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A&P 1 > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Common Chemicals in Chemical Synapse?

A

Neurotransmitters

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2
Q

Signal Propagation

A

Think Myelinated (motor function) vs Unmyelinated (tickle, heat, etc)

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3
Q

What are Chemical Synapses dependent on?

A

What Receptors are located on the receiving cell

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4
Q

What would a small, Unmyelinated Neuron be good for?

A

Tickles, Cold, Warmth (R side of Chart)

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5
Q

In a Neuron, how long is an Action Potential?

A

Milliseconds

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6
Q

Where are Oligodendrocytes located?

A

CNS

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7
Q

What is Striated per Lecture?

A

Skeletal Muscle

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8
Q

How many binding sites does nACh-R have?

A

2 binding sites; both have to be occupied simultaneously to work

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9
Q

Purpose of Schwann Cells

A

PNS Myelin Producing Cell

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10
Q

Overall Slower Cell Signaling?

A

Longer Nerve, Narrow Diameter, Decreased Insulation

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11
Q

What receptors are located on the Heart at the NMJ?

A

Muscarinic/ACh receptors

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12
Q

What is the main ion that goes through an electrical synapse? Why?

A

Na+, it is small and can fit

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13
Q

What makes cells more resistant to crush injuries?

A

Myelin; add layer of robustness

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14
Q

Where are Schwann Cells located?

A

PNS

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15
Q

What action potential does Dr. Schmidt give an example of?

A

Electrical Probes being placed

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16
Q

What is Myelin?

A

The insulation around a Neuron

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17
Q

What happens if there are increased gap junctions?

A

Decreased resistance for AP; easier for signals to be sent

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18
Q

What Happens if you take away Cl- permeability?

A

Increased Vrm –> Seizures

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19
Q

Purpose of Oligodendrocytes

A

CNS Myelin Producing Cell

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20
Q

Multiple Sclerosis (MS)

A

Myelin sheath is damaged in the motor system, so signals are not conducted properly

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21
Q

How does Cl- affect the cell?

A

Hyperpolarizes the cell; “brakes” on the NS

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22
Q

What are the Macroglial Cells?

A

Astrocytes, Ependymal Cells, Oligodendrocytes, Schwann Cells

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23
Q

Normal HR per lecture?

A

70-72 b/min

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24
Q

How does Atropine Work?

A

Blocks normal vagus activity on the heart; Increase HR

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25
Q

How do Baroreceptors adapt?

A

Desensitize to increase in MAP, and make it the new “normal”

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26
Q

What does an Axon do for a Neuron?

A

Sends signals; Myelinated

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27
Q

What is a Threshold?

A

It determines if the cell generates an action potential. Depolarization has to get above the threshold line in order to generate an action potential

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28
Q

Are Electrical Synapses 1 direction?

A

No, 2 Directions; good or bad; if rogue cell in heart, random electrical impulses

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29
Q

What is the Node of Ranvier?

A

The spaces between the Myelin Sheath that are packed with Fast Na+ channels

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30
Q

Why are they named Astrocytes?

A

“They look like a star”

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31
Q

Purpose of Pseudounipolar Neuron?

A

Majority of sensor cells outside of spinal cord; sensory function that relays to the NS

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32
Q

Are Chemical Synapses faster or slower than Electrical Synapses?

A

Slower

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33
Q

Where in the Pseudounipolar Neuron is a decision made?

A

The Sensor

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34
Q

Myelinated Neuron Letter?

A

“A”

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35
Q

What does the Soma on a Pseudounipolar Neuron do?

A

Make proteins and replace things that need to be maintained

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36
Q

What is a Connexon?

A

A tube/cylinder protein that is implanted in the cell to conduct signals to other cells attached

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37
Q

Which directions can an action potential go on a cell?

A

Bidirectional

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38
Q

What Ion is Permeable in the Axon Hillock?

A

Cl-; suppress the CNS

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39
Q

What signs are a result of Hypocalcemia?

A

Trousseau and Chvostek Signs

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40
Q

What does Hypercalcemia do to Motor Neuron Activity?

A

Under activity of the Motor Neuron; decreased muscle contractions

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41
Q

What does Increased Gap Junctions mean for the Action Potential?

A

Decreased resistance for AP, so faster

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42
Q

Why is an action potential longer in the heart?

A

It allows for the heart to contract and pump blood; in seconds

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43
Q

Why would it be pointless if excitatory on Axon Hillock?

A

It would bypass the rest of the cell and interrupt the whole reason for making decisions

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44
Q

Which Vagus nerve releases ACh to the AV node?

A

L Vagus Nerve

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45
Q

What is an easier nerve to block?

A

Nerves that are located outside of a nerve bundle (not buried)

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46
Q

How does ACh and K react to each other?

A

ACh opens K channels, causing them to leave (makes cell more -)

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47
Q

How did Dr. Schmidt describe a Ca++ ion?

A

“Big and Clunky”

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48
Q

What do Dendrites do?

A

Receivers on the Soma; usually not myelinated

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49
Q

Where is the SA node located?

A

L side of Heart

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50
Q

How does ACh behave in Skeletal Muscle?

A

Excitatory

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51
Q

What is Demyelination?

A

Progressive loss of Myelin over time

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52
Q

What Neurotransmitter is located on the Axon Hillock?

A

GABA

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53
Q

In the Heart, how long is an Action Potential?

A

Seconds

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54
Q

What does Somatic Sensation mean?

A

“Able to be Sensed”

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55
Q

Guillain-Barre Syndrome

A

A lot of people Post-Covid got this, as their antibodies they built up were reacting and attacking their nervous system

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56
Q

What happens to the Fast Na+ and K+ channels that are located under the Myelin Sheath over time?

A

They disappear over time

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57
Q

Where do Paralytics work?

A

NMJ

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58
Q

What are support tissues/cells called in the NS?

A

Glial Cells

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59
Q

How do Pressure and Stretch Sensors work?

A

When flat and stretched, increased Na+ coming in, so Action Potential tells you there is pressure

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60
Q

Which takes more Local Anesthetic to block? Why?

A

Myelinated Cell; the density of Fast Na+ channels

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61
Q

Fast Adapting Sensors

A

Squeeze a ball and forget about it over time b/c brain does not need all this information; NS is concerned about change;

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62
Q

Another name for Neuron Cell Body?

A

Soma

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63
Q

Are Electrical Synapses faster or slower than Chemical Synapses?

A

Faster

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64
Q

Location of Electrical Synapses?

A

Myocardium, Smooth Muscle, Some Neurons

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65
Q

Are Schwann Cells good or bad at regenerating Myelin?

A

Good

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66
Q

Locations of Electrical Synapses?

A

Smooth Muscle, Myocardium, some Neurons

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67
Q

How many projections do Bipolar Neurons have?

A

2

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68
Q

Be Able to Label a Typical Neuron

A

Soma, Dendrite, Axon, Axon Hillock, Presynapsis, Postsynapsis, Myelin Sheath, Nodes of Ranvier

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69
Q

Normal MAP per lecture?

A

100 mmHg

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70
Q

What happens if Baroreceptors do not adapt?

A

If MAP jumps from 100 mmHg to 200 mmHg, without adaptation, then an action potential cannot fire any faster. This limits brain activity to get information from this high BP

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71
Q

Increased pressure = ? Na+ influx

A

Increased

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72
Q

What is Saltatory Conduction?

A

The Action Potential moving down a Myelinated Neuron

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73
Q

Where are Dendrites located?

A

Sticking out of the Soma

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74
Q

Purpose of Microglia Cells

A

Immune System in CSF cells; Macrophage that eats dead cells and clear up debris

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75
Q

What Ion is the “brakes” of the nervous system?

A

Cl-

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76
Q

What is Myelin derived from?

A

Sphingomyelin

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77
Q

Purpose of Multipolar Neuron?

A

Motor Neurons; Decision Making Cells (decides whether to fire an action potential or not)

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78
Q

Where is AV node located?

A

Top of Septum in Heart

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79
Q

What is very energy effecient?

A

Myelinated Neurons

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80
Q

Calcium Channels can also be called what?

A

L-Type channel

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81
Q

Important example of ADAPTATION?

A

Baroreceptors

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82
Q

How does Mg+ work in the cell?

A

Similar to Ca++; hyperpolarizes the cell; reduces electrical activity of the cell (heart)

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83
Q

Lightly Myelinated Neuron Letter?

A

“B”

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84
Q

Which Neuron Type is considered the “decision making cell”?

A

Multipolar Neuron

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85
Q

Examples of Pressure and Stretch Sensors?

A

Pacinian Corpuscle, Meissner’s Corpuscle

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86
Q

Brain tumors are called __?

A

Glial Tumors

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87
Q

What is an Axon Hillock?

A

Beginning of an Axon; GABA mediated to suppress electrical activity in the CNS

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88
Q

What will an antimuscarinic do to the heart?

A

Increases HR; closes K+ channels, which makes cell more (+)

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89
Q

Neuron Action Potential Pathway

A

Brain/SC - Motor Neuron - Action Potential - Neurotransmitter released at NMJ

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90
Q

How does ACh behave in the Heart?

A

Inhibitory

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91
Q

What shape is nACh-R?

A

Doughnut shaped (-) charged; attracts (+) Na to start AP

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92
Q

Without the Nervous System, what would be the normal HR per lecture?

A

110 b/min

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93
Q

What Does Myelin Sheaths do to Na+ channels?

A

Blocks the Na+ channels, sending Na+ down the line to the Nodes of Ranvier

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94
Q

Motor Neurons need a ? to talk to skeletal muscle?

A

Neurotransmitter

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95
Q

What does Myelin help the cell?

A

Increased protection, saves energy by blocking the NaKATP pump, speeds up signal transduction

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96
Q

Are Oligodendrocytes good or bad at regenerating Myelin?

A

Bad

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97
Q

Non-Myelinated Neuron Letter?

A

“C”

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98
Q

How long does it take a Baroreceptor to adapt?

A

2 days (slow)

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99
Q

What does Massive Vagus Stimulation do to the HR?

A

Slows HR, b/c causes Hyperpolarization

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100
Q

When you lose Myelin, what happens to the NaKATP pumps?

A

The continuously pump Na+ like normal, but since nothing to keep them in, will never reach the Node of Ranvier; signal will not be sent (paralysis)

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101
Q

What does Decreased Gap Junctions mean for the Action Potential?

A

Increased resistance for AP, so slower

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102
Q

How many Connexins make a Connexon?

A

6

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103
Q

Overall Faster Cell Signaling?

A

Shorter Nerve, Wider Diameter, Increased Insulation

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104
Q

What happens if you lose Myelin in your CN2 or Retina?

A

Blind or trouble seeing

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105
Q

What happens if there are decreased Gap Junctions?

A

Increased resistance for AP; some places in heart do this intentionally to pause/delay

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106
Q

What would a Big,Myelinated Neuron be good for?

A

Motor Neuron; Left side of Chart

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107
Q

What structures are included in the CNS?

A

Optic Nerve (CN2), Retina, Brain, Spinal Cord

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108
Q

Where is Muscarine found, per lecture?

A

Rainforests

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109
Q

What makes a cell less prone to ischemia?

A

Myelin

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110
Q

Per lecture, how many neurons can a neuron connect with?

A

10,000 (all connections influence what the cell does)

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111
Q

Is an Action Potential a (-) or (+) feedback?

A

(+) feedback

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112
Q

Example of Bipolar Neuron in the body?

A

Photoreceptors in the Optic Nerve and Retina

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113
Q

Where do Paralytics work?

A

NMJ

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114
Q

Purpose of Bipolar Neuron?

A

SPECIALIZED Senses; sense info and sends to NS

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115
Q

What Does Hypocalcemia do to Motor Neuron Activity?

A

Increased Na+, as it does not block the leaky Na+ channels; Increases Motor Neuron Activity (increased muscle activity)

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116
Q

Is Electrical Synapse diffusion or active transport?

A

Simple Diffusion

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117
Q

Which receptor suppresses electrical activity in the heart?

A

mACh-R

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118
Q

3 Types of Neurons?

A

Multipolar, Pseudounipolar, Bipolar

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119
Q

When a cell is flattened, what happens to the Fast Na+ Channels?

A

They are increased, which increases action potentials

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120
Q

What does ACh effect in the heart?

A

Pacemaker activity of heart (70-72 b/min)

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121
Q

What is a Free Nerve Ending?

A

Pain Sensor

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122
Q

What is in the Soma of a Neuron?

A

Nucleus, mitochondria, etc

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123
Q

If the Nervous System does not need 100 million neurons, what will it do?

A

Try to get rid of the ones it does not need

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124
Q

What part of the Astrocyte binds to the endothelial cells/capillary?

A

Astrocytic Infoot

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125
Q

How does Ca++ help in Hyperkalemia?

A

Ca++ will block Na+ permeability, making the Cell more (-); if the cell is more (-), will pull in K+ ions

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126
Q

Purpose of Ependymal Cells

A

Produce CSF; moves it downstream via cilia to circulate

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127
Q

What is another name for a Free Nerve Ending?

A

Nociceptor

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128
Q

Purpose of Golgi Tendon Apparatus?

A

On skeletal or smooth muscle to let body know how muscles are doing and moving

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129
Q

4 Causes of Demyelinating Diseases?

A

Genetics, infection, autoimmune, polyneuropathies

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130
Q

What happens if an alcoholic stops drinking?

A

GABA is not released anymore, so crazy CNS involvement; Increased +, so seizures and DTs

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131
Q

What happens to an action potential when there is an increased strength of a stimulus?

A

Increased action potential speed

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132
Q

What happens to Na+ when the cell is flattened/widened?

A

Increases the amount of Na+ channels, which increases amount of action potentials

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133
Q

What do 2 Connexons make?

A

Gap Junction

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134
Q

What are included in the PNS?

A

Everything outside of the Spinal Cord

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135
Q

Which Vagus nerve releases ACh to the SA node?

A

R Vagus Nerve

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136
Q

What is Dihydropyridine (DHP)?

A

A class of CCB, specifically for smooth muscle and heart. Vasodilator with little effect upon cardiac contractility

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137
Q

Purpose of Astrocytes

A

BBB support; maintain/buffer electrolyte balance within CNS (CSF);wrapped around BBB tight junction and capillaries

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138
Q

What are the subunits of “A”? - Order largest to smallest

A

Alpha, Beta, Gamma, Delta

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139
Q

Alcohol is a __ Agonist?

A

GABA

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140
Q

Superior

A

Head (top)

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141
Q

Inferior

A

Feet (bottom)

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142
Q

Dorsal

A

Back (posterior); fin of a dolphin or shark

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143
Q

Ventral

A

Front (anterior)

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144
Q

Anterior

A

Front

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145
Q

Posterior

A

Back

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146
Q

Medial

A

Middle

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147
Q

Lateral

A

Side

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148
Q

Rostral

A

Front and Upper (think Beak of a Bird)

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149
Q

Caudal

A

Lower and Rear (Tail of a Bird)

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150
Q

Distal

A

Further from NS

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151
Q

Proximal

A

Closer to NS

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152
Q

CNS Divisions: 4 Parts

A
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153
Q

Superficial

A

Closer to skin

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154
Q

Deep

A

Deeper in skin

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155
Q

Sagittal

A

Cut from L to R side of body (median); line right down the middle

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156
Q

Coronal

A

Cut Anterior to Posterior

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157
Q

Horizontal

A

Cut Superior to Inferior (head to feet)

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158
Q

Oblique

A

“Goofy or Odd Angle”

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159
Q

CNS: Telencephalon

A

The cerebral hemispheres or cortex; the upper and outer part of the brain

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160
Q

CNS: Diencephalon

A

The more inner part; middle between the Telencephalon and Brain Stem

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161
Q

CNS: 3 parts of Brainstem

A

Midbrain, Pons, Medulla Oblongata

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162
Q

Another name for Telencephalon?

A

Cerebral Hemispheres

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163
Q

Another name for Midbrain in Brain Stem? Location?

A

Mesencephalon; top of Brain Stem

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164
Q

Shape of Pons in Brain Stem? Location?

A

Olive Shaped Structure;

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165
Q

Lowest Level of Brain Stem?

A

Medulla Oblongata

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166
Q

What is a Sulcus?

A

It is a “groove” on the brain

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167
Q

What is a Gyrus (Gyri)?

A

“Lump” on brain; lumps of neurons and tissue

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168
Q

What is a Fissure?

A

“Really Deep Groove”

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169
Q

What do Grooves separate?

A

Groups of Tissue

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170
Q

What does the Frontal Lobe do?

A

It is the Thinking System of the brain; also, when you are “thinking to yourself”

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171
Q

What are the 4 Major Lobes?

A

Frontal, Parietal, Occipital, Temporal (separated by Sulci/Grooves)

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172
Q

What does the Parietal Lobe do?

A

Somatosensory (pain); located behind (posterior/dorsal) to the Frontal Lobe

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173
Q

Where is the Parietal Lobe in location to the Frontal Lobe?

A

Posterior/Dorsal

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174
Q

What does the Occipital Lobe do?

A

Vision processing and visual cortex; dorsal/posterior to Frontal

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175
Q

Where is the Occipital Lobe in relation to the Frontal Lobe?

A

Dorsal/Posterior

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176
Q

What does the Temporal Lobe do?

A

Auditory processing; located on Lateral side; “language listening and determining who is singing the song”

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177
Q

Major Landmarks in the Brain Divisions?

A

Central Sulcus and Temporal/temporolateral Fissure

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178
Q

What is the main anatomical marker when dissecting a brain?

A

The Central Sulcus

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179
Q

Why is the Temporal Fissure Important?

A

It separates the Temporal Lobe from the Frontal/Parietal Lobes

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180
Q

Why is the Precentral Gyrus Important?

A

It is the Primary Motor Cortex

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181
Q

Where is the Precentral Gyrus in relation to the Frontal Lobe?

A

It is Posterior to the Frontal Lobe

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182
Q

Why is the PostCentral Gyrus important?

A

It is the sematosensory portion of the parietal lobe

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183
Q

Where is the PostCentral Gyrus in relation to the Central Sulcus?

A

It is Posterior to the Central Sulcus

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184
Q

Why is the Longitudinal Fissure Important?

A

It separates the Left and R hemispheres

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185
Q

What does the Corpus Callosum do?

A

Cross Talk Communication between both sides of the brain

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186
Q

Where is the PreCentral Gyrus in relation to the Central Sulcus?

A

It is Anterior to the Central Sulcus

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187
Q

Why is the Corpus Callosum a lighter color on the diagram, per lecture?

A

It shows that it has a lot of myelinated neurons for cross talking

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188
Q

Per lecture, how do you expose the Corpus Callosum on the brain diagram?

A

Cut it in half with a saw

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189
Q

Per lecture, where does a concussion damage the brain?

A

Damages the gray areas of the brain; leads to decreased process in that area

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190
Q

What is the CSF a buffer between?

A

The Brain and the Cranium

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191
Q

Where is Gray Matter in relation to White Matter?

A

Superficial (closer to the cranium)

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192
Q

Where is White Matter compared to Gray Matter in the brain?

A

Deep to Gray Matter

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193
Q

Why is it easy to get blood flow to the Gray Matter?

A

The blood vessels are on the outside, so close in proximity to the Gray Matter

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194
Q

Why is Broca’s Area important?

A

The act of speaking and thinking about word formation/speaking is done here

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195
Q

Why is Wernicke’s Area Important?

A

Area where language comprehension is processed

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196
Q

Why is the Motor Cortex Important?

A

It is the primary acting on the action of motor functions

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197
Q

Why is the Limbic System Important?

A

It is the Emotional responses

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198
Q

Where are the Motor Plans Executed?

A

Back of the Frontal Lobe (Posterior, Dorsal)

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199
Q

Where are the Motor Plans Thought of?

A

Front of the Frontal Lobe (Anterior, Ventral)

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200
Q

What is White Matter?

A

Myelinated; generally axons; not many cell bodies; important for SENDING AND RECEIVING DECISIONS

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201
Q

T or F: The Spinal Cord does not have reflex decision making or problem-solving abilities

A

False

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202
Q

What is Gray Matter?

A

Unmyelinated; Butterfly shape; axons and dendrites; important for DECISION MAKING CENTER

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203
Q

Is Gray Matter Myelinated or Unmyelinated?

A

Gray Matter is Unmyelinated

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204
Q

Is White Matter Myelinated or Unmyelinated?

A

White Matter is Myelinated

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205
Q

What is the Anterior White Commissure (X-Over)? (AWC)

A

White portion of the spinal cord cross section that allows for signals to get from the L–> R side of the spinal cord (vice versa)

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206
Q

What shape is Gray Matter?

A

Butterfly shape

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207
Q

Describe the Posterior Median Sulcus

A

Really deep but narrow

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208
Q

Why is there a color difference in White and Gray Matter?

A

The myelination shows as a lighter color

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209
Q

Describe the Anterior Median Fissure

A

Wider (has an artery to wedge inside)

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210
Q

What are the 2 parts of Gray Matter?

A

Dorsal Horns and Ventral Horns

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211
Q

What are Dorsal Horns?

A

In the back of Gray Matter; have cell bodies on it; used for SENSORY

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212
Q

What are Ventral Horns?

A

In the front of Gray Matter; has cell bodies on it; used for MOTOR FUNCTION

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213
Q

Which access is easiest to get to the Dorsal Horns of Gray Matter?

A

Superficial Approach (epidurals, spinals)

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214
Q

Which way does information get into the Gray Matter?

A

Comes in from a horizontal direction, then jumps from Dorsal to Ventral horns

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215
Q

What is the Central Canal?

A

The center part of the gray matter that is responsible for producing the CSF and moving it down the Spinal Cord

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216
Q

What Surrounds the Central Canal?

A

Lamina 10

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217
Q

What Cells are in the Central Canal?

A

Ependymal Cells (CSF producing and Cilia moves it)

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218
Q

Lamina 10

A

The Gray Matter L and R side of cord connection; surrounds the Central Canal; made of Commissures

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219
Q

What is the Lateral Horn (Visceromotor)?

A

Random horn Dr. Schmidt pointed out in lecture

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220
Q

What is the Anterior Approach to blood supply in the Spinal cord?

A

Intercostal Arteries

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221
Q

What is the Posterior approach to blood supply in the Spinal Cord?

A

Upper Neck and Brain Stem

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222
Q

A Spinal Nerve is __ + __?

A

Posterior Rootlets + Anterior Rootlets

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223
Q

What functions do Spinal Nerves contain?

A

Sensory and Motor Function

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224
Q

Where are Posterior Rootlets attached?

A

Dorsal Horns

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225
Q

Where are Anterior Rootlets attached?

A

Ventral Horns

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226
Q

What are Posterior Rootlets used for?

A

SENSORY FUNCTION

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227
Q

What are Anterior Rootlets used for?

A

MOTOR FUNCTION

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228
Q

Where do all the Posterior Rootlets meet at?

A

The Posterior Root

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229
Q

Where do all the Anterior Rootlets meet at?

A

The Anterior Root

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230
Q

What is the Spinal Ganglion?

A

Where the big collection of cells on the posterior root side congregate

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231
Q

What type of Neurons are located on the Spinal Ganglion? Why?

A

Pseudounipolar Neurons; these are the sensory neurons so help with sensory signals being sent up the posterior side (to the Dorsal Horn)

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232
Q

What is the Primary purpose of the Descending Spinal Tract?

A

Motor Response

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233
Q

What is the Primary Purpose of the Ascending Spinal Tract?

A

Sensory

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234
Q

5 sections of the Spine?

A

Cervical, Thoracic, Lumbar, Sacral, Coccygeal

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235
Q

How many Vertebrae are located within the Cervical Region?

A

7 vertebrae

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236
Q

How many Pairs of Spinal Nerves are located within the Cervical Region?

A

8 spinal nerve pairs

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237
Q

Where are the spinal nerve pairs in the Cervical region compared to the location of the Cervical Vertebrae?

A

The 1st 7 pairs are above their vertebrae; the 8th is below the 7th vertebrae, setting up for the rest of the vertebrae and their nerve pairs

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238
Q

How many vertebrae are in the Thoracic region?

A

12 vertebrae

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239
Q

How many vertebrae are in the Sacral region?

A

5 vertebrae

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240
Q

How many spinal nerve pairs are in the Thoracic Region?

A

12 nerve pairs

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241
Q

How many Vertebrae are in the Lumbar region?

A

5 vertebrae

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242
Q

How many spinal nerve pairs are in the lumbar region?

A

5 spinal pairs

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243
Q

How many spinal nerve pairs are you born with in Coccygeal?

A

2, combine to 1 as you grow older

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244
Q

How many pairs of spinal nerves are in the sacral region?

A

5 pairs of spinal nerves

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245
Q

How many spinal nerve pairs are in the Coccygeal region?

A

1 pair

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246
Q

Where are the spinal nerve pairs located in relation to the vertebrae (excluding cervical spine)?

A

they originate under their vertebrae

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247
Q

What are Dermatomes? Dermatome Man?

A

The regions of the body split up by spinal nerves; the guy bend over with different colored regions of nerves

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248
Q

From a frontal view, what kind of curve is Thoracic Kyphosis?

A

Concave Curve

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249
Q

What are C2,C3 for?

A

Sensors for head and neck

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250
Q

What is Cervical Lordosis?

A

A natural occurring anterior curve of the neck

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251
Q

From a frontal approach, what kind of curve is Cervical Lordosis?

A

Convex Curve

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252
Q

What is Thoracic Kyphosis?

A

A natural posterior curve; if increased, leads to “hunchback”

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253
Q

What is Sacral Kyphosis?

A

A natural posterior curve

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254
Q

From a frontal view, what kind of curve is Sacral Kyphosis?

A

Concave curve

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255
Q

What is Scoliosis? What type of curve?

A

The lateral curvature of the spine; L–R; abnormal

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256
Q

What is Kyphotic Curvature?

A

Outward curve to force concave curve (from the front)

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257
Q

What is Lordotic Curvature?

A

Inward curve to force convex curve (from the front)

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258
Q

Is pathologic Lordosis normal or bad?

A

BAD

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259
Q

Is pathologic Kyphosis normal or bad?

A

BAD

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260
Q

What shape is the spine normally, per lecture?

A

“S” shaped

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261
Q

What is the most common abnormal curvature?

A

Kyphoscoliosis

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262
Q

What curvature are we born with? Which one do we develop as we get older?

A

We are born with kyphotic curves (thoracic); as we grow older, we develop Lordotic curves (cervical)

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263
Q

What is considered “hunchback”?

A

Increased Thoracic Kyphosis (think old ladies)

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264
Q

Why can a baby not hold their head up?

A

They do not have Cervical Lordosis yet; to be developed

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265
Q

What is Lumbar Lordosis?

A

A natural anterior curve

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266
Q

From a frontal view, what type of curve is lumbar lordosis?

A

Convex curve

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267
Q

What is the Vertebral Body of the Vertebrae?

A

the weight supporting part of the vertebrae; intervertebral discs sit on this

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268
Q

What are the 2 parts of the Vertebral Branch?

A

the Pedicle and the Lamina

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269
Q

What is the Superior Articular Process?

A

Superior from the Arch; connects with the Inferior Articular Process from the superior vertebrae (up above)

270
Q

What is the Inferior Articular Process?

A

Inferior to the Arch; connects with the posterior vertebrae (from below)

271
Q

What is a “Process”

A

A bony extension

272
Q

What is the Transverse Process?

A

the 2 bony extensions that stick out of both directions

273
Q

What is the Spinous Process?

A

The palpable portion of the vertebrae; the back (dorsal/posterior) portion of the vertebrae

274
Q

In the lower back, are the Vertebral Bodies bigger or smaller? Why?

A

Bigger; have to hold more weight

275
Q

In the upper back, are the Vertebral Bodies bigger or smaller? Why?

A

Smaller; have to hold less weight

276
Q

What is the palpable portion of the vertebrae?

A

The Spinous Process

277
Q

What is the Vertebral notch?

A

The area where the spinal nerves rest/stick out

278
Q

Where is the vertebral notch in comparison to the pedicle?

A

Inferior to the Pedicle

279
Q

What is the “gray” on the Interior Articular Facet?

A

Cartilage

280
Q

Where is the Lamina compared to the Pedicle in this picture?

A

Posterior to the pedicle

281
Q

What is the Inferior Articular Facet?

A

The joint

282
Q

What is a Foramen?

A

An opening

283
Q

What is the Vertebral Foramen?

A

The opening where the spinal cord would hang out; wider in cervical

284
Q

Where do the Carotid Arteries Pass through?

A

The Anterior Portion of the body

285
Q

What do the Vertebral Arteries Feed?

A

The brain and spinal cord

286
Q

Where do the Vertebral Arteries pass through?

A

C1-C6 transverse foramen

287
Q

Where do the Vertebral Arteries not pass through?

A

The C7 transverse foramen

288
Q

How is a spinous process in the Cervical region different than the other regions?

A

it is Bifid in nature, rather than single process (besides C7)

289
Q

What does Bifid mean?

A

2 bony projections

290
Q

C2-C5 Spinous Process?

A

Bifid, almost always

291
Q

C6 Spinous Process?

A

50% bifid, 50% chance to be singular

292
Q

C7 Spinous Process?

A

0.3% people have a Bifid C7

293
Q

Pedicle

A

1st part of the Vertebral Branch; spinal nerves sit here

294
Q

3 Structures only in the Cervical Vertebrae?

A

Transverse process with Sulcus for Spinal Nerve, Bifid Spinous Process, Transverse Foramen for Vertebral Arteries

295
Q

Describe Sulcus for Spinal Nerve

A

Hollow, Divet, Groove

296
Q

What is the C1 also called?

A

The Atlas

297
Q

What is the C2 also called?

A

The Axis

298
Q

What does the C1 do?

A

Bares the weight of the skull, so has a unique connection

299
Q

What is Broca’s Area?

A

The region where speaking and word formation is processed

300
Q

What is Wernicke’s Area?

A

Area where language comprehension is processed

301
Q

What is the Motor Cortex?

A

The area where motor function is processed and completed

302
Q

What is the Limbic System?

A

Area on Temporal Lobe that is responsible for emotional responses

303
Q

Where does the Execution of Motor Plans take place?

A

Back of the Frontal Lobe (posterior/dorsal)

304
Q

Where does the Thinking of Motor Plans take place?

A

Front of the Frontal Lobe (Anterior, ventral)

305
Q

Which receptors undergo reverse adaptation?

A

Nociceptors

306
Q

2 Ways to stop pain in nociceptors before it gets too bad?

A

Take your scheduled pain meds and nerve block the area

307
Q

Which way would a magician cut their assistant?

A

Horizontal Plane

308
Q

What are the 2 parts of the Diencephalon?

A

Thalamus and Hypothalamus

309
Q

Diencephalon: Thalamus

A

Relay Center between Cerebral Hemispheres and Brain Stem

310
Q

Diencephalon: Hypothalamus

A

sensory and control center, osmo receptors, body temp receptors

311
Q

Where is the Hypothalamus in comparison to the Thalamus?

A

Deep

312
Q

Where is the Diencephalon compared to the Telencephalon?

A

Inferior; Deep

313
Q

Where is the Diencephalon to the Brainstem?

A

Superior; Superficial

314
Q

Which structure separates the Frontal from the Parietal Lobe?

A

The Central Sulcus

315
Q

Which structure separates the Temporal Lobe from the Frontal and Parietal Lobes?

A

Temporolateral Fissure

316
Q

What Lobe is Broca’s Area a part of?

A

Frontal Lobe

317
Q

What lobe is Wernicke’s area a part of?

A

Temporal Lobe

318
Q

Is Broca’s Area motor or sensory?

A

Motor

319
Q

Is Wernicke’s Area Motor or Sensory?

A

Sensory

320
Q

What Lobe is the Frontal Cortex in?

A

Frontal Lobe

321
Q

How Wide is the Spinal Cord, per lecture?

A

No wider than the size of a quarter

322
Q

Where is the PostCentral Gyrus in relation to the Parietal Lobe?

A

The most Anterior Portion of the Parietal Lobe

323
Q

What is the Location of the Motor Cortex?

A

Anterior to the Central Sulcus; most Posterior part of the Frontal Lobe

324
Q

What Lobe is the Limbic System located on?

A

Temporal Lobe

325
Q

What makes the Gray Matter darker than White Matter?

A

Less Myelin and More Cell bodies (make it darker)

326
Q

Is Lamina 10 Gray or White Matter?

A

Gray Matter

327
Q

Are the main blood vessels for the brain superficial or deep?

A

Superficial; easier to supply to Telencephalon

328
Q

What structures separate L and R side of the spinal cord?

A

Posterior and Anterior Median Sulcus/Fissure

329
Q

Where is CSF produced?

A

The brain

330
Q

Is the Anterior White Commissure (X-Over) White or Gray Matter?

A

White Matter

331
Q

How is CSF sent from the Brain down the Spinal Cord?

A

The Central Canal in the Spinal Cord

331
Q

Neck: Posterior and Occipital

A

1.) Occipital Condyle
2.) Dens of Axis
3.) Atlas (C1)
4.) Axis (C2)
* Pivot Points - Nod up and down

332
Q

Ascending Pathway

A

Up the Brainstem and Spinal Cord (posterior, lateral, anterior cord)

333
Q

Why is there no Anterior Spinal Ganglion?

A

No Anterior Ganglion b/c cell bodies anterior are located in Anterior horn, so no extra cells to give (motor function), per lecture

334
Q

Where are Descending Pathways on the Cord?

A

Lateral and Anterior areas

335
Q

Where do the Inferior Articular Process and Superior Articular Process meet?

A

The Inferior Articular Facet

336
Q

Why is the Cervical Vertebral Foramen Wider than others?

A

The top of the Spinal Cord is larger towards the neck

337
Q

Name the structures

A

1) Soma
1a) Integrates signal
1b) Cellular machinery
2) Dendrites
2a) Receives and processes signal
3) Axon hillock
4) Myelin
5) Node of Ranvier
6) Axon
6a) Sends signal
7) Presynaptic terminal
7a) Releases neurotransmitters

338
Q

Name the structures

A

1) Brain stem
1a) Midbrain (mesencephalon)
1b) Pons
1c) Medulla oblongata
2) Telencephalon (cerebral hemisphere)
3) Diencephalon
4) Cerebellum
5) Spinal cord

339
Q

Name the structures

A

Grey Matter:
A) Dorsal Horns
B) Ventral Horns
C) Posterior medial sulcus
D) Anterior medial sulcus
E) Central Canal
F) Lamina 10 (grey portion); White portion is AWC

340
Q

Brain Superficial view
Name the structures

A
  1. Frontal lobe
  2. Lateral sulcus
  3. Temporal lobe
  4. Pons
  5. Medulla oblongata
  6. Cerebellum
  7. Occipital lobe
  8. Post Central gyrus
  9. Central sulcus
    10) precentral gyrus
341
Q

Brain: Coronal X-Sectional View
Name the structures

A
  1. Cerebral cortex
  2. Caudate nucleus
  3. Putamen
  4. Globus pallidus
  5. White matter
  6. Claustrum
  7. Amygdala
  8. Diencenhalon
342
Q

Brain Sagittal X-Section:
Name the structures

A
  1. Cingulate gyrus
  2. Pineal
  3. Corpus callosum
  4. Hypothalamus
  5. Hypophysis
  6. Pons
  7. Cerebellum
  8. Medulla oblongata
  9. Occipital lobe
343
Q

Spinal Nerves Detail

A

What do the red arrows indicate? Dorsal: Sensory
Ventral: Motor
Answer Blank Lines: Posterior Rootlets, Posterior Root, Spinal Ganglion, Anterior Rootlets, Anterior Root

344
Q

Cervical Vertebra

A

Vertebral Foramen, Lamina, Pedicle, Transverse Process with Sulcus for spinal nerve, Spinous Process, Superior Articular Facet, Transverse Foramen

345
Q

Ascending Spinal Tract

A

Rear of the Cord, Horizontal Cross-Section, White = ?

346
Q

CSpine Vasculature

A

Vertebral Transverse Foramen, Atlas, Axis, Transverse Process, Spinal Nerve in Sulcus, C7 Spinal Nerve, Vertebral Artery

347
Q

Dermatome Man

A

C2-C3 Sensory head and neck, T1,T2, L1-L5, S1,S5

348
Q

Descending Pathway

A

Laterial and Anterior Portions

349
Q

Spinal Curvature

A

Cervical Lordosis, Thoracic Kyphosis, Lumbar Lordosis, Sacral Kyphosis

350
Q

Vertebra Superior View

A

Spinous Process, Superior Articular Facet, Transverse Process, Superior Articular Process, Vertebral Foramen, Vertebral Arch, Body, Nerve Roots

351
Q

Normal Vertebral Anatomy

A

Vertebral Body, Vertebral Arch (pedicle, lamina), Superior/Inferior Articular Process, Spinous Process, Transverse Process

352
Q

Lateral Vertebral Anatomy

A

Body, Pedicle, Vertebral Notch (inferior), Inferior/Superior Articular Process, Spinous Process, Inferior Articular Facet

353
Q

Posterior Body View

A

1.) Iliac Crest
2.) Posterior Superior Iliac Spine
3.) Greater Trochanter of Femur

354
Q

Spinal Cord: Lateral View

A

1.) Inferior Costal Facets
Red Circles

355
Q

Thorax: Anterior View

A

1.) Sternum
a.) Manubrium
b.) Body
c.) Xiphoid Process

356
Q

Sacrum: Posterior View

A

1.) Posterior Sacral Foramen
2.) Sacral Canal
3.) Superior Articular Facet
4.) Lateral Sacral Crest
5.) Median Sacral Crest
6.) Medial Sacral Crest
7.) Sacral Hiatus
8.) Sacral Cornua

357
Q

Neck: Ligaments

A

1.) Anterior Atlanto-Occipital Ligament
2.) Posterior Atlanto-Occipital Ligament
3.) External Occipital Protuberance

358
Q

Neck: Posterior and Occipital

A

1.) Occipital Condyle
2.) Dens of Axis
3.) Atlas (C1)
4.) Axis (C2)
* Pivot Points - Nod up and down

359
Q

Spinal Ligaments

A

1.) Anterior Longitudinal Ligament
2.) Posterior Longitudinal Ligament
3.) Ligamentum Flava
4.) Interspinous Ligament
5.) Supra Spinous Ligament
6.) Inter Transverse Ligament

360
Q

Posterior Pelvis

A

1.) Iliolumbar Ligament
2.) Supraspinous Ligament

361
Q

Spinal Meninges

A

1.) Pia Mater
2.) Arachnoid Mater
3.) Subdural Space
4.) Dura Mater

362
Q

Intervertebral Discs

A

1.) Anulus Fibrosus
2.) Nucleus Pulposus
3.) Hyaline Cartilage End Plate

363
Q

Neck Ligaments

A

1.) Supraspinous Ligament
2.) Nuchal Ligament

364
Q

Rib Articulations

A

1.) Costal Facet (transverse process)
2.) Costal Tubercle
3.) Joint of Head Rib
Shape? Heart shape body
Aorta? compresses L side of vertebral bodies of T spine

365
Q

Disc Herniation

A

1.) Nucleus Pulposus
2.) Postolateral Herniation
3.) Spinal Nerve

366
Q

Anterior Pelvis

A

1.) Pubic Tubercle
2.) Promontory
3.) Anterior Superior and Inferior Iliac Spines

367
Q

Posterior Pelvis

A

1.) Iliac Crest
2.) Posterior Superior and Inferior Iliac Spines
3.) Sacral Canal

368
Q

Thoracic Vertebrae

A

1.) Body
2.) Inferior Costal Facet
3.) Inferior Articular Facet
4.) Spinous Process (diagonal)
5.) Costal Facet on Transverse Process
6.) Transverse Process
7.) Superior Articular Facet
8.) Superior Costal Facet

369
Q

Lumbar Spine

A

1.) InterVertebral Foramen
a.) Inferior Vertebral Notch
b.) Superior Vertebral Notch
2.) Inferior Articular Facet
3.) Spinous Process

370
Q

Neck MRI

A

1.) Apex of Dens (C2)
2.) Nuchal Ligament

371
Q

Spinal Cord

A

1.) Inter Transverse Ligament
2.) Posterior Longitudinal Ligament
3.) Anterior Longitudinal Ligament
4.) Ligamenta Flava
* Which structure was taken off for exposure? The vertebral Body

372
Q

Axis Superior

A

1.) Dens
2.) Transverse Process
3.) Spinous Process
4.) Vertebral Arch
5.) Transverse Foramen

372
Q

Lateral Sacrum

A

1.) Promontory

373
Q

Atlas

A

1.) Posterior arch
2.) Superior Articular Facet
3.) Facet for Dens
4.) Anterior Tubercle
5.) Anterior Arch
6.)Transverse Foramen
7.) Transverse Process
8.) Posterior Tubercle

374
Q

Anterior Sacrum

A

1.) Promontory
2.) Superior Articular Process
3.) Anterior Sacral Foramen
4.) Transverse Lines

375
Q

Rib

A

1.) Neck
2.) Head
3.) Costal Tubercle

376
Q

Axis Lateral View

A

1.) Anterior Articular Facet
2.) Dens

377
Q

Why is the C1 name Atlas, per lecture?

A

Atlas was the God who held the world on his shoulders

378
Q

Does the Atlas have a vertebral body?

A

No; Anterior Arch instead

379
Q

Does the Axis have a vertebral body?

A

Yes

380
Q

How do C1 and C2 connect?

A

On the anterior arch; C1 has a Facet for the Dens (posterior) for the Dens of C2 (anterior)

381
Q

How does C1 connect with the base of the skull?

A

C1 - Superior Articular Facets; Skull - Occipital Condyles (inferior)

382
Q

What is the Foramen Magnum?

A

Opening in the inferior skull for the spinal cord

383
Q

What are the Atlanto-Occipital Ligaments for?

A

Ant/Post - connect top of the spine together in the Foramen Magnum

384
Q

What is the Dens of Axis? Where is it located?

A

Connects C2 with C1 in the Posterior Anterior Arch (C1); located on superior portion of C2

385
Q

How are we able to “Nod up and down”?

A

Pivot points located on Base of Skull and C1

386
Q

How are we able to move our head side to side?

A

Swivel point on Dens of Axis (bone to bone connection, but flexible)

387
Q

Spinal Ligament: Anterior Longitudinal Ligament

A

Anterior portion of vertebral body; runs from sacrum to skull; made of collagen

388
Q

Spinal Ligament: Posterior Longitudinal Ligament

A

Posterior portion of vertebral body; made of collagen

389
Q

Spinal Ligament: Supraspinatous Ligament

A

On top of spinous process all the way down spinal cord; made of collagen

389
Q

Spinal Ligament: Inter-transverse Ligament

A

Links tips of transverse processes together; made of collagen

390
Q

Spinal Ligament: Interspinous Ligament

A

connects spinal processes together; more cover area than; made of collagen

391
Q

Spinal Ligament: Ligamentum Flava

A

connects anterior arches of vertebrae together; more stretchy and elastic (yellow color to show this); when poking with a needle, can feel a change in resistance

392
Q

On the Spinal Ligaments Anterior view, which structure was removed to show the underlying structures? Per lecture

A

the vertebral bodies were removed and pedicles were cut

393
Q

What is the midline opening/incomplete fusion in the spinal cord ligaments?

A

Most people have this, so when approaching cervical spine, go at a different angle to avoid hitting “empty” space

394
Q

How does Dr. Schmidt describe the appearance of the Nuchal Ligament?

A

Fan-Like/ shape

394
Q

What is the Nuchal Ligament?

A

The extension of the interspinous ligaments in the back of the neck; fan-like structure

395
Q

What does the Posterior Atlanto-Occipital Ligament connect together?

A

The Arch of C1 and the posterior part of the Foramen Magnum @ base of the skull

396
Q

What is the External Occipital Protuberance?

A

The nuchal ligament connects with the supraspinous ligament at the base of the skull

397
Q

How does Dr. Schmidt describe a protuberance?

A

A nub or raised bump

398
Q

What is the anatomical marker located on C7/T1?

A

Vertebral Prominens

399
Q

According to Dr. Schmidt, which vertebral body is bigger? C7 or T1? What does the textbook say?

A

Schmidt - T1>
Textbook - C7>

400
Q

What is different about the Thoracic vertebrae?

A

It is sloped at a downward angle, so must go in at a different angle than midline

401
Q

How many ribs do we have?

A

24, 12 pairs

402
Q

How does Dr. Schmidt describe the Thoracic Spine?

A

Very strong and robust, do to all the connections

403
Q

What does Robust mean?

A

Strong

404
Q

How many connections do most ribs have on the T-spine?

A

2; body of thoracic vertebrae and transverse process

405
Q

What are our true ribs?

A

Pairs 1-7

406
Q

What are the False ribs?

A

Pairs 8,9,10

407
Q

What are the floating ribs?

A

Pairs 11,12

408
Q

Why are they called false ribs?

A

They connect to the 7th rib’s cartilage, rather than the sternum itself

409
Q

What are the 3 parts of the Sternum?

A

Manubrium, body, xiphoid process

410
Q

How would a rib connect to a thoracic vertebrae? Specific example

A

Head attaches to superior costal facet of T7 and inferior costal facet of T6

411
Q

Where does the Neck of the rib combine with the transverse process of T spine?

A

The costal tubercle

412
Q

What is the T-spine body shape, per lecture

A

Heart

413
Q

Per lecture, why is the left side of the T-Spine vertebral body flat?

A

The Aorta compresses it

414
Q

What can you have a pt do to open up the L-spine further?

A

Make them lean forward

415
Q

How does L5 connect with S1?

A

L5 inferior articular facet and S1 superior articular facet

416
Q

What are the Intervertebral Foramen?

A

Inferior and Superior Vertebral Notch; come off the pedicle and give a space for spinal nerves to leave the spine

417
Q

How many Sacral Vertebrae are we born with?

A

5; fused by 14-15 years

418
Q

What do Sacral Transverse Lines Show?

A

Fusion of the 5 Sacral Vertebrae

418
Q

Why is the Sacral Promontory Important?

A

Has intervertebral disk sitting on it and helps bind S1 to L5

419
Q

Why is the Sacral Canal important?

A

The spinal ligaments and spinal nerves exit here

420
Q

How many anterior/posterior foramen do we have?

A

8 front/ 8 back (4 each side)

421
Q

What are the directions for a S2 block, after finding the anatomical marker?

A

Down 1 cm, midline 1 cm - right at S2

421
Q

What is the Anatomical Marker for a S2 block?

A

Posterior Superior Iliac Spine

422
Q

What is the less common anatomical marker for a S2 block?

A

Posterior Inferior Iliac Spine

423
Q

What is the palpable portion of the sacrum?

A

The remnants of the spinous processes

424
Q

What is the Lateral Sacral Crest?

A

Fusion of the transverse processes

425
Q

What is the Medial Sacral Crest?

A

Fusion of the Superior/Inferior Articular Processes

426
Q

What is the Sacral Hiatus?

A

The portion of the sacrum that allows for ligaments and the 1 coccygeal nerve pair to exit

427
Q

What are Sacral Cornu?

A

Raised projections on the Sacral Hiatus

428
Q

How many Coccygeal Vertebrae are we born with? Which ones fuse together?

A

4; 2,3,4 fuse together and 1 stays alone (giving us 1 pair)

429
Q

What is the Iliac Crest?

A

Most Superior ridge of the pelvis; palpable; if you draw a line between the iliac crests, you will be at the L4 body

430
Q

Anatomical marker for spinals/epidurals

A

Iliac Crests/L4 body

431
Q

What is the Pubic Tubercle?

A

Raised bump for the inguinal ligament to attach to

432
Q

What is the Inguinal Ligament?

A

Connects the Anterior Superior Iliac Spine to the Pubic Tubercle

433
Q

What is the Pubic Symphasis?

A

The cartilage that connects the L and R side of the pelvis anteriorly

434
Q

What is the Iliolumbar Ligament?

A

Connects L4,L5 to the Posterior Superior Pelvis

435
Q

How does a female pelvis differ from a male?

A

Wider and broader hips

436
Q

2 sets of hips?

A

Lower Set - Greater Trochanter of the Femur
Higher Set - Top side of the pelvis

437
Q

Where is the Supraspinous Ligament?

A

On the tips of the spinous process all the way down the spinal cord

438
Q

Do Sacral Vertebra have intervertebral disks?

A

No, all fused together

439
Q

What is the Nucleus Pulposus?

A

The gel-filled center of the disk

440
Q

What is the Anulus Fibrosis?

A

The fiber wrapped around the disk

441
Q

How does Dr. Schmidt describe the Anulus Fibrosis?

A

ROBUST/STRONG

442
Q

How does the Anterior Anulus Fibrosis differ from the Posterior portion?

A

Anterior has a criss-cross pattern, making it more STRONG; back has normal pattern, making it WEAKER

443
Q

What are 3 ways to fix disc herniation?

A

Discectomy, Spinal Fusion, Laminectomy

444
Q

What is the Hyaline Cartilage End Plate?

A

The cartilage that “sandwiches” the tops and bottoms of the disks together

445
Q

Spinal Fusion

A

Very Invasive; plates and screws added to the front of the vertebrae; after 6-7 years, can damage the disks above and below do to increased stress

445
Q

Discectomy

A

Minimally Invasive; remove the herniated disk

446
Q

Per lecture, who should do your spinal surgery?

A

Neurosurgeon>ortho

446
Q

Laminectomy

A

Shave part of the lamina bone to relieve pressure by giving the nerve a wider space

446
Q

Ways to help your back problems?

A

PT and Hamstring stretches

446
Q

Pia Mater

A

Layer directly attached to neurons and glial cells

446
Q

Arachnoid Mater

A

Layer superficial to Pia and Large blood vessels; translucent in color

446
Q

Dura Mater

A

Outermost Meninge; superficial; tough and robust

446
Q

Subdural Space

A

A “potential space” between the Dura Mater and Arachnoid Mater

446
Q

CSF in the Meninges

A

Located in the Subarachnoid Layer

446
Q

Out –> In layers of Meninges

A

Dura, Arachnoid, Pia Mater

446
Q

Blood vessels in the Meninges

A

Sit above the pia mater and below the arachnoid layer

447
Q

Neuron Types

A

1.) Multipolar
2.) Pseudounipolar
3.) Bipolar

448
Q

Glial Cells

A

1.) Astrocyte
2.) Ependymal Cell
3.) Oligodendrocyte
4.) Microglial Cell

448
Q

Spinal Cord: Lateral View

A

1.) Anterior Longitudinal Ligament
2.) Posterior Longitudinal Ligament
3.) Ligamentum Flava
4.) Interspinous Ligament
5.) Inter-transverse Ligament

448
Q

Spinal Cord Blood Supply

A

1.) Sulcal Artery
2.) Anterior Spinal Artery
3.) Anterior Segmental Medullary Artery (BF from Costal Arteries)
4.) Posterior Segmental Medullary Artery (BF from Costal Arteries)
5.) Vasocorona Artery
6.) Posterior Spinal Arteries (BF from Brain, Spinal Cord)

448
Q

Putting the Neck Together

A
  1. Intervertebral Disc: Name 3 Parts
  2. Anterior Longitudinal Ligament
  3. Posterior Longitudinal Ligament
  4. External Occipital Protuberance
  5. Dens of Axis
  6. Posterior Atlanto-Occipital Ligament
  7. Nuchal Ligament
  8. Ligamentum Flava
  9. Transverse Process
  10. Vertebral Foramen
  11. Spinous Process
  12. Interspinous Process
  13. Supraspinous Process
449
Q

Putting the Neck together

A

1.) Supraspinous Ligament
2.) Atlas (C1)
3.) Dens of Axis
4.) Ligamenta Flava
5.) Nuchal Ligament
6.) Anterior Longitudinal Ligament
7.) Posterior Longitudinal Ligament

450
Q
A

1.) Epidural Space (filled w/adipose tissue - yellow)
2.) Subarachnoid space
3.) Arachnoid Mater
4.) Spinal Dura Mater
5.) Posterior Root (dorsal)
6.) Anterior Root (Ventral)
7.) Spinal Nerve
8.) Spinal Ganglion

451
Q
A

1.) Dural Sac
2.) Spinal Dura Mater
3.) Spinal Ganglion
4.) Cauda Equina
5.) Epidural Space

451
Q
A

1.) Vertebra Prominens (C7)
2.) Cervical Enlargement
3.) Lumbrosacral Enlargement
4.) Conus Medullaris
5.) Cauda Equina
6.) Spinal Dura Mater
7.) Spinal Arachnoid
8.) Spinal Ganglia

452
Q
A

1.) Spinal Ganglion
2.) Cauda Equina (post/ant spinal roots)
3.) Spinal Dura Mater
4.) Spinal Arachnoid
5.) Filum Terminale
6.) Sacral Hiatus

453
Q
A

1.) Cervical
2.) Thoracic
3.) Lumbar
4.) Sacral
5.) Cauda Equina
6.) Conus Medullaris
7.) Nerve Roots

454
Q
A

1.) Conus Medullaris
2.) Cauda Equina
3.) Filum Terminale

455
Q
A

1.) Subarachnoid Space (CSF)
2.) Cerebellum
3.) Medulla
4.) Cisterna Magna
5.) Spinal Cord
6.) Spinous Process
7.) Ligamentum Flavum

456
Q
A

1.) Vertebral Bodies
2.) Intervertebral Disc
3.) Conus Medullaris
4.) Lumbar Cistern

457
Q

Why 15 degree angle?

A

To avoid hitting the T-Spine Spinous Process, at is is sloped at an inferior diagonal angle

458
Q
A

1.) If ventricles grow, hydrocephalus
2.) 3rd Ventricle
3.) Cerebral Aqueduct
4.) 4th Ventricle
5.) Lateral Apertures (Foramen of Luschka)

459
Q
A

1.) Arachnoid Granulations
2.) Superior Sagittal Sinus
3.) Dura Mater
4.) Pia Mater

460
Q
A

1.) Dura Mater
2.) Arachnoid Mater
3.) Tentorium cerbelli

461
Q
A

1.) Epidural Hematoma
2.) Arachnoid Mater
3.) Arachnoid Trabeculae
4.) Pia Mater
5.) Cerebral Artery
6.) Subarachnoid Space
7.) Cerebral Vein
8.) Subdural Hemorrhage
9.) Dura Mater
10.) Cranial Bone

462
Q
A

1.) Arachnoid Granulations
2.) Choroid Plexus (lateral vent)
3.) Choroid Plexus (3rd vent)
4.) Straight Sinus
5.) Cerebral Aqueduct
6.) Confluent of the Sinuses
7.) Choroid Plexus (4th vent)
8.) Cerebellomedullary Cistern (Cisterna Magna)
9.) Median Aperture (Foramen of Magendie)
10.) Central Canal of the Spinal Cord
11.) 4th Ventricle
12.) 3rd Ventricle
13.) Interventricular Foramen ( Foramen of Monroe)
14.) Superior Sagittal Sinus

463
Q
A

1.) Corpus Callosum
2.) Interventricular Foramen (Foramen of Monroe)
3.) Medulla Oblongata
4.) Pons
5.) Hypothalamus

464
Q
A

1.) Lateral Ventricle
2.) Cerebral Aqueduct
3.) Median Aperture of 4th vent (Foramen of Magendie)
4.) Central Canal
5.) Lateral Aperture of 4th vent
6.) 4th Vent
7.) 3rd Ventricle
8.) Interventricular Foramen (Foramen of Monroe)

465
Q

Other name Median Aperture of 4th Ventricle?

A

Foramen of Magendie

466
Q
A

1.) Superior Sagittal Sinus
2.) Confluence of the Sinuses
3.) Transverse Sinus
4.) External Occipital Protuberance
5.) Sigmoid Sinus
6.) Internal Jugular Vein

467
Q
A

1.) Falx Cerebri
2.) Superior Sagittal Sinus
3.) Inferior Sagittal Sinus
4.) Tentorium cerebelli
5.) Sinus Confluence
6.) Transverse Sinus

468
Q

Another name for Interventricular Foramen?

A

Foramen of Monroe

469
Q
A

1.) Cavernous Sinus
2.) Sigmoid Sinus
3.) Transverse Sinus
4.) Confluence of the Sinuses
5.) Superior Sagittal Sinus
6.) Straight Sinus
7.) Tentorium Cerebelli

470
Q

Another name for Cerebellomedullary Cistern?

A

Cisterna Magna

471
Q

Another name for Lateral Apertures of 4th ventricle?

A

Foramen of Lushka

472
Q
A

1.) Superior Sagittal Sinus
2.) Inferior Sagittal Sinus
3.) Straight Sinus
4.) Sinus Confluence
5.) Transverse Sinus
6.) Sigmoid Sinus
7.) Cavernous Sinus
8.)
9.)
10.) Falx Cerebri
11.) Tentorium Cerebelli

473
Q
A

1.) Superior Sagittal Sinus
2.) Inferior Sagittal Sinus
3.) Straight Sinus
4.) Confluence of Sinuses
5.) Transverse Sinus

474
Q
A

1.) Superior Sagittal Sinus
2.) Sinus Confluence
3.) Transverse Sinus
4.) Sigmoid Sinus
5.) External Jugular Vein
6.) Interior Jugular Vein

475
Q
A

1.) External Carotid Artery
2.) Common Carotid Artery (Internal)
3.) Vertebral Artery

476
Q

Where are vessels located in the meninges?

A

Inferior to the Arachnoid Layer

477
Q

What is the middle ground between the CNS and PNS?

A

Spinal Nerve

478
Q

What is the Epidural Space filled with? How does this effect blocks?

A

Adipose and vessels; makes onset of lipophilic anesthetic slower and end longer

479
Q

Safest place to do a spinal block? Why?

A

Cauda Equina; spinal cord is not behind these nerves, so less dangerous

480
Q

What does Cauda Equina mean?

A

“Horse’s Tail”

481
Q

Where does the spinal cord start and stop?

A

The medulla to the Conus Medullaris (at L1)

482
Q

What is the end of the spinal cord called? Where does it stop?

A

Conus Medullaris (L1)

483
Q

What are the 2 enlargements in the Spinal Cord? Why?

A

Cervical (C3-C6) and Lumbar (T11-L1); high sensory and motor functions such as hands, arms, legs, feet

484
Q

What does the Cervical Enlargement turn into?

A

Brachial Plexus (lots of nerves in shoulder)

485
Q

What does the Lumbar Enlargement turn into?

A

Lumbar Plexus/Sciatic Nerve

486
Q

What is the Conus Medullaris?

A

The end of the spinal cord @ L1 level

487
Q

What is the Cauda Equina?

A

“Horse tail”; collection of nerves that extends off Conus Medullaris

488
Q

What is the Filum Terminale (internum)?

A

Connective tissue that anchors the dural sac in place; located between the Conus Medullaris and the end of the Dural Sac

489
Q

What is the Filum Terminale (externum)?

A

Connective tissue that keeps the dural sac in place; located outside the dural sac and ends at the coccyx

490
Q

How far does the Dural Sac extend?

A

from below the Conus Medullaris to the “S2” area of the sacrum

490
Q

What is the Dural Sac? Another name for it?

A

A sac full of CSF; Lumbar Cistern

491
Q

What are the Filum Terminale’s extensions of?

A

The Pia Mater/Pia Layer

492
Q

The bone grows faster than the _ lengthens?

A

Cord

493
Q

In a newborn, where is the Conus Medullaris?

A

L3

494
Q

Nuchal Ligament is an extension of what?

A

Interspinous Ligaments

495
Q

How wide is the spinal cord?

A

As wide as a quarter

496
Q

What color is CSF/water on a CT scan?

A

Black

497
Q

Describe T-Spine spinous process, per lecture

A

Inferior diagonal angle

498
Q

How does CSF get from the brain down the spinal cord?

A

The central canal and the ependymal cells within

499
Q

Where can CSF get stale?

A

The Dural Sac (Lumbar Cistern)

500
Q

Where can you get CSF samples?

A

L3-L4, L4-L5, Sacral Hiatus

501
Q

What angle off midline do you use to get past an unfused Ligamentum Flava in the spine?

A

15 degrees off midline

502
Q

Which plane do you cut through to see the Corpus Callosum?

A

Sagittal Plane

503
Q

What controls the CSF?

A

Astrocytes

504
Q

pH of CSF?

A

7.31

505
Q

HCO3 of CSF

A

Lower in brain than Plasma

506
Q

Why is the CSF more acidic than the blood?

A

HCO3 buffers CO2 off brain cells from metabolism

507
Q

Na+ in CSF

A

Similar to body (140 mOsm/L)

508
Q

Cl- in CSF

A

Higher in CSF; close to Na+ levels (increased permeability = resting)

509
Q

K+ in CSF

A

40% less than in plasma

510
Q

Mg in CSF

A

Higher than plasma volume

511
Q

All of the differences in electrolytes in the CSF combine to become _ of the CNS?

A

“Brakes”

512
Q

Glucose in CSF vs Plasma

A

60 mg/dL vs 90 mg/dL

513
Q

How does glucose get into the CSF?

A

Glut-1 transporters from the CV system via facilitated diffusion

514
Q

What color is CSF (normally)

A

Clear

515
Q

How much total CSF is in the body if we took it out and put it in a beaker?

A

150 mL

516
Q

How much CSF do we produce each day? How many times does it get refreshed per day?

A

500 mL; 3 times per day; faster near brain

517
Q

What is an Epidural Hematoma? What is a common way to get one?

A

Bleeding in the epidural layer (Superior to the Dura); Skull fracture

518
Q

Is an Epidural Bleed: Arterial vs Venous Bleed?

A

Arterial

519
Q

Columns between the Pia and Arachnoid that create space for vessels and CSF?

A

Arachnoid Trabeculae

520
Q

What is a Subdural Hemorrhage?

A

Bleeding under the dura (inferior)/subdural space

521
Q

What type of bleed is a Subdural Hemorrhage: Arterial or Venous

A

Venous

522
Q

What does the Dura Mater go along with? Reason why it is a venous bleed in a subdural hemorrhage?

A

Goes along with the Venous Sinuses

523
Q

True or False, The cranial bone has arteries and veins?

A

True, bone needs to perfuse too

524
Q

What is a Subarachnoid Hemorrhage?

A

Vessels under the arachnoid layer rupture

525
Q

What type of bleed is a Subarachnoid Hemorrhage?

A

Arterial

526
Q

Which bleeds faster, Arterial or Venous bleed?

A

Arterial

527
Q

How do the Ependymal Cells push Na+ out from the Blood to the CSF?

A

Na+ ATPase pump

528
Q

What are Ependymal Cells “Leaky” to?

A

Na+, Cl-, H20

529
Q

What regulates the K+ in CSF?

A

Astrocytes

530
Q

What is the Tissue Group of Ependymal Cells responsible for producing CSF?

A

Choroid Plexus

531
Q

CSF Flow in Brain?

A

Lateral Vents –> Interventricular Foramen (Foramen of Monroe) –> 3rd Ventricle –> Cerebral Aqueduct (Aqueduct of Sylvius) –> 4th Ventricle –> Lateral Apertures (Foramen of Luschka) OR Median Apeture (Foramen of Magendie) OR Central Canal

532
Q

Another Name for Cerebral Aqueduct

A

Aqueduct of Sylvius

533
Q

What is the Cerebral Aqueduct?

A

Takes CSF from 3rd Ventricle to 4th Ventricle

534
Q

What happens if you block one of the paths of CSF flow?

A

CSF builds up in the Ventricles = increased ICP

535
Q

2 Types of Hydrocephalus

A

Communicating and Non-Communicating

536
Q

Communicating Hydrocephalus

A

Structures work fine, but CSF is not absorbed/removed like normal (issues with Arachnoid granulations); non-swelling vents

537
Q

Non-Communicating Hydrocephalus

A

Issues with blocking of CSF flow structures, leading to swelling ventricles

538
Q

What are Arachnoid Granulations

A

“Blow off Valves” located on superior brain @ longitudinal fissure; when ICP gets high, open up and release CSF

539
Q

Easiest CSF path to block? Why? Solution?

A

Cerebral Aqueduct (Aqueduct of Sylvius) b/c it is narrow; Cranial bolt

540
Q

Normal ICP per lecture

A

10 mmHg

541
Q

What does the Cerebellum do?

A

Coordinates complex tasks such as “walking down the street”

542
Q

What feeds the Cerebellum CSF from the Median Aperture (Foramen of Magendie)

A

The Cerebellomedullary Cistern (Cisterna Magna)

543
Q

Another name for the Cerebellomedullary Cistern?

A

Cisterna Magna

544
Q

What is the Straight Sinus?

A

Sinus that connects the Superior and Inferior Sagittal Sinuses

545
Q

What is the Sinus Confluence?

A

Sinus where all Sinuses come together before lateral flow

546
Q

Sigmoid Sinus and what kind of “turn” per Schmidt

A

Drains sinus into Internal Jugular; “hairpin” turn

547
Q

Transverse Sinus

A

Sends Blood Flow L or R

548
Q

Falx Cerebri

A

Connective tissue that separates L and R hemispheres

549
Q

Tentorium cerebelli

A

The floor for the occipital lobe to sit on like a shelf; cerebellum is deep compared to this structure; occipital lobe is superior

550
Q

Common (internal) Carotid Artery

A

Feeds brain blood

551
Q

External Carotid Artery

A

Feeds superficial structures blood

552
Q

Brain Blood Flow

A

750 mL/min OR 50 mL/min/100G of brain tissue

553
Q

Normal CO per lecture

A

5L/min

554
Q

Brain Blood flow is what % of the CO?

A

15%

555
Q

What % of weight in body is the brain

A

2-3%

555
Q

What % of Brain Blood Flow is Routed to White areas?

A

20%

555
Q

What % of Brain Blood Flow is routed to grey areas?

A

80%

556
Q
A
  1. Ruptured Aneurysm
557
Q
A
  1. Superior Sagittal Sinus
  2. Falx Cerebri
  3. Inferior Sagittal Sinus
558
Q
A
  1. Ruptured middle meningeal artery
  2. Subarachnoid Space
  3. Dura Mater
559
Q
A
  1. Anterior Cerebral Artery
    a.) A2, Postcommunicating Anterior Cerebral Artery
    b.)A1, Precommunicating Anterior Cerebral Artery
  2. P2, Postcommunicating Posterior Cerebral Artery
  3. Posterior Cerebral Artery
  4. P1, Precommunicating Posterior Cerebral Artery
  5. Anteroinferior Cerebellar Artery
  6. Posteroinferior Cerebellar Artery
  7. Vertebral Artery
  8. Basilar Artery
  9. Superior Cerebellar Artery
  10. Posterior Communicating Artery
  11. Middle Cerebral Artery
  12. Internal Carotid Arteries
  13. Anterior Communicating Artery
560
Q
A
  1. Vertebral Arteries
  2. Internal Carotid Arteries
  3. Basilar Artery
  4. P1, Precommunicating Posterior Cerebral Artery
  5. P2, Post-communicating Posterior Cerebral Artery
  6. Posterior Communicating Artery
  7. A1, Precommunicating Anterior Cerebral Artery
  8. A2, Post-communicating Anterior Cerebral Artery
  9. Anterior Cerebral Artery
  10. Anterior Communicating Artery
  11. Pons
  12. Superior Cerebellar Artery
  13. Middle Cerebral Artery
561
Q
A
  1. Superior Cerebellar Artery
  2. Basilar Artery
  3. Anteroinferior Cerebellar Artery
    4.Posteroinferior Cerebellar Artery
  4. Vertebral Artery
562
Q

What is the largest artery in the Circle of Willis?

A

Middle Cerebral Artery

563
Q

What are the 4 main arteries that feed brain circulation?

A

Carotid Arteries (2 internal), Vertebral Arteries (2)

563
Q

Brain Flow is dependent on _? Coma BF?

A

Cerebral Metabolism (CO2); Coma = Decreased metabolism (decreased CO2)

564
Q

Why is the Circle of Willis Important?

A

It is a pathway that ensures collateral blood flow if one of the arteries is blocked or damaged

565
Q

What do the 2 Vertebral Arteries form?

A

Basilar Artery

566
Q

3 Large Arteries in Brain

A

Anterior Cerebral Artery, Posterior Cerebral Artery, Middle Cerebral Artery (internal carotids)

567
Q

Which cerebral artery connects the 2 sides of the Anterior Cerebral Artery?

A

Anterior communicating artery

568
Q

Which artery connects the Posterior Cerebral Arteries to the Middle Cerebral Arteries?

A

Posterior Communicating Arteries

569
Q

What is autoregulation?

A

The system able to maintain blood flow to the brain, despite changes

570
Q

AR: Increase in BP, what happens to the vessels?

A

Vasoconstriction to maintain normal BP

571
Q

AR: Decrease in BP, what happens to the vessels?

A

Vasodilation to maintain normal BP

572
Q

AR: Normal Range

A

50 mmHg - 150 mmHg

573
Q

Shape of line if no AR?

A

Linear

574
Q

Shape of Line with Volatile Anesthetics?

A

Sloped Line (increased slope = increased change in AR)

575
Q

Pressure Examples in AR

A

MAP, CPP

576
Q

No AR: HTN

A

Blow up Aneurysms; vessels can only constrict so much, so after >150 mmHg, BP will increase

577
Q

No AR: Hypotension

A

Cell Death, vessels can only dilate so much, so once under 50 mmHg, BP will decrease

578
Q

Chronic HTN AR: What happens to arteries? What happens to LLA and ULA?

A

They harden to help constrict better (Arteriosclerosis); they increase as they adapt (cannot drop Pt to original LLA as it may cause cellular death)

578
Q

AR: Limits

A

2 points that if we go past, no AR will occur (<50 mmHg)(>150 mmHg)

579
Q

Chronic HTN AR: ULA and LLA

A

Right shift, as body and brain adapt to these chronic changes; Ex: 50 - 100 and 150 - 200

580
Q

How do Volatile Anesthetics affect AR?

A

They reduce the amount of AR (Slope line); more effected = more slope

580
Q

AR: How do DM2 and HTN affect blood vessels?

A

Zap the vessels ability to dilate, leading to increased stroke and HR risks

581
Q

AR: CV health = ?

A

Ability to dilate vessels

582
Q

AR: Error Bars

A

More variability in the data = longer length (means data is inconclusive)

583
Q

What are P-Type Ca++ Channels? How do they open?

A

Calcium channels that release Ca+ into the presynaptic cell after depolarization

584
Q

Ways the Cell resets a Motor Neuron Post AP (4 ways)

A

NaK ATPase pump, Ca++ ATPase pump, V-G K channels (open during AP), Ca++ sensitive K+ channels (Ca++ influx sends K out)

584
Q

What does Ca+ bind to within the Presynaptic cell? What do these cells do?

A

ACh vesicles near the cell wall; called Vesicle Pool 2 cells [VP2}; bind to the cell wall and release ACh into the NMJ

585
Q

Difference between VP2 and VP1 Vessicles?

A

VP2 are near cell wall and ready to drop ACh into the NMJ; VP1 are immature and need to finish filling up OR work on moving closer to the cell wall

586
Q

How does Calcium get shut off in the Presynaptic Cell?

A

Ca ATPase pump sends Ca++ out of the cell via Active Transport, preventing VP2 from being activated, stopping the release of ACh

587
Q

ACh receptors on Skeletal Muscle

A

Very close to NMJ, 2 binding sites that have to be bound simultaneously, nACh-R bound opens up for Na+ to flood in with small amounts of Ca++ (K+ small amount out)

588
Q

What is an End Plate Potential?

A

Type of Depolarization that is on the Postsynaptic terminal that results from influx of Na+ into the cell (localized depolarization)

589
Q

End plate potential, in comparison to, AP

A

EPP is the initial stimulus and AP is the reaction to that initial stimulus

590
Q

How does the Postsynaptic Terminal (skeletal muscle) create an AP?

A

The fast Na+ channels are next to the nACh-R, so with depolarization/end-plate potential, the Fast Na+ channels will be activated, creating an AP within the skeletal muscle, leading to muscle contraction

591
Q

What is the Sarcoplasmic Reticulum?

A

Sarco means muscle; The ER of a muscle cell; stores Ca++

592
Q

What are muscles good for?

A

Keeping body warm, locomotion, communication, expression

593
Q

How do Volatile Anesthetics effect Muscles?

A

They take them offline (no warmth, etc)

593
Q

How many motor neurons does it take to innervate a skeletal muscle? Give example of a Muscle that takes more than 1 Motor Neuron

A

1 or Many motor neurons; ocular muscle uses many motor neurons

594
Q

How do Motor Neurons get the signal to contract?

A

Descending pathways from the brain and spinal cord on the ventral horn or Reflex arcs (sensory/pain) from the dorsal horn

595
Q

What are transverse tubules and why are they important?

A

Since the muscle cells are very large, transverse tubules take the AP DEEPER into the muscle, making sure the muscle gets the full contraction; Perpendicular Pathway

596
Q

What is Actin/Myosin in a Skeletal Muscle? What are they driven by?

A

The contractile elements of the muscle; driven by Ca++

597
Q

Do muscles shorten or lengthen during a contraction?

A

Shorten

598
Q

How long is the longest muscle cell?

A

Over a foot

599
Q

What is AChesterase? How does it work and where is it located

A

Breaks down ACh as it comes in contact with Skeletal muscle; it is fastened to the skeletal muscle; limits rate of depolarization, as it breaks down ACh

599
Q

How does AChesterase break down ACh?

A

It uses Hydrolysis to degrade the Ester bond, separating Acetyl and Choline

600
Q

How is Choline sent back into Motor Neuron?

A

Choline is sent back to the Motor Neuron via a Choline ATPase pump and a 2nd Active Transport pump of Choline/Na+

601
Q

What produces Acetyl (acetate) in the Motor Neuron to be bound with choline?

A

The mitochondria

602
Q

Difference between Primary and Secondary Clefts on Skeletal Muscle

A

Primary - 1 infold (subneural)

Secondary - 2 infold

603
Q

How many ACh molecules does a motor neuron need to send to generate a response?

A

About 1 million (2 binding sites); usually will send around 2 million ACh molecules, as some do not make it and get chopped up by AChesterase

603
Q

How many ACh-R are located on Skeletal Muscle at NMJ

A

5 Million

604
Q

How many ACh-R are activated during a typical response?

A

500,000 (10%)

605
Q

How does K+ generally leave a skeletal muscle/motor neuron?

A

Leaky K+ channels

606
Q

What is Curare? Where is it found? What drugs are derived from it?

A

A paralytic agent found in the rainforest; NDMR are derived from Curare

607
Q

What is the DHP-receptor/sensor?

A

Dihydropyridine Sensor; senses an Action Potential and pulls on the door of the RyR channel, releasing Ca++ into the Sarcoplasm to cause contractions of the Actin/Myosin

607
Q

Where can we store extra choline?

A

Cell wall via Phosphatidylcholine

607
Q

The NMJ is _ dependent? What is this process called?

A

Ca++ dependent to send off VP2 cells to cell wall; Exocytosis

607
Q

What is a cleft on a skeletal muscle?

A

Place where ACh-R and Fast Na+ channels are located

608
Q

When a nACh-R is open, what ions come in? Out?

A

In - Na+ 1st, Ca++ 2nd
Out - Small amounts of K+

609
Q

What is the RyR channel? Where is it located?

A

Ryanodine Channel that has Ca++ stored behind a “door”; when an AP comes through, the DHP-Sensor will open the door, allowing for Ca++ to flood into the Sarcoplasm. It is located on the SR

610
Q

Where are the DHP-receptors located?

A

Cell wall and T-tubules (send contraction deep into the muscle)

611
Q

How is Ca++ put back into the SR after a muscle contraction?

A

The RyR door shuts and a SERCA Ca++ pumps uses active transport/ATP to shove the Ca++ back in

612
Q

Is MG a presynaptic or postsynapic disease?

A

Postsynaptic Disease

612
Q

What is the SERCA Pump? What does it do?

A

Sarcoplasmic Endoplasmic Reticulum Calcium ATPase Pump; pushes Ca++ back into the SR via active transport

613
Q

How does Ca++ get into the Motor Neuron?

A

After activated by an action potential, P-Type Ca++ channels send Ca++ into the Motor Neuron

613
Q

What is an End-Plate Potential?

A

Initial Stimulus on Skeletal Muscle that causes an Action Potential

613
Q

What structure in the Motor Neuron creates Acetate?

A

Mitochondria

614
Q

Patho of MG

A

Immune response to goofy Thymus; Antibodies bind to nACh-R and immune system destroys them and cause scarring in the Clefts (decreased surface area for Fast Na+ channels and nACh-R); no muscle contractions as decreased ACh binding/no fast Na+ activated

615
Q

How do “Stigmines” treat MG

A

Block AChesterase, allowing for increased depolarization at NMJ and allow for more ACh to bind to cause an AP (leading to muscle contraction)

615
Q

Tx for MG

A

Remove Thymus, Plasmapheresis, “Stigmines”

616
Q

What is LEMS/ELMS?

A

Lambert-Eaton Myasthenic Syndrome; Developed when a person has Lung Cx; Motor Neuron Based disease (Presynaptic); Send antibodies to block the P-Type Ca++ channels, resulting in less ACh being sent to the cell wall

617
Q

Tx for LEMS/ELMS

A

Plasmapheresis, Removal of Lung Tumor, Drugs: TEA [Tetraethyl ammonium] and 4-5 diaminopyridine (they block K+ channels, making it more depolarized to allow for more Ca++ to come in via unblocked P-Type Channels)

618
Q

Why are the drugs used to treat LEMS dangerous?

A

Although they block K+ channels, causing increased depolarization for more Ca++ to come in via P-Type Ca++ Channels, they are not specific to motor neurons. Can also block K+ channels in the heart, leading to arrythmias

619
Q

Curare NDMR

A

Block the nACh-R on skeletal muscle, which stops ACh from binding, leading to muscle paralysis [only has to block 1 receptor site, not both]

620
Q

What is Succinylcholine? What is the drug class?

A

Depolarizing muscle blocking agent that causes local depolarization at the NMJ; it is 2 ACh combined into 1, so AChesterase cannot break it down as it cannot reach the Ester bond

621
Q

Is LEMS a presynaptic or postsynaptic disease?

A

Motor Neuron based Disease (Presynaptic)

622
Q

Sux Phase 1

A

Muscle contraction/quiver

623
Q

Sux Phase 2

A

Constant Na+ leaking into cell, so constant depolarization makes the cell more + at this location and prevents the cell from repolarizing (pushes more K+ extracellularly)

624
Q

How much does Sux increase Serum K+? Why? In a healthy Pt

A

Increase by 0.5 mEq (4-4.5); increased depolarization sends more K+ out of the cell down the concentration gradient, leading to more K+ ECF

625
Q

When to Avoid giving Sux?

A

Hyperkalemic, Pre-existing slow HR or conditions, Pts with poor muscle quality such as stroke or paralyzed pts (denervated)

626
Q

Why avoid Sux in Pts with denervation or stroke like injuries?

A

These types of injuries cause more NMJ at different lengths of the Skeletal Muscle; if give Sux, then all the NMJ will increase the amount of K+ being pushed extracellularly, leading to increased hyperkalemia

627
Q
A
628
Q
A
629
Q
A
630
Q
A
631
Q
A
632
Q
A
633
Q
A
634
Q
A

A&P 1 (24 decks)

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