Pathophysiology1-Test 2

Front 1

1. What are the functions of neurons and neuroglia?

Back 1

..functions of neurons are to be the primary cells of the nervous system constisting of cell bodies, dendrites which are extensions that carry nerve impulses towards the cell body and axon which carry impulses away from the cell body

neuroglia are supporting cells of the nervous system and shwann cells are maintain myelin sheath

Front 2

2.Describe the structure and function of reticular activating system.

Back 2

..RAS regulates vital signs and is a network of connected nuclei in the brain stem that regulate vital reflexes such as cardiovascular and respiratory centers

Front 3

3.Where are Broca’s and Wernicke’s areas located? What are their functions?

Back 3

...broca is area 44, 45 for motor speech and dysfunciton would hinder this in the frontal lobe inferior frontal gyrus///wernicke is for receptive speech located in th area 22 for sensory speech reception and interpretation of speech and dysfunction would hinder this so a "stroke" could cause this

Front 4

4.What structures and/or substances protect the brain and spinal cord?

Back 4

...skin, muscle, skull, dura mater/periosteum as one function layer, arachnoid and its space, pia mater or PAD for the later 3

Hint 4

remember PAD

Front 5

5.How are somatic sensory and motor pathways similar and different?

Back 5

...similar is both cross over in the medulla
...different is sensory in posterior and motor is anterior, sensory is asending and motor is descending

Front 6

6. Distinguish between upper motor neurons and lower motor neurons.

Back 6

...upper motor neurons relays information from the cerebrum to the brain stem or spinal cord, synapse with interneurons, have no direct influence on muscles//////lower motor neruons have influence on muscle, originate in the gray matter on teh spinal cord and axons extend into the PNS

Front 7

7.Where do blood vessels that supply the brain come from?

Back 7

...interior carotid artery, vertabral artery,CO2 is the primary regulator in the CNS and for the brain

Front 8

8.What neurotransmitter blocks pain in the spinal cord?

Back 8

...endorphins

Front 9

9.What are the clinical manifestations of acute pain?

Back 9

...Fear and anxiety
Tachycardia, hypertension, fever, diaphoresis, dilated pupils, outward pain behaviors, elevated blood sugar levels, decreased gastric acid secretion and intestinal motility, and a general decrease in blood flow

Front 10

10.What is referred pain? Where does cardiac, hepatic and renal pain refer to?

Back 10

...referred pain is where pain that is present in an area removed or distant from its point of origin////

cardiac pain is often referred to include the neck, jaws, shoulders, arms and stomach...hepatic pain is the back shooting up to right shoulder...renal pain is lower throax to the groin

Front 11

11.What substances trigger the hypothalamus causing fever?

Back 11

...pyrogens

Front 12

12.What are the 2 phases of sleep?

Back 12

...REM and NREM

Front 13

13.What are the examples of sleep disorders?

Back 13

...Insomnia
Obstructive sleep apnea (OSA)
Jet-lag syndrome
Parasomnias
Somnambulism (sleep walking)
Night terrors
Enuresis

Front 14

14.What are the normal visual pathway and its defects?

Back 14

...eye-optic nerve-foramen-chiasma-tracts-superior colliculi-lateral geniculate nuclei of thalmus-radiators-visual cortex of occipital lobe/////chiasma-lesion causes bitemperoal hemianopia, nerve-lesion causes blindness on connected eye, tracts is lesion creates bilateral hemianopia

Front 15

15.How is conductive hearing loss different from sensorineural hearing loss?

Back 15

...impaired sound conduction vs impairment of organ of corti or its central connections....Conductive hearing loss/////
Impaired sound conduction
Sensorineural hearing loss
Impairment of the organ of Corti or its central connections

Front 16

16.What are the clinical features of Ménière disease?

Back 16

.A triad of tinnitus, vertigo, and deafness...TCM phlegm misting the head, or renal patient with diabetes with medical complicaitons

Front 17

17.How is the level of cerebral and brain stem dysfunction reflected?

Back 17

.brain dysfunction is reflected by an alteration in breathing pattern and level of coma///// brain stem dysfunciton is reflected by pupillary changes and abnormal eyeball movements

Front 18

18.How is brainstem death different from cerebral death?

Back 18

.brain death is no more homeostasis///
cerebral death which is irreversable coma but is not death of brainstem and cerebellum but is no more behavioral or environmental responses but can maintain normal respiratory and cadiovascular

Front 19

19.What are the differences among seizure, epilepsy, and dementia?

Back 19

.seizure is sudden transient alteration of brain function caused by an abrupt explosive disorderly discharge of cerebral neurons---motor, sensory, autonomic or psychic clinical mainfestations may be involved with convulsion(clonic tonic jerky contract relax movements associated with some seizures///epilepsy is "to be seized by a force from without(no underlying correctable cause for the siezures)---ideopathic without a known causeand is most common, symptomatic with an identifiable cause, cryptogenic with a hidden etiology/// dementia is progressive failure of cerebral funcitons that is not caused by an impaired level of consciousness
epilepsy is
dementia is

Front 20

20.What are the examples of alterations in cerebral hemodynamics?

Back 20

Cerebral ischemia
Increased intracranial pressure
Cerebral edema
Herniation
Hydrocephalus

Front 21

21.Dysfunction of what structure is associated with emotion and mood alterations?

Back 21

.limbic, frontal and hypothalamus but not the pineal gland

Front 22

22.What neurologic disorder affects both upper and lower motor neuron functions?

Back 22

.ALS or Lou Gerigs Disease

Front 23

23.What is the most common cause of brain trauma?

Back 23

50% are motor vehicle accidents

Front 24

24.Describe 4 different types of cerebrovascular accidents.

Back 24

Thrombotic stroke-Arterial occlusions caused by thrombi formed in arteries supplying the brain or in the intracranial vessels
Transient ischemic attacks (TIAs)-Embolic stroke
Fragments that break from a thrombus formed outside the brain
Hemorrhagic stroke-associated with high blood pressure
lacunar is small branch of a vessel has a blockage

Front 25

25.How are headaches differentiated?

Back 25

.Migraine headache-more vascular, Trigger factors,Aura
Cluster headache-(Neuro)hard to pinpoint where the pain is, several attacks can occur during the day for a period of days followed by a long period of spontaneous remission
Chronic paroxysmal hemicrania-changes locationwhen you have them, cluster-type headache that occurs with more daily frequency but with shorter duration
Tension type headache-Mild to moderate bilateral headache with a sensation of a tight band or pressure around the head

Front 26

26.What are the clinical consequences of CNS tumors?

Back 26

.increased intrcranial pressure, diminished cognitive functioning, headache, vomiting, siezures, papilledema, unsteady gait, loss of sphincter control

Front 27

27.What are the examples of CNS infection and inflammation?

Back 27

Meningitis
Bacterial meningitis
Aseptic-(viral, nonpurulent, lymphocytic) meningitis
Fungal meningitis
Tubercular (TB) meningitis
Encephalitis
Acute febrile illness, usually of viral origin with nervous system involvement
Most common forms of encephalitis are caused by arthropod-borne viruses and herpes simplex virus
Suppurative CNS masses:
1.Cerebral abscess
2.Spinal cord abscess

Hint 27

ch 17 slide 11,12,

Front 28

28.How is multiple sclerosis different from amyotrophic lateral sclerosis(AMS)?

Back 28

.Multiple sclerosis (MS)
A progressive, inflammatory, demyelinating disorder of the CNS
Amyotrophic lateral sclerosis (ALS)
Also known as Lou Gehrig disease
Diffusely affects upper and lower motor neurons of the cerebral cortex, brain stem, and spinal cord
Progressive weakness leads to respiratory failure
Patient has normal intellectual and sensory functions until death

Front 29

29.What are the examples of PNS and neuromuscular junction disorders?

Back 29

Radiculopathies:Nerve root disorders//
Plexus injures:Involves the nerve plexus distal to the spinal roots but proximal to the peripheral nerves
Neuropathies:Neuritis, sensorimotor neuropathies, sensory neuropathies (e.g. leprosy), and motor neuropathies (e.g. Guillain-Barré syndrome)

Front 30

30.What are the positive and negative symptoms of schizophrenia?

Back 30

Positive symptoms:::
Hallucinations: auditory, somatic-tactile, visual
Delusions: being controlled, mind reading, reference, guilt, grandiose, persecutory, etc.
Thought disorders: distractible speech, illogicality, incoherence, tangentiality, etc.
Bizarre behavior: aggressive (agitated), repetitive (stereotyped), social, sexual behavior
Negative symptoms
Flattened affect: nonresponsivity, decreased spontaneous movements, lack of vocal inflections, paucity of expressive gestures, poor eye contact, unchanging facial expression
Alogia: blocking, increase in response latency, poverty of speech or its content
Anhedonia-asociality: few recreational interests and social relationships, impaired intimacy, little sexual desire
Attentional deficits: social inattentiveness
Avolition-apathy: impaired personal hygiene, lack of persistence, physical anergia

Hint 30

negative all the "a's"
positive all the fun things

Front 31

31.What are the neurochemical and neurohormonal changes in schizophrenia and depression?

Back 31

.schizophreniathere is alteration of neurotransmitters, specifically increased dopaminergic neurotransmition(dopamine goes up)
Depression is neurochemical dysregulation which is decreased monoamin acitvity (NE , dopamine, serotonin (and it doe'snt include sexual dysfunction

Front 32

32.What are the diagnostic criteria for major depression and manic episodes?

Back 32

cortisol up, thyroid down, mona and dopomine and seratonic down...///
DEFINITIONS: Emotional states that are unremitting and disrupt normal functioning of the individual.
Major depression is characterized by an intense and sustained unpleasant state of sadness and hopelessness and according to DSM-IV the occurrence of 5 or more of the following symptoms during a 2-week period in which at least one of them includes depressed mood or loss of interest or pleasure.
Mania is characterized by extreme levels of energy and euphoria and The DSM-IV diagnostic criteria for manic episodes is a period lasting at least 1 week in which the individual experiences an abnormal and persistently elevated, expansive, or irritable mood. During this period, at least 3 (or 4 if the mood is only irritable) of the following symptoms are exhibited
Elevated mood, irritability, inflated self-esteem or grandiosity, decreased need for sleep, flight of ideas, excessive talking, pressured speech, distractibility, increased physical activities, increased pleasurable activities, psychomotor agitation

Bipolar disorder: recurrent patterns of depression and mania

Front 33

33.List the examples of neural tube defects.

Back 33

Defects of neural tube closure
Anencephaly- no brain developement
Encephalocele-protrusion
Meningocele- covering of brain
Myelomeningocele (spina bifida cystica) spinal cord and menenges protruding

Front 34

34.What are the examples of encephalopathies in children?

Back 34

Cerebral palsy-paranatal injury
Phenylketonuria (PKU)-does not have a certain phenylamin (amino acid)…is toxic to the brain and can cause brain damage
Epilepsy/benign febrile seizures- related to high fever, not a long term damage to brain
Reye syndrome-brain and liver damage, associated with the use of asprin with flu like symptoms
CNS intoxications (e.g. lead poisoning)…from old houses or toys…long term can cause brain damage
Meningitis- inflamation of menenges from virus, bacteria, or fungus

Front 35

35.How is hormone secretion regulated via feedback loops?

Back 35

.hypothalamus sends releasing hormones to anterior pituitary which sends hormones to target organ, then that organ sends a hormone back to hypthalamus and pituitary

Front 36

36.What is the difference between diabetes insipidus and diabetes mellitus?

Back 36

Diabetes isipidus-def. of ADH or resistance at target tissues to ADH
Diabetes mellitis is a def. of insulin or a resistance to insulin in target tissues

Front 37

37.Describe the common diseases of anterior pituitary, thyroid, parathyroid, and adrenal glands

Back 37

ant pituitary- Hyposecretion of GH=Pituitary dwarfism
Hypersecretion of GH=Gigantism (in growing children)
Acromegaly (in adults)=tumor cells overgrowing
Hypersecretion of prolactin
Galatorrhea=Milk discharge
Thyroid=hyporthyroid, hypothyroid
Parathyoid=Hyperparathyroidism
…Related to high calcium levels
Excess secretion of PTH from one or more parathyroid glands, leading to hypercalcemia
Bones (pain), stones (kidneys), moans (mental-high calcium), and groans (abdominal)
Hypoparathyroidism
Abnormally low PTH levels
Usually caused by parathyroid damage in thyroid surgery
…Can cause low calcium levels and may die
Adrenal glands=Disorders of the adrenal cortex
1.Adrenocortical hypofunction
Primary adrenal insufficiency (Addison disease)
2.Cushing disease
Excessive anterior pituitary secretion of ACTH
3.Cushing syndrome
Excessive level of cortisol, regardless of cause
4.Hyperaldosteronism
Primary hyperaldosteronism (Conn disease)
Hypernatremia, hypokalemia, hypervolemia(high calcium), and hypertension…

Front 38

38.What are the examples of diabetic complications?

Back 38

.muscle wasting, polydipsia, polyuria, ketoacidocis, dislipidemia leading to atheroscleroisis
Type 2 - same plus cardiovascular disease, diabetic neuropathy, neuropathyPNS, retinopathy eyes, amputaions

Front 39

39.Describe the menstrual cycle in terms of the ovarian and uterine phases.

Back 39

.beginning is estrogen and progesterone low levels and endometrial tissue breakdown during menstration, on release of FSH and LH follicle develops, prepares for release of ovum, endometrial tissue builds up to prepare for implantation of fertilized egg, estrogen secretion spikes and afterwards the follicle becomes the corpus luteum which degrades to scar tissue, progesterone levels increase, estrogen levels first drop, then increase slightly, and without implantation, hormone levels decrease, leading to the beginning of the menstrual cycle with endometrial tissue breakdown

Front 40

40.How are gonadal hormones regulated?

Back 40

.age, environment, health, stress, all affect the CNS this in tgurn affects the secretions of the hypothalamus...it releases GnRH(gonadaltropin releasing hormone) which stimulates the release of LH and FSH by the pituitary to the gonads (testes and ovearies) the standard feedback mechanism apply but mainly when the gonads have received adequate levels of stimulating hormones, they release their own feedback hormones (inhibin, activin, follistatin) to notify the CNS/hypothalsmus to stop releasing stimulating hormones

Front 41

41.What is the difference between primary and secondary dysmenorrhea?

Back 41

.Primary dysmenorrhea-means painful menstruation or cramping
Painful menstruation is associated with prostaglandin release in ovulatory cycles, but not with pelvic pathology.///
Secondary dysmenorrhea
Painful menstruation with underlying organic lesions, e.g. PID, endometriosis, inflamitory disease or fibroids etc.

Front 42

42.What is the difference between primary and secondary amenorrhea?

Back 42

.Primary amenorrhea is the
Failure of menarche or absence of menstruation by age 14 without development of secondary sex characteristics or by age 16 regardless of presence of secondary sex characteristics.///
Secondary amenorrhea
Absence of menstruation for a time equivalent to 3 or more cycles or 6 months in women who have previously menstruated

Front 43

43.Describe the diagnostic steps for amenorrhea.

Back 43

.First do a HCG test for pregnancy to exclude the most common reason for amenorrhea, serum prolactin, TSH, if prolactin elevated see if related to drugs or idiopathic and do a CT or MRI of head to check for tumors. If TSH normal do a prgesterone challange check FSH and LH assayultrasound and ckeck karotype
High prolactin is hypothalamic amenorrhea
The other is hypothyroid to mimic a regular cycle
High because ovary is no feedback need to check karotype might be genetic…turner syndrome (hypogonadism-missing a x chromosome, no ovulation or cycle)
End organ problem would be …lack of vagina, no uterus

Hint 43

review ch. 23 slide 5 for more detail

Front 44

44.What are the causes of amenorrhea?

Back 44

.disorders of hypothalamus or anterior pituary, Turners syndrome, male pseudohermaphroditism, superfemale syndrome, congenital abscense of vagina or uterus, congenital uterine hypoplasia

Front 45

45.What are the characteristics of polycystic ovarian syndromePCOS?

Back 45

.Most common endocrine disturbance affecting women
Leading cause of infertility in the United States////obesity, menstrual disturbance, elevated insulin, decreased SHBG, elevated androgens, elevated DHEA, elevated LH and prolactin, dyslipemia, DM, cardiovascular disease, endometrial carcinoma
Insulin resistance and hyperinsulinemia play a key role in androgen excess, anovulation, and pathogenesis of PCOS

Front 46

46.What are the clinical features of PID, leiomyomas, and endometriosis?

Back 46

.Inflammatory disease caused by polymicrobial infection (STD)
May involve any organ of the reproductive tract, e.g. salpingitis, oophoritis, etc.
Sexually transmitted diseases migrate from the vagina to the upper genital tract

Front 47

47.How are CIN 1, 2, and 3 differentiated?

Back 47

.degree of dysplasia 1 is mild, 2 is moderate and 3 is severe to carcinoma in situ

Front 48

48.What are the top metastatic sites of prostate cancer?

Back 48

.Mostly commonly diagnosed malignancy and 2nd leading cause of cancer death in men
Asymptomatic until its advanced stages
Symptoms are similar to benign prostatic hyperplasia (BPH)
Metastatic sites are bone, lung, liver, adrenal glands, peritoneum

Front 49

49.What are the common areas of breast cancer?

Back 49

.Most common cancer in American women
Second most common killer after lung cancer///
Areas are lateral right and left upper towards armpit
Leading cause of death from ages 40 to 44
Distribution in different areas

Front 50

50.What are the common causes of sexually transmitted diseases?

Back 50

.Gonorrhea-Caused by Neisseria gonorrhoeae
Syphilis-Caused by Treponema pallidum
Chlamydia-Infections caused by Chlamydia trachomatis
Most common STD in the United States
Genital herpes
Caused by Herpes simplex virus (HSV) type 1 and type 2
Genital warts
Caused by Human papilloma virus (HPV)
HIV infection/AIDS
Hepatitis B he added
Candidiasis
Caused by Candida albicans
Trichomoniasis
Caused by Trichomonas vaginalis
Scabies
Caused by the mite Sarcoptes scabiei
Pediculosis pubis (pubic lice)
Caused by the crab louse Phthirus pubis
Gay bowel syndrome – multi factors, male homosexual
Hepatitis B virus (HBV) infection
irus pubis