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new Flashcards

1
Q

lyonisation works how

A

inactivates one x chromosome copy(–> transcriptionally inactive) by wrapping it in heterochromatin

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2
Q

missense vs nonsense

A

both point mutations (substitution)
missense causes amino acid change
nonsense causes stop codon

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3
Q

how do nasal sinuses drain into nasal cavity

A

frontal= frontonasal duct
ethmoidal and maxillary = hiatus semilunaris
sphenoid= sphenoethmoidal recess

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4
Q

nasal sinuses innervated by

A

frontal =v1
ethmoidal=v2
maxillary =v2
sphenoid =v1

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5
Q

which nasal sinus infects most, and why

A

maxillary, drains from top

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6
Q

sensory innervation to

  • nasopharynx
  • oropharynx
  • laryngopharynx
  • larynx
A

cn v2
cn IX
cn X
cn X (internal branch of superior laryngeal= false vocal cords and above. recurrent laryngeal= true vocal cords and below)

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7
Q

muscular innervation to pharynx and larynx

A

pharynx

  • all muscles = cn X
  • except stilopharyngeus = cn IX

larynx = cnX

  • all muscles = recurrent laryngeal
  • except cricothyroid = superior laryngeal
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8
Q

chief cells secrete=

A

in stomach- pepsinogen and lipase

in parathyroid - PTH

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9
Q

saliva ph

A

7.2 ish

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10
Q

what increases and decreases hunger and where produced

A

ghrelin increases - stomach

leptin decreases - fat cells (in obesity however, increases hunger due to resistance)

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11
Q

where are vitamins absorbed

A

water soluble in jej

fat soluble in ileum

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12
Q

how is sodium, chlorine, water, potassium absorbed

A

cl- pumped in (bicarb out)
na+ actively in – water follows
k+ passively in

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13
Q

histology of oesophagus muscle

A

skeletal to smooth distally

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14
Q

swallowing stages and muscles

A

1 (vol). tongue, suprahyoid and buccinator (cheek) muscles push food up against roof–> oropharynx

  1. (invol) soft palate rises (tensor palatin and levator palatini) and this blocks nasopharynx.
    hyoid bone goes up (mouth floor muscles), pharynx widens and shortens. epiglottis closes trachea
  2. (invol) constrictor muscle contracts sequentially
    pharynx and hyoid go down (infrahyoid), relax
    upper oesophageal sphincter relaxes, peristalsis
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15
Q

bolus

chyme

A

whats swallowed

in tumtum

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16
Q

b12 route

A

binds with r protein in mouth. this protects it within the stomach. it seperates from r protein in duodenum due to protease(/hcl). absorbed in terminal ileum– intrinsic factor required.

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17
Q

endopeptidases vs exopeptidases

A

endopeptidases= split polypeptide in MIDdle,
(trypsin, elastase, chymotrypsin, pepsin)
exopeptidases= brush border, remove one amino acid from chain

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18
Q

hepatocytes derive from

A

endoderm

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19
Q

bile made from

A

cholesterol

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20
Q

liver vs skeletal glycogenolyis (x2)

A

liver- fasting
- direct to glucose (enzymes)

muscle- excercise
- indirect to glucose (no enzymes, via lactate)

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21
Q

good vs bad lipoproteins

A

good

  • hdl.
  • formed in liver
  • removes excess cholesterol from tissues and blood (As bile)

bad

  • ldl.
  • formed in blood
  • delivers cholesterol to tissues (membranes, steroid hormone production)
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22
Q

purine to

purine source

pyramidine to

A

uric acid

meat fish outmeal soft drinks (like phosphate)

cos2, h2o, urea

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23
Q

transamination

A

uses aminotrasnferase
Alanine aminotransferase removes amine from glutamate and adds it to pyruvate to form alanine and an alpha keto acid (used in Kreb cycle)

glutamate and pyruvate –> alanine and alpha ketoglutarate

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24
Q

oxidative deamintation

A

glutamate and water –> alpha ketoglutarate and ammonia

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25
Q

VLDL

A

very low density lipoprotein

made in hepatocytes

carries triglycerides from liver to adipocyte

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26
Q

what atp used/generated in urea cycle

A

3

used

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27
Q

glucose alanine cycle

whats going on

A

excess alanine from muscle (from transamination of pyruvate (from glucose) (nh2 needed, supply is from amino acids). other product used (alpha ketoglutarate)) goes to liver
liver makes back into pyruvate . (amino transferase used again).
glucose form this pyruvate then go back to muscle. other product is nh3 - urea cycle

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28
Q

glucose alanine cycle

why is this good

A

muscles dont have to use energy for glucose production, comes from liver via blood so their energy can go entirely to muscle contraction

liver recieves pyruvate and nh3 so has necessary ingredienets for gluconeogenesis and urea cycle

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29
Q

creon

A

replacement of pancreatic enzymes (protease, lipase, amylase) – pathology

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30
Q

what seperates pancrease from tummy

A

lesser sac

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31
Q

pancreatic secretion

  • cephallic
  • gastric
  • intestinal

inhibited by …

A
  • ach/ vagus in cephalic and gastric causes increase in enzyme production
  • gastrin from cephalic and gastric causes increase in enzyme production
  • intestinal - cck increases enzyme production
    - secretin increases enzyme and bicarb production (epithelial duct cells

inhibited by d cells- somatostatin (this makes sense)

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32
Q

pancreas blood supply

A

splenic artery (coeliac trunk)

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33
Q

pancreas venous drainage

A

splenic vein

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34
Q

amphipathic

A

hydrophilic and hydrophobic

bile

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35
Q

merkel cells

A

fine touch, epidermis- stratum spinosum

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36
Q

langerhans cells

A

APCs, epidermis- stratum spinosum

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37
Q

which is deeper - papillary or reticular dermis

A

reticular dermis

uneven junction- ridged. papillary dermis is inbetween ‘pegs’ protrusions

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38
Q

meisners vs paccinian corpuscle

A

similar!
both in dermis
meisners- fine touch (pressure)
paccinian - vibration, tickle, pressure

schwann cell at core= paccinian and maybe also meisners

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39
Q

nails=

A

compact keratin

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40
Q

subcutis
what
function

A

adipose connective tissue
shock absorbtion
energy store
insulation

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41
Q

skin barrier

A

swelled, plump corneocytes connected with intact corneodesmosomes. lipid lamellae= cement- retains water

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42
Q

ascending loop vs descending loop

A

ascending is water impermeable. na+ pumped out, cl- follows passively. this cause water in descending loop to more passively to salty medulla.

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43
Q

adh connects to what

A

V2 receptors (causes aquaporin….)

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44
Q

gfr

measured using

A

125/ml/min

creatinine (freely filtered)

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45
Q

renal clearance=

values–

A

volume of plasma to completely remove a substance in kidney

=125= freely filtered (eg creatinine)
more= freely filtered and secreted by nephron
less= not freely filtered or reabsorbed by nephron
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46
Q

filtration fraction

A

proportion of plasma that is filtered

20%ish

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47
Q

where na and cl reabsorbed in pct

how other stuff reabsorebed

A

BETWEEN cells
pct is leaky af

na/k pump drives it, allowing symporter to carry stuff (glucose, amino acids, lactate)

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48
Q

types of cells in collecting duct

A

principal cells- respond to adh/aldosterone

intercalated cells

  • alpha: secrete h+
  • beta: secrete hco3-
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49
Q

types of sphincted

A

anatomical- localised muscle thickening

functional= physiological- muscle contraction in or around structure

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50
Q

over vs underactive thyroid effects

A

over- weight loss, tachycardia, sweating, heat intoleracne

under- cold interolerance, weight gain, brady cardia , dry skin

51
Q

adrenal gland - blood supply and drainage

A

supply- superior (inf phrenic artery), middle (abdominal aorta), inferioir (renal arteries)

drainage: adrenal veins: L–> l renal veeins
r —> ivc
(this is same as testicular!!!!!)

52
Q

why females shorter

A

enter puberty later

slower growth velocity

53
Q

boys sexcharacteristcs due to

A

all- testicular androgens

54
Q

girls sex characteristivcs due to

A

oestrogen–> breasts and ext genitalia

ovarian and adrenal androgens –> pubic and axillary hair

55
Q

inguinal canal contents (male)

females??

A

3x veins

  • testicular
  • vein of the vas
  • cremasteric

3x arteries

  • testicular
  • artery of the vas
  • cremasteric

3x nerves

  • genitofemoral
  • ilio inguinal
  • sympathetic

3x other

  • vas deferens
  • lymphatics
  • tunica vaginalis (from peritoneum to ballllls)

females- ilioinguinal and genitofemoral nerve and round ligament (uterus to labia majora)

56
Q

which of the inguinal canal contents exits early, and where

A

ilioinguinal nerve. superficial ring

57
Q

inguinal canal hernias

A

through only deep= indirect
through deep and superficial = direct
if bowel is pushed down the tunica vaginalis tube = congenital hernia

58
Q

pampiniform plexus

A

network of testicular veins around testicular artery

cools the TEMPPPOrature

59
Q

varicocele

A

enlargened prominent scrotal veins

60
Q

nerve supply of pudendal nerve

A

posterior 2/3 of ext genitalia and bum hole

61
Q

nerve supply of ilioinguinal nerve

A

anterior 1/3 of external genitalia

62
Q

nerve supply of genitofemoral nerve

A

skin of mons pubis, labia majora, anterior scrotum (posterior = pudendal)

63
Q

GONAD EMBRYOLOGY

gonads indifferent til

what migrates from where to where, and when

what stimulates development of gonads and how

effects

A

w7

germ cells. hindgut (endoderm) to genital ridges (mesoderm) to form primitive sex cords. w4-7

SRY gene (Y chromosome) produces testis determining factor (or lack of)

males- have- sex cords become testis cords (which become seminiferous and straight tubules (inc sertoli and germ cells within) and rete testis. leydig between (testosterone from w8—> development of internal and external genitalia)

females- dont have- sex cords degenerate and gonad epithelium proliferates to cortical cords around oocyte (ovary)

64
Q

INTERNAL GENITALIA EMBRYOLOGY

initially=

males- what instigates and what happens

females- what instigates and what happens

A

initially males and females both have mesenephric ducts (wolffian) and paramesenerphric ducts (mullerian)

males

  • testosterone (from leydig): mesenephric duct develops–> vas deferens , seminal vesicles, epididymus
  • anti-mullerian hormone (from sertoli) (aka MIF- mullerian inhibiting factor): paramesenephric duct degenerates

females

  • lack of testosterone: mesenephric duct degenerates
  • lack of anti-mullerian hormone: paramesenephric duct develops–> upper 1/3 vagina and uterus and fallopian tubes
65
Q

EXTERNAL GENITALIA EMBYROLOGY

orignially
male
female
from what to what

A

cloaca–> urogenital sinus–>

genital tubercle (penis) (clitoris)
genital folds (surround urethra) (labia minora)
genital swellings (scrotum) (labia majora)
66
Q

male vs female pelvis x4

A
  • males have more prominent protruding coccyx
  • males have more prominent protruding ischial spines
  • females have a wider apperture (think of the baby)
  • males have a smaller subpubic angle - where crura cavernosum attaches- better for sex
67
Q

what surrounds the greater and lesser sciatic foramen

A

greater= sacrospinous ligament and iliac crest

lesser= sacrospinous ligament and sacrotuberous ligament

68
Q

urinary buffers x3

A

h+secreted - mops up bicarb for reabsorption

phsophate- mops up h+ that is in excess of bicarb

ammonia- into lumen to ammonium which is actively secreted

69
Q

where are amygdala and hippocampus

A

both temporal

70
Q

which of the meningeal layers has no nerves/vessels

A

arachnoid mater

71
Q

blood brain barrier layers

what allowed through, what not

A

blood vessel endothelium
basement membrane
pia mater
foot processes of astrocytes

lipophilic molecules=yes, lipid insoluble molecules=no

72
Q

arachnoid granulations=

A

protrusions of arachnoid mater
mainly superior saggital sinus
absorbs csf

73
Q

axon hillock

A

where soma (body) becomes axon

74
Q

microglia function

A

macrophages. on activation, retract processes and eat up them bitches

75
Q

astrocytes
types
function

A

type 1=fibrous
type 2 = protoplasmic

structural - stability and microarchitecture
insulate sinuses
buffer ions

76
Q

reticular=

A

mix of white and grey matter

77
Q

3 types of fibres

A 
commisure= connect hemispheres
projection= cortical to sub cortical
association = within lobe cortex
78
Q

motor pool

A

all LMNs that innervate a single muscle (opposite to motor unit)

79
Q

where on the medulla are the gracile, cuneate and pyramidal tracts

A

cuneate and gracile posteriorly (ascending) (gracile medial to cuneate)

pyramidal at front (descending) (medial to olives)

80
Q

cerebral peduncles vs cerebellar

A

cerebral= anterior of midbrain (tegmentum) –> thalamus/cerbrum
front bits=crus cerebri

cerebellar= superior, middle, inferior to midbrain, pons, medulla.

81
Q

olives

A

superior- hearing

inferioir- cerebellar related

82
Q

cerebellar input (2)

A

mossy fibres= are from brainstem (cerebellar peduncles)

climbing fibres= are from olives(on medulla)

83
Q

dentate nucleus role

A

planning and initiation of movement

84
Q

is cerebellum ipsi or contralateral

A

ipsi baby one more time

85
Q

where are internal, external and extreme capsule

A

internal capsule is between caudate nucleus and globus pallidus/putamen

external and extreme capsules are lateral to putamen, seperateed by claustrum

86
Q

lentiform nucleus =

A

globus pallidus and putamen

87
Q

striatum =

A

putamen meets caudate

88
Q

substance p

  • released from
  • effect (2)
A

released from damaged cells, noxious stimuli

vasodilator
neurotransmitter from c fibres– dull ache (compared to glutamate from a gamma)

89
Q

3x pain pathways

A

activation- temporary stimulus, temporary pain
-summation

modulation- prolonged stimulus, persistant pain
-sensitivity increase

modification - nerve damage, persistant pain
- denervation, cell death

90
Q

melzack wall pain gate

A

gate to pain can be closed with non-painful input

91
Q

parkinsons

neurotransmiter
where
effect

A

lacks dopamine, which is needed to inhibit thalamus in order to move freely

substantia nigra

reduced movement, increased tone

92
Q

huntingtons

where
effect

A

lacks gaba, so too much dopamine, which inhibits thalamus too much so lots of free movements and hard to stop movement

cuadate nucleus (and ventricles)

overshooting, reduced tone, dementia and peronality change

93
Q

excitatory vs inhibitatory

where
neurotransmitter

A

gaba= rostral, striatum and globus pallidus
= inhibitory

excitatory = dopamine, glutatmate
subthalamic nucleus and substantia nigra

94
Q

cortical vs subcortical loops

direct/indirect
whats the thing doing it
effect on thalamus
effect on movement

A 
cortical = direct
substantia nigra (with dopamine) inhibits thalamus-- free movement

subcortical= indirect
subthalamic nucles excites globus pallidus so thalamus is uninhibited – no movement

95
Q

conus medularris level

A

L1-2

96
Q

filum terminale
where
what made of

A

conus medullaris to coccyx

the three meningeal layers , contains csf, fibrous, surrounded by lumbar cistern (equivalent of subarachnoid space, csf)

97
Q

abcd2
hasbled
chadvasc
qrisk

A

tia recurrance
bleed
throboembolism
risk of stroke/heart attack in 10 years

98
Q

t lymphocytes types

A

t helper - regulate response, help b lymphocytes develop, activate macrophages
t cytoxic- target damged /infected kell to kill
t suppressor aka t regulator - inhibits t helper, so suppresses immune response

99
Q

where is sa node located

A

on crista terminalis, where trabeculated and smooth part of r atrium meet, below surface sulcus terminalis (auricular appendage) ,near svc

100
Q

where is moderator band

function

A

av bundle to tip or r ventricle

distance is greater to tip or r than l so it ensures contraction at the same time

101
Q

what line seperates superior and middle mediastinum

A

T4

102
Q

pericardial sinuses x2

A

oblique= culdesac on posterior surface

transverse= behind pulm art and aorta and in front of svc

103
Q

h+ vasodilator or constrictor

A

dilator

104
Q

NO, K+ vasodilator or contrictor

A

dilator

105
Q

where are baroreceptors

primary/secondary

effects

A 
carotid sinus (primary) 
-para/symp change
aortic arch (secondary)
- adh, renin, angitensin
106
Q

where are peripheral chemoreceptors

A

carotid and aortic bodies

107
Q

trabeculated carnea

A

ridges in heart

108
Q

pressor vs depressor region =

A

=central regulation of vardiovascular system
pressor (symp)= vasoconstriction, increase in hr, sv, contractility
depressor (parasymp) = inhibits pressor

109
Q

obstruction vs restriction

A

obstruction is narowing/ damge (reduced fev, 0.8)

restrction is less lung volume (reduced fev and fvc, 0.7)

110
Q

DLco =
measured how
indicator of what x4

A

= transfer factor
CO inhaled and exhaled and change in conc measured

measures alveolar sa, perfusion, capillary volume and integrity , haemoglibin levels

111
Q

adaptive change at altitude

A

low 02 so hyperventilation–> resp alkalosis

so more renal bicarb secreted compensates for respiratory alkosis

112
Q

how does acidic pH and temperature cause change to oxygen saturation

A

shift curve to right

decreased affinity for oxygen

113
Q

ageing lung (6)

A 
decrease fev and fvc
stiffer cartilage 
worse elastic recoil
worse vq
haemoglobin saturation worse
more infection - mucus and ciliary escalator worse
114
Q

pnc=
does what to drg and vrg

apn
does what to drg and vrg

where are they

A

pneumotaxic center
inhibits

apneustic center
stimulates

pons, pnc bit higher

115
Q

vrg and drg

where
control what
stimulate what

A

medulla- ventral and dorsal

drg- rhymicity, fine control
- insp and exhal

vrg- deep long inhales
- insp

stimulate phrenic and intercostal nerves

116
Q

where is anterior axillary fold

A

inferior border of pec major

117
Q

hilum of lung contains

A 
2 pulm veins, 
pulm art, 
bronchial arteries
main bronchus, 
symp and 
parasymp nerves, 
lympatics
118
Q

how many lobes in each lung

A

3 in r, 2 in L

119
Q

thoracic duct joins veins where

A

confluence of L subclavian and L internal jugular

120
Q

varus vs valgus

A 
varus= rum inbetween knees
valgus= kness together
121
Q

stellate ganglion =

A

fusion of lower cervical ganglia and T1 ganglia (not vertebrae)

122
Q

which muscles retract the scapula

A

trapezius

rhomboid major and minor

123
Q

arm adduction
0-10
10-90
90+

A

supraspinatus
deltoid
trapezius

124
Q

anterioir and posterior triangle of neck

A

infront of and behind sternocleidomastoid muscle

posterior= between that and trapezius

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