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412 Cards in this Set
- Front
- Back
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Vit C (about)
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regen of enzymes, collagen formation through hydroxylation. Found in citrus, fruits and veggies, light sensitive
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Vit C def
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Def: scurvy, weak CT, hemorrhages, petecha (tooth loss)
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Vit C name
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ascorbate
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Vit B7 about
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formation of antibodies and enzymes by carboxylaton
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Vit B7 def
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alopecia, low appetite, nausea, depression, seizures, encephalopathy, glossitis, immune suppression
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Vit B7 name
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biotin
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Vit A about
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needed for vision, sperm formation, epithelia of mucus membrane. found in green and yellow veggies, liver, dairy
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Vit A def
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eye damage, night blindness, skin damage, immune deficiency
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Vit A name
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Retinoids
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Vit D about
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stim of absorption of Ca, high need in last 2 months of preg
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Vit D def
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ricketts in children. osteomalacia in adults
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Vit D name
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Cholecalciferol
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Vit E about
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antioxidant, radical scavenger
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Vit E def
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flaky skin, anemia, liver degen
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Vit E name
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tocopherol
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Vit K about
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conversion of Glu to Gla, chelation site for Ca, blood clotting
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Vit K def
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hemorrhaging, stomach pain, bone malformation, deposits of Ca in arteries. Hemolytic disease of the newborn
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Vit B1 about
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oxidative carboxylation (pyruvate decarboxylase, a-ketogluterate dehydrogenase
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Vit B1 def
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Beri-Beri: weakness, muscle wasting, babie with thin inaudible cry, vomiting, costipation. Wernicke-Korsakoff in EtOH drinkers. Treat with B1 1st, then gluc
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Vit B1 name
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thiamin
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Vit B2 about
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oxidoreductases (FAD, FMN)
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Vit B2 def
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cracked lips, psyco deviations, anemia, glossitis, light sensitive
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Vit B2 name
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riboflavin
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Vit B3 about
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CO-substrate of oxidoreductases (NAD+, NADP+), can be made from Tryp, but insufficient
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Vit B3 name
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niacin
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Vit B3def
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Pellagra, dermatitis, diarrhea, dementia, death
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Vit B5 about
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component of CoA, preserves C-C bonds, destroyed by heat!
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Vit B5 def
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reduced cell health, increased infections, insomnia, vomiting, fatigue
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Vit B5 name
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pantothenic acid
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Vit B6 about
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cofactor in transaminase, deaminase, metabolism, hormone synth
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Vit B6 def
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weakness, hypochromic anemia, brain damage if def in 1st few months of preg and stores are reduced by OC
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Vit B6 name
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pyridoxine
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Vit B9 about
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needed to make pyrimadines, increase need during preg
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Vit B9 def
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neural tube defects in preg
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Vit B9 name
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folic acid
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Vit B12 about
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needed for several mutases, needed to recover folate from trap
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Vit B12 def
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megaloblastic anemia, demylination, caused by pernicious anemia, tested by Schilling's test, tapeworm can steal from diet, normal 5 year supply
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Vit B12 name
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cobalamin
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Tay-Sachs disease
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Hexoaminidase A def. GM2 ganglioside buildup. mental retardation; blindness; muscle weakness; seizures; cherry-red macula; early mortality
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Metachromatic leukodystrophy
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Arylsulfatase A def. Sulfatides buildup. cognitive deterioration; demyelination; progressive paralysis
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Faber disease
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Ceraminidase def. Ceramide buildup. progressive joint deformity; hoarse cry; granulomas in tissue; subcutaneous nodules of lipid laden cells;
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Neimann Pick
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Sphingomyelinase def. Sphingomyelin buildup. mental retardation; hepatosplenomegaly neurodegenerative course (type A) extensive phenotypic variations depending on the type
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Krabbes disease
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Β-galactosidase def. Galacto-cerebroside buildup. mental and motor deterioration; blindness and deafness; near-total loss of myelin
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Sandhodd disease
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Hexoaminidase A and B def. GM2 and globosides buildup. same neurological symptoms as Tay-Sachs but with visceral involvement
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Gaucher disease
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Gluco-ceribrosidase def. Glucocerebroside buildup. hepatosplenomegaly; mental retardation in rare forms; osteoporosis of long bones; most common
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Fabry disease
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a-galactosidase A def. Globosides buildup. kidney failure; heart failure; reddish-purple skin rashes; burning pain in lower extremities
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7 alpha hydroylase
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converts cholesterol into bile acids
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5 alpha reductase
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converts testosterone to DHT
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Medium chain Acyl-CoA dehydrogenase def
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high lvls of C6-C10 dicarboxylic acid in urine, high lvl of fatty acids in plasma, fat in liver, reduced ketone production. High mortality (Reyes syndrome, SIDS)
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Carnitine def (or carnitine Acyl transferase def)
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increased fatty acids in blood, hypoglycemia, low lvl of ketones, myoglobin and CK in blood, high VLD
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purine nucleoside phosphorylase (PNP) def
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in purine degredation. Leads to T-cell deficiency with normal B-cells
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adensoine desaminase (ADA) def
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in purine degredation. Leads to SCIDs. No T or B cells. Treat with marrow transplant
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Intermediates of catecholamine synth
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tyrosine, L-Dopa, dopamine, NE, Epi
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Inactivation of catecholamines
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monoamine oxidase (MAO) and catechol-O-methyltransferase (COMT)
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Indoleamine synth intermediates
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L-tryptophan, 5-hydroxytryptophan, 5-HT, melatonin
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17 alpha hyroxylase
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needed for progesterone to testosterone
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21-hydroxylase
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needed to make cortisol and aldosterone from progesterone. Def leads to ambigous genitalia w/hyperkalemia and salt craving
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11-hydroxylase
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needed to make corisol and aldosterone from progesterone. Def leads to ambigous genitalis with hypokalemia and edema from increased corticosterone (mineralcorticoid)
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Addison's Disease
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Primary adrenal insufficiency. fatigue, constipation, nausea, postural hypotension, hyponatremia, hyperpigmented skin, weight loss, high short T waves on EKG from hyperkalemia
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Cushing's Syndrome
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thin hair, cataracts, hypertension, osteoporosis, edema, gluose intolerance, fat deposition (moon face and buffalo hump), hirsutism, skeletal muscle wasting, depression, insomnia, psycosis
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enzymes needed for gluconeogenesis
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pyruvate carboxylase, PEP-carboxykinase, F-1,6 Bisphophatase, G6-phosphatase
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enzymes needed for fructose metabolism
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fructokinase, (makes F1P), aldolase B (makes GHAP), triokinase (makes G3P)
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why fructose metabolism is bab
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Fructose 1-P accumulates because Aldolase B is slow.Low energy due to phosphate trapping.2. Fructose bypasses PFK-1 controls in glycolysis Lactate and triglycerides accumulate
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defect in fructokinase
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causes Essential fructosuria, benign
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defect in Aldolase B
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leads to hereditary fructose intolerance (HFI), can change Glu lvls, treat with fructose free diet
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enzymes needed for galactose metabolism
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galactokinase, galactose 1-phophate uridyl-transferase, UDP-galactose 4-epimerase
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classical galactosemia
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def in galactose phosphate uridyl-transferase, can not metabolize galactose, AST and ALT high in newborns, cataract formation, treat with reduced dietary galactose
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Von Gierke's
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GSD 1a and 1B. G6P def, leads to fasting hypoglycemia, lactic acidemia, hyperuricemia and ketosis
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McCardle's disease
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GSD 5 . muscle phophorylase def, painful muscle cramps with exercise, increased blood Mb and CK
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Pompe's disease
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GSD 2. lysosomal alpha glucosidase def, can not break down glycogen, hypertrophy of heart and muscle leading to death
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licorice induced hypertension
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component of licorice root prevents cortisol to cortisone (the inactive versionin kidneys) so salt/water reabsorption is increased
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thyroperoxidase
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oxidizes iodide to iodine
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myxedema
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hypothyroidism in adults, reduced metobolic rate, sub-Q edema
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Cretinism
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hypothyroidism in infants, mental deficiency, stunted growth
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Causes of hyperthyroidism
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Graves disease, toxic nodules, excess TSH from pituitary adenoma
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products from arachidonic acid
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Prostaglandins, thromboxane, prostacyclin, leukotrienes
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Prostaglandin actions
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1. Platelet aggregation (TXA2). 2. Vasodilation (PGE2 , PGI2) 3. Uterine contraction (PGE2, PGF2α) 4. Inflammation (PGE2, TXA2) 5. Fever (PGE2, in preoptic area) 6. Reduced gastric acid secretion (PGE2)
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scaphocephaly
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long head from premature closure of sagittal suture
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oxycephaly
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tower head from premature closure of coronal suture, aka: turricephaly or bradycephaly
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lateral cervical cyst
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lateral side of neck, anterior to sternocleidomastoid, usually found under the angle of the manible, reminant of 3rd pharyngeal cleft
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thyroglossal duct cyst
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reminant of foramen cecum, will move with both tongue extension \and deglutation. Usually found in midline of the neck
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ectopic thyroid tissue
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may be found along path of thyoid migration, will move with deglutation but not with tongue extension
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Treacher Collins
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malformation of the 1st pharyngeal arch, mandible malformation
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DiGeorge Syndrome
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malformation of the 3rd pharyngeal arch, leading to lack of thymus, parathyroid, heart defects, and cleft palate
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COX 1
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constitutive enzyme that is present in most tissues, one of the targets of aspirin (also targets COX 3)
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COX 2
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inducible enzyme that is most prominent in white blood cells. It is induced by cytokines during inflammation.
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COX 3
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a splice variant of COX-1 in the brain, important for pain and fever, the main target of paracetamol and one of the targets of aspirin
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3 layers of the wall of the eye
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corneoscleral coat, uvea, retina
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3 chambers of the eye
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anterior chamber, posterior chamber, vitreous chamber
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uvea
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choriod, ciliary body, iris
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crystallins
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protiens in the fibers that make up the lens of the eye, long lived proteins,
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detached retina
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separation between pigmented layer and neural layer
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function of rods in eye
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detect dim light
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function of cones in eye
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detect bright light and color
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cause of dry macular degeneration
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formation of drusen, that leads to atrophy of the retinal pigment epithelial layer
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cause of wet macular degeneration
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abnormal blood vessel growth, damaging photoreceptors.
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striatum
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caudate nucleus, nucleus accumbens, putamen
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lateral olfactory tract
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axons project to the primary olfactory cortex amygdala, and entorhinal cortex, and thalamus
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medial olfactory tract
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axons project ipsilaterally to basal limbic forebrain structures e.g. medial septal nucleus. Others arise from the contralateral anterior olfactory nucleus (via anterior commissure)
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innervation of ant 2/3 tongue epithelium
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CN V
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innervation of post 1/3 tongue epithelium
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CN IX
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innervation of ant 2/3 taste
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CN VII
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innervation of post 1/3 taste
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CN IX
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taste of epiglottis
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CN X
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gamma motor neurons
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innervate intrafusal fibers, regulate sensitivey of muscle spindle
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golgi tendon organ (GTO)
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acts like a strain gauge, monitoring muscle tension, the opposite of the myotatic reflex
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layers of meninges
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dura mater, arachnoid mater, pia mater
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confluence of the Sinuses
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drain the superior sagittal, transverse, and straight sinuses
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Drainage of sigmoid sinus
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internal jugular vein
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potential spaces of the cranial vault
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epidural and subdural
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myotatic reflex
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stretch reflex, aka: deep tendon reflex, the tonic contraction of muscle in response to stretching force. EX: knee jerk
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alpha motor nueron function
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extrafusal muscle fibers
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Sensory 1a (Aa) neuron function
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muscle spindles, proprioception
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sensory 1b (Aa) neuron function
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GTO, proprioception
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A-delta fibers
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thick, myelinated fibers, sense cold and acute pain (Ow!)
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C fibers
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small, unmyelinated senses hot and chronic pain (aahhh)
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chemicals released that stim pain
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substance P and CGRP
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Brown Sequard syndrome
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compression of one half of spinal cord, results in i/l spastic paralysis, i/l loss of touch, and c/L loss of pain and temp
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Syringomyelia
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"cape syndrome", from cyst in central portion of spinal cord, loss of pain and temp bilaterally at and just below lesion
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Fredrich's ataxia
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hereditary disease of degen of white matter of spinocerebellar tracts (Clark's nucleus), dorsal columns, and corticospinal tracts.
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thalamic pain syndrome
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lesions to posterior thalamus resulting in chronic pain
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mech of pain suppression
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PAG secreteing enkepalin, nucleus raphe magnus
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tabes doralis
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manifestation of neurosyphilis, degen of dorsal columns, leads to paresthesia, pain, ataxia
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most dangerous place to get herpes zoster
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along the V1 dermatome because you can get lesions on your cornea and become blind
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sound pathway
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cochlear nerve, cochlear nuclei, superior olivary complex, inferior colliculus, brachium of the inf colliculus, medial geniculate body, primary auditory cortex
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facial nerve palsy
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CN VII innervates the stapedius, so if damaged, sound can not be damped, so everything is LOUD
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acoustic neuronima
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misnomer: is acually schwannoma and begins with vestibular system
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caloric nystagmus
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cold-opposite, warm-same side. (COWS)
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retinal artery occlusion
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seen as a "curtain coming down vertically over one eye"
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main output cell type of the cerebellum
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purkinje cell
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3 layers fo the cerebellum
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molecular layer, purkinje cell layer, granule cell layer
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where Basket cells of cerebellum are inhibitory
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purkinje cell body (stroma)
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where stellate cells of cerebellum are inhibitory
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purkinje cell dendrites in molecular layer
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mossy fibers to cerebellum
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from anywhere but inf olive
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climbing fibers to cerebellum
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from the inf olive
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cerebellar dyfunction result
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disequilibrium, ataxia, and dymetria, NOT paralysis
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anterior spinocerebellar
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GTO from distal lower limb, runs up spinal border cells, crosses twice (once upon entering cord, again in sup cerebellar peduncle)
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dorsal spinocerebellar
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GTO from proximal lower limb, never crosses
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cuneocerebellar
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GTO from upper limb and neck, never crosses
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truncal ataxia
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lesion to vermis/flocculonodular lobe, gives drunk like gait. Test with tandem gait (walk the line) and Romberg test
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appendicular ataxia
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lesion to cerebellar hemisphere/lateral zone. Affects extremities. Test with finger nose finger and dysdiadochokinesia
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medial medullary syndrome
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damage to ant spinal art, "inf alternating syndrome", loss contra to motor and fine touch, ipsil loss of tongue motor
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lateral medullary syndrome
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wallenburg's syndrome, damage to PICA, contra loss of pain/temp, ipsil loss of vocal cords, ataxia, nucleus ambiguus affected, SANS affected
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superior alternating syndrome
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Webers damage to PCA, occulomotor and Edenger westfall ipsilaterally, lateral corticospinal contralaterally
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brain waves of sleep
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wake/REM = beta. stage 1 = theta waves. stage 2 = K-complexes. stage 3 = delta.
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curare
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blocks nAch receptors
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organophosphates
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inhibit Ach-esterases. ex: serin gas
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degredation product of DA
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homovanillic acid
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degredation product of NE/Epi
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vanillymandelic acid
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degredation product of 5-HT
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hydroxyindoleacetic acid
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cocaine
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inhibits the uptake of DA, NE, 5-HT
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amphetamine
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releases DA, 5-HT, NE from nerve terminals
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Posterior Area of Hypo
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Posterior nucleus, Mamillary body
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Tuberal Area of Hypo
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Dorsomedial nucleus, ventromedical nucleus, acrucate nucleus
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Anterior are of hypo
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paraventricular nucleus, anterior nucleus, supraoptic nucleus, suprachiasmatic nucleus
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Preoptic area of hypo
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medial and lateral preoptic nucleuses
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Lateral area of Hypo
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feeding center, regulates food intake, destruction results in starvation
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Posterior nucleus
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thermoregulatory area, stimulation causes heat conservation, destruction=no temp regulation
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Mamillary body
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learning and memory. Destruction=disorders of memory, emotion, drive
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Dorsomedial nucleus
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stim=obesity and rage, makes hypocretin/orexin modulating wakefulness, orexin loss lead to narcolepsy
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Ventromedial nucleus
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anterior part sexually dimorphic, has female sex behavior, ii. Superior part- satiey center, leptin binds telling you you are full, Grehlin binds to increase food intake and fat mass
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c. Arcuate nucleus
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release dopamine to inhibit release of prolactin by pituitary gland. Other neurons influence hunger. Grehlin activate nuclei to increase food intake and fat mass
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Paraventricular nucleus
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regulate water balance, secretes oxytocin or vasopressin (ADH=water reabsorption). Destruction of 90% of neurons= diabetes insipidus=chronic excretion of large amounts of water
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b. Anterior nucleus
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thermoregulatory area, stim=heat dissipation. Destruction= anhydrosis and hyperthermia
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Supraoptic Nucleus
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same function as paraventricular. Mostly water balance
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Suprachiasmatic nucleus
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biological clock: endocrine cycles and sleep/wake cycles
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Preoptic Area
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sexually dimorphic, center of male sex behavior, regulates release of gonadotropic hormones
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Ant region of thalamus
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anterior nucleus
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medial region of thalamus
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dorsomedial nucleus
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lateral region of thalamus
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Ventral group- VA,VL,VP,VPL,VPMDorsal group- pulvinar, lateral posterior, lateral dorsalLateral geniculate nucleus (LGB)Medical geniculate nucleus (MGB)
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Thalamic Pain
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mostly unknown, damage to post. Thalamus can result in intense pain, usually includes damage to VPL/VML. Aching, burning, resistant to analgesia, can be triggered by light cutaneous stimulation
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Thalamic Syndrome
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Thalamic Syndrome
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components of Circle of Willis
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PCA, post comm art, internal carotid, ACA, ant comm art
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Kiesselback's area
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anastamosis of nasopalatine, internal nasal art, and twigs from facial art. High area for epistaxis
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Watershed zone
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region between two ajacent ischemic areas is effected the most.
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telencephalon
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cerebral hemispheres, lateral ventricles
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diencephalon
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thalamus, hypothalamus, epithalmus, subthalamus, 3rd ventricle
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mesencephalon
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midbrain, cerebral aqueduct
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metencephalon
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pons and cerebellum, upper 4th vent
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myelencephalon
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medulla, lower part of 4th vent
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2 components of Epithalamus
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pineal gland and habenular nuclei
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circumventricular organs of the brain
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are not in the BBB, pineal gland, neurohypophysis, lamina terminalis, subfornical organ
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components of subthalamus
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STN, zona incerta (ZI), red nucleus and substantia nigra
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function of LGN
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vision from optic tract to primary visual cortex
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function of MGN
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hearing from brachium of inf colliculus to primary auditory cortex
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function of VPL
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pain, temp, and touch from STT and MLP to somatosensory cortex
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function of VPM
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pain, temp, and touch from trigemial tracts and solitary nucleus to the primary sematosensory cortex
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function of VL and VA of thalamus
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movement from various to primary motor cortex
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functions of hypothalamus
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HEAL- homeostasis, endocrine, ANS, limbic
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neuronal path to pineal gland
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retina-suprachiasmatic nucleus, reticular formation, intermediolateral neurons of spinal cord, superior cervical ganglion, pineal gland
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function of amygdala
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emotion and drive, connecting emotional significance to stimuli
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Kluver-Bucy syndrome
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bilateral loss of amygdala.
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Papez circuit
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Hippocampus (fornix)- mammilary bodies - anterior nucleus of thalamus - cingulate gyrus - parahippocampal gyrus - entorhinal cortex - back to hippocampus
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bilateral loss of hippocampus
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anterograde amnesia
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Phinus Gage
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Pt with damage to prefrontal cortex, complete change in personality
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lead poisoning
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affects heme synth. Inactiavtes alpha-ALA-dehydratase and ferrochelatase, causing the buildup of alpha-ALA and protoporphyrin IX respectively
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acute intermittened porphyria
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AD inherit. defect in PBG-desaminase, resultling in buildup of PBG(porphobilinogen). Neurovisceral pain, constipation, cardio changes. Acute attacks precipitated by drugs that use p-450 system. Treat with hemtin
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congenital erythropoetic porphyria
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porphyria cutanea tarda
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AD inherit. Defet in uroporphyrinogen decarboxylase. Worse in alcholics or liver disease. They are photosensitive, urine pink in fluorescent light. Treat with phlebotomy
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sideroblastic anemia
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defective alpha-aminolevulinc acid synthase leads to Fe accumulation in RBCs
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Gilbert's syndrome
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AR inherit. Ineffeiceint bilirubin conjugation. Increase in plasma unconj bilirubin, often seen after hepatitis or mild illness.
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Crigler-Najjar syndrome
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defect in UDP-glucuronyltransferase resulting in hyper-unconjugated bilirubinemia. Type 1 is complete absence and can result in kernicterus. Type 2 is AD inherit, less severe, and can be reduced by phenobarbitone
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Dubin-Johnson syndrome
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harmless, due to defect in excretion of bilirubin. Results in raised plasma/urine conj bilirubin. Plasma ALP lvls are normal. Liver has dark brown appearance
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Rotor sydnrome
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same as Dubin-Johnson without pigmented liver
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Heme degredation path
|
hemoglobin- verdoglobin - bilverdine- bilirubin (indirect)- direct conj bilirubin - urobilinogen (by bact then reuptake) - to urobilin in urine and sterobilin in stool. The sterobilin in made by bact enzymes
|
|
|
PNP def (purine nucleoside phosphorylase)
|
purine degredation, specifically guanosine to guanine. Defect leads to normal B-cells, but NO T-cells.
|
|
|
ADA def (adenosine desaminase)
|
purine degredation, specifically adenosine to inosine. Defect leads to no B or T-cells, called SCID, bubble boy. Only treatable with bone marrow transplant
|
|
|
Gout
|
increased uric acid concentration from purine degredation, leading to crystal formation, usually in the extremities, hallux is the 1st classic sign. Treat acute with colchicine, cronic with allopurinol and probenecid
|
|
|
Tophi
|
uric acid concretions seen through the skin
|
|
|
orotate aciduria
|
from the pyrimadine synth, can be from a defect in the urea cycle, so excess carbamoyl phosphate is driving increased orotate synth, or from a defect in UMP synthase causeing a bottle neck in the pyrimadine synth
|
|
|
ribonucleotide reductase
|
turns ribonucleotides into deoxyribonucleotides, needed for DNA synth
|
|
|
hypoxanthin guanine phosphoribosyl transferase (HGPRT)
|
used in the the salvage of purine bases to nucleotides. Defect increases uric acid and destroys dopaminergic nerve cells. Leads to Lesch-Nyhan syndrome with mental retardation, choreoathetosis, and self destructive biting
|
|
|
methotrexate
|
anticancer that stops the recycling of folate, so inhibits DNA sythn.
|
|
|
sulfonamides
|
inhibit bact folate synth
|
|
|
sis oncogene
|
creates PDGF that autostimulates proliferation
|
|
|
SFFV (spleen focus forming virus)
|
makes gp55 that activates the Epo receptor, leading to polycythemia vera
|
|
|
HPV cancer factor
|
E5 polypeptide that mimics PDGF binding
|
|
|
Her2 cancer gene
|
receptor becomes mutated in the transmembrane domain so that there is nothing to keep 2 receptors apart, so they dimerize and activate without binding. Seen in many breast cancers
|
|
|
EGF receptor leading to cancer
|
receptor looses extracellcular domain that keeps 2 receptors separate. They can now dimerize and auto-activate
|
|
|
Ras leading to cancer
|
The GTPase is mutated, so Ras can not by inactiavted. It upregulates MAP kinase and transciption factors
|
|
|
SRC gene leading to cancer
|
oncogene is missing C-terminus end that allows phosphorylation for deactivation, so it is constiutively active
|
|
|
C-myc leading to cancer
|
C-myc moves a cell through cycle checkpoints. oncogene is translocated next to heavy chain antibody so B-cell are cancerous. Seen in Burkitt's lymphoma
|
|
|
Bcl2 gene
|
anti-apoptotic that is translocated next to heavy chain antibody enhancers, so cells can not apoptos, and lead to cancer
|
|
|
p16 and Rb gene
|
they are tumor suppressor genes, defect can push a cell through the G1 cycle checkpoint, leading to cancer
|
|
|
tyrosinase
|
activated by UV light for melanocytes to synth more melanin
|
|
|
albinism
|
AR inherit. Can not make melanin, issue with skin and eyes. Defect in tyrosinase activity or inability of cells to take up tyrsosine
|
|
|
vitiligo
|
common disorder where melanocytes are destroyed, resulting in white patches on skin. Ukn cause, but might be auto-immune
|
|
|
argininosuccinate synthase def
|
part of urea cycle. Results in citrullinemia from inability to convert citrulline to argininosuccinate
|
|
|
Results of urea cycle failure
|
hyperammonemia and encephalopathy. Can be inherited or aquired from liver cirrhosis
|
|
|
ornithine transcarbamoylase def
|
leads to an increase in carbamoylphosphate that is shunted to pyrimidine synth, leading to an increase in orotate aciduria. Only Urea cycle enzyme carried on the X-chrom, and was the 1st known sign of X inactivation. Is also a classic example of X inactivation.
|
|
|
chondroitin sulfate
|
Dietary suppl. stim proteoglycan synth that is important in articular cartilage sytn. Common use in osteoarthritis
|
|
|
Coenzyme Q10
|
Dietary suppl. Essential cofactor in ETC. Used to CHF, hyperlipidemia, use with statin meds, hypertension
|
|
|
Fish oils
|
Dietary suppl. Long chain fatty acis that make less efficeint TX2. Used for hypertriglceridemia, cardio disease, ulcerative colitis, early Alzheimers
|
|
|
Glucosamine
|
Dietary suppl. Component of articular cart. Used for osteoarthritis
|
|
|
Red Yeast Rice
|
Dietary suppl. Contains HMG-CoA reductase inhibitor lovastatin. Used to lower cholesterol.
|
|
|
Spirulina
|
dietary suppl. Blue-green algae that contain carotenoids, minerals, proteins. Used to allergic rhinitis, anti-viral, diabetes, elevated cholesterol, immune system booster
|
|
|
Malic acid
|
Dietary suppl. An intermedidate metabolite in TCA cycle. Used for fibromyalgia, chronic fatigue
|
|
|
Melatonin
|
deitary suppl. Same as hormone from pineal gland, involved in sleep/wake cycles. Used for sleep disorders, jet lag, cancer, immune disorders, GERD, and depression
|
|
|
S-adenosyl-L-methionine (SAM)
|
Sam the methyl donor man. Common use in depression, fibromyalgia, liver disorders, osteoarthritis
|
|
|
Essential fatty acids
|
linoleic acid and alpha-linolenic acid. Arachidonic is semi-essential since is can be made from linoleic acid
|
|
|
methylmalonyl aciduria
|
def. in B12 or methylmaloncyl-CoA mutase. Results in life threatening acidosis, treat with adenosylcobalamine
|
|
|
amyotrophic lateral sclerosis (AML) (aka Lou Gehrig's)
|
motor system disease that affects both LMN and UMNs, 40% begins with upper limbs, 40% with lower, and 20% with brainstem. Characterized by flaccid paralysis at the lvl of lesion, spastic paralysis below the lvl of the lesion
|
|
|
subacture combined degeneration
|
commonly seen with b12 def., bilateral spastic paralysis, bilateral loss of proprioception and fine touch
|
|
|
Horner Syndrome
|
damage to cervical sympathetic trunk, shows miosis, ptosis, enopthalmos, anhydrosis
|
|
|
location of retropharyngeal space
|
virtual space between buccopharyngeal fascia and prevertebral layer of deep cervical fascia. Provides a direct path to superior mediastinum
|
|
|
torticollis
|
wry neck, involuntary unilateral contration of sternocleidomastoid
|
|
|
muscles that come from styloid process and respective nerves
|
styloglossus (CN XII), stylohyoid (CN VII), stylopharyngeus (CN IX)
|
|
|
piriform recess
|
most common place in the pharynx for foreign body to lodge
|
|
|
posterior cricoarytenoid
|
the only laryngeal muscle to open the rima glotidis
|
|
|
cricothyroid muscle
|
only mucle of laynx that is innervated by the external laryngeal nerve, a branch of the superior laryngeal nerve, off of the vagus
|
|
|
1st brachial arch derivatives
|
CN V3, maxiallry art, muscle of mastication, mylohyoid, and ant digastic muscle, mandible, malleus, incus,
|
|
|
2nd brachial arch derivatives
|
CN VII, stapedial art, muscles of facial expression, stapedius, stylohyoid, and post digastric muscle, stapes, lesser horn of hyoid, styloid process
|
|
|
3rd brachial arch derivatives
|
CN IX, common carotid art, greater horn of hyoid, stylopharyngeus
|
|
|
4th brachial arch derivatives
|
CN X, right subclavian art and ductus arteriosus, palatoglossus, cricothyroid, palato and salpingo-pharyngeus
|
|
|
5th brachial arch derivative
|
does not exist in humans, only in whales
|
|
|
6th brachial arch derivative
|
CN X (recurrent laryngeal), roots of pulmonary art, intrinsic muscles of larynx EXCEPT for cricothroid
|
|
|
tecrum
|
sup and inf colliculus
|
|
|
tegmentum
|
substantia nigra and red nucleus
|
|
|
Basal ganglia direct pathway
|
cortex-striatum-Gpi-thalamus-cortex
|
|
|
Basal ganglia indirect pathway
|
cortex- striatum- GPe- STN- Gpi- thalamus- cortex
|
|
|
deep cerebellar nuclei, from lateral to medial
|
Dentate, globose, emboliform, fastigial
|
|
|
All corticobulbar are bilateral except for?
|
CN VII for lower quadrant of face (C/L and can lead to supranuclear lesion), CN XII ( C/L for genioglossus), and CN XI (I/L for trap and sternocleidomastoid)
|
|
|
main output cell of the olfactory bulb
|
mitral cell
|
|
|
LASIK (laser assisted In Situ Keratomileusis)
|
lift Bowman's capsule as a flap and reshape stroma
|
|
|
result of damage to chorda tympani
|
loss of ant 2/3 taste and dry mouth from loss to submandibular gland
|
|
|
risk of untreated otitis media
|
mastioditis that can spread to middle cranial fossa and lead to meningitis
|
|
|
increased intracranial pressure likely damages which cranial nerve
|
CN VI
|
|
|
cranial nerve most likely damaged with head trauma
|
CN IV
|
|
|
cerumen
|
ear wax
|
|
|
6 places to find hair cells
|
ant, lat, and post semicircular canals, saccule, utricle, and organ of Coti
|
|
|
|
|
|
|
drainage of sphenoid sinus
|
sphenoethmoidal recess
|
|
|
drainage of frontal sinus
|
only sinus that drain with gravity, to semilunar hiatus under middle concha
|
|
|
drainage of maxillary sinus
|
semilunar hiatus under middle concha. Sinus is close to upper molar teeth, so infection can spread, as well as mimic a tooth ache. Tap the zygomatic arch to test for pain
|
|
|
drainage of ethmoid air cells
|
post ethmoid air cells drain to superior meatus, middle and anterior ethmoid air cells drain to middle meatus
|
|
|
Lumbar nodes drain?
|
post abd wall, kidneys, testes, epidydimis, ovaries, fundus of uterus, uterine tube
|
|
|
Internal iliac nodes drain?
|
inf ureter, anal canal above pectinate line, inf rectum, body of uterus, prostate, lower bladder
|
|
|
external iliac nodes drain?
|
sup uteter, upper vagina, cervix, upper bladder
|
|
|
superficial inguinal nodes drain?
|
lower vagina, anal canal below pectinate line, scrotum, round ligament, labia majora
|
|
|
deep inguinal nodes drain?
|
glans of penis, clitoris, and labia minora
|
|
|
C6
|
Inferior border of cricoid cartilage, division of larynx and trachea
|
|
|
C3
|
hyoid bone
|
|
|
C6-T1
|
thyroid gland
|
|
|
C7
|
vertebra prominens
|
|
|
T1
|
sternoclavicular joint
|
|
|
T2
|
sup angle of scapula
|
|
|
T3
|
base of the spine of scapula
|
|
|
T4-T5
|
bifurcation of trachea, start/end of aortic arch, sternal angle
|
|
|
T8
|
caval hiatus, Acc. Hemiazygos transverses vert colum
|
|
|
T9
|
Hemiazygos traverses vert column
|
|
|
T9-T11
|
location of spleen
|
|
|
T10
|
esophageal hiatus
|
|
|
T12
|
aortic hiatus, Celiac Trunk
|
|
|
T12
|
sup border of kidneys
|
|
|
L1
|
transpyloric plane, SMA, 1st and 4th parts of duodenum
|
|
|
L1-L2
|
left crus of diaphragm
|
|
|
L1-L3
|
right crus of diaphragm
|
|
|
L2
|
Renal vessels
|
|
|
L3
|
IMA, lower border of 10th rib, 3rd part of duodenum
|
|
|
L3-L4
|
umbilicus
|
|
|
L4
|
bifurcation of abd aorta
|
|
|
L5
|
common iliac veins join
|
|
|
S2
|
PSIS
|
|
|
S3
|
transition between colon and rectum
|
|
|
1st brachial pouch derivative
|
external auditory tube
|
|
|
1st brachial cleft derivative
|
external auditory meatus
|
|
|
2nd brachial pouch derivative
|
palatine tonsil
|
|
|
3rd brachial pouch derivative
|
thymus and inferior parathyroid gland. Defect results in DiGeorge syndrome
|
|
|
4th brachial pouch derivative
|
superior parathyroid gland and ultimobranchial body
|
|
|
layers from kidney to environment
|
kidney - renal capsule - perirenal fat - renal fascia - pararenal fat - quadratus lumborum or abdominal muscles (depending on angle) - abdmoninal wall
|
|
|
recommended diet %'s
|
30% fat, 10-15% protein, 55% carbs
|
|
|
kcal per gram of food type
|
fat- 9kcal/g, protein - 4 kcal/g, carb - 4kcal/g
|
|
|
calculation of BMR
|
men- 1.0kcal/kg body weight/ hr women- 0.9kcal/kg body weight/hr
|
|
|
calculation of BMI
|
kg / height (m)2
|
|
|
Hesselbach's triangle
|
area for direct hernia, bounded by rectus abdominis, inguinal ligament, and inf epigastric vessels
|
|
|
anastamosis in portal hypertension
|
GUT, BUT, and CAPUT. Left gastric vein/esophageal veins gives esophageal varicies, super rectal vein/inf and middle rectal vein gives anal hemorrhoids, paraumbilical veins/inf epigastric veins give caput medusae
|
|
|
contents of splenorenal ligament
|
splenic vessel and tail of pancreas
|
|
|
contents of gastrosplenic ligament
|
short gastric vessels and left gastroepiploic vessel
|
|
|
change in salivary secretion if flow is slow
|
Na and Cl are removed, bicarb and K are secreted
|
|
|
change in pancreatic secretion
|
Na and K are CONSTANT, bicarn is secreted in exchange for Cl
|
|
|
|
|
|
|
contents of hepatoduodenal ligament
|
portal triad
|
|
|
layers of gallbladder
|
mucosa, muscularis externa, and serosa. NO muscularis mucosae or submucosa!
|
|
|
essential fatty acid def
|
scaly dermatitis, hair loss, poor wound healing, infertility, reduced ability to fight infection. Caused by problems with proliferatvie cells.
|
|
|
early proximal tubule
|
iso-osmotic reabsorption of solute and water, uses Na symport for glu, AA's, and H+. Reabsorption of old bicard. Target for acetazolamide
|
|
|
Late proximal tubule
|
iso-osmotic reabsorption of water. Cl reabsorption driven by Cl gradient
|
|
|
Thin descendling loop
|
water reabsorption
|
|
|
Thin ascending loop
|
solute reabsorption without water
|
|
|
Thick ascending loop of Henle
|
Na/K/2Cl cotransporter powered by the Na/KATPase, reabsorption of NEW bicarb. Cotransporter a target for loop diuretics like furosemide
|
|
|
Early distal tubule
|
Na/Cl co-transport without water. Target for thiazides
|
|
|
Late distal tubule
|
Intercalated cells reabsorb of NEW bicarb, excretion of H+, K/H ATP antiporter. Principal cells reabsorb Na with channels as K is excreted in channels (the Na channels are targets for spironolactone as they are increased by aldosterone). Principal cells also have water channels that are increased by ADH
|
|
|
Formula for GFR
|
Kf x deltaP
|
|
|
formula for delta P of a membrane of kidney
|
Pgc + (Pi of BS) - (P of BS) - (Pi of gc). Note that (Pi of BS is very close to or equal to zero in normal physiology)
|
|
|
formula for filtered load
|
GFR x Px if freely filtered, otherwise GFR x Px x filterability quotient. Note that anything below 15 angstoms has a filterability quotien of 1, and anytihng over 42 angstroms has a filterability quotient of zero.
|
|
|
formula for filtration fraction
|
GFR/RPF
|
|
|
formula for RBF
|
RPF / (1-HCT)
|
|
|
formula for clearance
|
(Ux x V) / Px
|
|
|
threshold for glucose
|
approx 200 mg/dL
|
|
|
transport max for glucose
|
approx 375 mg/min
|
|
|
substance used to calculate GFR
|
inulin. Though creatinine is used as a good approximation
|
|
|
substance used to estimate RPF
|
PAH (para-aminohippurate) since it is almost completely cleated by filtration and secretion.
|
|
|
PAH threshold
|
0.15 mg/mL
|
|
|
PAH transport max
|
80 mg/min
|
|
|
substance used to estimate TBW
|
tritiated H2O or Deuterium
|
|
|
substance used to estimate ECF
|
inulin, mannitol
|
|
|
substance used to estimate plasma volume
|
RISA, Evans blue dye
|
|
|
location of absorbtion of Fe, Folate, and B12
|
Fe in duodenum, folate in jejunum, and B12 in the ileum
|
|
|
|
|
|
|
embryonic Cranial Mullerian turns into what in the male
|
appendix testis (vestigial)
|
|
|
embryonic Caudal Mullerian turns into what in the male
|
prostatic utricle (vestigial)
|
|
|
embryonic Sinus tubercle (Mullerian origin) turns into what in the male
|
seminal colliculus
|
|
|
embryonic Cranial tip of Mesonephric duct turns into what in the male
|
appendix epididymis (vestigial)
|
|
|
embryonic Cranial end of Mesonephric duct turns into what in the male
|
ductuli efferetes and epididymis
|
|
|
embryonic Some Tubules (paragenital) turns into what in the male
|
paradidymis (vestigial)
|
|
|
embryonic Caudal end of Mesonephric duct turns into what in the male
|
ductus deferens and ejactulatory duct
|
|
|
embryonic prostatic urethra outgrowth turns into what in the male
|
prostate gland
|
|
|
embryonic urogenital sinus/spongy urethra outgrowth turns into what in the male
|
bulbourethral glands
|
|
|
embryonic mesonephric duct outgrowth turns into what in the male
|
seminal vesicle
|
|
|
embryonic Cranial Mullerian turns into what in the female
|
oviduct
|
|
|
embryonic Caudal Mullerian turns into what in the female
|
uterus
|
|
|
embryonic Sinus tubercle (Mullerian origin) turns into what in the female
|
hymen
|
|
|
embryonic Cranial tip of Mesonephric duct turns into what in the female
|
Epoophoron (degen)
|
|
|
embryonic Cranial end of Mesonephric duct turns into what in the female
|
Epoophoron (degen)
|
|
|
embryonic Some Tubules (paragenital) turns into what in the female
|
Paraophoron (degen)
|
|
|
embryonic Caudal end of Mesonephric duct turns into what in the female
|
Gartner's cyst
|
|
|
embryonic prostatic urethra outgrowth turns into what in the female
|
urethral gland (of Skene)
|
|
|
embryonic urogenital sinus/spongy urethra outgrowth turns into what in the female
|
Greater vesibular gland (of Bartholin)
|
|
|
renal segments supplied by the posterior segmental art
|
only the posterior segment
|
|
|
renal segments supplied by the anterior segmental art
|
apical, inferior, anterior superior, anterior inferior
|
|
|
difference in dropped kidney (nephroptosis) and ectoptic kidney
|
nephroptosis ureter will be slack and loose, ectopic kidney uteter will just be short
|
|
|
function of B1 adrenergic receptor
|
Increases cAMP through Gs. increase heart rate, contracility, and AV node conduction, increase renin secretion, increase lipolysis
|
|
|
function of B2 adrenergic receptor
|
increases cAMP through Gs. Dilates blood vessels in skeletal muscle, dialtes bronchiolar smooth muscle, relaxes bladder wall
|
|
|
function of A1 adrenergic receptor
|
Gq activating IP3 and DAG to increase Ca lvl. Consticts blood vessels in skin, contricts GI sphincters, constricts bladder sphincters.
|
|
|
function of A2 adrenergic receptors
|
Gi, reducing cAMP lvls. Decrease GI motility
|
|
|
function of M3 cholenergic receptor
|
Gq activating IP3 and DAG to increase Ca lvl. Constricts bronchioles, relaxes smooth muscle through increase in NO production, increases GI secretions,
|
|
|
function of M2 cholenergic receptor
|
uses Gi to reduce cAMP, slows HR and decreases contractile force
|
|
|
MLF (medial longitudinal fasciculus)
|
connects eye muscle nuclei with each other and with vestibular nuclei, and with neck muscle motorneurons.
|
|
|
PPRF (paramedian pontine reticular formation)
|
horizontal gaze center, input from the C/L frontal eye field, vestibular nuclei and superoir colliculus. Output to the ipsilateral abducens nucleus
|
|
|
voluntary control of eye movements
|
Ex: right frontal eye field - left PPRF - to both left CN VI (to move left lateral rectus) and right MLF - right CN III to move medial rectus
|
|
|
damage to frontal eye field
|
right way eyes, because eyes look at toward the lesion because they can not look away
|
|
|
pontine lesion to visual system
|
wrong way eyes
|
|
|
internuclear opthalmoplegia (INO)
|
damage to MLF prevents eye on the side of the lesion from adducting
|
|
|
one and a half syndrome
|
lesion to both MLF and abducens nucleus on one side. Pt can only abduct the eye on the unaffected side. It is a combination of horizoonatl gaze palsy in one direction and internuclear opthalmoplegia in the other
|
|
|
Rostral Interstitial nucleus of the MLF
|
vertical gaze center in reticular formation of rostral midbrain, leads to Parinaud's syndrome
|
|
|
pupilary light reflex pathway
|
afferent signal to pretectal nucleus - Edinger Westphal bilaterally - ciliary ganglion of both sides - pupillary sphincter for contraction
|
|
|
amount of ultrafiltrate generated daily
|
approx 180L/day
|
|
|
formula for net transport
|
FL - ER, filtered load - excretion rate, FL = GFR x Px, ER = Ux x V
|
|
|
Gastrin
|
Made :(G-cells) stimulus for secretion:increase Vagus activity (ACh)Amino Acids in the stomach, Target: Stomach Major effect: increase secretion of histamine and acid
|
|
|
Cholecystokinin (CCK)
|
Made in:(I cells) stimulus for secretion:Fats, peptides in small intestine Target: Gall bladder and pancreas Major effect: increase pancreatic enzyme secretion and gall bladder contraction
|
|
|
Secretin
|
Made in:(S cells) stimulus for secretion:H+ in duodenum Target: pancreatic duct cells Major effect: increase pancreatic secretion of water and bicarb
|
|
|
GastricInhibitory Peptide (GIP)
|
Made in:(K-cells) stimulus for secretion:Glucose and fats in small intestine Target: pancreatic B-cells Major effect: increase insulin secretion
|
|
|
Motilin
|
Made in:(M cells) stimulus for secretion:ENS "clock" Target: stomach, duodenum Major effect: increase smooth muscle contraction
|
|
|
GLP-1
|
Made in:(L-cells) stimulus for secretion:Glucose in small intestine Target: pancreatic B-cells Major effect: increase insulin secretion and decrease glucagon secretion
|
|
|
Ghrelin
|
stimulus for secretion:hypoglycemia Target: CNS Major effect: increase food intake and GH secretion
|
|
|
Somatostatin
|
Made in:(D-cells: gastric atrium) stimulus for secretion:low pH in stomach(high PNS, low SNS) Target: stomach and parietal cells Major effect: decrease acid secretion
|
|
|
Histamine
|
Made in:ECL, mast cells of gastric mucosa stimulus for secretion:gastrin Target: Parietal cells of the stomach Major effect: increase acid secretion
|
|
|
Prostaglandin E2
|
Made in:(PGE2) stimulus for secretion:stomach Target: stomachparietal and mucus-secreting cells Major effect: decrease acid secretionincrease mucus production
|
|
|
ACh
|
Made in:(vagal axon terminals) stimulus for secretion:vago-vagal reflexes Target: various Major effect: increase secretion and motility
|
|
|
NE
|
Made in:(symp. Axon terminals) stimulus for secretion:tonically active Target: various Major effect: decrease secretion and motility
|
|
|
Gastrin releaseing peptide (GRP)
|
Made in:(gastric vagal axon terminals) stimulus for secretion:vago-vagal reflexes Target: various Major effect: relaxation of sphincters and smooth muscle, increase secretions (small intestine and pancreas)
|
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Vasoactive intestinal polypeptide (VIP)
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Made in:(vagal axon terminals) stimulus for secretion:vago-vagal reflexes Target: various Major effect: relaxes sphincters and circular muscle, dilates blood vessels, stimulates intestinal and pancreatic secretion
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NO
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Made in:(vagal axon terminals) stimulus for secretion:vago-vagal reflexes Target: various Major effect: relaxes sphincters and circular muscle, dilates blood vessels
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4 general layers of the GI tract
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mucosa, submucosa, muscularis externa, serosa/adventitia
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innervation of the parotid gland
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from CN IX to the lesser petrosal to the otic ganglion to the auriculotemporal nerve to the parotid gland
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mandibular nerve block
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inject into the manibular foramen
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adenoids and their danger
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enlarged phayngeal tonsils that can narrow or block the choanae, resulting in oral breathing
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muscles in which the brachial plexus emerges from the neck
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between the medial and anterior scalene. NOTE the pherenic nerve in on top of the anterior scalene
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slow wave pacemaker cells of the gut
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interstitial cells of Cajal (ICC), they become more numerous as you progess in the GI tract
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xerostimia
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dry mouth, common with increased age
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Sjogren syndrome
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dry mouth from autoimmine on salaivary glands.
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achalasia
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fail to relax, referring to the LES. Looks like a birds beak on radiograph
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3 categories of ARF (acute renal failure)
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prerenal, intrarenal, postrenal
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