Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

A/P > Lecture 10/4 - Refelxes pt 2 > Flashcards

Lecture 10/4 - Refelxes pt 2 Flashcards

Test 2

1
Q

What happens to our fetal nAch-R as we grow?

A

They are swapped out for Adult nAch-R

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When there’s a problem with contracting skeletal muscle, what will our body do to fix that?

A

Add more nAch-R

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe these areas in the post synpase:
Junctional area
Perijunctional area
Postjunctional area

A

Junctional: Center, right under clefts

Perijunctional: on the side, side of clefts

Postjunctional: on the side of perijunctional

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where should nAch-R be?

A

NMJ - junctional area only.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where can fetal nAch-R appear in skeletal muscle?

A

NMJ in the junction, perijunctional, and postjunctional areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are ways to assess neuromusclar activity?

A

TOF
Single Twitch
PTC (Post-tetanic count)
DBS (Double burst stimulation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What muscle does the ulnar nerve activate?

A

Adductor Pollicis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Define the Supramaximal Stimuli

A

Voltage strong enough to fully recruit all motor neurons and fully activate the skeletal muscle cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What happens if you dont get a twitch at all?

A

Not enough voltage or something wrong at the NMJ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is TOF?

A

Train of Four

Repetitive stimulation at 2hz/2sec

Ex) 2 secs = 4 twitches
4 secs = 8 twicthes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Define tetanic

A

Contractions when stimulated at a high frequency repeatedly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is post-tetanic count?

A

Number of contracts after tetanic contraction

Helps determine health of the synapse

Increases PTC = light block
Decreases PTC = deep block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is DBS?

A

Double Burst Stimulation

2 short burst of 3 electrical stimuli at 50 Hz with brief pause in between

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the Hz with DBS?

A

50 Hz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What happens if you stimulate the ulnar nerve and get a really big contraction?

A

Block is not deep enough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What happens if stimulate the ulnar nerve and get no contraction?

A

Deep block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What happens while stimulating a nerve?

A

Electrons depolarize the outside which changes the polarity of the outer cell…

This indirectly depolarizes the inside of the cell causing an AP and muscle contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What fingers muscles are affected and what fingers move when the ulnar nerve is stimulated?

A

Adductor Pollicis

Thumb twitches forward
Pinky twitches
one or both will happen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What will happen if you are completely paralyed and the ulnar nerve is stimulated in TOF?

A

Nothing - no twitches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are some alt sights for nerve stimulation if you cant use ulnar nerve?

A

Ophthalmic branch of Facial Nerve (outer side of eye socket)
Peroneal nerve (butt)
Posterior tibial nerve (lower extremity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

T/F: Depolarizing blocks have a short half life

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Onset/Half life nondepolarizing block:

A

Few minutes

lasts extremely long

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Onset/Half life depolarizing block:

A

quick

short lasting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

In TOF responses: Which twitch is A? B?

A

1st twitch = A
Last = B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the TOF ratio?
B/A
26
What does a higher TOF ratio mean?
drug is wearing off
27
Which paralytic can you have a TOF ratio in?
Nondepolarizing Block
28
T/F: In TOF, all 4 twitches will be the same height and highest as before you give the drug
T
29
In TOF responses: which twitch is often the strongest?
1st A
30
In TOF responses: what does the 4 twitches being different heights mean?
Incomplete block
31
T/F: In TOF responses: The twitches all come back at the same rate as the drug wears off
F The twitches come back in different stages
32
What is the TOF ratio in depolarizing block? Why?
1 All the twitch as the same size because this is a complete block
33
Describe an Alpha-3 Beta-2 Receptor
nAch-R on motor nueron = autoreceptor 3 alpha subunits; 2 beta subunits
34
What does the Alpha-3 Beta-2-R do?
When activated by Ach, Na+ and Ca++ flows in. This moves VP1 vesicles towards to to synapse and VP2 vesicles to the membrane for exocytosis
35
What is Succs broken down by?
Plasma Cholinesterase
36
Nondepolarizing blockers inhibit ________of the synapse
both sides
37
Depolarizing blockers inhibits _________ of the synapse
more of the skeletal muscle side
38
What are the L-type Ca++ channel's role in the motor neuron?
Supplement the P-Type **Faster than P-type**
39
What type of drug can you give an alcoholic who has tremors?
CCB
40
If you give an _______ dose of CCB you will not paralyze them
High
41
What happens when you give Succs with fetal nAch-R present?
Prolonged depolarization in MULTIPLE areas Increased K leaving the cell. Vfib
42
What are the nerves called that connect to the diaphragm?
Phrenic nerves
43
Where do the phernic nerves originate and connect to the diaphragm?
C3, C4, C5
44
Where does Adductor Pollicis inhibition start?
20 micrograms/kg
45
Where does Adductor Pollicis have total inhibition?
40 micrograms/kg
46
T/F: If there are 4 strong twitches in the adductor pollicis, pt can probably breath on their own.
T PROBABLY
47
Where does Diaphragm inhibition start?
40 micrograms/kg
48
Where does Diaphragm have total inhibition?
90 micrograms/kg
49
In less important muscles: They are the ____ to be paralyzed and the _____ to recover.
1st Last
50
In more important muscles: They are the _____ to be paralyzed and the ______ to recover.
Last 1st
51
What type of neuromusclar blocker are you generally using TOF for?
Non depolarizing
52
In TOF: What happens when the 4th twitch disappears?
75-80% of nAch-R blocked
53
In TOF: What happens when the 3th twitch disappears?
85% of nAch-R blocked
54
In TOF: What happens when the 2th twitch disappears?
85-90% nAch-R blocked
55
In TOF: What happens when the All twitches disappears?
90-95% nAch-R blocked
56
If the patient is coming out of a block and can lift their head, what can we assume?
All 4 twitches are present Maybe able to breathe on their own
57
What are your stimulator settings (TOF Voltage)?
50-80 mA
58
Define voltage
Force/push stimulator applies
59
T/F: Your stimulator settings is equal to the supramaximal stimuli
T
60
What additional aspect is needed to cause contractions with fetal nAch-R when using Succs?
Bad motor deficits
61
Why does Succs cause an increase in IOP?
IOP = intraocular pressure Ocular muscle is controlled by mulitple motor neurons = multiple NMJ Ca++ coming in causes contractions which increases the pressure
62
What can happen with increased IOP?
Blindness
63
Describe GABA
inhibitory neurotransmitter in CNS increases Cl- conductance
64
What happens if you suppress GABA?
uncontrolled activity of CNS ---> seizures
65
Describe Gylcine
inhibitory neurotransmitter in CNS Similar to GABA **Very important in spinal cord**
66
What are the 2 main neurotransmitters in the CNS/spinal cord?
GABA Glycine
67
What neurotransmitters increase alertness and awareness?
Ach Histamine Glutamate NE
68
What is the neurotransmitter in the PNS?
Ach
69
Anticholinergics block ____ and cause _______
Ach Drowsiness
70
What type of drug is Benadryl? What can a large dose do?
Central histamine and central anticholinergic Increase heart rate d/t mAch-R in the heart
71
What happens if you inhibit Ach-ase?
Increase alertness/awareness
72
What types of drugs can we give to reverse a paralytic without waking the patient up?
Drugs that inhibit Ach-ase that DO NOT cross the BBB **NOT -STIGMINES**
73
What is the main neurotransmitter for pain?
Glutamate
74
What does too much glutamate cause?
Brain cell death
75
What drug Tx Parkinsons?
Dopamine
76
What is dopamine?
Potent motor inhibitor
77
What are 3 inhibitory neurotransmitters?
GABA, Dopamine, Glycine
78
What were NE reuptake inhibitors used for?
Chronic pain
79
What does severe acidosis do?
decrease CNS activity
80
What does severe alkalosis do?
increase CNS activity
81
How are Acid-Base imbalances related to Ca++?
Albumin is largely present in blood plasma & negatively charged -The less H+ ions = The more Ca++ the albumin will attract This means less free Ca++ in the blood stream = increased CNS activity (alkalosis) -The more H+ ion = less Ca++ the albumin will attract This means more free Ca++ in the blood = decreased CNS activity (acidosis)
82
Hypoventilate =
increase H+
83
Hyperventilate =
decrease H+

A/P (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions