Week 1 Flashcards
(192 cards)
1
Q
How muscle can be affected after neural fibers are removed from the muscle?
A
Muscle atrophy
2
Q
What is Spondylolisthesis?
A
Displacement of vertebra
3
Q
What degeneration of cartilage between bones might lead to?
A
More bone rubbing leading to bone growth
4
Q
Which part of vertebra are fused?
A
Coccygeal
5
Q
Which vertebra do not have the intervertebral disk?
A
Atlas and axis
6
Q
How many cervical nerves are there?
How many cervical vertebra are there?
A
8
7
7
Q
What is the name of the hole that spinal cord is passing through?
A
Vertebral foramen
8
Q
What forms neural arch?
A
Pedicle
Lamina
Body
9
Q
What is the join between inferior and superior transverse proceeses of vertebra
A
azygoshypophyseal joint
10
Q
Name the locations where nerves are exiting from spinal cord
A
Intravertebral foramen
11
Q
What is the effect of anastetic injected in sacral hiatus?
A
Only affects spinal nerves not spinal cord
12
Q
What artery passes through transverse foramen of cervical vertebra?
Exception?
A
Vertebral artery C1-6 not 7
13
Q
Which vertebra can be felt on the back of the neck?
A
C7
14
Q
What articular facets are connected to?
Which type of vertebra are they found in?
A
Ribs
Thoracic
15
Q
Direction of superior/inferior articular proceses:
Cervical vertebra
Thoracic vertebra
Lumbar vertebra
A
Transverse plane
Frontal plane
Saggital plane
16
Q
Would thicker or thinker disc allow more movement?
A
Thicker
17
Q
What is found in all vertebra except atlas?
A
Body
18
Q
What is the difference in shape of inferior vs. superior articular fovea?
What movement is allowed by superior articular fovea?
A
Superior is more concave
Front/back
19
Q
Why spinal cord does not extend entire length of vertebral column?
A
It does not grow as much as vertrebral column
20
Q
What is the special innervation of trapeizus muscle?
A
Innervated by CN XI
21
Q
What is osteophytes?
A
a bony outgrowth associated with the degeneration of cartilage at joints
22
Q
Components of axial skeleton
A
Skull
Vertebral column
Ribs
Sternum (not pelvis)
23
Q
How many vertebra are there?
How many at each level?
A
7C, 12T, 5L, 5S, 4C
24
Q
Which segment of vertebral colum belong to primary / secondary curvatures
A
Primary: thoracic & sacral
Secondary: cervical & lumbar
25
Name the parts of vertebra
BOdy
Pedicle
Lamina
Transverse process
Spinous process
Articular process
26
What is intervertebral foramen made of?
Inferior and superior vertebral notches
27
What is present on the lateral surface of each superior articular facet (muscle attachement)? -- name it
Mammillary prossess
28
Name these two structures:
Posterior sacral foramina (anterior is behind)
Sacral Hiatus
29
Name the characteristics structure for each group of vertebra
30
Name the structures
31
Complete the table
32
What are the restrictions on movement of vertebral column?
Thickness of the intervertebral discs
Orientation of the articular facets
Attachements of ribs
Size, elasticsity, and orientation of muscle of th back and abdominal wall
33
Definition of pain
An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage
34
Defintion of
Actute Pain
Chronic Pain
Paid due to injury of tissues and activation of nocioceptors
Pain that extends beoynd the expected period of healing
35
Three general types of pain
Nociceptive pain (somatic pain / visceral pain)
Neuropathic pain (lesion or disease affecting the somatosensory system)
Mixen pain (cancers e.g. lung)
36
Two types of nociceptive pain
Arthritis (most common) : mechanical-osteoarthiritis & inflammatory-rheumatoid arthiritis
Low Back Pain
37
Examples of neuropathic pain
Herpes Zoster dormant in DRG -\> Shingles and Post Herpetic Neuralgia (pain that could last for years)
Complex Regional Pain Syndrome (CRPS) - Involvement of sympathetic nervous system BPPS model (fire hand)
Central pain (pain associated with lesions of the CNS including spinal and central -opposite)
Phantom pain (stabbing, throbbing, burning)
38
Dependence vs. Addiction
Physical vs. Psychological
39
What fibers carry the pain signals?
Characteristics?
Location?
C-fiber and Ad-fiber
Heretogenous, unmylenated
Sking, muscle, joints, and viscera
40
Two types of sensitization
Location of central?
Primary / peripheral
Central (Lamina V)
41
What receptor triggers pain and exaple of molecule that binds to it?
How voltage gated sodium channels can be inhibited?
What voltage channels promote propagation of pain signals? Medications?
TRPV1 receptor / Capsaicin
Local Anasthetics and Lidoderm patches
N-type calcium channels
42
What is
Hyperalgesia
Allodynia
Hyperalgesia – heightened sense of pain to noxious stimuli
Allodynia – pain resulting from normally painless stimuli
43
What is the location when synapse of primary afferent neurons?
substantia gelatinosa
44
What tract carries pain signal?
Spinalthalamic tract (STT)
45
How pain is regulated?
Spinoreticular neurons have targets in medulla and brainstem
Spinomesencephalic neurons have targets midbrain and periaqueductal grey (PAG)
46
Where are all sensory system send to?
Thalamus
47
Two pathways of pain signals from thalamus to cerebrum
Lateral pain system -\> Cerebral coretex (localization and intensity)
Medial pain system -\> Limbic System
48
What is gate control theory (of melzack and wall)
Jamming pain signals (rubbin or massaging injured parts of body in order to achieve pain relief)
49
What can cause central sensitization
high intensity or prolonged stimuli such as occur with nonneuronal tissue injury and inflammation
50
Difference between:
Spondylolysis
Spondylolisthesis
Scotty Dog (Scotty Dog=fracture of pars interarticularis)
Displacement of vertebra
51
Ligaments that prevent flexion in spinal column?
Ligmanets that prevent extension in spinal column?
Importance?
Anteior Longitidinal Ligament = largest
Posterior Longitidinal Ligament = prevent disk herniation
52
What ligament on atlas surrounds dens?
What is the connection between skull and dens?
Cruciate ligament
Alar ligament
53
Parts of intervertebral disk
Annulus fibrosis = fibrocartilage thinner posteriorly
Nucleus pulposis= gelatinous fore
54
Where do spinal nerves exit in cervical region?
Where do spinal nerves exit in thoracic/lumbar/sacral region?
What nerve gets pinched?
Above same number vertebra
Below same number verebra
One number below
55
Spinal Meninges
56
What is the name of collection of fibers below the spinal cord?
Where does the spinal cord end?
Cauda equina
L2
57
Artery that runs in back/front of spinal cord?
What supplies these arteries?
Posterior / Anterior spinal
Posterior radicular artery / anterior medullary artery
58
Where is the Adamkiewicz artery located (level)?
T8-L2
59
What is Anterior Spinal Artery Syndrome?
Loss of blood flow to a spinal cord
60
Importance about venous drainage in vertebral column?
Conntected to both brain and prostatic venous plexus (prostate cancer metastasize to the CNS).
61
On what level are the dimples?
On what level is the iliac crest?
On L4/L5
Dimples on S2
62
Back muscles
63
Three groups of intrinsic back muscles
Spinotransverse (superficial)
Erector spinae (intermediate)
Transversospinae (deep)
64
What innervates back muscle?
Dorsal rami
65
What is the relationship between the direction of the muscle and vertebra turn?
Oblique
Transversospinal
Same side
Opposite side
66
Another name for spinotransverse
Splenius (superficial)
67
What are the three erector spinae muscle?
Spinalis
Longissimus
Ileocostalis
68
Two components of splenius group
Capitis and Cervicis
69
Transversospinae muscle group members
Semispinalis spanning 6-8 vertebrae
Multifidus spanning 3-5 vertebrae
Long rotators spanning 2
Short rotators spanning 1
70
What is the most powerful extender of the head
Semispinalis capitis (transversospinae muscle)
71
Microfailure
72
Yield Point
Failure Point
Elastic Region
Plastic Region
73
Isotropy
Anisotropy
Orthotropy
Mechanical properties independent of direction of stress
Mechanical properties different in all directions of loading
Mechanical properties symmetric within two planes
74
Hysteresis
The dependence of the output of a system not only on its current input, but also on its history of past inputs
Cyclic loading leads to smaller difference between loading and unloading curves
75
How multiple cycle of load affects failure strength?
76
Condition?
Stress Fracture
77
Stress vs. Strain curve
Brittle / Ductile material
78
Wolff’s Law
Bone remodels in response to stress placed on it
79
Which portion of the bode is responsible for hematopoiesis?
Proximal/distal
80
Trabecular bone vs. cortical bone properties?
Trabecular: lower ultimate stress, ductile
Cortical bone: high ultimate stress brittle
81
Weakest axis for loading on the bone?
Transverse
82
Viscoelastic
How bone is affected at low and high frequency?
Sensitive to strain rate and duration of applied loads
Low frequency = ductile
High frequency = britle
83
If force is applied over long period time then what happens to strain?
What changes if strain is maintained over long period?
Strain increases (creep)
Required stress decreases (stress relaxation)
84
What is toughness?
Energy absorbed before ultimate failure
85
Ductility
Ultimate strain substantially larger than yield strain
86
Senile Osteoporosis symptoms / gender
Postmenopausal Osteoporosis
Both geneder / Both compact & trebecular
Female / Trabecular bone
87
How vertical trabeculae are effected with aging?
Reduction in vertical trabecula disproportionally
Reduction in thickness of trabeculae
Increase in length of trabeculae
88
How modulus relates to density?
2^n
power-law function of density
89
How bone reacts to aging?
Density decreases
Cortical thicknes decreases
Diameter increases
90
What are the main component of tendon?
Substructures?
Type I Collagen (Also water IIIm tenocytes, proteoglycans)
Tripple Helix -\> Microfibril -\> Fibrils -\> Fascicles -\> Tendon
91
Stress vs. Strain curve regions for tendon
Regions?
Toe Region: uncrimping of collagen fibers
Linear Region: slope is elastic modulus of tendon
Failure Region: permanent stretching
92
Ligament vs. Tednon
Ligament has less % collagen
More ground substance and type III collagen
Less longitudinal organization
93
Tendon Insertion Into Bone
4 Zonez
Zone I:parallel collagen fibers
Zone II: unmineralized fibrocartilage
Zone III: mineralized fibrocartilage
Zone IV: Cortical Bone
94
How tendon strength is affected with age?
How ligament strength is affected with age?
Increases to maturity then stays the same
It increases with age
95
How steroid affect strength?
Corticosteroids reduce failure load
Estrogens reduce collagen production (e.g. pubic symphysis laxity)
96
What collagen fibers are found in articular cartilage?
Type II
97
What is responsible for 90 percent of load transmitted in cartilage ?
Flow Dependent Rate of Creep
rest: Flow Independent (friction between long chains)
98
Which cartilage does not have perichondrium?
Which cartilage does not go through calcification?
Fibrocartilage
Elastic cartilage
99
Function of:
Hyaline cartilage
Elastic cartilage
Fibrocartilage
Resistance to compression
Flexible support
Resist deformatin
100
Two types of matrix in hyaline cartilage
Teritorial matrix
Interteritorial matrix
101
Does hyaline cartilage have a lot of water? Why?
Evenly distributed?
Importance in development?
Yes (aggrecam)
No
Model for skeleton development
102
Zones of Articular Cartilage
Direction of fibers
Tangential layer = parallel to join surface
Transitional zone = oblique
Radial zone = perpendicular
Calcified cartilage =
103
Is there perichondrium at articular cartilage?
No
104
What is the stain for elastin fibers?
Verhoeff (type II are masked by stain)
105
What is the difference in mitosis between elastic cartilage and hyaline cartilage?
Mitosis occurs in elastic chondrocytes (more cells in cartilage)
106
What is the arrangement of cells in fibrocartilage?
What does it connect?
Parallel columns of chondrocytes
Dense connective tissue and hyaline cartilage
107
Where do chondroblast come from?
What gives rise to cartilage proper?
What produces perichondrium?
Mesenchymal cells
Chondroblasts
Fibroblasts
108
What is the tissue that makes perichondrium?
What are the two layers of perichondrium?
Inner chondrogenic layer
Outer fibrous layer
109
Two types of growth in cartilage?
Which cartilage?
**Appositional**
Hyaline and Elastic Cartilage
Chondrogenic cells -\> Chondroblasts
Most of the growth in newly formed cartilage
**Interstitial**
All
Only growth in cartilage that do not have perichondrium
Epiphyseal plate
110
Components of the bone
3 organic components 35%
1 inorganic component 65%
Type I collagen
Proteoglycans (compressive strength)
Multi-adhesive glycoproteins
Hydroxyapatite crystals (calcium+phosphate)
111
Location of osteoblasts?
Location of osteocytes?
Location of bone lining cells?
Location of osteoclasts?
periosteum (inner)
endosteum
lining of Haversian canal
Lacuna
Cells that remain on the surface with no active growth
Bonemarrow
112
What hormone targets osteoclasts?
What hormone inhibits osteoclasts?
PTH
Calcitonin
113
Types of bones classification based on their shape
Long
Short
Flat
Irregular
114
What structures are present in spongy bone and what are absent?
Lamellae present
Osteons absent
115
What are the three blood supplies to **long** bones?
Characteristics
**Nutrient arterial system**
High pressure from major systemic arteries
Enter through nutrient foramina
Supply medullary cavity and 2/3 cortex via haversian system
**Metaphseal-epiphyseal system**
Arises from periarticular vascular plexus
**Periosteal system**
Low pressure
1/3 of cortex
116
Blood supply to large irregular, short, and flat bones
receive blood supply from **periosteum** and often large **nutrient arteries **
many anastomosis
117
Where is lymphatic drainage in bones?
Periosteum and absent in medulla
118
What is and where is the nerve supply to the bone?
Periosteal = sensory (some are pain)
Medulla = vasomotor
119
Two ways that bone is formed?
Which type of bones are formed by these proceses?
Intramembranous - flat and irregular
Endochondral - short and long
120
Intramembranous Bone Formation
Trabeculated spongy bone formation
Mesenchymal cells differentiate into osteoblasts
Secretion of bone matrix
Formation of spiculates and trabeculate (random orientation of collagen)
Calcification
Trapping
Osteocytes
121
What is subperiosteal bone collar?
What is periosteal bud?
Produced by osteoblasts allow blood vessels to come in to cartilage
Enters the cartilage
122
Growth of Long bone (zones)
Epiphyseal cartilage
Reserve Zone
Proliferative Zone
Hypertrophic Zone
Vascular invasion Zone
123
Where are only one epiphyseal plates present at?
metacarpals
metatarsals (proximal 1st and distal 2nd-5th)
clavicles
ribs.
124
What ypes of myosin is involved in heart contraction?
cell division?
vescile transport?
cardiac
II
V
125
What is similar in all myosins?
What makes myosins different?
Motor
Tail
126
What happens if myosin is broken
II
V
VI & VII
Muscle myopathies (cell division)
Griscelli Synrome (melanosome transport - hypopigmentations and neurological defects))
Hearing loss (organization of actin-filled stereocilia)
127
Structure of myosin II
Dimer
Actin binding site
Active site
Regulatory domain
Essential domain
128
What is special about myosin IV?
It is minus-end directed
129
Myosin-actin cycle
ATP binding causes head release
ATP-\>ADP+P causes confromational change
Release of phosphate allows binding back to the new site
Release of ADP causes power stroke
130
What is the difference between myosin II and V?
Neck?
Duty?
Function?
Functional Units?
Long 6IQ / Short 2IQ
50% / 10%
Organelle motor / Muscle contraction
Two heads / ~20 heads
131
What connects myosin fibers together?
Hydrophobic tail region
132
Function of:
CapZ and tropomodulin
Z disc
Titin
Nebulin
Keep filaments length constant
has a-actinin that joins sacromeres
mantains thick filament position
sets the length of the thin filament
133
Where does the regulation occur in:
Skeletal and cardiac muscle?
Smooth muscle?
Thin filament
Thick filament (Myosin Light Chain Kinease/Phosphatase calcium dependent)
134
What affects the muscle ability to generate force and contract?
Myosin isofroms
Frequency of stimulation
Number of motor units stimulated
Degree of strech (Frank-Starling relationship)
Whether muscle is allowed to shorten (Force-velocity relationship)
135
Isomatric vs. isotonic muscle contraction
136
Mutations to MyHC IIa (MYHC2)
Disease?
Features?
Pathogenesis?
**Disease:** Muscle Myopathy.
**Clinical Features:** Muscle Weakness. Atrophy near shoulders, back, hand and thigh muscles. Muscle weakness.
**Pathogenesis:** Mutations primarily to SH1 Helix in myosin. Thought to alter actin-myosin ATPase activity.
137
Mutations to embryonic MyHC (MYH3):
Disease?
Features?
Pathogenesis?
**Disease:** Distal arthrogryposis. Freeman-Sheldon Syndrome, Sheldon-Hall Syndrome.
**Clinical Features:** Joint contractures with predominant distal involvement.
**Pathogenesis:** Mutations in troponin I, troponin T, tropomyosin, perinatal myosin and embryonic myosin. Thought to disrupt sarcomere development.
138
Mutations to B-Cardiac myosin (MyHC7):
Disease?
Features?
Pathogenesis?
**Disease:** Laing myopathy.
**Clinical Features:** Weakness of ankle dorsiflexion and “hanging big toe”.
**Pathogenesis:** Mutations are in the LMM region of Myosin. Thought to disrupt myosin filament formation or disrupt interactions with myosin binding proteins like titin.
139
What two cardiovascular diseases can be caused by myosin mutations?
Pathogenesis
familial hypertrophic cardiomyopathy (FHC) and dilated cardiomyopathy (DCM). \
FHC mutations enhance myosin force generation
DCM mutations decrease myosin force generation
140
What is the effect of ___ on Ca++ levels?
**Parathyroid hormone (PTH)**
**Fibroblast growth factors 23 (FGF23)**
**Vitamind D**
Calcitonin
RANKL (receptor activator of nuclear kappaB ligand)
M-CSF: macrophage colony stimulating factor
OPG: osteoprogenin
PTH Increases plasma Ca++ concentration: activation of vit D in kidneys, stimulate osteoclasts (and osteoblasts)
FGF23: inhibition of activation of vit D in kidneys
Vit D: inhibits PTH secretion, calcium absorption and deposition
Promotes osteoclasts differentiation
Promotes osteoclasts differentiation
Inhbits osteoclasts differentiation
141
What type of hormone is PTH?
What is required for PTH to function?
Peptide 84 amino acids
1-34 amino acids
142
How PTH is regulated? (three ways)
Calcium sensitive receptors
Calcium sensitve protease (limit PTH product)
Vit D receptor
143
Effects of Parathyroid hormone?
\* little clinical use
Mobilizes bone calcium
Decreases renal excretion of calcium
Stimulates Vitamin D3 synthesis
Promotes phosphate excretion
144
Vit D biosynthesis
145
Calcitriol (Vitamin D)
Effects?
Stimulates absorption of calcium and phosphate in the intestine and the mobilization of calcium from bone.
146
Fibroblast growth factor 23
Effects?
Where is it produced?
How is it inactived?
Mutations in this site leads to?
What is the production stimulated by? inhibited?
inhibits 1,25(OH)2D production and inhibits phosphate reabsorption in the kidney
Osteoblasts and osteocytes in bone
At RXXR site
Hypophosphatemic rickets (autosomal dominant)
1,25(OH)2D01 / dentin matrix protein DMP1
147
Application of calcitonin?
Hypercalcemia associated with neoplasams
148
Glucocorticoids effect on bone regulation?
Uses?
Prolonged use?
Antagonize Vit-D intestinal calcium transport & stimulate renal calcium excretion, block bone formation
Hypercalcemia associated with lymphomas and granulomatous disease (sarcoidosis) where 1,25(OH)2D is elevated
Ostoporesis
149
How estrogen affects bone mass?
Decreases PTH action
Increases 1,25[OH]2D levels with no direct effects
Bone remodling (receptors present in bone)
150
What is osteoporosisis? Accelerated by?
What is osteomalacia? Children? Adults? Cause?
Reduced quantity of bone / Loss of ovary, drugs (e.g. corticosteroids), lifestyle
Lack of mineralization / Rickets / Bone pain & fractures / Vit Deficiency
151
Pagets disease?
Results?
Pathology?
Abnormal bone production (bone pain, skeletal deformity, neurological complications)
Osteolytic, osteoblastic, and quiescent (excessive bone resorption and formation)
152
How osteoporosis is diagnosed?
Dual-energy X-ray absorptiometry (DEXA or DXA)
-1 to -2.5 osteopenia
below -2.5 osteoporosis
153
Selective Estrogen Receptor Modulators (SERMs)
e.g. Tamoxifen and Raloxifene
Speficicity?
Mechanism?
Tissue specifc
Competitive inhibition of a-receptors and agonist in b-estrogen receptors
154
Tamoxifen
Mechanism?
Affects osteoporosis? Lipids?
Risk?
Side effects?
Blocks estrogen receptor
No (has some antiestrogenic effects), No
Endometrial cancer
Hot flashes, nausea, vomiting
155
Raloxifene
Affects osteoporosis?
Estrogenic activity?
Lipids?
Side effects?
Yes (first aproved treatment)
Yes
Decreases total cholesterol
Thromboembolic events (similar to estrogens) hot flashes and leg cramps
156
Bisphosphonates
Molecular structure?
Mechanism?
Can be given continously?
Effectiveness?
Not combine with what diet?
Side effects?
Analogs of pyrophosphate -- Designed to mimic pyrophosphate (P-O-P structure replaced by P-C-P).
Reduce osteoclasts (48 hours), block transformation of calcium phosphate into hydroxyapatite (preventing dissolution)
2 week off
Increase bone density by 4-9% over first 3 years
Milk products, food or Ca2+ supplements
Heartburn, nausea, and abdominal pain
157
Denosumab
Mechanism?
Contraindications?
Side effects?
**Denosumab inhibit** the **maturation** of **pre**-**osteoclasts** into osteoclasts and therefore prevents bone resorption. Denosumab **mimics** the actions of **osteoprogenin**, an endogenous **RANKL inhibitor** that is decreased in patients with osteoporosis.
Hypocalcemia
Increased UTI and respiratory infections, rashes, joint pain, eczema
158
Tibolone
Teriparatide (PTH analog)
C-19 steroid with weak hormonal properties
Effective
159
Hypercalcemia
Treatment?
Loop diuretics secrete Ca2+
Biphosphates IV
Cinacalcet a calcium sensor mimetic
160
Name the structures
161
Epidermis
Embryological origin?
Regeneration time?
What time of the day the division occurs?
Steps in life of keratinocytes?
Ectoderm
30days
Night
Mitosis, differentiation (keratinization), cell death, exfoliation
162
Five layers of the skin
Stratum basale
Stratum spinosum
Stratum granulosum
Stratum lucidum
Stratum corneum
163
Stratum Basale
What connections do keratinocytes have?
Intermediate filament? Change in amount?
Other cells?
Desmosomes and hemidesmosomes
Cytokeratin, increases toward surface
Melanocytes and Merkel's cells
164
Stratum Spinosum
Thickness?
Bundles of cytokeratin?
Shape?
Other cells?
Several layers
Tonofibrils
Langerhans cells and melanocytes
165
Mitotically active layers
Stratum Basale and Spinosum
Malpighian layer
166
Stratum Granulosum
Contain what structures?
Insulation?
Formation of keratin?
Lamellar bodies, membrane-less keratohyalin granules, and bundles of tonofilaments (cytokeratin)
Lamellar bodies fues with PM and release GAGS and phsopolipids to ECM
Keratohyalin has histidine and cystine rich proteins binding to tonofilaments. This convers cells to conified cells (first step in keratinization)
167
Stratum Lucidum
Present in what type of skin?
Staining?
Keratin type?
Thick only
Acidophilic
Contains immature keratin (eleidin)
168
Stratum Corneum
Cell charactersitics?
Dead, platelike, enucleated keratinocytes containing mature keratin
169
Psoriasis
Accelerated keratinocyte mitosis in stratum basale and spinosum
Turnover (one week instead of 4 weeks); leads to thickening of epidermis
170
Langerhans’ Cells
Origin?
Function?
Characteristic molecule?
Location?
Where are they present?
Bone marrow (MNP)
APC
Birbeck’s Granules rodlike or racket-shaped
Stratum spinosum
oral, esophageal, rectal and vaginal epithelium as well as thymus
171
Merkel’s Cells
Layer?
Origin?
Structures?
Where are found the most?
Function?
Stratum basale
Neural crest cells
Desmosomes and tonofilaments
Thick skin
Sensory mechnoreceptors
172
Melanin
Contribution to?
Origin?
Layer?
Have desmosomes?
Enzymes?
Why different skin colors?
Skin, eye, hair color, freckles
Neural crest
Stratum basale 10-25%
No
Tyrosinase, an UV-sensitive enzyme involved in melanin synthesis
Not related to number but activity
173
Mature melanin granules
Where does melanin initially go to?
Location of accumulation?
Removal of melanin?
Protective role
Injected into keratinocytes
Around nuclei
Attacked by lysozomes (over a few days)
Absorption of free radicals
174
Two layers of dermis?
Structures present?
**Papillary Layer (superficial)**
Dermal papillae
Meissner's corpuscules (fine touch)
Type III and type VII collagen bindin to epidermis
**Reticular Layer**
follicles, sweat, and sebaceous glands
dense irregular connective tissue
elastic fibers and collagen type 1
175
Hypodermis
Thicknes variations?
Type of tissue?
Really thick hypdermis name?
Another name?
nutritional status, level of activity, body region and gender
Loose ct and adipose tissue
Panniculus adiposus
Subcutaneous fascia
176
Sensory Receptors
Meissner corpuscule
Merkel cells
Free nerve endings
Ruffini end organ (pacinian corupuscle pressure)
Peritrichial nerve ending
177
Thick vs. Thin skin
178
Hair and Arrector Pili Muscle
What layers form these structures?
What is hair follicle composed of?
Any hair follicles formed after birth?
Both epidermis and dermis
Shaft and bulb
No
179
Sebaceous gland
Types?
Where does it empty?
Health problems associated with them?
When do they form?
What the baby is slippery?
When become inactive/active?
Hair dependent and independent
Into the neck of hair follicle
acne
6th moth in utero
vernix caseosa
At birth / at puberty
180
Eccrine Sweat gland
Shape?
Secretory unit?
Ducts lining?
Type of secretion?
Sensitive to?
Function?
Simple coiled ubular gland
Dark, celar, and myoepithelial cells
Stratified cuboidal epithelium (modification sweat by absorbing, electrolytes, excreting ions, urea, and lactic acid)
Merocrine
Heat and nervous stress
Thermoregulatory and excretion (urea, ammonia)
181
Hyperhidrosis
What is it?
Location?
Treatment?
Excessive sweating
Hands
1.antiperspirants 2.Iontophoresis 3.drugs 4. surgery for axillary glands
182
Apocrine Sweat Gland
Location?
Function?
When activated?
Sensitive to?
Specialized sweat glands in axilla, areola of the niple, and perianal region of Moll, ceruminous (Wax) glands of the ear
Vestigial scent glands
Puberty
Hormonal, emotional, and sensory NOT heat
183
Sunburn
Effect on keratinocytes?
Melanocytes?
Langerhans?
Dermal changes?
Lose alignment, flatten, obtain nuclear inclusion
Melanocytes enlarge, increase in number, and migrate to higher levels of epidermis
Reduceing antigen presenting capability
Less elastic, leaky vasculature, increase in mast cells
184
Actinic keratosis
What is it?
Progression to?
Colors?
Which part of the body does it present?
Pre malignant condition of thick, scaly, or crusty patches of skin.
Squamous cell carcinoma / or dissapear (1/2 will go away if not exposed to sun damage)
Vary
scale or crust is dry, rough
Part that is exposed to the sun
185
Skin cancer
Characteristics?
Basal cell carcinoma
186
Melanoma
Initial apparance?
Common location
usually appears as dark brown or black mole like lesions
upper back in men and legs in women
187
ABCD
for melanoma
A: asymmetry- one side or half does not look like the other
B: border irregularity
C: color-black, or much darker than patient's other moles, often with red, white or blue areas.
D: diameter \> 6 millimeters
188
What is kyphosis?
What is lordosis?
**Kyphosis**
Abnormal increase in thoracic curvature (thoracic wedge fracture; osteoporosis; loss of heigh)
**Lordosis**
Abnormal increase in lumbar curvature (obesity; compensatiory lordsis)
189
What is scoliosis?
Abnormal lateral curvature
190
Steele's rule of 3
191
Hangman's fracture
192
Hyperextension injury
