Physiology and Anatomy Flashcards
(131 cards)
1
Q
4 chemical types of hormones
A
modified amino acids
steroid
peptide
protein
2
Q
example of a protein hormone
A
insulin
3
Q
modified amino acid acids eg from __+__
examples __+__
A
tyrosine and tyramine
adrenaline, T3 and T4
4
Q
examples of steroid hormones
A
cortisol, progesterone, testosterone
5
Q
examples of peptide hormones
A
ACTH oxytocin ADH
6
Q
6 main hormones from anterior pituitary
It releases ___ chemical type hormones
A
ACTH, GH, FSH, LH, prolactin, TSH
peptide/protein
7
Q
intermediate pituitary hormone
A
MSH
8
Q
posterior pituitary hormones
A
ADH/vasopressin
oxytocin
9
Q
pineal gland hormone
and its target
A
melatonin
hypothalamus
10
Q
Zollinger Ellison syndrome is a tumour of the ___ that releases ___
A
pancreas/duodenum
gastrin
11
Q
definition of autocrine
A
acts on the same cell
12
Q
definition of paracrine
A
acts on other cells within that organ/tissue
13
Q
definition of endocrine
A
enters circulation to act on distant cells
14
Q
hormones act at __ concns over a ___ distance with ___ receptors and __ potency
A
low concns
large distance
specific receptors
high potency
15
Q
3 hormones involved in homeostasis short term during exercise and their function
A
glucagon - gluconeogenesis and glucose release
cortisol - enhance metabolic use of glucose
adrenaline - prevent hypoK+
16
Q
4 hormones involved in long term effect of exercise for normal growth
A
GH
insulin
IGF-1
sex hormones
17
Q
insulin has antagonistic actions to __+__
A
adrenaline and glucagon
18
Q
amine hormones: ___ converted to adrenaline it is then ___ and then released in response to ___ = ___ - is highly hydrophilic and so travels ___ in plasma
A
tyrosine stored pre-synthed in vesicles Ca2+ in cell exocytosis free in plasma
19
Q
peptide and protein hormones:
precursor (synthed at __) >____>hormone>____>___dependent exocytosis>highly hydrophilic so travels ___
A
rER proteolytic steps by convertases stored pre-synthed in vesicles Ca2+ free in plasma
20
Q
steroid hormones:
__+__ stimulated > __ uptake > converted into ___ (rate limiting step) > steroid hormone which is ___ and released>is ___ and so 90% travels bound in blood
A
intracellular ligand and receptor cholesterol uptake pregnenolone not stored hydrophobic
21
Q
carrier proteins provide a ___ for hormones and increase ___ and so maintains a ___ concn
A
reservoir
t1/2
relatively constant
22
Q
3 specific carrier proteins
A
CBG - binds cortisol
TBG - binds T4
SSBG - bind sex steroid hormones
23
Q
general carrier proteins (2)
A
albumin (steroids and thyroxine)
transthyretin (thyroxine and some steroids)
24
Q
5 factors that the control of hormone levels depend on
A
rate of secretion negative feedback neuroendocrine circadian rhythm rate of elimination
25
t1/2 of amine, peptide/protein and steroid+thyroid hormones
amine - seconds
p+p = minutes
s+t = hours-days (due to carrier protein binding)
26
GPCR are the receptors for __+___ hormones eg.
amines and some peptides
| adrenaline, glucagon, CRH,ATII, GRH, TRH, malatonin
27
ATII/GRH/TRH to GPCR => __>__/__
Gq
IP3
PKC
28
adrenaline, glucagon CRH to GPCR =>__>__>___>phosporylation
Gs
increase cAMP
PKA
29
melatonin to GPCR => __>__>__
Gi
decrease cAMP
decrease PKA
30
type of receptor for protein and peptide hormones
receptor kinase on cell surface
31
type of receptor that is for insulin
receptor kinase on cell surface
32
insulin binds to ___ (receptor) to cause ____ which recruits ___ notably ___
receptor kinase
autophosphorylation of intracellular tyrosine residues
adapter proteins - ISR1
33
Class 1 nuclear receptors are activated by __ hormones
in inactive form are found in ___ bound to __
then bound to and move to __ to ___ genes
```
steroid
cytoplasm
inhibitory HSPs
nucleus
transactivate/repress genes
```
34
Class 2 nuclear receptors activated by __
| are found in the __ always
lipids
| nucleus
35
Hybrid nuclear receptors are activated by ___
T3 and others
36
exocrine pancreas is made of __ cells
acinar
37
pancreatic islet cells and their % they contribute to its composition
alpha (10-20%)
beta (60-80%)
𝛿 (5%)
PP (<1%)
38
glucagon is produced by __ cells in the __
alpha
| pancreas
39
somatostatin is produced by __ cells in the pancreas
𝛿
40
Insulin production:
synthed in __ of beta cells as a ____>cleaved to leave signal peptide + __>insulin + ___ (used to measure insulin release)
rER
larger single chain preproinsulin
proinsulin
C peptide
41
biochemistry of insulin =
2 polypeptide chains linked by disulfide bonds
42
glucose enters beta cells by ___ >___ phosphorylates > increase __>increase __concn> inhibits ___> increase intracellular __ depolarises cell membrane> __ open > increase __ > __ fuse with cell membrane and insulin is released
```
GLUT2
glucokinase
metabolism of glucose
ATP
KATP channel
K+
voltage-gated Ca2+ channels
intracelular Ca2+
vesicles
```
43
release of insulin is ___ as 5% are in ____ then the rest are in ____ which need to be acted upon before release
biphasic
RRP (readily releasable pool)
reserve pool
44
2 proteins in KATP channels
| is a __ structured channel
inward rectifier - KIR6 - pore subunit
sulfonylurea receptor - SUR1 - regulatory subunit
octomeric
45
3 things that regulate KATP channels
___ inhibits by binding to __
directly inhibited by ___ on ___
stimulated extracellularly by ___ on ___ to inhibit insulin release
intracellular ATP KIR6
sulfonylurea drugs SUR1
diazoxide on SUR1
46
neonatal diabetes is caused by __ mutation causing __ of KATP channels
Rx =
KIR6.2
overactivity
sulfonylureas
47
inhibiting mutations on __/__ can cause congenital hyperinsulinaemia
Rx =
SUR1/KIR6.2
| diazoxide
48
diencephalon = __+__
thalamus and hypothalamus
49
infundibulum connects __ to __
hypothalamus to pituitary
50
pituitary gland lies in the ___ in the __ in the ___ bone
pituitary fossa
sella turcica
sphenoid
51
temporal side of vision is seen on the ___ retina
nasal
52
nasal side of vision is seen on the ___ retina
temporal
53
inbetween retina and optic chiasm in visual pathway =
optic canal
54
between optic chiasm and thalamus synapse in the visual pathway
optic tract
55
pituitary lies __ to the optic chiasm
inferior
56
the ___ optic canals cross sides at the optic chiasm
nasal (from temporal light rays ->nasal retina)
57
nasal light rays > ___ retina > ___ optic canal and tract
temporal
| ipsilateral
58
temporal light rays > ___ retina > ___optic canal > ___ > ___ optic tract
nasal
ipsilateral
optic chiasm
contralateral
59
pituitary tumour can cause this visual defect because it compresses the optic chiasm
bitemporal hemianopia
60
most common Sx approach to the pituitary
transsphenoidal (via nasal cavities and sphenoid sinus - surgically # the nasal septum)
61
nasal conchae bones =
sup and middle from ethmoid
| inferior = its own bone
62
roof of nasal cavity made from
cribriform plate of ethmoid bone
63
superior part of nasal septum is made from
perpendicular plate of ethmoid bone
64
inferior nasal septum is made from
vomer
65
4 paranasal sinuses=
ethmoid air cells
sphenoid
maxillary
frontal
66
paranasal sinuses drain through __ to __
ostia
| nasal cavities
67
adherent to the internal aspects of all the cranial vault bones
dura mater
68
pituitary lies inferior to ___ (dura mater)
diaphragm sella
69
tentorium cerebelli =
dura mater over the cerebellum with central gap for the brainstem
70
below dura mater in middle cranial fossa that are susceptible to damage by a pituitary tumour =
CN II, III IV, V, VI
| dural venous sinuses
71
dural venous sinuses =
venous channels in dura mater that drain most of the blood from the cranial cavity to the internal jugular veins
72
___ pass through the cavernous sinuses
internal carotid arteries
73
cavernous sinuses lie ___ to pituitary
lateral (on both sides
74
intercavernous sinus connects ___ lies ___ to pituitary
R+L cavernous sinuses
| anterior
75
8 structures at risk in pituitary Sx
```
CN III
CN IV
CN V
CN VI
optic chiasm
cavernous sinus
ICA
dura mater
```
76
functions of CNIII (3)
motor to 4/6 occular muscles
constrictor pupillae
elevates upper eyelid
77
damage to CN III causes
eye movement problems
| dilated pupil
78
CN IV function
moves eye up and down
79
CNV functions (2)
facial sensory
| muscles of mastication motor
80
CNVI function
lateral rectus motor supply - abducts eyeball
81
Thyroid lobes attach to __+__+__
trachea
thyroid cartilage
cricoid cartilage
82
isthmus of thyroid lies anterior to __+__ tracheal cartilages
2nd and 3rd
83
pyramidal lobe of thyroid is present in __% of population
usually originates from the __ lobe
most attach to __ but may extend to __
28-55%
Left
thyroid cartilage
hyoid bone
84
embryology - thyroid starts as an ___ at the junction between __+__ (___ in adults)
epithelial proliferation
| ant and post tongue (foramen caecum)
85
embryology:
| thyroid migrates inferiorly but still attached to tongue by ___
thyroglossal duct
86
thyroid reaches its final destination by ___ gestation
wk7
87
__/___ can be found anywhere along the migratory pathway of the thyroid
thyroglossal duct cysts
| ectopic thyroid tissue
88
platysma is supplied by __ as it is a ___
CNVII
| muscle of facial expression
89
thyroid lies at ___ with ___ in superficial fascia anteriorly
C7
| platysma muscle
90
prevertebral (deep) fascia is located __ to thyroid and contains ___+__
posteriorly
cervical vertebrae
postural neck muscles
91
investing (deep) fascia encloses ___ +__+__
all other neck fascial compartments
sternocleidomastoid
trapezius
92
carotid sheaths contents
IJV
CNX
deep cervical lymph nodes
common>ICA
93
pretracheal (deep)fascia encloses _+_+_+_+_
```
strap muscles
thyroid
trachea
oesophagus
recurrent laryngeal nerve
```
94
___ lies between pretracheal and prevertebral fascia
retropharyngeal space
95
attachments (3) of the sternocleidomastoid
manubrium
medial clavicle
mastoid process of temporal bone
96
___ nerve supply to sternocleidomastoid and trapezius it lies ___
CNXI
| in between them
97
___ lies anterior to sternocleidomastoid and drains to the EJV
anterior jugular vein
98
__+__ lie posterior to sternocleidomastoid
trapezius
| External jugular vein
99
EJV drains to the ___
subclavian vein
100
descending part of trapezius attaches to
occipital bone
spine of scapula
lateral clavicle
101
superior thyroid artery is a branch from _
ECA
102
inferior thyroid arteries are branches from __
subclavian arteries
103
superior middle and inferior thyroid veins drain to __
IJV
104
lymphatics of the thyroid (4)
superior and inferior deep cervical nodes
pretracheal
paratracheal
105
CNX connects with ___ at brain >___>carotid sheath
medulla oblongata
| jugular foramen
106
somatic branches of CNX in neck =
superior and right recurrent laryngeal nerve
107
the route of the Right recurrent laryngeal n. in the chest
lateral right aspect of trachea
posterior to right lung root
onto oesophagus
108
right laryngeal recurs under the ___
left under the ___
both pass __ to the thyroid
right = subclavian artery
left = aortic arch
posterior
109
contents of carotid sheath lateral to medial
IJV > CNX>common carotid
110
3 strap muscles =
omohyoid
sternohyoid
thyrohyoid
111
attaches the intermediate tendon of omohyoid to the clavicle
fascial sling
112
collar incision goes through the __+__
skin
| platysma
113
unilateral recurrent laryngeal nerve injury results in:
| bilateral results in :
```
uni = hoarse/weak voice and weak cough
bi = aphonia and can't close rima glottis to produce a cough
```
114
__+__ have cytokine receptors linked to tyrosine kinase activity
prolactin and GH
115
accuracy of measuring levels of hormones depends on (6)
```
main = rate of secretion
pattern of secretion
carrier proteins
interfering agents
t1/2
absolute concns
```
116
___ is measured to assess GH levels because GH -> __ = ___ formed
IGF-1
liver
IGF-1
117
time to measure levels of testosterone as this is when they are highest
9am
118
prolactin secretion is under tonic inhibition by
hypothalamic dopamine
119
physiological causes (3) of hyperprolactinaemia
pregnancy
lactation
nipple stimulation
120
pathological causes of hyperprolactinaemia (7)
```
prolactinomas
dopamine antagonists
CKD
hypophysitis
ovarian dermoids
hypernephroma
bronchogenic carcinoma
```
121
95% of CAH is caused by deficiencies in __/___
21-hydroxylase
| CYP21A2
122
CAH hormone effects
increased aldosterone and cortisol
| decerased androgens
123
if suspect hormone excess = ___test
| if deficiency = ___ test
```
excess = suppression
deficiency = stimulation
```
124
stimulation test for cortisol deficiency =
synacthen
125
suppression test for cortisol excess =
dexamethasone
126
70% of Cushings is caused by
tumour from ant pit corticotroph cells - Pituitary Cushing's
127
if suspect Cushings Ix = screening ___ => formal diagnostic test ____
1mg overnight dexamethasone suppression test
| low dose dexamethasone suppression test
128
If ACTH decreased in dexamethasone suppression test =
likely an adrenal cause
129
If ACTH increased in dexamethasone suppression test =
still need to distinguish if is Cushing's syndrome or ectopic ACTH
130
If increase in cortisol and ACTH on CRH test = ___ source => ___ (Ix)
pituitary
| MRI pituitary
131
Ix used to lateralise a pituitary tumour pre Sx
inferior petrosal sinus sampling
