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143 Cards in this Set
- Front
- Back
- 3rd side (hint)
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the nervous system is divided into
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central nervous system and
peripheral nervous system |
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the central nervous system is composed of
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the brain and spinal cord
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the peripheral nervous system is divided into
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the autonomic division and
the somatic division |
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the autonomic nervous system is responsible for regulating
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the internal environment and carrying information from the CNS to smooth muscles and glands
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the somatic division of the peripheral nervous system is responsible for
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carrying information to the CNS from the senses and from the CNS to the skeletal muscles
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the autonomic division of the peripheral nervous system is further divided into
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the sympathetic and the parasympathetic system
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the sympathetic system activities are summed up as
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arouses the body
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the parasympathetic system activities are summed up as
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calms the body after arousal
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are the cranial nerves in the CNS or PNS
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PNS
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two types of cells in the CNS
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neurons and neuroglial cells
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neurons are composed of
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cell body, dendrites, and axon - the axon emerges from the hillock on the cell body
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how long are axons
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a few mm to a meter and can branch at the end
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what is the basic functional cell of the CNS
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the neuron
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different shapes of neuronal cell bodies are classified as
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unipolar, bipolar
pseudounipolar, multipolar |
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neurons are also classified by function
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motor, sensory, interneuron
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when the signal of transmission down a neuron jumps from one node of ranvier to the next it is called
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saltatory conduction
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types of neuroglial cells
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astrocytes, oligodendrocytes, microglial cells, ependymal cells
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brain neoplasms usually occur in what cells
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neuroglial - astrocytes
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how do neuroglial cells differ from neurons
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do not transmit signal
smaller and more numerous no dendrites |
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function of the neuroglial cells are
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maintenance of the neuron
proper ionic environments modulate nerve cell electrical conduction control reuptake of neurotransmitters repair of neurons after injury |
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what is the major neuroglial cell
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the astrocyte
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astrocytes are found
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in the white and grey matter
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function of the astrocytes
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structural support, pair neurons and nerve terminals
regulate metabolic environment repair injured neurons help with the blood brain barrier (we think) |
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what do astrocytes look like
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stars with many processes and the feet of the dendrites land on the capillary epithelium which makes people think they have to do with the BBB
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To test grip strength, how do you palpate?
Muscle strength grades less than three indicates what? How is muscle strength compared, and what is considered complete AROM? |
-cris cross hands using two fingers for them to grasp
- disability -bilateral, symmetric, -full muscle str |
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oligo dendro means
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few branches
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function of the oligodendrocytes
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form myelin sheath of axons in the brain and spinal cord and can myelinate more than one axon
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oligodendrocytes cannot
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regenerate
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what makes myelin sheaths in the PNS
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Schwann cells
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what is the function of the macroglial cells
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they are transported to sites of neuronal injury or degeneration where they proliferate and become large macrophages that eat neural debris
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macroglial cells are found
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small size cells scattered throughout the CNS
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ependymal cells are found
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lining the roof of the 3rd and 4th ventricles and the central spinal canal
and in the choroid plexus |
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ependymal cells function is
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to form the cuboidal epithelium (choroid plexus) which secretes CSF
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does grey or white matter have a higher metabolic rate
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grey matter
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Side effects of isoniazid
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Age-dependant hepatitis, peripheral neuritis (use B6), sideroblastic anemia (use B6), hemolysis in G6PDH deficiency, drug-induced lupus in slow acetylators
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Antimalarial drugs that can cause acute haemolysis in people with G6PD deficiency: primaquine, pamaquine and chloroquine.
Sulfonamides (such as sulfanilamide, sulfamethoxazole and mafenide),should also be avoided by people with G6PD deficiency, as should certain analgesics (such as aspirin, phenazopyridine and acetanilide) and a few non-sulfa antibiotics (nalidixic acid, nitrofurantoin, isoniazid and furazolidone) |
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white matter is composed of
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myelinated cell neurons
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why do you think the white matter has a lower metabolic rate
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fewer cell bodies because the myelinated sheaths take up a lot of room
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somatosensory and motor cortexes are located
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on the lateral side of the brain
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blood brain barrier covers
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most of the brain and the spinal cord
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areas of the brain not protected by the BBB
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postrema, pituitary, pineal, and portions of the hypothalamus glands
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the postrema is located
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at the base of the 4th ventricle outside the BBB
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why is the postrema important
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location of the chemo trigger zone - the area that is stimulated by drugs, emotion, etc. to elicit a nausea and vomiting reflex - several antiemetics target this area
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why is important that the hypothalamus is partly outside the BBB
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needs to detect changes in the blood chemistry to impact release of hormones or neurotransmitters to regulate the autonomic nervous system and choroid plexus
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what about newborns and the BBB
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the BBB not complete in newborns so drugs that would not normally affect the brain, may in newborns. Also, bilirubin can pass the BBB
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high levels of bilirubin in a newborn can cause
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kerniturous (I don't know the spelling) because the bilirubin will pass into the brain and cause brain damage
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what type of substances can penetrate the BBB
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osmotic substances
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how do you get a chem agent across the BBB
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osmotically shrink the endothelial cells causing the opening of the tight junctions
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BBB disruption can occur with
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trauma, cerebral ischemia, bleeds, tumors
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the 4th ventricle sits over
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the medulla oblongata
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all the different causes of vomiting are coordinated in
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the medulla oblongata (see slide on page 10)
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total volume of CSF at any time
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150 ml
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CSF is produced by
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the choroid plexus
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the CSF is made at a rate of
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21 - 30 ml/hr
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total volume of CSF is replaced every
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3-4 hours
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specific gravity of CSF is
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1.002 - 1.009 (1.006 avg) - useful to know for SABs
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the pressure in the subarachnoid space due to CSF is normally
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5 - 15 torr (other components also contribute to pressure but are not listed in this unit)
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the somatic nervous system contains what neurons
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sensory and motor neurons
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what is a mixed nerve
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a nerve fiber that contains both afferent and efferent nerves
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examples of mixed nerves
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cranial and spinal nerves
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after leaving the spinal cord the afferent nerve fibers
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join the efferent nerve fibers to form a spinal nerve
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pneumonic for remembering which cranial nerves are sensory, motor, or both
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Some Say Marry Money But My Brother Says Big Butts Mean More
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3 division of the autonomic nervous system (I know - usually its two)
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sympathetic, parasympathetic, and enteric
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two different efferent neurons are needed for signals from the sympathetic and parasympathetic systems
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a preganglionic neuron originating in the CNS and a post ganglionic neuron that terminates with the effector neuron
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review anatomy of nerves, spinal cord, ganglions on page 15
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review anatomy of nerves, spinal cord, ganglions on page 15
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are preganglionic neurons myelinated
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yes
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preganglionic axons exit the spinal cord via
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the anterior ventral nerve root in the white rami communicans
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the preganglionic fiber synapses with the post ganglionic fiber in the
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ganglion of the sympathetic chaing
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the collection of ganglion that align with the spinal cord and are a relay station for messages is the
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sympathetic chain (paravertebral ganglia)
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another name for the sympathetic chain
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paravertebral ganglion
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the post ganglionic fiber exits the ganglion via
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the grey ramus and extends to the effector organ
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the preganglionic fiber can run
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up or down the sympathetic chain
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the sympathetic preganglionic fiber is (short or long)
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short
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the sympathetic preganglionic terminal releases which neurotransmitter
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acetylcholine
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what receptors are located on the post synaptic membrane of the sympathetic ganglion fibers
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nicotinic receptors
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the post synaptic axon of the SNS is short or long
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long
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what neurotransmitter is released from the end of the postganglionic fiber of the SNS
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norepinephrine to effect organ
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what receptors do the receptor organs have
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alpha 1 and 2, beta 1
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the adrenal medulla is directly innervated by
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the preganglionic sympathetic nerve fibers
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the preganglionic sympathetic nerve fibers of the adrenal medulla release what neurotransitter
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acetylcholine
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why are sweat glands unique
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both the preganglionic and postganglionic nerve fibers release acetylcholine which bind to the nicotinic receptors of the sweat gland
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another name for the sympathetic nervous system
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thorabolumbar nervous system
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the sympathetic cardiac accelerant fibers are at what levels
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T1 - T4
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the sympathetic chain extends above T1 level ...
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the ganglion above this level are named
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effects of the parasympathetic nervous system on eyes
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constricts pupil
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effects of the parasympathetic nervous system on tears
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stimulates tear glands
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effects of the parasympathetic nervous system on salivation
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strong salivatory flow
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effects of the parasympathetic nervous system on cardiovascular
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inhibits heart, dilates arterioles
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effects of the parasympathetic nervous system on lungs
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constricts bronchi
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effects of the parasympathetic nervous system on GI
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stimulates stomach motility and secretion, stimulates pancreas, stimulates intestinal motility
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effects of the parasympathetic nervous system on bladder
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contracts
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effects of the parasympathetic nervous system on penis
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stimulates erection
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effects of the sympathetic nervous system on eyes
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dilates
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effects of the sympathetic nervous system on tear glands
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none
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effects of the sympathetic nervous system on salivation
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weak salivary flow
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effects of the sympathetic nervous system on cardiovascular
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accelerates heart, constricts arterioles
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effects of the sympathetic nervous system on lungs
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dilates bronchi
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effects of the sympathetic nervous system on GI
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inhibits GI motility, pancreas, adrenals, and intestinal motility
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effects of the sympathetic nervous system on bladder
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relaxes bladder
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effects of the sympathetic nervous system on penis
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stimulates ejaculation
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sympathetic nervous system is associated with what response
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fight or flight
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surgery triggers what response
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fight or flight (SNS) - this is what we are trying to control during surgery
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the inferior cervical and first thoracic ganglia is aka
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stellate ganglia
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a block of the stellate ganglia will cause
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horner's syndrome
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page 21 has a picture of the ganglions and trees out to the organs of effect
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page 21 has a picture of the ganglions and trees out to the organs of effect
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blocking the stellate ganglion is a SE of what procedure
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intrascalene block
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horner's syndrome is
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a block of the stellate ganglion resulting in
ipsilateral pupil constriction, ptosis, anhydrosis (no tears), flushing, increased skin temperature, nasal stuffiness and congestion |
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miosis is
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pupil constriction
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midriosis is
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dilation of pupils
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anhydrosis is
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no tears
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efferent neurons of the parasympathetic nervous system originate
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in the grey matter of the midbrain and medulla
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cell bodies of the parasympathetic nervous system that are not in the brain are
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arise from the lateral horn of the sacral potion of the spinal cord (S-2 to S-5)
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what about cranial nerves II, VII, IX, X
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I don't know - but aren't these the vit K dependent clotting factors :)
see page 23 |
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parasympathetic nervous systems preganglionic fibers are short or long
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long
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parasympathetic nervous systems preganglionic fibers release what neurotransmitter to stimulate what receptor on the postganglionic fiber
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acetylcholine will stimulate a nicotinic receptor
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parasympathetic nervous systems postganglionic fibers are short or long
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short
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parasympathetic nervous systems postganglionic fibers release what neurotransmitter
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acetylcholine
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why does the parasympathetic nervous system have long preganglionic fibers
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there's nothing between the cranium and the sacrum so must reach the sacrum
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loss of the parasympathetic nervous system or the sympathetic nervous system is incompatible with life
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parasympathetic nervous system
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which system is "rest and digest"
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parasympathetic nervous system
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which system is referred to as sludge
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parasympathetic nervous system
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what does sludge stand for
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salivating, lacrimating, urinating, defecating, gastric agony, and emesis
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never give demerol to patients taking what type of drugs
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MAOIs
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review how acetylcholine is made
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review how acetylcholine is made
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pheochromocytoma affects what structure
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adrenal medulla
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source of tyrosine
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diet
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synthesis of norepi
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tyrosine to DOPA to dopamine to norepi
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where is dopamine converted to norepi
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in the presynaptic vesicles
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norepi is stored in the presynaptic vesicles until
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depolarization opens the voltage gated Ca++ channels which then causes them to move to the terminal where the fuse and release the contents into the synapse
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where is norepi converted to epi
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in the adrenal medulla
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both epi and norepi are stored
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in the adrenal medulla
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what is the ratio of epi to norepi in the adrenal medulla
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80% epi
20% norepi |
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once norepi is released, its effect is
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tissue specific, but can open ion channels or stimulate cAMP
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what stops the action produced by norepi
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1. diffusion of norepi away from receptor
2. norepi is actively transported back into the presynaptic terminal through a reuptake mechanism 3. small amounts are metabolized in the synaps by MAO 4. small amounts leak into the blood stream and are metabolized by COMT |
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COMT stands for
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catechol O Methyl Transferase
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MAO stands for
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mono amine oxidase
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how much norepi is reuptaken into the presynaptic terminal (recycled)
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80%
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two drugs that trigger the release of norepi
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ephedrine
demerol |
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indirect drugs are different than direct drugs
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direct drugs bind directly to the receptor to effect an action
indirect drugs cause an effect through causing release of a neurotransmitter or catecholamine |
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is ephedrine direct or indirect
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indirect - mimics SNS
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how doe ephedrine work
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displaces norepi from sympathetic nerve terminals and has a direct action on the receptor but the indirect action is more pronounced
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if a person does not have a large store of norepi should you give ephedrin
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ephedrine would be ineffective, give a direct acting drug
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why do you not give patients on MAOIs demerol
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could dangerously elevate BP and HR because people on MAOIs will have an elevated HR and BP to begin with
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how does demerol affect HR and BP
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increases
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