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183 Cards in this Set
- Front
- Back
Most common location for an orbital fracture. |
(Floor) Maxillary bone. 'Blowout Fracture' Enopthalmia=sunken in eyeball position
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Thinnest part of the bony orbit. |
(Medial wall) Ethmoid bone also called the lamina papyracea. Despite thinness it rarely fractures. Severe sinuses can erode through this thin was causing orbital cellulitis |
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Back wall of orbital walls. |
Greater wing is sphenoid bone with lesser wing surrounding the Optic Canal. Palatine Bone. |
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Corrugator Supercilii Muscle |
contraction moves eyebrows together (medially) for facial expression |
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Eyelids are also called... |
Palpebrae |
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Opening between the eyelids |
Palpebral fissure. eyelids meet medially and laterally at the medial lateral commisure |
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Elevated bit of flesh found at the medial canthus |
Lacrimal Caruncle- has sebaceous & sweat glands that make a whitish yellow oil |
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Epicanthic Folds |
Vertical skin covering medial commissure. Normally expressed in Asian races. |
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Tarsal glands aka Meibomian Glands |
-modifies sebaceous gland located underneath and inside tarsal plate. posterior to the eyelashes. - secretes oily substance to keep eyelids from sticking together and prevents tear film evaporation. makes eyelids close air tight |
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Ciliary Glands |
sebaceous glands & modified sweat glands found between eyelashes and superficial to the tarsal plate |
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Chalazion |
Blockage of the tarsal glands |
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Stye |
Blockage of ciliary glands |
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Levator Palpebrae Superioris |
-Opens eyelid. -damage causes Ptosis (droopy eyelid) -Cranial Nerve III. Oculomotor nerve |
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Orbicularis Oculi Muscle |
-Closes eyelid (depresses eyebrows) -Damage causes difficulty to fully close eyelids -Hook closes eyelid -blinking reflex every 3-7 second to protect eye |
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Lacrimal Gland |
-Where tears are formed -Tears flow across eye medially |
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Lacrimal puncta |
-where tears enter -openings of the lacrimal canaliculi |
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Lacrimal Sac |
-where tears collect |
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Nasolacrimal Ducts |
-where tears drain into the nose |
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Inferior Nasal Meatus |
-where tears exit into nose |
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Lacrimal fluid contains... |
Mucus, antibodies and lysozyme an enzyme that destroys bacteria |
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Palpebral Conjunctiva |
-thin sheet that lines the inner surface of the lids - conjunctive- a transparent mucous membrane |
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Bulbar Conjunctiva |
-part covering sclera(white part of the eye) and not covering the cornea |
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Conjunctival Sac |
-space created by the fold of the palpebral over the bulbar. -good for holding contacts and spot for eye medication |
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Conjunctivitis is the same as... |
Pink eye |
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Movement of each eyeball is controlled by six extrinsic eye muscles |
-originate from the bony orbit -4 rectus muscles; originates from the annular ring(common tendinous ring) -2 oblique muscles; superior oblique, only eye muscle that passes through the trochlea, also originates in the common. the inferior oblique originates from the medial orbit surface -all 6 extrinsic muscles insert on eyeball surface |
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Lateral Rectus |
Moves eye laterally Cranial nerve VI (abducens) |
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Medial Rectus |
moves eye medially Cranial nerve III (oculomotor) |
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Superior Rectus |
Elevates eye and turns it medially Cranial nerve III (oculomotor) |
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Inferior Rectus |
Depresses eye and turns it medially Cranial nerve III (oculomotor) |
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Inferior Oblique |
Elevates eye turns it laterally Cranial nerve III (oculomotor) |
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Superior Oblique |
Depresses eye and turns it laterally Cranial Nerve IV (trochlear) |
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Diplopia |
-Double Vision -temporary poor coordination of extrinsic eye muscles |
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Strabismus is... |
Cross eyes congenital weakness of extrinsic eye muscle |
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Sclera (Fibrous Layer) |
White part of the eye. -where the extrinsic eye muscles attach -avascular |
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Cornea (fibrous layer) |
Clear and bulges is about 540 microns thin -outside of cornea-stratifies squamous -inside of cornea-simple squamous - bends light entering eye affecting vision |
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Vascular Layer |
-Choroid Plexus -Ciliary body-round sphincter like smooth muscle -Iris-smooth and elastic fibers. identification, color varies -Pupil-round opening in iris |
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Mydiasis |
Excessive dilation |
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Dilator Pupillae |
-Fibers are radial -is outer layer -increases pupil size |
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Dilation= |
Sympathetic Activation (via CN V1) -distant vision and dim light, LSD, Marijuana, drugs, sexual arousal Fight or flight |
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Sphincter Pupillae |
-is inner layer -fibers are circular -decreases pupil size |
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Miosis |
Excessive pupil constriction |
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Constriction |
-Parasympathetic activation (via CN III) -close vision, bright light, boredom, opiates, morphine |
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Iris has two muscles |
-Sphincter pupillae-inner layer -Dilator pupillae-outer layer |
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Outer pigmented layer of the retina |
stores vitamin A -single cell layer of pigmented cells -act as phagocytes to remove damaged photoreceptors |
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Inner neural layer of retina |
-play direct role in vision -has 3 neuron layers 1.photoreceptor cells; rods and cones 2.bipolar cells-middle layer signal sent to ganglions 3. ganglion cells-inner layer action potential to brain |
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Macular Edema |
most common cause of blindness in diabetics -treatment- argon laser, vitrectomy and replacement with saline, pan-ratinal photocoagulation using argon laser |
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Types of retinal detachment |
1. Rhegmatogenous-tear through retinal layer 2. Traction- retina pulled off by neovascularization 3. Hemorrahgic/Exudative-blood or fluid build up behind retina and pushes it off
fully detached retinas will still be attached to the ora seratta and optic disc |
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Fundus |
back of the eye the doctor looks at with apthalmascope -optic disc -macula lutea |
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Optic disk aka blind spot |
lacks photoreceptors spot where optic nerve exits the eye (CN II) |
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Choroid |
-supplies the photoreceptor (rods & cones) -Retinal detachment vitreous humor leak between pigmented layer of retina and photoreceptors |
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Central artery and central vein |
-supplies the bipolar and ganglion cells layers of fundus -enters and exits the eye via the optic disc |
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Posterior Segment |
-area behind the lens and the Vitreous humor fills it. transmits light -pushes neural retina firmly against pigmented layer |
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Anterior Chamber |
anterior to the iris and pupil but behind the cornea |
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Posterior Chamber |
behind the iris and pupil but in front of lens |
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Aqueous humor |
-supplies nutrients and removes metabolic waste mostly for lens and cornea -forma, circulates, and drains continuously -fluid goes from posterior to anterior chamber -normal pressure 10-22 mm Hg |
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Glaucoma |
-disease where optic nerve dies -high intraocular pressure -Open angle (chronic) most common in US with patients over 40yrs -Closed angle (Acute) opthalmological emergency can result in irreversible vision loss to full blindness, angle between the cornea and iris closes abruptly |
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The Lens |
-biconvex, transparent, flexible -held in place by suspensory ligaments -avascular & no innervation -Lens epithelium(anterior) cuboidal cells -Lens fiber, no nuclei and few organelles, 35% protein and 65% water. protein called crystallins |
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Cataracts |
-cornea is fine, lens is milky ad opaque -clumping of crystallin proteins |
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Visible light spectrum is... |
-about 400-700nm |
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Focal Point |
lens surface is convex so they are bent so they converge at this single point |
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Constant Refraction |
cornea, aqueous humor, vitreous humor |
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Variable Refraction |
-accomplished via Lens -Sympathetic activation- distant vision -Parasympathetic activation- close vision |
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Emmetropic Normal Eye |
-normal eye far point of vision is 20ft. -the eye is best adapted for distant vision -99% of refractive problems are related to eyeball shape not the lens. |
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Lens is flattened for distant vision |
sympathetic input relaxes the ciliary muscle tightening the ciliary zonule and flattening the lens |
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Phototrandsuction |
process by which light energy is converted into a graded receptor potential |
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Photoreceptors |
-modified neurons that can respond to light -two basic cell type are cones and rods -highly vulnerable to damage |
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Rod Cells |
-contain the visual pigment called Rhodopsin(pigment is deep purple or violet) -sensitive to very, very low amounts of light -best suited for night vision -inputs perceived only as shades of gray -100 rod cells connect to the single ganglion cell |
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Cone cells |
-3 different types of photopigments -blue cones-respond maximally at 420nm -green cones- 530nm -red cones- 560 nm
-need bright light for activation inputs perceived as color vision -each cone has its own bipolar and ganglion cell |
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Low-intensity light |
-little rhodopsin is bleached and the retina continues to respond to light stimuli |
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High-intensity light |
-great amount of rhodopsin that is bleached, rods become nonfunctional but the cones still work |
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Light adaptation |
-going from a dark room to light. within about 1 minute the cones initially are overexcited by the bright light and are desensitized and visual acuity and color vision improve over the next 5-10min. |
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Dark Adaptation |
-cone cells stop functioning in low intensity light -initially we see nothing because rod cells have not started working yet. -rhodopsin start accumulating, transducing returns to outer segment and retina is then able to be more sensitive to low light envi. -adaptation takes about 20min |
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Night Blindness aka Nyctalopia |
-rod function is very poor -2 common causes 1. vitamin a deficiency 2. retinitis pigmentosa disease where pigmented layer of retina is poor at recycling damaged rod cells |
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Color Blindness |
-congenital lack of one or more cone types -x linked, more common in males. -most common is red-green blindness; red and green cones very low or completely absent - red/green are seen as the same color |
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Chemoreceptors |
-respond to chemical mixed in aqueous solution -gustation- food chemicals dissolved in saliva -olfaction- smell chemicals dissolved in nasal mucous |
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Olfactory Epithelium |
-located in roof od nasal cavity -pseudostratified epithelium -olfactory receptor cells-ability to process smell (CN I) -Supporting cells-make nasal mucous -Basal cell- make new olfactory receptor cells |
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Olfactory pathway |
Olfactory receptor cells -mitral cells in the olfactory bulb -olfactory tracts -frontal lobe-what was smelled -hypthalmus, amygdala & limbic system-associates smell with appetite, danger, memory... |
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Olfactory Disorders |
-Anosmias(without smell)- damaged olfactory nerve (CN I) head injury
-Uncinate Fits(olfactory hallucinations)- after brain surgery, trauma, seizures
-TASTE IS 80% Smell |
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Gustation (Taste) Taste buds |
-fungiform papillae-most on top of tongue -foliate papillae- side part of the tongue toward the back -circumvallate papillae- 7 to 12 of these in v-shape on back of tongue
-taste cells project long microvilli gustatory hairs through the taste pore onto the saliva covered tongue. |
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Basal cells |
act as stem cells dividing and differentiating into new gustatory cells as they are damaged |
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5 Basics Tastes |
-sweet -sour -salty -bitter -umami (natural amino acids) |
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Anterior 2/3 of tongue transmits taste |
-facial nerve CN VII
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Posterior 1/3 of tongue transmits taste |
-Glossopharyngeal nerve CN IX |
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Tongue movement |
-hypoglossal nerve CN XII |
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External Ear |
-Auricle aka Pinna aka Ear -External acoustic meatus aka ear canal- in adults about 1 in long, lined with modified apocrine sweat glands, ceruminus glands secretes cerumen wax, bug catcher |
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Middle ear aka Tympanic cavity |
-tympanic membrane aka eardrum -malleus, incus and stapes -pharyngotympanic/auditory/Eustachian tube -oval (vestibular) and round (cochlear) windows |
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Inner ear aka labyrinth |
-semicircular canals and cochlea |
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Otitis Media |
-middle ear infection -most common cause of hearing loss in children -antibiotics, Tm tubes |
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Presbycusis |
-normal gradual hearing loss of high pitched sounds as one ages |
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Conduction deafness |
-external and middle ear problem |
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Sensorineural deafness |
-inner ear problem |
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Weber (tuning fork) |
tests for lateralization vs no lateralization |
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Rinne (tuning fork) |
test for air conduction > bone conduction |
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Endocrine System aka ductless glands |
-release its hormone product into the surrounding tissue fluid and blood stream |
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Exocrine Glands |
-release products via duct on surface such as sweat |
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Hormones |
-long distance chemical signals that travel in the blood or lymph fluid throughout the body |
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Autocrines |
chemicals that exert their effects on the same cells that secrete them |
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Paracrines |
-chemicals that also act locally but affect cells types other than those releasing the paracrine chemicals.
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Chemical Classes of hormones |
-amino acids-most hormones are amino acids based -Steroid - synthesized from cholesterol -Eicosanoids- both subtypes synthesized from arachnoid acid |
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4 Basic parts of hormone action |
1. endocrines glands make hormone 2. hormones released into blood stream 3. hormones influence target cells that have specific receptors a specific hormone 4. target cell response is the end result of hormone binding |
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Cascade effect |
Single hormone molecule activates hundreds of second messenger hormones which in turn can activate thousands of active protein kinases. very strong cellular response.
- second messenger signaling stops when the enzymes like phosphodiesterase degrade the cAMP |
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5 common hormone effects |
-alters plasma membrane permeability or membrane potential - stimulates synthesis of proteins or regulatory molecules such as enzymes - activate/ deactivates enzymes -induces secretory activity -stimulates mitosis |
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Strength level of the end response on target cell depends on... |
-blood levels of hormone -number o receptors for that hormone or in target cells - affinity (strength) of the bond between receptors and hormone |
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Hormone circulates blood in 2 forms... |
-free -bound, to a protein carrier,
Hormones do not last very long in body and most excreted in the urine. |
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3 types of hormone action at target cells |
1. Permissiveness-hormone A needs Hormone B to exert full effect 2. Synergism- Hormone 1 &2 have equal effects on target cell with amplifies effect 3. Antagonism- Hormone X opposes the effect of hormone Y |
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3 types of endocrine gland stimuli |
1.humoral-blood levels of ions and nutrients 2. neural-nerve fiber stimulates hormone release 3. hormonal- another hormone stimulates the release |
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Thyrotropin Releasing Hormone |
-released by hypothalamus -stimulates release of Thyroid stimulating hormone by thyrotroph cells in the anterior pituitary. - TSH enters blood and stimulates Thyroid - Thyroxine (T4) and Triiodothyronine (T3) are released from the colloid of thyroid gland -iodine is needed to make T3 and T4 |
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Parafollicular or C Cells of the thyroid gland |
-makes the hormone calcitonin -calcitonin lowers calcium blood levels by shifting it to the bones. -stimulates calcium uptake by inhibiting osteoclast activity |
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goiter |
symptom of hypothyroid disease. a lack of iodine in diet causes unusable colloid to form & build up in thyroid gland. |
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Graves’ disease |
The most common hyperthyroid disease. Due to abnormal antibodies in the body that “mimic” TSH causing very high T3, T4 levels. |
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Oxytocin |
stimulates smooth muscle contraction in the Uterus and Breasts. • The drug Pitocin is synthetic oxytocin to augment labor. – induces the let-down reflex to release milk. – in males and non-lactating females it may have some role in sexual arousal and orgasm. – stretch of the uterus or stimulating the nipples can trigger its release. |
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Antidiuretic Hormone (ADH) |
- also known as Vasopressin -Stops the kidney from making urine. - – ADH released with ↓ blood volume, pain, low BP. • very high ADH release causes vasoconstriction. – Too Little (brain injury): Diabetes Insipidus – Too Much (mass, injury, meningitis): SIADH |
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Mineralcorticoids |
-secreted by the cells of the Zona Glomerulosa -Aldosterone -"Salt" |
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Glucocorticoids |
-secreted by the cells of the Zone Fasciculata -Cortisol -"Sugar" |
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Gonadocorticoids |
-secreted by the cells of the Zona Reticularis -Androgen -"SEX" |
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Catecholmines |
-secreted by the Adrenal Medulla -Epinephrine & Norepinephrine -Fight or Flight |
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Blood is Fluid Connective Tissue |
– Erythrocytes aka Red Blood Cells (RBCs) – Leukocytes aka White Blood Cells (WBCs) – Granulocytes: Neutrophils, Eosinophils, Basophils – Agranulocytes: Lymphocytes, Monocytes – Thrombocytes aka Platelets (PLTs) |
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Blood is Suspension |
only stays fluid while in constant motion |
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Physical characteristics of blood |
- ph 7.35-7.45 -metallic salty taste - temp is 100.4F -sticky opaque fluid volume of blood in females- 4-5L volume of blood in males-5-6L |
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Blood collection centers typically on using... |
Mass which means the final volume may vary - 1 unit of whole blood= ~450mL (.95 pints) - 1 units of packed RBCs= ~340mL(.72pints) |
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Distribution functions of the blood |
-delivering oxygen from the lungs & nutrients to rest of body - transporting metabolic waste to lungs for elimination of carbon dioxide and to kidneys for disposal of nitrogenous waste. |
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Regulation functions of blood |
-maintains normal body temp -transport heat to skin surface if too hot -maintains normal ph in body tissues -maintains normal fluid volumes in tissue and in blood |
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Protection and access of blood |
Protection -prevents its own loss through clotting -fights infectious microorganisms Access -route for medication -pathway for procedures |
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Formed elements in the blood |
-Erythrocytes have no nucleus or organelles -platelets are cell fragments -leukocytes |
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Erythrocyte RBCs |
-biconcave -no nucleus or organelles -lifespan about 120 days -make ATP via anaerobic metabolism -main contributor to blood viscosity (thickness) |
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Hemoglobin |
- made up of protein globulin bound to red heme pigment -globulin consist of 4 polypeptide chains; 2 alpha chains, 2 beta chains -heme is the red pigment contains iron |
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Production of Erythrocyte |
-process called hematopoises or hemopoises -process occurs in red bone marrow |
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Erythropoises |
-once a particular cell has committed to a pathway it can only become that particular type of cell -process takes about 15 days |
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Reticulocytes |
-account for 1-2% of all RBCs in blood -no nucleus |
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Erythropoietin (EPO) (hormone control of RBC formation) |
-mostly made in the kidney some in liver -triggered when sense of lack of oxygen, so make more EPO -Not the number of RBCs or reticulocytes but the "availability of oxygen that triggers this process of RBC formation" |
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Testosterone enhance EPO formation |
this explain the difference in the normal value of males and females |
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Iron |
-65% of all iron in your blood is in hemoglobin -the rest is in the liver, spleen and bone marrow -Vitamin B12 and folic acid are normal for DNA synthesis |
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Anemia |
-lacking RBCs in number for function -blood has low capacity to carry oxygen -symp. fatigue, pale, cold short of breath |
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Granulocytes |
-Neutrophils (50-70%) -Eosinophils(2-4%) -Basophils(.5-1%) |
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Agranulocytes |
-Lymphocytes (25-45%) -Monocytes (3-8%) |
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Universal Donor |
O negative |
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Universal Recipient |
AB positive |
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Typing blood is determined by |
-patients own ABO and Rh groups -cross matching = mixing patients and the donor blood looking for agglutination |
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Types of transfusions |
-whole blood transfusion, extreme emergency use -Packed RBCs, preferred |
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damage exposes the underlying collagen fibers and the von-Willebrand Factor (VWF) located there that the platelets stick to. |
after attachment, platelets activate & release their granule’s contents. – Serotonin leads to more vascular spasm. – ADP attracts more platelets to the damaged area. – Thromboxane A2 leads to vascular spasm & attracts PLTs. |
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Lens bulges for close vision |
Parasympathetic input contracts the ciliary muscle, loosening the ciliary zonule allowing the lens to bulge
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At the junction of what two structures is the Limbus located? |
Cornea & Sclera |
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A 30 year old welder has metal shavings deeply cut into his cornea in a job accident. Which of the following might leak from his severe corneal laceration? |
Aqueous humor |
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A 23 yr old females right upper eyelid is drooping(ptosis) after a botched chalazion removal surgery. Which structure most likely receives the accidental surgical damage to cause pitosis? |
Levator Palpebral Superioris muscle |
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A 21 yr old male is punched in the eye, and afterwards his eye has a sunken in appearance(enopthalmia). Which bone of the orbit was the most likely fractured? |
Maxillary |
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When your eye are bloodshot from conjunctivitis(pink eye) under (deep) to what structure are these dilated blood vessels located? |
Sclera |
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To what direction does the gaze of the right eye move when the right medial rectus contracts? |
Medially |
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In what cell is the bleaching and unbleaching of the rhodopsin pigment occurring? |
Rod Cell |
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Damage to CN v1; Trigeminal Nerve, ophthalmic division results in what two problems of the eye? |
impaired pupil dilation and impaired eyeball surface sensation |
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When looking at an eardrum with an otoscope, which bone is the easiest to see because it is located just behind it? |
Malleus |
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With what part of the ear is the disease Presbycusis located? |
Cochlea |
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Sounds with the lowest frequencies that are still perceivable byhuman are processed near what part of the ear? |
oval window |
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Otoliths are normally found on the surface of what structure as they will enhance its motion during linear acceleration or deceleration events? |
Macula |
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The cascade effect of hormones is going to occur immediately after what event? |
binding of the hormone to the target cell receptor |
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Which hormone is made in the posterior pituitary gland, and has target cell's in the breast and uterus? |
Oxytocin |
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Which location is triggered to release hormone by nerve stimulation? |
Adrenal Medulla |
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When there is too muchT4 and T3 what kind of response by the body's tissue is expected? |
Diarrhea |
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Calcitonin is made by a cell found in what organ? |
Thyroid glands |
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What hormone stimulates the zona reticularis? |
androgens |
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What part of the adrenal gland makes a hormone that can cause females to grow a beard if it is stimulated to excess? |
Zona reticularis |
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Excessive secretion of growth hormone when the epiphyseal plates are present results in what condition? |
giantism |
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All of the following are symptoms of severe, uncontrolled and possibly life-threatening Diabetes mellitus ACCEPT? |
Fast respiratory rate |
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Testosterone causes what cell in males to increase in number? |
Erythrocyte |
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In a healthy, normal adult female, which of the following choices is FALSE regarding whole blood? |
the temp is 98.6 degrees |
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The water component of the bloods plasma is able to stay inside of blood vessels due to plasma proteins and other factors. What organ is primarily responsible for for making these plasma proteins? |
Liver |
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The____is the name of the cell that is present before it transforms into a mature erythrocyte? |
Reticulocyte |
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What breakdown of old blood is metabolized into stercobilin by the normal flora bacteria located in the intestines? |
bilirubin |
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What organ monitors the oxygen carrying capacity of blood and makes a hormone to start the processes of erythropoiesis? |
Kidney |
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Blood doping can result in the following EXCEPT |
a lower blood viscocity |
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Which formed elements is the most common in the whole blood of a normal adult male or female? |
Neutrophil |
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Which lymphocyte has granules full of histamine, and is the rarest lymphocyte as well? |
Basophil |
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Which covering of the heart is the thickest? |
Fibrous Pericardium |
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Which chamber of the heart has one entrance and has a low blood pressure? |
Right ventricle |
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Cell death from heart attack , to which of the following locations is most likely to result in mitral valve prolapse? |
Papillary muscle |
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What artery runs in the same location as the Middle Cardiac Vein |
Posterior interventricular artery |
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which of the following statement is false regarding myocardial infarction? |
the presence of collateral circulation around the block increases cell death |
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What valve is best heart when listening at the right 5th intercostal space just next to the sternal border? |
Tricuspid valve |
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The ___ valve opens when the pressure in the ___ has increased enough during systole to push it open. |
Tricuspid, left atrium |
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Which of the following is the first step in the development of an action potential (specifically the start of the depolarization) in a cardiac muscle cell? |
Increased Na+ permeability |
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List any three facts regarding neovascularization of the eye? |
-common in hypertension and diabetes - new vessels grow in wrong location -new vessels are fragile and leak easily |
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Explain how olfactory adaptation works. |
Smell enters nose and bounds receptors on cilia of olfactory cells. sodium influx stimulates depolarization calcium influx decreases response to sustained stimulus. |
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Hemophilia |
hereditary bleeding disorders |
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Thrombocytopenia |
-low number of circulating platelets - spontaneously bleed -suppress destroy bone marrow |