Exam 2 Flashcards
Histamine
Inflammation
*Vasodilator
*Bronchoconstrictor
Edema
swelling
Hypermetabolic state may lead to…?
loss in muscle mass- atrophy
Where would you find a thick epidermis and why?
palms or soles of the feet; has the most friction/ abrasion
How would a plastic surgeon cut the skin and why?
Parallel, so it’s less noticeable
Lanugo
type of fine hair that grows in fetuses in the womb (disappear by birth)
Vellus
fine hair, like on arms replaced by lanugo
Goosebumps are…?
Arrector Pili (smooth) muscles contracting when cold or emotional response
What layers of the epidermis are dead
-Corneum
-Lucidum
Moribund
dying, apoptosis
Protective elements of the skin
-Sebum
-Keratin
Parts of the hair which DNA can be extracted?
-Cortex
-Follicle
What do free nerve endings detect
-Pain
-Follicle
What layer of the skin is melanin found
Statum Basale
Sunburns lead to
damage of Epidermis and Dermis
->
Peeling
->
Cancer
Basal cell carcinoma
-Starts in stratum Basale
- slow growing
Least in terms of lethality
Squamos cell carcinoma
Starts in stratum spinosum
Melanoma
-Starts in a melanocyte
-might start as a mole; often will metastasize
Worst in terms of lethality
Nocireceptor
detect both pain, and itching/tickle (same free nerve ending) just depends wher
Hyperplasia vs Hypertrophy vs Atrophy
*Hyperplasia: increase of number of cells
*Hypertrophy: Increase in the size of the individual cell
*Atrophy: Decrease in the size or mass of tissue
What is the order of the Epiphyseal Growth Plate
*Cartilage
* Hyperplasia
* Hypertrophy
*Calcification
*Oscification
Calcification
Apoptosis
HA
What happens to blood Ca2+ levels when osteoblasts are active?
they help build bone tissue by depositing calcium into the bones. This process leads to a decrease in blood calcium levels
What happens to blood Ca2+ when the osteoclasts are active?
they break down bone tissue, releasing calcium into the bloodstream. As a result, blood calcium levels increase when osteoclasts are active.
Osteogenesis Imperfecta cause
Brittle bone disease
~lack of collagen type 1
Osteogenesis Imperfecta symptoms
*whites is the eye (sclera) are blue
*loose joints
*hearing loss
*problems w teeth
Genetics (ie Osteogenesis)
Most of the time, COL1A1 and COL1A2 genes are hereditary in an autosomal dominant manner
Osteoporosis
*decrease in bone density and mass, leading to weak and porous bones.
*It primarily affects older adults, especially postmenopausal women
* This is because estrogen, a hormone that helps maintain bone density, decreases significantly after menopause.
Obligate anaerobes are going to turn
a) CO2—>
b) (SO4)2 —>
a) Methane (CH4)
b) Hydrogen sulfide (H2S)
Propioception
Receptors in our tendons, ligaments, and components of our inner ear allow us to know where our limbs are, whether we are accelerating or slowing
Osteogenesis imperfecta is an autosomal____ genetic disorder involving what two genes
Dominant; COL1A1, COL1A2
Superficial vs visceral fascia
*Superficial: surface, below dermis and around subcutaneous tissue
*visceral: deep/around organs
Retinaculum? Where have we talked about it?
Band of connective tissue; deep fascia
-carpal tunnel
To replace a ligament, you may take a piece of…?
Tendon (palmaris longus, gracilis)
Where does the AC joint
Acromioclavicular
-Acromial end/ outer of clavicle
-Acromion of scapula
Does the tibia or fibula heal faster? Why?
Fibula, it’s the non-weight bearing bone
____fractures are when the break is at an angle. A____fracture has broken the skin
Oblique;
Compound
Interstitium
Space between cells
Our defenses can, paradoxically lead to…?
Physiological conditions becoming worse
Arthritis, root
Arthro= joint
Itis= inflammation
inflammation of the joints, resulting in pain, stiffness, swelling, and decreased range of motion.
Traverse fracture
occurs when the fracture line is perpendicular to the long axis of the bone, resulting in two bone fragments separated by a horizontal line. It’s like breaking a stick into two pieces.
Linear fracture
fracture line is parallel to the long axis of the bone. This type of fracture often occurs as a simple, straight break without significant displacement of the bone fragments.
What fracture is parallel/ perpendicular to the diaphysis
*Parallel= linear
*Perpendicular= transverse
Oblique non-displaced fracture
diagonal fracture line across the bone.
When it’s non-displaced, it means the bone fragments remain in their original alignment without significant displacement or separation.
Oblique displaced fracture
Diagonal fracture line. the bone fragments are displaced or separated from their original alignment.
Spiral fracture
bone is twisted with a torsional force. often occur due to twisting injuries and are commonly seen in long bones like the femur or tibia
Greenstick fracture
-where is it mostly seen?
commonly seen in children, where one side of the bone is broken and the other side is bent but not completely fractured. Greenstick fractures are more flexible than adult bones due to the higher proportion of collagen and less mineralization, making them more prone to bending rather than breaking completely.
Comminuted
the bone is broken into three or more fragments. This type of fracture can occur due to high-energy trauma, such as a car accident or a fall from a heigh
Rotator Cuff
Group of muscles and their tendons that act to stabilize the human shoulder and allow for its extensive range of motion
Rotator cuff muscles and importance
1) supraspinatus
2) infraspunatus
3) teres minor
4) subscapularis
**shoulder movement and in maintaining glenohumeral joint (GH) stability
Blunt force trauma can lead to___and/or a_____.
Fracture; contusion (bruise)
What are depression fractures?
Dent to skull
*cranium
*forensics report
Tendinopathy
Pain, tenderness or swelling due to overuse
-broader term that encompasses various tendon disorders, including inflammation, degeneration, and microtears.
Tendonitis
specifically refers to inflammation of the tendon
*Causes: Repetitive movements, sports activities, poor biomechanics, or sudden increase in intensity of exercise.
Tear of the tendon
A partial or complete rupture of the tendon fibers, resulting in loss of structural integrity and function
Rank injuries to the rotator cuff in order of least to most severe
-Tendonitis
-Tendonopathy
-Tear
What is a contusion?
Bruise: hematoma, caused by damaged capillaries
Blanching
skin has whitish appearance cause by diminished blood flow to that region
Why is there visible discoloration in a bruise?
making sure no iron toxicity occurs
due to the breakdown of hemoglobin. Initially, a bruise appears red or purple because of the presence of oxygenated hemoglobin. As time passes, the hemoglobin breaks down into different compounds, including biliverdin and bilirubin, which are yellow and greenish in color. Eventually, these compounds are metabolized and cleared from the body, leading to the fading of the bruise.
Tommy John Surgery
surgical graft procedure where ulnar collateral ligament in the medial elbow is replaced with a tendon
Which subset of humanity is most likely to get TMJ? Why?
baseball players, as the ulnar collateral ligament can become streched or torn thru repetitive stress.
tensile strength
Turf toe
Turf Toe: ligament sprain of the big toe joint
May cause tenderness and swelling
Occurs when the big toe joint bends beyond normal ROM, in turn spraining ligaments that support the joint.
Hallux
big toe joint
Where is the acromioclavicular joint located?
At the outer end of the clavicle where it attaches to the acromion of the scapula.
Hydroxyapatite
Ca10(PO4)6(OH)2
*inorganic supporting connective bone tissue (calcium and phosphate)
*secreted after collagen
Hormones involved with bone remodeling
- Calcitonin
2. PTH - Calcitriol
- Estrogen
How can you recognize an osteoclast? What acid does an osteoclast secrete?
An osteoclast is multinucleated
-osteoclasts secrete hydrochloric acid
Canaliculi
Facilitate nutrient, gas, and waste exchange with the blood
Lacunae
House osteocytes
Central canal (haversian canal)
Center of osteon, contains blood vessels and nerves
Volkmans canal
Run perpendicular to the haversian canals to interconnect them
Concentric Lamellae
Rings of calcified matrix that surround the osteon
Is human skull (cranial bones) fused at parturition? why/ why not? what is parturition?
Human skull is NOT fused at childbirth, rather consists of fontanelles or soft spots in a newborns cranium (anywhere from 2-6)
Fontanelles allow for contortion
Parturition=childbirth
PG F2 and parturition as well as other elements
Prostaglandin F2 Alpha
1.) C.L —> E2 and P4 (regression of cycle)
2.) Increase skeletal muscle —> growth/repair —> skeletal muscle —> hypertrophy
Chondroblasts
- form cartilage
- located in perichondrium, which surrounds developing bone.
where is the growth plate located?
between epiphysis and diaphysis
what happens in each level of a growth plate?
- chondroblast lay down cartilage
- hyperplasia of the plate
- hypertrophy (cell size increases)
- hydroxyapatite and apoptosis (osteoblasts)
- new diaphysis
synovial fluid and hyaluronic acid
Found in synovial membranes, which line freely moveable joints
Synovial fluid is rich in hyaluronic acid
Hyaluronic acid: polysaccharide, good lubricant; helps retain water in the skin = helps skin stretch
Olecranon (fossa and process)
Olecranon fossa is found on the posterior distal end of the humerus, and the Olecranon process is found on the posterior proximal end of the ulna
Together they allow for a smooth movement of the elbow joint.
Popliteal
back of knee
Anterior crest of tibia
Gives attachment to the retinaculum
Nuchal
back of neck
Calcaneal
heel
calcaneal tendon is the largest tendon
COVID 19 and our defense
Our defense to COVID-19 is inflammation, however it can become overzealous and lead to increase in fluid concentration in the lungs, which leads to pneumonia
T/F collagen is double helix
FALSE, it is a triple helix
Carpel tunnel syndrome- elements
*median nerve
*muscle tendons
*transverse carpal ligament
Carpel tunnel syndrome is caused by?
Pressure on the median nerve
When the median nerve is compressed, symptoms can include numbness, tingling, and weakness and arm
what can contribute to carpel tunnel syndrome?
Anatomy of the wrist, health problems and repetitive hand motions
Why does the color of one’s eye matter?? Is the sclera ALWAYS white??? In what regard might the sclera NOT be white?
The color in one’s eyes matter because they can indicate a medical condition.
The sclera is always white unless the color is altered due to a disease or medical condition
Example 1: with OI (brittle bone) the sclera is blue rather than white.
Example 2: Our professors father had a yellow colored sclera due to cancer.
AC joint vs GH joint vs separated shoulder
A separated shoulder joint is also known as an acromioclavicular (AC) joint injury or a glenohumeral (GH) joint injury
AC joint is located at the outer end of the clavicle where it attaches to the acromion of the scapula
Symptoms: non-radiating pain making it difficult to move shoulder, swelling, bruising or deformity formation.
The COVID 19 virus binds to receptors deep in the___.And post-exposure, the____response can be so enhanced, severe can impactful that one might literally___
lungs; inflammatory; drown
High Ankle Sprain — which ligament is involved?
Also known as Syndesmotic ankle sprain
Stretching and twisting of the syndesmotic ligaments that connect the tibia and fibula of the lower leg
8-10 weeks rehab
GH joint vs AC joint (attachment points)
The GH (glenohumeral) joint connects the humerus to the glenoid cavity of the scapula
The AC (acromioclavicular) joint connects the clavicle to the acromion
What is a scar?
As skin repairs itself, collagen and fibrous tissue create a scar
can capillaries be damaged
Yes, the most common cause of bruising is caused by capillaries being damaged by trauma, this causes localized bleeding that extravasates into surrounding interstitial tissues
what are the 5 cardinal signs of inflammation?
- heat
- pain
- redness
- swelling
- loss of function
mediators of inflammation (4)
- arachidonic acid derivatives (leukotrienes and prostaglandins)
- vasoactive peptides (kinins)
- phospholipid mediators (platelet activating factor)
- cytokines (interleukins and other bio-response modifyer)
Degrees of severity of separated shoulders
Symptoms include non-radiating pain which makes it difficult to move the shoulder.
The presence of swelling or bruising and a deformity in the shoulder is also common depending on the level of severity
what is the evolutionary significance of inflammation?
Defense to our body
if one scratches their arm with a key in a linear matter…. what is the initial color of the line?
white then it will turn red
white color is due to lack of blood flow
it becomes red because of the increased blood flow to the area
COVID why so lethal?
lysing of cells cause fluid to build up in the lungs which makes it difficult for us to breathe
can become overzealous and lead to pneumonia which is fluid in air sacs, which can lead to death
stages of vitamin D
skin→liver→kidney (calcitriol)
Vitamin D whole process
The skin helps produce vitamin D (cholecalciferol) when exposed to sunlight, cholecalciferol is then modified in the liver to become calciferol, then the final modification is in the kidneys known as calcitriol, one of the 4 bone remolding hormones, which leads to elevated blood Ca++, thus stimulating osteoclasts and promoting renal reabsorption of Ca++.
Which major arteries are exposed? Why are they deep?
Carotid, jugular and femoral arteries
For protection
Potential issue with them being exposed?
Bleeding/ Hemorrhage; nerve damage
Keratin
protects epithelial cells from damage or stress
-extremely insoluble in water and organic solvents
-helps us with UV radiation and electromagnetic (preventing from going too deep in the skin)
-hair, nails, outer layer of skin
Desmosomes
Specialized junctions that occur between cells for cell adhesion
Gap junctions
Protein channels aid intercellular communication
- allows ions and small molecules to pass through
- coordinate function in cardiac and smooth muscle by allowing electrical signals to pass from cell to cell
5 layers of Epidermis
- stratum corneum (most superficial layer)
- Stratum lucidum
- Stratum granulosum
- Stratum spinosum
- Stratum basale
what enzymes do obligate aerobes have? (like us)
*catalase
*S.O.D (superoxide dismutase)
*peroxidase
*glutathione (GSH)
Dermis or epidermis is thicker. All layers are alive?? Why or why not?? Why does “6-8___” keep flying into the conversation vis-à-vis the tissue is alive or dead???
Dermis layer is thicker
All layers of the dermis are alive, the top two layers of the epidermis, stratum corneum and lucidum, are dead, because they are further than 6-8 cell lengths away from capillary bed and cannot receive oxygen.
What is a poison to obligate anaerobes?
Oxygen, do not have the 3 enzymes
Pour H2O2 into a cut…what do you see? Why is this performed?? Be specific!
When you pour H2O2 into a cut, it will be broken down into water and oxygen (bubbles), this oxygen will help kill obligate anaerobes.
Apocrine vs Eccrine Sweat glands…AND bacterial growth…smell??
Apocrine: Mainly in the groin and axillary region, activated when nervous (what anaerobes like)
Eccrine: all over the body, secrete sweat which is water, NaCl, and nitrogenous waste
They apocrine glands secretes oil as well which stimulate bacterial growth = bad smell
Parts of human nail
Nail plate
Nail groove
Lunula
Eponychium (cuticle, extension of stratum corneum, from proximal nail fold)
Why immunosuppressants IF one has to be given a skin graft (from another person)??
the skin graft is coming from a different person and sometimes that skin is not a MHC match; immunosuppressants are given to help the body NOT fight the new skin and accept it
What is MHC and what is its relevance with our cells recognizing OTHER cells as foreign or “self”??
MHC - Major Histocompatibility Complex
MHC is how we recognize our own tissue as “self” so as to avoid an immune attack against our own tissue
Fascia vs retinaculum
Fascia: macroscopic membranous tissue that support structures (aids in holding them “in place”)
- superficial, deep or visceral
Retinaculum: (type of deep fascia) deep layer of dense connective tissue, that holds tendons in place to stabilize the tendons and sometimes even muscles themselves
Schock?
Anaphylatic
Condition whereby there is insufficient blood flow to organs causing a sudden drop in blood pressure
Vasodilation
decreases resistance which in turn decreases blood pressure
What is the connection to EGF, a wound and a scar?
Epidermal growth factor is not able to heal these wounds. a lot of collagen and mitotic activity leads to scar formation
What is in a scar?
contains collagen (fibrocartilage and granulation)
Debridement
the removal of necrotic (dead) tissues from injury site in order to prevent bacterial infection and assist in the healing process
Stress……Cortisol levels (made where??)…..immune system function….incidence of sickness??
The stress hormone, cortisol (from adrenal cortex) is good in short periods of time, reducing pain and inflammation, however over long periods of stress, cortisol levels are elevated for too long interfering with immune defense and sleep, thus you are more likely to get sick.
herpes flare up are caused when?
when cortisol levels are high which causes immune system function to go down and that is when the virus takes advantage
How is herpes transmitted?
mouth to mouth contact (types 1)– cold sores
sexual contact (type 2)– genital lesions
Hernia is a what?
Abnormal exit of a tissue or an organ
Hernias……presents as what when one has an ??
Presented as bulges when one has a hernia
Inguinal hernia = bulge in groin from lifting too heavy
Most common hernia
Inguinal hernia
Epigastric
Upon the stomach
Where in the osteon are the nerves?
haversian canal/ central canal
Which type of ossification are growth plates present as a toddler?
Endochondral osscification
_______ ossification takes place within the embryonic mesenchyme and turns into bone.
Intermembranous
What 3 organs are involved in brain monitoring for calcium levels in the brain?
1.Bone hormones (calcitonin, PTH, estrogen, calcitriol)
2.Gi tract
3. Kidney
What is the functional unit of bone?
Osteon
What happens in the zone of ossification?
calcified cartilage is replaced with bone and new diaphysis is made
If Calcium levels are too low in the blood then the brain sends signals to the GI TRACT to ____ calcium _____.
increase
absorption
If calcium is too low in the blood then the brain tells the KIDNEYS to filter the calcium through the ______ and then ______ more.
urine
reabsorb
Osteoporosis is found in ___-_____ women and we see estrogen levels go ___ which means bone density goes _____.
Post-menapausal women
down
down
Osteoporosis treatment
- estrogen replacement therapy (E2↑)
- Ca++ in diet ↑
- PTH levels
pulsatile PTH (trick brain) → see negative feedback of PTH → PTH levels are down↓ (less calcium in the blood; more for the bones;inhibits osteoclast activity)
Histamine in the brain is a ______.
neurotransmitter
effects of histamine (in terms of allergies)
- nose → run and congestion
- sneeze
- eyes → red and tears and puffy
- vasodilation ○→◯
- bronchoconstrictor ◯→○
histamine is the opposite of what?
adrenaline and epinephrine
(opposite physiological responses)
in allergies, our histamine levels go ____.
up
In allergies when we vasodilate then resistance goes _____ and our Blood pressure goes ____.
down
down
If someone has a VERY bad allergic reaction to where there blood pressure and oxygen levels go down then people will typically carry a _____.
Epipen
What is epipen?
has epinephrine meaning adrenaline
Where is epinephrin produced
Adrenal medulla in the kidney
Allergens cause _____.
Allergies
bronchoconstrictor is?
airways are getting smaller and oxygen goes down
t/f histamine and adrenal/epinephrine are the same thing?
F, they are opposites meaning we use epinephrine to lower the effects that histamine gives
How many histamine receptors are there?
4 receptors
H1, H2, H3, H4 (but we only care about H1 and H2)
What 2 enzymes turn arachidonic acid into prosta-glandies?
COX1 and COX2
What are the 4 different types of prosta-glandies? and what is a derivative?
PG I2
PG D2
PG E2
PG F2-alpha
PG H2 is the derivative
PG I2
Vasodilation (more blood)
platalet aggregation goes down
what blocks COX1?
Nsaids such as:
1). Ibuprofen (Advil)
2). Naproxen (Aleve)
3. Acetylsalicylic Acid (Aspirin)
What blocks COX2?
acetaminophen (tylenol)
The prosta-gland PED2 is a mediator of…?
Inflammation
The prosta-gland PGE2 is associated with _____ and is also a pyretic (___).
Pain
Fever
Benadryl for low allergies inhibits the __receptor and should only be taken at__to prevent drowsiness
H1
night
Pepcid AC is antagonist to what?
H2
Where are H1 receptors found? How about H2?
H1= all over body
H2=
*stomach
*EYE
*genitalia
NSAIDS?
Non-steroidal Anti-anflammatory drugs
are inhibitors of Cox
ex. 1). Ibuprofen (Advil)
2). Naproxen (Aleve)
3. Acetylsalicylic Acid (Aspirin)
what does tylenol (acetaminophen) and ibuprofen (advil) do?
tylenol inhibits/blocks COX2 while ibuprofen blocks/inhibits COX1
blocking COX1 and COX2 means pain, inflammation, and fever goes down
What major organ detoxifies ibuprofen and tylenol before we can see if we can use stronger meds?
liver detoxifies and kidney filters it out throught the blood
what is Lance Armstrong resting heart rate? vs a baby
41 bpm (high stroke volume)
a baby’s heart rate will be much higher due to a lower stroke volume
Baroreceptors
detect pressure —>send signal to medulla oblongata
- aortic arch (left ventricle)
- carotid bodies (located on neck)
- Atria
- Atrial Vessels
how do we block H1?
anti histamines; specifically benadryl, zyrtec
how do we block H2?
H2 receptor antagonist like Pepcid AC
(anti heartburn drugs)
where are H2 receptors located?
around the eye (wife→new eyeliner → inflammation and ER visit → heartburn medicines for treatment)
what is this formula for? _____ _____ = stroke volume X heart rate
cardiac output
Stroke volume is the amount of ___ that leaves the left ____ per beat.
blood
ventricle
What is this formula for?
_____ = flow X resistance
change in pressure
What is the formula for mean arterial pressure?
D + S-D/3
In ________, resistance goes up and BP goes up because the lumen is getting smaller
Vasoconstriction
stroke volume
the amount of blood ejected by the heart in any one contraction
Pressure is measure in?
mmHg (milimeters of Mercury)
Vasodilation/ Vasoconstriction is determined by?
Pre-Capillary Sphincter (resistance)
*smooth muscle
In ______, resistance is going down and BP is going down because the lumen is getting bigger.
vasodilation
cardiac output=
flow into system
Pre-capillary sphincters are under…?
Adrenergic control (Adrenaline-Sympathetic)
Epinephrin/ Adrenaline
*Vasochonstrictor
*Bronchodilator
PG D2
Fever goes up/ sleep/ wake cycles/ pain!!
PG E2
Swelling, pain, redness–>inflammation!
PG H2
opposite of of PGI2
Thromboxane goes up
*Vasoconstrict (+)
-promote platalete aggregation
Where are Arachidonic acids found?
Cell membranes (skin, liver)
What three things can A.A turn into?
*Prostaglandin
*Thromboxane
*Leukotrienes
3 sources of histamine
*Mast cells–>exocytosis (degranulation)
*Basophils
*Histamine neurons
