant flavor

taste sensations

taste: what does this list describe? -sour -sweet -salty -bitter -umami (savoriness)

infants

temperature regulation: ______ produce sufficient body heat but are unable to conserve heat produced -reasons: small body size and high body surface-to-weight ratio, thin subcutaneous layer, inability to shiver, lower sweating rate, higher peripheral blood flow in the heat

heat loss

temperature regulation: _________ is achieved through: 1. radiation 2. conduction 3. convection 4. vasodilation 5. evaporation (sweating) 6. decreased muscle tone 7. increased respiration 8. voluntary measures 9. adaptation to warmer climates (i.e. inc or dec the volume of sweat)

central thermoreceptors

temperature regulation: ______________ are found in the hypothalamus, spinal cord, and viscera

peripheral thermoreceptors

temperature regulation: ______________ are found in the skin, liver, and skeletal muscle

heat production

temperature regulation: ________________ is formed by chemical reactions of metabolism and skeletal muscle tone and contraction

hypothalamus; endocrine system

temperature regulation: temperature regulation is maintained by the ________ and the _________

elderly

temperature regulation: the ________ respond poorly to temperature extremes -reasons: slow blood circulation, skin changes, dec heat-producing activities, and disease -more reasons: dec shivering and sweating response, metabolic rate, vasoconstrictive response, and perception of heat and cold

heat conservation

temperature regulation: the hypothalamus triggers _______ by stimulating the SNS resulting in increased skeletal muscle tone, initiating shivering response, producing vasoconstriction, and relaying info to the cerebral cortex about cold and voluntary responses result (i.e. bundling up, moving)

chemical thermogenesis

temperature regulation: this is the heat-producing mechanism of the body; an increase in circulating epinephrine and norepinephrine in the blood rapidly increase the rate of cellular metabolism

macrocytic anemias

termed megaloblastic anemias; this is the result of defective DNA synthesis caused by deficiencies in vitamin B12 or folate -characteristics: unusually large stem cells => erythrocytes large in thickness, size, volume

pancreas

the ________ is both an endocrine and exocrine gland

anterior pituitary

the __________ is composed of 3 regions: 1. pars distalis 2. pars tuberalis 3. pars intermedia

hypothalamic-pituitary system (HPA)

the ____________ forms the structural and functional basis for integration od neurologic and endocrine systems, creating what is called the neuroendocrine system

posterior pituitary

the ____________ is derived from the hypothalamus and has 3 parts: 1. median eminence 2. pituitary stalk 3. infundibular process

external ear

the ear: involved in hearing; composed of the pinna and external auditory canal -tympanic membrane separates this from the middle ear

middle ear

the ear: involved in hearing; composed of the tympanic cavity (composed of ossicles -> malleus, incus, and stapes) -connected to thorax by eustachian tube

inner ear

the ear: involved w/ hearing and equilibrium; composed of osseous labyrinths filled w/ perilymph (include cochlea, vestibule, semicircular canals) -organ of corti -> hair cells that are hearing receptors -equilibrium receptors: crista ampullaris and maculae

depolarization

the electrical activation of the muscle cells termed ___________ is caused by the movement of ions, including sodium, potassium, calcium, and chloride across cardiac cell membranes -inside of cell becomes less neg charged: pos ions moving in

choroid

the eye: deeply pigmented middle layer; prevents light from scattering inside the eye -consists of the iris and pupil

aqueous humor

the eye: aqueous chamber is filled with _________ and helps maintain pressure inside the eye, as well as provide nutrients to lens and cornea

cones

the eye: color and detail receptors and densest in the center of the retina

lens

the eye: light entering the eye is focused on retina by ______, a flexible biconcave structure

optic nerves

the eye: nerve impulses pass through the _________ (cranial nerve II) to optic chiasm

iris

the eye: part of choroid has round smooth opening through which light passes

retina

the eye: the innermost layer that contains rods and cones

anterior chamber

the eye: the lens divides the __________ into the anterior chamber and the vitreous chamber

virtreous humor

the eye: the vitreous chamber is filled w/ _____________ which is a gel-like substance that cannot regenerate -helps prevent the eyeball from collapsing inward

rods

the eye: these mediate peripheral and dim light vision and are densest at the periphery

sclera

the eye: thick, white outermost layer -becomes transparent at the cornea: portion that allows light to enter the eye

accomodation

the eye: this is lens flexibility that allows eyes to focus at different distances

pupil

the eye: this is the opening through which light passes

adipose tissue

the functions of __________ are insulation, mechanical support, secreting adipokines, immune cell function, and being an energy reserve -classified according to color

acute complications

the major ____________ of diabetes mellitus include hypoglycemia, diabetic ketoacidosis (DKA), and hyperosmolar hyperglycemic nonketotic syndrome (HHNKS)

coronary circulation

the myocardium and other heart structures are supplied w/ oxygen and nutrients by the ____________

gait

there are 4 predominant types of _______ associated w/ neurological disorders: 1. upper motor neuron dysfunction 2. cerebellar (ataxic) 3. basal ganglion 4. frontal lobe ataxic

microcytic hypochromic anemias

these anemias are characterized by red cells that are abnormally small and contain reduced amounts of hemoglobin

malignant lymphomas

these are a diverse group of neoplasms that develop from the proliferation of malignant lymphocytes in the lymphoid system -most common blood cancer in the US

vertebral injuries

these are a result from acceleration, deceleration, or deformation forces occurring at impact -classifications: simple fracture, compressed (wedge) fracture, comminuted (burst) fracture, dislocation

neurotransmitters

these are chemicals synthesized in the neuron and localized in the presynaptic terminal -can be excitatory or inhibatory

acquired hypercoagulability

these are deficiencies in proteins S and C and AT-III that are acquired

hereditary thrombophilias

these are inherited conditions that inc risk of developing thrombosis -most autosomal dominant -mutations affecting: platelet receptors, coagulation proteins, fibrinolytic proteins

adrenal glands

these are located close to upper pole of each kidney -consist of two portions: cortex and medulla -cortex and medulla function like two separate but interrelated glands

data processing deficits

these are problems associated w/ recognizing and processing sensory info -agnosia, aphasia, acute confusional states

water-soluble hormones

these are protein hormones and catecholamines that circulate in free, unbound forms -high in molecular weight -create short-acting response -cannot diffuse across the plasma membrane -> bind to surface receptors and initiate 1st and 2nd messengers

vascular malformations

these are rare congenital vascular lesions

parathyroid glands

these are small glands located behind the upper and lower poles of the thyroid gland -produce parathyroid hormone (PTH)

lipid-soluble hormones

these are steroid hormones which primarily circulate bound to carrier (provides protection and supervises) -relatively small -create rapid and long-lasting response -diffuse freely across the plasma or nuclear membranes: bind w/ cytosolic or nuclear receptors

thyroid gland

these are the two lobes that lie on either side of the trachea; located in neck just below larynx -produce hormones that control rates of metabolic processes throughout the body

convulsion

these are tonic-clonic (jerky, contract-relax) movements associated w/ some seizures

parasomnias

these are unusual behaviors occurring during NREM stage 3 sleep -include: sleepwalking (somnambulism), night terrors, rearranging furniture, eating food, sleep sex, violent behavior, restless leg syndrome

lower motor neuron syndromes

these occur as a result of injury to alpha motor neurons -impairs both voluntary and involuntary movement in the muscles innervated by involved nerves -conditions: flaccid paresis/paralysis, fasiculations, fibrillation

motor neuron diseases

these result from progressive degeneration of upper or lower motor neurons -conditions: guillain-barré syndrome; spinal muscular atrophy; progressive bulbar palsy; bulbar palsy

diabetes mellitus

this a group of metabolic diseases characterized by hyperglycemia -results in defects in: insulin secretion, insulin action, or both -categories: type 1, type 2, gestational

adrenal cortex

this accounts for 80% of adrenal gland's total weight; stimulated by ACTH -made up of 3 zones: zona glomerulosa; zona fasciculata, and zona reticularis -hormones synthesized from cholesterol

blood brain barrier (BBB)

this describes cellular structures that selectively inhibit certain substances in the blood from entering the interstitial spaces of the brain or CSF -site: endothelial cells in brain capillaries w/ intracellular tight junctions -supporting cells: astrocytes, pericytes, microglia

iron cycle

this describes how iron is produced from recycling iron from erythrocytes -controlled by hepcidin: regulates iron levels thru binding to ferroportin

hemorrhagic stroke

this happens when bleeding occurs in brain tissue or subarachnoid/subdural spaces -primary cause: hypertension -mass of blood causes compressed brain tissue, leading to ischemia, edema, and inc ICP and necrosis

neuroglia

this is "nerve glue"; general classification of nonneuronal cells that support the neurons of the nervous system -make up 1/2 of total brain and spinal cord volume -found in CNS and PNS

burkitt lymphoma

this is a B-cell non-Hodgkin lymphoma in children; fast growing tumor of the jaw and facial bones -types: endemic (linked to EBV), sporadic, immunodeficiency related (AIDS patients) -tx: aggressive multidrug regimens

infectious mononucleosis (IM)

this is a benign, acute, self-limiting infection of B lymphocytes transmitted by saliva thru personal contact -most common cause: EBV -other viruses that cause similar symptoms: cytomegalovirus (CMV), hepatitis, influenza, HIV, rubella -serious complications are rare

multiple sclerosis (MS)

this is a chronic progressive immune mediated inflammatory disease; multiple focal areas of myelin loss (plaque) -four subtypes based on clinical course

vascular dementia

this is a consequence of cerebrovascular disease; associated w/ conditions that cause hypoperfusion in the brain -diseases associated w/: larger artery disease, cardioembolism, small vessel disease of the brain, stroke -second most common cause of dementia after AD

intracranial aneurysm

this is a dilation or ballooning of cerebral vessel from weakness in vessel wall -classifications by shape: saccular (berry); fusiform (giant)

epilepsy

this is a disease of recurrent unpredictable seizures

brain

this is a functionally integrated circuit made of millions of neurons -enables a person to reason, function intellectually, express mood and interact

non-hodgkin lymphoma

this is a generic term for a diverse group of lymphoid tissue neoplasms -REAL classification: B-cell neoplasms; T-cell and NK-cell neoplasms -types: Burkitt and lymphoblastic -manifestations: painless generalized lymphadectomy

congenital heart disease

this is a heart disease present since birth; major cause of death in the 1st yr of life other than prematurity -prenatal, environmental, and genetic risk factors: maternal infection or inc age, metabolic disorders, PKU, drugs; antepartal bleeding; prematurity

malnutrition

this is a lack of nourishment from inadequate amounts of calories, protein, vitamins, or minerals -cause: diet, alterations in digestion, or disease

brain or spinal cord abscess

this is a localized collection of pus w/in the parenchyma -immunosuppressed people at particular risk

leukemia

this is a malignant disorder of the bone marrow and blood -excessive accumulation of malignant leukocytes => cells crowd bone marrow, dec func of hematopoietic cells, pancytopenia

hodgkin lymphoma

this is a malignant lymphoma that progresses from one group of lymph nodes to another -systemic symptoms -presence of reed-sternberg (RS) cells -types: classic and nodular lymphocyte-predominant -symptoms: fever, weight loss, night sweats, pruritus

amyotrophic lateral sclerosis (ALS)

this is a neurodegenerative disorder involving upper and lower motor neurons; causes progressive muscle weakness -unknown etiology -starts w/ muscle weakness and progresses to muscular atrophy, spasticity, and loss of manual dexterity and gait -usually fatal from resp failure w/in 3 years of diagnosis

secondary spinal cord injury

this is a pathophysiologic cascade of events that begins immediately after injury and continues for weeks -includes: hemorrhages, inflammation, edema, ischemia

multiple organ dysfunction syndrome (MODS)

this is a progressive dysfunction of two or more organ systems resulting from an uncontrolled inflam resp to illness or injury -most common causes: sepsis, septic shock -other causes: severe trauma, burns, major surgery, blood transfusion, renal or liver failure, pancreatitis

starvation

this is a reduction in energy intake leading to weight loss

anemia

this is a reduction in the total number of erythrocytes in the circulating blood or in the quality or quantity of hemoglobin -results from: impaired erythrocyte production, acute or chronic blood loss, inc erythrocyte production, or a combination of the above

lymphoblastic lymphoma

this is a relatively rare T-cell non-Hodgkin lymphoma in children; clone of immature T cells that becomes malignant in the thymus -painless lymphadenopathy of the neck, possible chest (mediastinal mass) -tx: combined chemo

lymphatic system

this is a special vascular system that picks up excess fluid and returns it to the bloodstream

rheumatic fever

this is a systematic inflam disease caused by a delayed immune response to pharyngeal infection by the group A beta-hemolytic streptococci -left untreated can cause rheumatic heart disease

fever

this is a temporary resetting of the hypothalamic thermostat to a higher level -inc in heat production and conservation -causes person to feel cold and dress warmly or curl up to get warm

guillain-barré syndrome

this is an acquired inflammatory disease causing demyelination of the peripheral nerves -symptoms: tingling, weakness, paralysis of the legs, quadriplegia, respiratory insufficiency, autonomic nervous system instability -usually follows respiratory tract or GI infection -recovery in weeks to months

sleep

this is an active, multiphase process that restores functions and promotes memory consolidation

encephalitis

this is an acute inflammation of the brain, usually of viral origin -causes: bites of mosquitoes, ticks, or flies (most common); herpes simplex type 1; may occur as complication of systemic viral disease -ranges from mild infectious disease to life-threatening disorder

hyperthermia

this is an elevation of the body temperature without an increase in the hypothalamic set point -can produce nerve damage, coagulation of cell proteins, and death -may be associated w/ stroke or head trauma

myocardial infarction

this is an extended obstruction of the myocardial blood supply causing myocyte necrosis -can be STEMI or non-STEMI -can be subendocardial or transmural -manifestations: sudden severe chest pain (may radiate); nausea, vomiting, diaphoresis, dyspnea -complications: sudden cardiac arrest due to ischemia, left ventricular dysfunction, electrical instability

obesity

this is an inc in body adipose tissue -BMI greater than 30 kg/m^2 for adults -greater than the 95th percentile on growth charts for children -major cause of death: cardiovascular disease, T2DM, cancer

cerebral edema

this is an increase in the fluid (intracellular or extracellular) w/in the brain -types: vasogenic, cytotoxic, interstitial/hydrocephalic -treatment directed at dec IICP

secondary brain injury

this is an indirect result of primary brain injury; includes trauma and stroke symptoms -management: prevention of hypoxia and maintenance of cerebral perfusion pressure

cerebrovascular disease (CVD)

this is any abnormality of the brain caused by a process in the blood vessels -most frequently occurring neurologic disorder

cardiac output

this is calculated by multiplying heart rate times stroke volume -normal adult: 5 L/minute

type 2 diabetes mellitus

this is caused by insulin resistance and dec insulin secretion by beta cells -caused by genetic-environmental interaction -risk factors: family history, age, obesity, hypertension, poor diet, and physical inactivity

lymphadenopathy

this is characterized by enlarged lymph nodes that become palpable and tender

thrombocytopenia

this is defined as a blood count < 150,000/mm^3 -<100,000/mm^3: clinically significant -<50,000/mm^3: hemorrhage from minor trauma -<15,000/mm^3: spontaneous bleeding -<10,000/mm^3: severe bleeding

hypothermia

this is defined as a core body temperature less than 35 degrees C (95 degrees F) -produces: depression of nervous and respiratory systems ; vasoconstriction and changes in microcirculation and coagulation; ischemic tissue damage -severe cases: ice crystals form inside cells causing them to rupture and die

anorexia of aging

this is defined as a dec in appetite or food intake in older adults -risk factors: functional impairments, medical and psychiatric conditions, loneliness and grief; social isolation, abuse or neglect

thrombocythemia

this is defined as platelet count >400,000/mm^3 ->1,000,000/mm^3 is when symptoms occur -can be primary or secondary (reactive)

hydrocephalus

this is excess fluid w/in the cerebral ventricles, subarachnoid space, or both -caused by interference in CSF flow ---causes: inc fluid production, obstruction w/in ventricular system, defective reabsorption

meningitis

this is inflammation of the brain or spinal cord -may be acute, subacute, or chronic

open brain injury

this is injury that breaks the dura and exposes the cranial contents to the environment -causes both focal and diffuse injuries -includes compound skull fractures and missile injuries

adrenal medulla

this is innervated by the sympathetic nervous systems -contains of chromaffin cells

cerebral death

this is known as irreversible coma; death of the cerebral hemispheres exclusive of the brain stem and cerebellum -no behavioral or environmental responses -the brainstem can continue to maintain internal homeostasis

pineal gland

this is located near the center of the brain and secretes melatonin

chronic pain

this is pain lasting longer than the expected healing time -defined as lasting at least 3-6 months -may be ongoing or intermittent -manifestations thought ti be due to stress

narcolepsy

this is primary hypersomnia w/ disruptions of sleep-wake cycles -characteristics: hallucinations, sleep paralysis, and rarely cataplexy -usually sporadic -assoc w/ immune-mediated destruction of hypocretin (orexin)-secreting cells in the hypothalamus

hemostasis

this is the arrest of bleeding by the formation of blood clots

leukemia

this is the cancer of blood-forming tissues -most common types in kids and teens: acute lymphoblastic; acute myelogenous -cause unknown, may involve inherited mutations or epigenetic modifications -5 yr survival rate is 85%

thrombopoiesis

this is the development of platelets, which circulate for 10 days before losing functional capacity

olfaction

this is the function of cranial nerve I and part of V -there is a strong relationship between ________ and taste (gustation)

taste

this is the function of cranial nerve VII and part of IX -nerves in the tongue, soft palate, uvula, pharynx, and upper esophagus

high output failure

this is the inability of the heart to supply the body w/ blood-borne nutrients despite adequate blood volume and normal or elevated myocardial contractility -heart inc output, but body's needs are still not met -causes: anemia, hyperthyroidism, septicemia, and beriberi

right heart failure

this is the inability of the right ventricle to provide adequate blood flow at a normal venous pressure; can result from an inc in left ventricular filling pressure that is reflected back into the pulmonary circulation -most common cause: diffuse hypoxic pulmonary disease (i.e. COPD, cystic fibrosis, acute resp distress syndrome)

impaired hemostasis

this is the inability to promote coagulation and the development of a stable fibrin clot -caused by vitamin K deficiency or liver disease

infective endocarditis

this is the inflam of the endocardium -agents: bacteria, viruses, fungi, rickettsiae, parasites -classic findings: fever; new or changed cardiac murmur; petechial lesions of the skin, conjunctiva, and oral mucosa -other findings: weight loss, back pain, night sweats, and heart failure

cerebrovascular accidents (stroke syndromes)

this is the leading cause of disability and the 3rd (females) and 5th (males) leading cause of death in the US -25% of strokes are recurrent -classfications: ischemic (thrombotic, embolic) -> 87%; hemorrhagic -> 13%; undetermined/cryptogenic

thyroid carcinoma

this is the most common endocrine malignancy -most common cause: ionizing radiation -tx: thyroidectomy, supression therapy, radiation, chemo

type 1 diabetes mellitus

this is the most common pediatric chronic disease; can be diagnosed throughout the lifespan -types: idiopathic or autoimmune -immunologically mediated beta cell destruction and apoptosis: 80-90% cells lost, insulin synthesis declines, hyperglycemia develops -alterations in insulin, amylin, glucagon

embolism

this is the obstruction of a vessel by a bolus of matter that is circulating in the bloodstream -may consist of: dislodged thrombus, air bubble, amniotic fluid, aggregate of fat, bacteria, cancer cells, or a foreign substance

hemoglobin

this is the oxygen-carrying protein of the erythrocyte; contains two pairs of polypeptide chains (globulins) and four colorful iron-protoporphyrin complexes (heme)

craniosynostosis

this is the premature closure of one or more cranial sutures -prevents growth perpendicular to the suture line

hematopoiesis

this is the process of blood cell production -occurs in the liver and spleen in the fetus -occurs in the bone marrow after birth (medullary) -proliferation into cell types happens spontaneously

erythropoiesis

this is the process of red blood cell development -happens in the confines of bone marrow

synapse

this is the region between adjacent neurons -impulses are transmitted across this by chemical and electrical conduction

disseminated intravascular coagulation (DIC)

this is the widespread activation of coagulation and simultaneous hemorrhage, resulting in the formation of fibrin clots in small vessels and microvasculature -blood flow to organs blocked -> multiple organ failure -consumption of platelets and clotting factors => leading to tendency to bleed despite clots

subarachnoid hemorrhage (SAH)

this is when blood escapes from defective or injured vasculature into the subarachnoid space -often recur -clinical manifestations: kernig sign or brudzinski sign

shock

this is when the cardiovascular system fails to perfuse the tissues adequately -leads to widespread impaired cell metabolism: impaired O2 and glucose use -manifestations based on type: feeling weak, cold, hot, nauseated, dizzy, confused, afraid, thirsty, SOB; hypotension, tachycardia, inc resp rate

heart failure

this is when the heart is unable to generate adequate cardiac output causing inadequate perfusion of tissues, inc diastolic filling pressure of left ventricle, and inc pulmonary capillary pressure

primary spinal cord injury

this occurs w/ initial mechanical trauma and immediate tissue destruction -occurs if inadequate mobilization is had following injury -may occur in absence of vertebral fracture or dislocation

ischemic stroke

this occurs when there is an obstruction to arterial blood flow to the brain from thrombus formation, an embolus, or hypoperfusion related to dec blood volume or heart failure

obstructive sleep apnea syndrome (OSAS)

this results from total or partial upper airway obstruction -excessive loud snoring -gasping -multiple apneic episodes longer than 10 seconds -disrupts total sleep time and produces hypercapnia and low oxygen saturation -untreated: polycythemia, hypertension, stroke, heart failure, dysrhythmias, liver congestion, edema

parasympathetic nervous system

this system conserves and restores energy -"rest and tranquility" response -innervation from cell bodies located in cranial nerve nuclei and sacral region of the spinal cord: craniosacral division -reduced HR, enhanced visceral funcs

sympathetic nervous system

this system mobilizes energy stores in times of need -"fight or flight response" -innervated from cell bodies located from T1 thru L2 regions of the spinal cord: thoracolumbar division -promotes responses for protection of the indiv: inc heart rate, temp, blood glucose, BP

secondary thrombocythemia

thrombocythemia: this happens following splenecetomy because platelets cannot be stored in spleen

essential (primary) thrombocythemia (ET)

thrombocythemia: this is a myeloproliferative neoplasm involving defect in bone marrow megakaryocyte progenitor cells -megakaryocytes are produced in excess -microvasculature thrombosis (most common complication) or hemorrhage occurs

chronic ITP

thrombocytopenia: this is caused by IgG autoantibodies that target platelet glycoproteins -antibody-coated platelets are sequestered and removed from circulation

chronic relapsing; acute idiopathic

thrombocytopenia: _______________ TTP is a rare familial form of TTP observed in children and usually recognized and successfully treated the acquired ______________ TTP is much more common and more severe

immune (idiopathic) thrombocytopenic purpura (ITP)

thrombocytopenia: the most common cause of thrombocytopenia secondary to inc platelet destruction is _______________ -manifestations: petechiae and purpura, progressing to major hemorrhage

acute ITP

thrombocytopenia: this develops after a viral infection; one of the most common childhood bleeding disorders -resolves as source of antigen is gone or removed

heparin-induced thrombocytopenia (HIT)

thrombocytopenia: this is an adverse drug reaction caused by IgG antibodies targeting heparin-platelet factor 4 complex -typically causes 50% drop in platelet count -tx: withdrawing heparin

pseudothrombocytopenia

thrombocytopenia: this is an error in lab tests giving a false reading for thrombocytopenia

thrombotic thrombocytopenia purpura (TTP)

thrombocytopenia: this is characterized by a thrombotic microangiopathy (small or microvessel disease) in which platelets aggregate, form microthrombi, and cause occlusion of arterioles and capillaries -can be familial or acquired -can be chronic relapsing or acute idiopathic

decrease; increase

thrombocytopenia: thrombocytopenia may be caused by a _________ in platelet production due to viral infections, drug or radiation therapy, chronic renal failure, bone marrow hypoplasia, or cancer thrombocytopenia may be caused by a ________ in platelet consumption resulting in heparin-induced thrombocytopenia, idiopathic (immune) thrombocytopenia purpura, thrombotic thrombocytopenia purpura, or disseminated intravascular coagulation (DIC)

arterial thrombi

thromboembolic disorders: these form under conditions of high blood flow and are composed mostly of platelet aggregates held together by fibrin strands

venous thrombi

thromboembolic disorders: these form under conditions of low flow and are composed mostly of red cells w/ larger amounts of fibrin and few platelets

embolus

thromboembolic disorders: this is a clot circulating w/in the bloodstream, which may become lodged in smaller blood vessels and block blood flow

thrombus

thromboembolic disorders: this is a stationary clot attached to a vessel wall -can be arterial or venous

virchow triad

thromboembolic disorders: what does this list describe? -injury to a vessel -abnormal blood flow -hypercoagulopathy

megakaryocyte; elongations; platelets

thrombopoiesis: 1. _________ undergoes DNA replication but does not divide 2. cell surface ______ fragment into platelets 3. one large megakaryocyte produces thousands of ____________

thrombopoietin

thrombopoiesis: platelet levels are regulated by _________, which stimulates the production and differentiation of megakaryocytes

spleen

thrombopoiesis: senescent platelets are destroyed in the _________ by macrophage phagocytosis

arterial thrombi

thrombus formation: __________ pose 2 potential threats to the circulation 1) thrombus may grow large enough to occlude the artery => ischemia in tissue supplied by artery 2) thrombus may dislodge becoming a thromboembolus that travels thru vasc system until it occludes flow into a distal systemic vascular bed

thyroxine-binding globulin (TBG)

thyroid gland: once released into circulation, T3 and T4 are primarily transported bound to __________

follicles

thyroid gland: the thyroid gland consists of _______ that contain follicular cells surrounding a vicious substance called colloid

90;10

thyroid gland: the thyroid gland normally produces ____% T4 and _____%T3 -most T4 and then converted to T3

thyroid hormone (TH)

thyroid gland: the thyroid gland plays a role in the negative feedback loop of regulation of the ___________

TSH (thyroid stimulating hormone)

thyroid gland: the thyroid hormone (TH) is secreted in response to ___________

parafollicular cells (C cells)

thyroid gland: these cells secrete various polypeptides, most importantly calcitonin -lowers serum Ca levels by inhibiting bone-resorbing osteoclats

isthmus

thyroid gland: this is the small band of tissue that joins the two lobes of the thyroid gland

actions of TH

thyroid gland: what does this list describe? 1. growth, maturation and functions of cells and tissues 2. genetic expression of proteins 3. function of blood cells and muscle tissue 4. cell metabolism, heat production, and oxygen consumption

central fever

trauma and temperature: CNS trauma leads to ____________, causing inflammation, increased intracranial pressure, and intracranial bleeding -does not induce sweating -resistant to antipyretic therapy

trauma

trauma and temperature: other _______ that alters temperature include accidental injuries, hemorrhagic shock, major surgery, and thermal burns

secondary TBI

traumatic brain injury (TBI): indirect consequence of primary injury; systemic and brain tissue responses

primary TBI

traumatic brain injury (TBI): this is direct impact; -can be focal (closed or open): affecting one side of the brain -or can be diffuse: involves more than one area of the brain

true

true or false: chronic pain produces behavior or psychologic changes and physiologic adaptation

true

true or false: mature nerve cells do not divide, so injury can cause permanent loss of function

pheochromocytomas; sympathetic paragangliomas

tumors of the adrenal medulla: adrenal medulla hyperfunction is caused by _______________, which are tumors derived from chromaffin cells, or _____________ -tumors cause excess production of catecholamines

idiopathic type 1 diabetes

type 1 diabetes mellitus: affected indivs have no evidence of beta cell autoimmunity and have varying degrees of insulin deficiency -far less common than autoimmune diabetes -occurs in people of Asian or African descent

autoimmune type 1 diabetes

type 1 diabetes mellitus: slowly progressive disease that destroys beta cells and the pancreas

insulin deficiency and hyperglycemia

type 1 diabetes mellitus: what are the two common clinical manifestations of type 1 diabetes?

true

type 1 diabetes mellitus: true or false genetic and environmental factors may be involved with the development of type 1 diabetes

manifestations resulting from insulin deficiency

type 1 diabetes mellitus: what does this list describe? -hyperglycemia -polydipsia -polyuria -polyphagia -weight loss -fatigue -recurrent infections -prolonged wound healing

GI (gastrointestinal)

type 2 diabetes mellitus: ________ hormones play a role in insulin resistance, beta function, and diabetes

hyperinsulinemia

type 2 diabetes mellitus: compensatory ___________ prevents the clinical appearance of diabetes for many years

beta cells

type 2 diabetes mellitus: later on, loss of __________ cells causes deficiency of insulin activity

pregnancy

type 2 diabetes mellitus: there is increasing evidence that a diet during _______ influences the long-term risk of type 2 diabetes in children and adults

manifestations of type 2 diabetes

type 2 diabetes mellitus: what does this list describe -fatigue -pruritus -recurrent infections -visual changes -symptoms of neuropathy -often overweight, dyslipidemic, and hypertensive

refeeding syndrome

types of starvation: a life-threatening condition that occurs in severely malnourished indivs when parenteral or enteral nutritonal therapy is initiated

protein mass

types of starvation: body responds to protect ____________ by the processes of glycogenolysis and gluconeogenesis

long-term starvation

types of starvation: this begins several days of dietary abstinence -therapeutic: weight loss in morbidly obese people -pathologic: poverty, disease, and anorexia nervosa -causes death from proteolysis

short-term starvation

types of starvation: this is extended fasting, several days of dietary abstinence or deprivation -therapeutic: initial rapid weight loss

cachexia

types of starvation: this is physical wasting w/ loss of weight and muscle atrophy, fatigue, and weakness

kwashiorkor

types of starvation: this is protein deprivation w/ carbohydrate intake

marasmus

types of starvation: this is protein energy malnutrition

pain

unpleasant but protective phenomenon that is uniquely experienced by each individual -cannot be defined, identified, or measured by an observer -"whatever the experiencing person says it is, existing whenever he says it does"

upper motor neuron paresis (weakness) or paralysis

upper motor neuron syndromes: ___________ includes conditions of hemiparesis or hemiplegia, diplegia, paraparesis or paraplegia, quadriparesis or quadriplegia

diplegia

upper motor neuron syndromes: paralysis of corresponding parts of both sides of the body as a result of cerebral hemisphere injuries

quadriparesis/quadriplegia

upper motor neuron syndromes: paresis/ paralysis of all 4 extremities as a result of upper spinal cord injury

hemiparesis/hemiplegia

upper motor neuron syndromes: paresis/ paralysis of the upper and lower extremities on one side

paraparesis/paraplegia

upper motor neuron syndromes: weakness/ paralysis of lower extremities as a result of lower spinal cord injury

pulmonary semilunar valve; aortic semilunar valve

valves of the heart: blood leaves the right ventricle through the ______________ and it leaves the left ventricle through the ___________

atrioventricular valves

valves of the heart: the __________ are termed as such because they fall b/w the atria and ventricles -openings are composed of tissue flaps -tricupsid valve (right heart) and mitral valve (left heart)

semilunar valves

valves of the heart: the openings of these are composed of cup-shaped cusps -pulmonary and aortic

mitral and tricuspid complex

valves of the heart: the tricupsid and mitral valves function as a unit along with the connected atria, fibrous rings, valvular tissue, chordae tendineae, papillary muscles are ventricular walls to function in the ______________

mitral stenosis

valvular dysfunction: ________ impairs the flow of blood from the left atrium to the left ventricle; most common form of rheumatic heart disease -leaflets become fibrous and fused

valvular regurgitation

valvular dysfunction: in _________, the valve leaflets, or cusps, fail to shut completely, permitting blood flow to continue even when the valve is presumably closed

valvular stenosis

valvular dysfunction: in _________, the valve orifice is constricted and narrowed, so blood cannot flow forward and the workload of the cardiac chamber proximal to the diseased valve increases

tricuspid regurgitation

valvular dysfunction: this leads to volume overload in the right atrium and ventricle, inc systemic venous BP, and right heart failure -primary: congenital defects, rheumatic heart disease, endocarditis, trauma -80% cases: annular dilation related to pulmonary hypertension and dilation of right ventricle

aortic stenosis

valvular dysfunction: this occurs when the orifice of the valve narrows, causing resistance to blood flow from the left ventricle into the aorta; most common valvular abnormality -3 common causes: 1) congenital bicuspid valve, 2) degeneration w/ aging, 3) inflam damage caused by rheumatic hear disease

mitral regurgitation

valvular dysfunction: this permits backflow of blood from the left ventricle into left atrium during ventricular systole; left atrium and ventricle hypertrophy to maintain adequate CO -primary: mitral valve prolapse, rheumatic heart disease, infective endocarditis, MI, connective tissue diseases, dilated cardiomyopathy -secondary: ischemic/ nonischemic myocardial disease

aortic regurgitation

valvular dysfunction: this results from an inability of the aortic valve leaflets to close properly during diastole because of abnormalities of the leaflets, aortic root and annulus, or both -primary: congenital bicuspid vale, degneration of elderly -secondary: chronic hypertension, rheumatic heart disease, bacterial endocarditis, syphilis, connective tissue disorders, appetite suppressing meds, trauma, atherosclerosis

arteriovenous malformation (AVM)

vascular malformations: this is a mass of dilated vessels b/w arterial and venous systems -occurs in any part of the brain -usually present at birth w/ delayed onset of symptoms

simple fracture

vertebral injuries: this is a single break usually affecting transverse or spinous processes

compressed (wedge) fracture

vertebral injuries: vertebral body compressed anteriorly

comminuted (burst) fracture

vertebral injuries: vertebral body shattered into several fragments

paralysis of indiv extraocular muscles

visual dysfunction: ___________ may cause limited abduction, abnormal closure of eyelid, ptosis, diplopia

manifestations of alterations in accommodation

visual dysfunction: _______________ include diplopia, blurred vision, and headache

yellowing

visual dysfunction: alterations in color vision when it comes to aging is the progressive _________ of the lens -colors become less intense

irregularities

visual dysfunction: alterations in refraction causes include ____________ in corneal, curvature, focusing power on lens, length of eye

hemianopia

visual dysfunction: blindness in half of the visual field caused by visual changes

color blindness

visual dysfunction: cause of abnormal color vision -X-linked trait -commonly w/ distinguishing red from green -may be acquired w/ diseases (i.e. ocular, neurologic, systemic)

nystagmus

visual dysfunction: involuntary rhythmic movement -pendular: regular back and forth movement -jerk: one phase of eye movement is faster

presbyopia

visual dysfunction: loss of accommodation w/ age -ocular lens becomes larger, firmer, and less elastic

strabismus

visual dysfunction: one eye deviates -amblyopia: reduced vision in affected eye -diplopia: double vision; primary symptom of this

astigmatism

visual dysfunction: refraction alteration that is caused by an unequal curvature of cornea -may coexist w/ myopia, hyperopia, or presbyopia

hyperopia

visual dysfunction: refraction alteration that results in farsightedness

myopia

visual dysfunction: refraction alteration that results in nearsightedness

refraction

visual dysfunction: the most common visual problems have to deal with alterations in _________

visual acuity

visual dysfunction: this is the ability to see sharp detail

accommodation

visual dysfunction: this is the change in shape of the lens to change focus -mediated thru oculomotor nerve

alterations in visual acuity

visual dysfunction: causes of ______________: 1. amblyopia (reduced or dimmed vision) 2. scotoma (blind spot) 3. cataracts (cloudy area in lens) 4. papilledema (edema of optic nerve) 5. dark adaptation 6. glaucoma (high intraocular pressure) 7. retinal detachment 8. age-related macular degeneration

second-messenger

water-soluble hormones: this is the term for small molecule inside the cell produced by the first messenger interaction -ex. cAMP, cGMP, tyrosine kinase system, IP3

first messenger

water-soluble hormones: this is the term for the hormone that initiates cascade when it binds to membrane receptor

external, middle, inner ear

what are the 3 areas of the ear?

sclera, choroid, retina

what are the 3 layers of the eye?

cerebrum and brainstem

what are the two major components of the brain?

alterations in lymphoid function

what does this list describe? -lymphadenopathy -malignant lymphomas -plasma cell malignancy

common dyssomnias

what does this list describe?: -obstructive sleep apnea syndrome -hypersomnia -narcolepsy -circadian rhythm sleep disorders

special senses

what does this list describe?: -vision -hearing -olfaction (smell) -taste (gustation)

systemic circulation

what does this list describe?: -arteries -arterioles -capillaries -venules -veins

external eye disorders

what does this list describe?: -blepharitis -hordeolum (stye) -chalazion -entropion -conjunctivitis -keratitis

aging and the nervous system

what does this list describe?: -decrease in # of neurons -> dec brain weight and size -lipofuscin and neurfibrillary tangles -slowing of neurologic responses

diseases of the arteries

what does this list describe?: -hypertension and hypotension -aneurysm -thrombus formation and embolism -peripheral vascular disease -peripheral artery disease -atherosclerosis -coronary artery disease -myocardial ischemia

motor pathways

what does this list describe?: -lateral corticospinal -corticobubular -reticulospinal -vestibulospinal -rubrospinal

associated conditions of seizures

what does this list describe?: -metabolic disorders -congenital malformations -genetic predisposition -perinatal injury; postnatal trauma -myoclonic syndromes -infection -brain tumor -vascular disease -substance abuse

neurotransmitters of pain modulation

what does this list describe?: -modulate control in periphery, spinal cord, and brain -triggered by tissue injury and/or inflammation

sensory pathways

what does this list describe?: -posterior column -anterior spinothalamic tract -lateral spinothalamic tract

functional classification of neurons

what does this list describe?: -sensory -associational -motor

eye movement disorders

what does this list describe?: -strabismus -nyastagmus -paralysis of indiv extraocular muscles

alterations in arousal

what does this list describe?: -structural -metabolic -psychogenic (functional)

interruption of pituitary stalk

what is the most common cause of apparent hypothalamic dysfunction?

leukemia

what is the most common malignancy of childhood?

obstructive sleep apnea syndrome (OSAS)

what is the most commonly diagnosed sleep disorder?

astrocytomas

which primary brain tumor is the most common?