Hello Flashcards
(118 cards)
1
Q
Thalamus
A
Very complex and many different parts
- Connections of both motoric and sensoric tracts between cerebrum and medulla spinalis
- Transfers signals from the formation reticular to cerebral cortex
- Transfers signals between different parts of the limbic system
2
Q
Hypothalamus
A
Grey matter and wall between third ventricle and the hypophysis. Produces thyroid hormones, sex hormones, lactation and cortisol. Important for inner environment of the body. Control of circulation and temperatur. Basal function for survival - thirst, hunger, sleep
3
Q
Pineal gland
A
An endocrine gland. Controls our awakeness/sleeping hormone. Contains melatonin
4
Q
Cerebral dominance
A
Left side (95%). All right handed and most of the left handed have a left hemisphere that is dominating.
5
Q
Cerebrum
A
Contains Cerebral cortex, basal ganglia, limbic system, diencephalon, white matter.
6
Q
Thalamus syndrome
A
The patient gets headache, hemianesthesia and sensory ataxia and develops a stroke
7
Q
Four different lobes (cerebral hemispheres)
A
Frontal lobe, Parietal lobe, occipital lobe, and temporal lobe
8
Q
Prefrontal cortex
A
- Located in the frontal lobe
- Involved in our personality, insight, foresight
- Association cortex: In many of these areas diffuse functions are found, ex abstract thinking
Phineas Gages accident, stick up through frontal lobe
9
Q
Premotor cortex
A
- Located in the frontal lobe
- The planning of movements. Infront of primary motor cortex, can also be called supplementary motor cortex (SMA)
10
Q
Primary motor cortex
A
- Located in the frontal lobe
- Origin of descending motor pathways, corticospinal tract
- Controls all of our voluntary movements
Humonculus: Distribution of primary cortex
Injuries to motor cortex may cause paresis, tumor or stroke.
Twitching means there is a problem in this area.
11
Q
Broca’s Area
A
Involved in the ability to produce and make words
Diseases: Afasia (=inability to speak), motoric aphasia (=the patient knows what to say, but can’t produce words) Always located on the left side.
12
Q
Areas of and injuries in frontal lobe
A
Areas: Prefrontal cortex, premotor cortex, primary cortex and the Broca’s area
- No internal brake, actions without responsibilities, manic, egocentrism
- Decrease in energy, no initiative, unable to care
- Affected in consciousness, affected memory, disorientation, confabulation
13
Q
Temporal lobe
A
Language, learning, Memory, auditory cortex, part of limbic system
Diseases: Herpes encephilatis, Temporal messiah sclerosis (may give epilepsy), temporal lobe resection
-Sensoric afasia = speech can be fluent with little or no meaning, the patient do not understand speech or text.
14
Q
Parietal lobe
A
Spatial orientation and perception
Primary sensory cortex and Wernicke area
Syndromes:
- Neglect on the right side (You don’t know what is up or down)
- Gerstmann Syndrome = Right and left confusion (Not aware of your fingers (?)
- Appraxia = Looses the ability to do everyday stuff, for example tie a showcase or lock the door
15
Q
Primary sensory cortex
A
Information about sensory perception
Located in the parietal lobe
16
Q
Wernicke area
A
Partly in the parietal lobe
17
Q
Occipital lobe
A
Visual cortex
Syndromes:
- Cortical blindness = Can come out of stroke or trauma
- Anton-Babinski syndrome = Visual neglect
Visual pathway is crossed = Left eye is presented on the right occipital lobe, etc.
18
Q
Tracts
A
Exists in the white matter of the cerebrum
- Projection tracts: between levels in the CNS
- Commisure tracts: between the hemispheres
- Association tracts: Tracts within a hemisphere
19
Q
Basal ganglia - Motor control
A
It is the grey matter deep within each hemisphere. They are involved in motor control and movements. –> Extrapyramid system
BG is needed to make movements smooth
20
Q
Diseases in Basal Ganglia
A
- Parkinsons: The BG need dopamin not to shake and not to be stiff/rigid. The patient can’t relax.
- Huntingstons chorea: Unwanted movements, often in pairs
- Hemiballismus: Arm/leg on one side is uncontrolled, involuntary movements
21
Q
Limbic system
A
Emotions and memory, numerous connections
- Bilateral lesion of Hippocampus –> inability to form new memories
- Bilateral lesion of amygdala –> Hypersexuality, fearless and hyperorality
- Kluver-Bucy syndrome
22
Q
Brainstem
A
A large number of axons to and from the brain pass through the brainstem. Ascending/Descending pathways.
Lots of cranial nerves connect here.
Including medulla oblongata, pons and the midbrain
It is the center for consciousness, control of breathing and heart rate, and pattern generators for swallowing and sneezing
23
Q
Cerebellum
A
Two hemispheres with white and grey matter. The grey matter is deeper than the white matter.
Functions:
- Involved in eye-coordination, trunk and head movements using signals from the ear (balance organ)
- Helps to maintain posture and balance
- Takes part in fine motor movements of the arms and hands and trained fast and complicated movements.
Diseases:
- Intention tremor: Still at rest but start to shake when trying to do fine and precise movements
- Dysmetri
- Ataxic gait
24
Q
PNS
A
Connects the CNS to the limbs and organs
25
Spinal nerves
Mixed, both motoric and sensoric
Motoric: efferent (output)
Sensoric: afferent (input)
26
Afferent signals
(Sensoric, input)
1. Reflex
2. Continue upwards in the dorsal column, cross midline, via the thalamus reaching the cerebral cortex - vibration and proprioception (muscles tendon)
3. Spinothalamic tract, cross midline, via thalamus to cerebral cortex - pain and temperature
27
Efferent signals
(Motoric, output)
1. Pyramidal tract - from cerebral cortex via medulla spinal is to muscles. Cross midline in the brainstem.
2. Non-voluntary autonomic signals to organs
28
Cranial nerves
Close link between the olfactory system and the limbic system with emotions. Ex. you smell soothing and you get a feeling of love.
29
ANS - Autonomic nervous system
- Not controlled by free will (ex. heart rate, blood pressure, glands)
- Controlled by the hypothalamus (and a little bit by the brainstem)
- Can be found in the CNS and PNS
- Divided into two parts (sympathetic - fight or flight, parasympathetic - energy saving mode and recharging)
30
ENS - Enteric nervous system
- Located at the wall of the intestines. Controls motility and secretory functions.
- Contains many neurotransmitters, which means side effects from medicines may occur here (ex. stomach ache or nausea)
31
Sensory organs
How does the PNS get all the information? Different receptors in the sensory organs detects stimuli.
Sensation: Conscious or subconscious awareness of external or internal conditions of the body
1. Stimulus (ray of light)
2. Sensory receptor (eye)
3. Conduction along a neural pathway (axion potential)
4. Integration in the brain
Perception: Conscious sensation. How do you perceive sensations is very individual. Strong psychological aspect
Adaptaion: Affects both sensations and perceptions. Decrease in the strength of a sensation during a prolonged stimulus (when you get into a hot bath, it feels really warm at first, but you adapt after a short while. There is no adaptation if the sensation is potentially harmful.
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Somatosensory (general senses)
- Tactile
- Thermal
- Pain
- Proprioception
- Visceral
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Sensory receptors
- Mechanoreceptors: Mechanical pressure, vibration, proprioception
- Thermoreceptors: Changes in temperature, different receptors for different temperatures
- Nociceptors: Painreceptors, respond to physical or chemical damage to tissue. Very little adaptation. There is both fast and slow pain.
- Photoreceptors: Detect light that meets the retina of the eye
- Chemoreceptors: Detect chemicals in the mouth (taste), nose (smell), and body fluids
- Osmoreceptors: Sense osmotic pressure in body fluids
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Type of sensory receptors
- Free nerve endings: Pain, touch pressure
- Meissner corpuscle: Light touch, small receptive fields
- Merkel disc: Touch and pressure, small receptive fields
- Ruffini end organs: touch, heavy pressure, large receptive fields
- Pacinian corpuscles: Vibration
- Hair end organ: touch
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Pain
- Tissue damage
- Tissue ischemia (acidosis, laktate)
- Thermal pain
- Spasm of muscle, artery or "hollow viscus"
- Inflammation
- Neurogenic pain
Syndromes:
- Hyperalgesia: increased sensitivity
- CRPS: complex signal regional pain syndrome (neurogenic pain)
36
Referred pain
Pain in the left arm when having a heart attack due to nerves from the left arm and heart enter the brain at the same place
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Gate control
Stimulation of large fibers (touch) prevents pain impulses. Blow on your pain stops the pain signals from reaching the brain
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Proprioceptive sensations
Knowledge of position, both static and dynamic that depend on knowing the degrees of angulation in all joints. Both conscious and subconscious
1. Static position sense: Conscious perception of the orientation of the different parts of the body with respect to one another
2. Dynamic proprioception: Rate of movement sense
Almost no adaptation
39
Special senses
Olfaction = Sense of smell
Gustation = Sense of taste (sweet, sour, bitter, salty, umami)
Vision
Hearing and equilibrium
40
Benign prostatic hyperplasia
Symptoms:
- Urinary tract infections, stone formation
- Increased frequency
- Stranguria
- Urinary retention
- Incomplete emptying of the bladder
Diagnostics:
- History
- Medical examination
- Micturition diary (write down when he peed, for how long, and how much)
- Flow measurements
- Ultrasonic measurement of the prostate
- Cytoscopy
- Pressure/flow studies
Treatments:
- Inhibitors (a-adrenoreceptor or 5a-reductase inhibitors)
- Sometimes open surgery, but only when the prostate is too large
- TURP: cut away prosthetic tissue piece by piece by electric current. Faster healing time, but dangerous for large prostates
41
Erectile dysfunctions
Problems with the heart or vessels may cause erectile dysfunction (ED). Heart syndromes might develop 5-6 years later than ED.
Treatments:
- The spider acid metabolism (injection)
- Injectons are far more effective, Caverject is the most effective. Hardly feel it.
- Viagra is the most common (tablets work for 60% of the patients)
42
Kidney stone disease
Common disorder, but not sure what causes it. It may be by metabolic disturbance or over production of parathyroid hormone.
Symptoms:
- Extremely painful, by the hip
- Nausea and vomiting
- Hematuria
Diagnostics:
- History
- Urin-analysis
- Intravenous urography, CT
- Uteroscopy
Treatment:
- None (pee the stones out when stones are < 3 mm)
- Shockwave therapy (ESWL)
- Chemical castration (rarely used)
- Open surgical removal (rarely used)
- Ureteroscopy with fragmentation of the stone --> small fragments of the stone can be peed out
- Percutaneous stone extraction - patient can leave the hospital the same day
43
Prostate cancer
Most common form of cancer amongst men in Sweden
Symptoms:
- Voiding dysfunction
- Urinary retention
- Pain
- Anemia (bone marrow is occupied by cancer tumors)
Diagnostics:
- Serum-PSA < 3 (200-300, the cancer has spread)
- Digital rectal exam
- Transrectal ultrasound with biopsy
Treatment:
- Take away entire prostate: radical prostatectomy. Preferable, but leads to inability to reproduce.
- External beam radiation
- Inner radiation therapy
44
Treatment of incurable prostate cancer
- Surgical castration
- Chemical castration (every 3-6 months) GnRH --> no testosterone is produced
- Other kinds of hormonal manipulation
- No treatment at all (Gustav)
- Important to individualise the treatment
- Castration may leed to severe side effects
45
Kidney cancer
- Diagnosed by chance often
- Treatment: remove the whole part of the kidney
- Can often be spread all over the body - incurable
46
Testis cancer
- Affects young men (18-25)
- High survival rate these days. (95 %)
- Sometimes remove the entire testicle
- Radiotherapy
47
Bladder disorders
- Overactive
- Cancer - common
- Bladder stone
- Incontinence
- Inflammatory conditions
Treatments:
- Pharmacological treatment - overactive bladder
- Electrical stimulation
- Surgical extirpation or reconstruction
48
Urethral stricture disease
- Common for men
- Internal urethrotomy (cut it open), 50 % stay open, the rest will have to do it again
- Perineal urethrostomy, will leed to the patient having to pee as a girl
49
Overactive bladder treatment
- Behavioural therapy
- Adjusted fluid intake
- Pharmacological treatment
- Injection in the bladder with botox
- Surgical reconstruction
50
Hematuria
=blood in the urine
- May be caused by cancer of the upper or lower urinary tract
- Microhematuria cannot be seen (only microscopically)
- Frank hematuria (macrohematuria) is visible by the human eye
- Frank hematuria necessitates prompt and full investigation with cytoscopy and contrast enhanced computed tomography of the kidneys (IMPORTANT)
- Microhematuria does not warrant investigation
51
Diagnosing pathology in the nervous system
- Medical history
- Neurological examination: strength, reflexes, sensory deficits with the help of reflex hammer, flashlight, needles and measure strength in arm
- Imaging
52
Which index measures different stages of brain damage?
RLS
| RLS 1 means fully awake, and RLS 8 is dead.
53
Subdural hematoma
The white matter is bleeding (under the dura)
54
Epidural hematoma
Bleeding outside of the dura
55
Primary brain trauma
There is a bleeding inside the brain. The patient is bad off.
56
Secondary brain trauma
Bleeding outside the brain. If quickly fixed, the patient can survive.
57
What to do when there is a brain trauma?
- Stabilise vital parameters (breathing, circulation, etc.)
- Clinical evaluation
- Suspected damage to the brain
- Further diagnostics are necessary
58
DAI = Diffuse axonal injury
Axons get ripped appart (primary brain damage) which is very common in a high velocity injury. Cannot be fixed.
59
Brain tumors
- Primary: Starts in the brain and are very hard to reach --> lethal
- Secondary: metastasis (comes from breast/kidney/lung cancers)
- Malignant tumors spread
- Benign tumors don't spread, can be removed and the patient survives.
Symptoms:
- Headache (worse in the morning, does not get better)
- Epilepsy
- Focal neurological deficits (paresis of the left arm for example)
60
Stroke
Bleeding or infarction (lack of oxygen)
- Infarction: Dark side of the brain
- Bleeding: White area of the brain
61
Aneurism
= blob on an artery
- Clipping: open scull and put a clip on it. No further treatment is needed
- Coiling: hard to reach, endovascular. Go in at the groin and leave platinum coils. Need to be redone.
62
DBS = Deep brain stimulation
Stereotactic apparatus. Can place an electrode with high precision. May help out patients with Parkinson's, but not permanently. Need to implant a battery.
63
Three major regions of the skin
Epidermis: outermost superficial region - squamos
Dermis: connective tissue, vessels, middle region
Hypodermis: (subcutaneous fat) - deepest region
64
Functions of the skin (integumentary system)
- Protection: chemical, physical and mechanical barrier
- Body temperature regulation: Dialation (cooling) and sweat glands to loose heat
- Cutaneous sensation: exoreceptors sense touch and pain
- Metabolic functions: synthesis of vitamin D in dermal blood vessels
- Blood reservoir: skin blood vessels store up to 5 % of the body's entire blood volume
- Excretion: limited amounts of nitrogenous wastes are eliminated from the body in sweat. (Not as important as the kidney)
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Epidermis
- Keratinized squamous epithelium
- Consists of four distinct cell types: keratinocytes, melanocytes, Merkel cells, and Langerhans' cells.
- Langerhans' cell: epidermal macrophages that help activate the immune system
- Merkel cells: function as touch receptors in associations with sensory nerve endings
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Dermis
- Second major skin containing strong, flexible connective tissue
- Cell types include fibroblasts, macrophages, and occasionally mast cells and white blood cells
- Composed of two layers, papillary and reticular layer
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Hypodermis
- Subcutaneous layer of the skin
| - Composed of adipose and areolar connective tissue
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Skin color
Three pigments contribute to skin color:
- Melanin: yellow-reddish brown to black pigment, responsible for dark skin colors
- Carotene: yellow to orange pigment, most obvious in the palms and soles of the feet
- Hemoglobin: reddish pigment responsible for the pinkish hue of the skin
69
Sweat Glands
Different types prevent overheating of the body, secrete cerumen and milk
- Eccrine sweat glands: found in palms, soles of the feet and forehead
- Apocrine sweat glands: found in axillary and anogenital areas
- Ceruminous glands: modified apocrine glands in external ear canal that secrete cerumen
70
Sebaceous glands
- Alveolar glands found all over the body
- Softens skin when stimulated by hormones
- Secrete an oily secretion called sebum
71
Hair
- Dead keratinised cells produced by hair follicles
- Consists of a core called medulla, a cortex and outermost cuticle
- Pigmented by the melanocytes at the base of the hair.
Functions:
- Helping maintain warmth
- Alerting the body to the insects of the skin
- Guarding scalp against physical trauma, heat loss and sunlight
- There are knots of sensory nerve endings located at hair roots.
72
Skin cancer
- Basal cell carcinoma
- Squamos cell carcinoma
- Melanoma
73
Burns
- First degree: Only epidermis is damaged, ex. sunburn
- Second degree: epidermis and upper regions of dermis is damaged. Similar symptoms to first degree burn, but blisters may appear
- Third degree: entire thickness of the skin is damaged. Burned areas appear white-gray, cherry red or black. There is no initial edema or pain since the nerve endings are destroyed
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Epididymis
(Bitestikel) sperms mature and will be stored
75
Scrotum
(pung) temperature is 2 degrees lower, due to sperm production. Contains two testis
76
Three bodies of the penis
2 corpus cavernous and 1 corpus spongiosum
77
Spermatogenis
Actual production of the sperm
78
Blood testis barrier
Risk that the male's own immune system attacks the sperm, therefore there is a need of a barrier.
Created by seritoli cells
79
Leydig cells
Interstitial cells which produces testosterone
80
Bone function
- Support
- Protection
- Assist in movements
- Mineral homeostasis, ex. calcium
- Blood cell production (in red bone marrow)
81
Epiphysis
Located at both ends. Where the bone grows, can roughly decide a person's age.
82
Periosteum
Where the sensory receptors are. Where the muscles will attach to the bone. Covers compact bone
83
Types of cells in bone
- Osteogenic cell develops into an osteoblast
- Osteoblast forms bone extracellular matrix
- Osteocyte maintains bone tissue
- Osteoclast functions in resorption, the breakdown of bone matrix
84
Compact bone
- Canaliculi ("little canals") which carry blood and lymph
| - No specific sensory receptors in the bone, can operate with local anaesthesia
85
Spongy bone
- Not arranged in osteons
- Spaces between trabecular may contain red bone marrow. Some RBM may be replaced by fat --> yellow bone.
- Lighter than compact bone --> reduces weight of skeleton
86
Growth of bone
- Initial bone development in embryo and fetes. All bones are laid out by cartilage (formed in the womb)
- Growth of bone into adulthood, beginning at 6 weeks and can end at 18 years
- Remodelling: replacement of old bone
- Repair if fracture occur. Core of the bone is calcified. Radiologists only see calcified parts.
87
Growth in length
- Chondrocytes divide and grow more cartilage on epiphyseal side of the epiphyseal plate
- Chondrocytes on the diaphysial side die and are replaced by bone, which means bone grows from the diaphysial side towards the epiphyseal side
- Growth in length stops between 18-25 years, which means the cartilage in epiphyseal plate is completely replaced by bone
88
Functions of vertebrae
- Encloses spinal cord
- Supports head
- Point of attachment for muscles of back, ribs and pelvic girdle
89
Thorax
Ribs on children are not mineralised - still made up of cartilage and are very hard to break. The older you get, the less cartilage your ribcage is made up of
90
Fractures
- Partial: incomplete break (crack)
- Complete: bone broken into two or more pieces
- Closed (simple): not through skin
- Open (compound): broken ends break skin, high bacterial risk
91
Green stick fracture
Small crack inside the bone which is not visible with the naked eye. There is bleeding into the tissue and the bone.
92
Repair after a fracture
- Dead tissue removed
| - Chondroblasts --> fibrocartilage --> spongy bone deposited by osteoblasts --> remodelled to compact bone
93
Surgical repair
= osteosynthesis
| Insertment of plates, screws, nails and/or ex-fix
94
Conservative repair
- Standardized way to fix bones in children
- Reduction of bone ends
- Immobilization in a plaster cast including joints above and below the fracture
- Time to heal!
Cons: Immobilization means the bone + 2 joints needs to be fixed for roughly 6-8 weeks
95
Renal artery
Gives blood to the kidney. There is about 1 L of the blood that goes through here
96
Nephron
Working unit in the kidney
97
Primary urin
About 200 L.
| 99% is reabsorbed --> 2 L urin is being expelled each day
98
What does the kidney do?
- Regulation of blood ionic composition: Need to be levelled, slight change may cause death
- Regulation of blood volume and blood pressure: High blood volume --> higher pressure
- Regulation of blood pH: Bring back blood pH to normal levels, slight change leads to death
- Regulation of blood cell production: EPO (=erythropetin) affects the red bone marrow and produces more red blood cells. Can be used for doping
- Vitamin D synthesis: Starts in the kidney and is finalised in the skin by the sun
- Excretion of wastes and foreign substances
99
Glomerulobephritis
Causes:
- Allergic reaction to bacterial toxins
- Autoimmune conditions (body attacks itself)
Symptoms:
- Hematuria: Blood in the urin
- Proteinuria: protein (äggvita) leaves the kidney because the holes are too big
100
Acute renal failure
- Suppression of urine flow
- Low blood volume
- Decreased cardiac output
- Damage to the renal tubules
- Dye reactions
- Drugs
101
Chronic renal failure
- Glomerulonephritis
- Pyelonephritis = urinvägsinfektion, can be deadly if it reaches the kidneys
- Polycystic kidney disease: born with it
- Traumatic loss of kidney tissue (due to accidents)
- Long standing obstruction of the urine flow
102
Dialysis
- Hemodialysis: need to be done at hospital or similar. Need to change the whole blood and go 2-3 times a week. Most common
- CAPD (Continous ambulatory peritoneal dialysis: Can do the dialysis at home
103
Na+ (sodium)
Extracellular ion
104
K+ (potassium)
Intracellular ion. If it comes out of the cell, it will kill you (cardiac arrest)
105
Three principal buffer systems
1. Protein buffer system
2. The carbonic acid - bicarbonate buffer system
3. The phosphate buffer system
106
Protein buffer system
- Composed of amino acids and contain at least one carboxyl group (-COOH)
- Carboxyl group releases one H+ when pH rises
- Proteins can buffer both acids and bases
- Main proteins are hemoglobin in red blood cells, and albumin in plasma
107
The carbonic acid - bicarbonate buffer system
- When pH falls: H+ + HCO3- --> H2CO3
| - When pH rises: H2CO3 --> H+ + HCO3-
108
The phosphate buffer system
- When buffering a strong base: H2PO4- + OH- --> HPO42- + H20
- When buffering a strong acid: H2PO42- + H+ --> H2PO4-
109
Acidosis
pH at about 7.35
- Respiratory acidosis: ex strangulation
- Metabolic acidosis: diabetic ketoacidosis
Metabolic and respiratory compensation
110
Alkalosis
pH above 7.45
- Respiratory alkalosis: ex. hyperventilation
- Metabolic alkalosis: increased bicarbonate in serum. May be caused by vomiting
Metabolic and respiratory compensation
111
Prostate
- Located immodestly below the urinary bladder
- Surrounds the urethra
- Produce semen but not sperm cell
- PSA: prostate specific antigen
112
What is a hormone?
- Common protein hormone: Insulin
- Lack of some hormones --> psychological issues
- Enters the bloodstream from a gland and approaches its target organ
- An advanced feedback system
113
Testosterone
- Derived from a steroid similar to cholesterol
- Regulated by positive and negative feedback
- Include muscular growth (anabola steroider)
- Responsible for starting to produce sperms, Adam's apple, muscles, beard, etc.
- Midbrain --> pituitary gland --> testicles --> testosterone is produced by Leydig cells
- Target organs: fatty tissue have high levels of testosterone, skeleton have high levels of testosterone, belly fat have high levels of testosterone
114
Genotype/Phenotype
Genotype: XY
Phenotype: What you see on the outside of the body
115
Air conduction hearing
hearing via vibrations in outer, middle, and inner ear
116
Bone conduction hearing
hearing via vibrations of the skull from own voice and surrounding sound or vibrating transducer
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Type of hearing losses
- Conductive loss: outer and middle ear
- Sensorineural loss: inner ear and auditory nerve
- Mixed loss: mixed loss of connective loss and sensorineural loss
118
Bone anchored hearing aid (BAHA)
- Direct bone conduction
- Skin penetration
- Bypass outer and middle ear
- Complications associated with skin penetration
