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BECOM 2 > BECOM Exam #5 (Week 2) > Flashcards

BECOM Exam #5 (Week 2) Flashcards

1
Q

volume and frequency are measured in

A

volume: decibels (amplitude of wave)
frequency: hertz (frequency of wave)

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2
Q

Tensor tympani vs stapedius

A

Tensor tympani: muscle that is attached to the malleus that can contract to lessen transduction of sound to the inner ear
-CN VII (fascial)

Stapedius:
-CN V (trigeminal - mandibular division)

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3
Q

low frequency vs high frequency sound transduction

A

low: detected in wider region near the apex
higher: detected in narrower region near the base

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4
Q

Endolymphatic hydrops (Meniere’s Disease)

A

when you have too much endolymph

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5
Q

inner hair cells vs. outer hair cells

A

Inner hair cells: perceive sounds ( >90% of afferent fibers)

outer hair cells: amplify sound wave propagation

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6
Q

41/42 vs. 22 (Brodmann’s areas)

A

41 and 42: basic properties of sound, like rainfall vs thunderclap
22 (wernickes): pitch, intensity, melody, prosody – important for interpreting emotional state of a speaker

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7
Q

Descending hearing pathways

A

Superior olivary nucleus receives afferent input, send efferent outputs:

  1. Lateral olivocochlear efferents go to IHCs (through spiral ganglion)
  2. Medial olivocochlear efferents go to OHCs (bypassing spiral ganglion)
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8
Q

Loud noise reflex

A

Loud noise reflex: hair cells and vestibulocochlear cranial nerve are (primarily) afferents (CN VIII), facial (CN VII) and trigeminal nerves (CN V) are efferents to the stapedius and tensor tympani (respectively)
-L and R sup olivary nucleus -> CN VII nuclei –CN VII–> L and R stapedius

Contraction of these muscles dampens/mitigates conduction and amplification of the stapes and malleus – your built-in ‘volume limiter’

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9
Q

Conductive hearing loss

Sensorineural hearing loss

A

Conductive hearing loss: dysfunction of a structure in the outer or middle ear
Sensorineural hearing loss: dysfunction of hair cells

-Conductive loss will be able to hear a tuning fork when placed on the skull but sensorineural will not

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10
Q

modiolus

A

Central axis of the cochlea containing spiral ganglion and cochlear nerve

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11
Q

Ascending hearing pathway

A

hair cell stimulation -> CN VIII -> synapse at cochlear nuclei (some fibers decussate at sup oliv nuc, some don’t) -> synapse at inferior colliculus -> auditory cortex

-END RESULT: both L & R auditory cortices are ALWAYS receiving input from BOTH EARS

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12
Q

Low vs high frequency processed where

A

Low frequency sounds are processed superficially/laterally

High frequency sounds are processed deep/medially

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13
Q

Fungiform vs. foliate vs. circumvallate
innervation
location

A

Fungiform (have taste buds)
Innervation: facial
Location: ant. 2/3 on sides and tip

Foliate (don’t have taste buds)
Innervation: mainly glossopharyngeal and some fascial
Location: on side of tongue

Circumvallate (have taste buds)
Innervation: glossopharyngeal
Location: post. tongue

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14
Q

Taste Receptor Communication (2 separate ways)

A
  • Tastant interacts with microvilli
  • Depolarization of receptor potentials
  1. Na+ channels -> ATP released through Ca2+ independent mechanisms, into extracellular space via gap junction channels (released to extracellular space) -> firing of nerve
  2. Ca2+ channel -> ATP release onto peripheral nerve ending (directly to neuron) -> firing of nerve
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15
Q

Salt taste

A

No receptors involved.
Na+ ions increase outside and move into the cell through cation channels, causing depolarization
-ATP released to extracellular space

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16
Q

Sour taste

A

Weak organic acids diffuse across membrane, dissociate and increase intracellular acidity and cause cation channels to open
Stronger acids act as a ligand that will open pH-sensitive cation channels

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17
Q

Sweet, Umami, and bitter taste

-atp release

A

Bind to GPCR, cause a second messenger cascade that results in cation channels being opened
-ATP released directly onto peripheral nerve ending

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18
Q

Gustatory Information Pathway

A

Nerves from taste buds travel through respective ganglia and synapse in the nuclei of the solitary tract

  1. Reflex: CN X will synapse will synapse with reticular fibers allowing reflex activities of salivation, swallowing, coughing
    Connections with reticular formation (RF)
  2. Interpretation of taste: Ipsilateral travel to the thalamus to synapse in the most medial portion of the ventral posteromedial nucleus
    Then to the gustatory cortex
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19
Q

Olfactory Receptors transduction mechanism

A

1 – cation channels that are closed when there is no odorant
2 – odorant binds, the G-protein dissociates from the GPCR and activates adenylate cyclase. That triggers the activation of the cAMP
3 – cAMP causes Na+ and Ca2+ in and K+ out
4 – increase in Ca2+ binds Cl- channel causes it to open and depolarize the cell
Depolarization triggers action potential

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20
Q

mitral cells

A

mitral cells make up the olfactory bulb and receive stimulation from incoming olfactory receptor cells preceding to pass down the olfactory tract
-Different odorants activate different glomeruli (mitral cell dendrites)

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21
Q 
Prostacyclin (PGI2)
NO
Heparan sulfate
Thrombomodulin
Tissue factor pathway inhibitor
Ectonucleotidase
Adenosine
A

Prostacyclin (PGI2): inhibits platelet activation, aggregation, and vasodilates
NO: inhibits platelet activation, aggregation, and vasodilates
Heparan sulfate: activates antithrombin
Thrombomodulin: modifies thrombin activation
Tissue factor pathway inhibitor: inhibits tissue factor not allowing blood coagulation
Ectonucleotidase: destroys nucleotides resulting in the breakdown of ADP which is needed for coagulation
Adenosine: binds to the ADP receptors in the coagulation pathway blocking it

-all released by endothelial cells

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22
Q

GP Ib-V-IX

A

binds to von wilibrand factor (vWF) that is attached to collagen
-vWF must be bound to collagen for 159 to recognize it

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23
Q

GP IIb/IIIa (integrin alpha IIb beta3)

A

binds to loose fibrinogen and loose vWF

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24
Q

GP Ia/IIa and GP VI

A

bind directly to collagen

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25
Q

Platelet secretions upon activation

A
  • Thromboxane A2 (AA derivative using COX), diffuses through the platelet membrane: activates platelet and also secreted by platelets
  • Alpha granules exocytosis -> fibrinogen, vWF, coagulation factor V
  • Dense granules exocytosis -> ADP, Ca2+
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26
Q

ADAMTS13

A

breaks down vWF multimers

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27
Q

P2Y1 and P2Y12 receptors

A

receptors that bind ADP resulting in autocrine and paracrine activation of platelets

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28
Q

shortage of vWF will cause what intrinsic factor def.?

A

VIIIa

-increases VIIIa half-life

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29
Q

thrombomodulin causes

A

binds to thrombin making a inhibitory complex that activates Protein C -> inactivation of Va and VIIIa

  • secreted by normal endothelium
  • Protein S (cofactor) is needed by thrombin/thrombomodulin to activate protein C
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30
Q

Antithrombin

A

Serine protease inhibitor (serpin) when it binds to heparan it inactivates thrombin, IXa, Xa and XIa

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31
Q

Tissue factor pathway inhibitor

A

Circulating or attached to vascular endothelium, inhibits Xa and VIIa-TF complex

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32
Q

Role of calcium (IV) in coagulation cascade

A
  • platelet morphological changes

- activation of several coagulation factors

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33
Q

plasmin

A

active enzyme that breaks up clot by cleaving fibrin threads resulting in the degradation products D-DIMERs
-associated with fibrinolysis

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34
Q

Hemophilia

A

Excessive bleeding caused by deficiency of one of the factors in the clotting cascade

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35
Q

MOTION DETECTION
semicircular ducts
utricle’s macula
saccule’s macula

A

semicircular ducts: rotational movement of the head
utricle’s macula: side to side movement (ant. to post. movement)
saccule’s macula: vertical movement

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36
Q

otoconia

A

Enables continued sensation of head’s position in absence of acceleration
-head is put sideway but you know you head is still sideways although the movement is no longer occurring

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37
Q

loss of one vs loss of two vestibule system sources (eyes, inner ears, body’s proprioceptors)

A

Loss of one of these systems usually does not produce problems (especially if temporary)

Loss of two of these systems usually results in dizziness/vertigo/system failure

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38
Q

Vestibuloocular reflex

A

allows eyes to stay fixed with movement of the head

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39
Q

dorsal column medial lemniscal tract issue vs. cerebellar dysfunction (Romberg test)

A

Medial lemniscal tract/dorsal column: can stand normally with eye open but will fall when eyes are closed

-Cerebellar dysfunction: can’t stand when eyes are open or closed

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40
Q

Nystagmus

-ABNORMAL nystagmus issue

A

“snapping back”

  • jumping from one object to another while driving
  • ABNORMAL nystagmus: tracking finger and left eye follows but right eye stops but then snaps back to following (CN VIII)
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41
Q

Benign paroxysmal positional vertigo

A

Forceful, abrupt head movement (trauma ) cause the otoconia to dislodge -> loose otoconia can cause vertigo when the head is in certain, specific positions

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42
Q

alc effect on hearing

A

Relaxation of stapedius and tympani -> inc sound transduction

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43
Q

alc effect on vestibulocochlear system

A

alc infiltrates the endolymph causing a drop in density of cupulae relative to endolymph -> body is more sensitive to movement

as alc exfiltrates the cupulae density increases leading to slower movement of hair cells -> slow/exaggerated movements

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44
Q

scala vestibule
scala media
scala tympani

A 
Scala vestibule (starts with oval window)
-perilymph (Na+)
Scala media
-endolymph (K+)
Scala tympani (ends with round window)
-perilymph (Na+)
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45
Q

stria vascularis

A

pushes K+ and Ca2+ out of the cells into endolymph

  • K+ has a strong gradient into cell
  • it produces endolymph gradient for the scala media
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46
Q

prestin

A

once OHC is stimulated causes contraction and elongation of leading to amplification of sound

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47
Q

depolarization route in IHC

A

Tip link: connects stereocilia

  • also connected to a cation gate that can be physically opened when stereocilia are displaced
  • allows K+ in depolarizing cell -> activate Ca2+ channles -> neurotransmitter released
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48
Q

olfactory pathway

A

cilia on olfactory receptor cell -> glomeruli -> mitral cells -> olfactory tract

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49
Q

olfactory receptor activation pathway

A

Ligand binds -> cAMP -> activation of CNG channel -> influx of Na+ and Ca2+ -> depolarization

50
Q

olfactory adaptation via

A
  1. internalization of receptor on olfactory receptor cell
  2. Ca2+ inhibits AC and CNG channel
  3. GABA released from inhibitory neurons inhibits synapse

-mechanism so not one odor can control system

51
Q

Ageusia
Disguise
Hypogeusia

A

Ageusia: Absence of taste sensation

Dysgeusia: Disturbed taste sensation

Hypogeusia: Diminished taste sensation

52
Q

Injection of an anesthetic in celiac plexus nerve fibers can relieve intractable pain arising from

A

foregut

53
Q

Lumbar epidural space (L3 IV space) will block pain signals from both

A

uterus and the vagina

54
Q

Obstetric anesthetics via a caudal epidural block (sacral hiatus) will anesthetize

A

uterine cervix and the vagina (inferior to the pelvic pain line) but will have little effect on pain signals from the uterine body -> allowing the mother to be aware of her uterine contractions during participatory childbirth

55
Q

Horner syndrome

A

Interruption (central or peripheral) of the sympathetic pathway through the superior cervical ganglion results in

  • Constriction of the pupil (miosis)
  • Drooping of the upper eyelid (ptosis)
  • Flushing of the face
  • Diminished or absent sweating (anhidrosis) on the face
56
Q

Contraction of the detrusor and inhibition of the internal sphincter are mediated by

A

parasympathetic outflow

57
Q

medial preoptic nucleus

A

controls temp and body water

  • detect changes in temp and will initiate heat retention/production
  • will cause supraoptic nuclei secrete ADH
58
Q

Ventromedial nucleus control and lesion

A

controls satiety/rage

-lesions leads to chronic hunger

59
Q

Lateral hypothalamic area control and lesion

A

controls desire to eat

-wont eat leading to death

60
Q

Arcuate nucleus control and lesion

A 
secretes ghrelin (hunger hormone) and leptin (inhibit hunger)
-drive hunger via glucose levels and stomach distention
61
Q

Suprachiasmatic nuclei

A

involved in regulation of circadian rhythms

62
Q

Therapeutic window equals

A

TD50 (toxic dose) / ED50 (effective dose)

63
Q

Efficacy

A

the effect of a drug

-if two drugs have the same efficacy then they have the same effect

64
Q

Potency

A

the amount of drug needed to get an effect

65
Q

Volume of distribution def and equation

A

Volume of distribution: the measure of the apparent space in the body available to contain the drug

Vd = amount of drug in body / concentration of drug in plasma

-low Vd = drug got absorbed into tissue somewhere

66
Q

Compression of the optic chiasm

A

bitemporal hemianopia: blindness in the temporal field of vision of both eyes

67
Q

Vascular and neoplastic lesions of the optic tract, optic radiation or occipital cortex

A

homonymous hemianopia
blindness in the corresponding (right or left) field of vision of each eye
-left and right eye loose same side of vision

68
Q

Lateral corticospinal tract controls

A

Lateral corticospinal tract: limbs and digits

-Decussates at the pyramids

69
Q

Anterior corticospinal tract controls

A

Anterior corticospinal tract: trunk/axial muscles

-Does NOT decussate at pyramids but rather spinal segment

70
Q

Muscle unit and control range

A

lower motor neuron + muscle fibers being innervated

Low muscles fibers per motor unit = finer movement
More muscle fibers per motor unit = gross movement

71
Q

lower motor neuron cell body location (lateral vs medial) given muscle location

A

more medial cell body control a muscle of limb that are more proximal

72
Q

Vestibulospinal tracts controls

  • medial
  • lateral
A

postural adjustments to body in response to tilting and movement and postural adjustments to head in response to movement, including walking

  • Medial: antigravity muscles (extensors)
  • Lateral: stabilizes head
  • disfunction: cant walk and read at the same time
73
Q

Reticulospinal tracts controls

  • medial
  • lateral
A

is another alternate motor control pathway

  • medial: pons (ipsilateral only)
  • lateral: medulla (ipsilateral and contralateral)
74
Q

Corticobulbar tract

A

motor to cranial nerve innervated muscles

75
Q

upper vs lower motor neuron damage

A

Upper damage: increase muscle tone and strength reflexes, moderate atrophy

  • clonus (babinski sign) CUM
  • hyperreflexia

Lower damage: decrease muscle tone and strength reflexes, severe atrophy

  • fasciculations
  • hypotonia/paralysis
76
Q

Motor cortex/corticospinal tract lesions

A

contralateral motor deficits to limbs, hands, and feet

77
Q

Hereditary spastic paraplegia

A

disfunction in the long axons/UMNs of the spinal cord causing Weakness and spasticity of the lower limb, bilaterally (gate problems)

78
Q

Primary lateral sclerosis

A

Gradual degeneration of motor cortex neuronal cell bodies (Betz cells) causing gradual loss of lower limb first, then body, then arms, then laryngopharyngeal muscles

79
Q

The study of genomic influence on drug response, often using high-throughput data

A

Pharmacogenomics

80
Q

The study of individual gene-drug interactions, usually one or two genes that have dominant effect on a drug response

A

Pharmacogenetics

81
Q

An alteration of DNA sequence that is present commonly in the population (affects > 1% of the population

A

Polymorphism

82
Q

Single nucleotide polymorphism (SNP)

A

a polymorphism due to a change in a single nucleotide

  • Coding nonsynonymous SNPs
  • Coding synonymous SNPs
  • Noncoding SNPs
83
Q

Indels

A

Short repeats in the promoter (which can affect transcript amount) or indels that add or subtract amino acids

84
Q

refer to a combination of alleles or to a set of SNPs found on the same chromosome and tend to inherit together

A

haploid

85
Q

CYP 2D6

A

codeine metabolizer that depending on variant can lead to increased activity, decreased activity, or normal activity

86
Q

CYP 2C19

A

The CYP 2C19 is responsible for metabolizing or activating approximately 10% of commonly prescribed drugs

87
Q

CYP 2C9

A

assists in metabolizing numerous drugs, such as Phenytoin, Tamoxifen, Warfarin, NSAIDs such as Aspirin, Ibuprofen and Naproxen

  • can decrease metabolism of warfarin so won’t need to give as much medication
  • all individuals with atrial fibrillation will be given anticoagulants
88
Q

Role of lateral/medial superior olives in hearing

A

locate sound sources in space

89
Q

pain sensation in the nose

A

trigeminal nerve is stimulated by irritating substances in the nose
-responsible for initiating sneezing, lacrimation and other reflex responses

90
Q

bowman’s gland

A

produce mucous in the nose that allow odorants smelt

91
Q

hippocampus
orbitofrontal cortex
Hypothalamus/Amygdala
-smell

A

hippocampus: odor memory
orbitofrontal cortex: conscious perception of smell
Hypothalamus/Amygdala: motivational and emotional aspect of smell

92
Q

Proust effect

A

memories produced by smell

93
Q

Amiloride

A

blocks ENAC (salt taste)

94
Q

Gustatory Pathway

A

CN VII, IX, and X -> solitary nucleus -> VPM of thalamus ->

  1. gustatory cortex (taste)
  2. hypothalamic/limbic system (emotion/memory)
95
Q

coratid body and aortic body sensory pathway

A

Carotid body: glossopharyngeal
Aortic body: vagus

jugular foramen ->solitary nucleus ->

  1. Dorsal Vagal Nucleus: parasympathetic
    - to heart via vagus
  2. Nucleus Ambiguus: parasympathetic
    - to heart via vagus
  3. Anterolateral Medulla: sympathetic
    - -> Intermediolateral cell column
96
Q

cortical areas responsible for viscerosensory information

A

spinal cord -> VPL -> inferolateral part of the post central gyrus or insular cortex
-inferolateral part of the post central gyrus or insular cortex

97
Q

Ascending Reticular Activation System

-lesion

A

afferent visceral information from the gut (sympathetic) and pelvic viscera (sympathetic)

spinorecticular fibers -> reticulothalamic -> intralaminar nuclei of the thalamus

(stomach/SI pain or full bladder)

  • Wake a person from deep sleep
  • Alert person to internal stimulus

Damage can result in persistent coma

98
Q

referred pain

  • heart
  • diaphragm
A

Heart: left arm
Lungs: left shoulder

99
Q

Hirschsprung disease

A

A congenital disease caused by a disruption of neural blast cell migration in the colon. The lack of nerve innervation in the colon results in no peristalsis of that segment resulting in a bowel obstruction and megacolon.

100
Q

sympathetic preganglionic neuron location

A

intermeidolateral nucleus ->

  • up and down sympathetic trunk
  • splanchnic nerve
101
Q

Sup cervical gang

A

innervate blood vessels and cutaneous targets of the face, scalp, and neck via branches of the internal and external carotid nerves
-also innervates the salivary glands, nasal glands, lacrimal glands, and structures of the eye such as the pupillary dilator muscle and the superior and inferior tarsal muscles

102
Q

Horizontal gaze center

A

paramedian pontine reticular formation (PPRF)

103
Q

Vertical Gaze Center

A

Rostral Interstitial Nucleus of the Medial Longitudinal Fasciculus (riNMLF)
-main control rostrally

104
Q

Akinetic Mutism

  • symptoms
  • lesion
A

patients that neither move nor speak; however, their eyes may follow their observer or be diverted by sound. Patients lack most motor functions such as speech, facial expression, and gestures, but demonstrate apparent alertness
-lesion: frontal lobe damage, thalamic stroke, damage to cingulate gyrus

105
Q

Kluver-Bucy Syndrome

  • symptoms
  • lesion
A

behavioral changes
placidity (fear and anger non longer shown), hyperorality (examine things with mouth), hypersexuality, hyperphagia (eating excessive amounts), and visual agnosia (inability to recognize objects by sight)
-lesion: bilateral temporal lobe lesions that abolish both amygdalas

106
Q

Alzheimer Disease

  • symptoms
  • lesion
A

loss of recent memories

-lesion: loss of neuron in the hippocampus

107
Q

Lewis-Sommer Syndrome

-symptoms

A

demyelinating polyneuropathy characterized by asymmetrical distal weakness of the upper or lower extremities and motor dysfunction with adult onset

108
Q

Korsakoff

  • symptoms
  • lesion
A

loss of recent memory and tendency to FABRICATE recent events
-medial dorsal thalamic nuclei and mammillary bodies

109
Q

Papez circuit

A

Mammillary Bodies
Anterior Thalamic Nucleus
Cingulate Gyrus
Hippocampus

Ant thalamic n -> cingulate gyrus -> parahippocampal gyrus & entorhinal cortex -> hippocampus (subiculum) -> mammillary body bodies

110
Q

Orbitofrontal Cortex function

A

associated with social behavior

-if effected complete personality change can take place

111
Q

Anterior Part of Cingulate Gyrus

A

controls second thoughts or caution before performing an action
-problem may be present in drug addicts that cannot control their addiction

112
Q

Subcallosal Part of the Cingulate Gyrus

A

associated with sadness

-stimulation of this area can relieve depression

113
Q

Medial forebrain bundle connects what to the hypothalamus

A

brainstem structure
septal nuclei
insula/orbitofrontal cortex

114
Q 
Drug development stages
Stage 1
Stage 2
Stage 3
Stage 4
A

Stage 1: safety
Stage 2: efficacy and dosage range
Stage 3: safety and efficacy in different populations
Stage 4: adverse events, drug-drug interaction

115
Q

what drug precipitate together (chemical antagonist)

A

penicillin and aminoglycoside

116
Q

what binds to digoxin preventing absorption

A

cholestyramine

-digoxin is broken down by bacterial flora

117
Q

what increases cyclosporine absorption

A

Antiemetic (metochopramide)

118
Q

what displaces warfarin from albumin

A

bucolome

119
Q

CYP inducers

A

Carbamazepine
rifampin
-inc warfarin metabolism

120
Q

CYP inhibitor to warfarin theophylline phenytoin

A

cimetidine

  • grape fruit juice
  • ethanol
121
Q

inhibits CYP3A4 which breaks down cylocsprine

A

ketoconazole

122
Q

Synergistic effects -> increase beyond double

A

nitroglycerin and phosphodiesterase inhibitors (sildenafil)

BECOM 2 (7 decks)

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