Flashcards in test #15 4.3 Deck (129)
motor innervation of tongue?
hypoglossal CN XII, w/ exception of palatoglossus muscle CN X
general sensation of tongue?
anterior 2/3: mandibular branch of trigeminal (CN V3).
posterior 1/3: glossopharyngeal (CN IX).
posterior area of tongue root: vagus CN X.
gustatory innervation of tongue?
anterior 2/3: chorda tympani of facial n (CN VII).
posterior 1/3: glossopharyngeal CN IX.
posterior area of tongue root / taste buds of larynx and upper esophagus: vagus CN X
anterior 2/3rd of tongue vs. posterior 1/3rd?
foramen cecum on tongue?
located along terminal sulcus at midline.
differentiate cystic fibrosis symptoms from kartagener?
both have (1) recurrent sinopulmonary infxn (2) infertility. but, kartagener has situs inversus
acetaminophen toxicity achieved when..
single dose of 250mg/kg bodyweight OR cumulative 24hr dose more than 12g/day
90% in liver by sulfation and glucoronide conjugation. remaining, oxidized via cytochromeP450 & urinary excretion of unmetabolized drug.
metabolite of acetaminophen metabolism by CP450 system?
NAPQI: toxic & highly reactive. usu metabolized by hepatic glutathione into non-toxic compounds.
saturate hepatic sulfation&glucuronidation in liver; excess NAPQI made by CP450, depletion of glutathione. NAPQI causes hepatocellular injury and centrilobular necrosis
rx for acetaminophen toxicity. mechanism (2)
NAC (n-acetyl-cysteine). acts as glutathione substitute & (1) binds toxic NAPQI. also (2) provides sulhydryl groups to enhance non-toxic sulfation elimination of acetaminophen
aspirin (salicylate) & barbituate overdose rx?
(1) gastric decontamination (2) decrease GI absorption (3) correct fluid/electrolyte imbalance (4) alkalinize urine (increase excretion)
rx for TCA overdose?
NaHCO3; prevent cardiac arrythmia
opiod overdose rx?
opiod antagonist: naloxone or naltrexone
3 most common cancers in women?
(1) breast - low mortality (2) lung - highest mortality (3) colon. ovarian and cervical cancers have much lower incidence
which 2 vitamins are absent from breast milk? how do we manage this?
vitamin D and vitamin K. vitamin K given parenterally at birth (prevent hemorrhagic disease of new born). if baby dark, supplement vitamin D
cross-sectional study is also known as..
prevalence study. simultaneously measure exposure & outcome
filtration fraction determined by..
GFR and RPF (not saturable)
how is PAH secreted into urine?
clearance = RPF. filtered freely & actively secreted in PCT (carrier enzyme-mediated process aka saturable)
hallmark of reversible injury?
how do mitochondrial react during irreversible injury?
CHF triggers what 3 compensatory responses?
(1) decreased GFR stimulates macula densa --> RENIN, angiotensin, aldosterone. (2) increased SYMPATHETIC output (baroreceptors perceive low perfusion). increased contractility (good) & HR (good), but also increase peripheral arterial resistance, which increases afterload (bad) (3) ADH, increased H20 retention, increased preload.
viscous cycle of CHF & renin & ADH
CHF --> bad pump, decrease perfusion to tissue. renin-angiotensin-aldosterone stimulated --> vasocontriction. increased afterload further impairs weak pump.
what type of CHF impairs cardiac output, systolic or diastolic
the concentration of which 4 substances INCREASE as fluid runs along the PCT?
PAH, creatinine, inulin, urea (due to either active PCT secretion (PAH) or just nonreabsorption -- concentrate bc water is reabsorbed)
the concentration of which 4 substances DECREASE as fluid runs through PCT?
greatest to modest decrease in conc: glucose, amino acid, bicarbonate (all reabsorbed in PCT)
the concentration of which 2 substances stay the same as fluid runs through PCT?
Na+ and K+ (bc travel w/ water)
incision layers for cricothyrotomy? between which two structures?
(1) skin (2) superficial cervical fascia (inclu subcutaneous fat and platysma) (3) investing and pretrachael layers of deep cervical fascia (4) cricothyroid membrane. between thyroid cartilage and cricoid cartilage.
buccopharyngeal fascia? acute necrotizing mediastinitis can be caused by..
extends from carotid sheath to invest the pharyngeal constrictor muscles. lies anterior to prevertebral fascia (forming retropharyngeal space between them). infxn involving the retropharyngeal space can extend directly into the superior mediastinum