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103 Cards in this Set
- Front
- Back
EKG findings for 1st, 2nd, and 3rd degree blocks
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1= increased PR (norm -.12-.2)
2= Q with P, but PR increases; P not always with Q 3= p without A, Q without P |
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Enchancement of S2
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Enchancement of S2 by delaying pulmonic valve closure
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How does Ach Effect the heart
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Ach -> Sa and AV nodes, increasing PR interval
effects mediated by modification of phase 4 slope |
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Phase 0, 3 and 4 in SA node
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Phase 0 (upstroke) - ca influx
Phase 3 (downstoke) - K+ Phase 4 (slow upstroke) - Na funny |
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Inspiration and Systemic Arterial Pressure
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Insp decreases SAP by decreasing LV output
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Cushing's Response
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Increased ICP leads to increased Systemic arterial pressure (via VMC) in order to maintain cerebral blood flow. There may be profound bradycardia (via Baroreceptors)
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LaPlaces Law
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wall tension = T*P*r/thickness
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Control of Breathing
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Basic rhythym set at Dorsal Medulla
Input comes from apneustitic centers in pons; and pnemotaxic centers (nucleas parabronchialis) |
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FeV1 and Vital Capacity
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FeV1 is usually 85% VC
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Alveolar Volume Eqn
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Va=Vt-Vdead Times Frequency
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relation between Alveolar oxygen, and inspired oxygen
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PAo2 = PiO2-PaCo2/.8
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What happens to pCo2 in V/Q mismatch
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with V/Q mismatch you see a decrease in PCo2 as a result of in an increase in ventilation due to the drop in P02
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V/Q ration in the normal lung: where is it highest
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in the apex (low lung compliance b/c the artery is big)
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Central vs. Peripheral Chemoreceptors
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Central respond only to Pco2 (main) and pH
Peripheral respond to pC02, pH, O2 (less than 60 mmHg) |
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Hering-Breuer Reflex
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Lung stretch receptors -> inh inspiration
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muscle that contracts during inspiration
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external intercostals
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Define DlCO
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amt of O2 that pass per 1 mmHg of gradient of O2
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HyperKalemia and paralysis
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HyperK decreases the gradient for K+, thus DEpolarizes the membrane and leads to sodium channel inactivation
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Dihydropyridine Receptors
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Voltage gated ion Ca channels in striated muscle that aid in excitation-contraction coupling
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Excitation contraction coupling in smooth muscle and cardiac cells
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Cardiac -> Ca opens SR
SM -> IP3 |
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Phospholamban
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inhibits ryanodine receptor Ca pump... inhibition of phospholamban leads to increased calcium sequestration (this occurs via PKA phosphorylation
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Mg2+ and muscle contraction
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Mg2+ inhibits it
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Calcium and muscle excitabilty
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decreased calcium leads to increased excitability (I believe this is because Na gets activated)
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Capacitance and conduction velocity of neurons
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decreased capcitance leads to increased velocity (less electrons must flow)
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Light Rxn with Eye
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Light hits Rods, causes increased hydrolysis of cGMP (via more all trans) which hyperpolarizes cell leads to decreased inh NT release on bipolar and ganglion
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Substance P
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Subs P is released pain fibers (C-delta) on spinal cords
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Molecular effects of epinephrine on smooth muscle
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epi increase PLC which increases Ip3
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PKA and Phospholamban
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PKA phosphorylates Phospholamban, increasing Ca sequestration (and decreases SM contractility)
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A, C, V waves
W and Y decents |
a wave -> atrial contraction
c wave -> tricuspid be pushed back by contracting ventricle x decent -> continued atrial relaxation during systole v wave -> atrial filling against closed mitral valve y descent -> rapid ventricular filling |
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Organ with highest AV gradient
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the heart
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pressure gradient between aorta and ventricle
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think aortic stenosis
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How much blood is in your arteries and veins vs. Pulmonary Circulation at a given time
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Arteries and veins -> 2/3 blood
Pulmonary circulation -> 10% of blood |
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How do you keep PDA open?
How does it close? |
keep open with prostaglandins
Closure: Oxygen -> bradykinin -> closure DA (pharmacologically closed with indomethicin) |
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Why do the lungs have lots of lymph?
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High lymph b/c of high levels of interstitual proteins
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Coorelation of turbulence and vessel size, blood velocity, blood density, and blood viscosity
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Reynolds Eqn: http://www.cvphysiology.com/Hemodynamics/H007.htm
more turbulence with bigger vessel, higher velocity, high blood density and LOWER viscosity (velocity and viscos should be inversely related) Don't get caught up on the diameter thing though, because increased diameter also leads to decreased velocity which reduces turbulence and the likelihood of seeing turbulence |
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compare CO and met actvity of kidney
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Kidney si unique in that it receives 20% of CO with relatively low metabolic activity (most in cortex, where Na reabs occurs
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TPR and Pulm BF changes at Birth
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TPR increases with loss of placenta
PBF increases as pulm resistance decreases |
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Major contractility pattern during digestive phase? How is it activated?
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Segmentation, which is activated by wall distention
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Role of Ca2+ in B12 absorption
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IF-B12 bind to enterocytes via interaction with calcium
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effect of VIP, ACh, Sub P, and Dopamine of Smooth Muscle (GI)
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VIP -> relaxation (VIPoma presents with diarrhea)
ACh, Sub P, and Dopamine -> contraction |
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Where is most water and Na reabsorbed?
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most H2o/Na reabs occurs in the small bowel (jejunem = #1 site, duodeum = #2)
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Motilin
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MMC hormone
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Amino Acid absorption
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occurs in the jejunum
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Vitamin synthesized by bacteria, and is abosorbed by humans (humans still will get it form other sources however)
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folic acid
vit K, B6, thiamine are also synthesized by bacteria, however not absorbed in appreciable amounts |
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Aldosterone and the colon
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Na/K under it's control (net K= secretion?)
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Bicarb and the colon
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Hco3- is secreted in the colon (think diarrhea gives you met acidosis-- norm anion gap)
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Two things needed for Absorption of fat soluable vitamins (besides intact bowel)
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1) Bile
2) Pancreatic Lipases |
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Absorption of fructose glucose and galactose
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fructose -> facilitated diffusion
Glucose and Galactose -> Na-dep active transport |
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pH of Saliva
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Saliva has HCo3-, thus it it basic
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What is the effect of sulfonylation of Bile Acids
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aids in excretion
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How are Bile Acids conjugated
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With Taurine and Glycine. Bile acids are secreted conjugated with these amino acids
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Caffiene and EtoH on stomach pH
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Both stimulate the secretion of Gastric Acid
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2 regulators of Pancreatic enzyme secretion
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Neural (vagus-Ach)
Hormonal (CCK; secretin -> Hco3- and water secretion, not enzyme) |
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Where are secondary Bile acids formed?
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in the small intestine
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Enterogasterone
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released by SI. Acts to inhibit antrul Gastrin release
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Where is most renal Na reabsorption occur?
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In the cortex
Na reabso is proportional to O2 consumption |
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What does the Tmax for glucose refer to?
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Tmax refers to the maximal reabosprion rate of glucose (mg/min)
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What are the 2 things that regulate Aldosterone
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1) Ang II
2) K+ (high leads to it's secretion) |
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What percent of TBW is Plasma?
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plasma is 8%, or 1/4 of ECF, which is 1/3
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What things increase Renin secretion?
Decrease it? |
Renin Secretion increased by sym. stimulation; adenosine from macula densa increases it too
Decreased by: Ang II and ANF |
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How is Na reaborbed in the Proximal Tubule? Where are the transporters?
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Na/K on basolateral
Na/H, Na/glucose, etc. on apical |
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Anion Gap
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Na-(Cl+Hco3-)
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Importance of PAH
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PAH clearance is a good indicator of RPF, since all of it is secreted
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Filtered Load
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FL=GFR*plasma conc
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Net Acid Excretion
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NAE= NH4 + TA- bicarb
TA is mostly Po4- |
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What is the normal amount of fixed acid load
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70-100 meq of acid
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Why is there a lower pH and higher Na gradient in the distal neph when compared with the proximal
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distal has more tight jxns
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Aldosterone and H+ secretion
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Aldosterone increases Na/K exchanger, decreasing the activity of the Na/H exchanger... this increases H+ secretion
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Sympathetic stimulation of kidney and protein excretion
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Sym Stim increases protein excretion (I think it's secondary to vasocontriction)
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Prostaglandins and Renin
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PG's stimulate Renin release (like adenosine)
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Volume depletion and Hyperaldo on systemic pH
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Volume depletion and Hyperaldo create met ALKALOSIS (both lead to increased Na reabsorption which created increased proton excretion)
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Trophic Effects of ACTH
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ACTH -> GC andSex hormones, not Aldosterone (zona glomerulosa)
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Distal Tubule, acid secretion, and potassium
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In situations of hypoKalemia, H+ goes inside of cell instead of K+, leading to increased K+ secretion
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Glutamine and the kidney
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Glutamine uptake used to make NH4+-> H+ secretion
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Which arteries bath Loop of henle
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Vaso Recta
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Supraoptic and Paraventricular Nuclei
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Supraoptic -> ADH
Paraventricular Nuclei ->oxytocin |
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FSH and LH in spermatogensis
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pulsatile GnRH -> FSH and LH
FSH -> Sertoli cells -> meiotic and mitotic division of sperm LH -> testerone release by leydig cells |
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Hormone of fetal Adrenal Cortex
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fetus makes primarily DHEA (they lack 3beta-hydroxy steroid DH)
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Hormone sensitive Lipase
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the hormone is epinephrine and glucogon, not insulin
epinephrine and glucogon -> increased cAMP -> phosphorylates Lipase -> increased TG's breakdown in fat |
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Of the 3 effects of PTH, which is predominant?
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the effect on bone (reabs)
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Ang II and thrist
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Ang II activates subfornical organ in Diencephalon
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Heat Intolerance and Thyroid hormones
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Heat intolerance = hyperthyroid
cold -> hypo |
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Cabbage and turnips
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have goitrogens (increase thyroid size)
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L-arg
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stimulates GH release
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Melatonin
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syn by Pineal Gland; in dark, synthesis increases via norepi from postgang sym fibers; fxns include inhibition of GHRH
IS NOT ASSOCIATED WITH SKIN COLOR (that is melanin) |
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Anti-inflammatory actions of cortisol
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1) decreases vasc permeability
2) decreases IL-1 secretion 3) stabilizes lysozomal membranes 4) inhibits PPLA2 |
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Ductal and glandular growth in breast
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Estrogen -> ductal
Progesterone -> Glandular |
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Effect of progesterone and estrogen on cervical mucosa
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Est -> thinner, more fernlike
Progest -> thicker (blocks sperm) |
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Milk Let-down
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associated with oxytocin
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Secretion of Pancreatic polypeptide
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Secreted by F cells in Islet
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Near Vision
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near vision = increased refractive power= contraction of ciliary body
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Spindle fibers
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Spindle -> Ia fibers -> length and velocity
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Golgi tendon
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Golgi tendon -> Ib fibers -> tension of muscle
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Tetany and contraction strength. Why?
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Tentany (or increased firing rate) -> increased contraction b/c of increased cross bridge cycling time (not b/c of increased intracellular calcium)
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gamma motor fibers
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maintain Ia spingle activity during contraction of muscle
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Raffini ending
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= tonic receptors-- pressure sensors in the skin
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Pacacian (?Sp) Receptors
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Deeper, detect skin deformation (vibration)
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Muscle Recruitment for activity
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Small MU before Large
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Spacticity
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spasticity is associated with loss? of corticoreticular fiber that inhibit vesttibular spinal and reticulospinal neurons. These act on Ia fibers, and cause spacticity...
GET BETTER EXPLANATION |
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Primary Fxn of cerebellum
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Posture
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EEG: alpha and delta waves
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alpha- normal, awake with shut eyes, 8-12 waves/min?
delta- sleep, slow and big |
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Vibration of basilar mem in cochlea
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High Freq-> base (oval and round window)
Low -> apex of cochlear |
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Babinski Reflex
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Rep UPM damage
due to damage of CST in pyramids to spinal cord |