MD2002 Week 4 Flashcards
(110 cards)
1
Q
paraesthesia
A
pins and needles sensation
2
Q
which neurones detect non-discriminating touch?
A
A-delta and C fibres detect this type of touch
3
Q
3 modalities of pain
A
- mechanical
- chemical
- thermal
4
Q
what NT is released from nociceptors when stimulated in fast succession and increases sensitivity
A
substance P
5
Q
how does ventral spinocerebellar tract enter cerebellum?
A
this neuronal tract ascends contra laterally and entered cerebellum via superior peduncle
6
Q
how does dorsal spinocerebellar tract enter cerebellum?
A
this neuronal tract ascends ipsiaterally and entered cerebellum via inferior peduncle
7
Q
Friedreich’s ataxia
A
inherited disease affecting spinocerebellar tract caused by multiple repeats of a gene for protein Frataxin which is responsible for iron metabolism in mitochondria
8
Q
symptoms of Friedreich’s ataxia
A
- uncoordinated arms/legs
- wide based gait
- intention tremor
9
Q
define receptors
A
specialized, localized proteins that recognize stimulants and translates result to cell
10
Q
Law of Mass Action
A
“rate of a chem rxn is proportional to product of concentration of reactants”
11
Q
define equilibrium dissociation constant
A
concentrating of drug required to occupy 50% of receptors at equilibrium (Kd)
12
Q
equation for fractional occupancy
A
[drug]/([drug] + Kd)
13
Q
equation for affinity
A
pD2 = -log10(Kd)
14
Q
equation for occupancy theory
A
response = occupied receptors/total receptors
15
Q
spare receptors
A
free receptors after maximum response has already been reached
16
Q
equation for ratio by which [D] must be increased to overcome competition by [A]
A
r = [A]/Ka + 1
17
Q
define efficacy
A
ability of drug to generate a stimulus once bound to receptor
18
Q
termination of musculocutaneous nerve
A
this nerve terminates as the lateral cutaneous nerve of forearm
19
Q
contents of cubital fossa from medial to lateral
A
medial to lateral:
- median nerve
- brachial artery
- biceps tendon
- radial nerve
20
Q
spinal segments of superior gluteal nerve
A
nerve stems from L4-S1
21
Q
spinal segments of inferior gluteal nerve and superficial fibular
A
these nerves stem from L5-S2
22
Q
branches and innervations of superior gluteal nerve
A
superior branch (glut med) and inferior branch (glut min, tensor fasciae latae)
23
Q
injury to which nerve causes trendelenburg gait
A
injury to sup gluteal nerve causes this condition
24
Q
how does sciatic nerve enter the gluteal region?
A
this nerve enters gluteal region below piriformis along with glut max
25
condition caused by damage to common peroneal nerve
foot drop caused by damage to this nerve
26
nerve innervating skin on ant distal leg and dorsal foot
superficial peroneal innervates skin here
27
nerve innervating skin b/w toes 1-2
deep peroneal innervates skin here
28
spinal segments of deep peroneal nerve
nerve stems from L4-L5
29
cutaneous nerves that branch from femoral nerve
- saphenous nerve
| - lateral femoral cutaneous nerve (lateral cutaneous nerve of thigh)
30
meralgia paraesthetica
disorder caused by damage to lateral cutaneous nerve of thigh (lateral femoral cutaneous nerve)
31
cutaneous branches of radial nerve (4)
1. posterior cut. of arm
2. inferior lateral cut. of arm
3. posterior cut. of forearm
4. sup/deep branch of radius
32
difference b/w fibre and tract
the latter is large number of axons travelling in parallel within CNS instead of a few
33
define system (neurology)
a group of nerve tracts serving a similar function
34
2 major classes of motor neurone pathway
1. lateral (corticospinal) pathway
| 2. ventromedial (corticobulbar) pathway
35
4 ventromedial pathways and their roles
1. vestibulospinal - balance
2. reticulospinal - muscle tone, head orientation, breathing
3. rubrospinal - cerebellar influenced UL movement
4. tectospinal pathways - head movements to follow sight
36
what are the lateral and ventromedial motor neurone pathways controlled by?
former motor neurone pathway is controlled by motor cortex, latter by brainstem
37
sensory inputs used in controlling posture (3)
1. muscle proprioceptors
2. sense of balance derived from movements of head (vestibular apparatus)
3. visual inputs
38
4 sections of the brainstem
1. midbrain
2. pons
3. medulla
4. spinal cord
39
where is the superior colliculus found (tectum)?
this structure is found in the midbrain
40
roles of lateral vestibulospinal pathway
this pathway increases tone to antigravity muscles by exciting extensor and inhibit flexor MNs (A-alpha), and activate A-gamma
41
role of medial vestibulospinal pathway
this pathway controls head and eye movement in response to a moving target
42
characteristics of voluntary movement (4)
1. purposeful (non automatic)
2. conscious
3. goal directed
4. often learned
43
how does the anterior corticospinal tract descend?
this neural tract descends ipsilaterally, ends at L2, and decussates at each segment, innervating bilaterally
44
do corticospinal lesions affect upper or lower motor neurones?
lesions in this tract affect upper motor neurones
45
does a positive Babinski sign indicate upper or lower motor neurone lesion?
this foot response indicates upper motor neurone damage
46
name the superficial flexors from lateral to medial (5)
1. pronator teres
2. flexor carpi radialis
3. flexor digitorum superficialis
3. palmaris longus
4. flexor carpi ulnaris
47
insertion of flexor carpi ulnaris
this muscle inserts into pisiform, hook of hamate, and 5th MC
48
which flexor tendon enters wrist above carpal tunnel?
palmaris longus tendon enters wrist here
49
deep flexors of arm (3)
1. flexor digitorum profundus
2. flexor pollicis longus
3. pronator quadratus
50
palmar branch of median nerve
cutaneous nerve supplying medial palm lying above carpal tunnel
51
pathogenesis of thrombosis
1. endothelial injury and vasoconstriction
2. primary hemostasis: platelet adhesion and granule release
3. secondary hemostasis: thrombin activation and fibrin aggregation
4. thrombus: trapping neutrophils, RBCs
52
granules released by platelets in thrombosis (3)
1. ADP
2. thromboxane A2 (TXA2)
3. platelet factor 4 (Pf4)
53
what do platelets adhere to upon endothelial injury?
von Willebrand factor (vWF)
54
2 types of abnormal blood flow and types of thrombi they cause
1. turbulence (causing arterial/cardiac thrombus)
| 2. stasis (causing venous thrombus)
55
term for venous thrombosis
phlebothrombosis
56
common sites of arterial thrombi (3)
common sites of this type of thrombus: coronary, cerebral, femoral
57
pale bands of fibrin + platelets in thrombi
lines of Zahn
58
thrombophlebitis
phlebothrombosis with inflammation
59
4 Ps of arterial thrombosis
1. perishing cold
2. pale
3. painful
4. paraesthesia
60
define embolus
a detached intravascular mass that is carried by blood to a site different from origin
61
haemoptysis
term for coughing up blood
62
80-85% of systemic emboli arise from where?
80-85% of this type of embolism arise from the heart
63
most common site where emboli lodge
emboli lodge most commonly in the lower extremities
64
symptoms of fat embolism
symptoms of this type of embolism include tachypnoea (high BR), dyspnoea (difficult breathing), and tachycardia
65
define infarction
an area of ischaemic necrosis caused by occlusion of vessel
66
factors influencing infarct development (4)
1. nature of vascular supply of organ
2. rate of development of occlusion
3. vulnerability of cell to hypoxia
4. oxygen content of blood
67
3 types of infarcts
1. red (hemorrhagic)
2. white (anaemic)
3. septic or bland
68
family and genus of HIV
family: retroviridae
genus: lentivirus
69
surface protein on HIV
gp120
70
retrovirus
viruses that replicate by reverse transcriptase to make DNA from viral RNA
71
3 treatments of HIV
1. nucleoside reverse transcriptase inhibitor (NRTIs)
2. non-nucleoside reverse transcriptase inhibitor (NNRTIs)
3. protease inhibitors (PIs)
72
family of HBV
hepadnavirus
73
what does presence of HbsAg indicate?
this HBV antigen indicates infectivity
74
what does presence of HbeAg indicate?
this HBV antigen indicates high transmissibility
75
incubation period of HBV
incubation of this virus is up to 6 months
76
2 characteristics of chronic active HBV
1. cirrhosis
| 2. hepatocellular carcinoma
77
treatment of HBV
pegylated interferon
78
blood borne pathogen with a vaccine
HBV has a vaccine
79
family of HCV
flavivirus
80
genus causing Malaria
plasmodium
81
what inject Malaria-carrying sporozoa into the bloodstream
female anopheles mosquitos inject this
82
nerves supplying skin of medial, posterior, and lateral leg respectively
saphenous, sural, and lat cutaneous (common fibular) supply these respectively
83
nerves supplying skin of medial sole and 3.5 digits
medial plantar nerve (from tibia) innervates skin here
84
what skin does median nerve innervate?
this nerve innervates skin of lateral palm and 3.5 digits
85
autonomous sensory testing area of deep fibular nerve
autonomous sensory testing area of this nerve is b/w dorsum of 1-2 digits
86
what muscles do the deep and superficial branch of radial nerve pass into respectively?
these branches of radial nerve pass into supinator or to brachioradialis respectively
87
inability to make "OK" sign indicates injury to what nerve?
injury to ant. interosseous nerve prevents patient to do this hand sign
88
what nerve is mostly likely to be injured at the elbow (med epicondyle)?
ulnar nerve is most likely to be injured here
89
positive Froment's sign
test showing ulnar nerve damage as patient uses FPL instead of adductor pollicis to clasp paper
90
ulnar claw
clinical sign showing MCP extension and interphalangeal flexion of ulnar 2 digits
91
ulnar paradox
fact that ulnar claw is less pronounced if injury is at elbow as flexion by FDP is lost
92
sensory supply of each compartment of the leg
anterior: deep fibular
lateral: superficial fibular
posterior: tibial
93
arterial supply of each compartment of the leg
anterior: anterior tibial
lateral: fibular
posterior: posterior tibial
94
what muscles does the medial plantar nerve innervate? (4)
this nerve innervates:
1. abductor hallucis (1st layer)
2. flexor digitorum brevis (1st layer)
3. lumbrical to digit 2 (2nd layer)
4. flexor hallucis brevis (3rd layer)
95
where do sympathetic trunks on either side fuse together?
they fuse at the ganglion impair opposite coccyx
96
Stellate ganglion
fusion of inferior cervical ganglion to T1 ganglion, lying on neck of 1st rib
97
sympathetic effect on liver
this ANS causes glycogenolysis and gluconeogenesis in the liver
98
sympathetic effect on bladder
this ANS relaxes detrusor muscles and contract internal sphincter muscles
99
4 types of receptors
1. ligand-gated ion channels
2. G-protein
3. kinase-linked
4. nuclear receptors
100
what happens when G-protein binds to receptor?
GDP is replaced by GTP when this happens to G-protein
101
how does alpha subunit of G-protein dissociate from effector?
GTP is hydrolyses to GDP during this part of G-protein action
102
rotatory nystagmus
when, while turning, eyes track an object and then flick rapidly in direction of rotation to fix on another object
103
what does Gt protein do?
this G protein transduces visual signals with rhodopsin in the retina
104
What does Gs protein do?
this G protein activates adenylate cyclase, making cAMP
105
how does PKA activate transcription of genes?
this enzyme phosphorylates cAMP response element binding protein (CREB), which binds to the promoter CRE and activates transcription
106
what does PLC do?
this enzyme liberates phosphatidylinositol 4,5-bisphosphate (PIP2) into inositol 1,4,5 triphosphate (IP3) and diacylglyceral (DAG)
107
3 types of PKC
1. conventional
2. novel
3. atypical
108
estimated blood loss caused by fractures in
1. humerus
2. tibia
3. femur
4. pelvis
estimated blood loss from bone fractures
1. 0.5 - 1.5L
2. 0.5. - 1.5L
3. 1 - 2.5L
4. 1 - 4L
109
borders of anatomical snuff box (lat to medial)
abductor pollicis longus, extensor pollicis brevis, and extensor pollicis longus make this structure
110
therapeutic regimens for osteomyelitis
- standard empirical (flucloxacillin/fucidin)
| - alternate empirical
