2015.04.10 Flashcards
Serratus Anterior Muscle
Fixes the scapula against the posterior chest wall and rotate the scapula to allow abduction of the arm over the head.
Long thoracic nerve injury paralyzes this muscle and results in winging of the scapula.
Latissimus Dorsi Muscle
Adduct and extend the humerus.
Thoracodorsal Nerve
Deltoid Muscle
Three segments that act to flex, extend, and abduct the arm.
Axillary nerve innervation
Rhomboid major
Draw the scapula medially at its medial border
Dorsal Scapular Nerve
Teres Major
Adduct and medially rotate the arm.
Subscapular Nerve.
Urachus
Remnant of the allantois (protrudes from yolk sac that extends into the area of the urogenital sinus during the 3rd week of gestation).
Connects the bladders with the yolk sac.
Failure of Urachus to obliterate before birth
- Patent urachus - connects umbilicus and the bladder.
- Vesicourachal diverticulum - failure to close part of urachus adjacent to the bladder. Outpouching of apex of bladder.
- Urachal sinus - failure to close distal part of urachus (adjacent to the umbilicus). Periumbilicial tenderness and purulent discharge from umbilicus.
- Urachal cyst - failure of central portion to obliterate. Fluid-filled structure located between the two obliterated ends of the urachus.
Meckel Diverticulum
Incomplete obliteration of the vitelline duct (persistent yolk stalk that connects small intestine with the skin at the umbilicus)
Meconium discharge from the umbilicus.
Omphalocele
Incomplete closure of anterior abdominal wall during development.
Ventral opening at the umbilicus with protruding viscera COVERED by peritoneum.
Gastroschisis
Inadequate enlargement of peritoneal cavity.
Viscera protrude through a defect in the anterior abdominal wall adjacent to the umbilicus and are NOT covered by peritoneum.
Crossover Study
Subjects randomly allocated to a sequence of 2 or more treatments given consecutively.
A washout (no treatment) period is often added between treatment intervals to limit the confounding effects of prior treatment.
Diagnostic confirmation of Menopause
Elevated serum FSH levels. (Loss of estrogen production since ovaries are less active leads to loss of inhibition)
LH levels also elevated (but later and less prominent phenomenon).
Phosphodiesterase Inhibitors
Increases cardiac contractility via increased intracellular cAMP concentration (promotes increased intracellular calcium in myocytes).
In vascular SM, increases in cAMP cause vasodilation.
Neonatal Intraventricular Hemorrage
Complication of prematurity (decreasing age and birth weight) that leads to long-term neurodevelopmental impairment.
Germinal matrix, highly cellular and vascularized layer in subventricular zone, from which neurons and glial cells migrate out lack glial fibers that support other blood vessels throught out the brain. (Becomes less prominent and vascular by 24-32 weeks of gestation, decreasing risk of IVH).
Haloperidol
Treatment of agitation
Most commonly associated with neurleptic malignant syndrome (NMS) due to anti-dopaminergic activity of antipsychotic medications (D2 receptor).
Central dopaminergic systems are involved in thermoregulation, muscle tone and movement.
Results in: hyperthermia, generalized rigidity, autonomic instability, altered mental status.
Use Dopamine agonists (bromocriptine) and/or muscle relaxants (dantrolene)
Difference between Serotonin Syndrome and Neuroleptic Malignant Syndrome
NMS has absence of myoclonus and presence of rigidity.
Vitamin K
Assistance of glutamate residue carboxylation that is essential for production of clotting factors VII, IX, and X
Increased 2,3-Biphosphoglycerate (BPG)
Achieved within erythrocytes to enable increased oxygen delivery in peripheral tissues in the presence of lower blood oxygen concentration (2,3-BPG decreases affinity of hemoglobin for oxygen).
2,3-BPG is produced from 1,3-BPG by Biphosphoglycerate Mutase. (Bypass step that forms ATP)
Caldribine
Purine analog that is drug of choice for hairy cell leukemia.
Resistant to degradation by adenosine deaminase (purine disposal pathway). Allows it to reach high intracellular concentrations where is is incorporated into DNA and causes DNA strand breaks - antineoplastic.
Superantigens
Enterotoxins, Exfoliative Toxins, Toxic Shock Syndrome Toxin (TSST-1)
MHC on APCs with variable region of T lymphocyte receptor to cause nonspecific “widespread” activation of T-cells resulting in release of IL-2 from T-cells and IL-1 and TNF from macrophages.
Polyarteritis Nodosa (PAN)
Segmental, transmural, necrotizing inflamation of medium to small sized arteries in any organ.
Kidneys, heart, liver, and GI tract are most common.
Typically spares pulmonary and bronchial arteries.
Cutaneous manifestions in 1/3 of patients - palpable purpura.
Androgens and acne
Androgens stimulate follicular epidermal hyperproliferation and excessive sebum production, thereby promoting acne development.
Anabolic steroid misuse, esp in competitive athletes is a known cause of acne.
Risperidone
Anti-psychotic drug used for schizophrenia.
Antidopaminergic effects lead to hyperprolactinemia, which causes ameorrhea, galactorrhea, and breast soreness.
Hyperprolactinemia causes hypogonadism by inhibiting the release of gonadotrophin-releasing hormone from the hypothalamus.
Tamoxifen and Raloxifene
Selective estrogen receptor modulators (SERMs) - tissue selective estrogen agonist and antagonist properties.
In Breast tissue, they are anti-estrogenic.
In Endometrial tissue and bone, they are stimulatory and cause endometrial hyperplasia/polyps/cancer and treat osteoporosis.
