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Flashcards in test #43 4.30 Deck (165)
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S4 heart sound results from

suddent rise in end diastolic ventricular pressure caused by atrial contraction against a ventricle that has reached the limit of its capacitance.

stiff ventricle

presystolic sound, precedes S1


when are the papillary muscles placed under tension

during ventricular systole


describe axoneme in flagella and cilia

circular array of microtubule doublets anchored at basal body and surrounding 2 central microtubules (9+2)

doublets connected by ATP-splitting dynein arms


primary ciliary dyskinesia

autosomal recessive

impaired ciliary & flagellar motility due to dynein protein defect

about 1/2 develop kartagener: male infertility, situs inversus, recurrent sinusitis/otitis, and bronchiectasis.


reaction formation

behavior pattern in which person does opposite of what he feels/desires

usu: person uses excessive havior to cover up how she/he really feels bc feeling that might be perceived as unacceptable by others in society.

wants to do crack, gives talks about how people who do crack should be shunned

(diff from altruism bc here, hope is to cover up a desire)

or angry at wife, tells her she looks great

short-term, immature, eventually breaks down


describe polyol pathway

glucose -> sorbitol
consume NADPH -> NADP+
via: aldose reductase

sorbitol -> fructose
consume NAD+ -> NADH
via: sorbitol dehydrogenase

note: retina, renal papilla, schwann cells have much less sorbitol dehydrogenase activity: prone to osmotic damage w/ glucose overload

lens has significant sorbitol dehydrogenase, but can still be overwhelmed.

note: oxidative stress from NADPH depletion also plays a role


primary energy source for sperm



where is the polyol pathway particularly prominent

seminal vesicles, make fructose for sperm


how does hyperglycemia lead to cataracts

overwhelm sorbitol dehydrogenase ability to convert sorbitol to fructose

sorbitol generates osmotic prssure, influx of water into lens cells --> hydropic lens fibers that degenerate. lens opacification.

oxidative stress from NADPH depletion also plays a role!


2 ways damage induced w/ hyperglycemia in lens, retina, schwann cells, renal papillae..

sorbitol accumulation -> osmotic damage

NADPH depletion: oxidative damage



end product of glucoronic acid metabolism, and intermediate in pentose phosphate pathway


presentation of klinefelters

hypogonadism, eunuchoid habitus, small firm testes, genotype 47 XXY. have barr body


hormonal abnormalities in klinefelter

high LH, FSH.
low inhibin, testosterone

sperm count is decreased

seminferous tubules progressively destroyed & hyalinized --> small firm testes.

results in low inhbin & low testosterone (leydig cells also hurt)

results in high LH and FSH


congenital absence of GnRH-neurons called

Kallmann syndrome

decreased LH, FSH, testosteone, and sperm count


why is sperm count low w/ exogenous steroids

high LOCAL concentration of androgens needed for spermatogenesis.

exogenous steroids decrease LH production, reducing local testosterone in testes.

ends up w/ testicular atrophy over time.


hormonal problems in cryptoorchidism

high FSH, normal LH, normal testosterone, decreased sperm

sertoli cells susceptible to heat, poor inhibin, high FSH


when is aortic regurg heard loudest (peak murmur intensity)

greatest pressure difference,
when incompetent aortic valve closes

early diastolic, high-pitched, blowing descrendo.

mid to late diastole, intensity of murmur would be less bc magnitude of the gradient diminished.

left sternal border, patient leaning forward (valve to wall), end expiration


peak murmur intensity of mitral regurg

greatest pressure diff in ventricle and atria.

early systole. opening of aortic valve


peak murmur intensity of aortic stenosis

greatest pressure diff in aorta and ventricle.

peak of systole



peak murmur intensity of mitral stenosis

greatest pressure diff in atria and ventricle

mid-diastole. low pitch rumble after the opening snap


low grade vs. high grade tumors

low grade: well differentiated. morphologically and architecturally similar to normal cells in tissue of origin

high grade: poorly differentiated, lack most characteristic feature of original tissue.

complete lack of differentiation: anaplastic


features of anaplastic (high-grade, poorly differentiated) tumors

pleomorphic cells w/ large, hyperchromatic nuclei, grow in disorganized fashion. contain numerous mitoses, and giant multinucleated cells.

1. loss of cell polarity, complete disruption of normal tissue architecture, cells coalsce into sheets / islands in a disorganized, infiltrative fashion

2. significant variation in shape & size (cellular pleomorphism) and nuclei (nuclear pleomorphism)

3. disproportionately large nuclei (high NC ratio) often deep staining (hyperchromatic) w/ abdunfant coarsely clumped chromatin and nucleoli

4. numerous, abnormal, mitotic figues

5. giant, multinucleated tumor cells


bronchial epithelium



relative risk reduction

absolute risk (control) - absolute risk (treatment)

divided by

absolute risk control


musculocutaneous n

major upper arm flexors
biceps brachii, coracobrachialis, brachialis muscles.

continues as lateral cutaneous nerve of forearm, sensory to lateral forearm


sensory innervation to the foot

mostly superficial peroneal n.

deep only: region between 1st & 2nd digits


impt strxr near medial malleolus

saphenous n & great saphenous vein; course anteriorly

posterior tibial artery, tibial n, tendons of flexor digitorum longus, flexor hallucis longus, tibialis posterior; course posteriorly


anastrozole, letrozole, exemestane

aromatase inhibitor


describe how the lens is attached to eye

lens is attached to suspensory ligaments, which are attached to the ciliary muscle.

ciliary muscle relaxes->
suspensory fibers are taut
lens flatten

ciliary muscle contracts ->
suspensory fibers are loose
lens thicken


age related changes in lens --? ]

presbyopia, inability of lens to focus on near objects

lens is hardened; loose elasticity as proteins undergo progressive degeneration

also, ciliary muscle less strong.

when contract ciliary muscle
loosen suspensory ligaments
lens no longer thickens

loose accomodation