new Flashcards
lyonisation works how
inactivates one x chromosome copy(–> transcriptionally inactive) by wrapping it in heterochromatin
missense vs nonsense
both point mutations (substitution)
missense causes amino acid change
nonsense causes stop codon
how do nasal sinuses drain into nasal cavity
frontal= frontonasal duct
ethmoidal and maxillary = hiatus semilunaris
sphenoid= sphenoethmoidal recess
nasal sinuses innervated by
frontal =v1
ethmoidal=v2
maxillary =v2
sphenoid =v1
which nasal sinus infects most, and why
maxillary, drains from top
sensory innervation to
- nasopharynx
- oropharynx
- laryngopharynx
- larynx
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)
muscular innervation to pharynx and larynx
pharynx
- all muscles = cn X
- except stilopharyngeus = cn IX
larynx = cnX
- all muscles = recurrent laryngeal
- except cricothyroid = superior laryngeal
chief cells secrete=
in stomach- pepsinogen and lipase
in parathyroid - PTH
saliva ph
7.2 ish
what increases and decreases hunger and where produced
ghrelin increases - stomach
leptin decreases - fat cells (in obesity however, increases hunger due to resistance)
where are vitamins absorbed
water soluble in jej
fat soluble in ileum
how is sodium, chlorine, water, potassium absorbed
cl- pumped in (bicarb out)
na+ actively in – water follows
k+ passively in
histology of oesophagus muscle
skeletal to smooth distally
swallowing stages and muscles
1 (vol). tongue, suprahyoid and buccinator (cheek) muscles push food up against roof–> oropharynx
- (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 - (invol) constrictor muscle contracts sequentially
pharynx and hyoid go down (infrahyoid), relax
upper oesophageal sphincter relaxes, peristalsis
bolus
chyme
whats swallowed
in tumtum
b12 route
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.
endopeptidases vs exopeptidases
endopeptidases= split polypeptide in MIDdle,
(trypsin, elastase, chymotrypsin, pepsin)
exopeptidases= brush border, remove one amino acid from chain
hepatocytes derive from
endoderm
bile made from
cholesterol
liver vs skeletal glycogenolyis (x2)
liver- fasting
- direct to glucose (enzymes)
muscle- excercise
- indirect to glucose (no enzymes, via lactate)
good vs bad lipoproteins
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)
purine to
purine source
pyramidine to
uric acid
meat fish outmeal soft drinks (like phosphate)
cos2, h2o, urea
transamination
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
oxidative deamintation
glutamate and water –> alpha ketoglutarate and ammonia
VLDL
very low density lipoprotein
made in hepatocytes
carries triglycerides from liver to adipocyte
what atp used/generated in urea cycle
3
used
glucose alanine cycle
whats going on
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
glucose alanine cycle
why is this good
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
creon
replacement of pancreatic enzymes (protease, lipase, amylase) – pathology
what seperates pancrease from tummy
lesser sac
pancreatic secretion
- cephallic
- gastric
- intestinal
inhibited by …
- 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)
pancreas blood supply
splenic artery (coeliac trunk)
pancreas venous drainage
splenic vein
amphipathic
hydrophilic and hydrophobic
bile
merkel cells
fine touch, epidermis- stratum spinosum
langerhans cells
APCs, epidermis- stratum spinosum
which is deeper - papillary or reticular dermis
reticular dermis
uneven junction- ridged. papillary dermis is inbetween ‘pegs’ protrusions
meisners vs paccinian corpuscle
similar!
both in dermis
meisners- fine touch (pressure)
paccinian - vibration, tickle, pressure
schwann cell at core= paccinian and maybe also meisners
nails=
compact keratin
subcutis
what
function
adipose connective tissue
shock absorbtion
energy store
insulation
skin barrier
swelled, plump corneocytes connected with intact corneodesmosomes. lipid lamellae= cement- retains water
ascending loop vs descending loop
ascending is water impermeable. na+ pumped out, cl- follows passively. this cause water in descending loop to more passively to salty medulla.
adh connects to what
V2 receptors (causes aquaporin….)
gfr
measured using
125/ml/min
creatinine (freely filtered)
renal clearance=
values–
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
filtration fraction
proportion of plasma that is filtered
20%ish
where na and cl reabsorbed in pct
how other stuff reabsorebed
BETWEEN cells
pct is leaky af
na/k pump drives it, allowing symporter to carry stuff (glucose, amino acids, lactate)
types of cells in collecting duct
principal cells- respond to adh/aldosterone
intercalated cells
- alpha: secrete h+
- beta: secrete hco3-
types of sphincted
anatomical- localised muscle thickening
functional= physiological- muscle contraction in or around structure
over vs underactive thyroid effects
over- weight loss, tachycardia, sweating, heat intoleracne
under- cold interolerance, weight gain, brady cardia , dry skin
adrenal gland - blood supply and drainage
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!!!!!)
why females shorter
enter puberty later
slower growth velocity
boys sexcharacteristcs due to
all- testicular androgens
girls sex characteristivcs due to
oestrogen–> breasts and ext genitalia
ovarian and adrenal androgens –> pubic and axillary hair
inguinal canal contents (male)
females??
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)
which of the inguinal canal contents exits early, and where
ilioinguinal nerve. superficial ring
inguinal canal hernias
through only deep= indirect
through deep and superficial = direct
if bowel is pushed down the tunica vaginalis tube = congenital hernia
pampiniform plexus
network of testicular veins around testicular artery
cools the TEMPPPOrature
varicocele
enlargened prominent scrotal veins
nerve supply of pudendal nerve
posterior 2/3 of ext genitalia and bum hole
nerve supply of ilioinguinal nerve
anterior 1/3 of external genitalia
nerve supply of genitofemoral nerve
skin of mons pubis, labia majora, anterior scrotum (posterior = pudendal)
GONAD EMBRYOLOGY
gonads indifferent til
what migrates from where to where, and when
what stimulates development of gonads and how
effects
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)
INTERNAL GENITALIA EMBRYOLOGY
initially=
males- what instigates and what happens
females- what instigates and what happens
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
EXTERNAL GENITALIA EMBYROLOGY
orignially
male
female
from what to what
cloaca–> urogenital sinus–>
genital tubercle (penis) (clitoris) genital folds (surround urethra) (labia minora) genital swellings (scrotum) (labia majora)
male vs female pelvis x4
- 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
what surrounds the greater and lesser sciatic foramen
greater= sacrospinous ligament and iliac crest
lesser= sacrospinous ligament and sacrotuberous ligament
urinary buffers x3
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
where are amygdala and hippocampus
both temporal
which of the meningeal layers has no nerves/vessels
arachnoid mater
blood brain barrier layers
what allowed through, what not
blood vessel endothelium
basement membrane
pia mater
foot processes of astrocytes
lipophilic molecules=yes, lipid insoluble molecules=no
arachnoid granulations=
protrusions of arachnoid mater
mainly superior saggital sinus
absorbs csf
axon hillock
where soma (body) becomes axon
microglia function
macrophages. on activation, retract processes and eat up them bitches
astrocytes
types
function
type 1=fibrous
type 2 = protoplasmic
structural - stability and microarchitecture
insulate sinuses
buffer ions
reticular=
mix of white and grey matter
3 types of fibres
commisure= connect hemispheres projection= cortical to sub cortical association = within lobe cortex
motor pool
all LMNs that innervate a single muscle (opposite to motor unit)
where on the medulla are the gracile, cuneate and pyramidal tracts
cuneate and gracile posteriorly (ascending) (gracile medial to cuneate)
pyramidal at front (descending) (medial to olives)
cerebral peduncles vs cerebellar
cerebral= anterior of midbrain (tegmentum) –> thalamus/cerbrum
front bits=crus cerebri
cerebellar= superior, middle, inferior to midbrain, pons, medulla.
olives
superior- hearing
inferioir- cerebellar related
cerebellar input (2)
mossy fibres= are from brainstem (cerebellar peduncles)
climbing fibres= are from olives(on medulla)
dentate nucleus role
planning and initiation of movement
is cerebellum ipsi or contralateral
ipsi baby one more time
where are internal, external and extreme capsule
internal capsule is between caudate nucleus and globus pallidus/putamen
external and extreme capsules are lateral to putamen, seperateed by claustrum
lentiform nucleus =
globus pallidus and putamen
striatum =
putamen meets caudate
substance p
- released from
- effect (2)
released from damaged cells, noxious stimuli
vasodilator
neurotransmitter from c fibres– dull ache (compared to glutamate from a gamma)
3x pain pathways
activation- temporary stimulus, temporary pain
-summation
modulation- prolonged stimulus, persistant pain
-sensitivity increase
modification - nerve damage, persistant pain
- denervation, cell death
melzack wall pain gate
gate to pain can be closed with non-painful input
parkinsons
neurotransmiter
where
effect
lacks dopamine, which is needed to inhibit thalamus in order to move freely
substantia nigra
reduced movement, increased tone
huntingtons
where
effect
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
excitatory vs inhibitatory
where
neurotransmitter
gaba= rostral, striatum and globus pallidus
= inhibitory
excitatory = dopamine, glutatmate
subthalamic nucleus and substantia nigra
cortical vs subcortical loops
direct/indirect
whats the thing doing it
effect on thalamus
effect on movement
cortical = direct substantia nigra (with dopamine) inhibits thalamus-- free movement
subcortical= indirect
subthalamic nucles excites globus pallidus so thalamus is uninhibited – no movement
conus medularris level
L1-2
filum terminale
where
what made of
conus medullaris to coccyx
the three meningeal layers , contains csf, fibrous, surrounded by lumbar cistern (equivalent of subarachnoid space, csf)
abcd2
hasbled
chadvasc
qrisk
tia recurrance
bleed
throboembolism
risk of stroke/heart attack in 10 years
t lymphocytes types
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
where is sa node located
on crista terminalis, where trabeculated and smooth part of r atrium meet, below surface sulcus terminalis (auricular appendage) ,near svc
where is moderator band
function
av bundle to tip or r ventricle
distance is greater to tip or r than l so it ensures contraction at the same time
what line seperates superior and middle mediastinum
T4
pericardial sinuses x2
oblique= culdesac on posterior surface
transverse= behind pulm art and aorta and in front of svc
h+ vasodilator or constrictor
dilator
NO, K+ vasodilator or contrictor
dilator
where are baroreceptors
primary/secondary
effects
carotid sinus (primary) -para/symp change
aortic arch (secondary) - adh, renin, angitensin
where are peripheral chemoreceptors
carotid and aortic bodies
trabeculated carnea
ridges in heart
pressor vs depressor region =
=central regulation of vardiovascular system
pressor (symp)= vasoconstriction, increase in hr, sv, contractility
depressor (parasymp) = inhibits pressor
obstruction vs restriction
obstruction is narowing/ damge (reduced fev, 0.8)
restrction is less lung volume (reduced fev and fvc, 0.7)
DLco =
measured how
indicator of what x4
= transfer factor
CO inhaled and exhaled and change in conc measured
measures alveolar sa, perfusion, capillary volume and integrity , haemoglibin levels
adaptive change at altitude
low 02 so hyperventilation–> resp alkalosis
so more renal bicarb secreted compensates for respiratory alkosis
how does acidic pH and temperature cause change to oxygen saturation
shift curve to right
decreased affinity for oxygen
ageing lung (6)
decrease fev and fvc stiffer cartilage worse elastic recoil worse vq haemoglobin saturation worse more infection - mucus and ciliary escalator worse
pnc=
does what to drg and vrg
apn
does what to drg and vrg
where are they
pneumotaxic center
inhibits
apneustic center
stimulates
pons, pnc bit higher
vrg and drg
where
control what
stimulate what
medulla- ventral and dorsal
drg- rhymicity, fine control
- insp and exhal
vrg- deep long inhales
- insp
stimulate phrenic and intercostal nerves
where is anterior axillary fold
inferior border of pec major
hilum of lung contains
2 pulm veins, pulm art, bronchial arteries main bronchus, symp and parasymp nerves, lympatics
how many lobes in each lung
3 in r, 2 in L
thoracic duct joins veins where
confluence of L subclavian and L internal jugular
varus vs valgus
varus= rum inbetween knees valgus= kness together
stellate ganglion =
fusion of lower cervical ganglia and T1 ganglia (not vertebrae)
which muscles retract the scapula
trapezius
rhomboid major and minor
arm adduction
0-10
10-90
90+
supraspinatus
deltoid
trapezius
anterioir and posterior triangle of neck
infront of and behind sternocleidomastoid muscle
posterior= between that and trapezius
