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152 Cards in this Set
- Front
- Back
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N-acetylglucosamine-phosphotransferase results in what disease?
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I-cell disease
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What organelle is involved in the syntheiss of bile acids?
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Peroxisomes
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What is Zellweger's syndrome?
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Empty peroxisomes
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What are two examples of calcium dependent adhesion molecules? What is one example of a calcium independent adhesion molecule?
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Ca2+ depend: cadherin, selectin; independent: integrin
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What are zonula adherens? What is the cytoskeletal element? What is the linker molecule?
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Apicolateral belt below the tight junctions; actin; cadherins
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What are macula adherens? What cytoskeletal element do they use? What linker molecule do they use?
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Desmosomes; intermediate filaments; cadherins
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What linker elmeent do hemidesmosomes use?
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Integrins
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Where is the only place you find stratified cuboidal cells?
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Ducts of sweat glands
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In what cell compartment do collagen triple helixs form?
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ER
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Where does lysyl oxidase act? What is its cofactor?
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ECM, copper
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What type of collagen is in the intervertebral discs?
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Type II
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What is the appaearance of collagen on EM?
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Distinct banding patter at 64 nm length; kind of looks like striated muscle
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What disease is characterized by the inability ot convert procollagen to tropocollagen?
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Ehler's Danlos syndrome
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What is the predominant component of proteoglycans and glycoproteins?
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Proteoglycans = carbs, glycoproteins = proteins
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What is laminin?
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Glycoprotein component of basement membrane; binds integrins
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Do Haversian canals grow from center out or from out to center?
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From out to the center
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What is the I, A, H band?
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I = only actin, near the zine line; A band: length is = to mysoin, but it has overlap of actin and mysoin; H band: only myosin
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What is neublin?
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Scaffolding protien, binds actin along I line, binds Z line
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What is titin?
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Scafolding protein, binds myosin, not only achored to M line but extends to Z line
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What is the M line?
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Middle of H band
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Are skeletal, cardiac, and smooth mucsles all multinucleated?
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Only skeletal is multinucleated
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What causes red pulp hyperplasia?
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Portal hypertension
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What type of cell surrounds the periarteriole sheath in the spleen?
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T-cells
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What are the functions of clara cells?
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Detoxification (CYT-P450), increase in # with pollution / smoking, involved in chloride transport into lumens of bronchioles (involved in CF)
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Where are stem cells found in the esophagus, stomach, small intestine, large intestines?
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Esophagus: basal cells; stomach: isthmus; small&large intestine: crypts of leiberkuhn
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What two layers does the muscularis mucosa divide?
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Mucosa (& lamina propria) and the submucosa
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What type of saliva gland produces MOST of the saliva?
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submandibular
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What is the role of Kupffer cells? Stellate cells of ito?
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Kupffer are liver macrophages; Stellate store vitamin A/ fats
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What cells mediate fibrosis of the liver?
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Stellate cells of ito
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What germ cell layer produces the dermis?
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Mesoderm
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What germ cell layer produces the pia?
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Neural crest
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Layers passed through in a lumbar puncture are?***
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Supraspinous ligament, interspinous ligament, epidural space, dural, arachnoid, subarachnoid space
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What vertebral level does the spinal cord end in an adult? What level does the subarachnoid space end?
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Around L2; around S2
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What ligament does a intervertebral disk herniate through?
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Posteriolaterally through the POSTERIOR LONGITUDINAL LIGAMENT
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What is the bottom of the lung and bottom of pleura at midclavicular line?
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6th / 8th rib
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What is the bottom of the lung and bottom of pleura at midaxillary line?
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8th / 10th rib
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What is the bottom of the lung and bottom of pleura at paravertebral line?
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10th / 12th rib
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What intercostal space do you pass a needle through at midclavicular, midaxillary, paravetebral lines?
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7th / 9th / 11th intercostal space (top of the rib)
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If I stabbed you in the left thoracic cavity, what lung lobe at any point would be penetrated?
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Inferior lobe at all points, because the lungs are divided obliquely; inferior lobe goes all the way up to the top of the lung at the posterior part of the lung
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What is the level of the oblique fissure at on the left and right lung?
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5th intercostal space
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On anterior side, what rib levels define upper vs lower lobes?
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Upper is above 5th rib; lower is below 6th rib
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On anterior side, what rib levels define upper vs middle vs lower lobes?
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Upper: above 4th, middle 4-6th; lower below 6th rib
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Describe the lymph drainage of the left and right lungs?
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Right lung can go to right lymphatic duct; left lung all goes to thoracic duct
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Is the AV/SA node a nerve or specialized cardiac muscle?
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Specialized cardiac muscle
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What structures go through the diaphragm with the IVC? What vertebra level?
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Phrenic nerve; T8
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What structures go through the diaphragm with the esophagus? What vertebra level?
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Vagus nerve; T10
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What structures go through the diaphragm with the aorta? What vertebra level?
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Thoracic duct; T12
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What are all of the layers of the anterior abdominal wall starting from skin?
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Skin, camper's fatty fascia, scarpa's fibrous fasica, external oblique, internal oblique, transveralis muscle, tranversalis fascia, parietal peritoneum
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Where does pain from the foregut, midgut, and hindgut refer to?
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Fore: epigastric, midgut: umbilical, hindgut: hypogastric
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What are the major intraperitoneal organs?
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Stomach, liver/gal, spleen, duodenum 1st part, tail of pancreas, jejunum, ileum, appendix, transverse colon, sigmoid colon
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What are the major secondary retropertioneal organs?
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Duodenum 2 and 3, head/neck/body of pancreas, ascending and descending colon, upper rectum
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What are the major primary retroperitoneal organs?
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Kidney, adrenals, ureters, aorta, IVC, lower rectum, anal canal
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What side of the gut will you find the illeum and jejunum? (right vs left)
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Illeum will be right; jejunum will be left
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What vein does the IMA drain to?
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Spleen
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What brachial plexus nerves are C5 & C6?
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Suprascapular, musculocutaneous, axillary
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What brachial plexus nerves are C8 & T1?
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Ulnar
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What are the two actions of the biceps brachii?
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Flexion of arm and supination
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What muscles in the anterior forearm are innervated by the ulnar nerve?
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Flexor carpi ulnaris, 1/2 of flexor digitorum profundus
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What muscles in the hand are innervated by the ulnar nerve?
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Adductor pollicis, interossei, lumbricals 4/5, hypothenar compartment
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What are the actions of the teres minor and deltoid muscles?
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Lateral rotation, abduction
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What nerve controls the abductor pollicis longus?
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Radial nerve
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What innervates the dorsal hand tips?
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Median nerve for digitsl 1-4 & 1/th; ulnar is 4 & 1/2 to 5th
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What dermatome is foud at the thumb? Pinky?
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Thumb is C6; pinky is T1
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What would be the symptoms of an upper trunk injury? What is most likely cause?
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C5/C6; loss of abduction and external rotation (waiter's tip sign); Erb's palsy is caused by head and neck pulling away from the shoulder [falling from tree, obstrectrical complication]
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What nerve would be damaged by use of a crutch, or "Saturday night palsy"?
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Radial nerve
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What innervates the dorsal hand?
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Tip of all fingers is median nerve; thumb side is radial nerve, pinky side is ulnar nerve
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What nerve would be injured by a radial head fracture? What would the symptoms be?
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Raidal nerve; weakened extensor digits and weakened supination (normal extension of forearm)
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What is clawing an indication of? What could cause clawing of all 4 digits?
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Lumbrical muscle paralysis (ulnar and median nerve); damage of C8 and T1 (inferior trunk)
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If hand has radial or ulnar deviation on flexion of the wrist, what nerve is damaged?
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Radial deviaton: ulnar damage; ulnar deviation: median damage
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What is the order of muscles of the rotator cuff?
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Superior: supraspinatous, posterior: infraspinatious, teres minor, anteiror: subscapularis
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Where is the capitulum?
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Distal end of the humerus, near the radial head
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What hand bone is most likely to be injured by falling on the outstretched hand?
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Scaphoid
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Dislocation of lunate from hypertension injury results in damage of what nerve?
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Median nerve for digitsl 1-4 & 1/th; ulnar is 4 & 1/2 to 5th
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What foot bone articulates with the tibia? What bone makes up the heel?
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Talus; calcaneus
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What nerve damage would cause isolated loss of eversion?
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Superficial fibular nerve
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What artery becomes the dorsalis pedis artery?
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Anterior tibial artery
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What artery is compressed by anterior leg compartment syndrome?
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Anterior tibial arteyr
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What ligament would be torn by a valgus and varus strain on knee?
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Valgus strain tears the MCL, varus strain tears the LCL
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Hyperextension injuries of the knee tears what ligament?
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ACL
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Via what foramen does the middle meningeal artery enter the skull?
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Foramen spinosum
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What arch forms the common and internal carotids?
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III
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What arteries are formed by arch 4?
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Arch of aorta (left), right subclavian (right arch)
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What arteries are formed by arch 6?
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Pulmonary arteries, ductus arteriosus
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What arch forms the superior laryngeal nerve / innervates cricothyroid?
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IV
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Alar and basal plates: which is motor/sensory? Which is anterior/posterior?
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Alar: posterior, sensory; sensory: anterior, motor
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Where does the retina nad the optic nerve come from in terms of the brain vesicles?
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Diencephalon
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What nerve innervates the parotid gland?
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XI via otic ganglion
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What nerve innervates the pterygopalatine ganglion? What structures does this ganglion innervate?
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VII; lacrimal gland, nasal mucosa, oral mucosa gladns
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What are thoracic/lumbar splanchnic nerves?
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Preganglionic sympathetic nerves that innervate the gut; they also provide afferent sensory for gut pain
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What is Wallerian degeneration?
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Anterograde degeneration of axon that is distal to the cut
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What does the filum terminale consist of?
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Pia mater extension
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Ia fibers innervate? Ib fibers innervate?
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Ia are muscle spindle cells; Ib are golgi tendon organs
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What is the function of the gamma motor neuron?
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Mediates the stretch of the muscle spindle cells
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What is the function of the golgi tendon organ?
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Ib neurons inhibit alpha motor neurons when they sense excessive contractile force
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Is the corticospinal tract ipsilateral or contralateral to the ventral alpha motor neuron?
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Ipsilateral
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Describe the pathway of the dorsal column system
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DRG => ascend ipsi in the posterior column => synapse on inpsi cuneate/gracilis nucelus in medulla => go contralateral to the medial lemiscus => go to VPL => go postcentral gyrus
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Describe the pathway of the anteriolateral system
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DRG => ascend 1-2 levels (lissaur's tract) => synapse ipsilateral dorsal horn =>travel to contralateral side via anterior white commisure to spinothalamic tract => ascend contralateral => synapse VPL => go postcentral gyrus
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If I hemisected the T5 spinal level, what would be affected?
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Ipsilateral UMN loss below T5, ipsilateral LMN loss at T5, contralateral ALS loss at T7 (some minor ipsilateral ALS at T5), ipsilateral DCS at T5
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What are the external cuneate nucleus and Clarke's nucleus?
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Found in the spinal cord; they are sites where DRGs carrying unconscious proprioception synapse before ascending ipislaterally to the cerebellum
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What would happen with an anterior spinal artery occulsion and posterior spinal artery occlusion in the spinal cord?
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Anterior: dorsal column spared, bilateral loss of all ALS and motor; posterior: loss of DCS
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If you see inferior colliculus, what level of the brainstem are you at?
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Midbrain
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Where do you see the trochlear nucelus?
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Midbrain; next to inferior colliculus
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What is the function of the infeiror olivary nucleus?
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Bilaterally innervated by CN VIII; first site of sound processing
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Where do you find CN8 nucleus?
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Lateral medulla
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What are the two functions of the solitary nucelus?
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Cranial: taste; caudal: GI and cardiorespiratory sensations
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What is the function of the dorsal motor nucleus of CNX?
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Innervates smooth muscle and glands of thorax and abdomen
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Why would a lesion of the abducens nucelus affect the facial nerve?
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Facial colliculus = abducens nucleus; facial nerve fibers wrap around it before they exit
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How could you get a pure pain/temp loss of cranial nerve 5 vs a fine touch loss of cranial nerve 5?
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Pure pain and temp would be from a lateral medullary syndrome; fine touch would be from a lateral pons syndrome
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At what point does hearing loss become bilateral vs unilateral?
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Unilateral: no higher than choclear nucleus; bilatearl: at any point above choclear nucelus (inferior olive!)
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What is the effect of a left and right frontal eye field lesion?
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Left FEF: both eyes can't look to the right, right FEF: both eyes can't look to the left (FEF innervates contralateral PPRF)
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How do you distinguish a frontal eye field vs PPRF/abducens nucleus lesion?
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FEF will have less facial weakness; PPRF/CN6 nucleus will have profound facial weakness
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What supplies the lateral rostral pons? Lateral caudal pons?
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SCA / AICA
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What supplies the midbrain?
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PCA
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What artery does the PICA come off of? AICA?
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PICA from the vertebral artery, AICA from the basilar artery
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Where do you find the medial lemiscus at the midbrain, pons, and medulla?
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Lateral in midbrain and pons; medial in medulla
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What are the symptoms of medial medullary lesion? What artery?
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Anterior spinal artery; contra UMN, contra DCS, ipsi CN12 (deviate to same side)
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What are the symptoms of lateral medullary lesion? What artery?
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PICA; loss of CN X/XI (dysphagia, uvula to opposite side), contra ALS body, ipsi ALS face, loss of taste, ipsi horners, ataxia
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What are the symptoms of medial pontine lesion? What artery?
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Paramedian pontine artery; contra UMN, contra DCS, ipsi CN6 (abduction defect)
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What are the symptoms of lateral pontine lesion? What artery?
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AICA; loss of hearning (CN8), loss of facial muscles (CN7), loss of ipsi face ALS/contra body ALS, ipsi horner's
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What are the symptoms of medial midbrai lesion? What artery?
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PCA; loss of ipsi CN3, contra corticospinal and corticobulbar UMN
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What is the function of the cerebellar vermis and intermediate zones? What is its input?
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Ongoing motor execution; spinal cord
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What is the function of the cerebellar lateral zones? What is its input?
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Planning/coordination; cerebral cortex and inferior olive
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What is the function of the folcculonodular lobe? What is its input?'
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Balance and eye movements; CN8
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What is the purpose of the inferior, middle, and superior cerebellar peduncles?
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Inferior and middle are inflow tracts; superior is an outflow tract
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What is the online excitatory neuron of the cerebellar cortex? What is their function?
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Granule cell; excite the purkinje cells
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Where do climbing fibers come from? How do they enter the cerebellum? Function?
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Olivocerebellar; ICP (decussate), excite purkinje cells
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Where do mossy fibers comef rom? How do they enter the cerebellum? Function?
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Vestibulocerebellar tract, spinocerebellar tract; ICP/MCP/SCP; excite granule cells which excite purkinje cells via parallel fibers
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What is the effect of purkinje cells on deep cerebellar nuclei?
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Inhibitory via GABA
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What do the deep cerebellar nuclei project to?
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Contralateral VA/VL and then the precentral gyrus
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What are the symptoms of a right hemisphere cerebellar lesion? Right cerebellar vermis lesion?
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Right sided intention tremor & dysdiadochokinesia, dysmetria; falling toward right side (ataxia) due to loss of proprioception of midline muscles
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How do you distinguish between tabes dorsalis and a vermis lesion?
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Vermis lesion will have + rombergs with eyes open and closed; tabes doraslis will only show romberg with eyes lcosed
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What diseases are associated with Tourette syndrome? *****
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OCD and ADHD
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Does the basal ganglia innervate contralatearl or ipsilateral cerebrla cortex?
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Ipsilateral
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What causes homonymous hemianopsia with macular sparing?
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PCA infarct of occipital lobe
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What is dorsomedila thalamic nucleus associated with?
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Wernicke-Korsakoff syndrome
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What is the anterior thalamic nucleus?
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Input from mamillary body, output to cingulate gyrus; part of Papez circuit
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What part of the thalamus does taste synapse on?
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VPM
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What would a lesion of the preoptic hypothalamic nucleus result in?
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Loss of sexual development/differentiation if before puberty; amenorrhea/impotence if after
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What would a lesion of the supraoptic nuclei result in?
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Diabetes insipidus
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What part of the hypothalamus controls the anterior pituitary?
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Arcuate nucleus
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What would a ventromedial hypothalamic nucleus lesion result in?
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Obesity (loss of anorexic center)
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What part of the hypothalamus causes sweating / shiver?
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Anterior: sweating; posterior: shiver
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What part of the hypothalamus is involved in shame rage?
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Dorsomedial
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What could cause alexia without agraphia? Alexia with agraphia?
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Left PCA infarct of the corpus collusum; angular gyrus infarct (gerstmann's syndrome)
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What could cause a hemorrhagic vs pale infarct of the brain?
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Hemorrhage is an embolism (gets lysed); pale is a thrombotic
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Lesion of what part of the brain could cause apraxia? What is apraxia?
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Premotor cortex; motor planning
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What is the effect of an infarct of the primary auditory cortex?
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Slight bilateral decrease in hearing (NOTE NOT UNILATERAL HEARING LOSS!)
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Lesion of what part of the brain could cause asterognosia? What is asterognosia?
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Somatosensory association cortex; inability to reocgnize objects by touch
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What is the most common side of hemispaital neglect? What part of the brain is infarcted?
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Right parietal lobe; hemispatial neglect of left side of space
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Lesion of what part of the brain will cause a prosopagnosia? What is prosopagnosia?
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Temporal lobe; inability to recognize objects or name objects
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What can cause a transcortical apraxia? What is a transcortical apraxia?
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ACA infarct of the corpus collusum; "disconnect syndrome", the left side of the body cannot undertake actions, only the right side (because it's ipsilateral to wernicke's area)
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What type of infarcts can cause dysprodias?
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Right hemisphere via MCA (intonation, emotion of langauge)
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