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FFM-I Mini 2 > FFM2 - Mini I > Flashcards

FFM2 - Mini I Flashcards

1
Q

Pharmacology

A

Study of substances that will interact with living systems via chemical processes

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2
Q

Drug

A

Molecule that will bind to target to exert effect

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3
Q

Prototype drug

A

First form of a drug/medication
Is used to formulate alternative forms

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4
Q

Pharmacokinetics

A

What body does to drug

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5
Q

Pharmacodynamics

A

What drug does to body

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6
Q

Toxicology

A

Science of adverse effects of chemicals on body

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7
Q

Pharmacogenetics

A

Relationship between persons genetic makeup and response to specific drugs

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8
Q

What is main item that NBME tests on for medication names?

A

Generic names of medications

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9
Q

Mechanism of action

A

How drug works to produce change in body

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10
Q

Pharmacologic drug action

A

Consequences of drug-receptor combination

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11
Q

Pharmacologic effect

A

Results of drug action
Consequences of drugs own actions

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12
Q

Precaution

A

Used when medication use should be used with care and careful monitoring of patient

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13
Q

Contraindication

A

Specific circumstance where medication should NOT be used

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14
Q

Relative Contraindication

A

Caution needs to be used when 2 meds used together
Benefits outweigh risks

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15
Q

Absolute contraindication

A

Substance can cause life-threatening and should be avoided

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16
Q

Black box warning

A

Serious/life threatening risks associated with
Most serious medication warning from FDA

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17
Q

Therapeutic effect

A

Beneficial consequence of treatment

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18
Q

Adverse event

A

Harmful/abnormal result form medication

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19
Q

Pregnancy Risk Catagories

A

A
B
C
D
X

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20
Q

Which pregnancy risk catagories are adverse?

A

C
D
X

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21
Q

Affinity

A

Strength of interaction between drug and target

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22
Q

Potency

A

Amount of drug necessary to produce effect

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23
Q

EC50

A

Concentration drug needed to produce 50% of max effect

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24
Q

Efficacy

A

Largest effect achieved with drug, regardless of dosage

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25
Q

Agonist

A

Bind to receptor
Produce normal response

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26
Q

Antagonist

A

Bind to receptor
Compete and prevent binding by other molecules
Will block actions OF agonist

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27
Q

Full Agonist

A

Complete 100% activation of receptor

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28
Q

Partial agonist

A

Binding to receptor results in >0% but < 100% of activation even with high concentrations

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29
Q

Inverse agonist

A

Bind to receptor and will produce a response BELOW baseline response
Decreased concentration of drug

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30
Q

Competitive antagonist

A

Bind to same site
Lowers efficacy of medication
Decreases EC50 of medication

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31
Q

Noncompetitive anatgonist

A

Bind covalently to receptor
Permanent reduction of # of receptors
Irreversible
EC50 remains same; efficacy decreases

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32
Q

Selectivity

A

Degree to which drug acts on given site relative to other sites

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33
Q

Nonselective drug

A

Affects many different tissues producing range of effects

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34
Q

Selective drug

A

Affects single organ/system

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35
Q

Local effects of medication

A

Application to site of action

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36
Q

Systemic effects

A

Drug enters circulation and transported to cellular site of action

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37
Q

Routes of Administration:
Enteral

A

Oral, sublingual/buccal, rectal

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38
Q

Routes of Administration:
Paraenteral

A

IV/IA
IM
SubQ
Intradermal

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39
Q

Routes of Administration:
Other types

A

Oral inhalation
Intrathecal/intraventricular
Topical
Transdermal
Vaginal
Urethral

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40
Q

Absorption

A

Entering blood stream from site of administration

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41
Q

Distribution

A

Process which drug reversibly leave bloodstream and enters ECF and tissues

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42
Q

Metabolism

A

Biochemical changes to medication to facilitate elimination from body

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43
Q

Elimination

A

Irreversible removal of medication from body
Renal most common

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44
Q

Bioavailability

A

Extent to which medication reaches systemic circulation

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45
Q

Factors affecting Absorption

A

ph changes
Blood low
Presence/absence of transporters
First pass effect (Liver/GI metabolism)
Drug formulation

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46
Q

Factors affecting Distribution

A

CO and Blood flow
Permeability of capillaries
Degree of binding of drug to proteins in blood/tissue
Lipophilicity of medication
MW

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47
Q

Central compartment of body

A

Highly perfused organs
Heart/Liver/Kidneys

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48
Q

Peripheral compartment of body

A

Fat tissues
Muscle tissues
CSF

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49
Q

Instantaneous distribution within body

A

One-compartment
All fluids/tissues considered part of compartment

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50
Q

Delayed distribution within body
Some areas get medication faster than others…

A

Two-compartments
Distribution into high vascular organs then everywhere else more slowly

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51
Q

Metabolism of meds in 3 ways
1)
2)
3)

A

1) Active med to inactive med
2) Active med to active metabolite
3) Inactive med to active med

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52
Q

Volume of Distribution (Vd)

A

Fluid volume required to contain entire drug in body at same concentration as measured in plasma

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53
Q

Equation for Vd

A

Dose of drug/drug concentration

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54
Q

Factors affecting Vd

A

Drug MW
Lipophilic or hydrophilic
Ionization at pH
Protein binding
Disease states

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55
Q

Half Life (T1/2)

A

Time it takes to reduce plasma concentration by 1/2

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56
Q

Clearance (CL)

A

Volume of blood from which drug is cleared per unit of time

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57
Q

Equation of CL

A

CL(total) = CL(hepatic) + CL(renal) + CL (other)

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58
Q

Clearance is dependent on…

A

Half Life - t1/2
Volume of Distribution - Vd

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59
Q

Notable CYP-450 Interactions:
Inducers (8)

A

1) Carbamazepine
2) Chronic alcohol abuse
3) Modofinil
4) Nevirapine
5) Phenobarbital
6) Phenytoin
7) Rifampin
8) St Johns Wort

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60
Q

Notable CYP-450 Interactions:
Substrates (5)

A

1) Anto-epileptics
2) Oral contraceptives
3) Statins (EXCEPT FOR pravastatin)
4) Theophylline
5) Warfarin

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61
Q

Notable CYP-450 Interactions:
Inhibitors (16)

A

1) Acute alcohol overdose
2) Acetomenophen
3) Amniodarone
4) Chloramphenicol
5) Cimitidine
6) Clarithromycin
7) Erythromycin
8) Fluconazole
9) Grapefruit juice
10) Isoniazid
11) Ketoconazole
12) NSAID’s
13) Omeprazole
14) Ritonavir
15) Sulfonamides
16) Valporic Acid

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62
Q

Types of Tissues

A

Epithelial
Connective
Nervous
Muscular

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63
Q

Characteristics of Epithelium

A

Avascular
Packed cells with shape/arrangement associated with function

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64
Q

Cell characteristics of epithelium

A

Arranged as sheets or masses
Close to one another
Have intercellular junctions
Polarized
Rest on basal lamina

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65
Q

Polarization in epithelium

A

Distinct surface domains
Apical, Lateral and basal surfaces

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66
Q

Classification of cells:
1)
2)

A

Arrangement
Shape

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67
Q

Examples of Arrangement for cells

A

Simple
Stratified

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68
Q

Examples of Shape of cells

A

Squamous
Cuboidal
Columnar

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69
Q

Features of Simple Squamous cells

A

Width greater than height
One cell layer thick
Nucleus protrudes into lumen

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70
Q

Location of Simple Squamous cells

A

Lining of BV and Lymphatic vessels
Wall of Bowmans capsule
Covering of mesentery
Lining of respiratory spaces/alveoli in lungs

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71
Q

Function of Simple Squamous cells

A

Diffusion
Transportation in/out of lumen

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72
Q

Special terminology for certain simple squamous epithelia

A

Endothelium
Mesothelium

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73
Q

Endothelium

A

Simple Squamous cells lining blood vessels, lymph vessels, lining of heart (atria/ventricles)

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74
Q

Mesothelium

A

Simple Squamous cells lining walls and covering contents of body cavities (C/A/P)

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75
Q

Features of Simple Cuboidal cells

A

Width, depth and height all similar
One cell layer
Centrally located nuclei

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76
Q

Location of Simple Cuboidal cells

A

Wall of thyroid follicle
Walls of kidney tubules (DCT)
Surface of ovary (germinal epithelium)
Interior surface of tympanic membrane

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77
Q

Function of Simple Cuboidal cells

A

Absorption
Secretion
Conduction involving different metabolic processes

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78
Q

Features of Simple Columnar cells

A

Height greater than width
One cell layer
Nuclei seen near basement membrane

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79
Q

Location of Simple Columnar cells

A

Intestinal tract (stomach to rectum)
Gallbladder
Uterus/cervix
Kidney collecting ducts (lower portion of)
Inner ear
Larger glands and ducts

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80
Q

Function of Simple Columnar cells

A

Protection
Lubrication
Absorption
Secretion
Conduction involving different metabolic processes

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81
Q

Features of Stratified Squamous cells

A

Multilayered
Superficial layer is squamous
Can be keratinzied/nonkeratinized

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82
Q

Location of Stratified Squamous cells

A

Epidermis (K)
Lining of oral cavity (NK)
Lips
Lining of esophagus (NK)
Lining of vagina (NK)

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83
Q

Functions of Stratified Squamous cells

A

Barrier
Protection

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84
Q

Keratinized Stratified Squamous cells seen…

A

Dry environment

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85
Q

Non-keratinized Stratified Squamous cells seen…

A

Wet environment

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86
Q

Features of Stratified Cuboidal cells

A

Multilayered

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87
Q

Location of Stratified Cuboidal cells

A

Ducts of sweat glands
Larger ducts of exocrine glands
Anal canal

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88
Q

Functions of Stratified Cuboidal cells

A

Barrier
Conduit

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89
Q

Features of Stratified Columnar cells

A

Multilayered
Basal layer appears cuboidal
Superficial layer appears columnar

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90
Q

Location of Stratified Columnar cells

A

Largest ducts of exocrine glands
Anal canal
Conjunctiva of eye
Male urethra
Submandibular salivary gland

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91
Q

Function of Stratified Columnar cells

A

Barrier
Conduit

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92
Q

Features of Transitional Epithelium

A

Stratified
Upper cells domed shaped
Some cells are binucleated
Apical surface will stain more pink due to actin filaments

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93
Q

Location of Transitional Epithelium

A

Ureters
Urinary bladder
Renal calyces
Urethra

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94
Q

Function of Transitional Epithelium

A

Accommodation of distention

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95
Q

Another name for Transitional Epithelium

A

Urothelium

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96
Q

Features of Pseudostratified Epithelium

A

Appearance of being stratified but is NOT
Some cells do not reach free surface
Nuclei located at different distances from basal lamina
All cells rest on basement membrane

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97
Q

Location of Pseudostratified Epithelium

A

Upper Respiratory Tract
Epididymis
Ductus deferens
Middle Ear

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98
Q

Special features usually seen with Pseudostratified epithelium

A

Ciliated or Stereocilia
Goblet cells

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99
Q

Features of Basal Lamina

A

Acellular
Attachment site
Components synthesized and secreted by epithelial cells
Seen with PAS and Silver salts

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100
Q

Layers of Basal Lamina

A

1) Lamina Densa
2) Lamina Lucida

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101
Q

Features of Lamina Densa

A

Network of fine filaments

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102
Q

Features of Lamina Lucida

A

Clear space between base of cell and Lamina Densa
Cause by artifact

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103
Q

Functions of Basal Lamina
1)
2)
3)

A

Structure Attachement
Compartmentalization
Filtration

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104
Q

Function of Basal Lamina:
Attachement

A

Connection of epithelial cells to connective tissue

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105
Q

Function of Basal Lamina:
Compartmentalization

A

Separates connective tissue FROM nervous, epithelial, and muscular tissue

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106
Q

Function of Basal Lamina:
Filtration

A

Movement of blood filtrate within kidney
Negatively charged molecules in lamina lucida/collagen fibrils in lamina densa
Regulated via ion exchange and molecular sieve

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107
Q

Composition of Basal Lamina

A

Laminins
Collagens
Entactins/Nidogen
Proteoglycans

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108
Q

Functions of Laminins

A

Possess integrins
Link basal lamina to basal plasma membrane

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109
Q

Functions of Collagens

A

Type IV collagen
Short filaments
Structural integrity
Molecular sieve

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110
Q

Functions of Entactin/Nidogen

A

Link between laminins and Type IV collagen
Supports cell adhesion

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111
Q

Functions of Proteoglycans

A

Bulk of basal lamina
Protein cores
Attached to cores are negatively charges GAG’s
VERY EXTENSIVELY HYDRATED
Role in regulation of ions across basal lamina

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112
Q

Types of cell surface modifications

A

Microvilli
Cilia
Stereocilia
Lateral/Basal foldings

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113
Q

Features of Microvilli

A
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114
Q

Features of Stereocilia

A
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115
Q

Features of Lateral folds

A
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116
Q

Types of Junctional Complexes

A

Zonula Occludens
Zonula Adherens
Macula Adherens/Desmosomes
Gap Junctions

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117
Q

Features of Zonula Occludens

A
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118
Q

Features of Zonula Adherens

A
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119
Q

Features of Macula Adherens

A
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120
Q

Features of Gap Junctions

A
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121
Q

Features of Hemidesmosomes

A

Located on basal surface of plasma membrane
Connects basal PM to basal lamina

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122
Q

Locations with hemidesmosomes

A

Epithelia subjected to abrasion and mechanical shearing
Skin
Cornea
Mucosa of Oral cavity, Esophagus, and vagina

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123
Q

Composition of hemidesmosomes

A

Attachment plaque (plectin and BP230)
Plaque on cytoplasmic side
Intermediate filaments bind to attachment plaque
Integrins bind attachent plaque to ECM

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124
Q

Features of Focal Adhesions

A

Dynamic attachments
Link actin filaments to ECM proteins

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125
Q

Composition of Focal Adhesions

A

Actin filaments
Integrins
Laminin and Fibronectin

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126
Q

Role of Focal Adhesions

A

Attachment and migration of cells

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127
Q

CN-I
Name:
Sensory Function:
Motor Function:
Origin from brain:

A
  • Olfactory
  • Sensory Nerve - sense of smell
  • No motor function
  • Cerebrum
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128
Q

CN-II
Name:
Sensory Function:
Motor Function:
Origin from brain:

A
  • Optic
  • Sensory Nerve - sense of sight
  • No motor function
  • Cerebrum
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129
Q

CN-III
Name:
Sensory Function:
Motor Function:
Origin from brain:

A
  • Oculomotor
  • No sensory function
  • Motor function - controls 5/7 muscles of orbit/eye
  • Midbrain
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130
Q

CN-IV
Name:
Sensory Function:
Motor Function:
Origin from brain:

A
  • Trochlear
  • No sensory function
  • Downward internal rotation of eye (Superior Oblique)
  • Midbrain
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131
Q

CN-V
Name:
Sensory Function:
Motor Function:

A
  • Trigeminal
  • Sensory for facial sensations (pain, hot/cold)
  • Motor function for muscles of mastication
  • Motor function of myohyloid, anterior belly of digastric; tensor veli palantini; tensor tympani
  • Pons
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132
Q

Muscles of mastication

A

Temporalis muscle
Massetter muscle
Lateral/Medial Pterygoid

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133
Q

CN-VI
Name:
Sensory Function:
Motor Function:
Origin from brain:

A
  • Abducens
  • No sensory function
  • Motor function for lateral deviation of eye (Lateral Rectus)
  • Pons
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134
Q

CN-VII
Name:
Sensory Function:
Motor Function:
Origin from brain:

A
  • Facial
  • Sensory function of taste on anterior 2/3 of tongue and sensation of ear
  • Motor function of facial expressions (posterior belly of digastric; stapedius muscle)
  • Pons
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135
Q

CN-VIII
Name:
Sensory Function:
Motor Function:
Origin from brain:

A
  • Vestibulocochlear
  • Sensory function of hearing (cochlear) and balance (vestibular)
  • No motor function
  • Pons
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136
Q

CN-IX
Name:
Sensory Function:
Motor Function:
Origin from brain:

A
  • Glossopharyngeal
  • Sensory function of taste on posterior 1/3 of tongue
  • Sensory of pharynx, posterior portion of eardrum and ear canal
  • Motor function of the stylopharyngeus muscle
  • Medulla Oblongata
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137
Q

CN-X
Name:
Sensory Function:
Motor Function:
Origin from brain:

A
  • Vagus
  • Sensory function of pharynx and larynx
  • Motor function of pharynx, larynx, and palatal muscles
  • Medulla Oblongata
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138
Q

CN-XI
Name:
Sensory Function:
Motor Function:
Origin from brain:

A
  • Spinal Accessory
  • No sensory function
  • Motor function of SCM and trapezius
  • Medulla Oblongata
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139
Q

CN-XII
Name:
Sensory Function:
Motor Function:
Origin from brain:

A
  • Hypoglossal
  • No sensory function
  • Motor function of the intrinsic and extrinsic muscles of the tongue
  • Medulla Oblongata
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140
Q

Membrane potential

A

Differences in charges between 2 sets of ions

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141
Q

ICF or ECF:
Higher concentration of K+

A

ICF

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142
Q

ICF or ECF:
Higher concentration of Na+

A

ECF

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143
Q

ICF or ECF:
Higher concentration of Ca2+

A

ECF

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144
Q

ICF or ECF:
Higher concentration of Cl-

A

ECF

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145
Q

ICF or ECF:
Higher concentration of PO4(3-)

A

ICF

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146
Q

Nernst Equation
Na+, K+

A

~60 mV log (Concentration outside)/(Concentration inside)

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147
Q

Nernst Equation
Cl-

A

~60 mV log (Concentration inside)/(Concentration outside)

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148
Q

Pump Leak model

A

Pumps: Process using energy to move system away from equilibrium
Leaks:Process that drives a system towards equilibrium

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149
Q

Will excess Na+ outside cell change extracellular potential

A

No

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150
Q

Will excess K+ outside cell change extracellular potential

A

Yes

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151
Q

Goldman-Hodgkin-Katz Equation

A

It’s an estimation of Vm when no net current through membrane

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152
Q

Which way do ions move?
Na+
K+

A
  • Na will move positive charge into cells to move the internal cell potential from -70 to +60 mV (Na+ equilibrium)
  • K will move positive charge out of cell to move internal cell potential from -70 to -90 mV
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153
Q

Types of graded potentials

A

Depolarization
Hyperpolarization

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154
Q

Electrotonic conduction

A

Passive process
Localized
Graded process

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155
Q

Examples of Graded potentials

A

Pacemaker potential in heart
Post-synaptic potentials

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156
Q
A
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157
Q

EPSP

A

Excitatory Post Synaptic Potential
Will move to threshold
Na+ will enter

158
Q

IPSP

A

Inhibitory Post Synaptic Potential
Will move to hyperpolarization
Chloride enters or K+ leaves

159
Q

Types of Graded potential summation

A

1) Temporal summation
2) Spatial summation

160
Q

Temporal Summation

A

1 synapse can fire multiple AP’s over time
May or may not actual action potential

161
Q

Spatial Summation

A

Multiple synapses firing at various times intergrating at cell body to determine AP

162
Q

Refractory Period

A

Period of time when cell is totally or partially inhibited from being able to respond to stimuli

163
Q

Types of Refractory period

A

1) Absolute - NO AP can be generated bar none
2) Relative - able to achieve AP but requires larger amount of stimuli

164
Q

Aqueous diffusion:

A

< 100 D
Small molecules
Passive
Nonselective

165
Q

Lipid Diffusion

A

100 - 1500 D
Passive process
Non-selective

166
Q

Facilitated diffusion

A

Passive process
Carrier-mediated
Confers selectivity
Able to be saturated
Competative

167
Q

Bulk Transport

A

Passive process
<15000 but up to 16000 D
Non selective

168
Q

Active Diffusion

A

Energy Dependent
Carrier dependent
Saturable
Competitive
Selective

169
Q

Endocytosis/exocytosis

A

Require energy
Large molecules > 100,000 D

170
Q

Efflux transporters

A

Decrease drug absorption

171
Q

Influx transporters

A

Increase drug absorption

172
Q

If pH > pKa…what is favored

A

Ionized H+ and A-
Unionized B and A-

173
Q

Lipophillic

A

Uncharged or unionized molecule

174
Q

If pH < pKa…what is favored

A

Unionized HA
Ionized BA+

175
Q

Hydrophilic

A

Charged or ionized molecule

176
Q

Ion trapping

A

Ionized forms of meds are more likely to undergo ion trapping - unionized forms will be readily reabsorbed back into system

177
Q

Calculation of pH and pKa for water solubility

A
178
Q

Absorption:
Sublingual

A
179
Q

Absorption:
Oral

A

Small intestine transit time = 3-4 hrs

180
Q

Absorption:
Rectal

A

Systemic and Local effects

181
Q

Absorption:
Topical

A

Local effect

182
Q

Absorption:
Transdermal

A

Systemic effect

183
Q

Absorption:
Pulmonary (gases)

A

Systemic effects

184
Q

Absorption:
IM

A

Systemic effect

185
Q

Absorption:
IV

A

100% bioavailability; systemic effect

186
Q

Absorption:
Pulmonary (aerosols)

A

Local effect

187
Q

Absorption:
SubQ

A

Systemic effect

188
Q

Absorption:
Intraarticular

A

Localized to tissue/organs
Delay systemic effect

189
Q

Absorption:
Intrathecal

A

Used to bypass BBB
Administration of drugs through CSF

190
Q

Absorption:
Intracardiac

A

Used for cardiac emergencies

191
Q

Absolute bioavailability

A

(AUC oral)(Dose IV) / (AUC IV)(Dose oral)

192
Q

F

A

Bioavailability

193
Q

Absorption:
Intrapleural/intraperitoneal

A

Local effect
Decreased availability to system

194
Q

Tmax

A

Time is takes for maximum [Drug] within plasma

195
Q

Cmax

A

Max [Drug] reached in plasma AFTER administration of dose

196
Q

MTC

A

Minimum Toxic concentration

197
Q

MEC

A

Minimum effective concentration

198
Q

Vd

A

(Drug Dose)(F) / CPo

199
Q

CL total

A

CL hep + CL renal + Renal others

200
Q

t 1/2

A

(0.7)(Vd) / CL

201
Q

Steady State

A

Dose/CL

202
Q

Loading Dose

A

(Css)(Vd) / F

203
Q

Maintenance Dose

A

(Css)(CL)(infusion time) / F

204
Q

CL

A

Rate of elimination / Plasma concentration

205
Q

Dosing Rate

A

CL / Css

206
Q

Distribution:
BBB

A
207
Q

Distribution:
Placenta

A
208
Q

Types of muscles
1)
2)
3)

A

Skeletal
Cardiac
Smooth

209
Q

Sarcolemma of muscle types surrounded by…

A

Basal or external lamina

210
Q

Composition of External Lamina

A

Collagen Type IV
Laminin
Perlecan

211
Q

Composition of Skeletal Muscle Cells

A
  • Long, multinucleated cells
  • Long, oval nuclei seen at periphery of cells
  • Nuclei underneath the sarcolemma
212
Q

Origin of Skeletal Muscle

A

Mesodermal

213
Q

Embryonic formation of skeletal muscles
1)
2)
3)

A

1) Mesenchymal myoblasts fuse and form myotubes (with many nuclei)
2) Myotubes differentiate into muscle fibers
3) Some don’t differentiate - satellite cells

214
Q

Function of muscle Satellite cells

A

Form new muscle fibers after injury

215
Q

Endomysium

A

Surrounds muscle fiber (single muscle cell)

216
Q

Contents of endomysium

A

Small BV’s and small nerve branches

217
Q

Composition of endomysium

A

Type I and type III collagen

218
Q

Perimysium

A

Surround group of muscle fibers (fasicles)

219
Q

Contents of Perimysium

A

Contains larger BV’s and nerves

220
Q

Composition of perimysium

A

Type I collagen

221
Q

Epimysium

A
  • Sheath of DCT surrounding collection of fascicles
222
Q

Contents of epimysium

A

Major vascular structures and nerves

223
Q

Composition of epimysium

A

Type I collagen

224
Q

Myotendinous junctions - meeting of what 2 structures

A

Muscle fibers and tendon

225
Q

At transition of muscles and tendon of myotendinous junction, fibers seen

A

Collagen

226
Q

Blood supply of skeletal muscles

A

High vascularity

227
Q

Reason for high vascularity of skeletal muscles

A

High O2 req
High energy requirements

228
Q

What are neurovascular bundles?

A

Where vasculature/nerves enter muscles

229
Q

Function of Muscle Spindles

A

Stretch detection in the muscle fibers

230
Q

Structure of Muscle Spindles

A

Connective tissue capsule surrounding fluid filled space
Space contains thin, non-striated fibers filled with nuclei (intrafusal fibers)

231
Q

Function of intrafusal muscle fibers

A

Proprioception
Detect amount and rate of length change in muscle

232
Q

Function of Golgi Tendon Organs

A

Detection of tension in tendons

233
Q

Clinical Correlation:
Polymyositis

A

Inflammatory disease attacking endomysium of muscles

234
Q

Clinical Correlation:
Polymyositis S/S

A

Loss of muscle tisse
Progressive SYMMETRICAL proximal muscle weakness

235
Q

Clinical Correlation:
Dermatomyositis

A

Inflammatory disease affecting perimysium

236
Q

Clinical Correlation:
Dermatomyositis S/S

A

Progressive SYMMETRICAL proximal muscle weakness along with cutaneous findings

237
Q

A-bands

A

Comprised of H-band
Area where overlap of myosin and actin fibers occur
Will remain the same with contraction/relaxation

238
Q

I-bands

A

Actin filaments
Area with shorten/expand with contraction/relaxation

239
Q

Z-line

A

Beginning and ending of ONE Sarcolemma unit

240
Q

H-band

A

Area within A band where myosin filaments do not overlap actin filaments

241
Q

M-line

A

Area where mysoin attaches

242
Q

Thick myofilaments

A

Myosin

243
Q

Structure of myosin

A

2 heavy chains = thin, motor proteins with heads twisted together
4 light chains = Binding sites

244
Q

Thin myofilament

A

Thin, helical actin filaments running between thick filaments

245
Q

Regulation sites of thin filamaments

A

Tropomyosin
Troponin

246
Q

Structure/Function of Tropomyosin

A

Coil of 2 polypeptide chains situated in a groove between 2 actin strands
Will block myosin from binding to actin filaments

247
Q

Structure/Function of Troponin:
1) Troponin T
2) Troponin C
3) Troponin I

A

Troponin T = attaches to tropomyosin
Troponin C = Ca2+ binding site
Troponin I = regulates myosin/actin interaction

248
Q

Function of accessory muscle proteins

A

Maintain efficiency of contraction
Maintain speed of contraction

249
Q

Examples of accessory muscle proteins (8)

A

Titin
𝛼-actinin
Nebulin
Myomesin
C protein
Tropomodulin
Desmin/Vimentin
Dystrophin

250
Q

Function of:
Titin

A
  • Anchor thick filaments to Z line
  • Will prevent excessive stretching of sarcomere
251
Q

Clinical correlation:
Dilated cardiomyopathy

A

Mutation of TTN gene encoding titin

252
Q

Function of:
𝛼-actinin

A
  • Bundle thin filaments into parallel arrays
  • Anchor thin filaments to Z line
253
Q

Function of:
Nebulin

A
  • Runs parallel to actin filaments
  • Helps anchor 𝛼-actinin to actin filaments to Z line
  • Regulate length of thin filament during muscle development
254
Q

Function of:
Myomesin

A
  • Myosin binding protein
  • Holds thick filaments at M line
255
Q

Function of:
C protein

A
  • Myosin binding protein
  • Holds thick filaments at M line
  • Will form stripes on either side of M line
256
Q

Function of:
Tropomodulin

A
  • Small protein attached to free part of actin
  • Maintain/regulate length of actin filament in sarcomere
  • Affects length-tension relationship in contractions
257
Q

Function of:
Desmin/Vimentin

A
  • Intermediate fibers - form lattice around sarcolemma at Z line
  • Attaches Z discs to one another and to sarcolemma
  • Crosslink/stabilizes myofibrils
258
Q

Function of:
Dystrophin

A
  • Seen beneath cell membrane
  • Links laminin and agrin of external lamina to actin filaments (thru membrane)
259
Q
A
260
Q

Clinical Correlation:
Muscular Dystrophy

A
  • Disorder where organ/tissue wastes away
  • Progressive weakness and wasting of muscles
  • Links actin cytoskeleton to sarcoglycan complex
  • Sarcoglycan complex links to external lamina/laminin
  • Laminin links to collagen fibers for endomysium
  • Impairment of dystrophin causes microruptures in cell membranes - cell death
261
Q

Function of sarcoplasmic reticulum

A

Concentrate and sequester Ca2+

262
Q

Consists of…

A

Longitudinal tubules with enlarged region at the end (terminal cisternae)

263
Q

Terminal cisternae associated with

A

T-tubules
1 T-tubule flanked by 2 terminal cisternae

264
Q

1 T-tubule with 2 associated flanking terminal cisternae are called…

A

a Triad

265
Q

Membranes of T-tubules continuous with…

A

Muscle fiber membranes

266
Q

Lumen of T-tubules continuous with…

A

ECF

267
Q

Function of T-tubules

A

Allow AP to move rapidly from cell surface into interior fiber to reach terminal cisternae

268
Q

Composition of cardiac muscle

A
  • Striated, single nucleus (rare for 2)
  • Elongated/branched cells bound to intercalated discs
  • Contraction involuntary, vigorous, rhythmic
269
Q

Origins of Cardiac muscle

A
  • Splanchnic mesoderm cells
  • Will form primitive heart tube
  • Cells align into chainlike array
  • Cells form complex junctions between intercalated discs
270
Q

Structure of intercalated disc in Cardia muscle

A

Cells in one fiber branch and join cells of another fiber

271
Q

Cardiac muscle fiber components

A
  • Single nucleus (sometimes 2, rare)
  • Contain myosin/actin filaments arranged in sarcomeres
  • 40% of cell volume is mitochondria
  • Store FA’s stored as TG’s in lipid droplets
272
Q

Components of intercalated discs

A
  • Gap junctions
  • Desmosomes
  • Fascia adherens
273
Q

Function of ______ in Cardiac muscle:
Gap junctions

A

Ionic continuity between cells
Allows cells to act in multinucleated syncytium

274
Q

Function of ______ in Cardiac muscle:
Desmosomes

A

Macula Adherens

275
Q

Function of ______ in Cardiac muscle:
Fascia adherens

A

Ribbon-link structure to stabilize non-epithelial tissue
Anchors actin filaments

276
Q

Organells of cells located in…

A

Juxtanuclear region

277
Q

Granules located in atria

A

Atrial natriuretic factor (ANF)
Brain natriuretic factor (BNF/BNP)

278
Q

Function of ANF and BNF

A

Inhibit renin secretion in kidneys
Inhibit contraction of vascular smooth muscle

279
Q

Function of lipofuscin granules

A

Pigment seen in older cardiomyocyte cells

280
Q

Composition of Smooth muscle

A
  • Collection of spindle cells with one central nucleus
  • NO STRIATIONS SEEN
  • Slow, involuntary movements
281
Q

Origin of smooth muscles

A
282
Q

Smooth muscles found where in the body?

A

Everywhere!
Wall of BV and airways
GIT
Pupillary dilation
Lens shape
etc…

283
Q

Regulation of smooth muscle contraction

A

Electrical signals
Chemicals
Hormones
Drugs

284
Q

Response of SM depends on:
1)
2)
3)

A

1) Function of tissue
2) ° of innervation from ANS
3) Expression of receptors for chemicals/hormones

285
Q

Smooth muscle cells attached to one another via…

A

Desmosomes
Gap junctions

286
Q

Types of fibers seen in Smooth muscle

A

Think, thin and intermediate filaments

287
Q

Function of:
Thin filaments

A

Attach to dense bodies
Function like Z disc (one sarcomere from one another)

288
Q

Function of:
Dense bodies

A
  • Contain 𝛼-actin for thin filament attachment
  • Attachment sites for intermediate filaments and adhesive junctions
289
Q

Function of:
Intermediate filaments

A

Desmin/vimentin

290
Q

Arrangement of Smooth muscle in GIT

A

Sheets of opposing fibers
Form inner circular layer
Outer longitudinal layer

291
Q

Peristalsis

A

Contraction of inner and outer opposing layers of smooth muscle

292
Q

Arrangement of Smooth muscle in vasculature (BV)

A

Seen in tunica media of blood vessels
Contracts to narrow lumen of BV

293
Q

Seen in which types of BV’s?

A

Medium arteries
Small arteries

294
Q

Myoepithelial cells

A
  • Seen in glands
  • Share basal lamina of secretory/duct cells
  • Contract to express contents from ducts out of gland
  • Contraction mediated via calmodulin process
295
Q

Myofibroblasts

A
  • Possess vimentin
  • Contain higher amounts of actin/myosin
  • Capable of contractions
  • Contract during wound healing
296
Q

Excitation-contraction coupling

A

Events between generation of AP in skeletal muscle cell and release of Ca2+ from SR

297
Q

First receptor to open to AP in skeletal muscle

A

Dihydropyridine receptors (DHPR)

298
Q

Dihydropyridine is what types of receptor?

A

Voltage gated Ca2+ channels

299
Q

How are DHPR arranged and where are they arranged?

A

1) Arranged in rows
2) On the T-tubule

300
Q

What is the receptor associated with DHPR?

A

Ryanodine receptors

301
Q

Describe Ryanodine receptors

A

Ca2+ release channels

302
Q

How are Ryanodine receptors/channels opened?

A

1) AP signal in T-tubule causes conformational change in DHPR
2) Conformational change opens Ryanodine channels
3) Ca2+ released from SR

303
Q

How is Ca2+ removed from intracellular concentration?

A

Ca2+ pump
Ca2+-ATPase pump

304
Q

Other name for Ca2+-ATPase

A

SERCA
Sarcoplasmic endoplasmic reticulum calcium ATPase

305
Q

How many molecules of Ca2+ does the SERCA pump back into the SR?

A

2 molecules of Ca2+ for every 1 ATP hydrolyzed

306
Q

Steps to induce a contraction of muscle:

A

1) Troponin-tropomyocin complex covers myosin binding site on actin
2) Myosin is bound to ADP and Pi
3) AP signal is released to muscle membrane
4) Ca2+ released via RYN receptors/channels in SR
5) Ca2+ binds to Troponin-C; activates movement of tropomyosin from binding site
6) Myosin binds to binding site
7) Binding triggers conformational change in myosin head - power stroke occurs
8) ADP + Pi dissociate; ATP binds to myosin head
9) ATP binding causes detachment of myosin from actin; ATP immediately hydrolyzed to ADP + Pi
10) Myosin returns to resting state

307
Q

Steps to allow for relaxation

A

1) Cycle continues AS LONG AS ATP/Ca2+ present at all times
2) Ca2+ re-sequestered in SR via SERCA
3) Ca2+ lvls drop; tropomyosin moves over myosin binding site on actin

308
Q

What occurs when ATP is not available?

A

Myosin and actin will remain attached to one another - rigor mortis

309
Q

What difference is there between Ca2+ binding in skeletal muscle and smooth muscle

A
  • Ca2+ binding in skeletal muscle occurs with Troponin C
  • Ca2+ bind in smooth muscle occurs with calmodulin
310
Q

Sliding Filament Theory

A

Sliding part of actin past myosin generates muscle tension

311
Q

Energy sources during muscle contraction

A

ATP
Creatine Phosphate
Carbs/Glycogen/Glucose
FA’s/TAG’s

312
Q

Cells that generate AP in the heart

A

Pacemaker cells

313
Q

Propagation of AP in the heart

A

SinoAtrial node

314
Q

Difference between SR in skeletal muscle and cardiac muscle

A

Cardiac muscle SR is less dense and not as well developed

315
Q

30% of heart is comprised of

A

Mitochondria

316
Q

Why the high amount of mitochondria in the heart?

A

Increase ability for oxidative capacity and generation of ATP

317
Q

Pacemaker cells able to undergo…

A

Spontaneous depolarization to generate AP

318
Q

Reason for long duration of cardiac AP

A

Slow inward movement of Ca2+ thru voltage gated L type Ca2+ channels in sarcolemma

319
Q

Composition of voltage gated L type Ca2+ channels…

A

5 subunits
𝛼1, 𝛼2, β, 𝛾, δ

320
Q

Other name of 𝛼1 subunit

A

Dihydropyridine receptor

321
Q

Amount of Ca2+ entering cardiac muscle cell…

A

Normally, small amount.

322
Q

Absence of extracellular Ca2+

A

Duration of AP is shorter and unable to initiate contraction of heart

323
Q

Ryanodine receptors in cardiac muscle - opens what kind of channel

A

Calcium gated calcium channel
Influx of Ca2+ initiates release OF Ca2+ from SR

324
Q

Removal of excess Ca2+ from cardiac muscle cells

A

Through sarcolemma Na+/Ca2+ antiporter and Ca2+ pump

325
Q

Type of NS stimulation on heart

A

Sympathetic NS

326
Q

Types of Sympathetic receptors in cardiac muscle

A

β1 adrenergic

327
Q

Sympathetic receptors are connected to which signaling pathway in cardiac muscle?

A

cAMP/PKA
↑ Ca2+ entry into cells

328
Q

How often will myocardial ATP pool turnover?

A

Every 10 seconds

329
Q

Which products produce 60-90% of the cardiac ATP generated?

A

Fatty Acid Oxidation

330
Q

Differences between skeletal/cardiac muscle and smooth muscle

A
  • Smooth muscle has no troponin
  • Smooth muscles are not arranged in sarcomeres
331
Q

Direct Entry of Ca2+ into Smooth muscle cell

A
  • Enters via voltage-gated, ligand-gated, or mechanically gated channels
  • Some cells (BV) have stretch activated channels
  • Ca2+ entry induces Ca2+ release from SR
332
Q

Second messenger Signaling of Smooth Muscle

A
  • Chemical messenger binds to GPCR
  • GPCR causes release of IP3
  • IP3 binds to receptors on SR membrane
  • Binding releases Ca2+ from SR
333
Q

Release of Ca2+ for relaxation

A
  • Removal of Ca2+ via Ca2+ pumps and exchangers
  • Move Ca2+ into ECF and SR
334
Q

Differences in Contraction in Smooth muscle vs Skeletal/Cardiac muscle

A

Smooth muscle have Pi associated with the myosin head AND with the MLC

335
Q

Regulation of actin/myosin interaction in smooth muscle

A

Altering properties of myosin itself - phosphorylation of MLC

336
Q

Phosphorylation of MLC =…

A

Activation of MLC binding to actin filaments

337
Q

Enzyme that phosphorylates MLC

A

MLC Kinase

338
Q

Activation of MLC Kinase due to

A

Ca2+-Calmodulin complex

339
Q

Relaxation of smooth muscle due to which enzyme?

A

MLC Phosphatase

340
Q

Function of MLC Phosphatase

A

Dephosphorylation of MLC

341
Q

Latch State of myosin

A

Dephosphorylation of myosin while attached to actin

342
Q

Control of Latch mechanism for smooth muscle

A
  • MLCP dephosphorylation MLC
  • Dephosphorylation during actin/myosin binding = latch state
  • Cross bridge proceeds just MUCH slower
  • Actin/Myosin complex has ↓ affinity for ATP
343
Q

Latch mechanism is sustainable for

A

BV’s, spinchters, and hollow organs

344
Q

Rationale for Latch mechanism

A

Prolonged contractions using minimal ATP

345
Q

Types of smooth muscle

A

Single-unit
Multi-unit

346
Q

Single Unit Smooth muscle seen

A

Walls of hollow viscera

347
Q

Multiunit Smooth muscle seen

A

Iris of eye

348
Q

Divisions of the ANS

A

1) Sympathetic NS
2) Parasympathetic NS
3) Enteric NS

349
Q

Describe the Enteric NS

A

Located within the GIT
Connected to CNS via parasympathetic/sympathetic fibers

350
Q

Neural plexuses of Enteric NS

A

Submucosal plexus
Myenteric plexus

351
Q

Submucosal plexus:
Where:
Function

A

Between submucosa and circular muscle layer
Controls secretions and GI blood flow

352
Q

Myenteric plexus:
Where:
Function

A

Between circular muscle and Longitudinal muscle layers
Controls motility, contractions, and relaxation

353
Q

Parasympathetic system located where in spinal cord?

A

Cranial and sacral

354
Q

Sympathetic system located where in spinal cord?

A

Thoracolumbar

355
Q

Only NT transmitted in Parasympathetic system

A

Acetylcholine (ACh)

356
Q

NT transmitted in Sympathetic NS

A

Norepinephrine
Acetylcholine (ACh)

357
Q

Preganglionic fibers of Para/Sympathetic NS secreted…

A

Acetylcholine (ACh)

358
Q

Receptor type in the Parasympathetic NS
(pre to post ganglion)

A

Nicotinic receptors in the post ganglion
(nAChR)

359
Q

Receptor type in the Parasympathetic NS
(post ganglion to target tissue)

A

Muscarinic receptor

360
Q

Receptor type in the Sympathetic NS
(pre to post ganglion)

A

Nicotinic receptors in post ganglion

361
Q

EXCEPTION:
Receptor type in the Parasympathetic NS
(pre ganglion to target tissue)

A

Seen in adrenal medulla
There are no post receptor fibers
Targer Adrenal medulla tissue directly

362
Q

Receptor type in the Sympathetic NS
(post ganglion to target tissue)

A

1) Regular target tissue = Adrenergenic
2) Exception to the rule: sweat glands (muscarinic)

363
Q

Nerves types according to what NT they release

A

1) Cholinergic - ACh
2) Adrenergic - Nor/Epinephrine

364
Q

Types of ACh receptors and their specific mechanism of function
(Ligand, Voltage, GPCR, etc)

A

Nicotinic (nAChRs)- Ligand gated ion channel
Muscarinic (mAChRs) - GPCR

365
Q

Types of Adrenergic receptors and their specific mechanism of function
(Ligand, Voltage, GPCR, etc)

A

𝛼-adrenergic; β-adrenergic
GPCR

366
Q

Long preganglionic fibers
Short post ganglionic fiber

A

Short pre ganglionic fiber
Long post ganglionic fiber

367
Q

Cells in adrenal medulla affected by pre-ganglionic secretion of ACh?

A

Chromaffin cells

368
Q

Muscarinic receptors:
Stimulatory

A

M1, M3, M5

369
Q

Muscarinic receptors:
Inhibitory

A

M2, M4

370
Q

Stimulatory muscarinic receptors activate which type of G protein

A

Gq

371
Q

Inhibitory muscarinic receptors activate which type of G protein

A

Gi

372
Q

Activation of Gq protein leads to…

A

Increased PLC and increased Ca2+

373
Q

Activation of Gi protein leads to…

A

Inhibition of Adenylate cyclase (AC) and decrease in cAMP

374
Q

Activation of Gs protein leads to…

A

Stimulation of Adenylate Cyclase
Increased production of cAMP

375
Q

Adrenergic receptors

A

𝛼1, 𝛼2
β1, β2, β3

376
Q

Adrenergic receptors:
Stimulatory

A

𝛼1 = stimulates Gq protein
β1, β2, β3 = stimulate Gs protein

377
Q

Adrenergic receptors:
Inhibitory

A

𝛼2 = stimulates Gi protein

378
Q

Post ganglionic innervation at which sites?

A

Smooth muscle
Cardiac
Secretory glands

379
Q

↑ intracellular Ca2+ stimulates…

A

Contraction of smooth muscle

380
Q

↑ cAMP stimulates…on smooth muscle

A

Relaxation

381
Q

↑ cAMP on cardia muscle stimulates…

A

↑ HR and ↑ force of contraction

382
Q

Sympathetic responses to CVS

A

↑ HR = SA/AV node, β1
↑ force = β1 on atrial/ventricular muscles
↑ dilation of BV in skeletal muscles - β
↓ dilation of skin BV -

383
Q

CO

A

of heartbeats per minute

384
Q

SV

A

Amount blood pumped by each ventricle with each contractionSV

385
Q

EDV

A

End distolic volume - amount of blood left in ventricle after diastole/relaxation

386
Q

ESV

A

End systolic volume - amount of blood left in ventricle after systole/contraction

387
Q

Calculation of SV

A

EDV - ESV
normal should be around 70 mL

388
Q

Calculation of CO

A

CO = SV - HR

389
Q

MAP

A

Mean arterial pressure
Average arterial pressure during one contraction of heart

390
Q

Calculation of MAP

A

DP + 1/3 (SP-DP)
CO x TRP

391
Q

TPR

A

Total Peripheral Resistance
Total resistance of BV to blood flow thry them

392
Q
A

FFM-I Mini 2 (7 decks)

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