Week 5 Flashcards
1
Q
General somatic afferent fibers
A
Bring conscious/unconscious sensory memory from body wall and limbs
2
Q
General visceral afferent fibers
A
Bring sensory information from visceral structures to CNS
3
Q
General somatic efferent fibers
A
Innervation of voluntary skeletal muscles
4
Q
General visceral efferent fibers
A
Innervation of cardiac muscles, smooth muscles, and glands
5
Q
Dorsal root ganglions
A
Afferent nerve fibers
6
Q
Dorsal horn
A
Entry of sensory information
7
Q
Ventral horn
A
Location of motor neurons
8
Q
Lateral Horn (Thoracolumbar)
A
T1-L2Location of preganglionic sympathetic neurons
9
Q
Craniosacral preganglionic nerves
A
Parasympathetic originsBrainstem and S2-S4
10
Q
Path of efferent sympathetic nerve transmission
A
Information from CNS –> Travel down to spinal cord –> Leave through lateral horn via ventral root –> Enter spinal nerve –> Enter sympathetic ganglion via white ramus –> Exit sympathetic ganglion via gray ramus –> Travel through spinal nerve to target
11
Q
White ramus
A
Myelinated connection between spinal nerve and sympathetic ganglionOnly T1-L2
12
Q
Gray ramus
A
Unmyelinated connection between sympathetic ganglion and spinal nerveAll levels
13
Q
Path of efferent sympathetic nerve transmission (to cervical/lumbar area)
A
Information from CNS –> Travel down to spinal cord –> Leave through lateral horn via ventral root –> Enter spinal nerve –> Enter sympathetic ganglion via white ramus –> TRAVEL UP OR DOWN SYMPATHETIC CHAIN –> Synapse –> Exit sympathetic ganglion via gray ramus –> Travel through spinal nerve to target
14
Q
Tyrosine –> Epinephrine synthesis pathway
A
Tyrosine –> DOPA –> Dopamine –> Norepinephrine –> Epinephrine
15
Q
Neurotransmitter synthesis enzymes (Tyrosine –> Epi)
A
Tyrosine HydroxylaseDOPA decarboxylase D-beta-hydroxylasePNMT
16
Q
Major mechanism for termination of NE action
A
Reuptake pumpUptake-1
17
Q
Monoamine oxidase
A
Oxidizes NE to be degraded
18
Q
Cocaine
A
Inhibits NE re-uptake into nerve terminalMore NE –> enhanced response
19
Q
Imipramine
A
Tricyclic antidepressantInhibits NE reuptake
20
Q
Tyramine
A
Indirectly acting sympathomimeticMimics NE activity by using NETaken up by uptake-1 pump –> oxidized by MAOIf MAO-inhibitor –> Not oxidized –> displaces NE from vesicles
21
Q
Resperpine
A
Root of Rauwolfia serpentinaInhibits vesicular uptake of NE –> depletes vesicle so less NT when released
22
Q
D-beta hydroxylase location
A
Within vesicle, released during exocytosis
23
Q
Readily Reversible AChE inhibitor
A
Binds to active site but no covalent bond formation
24
Q
Intermediate reversible AChE inhibitor
A
Covalent bond formation and then bond hydrolyzed - carbamates
25
Irreversible AChE inhibitor
Non hydrolysable covalent bondOrganophosphate
26
Regeneration
Proliferation of cells and tissue with host replacement tissueLiver regeneration after resection
27
Repair
Combination regeneration and deposition of collagen (scar formation)Dermal wound healing
28
Stimulatory control of cell proliferation and growth
Growth factors and cytokinesHormonesCell-cell interactionsCell matrix interaction
29
Inhibitory control of cell proliferation and growth
Contact inhibitionGrowth factors
30
Stages of liver regeneration
Priming: IL-6 produced by Kuppfer cells make hepatocytes competent to respond to growth factorsGrowth factors: HGF, TGF-a act on primed hepatocytesHepatocytes move from G0 to G1 phase of cell cycle
31
Kuppfer cells
Resident liver macrophages
32
Oval cells
Hepatic ductal cells which accumulate during toxin exposureReplace parenchymal cells and restore function
33
Primary union of skin incision
Clean injurySpace clots --> neutrophil infiltrate --> epithelial cell migration/proliferation --> Macrophage --> Granulation tissue forms --> Collagen begins to bridge wound ~1 week
34
Angiogenesis
Blood vessel formationNotch signaling pathway
35
Secondary union of skin
Larger wound, more inflammation, more granulation tissue fills defect, longer healing timeWound contraction reduces size
36
Labile cells
Continuously dividingEpidermis, bone marrow, GI mucosa
37
Stable/Quiescent cells
Potential to divideHepatocytes, renal tubular epithelium, endothelium, connective tissue, smooth muscle
38
Permanent cells
Unable to divideNeurons, cardiac myocytes, skeletal muscle
39
Determinants of quality of healing
Regenerative capacity, stromal injury, contamination, proliferative activity of connective tissue
40
Excessive repair
Hypertrophic scarsKeloids
41
Characteristics of benign neoplasms
Pushing, smooth borderHistology looks like normal tissueDo no metastasize
42
Malignant neoplasms
Hard tumorInfiltrating, invasive locallyLack of differentiation: anaplasiaMay extend into adjacent tissue or invade nerve sheaths (perineural invasion) and blood vessels (vascular invasion)
43
Invasion of matrix across basement membrane
Tumor cells lose cohesion --> secrete proteolytic enzymes --> Attach to extracellular matrix via receptors for laminin/fibronectin --> locomote through matrix
44
Alpha-1 receptor activation effects
Vasoconstriction
45
Alpha-2 receptor activation effect
Inhibition of transmitter release (NE and ACh)
46
Beta-1 receptor activation effects
Increased cardiac rate (SA node) and force (and output)
47
Beta-2 receptor activation effects
Bronchodilation, vasodilation Only Epinephrine
48
Beta-1 agonist activity
Increased cardiac output, HR
49
Beta-1 antagonist activity
Prevent increase in cardiac output
50
Beta-2 agonist activity
Dilate airways, decrease resistance
51
Beta-2 antagonist activity
Constrict airways, increase resistance
52
Alpha-1 agonist activity
Constrict blood vessels, increase BP
53
Alpha-1 antagonist activity
Dilate vessels, decrease BP
54
Pheochromocytoma
Tumor of adrenal gland, releases Epi and NEIncrease BP, HRHeadache, sweating, hypertensive crisis
55
Route 1 for sympathetic transmission
Preganglionic axon enters sympathetic chain (white ramus) --> synapse --> exit via gray ramus --> postganglionic axon to target
56
Route 2 for sympathetic transmission
Preganglionic axon enters sympathetic chain (white ramus) --> Travel up/down sympathetic chain --> synapse --> postganglionic axon to target
57
Route 3 for sympathetic transmission (thoracic)
Preganglionic axon enters sympathetic chain (white ramus) --> synapse --> Travel to heart via splanchnic nerve
58
Route 4 for sympathetic transmission (Abdominal)
Preganglionic axon enters sympathetic chain (white ramus) --> Splanchnic nerve to target organ --> synapse and postganglionic innervation
59
Parasympathetic preganglionic synapse location
Intramural ganglia on wall of visceral structure
60
Vagus nerve
Parasympathetic nerve which branches off to target organsInnervates GI tract up to splenic flexure
61
Pelvic splanchnic nerves
Sacral portion of parasympathetic divisionPelvic viscera, GI tract distal to splenic flexure
62
Heart muscle sympathetic vs parasympathetic
S: Increase rate/forceP: Decrease rate
63
Bladder urethra sympathetic vs parasympathetic
S: Detrusor relaxation, constriction of sphincterP: Detrusor constriction, relaxation of sphincter
64
Lungs sympathetic vs parasympathetic
S: BronchodilationP: Bronchoconstriction
65
GI organs sympathetic vs parasympathetic
S: Decreased peristalsis/secretionP: Increased peristalsis/secretion
66
Eye sympathetic vs parasympathetic
S: DilationP: Constriction
67
Glands sympathetic vs parasympathetic
S: Less secretionP: Increased secretion
68
Phenylephrine
Alpha adrenergic agonist
69
Epinephrine
Alpha and Beta adrenergic agonist
70
Scopolamine
Muscarinic receptor antagonist
71
Pupil innervation
Cholinergic and AdrenergicACh = parasympathetic = constriction = miosis *Circular muscle contraction*NE = sympathetic = dilation *Radial muscle contraction*
72
Ciliary muscle innervation
M: ContractionBeta2: RelaxationPrimarily Parasympathetic innervation
73
Vascular smooth muscle innervation
Single innervation: SympatheticAlpha1: ContractionBeta2: RelaxationNO CHOLINERGIC
74
Muscarinic receptors on endothelium
Can release NO which relaxes VSM
75
Sinoatrial node innervation
Dual innervation: Primarily parasympatheticACh & NEBeta1: Increase HR, contractilityBeta2: Only EpiM: Decrease HR
76
Atropine
Muscarinic receptor antagonist
77
GI innervation
Dual innervation: primarily sympatheticM: Contract, peristalsisBeta2: Relax, no peristalsis
78
Sphincter muscle innervation
Dual innervation: primarily sympatheticMuscarinic receptor mediated relaxation (via NO)Alpha1: Contraction, retention
79
Isoproterenol and VSM
Activates B2 --> relaxation
80
Sarin gas
AChE inhibitorIrreversible
81
Wound contraction
Reduction of size of defectMyofibroblasts3-5 days after injury
82
Wound strength
Early (week 1)- 5-10% original strength- Fibrin, re-epithelializationFirst month- Collagen content- 15%Month-years- Collagen linking/remodeling- Max 60% original strength
83
Phases of wound strength
LagRapid increase Slow increasePlateau
84
Keloids vs hypertrophic scars: Similarities
Excessive granulation tissueExcessive collagenInitial morphological similarity
85
Keloids vs Hypertrophic scarsL Differences
Keloids do not regress, recur, extend beyond injury site
86
Biological aging of cells: Increase and decrease
Increase: Organelle damageDecrease: Oxidative phosphorylation, protein synthesis, nutrient uptake, DNA repair
87
Cardiovascular aging
Intimal thickeningVascular stiffnessHypertension, atherosclerosis
88
Urinary aging
Bladder elasticity declines, glomerulosclerosisBladder control problems decline in kidney function
89
Respiratory aging
Loss of elasticity, immunityInfection, reduced exercise tolerance
90
Endocrine system
Hormone levels changeAge associated disease, diabetes, hypotension
91
Liver aging
Decreased blood flow, loss of hepatocytesDrug metabolism declines, Adverse drug reactions
92
GI aging
Gi hormone decrease, smooth muscle atrophyConstipation, Reflux, nutritional defecits
93
Trauma and aging
Inflammation and re-epithelialization is delayed
94
Cumulative damage and aging - Accumulation
Waste product accumulation: LipofuscinAdvanced glycation end products- non enzymatic addition of sugars to proteins- Affect multiple tissues-Skin collagen and lens
95
Hutchinson Gilford Progeria syndrome
Hydrocephalic appearancePremature aging lookAge associated pathology - osteoporosis, insulin resistance, CVDLamin A gene-Splice disorder --> Deletes 50 amino acidsNew protein is progerinDisrupts nuclear envelope
96
Werner's Syndrome
Autosomal recessivePremature wrinkling and graying, age related pathologyCancerMutant gene: WRN-1 (helicase)
97
Telomeres
Added by telomeraseLength shortens after division --> trigger p53
98
Resveratrol
Extends lifespan in lower organisms
99
Rapamycin
Increases lifespanEnhances progerin clearanceImmunosuppressive
100
HPV protein E6
Mimics MDM2Ubiquination and degradation of p53 protein--> loss of tumor suppressor
101
HPV protein E7
Eradicates function of RBRemove brake against proliferation
102
EBV in immune suppressed patients
Activates BCL2Prevents apoptosis
103
Chronic inflammation and cancer promotion
Release factors for cell proliferation by leukocytes or by protease digestion of ECM
104
HER2/neu
Amplification in breast cancer
105
N-myc
Amplification in neuroblastoma
106
Acute leukemias defect
Translocation
107
ZAP-70
Chronic lymphocytic leukemia
108
Chronic phase CML
Elevated WBC, eosiniphilia and basophilia
109
Accelerated phase CML
20% blasts
110
Imatinib (Gleevec)
Inhibits bcr-abl tyrosine kinaseStops leukemia
111
Familial breast cancer cause
BRCA-1, BRCA-2
112
Familial polyposis cause
APC tumor supressor
113
Hereditary nonpolyposis colon cancer cause
Double stranded DNA repair genes
114
Xeroderma pigmentosum cause
Nucleotide excision repair genesUV light exposure --> Pyrimidine-pyrimidine dimers
115
Order for cancerInitiator/promotor
Initiator first then promotor
116
HTLV I
T-cell leukemia/lymphomaCommon in Japan and Caribbean
117
SA node resting tone and effect of ganglionic blocker
ParasympatheticGanglionic blocker = tachycardia
118
Myocardium ventricle resting tone and effect of ganglionic blocker
SympatheticGanglionic blocker = Reduced contractility
119
Basic steps of wound healing
InflammationGranulation tissue formationRe-epithelizalizationWound contraction and ECM deposition
120
Stimuli for GVA (pain)
pH (ischemia/hypoxia)distention (stretch)Spasms of strong activationChemical irritantsLowering of membrane potential for stimulation
121
Granulation cell
ECMInflammatory cellsFibroblastsBlood vessels
122
Wound healing cells
MyofibroblastsSmooth muscleParenchymalLeukocytesEndothelialFibroblasts
123
Cytokines for wound healing
Platelet derived GFTGF betaBasic Fibrobalst GFEpidermal GFVascular endothelial GFIL-1,8
124
Growth factor functions
ProliferationLocomotionDifferentiationAngiogenesisSurvival
125
miRNA tumor suppressor
145Breast, colon
126
Her2/neu treatment
Monoclonal antibody
127
Perineoplastic syndrome
CushingsHypercalcemiaSIA-Dehydrogenase
128
Rituximab
Drug that acts on CD20 of B cells
