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130 Cards in this Set
- Front
- Back
- 3rd side (hint)
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what part of the body is controlled by parasympathetics? sympathetics?
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parasymps = craniosacral
symps = thoracolumbar |
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neurotransmitter that acts inhibitory on brain?
spinal cord? |
brain = GABA
spinal cord = glycine |
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MC excitatory neurotransmitter
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glutamate
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neurotransmitter that acts on NMDA receptors
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aspartate
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monoamine excitatory neurotransmitters
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serotonin
dopamine NE |
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catecholamine excitatory neurotransmitters
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dopamine
NE epinephrine (hormone) |
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which neurotransmitter controls the autonomic nervous system?
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NE
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which neurotransmitter goes to the vomiting center, basal ganglia, controls urges?
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dopamine
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which neurotransmitter controls the reticular activating system and hallucinations
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serotonin
where made? where are most ganglia? |
raphe nucleus
ganglia in GI |
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which polypeptide mediates pain?
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substance P
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most abundant polypeptide
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neuropeptide Y
what does it respond to? inhibit? control? |
responds to stress and circadian rhythms
inhibits glutamate release controls CV system and inc appetite |
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enz needed to make ACh
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choline ACh transferase (ChAT)
enz needed to break it down |
ACh Esterase
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brkdn product of ACh? dopamine? NE? Serotonin?
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ACh: acetate
dopamine: HVA NE: VMA, metanephrine (epi too) serotonin: 5HIAA |
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only places in parasymp targets that has nicotinic receptors
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skeletal muscle and ganglia
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drug used for CF sweat test
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pilocarpine
class of drug |
cholinergic agonist
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cholinergic agonists used for urinary retention
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bethanecol
carbachol |
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drug used to dx asthma
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methacholine
class of drug |
cholinergic agonist
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serotonin agonist that USED to be used to treat GERD
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cisapride
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serotonin agonist used to treat migraines
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methysergide
side effects? |
MI, stroke, retroperitoneal fibrosis
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DOC for migraines
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--triptans
(sumatriptan, eg) |
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only place where sympathetic receptor is muscarinic
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sweat glands
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how do we separate use of anticholinergic vs use of sympathomimetic
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sympathomimetic will have hot dry skin
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places where alpha 1 receptors are located
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arteries
sphincters radial muscles of eyes fxns at each? |
arteries: vasoconstriction
sphincters: tighten radial muscles: mydriasis w/o cycloplegia |
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alpha 1 agonists (5 of em)
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epinephrine
NE ephedrine pseudoephedrine phenylephrine |
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DOC for anaphylaxis
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epinephrine
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DOC for v-fib
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epinephrine
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MC over the counter cold med
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ephedrine
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alpha 1 agonist used for urinary incontinence
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pseudophedrine
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alpha 1 agonist most abused on street
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pseudoephedrine
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DOC for neurogenic shock
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phenylephrine
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alpha 1 antags?
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phenotlamine
phenoxybenzamine yohimbine prazocin terazocin doxacin tamsulocin which are nonspecific alpha antags? |
phentolamine
phenoxybenzamine yohimbine |
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drug used to dx pheochromocytoma
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phentolamine
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drug used to treat pheochromocytoma
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phenoxybenzamine
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drug used for HTN that cuases first dose syncope
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prazocin
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DOC for BPH
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terazocin
doxazocin |
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fxn of alpha 2 receptors
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inhibit NE release from presynaptic sympathetic fibers
inhibit insulin secretion |
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alpha 2 agonists?
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clonidine
alphamethyl dopa guanabenz |
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alpha 2 agonist that's DOC for HTN in pregnant women
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alphamethyl dopa
side effect? |
coomb's +ve hemolytic anemia
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fxn of beta 1 receptors
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inc CNS activity
inc heart rate and contractility inc renin release inc glucagon release |
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fxn of beta 2 receptors
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inc CNS activity
increased contractility bronchodilation vasodilation of arterioles inc insulin relaxation of uterus and bladder |
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beta agonists that are more slightly more beta 2 responsive?
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isoproterenol
levoproterenol metaproterenol |
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beta agonists that are much more beta 2 responsive
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albuterol
terbutaline ritodrine fometerol salmeterol ones used in inhalers (2) ones used for preterm labor to relax uterus (2) |
inhalers: albuterol, terbutaline
relax uterus: terbutaline, ritodrine |
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longest acting beta blocker
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propanolol
specific or nonspecific? |
nonspecific
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shortest acting beta blocker
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esmalol
specific or nonspecific? use? |
used in anesthesiology
specific |
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betablockers used for glaucoma
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timalol
butaxelol carteolol |
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beta blocker that also blocks K+ channels
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sotalol
what should you watch for on EKG? |
QT interval prolongation
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beta blocker that is used to relax smooth muscle
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nebivalol
specific or non? |
non
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beta blockers used for HTN crisis
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labetalol
carvedalol specific or non? |
non! - these are the only 2 in A-M category that are nonspecific
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which beta blockers have intrinsic sympathomimetic action (don't block beta receptors completely)
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acebutalol
atenalol pindolol 5 reasons to use these |
diabetics
obstructive lung dz cardiovascular dz herat failure heart block |
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what movement of ions needs to happen in order to stimulate things
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move Na into the cell
move Ca into the SA node |
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what movement of ions needs to happen in order to inhibit the CNS? PNS?
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CNS: move Cl into the cell
PNS: move K out of cell |
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what characteristic of skeletal muscle is best seen after an MI?
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recruitment
what's this called? |
stunned myocardium - units not previously used are suddenly woken up
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which type(s) of muscle use intracellular Ca++ to contract?
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all of them
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contrato de paga y señal
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earnest money contract
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which type(s) of muscle use extracellular Ca++ as a 2nd messenger
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smooth muscle
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which type(s) of muscle have autonomics?
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cardiac and smooth
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which type(s) of muscle have syncitial activity
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cardiac and smooth (has partial)
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which type(s) of muscle can fxn w/o innervation, neurotransmitters or hormones
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cardiac and smooth
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which type(s) of muscle can be affected by calcium channel blockers?
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cardiac muscle
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what's needed for vesicular movement down neuron
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kinesin
dynein Ca++ ATP microtubules which direction do kinesin and dynein move things? |
kinesin: anterograde
dynein: retrograde (derrier) |
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what 2 things are needed in the t-tubules to complete Ca++ release from sarcoplasmic reticulum
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DHP -activates ryanodine arm
ryanodine arm - opens to release Ca++ |
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MOA of reserpine? side effects?
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MOA: blocks vesiculization of catecholamines
SE: depression, autonomic dysfxn, Parkinson's what's the MOA of the other drug that has the same side effects? |
drug = guanethidine
MOA: displaces catecholamines when taken up presynaptically |
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4 drugs that block Ca++
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penicillamine
EDTA dimercaprol aminoglycosides common side effect of all? |
cuase neuropathy
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which substances block fusion of neurotransmitter vesicles
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botulinum toxin and tetanus toxin
specific neurotransmitter blocked by tetanus toxin |
glycine from spinal cord - causes disinhibition
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pt comes in because he was in an old barn and he felt a prick on his arm - the area has turned black - dx?
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brown recluse spider
MOA of spider bite? |
inject toxin that causes immediate necrosis
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pt comes in b/c he was doing yard work outside and he felt a prick on his arm - his arm suddenly started twitching - dx?
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black widow spider
MOA of spider bite? |
venom cuases massive release of ACh leading to inc activity of muscle
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when is ATP required in muscle contraction?
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for release
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fxn of phospholambin in muscle contraction
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inhibits Ca-ATPase when done pumping Ca++ back into the sarcoplasmic reticulum
MCC death if missing phospholambin? |
respiratory failure b/c can't stop the pump and so intracellular Ca++ will decr
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what does Ca++ bind to in muscle contraction?
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trop C
fxn? |
release trop I
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what does tropomyosin bind? trop I? trop C?
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tropomyosin: actin
trop I: tropomyosin trop C: trop I |
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paraneoplastic syndrome of squamous cell carcinoma of lung?
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eaton lambert syndrome
problem? |
can't resequester Ca++ so inc intracellular concn - cramps will get worse as day goes on
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when have chest pain, what 3 things should you rule out?
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MI
dissection angina |
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which CCB's should be used for vasospasm
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verapamil
diltiazem which CCB shold be used to block vasospasm after subarachnoid hemorrhage? |
nimodipine
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what's the quickest way to pick up an MI?
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EKG
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what will be seen on EKG when have MI?
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peaked T-wave (from what?)
ST wave depression (when?) ST wave elevation T wave depression (what does it mean?) Q wave (what does it mean? |
peaked T: inc K+ outside of cell
ST depression: 70% stenosis T depression: injured myocardium Q wave: dead cells |
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what can you measure to see if having MI?
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troponin I
CK-mb LDH time periods? |
troponin I rises 2 hrs, peaks 2 days, +ve for 7days
CK-mb rises 6 hrs, peaks 12 hors, gone 24-36 hrs LDH rises 24 hrs, peaks 48hrs, gone 72hrs |
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pt has chest pain when doing yard work, but goes away when sits down - dx?
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stable angina
how much occlusion? |
70%
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pt comes in and describes what seems like a curtain moving over his sight - dx?
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ophthalmic artery occlusion
how much is occluded? |
70%
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pt comes in and says his butt hurts when he walks up stairs and lately, he's had problems getting an erection - dx/
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claudication due iliac artery stenosis
how much is occluded? |
70%
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ST wave depression or elevation: which comes w/ >90% occlusion?
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elevation
what's the other one? |
>70%
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ST wave depression or elevation: which is due to decr K+ in cell?
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depression
what's the other one due to? |
inc Na in cell
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ST wave depression or elevation: which is transmural ischemia
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elevation
what's the other one? |
subendocardial ischemia
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ST wave depression or elevation: which can cause stroke?
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elevation
what can the other one cause? |
TIA
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ST wave depression or elevation: which is associated w/ abdominal angina?
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depression
what's the other one associated w/? |
ischemic bowel
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what's the difference b/t prinzmetal's and unstable angina
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they're both quick vasospasms, but prinzmetal is w/o hx of stable angina while unstable has hx
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which part of the muscle has only actin?
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I band
what color/shade is this? |
light (thin)
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which part of the muscle has only myosin?
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H band
what color/shade is this? |
dark (thick)
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which part of the muscle has both actin and myosin?
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A band
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which part of the muscle are the t-tubules of skeletal muscle located? cardiac?
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skeletal: AI junction
cardiac: Z line |
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which part of the muscle is CPK found?
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M line
what's the fxn of CPK? |
reserve energy
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problem if have huge inc in CPK?
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myositis
MCC? |
hypothyroidism
then cushings |
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drugs that cause myositis?
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RIPS
Rifampin INH Prednisone Statins infection that causes it? |
trichenella spiralis
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what is latching in reference to muscles?
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when actin and myosin are always bound as in smooth muscle - muscles are always moving
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what does smooth muscle use instead of ATPase?
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MLCK and MLCP
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as muscle contracts, which part of the fibers remains the same?
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A band
which shrinks? |
H band and I band and distance b/t Z lines
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what is the optimum length of muscle for max tension
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2.2 micrometers
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what do wt lifters die from?
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heart attack
why? |
b/c they have too many crossbridges that are always contracted and compress vein that inc resistance
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what allows the muscle to hold max contraction force?
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golgi tendon organ
for how long? |
1 second
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what is fxn of golgi tendon organ?
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prevent destruction of sarcomeres and monitor muscle contractions
how? |
will sense anytime you lift more than you should - will fire and force muscle to relax
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which NSAID is best for relaxing muscle spasms after a strain?
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baclofen - why?
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has GABA effects
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after spending a couple of months out of the gym, pt decided to go back and now presents w/ swollen arms and inability to straighten out arms - dx?
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muscle strain - overstretching or tear of muscle - contracted to keep fibers together to heal
treatment? |
rest - heat - baclofen - muscle relaxant if necessary
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pt comes in w/ swollen ankle that is already bruised after twisting it in a soccer game - dx?
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joint sprain from torn tendon or ligament
treatment? |
rest - ice - compression - elevation
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MC muscular dystrophy
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duchenne's
where does pain start? |
hip girdle
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muscle biopsy shows fatty deposits in muscle fibers
dx? |
duchenne's
problem? |
dystrophin protein
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pt grabs on your hand and doesn't let go - also notice that nose sticks out a little farther than it used to
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myotonic dystrophy
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ascending paralysis 2 wks after a respiratory infection
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guillain barre
assoc w/ what types of infections |
campylobacter jejuni
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tingling in hands and feet in glove stocking distribution - also can get ulcers in the feet
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diabetes
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shooting stabbing pain w/ pupils that are slow to react
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syphilis
where does it attack? |
dorsal column and edinger westphal nucleus
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middle aged female w/ ptosis who also tires as day goes on - dx?
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myasthenia gravis
what mass is it assoc w/? what Abs? |
mass: thymoma
Abs: against ACh receptors |
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pt comes in complaining of increasingly worse muscle cramps throughout the day. he has also been having some breathing difficulties - you notice a mass in the lung - dx?
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small cell carcinoma leading to eaton-lambert syndrome
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reversible AChE inhibitors?
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edrephonium
neostigmine pyridostigmine physostigmine which is used to dx myasthenia gravis |
edrephonium
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irreversible AChE inhibitors?
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organophosphates
end in "phate" and "thion" drug that can block organophosphates? |
pralidoxime
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DOC in cholinergic crisis
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atropine
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drug that decr pulmonary secretions prior to surgery
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glycopyrollate
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drug that treats dystonia and can be used in parkinson's
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benztropine
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2 drugs that will decr cGMP and so can treat obstructive lung dzs
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ipratropium and tiatropium
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anticholinergic used for motion sickness
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scopalamine
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middle aged female w/ visual problems and sciatic nerve problem - complains of not being able to see what she's looking at, but has peripheral vision - dx?
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multiple sclerosis
what if this was in a child? |
metachromatic leukodystrophy
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anti myelin Ab?
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multiple sclerosis
what will you see in lumbar puncture? |
myelin basic protein
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middle aged male w/ fasciulations and descending paralysis - dx?
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ALS
what part of the nervous system is involved? |
ventral horn and corticospinal tract
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fasciculations in newborn baby?
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werdnig-hoffman dz
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fasciculations in child 2 wks after diarrhea - dx?
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polio
where does it hide? |
dorsal root ganglia
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child has difficulty walking and has spots all over body - dx?
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ataxia telangiectasia
problem? |
IgA deficiency and DNA breakage repair problem
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child has difficulty walking and shakes when reaching for glass - you do muscle biopsy and see long chain fatty acids - also has metabolic acidosis - dx?
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adrenoleukodystrophy
problem? |
CATI is missing so can't transport the long chain fatty acids in for oxidation
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what are kids w/ fredrick's ataxia at incr risk for?
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scoliosis
retinitis pigmentosa hypertrophic cardiomyopathy |
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4 types of cerebral palsy?
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spastic diplegia
spastic hemiplegia choreoathetsis atonic |
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MCC of spastic diplegia?
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hydrocephalus
what virus can cause this? |
CMV
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what bugs/viruses can cause spastic hemiplegia?
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herpes
toxoplasmosis what lobes for each? |
herpes: temporal lobe
toxoplasmosis: parietal lobe |
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type of cerebral palsy w/ kernicterus
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choreoathetosis
what neurological structure is involved? |
basal ganglia
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neurological structure involved in atonic cerebral palsy
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frontal cortex
MCC death? |
respiratory failure (cuz frontal cortex is where corticospinal tract begins)
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