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NBEO non-big 8 > NBEO non-big 8 > Flashcards

NBEO non-big 8 Flashcards

1
Q

Warburg Effect

A

When a cell use aerobic & anaerobic glycolysis simultaneously. Ex Lens

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2
Q

Glycogenesis

A

Converting glucose to glycogen for storage. In muscle & liver. Glycogen can be stored under pressure w/out exploding
1. Happens in muscle & liver
2. store glucose as glyogen
3. end product: bound G6P -> glycogen

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2
Q

Glycogenolysis

A

breakdown of glycogen. ex muscles & liver. G6P can either go into glycolysis to make glucose or to the Pentose phosphate shunt.
End products: Free G6P

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3
Q

what is the role of the liver?

A
  • maintain blood glucose
  • if incr carb intake: does glycogenesis (store glucose & glycogen)
  • lipolysis: store triglycerides
  • if fasting or starved & no glucose: break down ketone bodies
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4
Q

Gluconeogenesis

A
  1. happens in liver&raquo_space;> kidneys
  2. critical facts: get glucose & ATP w/o glucose breakdown
    -uses 6 ATP in process
  3. End product: glucose
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5
Q

Pentose phoshate Shunt

A
  1. happens in cell cytoplasm
  2. critical fact: detox cells from free 02. Done by cells that use FA & cholesterol
  3. End products: 12 NADPH/glucose, ribose-5-phosphate
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6
Q

Glycogenolysis

A
  1. happens in Muscle & liver
  2. free G6P -> glycolysis or pentose phosphate shunt
  3. end product: free G6P
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7
Q

what are the parts of a phospholipids?

A

3 carbon glycerol, 2 FA tails, and phoshpate head group.
- major component of lipid bilayer in cell membranes & myelin sheath (intraocular prelaminar ON is NOT myelinated)

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8
Q

Tay-sachs Disease?

A

affects enxyne breaks down small lipids, presentation similiar to Cherry red macula

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9
Q

what is a cholesterol?

A

made from Acetyl CoA: cytoplasm if liver cells
- precursor to steroids
-major component w/in LIPID MEMBRANE

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10
Q

what is Eicosanoids?

A

short rage signal molecule
made from Arachondonic acid by PLA2
- prostaglandins - pro-inflammatory; @ uveoscleral membrane: incrs outflow
- Thromboxone: promote arterial constriction & plaletet aggregation
- Lipoxygenase: makes leukotrienese -> WBC -> allergic rxns

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11
Q

Very low density lipoprotein VLDL:

A

delivers cholesterol to organs

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12
Q

Low density liprotein/ LDL?

A

what VLDL becomes LDL after it is delivers cholesterol -> lousy

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13
Q

HDL high denisty liproteins

A

returns excess cholesterol & lipids from organs to liver - GOOD

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14
Q

what is normal total cholesterol?

A

< 200

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15
Q

What is healthy level of LDL?

A
  • Healthy or 2 or more risk factors for heart dz < 130
  • if have cardiovascular dz or DM < 100
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16
Q

What is healthy level for HDL?

A

> 40

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17
Q

what is normal level for triglycerides?

A

< 150

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18
Q

What is Xanthelasma?

A

cholesterol deposit with periorbital skin use to high cholesterol or aging

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19
Q

what is resting potential of photoreceptor?

A

PR = -65mV charge is derived from Na+/K+ crossing membrane

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20
Q

Resting state?

A

conductivity @ rest
- K+ conductivity is high
- Na+/K+ pump
this two determines resting potential

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21
Q

What is conductivity?

A

measure of how easy ions can cross membrane exist if K+ had incrs conductivity = pass easily

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22
Q

The training of Na+ is what causes the DARK current, this allows for _________.

A

Allows for Depolarization

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23
Q

What are the Stages of neuro Action potential

A
  1. Na+ conductance increase (Na+ can cross membrane cells easily)
    - In response to local depolarization
  2. membrane potential incrs steeply = more Na+ channel open = snow ball effects
  3. Membrane potenial (Vm) = peaks @ 40 mV
  4. K+ conductance incrs = K+ exists cells = increase Na+ channel
  5. fall in Vm = hyper-polarization (more neg than resting state)
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24
Q

What are action potential cells?

A

Photoreceptor & horizontal

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25
Q

What are grades potential cells?

A

AP = IN the BAG,

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26
Q

what is MOA of Digoxin?

A

Digitalis have a NAK for getting digits
- inhibits Na+/K+ ATPase

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27
Q

what are synapse?

A

a physical meeting point btw cells
- facilitates communication btw cells

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28
Q

what is a chemical synapse?

A

Via Neurotransmitter
- limited by
1. Diffusion rate of NT
2. binding of NT to cell membrane = DAMAGED in MG

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29
Q

what is simplified cascade?

A

Action potential (hyperpolarized - more neg) to cell 1
- Ca2+ permeability incrs = Ca2+ enters
- NTs diffuse across across synaptic cleft
- NTs bind to cell 2
- Binding causes a post-synaptic potential (PSP) -> can be inhibitory or excitatory
- multiple PSP, have additive effect = total response to cell 2
- New Vm/ membrane potential is reached if = a > threshold then new AP is sent down line === DAMAGED in MS bc lose myelin sheath = lose charge

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30
Q

What is GABA?

A

most common inhibitory NTs

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31
Q

Glycine?

A

Inhibitory NT st brainstem, spinal cord, and retina

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32
Q

What is glutamate?

A

excitatory NT

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33
Q

Cholinergic receptor types (2)?

A

2 receptor types:
- nicotinic in skeletal muscles: block by curare, snake venom (alpha Borgarotoxin)
- muscarinic: smooth & cardiac muscle

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34
Q

Adrenergic receptors

A

epinephrine, serotonin - release at SAN post-SAN
- Neuro-muscular junction
- ACH at PSAN pre and post PSAN

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35
Q

what is an Electrical synapse?

A

Gap junction and much faster than chemical synapse

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36
Q

What are the two SNS/sympathetic controls?

A

SNS - sensory and motor (somatic and autonomic)

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37
Q

what is a Ganglia?

A

Ganglia - location collection of cell nerve bodies (soma) ex. Superior Cervical ganglion

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38
Q

what is a nerve?

A

bundle of axons

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39
Q

What is the sensory division>

A

Ganglia near the spinal cord (dorsal root ganglia)
- the brainstem (cranial nerve ganglia)

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40
Q

What is somatic motor?

A

Innervate skeletal muscles
reponsible for voluntary behavior

41
Q

what is the autonomic motor division?

A

innervate cardia, smooth muscle, glands
peripheral motor neuron: autonomic ganglia from the brainstem

42
Q

sympathetics

A

ganglia near vertebral column -> go to periphery
ex Ciliospinal center of budge C8-T2

43
Q

parasympathetics

A

goes to organs

44
Q

Central Nervous system

A

organized in
1. Nuclei: collection of nuclei w/ similar function & location (CNS analogue to ganglia)

45
Q

What is cortex?

A

Shelt-like layers of cells
- allows fro higher level cognition, sensory & motor processing
-divided into LOBES

46
Q

Frontal lobes -> premotor- cortex functions?

A
  1. Pre-motor cortex = planning and execute movement. Developing during infancy
    - general personality

lesion -> out of character behavior & comments

  1. Brocca Area = speech production
    lesion -> broken speech/ cannot produce intended words = Brocca’s Aphasia
47
Q

Which arteries supplies blood to frontal lobe?

A

Middle cerebral artery
Anterior Cerebral artery

48
Q

Parietal lobe functions?

A
  1. Sensory activity & recognition
    Lesion -> cannot identify object, but can describe what it does
    ex. pencil
    - Blood vessel: Middle cerebral artery
49
Q

Occipital lobe blood supply?

A

Middle cerebral & posterior cerebral
- Visual processing
Lesion - VF defect

50
Q

Temporal lobe?

A

Perception & sensory recognition: auditory stimuli & speech, memory
- Hippocampus: short term memory, spatial orientation

  • Wernicke’s Area: Speeck recognition
  • Lesion: Wordy speech

Blood supply; ICA -> Middle Cerebral, Anterior choroidal
Vertebral (basilar)

51
Q

what makes up the division of the central nervous system?

A

Spinal cord, (Medulla, pons, midbrain) = brainstem
- Diencephalon, cerebral hemisphere, cerebellum

52
Q

Spinal Cord?

A

center of spinal cord
- Gray matter: made of cell bodies & unmyelinated axons

53
Q

What are the two roots of the spinal cord?

A

Dorsal Root: sensory
Ventral root: motor

54
Q

What is white matter?

A

Myelinated, fasiculus tracts

55
Q

What are the 3 division of White matter?

A

Post fasiculus
Lateral fasiculus
Anterior Fasiculus

56
Q

What is the ascending pathway?

A

From periphery to brain
- carry sensory information

57
Q

What are the 3 neurons of the Ascending pw?

A
  • Ascending: small to large.
    1st order: Soma bundle in dorsal root ganglion (1st synapse)
    2nd order: connects 1st & 3rd order
    3r order neuron: cell body in thalamus projects to cortex.
58
Q

What is the descending pw?

A

Also called Pyramidal Tracts
- From brain to the muscle
- carry motor impulse from brain to muscle

59
Q

what is the higher cervical region?

A

Nerve: C1-c8
- C8-T2: ciliospinal center of budge
Innervate: C1-C4
C5-C8 Upper extremities

60
Q

What is the thoracic region?

A

Nerve: T1-T12
Innervate T1-T12 upper extremities

61
Q

What is the lumber region?

A

Nerve: L1-L5
Innvervate: L1-L4: Thigh
L4-L5: thigh, leg foot

62
Q

What is the sacral region?

A

Nerve: S1-S5
Innervate: S1-S3: thigh, leg, foot
S2-S4: pelvis

63
Q

What is the coccygeal region?

A

Coccygeal nerve: Corgis … :> Butt and maintain balance

64
Q

What is the brainstem?

A

Midbrain, pons, medulla

65
Q

What is the midbrain function?

A

CN 3,4
control sensory & motor function
controls coordination of eye movement & reflex

66
Q

What is does the upper midbrain function?

A
  1. has superior colliculus: controls saccades (w/ FEF)
  2. Red Nucleus: controls movement of arms and occulomotor nuclei. involved in executing hand-eye coordination
  3. EW nucleus = CN3: parasympathetic innervation of iris (ciliary muscles, sphincter muscle)
67
Q

Lower midbrain?.

A
  1. Inferior colliculus - reflex of head and neck to auditory stimuli
  2. CN4 nucleus: inner controlled SO muscle (“SO contralateral SR” )
  3. Site of cerebella pedicules - connects to cerebellum
68
Q

Function of pons?

A
  1. coordinate movement relayed info transfer btw cerebral hemispheres & cerebellum
  2. relays info btw midbrains & meddulla
    - location of pontine nucleus -> relay information for motor relay info btw cortex and cerebellum
69
Q

What is medulla?
1. What is 1. Upper medulla: had pyramidal?

  1. Medial longitudinal fasciculus?
  2. Lower middle medulla?
A

CN 9-12

Controls autonomic function (digestion, heart heart, breathing)

  1. Upper medulla: had pyramidal tracts (descending brain -> motor)
    - Medial lemiscus (ascending dorsal tract). carries inform from lower body and trunk to brain
  2. Medial longitudinal fasciculus: relay vestibular info to EOMs
    -coordinates VOR
    - lesion: INO
  3. Lower middle medulla: location of vestibular nuclei, olivary nuclei
    - do learning long-term memory in cerebellar function
    - 4th ventricule
70
Q

What is the Diencephalon?
- Epithalamus:
- thalamus
- subthalamus
-hypothalamus

A

extension of the eye

  • Epithalamus: has pineal gland -> secretes melatonin
  • Thalamus: relays info to cortex -> has nuclei for voluntary muscle control
  • Subthalamus: communicate w/ basal ganglia. Helps to control muscle movement
  • hypothalamus: regulate body temp, eating & sleeping behavior. start of sympathetic pw for dilation
71
Q

What is the cerebral hemisphere?

A

do higher level processing for sensory interpretation, motor control, intelligence, emotion

2 hemisphere

A. Dominant hemisphere: help to understand and process language. - Interconnection of long-term memory.
- Word retrieval & emotional stability

B. Non-dominant hemisphere
- recognition of facial expression & vocal information, music, visual learning

72
Q

What is Prosopagnosia?

A

can’t recognize faces due to occipital & temporal lobe damage

73
Q

What is the cerebrum?

A

fine motor control
postural balance

74
Q

what are the arteries that makes up the Circle of Willis (4)?

A
  1. Basilar
    - Posterior cerebral
  2. ICA
    - Pcomm
    - Ant. cerebral
    - Ant. communicating
75
Q

What is Diabetic papillopathy?

A

~ mild form of NAION

Epi: young <50 yr type 1 DM (70%)

Patho: mild form of NAION.
- reversible ischemia

Symptoms: mild to no decrs VA
- mild APD
- disc edema, 60% unilat
- mild VF defect = no cecocentral VFD, or altitudinal
- fellow ONH is disc at risk

Diagnosis: Dx of exclusion (like NAION)
- r/o GCA
-CME
- Malignant HTN -> BP check

76
Q

what is CRVO?

A

Bleeding in all 4 quadrants, dilated & tortuous vessel
- collaterals: vein to vein connection
-due to thrombus (form at site)
- just post ONH

77
Q

Hypotony

A

sx hx of trabelecutomy, trauma blunt, cyclodestruction sx, intracranular inflammation

  • IOP < 6mmHg
  • depends on scleral rigidity -> becomes more rigid w/ age
  • may occur due to over-filtering bleb, wound, leak

S/S: painful, esp w/ corneal edema

78
Q

Optic Disc Drusen

A

Epi: presents 3-24 ppl

patho: hyaline deposits @ optic disc
- can be hereditary acquired

Diagnosis: B-scan: drusen = hyper-reflective

S/S: asymptomatic
- buried when young -> surface w/ age
- excessive drusen -> compress ganglion cells @ ONH -> gluacoma like VF defects
- pseudo disc edema - rim elevated due to due
- true edema: due to compression of nerve. Uni or bilateral
- may cause CNVM - due to break bruch @ ONH -> at area of peripapillary atrophy

79
Q

Sarcoidosis?

A

Epi: often affecting Middle-aged, AA, women, smoke

Patho: idiopathatic

S/S: chronic dacryoadenditis
- S-shape ptosis

Testing: ACE & chest xray -> granulomatous inflam
- 90% lung involvement
- only 1-5% have ON edema

80
Q

Lists some Collagen Vascular Disorders ?

A

RA, SLE, polyarteritis nudosa, granulomatous w/ polyangitis

81
Q

SLE = lupus

A

Epi: women > men
- 2nd-3rd decades of life

Patho: autoimmune effects multi organs

S/S: unilateral disc edema & papilledema
malar rash

Testing: ANA

82
Q

Syphilis

A

Inflammatory, Infection unilateral disc edema

STD due to spirochete treponema pallidum

Testing:
1. FTA-ABS: ever had syphilis
2. VDRL, RPR: if have now/active

83
Q

What is the 4 phases of syphilis?

A
  1. Primary chancer sore (painless genital ulcer)
  2. Secondary: involve eye, kidneys, mucus membrane inflamm, skin
    —-»> latent phase
    - CNS not involved
  3. Tertiary : CNS involvement, Argyll-Robertson pw: btw pretectaL & EW

Stage 1-2: tx w/ PCN to prevent next stage

84
Q

TB

A

Inflammatory Dz of lungs by Myobacterin Tuberculosis

Symptoms: NIGHT SWEATS, fever, chronic cough
- Bilateral granulomatous uveitis, CME, rarely optic disc edema

Testing: Chest-xRay, PPD skin test (Type 4 rxn)
-Indentation healthcare worker >10mm
immunocompromised > 15mm
Normal > 5mm

84
Q

What is IIH/Pseudotumor cerebri?

A

Epi: women, overweight, child bearing age

Patho: incrs ICP from unknown etiology

Diagnose of exclusion/Dxe

Testing:
Check BP in office
MRI/MRV - r/o tumor

-CBC = no blood clot

Spinal Tap -> CSF analysis, r/o syphilis
-Opening pressure > 200 mmH2O or >21 cmH2O

Normal: <15.5cm H20 or 155mm H20

Causes: “CANT”
-Contraceptive
-Vit A
Nalidixic acid
-Tetracylines

Symptoms:
HA, transient vision/Amurosis fugax, nausea/vomiting, VA is normal

Signs: Enlarged blind spot VF, diplopia (CN 6 palsy) pinched by petrous ridge of temporal bone
-Variable VFD, bilateral ON atrophy

84
Q

Orbital Cavernous Hemagioma?

A

MC benign orbital neoplasm in adults
- Epi: MC women in 4th - 5th decade
- affects muscle cone -> compresses the ON

84
Q

Causes of unilateral vision/bilateral optic atrophy

A
  1. Excavation: loss of neuro rim tissue -> Glaucoma
  2. Pallor: whitening of neuroretinal rim tissue
    - primary optic atrophy: ON has never ben edematous
    - ex. Trauma, nutritional, orthograde degeneration /ascending -> eye to brain (PRP, CRAO, RP, geographic atrophy
  • retrograde degeneration, brain -> Eye / Descending (ex. Pituitary tumor
  1. Hereditary: Leber’s Dominant Optic Atrophy
  2. Secondary Optic atrophy: ON has been edematous before
    -any primary causes
    Foster Kennedy
85
Q

What is optic nerve atrophy?

A

distruction of RNFL -> axons of ganglion cell s

85
Q

Toxic /Nutritional

A

Most Common/MC
- Alcohol -> Wernicke Korsakolf
-Malnutrition
- Med Toxicity (ethambutal, ioniazide, amiodarone)

Classically w/ temporal pallor of ON (papillomacular bundle)
-cecocentral w/ central VFD
- causes bilateral, painless, progressive

86
Q

what is orthograde degeneration/ ascending?

A

Eye -> brain

Extensive RNFL damage -> cause neutro-retinal tissue damage

PRP, CRAO, RP (wavy optic, disc PSC, attenuated vessels), extensive geographic atrophy

87
Q

What is retrograde degeneration?

A

Brain -> eye
-damage to retrobulbar ON -> descending degeneration of ON axons

ex Pituitary Tumor
Normally compresses nasal optic fiber
-> horizontal band of pallor on ON (Bow-tie atrophy)
- Junctional Scotoma

Hereditary
- Leber’s Optic neuropathy: mutation in mitochondrial DNA
-85% male, onset in early 20s
-sudden onset of decrs color vision (20/200-CF)

  • Early signs: optic disc hyperemia -> OD pallor in late stage
  • spontaneously improves in 35%

-Foster Kennedy Syndrome: rare, due to Frontal lobe tumor -> simultaneous OD edema in one eye vs OD atrophy (lesioned side) `

88
Q

Congeneitcal optic nerve anomalies?

A
  1. Opticc nerve pit: unilateral depression of Optic disc Inf-temp
    - may develop SRD from optic cup to macular
    - asymptomatic unless macular involved

Morning Glory Syndrome: unilateral
- funnel-shaped, excavated optic nerve = poor VA
- spontaneous formation congenital

89
Q

What is ON hypolasia?

A

incomplete development of ON, uni/bilateral
- double ring sign
- a ring of sclera or hyperpigmentation

90
Q

What does a pt in a coma pupil look like?

A

Called Hutchinson Pupil
- dilated pupil in comatose state
- due to ipsilateral compression of CN23 hematoma or tumor
- sudden

If Miosis: in early coma miosis bc of loss of cortical control
- still responde to light (bc pretectaL nucleus nerve goes to cortex )

91
Q

CN 4 palsy?

A

Innervates SO
- contralateral, dorsal, long, thin
** most susceptible to TRAUMA

92
Q

Congenital CN4 vs Acquired, which have a larger vertical palsy?

A

Congenital CN4 palsy
- 0-2prism
- no diplopia, bc of Eccentric fixation or suppression/amblyopia = form deprivation

Acquired CN 4 palsy: vertical ranges, diplopia
- Head tilt AWAY

Dx = Park three step

93
Q

what is park 3 step?

A

Vertical
head tilt
gaze

where is it WORSE?

94
Q

where is the lesion?
Right Hyper
right head tilt
worse w/ left gaze = worse w/ R head turn

“walking in w/ left head tilt or left head turn

A

Right SO problem

95
Q

CN 6 palsy?

A

Abducen -> LR
- travels in the Cavernous sinus laterally, btwn ICA and Petrosal ridge on the temporal bone - gets compress in btw

MC: microvascular Dz
MC affects EOM
Tumor
Incr ICP - papilledema
- Trauma
-cavernous sinus issue

96
Q
A
97
Q
A

NBEO non-big 8 (2 decks)

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