Problem Based Learning II Basic Science Test 2

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Innervation of salivary glands (parasympathetics)

All facial, except for parotid (glossopharyngeal)

A 75-year-old woman complained of postural dizziness, dry mouth, intermittent diarrhea, and numbness in both her feet. On examination, there was a marked decrease in blood pressure on assuming the upright posture. A chest radiogram revealed lytic lesions in the sternum. Her urine contained Bence Jones protein. A bone marrow examination demonstrated increased numbers of plasma cells What conditoin?

Amyloidosis

Anterior part of temporal fascia Into helix of ear Facial nerve [VII] Draws ear upward and forward What muscle?

Anterior aricular

S. pneumoniae, H. influenzae Meningitis due to what injury?

Basal skull fracture

_______ neurons, with one dendrite and one axon, comprise the sensory neurons of the retina, the olfactory epithelium, and the inner ear.

Bipolar

Terminal sympathetic ganglia innervate what structures (2)

Bladder rectum

Muscarinic: atropine; nicotinic: tubocurarine, trimethaphan α1 and α2 Receptors: phentolamine; α1 receptor: prazosin; α2 receptor: yohimbine; β1 and β2 receptors: propranolol; β1 receptor: metoprolol Mechanism?

Blocks access of NT to receptors

K+ Ca2+ Glucose Amino acids pH Cholesterol* Protein Higher in CSF, blood or the same?

Blood

gives rise to about one-third of the volume of CSF, and is known as the interstitial fluid source.

Blood brain barrier

Melena AKA

Bloody stools

Symptoms of primary hyperparathyroidism (3)

Bones, stones, abdominal groans

used in special cases of spasticity such as torticollis, in which the patient can be relieved of the excessive contractures of the neck muscles, which turn the head chronically to one side and thus cause pain and distraction if untreated. What compound?

Botulism toxin

Decreased heart rate

Bradycardia

Location of 2' neuron in each system: dorsal column? Anterolateral system?

Brain stem Spinal cord

Blood supply to choroid plexus in 4th ventricle (2)

Branches of anterior inferior cerebellar artery Branches of posteiror inferiro cerebellar artery

Atlas AKA

Paravertebral ganglia are found at which vertebral levels?

C1-S5

Axis AKA

In the neck, the two important vertebral levels are: ▪ between __ and __, at approximately the superior border of the thyroid cartilage of the larynx (which can be palpated) and where the major artery on each side of the neck (the common carotid artery) bifurcates into internal and external carotid arteries; and ▪ between __ and __, which marks the lower limit of the pharynx and larynx, and the superior limit of the trachea and esophagus—the indentation between the cricoid cartilage of the larynx and the first tracheal ring can be palpated.

C3, C4 C5, C6

at approximately the superior border of the thyroid cartilage of the larynx (which can be palpated) and where the major artery on each side of the neck (the common carotid artery) bifurcates into internal and external carotid arteries What vertebral level?

C3/C4

The anterior rami of __ to __, together with a large component of the __________ ramus of __, form the brachial plexus, which innervates the upper limb.

C5, C8, anteiorr, T1

Brachail plexus is made of what nerves?

C5-T1

Exocytosis of digestive enzymes from secretory granules is promoted by ___, released by _______________ cells of the ________ when food enters that region from the stomach.

CCK, enteroendocrine, duodenum

The binding of the TCR to the MHC II—peptide complex (for ___ cells) or the MHC l-peptide complex (for ___ cells) initiates a series of signal transductions via the associated ___ polypeptides. In simple terms, the T cell is activated to produce __-_ and __-__. This process takes place via the activation of ________ ______ _ and small ___-binding proteins and the release of intracellular _______, all leading to the production of active _____________ _______

CD4, CD8, CD3, IL 2, IL 2R, protein kinase C, GTP, calcium, transcription factors

When Β cells are presenting antigen, _____ on T cells bind to _____ on Β cells.

CD40L, CD40

Vagus n. AKA

CN X

vagus n. AKA

CN X

Heart Bronchial tree Stomach Small intestine Large intestine What CN provides parasympathetics to them?

CN X (vagus)

Accessory n. AKA

CN XI

accessory n. AKA

CN XI

Aspartate is made where?

CNS

Central Nervous System AKA

CNS

Central nervous system AKA

CNS

Cerebrum Cerebellum Spinal cord Which part of nervous sytem?

CNS

Glutamate is made where?

CNS

Oligodendrocytes Astrocytes Microglia Ependymal cells Found where?

CNS

The complexity and distances of the neuronal and glial interconnections with the ___ make regeneration and restoration of function within this tissue after major injury very difficult.

CNS

Taste innervation of 2/3 of the tongue

Chorda tympani (facial n.)

patchy erosions and ulcerations, with noncaseating granulomas that can arise in any part of the gastrointestinal tract. What disease?

Chron's disease

the roots of CNs IX-XII come into close apposition immediately upon their exit from the skull base and may be collectively damaged by a lesion in this confined area. Deficits in the ______-______ syndrome (one of the ________ __________ syndromes) reflect damage to CNs IX, X, XI, and XII.

Collet Sicard, Jugular foramen

Major artery of the neck? What vertebral level does it bifurcate at? Into what?

Common carotid a. C3/C4 Internal and external carotid A.'s

Greater occipital n. origin

Cutaneous branch of C2

How many CN's originate in brainstem? Which ones?

10 III-XII

More than __ serotonin (5-HT) receptors have been isolated using molecular biological techniques.

Visual cortex = area __ on teh cortex

Most common site of peptic ulcer in US? Asia?

1st part of duodenum staomch

How many main classes of ACh receptors ? Name them!

2 Nicotinic, muscarinic

Th_ cell responses can inhibit inflammatory and autoimmune conditions by limiting Th_ cell responses, but this can also result in an inability to fight off intracellular infection

2, 1

The human ear is sensitive to tones with frequencies between __ and ______ Hz and is most sensitive between ____ and ____ Hz.

20, 20,000, 2000, 5000

if a sound pressure is 10 times the reference pressure, it is __ dB. If a sound pressure is 100 times the reference pressure, it is __ dB

20, 40

Muscarinic: choline esters, cholinomimetic alkaloids; nicotinic: nicotine α1 Receptor: phenylephrine; α2 receptor: clonidine; β1 and β2 receptors: isoproterenol; β2 receptor: albuterol Mechanism?

Activate postjunctional receptors

ACh Nicotine Drug types?

Nicotinic agonists

Curare Hexamethonium Drug types?

Nicotinic antagonists

Other types of neurotransmitters (2)

Nitric Oxide Adenosine

230/125 Is this BP normal?

No, severely elevated!

Pacinian corpuscle Merkel's receptor Meissner's corpuscle hairy or nonhairy skin?

Nonhairy

Norepinepherine AKA

Noradrenaline

If the rotation is stopped abruptly, the eyes will move in which direction of that of the original rotation? This eye movement is called __________ _________

Opposite postroraty nystagmus

Sensory innervation of face above external canthus of eye?

Opthalmic n.

heteronymous (both eyes) bitemporal (both temporal visual fields) hemianopia. Lesion where?

Optic chiasm

blindness in the ipsilateral (same side) eye. Lesion where?

Optic n.

homonymous contralateral hemianopia. Lesion where?

Optic tract

From muscles in area; maxilla and mandible in midline Forms ellipse around mouth Facial nerve [VII] Closes lips; protrudes lips What muscle?

Orbicularis oris

Nasal part of frontal bone; frontal process of maxilla; medial palpebral ligament Fibers form an uninterrupted ellipse around orbit Facial nerve [VII] Closes the eyelids forcefully What muscle?

Orbital part of orbicularis oculi

Increased alkalaline phosphatase means increased activity of what cells in bone?

Osteoblasts

Four-drug treatment regimens, including a ____ plus three antimicrobials (_____________, _____________ or tinidazole, and ___________), or a ___ plus a _______ plus ____________ and _____________, provide the best results for persons with a peptic ulcer and H. pylori infection

PPI, clarithromycin, metronidazole, amoxicillin, PPI, bismuth, tetrecycline, metronidazole

Active alpha1 receptor: Norepinepherine binds to alpha1 receptor. GTP binds alphaq subunit of Gq protein and alphaq dissociates. alphaq binds phospholipase C, which turns ____ into ___ and ___ Which of the above increases protein Kinase C activity and physiologic activities? Which of the above Causes Ca2+ release?

PIP2, IP3, DAG DAG IP3

Pyridoxal phosphate AKA

PLP

catalyzes the conversion of norepinephrine to epinephrine, occurs almost exclusively in the chromaffin cells of the adrenal medulla and is missing in peripheral nerve terminals What enzyme?

PNMT

pyridox(am)ine-5′-phosphate oxidase AKA

PNPO

Peripheral nervous system AKA

PNS

What test do you run to test production of hepatic coagulation factors?

Medial palpebral ligament Lateral palpebral raphe Facial nerve [VII] Closes the eyelids gently What muscle?

Palpebral part of orbicularis oculi

In or near effector organs Locations of autonomic ganglia in what branch of NS?

Parasympathetic

Nuclei of CN III, VII, IX, and X; spinal cord segments S2-S4 (craniosacral) Origins of what branch of nervous system?

Parasympathetic

Smooth muscle; cardiac muscle; glands Effector organs of which branch of NS?

Parasympathetic

ACh NT in effector organs of what branch of NS?

Parasympathetic & Somatic!

Long Length of preganglionic axons in what branch of NS?

Parasypathetic

Gastric gland: large cells with many mitochondria and large intracellular canaliculi for production of HCl in the gastric secretion; they also secrete intrinsic factor for vitamin B12 uptake. What cells?

Parietal

Endorphins, tachykinins, many others What type of neurotransmitters?

Peptides

Cell body of neuron AKA (2)

Perikaryon Soma

__________ nerves establish communication between centers in the CNS and the sense organs and effectors (muscles, glands, etc).

Peripheral

a chamber in the shape of a half-cylinder with walls formed by muscles and fascia.

Pharynx

the polarity of the drug is increased by oxidation or hydroxylation catalyzed by a family of microsomal cytochrome P-450 oxidases. Which phase of drug metabolism?

Phase I

_________ nociceptors are supplied by unmyelinated C fibers and respond to high-intensity mechanical or chemical stimuli and hot and cold stimuli. unders

Polymodal

Origin of trigeminal n.

Pons

Brain attachment of vestibulocochlear n.

Pontomedullary junction

Origin of abducens n.

Pontomedullary junction

Origin of facial n.

Pontomedullary junction

Origin of oculomotor n.

Pontomedullary junction

present clinically as the sensitivity of skin to light (photosensitivity) which may cause disfiguration and scarring. Also, the pathway is inhibited by lead at the stage of porphobilinogen synthase. What disease?

Porphoryia cutanea tarda

Contralateral hemiplegia Ipsilateral abducens palsy Diplopia Ipsilateral parallysis of facial muscles Contralateral lsos of pain and temeprature sensation on UE, trunk and LE Ipsilateral paralysis of masticatory muscels, Ipsilateral loss of pain and thermal sensation on face What condition? What is effected?

Raymond syndrome Medial pons

hypocalcemia, hyperphosphatemia, and increased concentrations of PTH(1-84) What disease?

Pseudohypoparathyroidism

Contents of pterygoid canal?

Pterygoid nerve and vessels

Lacrimal and nasal glands What parasympathetic ganglion controls them?

Pterygopalatine ganglion

ATP, adenosine What type of neurotransmitters?

Purines

OUtput cells of cerebellar cortex Excitatory or inhibitory? Why?

Purkinjie cells Inhibitory They release GABA

Write out all 12 cranial nerves

DO IT!!!!!

Corticospinal fibers Abducens fibers in pons Corticospinal fibers Facial fibers or nucleus Anterolateral system Trigeminal n. Effected in what condition? Where does this take place?

Raymond syndrome Medial pons

__________ neurotransmitters cause a depolarizing change in voltage, in which case an action potential is more likely to occur. In contrast, __________ transmitters hyperpolarize the membrane and an action potential is then less likely to occur.

Excitatory, inhibitory

Low threshold Sensitive to low-intensity light Night vision Which photoreceptors?

Rods

Lateral vestibulospinal tract does the opposite of what other extrapyramidal tract?

Rubrospinal!

Hairy skin Slowly Stretch, joint rotation What type of mechanoreceptors?

Ruffin's corpsucle

Pelvic sphlnancnic nerves consists of what spinal cord segments?

S2- S4

Parasymathetic efferent fibers arise from what segments of the spinal cord?

S2-S4

sinoatrial node AKA

SA node

Nitric oxide What type of neurotransmitters?

Gases

GTP binding protein AKA

G-protein

gamma amino butaryic acid AKA

GABA

gamma-amion butyric acid AKA

GABA

_______ are typically ovoid structures containing neuronal cell bodies and their surrounding glial satellite cells supported by delicate connective tissue and surrounded by a denser capsule.

Ganglia

_________, which can be either sensory or autonomic, contain neuronal cell bodies and their _________ cells and are surrounded by connective tissue continuous with that of nerves.

Ganglia, satellite

Selective Serotonin Reuptake Inhibitors AKA

SSRI's

Selective Serotonin Reuptake Inhibitors AKA

SSRIs

Five elementary tastes

Salty Sweet Sour Bitter Umami

Food intake AKA

Satiety

_________, also called 5-hydroxytryptamine (5-HT), is derived from __________

Serotonin, tryptophan

homonymous contralateral hemianopia with macular sparing (the visual field from the macula is intact). Macular sparing occurs because lesions of the visual cortex do not destroy all neurons that represent the macula. Lesion where?

Geniculocalacrine tract

Glial cells AKA

Glia

_____ cells support neuronal survival and activities, and are ten times more abundant than neurons in the mammalian brain.

Glial

GFAP AKA Found in what cells?

Glial Fibrillary Acidic Protein Astrocytes

permits the release of free glucose to the blood What liver enzyme? Is it in muscles? Kidneys?

Glucose-6-phosphatase no yes, but doenst contribute much to glucose levels in blood

_________ is the most important excitatory transmitter in the CNS

Glutamate

GABA: Precursor? Made where?

Glutamate CNS

Stem cells in these intestinal glands produce the columnar epithelial cells of villi, mainly ________ cells and ___________ for nutrient absorption, as well as defensin-producing ______ cells deep in the glands.

Goblet, enterocytes, Paneth

Inverse myotactic reflex AKA

Golgi tendon reflex

Blocks ganglionic N2 receptors What drug?

Hexamethonium

Impaired bile acid metabolism leads to high or low bile acids in blood?

High

B12 and folate work together to convert what to what?

Homocysteine to methionine

excess dopamine is metabolized to ____________ ____via non-neuronal monoamine oxidase and catechol-O-methyltransferase.

Homovanillic Acid

deviation of the tongue to the side of the root damage on attempted protrusion Waht CN lesion?

Hypoglossal n.

Contents of hypoglossal canal?

Hypoglossal nerve [XII] and vessels

The tumor is usually localized by radiologic techniques such as nuclear magnetic resonance (NMR) or computed tomography (CT) scanning. What disease?

Pheochromocytoma

consequences of photon activation of rhodopsin via G-protein coupling in a rod cell: ________________ is activated and hydrolyzes the second messenger, ____, thereby blocking the entry of ______ and causing _________________ of the cell. Currently, the steps through which neurotransmission subsequently proceeds to produce the final action potential in the ________ neuron are not known in detail.

Phosphodiesterase, cGMP, sodium, hyperpolarization, ganglion

Vision Rods and cones Retina What type of receptor?

Photoreceptor

The parasympathetic nervous system, or craniosacral division, has its origin in neurons with cell bodies located in the brainstem nuclei of four cranial nerves Name them!

III VII IX X

Th2 cells main cytokines?

IL-4, IL-5, IL-13

Internuclear ophthalmoplegia AKA

INO

High conjugated bilirubin High ALT and AST Normal ALP What type of jaundice?

INtrahepatic

Inositol Triphosphate AKA

IP3

MEchanism of action of alpha1 adrenoreceptors

IP3 Increased intracellular Ca2+

Eye movement Midbrain, caudal to inferior colliculus Superior orbital fissure Which CN?

Decrease of secretory function Loss of taste on posterior third of tongue; not tested Which CN lesion?

Difficulty swallowing and loss of gag reflex Which CN lesion?

Loss of sensation in external auditory meatus Which CN lesion?

Muscle spindle afferents Largest Fastest Myelin What sensory fibers?

Sensory innervation of the muscle spindle consists of a single group __ afferent nerve, which innervates the central region of both the nuclear bag fibers and the nuclear chain fibers, and group __ afferent nerves, which primarily innervate the nuclear ____ fibers.

Ia, II, chain

The following steps occur in the stretch reflex, which has only one synapse between the sensory afferent nerves (group __ afferents) and the motor efferent nerves (_____motoneurons)

Ia, alpha

Phases of drug metabolism. name them!

Polarizaiton Congjugation

Muscle spindle: The group __ afferent fibers (innervating the central region of nuclear bag and nuclear chain fibers) detect the ________ of length change, and the group __ afferent fibers (innervating the nuclear chain fibers) detect the ______ of the muscle fiber.

Ia, velocity, II, length

Golgi tendon organ afferents Largest Fastest Which sensory fibers?

Plasma cells in the connective tissue surrounding the small intralobular ducts release ___, which forms a complex with the secretory component synthesized by the epithelial cells of the serous acini and intralobular ducts.

IgA

Large intestine Male genetalia Innervated by sympathetics from what plexus?

Inferior mesenteric plexus

Structures passing through cavernous sinus (2)

Internal carotid a. Abducens n.

Contents of carotid canal?

Internal carotid artery and nerve plexus

Contents of jugular foramen (5)

Internal jugular vein; inferior petrosal sinus; glossopharyngeal nerve [IX]; vagus nerve [X]; accessory nerve [XI]

Mutation of the gene encoding for ____ was shown to increase bone mass and the formation of dense bone. On the other hand, the loss-of-function mutation caused osteoporosis.

LRP5

Parasympathetic nucli arising from the pons (2)? What CN arises from them both? Where do they lead (2)

Lacrimal nuclues Superior salivatory nucleus CN VII (Facial) Pterygopalatine ganglion, Submandibular ganglion

Disase blocking presynaptic ACh release? Disease blocking postsynaptic ACh release?

Lambert-Eaton syndrome Myasthenia gravis

Which is more anterior, pharynx or larynx?

Larynx

the upper part of the lower airway and is attached below to the top of the trachea and above, by a flexible membrane, to the hyoid bone, which in turn is attached to the floor of the oral cavity.

Larynx

aid in the precise localization of the stimulus by defining its boundaries and providing a contrasting border. What sensory phenomena?

Lateral inhibitoin

Gubler syndrome is lesion where

Lateral pons lesion

Maxilla below infra-orbital foramen Skin at the corner of mouth Facial nerve [VII] Raises corner of mouth; helps form nasolabial furrow What muscle?

Levator anguli oris

Infra-orbital margin of maxilla Skin of upper lateral half of upper lip Facial nerve [VII] Raises upper lip; helps form nasolabial furrow What muscle?

Levator labii superioris

Frontal process of maxilla Alar cartilage of nose and upper lip Facial nerve [VII] Raises upper lip and opens nostril What muscle?

Levator labii superioris alaquae nasii

Maculae are sensitive to what type of acceleration of the head?

Linear

Drug metabolism problems leads to short or long half-life of a drug in blood?

Long

Dilation of pupils

Mydrasis

Vasomotor center Respiratory center Coughing, swallowing, vomiting centers Found where?

Medulla

contains autonomic centers that regulate breathing and blood pressure, as well as the centers that coordinate swallowing, coughing, and vomiting reflexes Which part of brainstem?

Medulla

Vagus n. origin

Medullla

Submucosal plexus AKA

Meissner's plexus

Submucosal plexus AKA Myenteric plexus AKA

Meissner's plexus Auerbach's plexus

Brain associated membranes

Meninges

results from copper depletion caused by a deficiency of the intestinal ATP7A ATPase. What syndrome?

Menkes syndrome

slowly adapting receptors found in nonhairy skin and have very small receptive fields. These receptors detect vertical indentations of the skin, and their response is proportional to stimulus intensity. (2 answers)

Merkel's receptors/tactile discs

Hemicholinium Metyrosine What do they do?

Mess with synthesis of Neurotransmitters

autoantibodies are formed against the nicotinic receptor. However, by blocking the hydrolysis of ACh, for example by means of the drug edrophonium (which inhibits acetylcholinesterase), the concentration of ACh can be effectively increased What disease?

Myasthenia gravis

Contents of incisive foramen? (2)

Nasopalatine nerve; sphenopalatine vessels

Glycine is made where?

Spinal cord

Weakness/paralysis of facial muscles and loss of efferent limb corneal reflex Which CN lesion?

VII

one of many peptides that affect the function of the intestine through the enteric nervous system

Vasoactive Intestinal Peptide

Muscle originating in the 3rd pharyngeal arch

Stylopharyngeus m.

Meningitis normally occurs where?

Subarachnoid space

Ruptured anyeurisms of the circle of willis result of bleeding where?

Subarachnoid space and CSF!

Tarsal musclle Lacrimal Gland Radial muscle Submandibular and sublingual glands Parotid gland All innervated by sympathetics from what ganglion?

Superior cervical ganglion

sites where nerve impulses are transmitted from one neuron to another, or from neurons and other effector cells.

Synapses

Increased heart rate

Tachycardia

supplied by finely myelinated A-delta afferent nerve fibers and respond to mechanical stimuli such as sharp, pricking pain What receptos?

Thermal or mechanical nocireceptors

SLowly adapting mechanoreceptor

Tonic

_____ receptors are illustrated by mechanoreceptors (e.g., Merkel's receptors) in the skin, which detect steady pressure. When compared with the pacinian corpuscles (which detect vibration with their fast on-off response), tonic mechanoreceptors are designed to encode duration and intensity of stimulus.

Tonic

Maxilla just lateral to nose Aponeurosis across dorsum of nose with muscle fibers from the other side Facial nerve [VII] Compresses nasal aperture What muscle?

Transverse part of nasilis

Corticospinal fibers Oculomotor fibers Corticonuclear fibers Effected in what conditon? What is effected?

Weber syndrome Cerebral peduncle of midbrain

Epinepherine: Precursor? Made where?

Tyrosine adrenal medulla, a few CNS cells

dopamine: Precursor? Made where?

Tyrosine CNS

Norepinpherine: Precursor? Made where (2)?

Tyrosine Sympathetic nerves, CNS

Palpebral part of orbicularis oculi innervation

VII

What brain waves: Eyes open and awake? Eyes closed and awake? When are sleep spindles seen? When are K complexes seen? When are delta waves seen? Theta waves? How often does slow wave sleep turn to REM sleep?

beta alpha stage 2 stage 2 stage 3 and a ton at stage 4 stage 1 every 90 minutes

Propanalol Metoprolol Drug type?

beta 1

Norepinepherine Epinepherine Isoproterenol Dobutamine Drug type?

beta 1 agonist

Epinepherine Norepinepherine Isoprotenerol Albuterol Drug types?

beta 2 agonists

excitatory cellular responses, which beta receptor?

beta1

Temporal process is part of what bone?

Zygomatic

Zygomaticofacial nerve What foramen?

Zygomaticofacial foramen

Cheif cells AKA

Zymogenic cells

Best indicator of liver function

`PT

This control is exquisitely clear, for example, when considering the function of the urinary bladder. In this organ, there must be a timely coordination between activity of the _________ muscle in the bladder wall and in the __________

detrusor, sphincters

Whatever types of interconnections occur, five terminal groups of branches of the facial nerve [VII]—the temporal, zygomatic, buccal, marginal mandibular, and cervical branches—emerge from the _______ ______

parotid gland

In myasthenia gravis, autoantibodies are formed against the _________ receptor. However, by blocking the hydrolysis of ___, for example by means of the drug ___________ (which inhibits acetylcholinesterase), the concentration of ACh can be effectively increased

nicotinic, ACh, edrophonium

The _______ ______ are the largest of the three pairs of main salivary glands in the head and numerous structures pass through them.

parotid glands

At the esophagogastric junction, stratified squamous epithelium changes abruptly to ______ ________ epithelium invaginating into the lamina propria as many branched tubular glands.

simple columnar

Parts of the brain, name them from rostral to caudal. What makes them up?

Telencephalon- cerebrum Diencephalon- Thalamus, hypothalamus Mesencephalon- Midbrain Metencephalon- Cerebellum, pons Myencephalon- medulla oblongata

The parasympathetic nervous system is characterized by _____ preganglionic and very _____ postganglionic nerves and, with only a few exceptions, an absence of well-defined, anatomically distinct ganglia.

long, short

Protein synthesis problems leads to high or low albumin? long or short PT?

low albumin long PT

Carbohydrate catabolism problems leads to what marker in blood?

low glucose

Rods have ____ acuity and ____ sensitivty

low, high

The sympathetic innervation of the detrusor muscle and the internal sphincter originates in the ______ spinal cord (__-__), and the parasympathetic innervation originates in the ______ spinal cord (__-__)

lumbar, L1, L3, sacral, S2, S4

α1-Antitrypsin is a member of the serpin family of serine protease inhibitors, and, contrary to its name, its predominant target is _________-_______ ________

macrophage derived elastase

Osteoclasts are multinucleated, giant tissue-specific ____________

macrophages

Tympanic part is part of what bone?

Temporal

Zygomatic process is part of what bone?

Temporal

located on the midline, close to the rostral edge of the tentorium, and on its inferior surface. Which meningioma?

Tentorium meningioma

Bilirubin is a pigmented breakdown product of heme that is released from splenic ____________ primarily, but also from _____ cells, and carried to hepatocytes bound to ______.

macrophages, Kuppfer, albumin

Visual acuity is highest at a central point of the retina, called the ______; light is focused at a depression in here, called the _____. The eye also contains a ____, which focuses light; pigments, which absorb light and reduce scatter; and two fluids, ________ and _________ humors. ________ humor fills the anterior chamber of the eye, and __________ humor fills the posterior chamber of the eye.

macula, fovea, lens, aqueous, vitrous, aqueous, vitrious

These cells are produced first in an immune response and secrete IFN-γ (also known as macrophage-activating factor), IL-2, and tumor necrosis factor-beta (TNF-β; lymphotoxin), which stimulate local responses. IL-2 stimulates Β cells, cytotoxic T lymphocytes, natural cytotoxic cells, and ThJ cells (autocrine stimulation). IFN-γ activates Β cells and macrophages, promoting IL-12 production by the macrophages, which in turn stimulates Th1 cells. What cells produce the factors above?

Th1

IL-12 expression leads to what transformation of Th0 cell? What stimulates this?

Th1 bacterial lipopolysaccharide

Activation of the immune system via antigen presentation by dendritic cells. Immature dendritic cells mature and present antigen to naïve T cells to initiate the antigen-specific responses. Naïve T cells differentiate into ___, ___, or ____ cells. ___ cells stimulate cell-mediated immune responses,___ cells stimulate humoral immune responses, and ____ cells stimulate intestinal immunity to infection. During a secondary or memory response, Β cells, macrophages, and dendritic cells present antigen to the memory T cells

Th1, Th2, Th17, Th1, Th2, Th17

Dendritic cells stimulated by the presence of bacteria and fungi secrete IL-1, IL-6, and IL-23. CD4+ helper T cells exposed to these interleukins differentiate to become ____ cells.

Th17

processes almost all sensory information going to the cerebral cortex and almost all motor information coming from the cerebral cortex to the brain stem and spinal cord.

Thalamus

The prominent electron-dense layers visible ultrastructurally in the sheath, the _____ ______ ______, represent the fused, protein-rich cytoplasmic surfaces of the Schwann cell membrane. Along the myelin sheath, these surfaces periodically separate slightly to allow transient movement of cytoplasm for membrane maintenance; at these _______ ______ (or _______-_________ clefts) the major dense lines temporarily disappear

major dense lines, myelin clefts, Schmidt Lanterman

The lower jaw (_________) is the most inferior structure in the anterior view of the skull. It consists of the ____ of the mandible anteriorly and the _____ of the mandible posteriorly. These meet posteriorly at the _____ of the mandible.

mandible, body, ramus, angle,

Study of histamine in nerves is complicated by the large amounts that are present in ____ _____

mast cells

Inferiorly, a large bony prominence (the _______ _______) projects from the inferior border of the mastoid part of the temporal bone

mastoid process

A major structure passing through the pterygopalatine fossa is the _________ nerve (the _________ division of the ____________ nerve [CN __])

maxillary, maxillary, trigeminal, V2

When the bladder is full, this fullness is sensed by ________________ in the bladder wall, and afferent neurons transmit this information to the spinal cord and then to the brain stem. The micturition reflex is coordinated by centers in the ________, and now _______________ control predominates. Parasympathetic activity produces ___________ of the detrusor muscle (to ________ pressure and eject urine) and __________ of the internal sphincters.

mechanoreceptors, midrain, parasympathetic, contraction, increase, relaxation

Fibers from nuclei of the inferior colliculus ascend to the ______ __________ nucleus of the _______. Fibers from the thalamus ascend to the auditory cortex.

medial geniculate, thalamus

The inferior vestibular nucleus receives its input from the utricles, saccules, and semicircular canals. It projects to the brain stem and the cerebellum via the ______ ____________ _________

medial longitudinal fasiculus

Origin of hypoglossal n.

medulla

Cerebellar cortex: Higher magnification shows that the granular layer (GL) immediately surrounding the _______ is densely packed with several different types of very small rounded neuronal cell bodies. The outer molecular layer consists of neuropil with fewer, much more scattered small neurons. At the interface of these two regions a layer of large _________ neuron perikarya can be seen

medulla, Purkinjie

The medullary reticulospinal tract originates in the _________ _________ _________ and projects to motoneurons in the spinal cord. Stimulation has a generalized __________ effect on both flexor and extensor muscles, with the predominant effect on ___________.

medullary reticular formation, inhibitory, extensors

The _________ ______________ tract originates in the medullary reticular formation and projects to motoneurons in the spinal cord. Stimulation has a generalized inhibitory effect on both flexor and extensor muscles, with the predominant effect on extensors.

medullary reticulospinal

the skull and the vertebral column protect the CNS, but between the bone and nervous tissue are membranes of connective tissue called the ________

meninges

The CNS is completely enclosed by three connective tissue layers called ________: (1) the tough external ____ mater; (2) the middle _________ layer; and (3) the delicate ___ mater that directly contacts neural tissue.

meninges, dura, arachnoid, pia

Laterally, a ______ ________ is visible halfway between the upper border of the alveolar part of the mandible and the lower border of the base of the mandible. Continuing past this foramen is a ridge (the _______ ____) passing from the front of the ramus onto the body of the mandible

mental foramen, oblique line

The base of the mandible has a midline swelling (the ______ ____________) on its anterior surface where the two sides of the mandible come together. Just lateral to the mental protuberance, on either side, are slightly more pronounced bumps (______ __________)

mental protuberance, mental tubercles

The ________ helps position the lip when drinking from a cup or when pouting. It is the deepest muscle of the lower group arising from the mandible just inferior to the incisor teeth, with its fibers passing downward and medially to insert into the skin of the chin. It raises and protrudes the lower lip as it wrinkles the skin of the chin.

mentalis

All known ______________ receptors are coupled to G-proteins

metabotropic

Muscarinic ACh receptors are ____________ What is the fungal toxin they respond to?

metabotropic Muscarine

Temperature Cold receptors Skin Warm receptors Skin What type fo sensory receptor?

Thermoreceptor

Superior throacic aperture AKA

Thoracic inlet

Trigeminal neuralgia KAA

Tic doloreaux

Light strikes the retina, which initiates photoisomerization of retinal. 11-cis Retinal is converted to all-trans retinal. From there, a series of conformational changes occur in the opsin that culminate in the production of _____________ __. (Regeneration of 11-cis retinal requires vitamin A, and deficiency of vitamin A causes_____ _________)

metarhodopsin II, night blindness

Less numerous than oligodendrocytes or astrocytes but nearly as common as neurons in some CNS regions, __________ are small cells with actively mobile processes evenly distributed throughout gray and white matter

microglia

Nuclei of __________ cells can often be recognized in routine hematoxylin and eosin (H&E) preparations by their small, dense, slightly elongated structure, which contrasts with the larger, spherical, more lightly stained nuclei of other glial cells.

microglial

The inset shows a portion of myelin at higher magnification in which the major dense lines of individual membrane layers can be distinguished, as well as the neurofilaments (NF) and ____________ in the axoplasm (A). At the center of the photo is a Schwann cell showing its active nucleus (SN) and _____-rich cytoplasm. At the right is an axon around which myelin is still forming

microtubules, Golgi

Lesions above the _________ do not cause decerebrate rigidity.

midbrain

location of 5-ALA synthase Why is it important?

mitochondria rate limiting step of heme synthesis reaction

The pathway of heme synthesis. Part of the pathway is located in the _______________ and part in the _______

mitochondria, cytosol

Microglia are ________-derived, antigen-presenting cells of the ___, ____ numerous than astrocytes but nearly as common as neurons and evenly distributed in both gray and white matter. By immunohistochemistry, here using a monoclonal antibody against human leukocyte antigens (HLA) of immune-related cells, the short branching processes of microglia can be seen. Routine staining demonstrates only the small dark nuclei of the cells. Unlike other glia of the CNS, microglia are not interconnected; they are motile cells, constantly used in immune surveillance of CNS tissues. When activated by products of cell damage or by invading microorganisms, the cells retract their processes, begin _______________ the damage- or danger-related material, and behave as antigen-presenting cells

monocyte, CNS, less, phagocytosing

appearing to radiate from it, the central vein (C) of the lobule has ____ collagen than the smaller sinusoids (S) that drain into it from all directions

If the stereocilia in the vestibular apparatus are bent toward or away from the kinocilium, the hair cell depolarizes and there is an increased firing ?

Towards!

WHich is more anteiror, esophagus or trachea?

Trachea

Protein that transports B12 from ileum to liver in blood?

Transcobalamin (mainly TC II)

Sensory innervation of face?

Trigeminal n.

a lancinating paroxysmal pain within the V2 to V3 territories frequently triggered by stimuli around the corner of the mouth. The causes probably are multiple and may include neurovascular compression by aberrant branches of the superior cerebellar artery (see the apposition of this vessel to the nerve root in C), multiple sclerosis, tumors, and ephaptic transmission within the nerve or ganglion. What condition?

Trigeminal neuralgia

Only CN to leave posterior portion of brainstem?

Trochlear

5HT: Precursor? Made where?

Tryptophan CNS, enterochromaffin gut cells, enteric nerves

Enterochromaffin cells convert what to what?

Tryptophan to serotonin

There are, however, several structural and functional differences with the neuromuscular junction. (1) The neuromuscular junction has a discrete arrangement, whereby the "effector," a skeletal muscle fiber, is innervated by a single ___________. In contrast, in the autonomic nervous system, the postganglionic neurons that innervate target tissues form diffuse, branching networks. Beads, or _______________, line these branches and are the sites of neurotransmitter synthesis, storage, and release. The varicosities are therefore analogous to the ___________ _____ _________ of the neuromuscular junction. (2) There is overlap in the branching networks from different postganglionic neurons, such that target tissues may be innervated by many _______________ neurons. (3) In the autonomic nervous system, postsynaptic receptors are widely distributed on the target tissues, and there is no specialized region of receptors analogous to the _____ ____ _____ of skeletal muscle.

motoneruon, vasicosities, presynaptic nerve terminal postsynaptic motor end plate

Major protein in bone

Type I Collagen

rate-limiting regulatory enzyme in the synthesis of catecholamines and is a target for the enzyme inhibitor metyrosine.

Tyrosine hydroxylase

friable, granular, erythematous, and eroded mucosa of the colon, with regions of edema and chronic inflammation seen on endoscopic and microscopic examinations. What diseaes?

CN's V, VII, IX, X: are ______ nerves in that they have _____ and _______ components

motor, sensory

minor salivary glands are usually ______, except for the small ______ glands at the bases of _____________ papillae. Plasma cells releasing ___ are also common within the minor salivary glands.

mucos, serous, circumvallate, IgA

The ______ varies regionally along the tract but always consists of a lining epithelium on a lamina propria of loose connective tissue and smooth muscle fibers extending from __________ ______ layer.

mucosa, mucsularis mucosa

________ or ______________ neurons, which include all other sensory neurons, each have a single process that bifurcates close to the perikaryon, with the longer branch extending to a peripheral ending and the other toward the CNS.

Unipolar, pseudounipolar

The oral cavity is lined primarily by ______ with ______________ __________ ________ epithelium, with ___________ __________ ________ epithelium on the hard palate and gingiva.

mucosa, nonkeratinized stratified squamous, keratinized stratified squamous

S. agalactiae, E. coli, Haemophilus influenzae Meningitis in what age group?

Up to 2 year olds

Important enzyme detected in biopsy of peptic ulcer

Urease

A micrograph of a mixed acinus from a submandibular gland shows both serous and mucous cells surrounding the small lumen . ______ cells have large, hydrophilic granules like those of goblet cells, while ________ cells have small, dense granules. Small ______________ cells extend contractile processes around each acinus

mucous, serous, myoepithelial

Stomach: The surface mucous cells secrete a thick layer of viscous ____ with __________ ions, which protects these cells and the underlying lamina propria.

mucus, bicarbonate

In ________ _________ the myelin sheaths surrounding axons are damaged by an autoimmune mechanism that interferes with the activity of the affected neurons and produces various neurologic problems. T lymphocytes and microglia, which phagocytose and degrade myelin debris, play major roles in progression of this disease. In MS, destructive actions of these cells exceed the capacity of oligodendrocytes to produce myelin and repair the myelin sheaths

multiple sclerosis

Shown are the four main types of neurons, with short descriptions. (a) Most neurons, including all motor neurons and CNS interneurons, are __________. (b) _______ neurons include sensory neurons of the retina, olfactory mucosa, and inner ear. (c) All other sensory neurons are ________ or ______________. (d) ________ neurons of the CNS lack true axons and do not produce action potentials, but regulate local electrical changes of adjacent neurons.

multipolar Bipolar unipolar, pseudounipolar Anaxonic

* All parasympathetic responses are mediated by activation of ___________ receptors.

muscarinic

In some cases (e.g., certain _________ receptors), the G protein directly alters the function of an ion channel without the mediation of a second messenger

muscarinic

Salivary and sweat glands have what type of autonomic receptors?

muscarinic

It exits at an intermediate position on the lateral aspect of the pons roughly in line with CNs VII, IX, and X Which CN?

Loss of sensation and pain in the region supplied by the three divisions of the nerve over the face; loss of motor function of the muscles of mastication on the side of the lesion Typically, in the region of the trigeminal ganglion, though local masses around the foramina through which the divisions pass can produce symptoms What CN lesion?

Loss of sensation on areas of face and in oral cavity served by each division; loss of afferent limb corneal and jaw-jerk reflexes Which CN lesion?

Masticatory muscle weakness/paralysis and loss of efferent limb jaw-jerk reflex Which CN lesion?

Sensation in face, sinuses, oral cavity, teeth, eyelids, cornea, tongue, forehead, TMJ, and palate (see Figs. on pp. 202—205) Motor to masticatory muscles plus others (see Figs. on pp. 230—233) Lateral aspect of pons Lateral aspect of pons Superior orbital fissure (V1); Foramen rotundum (V2); Foramen ovale (V3) Foramen ovale Which CN?

Innervation of the musculature derived from the five pharyngeal arches that do develop is as follows: ▪ first arch— ? ▪ second arch— ? ▪ third arch— ? ▪ fourth arch— ? ▪ sixth arch— ?

V VII IX superior laryngeal branch of X recurrent laryngeal branch of X

The ability of TCRs to recognize diverse antigens is enabled by their generation via the combination of genes encoding _, _, and _ regions

V, D, J

Opthalmic n. AKA

Maxillary n. AKA

Trigeminal neuralgia (tic douloureux) is a lancinating paroxysmal pain within the __ to __ territories frequently triggered by stimuli around the ______ of the _____. The causes probably are multiple and may include neurovascular compression by aberrant branches of the ___________ __________ artery, multiple sclerosis, tumors, and ephaptic transmission within the _______ or _________.

V2, V3, corners, mouth, superior cerebellar, nerve, ganglioin

The maxillary nerve [__] exits the skull through the foramen ________. Branches (Fig. 8.61) that innervate the face include: ▪ a small __________________ branch, which exits the zygomatic bone and supplies a small area of the anterior temple above the zygomatic arch; ▪ a small ________________ branch, which exits the zygomatic bone and supplies a small area of skin over the zygomatic bone; and ▪ the large_____-_______ nerve, which exits the maxilla through the infra-orbital foramen and immediately divides into multiple branches to supply the lower eyelid, cheek, side of the nose, and upper lip

V2, rotundum zygomaticotemporal zygomaticofacial infra orbital

Mandibular n. AKA

Eye movement Pons—medulla junction (medial location) Superior orbital fissure Which CN?

Inability of lateral eye movement Brain lesion or cavernous sinus lesion extending onto the orbit What CN lesion?

Lateral gaze palsy and diplopia Which CN lesion?

Decrease in secretions Loss of taste on anterior two-thirds of tongue Which CN lesion?

VII

Loss of ear sensation Which CN lesion?

VII

Motor to muscles of facial expression plus others (see Figs. on pp. 230—233) To parasympathetic ganglia (see Figs. on pp. 230—233) Taste from anterior two-thirds of tongue (see Figs. on pp. 202—203, 206—207) Sensation on pinna (see Figs. on pp. 202—203) Visceral sense from salivary glands Pons—medulla junction (intermediate location) Internal acoustic meatus and stylomastoid foramen Internal acoustic meatus Internal acoustic meatus and stylomastoid foramen Internal acoustic meatus and stylomastoid foramen Internal acoustic meatus and stylomastoid foramen Which CN?

VII

Paralysis of facial muscles Abnormal taste sensation from the anterior two-thirds of the tongue and dry conjunctivae Paralysis of contralateral facial muscles below the eye Damage to the branches within the parotid gland Injury to temporal bone; viral inflammation of nerve Brainstem injury What CN lesion?

VII

The taste cells in circumvallate papillae are innervated by CN ___ and __

VII, IX

Taste: The 3 cranial nerves (CN ___, __, and _) enter the _____ ____, ascend in the ________ tract, and terminate on second-order neurons in the _________ nucleus of the ______. The second-order neurons project ipsilaterally to the _______ _____________ nucleus of the _______. Third-order neurons leave the thalamus and terminate in the taste cortex.

VII, IX, X, brain stem, solitary, solitary, medulla, ventral posteromedial, thalamus

Deafness, tinnitus, vertigo, unsteady gait, and nystagmus Which CN lesion?

VIII

Hearing, balance, and equilibrium (see Figs. on pp. 270—273) Pons—medulla junction (lateral location) Internal acoustic meatus Associated Which CN?

VIII

Progressive unilateral hearing loss and tinnitus (ringing in the ear) Tumor at the cerebellopontine angle What CN lesion?

VIII

___ enhances the effect of ACh on salivary gland secretion in cat submandibular glands (glands located under the jawbone) by causing vasodilatation and potentiating the cholinergic component.

VIP

3-methoxy-4-hydroxymandelic acid AKA

VMA

leaves the head and neck to deliver parasympathetic fibers to the thoracic and abdominal viscera. Which CN?

Vagus

nerve in the vascular compartments of the neck

Vagus

4-hydroxy-3-methoxymandelic acid AKA What is this an indicator of?

Vanillylmandelic acid Adrenal medulla function

Cardiovascular AKA

Vasomotor

Most patients with this tumor have hearing loss, tinnitus, and equilibrium problems, or vertigo. As the tumor enlarges (to more than about 2 cm) it may cause facial weakness (seventh root), numbness (fifth root), or abnormal corneal reflex (fifth or seventh root). Treatment is usually by surgery, radiation therapy, or a combination thereof.

Vestibular Schwanoma

Vitamin made in liver Stored where?

Vitamin A Stellate cells

Together with other soft tissue structures close and opens the cavity of larynx

Vocal folds

which CN's are sensory, which are motor?

WRITE IT OUT! (Some Say Mary Money But My Brother Says Big Brains Matter More)

Lateral Medullary syndrome AKA

Wallenberg syndrome

Contralateral hemiplegia IPsilatateral oculomotor paralysis, diplopia, dilated pupil Contralateral weakness of facial muscles on lower face Deviation of tongue to contralateral side on protrusion Ipsilateral trapezius + Sternocliedomastoid weakness Waht condition? What is affected?

Weber syndrome Cerebral peduncle of midbrain

Decrease in secretory action and effect on intestinal motility and heart rate Which CN lesion?

Decrease/loss of sensations from viscera; may affect gag reflex Which CN lesion?

Dysphagia, dysarthria, loss of vocalis function (hoarseness), and loss of gag reflex Which CN lesion?

Loss of taste; not tested Loss of sensation in external auditory meatus and on eardrum Which CN lesion?

Motor to constrictors of pharynx, intrinsic laryngeal muscles, much of palate, upper esophagus, and vocalis (see Figs. on pp. 230—231) To ganglia in/on trachea, bronchi, gut, and heart (see Figs. on pp. 230—231 From taste buds on epiglottis, base of tongue, and palate (see Figs. on pp. 206—207) Sensation on eardrum, external auditory meatus, and dura of posterior fossa (see Figs. on pp. 202—203) From larynx, pharynx, heart, trachea and bronchi, esophagus, and gut (see Figs. on pp. 206—207) Postolivary sulcus Jugular foramen Which CN?

Soft palate deviation with deviation of the uvula to the normal side; vocal cord paralysis Brainstem lesion; penetrating neck injury Waht CN lesion?

Motor to sternocleidomastoid and trapezius muscles (see Figs. on pp. 226—227) Lateral aspect of spinal cord C1-C4/C5 Enters foramen magnum; exits jugular foramen Which CN lesion?

Paralysis of sternocleidomastoid and trapezius muscles Penetrating injury to the posterior triangle of the neck What CN lesion?

Weakness of trapezius and sternocleidomas-toid muscles Which CN lesion?

Atrophy of ipsilateral muscles of the tongue and deviation toward the affected side; speech disturbance Penetrating injury to the neck and skull base pathology What CN lesion?

XII

Deviation of the tongue on protrusion Which CN lesion?

XII

Motor to extrinsic and intrinsic tongue muscles (see Figs. on pp. 226—227) Preolivary sulcus Hypoglossal canal Which CN lesion?

XII

(1) In the parasympathetic division, effector organs have only __________ receptors. (2) In the sympathetic division, there are multiple receptor types in effector organs including the four ______________ (α1, α2, β1, β2), and in tissues with sympathetic __________ innervation, there are _________ receptors. (3) Among the sympathetic adrenoreceptors, receptor type is related to function. The _____ receptors cause contraction of smooth muscle such as vascular smooth muscle, gastrointestinal and bladder sphincters, pilomotor muscles, and the radial muscle of the iris. The _____ receptors are involved in metabolic functions such as gluconeogenesis, lipolysis, renin secretion, and in all functions in the heart. The _____ receptors cause relaxation of smooth muscle in bronchioles, wall of the bladder, and wall of the gastrointestinal tract.

muscarinic adrenergic, cholinergic, muscarinic alpha1, beta1, beta2

pilocarpine drug type

muscarinic agonist

The __________ of the colon has its outer longitudinal layer subdivided into three bands of smooth muscle called ______ ____, which act in the peristaltic movement of feces to the rectum.

muscularis, teniae coli

Horner's Syndrome: His physician orders a test with cocaine eye drops. When a solution of 10% cocaine was applied in the left eye, it caused dilation of the pupil (_________).

mydriasis

Cross section of PNS fibers in the TEM reveals differences between myelinated and unmyelinated axons. Large axons are wrapped in a thick ______ ______ of multiple layers of Schwann cell membrane.

myelin sheath

The multiple layers of Schwann cell membrane unite as a thick ______ ______

myelin sheath

As axons of large diameter grow in the PNS, they are engulfed along their length by a series of differentiating neurolemmocytes and become __________ nerve fibers.

myelinated

Muscle making up floor of mouth

mylohyoid

The negative ion chloride moves through separate channels, which are implicated in specific pathologic states such as ________.

myotonia

The anterior openings to the nasal cavities are _____, and the posterior openings are ______

nares, choanae

The _____ ________ are the upper parts of the respiratory tract and are between the orbits.

nasal cavities

Visible through the piriform aperture are the fused _____ _______, forming the lower part of the bony _____ ______ and ending anteriorly as the anterior nasal spine, and the paired ________ _____ _______

nasal crests, nasal septum, inferior nasal conchae

Anterior part of lateral surface of zygomatic bone Upper lip just medial to corner of mouth Facial nerve [VII] Draws the upper lip upward What muscle?

Zygomaticus minor

Touch, pressure What type of fibers?

abeta

Medium Medium Myeline What type of fiber?

abeta or agamma

There are eight cervical nerves (C1 to C8): ▪ C1 to C7 emerge from the vertebral canal ______ their respective vertebrae. ▪ C8 emerges between vertebrae __ and __

above C7, T1

The chemical transmitter used at neuromuscular junctions and some synapses of the CNS is _____________. Within the CNS other major categories of neurotransmitters include: Certain ______ _____ (often modified), such as glutamate and γ-aminobutyrate (____) __________, such as serotonin (5-hydroxytryptamine or 5-HT) and _______________, such as dopamine, all of which are synthesized from amino acids Small ______________, such as endorphins and substance P.

acetylcholine amino acids, GAB monoamines, catecholamines polypeptides

Enzymes such as ____________________, which cleaves ACh, may destroy any remaining transmitter.

acetylcholinesterase

when ____________________ is inhibited by organophosphate insecticides or nerve gases, a toxic syndrome is caused by the resulting excess of ACh

acetylcholinesterase

A specific inherited defect in the absorption of zinc from the gut was identified in the 1970s; it was termed ______________ _____________ and presented with severe skin lesions, diarrhea and loss of hair (alopecia).

acrodermatitis enteropathica

A nerve impulse, or _______ _________, travels along an axon like a spark moves along an explosive's fuse. It is an electrochemical process initiated at the axon hillock when other impulses received at the cell body or dendrites meet a certain threshold. The action potential is propagated along the axon as a wave of membrane depolarization produced by voltage-gated Na+ and K+ channels in the axolemma that allow diffusion of these ions into and out of the axoplasm

action potential

nerve cells contain voltage-dependent sodium channels that open very rapidly when a depolarizing change in voltage is applied. When they open, they allow the inward passage of huge numbers of Na+ ions from the extracellular fluid, which swamps the resting voltage and drives the membrane potential to positive values. This reversal of voltage is the ______ _________

action potential

receptors ________ the cAMP pathway, including dopamine D1 and D5 receptors, 5-HT4 receptors, histamine H2 receptors, adenosine A2 receptors, and certain peptide and prostanoid receptors

activate

Touch, pressure, temperature, fast pain Small Medium Myelinated What type of fibers?

adelta

alpha2 receptors: The mechanism of action of these receptors involves the inhibition of ______ _______, described by the following steps: 1. The agonist (e.g., _______________) binds to the α2 receptor, which is coupled to ______ ________ by an inhibitory G protein, __. 2. When norepinephrine is bound, the Gi protein releases ___ and binds ___, and the ______ subunit dissociates from the G protein complex. 3. The αi subunit then migrates in the membrane and binds to and ________ adenylyl cyclase. As a result, cAMP levels ________, producing the final physiologic action.

adenyl cyclase norepinepherine, adenyl cyclase, Gi GDP, GTP, alphai inhibits, decrease

G proteins couple G protein-linked autonomic receptors to enzymes that execute physiologic actions. These enzymes are _____ _______ and _____________ _, which, when activated, generate a second messenger (____ or ___, respectively). The second messenger then amplifies the message and executes the final physiologic action.

adenyl cylcase, phospholipase C, GDP, GTP

Sympathetics act on target tissues through what type of receptors? What is the exception?

adrenergic muscarinic in sweat glands, through sympathetic cholinergic neurons

Receptors for neurotransmitters in the autonomic nervous system are either __________ (_______________) or ___________ (________________). _______________ are activated by the catecholamines norepinephrine and epinephrine. _________________ are activated by ACh.

adrenergic, adrenoreceptors, cholinergic, cholinoreceptors, adrenoreceptors, cholinoreceptors

Postganglionic neurons of the sympathetic division are ___________ in all of the effector organs, except in the thermoregulatory sweat glands (where they are ___________). The effector organs that are innervated by sympathetic adrenergic neurons have one or more of the following types of adrenoreceptors: ______, ______, _____, _____. The thermoregulatory sweat glands innervated by sympathetic cholinergic neurons have __________ cholinoreceptors.

adrenergic, cholinergic, alpha1, alpha 2, beta1, beta2, muscarinic

Pheochromocytoma: The woman's other symptoms also can be explained by the activation of _______________ in other organ systems (i.e., gastrointestinal symptoms of nausea and vomiting and visual disturbances).

adrenoreceptors

The receptors for norepinephrine and epinephrine are called _______________. They are divided into _____- and ____-receptor classes and subclasses on the basis of their pharmacology. ______________ acts on all classes of the receptors but ______________ is more specific for _____-receptors

adrenoreceptors, alpha, beta, epinepherine, norepinepherine, alpha

Most of the outer layer of the esophagus is __________, merging with other tissues of the mediastinum.

adventitia

Sensory neurons are _________, receiving stimuli from receptors throughout the body. Motor neurons are ________, sending impulses to effector organs such as muscle fibers and glands.

afferent, efferent

Motoneurons to muscle spindles (intrafusal fibers) What type of fibers?

agamma

oxotermarine is a muscarinic _______ and a nicotinic _______

agonist, agonist

A table arranged similarly by receptor type and lists the prototypical drugs that either activate (________) or block (___________) the receptors.

agonists, antagonists

The action of catecholamines is terminated by their reuptake and degradation to ________ by ___ and subsequent methylation by ____ to ____________ or _________________ acids, which are excreted with _____. Excess of these compounds in urine may indicate the presence of adrenal medullar tumor, pheochromocytoma.

aldehydes, MAO, COMT, homovanillic, vanillyvanillyic, urine

Photoreception pathway: 11-cis retinal --> ___ _____ retinal --> metarhodopsin II --> activation of __________ --> activation of phosphodiesterase --> decreased ____ --> ________ of Na+ channels --> _________________ of photoreceptor membrane --> _________ release of glutamate --> decreased __________ glutamate response in ionotropic receptors and decreased __________ glutamate response in metabotropic receptors --> hyperpolarzation and depolarization of various ________ and ________ cells

all trans, transducin (g protein), cGMP, closure, hyperpolarization, decreased, excitatory, inhibitory, bipolar, horizontal

Pigment conversion made by pigment cells in the retina

all-trans retinal to 11-cis retinal

Largest Fastest myleinated Which type of fibers?

alpha

Nicotinic neuronal receptor classes

alpha beta

Norepinepherine Phenylepherine What type of drugs?

alpha 1 agonists

Drug used to treat pheochromocytoma

alpha 1 antagonist

phenoxybenzamine or prazosin Drug type?

alpha 1 antagonist

Phenoxybenazmine Prazosin What type of drugs?

alpha 1 antagonists

Drugs used to treat pheochromocytoma (2)

alpha 1 antagonists beta 1 antagonists

Receptor types in sympathetic NS? Parasympathetic? Somatic?

alpha 1, beta 1, alpha 2, beta 2 Muscarinic Nicotinic

Clonidine drug type?

alpha 2 agonist

Yohimbine Drug type?

alpha 2 antagonist

Catecholamines: Their actions are mediated through two separate receptors: _____-__________ receptor, blocked by phentolamine, and ____-__________ receptor, blocked by propranolol.

alpha adrenergic, beta adrenergic

Liver cancer is associated with particularly high plasma concentrations of _____-___________

alpha fetoproetin

Glutamate is synthesized from _____-____________ by glutamate dehydrogenase and aminotransferases or from _________ by phosphate-activated glutaminase. The L-glutamate/glutamate-____ complex is taken up by synaptic vesicles of glutamatergic presynaptic nerve terminals, where it reaches concentrations exceeding 100 mmol/L.

alpha ketogluterate, glutamine, zinc

innervate extrafusal skeletal muscle fibers. Action potentials in these motoneurons lead to action potentials in the extrafusal muscle fibers they innervate, which results in contraction What type of motoneurons?

alpha motoneurons

The schematic structure of an MHC II molecule, composed of a polymorphic _____ chain and a polymorphic ____ chain.

alpha, beta

Adrenoreceptors are divided into two types, _____ and ____, which are further designated as ______, ______, _____, and _____ receptors. Each of the receptor types has a different mechanism of action (except the _____ and _____ receptors, which have the same mechanism of action), resulting in different physiologic effects

alpha, beta, alpha1, alpha2, beta1, beta2, beta1, beta2

The schematic structure of an MHC I molecule, composed of a polymorphic _____ chain and the noncovalently attached _____-microglobulin.

alpha, beta2

A lesion of the abducens nucleus damages _____ motor neurons innervating the ___________ _______ ______ muscle and the interneurons that terminate on ______ ________ _____ motor neurons residing in the __________________ __________ nucleus. A patient with this lesion experiences a loss of horizontal gaze in both eyes during attempted voluntary eye movement _______ the side of the lesion; horizontal gaze toward the _________________ side is normal. This is basically an abducens root lesion plus an ___.

alpha, ipislateral lateral rectus, lateral rectus alpha, contralateral oculomotor, towards, contralateral, INO

mediate smooth muscle contraction and glandular secretion and are often excitatory. What receptors?

alpha1

predominant postjunctional membrane alpha receptor

alpha1

Adrenoreceptor types (4)

alpha1 alpha2 beta1 beta2

The largest and best developed of the muscles of the nasal group is the ________, which is active when the nares are flared. It consists of a __________ part (the compressor naris) and an ____ part (the dilator naris): ▪ The ___________ part of the nasalis compresses the nares—it originates from the maxilla and its fibers pass upward and medially to insert, along with fibers from the same muscle on the opposite side, into an aponeurosis across the dorsum of the nose. ▪ The ____ part of the nasalis draws the alar cartilages downward and laterally, so opening the nares—it originates from the maxilla, below and medial to the transverse part, and inserts into the alar cartilage.

nasalis, transverse, alar transverse alar

The center of the frontonasal suture formed by the articulation of the nasal bones and the frontal bone is the ______

nasion

The part of the pharynx posterior to the nasal cavities is the ___________. Those parts posterior to the oral cavity and larynx are the ___________ and _________________, respectively.

nasopharynx, oropharynx, laryngopharynx

The ____ extends from the head above to the shoulders and thorax below

neck

The boundaries of each anterior triangle are: ▪ the median vertical line of the ____, ▪ the inferior margin of the __________, and ▪ the anterior margin of the ____________________ muscle.

neck mandible sternocliedomastoid

The most common cause of hypoparathyroidism is a complication of ____ _______

neck surgery

In sections of mesentery and other tissues, a highly wavy or tortuous disposition of a single small _____ will be seen as multiple oblique or transverse pieces as the nerve enters and leaves the area in the section

nerve

A _____ _______ or action potential, travels along an axon like a spark moves along an explosive's fuse. It is an electrochemical process initiated at the axon hillock when other impulses received at the cell body or dendrites meet a certain threshold. The action potential is propagated along the axon as a wave of membrane depolarization produced by _______-gated ___ and __ channels in the axolemma that allow diffusion of these ions into and out of the axoplasm.

nerve impulse, voltage, Na+, K+

In the PNS cell bodies are found in ganglia and in some sensory regions, such as the olfactory mucosa, and axons are bundled in ______

nerves

In the PNS nerve fibers are grouped into bundles to form ______

nerves

The main components of the peripheral nervous system (PNS) are the ______, _______, and _____ _______. Nerves are bundles of nerve fibers (_____) surrounded by _______ cells and layers of __________ tissue.

nerves, ganglia, nerve endings, axons, Schwann, connective

As the folds fuse and the neural tube separates from the now overlying surface ectoderm that will form epidermis, a large population of developmentally important cells, the ______ _____, separates from the neuroepithelium and becomes mesenchymal. Neural crest cells migrate extensively and differentiate as all the cells of the PNS, as well as a number of other non-neuronal cell types.

neural crest

As the neural tube detaches from the now overlying ectoderm, many cells separate from it and produce a mass of mesenchymal cells called the ______ _____

neural crest

Changes in dendritic spines are of key importance in the constant changes of the ______ __________ that occurs during embryonic brain development and underlies adaptation, learning, and memory postnatally.

neural plasticitiy

new communications are established with some degree of functional recovery. This ______ ____________ and reformation of processes are controlled by several growth factors produced by both neurons and glial cells in a family of proteins called _____________

neural plasticity, neurotrophins

Nervous tissue develops in the early embryo when the dorsal ectoderm ______ ____ folds lengthwise to form the ______ ____, the precursor of the CNS, and releases ______ _____ cells, precursors for much of the PNS.

neural plate, neural tube, neural crest

Alzheimer disease, a common type of dementia in the elderly, affects both neuronal perikarya and synapses within the cerebrum. Functional defects are due to _______________ _______, which are accumulations of ___ protein associated with microtubules of the neuronal perikaryon and axon hillock regions, and ________ _______, which are dense aggregates of ____-_________ protein that form around the outside of these neuronal regions.

neurofibrillary tangles,tau, neuritic plaques, beta amyloid

In both perikarya and processes microtubules, actin filaments, and intermediate filaments are abundant, with the latter formed by unique protein subunits and called ______________ in this cell type.

neurofilaments

A Schwann cell (______________) engulfs one portion along the length of a large-diameter axon. The Schwann cell membrane fuses around the axon and one thin extension of the Schwann cell elongates greatly and wraps itself repeatedly around the ____ to form multiple, compacted layers. The Schwann cell membrane wrappings constitute the ______ ______, with the Schwann cell body always on its _____ surface. The myelin layers are very rich in _____, and provide insulation and facilitate formation of action potentials along the axolemma.

neurolemmocyte, axon, myelin sheath, outer, lipid

Neuropeptides can act as _______________

neuromodulators

nitric oxide (NO), adenosine, neurosteroids, polyamines, etc., are often termed _______________ rather than neurotransmitters.

neuromodulators

The functional unit in both the CNS and PNS is the _______

neuron

There are significant differences in the responses of α1, β1, and β2 adrenoreceptors to the catecholamines epinephrine and norepinephrine. (1) Norepinephrine and epinephrine have almost the same potency at _______ receptors, with epinepherine being slightly more potent. However, compared with ____ receptors, α1 receptors are relatively insensitive to catecholamines. ______ concentrations of catecholamines are necessary to activate α1 receptors than to activate β receptors. Physiologically, such high concentrations are reached locally when norepinephrine is released from ______________ ____________ nerve fibers but not when catecholamines are released from the _______ _______. For example, the amount of epinephrine (and norepinephrine) released from the adrenal medulla in the fight or flight response is insufficient to activate ______ receptors. (2) Norepinephrine and epinephrine are equipotent at _____ receptors. As noted previously, much _____ concentrations of catecholamines will activate β1 receptors than will activate α1 receptors. Thus, norepinephrine released from sympathetic nerve fibers or epinephrine released from the adrenal medulla will activate β1 receptors. (3) β2 receptors are preferentially activated by ____________.

alpha1, beta, higher, postganglionic sympathetic, adrenal medulla, alpha1 beta1, lower epinepherine

pheochromocytoma is a tumor of the adrenal medulla that secretes catecholamines. Both norepinephrine and epinephrine may be secreted: norepinephrine causes hypertension by activating ______-adrenoceptors on vascular smooth muscle, and epinephrine increases heart rate by activating _____-adrenoceptors on the heart muscle.

alpha1, beta1

The mechanism of action of the adrenoreceptors can be explained as follows: ______ Receptors act through activation of phospholipase C and generation of IP3. _____ and _____ receptors act through activation of adenylyl cyclase and generation of cAMP. ______ Receptors act through inhibition of adenylyl cyclase.

alpha1, beta1, beta2, alpha2

In most smooth muscles, including blood vessels, ______ receptors contract (constrict), whereas _____ receptors relax (dilate). Prejunctional α2 receptors on sympathetic nerve terminals inhibit norepinephrine release, which relaxes blood vessels and causes vasodilation; postjunctional α2 receptors cause vasoconstriction.

alpha1, beta2

______ Receptors are found in vascular smooth muscle of the skin, skeletal muscle, and the splanchnic region, in the sphincters of the gastrointestinal tract and bladder, and in the radial muscle of the iris. Activation of these receptors leads to ___________ in each of these tissues. The mechanism of action involves a G protein called __ and activation of _____________ _

alpha1, contraction, Gq, phosphlipase C

Centrally, known to be involved in the regulation of blood pressure What receptors?

alpha2

Norepinephrine acts on prejunctional ______ receptors to inhibit transmitter release. This negative feedback control is supported by the observation that antagonists for these receptors (e.g., phentolamine) cause an increase in the release of transmitter in response to nerve stimulation.

alpha2

Which adrenergic receptor is found a lot of prejunctional membranes?

alpha2

regulation of several metabolic functions (e.g., glycogenolysis, lipolysis, and water absorption) and vascular smooth muscle contraction. What recptors?

alpha2

clonidine drug type? Used to treat what?

alpha2 blocker hypertension

Mechanism of action of β adrenoreceptors. In the inactive state, the ______ subunit of the __ protein is bound to GDP. In the active state, with ________________ bound to the β receptor, the αs subunit is bound to ___. β1 and β2 receptors have the same mechanism of action.

alphaS, Gs norepinepherine, GTP

Mechanism of action of α1 adrenoreceptors. In the inactive state, the ______ subunit of the __ protein is bound to GDP. In the active state, with _______________ bound to the α1 receptor, the αq subunit is bound to ___. αq, β, and γ are subunits of the __ protein.

alphaq, Gq norepinepherine, GTP, Gq

Inferiorly, each maxilla ends as the ________ _______, which contains the teeth and forms the upper jaw.

alveolar process

These findings gave rise to the 'amine theory of depression': this states that depression is caused by a relative defeciency of _____ _________________ at central synapses, and predicts that drugs which ________ amine concentrations should improve symptoms of the condition.

amine neurotransmitters, increase

What does H. pylori make that damages tissues? Is it G+ or G-?

ammonia G-

The stimulatory effects of _____________ are caused by their close chemical similarity to catecholamines

amphetamines

In Alzheimer's disease, _______-____ _,__, in combination with other neurotoxic factors, causes preferential impairment of _________ neurons in the _____ _______, yielding progressive loss of cognitive function, which leads to ________. In the early stages of this disease, the inhibitors of ____________________ with __ receptor _________ properties improved cognitive functions but had no effect on disease progress. The antagonists of glutamatergic ____ receptors are employed to reduce excitotoxic effects of excessive activation of glutamatergic neurons.

amyloid beta 1, 42, cholinergic, brain septum, dimentia, acetylcholinesterase, M2, agonists, NMDA

At the ____ _____ the simple columnar epithelium lining the rectum shifts abruptly to stratified squamous epithelium of the skin at the ____

anal canal, anus

Cells in both central and peripheral nerve tissue are of two kinds: _______, which typically have numerous long processes, and various _____ cells, which have short processes, support and protect neurons, and participate in many neural activities, neural nutrition, and defense of cells in the CNS.

neurons, glial

The terms sympathetic and parasympathetic are strictly ________ terms and refer to the ________ origin of the ______________ neurons in the CNS. Preganglionic neurons in the ___________ division originate in the thoracolumbar spinal cord. Preganglionic neurons in the _______________ division originate in the brain stem and sacral spinal cord.

anatomic, anatomic, preganglionic, sympathetic, parasympathetic

The semicircular canals, which are arranged perpendicular to each other, are used to detect ______ or rotational acceleration of the head

angular

The function of the horizontal semicircular canals is to detect _______ ____________ of the head

angular acceleration

The semicircular canals detect _______ acceleration of the head, and the otolith organs detect ______ acceleration.

angular, linear

Nystagmus occurs in response to _________ or ___________ acceleration of the head. When the head is rotated, the eyes initially move in the ___________ direction of the rotation, attempting to maintain a constant direction of gaze. This initial movement is the ____ component of nystagmus. Once the eyes approach the limit of their lateral movement, there is a rapid eye movement in the ____ direction as the head's rotation. This movement is the _____ component of nystagmus, in which the eyes "jump ahead" to fix on a new position in space. Nystagmus is defined by the direction of the _____ component: The nystagmus is in the direction of the head's rotation.

angular, rotational, opposite, slow, same, rapid, rapid

antibiotics and dietary supplements should be taken 2 hours before or 2 hours after _______ are ingested.

antacids

quinuclindyl benzilate and propylbenziylcholine are nicotinic ________ and muscarinic ________

antagonist, antagonists

The __________ rami of __ to __ form the cervical plexus. The major branches from this plexus supply the strap muscles, the diaphragm (__________ nerve), skin on the anterior and lateral parts of the neck, skin on the upper anterior thoracic wall, and skin on the inferior parts of the head

anteiorr, C1, C4, phrenic

________, ______ __________, and _______ _________ choroidal arteries serve the plexuses of the lateral and third ventricles.

anteiorr, medial posterior, lateral posterior

The boundaries of each ________ triangle are: ▪ the median vertical line of the neck, ▪ the inferior margin of the mandible, and ▪ the anterior margin of the sternocleidomastoid muscle.

anteiror

note the relationship between the _________ ________ artery, _________ _____________ artery, and the structures around the optic chiasm

anterior cerebral, anterior communicating

The ________ _________ artery serves the optic tract and portions of the internal capsule immediately internal to this structure. This explains the unusual combination of a homonymous hemianopia coupled with a contralateral hemiplegia and hemianesthesia (to all somatosensory modalities) in the ________ _________ ______ syndrome.

anterior choroidal, anteiror choroidal artery

The typical transverse process of a cervical vertebra also has _________ and _________ _________ for muscle attachment.

anterior, posteiror tubercles

Organelles and macromolecules synthesized in the cell body move by ___________ transport along axonal microtubules via _______ from the perikaryon to the synaptic terminals. __________ transport in the opposite direction along microtubules via _______ carries certain other macromolecules, such as material taken up by ___________ (including viruses and toxins), from the periphery to the cell body.

anterograde, kinesin, retrograde, dynein, endocytosis

The ________ _____________ artery or its junction with the ________ ________ artery is the most common site of supratentorial (_______ system) aneurysms. Rupture of aneurysms at this location is one of the more common causes of ____________ (also called nontraumatic) ___-_________ hemorrhage. The proximity of these vessels to optic structures and the _____________ explains the variety of visual and hypothalamic disorders that may be experienced by these patients. A lesion of the optic nerve results in __________ in that eye and loss of the ________ limb of the _________ _____ reflex. Lesions caudal to the optic chiasm result in deficits in the visual fields of both eyes (______________ [right or left] ____________ _________).

anteror communicating, anterior cerebral, carotid, spontaneous, sub arachnoid, hypothalamus, blindness, afferent, pupillary light, contralateral, homonymous hemaniopia

Monoamine oxidase (MAO) inhibitors prevent the catabolism of catecholamines and serotonin. They therefore increase the concentrations of these compounds at the synapse and increase the action of the transmitters. Compounds with this property are _______________

antidepressants

Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), are also highly effective _______________

antidepressants

human nervous system, by far the most complex system in the body, is formed by a network of many billion nerve cells (_______), all assisted by many more supporting cells called _____ cells.

neurons, glial

The fibrous intercellular network of CNS tissue superficially resembles collagen by light microscopy, but is actually the network of fine cellular processes emerging from neurons and glial cells. Such processes are collectively called the ________

neuropil

With the use of gold staining for neurofibrils, _________ is more apparent

neuropil

In general, increasing the brain concentration of 5-HT appears to increase _______, whereas reducing its concentration is helpful in treating the condition. The antidepressant buspirone acts as an agonist at _-____ receptors, and presumably causes a ________ in production of 5-HT. In addition to its effects on the __ dopamine receptor, clozapine binds strongly to the _-____ receptor, and it may be that a combination of a high level of _-____ antagonism and low __-binding activity is desirable for drugs that can be used to treat schizophrenia with the minimum frequency of side effects. The _-___ blocker ondansetron is an antiemetic, extensively used to prevent vomiting during chemotherapy. Migraine can be treated with sumatriptan, a _-____ agonist.

anxiety, 5HT1A, decrease, D2, 5HT2A, 5HT2A, D2, 5HT3, 5HT1D

The _________ mater has two components: (1) a sheet of connective tissue in contact with the dura mater and (2) a system of loosely arranged trabeculae composed of collagen and fibroblasts, continuous with the underlying pia mater layer. Surrounding these trabeculae is a large, sponge-like cavity, the subarachnoid space, filled with CSF.

arachnoid

In some areas, the arachnoid penetrates the dura mater and protrudes into blood-filled dural venous sinuses located there. These CSF-filled protrusions, which are covered by the vascular endothelial cells lining the sinuses, are called _________ _____ and function as sites for absorption of CSF into the blood of the venous sinuses.

arachnoid villi

The _________ layer contains much ___, which helps cushion the CNS within its bony enclosure.

arachnoid, SF

In autonomic and enteric nerves, nitric oxide (NO) is produced from ________ by the ____________________-dependent ______ _____ _________

arginine, tetrahydrabiopterin, nitric oxide synthase

One characteristic and useful marker protein in the CSF is _________________, which is __________ lacking ______ ____.

asialotransferrin, transferrin, sialic acid

In the cortex, or gray matter, one typically finds a protoplasmic _________ with one set of processes surrounding the endothelial cells, thereby helping to 'filter' materials from the blood, and a separate set of processes surrounding the neurons, which are thereby being 'fed' selected substances that have been extracted from the blood for passage to the neurons.

astrocyte

A length of capillary (C) is shown here completely covered by silver-stained terminal processes extending from __________

astrocytes

When there is injury to the CNS, __________ can play a major part in the reaction, synthesizing large amounts of the____. This is the cellular equivalent of scar tissue and is found in diseases such as ________ _________, in which it is the major constituent of the characteristic plaques. __________ are not present in the PNS.

astrocytes, GFAP, multiple scleorsis, astrocytes

Also unique to the CNS __________ have a large number of long radiating, branching processes. Proximal regions of the astrocytic processes are reinforced with bundles of intermediate filaments made of _____ __________ _________ _______, which serves as a unique marker for this glial cell.

astrocytes, glial fibrillary acid protein

The three major cell types in the nervous system (which each constitute about 30%) are __________, which also make up part of the blood-brain barrier; ________________, which are principally composed of fat and serve to insulate the axons; and ________, which are essentially resident macrophages (scavengers).

astrocytes, oligodendrocytes, microglia

Most brain tumors are ____________ derived from _______ __________. These are distinguished pathologically by their expression of ____

astrocytomas, fibrous astrocytes, GFAP

The classic antagonist of the muscarinic effect is ________ and the best-studied blocker for the nicotinic receptor is the poisonous snake venom ______-____________

atropine, alpha bungarotoxin

Sensory innervation of the parotid gland is provided by the _________________ nerve, which is a branch of the __________ nerve This exits the skull where?

auricotemporal, mandibular foramen ovale

Three of these muscles, "other muscles of facial expression," are associated with the ear—the anterior, superior, and posterior __________ muscles: * The _________ muscle is anterolateral and pulls the ear upward and forward. ▪ The ________ muscle is superior and elevates the ear. ▪ The __________ muscle is posterior and retracts and elevates the ear

auricular anteiorr superior posterior

The _________ nervous system is an involuntary system that controls and modulates the functions primarily of visceral organs.

autonomic

The autonomic motor nerves, comprising what is often called the _________ nervous system (___), all have pathways involving two neurons: a ____________ neuron with the cell body in the CNS and a _____________ neuron with the cell body in a ganglion. The ANS has two divisions: (1) The _________________ division, with its ganglia within or near the effector organs, maintains normal body homeostasis. (2) The ____________ division has its ganglia close to the CNS and controls the body's responses during emergencies and excitement.

autonomic, ANS, preganglionic, postganglionic parasympathetic, sympathetic

As indicated earlier autonomic nerves make up the _________ nervous system. This has two parts: the ___________ and the _______________ divisions.

autonomic, sympathetic, parasympathetic

α2 receptors are found in two forms, _____________ and _______________

autoreceptors, heteroreceptors

α2 Receptors present on sympathetic postganglionic nerve terminals are called ____________. In this function, activation of α2 receptors by _______________ released from presynaptic nerve terminals inhibits further release of norepinephrine from the same terminals; this ________ feedback conserves norepinephrine in states of high stimulation of the ____________ nervous system. Interestingly, the adrenal medulla does not have ______ receptors and, therefore, is not subject to feedback inhibition; consequently, the adrenal medulla can become depleted of ________________ during periods of prolonged stress.

autoreceptors, norepinepherine, negative, sympathetic, alpha2, catecholamines

There is an ________ ________ (gateway to the upper limb) on each side of the superior thoracic aperture at the base of the neck: ▪ Structures such as blood vessels pass over rib _ when passing between the axillary inlet and thorax. ▪ Cervical components of the _________ _______ pass directly from the neck through the axillary inlets to enter the upper limb

axillary inlet 1 brachail plexus

The plasma membrane of the axon is often called the __________ and its contents are known as ________

axolemma, axoplasm

Most neurons have only one ____, typically longer than its dendrites

axon

The ____, which is a single long process ending at synapses specialized to generate and conduct nerve impulses to other cells (nerve, muscle, and gland cells). Axons may also receive information from other neurons, information that mainly modifies the transmission of action potentials to those neurons.

axon

Axons originate from a pyramid-shaped region of the perikaryon called the ____ _______, just beyond which the axolemma has concentrated ion channels which generate the action potential.

axon hillock

Micrograph of a large motor neuron showing the large cell body and nucleus, a long ____ emerging from an axon hillock, and several dendrites. _____ __________ can be seen throughout the cell body and cytoskeletal elements can be detected in the processes. Nuclei of scattered _____ cells are seen among the surrounding tissue.

axon, Nissl bodies, glial

The more simply organized peripheral nerves have better capacity for ______ regeneration, a process involving reactivation of the perikaryon, Schwann cells, and macrophages.

axonal

Several GABAA receptor agonists and GABA uptake or GABA-transaminase inhibitors are used as sedatives, tranquilizers or anxiolytic drugs. The most common groups include ___________, _______________, chloral hydrate and valproate. ________ also acts as the GABAA receptor agonist.

barbituates, benzodiazepines, ethanol

Arterial blood pressure is sensed by ______________ located in the walls of the _______ _____. This information is transmitted, via the ______________ nerve (cranial nerve __), to the _________ center in the _______ of the _____ ____—this is the sensory or ________ limb of blood pressure regulation

baroreceptors, carotid sinus, glossopharyngeal, IX, vasomaotor, medlla, brain stem, afferent

The _____ _______ are the deep nuclei of the telencephalon Name them!

basal ganglia Caudate nucleus, putamen, globus pallidus, amygdala

The body of the mandible is arbitrarily divided into two parts: ▪ The lower part is the ____ of the mandible. ▪ The upper part is the _________ ____ of the mandible.

base alveolar part

Rupture of a _______ ___ aneurysm may result in the cardinal signs (sudden severe headache, nausea, vomiting, and possibly syncope) that signal a stroke as broadly defined. In addition, the extravasated blood may dissect its way into the ventricular system through the floor of the third ventricle

basilar tip

The finding that _______________ reduce sympathetic responses to oral surgery emphasizes the role of the CNS in initiating and coordinating sympathetic responses to stress

benzodiazepines

the ____-adrenergic receptor, which responds to norepinephrine and epinephrine, causes an increase in cAMP, which stimulates a kinase to phosphorylate and activate a calcium channel.

beta

There are several sequence homologies of rhodopsin with what receptors (2)?

beta adrenergic muscarinic cholinergic

prazosin drug type? Used to treat what?

beta1 blocker hypertension

The β2 receptors have a mechanism of action similar to that of _____ receptors: activation of a __ _______, release of the ______ subunit, stimulation of ______ _________, and generation of ____

beta1, Gs protein, alphaS, adenyl cyclase, cAMP

______ Receptors are prominent in the heart. They are present in the SA node, in the atrioventricular node, and in ventricular muscle. Activation of β1 receptors in these tissues produces __________ heart rate in the SA node, _________ conduction velocity in the AV node, and __________ contractility in ventricular muscle, respectively. β1 Receptors also are located in the salivary glands, in adipose tissue, and in the kidney (where they promote _____ secretion). The mechanism of action of β1 receptors involves a __ protein and ____________ of ______ _______

beta1, increased, increased, increased, renin, Gs, activation, adenyl cylcase

associated with relaxation which beta receptors?

beta2

epinephrine released from the adrenal medulla is expected to activate ______ receptors, whereas norepinephrine released from sympathetic nerve endings is not.

beta2

_____ Receptors are found in the vascular smooth muscle of skeletal muscle, in the walls of the gastrointestinal tract and bladder, and in the bronchioles. The activation of _____ receptors in these tissues leads to relaxation or dilation.

beta2, beta2

Certain subclasses of β-receptors are found in particular tissues; for instance, the _____-receptor is present in lung and ______-receptor _________ such as salmbuamol are therefore used to produce bronchial dilatation in asthma without stimulating the _____-receptor in the heart.

beta2, beta2, agonists, beta1

primarily stimulate lipolysis in fat cells Which beta receptor?

beta3

Interpeduncular cistern is located where?

between rostral/anteiror parts of midbrain

Patients with aneurysms at this location may present with eye movement disorders, pupillary dilation caused by damage to the root of the third nerve, and diplopia.

bifurcation of the basilar artery, also called the basilar tip.

The spinal cord varies slightly in diameter along its length but in cross section always shows _________ symmetry around the small, CSF-filled _______ _____. Unlike the cerebrum and cerebellum, in the spinal cord the _____ matter is internal, forming a roughly H-shaped structure that consists of two ___________ horns (sensory) and two ________ (motor) horns, all joined by the ____ __________ around the central canal.

bilateral, central canal, gray, posterior, anterior, gray commissure

Bile canaliculi are the smallest branches of the biliary tree or bile conducting system. They empty into ____ ______ of _____ composed of _______ epithelial cells called ______________. The short bile canals quickly merge in the portal areas with the bile ductules lined by ________ or ________ ______________ and with a distinct connective tissue sheath. Bile ductules gradually merge, enlarge, and form _____ and ____ _______ ducts leaving the liver.

bile canals, Hering, cuboidal, cholangiocytes, cuboidal, columnar cholangiocytes, left, right hepatic

photoreceptors synapse on __________ cells and __________ cells in the _____ _________ layer

bipolar, horizontal, outer plexiform

significant antiosteoclastic activity, and are the drugs of first choice for treating Paget's disease. What drugs?

bisphosphonates

The posterior one third of the tongue (where _______ and ____ sensations are most sensitive) is innervated by the ______________ nerve (CN __)

bitter, sour, glosspharyngeal, IX

The _____ _____ _______ is a functional barrier that allows much tighter control than that in most tissues over the passage of substances moving from blood into the CNS tissue. The main structural component of the BBB is the _________ ___________, in which the cells are tightly sealed together with well-developed occluding junctions, with little or no transcytosis activity, and surrounded by the basement membrane. The ________ ______ __ __________ __________ _____ that envelops the basement membrane of capillaries in most CNS regions contributes to the BBB and further regulates passage of molecules and ions from blood to brain.

blood brain barrier, capillary endothelium, limiting membrane of perivascular astrocytic feet

All astrocytic processes contain intermediate filaments of GFAP, and antibodies against this protein provide a simple method to stain these cells, as seen here in a fibrous astrocyte (A) and its processes. The small pieces of other GFAP-positive processes in the neuropil around this cell give an idea of the density of this glial cell and its processes in the CNS. Astrocytes form part of the _____-_____ _______ and help regulate entry of molecules and ions from blood into CNS tissue. Capillaries at the extreme upper right and lower left corners are enclosed by GFAP-positive ____________ _____ at the ends of numerous astrocytic processes.

blood brain barrier, perivascular feet

Inferiorly, the part of each maxilla, lateral to the opening of the nasal cavity, is the ____ of the maxilla.

body

Hyoid bone: ▪ The ____ of the hyoid bone is anterior and forms the base of the U. ▪ The two arms of the U (_______ ______) project posteriorly from the lateral ends of the body.

body greater horns

The inner ear consists of a bony labyrinth and a membranous labyrinth. The ____ labyrinth consists of three semicircular canals (________, _________, and ________). The membranous labyrinth consists of a series of ducts called the scala vestibuli, scala tympani, and scala media.

bony, lateral, superior, posterior

The anterior rami of C5 to C8, together with a large component of the anterior ramus of T1, form the _________ ________, which innervates the upper limb.

brachial plexus

The dorsal column system crosses the midline in the _____ ____. The anterolateral system crosses the midline in the ______ ____

brain stem, dorsal column

Innervation of the parasympathetic nervous system. Preganglionic neurons originate in nuclei of the _____ ____ (________, ____, _______) and in ______ segments (__-__) of the spinal cord.

brain stem, midbrain, pons, medulla, sacral, S2, S4

The columns of cells within the spinal cord are rostrally continuous with comparable cell columns in the _________ that have similar functions. For example, general motor cell columns of the spinal cord are continuous with the groups of motor nuclei that innervate the ______ and the ____________ muscles; both cell columns innervate ________ muscles. The same is the case for general sensation. Nuclei conveying special senses are found only in the ________ and are associated with only certain cranial nerves.

brainstem, tongue, extraocular, skeletal, brainstem

Cyclic AMP AKA

cAMP

Many adrenergic effects are mediated by ____

cAMP

Second messenger of norepenepherine?

cAMP

Low __________ causes abnormal mineralization of newly formed osteoid as a result of low calcium and phosphate availability and reduced osteoblast function. It leads to the development of rickets in children or osteomalacia in adults.

calcitriol

The concentration of the 24,25[OH]2D3 in the circulation is reciprocally related to the level of the __________

calcitriol

The activation of NMDA receptor allows ________ entry into cells. This activates various __________, which in turn initiate the pathway of programmed cell death or __________

calcium, proteases, apoptosis

The cranium can be subdivided into: ▪ an upper domed part (the _________), which covers the cranial cavity containing the brain, ▪ a base that consists of the _____ of the cranial cavity, and ▪ a lower anterior part—the facial skeleton (________________).

calvaria base viscerocranium

Gastric gland: Parietal cells are large cells with many mitochondria and large intracellular _________ for production of ___ in the gastric secretion; they also secrete _________ ______ for vitamin B12 uptake.

canalaculli, HCl, intrinsic factor

At higher magnification each fold of choroid plexus is seen to be well-vascularized with large ___________ and covered by a continuous layer of cuboidal ependymal cells

capillaries

A sensory ganglion (G) has a distinct connective tissue _______ and internal framework continuous with the epineurium and other components of peripheral nerves, except that no perineurium is present and that there is no blood-nerve barrier function. ________ of nerve fibers (F) enter and leave these ganglia.

capsule, fasicles

The stomach has four major regions: the superior ______ and inferior _______, which are rather similar histologically, and the intervening ______ and ____, which are also similar.

cardia, pylorus, body, fundus

The mucosa of the stomach cardiac and pyloric regions has branching ______ and _______ glands that consist almost entirely of columnar ______ cells, lacking ________ and _____ cells.

cardial, pyloric, mucous, parietal, Chief

Rupture of a basilar tip aneurysm may result in the ________ signs (sudden severe headache, nausea, vomiting, and possibly syncope) that signal a stroke as broadly defined. In addition, the extravasated blood may dissect its way into the ___________ system through the floor of the ___ ventricle.

cardinal, ventricular, 3rd

Pheochromocytoma: The increased amounts of circulating ______________ activated _____ receptors in the heart, increasing the heart rate and increasing contractility (pounding of the heart). Activation of ______ receptors in vascular smooth muscle of the skin produced vasoconstriction, which presented as cold hands and feet.

catecholamines, beta1, alpha1

The action of ____________ is terminated by their reuptake and degradation to aldehydes by mitochondrial monoamine oxidases and subsequent methylation by catechol-O-methyltransferase to homovanillic or vanillylmandelic acids, which are excreted with urine. Excess of these compounds in urine may indicate the presence of adrenal medullar tumor, _______________.

catecholamines, pheochromocytoma

Monoamine oxidase (MAO) inhibitors prevent the catabolism of ______________ and __________

catecholamines, serotinin

Norepinephrine, epinephrine, and dopamine, known as ______________, are all derived from the amino acid ________

catecholamines, tyrosine

The ____ ____ (also called the perikaryon or soma) which contains the nucleus and most of the cell's organelles and serves as the synthetic or trophic center for the entire neuron.

cell body

The neuronal ____ ____ contains the nucleus and surrounding cytoplasm, exclusive of the cell processes

cell body

Ependymal cells (E) lining the _______ _____ of the ______ ____ help move CSF in that CNS region.

central canal, spinal cord

The cell body of the motoneuron is located in the _______ nervous system, in either the brain stem or spinal cord, and its axon synapses directly on skeletal muscle, the effector organ. The neurotransmitter _____________ is released from presynaptic terminals of the motoneurons and activates _________ receptors located on the motor end plates of the skeletal muscle.

central, acetylcholine, nicotinic

The sharply folded __________ ______ coordinates muscular activity throughout the body and is organized with three layers: A thick outer _________ layer has much neuropil and scattered neuronal cell bodies. A thin middle layer consists only of very large neurons called ________ cells (named for the 19th century Czech histologist Jan Purkinje). These are conspicuous even in H&E-stained sections, and their dendrites extend throughout the molecular layer as a branching basket of nerve fibers (Figures 9-16c and d). A thick inner ________ layer contains various very small, densely packed neurons (including granule cells, with diameters of only 4-5 μm) and little neuropil.

cerebellar cortex molecular Purkinjie granular

Deep within the brain are localized, variously shaped darker areas called the ________ ______, each containing large numbers of aggregated neuronal cell bodies.

cerebral nuclei

The major structures comprising the CNS are the _________, __________, _____ ____

cerebrum, cerebellum, spinal cord

The anterior rami of C1 to C4 form the __________ plexus. The major branches from this plexus supply the strap muscles, the ________ (phrenic nerve), skin on the anterior and lateral parts of the neck, skin on the upper anterior thoracic wall, and skin on the inferior parts of the head

cervical, diaphragm

Very rapidly and rapidly adapting receptors detect _______ in the stimulus and, therefore, detect changes in ________. Slowly adapting receptors respond to _________ and ________ of the stimulus.

changes, velocity intesnsity, duration

pH of CSF What type of sensory receptor?

chemoreceptor

PTH is an 84-amino acid, single-chain peptide hormone secreted by the _____ cells of the ___________ glands.

chief, parathyroid

To move stored bile into the duodenum, contraction of the gallbladder muscularis is induced by _______________ released from _______________ cells of the small intestine.

cholecystokinin, enteroendocrine

Preganglionic neurons of the sympathetic division are always ___________. They release ___, which interacts with _________ receptors on the cell bodies of postganglionic neurons.

cholinergic, ACh, nicotinic

As in the sympathetic division, all parasympathetic preganglionic neurons are ___________ and release ___, which interacts at _________ receptors on the cell bodies of postganglionic neurons. Most postganglionic neurons of the parasympathetic division are also _________. Receptors for ___ in the effector organs are __________ receptors rather than _________ receptors.

cholinergic, ACh, nicotinic, nicotinic, ACh, muscarinic, nicotinic

Acetylcholine (ACh) is synthesized in the cytoplasmic compartment of __________ nerve terminals from acetyl-CoA and choline by _______ _________________. The enzyme is expressed exclusively in the cholinergic neurons. Acetyl-CoA is synthesized from ________ derived from __________, whereas choline is taken up from extracellular compartment by plasma membrane-potential-driven high-affinity choline uptake system

cholinergic, choline acetyltransferase, pyruvate, glycolysis

Peripheral __________ neurons are located in _______________ ganglia and innervate all visceral tissues. They ______ blood vessels of the gatrointestinal tract and ________ salivation and peristalsis. They also _________ airways, control heart function, ________ the pupils and regulate lens accommodation, and stimulate sexual arousal and genital erection.

cholinergic, parasympathetic, dilate, increase, constrict, constrict

The taste cells in fungiform papillae are innervated exclusively by the ______ _______ branch of CN ___

chorda tympani, VII

The _______ ______ consists of ependyma and vascularized pia mater and projects many thin folds from certain walls of the ventricles.

choroid plexus

The _______ ______ consists of highly vascular tissue, elaborately folded and projecting into the large ventricles of the brain

choroid plexus

The _______ ______ consists of elaborate folds of vascularized ___ mater covered by ________ that project from walls of the cerebral ventricles; there water is removed from capillaries and transferred into the ventricles as __________________ _____

choroid plexus, pia, ependyma, cerebrospinal fluid

The terms adrenergic and cholinergic are used to describe neurons of either division, according to which ________________ they synthesize and release. __________ neurons release norepinephrine; receptors for norepinephrine on the effector organs are called _______________. These may be activated by norepinephrine, which is released from adrenergic neurons, or by ____________, which is secreted into the circulation by the adrenal medulla. _________ neurons release ACh; receptors for ACh are called ________________. (A third term is nonadrenergic, noncholinergic, which describes some postganglionic parasympathetic neurons of the _________________ tract that release ________ [e.g., substance P] or other substances [e.g., nitric oxide] as their neurotransmitter rather than ___.)

neurotransmitter Adrenergic, adrenoreceptors, norepinepherine Cholineric, cholinoreceptors gastrointestinal, peptides, ACh

A large number of compounds, whether of low molecular weight, such as the biogenic amines, or larger peptides, can act as _________________

neurotransmitters

Many peptides act as _________________

neurotransmitters

Stages in the process of _____________, by which cells of the CNS and PNS are produced, are shown in diagrammatic cross sections of a 3- and 4-week human embryo with the extraembryonic membranes removed. Under an inductive influence from the medial notochord, the overlying layer of ectodermal cells thickens as a bending _______ _____, with a medial neural groove and lateral neural folds (1). All other ectoderm will become epidermis. The plate bends further, making the ______ _____ and ______ more prominent (2). The neural folds rise and fuse at the midline (3), converting the groove into the ______ ____ (4), which is large at the cranial end of the embryo and much narrower caudally. The neural tube will give rise to the entire CNS.

neurulation, neural plate neural folds, groove neural tube

Certain drugs, e.g. the antituberculosis drug isoniazid, predispose to ______ deficiency.

niacin

alpha turbocuranine drug class

nicotinic antagonist

phenyl trimethylammonium drug type

nicotinic muscle agonist

elapid alpha toxins drug type

nicotinic muscle antagonist

The adrenal medulla is a specialized ganglion in the sympathetic division of the autonomic nervous system. The cell bodies of its preganglionic neurons are located in the thoracic spinal cord. The axons of these preganglionic neurons travel in the greater splanchnic nerve to the adrenal medulla, where they synapse on chromaffin cells and release ACh, which activates nicotinic receptors. When activated, the __________ cells of the adrenal medulla secrete catecholamines (____________ and _______________) into the general circulation. In contrast with sympathetic postganglionic neurons, which release only _______________, the adrenal medulla secretes mainly ___________ (80%) and a small amount of _______________ (20%). The reason for this difference is the presence of ____ in the adrenal medulla, but not in sympathetic postganglionic adrenergic neurons. This catalyzes the conversion of ______________ to ____________, a step that, interestingly, requires _________ from the nearby adrenal cortex; cortisol is supplied to the adrenal medulla in venous effluent from the adrenal cortex.

chromaffin, norepinepherine, epinepherine, norepinepherine, epinepherine, norepinepherine, PMNT, norepinepherine, epinepherine, cortisol

The onset of regeneration is signaled by changes in the perikaryon that characterize the process of ____________: the cell body swells slightly, Nissl substance is initially diminished, and the nucleus migrates to a peripheral position within the perikaryon.

chromatolysis

oxotremarine drug type

nicotinic neuronal agonist

quinuclindyl benzilate drug type

nicotinic neuronal antagonist

Cytoplasm of perikarya often contains numerous free polyribosomes and highly developed RER, indicating active production of both cytoskeletal proteins and proteins for transport and secretion. Histologically these regions with concentrated RER and other polysomes are basophilic and are distinguished as ______________ substance (or _____ substance, _____ bodies)

chromatophillic, Nissl, Nissl

ACh released from preganglionic neurons of the parasympathetic division activates _________ receptors, whereas ACh released from postganglionic neurons of the parasympathetic division activates __________ receptors.

nicotinic, muscarinic

The _________ type of transmission is exerted by motor neurons located in the brainstem and anterior horns of the medulla oblongata. Another group of central cholinergic neurons located in the brain septum plays a key role in the basic and higher cognitive functions through activation of postsynaptic __________ receptors. k file.

nicotinic, muscarinic

Visual pathway: ▪ ___-_______ is converted to ______-_______. ▪ __________ becomes activated. ▪ The level of cGMP __________. ▪ ___ entry into the cell is blocked. ▪ The rod cell ______________. ▪ There is release of _________ (or aspartate). ▪ An action potential _____________ the adjacent ________ cell. ▪ This depolarizes the associated ________ neuron, to send an action potential out of the eye.

cis retinal, trans retinal rhodopsin decreases Na+ depolarizes glutamate depolarizes, bipolar ganglion

_________ are the enlarged portions of the subarachnoid space that contain arteries and veins, roots of cranial nerves, and, of course, cerebrospinal fluid.

cisterns

The posterior triangle is bounded by: ▪ the middle one-third of the ________, ▪ the anterior margin of the _________, and ▪ the posterior margin of the ___________________

clavicle trapezius sternocliedomastoid

The upper diagram shows one set of such clefts ultrastructurally. The clefts contain Schwann cell cytoplasm that was not displaced to the cell body during myelin formation. This cytoplasm moves slowly along the myelin sheath, opening temporary spaces (the _______) that allow renewal of some membrane components as needed for maintenance of the sheath.

clefts

When no ACh is bound, the mouth of the nicotinic ACh channel is _______. When ACh is bound to each of the two _____ subunits, a conformational change occurs in all of the subunits, resulting in _________ of the central core of the channel. When the core of the channel opens, ___ and __ flow down their respective electrochemical gradients (___ into the cell, and __ out of the cell), with each ion attempting to drive the membrane potential to its equilibrium potential.

closed, alpha, opening, Na+, K+,Na+, K+

The oscillating receptor potential of the cochlea is called the ________ ____________ potential.

cochlear microphonic

The _________ portion of the ______ cranial nerve is concerned with the perception of sound. Damage to the cochlea itself, or the cochlear root, may profoundly alter one's perception of sound or may result in ________. The ____________ portion of the ___ cranial nerve functions in the arena of balance, equilibrium, and maintenance of posture. Damage to the semicircular canals, to the vestibular root, or to central structures that receive vestibular input, may result in vertigo, ataxia, difficulty _______ or maintaining _______, and/or a variety of ___ movement problems.

cochlear, 8th, dafness, vestibular, 8th, walking, balance, eye

This low-magnification TEM shows a fibroblast surrounded by ________ in the epineurium (E) and three layers of flattened cells in the ___________ which form another part of the blood-nerve barrier. Inside the perineurium the endoneurium (En) is rich in _________ fibers that surround all Schwann cells. Nuclei of two Schwann cells (SC) of myelinated _____ are visible as well as many unmyelinated axons (UM) within Schwann cells.

collagen, perineurium,reticulin, axons

A striated duct (SD) shows very faint striations in the basal half of the ________ cells, which represent ____________ located in the folds of the lateral cell membrane.

columnar, mitochondria

Areas of the brain that contain only decussating axons are called _______________; for example, the ______ __________ is the commissure connecting the two cerebral hemispheres.

commissures, corpus callosum

The Dubin-Johnson and Rotor's syndromes impair biliary secretion of ___________ bilirubin and therefore cause __________ hyperbilirubinemia, which is usually mild.

conjugatd, conjugated

Posthepatic jaundice. Plasma bilirubin is elevated due to an increase in the ________ fraction. Obstruction of the ____ ____ does not allow passage of bile to the gut. Stools are characteristically ____ in color

conjugated, bile duct, pale

Intrahepatic jaundice. Bilirubin in plasma is increased due to an increase in the __________ fraction. _________ serum enzyme activities signify hepatocyte damage

conjugated, increased

There are two types of cholinoreceptors: nicotinic and muscarinic. __________ receptors are found on the motor end plate, in all autonomic ganglia, and on chromaffin cells of the adrenal medulla. __________ receptors are found in all effector organs of the parasympathetic division and in a few effector organs of the sympathetic division.

nicotinic, muscarinic

Lesions caudal to the optic chiasm result in deficits in the visual fields of both eyes (_______________ [right or left] __________ ___________).

contralateral, homonymous hemaniopia

In upper regions, the frontal bone articulates with the parietal bone at the _______ suture. The parietal bone then articulates with the occipital bone at the _______ suture.

coronal, lamboid

The second muscle in the orbital group is the much smaller __________ __________, which is deep to the eyebrows and the orbicularis oculi muscle and is active when frowning.

corrugator supercilli

The mechanism of action of cholinoreceptors can be explained as follows: _________ receptors act as ion channels for Na+ and K+. Many __________ receptors have the same mechanism of action as alpha1 receptors; some muscarinic receptors act by __________ adenylyl cyclase; a few muscarinic receptors involve direct action of a _ ______ on the physiologic mechanism.

nicotinic, muscarinic, activation, G protein

propylbenziylcholine drug type

nicotninic neuronal antagonist

Nerves containing dopamine run in well-defined tracts. One of the most important tracts, the ____________, connects the substantia nigra in the midbrain with the basal ganglia below the cortex. Damage to this causes ___________ disease, with loss of fine control of movement.

nigrostriatal, Parkinson's

In autonomic and enteric nerves, ______ ______ is produced from arginine by the tetrahydrobiopterin-dependent nitric oxide synthases

nitric oxide

The cerebral cortex influences cranial nerve nuclei via ____________ fibers. In the neurological examination, this is most evident when testing motor functions of CNs ___, __, _, __, and ___. In many situations, the deficit is seen by the inability of the patient to perform a movement "against _____________." Comparing the deficit(s) of a lesion of these fibers to damage of cranial nerves within the brainstem, or the periphery, is essential to localizing the lesion within the central nervous system.

corticonuclear, VII, IX, X, XI, XII, resistance

Pyramidal tracts are ______________ and _____________ tracts that pass through the medullary pyramids and descend directly onto lower motoneurons in the spinal cord

corticospinal, corticobulbar

Preganglionic neurons of the parasympathetic division arise from nuclei of ______ nerves (CN) ___, ___, __, and _ or from ______ spinal cord segments __-__; therefore, the parasympathetic division is called ____________

cranial, III, VII, IX, X, sacral, S2, S4, craniosacral

Except for the mandible, which forms the lower jaw, the bones of the skull are attached to each other by sutures, are immobile, and form the _______

cranium

Axons from the receptor cells leave the olfactory epithelium, pass through the __________ ______, and synapse on apical dendrites of ______ cells (the second-order neurons) in the _________ ____. These synapses occur in clusters called _________

cribiform plate, mitral, olfactory bulb, glomeruli

Accessing the larynx and trachea: A ______________ makes use of the easiest route of access through the _______________ ligament (cricovocal membrane, cricothyroid membrane) between the cricoid and thyroid cartilages of the larynx. The ligament can be palpated in the midline, and usually there are only small blood vessels, connective tissue, and skin (though occasionally, a small lobe of the _______ gland—_________ lobe) overlying it. At a lower level, the airway can be accessed surgically through the anterior wall of the trachea by _____________.

cricothryrostomy, cricithyroid, thyroid, pyramidal, tracheostomy

Each tooth has enamel covering its _____ and _____ and a vascularized, innervated central pulp cavity within the dentin that makes up the roots and extends into the neck.

crown, neck

The question arises as to whether the nicotinic receptor on the motor end plate is identical to the nicotinic receptor in the autonomic ganglia. This question can be answered by examining the actions of drugs that serve as agonists or antagonists to the nicotinic receptor. The nicotinic receptors at the two loci are certainly similar: Both are activated by the agonists ACh, nicotine, and carbachol, and both are antagonized by the drug ______. However, another antagonist to the nicotinic receptor, ________________, blocks the nicotinic receptor in the ganglia but not the nicotinic receptor on the motor end plate. Thus, it can be concluded that the receptors at the two loci are similar but not identical, where the nicotinic receptor on the skeletal muscle end plate is designated __ and the nicotinic receptor in the autonomic ganglia is designated __

curare, hexamethonium N1, N2

Intravenous administration of ____________, an immunosuppressant, also has been used to heal fistulas caused by ulcerative colitis and Crohn disease

cyclosporine

Hyperpolarization of the photoreceptor membrane _________ the release of _________, an __________ neurotransmitter, from the synaptic terminals of the photoreceptor.

decreases, glutamate, excitatory

The large Purkinje neuron in this silver-impregnated section of cerebellum has many __________ emerging from its cell body (CB) and forming branches. The small dendritic branches each have many tiny projecting _________ ______ spaced closely along their length, each of which is a site of a synapse with another neuron. Dendritic spines are highly dynamic, the number of synapses changing constantly.

dendrites, dendritic spines

The _________, which are the numerous elongated processes extending from the perikaryon and specialized to receive stimuli from other neurons at unique sites called ________.

dendrites, synapses

In the CNS most synapses on dendrites occur on _________ ______, which are dynamic membrane protrusions along the small dendritic branches, visualized with silver staining (Figure 9-5) and studied by confocal or electron microscopy.

dendritic spines

APCs comprise _________ cells, ___________, and _ cells.

dendritic, macrophages, B

Changes in _________ ______ are of key importance in the constant changes of the neural plasticity that occurs during embryonic brain development and underlies adaptation, learning, and memory postnatally.

dendrtic spines

Predentin is secreted as elongated ________ _______ from tall _____________ that line the pulp cavity and persist in the fully formed tooth, with apical ___________ _________ extending between the tubules.

dentinal tubules, odontoblasts, odontoblast processes

decreased release of glutamate that interacts with metabotropic receptors will result in ______________ and __________ of the bipolar or horizontal cell

depolarization, excitation

A change in voltage which tends to drive the resting potential towards zero from the normal negative voltage is known as a ______________, whereas a process that increases the negative potential is called _________________

depolarization, hyperpolarization

Action potential is formed as follows. At the start of an action potential, the membrane is at its resting potential of about ___ mV. This is maintained by _______-___________ __ channels. When an impulse is initiated by a signal from a neurotransmitter, _______-_________ ___ channels open. These allow inflow of ___ ions, which alter the membrane potential to ________ values. The Na+ channels then close and __ channels, called _______ __________ channels, open to restore the initial balance of ions and the ________ membrane potential.

-70, voltage independent K+, voltage dependent Na+, Na+, positive, K+, delayed rectifier, negative

When the threshold for triggering an impulse is met, channels at the axon's initial segment open and allow a very rapid influx of extracellular Na+ that makes the axoplasm positive in relation to the extracellular environment and shifts (___________) the resting potential from negative to positive, to __ mV

depolarizes, 30

Excitatory neurotransmitters cause a ____________ change in voltage, in which case an action potential is more likely to occur. In contrast, inhibitory transmitters _____________ the membrane and an action potential is then less likely to occur.

depolarizing, hyperpolarize

The __________ _____ __________ arises from the front of the mandible, deep to the depressor anguli oris. Its fibers move superiorly and medially, some merging with fibers from the same muscle on the opposite side and fibers from the orbicularis oris before inserting into the lower lip. It depresses the lower lip and moves it laterally.

depressor labii inferioris

The final muscle in the nasal group is the _________ _____ ____, another muscle that assists in widening the nares

depressor septi nasi

The _________ ______ ____ is active during frowning. It arises along the side of the mandible below the canine, premolar, and first molar teeth and inserts into skin and the upper part of the orbicularis oris near the corner of the mouth. It depresses the corner of the mouth.

depresssor anguli oris

Gastric gland: Enteroendocrine cells are scattered epithelial cells of the _______ _______________ system, which release ________ ________ to regulate activities of neighboring tissues during food digestion.

diffuse neuroendocrine, peptide hormones

Between adjacent Schwann cells on an axon the myelin sheath shows small _____ __ ________ (or _____ ____), where the axon is only partially covered by interdigitating Schwann cell processes. At these nodes the axolemma is exposed to ions in the interstitial fluid and has a much higher concentration of voltage-gated Na+ channels, which renew the action potential and produce _________ ___________ of nerve impulses, their rapid movement from node to node. The length of axon ensheathed by one Schwann cell, the __________ segment, varies directly with axonal diameter and ranges from 300 to 1500 μm.

nodes of Ranvier, nodal gaps, saltatory conduction, internodal

The size of the pupil is reciprocally controlled by two muscles of the iris: the pupillary _______ (radial) muscle and pupillary ___________ (sphincter) muscle. The pupillary dilator muscle is controlled by ___________ innervation through ______ receptors. Activation of these α1 receptors causes ____________ of the radial muscle, which causes dilation of the pupil, or _________. The pupillary constrictor muscle is controlled by _______________ innervation through __________ receptors. Activation of these muscarinic receptors causes _____________ of the sphincter muscle, which causes ____________ of the pupil, or ______.

dilator, constrictor, sympathetic, alpha1, constriction, mydriasis, parasympathetic, muscarinic, constiction, constriction, miosis

Damage to the third and fourth nerves also results in ________

diplopia

Regeneration of peripheral nerves is functionally efficient only when the fibers and the columns of Schwann cells are directed properly. In a mixed nerve, if regenerating sensory fibers grow into columns formerly occupied by motor fibers connected to motor end plates, the function of the muscle will not be reestablished. When there is an extensive gap between the distal and proximal segments of cut or injured peripheral nerves or when the ______ segment disappears altogether (as in the case of amputation of a limb), the newly growing axons may form a swelling, or _______, that can be the source of spontaneous pain.

distal, neuroma

Disturbances of _________ metabolism are associated with several central nervous system pathologies including Parkinson's disease, schizophrenia, and restless legs syndrome.

dopamine

Hypothalamic ________ is an inhibitor of the release of prolactin from the pituitary.

dopamine

Several drugs, including amphetamines, cocaine, and nicotine, exert their behavioral and addictive effects through excessive stimulation of the release and the increase of ________ level in the synaptic cleft

dopamine

_______ is given to patients in shock and heart failure to elevate cardiac output and increase blood pressure and renal filtration.

dopamine

The mucosa of the esophagus has ______________ __________ ________ epithelium; its muscularis is _______ at its superior end with ______ muscle at its inferior end, with mixed fiber types in the middle.

nonkeratinized stratified squamous, striated, smooth

Do epidural hematomas cross suture lines?

nope

Stretch reflex (knee jerk) Number of synapses? Stimulus for reflex? Sensory afferent fibers? response?

1 stretch Ia contraction of the muscle

In addition to the basic circuitry of the indirect and direct pathways, there is an additional connection, back and forth, between the striatum and the pars compacta of the substantia nigra. The neurotransmitter for the connection back to the striatum is ________. This additional connection between the substantia nigra and the striatum means that dopamine will be __________ (via __ receptors) in the indirect pathway and ___________ (via __ receptors) in the direct pathway

dopamine, inhibitory, D2, excitatory, D1

AADC catalyzes the conversion of L-dopa to ________ and 5-hydroxytryptophan to _________.

dopamine, serotonin

In subdural hematoma, surgical evacuation is the preferred treatment in symptomatic patients with acute lesions that are _ cm thick (___ in pediatric patients) and a midline shift of greater than _ mm.

1, 0.5, 5

The treatment of choice for epidural hematoma, especially if the patient is symptomatic, or if the patient is asymptomatic but the acute lesion is greater than _ cm thick at its widest point and has a volume of greater than __ cm3, is surgical removal and hemostasis of bleeders.

1, 30

Nerves containing ________ run in well-defined tracts. One of the most important tracts, the nigrostriatal, connects the __________ _____ in the __________ with the _____ _______ below the ______. Damage to this causes ___________ disease, with loss of fine control of movement.

dopamine, substrantia nigra, midbrain, basal ganglia, cortex, Parkinson's

Sequence of catecholamine generation from tyrosine: Tyrosein --> _______ (what enzyme?) ________-> ________ (enzyme?) _________ --> ________ (enzyme?)

dopamine, tyrosine hydroxylase dopamine, norepinepherine, beta-hydroxylase norepinepherine, epinepherine, phentolamine N methyltransferase

Defects in ____________ systems are implicated in Schizophrenia because many antipsychotic drugs used to treat this disease have been found to bind to ________ receptors.

dopaminergic, dopamine

There are two pathways for transmission of somatosensory information to the CNS: the_______ _______ system and the _____________ system. Which system processes the sensations of fine touch, pressure, two-point discrimination, vibration, and proprioception (limb position)? Which system processes the sensations of pain, temperature, and light touch?

dorsal column anterolateral dorsal column anterolateral

There are two pathways for transmission of somatosensory information to the CNS: the _______ ______ system and the _______________ or _____________ system

dorsal column, anterolateral, spinothalamic

The main visual pathway is through the ______ ________ __________ nucleus of the _________, which projects to the visual cortex.

dorsal lateral geniculate, thalamus

The cochlear nerves synapse on neurons of the ______ and _______ ________ nuclei of the ________, which send out axons that ascend in the CNS. Some of these axons cross to the contralateral side and ascend in the _______ __________ (the primary auditory tract) to the ________ __________. Other axons remain ipsilateral.

dorsal, ventral cochlear, medulla, lateral leminsicus, inferior colliculus

Layers of retina, from superficial to deep

1. Pigment cell layer 2. photoreceptor layer 3. outer nuclear layer 4. outer plexiform layer 5. inner nuclear layer 6. inner plexiform layer 7. ganglion cell layer 8. optic nerve layer

When the oral cavity is full of liquid or food, the soft palate is swung ____ to close the oropharyngeal isthmus, thereby allowing manipulation of food and fluid in the oral cavity while breathing

down

The small intestine has three regions: the duodenum with large mucous glands in the submucosa called _______ ______; the jejunum; and the ileum with the large mucosal and submucosal ______ _______

duodenal glands, Peyer patches

The small intestine has _ regions: the ________ with large mucous glands in the submucosa called duodenal glands; the _______; and the _____ with the large mucosal and submucosal Peyer patches.

duodenum, ileum, jejunum

The arachnoid (Gr. arachnoeides, spider web-like) has two components: (1) a sheet of connective tissue in contact with the ____ mater and (2) a system of loosely arranged __________ composed of collagen and fibroblasts, continuous with the underlying ___ mater layer. Surrounding these trabeculae is a large, sponge-like cavity, the ____________ space, filled with ___.

dura trabeculae, pia, subarachnoid, CSF

Because the face is primarily derived from the ___ and ___ pharyngeal arches, innervation of neighboring facial structures is as follows: ▪ The _________ n. innervates facial structures derived from the first arch. ▪ The ______ nerve innervates facial structures derived from the second arch.

1st, 2nd trigeminal facial

The preganglionic neurons of the sympathetic division arise from nuclei in the thoracic and lumbar spinal cord segments, specifically from the ___ thoracic segment to the ___ lumbar segment (__-__). Thus, the sympathetic division is referred to as ___________.

1st, 3rd, T1, L3, throacolumbarq

Golgi tendon reflex (clasp knife) Number of synapses? Stimulus for reflex? Sensory afferent fibers? response?

2 Contraction of the muscle Ib Relaxation of the muscle

antibiotics and dietary supplements should be taken when in relation to antacids?

2 hours before or 2 hours after taking them

α_ Receptors are inhibitory, are located both presynaptically and postsynaptically, and are less common than α_ receptors.

2, 1

There are _ known GABA receptors: the _____ receptor is ionotropic and the _____ receptor is metabotropic. The GABAA receptor consists of _ subunits that arise from several gene families, giving an enormous number of potential receptors with different binding affinities.

2, GABAA, GABAB, 5

The autonomic nervous system is composed of _ major divisions, the ___________ and the _______________, which operate in a coordinated fashion to regulate involuntary functions. The sympathetic division is ____________, referring to its origin in the ______ ____. The parasympathetic division is ___________, referring to its origin in the _____ _____ and ______ ______ ____

2, sympathetic, parasympathetic, thoracolumbar, spinal cord, craniosacral, brain stem, sacral spinal cord

Streptococcus pneumoniae, Neisseria meningitidis; Meningitis in what age grop?

2-50 yars

How many paravertebral ganglia are there?

Embryo origin of facial muscles

2nd pharyngeal arch (therefore innervated by CN VII)

Several additional muscles or groups of muscles not in the area defined as the face, but derived from the ___ pharyngeal arch and innervated by the ______ nerve,are considered muscles of facial expression. They include the platysma, auricular, and occipitofrontalis muscles (

2nd, facial

The muscles of the face, as well as those associated with the external ear and the scalp, are derived from the ___ pharyngeal arch. The cranial nerve associated with this arch is the ______ nerveand therefore branches of the _______ nerve innervate all these muscles

2nd, facial, facial

___-order neurons cross the midline either in the ______ ____ or in the _____ ____ so that information from one side of the body is transmitted to the contralateral ________ and cerebral cortex.

2nd, spinal cord, brain stem, thalamus

How many synovial joints in the head? Name them!

3 TMJ, joints between the inner ear bones (malleus, incus, stapes)

The large intestine has _ major regions: the short ______, with the appendix; the long _____, with its ascending, transverse, descending, and sigmoid portions; and the _______.

3, cecum, colon, rectum

The trigeminal nerve [V] divides into _ major divisions—the __________ [V1], _________ [V2], and __________ [V3] nerves—before leaving the _______ cranial fossa. Each of these divisions passes out of the cranial cavity to innervate a part of the face, so most of the skin covering the face is innervated solely by branches of the trigeminal nerve [V]. The exception is a small area covering the angle and lower border of the ramus of the mandible and parts of the ear, where the ______, _____, and ________ nerves contribute to the innervation.

3, opthalmic, maxillary, mandibular, middle, facial, vagus, cervical

How many spinal nerves?

31 pairs

Baseline temperature at which both types of thermoreceptors are working

36C (warm and cold active)

Basilar tip anyeurism infiltrates which ventricle?

3rd

Cerebral aqueduct connects which ventricles?

3rd to 4th

Anterior communicating and anterior cerebral artery junction anyeurism infiltrates which ventricle (2 possiblities)?

3rd ventricle, lateral ventrciel

The production of IL-_ by follicular Th cells in lymph nodes stimulates Th0 cells to differentiate into Th_ cells, which stimulate B-cell growth and their differentiation into plasma cells.

4, 2

IBD Patients who have less than _ bowel movements per day with little or no blood, no fever, few symptoms, and a sedimentation rate below __ mm/hour are considered to have mild disease and can receive dental care in the dentist's office.

4, 20

From the esophagus to the rectum, the digestive tract has _ major layers: a lining ______, a _________, a __________, and an outermost ____________ or mesothelium-covered ______

4, mucosa, submucosa, muscularis, adventitia, serosa

The gastric glands are lined by epithelium with _ major cell types, as well as their pluripotent ____ cells that are located in the narrow _____ regions of these gland Name the cells!

4, stem, neck Mucous neck, parietal, Cheif, enteroendocrine

For humans, the wavelengths between ___ and ___ nanometers are called visible light.

400, 750

Section of the bilateral choroid plexus (CP) projecting into the ___ ventricle near the cerebellum.

4th

The ___ CN is unique in that it is the only cranial nerve to exit the posterior (dorsal) aspect of the brainstem and is the only cranial nerve motor nucleus to innervate, exclusively, a muscle on the contralateral side of the midline.

4th

Ventricle around the tentroium cerebellum

4th

Which ventricle is most likely to be filled with blood by an anyeurism rupture? Which is least?

4th Lateral

The choroid plexus in the ___ ventricle and the clump of choroid plexus protruding out of the _______ of _______ are served by posterior inferior and anterior inferior cerebellar arteries

4th, foramen, Luschka

Heme controls the rate of its synthesis by feedback inhibition of _-___ _________

5 ALA synthase

The nicotinic receptor is an integral cell membrane protein consisting of _ subunits: _ α, _ β, _ delta (δ), and _ gamma (γ).

5, 2, 1, 1, 1

Rate limiting enzyme of heme synthesis

5-ALA synthase

Drug used to treat ulcerative colitis (antiinflammatory)

5-ASA

5-hydroxyindoleacetic acid AKA

5-HIAA

Major urinary product of 5-HT breakdown

5-HIAA

Serotonin AKA

5-HT

S. pneumoniae, N. meningitidis, L. monocytogenes Meningitis frmo what age group?

50+ years

Acute Intermittent Porphoryia is caused by the deficiency of hydroxymethylbilane synthase, an enzyme converting PBG to a linear tetrapyrrole; in this disorder the concentrations of _-___ and ___ increase in plasma and urine

5ALA, BPG

Serotonin receptors: Most are metabotropic, although the _-___ receptor is ionotropic and mediates a fast signal in the enteric nervous system. The _-____ receptor is found on many presynaptic neurons, where it acts as an autoreceptor to _______ the release of 5-HT.

5HT3, 5HT1A, inhibit

Glial cells (glia), required to support neurons in many ways, consist of _ major types: ________________ wrap processes around portions of axons in the CNS, forming ______ _______ that insulate the axons and facilitate nerve impulses. __________, the most numerous cell of the CNS, all produce hundreds of processes to cover and provide regulated microenvironments for neuronal perikarya, synapses, and capillaries. _________ cells are epithelial-like cells, lacking basement membranes, which line the fluid-filled cerebral ventricles and central canal of the spinal cord. _________ differs from all other glial cells in originating from blood monocytes, not from neural tissue precursors; they mediate immune defense activity within the CNS. _______ cells (neurolemmocytes) enclose all axons in nerves of the PNS, producing ______ _______ around large-diameter axons, whose impulse conductivity is augmented at the _____ __ _______ between successive Schwann cells. _________ cells are located within PNS _______, aggregated sensory or autonomic neuronal cell bodies, where they enclose each perikaryon and regulate its microenvironment.

6 oligodendrocytes, myelin sheaths Astrocytes Astrocytes Ependymal Microglia Schwann, mylein sheaths, Nodes of Ranvier Satellite, ganglia

In human embryology, _ pharyngeal arches are designated, but the ___ pharyngeal arch never develops.

6, 5th

Vestibular Schwanoma: Most patients with this tumor have hearing loss, tinnitus, and equilibrium problems, or vertigo. As the tumor enlarges (to more than about 2 cm) it may cause facial weakness (___ root), numbness (___ root), or abnormal corneal reflex (___ or ___ root). Treatment is usually by surgery, radiation therapy, or a combination thereof.

7th, 5th, 5th, 7th

There are _ cervical nerves (__ to __): ▪ __ to __ emerge from the vertebral canal above their respective vertebrae. ▪ __ emerges between vertebrae CVII and TI

8, C1, C8 C1, C7 C8

Adrenal medulla releases: __% epinepherine to circulation, and __% norepinepherine

80, 20

Glossopharyngeal neuralgia is a lancinating pain originating from the territories served by the ___ and ____ nerves at the base of the tongue and throat. Trigger events may include chewing and swallowing.

9th, 10th

TGF-β also induces Β cells to class switch to Ig_ production.

Aromatic Amino Acid Decarboxylase AKA

AADC

____ catalyzes the conversion of L-dopa to dopamine and 5-hydroxytryptophan to serotonin.

AADC

aromatic amino acid decarboxylase AKA

AADC

Acetylcholine AKA

ACh

VIP enhances the effect of ___ on salivary gland secretion in cat submandibular glands (glands located under the jawbone) by causing vasodilatation and potentiating the cholinergic component.

ACh

All preganglionic neurons of the autonomic nervous system release ___. Postganglionic neurons release either ___ or __, or, in some cases, _____________.

ACh, ACh, NE, neuropeptides

The mechanism of action of nicotinic receptors, whether at the motor end plate or in the ganglia, is based on the fact that this ___ receptor is also an ion channel for ___ and __.

ACh, Na+, K+

When parasympathetic postganglionic cholinergic neurons are stimulated, ___ is released from the varicosities and binds to muscarinic receptors on the target tissue, which direct its physiologic action. With intense or high-frequency stimulation, the large dense-core vesicles release their peptides (e.g., ___), which bind to receptors on the target tissues and augment the actions of ___

ACh, VIP, ACh

To summarize, whether located in the sympathetic division or in the parasympathetic division, all preganglionic neurons release ___ and, therefore, are called ___________. Postganglionic neurons may be either __________ (they release norepinephrine) or ___________ (they release ACh). Most postganglionic parasympathetic neurons are _________; postganglionic sympathetic neurons may be either _________ or ___________.

ACh, cholinergic adrenergic, cholinergic, cholinergic, adrenergic, cholinergic

Blood vessels in skeletal muscle are innervated by some sympathetic nerves that release ___, which acts on __________ receptors to cause vasodilation.

ACh, muscarinic

Epinephrine (also known as adrenaline) is produced by the adrenal medulla under the influence of ___-containing nerves, analogous to ___________ ____________ nerves

ACh, sympathetic pregnaglionic

The hypothalamus also contains the cell bodies of neurons of the posterior pituitary gland that secrete what hormones?

ADH, OT

Digastric m. innervation

ANterior belly = V3 Posterir belly = VII

Adenosine: Precursor? Made where?

ATP CNS, peripheral nerves

Sometimes, there may even be more than one possible transmitter in a particular vesicle, as is believed to be the case for ___ and _______________ in sympathetic nerves.file.

ATP, norepninepherine

Sympathetic nerves: ___ causes their rapid excitation, whereas _______________ and the neuromodulator ____________ _ cause a slower phase of action.

ATP, norepninepherine, neuropeptide Y

Copper is transported within the hepatocyte to sites of protein synthesis by a chaperone protein and it is incorporated into apoceruloplasmin. The incorporation is catalyzed by an ATPase called _____

ATP7B

The cranial nerves at the pons-medulla junction? (3)

Abducens Facial Vestibulocochlear (6, 7, 8)

_____________ is the transmitter of the parasympathetic autonomic nervous system and of the sympathetic ganglia

Acetylcholine

Mechanism of action of beta2 adrenoreceptors

Activation of adenyl cyclase, increased cAMP

Mechanism of action of beta1 adrenoreceptors

Activation of adenyl cylcase, increased cAMP

__________ of muscarinic receptors causes increased salivation, constriction of the pupils, decreased heart rate (bradycardia), and contraction of the bladder wall during voiding. __________ of the muscarinic receptors would be expected to cause symptoms of decreased salivation (dry mouth), dilation of the pupils (due to the unopposed influence of the sympathetic nervous system on the radial muscles), increased heart rate, and slowed voiding of urine (caused by the loss of contractile tone of the bladder wall). What drug ususally inhibits them?

Activation, inhibition Scopolamine

caused by the deficiency of hydroxymethylbilane synthase, an enzyme converting PBG to a linear tetrapyrrole; in this disorder the concentrations of 5-ALA and PBG increase in plasma and urine What disease?

Acute Intermittent Porphoryia

Sympathetics: Postganglionic neurons release ACh to what type of receptors?

Adrenergic (alpha 1, beta 1, alpha 2, beta 2)

________ fibers carry information from internal body regions and the environment to the CNS. ________ fibers carry impulses from the CNS to effector organs commanded by these centers. Nerves possessing only sensory fibers are called _______ nerves; those composed only of fibers carrying impulses to the effectors are called _____ nerves. Most nerves have both sensory and motor fibers and are called _____ nerves, usually also with both myelinated and unmyelinated axons.

Afferent, efferent, sensory, motor, mixed

Maxilla over lateral incisor Alar cartilage of nose Facial nerve [VII] Draws cartilage downward and laterally, opening nostril What muscle?

Alar part of nasalis

_________ _________, a common type of dementia in the elderly, affects both neuronal perikarya and synapses within the cerebrum. Functional defects are due to neurofibrillary tangles, which are accumulations of tau protein associated with microtubules of the neuronal perikaryon and axon hillock regions, and neuritic plaques, which are dense aggregates of β-amyloid protein that form around the outside of these neuronal regions.

Alzheimer disease

In __________ disease, amyloid-β(1-42), in combination with other neurotoxic factors, causes preferential impairment of cholinergic neurons in the brain septum, yielding progressive loss of cognitive function, which leads to dementia. In the early stages of this disease, the inhibitors of acetylcholinesterase with M2 receptor agonist properties improved cognitive functions but had no effect on disease progress. The antagonists of glutamatergic NMDA receptors are employed to reduce excitotoxic effects of excessive activation of glutamatergic neurons.

Alzheimers

Location of trochlear n.

Ambient cistern

Acetylcholine (ACh), norepinephrine, epinephrine, dopamine, 5-HT What type of neurotransmitters?

Amines

CSF synthesis of oligoclonal antibodies seen in what condition? What about in serum? What antibody is involved?

Amyloidosis Neurosarcoidosis IgG

_________ neurons, with many dendrites but no true axon, do not produce action potentials, but regulate electrical changes of adjacent CNS neurons.

Anaxonic

Great auricular n. comes from where?

Anteriro rami of C2 and C3

Pain Temperature Light touch What system?

Anterolateral system

What is elevated in patient's serum with myasthenia?

Antiacethycholine receptor antibodies

______________ designed to control allergies caused by release from mast cells act on the H1 receptor and tend to be sedative, suggesting that other central functions also probably exist. The histamine receptor in the stomach is of the H2 class; therefore, the H2 inhibitors, such as __________ and __________, that are used to treat peptic ulcers have no effect on allergy.

Antihistamines, cimetidine, rantidine

Atropine drug type

Antimuscarinic

Cause of most subarachnoid hemmorrhages

Anyeurism rupture

Nitric oxide: Precursor? Made where?

Arginine Genitourinary tract, CNS

GFAP Associated with what cell type? What disease is it a marker of?

Astrocyte Plaque or scarring

__________ are the most abundant glial cells of the CNS and are characterized by numerous cytoplasmic processes (P) radiating from the glial cell body or ____. Astrocytic processes are not seen with routine light microscope staining but are easily seen after gold staining. Morphology of the processes allows astrocytes to be classified as _______ (relatively few and straight processes) or ____________ (numerous branching processes), but functional differences between these types are not clear.

Astrocytes, soma, fibrous, protoplasmic

Glomus choroideum is contained where?

Atrium of lateral ventricle

Myenteric plexus AKA

Auerbach's plexus

If the stereocilia are bent towards or away from the kinocilium, the hair cell hyperpolarizes and there is a decreased firing rate in the afferent vestibular nerves?

Away from

Preganglionic autonomic nerves Small Medium Myelinated What type of fibres?

it is a coenzyme of pyruvate dehydrogenase (the E1 enzyme in the PDH complex, Chapter 14). It participates in a similar reaction of oxidative decarboxylation of α-ketoglutarate and also in the metabolism of branched chain amino acids. It is also a coenzyme for transketolase in the pentose phosphate pathway (Chapter 12), and it is important in the production of hydrochloric acid in the stomach What vitamin?

B1 (thaimine)

results in the accumulation of methylmalonic acid and homocysteine, and consequent methylmalonic aciduria and homocystinuria. What vitamin defeciency?

B12

Pyridoxal phosphate, the biologically active form of vitamin __, is utilized as a cofactor by more than 100 enzymes, including reactions catalyzed by ____, threonine dehydratase and the glycine cleavage system. Vitamin __ is present in the human body as a number of 'vitamers' that are precursors to ___. A pivotal enzyme in the formation of ____.

B6, AADC, B6, PLP, PNPO

Activation of the T cell during antigen presentation is also dependent on co-stimulatory signals, such as the binding of __-_or __-_ molecules on the APC to ____/____-_ on the T cell.

B7 1, B7 2, CD28, CTLA 4

Tetrahydrabiopterin AKA

BH4

Dynamic gamma motoneuron Group Ia afferent motoneuron Nuclear bag or chain fibers in muscle spindle?

Bag

The ____, _________, and ___ maters also surround the brain and as shown here the relationships among the cranial meninges are similar to those of the spinal cord. The diagram includes _________ _____, which are outpocketings of arachnoid away from the brain, which penetrate the dura mater and enter blood-filled ______ _______ located within that layer. The arachnoid villi function in releasing excess CSF into the blood. Blood vessels from the arachnoid branch into smaller arteries and veins that enter brain tissue carrying oxygen and nutrients. These small vessels are initially covered with pia mater, but as capillaries they are covered only by the perivascular feet of astrocytes.

dura, arachnoid, pia, arachnoid villi, venous sinuses

The ______ test involves rotating a person on a special chair for about 10 revolutions. In a person with normal vestibular function, rotation to the right causes a right rotatory nystagmus, a left postrotatory nystagmus, and the person falls to the right during the postrotatory period. Likewise, rotation to the left causes a left rotatory nystagmus, a right postrotatory nystagmus, and the person falls to the left during the postrotatory period.

Barany

bind to the GABA receptor and stimulate it directly in the absence of GABA; because of this lack of dependence on endogenous ligand, they are more likely to cause toxic side effects in overdose. What drugs?

Barbituates

consist of the caudate nucleus, the putamen, and the globus pallidus. Receives input from all lobes of the cerebral cortex and have projections, via the thalamus, to the frontal cortex to assist in regulating movement..

Basal ganglia

The thick external ____ mater consists of dense irregular connective tissue organized as an outer periosteal layer continuous with the periosteum of the skull, and an inner meningeal layer. These two layers are usually fused, but along the superior sagittal surface and other specific areas around the brain they separate to form the blood-filled _____ ______ _______. Around the spinal cord the dura mater is separated from the periosteum of the vertebrae by the ________ _____, which contains a plexus of thin-walled veins and loose connective tissue

dura, dural venous sinuses, epidural space

Defecits of both Weber syndrome and Claude syndrome = ? What parts of brain are affected ?

Bendikt syndrome Cerebral peduncle and red nucleus of midbrain!

bind to GABAA and cause a potentiation of the response to endogenous GABA; these drugs reduce anxiety and also cause muscle relaxation. What drugs?

Benzodiazepines

GABAA: _______________ bind to it and cause a potentiation of the response to endogenous GABA; these drugs reduce anxiety and also cause muscle relaxation. ___________ also bind to the GABA receptor and stimulate it directly in the absence of GABA; because of this lack of dependence on endogenous ligand, they are more likely to cause toxic side effects in overdose.

Benzodiazepines Barbituates

Propanalol Butoxamine Drug types?

Beta 2 antagonists

What drugs? such as atenolol, are used to treat hypertension and chest pain (angina) in ischemic heart disease because they antagonize the stimulatory effects of catecholamines on the heart.

Beta blockers

Portal triad components (3)

Bile duct Hepatic portal v. Hepatic a.

Heme catabolism problems leads to what marker in blood?

Bilirubin

When sympathetic postganglionic adrenergic neurons are stimulated, ______________ and ___ are released from the small dense-core vesicles. Both serve as neurotransmitters at the neuroeffector junction, binding to and activating their respective receptors on the target tissue (e.g., vascular smooth muscle). Actually, ___ acts first, binding to ___________ receptors on the target tissue and causing a physiologic effect (e.g., contraction of the vascular smooth muscle). The action of _____________ follows ATP; norepinephrine binds to its receptors on the target tissue (e.g., α1-adrenergic receptors on vascular smooth muscle) and causes a second, more prolonged contraction. What NT is released last?

norepinepherine, ATP, ATP, purinergic, norepinepherine Neuropeptide Y

The principal transmitters in the peripheral nervous system are _______________ and ______________

norepinepherine, acetylcholine

provides the bulk of CSF (almost all of the remaining two-thirds), termed choroidal fluid because it is principally provided by the choroid plexi (capillary tufts) situated in the lateral ventricles and, to a lesser degree, the plexi situated in the third and fourth ventricles.

Blood-CSF barrier

Horner syndrome: When cocaine drops were instilled in the left eye (the unaffected side), the cocaine blocked reuptake of _______________ into sympathetic nerves innervating the pupillary _______ muscle; with higher _______________ levels in those __________ synapses, there was constriction of the ______ muscle of the iris, leading to prolonged ________ of the pupil.

norepinepherine, dilator, norepinepherine, adrenergic, radial, dilation

Posterior parts of maxilla and mandible; pterygomandibular raphe Blends with orbicularis oris and into lips Facial nerve [VII] Presses the cheek against teeth; compresses distended cheeks What muscle?

Buccinator

parotid duct runs through what muscle? Where does it enter the mouth?

Buccinator Maxillary 2nd molar

Slow pain; postganglionic autonomic nerves; olfaction Smallest Slowest No myelin What type of fibers?

What vertebral level does spinal cord begin at?

The upper two cervical vertebrae (__ and __) are modified for moving the head

C1, C2

Cervical plexus made of what nerves?

C1-C4

Origin of accessory n.

C1-C5

pheochromocytoma is a tumor of the adrenal medulla that secretes catecholamines. Both norepinephrine and epinephrine may be secreted: ________________ causes hypertension by activating α1-adrenoceptors on vascular smooth muscle, and ____________ increases heart rate by activating β1-adrenoceptors on the heart muscle.

norepinepherine, epinepherine

marks the lower limit of the pharynx and larynx, and the superior limit of the trachea and esophagus—the indentation between the cricoid cartilage of the larynx and the first tracheal ring can be palpated What vertebral level?

C5/C6

the β-adrenergic receptor, which responds to _______________ and ____________, causes an ________ in cAMP, which stimulates a ______ to phosphorylate and _________ a _________ channel.

norepinepherine, epinepherine, increase, kinase, activate, calcium

Blindness/visual field abnormalities, loss of pupillary constriction Direct trauma to the orbit; disruption of the optic pathway What CN lesion?

CN II

Oculomotor n. AKA

CN III

Glossopharygeal n. AKA

CN IX

Glossopharyngeal n. AKA

CN IX

Trigeminal n. AKA

CN V

OPthalmic n. AKA

CN V1

Opthalmic n. AKA

CN V1

Maxillayr n. AKA

CN V2

Mandibular n. AKA

CN V3

Which CN"s are attached to medulla/

CN VI-XII

Facial n. AKA

CN VII

Facial n. KAA

CN VII

Facial nerve AKA

CN VII

facial n. AKA

CN VII

Anatomically the nervous system is divided into the ___ and ___, which have the major components shown in the diagram. Functionally the nervous system consists of: 1. Sensory division (________) A. _______ - sensory input perceived consciously (eg, from eyes ears, skin, musculoskeletal structures) B. _________ - sensory input not perceived consciously (eg, from internal organs and cardiovascular structures) 2. Motor division (________) A. _______ - motor output controlled consciously or voluntarily (eg, by skeletal muscle effectors) B. _________ - motor output not controlled consciously (eg, by heart or gland effectors)

CNS, PNS afferent Somatic Visceral efferent somatic autonomic

Oligodendrocytes= CNS or PNS? Surround one or multiple neurons? What about schwann cells?

CNS, multipel PNS, single

Sensory ganglia are associated with both cranial nerves (_______ ganglia) and the ______ roots of the spinal nerves (______ ganglia). The large neuronal cell bodies of ganglia are associated with thin, sheet-like extensions of small glial _________ cells

CRANIAL, dorsal, spinal, satellite

Each villus of the choroid plexus contains a thin layer of well-vascularized pia mater covered by cuboidal ependymal cells. The function of the choroid plexus is to remove water from blood and release it as the ___

CSF

Mg2+ Creatinine Higher in CSF, blood, or the same?

CSF

cerebrospinal fluid AKA

CSF

In order to facilitate communication within the brain, there are two specialized methods of moving cells, organelles and proteins. Name them

CSF axonal transport

Computed Tomography AKA

Posteriorly, the inferior limit of the neck is less well defined, but can be approximated by a line between the acromion and the spinous process of vertebra _____, which is prominent and easily palpable. The inferior border of the neck encloses the ____ of the neck

CVII, base

______ metabolizes, among others, caffeine and theophylline. It can be inhibited by grapefruit juice, that contains a substance known as naringin, or by the antibiotic ciprofloxacin. When a person takes any of the inhibitory substances, normal substrates for _______ are metabolized more slowly and their plasma levels increase.

CYP1A2, CYP1A2

one of the most important cytochrome P-450 enzymes.

CYP3A4

Calcium AKA

Ca2+

The _______ test involves thermal stimulation of the inner ears, in which the right and left horizontal semicircular canals can be stimulated separately. In this test, the head is tilted back 60 degrees so that the __________ canals have a ________ orientation. Rinsing the ear with warm or cold water causes _________ to flow, which deflects the ______ as if the head were rotated. A nystagmus occurs, lasting approximately 2 minutes. ___ water produces a nystagmus toward the treated side; ____ water produces a nystagmus toward the untreated side.

Caloric, horizontal, vertical, endolymph, endolymph, Warm, cold

To confirm this, a urine sample was taken for measurement of 5-hydroxyindoleacetic acid (5-HIAA), the major metabolite of 5-HT; the concentration was found to be 120 mmol/24 h (23 mg/24 h) (reference range 10-52 mmol/24 h, 3-14 mg/24 h). What diagnosis? What causes it?

Carcinoid syndrome tumor of enterochromaffin cells of the ileum, metastaized to the liver usually

Vasomotor center AKA

Cardiovascular center

Supratentorial anyeurism AKA

Carotid anyeurism

____________ and _____________ are transmitters in the sympathetic and parasympathetic nervous systems. Preganglionic nerves all release ___, which binds to _________ receptors. Most postganglionic sympathetic nerves release _______________, whereas postganglionic parasympathetic nerves release ___, which acts at ____________ receptors. Adrenal glands release ______________. Motor neurons release ___, which acts at distinct _________ receptors

Catecholamines, acetylcholine, ACh, nicotinic, norepinepherine, ACh, muscarinic, epinepherine, ACh, nicotinic

Carbachol Tyramine, amphetamine Mechanism?

Cause release of NT

Methyldopa Mechanism?

Causes formation of "false" transmitter

Prevertebral ganglia (3)

Celiac Superior mesenteric Inferior mesenteric

Stomach and duodenum Innervated by sympathetics from what plexus?

Celiac plexus

Divisions of the nervous system: _______ nervous system (___), consisting of the brain and spinal cord __________ nervous system (___), composed of the cranial, spinal, and peripheral nerves conducting impulses to and from the CNS (_______ and _____ nerves, respectively) and _______ that are small aggregates of nerve cells outside the CNS.

Central, CNS Peripheral, PNS, sensory, motor, ganglia

Weber syndrome AKA What structure is effected?

Cerebral peduncle syndrome Midbrain

There are significant differences in the responses of α1, β1, and β2 adrenoreceptors to the catecholamines ____________ and ________________. These differences are explained as follows, recalling that _____________ is the catecholamine released from postganglionic sympathetic adrenergic nerve fibers, while ____________ is the primary catecholamine released from the adrenal medulla

norepinepherine, epinepherine, norepinepherine, epinepherine

_______________ (also known as _____________) is a major transmitter in the sympathetic nervous system

norepinepherine, noradrenaline

The type of receptor also predicts which pharmacologic agonists or antagonists will activate it or block it. The effects of such drugs can be readily predicted by understanding the ______ physiologic responses. For example, drugs that are β1 agonists are expected to cause _________ heart rate and _________ contractility, and drugs that are β1 antagonists are expected to cause _________ heart rate and _________ contractility.

normal, increased, increased, decreased, decreased

are nonspecific alpha blockers useful?

not really...

_________ vertebrae are characterized by: ▪ small bodies, ▪ bifid spinous processes, and ▪ transverse processes that contain a foramen (foramen transversarium).

Cervical

Lesser occipital and great auricular n. comes from where?

Cervical plexus

Static gamma motoneuron Group II afferent neuron Nuclear bag or chain fibers in muscle spindle?

Chain

Which is more abundant in a muscle fiber: bag or chain fibers?

Chain

Arterial PO2 Carotid and aortic bodies What type of receptor?

Chemoreceptor

Taste Taste buds Tongue What type of receptor?

Chemoreceptor

Olfaction Olfactory receptor Olfactory mucosa What type of receptor?

Chemorecptor

The __________ sign is the presence of twitching of the muscles around the mouth (circumoral muscles) in response to tapping the facial nerve anterior to the ear, and the __________ sign is the typical contraction of the hand in response to reduced blood flow in the arm induced by inflation of a blood pressure cuff. Signs of what?

Chevostek's, Trousseau's hypocalcemia

Gastic gland: clustered mainly in the lower half of the gastric glands, secrete the protein pepsinogen that is activated by the low pH in the lumen to form the major protease pepsin. What cells?

Chief cells

Acetylcholine: Precursor? Made where?

Choine Parasympathetic nerves, CNS

_______________ stimulates enzyme secretion by the acinar cells. ________ promotes water and HCO3− secretion by the duct cells. Autonomic (_______________) nerve fibers also stimulate secretion from both acinar and duct cells.

Cholecystokinin Secretin parasympathetic

blocks the ability of Gαs to hydrolyze GTP. Gαs is permanently activated, contributing to the signs and symptoms What substance?

Cholera toxin

Asailotransferrin Associated with what cell type? What disease is it a marker of?

Chorolid plexus Rinnorrhea (CSF Leak)

The midbrain outflow from the nucleus of the oculomotor nerve synapses in what ganglion?

Ciliary

Parasympathetic ganglia (4)

Ciliary Otic Pterygopalatine Submandibular

Nerves associated with each parasympathetic ganglion of head (4)

Ciliary- Oculomotor Otic- Glossopharyngeal Pterygopalatine- Facial (greater petrosal) Submandibular- Facial (Chorda tympani)

the largest in size but fewest in number. They are arranged in rows at the base of the tongue. What type of papillae?

Circumvallate

Dorsal cerebellomedullar cistern AKA

Cisterna magna

Ipsilateral oculomotor palsy, diploplia, dilated pupil Contralateral ataxia, tremor, + red nucleus hyperkinesis Waht condition? What is affected?

Claude syndrome Red nucleus of midbrain

Oculomotor n. Corticonuclear fibers What conditon? What is effected?

Claude syndrome Red nucleus of midbrain

Cerebellum: __________ fibers originate in the inferior olive of the medulla and project directly onto Purkinje cells. These fibers make multiple synaptic connections along the dendrites of Purkinje cells, although each Purkinje cell receives input from only one climbing fiber. These synaptic connections are powerful! A single action potential from a climbing fiber can elicit multiple excitatory bursts, called _______ ______, in the dendrites of the Purkinje cell. It is believed that climbing fibers "condition" the Purkinje cells and modulate their responses to mossy fiber input. Climbing fibers also may play a role in cerebellar learning.

Climbing, complex spikes

Transverse part of nasalis AKA

Compressor naris

injury in which the lesion is on the side opposite the initial impact.

Contrecoup injury

AChE activity?

Converts ACh --> Choline + Acetate Choline is then taken back up into the presynaptic nerve terminal to be recycled.

located in the medial aspect of the superior frontal gyrus rostral to the paracentral gyri What type of meningioma?

Convexity meningioma

Deficiency manifests itself as a microcytic hypochromic anemia (small pale erythrocytes) resistant to iron therapy. What trace metal?

Copper

Medial end of the superciliary arch Skin of the medial half of eyebrow Facial nerve [VII] Draws the eyebrows medially and downward What muscle?

Corrugator supercilli

largest compartment of the head and contains the brain and associated membranes (meninges).

Cranial cavity

the result of a complete absence or marked reduction in bilirubin conjugation, causes severe unconjugated hyperbilirubinemia that presents at birth; when the enzyme is completely absent, the condition is fatal. What disease?

Creigler-Najjaar syndrome

Blocks neuromuscular N1 recpetors Drug?

Curare

There are _ known dopamine receptors, falling into two main groups (D1-like: __ and __, and D2-like: __, __, and __) that differ in their signaling pathways. __ receptors increase the production of cAMP, whereas __ receptors inhibit it. Antipsychotic drugs such as phenothiazines and haloperidol tend to inhibit __-like receptors, suggesting that excessive dopamine activity may be important in causing the symptoms of schizophrenia.

D1, D5, D2, D3, D4, D1, D2, D2

Dopamine: The __ receptor is a major receptor in the nerves that interconnect the basal ganglia. As it is known that destruction of these nerves causes ___________ disease, it is not surprising that antipsychotic drugs that inhibit the __ receptor tend to have the side effect of causing abnormal movements. Drug, such as clozapine that bind preferentially to the __ receptor appear to be free of such side effects, although that particular drug also binds to several other receptors.

D2, Parkinson's, D2, D4

Gq pathway: ___ activates protein kinase C, which catalyzes the phosphorylation of numerous target proteins. ___ increases intracellular Ca++ release from intracellular storage sites, resulting in activation of calmodulin and other Ca++-dependent events.

DAG, IP3

Dopamine released into the synaptic cleft is taken back, via ___ into presynaptic neurons where it can be recycled. _________ _________ mutations are now documented that affect the DAT.

DAT, autosomal recessive

Section of an area near the anterior median fissure showing the tough ____ mater. Surrounding the dura, the epidural space contains cushioning adipose tissue and vascular plexuses. The ________ space is an artifact created by separation of the dura from underlying tissue. The middle meningeal layer is the thicker weblike __________ mater containing the large subarachnoid space and connective tissue __________. The subarachnoid space is filled with CSF and the arachnoid acts as a shock-absorbing pad between the CNS and bone. Fairly large blood vessels course through the _________. The innermost ___ mater is thin and is not clearly separate from the arachnoid; together, they are sometimes referred to as the pia-arachnoid or the leptomeninges. The space between the pia and the white matter of the spinal cord here is an artifact created during dissection; normally the pia is very closely applied to a layer of __________ processes at the surface of the CNS tissue.

dura, subdural, arachnoid, trabeculae, arachnoid, pia, astrocytic

Mechanism of action of muscarinic cholinoreceptors in sweat glands of the sympathetic nervous system What recpetors do this?

Decreased adenyl cylclase, decreased cAMP M2, M4

Loss of contractile tone of the bladder wall leads to what?

Decreased voiding of urine

Leptin effects on bone formation?

Decreases it

Medial medullary syndrome AKA

Dejenere syndrome

typically short, small processes emerging and branching off the soma

Dendrites

Swing down AKA

Depress

Oblique line of mandible below canine, premolar, and first molar teeth Skin at the corner of mouth and blending with orbicularis oris Facial nerve [VII] Draws corner of mouth downward and laterally What muscle?

Depressor anguli oris

Anterior part of oblique line of mandible Lower lip at midline; blends with muscle from opposite side Facial nerve [VII] Draws lower lip downward and laterally What muscle?

Depressor labii inferioris

Maxilla above medial incisor Mobile part of the nasal septum Facial nerve [VII] Pulls nose inferiorly what muscle?

Depressor septi

The nervous system develops from the outermost of the three early embryonic layers, the ________, beginning in the ___ week of development. With signals from the underlying axial structure, the notochord, ectoderm on the mid-dorsal side of the embryo thickens to form the epithelial ______ _____. The sides of this plate fold upward and grow toward each other medially, and within a few days fuse to form the ______ ____

ectoderm, 3rd, neural plate, neural tube

Unopposed action of sympathetic nevous system on the radial muscles leads to what?

Dilated pupils

Pupillary constrictor muscle AKA

Dilator m.

Alar part of nasalis AKA

Dilator naris

Pathways of striatum: Which is excitatory to the cortex? Which is inhibitory?

Direct Indirect

In the folded cerebral cortex neuroscientists recognize _ layers of neurons with different sizes and shapes. The most conspicuous of these cells are the ________ _________ neurons

efferent pyramidal

The tumor commonly associated with the ___ nerve is correctly called a vestibular schwannoma because it arises from the neurilemma sheath of the vestibular root. It is not correct to refer to this as an _________ _______; it is neither acoustic (does not arise for the ________ root) nor a neuroma (does not arise from _____ tissue).

eighth, acoustic neuroma, cochlear, nerve

Enamel calcifies as parallel ______ _____ in a process guided by the protein ___________ after secretion from ________ epithelial cells called ___________ in the ______ _____ of the embryonic _____ ____

enamel rods, amelogenin, columnar, ameloblasts, enamel organ, tooth bud

Each tooth has ______ covering its crown and neck and a vascularized, innervated central ____ ______ within the _______ that makes up the _____ and extends into the neck.

enamel, pulp cavity, dentin, roots

The fluid in the scala media is called _________, which has a high-___ concentration and a low-___ concentration. Thus, it is unusual in that its composition is similar to that of _______________ fluid, even though, technically, it is ____________ fluid.

endolymph, K+, Na+, intracellular, extracellular

As shown here and in the diagram, septa (S) of connective tissue often extend from the perineurium into larger fascicles. The ____________ and lamellar nature of the perineurium (P) are also shown at this magnification, along with some adjacent epineurium

endoneurium

A longitudinally oriented nerve shows one node of Ranvier with the axon visible. Collagen of the sparse _____________, blue in this trichrome stain, surrounds the Schwann cells and a _________. At least one Schwann cell nucleus (S) is also clearly seen

endoneurium, capillary

Immediately around the external lamina of the Schwann cells is a thin layer called the ___________, consisting of reticular fibers, scattered fibroblasts, and capillaries. Groups of axons with Schwann cells and endoneurium are bundled together as _________ by a sleeve of ___________, containing flat fibrocytes with their edges sealed together by tight junctions. From two to six layers of these unique connective tissue cells regulate diffusion into the fascicle and make up the _____-_____ _______ that helps maintain the fibers' microenvironment. Externally, peripheral nerves have a dense, irregular fibrous coat called the __________, which extends deeply to fill the space between fascicles.

endoneurium, fasicles, perineurium, blood nerve barrier, epineurium

Often, a section of small nerve will have some fibers cut transversely and others cut obliquely within the same fascicle, again suggesting the relatively unrestrained nature of the fibers within the ___________ and ___________

endoneurium, perineurium

It has been shown that __________ are released after strenuous exercise, giving the so-called 'jogger's high'.

endorphins

Surrounding the perineurium is a thick, outermost layer of dense irregular connective tissue, the __________

epineurium

The diagram shows the relationship among these three connective tissue layers in large peripheral nerves. The ___________ consists of a dense superficial region and a looser deep region that contains the larger blood vessels.

epineurium

The mucosa varies regionally along the tract but always consists of a lining __________ on a ______ _______ of loose connective tissue and smooth muscle fibers extending from __________ ______ layer.

epithelium, lamina propira, muscularis mucosa

Use of orally administered nitrogen-containing bisphosphonate drugs (aledronate, risedronate) for the treatment of osteoporosis and immunosuppressive medications such as mycophenolate is associated with development of __________ and _______ ulcers.

esophageal, gastric

At the _______________ ________, stratified squamous epithelium changes abruptly to simple columnar epithelium invaginating into the lamina propria as many branched tubular glands.

esophagogastric junction

Neurons use the common cell property of _____________ to produce and move an ______ _________ (nerve impulse) along the axon to excite another neuron or other effector cell.

excitability, action potential

Otolith organs: Movement of the stereocilia toward the kinocilium causes _____________ of the hair cell and __________. Movement of the stereocilia away from the kinocilium causes _________________ of the hair cell and __________.

excitation, depolarization, inhibition, hyperpolarization

Counterclockwise (left) rotation of the head causes _________ of the left semicircular canals and __________ of the right semicircular canals.

excitation, inhibition

Neurotransmitters from ____________ synapses cause postsynaptic Na+ channels to open, and the resulting Na+ influx initiates a depolarization wave in the postsynaptic neuron or effector cell as just described.

excitatory

In the case of a ligand-gated Na+ or Ca++ channel, opening produces an excitatory postsIn the case of a ligand-gated Na+ or Ca++ channel, opening produces an ___________ postsynaptic potential, and in the case of a ligand-gated K+ or Cl− channel, an ___________ postsynaptic potential.

excitatory, inhibitory

During the initial leftward rotation of the head, the left horizontal canal is _______ and the right horizontal canal is _________.

excited, inhibited

The muscle groups in the head include: ▪ the _____-________ muscles (move the eyeball and open the upper eyelid), ▪ muscles of the ______ ___ (adjust the movement of the middle ear bones), ▪ muscles of ______ __________(move the face), ▪ muscles of ___________ (move the jaw—temporomandibular joint), ▪ muscles of the ____ ______ (elevate and depress the palate), and ▪ muscles of the ______ (move and change the contour of the tongue).

extra ocular middle ear facial expression mastication soft palate tongue

G-protein linked receptors: The ligand (e.g., ACh, norepinephrine) binds to the _____________ domain of its G protein-linked receptor. The _____________ domain of the receptor binds to (is "linked" to) a G protein.

extracellular, intracellular

__________ fibers constitute the majority of skeletal muscle, are innervated by α motoneurons, and are used to generate force.

extrafusal

Uptake-2, synonymous with the _____________ transporter or _______ ______ ___________ _, has a greater capacity but lower affinity than uptake-1. At high concentrations of norepinephrine, uptake-2 results in the rapid removal of the transmitter. Uptake-2 is sometimes described as the _______-insensitive uptake.

extraneuronal, organic cation transporter 3, cocaine

The ____ is the anterior aspect of the head and contains a unique group of muscles that move the skin relative to underlying bone and control the anterior openings to the orbits and oral cavity

face

The ______ nerve exits the skull through the stylomastoid foramen and then passes into the parotid gland, where it usually divides into upper and lower trunks.

facial

The intimate relationships between the ______ nerveand the parotid gland mean that surgical removal of the parotid gland is a difficult dissection if all branches of the nerve are to be spared.

facial

Several major structures enter and pass through or pass just deep to the parotid gland. These include the _______, the _________ ________ artery and its branches, and the _______________ vein and its tributaries

facial, external carotid, retromandibular

The ______ and _________________ nerves both enter the internal acoustic meatus, the ______ nerve distributing eventually to the face through the stylomastoid foramen, and the _________________ nerve to structures of the inner ear.

facial, vesitublocochlear, facial, vestibulocochlear

In large peripheral nerves, groups of axons are subdivided as ________, each of which is surrounded by perineurium

fasicles

The micrograph shows a small vein (V) and artery (A) in the deep epineurium (E). Nerve fibers (N) are bundled in ________. Each fascicle is surrounded by the ___________, consisting of a few layers of unusual squamous fibroblastic cells that are all joined at the peripheries by tight junctions. The resulting blood-nerve barrier helps regulate the microenvironment inside the fascicle. Axons and Schwann cells are in turn surrounded by a thin layer of ___________.

fasicles, perineurium, endoneurium

________ astrocytes, with long delicate processes, are abundant in white matter; those with many shorter processes are called ____________ astrocytes and predominate in the gray matter.

fibrous, protoplasmic

The body responds to fear, extreme stress, and intense exercise with a massive, coordinated activation of the sympathetic nervous system including the adrenal medulla. This activation, the _____ __ ______ response, ensures that the body can respond appropriately to a stressful situation (e.g., take a difficult exam, run away from a burning house, fight an attacker).

fight or flight

All lingual papillae, except the __________ type, have epithelial taste buds on their sides, with chemosensory ________ cells with synapses to basal sensory innervation, _______ cells, and an apical ______ _____.

filliform, gustatory, support, taste pore

In the fetus and newborn, large membranous and unossified gaps (___________) between the bones of the skull, particularly between the large flat bones that cover the top of the cranial cavity, allow: ▪ the head to deform during its passage through the birth canal, and ▪ postnatal growth.

fontanelles

The anterior view of the skull includes the _______ superiorly, and, inferiorly, the orbits, the _____ region, the part of the face between the orbit and the upper jaw, the upper jaw, and the lower jaw

forehead, nasal

Laterally, each nasal bone articulates with the _______ process of each maxilla.

frontal

The forehead consists of the ________ bone, which also forms the superior part of the rim of each orbit

frontal

Zygomatic process articulates with the ________ _________ of the zygomatic bone.

frontal process

The center of the ___________ ______ formed by the articulation of the nasal bones and the frontal bone is the nasion

frontonasal suture

Testing cranial nerve reflexes is a routine part of any complete neurological examination. This part of the neurological exam tests the integrity of the afferent and efferent limbs of the reflex. Sometimes both of these are on the same cranial nerve; sometimes they are on different cranial nerves. In addition, deficits may be seen that reflect damage affecting cranial nerve ________, but this damage is not in the afferent or efferent limbs of the reflex; this suggests a broader problem within the central nervous system.

function

The use of systemic antibiotics for peptic ulcer disease may result in ______ overgrowth (___________) in the oral cavity. The dentist should be alert to identifying oral fungal infections, including ______ ________ _________, in this patient population

fungal, candidiasis, median rhomboid glossitis

The taste cells in _________ papillae are innervated exclusively by the chorda tympani branch of CN VII.

fungiform

meningitis can be imaged using ___________ and to a reasonable level its degree and extent visualized.

gadolinium

innervate specialized intrafusal muscle fibers, a component of the muscle spindles. The overall function of the muscle spindle is to sense muscle length; the function of the motoneurons innervating them is to adjust the sensitivity of the muscle spindles (so that they respond appropriately as the extrafusal fibers contract and shorten). What type of motoneurons?

gamma motoneurons

Motor innervation of the muscle spindle consists of two types of _____ motoneurons: _______ and ______. _______ γ motoneurons synapse on nuclear ___ fibers in "plate endings." ______ γ motoneurons synapse on nuclear _____ fibers in "trail endings," which spread out over longer distances.

gamma, dynamic, static, dynamic, bag, static, chain

The output cells of the retina are the retinal ________ cells, whose axons form the _____ ________

ganglion,optic nerves

The mucosa of the stomach fundus and body is penetrated by numerous _______ ____, which are lined like the stomach lumen with surface ______ cells and which lead into branching _______ ______

gastric pits, mucous, gastric glands

Axons from retinal ganglion cells form the optic nerves and optic tracts, synapse in the lateral geniculate body of the thalamus, and ascend to the visual cortex in the __________________ tract

geniculocalacrine

Between the superciliary arches is a small depression (the _________)

glabella

Clinically, ACh agonists, in common with acetylcholinesterase inhibitors, are used to treat ________, an eye disease characterized by high intraocular pressure, by increasing the tone of the muscles of accommodation of the eye.

glaucoma

The large expanded portion of the choroid plexus found in the area of the atrium is the ______ _________

glomus choroideum

______________ and ______ nerves exit the lateral aspect of the medulla via the postolivary sulcus; the ___ nerve exits rostral to the row of rootlets comprising the ____ nerve

glossopharyngeal, vagus, 9th, 10th

Excess _________ is toxic to nerve cells

glutamate

Excessive _________ release or its impaired uptake, which takes place, among others, in ischemia, hypoglycemia and exposure to neurotoxic xenobiotics, may cause its excessive accumulation in the extracellular space. This in turn causes prolonged depolarization of the recipient cells and, consequently, excitotoxic injury.

glutamate

Extracellular __________ concentration is increased after trauma and stroke, during severe convulsions, and in some organic brain diseases such as Huntington's chorea, AIDS-related dementia, and Parkinson's disease.

glutamate

Vitamin K-mediated carboxylation of _________ residues. The carboxylated residues are required for ____ chelation.

glutamate, Ca2+

Epilepsy is the pathologic condition caused by excessive _________ release by pathologically stimulated neurons and/or the deficiency of inhibitory _________ transmission

glutamate, GABAergic

The mechanism of long-term potentiation involves synaptic pathways that use the excitatory neurotransmitter __________ and its ____ receptor

glutamate, NMDA

The _________ receptor that binds N-methyl-D-aspartate (NMDA) is complex. This receptor is clinically important because it may cause damage to neurons after stroke (_________________). It contains several ___________ binding sites, so it may be possible to develop drugs that could alter its function. ________ is an obligatory cofactor, as are polyamines such as ________. ___________ physiologically blocks the channel at the resting potential, so the channel can open only when the cell has been partially depolarized by a separate stimulus. It therefore causes a prolongation of the excitation. This receptor also binds ___. Because this drug of abuse can cause psychotic symptoms, it is possible that dysfunction of pathways involving _____ receptors causes some of the symptoms of schizophrenia.

glutamate, excitotoxicity, modulatory, Glycine, spermine, Magnesium, PCP, NMDA

GABA is synthesized from _________ by the enzyme _________ _____________

glutamate, glutamate decarboxylase

Most ammonia is detoxified at its site of formation, by amidation of _________ to _________, which is mainly derived from muscle and is used as an energy source by the enterocytes. The remaining nitrogen enters the portal vein either as _________ or as ________, both of which are used by the liver for the synthesis of ____

glutamate, glutamine, ammonia, alanine, urea

The _______ receptor on motor neurons is ionotropic and is blocked by strychnine; motor impulses can then be passed without negative control, which accounts for the rigidity and convulsions caused by this toxin.

glycine

Within the cell body, there is specialized movement through the _____ ______ by the components required to form synaptic vesicles (V1, V2). In the axon, there is fast axonal transport along ____________ via the motile proteins, _______ (in anterograde transport) or ______ (in retrograde transport).

golgi stack, microtubules, kinesin, dynein

Cerebellum: A single intervening layer contains the very large cell bodies of unique Purkinje neurons (P), whose axons pass through the ________ layer to join tracts in the medulla and whose multiple branching dendrites ramify throughout the __________ layer. Dendrites are not seen well with H&E staining

granular, molecular

Layers of cerebellar cortex: ♦ The ________ layer is the innermost layer. It contains granule cells, Golgi II cells, and glomeruli. In the glomeruli, axons of mossy fibers from the ________________ and _______________ tracts synapse on dendrites of granule and Golgi type II cells. ♦ The __________ cell layer is the middle layer. It contains Purkinje cells, and its output is always __________. ♦ The __________ layer is the outermost layer. It contains outer stellate cells, basket cells, dendrites of Purkinje and Golgi II cells, and axons of granule cells. The axons of granule cells form parallel fibers, which synapse on the dendrites of Purkinje cells, basket cells, outer stellate cells, and Golgi type II cells.

granular, pontocerebellar, spinocerebellar Purkinjie, inhibitory molecular

Spinal cord: The _____ matter contains abundant astrocytes and large neuronal cell bodies, especially those of motor neurons in the _______ horns.

gray, ventral

A cross section of H&E-stained spinal cord shows the transition between white matter and gray matter. The _____ matter has many glial cells (G), neuronal cell bodies (N), and neuropil; _____ matter also contains glia (G) but consists mainly of axons (A) whose myelin sheaths were lost during preparation, leaving the round empty spaces shown. Each such space surrounds a dark-stained spot that is a small section of the axon

gray, white

In the CNS most neuronal perikarya occur in the ____ matter, with their axons concentrated in the ______ matter.

gray, white

Within the brain and spinal cord, regions rich in neuronal perikarya and astrocytes comprise the _____ matter and regions containing tracts of myelinated axons comprise _____ matter.

gray, white

As each cell in the brain receives input from a huge number of neurons, this implies that there is a far _______ capability for the fine control of responses in the central nervous system than there is at the neuromuscular junction.

greater

At the geniculate ganglion the facial nerve [VII] turns and gives off the _______ ________ nerve, which carries mainly preganglionic parasympathetics

greater petrosal

In lower parts of the lateral portion of the calvaria, the frontal bone articulates with the _______ wing of the ________ bone, which then articulates with the parietal bone at the _______________ suture, and with the anterior edge of the temporal bone at the ____________ suture.

greater, sphenoid, sphenoparietal, sphenosquamous

Most likely location of anyeurism rupture? Which ventricle can be filled?

Distal posterior cerebellar artery 4th

used for transmitting somatosensory information about discriminative touch, pressure, vibration, two-point discrimination, and proprioception. Which system?

Dorsal column

arrays of nerve fibers surrounding hair follicles in hairy skin. When the hair is displaced, it excites the receptors. These receptors are also rapidly adapting and detect velocity and direction of movement across the ski What type of receptor?

hair follicle

The oral cavity is lined primarily by mucosa with nonkeratinized stratified squamous epithelium, with keratinized stratified squamous epithelium on the ____ ______ and _______

hard palate, gingiva

The oral cavity is inferior to the nasal cavities, and separated from them by the ____ and ____ _______

hard, soft palates

Decreased salivation

Dry mouth

Vestibular Schwanoma: Most patients with this tumor have _______ loss, tinnitus, and _____________ problems, or _______. As the tumor enlarges (to more than about _ cm) it may cause ______ weakness (seventh root), ________ (fifth root), or abnormal ________ reflex (fifth or seventh root). Treatment is usually by surgery, radiation therapy, or a combination thereof.

hearing, equilibrium, vertigo, 2, facial, numbness, corneal

Meningioma attachment to the dura

Dural tail

The digestive tract (__________) can be accessed through the nasal cavity by feeding tubes.

ESOPHAGUS

External acoustic meatus AKA

Ear canal

the parasympathetic innervation of eye muscles originates in the _________-________ nucleus in the ________ and travels to the periphery in CN ___; the parasympathetic innervation of the heart, bronchioles, and gastrointestinal tract originates in nuclei of the _______ and travels to the periphery in CN _ (_____ nerve); and the parasympathetic innervation of the genitourinary organs originates in the ______ spinal cord and travels to the periphery in the ______ nerves.

Edinger Westphal, midbrain, III, medulla, X, vagus, sacral, pelvic

Parasympathetic nucleus in the midbrain? What CN arises from it? Where does it lead to?

Edinger-Westphal nucleus CN III (Oculomotor) Ciliary ganglion

Motor nervous system AKA Divisions (2)

Efferent Somatic, autonomic

What passes through parietal foramen?

Emissary veins

Contents of condylar canal?

Emissry veins

____________ is a thin connective tissue layer immediately surrounding Schwann cells in peripheral nerves, containing a few nonfenestrated capillaries and much reticulin.

Endoneurium

_________ cells are epithelial-like cells that form a single layer lining the fluid-filled ventricles and central canal of the CNS. (a) Lining the ventricles of the cerebrum, ________ ependymal cells (E) extend cilia and microvilli from the apical surfaces into the ventricle (V). These modifications help circulate the ___ and monitor its contents. Ependymal cells have junctional complexes at their ______ ends like those of epithelial cells but lack a _____ ______. The cells' basal ends are tapered, extending processes that branch and penetrate some distance into the adjacent ________. Other areas of ependyma are responsible for production of CSF.

Ependymal columnar, CSF, apical, basal lamina, neuropil

_________ cells are columnar or cuboidal cells that line the fluid-filled ventricles of the brain and the central canal of the spinal cord. In some CNS locations, the apical ends of ependymal cells have cilia, which facilitate the movement of _____________ ____, and long microvilli, which are likely involved in absorption.

Ependymal, cerebrospinal fluid

Opens and closes near laryngeal inlet

Epiglottis

________ is the pathologic condition caused by excessive glutamate release by pathologically stimulated glutamatergic neurons and/or the deficiency of inhibitory GABAergic transmission

Epilepsy

____________ (also known as __________) is produced by the adrenal medulla under the influence of ACh-containing nerves, analogous to the sympathetic preganglionic nerves

Epinepherine, adrenaline

These lesions are frequently large, lens (lenticular) shaped, may appear loculated, and are "short and thick"

Extradural hematoma

Jaundice caused by bile duct blockage

Extrahepatic

What nerve runs through parotid gland?

Facial

Contents of stylomastoid foramen?

Facial n.

Tumor arising from falx cerebri

Falcine meningioma

____ pain (e.g., pin prick) is carried on A delta, group II, and group III fibers, has a rapid onset and offset, and is precisely localized. ____ pain (e.g., burn) is carried on C fibers and is characterized as aching, burning, or throbbing pain that is poorly localized.

Fast Slow

Although this response, per se, is rarely employed, the sympathetic nervous system operates continuously to modulate the functions of many organ systems such as heart, blood vessels, gastrointestinal tract, bronchi, and sweat glands. What response?

Fight or flight

located on the lateral borders of the tongue. Taste buds are located in folds on the sides of the papillae. What papillae?

Foliate

Continuation of brain and spinal cord; vertebral arteries and nerve plexuses; anterior spinal artery; posterior spinal arteries; roots of accessory nerve [XI]; meninges What foramen?

Foramen magnum

Two major transciption factors activated during binding of TCR to MHC complex? What do they result in?

Fos, Jun Expression of IL-2

Raymond syndrome AKA Where does it take place?

Fovile syndrome Medial pons

Skin of eyebrows Into galea aponeurotica Facial nerve [VII] Wrinkles forehead; raises eyebrows What muscle?

Frontal belly of occipitofrontalis

Zygomatic processes are part of what bones?

Frontal, maxilla

scattered on the dorsal surface of the tongue and are most numerous near the anterior tip. What type of papillae?

Fungiform

Autonomic receptors are coupled to _ ________, which may be stimulatory (__) or inhibitory (__). The G proteins in turn activate or inhibit ________ that are responsible for the final physiologic actions

G proteins, Gs, Gi, enzymes

_____ is synthesized by L-glutamate decarboxylase present in the cytoplasm of specific neurons. Its action is terminated mainly by its uptake by presynaptic terminals through high-affinity ____ transporter. It may then be either loaded again into vesicles or metabolized to ________ - a TCA cycle intermediate

GABA, GABA, succinate

Indirect pathway of the striatum: In this pathway, the inhibitory neurotransmitter is ____, and the excitatory neurotransmitter is _________. The overall output of the indirect pathway is __________

GABA, glutamate, inhibitory

Several _____ receptor agonists and ____ uptake or ____ ____________ inhibitors are used as sedatives, tranquilizers or anxiolytic drugs. The most common groups include barbiturates, benzodiazepines, chloral hydrate and valproate. Ethanol also acts as the _____ receptor _______.

GABAA, GABA, GABA decarboxylase, GABA, agonist

Glial Fibrillary Acid Protein AKA

GFAP

Autonomic receptors are coupled to ___-binding proteins (_ proteins) and, therefore, are called _ _______ _______ receptors

GTP, G, G protein linked

Alpha1 receptors activate the second messenger system linked to _______—Ca++, DAG, and IP3. Additional receptors that activate this second messenger system include histamine H1 receptors; M1-muscarinic and M3-muscarinic receptors; leukotriene receptors; several 5-HT2 receptors; and certain receptors for glutamate and various peptides, including angiotensin, bradykinin, cholecystokinin, and substance P

GalphaQ

alpha1 receptors activate Gs or Gi proteins

a lancinating pain originating from the territories served by the ninth and tenth nerves at the base of the tongue and throat. Trigger events may include chewing and swallowing What condition?

Glossopharyngeal neuarlgia

Glutamate Decarboxylase converts what to what?

Glutamate to GABA

________ granules and small ____ droplets in hepatocytes, and very small electron-dense ferritin complexes (__________) primarily in the Kupffer cells, respectively mediate temporary storage of glucose, triglycerides, and iron.

Glycogen, lipid, hemosiderin

alpha1 receptors: 1. The α1 receptor is embedded in the cell membrane, where it is coupled, via the __ protein, to _____________ _. In the inactive state, the αq subunit of the heterotrimeric Gq protein is bound to ___. 2. When an agonist such as _______________ binds to the α1 receptor, a conformational change occurs in the αq subunit of the Gq protein. This conformational change has two effects: ___ is released from the αq subunit and replaced by ___, and the αq subunit (with GTP attached) detaches from the rest of the Gq protein. 3. The αq-GTP complex migrates within the cell membrane and binds to and activates phospholipase C. Intrinsic ______ activity then converts GTP back to GDP, and the αq subunit returns to the inactive state. 4. Activated phospholipase C catalyzes the liberation of ___ and ___ from phosphatidylinositol 4,5-diphosphate. The IP3 that is generated causes the release of ____ from intracellular stores in the endoplasmic or sarcoplasmic reticulum, resulting in an ________ in intracellular Ca2+ concentration. Together, Ca2+ and ___ activate _______ ______ _, which phosphorylates proteins. These phosphorylated proteins execute the final physiologic actions, such as ____________ of smooth muscle.

Gq, phospholipase C, GDP norepinepherine, GDP, GTP GTPase DAG, IP3, Ca2+, increase, DAG, protein kinase C, contraction

Only excitatory cells in the cerebellum

Granule cells

Most likely place for an ulcer to develop into lymphoma?

Greater curvature of stomach

Contents of greater palatine foramne?

Greater palatine nerve and vessels

beta receptors activate Gs or Gi proteins?

beta1 receptors: 1. Similar to other autonomic receptors, β1 receptors are embedded in the cell membrane. They are coupled, via a __ protein, to ______ _______. In the inactive state, the αs subunit of the Gs protein is bound to ___. 2. When an agonist such as _______________ binds to the β1 receptor, a conformational change occurs in the αs subunit. This change has two effects: ___ is released from the αs subunit and replaced by ___, and the activated αs subunit detaches from the G protein complex. 3. The αs-GTP complex migrates within the cell membrane and binds to and activates ______ _______. ______ activity converts GTP back to GDP, and the αs subunit is returned to its inactive state 4. Activated adenylyl cyclase catalyzes the conversion of ___ to _____, which serves as the second messenger. cAMP, via steps involving activation of _______ ________, initiates the final physiologic actions. As mentioned previously, these physiologic actions are tissue specific and cell type specific. When β1 receptors are activated in the SA node, heart rate _________; when β1 receptors are activated in ventricular muscle, contractility _________; when β1 receptors are activated in the salivary gland, secretion _________; when β1 receptors are activated in the kidney, ____ is secreted.

Gs, adenyl cyclase, GDP norepinepherine, GDP, GTP adenyl cylcase, GTPase ATP, cAMP, adenyl cyclase, increases, increases, increases, renin

GTP AKA

Guanosine Triphosphate

Corticospinal fibers Trigeminal fibers What lesion is it effected in?

Gubler syndrome

Contralateral hemiplegia Ipsilateral paralysis of masticatory muscles, ipsilateral loss of pain and thermal sensation on face What condition? What is effected?

Gubler syndrome Lateral pons

predominantly motor neuropathy is ________ _____ syndrome and the patient has antibodies developed as a result of infection with the bacterium _. ______. The organism contains the antigen, _________ _____ ___, which is shared with a ganglioside on peripheral nerves. Antibodies bind to peripheral motor nerves and cause the neuropathy. It is an example of ________________ _______

Guillan Barre, C jejuni, ganglioside sugar GM1, molecular mimicry

Antihistamines designed to control allergies caused by release from mast cells act on the __ receptor and tend to be sedative, suggesting that other central functions also probably exist. The histamine receptor in the stomach is of the __ class; therefore, the __ inhibitors, such as cimetidine and ranitidine, that are used to treat peptic ulcers have no effect on allergy.

H1, H2, H2

Cimetidine, rinantidine, famotidine, nizantidine drug class

H2 histamine anatagonists

Homovanillic Acid AKa

HVA

The catabolism of dopamine is comparable to norepinephrine. However, the major metabolite formed is ___

HVA

Homovanillic Acid AKA Breakdown product of what?

HVA Dopamine

Hairy skin Rapidly Velocity, direction of movement Waht type of mechanoreceptors?

Hair follicles

Pacinian corpuscle Ruffini's corpuscle Tactile receptor Hair follicle receptor Hairy or nonhairy skin?

Hairy

due to a defect in the conversion of coproporphyrinogen III to protoporphyrinogen III (coprooxidase) What disease?

Heridetary coproporphoryia

Histamine: Precursor? Made where?

Histidine Hypothalamus

Paramedian pontine reticular formation AKA

Horizontal Gaze Center

involving guanosine triphosphate (GTP)-binding proteins (G proteins), adenylyl cyclase, and inositol 1,4,5-triphosphate (IP3) What type of messaging?

Hormones

a hereditary disorder caused by destruction of striatal and cortical cholinergic neurons and inhibitory GABAergic neurons. The neurologic symptoms of the disease are choreic (writhing) movements and dementia. There is no cure. What disease?

Huntington disease

Temperature regulation Thirst Food intake What part of brain?

Hypothalamus

contains centers that regulate body temperature, food intake, and water balance.

Hypothalamus

Anosmia, hyposmia, hyperosmia, and olfactory hypesthesia/hyperesthesia Lesion to which CN?

Loss of smell (anosmia) Injury to the cribriform plate; congenital absence What CN lesion?

Sense of smell Olfactory bulb, olfactory trigone Ethmoid foramina of cribriform plate What CN?

Sense of smell What CN?

The dorsal column system consists mainly of group _ and __ nerve fibers. The first-order neurons have their cell bodies in the dorsal root ganglion cells or in cranial nerve ganglion cells and ascend ipsilaterally to the ________ ________ (lower body) or ________ ________ (upper body) in the ________ of the brain stem.

I, II, nucleus gracilis, nucleus cuneatis, medulla

Th1 cells main cytokine?

IFN-gamma

Blindness, hemianopia, quadrantanopia, and loss of afferent limb corneal reflex Which CN lesion?

Secondary afferents of muscle spindles; touch, pressure Medium Medium Myelinated Which sensory fibers?

Vision Optic chiasm (optic nerve to chiasm to tract) Optic canal what CN?

A better index of hepatocyte synthetic function is the production of the coagulation factors __, ____, __, _

II, VII, IX, X

Vitamin K dependent clotting factors (4)

II, VII, IX, X

Follicular dendritic cells lack MHC __ but capture antigens via _______ and present them to _ cells.

II, lectins, B

Dilated pupil, ptosis, loss of normal pupillary reflex, eye moves down inferiorly and laterally (down and out) Pressure from an aneurysm arising from the posterior communicating, posterior cerebral, or superior cerebellar artery; pressure from a herniating cerebral uncus (false localizing sign); cavernous sinus mass or thrombosis What CN lesion?

III

Eye movement Pupil constriction Oculomotor sulcus, medial part of cerebral peduncle With root of CN III Superior orbital fissure Superior orbital fissure Which CN?

III

Paralysis of most eye movement and diplopia Pupillary dilation and loss of efferent limb corneal reflex Which CN lesion?

III

Touch, pressure, fast pain, temperature Small Medium Myelinated Which sensory fibers?

III

transmits somatosensory information about pain, temperature, and light touch. The system consists mainly of group ___ and group __ fibers.

III, IV anterolateral system

Cranial nerves with efferents (2 groups)

III-VII, IX-XII

Cytokine expressed by bacterial polysaccharide that leads from Th0-->Th1 cell?

IL-12

Th17 cells main cytokines?

IL-17, IL-22

IL's secreted by TH2 cells (3)

IL-4 IL-6 IL-10

Mechanism of action of muscarinic cholinoreceptors in all effector organs of parasympathetic nervous system Which receptors use this?

IP3, increased intracellular Ca2+ concentration M1, M3, M5

The TCR is composed of the α and β chains, which are linked noncovalently to the CD3 polypeptides ∊, δ, γ, and ζ. The _____ are found in the cytoplasmic domain of the proteins and are phosphorylated by ___ family kinases when the receptors are activated.

ITAMs, SRC

Inability to look down-and-out and diplopia Which CN lesion?

Inability to look inferiorly when the eye is adducted (down and in) Along the course of the nerve around the brainstem; orbital fracture What CN lesion?

Pain, temperature; olfaction Smallest Slowest No myelin Which sensory fibers?

Loss of taste to the posterior one-third of the tongue and sensation of the soft palate Brainstem lesion; penetrating neck injury Waht CN lesion?

Motor to stylopharyngeus muscle (see Figs. on pp. 230—233) To otic ganglion then parotid (see Figs. on pp. 230—233) Taste from posterior third of tongue (see Figs. on pp. 206—207, 232—233) Sensation in external auditory meatus (see Figs. on pp. 202—203, 232—233) From carotid body/sinus, parotid, and pharynx Postolivary sulcus Postolivary sulcus Jugular foramen Jugular foramen Which CN?

Possible bradycardia or tachycardia Which CN lesion?

syndromes of the jugular foramen commonly involve roots of cranial nerves (CNs) __, _ , and __ either together or in various combinations.

IX, X, XI

Recall that the jugular foramen (CNs __, _, __) and the hypoglossal canal (CN ___) are closely adjacent to each other, separated only by a small bar of bone on the inner aspect of the skull

IX, X, XI, XII

Lesions of nerves passing through the jugular foramen (__, _, __) may result in loss of the ___ reflex (_____ limb via ___ nerve), __________ of the ____________ shoulder accompanied by an inability to turn the head to the ________ side against resistance (____ nerve), and dysarthria and dysphagia (____ nerve). Syndromes of the jugular foramen may result from lesions/tumors located inside the cranial cavity adjacent to the foramen (as in the _____ syndrome, roots of IX, X, XI), within the foramen itself, or external to the foramen at the skull base. In the latter case, the lesion may encompass the roots of the ____, ____, and _____ nerves as well as the ____ (the ______-______ syndrome).

IX, X, XI, gag, motor, 9th, drooping, ipsilateral, opposite, 11th, 10th, Vernet, 9th, 10th, 11th, 12, Collet Sicard

the roots of CNs __-___ come into close apposition immediately upon their exit from the skull base and may be collectively damaged by a lesion in this confined area. Deficits in the Collet-Sicard syndrome (one of the jugular foramen syndromes) reflect damage to CNs __, _, __, and ___.

IX, XII, IX, X, XI, XII

Vasoconstriction leads to increased or decreased resistance of a blood vessel?

Increased

Parasympathetic nuclei arising from the medulla (2)? What CNs arise from them, respectively? (2) Where do they lead, respectively? (2)

Inferior salavitory nucleus Dorsal motor nucleus of vagus nerve CN IX (glossopharyngeal) CN X (vagus) Otic ganglion Viscera

Infra-orbital nerve and vessels What forament?

Infra-orbital foramen

Inhibit breakdown of NT

Mechanism of action of alpha2 adrenoreceptors

Inhibition of adenyl cyclase, decreased cAMP

Sensory root of facial n. AKA

Intermediate n.

Intestinal glands AKA

Intestinal crypts

__________ fibers are specialized fibers that are innervated by γ motoneurons and are too small to generate significant force. These fibers are encapsulated in sheaths, forming muscle spindles that run parallel to the extrafusal fibers.

Intrafusal

AST and ALT increased in what type of jaundice?

Intrahepatic

Jaundice caused by Infection, chemicals/drugs, autoimmune, neonatal, or genetic errors of bilirubin metabolism or synthesis of specific proteins

Intrahepatic

impaired hepatic metabolism or secretion of bilirubin What ytpe of jaundice?

Intrahepatic

Increased conjugated bilirubin in urine signifies what types of jaundice?

Intrehaptic Posthepatic

Musculofascial compartment of neck AKA

Investing fascia

Ionotropic receptors AKA

Ion channels

Examples include the nicotinic ACh receptor and some glutamate and γ-amino butyric acid (GABA) receptors. What type of receptor?

Ionotropic

___________ receptors directly open ion channels (in fact, they are themselves ion channels). The best studied example is the nicotinic ACh receptor. This is a transmembrane protein (A) consisting of _ nonidentical subunits (B), each one passing right through the __________. The subunits surround a ____ (C) that selectively allows certain ions through when it is opened by a ________

Ionotropic 5 membrane, pore ligand

To illustrate specificity, compare the effect of activating adrenergic β1 receptors in the SA node to the effect of activating β1 receptors in ventricular muscle. Both the SA node and the ventricular muscle are located in the _____, and their adrenergic receptors and mechanisms of action are the same. The resulting physiologic actions, however, are entirely different. The β1 receptor in the SA node is coupled to mechanisms that _______ the spontaneous rate of depolarization and ________ heart rate; binding of an agonist such as _______________ to this β1 receptor increases the heart rate. The β1 receptor in ventricular muscle is coupled to mechanisms that ________ intracellular Ca2+ concentration and contractility; binding of an agonist such as _______________ to this β1 receptor increases contractility, but it has no direct effect on the heart rate.

heart, increase, increase, norepinepherine increase, norepinepherine

The sympathetic pathways to organs in the thorax (e.g., _____) have preganglionic neurons originating in the _____ _______ spinal cord. Sympathetic pathways to organs in the pelvis (e.g., colon, genitals) have preganglionic neurons that originate in the ______ spinal cord.

heart, upper thoracic, lumbar

α2 Receptors present on parasympathetic postganglionic nerve terminals of the gastrointestinal tract are called _______________.

heteroreceptors

G proteins are ______________. In other words, they have _ different subunits: _____, ____, and _____. The α subunit binds either ___ or ___. When ___ is bound, the α subunit is inactive; when ___ is bound, the α subunit is active. Thus, activity of the G protein resides in its _____ subunit, and the G protein switches between active and inactive states according to whether it is bound to ___ or ___.

heterotrimeric, alpha, beta, gamma, GDP, GTP, GDP, GTP, alpha, GDP, GTP

containing many small lipid droplets for storage of vitamin A and other fat-soluble vitamins. WHat cells in liver? Where are they found?

Ito cells (stellate cells) Perisinousoidal space

A second conclusion can be drawn about ganglionic-blocking agents such as _____________. These agents should inhibit __________ receptors in both sympathetic and parasympathetic ganglia, and thus, they should produce widespread effects on autonomic function.

hexamehtonium, nicotinic

Lipid metabolism problems leads to high or low cholesterol? high or low triglycerides?

high high

Protein catabolism problems leads to high or low ammonia? high or low urea?

high ammonia low urea

Study of _________ in nerves is complicated by the large amounts that are present in mast cells

histamine

Bending of the cilia produces a change in __ conductance of the hair cell membrane.

K+

Because the membrane in all resting cells is comparatively permeable to __ as a result of the presence of voltage-independent (leakage) __ channels, this ion largely controls the resting potential.

K+, K+

There is a rare selenium-responsive cardiomyopathy (______ _______), which is endemic in China in areas of very low selenium intake

Keshan disease

Myotactic reflex AKA

Knee jerk reflex

Cells in liver that remove old erythrocytes

Kuppfer cells

Treatment of tyrosine hydroxylase deficiency is by the administration of _-____. In order to prevent the decarboxylation of L-dopa to ________ in the blood (by peripheral ____), an inhibitor (which does not affect the activity of the brain AADC enzyme) is given at the same time as the L-dopa. Such inhibition optimizes the transport of L-dopa across the blood-brain barrier. Within the brain, AADC can then convert the L-dopa to dopamine.

L dopa, dopamine, AADC

Hypokalemic periodic paralysis is inherited as a Mendelian dominant and results from a mutation in the gene encoding the _-____ _______ _______

L type calcium channel

Catecholamines, epinephrine and norepinephrine are synthesized from _-________ in the sequence of reactions catalyzed by tyrosine hydroxylase/aromatic amino acid decarboxylase, then dopamine β-hydroxylase and phentolamine-N-methyltransferase, yielding ________, _______________, and _____________, respectively. _________ is a precursor of norepinephrine and epinephrine.

L tyrosine, dopamine, norepinepherine, epinepherine, Dopamine

Inferoiro extent of spinal cord?

Autonomic (Gr. autos, self + nomos, law) nerves effect the activity of smooth muscle, the secretion of some glands, heart rate, and many other involuntary activities by which the body maintains a constant internal environment (___________)

homeostasis

Ipsilateral loss of pain and thermal sense on face Dysphagia Hoarseness Deviation of uvula to contralateral side Nystagmus Vertigo Nausea Contralateral loss of pain, thermal sense on UE, Trunk, and LE What condition?

Lateral medullary syndrome

Spinal trigeminal tract nucleus Nucleus ambiguus Vestibular nuclei Anterolateral system Injured in what syndrome?

Lateral medullary syndrome

The anterior choroidal artery serves the optic tract and portions of the internal capsule immediately internal to this structure. This explains the unusual combination of a __________ ________ coupled with a ____________ __________ and _______________ (to all somatosensory modalities) in the anterior choroidal artery syndrome.

homonymous hemianopia, contralateral hemiplegia, hemianesthesia

When the head is upright, the macula of the utricle is oriented ___________ and the saccule is oriented __________. In the utricle, tilting the head forward or laterally causes _________ of the ipsilateral utricle; tilting the head backward or medially causes __________ of the ipsilateral utricle.

horizontally, vertically, excitation, inhibition

Wallenberg syndrome: What is effected?

Laterall medulla

Voltage-independent K+ channel AKA

Leakage K+ Channel

Contents of lesser palatine forament?

Lesser palatine nerves and vessels

________ ____________ may penetrate phagosomes and enter the cytoplasm. A small polypeptide called ubiquitin binds the damaged or improperly folded cytosolic protein antigens, enabling the targeting of the antigens to the proteasome, where they are digested proteolytically.

Listeria monocytogenes

Part of scalp separated in scalping injuries?

Loose connective tisseu

A decrease in the absorption of CSF or a blockage of outflow from the ventricles during fetal or postnatal development results in the condition known as _____________, which promotes a progressive enlargement of the head followed by mental impairment.

hydrocephalus

The _____ bone is a small U-shaped bone oriented in the horizontal plane just superior to the larynx, where it can be palpated and moved from side to side.

hyoid

When light impinges on the retina, the photoreceptors are _______________. In turn, the photoreceptors ________ their release of glutamate, leading to either hyperpolarization or depolarization of _______ or ____________ cells.

hyperpolarized, decrease, bipolar, horizontal

When light hits the photoreceptors, they are always ______________ and release _________ amounts of glutamate (recall the steps in photoreception), as indicated by the minus signs on the photoreceptors. Photoreceptors synapse directly on ________ cells in the _____ __________ layer of the retina.

hyperpolarized, decreased, bipolar, outer plexiform

B-cell differentiation involves antibody class switching from immunoglobulin _ and Ig_ to Ig_, Ig_, and Ig_.

M, D, E, A, G

stimulation of the __-muscarinic receptor leads to release of Gαq, from its associated β and γ subunits

Some muscarinic receptors (e.g., __, __, and __) have the same mechanism of action as the ______ adrenoreceptors. In these cases, binding of the agonist (___) to the muscarinic receptor causes dissociation of the _____ subunit of the _ protein, activation of _____________ _, and generation of ___ and ___. IP3 releases stored ____, and the increased intracellular Ca2+ with ___ produces the tissue-specific physiologic actions.

M1, M3, M5, alpha1, ACh, alpha, G, phospholipase C, IP3, DAG, Ca2+, DAG

Other muscarinic receptors (__) alter physiologic processes via a direct action of the _ _______. In these cases, no other second messenger is involved. For example, muscarinic receptors in the cardiac SA node, when activated by ___, produce activation of a __ protein and release of the ______ subunit, which binds directly to __ channels of the SA node. When the αi subunits bind to K+ channels, the channels ____, __________ the rate of depolarization of the SA node and __________ the heart rate.

M2, G protein, ACh, Gi, alphai, K+, open, decreasing, decreasing

Other muscarinic receptors (e.g., __) act by inhibiting adenylyl cyclase and decreasing intracellular cAMP levels.

Monoamine Oxidase AKA

MAO

Main intraneuronal enzyme to break down catecholamines? Main extraneuronal enzyme?

MAO COMT

How to treat AADC defeciency (what drug?)

MAO inhibitor

Catecholamines are degraded by oxidation of the amino group by the enzyme ___, and by methylation by ____. The pathway shown is for norepinephrine but the pathways for epinephrine, dopamine, and 5-HT are analogous.

MAO, COMT

Norepinephrine is taken up into cells by a high-affinity transporter and catabolized by the enzyme ___. Further oxidation and methylation by ____ convert the products to metanephrines and vanillylmandelic acid, which can be measured in the urine as indices of the function of the _______ _______

MAO, COMT, adrenal medulla

Which cranial fossa is trigeminal ganglion in ?

MIddle

Multiple sclerosis AKA

Demyleinating disease of CNS? What about PNS?

MS Guillan Barre

The ___________ nerve exits the inferolateral aspect of the medulla via the preolivary sulcus. This cranial nerve exits in line with the abducens nerve found at the pons-medulla junction and in line with the exits of the third and fourth nerves of the midbrain. The twelfth nerve exit is characteristically located laterally adjacent to the pyramid, which contains corticospinal fibers

hypoglossal

Only division of trigmeinal n. with a motor component

Mandibular (V3)

The hypoglossal exits the base of the skull by traversing the ___________ _____. A lesion of the hypoglossal root, or in its peripheral distribution, will result in a deviation of the _______ _______ the side of the root damage on attempted protrusion; the ____________ muscle on that side is paralyzed. A lesion in the medulla, such as a medial medullary syndrome (__________ syndrome), can result in the same deviation of the tongue (_________ the side of the lesion on protrusion) plus additional motor (_______________) and sensory (______ __________) deficits on the ________ side of the body.

hypoglossal canal, tongue towards, genioglossus, Dejenere, towards, corticospinal, medial lemniscus, opposite

Sensory innervation of face below opening of mouth?

Mandibular n

Contents of foramen ovale (2)?

Mandibular nerve [V3]; lesser petrosal nerve

Flexor withdrawal reflex: Number of synapses? Stimulus for reflex? Sensory afferent fibers? response?

Many Pain, temperature II, III, and IV Flexion on ipsilateral side, extension on contralateral side

Frontal process is part of what bone?

Maxilla

Zygomatic processes are part of what bones?

Maxilla, frontal

Sensory of innervation of face between external canthus of eye and opening of mouth?

Maxillary n.

Audition Hair cell Organ of Corti What type of sensory receptor?

Mechanoreceptor

Touch Pacinian corpuscle Skin Which type of sensory receptor?

Mechanoreceptor

Vestibular Hair cell Macula, semicircular canal What type of sensory receptor?

Mechanoreceptor

The BBB is not present in regions of the _____________ where plasma components are monitored, in the ___________ _________ which releases hormones, or in the ________ _______ where CSF is produced.

hypothalamus, posterior pituitary, choroid plexus

deviation of the tongue (to the side of the lesion on protrusion) plus additional motor (corticospinal) and sensory (medial lemniscus) deficits on the opposite side of the body What condition?

Medial Medullary Syndrome

Hypoglossal n. nucleus Corticospinal nerve fibers Medial leminiscus Injured in what sydnrome?

Medial medullary syndrome

Ipsilateral paralysis of tongue Contralateral hemiplegia Contralateral loss of discriminatory touch, vibratory, and position sense on UE, trunk and LE What condition?

Medial medullary syndrome

______ and ________ vestibular nuclei receive their input from the semicircular canals and project to nerves innervating extraocular muscles via the medial longitudinal fasciculus.

Medial, superior

CSF enters the subarachnoid space via the medial foramen of ___________ and the two lateral foramina of __________.

Meginde, Luschka

Nonhairy skin Rapidly Point discrimination, tapping, flutter What type of mechanoreceptor?

Meissner's corpsuscle

rapidly adapting receptors that encode point discrimination, precise location, tapping, and flutter.

Meissner's corpuscles

encapsulated receptors found in the dermis of nonhairy skin, most prominently on the fingertips, lips, and other locations where tactile discrimination is especially good. They have small receptive fields and can be used for two-point discrimination.

Meissners corpsuscles

Mental nerve and vessels What foramen?

Mental foramen

Mandible inferior to incisor teeth Skin of chin Facial nerve [VII] Raises and protrudes lower lip as it wrinkles skin on chin What muscle?

Mentalis

Nonhairy skin Slowly Vertical indentation of skin What type of mechanoreceptors?

Merkel's receptors

Tactile discs are similar to _______ ___________ but are found in ________, rather than _________, skin.

Merkel's receptors, hairy, nonhairy

A particular form of cAMP phosphodiesterase is the site of action for _________ and ___________, agents used to treat congestive heart failure

inamrinone, milironone

Low BP: The sympathetic and parasympathetic actions do not compete with each other but work synergistically to ________ the heart rate (which helps restore normal blood pressure)

increase

In the dark, there is ________ in cyclic GMP levels, which produces an Na+ inward current (or "dark current") and ______________ of the photoreceptor membrane. In the light, there is ________ in cyclic GMP levels, as already described, which closes Na+ channels in the photoreceptor membrane, reduces inward Na+ current, and produces _________________

increase, depolariztaion, decrease, hyperpolarization

Both the pontine reticular formation and the lateral vestibular nucleus have powerful excitatory effects on extensor muscles. Therefore, lesions of the brain stem above the pontine reticular formation and lateral vestibular nucleus, but below the midbrain, cause a dramatic ________ in _________ tone

increase, extensor

Growth hormone _________ the urinary excretion of calcium and hydroxyproline, whilst _________ the urinary excretion of phosphate

increases, decreasing

The _________ vestibular nucleus receives its input from the utricles, saccules, and semicircular canals. It projects to the brain stem and the cerebellum via the medial longitudinal fasciculus.

inferior

The hypoglossal nerve (XII) exits the ______________ aspect of the _________ via the ___________ _______. This cranial nerve exits in line with the ________ nerve found at the ____-________ junction and in line with the exits of the ___ and ___ nerves of the midbrain. The twelfth nerve exit is characteristically located laterally adjacent to the _______, which contains _____________ fibers.

inferolateral, midbrain, preolivary sulcus, abducens, pons medulla, 3rd, 4th, pyramid, coritcospinal

On the anterior surface of the body of the maxilla, just below the inferior rim of the orbit, is the _____-______ _______

infra orbital foramen

The _____________ fossa is an area between the posterior aspect (ramus) of the mandible and a flat region of bone (lateral plate of the pterygoid process) just posterior to the upper jaw (maxilla). This fossa, bounded by bone and soft tissues, is a conduit for one of the major cranial nerves—the mandibular nerve (the mandibular division of the trigeminal nerve [V3]), which passes between the cranial and oral cavities.

infratemporal

In addition to the major compartments of the head, two other anatomically defined regions (_____________ ______ and _______________ _____) of the head on each side are areas of transition from one compartment of the head to another

infratemporal fossa, pterygopalatine fossa

when the head stops moving left, the left horizontal canal will be _________ and the right canal will be ________.

inhibited, excited

Other muscarinic receptors (e.g., M4) act by __________ adenylyl cyclase and __________ intracellular cAMP levels.

inhibiting, decreasing

α2 Receptors present on parasympathetic postganglionic nerve terminals of the gastrointestinal tract are called heteroreceptors. Norepinephrine is released from sympathetic postganglionic fibers that synapse on these parasympathetic postganglionic fibers. When activated by norepinephrine, the α2 receptors cause __________ of release of ______________ from the parasympathetic postganglionic nerve terminals. In this way, the sympathetic nervous system indirectly ________ gastrointestinal function (i.e., by inhibiting the ______________ activity).

inhibition, norepinepherine, inhibits, parasympathetic

Ferretin Associated with what cell type? What disease is it a marker of?

Microglia Stroke

GABA is inhibitory or excitatory? GABA is the ligand for gated ___ channels

inhibitory Cl-

At __________ synapses neurotransmitters open Cl- or other anion channels, causing influx of anions and _________________ of the postsynaptic cell, making its membrane potential more negative and more resistant to depolarization.

inhibitory, hyperpolarization

Micturition center What part of brain?

Midbrain

participates in control of eye movements. It also contains relay nuclei of the auditory and visual systems Which part of brainstem?

Midbrain

Contents of foramen spinosum?

Middle meningeal artery

Layers of cerebellar cortex from superficial to deep (3)

Molecular Purkinjie Granular

Serotonin Catecholamines Dopamine Norepinepherine Epinpeherine What type of NT's?

Monoamines

Adenosine is largely __________ in the CNS, and inhibition of adenosine receptors is believed to underlie the ___________ effects of ________

inhibitory, stimulatory, caffiene

Cerebellum: _____ fibers constitute the majority of the cerebellar input. These fibers include _________________, _______________, and ________________ afferents. Mossy fibers project to granule cells, which are _________ interneurons located in collections of synapses called glomeruli. Axons from these granule cells then ascend to the molecular layer, where they bifurcate and give rise to parallel fibers. Parallel fibers from the granule cells contact the dendrites of many Purkinje cells, producing a "beam" of excitation along the row of Purkinje cells. The dendritic tree of each Purkinje cell may receive input from as many as 250,000 parallel fibers! In contrast to the climbing fiber input to the Purkinje dendrites (which produce complex spikes), the mossy fiber input produces single action potentials called _______ ______. These parallel fibers also synapse on cerebellar interneurons (basket, stellate, and Golgi II).

Mosy, pontocerebellar, spinocerebellar, vestibulocerebellar, excitatory, sipmle spikes

Tentorium meningioma symptoms? May occlude what important structure?

Motor defects associated with cerebellum Cerebral aqueduct

The gastric glands are lined by epithelium with four major cell types, as well as their pluripotent stem cells that are located in the narrow neck regions of these glands: _____ ____cells include immature precursors of the surface mucous cells but produce less alkaline mucus while migrating up into the gastric pits. ________ cells are large cells with many mitochondria and large intracellular canaliculi for production of HCl in the gastric secretion; they also secrete intrinsic factor for vitamin B12 uptake. _____ cells, clustered mainly in the lower half of the gastric glands, secrete the protein pepsinogen that is activated by the low pH in the lumen to form the major protease pepsin. _______________ cells are scattered epithelial cells of the diffuse neuroendocrine system, which release peptide hormones to regulate activities of neighboring tissues during food digestion.

Mucous neck Parietal Cheif Enteroendocrine

Gastric gland: include immature precursors of the surface mucous cells but produce less alkaline mucus while migrating up into the gastric pits. What cells?

Mucous neck cells

_________ neurons, each with one axon and two or more dendrites, are the most common.

Multipolar

Parasympathetics act on target tissues through what type of receptors?

Muscarinic

__________ receptors are located in all of the effector organs of the parasympathetic nervous system: in the heart, gastrointestinal tract, bronchioles, bladder, and male sex organs. These receptors also are found in certain effector organs of the sympathetic nervous system, specifically, in sweat glands.

Muscarinic

Sympathetics: Postganglionic neurons release NE to what type of receptors? Where are these normally found?

Muscarinic Sweat glands

Atropine Drug type?

Muscarinic Antagonist

ACh Muscarine Drug types?

Muscarinic agonists

Scopolamine drug type

Muscraininc antagonist

The teniae coli of the large intestine represent an organ-specific specialization of which layer of the intestinal tract wall?

Muscularis externa

Tonic receptors encode stimulus intensity: The greater the _________, the larger the depolarizing receptor potential, and the more likely action potentials are to occur. Thus, tonic receptors also encode stimulus ________: The longer the stimulus, the longer the period in which the receptor potential exceeds threshold

intensity, duration

The _______ ______ electrically insulates the axon and facilitates rapid transmission of nerve impulses.

Myelin sheath

are found inside the basal lamina surrounding acini, tubules, and the proximal ends of the duct system (Figures 16-2 and 16-4). These small, flattened cells extend several contractile processes around the associated secretory unit or duct and their activity is important for moving secretory products into and through the ducts. What cell type?

Myoepithelial cells

Salivary secretory units are drained by simple cuboidal ___________ ducts that merge as simple columnar __________ ducts, which merge as larger ____________ or ___________ ducts.

intercalated, striated, interlobular, excretory

Toxic metabolite formed by Cytochrome P450 processing of acetometaphin? What is the antidote to this?

NABQI NAC

Major glutamate receptor in CNS

NDMA receptor

Parasympathetics: Postganglionic neurons release what NT? What type of receptors?

NE Muscarinic

Glutamate acts on both ionotropic and metabotropic receptors. Clinically, the receptor characterized in vitro by ____ binding is particularly important

NMDA

N-methyl-D-aspartate AKA

NMDA

Nuclear Magnetic Resonance AKA

NMR

Nitric oxide AKA

Is NO stored in vesicles? What does it help produce when it enters into a cell?

NO! NO is not stored in vesicles, but released directly into the extracellular space ! cGMP

Neuropeptide Y AKA

NPY

Sodium AKA

Na+

What causes depolarization of an action potential? What causes repolarization?

Na+ rushing in K+ rushing out

Nicotinic receptors act as ion channels for ___ and __.

Na+, K+

In unstimulated neurons ATP-dependent Na-K pumps and other membrane proteins maintain an axoplasmic ___ concentration only one-tenth of that outside the cell and a ___ level many times greater than the extracellular concentration. This produces a potential electrical difference across the axolemma of about ___ mV, with the inside negative to the outside. This difference is the axon's _______ _________

Na+, K+, -65, resting potential

Streptococcus agalactiae, Escherichia coli, Listeria monocytogenes Causes meningitis in what age group?

Neonate

_____ ______ are analogous to tracts in the CNS, containing axons enclosed within sheaths of glial cells specialized to facilitate axonal function. In peripheral nerve fibers, axons are sheathed by _____ cells, or neurolemmocytes

Nerve fibers, Schwann

action potential AKA

Nerve impulse

Embryonic origins of all glial cells. Name the exception

Neural crest Microglia comes from bone marrow monocytes

Schwann cells AKA

Neurolemmocytes

Neuron-specific enolase Associated with what cell type? What disease is it a marker of?

Neurons Brain death

Enkephalin Neuropeptide Y Substance P Cholecystokinin Beta-endorphin Neurotensin What tpe of NT's?

Neuropeptides

_________________ are molecules that act as chemical signals between nerve cells

Neurotransmitters

The facial and vestibulocochlear nerves both enter the ________ ________ ______, the facial nerve distributing eventually to the face through the ________________ foramen, and the vestibulocochlear nerve to structures of the ______ ____

internal acoutstic meatus, stylomoastoid, inner ear

Adernal medulla has what type of autonomic receptors?

Nicotinic

Receptors on autonomic postganglionic neurons?

Nicotinic

Extremes of pain and temperature Thermal nociceptors Skin Polymodal nociceptors Skin What type fo sensory receptor?

Nocireceptor

Spontaneous hemmorrhage AKA

Non traumatic hemmorrhage

Near the anus the circular layer of the rectum's muscularis forms the ________ ____ _________, with further control exerted by __________ muscle of the ________ _____ _________

internal anal sphincter, striated, external anal sphincter

Interrupting communication between ventricles of the brain can cause what condition?

Noncommunicating hydrocephalus

_______________-containing neurons arise in the locus ceruleus in the brainstem and are distributed throughout the cortex.

Norepinepherine

____________ establish relationships among other neurons, forming complex functional networks or ________ in the CNS.

interneurons, circuits

Along its entire length, the mucosa of the large intestine has millions of short simple tubular __________ ______, lined by lubricant ______ cells and ___________ cells for the uptake of water and electrolytes.

intestinal glands, goblet, absorptive

Wilson's disease What type of jaundice?

intrahepatic

Autonomic ganglia are small bulbous dilations in autonomic nerves, usually with multipolar neurons. Some are located within certain organs, especially in the walls of the digestive tract, where they constitute the __________ ganglia.

intramural

By collecting, analyzing, and integrating information in such signals, the nervous system continuously stabilizes the _________ conditions of the body (eg, blood pressure, O2 and CO2 content, pH, blood glucose levels, and hormone levels) within normal ranges and maintains __________ patterns (eg, feeding, reproduction, defense, interaction with other living creatures).

intrinsic, behavioral

The autonomic nervous system is an ____________ system that controls and modulates the functions primarily of visceral organs.

involuntary

Neurotransmitters alter the activity of various ___ ________ to cause changes in the membrane potential

ion channels

Lateral part of superior nuchal line of occipital bone and mastoid process of temporal bone Into galea aponeurotica Facial nerve [VII] Draws scalp backward What muscle?

Occipital belly of occipitofrontalis

Action potentials are caused by changes in ___ flows across ____ _________

ion, cell membranes

Structures passing through lateral wall of cavernous sinus (4)

Oclomotor n. Trochlear n. Opthalmic n. Maxillary n. (CN's III, IV, V) CN VI goes through the middle along with ICA!

decreased release of glutamate that interacts with ___________ receptors will result in hyperpolarization and inhibition of the bipolar or horizontal cell (i.e., decreased excitation).

ionotrobic

Nicotininc ACh receptors are ___________

ionotropic

There are two types of glutamate receptors on bipolar and horizontal cells: ___________ receptors, which are depolarizing (excitatory), and ____________ receptors, which are hyperpolarizing (inhibitory)

ionotropic, metabatropic

Receptors that directly control the opening of an ion channel are called ____________, whereas _____________ receptors cause changes in second messenger systems, which in turn alter the function of channels that are separate from the receptor.

ionotropic, metabotropic

Motor neurons in the abducens nucleus innervate the ___________ ________ _______ muscle. Consequently, a patient with a lesion of the abducens root _________ to the ____ experiences a loss of voluntary lateral gaze in the eye on the side of the lesion, indicating a paralysis of the lateral rectus muscle. Other movements in the affected eye, and all movements in the _______________ eye, are normal. This patient will experience ________. When looking straight ahead, the eye on the lesioned side will deviate slightly ______ the midline (unopposed action of the ______ _______ in the same eye) and the diplopia is made worse when attempting to look ________ the lesioned side in a horizontal plane.

ipsilateral lateral rectus, external, pons, contralateral, diplopia, toward, medial rectus, toward

arise from the area of the cribriform plate and enlarge upward to impinge on the frontal lobes. What type of meningioma?

Olfactory groove meningiomas

Mylein is made of what cells in CNS? Which in PNS?

Oligodedrocytes = CNS Schwann cells = PNS

Myelin Basic Protein Associated with what cell type? What disease is it a marker of?

Oligodendrocyte Re or de-myleination

________________ extend many processes, each of which becomes sheet-like and wraps repeatedly around a portion of a nearby CNS axon. During this wrapping most cytoplasm gradually moves out of the growing extension, leaving multiple compacted layers of cell membrane collectively termed ______

Oligodendrocytes, myelin

Mechanism of action of Nicotinic cholinoreceptors

Opening of Na+ and K+ channels leading to depolarization

Parotid gland What parasympathetic ganglion controls it?

Otic ganglion

Lambert-Eaton syndrome is a disease that affects predominantly the _/_ subtype of _______ channels, in an example of molecular mimicry. The patient may have a primary oat cell carcinoma of the lung; the immune system responds by making antibodies against these malignant cells. However, the malignant cells and the ________ channels possess a common epitope, the effect of which is that the immune response causes the release of neurotransmitter to be blocked at the ___________ site

P, Q, calcium, calcium, presynaptic

That portion of the posterior cerebral artery located between the basilar artery and posterior communicating artery is the __ segment. The most common site of aneurysms in the infratentorial area (vertebrobasilar system) is at the ___________ of the _______ artery, also called the ________ ___. Patients with aneurysms at this location may present with eye movement disorders, pupillary dilation caused by damage to the root of the third nerve, and diplopia.

P1, bifurcation, basilar, basilar tip

ATP is stored in vesicles in purinergic nerve endings and, when released, directly activates purinergic receptors of the __ type, or it is broken down to adenosine, which activates __ or adenosine receptors.

P2, P1

Purine receptors: which are ion linked, which are G-protein ?

P2X P2Y

Schwann cells Satellite cells Found where?

PNS

Spinal nerves Cranial nerves Ganglia Components of what division of nervous system?

PNS

encapsulated receptors found in the subcutaneous layers of nonhairy and hairy skin and in muscle. They are the most rapidly adapting of all mechanoreceptors. Because of their very rapid on-off response, they can detect changes in stimulus velocity and encode the sensation of vibration.

Pacinian corpsucles

Subcutaneous; intramuscular Very rapidly Vibration, tapping Waht type of receptor? Tonic or phasic?

Pacinian corpuscle Phasic

_______ disease of bone is characterized by areas of accelerated bone turnover

Padget's

Internuclear ophthalmoplegia: In addition to abducens motor neurons that innervate the ____________ ________ _______ muscle, the abducens nucleus also contains ____________. The axons of these interneurons cross the midline, enter the ______ ______________ _________, and ascend to terminate on motor neurons in the _________ nucleus that innervate the medial rectus muscle on that side. A lesion in the MLF interrupts these axons and results in a loss of ______ gaze (medial rectus paralysis) in the eye on the side of the lesion during attempted conjugate eye movements. Other movements in the affected eye and all movements in the contralateral eye are normal. The laterality of the deficit reflects the side of the lesion and of the deficit. For example, a right internuclear ophthalmoplegia specifies a lesion in the _____ ____ and paralysis of the _____ ______ _______ muscle; a left internuclear ophthalmoplegia indicates a lesion in the ____ ___ and ____ _______ _______weakness.

ipsilateral medial rectus, interneurons, medial longitudinal fasiculus, oculomotor, medial, right MLF, right medial rectus, left MLF, left medial rectus

_________ _______ is a slowly progressing disorder affecting muscular activity characterized by tremors, reduced activity of the facial muscles, loss of balance, and postural stiffness. It is caused by gradual loss by apoptosis of ________-producing neurons whose cell bodies lie within the nuclei of the CNS __________ _____. Parkinson disease is treated with _-____ (L-3,4-dihydroxyphenylalanine), a precursor of dopamine which augments the declining production of this neurotransmitter.

Parkinson disease, dopamine, substantia nigra, L dopa

excessive NO formation has been implicated in the neurodegenerative process associated with _________ and ___________ disease. How do we think it does this?

Parkinson's, Alzheimer's Damages mitochondrial electron transport chain

In _________ disease, cells of the pars compacta of the substantia nigra degenerate, reducing inhibition via the indirect pathway and reducing excitation via the direct pathway. The characteristics of the disease are explainable by dysfunction of the basal ganglia: resting tremor, slowness and delay of movement, and shuffling gait. Treatment of the disease includes replacement of dopamine by treatment with L-dopa (the precursor to dopamine) or administration of dopamine agonists such as bromocriptine.

Parksinson's

The relationship of any tumor to the branches of the facial nerve [VII] must be defined because resection of the tumor may damage the nerve. What type of tumor?

Parotid gland tumor

Parasympathetics to urinary bladder, male genetalia, and lower large intestine come from what nerves? What spinal cord levels does it arise from?

Pelvic sphlancnic nerves S2- S4

Lesions of nerves passing through the _________ ________ (IX, X, XI) may result in loss of the gag reflex (motor limb via ninth nerve), drooping of the ipsilateral shoulder accompanied by an inability to turn the head to the opposite side against resistance (eleventh nerve), and dysarthria and dysphagia (tenth nerve). Syndromes of the jugular foramen may result from lesions/tumors located inside the cranial cavity adjacent to the foramen (as in the Vernet syndrome, roots of IX, X, XI), within the foramen itself, or external to the foramen at the skull base. In the latter case, the lesion may encompass the roots of the ninth, tenth, and eleventh nerves as well as the twelfth (the Collet-Sicard syndrome).

jugular foramen

syndromes of the _______ _______ commonly involve roots of cranial nerves (CNs) IX, X, and XI either together or in various combinations.

jugular foramen

Recall that the ________ _______ (CNs IX, X, XI) and the ___________ _____ (CN XII) are closely adjacent to each other, separated only by a small bar of bone on the inner aspect of the skull

jugular foramen, hypoglossal canal

Layers of dura mater (2)

Periosteal layer Meningeal layer

___________ nerves consist of axons from motor neurons (in the spinal cord), sensory neurons, and autonomic neurons (in _______); all the axons are enclosed within a series of ________ cells, but only large (__________) axons have myelin sheaths and nodes of Ranvier.

Peripheral, ganglia, Schwann, myleinated

cytoplasmic enzymes conjugate the functional groups introduced in the first phase reactions, most often by glucuronidation or sulfation, and also acetylation and methylation. Which phase of drug metabolism?

Phase II

Rapildy adapting mechanoreceptor

Phasic

______ receptors are illustrated by the pacinian corpuscles, which detect rapid changes in the stimulus or vibrations. These receptors adapt rapidly to a constant stimulus and primarily detect onset and offset of a stimulus and a changing stimulus.

Phasic

Pneumotaxic center is found where?

Pons

together with centers in the medulla, participates in balance and maintenance of posture and in regulation of breathing. In addition, it relays information from the cerebral hemispheres to the cerebellum.

Pons

Mastoid process of temporal bone Convexity of concha of ear Facial nerve [VII] Draws ear upward and backward What muscle?

Posteiror auricular

Tectorial membrane is upper part of what?

Posterior longitudinal ligament

Choanae AKA

Posterior nasal apertures

Sensory innervation of back of head/neck?

Posterior rami of C2-C4

ALP increased in what type of jaundice?

Posthepatic

High conjugated bilirubin Normal ALT and AST High ALP

Posthepatic

Urine urobillinogen absent in what type of jaundice

Posthepatic

obstruction to biliary excretion what type of jaundice?

Posthepatic

_________ is secreted as elongated dentinal tubules from tall odontoblasts that line the pulp cavity and persist in the fully formed tooth, with apical odontoblast processes extending between the tubules.

Predentin

Jaundice caused by hemolysis

Prehepatic

Urine billirubin absent in what type of jaundice?

Prehepatic

increased production or impaired hepatic uptake of bilirubin What type of jaundice?

Prehepatic

Vesamicol Reserpine MEchaism?

Prevent incorproation of NT into vesicles

Botulinum toxin Guanethidine Mechanism?

Prevent release of NT

Imipramine, cocaine MEchanism?

Prevent reuptake of NT

Bones, stones, abdominal groans What disease?

Primary hyperparathyroidism

The _________ is a small muscle superficial to the nasal bone and is active when an individual frowns

Procerus

contains sequences for dynorphin and several other peptides, which bind to the κ-class of receptors. Which gene of opiod peptides?

Prodynorphin

contains the sequences for Met- and Leu-enkephalins, which bind to δ-receptors and are involved in pain regulation at local levels in the brain and spinal cord Which gene of opioid peptides?

Proenkephalin A

contains β-endorphin, which binds to opiate µ-receptors, and also adrenocorticotropic hormone (ACTH) and the melanocyte-stimulating hormones (MSH), which are pituitary hormones Which gene of the opoid peptides?

Proopiomelanocortin

Opioids: There are at least _ genes that code for these peptides, and each contains the sequences for several active molecules: ▪ ___________________ contains β-endorphin, which binds to opiate µ-receptors, and also adrenocorticotropic hormone (ACTH) and the melanocyte-stimulating hormones (MSH), which are pituitary hormones ▪ _____________ _ contains the sequences for Met- and Leu-enkephalins, which bind to δ-receptors and are involved in pain regulation at local levels in the brain and spinal cord; ▪ ____________ contains sequences for dynorphin and several other peptides, which bind to the κ-class of receptors.

Proopiomelanocortin Proenkephalin A Prodynorphin

commonly used by cardiologists (other β-blockers are the mainstay of treatment in coronary heart disease), but neurologists also use it as part of the treatment of Parkinson's disease. What drug?

Propanalol

Omeprazole Lansoprazole Pantoprazole Raberprazole Esomeprazole Drug class?

Proton Pump Inhibitors

Cerebellum: With appropriate silver staining dendrites from each large __________ cell are shown to have hundreds of small branches, each covered with hundreds of dendritic spines. Axons from the small neurons of the ________ layer are unmyelinated and run together into the _________ layer where they form synapses with the dendritic spines of Purkinje cells.

Purkinjie, granular, molecular

The output of the cerebellar cortex is via axons of _________ cells and is always __________. Disorders of the cerebellum cause ______

Purkinjie, inhibitory, ataxia

Pustular raised lesions of palate in a patient with ulcerative colitis. What condition?

Pyostagmus vegetans

__________ tracts are corticospinal and corticobulbar tracts that pass through the medullary pyramids and descend directly onto lower motoneurons in the spinal cord.

Pyramidal

_________ _________, the biologically active form of vitamin B6, is utilized as a cofactor by more than 100 enzymes, including reactions catalyzed by aromatic amino acid decarboxylase (AADC), threonine dehydratase and the glycine cleavage system. Vitamin B6 is present in the human body as a number of 'vitamers' that are precursors to PLP. A pivotal enzyme in the formation of PLP is pyridox(am)ine-5′-phosphate oxidase (PNPO).

Pyridoxal phosphate

____ receptor and its ligand ______ are essential for differentiation, maturation, and regulation of osteoclasts

RANK, RANKL

_____ and ___ together control differentiation and activation of osteoclasts. _____ stimulates and ___ inhibits bone resorption. Importantly, estrogens induce ___ synthesis.

RANKL, OPG, RANKL, OPG, OPG

Unconjugated bilirubin is toxic to the immature brain and causes a condition known as ___________

kernicterus

The normal 'resting' movement within the axon is mediated by separate molecular 'motors' (motile proteins): _______ in the case of anterograde transport and ______ in retrograde transport.

kinesin, dynein

The vestibular hair cells differ from auditory hair cells in that the vestibular hair cells have a large _________ and a cluster of ____________.

kinocilum, stereocilia

In addition to two cranial nerves, the ___________ branch of the ________ __________ __________ artery also enters the internal acoustic meatus and sends branches to serve the cochlea and semicircular canals and their respective ganglia.

labrynthine, anteiror inferior cerebellar

The substrates for gluconeogenesis are derived from _______ released by glycolysis in the peripheral tissues and from hepatic deamination of amino acids (mainly _______) generated from the proteolysis of ________ _______

lactate, alanine, skeletal muscle

Astrocytes utilizing glucose release significant amounts ________ to extracellular brain compartment, and it serves as complementary energy source for the neurons. However, neither exogenous nor endogenous _______, can fully replace _______ as the principal energy source. (

lactate, lactate, glucose

Smooth muscle of the ______ _______ and __________ _______,under the control of the autonomic __________ plexus, moves the villi and helps propel lymph through the lacteals.

lamina propiara, muscularis mucosa, submucosal

The _____ _________ has three major regions: the short cecum, with the appendix; the long colon, with its ascending, transverse, descending, and sigmoid portions; and the rectum.

large intestine

Claude Syndrome AKA What structure is effected?

Red nucleus sydnreom Midbrain

_________ pain is of visceral origin. The pain is "referred" according to the dermatomal rule, which states that sites on the skin are innervated by nerves arising from the same spinal cord segments as those innervating the visceral organs.

Referred

The scala vestibuli is separated from the scala media by ___________ membrane. The _______ membrane separates the scala media from the scala tympani.

Reissner's, basilar

Most neuronal cell bodies (N) in the CNS are ______ than the much more numerous glial cells (G) that surround them. The various types of glial cells and their relationships with neurons are difficult to distinguish by most routine light microscopic methods. However, ________________ have condensed, rounded nuclei and unstained cytoplasm due to very abundant Golgi complexes, which stain poorly and are very likely represented by the cells with those properties seen here. The other glial cells seen here similar in overall size, but with very little cytoplasm and more elongated or oval nuclei, are mostly __________. Routine H&E staining does not allow neuropil to stand out well.

larger, oligodendrocytes, astrocytes

Pancreas is intra or retroperotineal?

Retroperitoneal

The upper opening of the larynx (_________ ______) is tilted posteriorly, and is continuous with the pharynx.

laryngeal inlet

The lateral vestibulospinal tract originates in the _______ _________ ________ (_______ nucleus) and projects to ipsilateral motoneurons in the spinal cord. Stimulation produces __________ of extensors and __________ of flexors.

lateral vestibular nucleus, Deiter's, activation, inhibtion

The _______ _______________ tract originates in the lateral vestibular nucleus (Deiters' nucleus) and projects to ipsilateral motoneurons in the spinal cord. Stimulation produces activation of extensors and inhibition of flexors.

lateral vestibulospinal

The synaptic vesicles contain a very high concentration of the relevant neurotransmitter, which is bounded by a membrane. During synaptic release of the transmitter, there is fusion of the synaptic vesicle membrane (containing the neurotransmitter) with the presynaptic membrane. This increase in total membrane mass is redressed by invagination of the ________ aspects of the nerve terminals, where an inward puckering movement of the membrane is effected by contractile movements of the protein _________. There then follows a form of pinocytosis of the excess membrane, which is transported in retrograde fashion toward the nucleus, to be digested in _________

lateral, clathrin, pinocytosis

The _______ vestibular nucleus receives input from the utricles and projects to spinal cord motoneurons via the _______ _______________ tract. Projections of the lateral vestibular nucleus play a role in maintaining postural reflexes.

lateral, lateral vestibulospinal

Fascia over masseter muscle Skin at the corner of the mouth Facial nerve [VII] Retracts corner of mouth What muscle?

Risorius

The _______ olfactory tract synapses in the primary olfactory cortex, which includes the prepiriform cortex. The ______ olfactory tract projects to the anterior commissure and the contralateral olfactory bulb

lateral, medial

located in the dermis of nonhairy and hairy skin and in joint capsules. These receptors have large receptive fields and are stimulated when the skin is stretched. The stimulus may be located some distance from the receptors it activates.

Ruffini's corpuscle

detect stretch and joint rotation.

Ruffini's corpuscles

Glossopharyngeal, vagus nerves exit the _______ aspect of the _________ via the____________ _______; the ninth nerve exits rostral to the row of rootlets comprising the tenth nerve

lateral, medulla, postolivary sulcus

Na+ Cl− HCO3− Osmolarity Higher in CSF or blood or the same?

Same

CN V: It exits at an intermediate position on the _______ aspect of the ____ roughly in line with CNs ___, __, and _

lateral, pons, VII, IX, X

Also derived from the embryonic neural crest, small _________ cells form a thin, intimate glial layer around each large neuronal cell body in the ganglia of the PNS

Satellite

_________ cells are very closely associated with neuronal cell bodies in sensory and autonomic ganglia of the PNS and support these cells in various ways.

Satellite

Defects in dopaminergic systems are implicated in ____________ because many antipsychotic drugs used to treat this disease have been found to bind to dopamine receptors.

Schizophrenia

The middle diagram shows schematically a myelinated peripheral nerve fiber as seen under the light microscope. The axon is enveloped by the myelin sheath, which, in addition to membrane, contains some Schwann cell cytoplasm in spaces called _______-_________ or ______ clefts between the major dense lines of membranes.

Schmidt Lanterman, myelin

Myelin clefts AKA

Schmidt-Lanterman Clefts

In longitudinal sections the flattened nuclei of endoneurial fibroblasts (F) and more oval nuclei of _____ cells can be distinguished. Nerve fibers are held rather loosely in the endoneurium and in low-magnification longitudinal section are seen to be wavy rather than straight. This indicates a slackness of fibers within the nerve, which allows nerves to stretch slightly during body movements with no potentially damaging tension on the fibers

Schwann

The lower diagram depicts the ultrastructure of a single node of Ranvier or nodal gap. Interdigitating processes extending from the outer layers of the _______ cells partly cover and contact the axolemma at the nodal gap. This contact acts as a partial barrier to the movement of materials in and out of the periaxonal space between the axolemma and the Schwann sheath. The basal or external lamina around Schwann cells is continuous over the nodal gap. The axolemma at nodal gaps has abundant voltage-gated ___ channels important for impulse conductance in

Schwann, Na+

Groups of axons (with _______ cells and ___________) are surrounded by ___________, consisting of layered, squamous fibroblastic cells joined by _____ _________ to make a _____-_____ _______

Schwann, endoneurium, perineurium, tight junctions, blood nerve barrier

_______ cells, sometimes called neurolemmocytes, are found only in the PNS and differentiate from precursors in the neural crest. These cells are the counterparts to _________________ of the CNS, having trophic interactions with axons and most importantly forming their _______ _______

Schwann, oligodendrocytes, myelin sheaths

Two glial cells occur in the PNS: ________ cells (sometimes called neurolemmocytes), which surround peripheral nerve fibers, and ___________ cells, which surround the nerve cell bodies and are thus found only in ganglia. Major functions of these cells are indicated.

Schwann, satellite

During development, portions of several small-diameter axons are engulfed by one _______ cell. Subsequently the axons are separated and each typically becomes enclosed within its own fold of Schwann cell surface. No ______ is formed by wrapping. Small-diameter axons utilize action potentials whose formation and maintenance do not depend on the insulation provided by the myelin sheath required by _____-diameter axons.

Scwann, myelin, large

Levels of neurotransmitters in the synaptic cleft and available for binding postsynaptic receptors are normally regulated by several local mechanisms. _________ __________ ________ __________, a widely used class of drugs for treatment of depression and anxiety disorders, were designed to augment levels of this neurotransmitter at the postsynaptic membrane of serotonergic CNS synapses by specifically inhibiting its reuptake at the presynaptic membrane.

Selective Serotonin Reuptake Inhibitors

such as fluoxetine (Prozac), are also highly effective antidepressants. What drugs?

Selective Serotonin Reuptake Inhibitors

arises from the sella turcica and, due to its position, may impinge on optic structures and/or cause deficits indicative of involvement of the hypothalamus What type of meningioma?

Sellar meningioma

ATP: Made where?

Sensory, enteric, sympathetic nerves

_________ neurons are afferent, receiving stimuli from receptors throughout the body. _____ neurons are efferent, sending impulses to effector organs such as muscle fibers and glands. _______ motor nerves are under voluntary control and typically innervate skeletal muscle; _________ motor nerves control the involuntary or unconscious activities of glands, cardiac muscle, and most smooth muscle.

Sensory, motor, somatic, autonomic

_________-containing nerves arise in the raphe nuclei, part of the reticular formation in the upper brainstem. In common with those containing norepinephrine, they are distributed widely.

Serotonin

Salivary gland: ______ cells are polarized protein-secreting cells, usually pyramidal in shape, with round nuclei, well-stained RER, and apical secretory granules

Serous

Effector organs of somatic NS?

Skeletal muscle

_____ nerves can be seen in sections from most organs.

Small

______ muscle in the inner ________ layer and the outer _____________ layer of the muscularis, under the control of the autonomic __________ plexus, produces strong peristalsis

Smooth, circular, longitudinal, myenteric

Opens and closes oropharyngeal isthmus

Soft palate

Discrete, organized; ACh receptors localized on motor end plate Neuroeffector junctions of what branch of NS?

Somatic

What caueses meningitis after head trauma?

Staphylococcus

These cells recognize and phagocytose aged erythrocytes, freeing heme and iron for reuse or storage in ferritin complexes. These cells are also antigen-presenting cells and remove any bacteria or debris present in the portal blood. What cells of the hepatic sinusoid (2 names)

Stellate macrophages Kuppfer cells

As axons arising from abducens motor neurons pass through the basilar pons, they are located __________ adjacent to _______________ fibers. A lesion in this portion of the pons may simultaneously damage the exiting ___________ fibers and ______________ axons. A patient with this lesion experiences an alternating (or crossed) __________, a paralysis of the ________ ________ muscle on the side of the lesion (loss of voluntary _________ gaze to that side, and _________), and a paralysis of the upper and lower extremities on the _________ side of the body. Alternating, or crossed, deficits are characteristic of ___________ lesions.

laterally, corticospinal, abducens, corticospinal, hemiplegia, lateral rectus, lateral, diplopia, contralateral, brainstem

In summary, rotation of the head to the _____ stimulates the left semicircular canals, and rotation to the _____ stimulates the right semicircular canals.

left, right

NSAID ulcers are seen more in stomach or duodenum?

Stomach

Infections of the meninges (bacterial meningitis) may be called __________________ because the causative organisms localize to the subarachnoid space and involve the pia and arachnoid. Extension into the dura is called _______________

leptomeningitis, pachymeningitis

The _______ ______ ______ more deeply placed and covered by the other two levators and the zygomaticus muscles (Fig. 8.56). It arises from the maxilla, just inferior to the infra-orbital foramen and inserts into the skin at the corner of the mouth. It elevates the corner of the mouth and may help deepen the furrow between the nose and the corner of the mouth during sadness

levator anguli oris

Serous demilunes found in what type of salivary gland?

Sublingual

the smallest of the major glands, are also considered branched tubuloacinar glands, but here secretory tubules of mucous cells predominate and the main product of the gland is mucus. The few serous cells present add amylase and lysozyme to the secretion. What glands?

Sublingual

Submandibular and sublingual glands What parasympathetic ganglion controls them?

Submandibular ganglion

Glands located under the jawbone

Submandibular glands

______________ glands, which produce two-thirds of all saliva, are branched tubuloacinar glands, having primarily serous acini, but with many mixed tubuloacinar secretory units . Within the mixed units grouped serous cells occur distally on short mucous tubules and often assume a crescent-shaped arrangement called a ______ ________. In addition to α-amylase and proline-rich proteins, serous cells of the gland secrete ________ for hydrolysis of bacterial walls.

Submandibular, serous demilune, lysozyme

another example of a member of a multigene family, known as the tachykinin family. It is present in afferent fibers of sensory nerves and transmits signals in response to pain.

Substance P

Cardinal signs of stroke (4)

Sudden severe headache Nausea Vomiting Syncope

______ and _____ _____ produced by final steps of digesting carbohydrates and polypeptides in the ____________ undergo transcytosis through ____________ for uptake by __________.

Sugars, amino acids, glycocylax, enterocytes, capillaries

Ganglia (3) giving sympathetics to the heart

Super cervical Middle cervical Inferior cervical

Epicranial aponeurosis on side of head Upper part of auricle Facial nerve [VII] Elevates ear What muscle?

Superior auricular

oculomotor nerve [III], the trochlear nerve [IV], the ophthalmic nerve [V1], the abducent nerve [VI], and ophthalmic veins. Contents of what?

Superior orbital fissure

The _______ _____ ___________ ________ ____ is medial to the levator labii superioris, arises from the maxilla next to the nose, and inserts into both the alar cartilage of the nose and skin of the upper lip (Fig. 8.56). It may assist in flaring the nares.

levator labii supeoris alaquae nasi

Taste bud: ________ cells are found among the taste receptor cells. These cells do not respond to taste stimuli, and their function is not known. _____ cells are undifferentiated stem cells that serve as precursors to taste receptor cells (just as basal cells serve as precursors to olfactory receptor cells). Basal cells undergo continuous replacement. New cells, which are generated approximately every 10 days, migrate toward the center of the taste bud and differentiate into new receptor cells. New receptor cells are needed to replace those cells that are sloughed from the tongue.

Supporting Basal

Olfactory epithelium: ♦ __________ cells are columnar epithelial cells lined with microvilli at their mucosal border and filled with secretory granules. ♦ _____ cells are located at the base of the olfactory epithelium and are undifferentiated stem cells that give rise to the olfactory receptor cells. These stem cells undergo mitosis, producing a continuous turnover of receptor cells. ♦ __________ ________ cells, which are also primary _________ neurons, are the site of odorant binding, detection, and transduction.

Supporting Basal Olfactory receptor, afferent

Supra-orbital nerve and vessels What foramen?

Supra orbital foramen

Supra-orbital notch AKA

Supra-orbital foramen

Supra orbital foramen AKA

Supra-orbital notch

Norepinephrine (except sweat glands) NT in effector organs of what branch of NS?

Sympathetic

Paravertebral and prevertebral Locations of autonomic ganglia in what branch of NS?

Sympathetic

Short Length of preganglionic axons in what branch of NS?

Sympathetic

Smooth muscle; cardiac muscle; Effector organs of which branch of NS?

Sympathetic

Spinal cord segments T1-L3 (thoracolumbar) Origins of which divison of autonomic nervous system?

Sympathetic

ACh/nicotinic receptor Neurotransmitter and effector type in ganglion in which branch of nS?

Sympathetic & Parasympathetic!

Diffuse, branching; receptors not concentrated in one region Neuroeffector junctions of what branch of NS?

Sympathetic & Parasympathetic!! Trick question!

Paravertebral AKA

Sympathetic chain

Adrenal medulla Bronchial tree Heart Innervated by sympathetics from where?

Sympathetic chain ganglia

Vertebral levels of sympathetic efferent fibers

T1-L3

Transduction of cold temperatures involves a different ___ channel, _____, which is also opened by compounds like menthol (which gives a cold sensation).

TRP, TRMP8

Thermal or mechanical nociceptors (____ or _____ channels) are supplied by finely ____________ _-_____ afferent nerve fibers and respond to mechanical stimuli such as sharp, pricking pain.

TRPV, TRPM8, myelinated a delta

Hairy skin Slowly Vertical indentation of skin What type of mechanoreceptors?

Tactile discs

______ ______ are similar to Merkel's receptors but are found in hairy, rather than nonhairy, skin.

Tactile discs

The ________ _____ __________ deepens the furrow between the nose and the corner of the mouth during sadness. It arises from the maxilla just superior to the infra-orbital foramen, and its fibers pass downward and medially to blend with the orbicularis oris and insert into the skin of the upper lip.

levator labii superioris

NMDA receptor is a ______-gated ____ channel

ligand, Ca2+

The ________ ________ of the brain is involved in emotions and memory. It consists of various areas surrounding the _____ ____________, including the hippocampus, the _____________ body, and the _________ gyrus. Removal of the _______________ prevents the laying down of short-term memory, while intact ________________ function is required for the emotion of fear.

limbic cystem, upper brainstem, amygdaloid, cingulate, hippocampus, amygdalaloid

The dorsal surface mucosa of the tongue has projecting _______ ________ of four types: ________ papillae with keratinized epithelium and nonkeratinized _______, _________, and large _______ papillae.

lingual papillae, filliform, fungiform, foliate, vallate

CNS: Many regions show organized areas of white matter and gray matter, differences caused by the differential distribution of _____-rich _______. The main components of _____ matter are myelinated axons, often grouped together as _______, and the myelin-producing oligodendrocytes.

lipid, myelin, white, tracts

Products of ____ digestion associate with bile salts, are taken up by enterocytes, and are converted to ____________ and ____________ for release as ____________ and uptake by a lymphatic called a _______ in the core of each villus.

lipid, triglycerides, lipoproteins, chylomicrons, lacteal

Some nerve cell bodies also contain inclusions of pigmented material, such as ___________, consisting of residual bodies left from lysosomal digestion.

lipofuschin

Sympathetic ganglia are smaller than most sensory ganglia but similar in having large neuronal cell bodies (N), some containing ___________. Sheets from satellite cells (S) enclose each neuronal cell body with morphology slightly different from that of sensory ganglia. Autonomic ganglia generally have less well-developed connective tissue ________ than sensory ganglia.

lipofuschin, capsules

Deficiency of α1-antitrypsin presents in infancy as _____ disease, or in adulthood as ____ disease

liver, lung

Most _____ ___________ are low-molecular-weight molecules that bind to the voltage-gated sodium channels of the axolemma, interfering with sodium ion influx and, consequently, inhibiting the action potential responsible for the nerve impulse.

local anesthetics

Norepinephrine-containing neurons arise in the _____ _______ in the _________ and are distributed throughout the ______

locus cerelus, brainstem, cortex

Superior articular surface of atlas is for what?

occipital condyle

The _________________ is the final muscle in this category of "other muscles of facial expression" and is associated with the scalp. It consists of a frontal belly anteriorly and an occipital belly posteriorly. An aponeurotic tendon connects the two: ▪ The _______ belly covers the forehead and is attached to the skin of the eyebrows. ▪ The _________ belly arises from the posterior aspect of the skull and is smaller than the frontal belly.

occipitofrontalis frontal occipital

The final articulation across the lower part of the lateral portion of the calvaria is between the temporal bone and the occipital bone at the _______________ suture.

occipitomastoid

. Damage to the __________ nerve may result in paralysis of most eye movement, a dilated pupil, and loss of the efferent limb of the pupillary light reflex, all in the ipsilateral eye.

oculomotor

Note the relationship of the __________ nerve to the adjacent posterior cerebral and superior cerebellar arteries

oculomotor

Parasympathetic fibers in the head are carried out of the brain as part of four cranial nerves—the _____________ nerve, the ______ nerve, the _______________ nerve, and the _____ nerve Parasympathetic fibers in the ___________ nerve, the ______ nerve, and the __________________ nerve destined for target tissues in the head leave these nerves, and are distributed with branches of the ____________ nerve

oculomotor, facial, glossopharynteal, vagus, oculomotor, facial, glossopharyngeal, trigeminal

The __________ and _________ nerves are the cranial nerves of the midbrain. The ___ nerve exits via the interpeduncular fossa to innervate _ major extraocular muscles, and through the ________ ganglion, the ________ ___________ muscles.

oculomotor, trochlear, 3rd, 4, cilicary, sphincter pupillae

There are four major kinds of glial cells in the CNS: ________________, ___________, _________ cells, and __________ cells.

oligodendrocytes, astrocytes, ependymal, microglial

The _______ peptides and ______ receptors provide a good example of a multigene family.

opioid, opoid

Rhodopsin, the photosensitive pigment, is composed of _____ (a protein belonging to the superfamily of G protein-coupled receptors) and _______ (an aldehyde of vitamin _)

opsin, retinal, A

note the relationship between the anterior cerebral artery, anterior communicating artery, and the structures around the _____ _______

optic chiasm

During normal breathing, the airway is open and air passes freely through the nasal cavities (or ____ cavity), pharynx, larynx, and trachea

oral

The ____ ______ is inferior to the nasal cavities, and separated from them by the hard and soft palates.

oral cavity

Hyoid: it is at the interface between three dynamic compartments: ▪ Superiorly, it is attached to the floor of the ____ ______. ▪ Inferiorly, it is attached to the _____. ▪ Posteriorly, it is attached to the _______

oral cavity pharynx larynx

The anterior opening to the oral cavity is the ____ _________, and the posterior opening is the _____________ _______

oral fissure, oropharyngeal fissure

The ___________ _____ is a large muscle that completely surrounds each orbital orifice and extends into each eyelid. It closes the eyelids. It has two major parts: ▪ The outer _______ part is a broad ring that encircles the orbital orifice and extends outward beyond the orbital rim. ▪ The inner ________ part is in the eyelids and consists of muscle fibers originating in the medial corner of the eye that arch across each lid to attach laterally

orbicularis oculi orbital palpebral

The ___________ ____ is a complex muscle consisting of fibers that completely encircle the mouth

orbicularis oris

The two _______ contain the eyes.

orbits

Serum biochemical markers reflecting __________ function are bone-specific alkaline phosphatase, osteocalcin, and markers of collagen formation: carboxy-terminal procollagen extension peptide (ICTP) and amino or carboxy-terminal procollagen extension peptides (PINP, P1CP).

osteoblast

Adrenal and gonadal steroids, particularly estrogens in women and testosterone in men, stimulate __________ and inhibit __________ function. They also ________ renal calcium and phosphate excretion and ________ intestinal calcium absorption.

osteoblast, osteoclast, decrease, increase

Increased mechanical load stimulates bone formation and excess ____________ activity underpins several diseases, in particular osteoporosis, rheumatoid arthritis, and metastatic cancers.

osteoclastic

When mineral deprivation exists, there is an increase in the percentage of the nonmineralized organic matrix (_______) within bone, resulting in the clinical condition of ____________

osteoid, osteomalacia

Circular muscle Ciliary muscle What parasympathetic ganglion controls them?

otic ganglion

The auriculotemporal nerve also carries secretomotor fibers to the parotid gland. These postganglionic parasympathetic fibers have their origin in the ____ ganglion associated with the __________ nerve [_] and are just inferior to the foramen _____. Preganglionic parasympathetic fibers to the otic ganglion come from the ________________ nerve [__].

otic, mandibular, V3, ovale, glossopharyngeal, IX

Nerves originating in the glossopharyngeal nuclei synapse in the ___ ganglion; its postganglionic neurons innervate the ______ _____

otic, parotid gland

Mastoiditis is almost always accompanied by other disease processes, most notably acute or chronic ______ _____. The close association of mastoid air cells to the _______ _____ represents one comparatively direct route into the central nervous system.

otitis media, sigmoid sinus

Within the utricle and saccule, an _______ mass composed of ____________________ and _______ _________ crystals overlies the vestibular hair cells (like a "pillow").

otolith, mucopolysaccharides, calcium carbonate

Liver stem cells, often called ____ cells, are present among cholangiocytes of the bile canals near portal areas and produce progenitor cells for both ___________ and ______________

oval, hepatocytes, cholangioccytes

The mandibular nerve [V3] exits the skull through the foramen _____. Branches innervating the face include: ▪ the ______________ nerve, which enters the face just posterior to the temporomandibular joint, passes through the parotid gland, and ascends just anterior to the ear to supply the external acoustic meatus, the surface of the tympanic membrane (eardrum), and a large area of the temple; ▪ the ______ nerve, which is on the surface of the buccinator muscle supplying the cheek; and ▪ the ______ nerve, which exits the mandible through the mental foramen and immediately divides into multiple branches to supply the skin and mucous membrane of the lower lip and skin of the chin

ovale auricotemporal buccal mental

Catecholamines are degraded by _________ of the _____ group by the enzyme monoamine oxidase (MAO), and by ____________ by catecholamine-O-methyltransferase (COMT). The pathway shown is for norepinephrine but the pathways for epinephrine, dopamine, and 5-HT are analogous.

oxidation, amino, methylation

Vagus n.: The BE fibers innervate one muscle of the tongue (_____________), the muscles of the soft palate (except the ______ _______ _________), pharynx (except the _______________), and larynx.

palatoglossus, tensor veli palatini, stylopharyngeus

Tumors of the choroid plexus (CP) constitute about 1% of all intracranial tumors and are generally classified as choroid plexus __________ (benign, most common of CP tumors) or choroid plexus _________ (malignant, rare).

papilloma, carcinoma

. Damage to the oculomotor nerve may result in ___________ of most ___ movement, a _______ pupil, and loss of the _________ limb of the ________ _____ reflex, all in the ___________ eye.

paralysis, eye, dilated, efferent, pupillary light, ipsilateral

Continuous with the nasal cavities are air-filled extensions (_________ ________), which project laterally, superiorly, and posteriorly into surrounding bones. The largest, the _________ sinuses, are inferior to the orbits.

paransal sinuses, maxillary

meningiomas that are directly adjacent to the midline and involve the superior sagittal sinus are called _____________ meningiomas.

parasaggital

Intracerebral hemorrhage, a bleed into the substance of the brain (also called ______________ hemorrhage), may extend into a ventricular space, bleeding from a brain tumor, arteriovenous malformation, or from a tumor of the _______ _______.

parenchymatous , choroid plexus

Bleeding within substance of brain AKA

parenchymatous hemmorrahage

The mastoid part is the most posterior part of the temporal bone, and is the only part of the petromastoid part of the temporal bone seen on a lateral view of the skull. It is continuous with the squamous part of the temporal bone anteriorly, and articulates with the parietal bone superiorly at the ______________ suture, and with the occipital bone posteriorly at the occipitomastoid suture

parietomastoid

The large _______ gland consists entirely of serous acini with cells producing amylase and other proteins for storage in secretory granules.

parotid

The _______ _____ leaves the anterior edge of the parotid gland midway between the zygomatic arch and the corner of the mouth

parotid duct

nicotinic receptors are ion channel receptors composed of an allosteric protein containing four different subunit types—α, β, δ, and γ—gathered together in a transmembrane _________. Each of the subunits has an intracellular and extracellular exposure, and together they surround a central channel. Recognition sites for acetylcholine and other agonists, cholinergic antagonists, and certain snake venom toxins are located primarily on the _____ subunits.

pentamer, alpha

Chief cells are clustered mainly in the lower half of the gastric glands, secrete the protein __________ that is activated by the low pH in the lumen to form the major protease ______

pepsinogen, pepsin

There are many kinds of neurons, but all consist of a cell body (__________) containing the nucleus, a long cytoplasmic extension called the ____, and one or more shorter processes called _________.

perikaryon, axon, dendrites

Nuclei of the many satellite cells (S) surrounding the __________ of neurons in an autonomic ganglion can be seen by light microscopy, but their cytoplasmic extensions are too thin to see with H&E staining. These long-lived neurons commonly accumulate brown ___________

perikaryon, lipofuschin

The cell body (also called the ___________ or ____) which contains the nucleus and most of the cell's organelles and serves as the synthetic or trophic center for the entire neuron.

perikaryon, soma

A "typical" neuron has three major parts: (1) The cell body (also called the __________ or ____) is often large, with a large, euchromatic nucleus and well-developed nucleolus. The cytoplasmic contains basophilic ______ _________ or Nissl bodies, which are large masses of free polysomes and RER indicating the cell's high rate of protein synthesis. 2) Numerous short __________ extend from the perikaryon, receiving input from other neurons. (3) A long ____ carries impulses from the cell body and is covered by a myelin sheath composed of other cells. The ends of axons usually have many small branches (___________), each of which ends in a knob-like structure that forms part of a functional connection (_______) with another neuron or other cell.

perikaryon, soma, Nissl substance dendrites axon, telodendria, synapse

Scala vestibula and scala tympani fluid AKA Similar to what?

perilymph ECF

SEM of transverse sections of a large peripheral nerve showing several fascicles, each surrounded by ___________ and packed with ___________ around the individual myelin sheaths. Each fascicle contains at least one _________. Endothelial cells of these capillaries are tightly joined as part of the blood-nerve barrier and regulate the kinds of plasma substances released to the ____________. Larger blood vessels course through the deep __________ that fills the space around the perineurium and fascicles.

perineurium, endoneurium, capillary, endoneurium, epineurium

The ____________ of each tooth consists of a thin layer of bone-like ________ surrounding dentin of the roots and the ___________ ________ binding the cementum to ________ ____ on the jaw socket.

periodontum, cementum, periodontal ligament, alveolar bone

In an injured or cut __________ nerve, proximal axon segments can regenerate from their cut ends after a delay. The main changes that take place in an injured nerve fiber are shown here. (a) Normal nerve fiber, with its perikaryon, extensive RER (______ _________), and ________ cell (muscle). (b) When the axon is injured, the RER is greatly _______ initially and the nerve fiber distal to the injury degenerates along with its ______ ______. Debris is phagocytosed by ___________ (c) In the following weeks after injury, muscle fiber shows denervation atrophy, but Schwann cells proliferate to form a compact cord penetrated by the regrowing axon. The axon grows at the rate of ___-_ mm/d. (d) After some ______, the nerve fiber regeneration is successful and functional connections with the muscle fiber are restored.

peripheral Nissl substance, effector reduced, myelin sheath, macrophages 0.5, 3 months

The venous and arterial blood mixes in these irregular hepatic sinusoids. The anastomosing sinusoids have thin, discontinuous linings of fenestrated endothelial cells surrounded by sparse basal lamina and reticular fibers. The discontinuities and fenestrations allow plasma to fill a narrow ________________ _____ (or space of _____) and directly bathe the many irregular microvilli projecting from the hepatocytes into this space (Figure 16-14). This direct contact between hepatocytes and plasma facilitates most key hepatocyte functions that involve uptake and release of nutrients, proteins, and potential toxins.

perisinousoidal space, Disse

Between the endothelium and the hepatocytes is a very thin space called the _______________ _____ of _____, in which are located small hepatic ________ cells, or __ cells, that maintain the very sparse ECM of this compartment and also store vitamin _ in small lipid droplets. These cells are numerous but are difficult to demonstrate in routine histologic preparations

perisinusoidal space, DIsse, stellate, Ito, A

In most CNS regions, neurons are also protected by the blood-brain barrier, consisting of the ____________ ____ __ __________ ________ and the nonfenestrated capillary endothelial cells' _____ _________

perivascular feet of astrocytic processes, tight junctions

Blood vessels penetrate CNS tissue through long _____________ ______ covered by pia mater, although the pia disappears when the blood vessels branch to form the small capillaries. However, these capillaries remain completely covered by the perivascular layer of astrocytic processes

perivascular spaces

inactivate Gαi so that it cannot inhibit adenylyl cyclase, which promotes an increase in cAMP and contributes to many of the signs and symptoms of whooping cough. WHat toxin?

pertussis toxin

In the neck, major muscle groups include: ▪ muscles of the ________ (constrict and elevate the pharynx), ▪ muscles of the ______ (adjust the dimensions of the air pathway), ▪ _____ muscles (position the larynx and hyoid bone in the neck), ▪ muscles of the _____ _________ ______ (move the head and upper limb), and ▪ _________ muscles in the muscular compartment of the neck (position the neck and head).

pharynx larynx strap outer cervical collar postural

The neck contains specialized structures (________ and _______) that connect the upper parts of the digestive and respiratory tracts (_____ and ____ cavities) in the head, with the esophagus and trachea, which begin relatively low in the neck and pass into the thorax.

pharynx, larynx, nasal, oral

Some receptors are _______, meaning they adapt rapidly to the stimulus (e.g., pacinian corpuscles), and others are _____, meaning they adapt slowly to the stimulus (e.g., Merkel's receptors).

phasic, tonic

Norepinephrine acts on prejunctional α2 receptors to inhibit transmitter release. This negative feedback control is supported by the observation that antagonists for these receptors (e.g., ____________) cause an increase in the release of transmitter in response to nerve stimulation.

phentolamine

Catecholamines: Their actions are mediated through two separate receptors: α-adrenergic receptor, blocked by ____________, and β-adrenergic receptor, blocked by _________.

phentolamine, propanalol

A tumor of the adrenal medulla, or _______________, may be located on or near the adrenal medulla, or at a distant (_______) location in the body. Unlike the normal adrenal medulla, which secretes mainly _____________, a pheochromocytoma secretes mainly ________________, which is explained by the fact that the tumor is too far from the _______ _______ to receive the ________ that is required by ____.

pheochromocytoma, ectopic, epinepherine, norepinepherine, adrenal cortex, cortisol, PNMT

Apoptosis involves the breakdown of the DNA into fragments of about 200 base pairs, exposure of the anionic phospholipid __________________ on the outer leaflet of the cell membrane, and the formation of apoptotic bodies that are then engulfed by macrophages and dendritic cells.

phosphatidylserine

What does caffiene inhibit? How does it work?

phosphodieserase, which mimics adrenergic activity by allowing cAMP to be present in the cells longer

Caffeine and related methylxanthines are effective inhibitors of __________________, at least in vitro.

phosphodiesterase

cAMP is broken down by what?

phosphodiesterase

Photoreceptors, the rods and cones, span several layers of the retina, as previously described. The outer and inner segments of photoreceptors are located in the ______________ layer, the nuclei are located in the _____ _______ layer, and the synaptic terminals (on _______ and __________ cells) are located in the ____ _________ layer.

photoreceptor, outer nuclear, bipolar, horizontal, outer plexiform

A diagram of the spinal cord indicates the relationship of the three meningeal layers of connective tissue: the innermost ___ mater, the __________, and the ____ mater. Also depicted are the blood vessels coursing through the subarachnoid space and the nerve rootlets that fuse to form the posterior and anterior roots of the spinal nerves. The posterior root ganglia contain the cell bodies of sensory nerve fibers and are located in intervertebral foramina.

pia, arachnoid, dura

The innermost ___ materconsists of flattened, mesenchymally derived cells closely applied to the entire surface of the CNS tissue. The pia does not directly contact nerve cells or fibers, being separated from the neural elements by the very thin superficial layer of ____________ processes (the _____ ________ ________, or ____ __________), which adheres firmly to the pia mater.

pia, astrocytic, glial limiting membrane, glia limitans

Inferiorly, the ________ ________ is the large opening in the nasal region and the anterior opening of the nasal cavity

piriform aperture

The ________ is a large, thin sheet of muscle in the superficial fascia of the neck.

platysma

The pontine reticulospinal tract originates in nuclei of the ____ and projects to the ____________ ______ ____. Stimulation has a generalized __________ effect on both flexor and extensor muscles, with its predominant effect on _________

pons, ventomedial spinal cord, activating, extensors

Both the _______ __________ ________ and the _________ __________ nucleus have powerful excitatory effects on extensor muscles. Therefore, lesions of the brain stem above these areas, but below the ________, cause a dramatic increase in extensor tone, called __________ ________

pontine reticular formation, lateral vestibular, midbrain, decerebrate rigidity

The _______ ______________ tract originates in nuclei of the pons and projects to the ventromedial spinal cord. Stimulation has a generalized activating effect on both flexor and extensor muscles, with its predominant effect on extensors

pontine reticulospinal

3rd occipital n. AKA

posteiror ramus of C3

The ___________ triangle is bounded by: ▪ the middle one-third of the clavicle, ▪ the anterior margin of the trapezius, and ▪ the posterior margin of the sternocleidomastoid

posterior

The facial nerve [VII] exits the ___________ cranial fossa through the internal acoustic meatus.

posterior

The facial nerve [VII] exits the posterior cranial fossa through the internal acoustic meatus. It passes through the temporal bone, giving off several branches, and emerges from the base of the skull through the stylomastoid foramen. At this point it gives off the _________ _________ nerve. This branch passes upward, behind the ear, to supply the occipital belly of the occipitofrontalis muscle of the scalp and the posterior auricular muscle of the ear.

posterior auricular

The external carotid artery enters into or passes deep to the inferior border of the parotid gland. As it continues in a superior direction, it gives off the _________ __________ artery before dividing into its two terminal branches (the __________ and ___________ ________ arteries) near the lower border of the ear: ▪ The ___________ artery passes horizontally, deep to the mandible. ▪ The _____________ __________ artery continues in a superior direction and emerges from the upper border of the gland after giving off the transverse facial artery.

posterior auritular, maxillary, superficial temporal maxillary superficial temporal

That portion of the _________ _________ artery located between the _________ artery and _________ _____________ artery (A) is the P1 segment. The most common site of aneurysms in the infratentorial area (vertebrobasilar system) is at the bifurcation of the basilar artery, also called the basilar tip. Patients with aneurysms at this location may present with ___ movement disorders, pupillary _________ caused by damage to the ____ of the ___ nerve, and ________.

posterior cerebral, basilar, posterior communicating, Eye, dilation, root, 3rd, diplopia

Note the relationship of the exiting fibers of the oculomotor nerve to the _________ ________ and ________ __________ arteries

posterior cerebral, superior cerebellar

Note the relationship of the oculomotor nerve to the adjacent _________ ________ and ________ __________ arteries

posterior cerebral, superior cerebellar

The fourth nerve is unique in that it is the only cranial nerve to exit the _________ aspect of the __________ and is the only cranial nerve motor nucleus to innervate, exclusively, a muscle on the ______________ side of the midline.

posterior, brainstem, contralateral

The main stem of the facial nerve [VII] then gives off another branch, which innervates the __________ belly of the _________ muscle and the stylohyoid muscle. At this point, the facial nerve [VII] enters the deep surface of the ________ gland

posterior, digastric, parotid

The __________ triangle in part lies over the axillary inlet, and is associated with structures (_______ and ________) that pass into and out of the upper limb.

posterior, nerves, vessels

Autonomic nerves use two-neuron circuits. The first neuron of the chain, with the ____________ fiber, is located in the CNS. Its axon forms a synapse with _______________ fibers of the second multipolar neuron in the chain located in a peripheral ganglion system. The chemical mediator present in the synaptic vesicles of all preganglionic axons is _____________

preganglionic, postganglionic, acetylcholine

In the pupillary light reflex, light strikes the retina and, through a series of CNS connections, activates _____________ ______________ nerves in the ________-________ nucleus; activation of these parasympathetic fibers causes contraction of the _________ muscle and pupillary ____________. In the accommodation response, a blurred retinal image activates parasympathetic preganglionic neurons in the Edinger-Westphal nuclei and leads to contraction of the _________ muscle and pupillary ____________.

pregnaglionic parasympathetic, Edinger Westphal, sphincter, constriction, sphincter, constriction

Conjugated bilirubin absent in what type of jaundice?

prehepatic

Synapses convert an electrical signal (nerve impulse) from the ____________ cell into a chemical signal that affects the _____________ cell. Most synapses act by releasing _________________, which are usually small molecules that bind specific receptor proteins to either open or close ion channels or initiate second-messenger cascades.

presynaptic, postsynaptic, neurotransmitters

Components of a synapse: The ___________ axonal terminal (_________ _______) contains mitochondria and numerous synaptic vesicles from which neurotransmitter is released by exocytosis. The ______________ cell membrane contains receptors for the neurotransmitter, and ion channels or other mechanisms to initiate a new impulse. A 20- to 30-nm-wide intercellular space called the ________ _____ separates these presynaptic and postsynaptic membranes.

presynaptic, terminal bouton postsynaptic synaptic cleft

Sympathetics: The other category of preganglionic neuron passes through the sympathetic chain without synapsing and continues on to synapse in ____________ ganglia (celiac, superior mesenteric, and inferior mesenteric) that supply visceral organs, glands, and the _______ nervous system of the gastrointestinal tract.. In the ganglia, the preganglionic neurons synapse on postganglionic neurons, which travel to the periphery and innervate the effector organs.

prevertebral, enteric

Nasal bone and upper part of lateral nasal cartilage Skin of lower forehead between eyebrows Facial nerve [VII] Draws down medial angle of eyebrows, producing transverse wrinkles over bridge of nose What muscle?

procerus

Hypothalamic dopamine is an inhibitor of the release of __________ from the pituitary.

prolactin

The brain parenchyma of the CNS produces a number of brain-specific proteins. These include _____________ ________ (formerly called β-trace protein), and ____________ (a protein formerly called prealbumin).

prostaglandin synthase, transthyretin

Clinically, a subpopulation of patients lacks plasma ____________________ activity and can have prolonged paralysis with muscle-relaxing agents such as succinylcholine, which is metabolized primarily by this enzyme

pseudocholinesterase

The junction where the frontal, parietal, sphenoid, and temporal bones are in close proximity is the _______

pterion

The buccinator arises from the posterior part of the maxilla and mandible opposite the molar teeth and the ____________________ _____, which is a tendinous band between the pterygoid hamulus superiorly and the mandible inferiorly and is a point of attachment for the buccinator and superior pharyngeal constrictor muscles.

pterygomandibular raphe

The ______________ fossa on each side is just posterior to the upper jaw.

pterygopalatine

A 66-year-old man who suffered a stroke on the right side has a drooping right eyelid (______), constriction of his right pupil (______), and lack of sweating on the right side of his face (__________). What condition?

ptosis, miosis, anhidrosis Horner's syndrome

The pupillary reflex (commonly called the _________ ______ reflex) has its afferent limb via the ___ cranial nerve and its efferent limb via the ___ cranial nerve. The reaction of the pupil when light is shined in one eye is a clear hint as to the location of the lesion. The optic nerve, chiasm, tract, and radiations and the visual cortex have a retinotopic representation throughout. Lesions of any of these structures result in _______ deficits, such as a hemianopia or quadrantanopia, that reflect the particular portion of the visual system that is damaged. Because visual pathways are widespread within the brain, lesions at various different locations may result in visual deficits.

pupillary light, 2nd, 3rd, visual

ATP and other ______-containing molecules derived from it are now known to have transmitter functions

purine

Hundreds of different neurons make up the CNS; large, unique _________ neurons characterize the cortex of the cerebellum, and layers of small __________ neurons form the cerebral cortex.

purkinjie, pyramidal

From the apical ends of _________ neurons, long dendrites extend in the direction of the cortical surface, which can be best seen in thick silver-stained sections in which only a few other protoplasmic astrocytes (A) cells are seen.

pyramidal

Important neurons of the cerebrum are the _________ neurons, which are arranged vertically and interspersed with numerous smaller glial cells, mostly __________, in the _____________ neuropil

pyramidal, astrocytes, eosinophillic

Assessment of __________ status is based on the measurement of erythrocyte aspartate aminotransferase.

pyridoxine

The infratemporal fossa is an area between the posterior aspect (_____) of the mandible and a flat region of bone (_______ plate of the __________ process) just posterior to the upper jaw (_______). This fossa, bounded by bone and soft tissues, is a conduit for one of the major cranial nerves—the ___________ nerve (the ___________ division of the ____________ nerve [CN __]), which passes between the cranial and oral cavities.

ramus, lateral, pterygoid, maxilla, mandibular, mandibualr, trigeminal, V3

Serotonin-containing nerves arise in the _____ ______, part of the _________ _________ in the _____ _________. In common with those containing ______________, they are distributed widely.

raphe nuclei, reticular formation, upper brainstm, norepinepherine

Meissner's corpuscle and hair follicles adaptation speed?

rapid

A large number of compounds, whether of low molecular weight, such as the biogenic amines, or larger peptides act on specific ________ and there is normally more than one ________ for each ________________

receptor, receptor, neurotransmitter

Neurotransmitters act by binding to specific __________, and opening or closing ___ __________

receptors, ion channels

Often, the sympathetic and parasympathetic innervations of organs or organ systems have __________ effects. These effects are coordinated by _________ centers in the _____ ____. For example, autonomic centers in the brain stem control the heart rate by modulating sympathetic and parasympathetic activity to the __ ____

reciprocal, autonomic, brain stem, SA node

Most organs have both sympathetic and parasympathetic innervation. These innervations operate _____________ or _______________ to produce coordinated responses. For example, the heart has both sympathetic and parasympathetic innervations that function reciprocally to regulate heart rate, conduction velocity, and the force of contraction (_____________). The smooth muscle walls of the gastrointestinal tract and the bladder have both sympathetic innervation (which produces __________) and parasympathetic innervation (which produces ___________). The radial muscles of the iris are responsible for dilation of the pupil (__________) and have sympathetic innervation; the circular muscle of the iris is responsible for constriction of the pupil (______) and has parasympathetic innervation. In this example of the eye muscles, different muscles control pupil size, but the overall effects of sympathetic and parasympathetic activity are reciprocal.

reciprocally, synergistically, contractility, relaxation, contraction, mydriasis, miosis

The rubrospinal tract originates in the ___ nucleus and projects to motoneurons in the _______ ______ ____. Stimulation of this nucleus produces activation of _______ muscles and inhibition of ________ muscles

red, lateral spinal cord, flexor, extensor

Other receptors that act by __________ cAMP include adenosine A1 receptors; dopamine D2 receptors; 5-HT1 receptors; GABAB receptors; M2-muscarinic and M4-muscarinic receptors; and several glutamate, opioid, and other peptide receptors.

reducing

Similar reasoning can be applied to the autonomic control of the gastrointestinal tract: Contraction of the wall of the gastrointestinal tract is accompanied by __________ of the sphincters (_____________), allowing the contents of the gastrointestinal tract to be propelled forward. Relaxation of the wall of the gastrointestinal tract is accompanied by ___________ of the sphincters (___________); the combined effect of these actions is to slow or stop movement of the contents.

relaxation, parasympathetic, contraction, sympathetic

First-order neurons synapse on second-order neurons in ______ ______, which are located in the spinal cord or in the brain stem.

relay nuclei

The choroid plexus epithelial cells are similar to those of the _____ _______ ______ and contain transport mechanisms that move solutes and fluid from capillary blood into CSF.

renal distal tubule

In the periphery, dopamine causes vasodilatation and it is therefore used clinically to stimulate renal blood flow, and is important in the treatment of _____ _______

renal failure

The drug best known for its ability to inhibit this transfer of norepinephrine and related compounds from the neuronal cytoplasm into storage vesicles is _________

resperine

The normal _______ _________ difference is a few millivolts, with the inside of the cell being ________, and is caused by an imbalance of ions across the plasma membrane: the concentration of K+ ion is much greater _______ cells than _______, whereas the opposite is true for Na+ ion. This difference is maintained by the action of the ___/__ ______

resting potential, negative, inside, outside, Na+ K+ ATPase

The overall function of the parasympathetic nervous system is __________, to ________ energy. The organization of the parasympathetic nervous system in relation to the ___ (brain stem and spinal cord), the parasympathetic ganglia, and the effector organs. Preganglionic neurons of the parasympathetic division have their cell bodies in either the _____ ____ (________, ____, and ________) or the _______ spinal cord.

restorative, conserve, CNS, brain stem, midbrain, pons, medulla, sacral

In the systemic circulation, this absence of sialic acid gives a molecular signal for transferrin to be recycled, and it is thus immediately removed from the systemic circulation by all ____________________ cells. The brain has no true ___________________ cells along the path of CSF flow, and hence _________________ is present in quite high concentrations. The _______ ______ of the anterior chamber of the eye also produces the characteristic asialotransferrin, and the same asialotransferrin can also be found in the _________ of the semicircular canals in the inner ear.

reticuloendothelial, reticuloendothelial, asialotransferrin, aqueous humor, perilymph

The _________________ vein is formed in the substance of the parotid gland when the superficial temporal and maxillary veins join together, and passes inferiorly in the substance of the parotid gland.

retromandibular

Lack of __________ in the diet causes a deficiency syndrome of inflammation of the corners of the mouth (angular stomatitis), the tongue (glossitis) and scaly dermatitis. Photophobia may also develop

riboflavin

To determine the __________ status, erythrocyte glutathione reductase activity is measured.

riboflavin

Low 1,25(OH)2D3 causes abnormal mineralization of newly formed osteoid as a result of low calcium and phosphate availability and reduced osteoblast function. It leads to the development of _______ in children or ____________ in adults.

rickets, osteomalacia

The ______ transverse sinus usually receives blood from the superior sagittal sinus and the _____ transverse sinus usually receives blood from the straight sinus.

right, left

The Bárány test involves rotating a person on a special chair for about 10 revolutions. In a person with normal vestibular function, rotation to the right causes a _____ rotatory nystagmus, a _____ postrotatory nystagmus, and the person falls to the _____ during the postrotatory period. Likewise, rotation to the left causes a ____ rotatory nystagmus, a _____ postrotatory nystagmus, and the person falls to the ______ during the postrotatory period.

right, left, right, left, right, left

The _________ helps produce a grin. It is a thin, superficial muscle that extends laterally from the corner of the mouth in a slightly upward direction. Contraction of its fibers pulls the corner of the mouth laterally and upward.

risorius

The extrapyramidal tracts originate in the following structures of the brain stem: ♦ The ___________ tract originates in the red nucleus and projects to motoneurons in the lateral spinal cord. Stimulation of the red nucleus produces activation of flexor muscles and inhibition of extensor muscles. ♦ The ________ ______________ tract originates in nuclei of the pons and projects to the ventromedial spinal cord. Stimulation has a generalized activating effect on both flexor and extensor muscles, with its predominant effect on extensors. ♦ The _________ ______________ tract originates in the medullary reticular formation and projects to motoneurons in the spinal cord. Stimulation has a generalized inhibitory effect on both flexor and extensor muscles, with the predominant effect on extensors.

rubrospinal pontine reticulospinal medullary reticulospinal

The _______ responds to head movements in all directions. Hair cells of this structure are excited with both forward and backward movements (called "_____") and lateral and medial movements (called "____"). The _______ also responds to up and down movements of the head.

saccule, pitch, roll, saccule

For _____ sensation (mediated by Na+), Na+ enters the taste receptor through the same epithelial Na+ channels, leading directly to depolarization.

salty

Higher magnification shows the small, rounded nuclei of glia cells called _________ cells that produce thin, sheet-like cytoplasmic extensions that completely envelop each large neuronal perikaryon.

satellite

Immunofluorescent staining of _________ cells reveals the cytoplasmic sheets extending from these cells and surrounding the neuronal cell bodies. The layer of satellite cells around each soma is continuous with the myelin sheath around the axon. Like the effect of Schwann cells on axons, satellite glial cells insulate, nourish, and regulate the microenvironment of the neuronal cell bodies

satellite

The _____ covers the superior, posterior, and lateral regions of the head

scalp

A woman planning a 10-day cruise asks her physician for medication to prevent motion sickness. The physician prescribes __________, a drug related to ________, and recommends that she take it for the entire duration of the cruise. While taking the drug, the woman experiences no nausea or vomiting, as hoped. However, she does experience dry mouth, dilation of the pupils (_________), increased heart rate (___________), and difficulty voiding urine.

scopolamine, atropine, mydriasis, tachycardia

The direction of the nerve impulse determines whether the ganglion will be a _______ or an _________ ganglion.

sensory, autonomic

Parotid glands are located in each cheek near the ear, are branched acinar glands with exclusively ______ acini

serous

Because the sympathetic ganglia are located near the spinal cord, the preganglionic nerve axons are _____ and the postganglionic nerve axons are _____ (so that they can reach the peripheral effector organs).

short, long

The autonomic innervation of the __________ ____ in the heart is an excellent example of coordinated control of function.

sinoatrial node

Cranial nerve nuclei are either motor to ________ muscle or visceromotor to ________ in the periphery. Lesions involving the nuclei, or roots, of motor nuclei result in __________ of the muscles served, with the predictable deficits, such as weakness of the facial muscles or deviation of the ______ on protrusion. Lesions that damage the visceromotor fibers of a cranial nerve result in an expected ____________ response, such as ________ of the pupil, or a ________ in secretory function or ______ muscle motility.

skeletal, ganglia, paralysis, tongue, visceromotor, dilation, decrease, smooth

Ruffini's corpuscle, Merkel's receptors, and tactile discs Adaptation speed?

slow

group IV fibers have the _______ conduction velocities of all the sensory nerves

slowest

Ruffini's corpuscles are _______ adapting receptors.

slowly

Thermoreceptors are ______ adapting receptors that detect changes in skin temperature.

slowly

Cervical vertebrae (Fig. 8.8A) are characterized by: ▪ _____ bodies, ▪ _____ spinous processes, and ▪ transverse processes that contain a foramen (________ _________________).

small bifid foramen transversarium

The _____ _________ has three regions: the duodenum with large mucous glands in the submucosa called duodenal glands; the jejunum; and the ileum with the large mucosal and submucosal Peyer patches.

small intestine

In cross section an isolated, resin-embedded nerve is seen to have a ____ perineurium (P), _ capillary (C), and many _____ axons (A) associated with _______ cells (S). A few nuclei of fibroblasts can be seen in the endoneurium between the myelinated fibers

small, 1, large, Schwann

Unmyelinated axons (UM) are much _______ in diameter, and many such fibers may be engulfed by a single Schwann cell. The glial cell does not form myelin wrappings around such small axons but simply encloses them. Whether it forms myelin or not, each Schwann cell is surrounded, as shown, by an external lamina containing type __ collagen and laminin like the basal laminae of epithelial cells

smaller, IV

Mutations of ______ ________ can occur at different sites and give rise to hyperkalemic periodic paralysis

sodium channels

The effect on membrane potential depends on the particular ions that are allowed to pass: the nicotinic ACh receptor is comparatively nonspecific towards ______ and __________ and causes depolarization, whereas the GABAA receptor is a ________ channel and causes __________________.

sodium, potassium, chloride, hyperpolarization

The diagrams show three common morphologic types of synapses. Branched axon terminals usually associate with and transmit a nerve impulse to another neuron's cell body (or ____) or a __________ _____. These types of connections are termed an ___________ synapse and an ____________ synapse, respectively. Less frequently, an axon terminal forms a synapse with an axon terminal of another neuron; such an ___________ synapse functions to modulate synaptic activity in the other two types.

soma, dendritic spine, axosomatic, axodendritic, axoaxonic

The ________ nervous system is a voluntary motor system under conscious control.

somatic

For ____ sensation (mediated by H+), H+ enters the taste receptor through epithelial ___ channels (____), leading to depolarization

sour, Na+, ENAC

The ganglia of the sympathetic nervous system are located near the _____ ____, either in the _____________ ganglia (known as the sympathetic chain) or in the ____________ ganglia.

spinal cord, paravertebral, prevertebral

A major contributor to the lower portion of the lateral wall of the cranium is the temporal bone (Fig. 8.19), which consists of several parts: ▪ The ________ part has the appearance of a large flat plate, forms the anterior and superior parts of the temporal bone, contributes to the lateral wall of the cranium, and articulates anteriorly with the greater wing of the sphenoid bone at the sphenosquamous suture, and with the parietal bone superiorly at the squamous suture. ▪ The ____________ process is an anterior bony projection from the lower surface of the squamous part of the temporal bone that initially projects laterally and then curves anteriorly to articulate with the temporal process of the zygomatic bone to form the ___________ _____ ▪ Immediately below the origin of the zygomatic process from the squamous part of the temporal bone is the _________ part of the temporal bone, and clearly visible on the surface of this part is the ________ ________ _______ leading to the ________ ________ ______ ▪ The petromastoid part, which is usually separated into a _______ part and a _________ part for descriptive purposes.

squamous zygomatic, zygomatic arch tympatnic, external acoustic opening, external acoustic meatus petrous, mastoid

The facial nerve [VII] continues along the bony canal, giving off the nerve to the ___________ and the ______ _______, before exiting the skull through the ____________ foramen.

stapedius, chorda tympani, stylomastoid

Certain regions of the CNS, such as near the ependyma, retain rare neural ____ and __________ cells that allow some replacement of neurons throughout life; ______ ____________ involving formation and remodeling of synaptic connections is also prevalent throughout life.

stem, progenitor, neural plasticity

The mechanism of action of the adrenoreceptors can be explained as follows: α1 Receptors act through __________ of _____________ _ and generation of ___. β1 and β2 receptors act through __________ of ______ _______ and generation of ____. α2 Receptors act through __________ of _______ _______

stimulation, phospholipase C, IP3, activation, adenyl cylcase, cAMP, inhibition, adenyl cyclase

Neurons respond to environmental changes (_______) by altering the ionic gradient that exists across their plasma membranes. All cells maintain such a gradient, also called an electrical potential, but cells that can rapidly change this potential in response to stimuli (eg, neurons, muscle cells, some gland cells) are said to be _________ or irritable. Neurons react promptly to stimuli with a reversal of the ionic gradient (membrane ______________) that generally spreads from the place that received the stimulus and is propagated across the neuron's entire plasma membrane. This propagation, called the ______ __________, the ______________ wave, or the _____ impulse, is capable of traveling long distances along neuronal processes, transmitting such signals to other neurons, muscles, and glands.

stimulus, excitable, depolarization, action potential, depolarization, nerve

The _______ has four major regions: the superior cardia and inferior pylorus, which are rather similar histologically, and the intervening fundus and body, which are also similar.

stomach

At the anal canal the simple columnar epithelium lining the rectum shifts abruptly to __________ ________ epithelium of the skin at the anus.

stratified squamous

Salivary gland: _______ _____ reabsorb Na+ ions from the initial secretion and their folded cell membranes present a large surface area with ion transporters, facilitating rapid ion transcytosis and making the secretion slightly hypotonic.

striated ducts

salivary gland: Cells of _______ ducts have mitochondria-lined, basolateral membrane folds specialized for electrolyte reabsorption from the secretion; _________ ducts are unusual in having stratified cuboidal or columnar cells.

striated, excretory

The glycine receptor on motor neurons is ionotropic and is blocked by ___________; motor impulses can then be passed without negative control, which accounts for the rigidity and convulsions caused by this toxin.

strychnine

Medial to the mastoid process, the _______ ________ projects from the lower border of the temporal bone.

styloid process

Cisterns are the enlarged portions of the _____________ space that contain arteries and veins, roots of cranial nerves, and, of course, cerebrospinal fluid.

subarachnoid

Long and thin on CT What type of cranial bleed?

subdural hematoma

Tearing of bridging veins (veins passing from the brain outward through the arachnoid and dura), usually the result of trauma, is a common cause of ________ ________. This designation is somewhat a misnomer because the extravasated blood actually dissects through a specialized, yet structurally weak, cell layer at the dura-arachnoid interface; this is the _____ ______ ____ _____

subdural hematoma, dural border cell layer

Types of herniations that may result from midline shift in subdural hematoma (2)

subfalcine herniation transtentorial herniation

The __________ gland is a mixed but largely mucous gland with a tubuloacinar arrangement of poorly stained mucous cells (M). Small intralobular ducts (ID) are seen in connective tissue, as well as small fascicles of lingual striated muscle

sublingual

The _____________ gland is a mixed serous and mucous gland (serous cells predominate), and shows well-stained serous acini (A) and "serous demilunes" (S) and pale-staining mucous cells (M) grouped as tubules in this tubuloacinar gland. (The crescent-shaped "serous demilunes" arise at least in part artifactually due to disproportionate swelling of the adjacent mucous cells during slide preparation.) Small intralobular ducts (ID)

submandibular

Clinically, a subpopulation of patients lacks plasma pseudocholinesterase activity and can have prolonged paralysis with muscle-relaxing agents such as _______________, which is metabolized primarily by this enzyme

succinylcholine

The retromandibular vein is formed in the substance of the _______ gland when the___________ _________ and _________ veins join together, and passes inferiorly in the substance of the parotid gland.

superficial temporal, maxillary

Ganglia giving sympathetics to the head and neck

superior cervical ganglia

The tectospinal tract originates in the ________ ___________ (tectum or "roof" of the brain stem) and projects to the ________ ______ ____. It is involved in control of ____ muscles.

superior colliculus, cervical spinal cord, neck

Small intestine Large intestine innervated by sympathetics from what plexus?

superior mesenteric plexus

The ophthalmic nerve [V1] exits the skull through the _________ ________ ________ and enters the orbit. Its branches (Fig. 8.61) that innervate the face include: ▪ the _____-_______ and ______________ nerves, which leave the orbit superiorly and innervate the upper eyelid, forehead, and scalp; ▪ the ______________ nerve, which exits the orbit in the medial angle to innervate the medial half of the upper eyelid, the skin in the area of the medial angle, and the side of the nose; ▪ the ________ nerve, which exits the orbit in the lateral angle to innervate the lateral half of the upper eyelid and the skin in the area of the lateral angle; and ▪ the ________ ______ nerve, which supplies the anterior part of the nose

superior orbital fissure supra orbital, supratrochlear infratrochlear lacrimal external nasal

Clearly visible in the medial part of the superior rim of each orbit is the ______-________ foramen

supra orbital

The many bones of the head collectively form the skull. Most of these bones are interconnected by _______, which are immovable ______ joints

sutures, fibrous

The tip of the tongue is most responsive to _____, _____ and _____, whereas the posterior tongue is most responsive to ______, and the sides of the tongue are most responsive to ____

sweet, salty, umami, bitter, sour

The anterior two thirds of the tongue (where ______, ______, and _____ sensations are most sensitive) is innervated by the ______ nerve (CN ___).

sweet, salty, umami, faciall, VII

Norepinephrine (also known as noradrenaline) is a major transmitter in the ____________ nervous system

sympathetic

Several organs have only ___________ innervation: sweat glands, vascular smooth muscle, pilomotor muscles of the skin, liver, adipose tissue, and kidney.

sympathetic

The human parotid glands do not receive _____________ innervation.

sympathetic

Sympathetics: one category of preganglionic neuron synapses on postganglionic neurons within the ____________ ______. These synapses may occur in ganglia at the same segmental level of the chain, or the preganglionic fibers may turn in the cranial or caudal direction and innervate ganglia at higher or lower levels in the chain, thereby permitting synapses in multiple ganglia (consistent with the _____________ of sympathetic functions)

sympathetic chain, diffuseness

As described previously, ___________ _____________ __________ nerves release their neurotransmitters from varicosities onto their target tissues (e.g., vascular smooth muscle). The sympathetic adrenergic _____________ contain both the classic neurotransmitter (______________) and nonclassic neurotransmitters (___ and ____________ _). The classic neurotransmitter, norepinephrine, is synthesized from ________ in the varicositie and stored in small dense-core vesicles, ready for release; these small dense-core vesicles also contain ________ ____-___________, which catalyzes the conversion of dopamine to ______________ (the final step in the synthetic pathway), and ___. ATP is said to be "colocalized" with norepinephrine. A separate group of large dense-core vesicles contain ____________ _

sympathetic postganglionic adrenergic, variscosities, norepinepherine, ATP, neuropeptide Y, tyrosine, dopamine beta hydroxylase, norepinephreine, ATP, neuropeptide Y

The overall function of the ____________ nervous system is to mobilize the body for activity. In the extreme, if a person is exposed to a stressful situation, the sympathetic nervous system is activated with a response known as "fight or flight," which includes __________ arterial pressure, _________ blood flow to active muscles, _________ metabolic rate, _________ blood glucose concentration, and _________ mental activity and alertness.

sympathetic, increased, increased, increased, increased, increased

Norepinephrine and epinephrine are synthesized in the brain and peripheral ___________ ganglia by respective groups of neurons acting as __________________. On the other hand, catecholamines released from __________ cells into circulation exert _________ effects

sympathetic, neurotransmitters, chromaffin, endocrine

In contrast to the ___________ ganglia, which are located near the CNS, the ganglia of the _______________ nervous system are located near, on, or in the effector organs

sympathetic, parasympathetic

Efferent pathways in the autonomic nervous system consist of a _____________ and a _____________ neuron, which synapse in _________ _______. The axons of _____________ neurons then travel to the periphery to innervate the effector organs. The adrenal medulla is a specialized ganglion of the ___________ division; when stimulated, it secretes ______________ into the circulation.

sympathetic, parasympathetic, autonomic ganglia, postganglionic, sympathetic, catecholamines

The urinary bladder is another example of reciprocal innervations by ___________ and _______________ divisions. In adults, ___________, or emptying of the bladder, is under voluntary control because the external sphincter is composed of skeletal muscle.

sympathetic, parasympathetic, micturition

When the bladder is filling with urine, ___________ control predominates. This sympathetic activity produces __________ of the detrusor muscle, via _____ receptors, and ___________ of the internal sphincter muscle, via ______ receptors.

sympathetic, relaxation, beta2, contraction, alpha1

vascular smooth muscle has only ___________ innervation, which causes vasoconstriction thus, ganglionic-blocking agents produce relaxation of vascular smooth muscle and ______________. (Because of this property, ganglionic-blocking agents can be used to treat _____________.) On the other hand, male sexual function is dramatically impaired by ganglionic-blocking agents because the male sexual response has both ____________ (ejaculation) and _________________ (erection) components.

sympathetic, vasodilation, hypertension, sympathetic, parasympathietic

Which is more divergent, sympathetics or parasymathetics?

sympathetics

Such nerve communication is transmitted to another neuron or effector cell via a _______, where ________________ is released at the ____________ membrane and binds receptors on the ____________ cell, initiating a new action potential there.

synapse, neurotransmitter, presynaptic, postsynaptic

Functions attributed to astrocytes of various CNS regions include the following: Extending processes that associate with or cover ________, affecting the formation, function, and plasticity of these structures Regulating the extracellular ionic concentrations around neurons, with particular importance in buffering extracellular __ levels Guiding and physically supporting movements and locations of differentiating neurons during ___ development Extending fibrous processes with expanded ____________ ____ that cover capillary endothelial cells and modulate blood flow and help move nutrients, wastes, and other metabolites between neurons and capillaries Forming a barrier layer of expanded protoplasmic processes, called the _____ _________ ________, which lines the meninges at the external CNS surface Filling tissue defects after CNS injury by proliferation to form an __________ ____

synapses K+ CNS perivascular feet glial limiting membrane astrocytic scar

Neurons communicate at ________ by means of _________________

synapses, neurotransmitters

The action of transmitters must be halted by their removal from the ________ _____

synaptic cleft

The TEM shows a large presynaptic terminal (T1) filled with synaptic vesicles and asymmetric electron-dense regions around 20- to 30-nm-wide ________ ______. The postsynaptic membrane contains the neurotransmitter receptors and mechanisms to initiate an impulse at the postsynaptic neuron. The postsynaptic membrane on the right is part of a dendrite, associated with fewer vesicles of any kind, showing this to be an axodendritic synapse. On the left is another presynaptic terminal (T2), suggesting an axoaxonic synapse with a role in modulating activity of the other terminal.

synaptic clefts

Diagram showing a synapse releasing neurotransmitters by exocytosis from the terminal bouton. Presynaptic terminals always contain a large number of ________ ________ containing neurotransmitters, numerous _____________, and smooth ER as a source of new membrane. Some neurotransmitters are synthesized in the cell body and then transported in vesicles to the presynaptic terminal. Upon arrival of a nerve impulse, voltage-regulated Ca2+ channels permit Ca2+ entry, which triggers neurotransmitter release into the synaptic cleft. Excess membrane accumulating at the presynaptic region as a result of exocytosis is recycled by clathrin-mediated endocytosis, which is not depicted here.

synaptic vesicles, micothcondria

The junctions between postganglionic autonomic neurons and their effectors (______ tissues), the ______________ _________, are analogous to the neuromuscular junctions of the somatic nervous system.

target, neuroeffector junctions

All lingual papillae, except the filiform type, have epithelial _____ ____ on their sides, with chemosensory gustatory cells with synapses to basal sensory innervation, support cells, and an apical taste pore.

taste buds

The __________ tract originates in the superior colliculus (tectum or "roof" of the brain stem) and projects to the cervical spinal cord. It is involved in control of neck muscles.

tectospinal

Facial n. Although there are variations in the pattern of distribution of the five terminal groups of branches, the basic pattern is as follows: ▪ ________ branches exit from the superior border of the parotid gland to supply muscles in the area of the temple, forehead, and supra-orbital area. ▪ __________ branches emerge from the anterosuperior border of the parotid gland to supply muscles in the infra-orbital area, the lateral nasal area, and the upper lip. ▪ ______ branches emerge from the anterior border of the parotid gland to supply muscles in the cheek, the upper lip, and the corner of the mouth. ▪ ________ ___________ branches emerge from the anteroinferior border of the parotid gland to supply muscles of the lower lip and chin. ▪ ________ branches emerge from the inferior border of the parotid gland to supply the platysma.

temporal zygomatic buccal marginal mandibular cervical (To Zanzabar By Motor Car)

The vestibular organ is located within the ________ bone, adjacent to the auditory apparatus (the _______). The vestibular organ consists of a __________ labyrinth within the ____ labyrinth. The __________ labyrinth consists of three perpendicular semicircular canals (__________, ________, and _________) and two otolith organs (_______ and ________). The semicircular canals and otolith organs are filled with __________ and are surrounded by _________, much like the auditory organ.

temporal, cochlea, membranous, bony, membranous, horizontal, superior, posterior, utricle, saccule, endolymph, perilymph

Fibers from the _________ visual fields cross at the optic chiasm, but fibers from the _____ visual fields remain uncrossed.

temporal, nasal

Five terminal groups of branches of the facial nerve [VII]—the ________, _________, _______, __________ __________, ___________branches—emerge from the upper, anterior, and lower borders of the parotid gland

temporal, zygomatic, buccal, marginal mandibular, cervical

Once in the parotid gland, the main stem of the facial nerve [VII] usually divides into upper (_____________) and lower (______________) branches. As these branches pass through the substance of the parotid gland they may branch further or take part in an anastomotic network (the _______ plexus).

temporofacial, cervicofacial, parotid

Axons generally branch less profusely than dendrites, but do undergo ________ ____________. Axons of interneurons and some motor neurons also have major branches called ____________ that end at smaller branches with synapses influencing the activity of many other neurons. Each small axonal branch ends with a dilation called a ________ ______ that contacts another neuron or non-nerve cell at a synapse to initiate an impulse in that cell.

terminal arborization, collaterals, terminal bouton

tryptophan hydroxylase, like tyrosine hydroxylase, displays a cofactor requirement for ___________________. Furthermore, 5-hydroxytryptophan is converted to serotonin by ____ _____________

tetrahydrabiopterin, dopa decarboxylase

The main function of the basal ganglia is to influence the motor cortex via pathways through the ________. The role of the basal ganglia is to aid in planning and execution of smooth movements.

thalamus

Where are relay nuclei especially prominent in CNS?

thalamus

Axons of the second-order neurons leave the relay nucleus and ascend to the next relay, located in the ________, where they synapse on third-order neurons. En route to the ________, the axons of these second-order neurons cross at the _________. The decussation, or crossing, may occur in the _______ ____ or ______ ____

thalamus, thalamus, midline, brain stem, spinal cord

The tests used to assess the ________ status include its direct measurement by high-pressure liquid chromatography and the 'classic' measurement of erythrocyte transketolase activity.

thiamine

The superior thoracic aperture (________ _______) opens directly into the base of the neck

thoracic inlet

The adrenal medulla is simply a specialized sympathetic ganglion whose preganglionic neurons originate in the _________ spinal cord (__-__), pass through the sympathetic chain and the celiac ganglion without synapsing, and travel in the _______ _________ nerve to the adrenal gland.

thoracic, T5, T9, greater sphlancnic

Innervation of the sympathetic nervous system. Preganglionic neurons originate in ________ and ______ segments of the spinal cord (__-__)

thoracic, lumbar, T1, L3

The terms sympathetic and parasympathetic are strictly anatomic terms and refer to the anatomic origin of the preganglionic neurons in the CNS. Preganglionic neurons in the sympathetic division originate in the _____________ spinal cord. Preganglionic neurons in the parasympathetic division originate in the ____ ____ and ______ spinal cord.

throacolumar, brain stem, sacral

The preganglionic sympathetic neurons originate in nuclei of the _____________ spinal cord, leave the spinal cord via the _______ _____ roots and _____ rami, and project either to the _____________ ganglia of the sympathetic chain or to a series of ____________ ganglia.

throacolumbar, ventral motor, white, prevertebral, paravertebral

The visceral compartment of the neck contains important glands (_______, ____________, and ________), and parts of the respiratory and digestive tracts that pass between the head and thorax.

thyroid, parathyroid, thymus

In the white commissure ventral to the central canal, _______ run lengthwise along the cord, seen here in cross section with empty ______ _______ surrounding axons, as well as small tracts running from one side of the cord to the other

tracts, myelin sheaths

Transduction of warm temperatures involves __________ _________ _________ channels in the family of _________ receptors (i.e., TRPV). These channels are activated by compounds in the _________ class, which includes capsaicin, an ingredient in spicy foods.

transient receptor potential, vanilloid, vanilloid

The presence of several __________ in the same nerves and the identification of multiple _________ suggest that there is a high degree of flexibility and complexity in the signals that can be produced in the nervous system.

transmitters, receptors

The superficial temporal artery continues in a superior direction and emerges from the upper border of the gland after giving off the __________ ______ artery.

transverse facial

The two muscles (_________ and ____________________) that form part of the outer cervical collar divide the neck into anterior and posterior triangles on each side

trapezius, sternocliedomastoid

Because the face is derived developmentally from a number of structures originating from the first pharyngeal arch, cutaneous innervation of the face is by branches of the __________ nerve

trigeminal

The glossopharyngeal (IX) and vagus (X) nerves (A) exit the lateral aspect of the medulla via the postolivary sulcus; the ninth nerve exits rostral to the row of rootlets comprising the tenth nerve. These nerves are generally in line with the exits of the _______ and ___________ nerves; all of these are _____ nerves. The exit of the glossopharyngeal nerve is close to the ____-________ ________ and correlates with the corresponding shape (more rectangular) of the _______. The vagus nerve exits at a slightly more _______ position; the shape of the medulla is more square and the ___ ventricle is smaller. The ninth and tenth cranial nerves and the spinal portion of the accessory nerve (XI) exit the skull via the _________ foramen.

trigeminal, facial, mixed, pons medulla junction, medulla, caudal, 4th, jugular

The ___________ nerve conveys sensory input from the face and oral cavity and provides motor innervation to the muscles of _____________. The spinal trigeminal tract and nucleus also receive general sensation via CNs ___, __, and _. In this respect, the ______ ___________ tract is the center for all general sensory sensations entering the brainstem on all cranial nerves. In the same sense, the _________ tract and nucleus is the brainstem center for all visceral sensation that enters the brainstem on CNs ___, __, and _. Both of these cranial nerve brainstem nuclei convey information to the __________ and eventually to the _________ ________.

trigeminal, mastication, VII, IX, X, spinal trigeminal, solitary, VII, IX, X, thalamus, cerebral cortex

Structural analogues of folate exhibit selective toxicity towards rapidly growing cells such as bacteria and cancer cells. This is the principle behind the development of drugs known as the folic acid antagonists, which are used as antibiotics (e.g. ____________) and anticancer agents (____________)

trimethoprim, methotrexate

the _________ nerve is seen passing through the ambient cistern around the lateral aspect of the midbrain

trochlear

___________ is cleaved and activated by enteropeptidases in the duodenum, generating ________ that activates the other proteases in a cascade

trypsinogen, trypsin

The enzyme ________ ___________, which catalyzes the conversion of tyrosine to dihydroxyphenylalanine, is the rate-limiting enzyme in the catecholamine synthesis process; any drug that inhibits the function of ________ ___________reduces the rate at which norepinephrine is produced in the nerve terminal.

tyrosin hydroxylase, tyrosine hydroxylase

Catecholamine synthesis: Phenylalanine --> _______ ________--> dihydroxyphenylalanine dihydroxyphenylalanine --> ________ ________ --> _______________ _______________ --> ___________ (only in adrenal medulla) What is the rate limiting enzyme?

tyrosine tyrosine dopamine dopamine, norepinepherine norepinepherine, epinepherine tyrosine hydroxylase (tyrosine to dihydroxyphenlalanine)

The enzyme tyrosine hydroxylase, which catalyzes the conversion of ________ to ______________________, is the rate-limiting enzyme in the catecholamine synthesis process; any drug that inhibits the function of tyrosine hydroxylase reduces the rate at which norepinephrine is produced in the nerve terminal.

tyrosine, dihydroxyphenylalanine

The amino acid ________ is the precursor of dopamine, norepinephrine and epinephrine. __________ is the precursor of serotonin (5-hydroxytryptamine), and _________ derives from the amino acid histidine. _______, an amino alcohol is the precursor of acetylcholine, and the common amino acid, ________ ____, is the precursor of the GABA.

tyrosine, tryptophan, histamine, choline, glutamic acid

Prehepatic (hemolytic) jaundice. There is an increased concentration of plasma total bilirubin due to excess of the ____________ fraction

unconjugated

The one-and-a-half syndrome (#5): This syndrome is so named because a ___________ _______ lesion may result in a loss of ______ and _________ voluntary eye movement on the side of the lesion (the "one") and a loss of _______ horizontal eye movement on the contralateral side (the "one-half"). The lesion resulting in this pattern of deficits involves the _________ nucleus on one side (deficits = ________ ________ paralysis on the side of the lesion, ______ _______ paralysis on the contralateral side) and the immediately adjacent ___ conveying the axons of abducens interneurons originating in the opposite abducens nucleus (deficit = ______ _______ paralysis on the side of the lesion). These lesions are usually large and involve portions of the __________ ________ __________ _________, commonly called the horizontal gaze center.

unilateral pontine, meidal, lateral, medial, oculomotor, lateral rectus, medial rectus, MLF, lateral rectus, paramedian pontine reticular formation

In ____________ fibers the glial cell does not form the multiple wrapping of a myelin sheath

unmyelinated

Polymodal nociceptors are supplied by _____________ _ fibers and respond to high-intensity mechanical or chemical stimuli and hot and cold stimuli.

unmyelinated C

________-_, also called the norepinephrine transporter, requires energy and extracellular ___ and exhibits stereospecificity. Amphetamines, tyramine, and levonordefrin (α-methylnorepinephrine) are examples of drugs that are taken up by this transporter system. Inhibitors of neuronal uptake include _________ and __________.

uptake 1, Na+, cocaine, imperimine

How does alcohol oxidation lead to potential lactic acidosis?

uses up NAD+ stores and oxidizes them to NADH. NAD+ is needed to oxidize lactate to pyruvate, which leads to a buildup of lactic acid

The otolith organs, the ______ and ________, are used to detect ______ acceleration (e.g., gravitational forces).

utricle, saccule, linear

All cranial nerves innervate structures in the head or neck. In addition, the _____ n. descends through the neck and into the thorax and abdomen where it innervates viscera

vagus

The back of the throat and epiglottis are innervated by the _____ nerve (CN_)

vagus, X

The third acute porphyria is the _________ porphyria, the clinical manifestations of which are very similar to ___.

variegate, AIC

parasympathetic postganglionic cholinergic nerves release their neurotransmitters from ______________ onto their target tissues (e.g., smooth muscle). The parasympathetic cholinergic varicosities release both the classic neurotransmitter (___) and nonclassic neurotransmitters (e.g., ___, __). The classic neurotransmitter, ___, is synthesized in the varicosities from _______ and _______ ___ and stored in small, clear vesicles. A separate group of large dense-core vesicles contains peptides such as ___. Lastly, the varicosities containing nitric oxide synthase and can synthesize __ on demand.

variscositites, ACh, VIP, NO, ACh, choline, acetyl CoA, VIP, NO

Together the foramina transversaria form a longitudinal passage on each side of the cervical vertebral column for blood vessels (___________ artery and veins) passing between the base of the neck and the cranial cavity.

vertebral

pacinian corpuscle adaption speed?

very rapid

Neurotransmitters are released from ________ at the synaptic membrane. (A) In the resting state, vesicles are attached to ____________. (B) When an action potential is received, _______ channels open. (C) Vesicles move to the plasma membrane, and (D) bind to a complex of ________ proteins. (E) _________________ is released, and (F) vesicles are _________.

vesicles microtubules calcium docking neurotransmitter recycled

The tumor commonly associated with the eighth nerve is correctly called a ____________ _________ because it arises from the ___________ _______ the ______________ root. It is not correct to refer to this as an ________ _________; it is neither __________ (does not arise for the __________ root) nor a _______ (does not arise from ______ tissue).

vestibular schwanoma, neurilemma sheath, vestibular, acoustic neuroma, acoustic, cochlear, neuroma, nerve

Afferent nerves from vestibular hair cells terminate in ___________ nuclei of the _______: the ________, ______, ________ (Deiters' nucleus), and __________ nuclei.

vestibular, medulla, superior, medial, lateral, inferior

Cerebellum parts: The ___________________ is dominated by vestibular input and controls balance and eye movements. The _________________ is dominated by spinal cord input and controls synergy of movement. The _______________ is dominated by cerebral input, via pontine nuclei, and controls the planning and initiation of movements.

vestibulocerebellum spinocerebellum pontocerebellum

In all regions of small intestine the mucosa has millions of projecting _____, with simple columnar epithelium over cores of lamina propria, and intervening simple tubular __________ ______

villia, intestinal glands

The ________ compartment of the neck contains important glands (thyroid, parathyroid, and thymus), and parts of the respiratory and digestive tracts that pass between the head and thorax

visceral

When hair cells are depolarized, the depolarization opens _______-gated ____ channels in the presynaptic terminals of the hair cells. As a result, Ca2+ enters the presynaptic terminals and causes release of ___________, which functions here as an excitatory neurotransmitter, causing action potentials in the afferent cochlear nerves that will transmit this information to the CNS. When the hair cells are hyperpolarized, the opposite events occur, and there is ___________ release of glutamate.

voltage, Ca2+, glutamate, decreased

The somatic nervous system is a _________ motor system under conscious control.

voluntary

The choroid plexus is specialized for transport of _____ and ____ across the capillary endothelium and ependymal layer and the elaboration of these as CSF.

water, ions

Saliva from the parotids is serous and ______. The submandibular and sublingual glands produce a __________ secretion, while that of the minor glands is mostly _______

watery, seromucous, mucous

Spianal cord: The ______ matter surrounds the _____ matter and contains primarily oligodendrocytes and tracts of myelinated axons running along the length of the cord.

white, gray

In cross sections of the spinal cord the _____ matter is peripheral and the ____ matter forms a deeper, H-shaped mass. The two anterior projections of this gray matter, the ________ _____, contain cell bodies of very large _____ neurons whose axons make up the _______ roots of spinal nerves. The two ___________ horns contain ____________ which receive _______ fibers from neurons in the _______ (______ ____) ganglia. Near the middle of the cord the gray matter surrounds a small _______ _____, which develops from the lumen of the neural tube, is continuous with the ___________ of the brain, is lined by _________ cells, and contains ___.

white, gray, anterior horns, motor, vntral, posterior, interneurons, sensory, spinal, dorsal root, central canal, ventricles, ependymal, CSF

The cerebellar cortex is convoluted with many distinctive small folds, each supported at its center by tracts of _____ matter in the cerebellar ________. Each fold has distinct __________ layers and ________ layers

white, medulla, molecular, granular

The lower lateral rim of the orbit, as well as the lateral part of the inferior rim of the orbit is formed by the __________ bone (the cheekbone).

zygomatic

Laterally, the _________ _______ of each maxilla articulates with the zygomatic bone and medially, the frontal process of each maxilla articulates with the frontal bone.

zygomatic process

Laterally, the __________ _______ of the frontal bone projects inferiorly forming the upper lateral rim of the orbit

zygomatic process

Usually a small foramen (the ______________________ foramen) is visible on the lateral surface of the zygomatic bone. A ___________________ foramen is present on the medial deep surface of the bone.

zygomaticofacial, zygomaticotemporal

Posterior part of lateral surface of zygomatic bone Skin at the corner of the mouth Facial nerve [VII] Draws mouth upward and laterally What muscle?

zygomaticus major

The ____________ _____ and ___________ _____ help produce a smile. The zygomaticus major is a superficial muscle that arises deep to the orbicularis oculi along the posterior part of the lateral surface of the zygomatic bone, and passes downward and forward, blending with the orbicularis oris and inserting into skin at the corner of the mouth. The zygomaticus minor arises from the zygomatic bone anterior to the origin of the zygomaticus major, parallels the path of the zygomaticus major, and inserts into the upper lip medial to the corner of the mouth. Both zygomaticus muscles raise the corner of the mouth and move it laterally.

zygomaticus majro, zygomaticus minor

Gag reflex pathway?

▪ Afferent—Glossopharyngeal nerve (CN IX) ▪ Efferent—Vagus nerve (CN X)

Corneal (blink) reflex What CN's involved?

▪ Afferent—Trigeminal nerve (CN V) ▪ Efferent—Facial nerve (CN VII)

Pupillary light reflex pathway?

▪ Afferent—optic nerve (CN II) ▪ Efferent—oculomotor nerve (CN III)

________ is both an intermediate in the synthesis of norepinephrine and a neurotransmitter

Dopamine

involved in reward-driven learning, regulation of mood, attention, learning, and prolactin release through different classes of receptors What NT? What are its receptors?

Dopamine D1-D5

Fine touch Pressure Proprioreception What system?

Dorsal column

a disease that affects predominantly the P/Q subtype of calcium channels, in an example of molecular mimicry. The patient may have a primary oat cell carcinoma of the lung; the immune system responds by making antibodies against these malignant cells. However, the malignant cells and the calcium channels possess a common epitope, the effect of which is that the immune response causes the release of neurotransmitter to be blocked at the presynaptic site. What disease?

Eaton-Lambert disease

These cells are related to the catecholamine-producing chromaffin cells in the adrenal medulla and convert tryptophan to serotonin (5-HT). What cells

Enterochromaffin cells of ileum

Gastric gland: scattered epithelial cells of the diffuse neuroendocrine system, which release peptide hormones to regulate activities of neighboring tissues during food digestion. What cells?

Enteroendocrine cells

All known metabotropic receptors are coupled to _-________ and, like hormone receptors, have _ transmembrane regions. Typically, they then couple either to _________ _______, altering the production of ____, or to the ___, which alters _______ fluxes.

G proteins, 7, adenylate cyclase, cAMP, PIP, calcium

5-hydroxytryptamin AKA

Serotonin

5-hydroxytryptamine AKA

Serotonin

Dopa Decarboxylase AKA

Amino Acid Decarboxylase

Glutamate GABA Glycine What type of NT's?

Amino acids

Glutamate, GABA What type of neurotransmitters?

Amino acids

What branch of nerves runs to strap muscles?

Ansa cervicialis

Transverse cervial n. comes from where?

Anteiorr rami of C2 and C3

Sensory innervation of anterior part of neck?

Anteiror rami of C2-C4

Contents of foramen lacerum?

Cartilage

How many cervical vertebrae?

Adenosine Triphosphate AKA

ATP

Epinepherine AKA

Adrenaline

Muscarinic ACh inhibitor

Atropine

Propanalol Drug type?

Beta blocker

Cerebrospinal fluid AKA

CSF

zygomatic bone AKA

Cheekbone

MEdial Medullary Syndroem AKA

Dejenere syndrome

Benzodiazepines and barbituates act on what receptor?

GABAA

Edrophonium mechanim

Inhibits acetylcholinesterase

Origin of trochlear n.

Midbrain

Oral fissure AKA

Mouth

Nares AKA

Nostrils

largest of the cranial nerve roots of the brainstem

Trigeminal

Origin of glosspharyngeal n.

Upper medulla

Vasoactive Intestinal Peptide AK

VIP

Facial skeleton AKA

Viscerocranium

Hypoglossal n. AKA

XII

atropine drug type

antimuscarinic

Pupillary dilator Muscle AKA

constrictor m.

COnes have ____ acuity and ____ sensitivity

high, low

Many neuropeptides belong to a single or multigene family?

multigene

Just superior to the rim of the orbit on each side are the raised ____________ ______

superciliary arches

Neurotransmitters act at ________

synapses

Third-order neurons typically reside in relay nuclei in the _______

thalamus

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