Exam 2 Flashcards
Basal cell carcinoma
Type of cancer
Slow-growing skin cancer that starts in stratum basale
Least lethal
Squamous cell carcinoma
Type of cancer
Starts in stratum spinosum
Melanoma
Type of cancer
Starts in melanocyte
May start looking like a mole
Will often metastasize
Most lethal
Epiphyseal growth plate mechanism
Fused = no more growth
Unfused = Continued growth
Cartilage: contains chondroblasts
Proliferation: hyperplasia (increase in cell number)
Hypertrophy: increased cell size
Calcification: cells are filled with hydroxyapatite (HA) Ca10(PO4)6(OH)2 and then apoptosis leaves the HA
Ossification: new diaphysis
Bone growth goes from ossification to calcification and up to create new diaphysis
Interstium
Space between cells (fluid in space is interstitial fluid)
Hydroxyapatite
Inorganic matrix
Ca10(PO4)6(OH)2
Compression strength
Bone
Material’s ability to resist forces that compress it or reduce its size
Hydroxyapatite
Softer bone = dehydration (brittle)
Bone decays when buried in dirt, so loses organic component = brittle bone
Tensile strength
Bone
Material’s ability to resist forces that stretch or elongate it
Collagen
Sulfuric acid will make HA leak out = bone will bend
Osteoblasts
Organic matrix
Induce formation of inorganic matrix
Form new bone
Remodel existing bone
Osteocytes
Lacunae within bone stabilize and maintain bone matrix
Osteoclasts
Periosteum
Endosteum reabsorb calcified bone matrix
What happens to blood Ca++ levels when osteoblasts or osteoclasts are active?
Osteoblasts: blood Ca++ levels decrease
Osteoclasts: blood Ca++ levels increase
Hormones involved with blood remodeling
Calcitonin, Parathyroid Hormone (PTH), Calcitriol (Activated Vitamin D), Estrogen
Hormones that elevate blood calcium
Parathyroid Hormone (PTH), and Calcitriol
Hormones that lower blood calcium
Calcitonin
Inhibits osteoclasts and stimulates osteoblasts
How to recognize an osteoclast
Osteoclasts have a ruffled border that connects with the bone and works to break the bone apart by secreting hydrochloric acid
Multinucleated
What acid do osteoclasts secrete
Hydrochloric acid
Microscopic bone anatomy
Know what lamellae, lacunae (spaces), canaliculi, osteon, periosteum, osteon of compact bone, trabeculae of spongy bone, haversian canal, volkmanns canal looks like in a bone
https://training.seer.cancer.gov/images/anatomy/skeletal/bone_tissue.jpg
Is human skull fused at parturition? Why or why not? What is partruition
No
Babies have a soft spot on top of their head (fontanelle) to help them go through the birth canal
Parturition: True labor
Chondroblasts
Form cartilage and chondrocytes
Descended from mesenchyme
Specialized cells in the perichondrium that actively produces the extracellular matrix components of cartilage and form it
5 regions of epiphyseal growth plate and characteristics (in order from shaft to plate)
Cartilage: Comes from chondroblasts
Proliferation: Hyperplasia
Hypertrophy: Cell size gets bigger
Calcification: Hydroxyapatite left behind after apoptosis; cell itself is gone, but HA is left
Ossification: New diaphysis
Hypertrophy vs. Hyperplasia vs. Atrophy
Hypertrophy: Cell size gets bigger
Hyperplasia: Number of cells in the area grow
Atrophy: Decrease in size of organ or tissue due to disuse or less use
Synovial fluid
Has high levels of hyaluronic acid allowing for free movement
Arthritis
Joint inflammation, typically from less articular cartilage due to wear and tear
NSAIDS can manage symptoms
Modified ball and socket joint
Condyloid synovial joint
Allows for flexion, extension, abduction, and adduction
Radiocarpal joint (wrist)
Anatomical points for reference
Olecranon, popliteal, anterior crest of tibia, nuchal, calcaneal
Olecranon: Back of elbow
Popliteal: Back of knee
Anterior crest of tibia: Shin bone
Nuchal: Back of neck
Calcaneal: Heel of foot
Osteogenesis Imperfecta
Known as brittle bone disease
Autosomal (non-sex) dominant (one parent to child)
19 genes involved
There are 28 types of collagen, but OI causes lack of collagen type I
Causative genes are COL1A1 and COL1A2
COVID 19 and our defense
Inflammation
Can become overzealous and lead to an increase in fluid concentration in the lungs (pneumonia)
Collagen helix
Triple helix
Carpal tunnel syndrome
Caused by pressure on the median nerve
Symptoms: Numbness, tingling, weakness in hand and arm
Neuropathy = Nerves are agitated
Carpal tunnel
Narrow passageway surrounded by bones and ligaments on palm side of hand; contains 9 tendons
Osteoporosis
Disease that develops when the bone mineral density and bone mass decreases (weak bones)
Most likely in menopausal women because estrogen levels have fallen
Estrogen
Prevents apoptosis of osteoblasts
Decreases likelihood of osteoporosis
Sclera changes
Change in the color of sclera can indicate disease
Sclera will be yellow if someone has jaundice
Sclera of eye will be blue if someone has osteogenesis imperfecta
Tommy John Surgery
Surgical graft
Ulnar collateral ligament in the medial elbow is replaced by either a tendon from patients body (gracilis and palmaris longus) or one from a deceased donor
Super common among collegiate and professional athletes that deal with throwing (baseball)
Turf toe
Ligament sprain of the big toe joint that occurs on turf surfaces
Causes tenderness and swelling around the hallux joint
Scientific name for big toe
Hallux
AC joint
Acromioclavicular Joint
Acromion of scapula and lateral end of clavicle
Injury to this is a separated shoulder (torn ligaments)
GH joint
Glenohumeral Joint
Humerus and glenoid fossa
Injury to this is a dislocated shoulder
High ankle sprain
Caused by external rotation and hyperdorsiflexion; Stretching and twisting of syndesmotic ligaments that connect tibia and fibula of lower leg
Long time to heal because high ankle ligaments have heavier load to lift
Non-weight bearing bone of lower leg
Fibula
Transverse
Broken bone
Perpendicular to medullary cavity
Linear
Broken bone
Parallel to medullary cavity
Oblique non-displaced
Broken bone
At an angle
Oblique displaced
Broken bone
At an angle
Cut clean in half
Spiral
Broken bone
Lower part of body is planted and upper body twists wrong
Greenstick
Broken bone
Typically with the very young
Bone bends before it breaks
Comminuted
Broken bone
In pieces
Compound
Broken bone
Penetrated through the skin
Blunt force trauma
Leads to a fracture and/or contusion
Depression Fracture
Located in cranium
Most often seen in forensics due to malicious intent
Bone fragment dislodged towards brain
Perfect impression from impact
Muscles of rotator cuff
Group of muscles and tendons that stabilize human shoulder and allow its range of motion
Arise from scapula and connect to head of humerus
Supraspinatus, infraspinatus, subscapularis, teres minor
Rotator cuff stabilizes
Glenohumeral joint
Tendonitis
Inflammation of tendon sheaths typically caused by overuse
Tendinopathy
General term for degeneration of a tendon in any joint
Ex: Rotator cuff
Tear of the tendon
An injury due to soft tissue that connects muscles to joints
Can happen suddenly, typically due to overuse/overstretching
Caused by muscle’s inability to absorb shock, load, or force
Bruise
Contusion
Most common cause being capillaries damaged by trauma, causing localized bleeding extravasates (leakage of blood, lymph fluid) into the surrounding interstitial tissue
Separated shoulder vs dislocated shoulder
Separated shoulder: Injury to the Acromioclavicular joint
Dislocated shoulder: Trauma to the Glenohumeral joint
Scar
Around a wound
When macrophages signal fibroblast activity to add collagen and other elements of the extracellular matrix
Epidermal Growth Factor (EGF) not sufficient in healing these wounds
Why does a bruise change color
Indicates hemoglobin (protein in red blood cells) has begun to break down
Most bruises occur close enough to the epidermis such that bleeding causes a visible discoloration
Blanching of skin
Skin has a whitish appearance caused by diminished blood flow to region
Can capillaries be damaged
Yes
Often causes contusion
5 signs of inflammation
Heat, pain, redness, swelling, loss of function
What is evolutionarily significant purpose of inflammation
To eliminate the initial cause of cell injury/clear out necrotic cell and tissues damaged from original insult and initiate tissue repair
If I scratch my arm with a key in a linear manner the initial color of the line is? Then it becomes what color? Why?
White to red
The line is whitish or pale immediately after the scratch
This is because the pressure from the key temporarily displaced blood from capillaries, reducing blood flow and causing a blanching effect
Reactive hyperemia, where blood rushes back into the area as part of the body’s inflammatory response
Histamine is released by cells, causing vasodilation and increased blood flow to the area, resulting in the red appearance
COVID 19 and inflammation is where in the body
Binds to the ACE-2 receptors in the lungs
Inflammation in the lungs can result in fluid buildup and drowing
Vitamin D3 formation
When skin is exposed to sunlight, cholecalciferol (Vitamin D3) is formed, sent to the liver for modification (calciferone), and then finally converted to calcitriol in the kidney
Calcitriol is a hormone responsible for the elevation of blood calcium levels
Arrector pili muscles
Smooth muscles in our skin that make our hair stand whenever we are cold/scared
Proprioception
Our ability to determine our body’s position, direction, and acceleration in space
Involves inner ear fluid, pacinian corpuscles, semicircular rings, vestibulochlear nerve, and tiny hairs within the ear
Which major arteries are exposed
Carotid, jugular, femoral
More prone to injury and massive blood loss because they are superficial
Keratin
Tough intermediate filament that makes up the outer layer of skin, hair, and the hooves, scales, feathers, etc. in most invertebrates
Protects the epidermis, but dries out easily because of its extreme insolubility in water and organic solvents
Skin cancer
Melanin: Genetic component
Sunburns
Damage of epidermis and dermis
Cells in skin mutates
Peeling
Cancer
Epigenetics
How your behaviors and environment can cause changes that affect the way your genes work
Unlike genetic changes (mutations), epigenetic changes are reversible and do not change the sequence of DNA bases, but they can change how your body reads a DNA sequence
Desmosomes
Intercellular junctions that provide strong adhesion between cells
Gap junctions
Allow for intracellular fluid and ions to flow between cells
Act like tunnels
Intercalated discs
5 layers of the skin
Corneum (top)
Luicium
Granulosum
Spinosum
Basale (bottom)
Come Lets Get Sun Burnt
Thickness of skin
Dermis is thicker than epidermis
Thickest dermis and epidermis are found between the scapulae
Calluses are the thickest epidermis and are found in the hands and feet
What layers of skin are alive?
Only stratum spinosum and basale are alive
These cells are responsible for mitotic activity while the granulosum is dying and the lucidum/corneum are dead to protect skin against abrasion
Cells going from deep to superficial takes 45 days
Bacteria
Obligate aerobes vs obligate anaerobes
Obligate aerobes
Need oxygen to survive
Obligate anaerobes
Oxygen is toxic
What do you see when you pour H2O2 into a cut? Why is this performed?
Hydrogen peroxide is converted to oxygen because obligate aerobes carry three enzymes that can perform this mechanism: catalase, superoxide dismutase (SOD), and glutathione peroxidase (GSH)
SOD makes H2O2 and
GSH and catalase are mainly responsibly for oxygen production by breaking down H2O2 to H2O and O2, which O2 is toxic to the obligate anaerobes that can cause infection
Melanin
Absorbs radiation in the skin
Secretory pathway (endoplasmic reticulum to golgi apparatus to the melanosomes)
Keratin phagocytes eat the melanosome membrane but melanin stays put because melanosome holds melanin
Apocrine vs Eccrine
Apocrine sweat glands are located in armpits and groin and excrete both sweat and oil
Eccrine sweat glands are everywhere and excrete only sweat
Parts of the human nail
Know where nail plate, nail groove, lunula, and cuticle (eponychium; extension of stratum corneum) are located
Immunosuppresants
Used when given a skin graft from another person
Needed because body will interpret the transplanted cells as foreign
Used so skin graft is not rejected
What is MHC
Major histocompatibility complex
A group of genes that encode proteins that help cells recognize “self”
Enzyme difference between obligate aerobes and obligate anaerobes
Obligate aerobes have three enzymes that obligate anaerobes are missing
They are missing these enzymes because of the oxygen products they produce
Catalase, superoxide dismutase (SOD), and glutathione (GSH) peroxidase (GPx)
Fascia
A very thin layer of connective tissue that wraps around internal organs and msucles
Retinaculum
A deep layer of dense connective tissue that is typically oval or circular in its morphology that can often times stabilize tendons or even muscles
Shock
Life-threatening condition where organs have insufficient blood flow
Sudden drop in blood pressure
Vasodilation
Leads to reduced resistance in system and reduced blood pressure
Connection between EGF, a wound, and a scar
EGF stimulates collagen production but cant heal wounds
Scar forms around a wound and macrophages signal fibroblast activity which also adds collagen and other elements of the ECM to help heal the wound
EGF is released when tissue is damaged; EGF shows up and mitotic activity goes up, able to heal most injuries
Debridement
When a doctor removes dead tissue from a wound to help a wound heal
Dead tissue can give bacteria a place to grow, which can lead to infection
Connection between cortisol levels and immune system function
When stressed cortisol levels go up, immune system function goes down
Body cannot fight off virus as easily and is therefore susceptible to sickness
Cortisol is from where
Adrenal cortex (the outer region of an adrenal gland)
Hernia
Abnormal exit of tissue or organ, such as the bowel, through the wall of the cavity in which it normally resides
Occurs when part of your insides bulges through an opening or weakness in the muscle or tissue that contains it
Types of hernias
Inguinals: Bulges in the groin
Epigastrics: Occurs in stomach (upper abdomen)
Laterals: Occurs in lateral abdomen
Femorals: Occurs in the upper thigh
Incisionals: Occurs at front of the abdomen where a previous incision was
Umbilicals: Occurs at or near the belly button
Cosmetic surgeons prefer what type of incision?
Parallel to the patterns of connective tissue found on the body, which promotes easier healing and less scarring
Osteons
Functional unit of bone
Tendons used for Tommy John surgery repair
Gracilis and palmaris longus
Bone remodeling and hormones
Calcitonin: lowers blood Ca++
Parathyroid Hormone: Elevates blood Ca++
Calcitriol: Activated Vitamin D; elevates blood Ca++
Estrogen: Helps prevent osteoblast apoptosis which is good for bone density
3 major organs or structures involved in Ca++ level in blood
Bone: Bones act as reservoir for calcium. When blood calcium levels are low, calcium can be released form bones through a process called bone reabsorption
GI tract: The intestines absorb calcium from the diet, allowing it to enter the bloodstream
Kidney: Regulate calcium levels by controlling how much calcium is reabsorbed into the blood or excreted in urine
Does brain want blood calcium levels higher or lower
Brain prefers normal calcium levels
Osteoporosis treatments
1) Ca++ diet (dairy products) and TUMS
2) E2 (form of estrogen) through ERT (estrogen replacement therapy)
3) Low weight-bearing exercise (stress on bone = increase bone remodeling)
4) Pulsatile PTH (exogenous source) tricks brain into thinking PTH levels are elevated, thus causing it to make less PTH so that osteoclast activity decreases
Histamine
A compound which is released by cells in response to injury and in allergic and inflammatory reactions, causing contraction of smooth muscle and dilation of capillaries
Stored in granules in mast cells
Can be released when mast cell comes into contact with an allergen
Allergy types
Seasonal allergies: Less severe
Casual allergy: A mild reaction; symptoms include runny nose, coughing, or itchy eyes
Life threatening: Anaphylaxis (whole body reaction that causes shock)
Allergic reactions
Eyes: Red; puffy; itch
Nose: “Stopped up”; runs
Trouble breathing: Bronchoconstricts of smooth muscle of respiratory tube
Causes vasodilation: Lowers blood pressure
Causes bronchoconstriction: Lowers O2 intake
Need EpiPen because epinephrine promotes vasoconstriction and bronchodilation
Allergen
A substance that produces an allergic reaction in an individual
H1
Histamine receptor found in vascular smooth muscle, in bronchi, and on sensory nerves
Stimulation results in itching, pain, edema, vasodilation, and bronchoconstriction
Characteristic of inflammation and allergy
H2
Histamine receptor located in stomach and eyes
Stimulation results in secretion of hydrochloric acid
Enterochromaffin-like cells produce histamine and bind with parietal cells, but heart-burn medications inhibit histamine (antagonists)
Can cause acid reflux
H3
Involved in central nervous system functioning and feedback control of histamine synthesis and release
H4
Located in peripheral white blood cells and mast cells
Involved in immune responses
Odor in apocrine sweat glands
Sweat/oil glands found in the groin and axillary region
The oil secreted acts as fuel for bacteria to grow which produces bad odor
Cyclooxygenase
COX1 and COX2 are enzymes that turn arachidonic acid into prostaglandins
Prostaglandins
Hormone-like substances that affect several bodily functions, including inflammation, pain and uterine contractions
Derived from Arachidonic Acid
There are 5 prostaglandins
PG I2
Wound stage 2
Causes vasodilation for increased blood flow/healing
Demotes platelet aggregation
PG D2
Pain, sleep/wake cycles, pyretic (fever inducing)
Mediates inflammation
PG E2
Main inflammation prostaglandin
Causes pain, redness, swelling, inflammation
PG F2 alpha
Corpus luteum (CL) regression, skeletal muscle
End of menstrual
Estrogen and oxytocin stimulate the release of oxytocin, which aids in the stimulation of uterine contraction
PG H2
Wound stage 1
Thromboxane (substance produced by platelets)
Vasoconstriction and increased clotting/platelet aggregation
Don’t want to endure massive blood loss
Cyclooxygenase inhibitors
COX1: Blocked by Advil (ibuprofen) and Aleve (naproxen); NSAID
COX2: Blocked by Tylenol (acetaminophen); Not an NSAID
Both: Blocked by Aspirin (Acetylsalicylic acid); NSAID; Acetylates Serine (EX: SER530) SER = Serine; 530 = AA#
Histamine blockers
H1: Blocked by Benadryl (night) and Zyrtec (morning) (antihistamines)
H2: Blocked by anti-heartburn drugs (Tagamet and Pepcid)
ABCDE of moles
Moles can be melanoma
Asymmetry: Not round or oval
Border: Notched, irregular, or scalloped
Color: Multiple colors, changes in color, uneven color
Diameter: Larger than 1/4”
Evolution: Itching, bleeding, tenderness
Glutathione vs GPx
Glutathione: A tripeptide (glutamate, cysteine, glycine) that protects cells by neutralizing reactive oxygen species AKA reducing the cysteine residue; Most ubiquitous triglyceride
GPx: Glutathione peroxidase; an enzyme
NSAIDs
Nonsteroidal anti-inflammatory drugs
Medications that reduce inflammation, pain and fever
COX1 Inhibitors and COX 1 and 2 Inhibitors: Ibuprofen, Naproxen, and Acetylsalicylic acid
Connection between baroreceptors, vasodilation, and blood pressure
Baroreceptors detect a change in blood pressure (too low or too high) and then mediate the appropriate response
If blood pressure is too high, vasodilation occurs and blood pressure will decrease due to the blood vessels expanding
EpiPen
Contains adrenaline
Causes vasoconstriction and bronchodilation, raising O2 levels and blood pressure
Inhibits further release of histamine
NSAIDs, Inhibitors, Antihistamines
NSAIDs: Non-Steroidal Anti-Inflammatory Drugs; COX1; Ibuprofen, Naproxen, and Acetylsalicylic acid
Tylenol: Acetaminophen; Not an NSAID; COX2 inhibitor
Benadryl: Diphenhydramine; Not an NSAID; antihistamine
Heart burn medications: Pepcid AC (famotidine); Not an NSAID
Tagamet (Cimetidine); H2 inhibitor; antihistamine
Deodorant vs Antiperspirant
Deodorant: Neutralize thiol alcohols which produce stink (mask odor)
Antiperspirant: Inhibit apocrine sweat glands, decreasing the amount of sweat and oil excreted
Skin tag
Acrochordons
Where skin has creased from elevated amount of friction
Found in the axillary region, neck, eye, and groin
Regions of epidermis and dermis
Epidermis: Stratum corneum, lucidum, granulosum, spinosum, basale
Dermis: Papillary and reticular layers
How did ancestors going upright and bipedal change anatomy
Affected anatomy of pelvic girdle
Pelvic girdle widened = birth canal widened = can give birth to babies with larger cranium = babies can have larger brains = development of prefrontal cortex, wernickes area, and brocas area
4 sinuses
Maxillary, frontal, ethmoid, sphenoid
Warms and humidifies air we breathe in
Secrete mucus to trap bacteria and impurities
Know orientation
https://ctsinuscenter.com/wp-content/uploads/2023/01/Paranasal-Sinuses.jpg
Referred pain
Maxillary sinus superior to upper teeth, so infection of maxillary sinus causes inflammation and leads to pressure on upper teeth, so brain interprets as toothache
3 elements of cleaning wound by pouring H2O2 in cut
Fluid: cleansing wound by pouring fluid
Toxic: O2 is toxic to obligate anaerobes that are trying to infect cut
Psychosomatic: Makes person feel better about cut healing; not stressing about cut
Glutathione molecular structure
https://file.medchemexpress.com/product_pic/hy-d0187.gif
Has HS and NH
Source of mutation within skin
Sun can be a source of mutation
Direct positive correlation between the number of times you burn and peel and the incidence of skin cancer
If cancers start in melanocytes they have the greatest incidence of metastasizing
Nociceptor
Pain receptors
Sensory receptors that are activated by noxious stimuli that damage or threaten the body’s integrity
Exception to skeletal muscle
Involuntary
Shiver
2 parts of hair for DNA
Follicle: Best to find DNA; takes dermal root cells and dermis
Root
Parts of hair
Shaft of hair: What you shave
Follicle: Foundation
Root: Between
Burn degrees
First degree burn: Epidermis
Second degree burn: Epidermis and dermis
Third degree burn: Epidermis, dermis, and subcutaneous tissue
Microscopic terms of bone
Volkmann canal: Contains arteries, veins, and nerves
Interstitial lamellae: Irregularly shaped and fill in the spaces between osteons
Concentric lamellae: Cylindrical rings of lamellae which are rich in collagen
Haversian canal: Surrounded by osteons; Nutrient canal of osteons that house nerve fibers and capillaries; allows bone to get oxygen and nutrition without being highly vascular
Calcitonin
From thyroid c-cells
Lowers blood calcium levels
Stimulus: Blood calcium was too high
Put osteoblasts to work; osteoblasts activity up; will take calcium out of blood and increase hydroxyapatite
Osteoclast activity go down
GI tract absorb less calcium and instead keep it in GI tract; GI absorption decreased
Kidney reabsorption decreased to filter calcium out of urine
Parathyroid (PTH)
From parathyroid gland
Increases blood calcium levels
Stimulus: Blood calcium low
Osteoclast activity increases
Osteoclast secrete hydrochloric acid to wither bone away; calcium from bone goes into bloodstream
Calcitriol
Sun activate precursors
Cholecalciferol goes to liver
Calciferol goes to kidneys
Activates vitamin D3 (calcitriol)
Elevates blood calcium levels by stimulating osteoclasts
Estrogen (E2)
Helps to prevent apoptosis of osteoblasts
E2 increases = increases number of osteoblasts = increases building bone = E2 decreases
Menopause = Osteoporosis
Strain vs Sprain
Strain: Tendon; Bone to muscle
Sprain: Ligament; Bone to bone
Mediators of inflammation
Arachidonic acid, vasoactive peptides, phospholipid mediators, cytokines
Vasoconstriction vs Vasodilation
Vasoconstriction: Blood vessel constricts; Systemic vascular resistance increases
Vasodilation: Blood vessels dilate; Systemic vascular resistance decreases
Histamine sources
Mast cells
Basolipids
Hypothalamus
Enterochromaffin-like cells
Effects of histamine
Inflammation, vasodilation, bronchoconstriction, mucous secretion, itching
Allergy feed forward stimulation
Eyes -> Histamine increases -> Puffy; red; itch -> Scratch or rub eyes -> Feels good (short term) -> Mast cell activity increases -> Histamine levels increase
Agonist vs Antagonist
Agonist: Always produces a specific action and triggers the receptor to produce a natural response
Antagonist: Block or oppose the natural action or response of a receptor
COXs
Constitutive (COX-1) or inducible (COX-2) enzymes that catalyze the conversion of arachidonic acid into prostaglandin H2
Acetylsalicylic acid
Donates acetyls tp SER530 (Serine AA#)
Stops transcription from COX1 to COX2
Degranulation of mast cells
Releases histamine
