Flashcards in test #43 4.30 Deck (165)
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.
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
impaired ciliary & flagellar motility due to dynein protein defect
about 1/2 develop kartagener: male infertility, situs inversus, recurrent sinusitis/otitis, and bronchiectasis.
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
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
relative risk reduction
absolute risk (control) - absolute risk (treatment)
absolute risk control
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
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
ciliary muscle contracts ->
suspensory fibers are loose