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157 Cards in this Set
- Front
- Back
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perception of pain stages
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transduction
transmission modulation perception |
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Functions of Bone (6)
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1. framework, support, protection
2. blood cell production 3. mineral homeostasis 4. attachment for muscles (movement) 5. fat cell storage 6. plasticity |
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Hyperalgesia
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pathological nociception
- increased sensitivity to subsequent stimuli b/c of enhanced responsiveness of involved nociceptors - primary hyperalgesia - at site of injury - secondary hyperalgesia - contingous uninjured areas, periphery or central nociceptive neuron sensitization |
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Middle Ear (tympanic cavity)
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- behind tympanic membrane
- Eustachian tube (auditory) - Ossicles - malleus, incus, stapes - oval and round windows - membrane covered, conduct vibrations - tensor tympani and stapedius muscles - modulate vibrations, striated skeletal muscle |
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Nociception
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- noxious stimulus of pain
- C afferent |
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responsible for lengthening of bone
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epiphyseal plate
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Body Pain Chemicals
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For Nociception
- enkephalin - opioid agonist - endorphin - opioid agonist |
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Stye
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infection of the Meibomian gland (sebaceous gland inside eyelid)
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Central sensitization and Windup
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Noxious stimulus of sufficient intensity causes c-fiber activity to increase in the number of discharges evoked by each volley
- WDR cells tend to become more sensitized than NS cells - sensitized NS cells develop novel response to not harmful stimuli and become functional WDR cells - NMDA receptors involved |
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spongy bone
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cancellous
- lines of stress, trabecule |
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Neuropathic vs Nociceptive
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- pain and sensory symptoms that persist beyond healing period
- negative and positive sensory phenomena - negative and positive motor phenomena or autonomic signs - Neuropathic - nerve damage, tingling in feet, pain complaint, burning, electrical tingling |
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Outer Ear
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auricle, external auditory canal (meatus), eardrum (tympanic membrane)
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tingling in feet, pain complaint, burning, electrical tingling
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Neuropathic Pain
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Cell Types of bone
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osteoprogenitor
osteoblasts osteocytes osteoclasts |
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assessment of pain
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PQRST
- provokes and palliative - quality - what kind of pain - region - severity - above 8,medical emergency - time - when does pain occur |
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Parkinson's disease
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anything that damages the substantia nigra
- idiopathic (aging, genetics, environment) - secondary parkinsonism (same symptoms but from other causes) - feature of other syndromes - dopamine deficiency due to damage to substantia nigra - lewy bodies (inclusion bodies) |
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how to prevent neuronal plasticity/windup
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block NMDA receptor
(methadone does this) |
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Bone Matrix
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matrix- water 25%, protein (collagen) 25%, mineral 50%
mineral - mostly Ca salts, hydroxyapatite Organic (osteiod) - collagen fibers embedded in amorphous ground substance (proteoglycans, glycoproteins) - not full minerlized --> flexible inorganic bone w/o collagen --> brittle |
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natural opioids
semisynthetic synthetic |
natural: morphine,codeine
semisynthetic: buprenorphine synthetic: methadone |
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Inner Ear
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encased in bone
- bony and membranous labyrinth - vestibule containing sacs and ducts (balance, equilibrium) - bony and membranous semicircular canals and attached ampulla, ie vestibular apparatus - Cochlea - hearing |
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Codeine
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natural opioid - precursor to morphine (pure mu agonist)
- only good for diarrhea and antitussive - not very effective pain med (needs to be converted to morphine to be useful) - ceiling dose |
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bone development
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1. intramembranous ossification - no cartilage used
2. endochondrial ossification - cartilage model is used |
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Opioid metabolism
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all opioids metabolized same way in liver (glucuronidation)
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Cataracts
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Lens become less transparent due to age, UV, drugs (steroids), disease
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Morphine
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natural opiod
pure mu agonist metabolism: --> M3G (50%) + M6G (10%) M3G low affinity for opioid receptors (low analgesic activity) M6G - 60x more potent than morphine |
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intramembranous ossification - no cartilage used
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1. very loose well vascularized tissue bed
2. osteoprogenitor cells 3. differentiate into osteoblasts 3. deposition of bone, osteoblasts become osteocytes 4. white part (osteiod) not fully calcified |
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Morphine-3-glucoronide toxicity profile
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- may block Mu receptors
- hyperalgesia, allodynia, seizures - role not clearly established in humans |
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Mechanism of hearing
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Cochlea, spiral organ of Corti
1. Sound wave enters external auditory canal (meatus) 2. eardrum (tympanic membrane) vibrates 3. ossicles - Malleus, incus, stapes vibrate 4. Oval window enters cochlea 5. Scala vestibuli - perilymph fluid vibrates, vestibular membrane 6. Helicotrema - turn of cochlea 7. Scala tympani - perilymph fluid, basilar membrane vibrates 8. out the round window - cochlear duct (scala media) contains endolypmh - spiral organ/ Organ of Corti - tectorial membrane vibrations activates stereocilia on inner hair cells - vibrates down the body of hair cell to nerve endings - nerve impulse to CN VIII |
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Methadone
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- purely synthetic
- pure Mu agonist - NMDA (neuronal plasticity) antagonist - additive benefits - good for neuropathic pain, long half life, dangerous for overdose side effects - sudden cardiac death - different metabolism than morphine - incomplete cross tolerance between Methadone and Morphine |
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Osteiod
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fresh deposition of bone in well vascularized connective tissue bed by osteoblast, not fully calcified
- organic part of bone matrix (collagen, proteoglycans, etc) |
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Buprenorphine
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- Semisynthetic
- Partial Agonist (partial mu agonist, kappa antagonist) - dont use too much, bell shaped dose response curve - high affinity to mu receptor, doesnt do much there - more potent than morphine - ceiling effect, very slow dissociation - used to treat opioid addiction - high affinity for mu receptor leads to preferential agonist effect - antagonist at kappa receptor |
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5 components of the brain
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cerebreum
diencephalon (thalamus, hypothalamus, pineal gland, epithalamus) ventricular system w/ CSF brain stem (midbrain, pons, medulla oblongata) cerebellum |
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Naloxene
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Pure opioid antagonist
- bind to opioid receptors but do not activate them - interfere with agonist actions, can induce withdrawl effect - used for alcoholism - treat opioid overdose |
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Endochondrial Ossification - hyaline cartilage model is used
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1. Cartilage is produced by chondrocytes, surrounded by perichondrium except where joints will form
2. the perichondrium of the diaphysis becomes the periosteum and a bone collar is produced - internally, chondrocytes hypertrophy (intestitial growth) and calcified cartilage is formed 4. primary ossification center forms as blood vessels and osteoblasts invade the calcified cartilage 5. process of bone collar formation, cartilage calcification, and cancellous bone production continues - calcified cartilage forms epiphysis, medullary cavity forms in center of diaphyses 6. secondary ossification center begins to form in epiphysis of long bones 7. original cartilage model is almost completely ossified - except epiphyseal plate and articular cartilage 8. in mature bone, epiphyseal plate becomes the epiphyseal line - only articular cartilage left |
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Opioid Side effects
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- constipation (wont go away)
- respiratory depression - addiction - pinpoint pupils (miosis) |
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Disorders of Hearing - Deafness
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- Sensorialneural - impairment of cochlea or CNVIII
- conduction - impairment of middle or external ear - impacted ear wax, ear drum injury, osscile joint stiffening |
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Type of Neuropathic Pain
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- direct stimulation of pain-sensitive receptors (carpal tunnel, tumor compression)
- automatic firing of damaged nerves (diabetic neuropathy) - deafferentation (phantom limb, stroke, post herpetic neuralgia) - Sympathetically mediated pain |
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Osteon - histology of compact bone
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- central canal (haversion) - blood supply to osteocytes and nutrients to reach cells by diffusion within canaliculi
- osteocytes - in lacuna - canaliculi - canals in matrix, extends to where blood supply is (tissue fluid, gas exchange, osteocytes not isolated) - concentric lamellae |
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Anticonvulsants
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- treat by preventing nerve impulses to brain
- sodium channel blocker - GABA potentiation - Gabapentin |
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Pink Eye
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Conjunctivitis - inflammation of conjunctiva
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Tricyclic Antidepressants
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- block presynaptic reuptake of serotinin and norepinephrine by amine pump
- pain relief for neuropathic pain before antidepressant effect |
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Cartilage composition
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- chondrocytes in lacuna
- matrix of water, collagen fibers, and ground substance (3 GAGs - hylauronic acid, chondroitin sulfate, keratin sulfate) - squishy - lacks calcified inorganic component - interstitial growth via daughter cells (isogenous groups) - hyaline cartilage - perichondrium |
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Other Antidepressents
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- SSRI
- block presynaptic uptake of serotonin and NE - pain relief before antidepressant effect |
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Middle Ear Infection
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Otitis Media
- infection passes from throat to middle ear via eustachian tube - ear infection with fluid behind tympanic membrane |
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Newer Agents for neuropathic pain
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Cymbalta (Duloxetine) - inhibition of NE and serotonin reuptake (similar to venlafaxine)
Lyrica (Pregabalin) - blockage of Ca channels, prevent nerve impulses from reaching the brain - diabetic neuropathy and postherpetic neuralgia |
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Cartilage Functions (5)
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1. flexibility and support
2. reduces friction and absorbs shock at joints 3. provides strength and elasticity 4. maintains shape of certain organs 5. essential for growth of long bones |
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what is used to treat opioid addiction?
what is used to treat opioid overdose? what is used to treat alcoholism? |
- buprenorphine for opioid addiction
- naloxene for opioid overdose and alcoholism |
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Dopamine receptors
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D1 family (+) adenyl cyclase
D2 family (-) adenyl cyclase, SN neurons |
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Phantom limb pain is what type of pain?
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neuropathic and nociceptive
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Bone vs Cartilage
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1. basic cells
2. blood supply 3. ability to repair 4. blast cells 5. remodeling |
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Mechanism of Equilibrium (balance)
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Vestibular System (ultricle, saccule, semicircular canals, etc)
1. semicircular canals lie at right angles to each other. positions of canals detect direction of motion 2. as head moves, groups of hair in ampullae stimulated by lymph fluid - sends impulses which pass with the vestibular part of CN VIII to maintain balance - groups of hair cells (stereocillia) at cristae within ampulla - cupula is gel like substance that moves in response to movement that activates the stereocillia at cristae in ampullae - otolith cystals stimulate hair cells in ultricle and saccule |
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what disorder of abnormal bone formation caused by inherited disorder of connective tissue
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fibrodysplasia ossifican progressiva
- ectopic bone present - excess production of morphogenetic protein 4 |
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Tear Productions and Flow Pathway
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1. Lacrimal gland secretes fluid through lacrimal duct
2. Tears move across the eye 3. Enter lacrimal canaliculi through lacrimal puncta 4. Nasolacrimal duct 5. Nasal Cavity |
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abnormal bone formation caused by defect in mineralization of bone matrix
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Rickets
- lack of vit D (necessary for absorption of calcium) - bone remodeling is defective, bulgy or bent long bones |
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disorders of equilibrium and balance
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1. motion sickness - excessive stimulation of vestibular apparatus brought on by repetitive angular, linear, or vertical motion. may cause nausea and vomiting (medullary centers)
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Osteoporosis
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- loss of bone mass, increased bone porosity, leading to fragility and susceptibility to hip and spinal fractures - deterioration of vetebral support
- due to deficiency of estrogen noted in postmenopausal females - balance between bone formation and resoprtion is disturbed - increased osteoclast |
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3 regions of brain
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forebrain (cerebrum. diencephalon)
midbrain (part of brain stem) hindbrain (pons, medulla oblongata, cerebellum) |
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Osteoarthritis
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- age related deterioration of cartilage and joint, bone against bone
- non inflammatory, degenerative wear and tear - osteophytes (bone spurs) - just pain, no swelling |
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2. Meniere's Syndrome
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increase in amount of lymph fluid which enlarges membranous labyrinth, causing fluctuating hearing loss, attacks of vertigo and roaring tinnitus (ringing in ears)
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Rheumatoid Arthritis
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Autoimmune, inflammatory response in synovial fluid
- pannus (synovial membrane) inflammation - red, swollen, painful - ankylosis - joint stiffness |
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Tears
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lacrimal fluid + hormones + growth factors + immune defense materials
- mebomian and conjunctiva contributes |
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Joint types
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- ball and socket
- gliding - suture - hinge |
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Triad of Parkinsonism
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before seeing symptoms, loss 70% of dopamine
- TRAP (tremor, rigidity, akinesia, posture) - dementia - autonomic |
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Bone types
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- long
- short - irregular - flat |
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decline in quality or quantity of tears
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dry eye disease
- linked to decreased prolactin hormone |
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Joint functions
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1. allow for varying degree of motion between 2 or more bones
- united by cartilage, CT, or synovial fluid - major motions: flexion, extension, abduction, adduction, rotation |
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protective coverings of meninges
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dura matter - hard
arachnoid matter - vascular, CSF pia matter - delicate |
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Synovial Fluid
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- encapsulated by CT = joint capsule - synovial membrane (Pannus) and fibrous capsule
- lubricant - synovial fluid formed as an ultrafiltrate from blood - thick viscous material lubricates synovial joints, reducing friction between articular cartilage and cushioning joints - supply oxygen and nutrients to chondrocytes of articular cartilage and removes CO2 and waste products - added to filtrate by cells in membrane are - hylauronic acid, lubricin, proteinases, collagenases |
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autoimmune attack on lacrimal glands
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Sjogren's syndrome
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Bursitis
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Bursae - more lubrication for joints, fluid filled sac to allow tendons to slide over bones
Bursitis - inflammation of bursae |
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Clinical presentation of parkinsons
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-Early complaints - aches pains numbness coldness
-Tremors - initially unilateral, occurs at rest, absent during sleep, not symmetrical -Postural changes - stooped -Dementia -Rigidity - cogwheeling catch/release -Bradykinesia - slow movement, unsteady gait, disease of inertia -autonomic disturbances-orthostatic HTN -other manifestations - drooling, constipation, speech diff |
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Gout
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- deposit of uric acid crystals in joints (usually big toe)
- acute inflammation and articular cartilage damage plus swelling and pain |
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Flow of Aqueous Fluid
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1. Produced by epithelial cells of ciliary bodies
2. Posterior Chamber 3. Through Pupillary Opening to 4. Anterior Chamber 5. Drained in Canal of Schlemm |
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Cretinism
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congenital hypothyroidism
- iodine deficiency, nonfunctional or absent thyroid - severe impairment of all aspects of growth |
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Hematoma (2)
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abnormal blood accumulation, internal cranial hemmorhage
- subdural hematoma - epidural hematoma |
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Gigantism
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abnormally high secretion of growth hormone from pituitary gland at any age prior to closure of growth plate (epiphyseal plate)
- pituitary tumor or increased secretion of hypothalamic GHRH - very tall |
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Glaucoma
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Disease of intraocculare pressure caused by failure of aqueous fluid to drain through canal of Schlemm
-causes optic nerve to degenerate, blindness can result if not treated - puff test |
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Acromegaly
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disorder of excess GH in adults
- hands, feet, face enlarge - lower jaw protrudes - arthritis |
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Why does handwriting sample get smaller and smaller?
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B/c of loss of dopamine, cant replenish it enough to continue functioning so writing gets smaller
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Dwarfism
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- abnormally short stature
- can arise from genetic or other conditions - GH deficiency, not bioactive GH, hypothalamus inactivity to not signal pituitary to release GH properly - bony deformities common |
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Cornea
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- cont with sclera (fibrous tunic)
- transparent due to less collagen and more proteoglycans - avascular - gets nutrients from aqueous fluid and tears, and oxygen from air - provides 70% of refractive power of eyes |
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Stroke (2)
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CVA
- red stroke - acute hemmorhage (20%) - white stroke - vascular occlussion.infarction - 80% |
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Choroid tunic
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- vascular tunic
- nourishes the retina by sending oxygen and nutrients via blood vessels - melanin pigments - absorb stray light, preventing internal light reflection - cont with ciliary bodies and iris |
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5 stages of parkinsons
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Stage 1. unilateral - aches and pain
Stage 2. bilateral, some tremor, normal posture Stage 3. bilateral, slightly abnormal posture, independent Stage 4. bilateral, posture instability, pt requires help (very little dopamine left) Stage 5. severe, fully developed, pt restricted to bed or chair (immobilized) |
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retina through opthalamoscope
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nervous tunic
- covers posterior 2/3 of eye - macula - sight of acute vision - fovea - center of macula - optic nerve - no visual cells, blind spot - fundus view - ground |
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Functions of CSF
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Protection against physical injury - shock absorber,
Supports brain (buoyancy) Nourish CNS - constant environment Unique microenvironment for neural tissue |
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retina anatomy
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- outer pigmented layer, pigment epithelial cells important for maintaining visual cells
- absorb stray light, constant turnover rods - shades of gray, shapes, movement, none in fovea centralis, rhodopsin cones - color, concentrated in fovea centralis, idopsin |
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Dopamine Agonist
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directly stimulate dopamine receptors
D1 (+) adenyl cyclase D2 (-) adenyl cyclase monotherapy early, adj later AR: impulsive behaviors, sleep attks, naus, vom, orthostatic HTN |
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macular degeneration
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age related vision deterioration
- drusin between choroids and retina distorts retinal layers |
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Pathway of CSF flow
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- produced by special capillaries/choroid plexus in ventricle system
- flows in ventricle system - emerges out of brain in subarachnoid space - reabsorbed into blood by arachnoid granulation/villi that return fluid to systemic circulation |
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genetic
damage to rods and cones decreased vision at night or in low light loss of side vision, tunnel vision loss of central vision (adv cases) |
retinitis pigmentosa
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Carbidopa/Levodopa
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Carbidopa prevents peripheral LDopa metabolism by DOPA decarboxylase
LDopa - dopamine replacement stimulation of D1 and D2 receptors Standard Therapy, replaced dopamine-Ldopa (gold standard) AR: nas, vom, anorexia, orthostasis, psychotic sx at higher doses, dyskinesias w/ prolonged use |
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obstruction of CSF flow leads the what disease
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Hydrocephalus
- CSF shunts inserted into a ventricle to drain CSF |
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MAO Inhibitors
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MOA: only work in CNS to inhibit metabolism of L-dopa
Adj to L-dopa, rarely used for monotherapy, tends to be used later in disease as more dopamine required AR: dizziness, confusion, vivid dreams, nightmares, hallucination, dyskinesias |
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Blood Brain Barrier - 3 elements
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Tight junctions btwn capillary endothelial cells
basement membrane processes of glial cells (astrocytes) - regulate phenotype but not barrier function |
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COMT inhibitors
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MOA: inhibit Ldopa metabolism in PNS by COMT so more Ldopa can enter the CNS
Adj to levodopa in later disease AR: nas, dry mouth, hypotension, dystonia, muscle cramps |
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BBB is compromised leads to what disease
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Multiple Sclerosis
- neural tissue are not under immune surveillance |
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Anticholinergic Agents
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MOA: restore cholinergic/dopamine balance by reducing levels of ACh
Early disease thearpy (tremor and sialorrhea) AE: peripheral anticholinergic effects (dry mouth, constipation), central effects at higher doses (paranoia, hallucinations), not well tolerated w/ age |
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BBB function (5)
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- helps maintain brain homeostasis
- barrier between brain capillaries and neurons - unique microenvironment - substances pass rapidly (O2, CO2, glucose, water, lipid sol) - substances pass slowly (ions, proteins, drugs) |
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Adaptation
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response to continued stress injury
- hypertrophy - hyperplasia - atrophy - metaplasia |
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How to disrupt BBB?
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Hyperosmolar solutions (concentrated sugar) to shrink the cells lining brain capillaries
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Irreversible cell injury
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- necrosis by ATP depletion
- necrosis by free radicals |
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12 Cranial Nerves
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1. Olfactory - smell
2. Optic - vision 3. Occulomotor - eye movement 4. Trochlear - eye movment 5. Trigeminal - chewing 6. Abducens - eye movement 7. Facial - facial expression, taste 8. Auditory - hearing, balance 9. Glossopharyngeal - taste, neck 10. Vagus - stimulates GI, heart rate, taste 11. Spinal Accessory - head movement 12. Hypoglossal - tongue, swallowing, speech |
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Hypoxia and ATP depletion
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- reversible injury by reintroduction of oxygen
- low oxygen, low ATP - Na, K pump stops --> cell swells, more permeable, Ca gets in and destroys mitochondria - anaerobic glycolysis increases --> lactic acid accumulation --> dec pH - ribosomes disassemble from rough ER --> dec protein synthesis --> lysosomal membrane breaks down, releasing digestive enzymes that digest the cell |
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Brain Stem
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Midbrain
Pons Medulla Oblongata (reticular formation) - with exception of CN I and II, all CN innervated the brainstem |
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Free radical generation
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- hydroxyl radical, hydrogen peroxide, superoxide
- free radical scavengers - vit E, SOD SOD: superoxide --> H2O2 --> H2O + O2 via catalase or H2O2 --> hydroxyl radical via fenton rxn |
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Medulla Oblongata Function
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Cardiovascular and respiratory reflex centers
- regulate rate and force of heart beat and diameter of blood vessels - adjusting beat rhythm |
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Tissue Changes in Response to Injury
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Acute Inflammation --> chronic infl, pain, organization
Chronic Inflammation |
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Pons Function
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pneumotaxic and apneustic areas
- works with medullary rhythmicity to help control respiration - make sure we dont overexpire - regulates normal respiratory function |
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Acute Inflammation - Blood Vessels
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Injured vessel becomes inflammed through direct damage, chemical mediators, nervous system reflex
Dilated vessel - inflammation - congestion, redness, heat, swelling |
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Midbrain Function
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(subconscious and conscious muscular movements)
- Substantia nigra - pigmented areas controlling subconscious muscle activity (sleeping) - Red Nucleus - functions with basal ganglia and cerebellum to coordinate conscious muscular movement |
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Acute Inflammation - Arteries and Capillaries
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Swelling reaction (endothelial cells) - two types of fluid will leak from inflamed vessel
- transudate (plasma, water, protein) - exudate (plasma, water, protein, formed elements) - edema (fluid stuck in tissue due to inflammation) - formed elements (inflammatory cells) - ability to actively move through endothelial cells and smooth muscle tissue to get into the CT |
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Reticular Formation
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center of arousal and motivation
- clusters in spinal cord, brain stem, diencephalon - motor input from brain controls muscular contraction and muscle tone - alerts cerebral cortex to incoming sensory signals - responsible for maintaining consciousness and awakening from sleep (Recticular Activating System, RAS) |
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Triggers of Leakage
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- physical stress
- chemical mediators - histamine (produced by mast cells, when stimulated release histamine --> inflammation and swelling) binds to receptors on endothelial cells and makes them contract, opening spaces between them and stuff will leak out |
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Cerebellum Structures
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2 cerebellar hemispheres - governs movement of muscles
Vermis - central constricted region - equilibrium Cerebellar Cortex - gray matter Arbor vitae - inside white matter Folia - slender parallel ridges |
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Sympathomimetic nervous system
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- constricts smooth muscle
- pseudoephedrine - contracts smooth muscle so vessel constricts, less flow (adrenergic receptors of sympathomimetic) |
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Functions of Cerebellum
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Propioception - position of body in space - spinocerebellar tracts
- finely tuned motor movements - posture, balance, dance, piano - integration of sensory perception and motor output - subconscious muscle movement and regulates posture and balance - cognitive function - processing of language and music |
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Antihistamines
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H1 antagonist
- prevents endothelial shrinkage, prevents leakage - relaxes smooth muscle (bronchodilation) H2 antagonist - prevents vasodilation |
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Cerebellar Disease
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Ataxia - lack of coordinated muscular contraction
- unsteady gait, falling, cant touch tip of nose with eyes closed - parkinson's |
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Other mediators of acute inflammation
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Derived from membrane lipids by phospholipase to Arachidonic Acid
1. Lipoxygenase: AA --> leukotrienes (chemotaxis for immune cells, increased permeability) 2. COX: AA --> prostaglandins (vasodilators, pain) |
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Thalamus
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two oval masses acting as relay centers for sensory impulses going to the brain from spinal cord, brain stem, cerebellum, etc
- may also play a role in acquisition of knowledge and cognition |
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Role of steroids
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- blocks cascade of infl mediator production at first step
- inhibits phospholipase from breaking down membrane lipids into arachidonic acid, needed to form other chemical mediators (leukotrienes, prostaglandins) - but also prevents wound healing |
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Hypothalamus
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- collection of nuclei/neurons
- receive input from different lvls of CNS - sound, taste, smell receptors - receptors within monitor osmotic pressure, hormonal concentration, blood temperature -connects with pituitary gland via neurohormones (controls pituitary function) - hypothalamo-hypophyseal portal system: 2 capillary systems linked by veins cap --> vein --> cap |
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Role of NSAIDs and aspirin
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target COX needed to convert arachidonic acid to prostaglandins (vasodilators, pain)
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Function of Hypothalamus
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- control and integrates activities of ANS
-controls pituitary secretions - regulates emotions and behavior - regulates thirst and hunger centers - controls body temperature - regulates diurnal rhythms and states of consciousness |
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Acute inflammation can lead to Organization (via excess pus)
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- growth of new blood vessels in area
- invasion of macrophages - proliferation of connective tissue cells (collagen) --> scarring |
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chemical synapse
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site at which electrical impulse is transferred from one neuron to another
- neurotransmitters for fast transmission over small distances |
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Pus
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Abcess of exudates - cells (neutrophils and macrophages), collagen, new blood vessels
Acute inflammation - neutrophils actively kill bacteria via phagocytosis and cytotoxic substances (free radicals) - recruited by chemicals (chemotaxis) - monocytes recruited --> macrophage clean up |
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neuroendocrine synapse
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endings adjacent to vasculature, slower mechanism for transmission over longer distances
- neurohormones released into vasculature |
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Scarring - organization following acute inflammation
- clean cut/suture |
clean cut/suture - heals via reformation of blood vessels, collagen, nice epithelium cover
- scab --> CT vascular --> nice epithelial layer --> less vascular CT to normal CT |
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2 cerebral hemispheres connected by...
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corpus collosum (longitudinal fissure)
right - art left - logic |
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Scarring - organization following acute inflammation
- jagged wound |
jagged wound - filled by connective tissue (granulation tissue), epithelium growing, uneven and not so nice
- CT over sides --> epithelium layer --> CT growing under and pushing up --> uneven healing |
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postcentral gyrus
central sulcus precentral gyrus white vs gray matter |
post - sensory cortex
pre - motor cortex white - inner gray - cerebral cortex |
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Ulceration
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surface necrosis and replacement by inflammatory tissue
- immune cells fill in crater initially for surface necrosis Surface necrosis --> crater (acute infl) --> crate (chronic infl) |
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4 lobes of brain
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frontal - higher cognitive function
parietal - comprehension of language temporal - intellectual and emotional functions occipital - primary visual areas |
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Chronic Inflammation
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Involvement of Immune Cells (humoral response)
- lymphocytes, plasma cells (secrete antibodies), macrophages (no neutrophils) - chemotaxis - recruitment of other cells to areas of inflammation (neurophils, lymphocytes, monocytes) reinforcement of immune response at multiple levels - complement system |
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Functional areas of cerebral cortex
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brains are regionalized in functional way
a. Motor Cortex – precentral gyrus b. Sensory cortex – postcentral gyrus c. Brocca’s area – speech (frontal lobe) d. Wernicke’s area – speech comprehension (temporal) |
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Complement System
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collection of proteins that work together in response to antigen-antibody complex and starts another effector pathway for inflammation
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homunculus
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functional areas of our bodies represented in specific sites in the cerebral cortex
- brain are highly organize, control of motor function |
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Insular Cortex
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processes convergent information to produce emotionally relevant context for sensory experiences such as digust and feelings of unease
- related to pain, taste, smell, naseua, - fear and avoidance |
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Basal Ganglia
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- cerebral nuceli
- input from cortex, thalamus, brainstem - output to motor cortex which influences motor system re-posture, coordinated movement, preparation and initiation of locomotion - learning |
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Disorders of Basal Ganglia
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Parkinson's
OCD ADHD Cerebral palsay (due to damage in utero) |
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The Limbic System
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"emotional part of the brain"
- hippocampus - amygdala - motivation and emotional association with memory - operates by influencing the endocrine system and ANS - interconnected with the brain's pleasure center - important connections to thalamus, hypothalamus, cerebral cortex, CN #1, etc |
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Functions of spinal cord
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sensory - spinothalamic tract (posterior column)
motor - pyramidal (lateral and anterior corticospinal tracts) |
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Sensory Pathways I
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for temp, pain, crude touch, tickle
1st, 2nd, 3rd order neuronal pathways - receptor, dorsal root ganglion, posterior gray horn, crosses to - Spinothalamic tract - anterior/lateral spinothalamic tract to - Thalamus, to somatosensory cortex (postcentral gyrus) |
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Motor tracts
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pyramidal or corticospinal tracts, two order neuronal pathways
- motor cortex, upper motor neurons, decussation in medulla, continues to - lateral/anterior corticospinal tracts to - lower motor neurons to skeletal muscles |
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sympathetic vs parasympathetic (3)
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structural differences
physiological differences types of neurotransmitters released (cholinergic vs adrenergic) |
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Structural differences btwn symp and parasym
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Sympathetic:
- cell bodies are location in lateral gray horns of thoracic and lumber parts of spinal cord - "thoracolumber" Parasympathetic: - nerve cell bodies are located in brainstem nuclei and gray matter of sacral part of spinal cord - "craniosacral" |
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Physiological Diff betwn symp and parasymp
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Sympathetic:
- fight or flight response - increase HR and RR and BP - dilates pupil, slow down gut activity, inc sweat gland secretion - dec salivary gland secretion - relaxes bronchiolar muscles - "excitatory system" Parasympathetic: - opposite of fight or flight - lowers HR, RR, and BP - constricts pupil, inc gut activity - inc salivary gland sec - "inhibitory system" |
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Somatic vs Autonomic (motor neuron transmission and neurotransmitters)
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Somatic:
- one myelinated motor neuron from anterior gray horn released ACh to effector muscle to cause contraction of skeletal muscle Autonomic: - Preganglionic motor neuron from lateral gray horn (myelinated) released ACh to autonomic ganglion - Postganglionic motor neuron (unmyelinated) releases ACh or NE to effectors, causing contraction of smooth or cardiac muscle, stimulation or inhibitions of glandular secretion |
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Neurotransmitter differences between Symp and ParaSymp
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Both:
- preganglionic neurons release ACh to nicotinic receptors on autonomic ganglion Symp: - preganglionic neurons release Norepinephrine (NE) or ACh to muscarinic receptors (sweat glands) Parasymp: -postganglionic neurons release ACh to muscarinic receptors |
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blocks the release of ACh from presynaptic terminals
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Botulinum toxin
--> paralysis of skeletal muscle --> death from resp failure - muscle tone becomes weak and flacid |
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compete with ACh for nicotinic receptors on the motor end plate
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Curare
--> reduction of EPP --> paralysis and death - respiratory death and muscles of diaphragm cannot move |
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tumors produce antibodies that go against motor end plate
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myasthenia gravis
- MEP doesnt work well, muscles dont work well - treat with AChesterase inhibitor until MEP doesnt work at all |
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ACh esterase inhibitor
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neostigmine
- prevent degradation of ACh - enhancement of ACh at MEP - tx for myasthenia gravis |
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Myelin gets degraded, conduction velocity is slow, movements/perception becomes sluggish
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multiple sclerosis
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BBB is compromised
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multiple sclerosis
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