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A/P exam 3 Flashcards

1
Q

bbf rate

A

750-900ml/min

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2
Q

brain is __ of body weight

A

2%

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2
Q

750 is __% of CO

A

15

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3
Q

brain autoregulation LLA and ULA

A

LLA: 65, ULA: 150

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3
Q

gray matter receives ___% nutrients, white matter gets ___%

A

80, 20

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4
Q

CO2 combines with ___ dissociates into ___

A

combines with water to dissociate into bicarb and protons

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5
Q

For each mmPaCO2 change

A

2-4% change in cerebral blood flow

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6
Q

each degree Celcius temp drops,

A

reduce oxygen demand by 6 to 7%

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7
Q

list of vasodilators

A

acetylcholine, ketamine, inhalational anesthetics (isoflurane, desflurane, sevoflurane), Nitrous oxide,

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8
Q

vasoconstrictors

A

serotonin, propofol/barbiturates,

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9
Q

COW supplied by ?

A

basilar and two internal carotid arteries

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10
Q

3 cerebellar arteries, which come off basilar and vertebral

A

superior and anteriorinferior cerebellar artery come off basilar

posterior inferior cerebellar artery come off vertebral

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11
Q

anterior vs posterior spinal artery % flow

A

anterior gives 75% blood flow, posterior gives 25% split between 2 so 12.5 each

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12
Q

GRA named after?
supplies?

A

polish guy
artery of adamkiewicz
great radicular artery
great anterior segmental artery
2/3 bottom of spinal cord, especially the anterior

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13
Q

GRA originates between?

A

T9-T12: 75%
T5 - L5: 25%

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14
Q

3 sources for posterior spinal arteries

A

cerebellar arteries, specifically posterior inferior cerebellar artery

vertebral arteries and radicular arteries

the

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15
Q

anterior spinal artery source

A

vertebral arteries at top and anterior radicular arteries at lower levels

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16
Q

SCPP = ?

A

distal aortic pressure - CSF pressure

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17
Q

spinal cord LLA and ULA

A

LLA 50, ULA 125

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18
Q

lateral inhibition pressure sensor type

A

A-beta, pain tracts run next to DCML

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19
Q

nervous system filters ___

A

97%

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20
Q

feed arteries in c spine, t spine, lumbar

A

C: 1-2
T: 2, 1 high and other is GRA
L: 1-2, radicular lumbosacral arteries

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21
Q

Golgi stretch organs located in?

A

tendons
golgi tendon organs
golgi stretch or tension sensors

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22
Q

example for tendon reflex

A

weight at 90 degree angle

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23
Q

limits of thermal pain

A

greater than 45C and less than 5C

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24
Q

appendix pain travel path

A

T10 is where visceral pain enters the cord
L1 is where parietal pain enters cord

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25
Q

anatomy of pain sensing neuron

A

pseudo-unipolar cell

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25
Q

AMPA located?

A

second-order neuron in dorsal horn

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26
Q

AMPA ion flow

A

sodium major player, permits K flow

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27
Q

NMDA ion flow

A

sodium and calcium

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28
Q

antagonists of NMDA receptor

A

Ketamine, nitrous, tramadol, lead, alcohol also inactivates them

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29
Q

glycogen found where

A

skeletal muscle and liver

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29
Q

length of smooth muscle

A

shorter

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30
Q

SR in smooth muscle

A

less developed, more reliant on outside Ca

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31
Q

smooth muscle actin myosin

A

skeletal 2:1
10-20:1

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32
Q

latch mechanism

A

smooth muscle able to generate lots of force for long periods of time using very little energy

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33
Q

smooth muscle examples

A

pupillary diameter, airway resistance, vascular smooth muscle (giving rise to SVR), intestines

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34
Q

esophagus made up of?

A

hybrid of skeletal and smooth muscle

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35
Q

visceral smooth muscle characteristics

A

act in coordinated way for peristalsis

electrical connections with gap junctions

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36
Q

3 layers of blood vessel

A

tunica intima, tunica media,
tunica adventitia/externa
(single endothelial layer)

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37
Q

which vessel doesnt have smooth muscle

A

capillaries

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38
Q

sarcomere length and structure smooth muscle

A

longer and no z-lines

39
Q

acetylcholine receptors has how much more?

40
Q

striation caused by

A

a and i bands

41
Q

Actin consists of

A

F-actin and tropomyosin

42
Q

how many contractions possible before running out calcium

A

10,000-20,000

43
Q

skeletal muscle cell wall

A

sarcolemme
contain mitochondria

44
Q

type 2 duration of twitch is __ type 1

45
Q

tx for alzheimers, what receptors are involved in it

A

treated with stigmines (physo and neo)
muscarinic receptors

46
Q

acetylcholinesterase produced by?

A

skeletal muscle

47
Q

system breakdown by acetylcholine by

A

plasma cholinesterase and liver

48
Q

mitochondria in presynaptic cell produces…

A

acetyl group

49
Q

TEA meaning

A

tetra ethyl ammonium

50
Q

ELMS LEMS stands for

A

Eaton Lambert Myasthenic syndrome

51
Q

choline transported how

A

cotransporter with Na in presynaptic cell

52
Q

succinylcholine made of?

53
Q

tx options for MG

A

acetylcholinesterase inhibitor
plasmapheresis
remove thymus gland
steroids

54
Q

tx options for ELMS LEMS

A

K channel blocker (TEA)
plasmapheresis
steroids

acetylcholinesterase inhibitors wont help

55
Q

outside forces for heart muscle

A

venous pressure, atrial pressure

56
Q

electrodes placed distance of?

A

3-6cm apart

57
Q

nerves alternative spots for assessing twitch

A

peroneal nerve
posterior tibial nerve
orbicularis oculi muscle by ophtalmic branch of facial nerve

58
Q

VP stands for?

A

vesicular pool

59
Q

what two determine smooth muscle response

A

what receptor complex is and what intracellular machinery

60
Q

only circulation with no adrenergic receptors?

A

cerebral circulation

61
Q

smallest part of the COW

A

anterior communicating

62
Q

which bleed has to do with sinuses

A

subdural hematoma, can break sinus and have bleed underneath dura

63
Q

internal volume of skeletal muscle is?

A

40% of overall body mass

64
Q

type 1 fiber traits

A

red, slow, lots of myoglobin, lots of mitochondria

64
Q

type 2 traits

A

white, fast, little myoglobin, fewer mitochondria

65
Q

gray matter requires ___ as much blood flow as white matter

66
Q

stretch reflex examples and goal

A

forehead pushe
patella hammer

keep muscles at constant length
keep posture

66
Q

muscle spindle fx

A

for stretch flex

feedback info on length and tension of muscle

67
Q

tendon reflex examples

A

falling out of tree
holding weight 90 degree

68
Q

muscles in hamstring

A

biceps femoris, semitendonosus, semimembranosus

69
Q

parietal pain def from slide

A

connective tissue pain, direct conduction into spinal cord from peritoneum, pleura or pericardium, highly localized

70
Q

pain in ureters or kidney stone

A

lower back pain

71
Q

visceral pain def from slide

A

internal organ pain via autonomic nerve bundles; usually referred

72
Q

appendix inflammation pain referred to?

A

umbilicus, LRQ

73
Q

heart pain sensors

A

left arm/ shoulder

73
Q

appendix visceral pain entry location

73
Q

anatomy of 1st order pain sensing

A

pseduo-unipolar

74
Q

sectioning autonomic ganglia is for which pain?

A

visceral pain

74
Q

appendix parietal pain entry location

75
Q

what makes skeletal muscle unique

A

multinucleiated

76
Q

troponin C binding to calcium causes?

A

tension alteration on tropomyosin and actin

changes affinity for troponin I and troponin T

77
Q

teloglial cell is what? and where?

A

schwann cell, perisynaptic

78
Q

with depolarizing paralytics, will have continuous leak of K where?

A

everywhere this is a neuromuscular junction (due to nicotinic Na channels)

79
Q

MH tx and cause

A

mutated gene on ryanodine receptor, uncontrolled calcium release from SR

dantrolene (ryanodine receptor antagonist)

80
Q

stigmines will have effect on muscarinic receptors how?

A

cross BBB help with alzheimers
Heart (brady)
Lungs (Sarin gas)

81
Q

fx of muscarinic receptors in lung

A

mucous fluid secretion in lungs

82
Q

fast sodium channels and L-type Ca channels close as

A

a function of time
l type is slower

83
Q

Ptype calcium channels closes as result of?

A

repolarization

84
Q

fetal receptors start getting placed

A

few days after

85
Q

wider sarcomeres can?

A

get more work done

86
Q

T-tubules located

A

not around NMJ

87
Q

conductance is due to?

A

speed of ion flow

87
Q

curare found where and used for?

A

rainforest and for hunting

88
Q

ulnar nerve is for what

A

adductor pollicis, has pinky finger and thumb

89
Q

75-80% block

A

4th twitch disappears

90
Q

85% block

A

3rd twitch disappears

91
Q

85-90% block

A

2nd twitch disappears

92
Q

90-95% block

A

all disappear

93
Q

stimulator settings

94
Q

head lift when

A/P (10 decks)

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