NBEO non-big 8 Flashcards
(102 cards)
1
Q
Warburg Effect
A
When a cell use aerobic & anaerobic glycolysis simultaneously. Ex Lens
2
Q
Glycogenesis
A
Converting glucose to glycogen for storage. In muscle & liver. Glycogen can be stored under pressure w/out exploding
1. Happens in muscle & liver
2. store glucose as glyogen
3. end product: bound G6P -> glycogen
2
Q
Glycogenolysis
A
breakdown of glycogen. ex muscles & liver. G6P can either go into glycolysis to make glucose or to the Pentose phosphate shunt.
End products: Free G6P
3
Q
what is the role of the liver?
A
- maintain blood glucose
- if incr carb intake: does glycogenesis (store glucose & glycogen)
- lipolysis: store triglycerides
- if fasting or starved & no glucose: break down ketone bodies
4
Q
Gluconeogenesis
A
- happens in liver»_space;> kidneys
- critical facts: get glucose & ATP w/o glucose breakdown
-uses 6 ATP in process - End product: glucose
5
Q
Pentose phoshate Shunt
A
- happens in cell cytoplasm
- critical fact: detox cells from free 02. Done by cells that use FA & cholesterol
- End products: 12 NADPH/glucose, ribose-5-phosphate
6
Q
Glycogenolysis
A
- happens in Muscle & liver
- free G6P -> glycolysis or pentose phosphate shunt
- end product: free G6P
7
Q
what are the parts of a phospholipids?
A
3 carbon glycerol, 2 FA tails, and phoshpate head group.
- major component of lipid bilayer in cell membranes & myelin sheath (intraocular prelaminar ON is NOT myelinated)
8
Q
Tay-sachs Disease?
A
affects enxyne breaks down small lipids, presentation similiar to Cherry red macula
9
Q
what is a cholesterol?
A
made from Acetyl CoA: cytoplasm if liver cells
- precursor to steroids
-major component w/in LIPID MEMBRANE
10
Q
what is Eicosanoids?
A
short rage signal molecule
made from Arachondonic acid by PLA2
- prostaglandins - pro-inflammatory; @ uveoscleral membrane: incrs outflow
- Thromboxone: promote arterial constriction & plaletet aggregation
- Lipoxygenase: makes leukotrienese -> WBC -> allergic rxns
11
Q
Very low density lipoprotein VLDL:
A
delivers cholesterol to organs
12
Q
Low density liprotein/ LDL?
A
what VLDL becomes LDL after it is delivers cholesterol -> lousy
13
Q
HDL high denisty liproteins
A
returns excess cholesterol & lipids from organs to liver - GOOD
14
Q
what is normal total cholesterol?
A
< 200
15
Q
What is healthy level of LDL?
A
- Healthy or 2 or more risk factors for heart dz < 130
- if have cardiovascular dz or DM < 100
16
Q
What is healthy level for HDL?
A
> 40
17
Q
what is normal level for triglycerides?
A
< 150
18
Q
What is Xanthelasma?
A
cholesterol deposit with periorbital skin use to high cholesterol or aging
19
Q
what is resting potential of photoreceptor?
A
PR = -65mV charge is derived from Na+/K+ crossing membrane
20
Q
Resting state?
A
conductivity @ rest
- K+ conductivity is high
- Na+/K+ pump
this two determines resting potential
21
Q
What is conductivity?
A
measure of how easy ions can cross membrane exist if K+ had incrs conductivity = pass easily
22
Q
The training of Na+ is what causes the DARK current, this allows for _________.
A
Allows for Depolarization
23
Q
What are the Stages of neuro Action potential
A
- Na+ conductance increase (Na+ can cross membrane cells easily)
- In response to local depolarization - membrane potential incrs steeply = more Na+ channel open = snow ball effects
- Membrane potenial (Vm) = peaks @ 40 mV
- K+ conductance incrs = K+ exists cells = increase Na+ channel
- fall in Vm = hyper-polarization (more neg than resting state)
24
What are action potential cells?
Photoreceptor & horizontal
25
What are grades potential cells?
AP = IN the BAG,
26
what is MOA of Digoxin?
Digitalis have a NAK for getting digits
- inhibits Na+/K+ ATPase
27
what are synapse?
a physical meeting point btw cells
- facilitates communication btw cells
28
what is a chemical synapse?
Via Neurotransmitter
- limited by
1. Diffusion rate of NT
2. binding of NT to cell membrane = DAMAGED in MG
29
what is simplified cascade?
Action potential (hyperpolarized - more neg) to cell 1
- Ca2+ permeability incrs = Ca2+ enters
- NTs diffuse across across synaptic cleft
- NTs bind to cell 2
- Binding causes a post-synaptic potential (PSP) -> can be inhibitory or excitatory
- multiple PSP, have additive effect = total response to cell 2
- New Vm/ membrane potential is reached if = a > threshold then new AP is sent down line === DAMAGED in MS bc lose myelin sheath = lose charge
30
What is GABA?
most common inhibitory NTs
31
Glycine?
Inhibitory NT st brainstem, spinal cord, and retina
32
What is glutamate?
excitatory NT
33
Cholinergic receptor types (2)?
2 receptor types:
- nicotinic in skeletal muscles: block by curare, snake venom (alpha Borgarotoxin)
- muscarinic: smooth & cardiac muscle
34
Adrenergic receptors
epinephrine, serotonin - release at SAN post-SAN
- Neuro-muscular junction
- ACH at PSAN pre and post PSAN
35
what is an Electrical synapse?
Gap junction and much faster than chemical synapse
36
What are the two SNS/sympathetic controls?
SNS - sensory and motor (somatic and autonomic)
37
what is a Ganglia?
Ganglia - location collection of cell nerve bodies (soma) ex. Superior Cervical ganglion
38
what is a nerve?
bundle of axons
39
What is the sensory division>
Ganglia near the spinal cord (dorsal root ganglia)
- the brainstem (cranial nerve ganglia)
40
What is somatic motor?
Innervate skeletal muscles
reponsible for voluntary behavior
41
what is the autonomic motor division?
innervate cardia, smooth muscle, glands
peripheral motor neuron: autonomic ganglia from the brainstem
42
sympathetics
ganglia near vertebral column -> go to periphery
ex Ciliospinal center of budge C8-T2
43
parasympathetics
goes to organs
44
Central Nervous system
organized in
1. Nuclei: collection of nuclei w/ similar function & location (CNS analogue to ganglia)
45
What is cortex?
Shelt-like layers of cells
- allows fro higher level cognition, sensory & motor processing
-divided into LOBES
46
Frontal lobes -> premotor- cortex functions?
1. Pre-motor cortex = planning and execute movement. Developing during infancy
- general personality
lesion -> out of character behavior & comments
2. Brocca Area = speech production
lesion -> broken speech/ cannot produce intended words = Brocca's Aphasia
47
Which arteries supplies blood to frontal lobe?
Middle cerebral artery
Anterior Cerebral artery
48
Parietal lobe functions?
1. Sensory activity & recognition
Lesion -> cannot identify object, but can describe what it does
ex. pencil
- Blood vessel: Middle cerebral artery
49
Occipital lobe blood supply?
Middle cerebral & posterior cerebral
- Visual processing
Lesion - VF defect
50
Temporal lobe?
Perception & sensory recognition: auditory stimuli & speech, memory
- Hippocampus: short term memory, spatial orientation
- Wernicke's Area: Speeck recognition
- Lesion: Wordy speech
Blood supply; ICA -> Middle Cerebral, Anterior choroidal
Vertebral (basilar)
51
what makes up the division of the central nervous system?
Spinal cord, (Medulla, pons, midbrain) = brainstem
- Diencephalon, cerebral hemisphere, cerebellum
52
Spinal Cord?
center of spinal cord
- Gray matter: made of cell bodies & unmyelinated axons
53
What are the two roots of the spinal cord?
Dorsal Root: sensory
Ventral root: motor
54
What is white matter?
Myelinated, fasiculus tracts
55
What are the 3 division of White matter?
Post fasiculus
Lateral fasiculus
Anterior Fasiculus
56
What is the ascending pathway?
From periphery to brain
- carry sensory information
57
What are the 3 neurons of the Ascending pw?
- Ascending: small to large.
1st order: Soma bundle in dorsal root ganglion (1st synapse)
2nd order: connects 1st & 3rd order
3r order neuron: cell body in thalamus projects to cortex.
58
What is the descending pw?
Also called Pyramidal Tracts
- From brain to the muscle
- carry motor impulse from brain to muscle
59
what is the higher cervical region?
Nerve: C1-c8
- C8-T2: ciliospinal center of budge
Innervate: C1-C4
C5-C8 Upper extremities
60
What is the thoracic region?
Nerve: T1-T12
Innervate T1-T12 upper extremities
61
What is the lumber region?
Nerve: L1-L5
Innvervate: L1-L4: Thigh
L4-L5: thigh, leg foot
62
What is the sacral region?
Nerve: S1-S5
Innervate: S1-S3: thigh, leg, foot
S2-S4: pelvis
63
What is the coccygeal region?
Coccygeal nerve: Corgis ... :> Butt and maintain balance
64
What is the brainstem?
Midbrain, pons, medulla
65
What is the midbrain function?
CN 3,4
control sensory & motor function
controls coordination of eye movement & reflex
66
What is does the upper midbrain function?
1. has superior colliculus: controls saccades (w/ FEF)
2. Red Nucleus: controls movement of arms and occulomotor nuclei. involved in executing hand-eye coordination
3. EW nucleus = CN3: parasympathetic innervation of iris (ciliary muscles, sphincter muscle)
67
Lower midbrain?.
1. Inferior colliculus - reflex of head and neck to auditory stimuli
2. CN4 nucleus: inner controlled SO muscle ("SO contralateral SR" )
3. Site of cerebella pedicules - connects to cerebellum
68
Function of pons?
1. coordinate movement relayed info transfer btw cerebral hemispheres & cerebellum
2. relays info btw midbrains & meddulla
- location of pontine nucleus -> relay information for motor relay info btw cortex and cerebellum
69
What is medulla?
1. What is 1. Upper medulla: had pyramidal?
2. Medial longitudinal fasciculus?
3. Lower middle medulla?
CN 9-12
Controls autonomic function (digestion, heart heart, breathing)
1. Upper medulla: had pyramidal tracts (descending brain -> motor)
- Medial lemiscus (ascending dorsal tract). carries inform from lower body and trunk to brain
2. Medial longitudinal fasciculus: relay vestibular info to EOMs
-coordinates VOR
- lesion: INO
3. Lower middle medulla: location of vestibular nuclei, olivary nuclei
- do learning long-term memory in cerebellar function
- 4th ventricule
70
What is the Diencephalon?
- Epithalamus:
- thalamus
- subthalamus
-hypothalamus
extension of the eye
- Epithalamus: has pineal gland -> secretes melatonin
- Thalamus: relays info to cortex -> has nuclei for voluntary muscle control
- Subthalamus: communicate w/ basal ganglia. Helps to control muscle movement
- hypothalamus: regulate body temp, eating & sleeping behavior. start of sympathetic pw for dilation
71
What is the cerebral hemisphere?
do higher level processing for sensory interpretation, motor control, intelligence, emotion
2 hemisphere
A. Dominant hemisphere: help to understand and process language. - Interconnection of long-term memory.
- Word retrieval & emotional stability
B. Non-dominant hemisphere
- recognition of facial expression & vocal information, music, visual learning
72
What is Prosopagnosia?
can't recognize faces due to occipital & temporal lobe damage
73
What is the cerebrum?
fine motor control
postural balance
74
what are the arteries that makes up the Circle of Willis (4)?
1. Basilar
- Posterior cerebral
2. ICA
- Pcomm
- Ant. cerebral
- Ant. communicating
75
What is Diabetic papillopathy?
~ mild form of NAION
Epi: young <50 yr type 1 DM (70%)
Patho: mild form of NAION.
- reversible ischemia
Symptoms: mild to no decrs VA
- mild APD
- disc edema, 60% unilat
- mild VF defect = no cecocentral VFD, or altitudinal
- fellow ONH is disc at risk
Diagnosis: Dx of exclusion (like NAION)
- r/o GCA
-CME
- Malignant HTN -> BP check
76
what is CRVO?
Bleeding in all 4 quadrants, dilated & tortuous vessel
- collaterals: vein to vein connection
-due to thrombus (form at site)
- just post ONH
77
Hypotony
sx hx of trabelecutomy, trauma blunt, cyclodestruction sx, intracranular inflammation
- IOP < 6mmHg
- depends on scleral rigidity -> becomes more rigid w/ age
- may occur due to over-filtering bleb, wound, leak
S/S: painful, esp w/ corneal edema
78
Optic Disc Drusen
Epi: presents 3-24 ppl
patho: hyaline deposits @ optic disc
- can be hereditary acquired
Diagnosis: B-scan: drusen = hyper-reflective
S/S: asymptomatic
- buried when young -> surface w/ age
- excessive drusen -> compress ganglion cells @ ONH -> gluacoma like VF defects
- pseudo disc edema - rim elevated due to due
- true edema: due to compression of nerve. Uni or bilateral
- may cause CNVM - due to break bruch @ ONH -> at area of peripapillary atrophy
79
Sarcoidosis?
Epi: often affecting Middle-aged, AA, women, smoke
Patho: idiopathatic
S/S: chronic dacryoadenditis
- S-shape ptosis
Testing: ACE & chest xray -> granulomatous inflam
- 90% lung involvement
- only 1-5% have ON edema
80
Lists some Collagen Vascular Disorders ?
RA, SLE, polyarteritis nudosa, granulomatous w/ polyangitis
81
SLE = lupus
Epi: women > men
- 2nd-3rd decades of life
Patho: autoimmune effects multi organs
S/S: unilateral disc edema & papilledema
malar rash
Testing: ANA
82
Syphilis
Inflammatory, Infection unilateral disc edema
STD due to spirochete treponema pallidum
Testing:
1. FTA-ABS: ever had syphilis
2. VDRL, RPR: if have now/active
83
What is the 4 phases of syphilis?
1. Primary chancer sore (painless genital ulcer)
2. Secondary: involve eye, kidneys, mucus membrane inflamm, skin
---->>> latent phase
- CNS not involved
3. Tertiary : CNS involvement, Argyll-Robertson pw: btw pretectaL & EW
Stage 1-2: tx w/ PCN to prevent next stage
84
TB
Inflammatory Dz of lungs by Myobacterin Tuberculosis
Symptoms: NIGHT SWEATS, fever, chronic cough
- Bilateral granulomatous uveitis, CME, rarely optic disc edema
Testing: Chest-xRay, PPD skin test (Type 4 rxn)
-Indentation healthcare worker >10mm
immunocompromised > 15mm
Normal > 5mm
84
What is IIH/Pseudotumor cerebri?
Epi: women, overweight, child bearing age
Patho: incrs ICP from unknown etiology
Diagnose of exclusion/Dxe
Testing:
Check BP in office
MRI/MRV - r/o tumor
-CBC = no blood clot
Spinal Tap -> CSF analysis, r/o syphilis
-Opening pressure > 200 mmH2O or >21 cmH2O
Normal: <15.5cm H20 or 155mm H20
Causes: "CANT"
-Contraceptive
-Vit A
Nalidixic acid
-Tetracylines
Symptoms:
HA, transient vision/Amurosis fugax, nausea/vomiting, VA is normal
Signs: Enlarged blind spot VF, diplopia (CN 6 palsy) pinched by petrous ridge of temporal bone
-Variable VFD, bilateral ON atrophy
84
Orbital Cavernous Hemagioma?
MC benign orbital neoplasm in adults
- Epi: MC women in 4th - 5th decade
- affects muscle cone -> compresses the ON
84
Causes of unilateral vision/bilateral optic atrophy
1. Excavation: loss of neuro rim tissue -> Glaucoma
2. Pallor: whitening of neuroretinal rim tissue
- primary optic atrophy: ON has never ben edematous
- ex. Trauma, nutritional, orthograde degeneration /ascending -> eye to brain (PRP, CRAO, RP, geographic atrophy
- retrograde degeneration, brain -> Eye / Descending (ex. Pituitary tumor
3. Hereditary: Leber's Dominant Optic Atrophy
4. Secondary Optic atrophy: ON has been edematous before
-any primary causes
Foster Kennedy
85
What is optic nerve atrophy?
distruction of RNFL -> axons of ganglion cell s
85
Toxic /Nutritional
Most Common/MC
- Alcohol -> Wernicke Korsakolf
-Malnutrition
- Med Toxicity (ethambutal, ioniazide, amiodarone)
Classically w/ temporal pallor of ON (papillomacular bundle)
-cecocentral w/ central VFD
- causes bilateral, painless, progressive
86
what is orthograde degeneration/ ascending?
Eye -> brain
Extensive RNFL damage -> cause neutro-retinal tissue damage
PRP, CRAO, RP (wavy optic, disc PSC, attenuated vessels), extensive geographic atrophy
87
What is retrograde degeneration?
Brain -> eye
-damage to retrobulbar ON -> descending degeneration of ON axons
ex Pituitary Tumor
Normally compresses nasal optic fiber
-> horizontal band of pallor on ON (Bow-tie atrophy)
- Junctional Scotoma
Hereditary
- Leber's Optic neuropathy: mutation in mitochondrial DNA
-85% male, onset in early 20s
-sudden onset of decrs color vision (20/200-CF)
- Early signs: optic disc hyperemia -> OD pallor in late stage
- spontaneously improves in 35%
-Foster Kennedy Syndrome: rare, due to Frontal lobe tumor -> simultaneous OD edema in one eye vs OD atrophy (lesioned side) `
88
Congeneitcal optic nerve anomalies?
1. Opticc nerve pit: unilateral depression of Optic disc Inf-temp
- may develop SRD from optic cup to macular
- asymptomatic unless macular involved
Morning Glory Syndrome: unilateral
- funnel-shaped, excavated optic nerve = poor VA
- spontaneous formation congenital
89
What is ON hypolasia?
incomplete development of ON, uni/bilateral
- double ring sign
- a ring of sclera or hyperpigmentation
90
What does a pt in a coma pupil look like?
Called Hutchinson Pupil
- dilated pupil in comatose state
- due to ipsilateral compression of CN23 hematoma or tumor
- sudden
If Miosis: in early coma miosis bc of loss of cortical control
- still responde to light (bc pretectaL nucleus nerve goes to cortex )
91
CN 4 palsy?
Innervates SO
- contralateral, dorsal, long, thin
** most susceptible to TRAUMA
92
Congenital CN4 vs Acquired, which have a larger vertical palsy?
Congenital CN4 palsy
- 0-2prism
- no diplopia, bc of Eccentric fixation or suppression/amblyopia = form deprivation
Acquired CN 4 palsy: vertical ranges, diplopia
- Head tilt AWAY
Dx = Park three step
93
what is park 3 step?
Vertical
head tilt
gaze
where is it WORSE?
94
where is the lesion?
Right Hyper
right head tilt
worse w/ left gaze = worse w/ R head turn
"walking in w/ left head tilt or left head turn
Right SO problem
95
CN 6 palsy?
Abducen -> LR
- travels in the Cavernous sinus laterally, btwn ICA and Petrosal ridge on the temporal bone - gets compress in btw
MC: microvascular Dz
MC affects EOM
Tumor
Incr ICP - papilledema
- Trauma
-cavernous sinus issue
96
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