Patho Exam 2 Flashcards
What are hormones
Hormones are chemical messengers secreted into the blood by specialized epithelial cells
What hormone(s), targets and responses come from the Hypothalamus
Trophic hormones [P,A] - Anterior Pituitary - Phosphorylate proteins. alters channel opening
What hormone(s), targets and responses come from the Posterior Pituitary
Oxytocin - breasts and uterus - milk ejection, labor and delivery - behavior
Vasopressin - kidney - water reabsorption
What hormone(s), targets and responses come from the Anterior pituitary
Prolactin - breast - milk production
growth hormone - liver, many tissues - growth factor secretion, growth and metabolism
Corticotropen - adrenal cortex - cortisol release
thyrotropin - throid gland - thyroid hormone synthesis
Follicle-stimulating hormone/ lutienizing hormone - gonads - egg or sperm production, sex hormone production
What hormone(s), targets and responses come from the thyroid gland
triiodothyronine and thyroxine - many tissues - metabolism, growth and development
calcitonin - bone - plasma calcium levels
What hormone(s), targets and responses come from the adrenal cortex
aldosterone - kidney - Na and K homeostasis
cortisol - many tissues - stress response
androgens - many tissues - sex drive in females
What hormone(s), targets and responses come from the adrenal medulla
epinephrine, norepinephrine - many tissues - fight or flight response
What hormone(s), targets and responses come from the Kidney
erythropoietin - bone marrow - red blood cell production
1,25 dihydroxy-vitamin D3 - intestine - increase calcium reabsorption
Describe a peptide or protein hormone
not steroid and not amino acid derived
short half life
dissolved in plasma
Bind to surface
describe a steriod hormone
derived from cholesterol
long half life
bound to carrier proteins
cross membrane
what is synergism
when two or more hormones interact at their target yielding a higher response that is greater than additive
what is a permissive hormone
when one hormone cannot act unless another is present
what is a antagonistic hormone
when two hormones have opposing effects
describe negative feed back
when hormones secreted by peripheral gland loop back and suppresses secretion of a hormone
what is down regulation
decrease in protein number or binding affinity that lessens response
what is glycogenesis
the synthesis of glycogen from glucose
what is lipogenesis
the conversion of excess glucose into fat
what is glycogenolysis
when plasma glucose decreases and the body converts glycogen to glucose and glucose 6 phosphate
what is gluconeogenesis
when amino acids are converted to glucose when there is low glucose intake
What is the state of carbohydrates in a fasted and fed state
used immediately for energy in aerobic pathways
used for lipoprotein synthesis in liver
stored as glycogen in liver and muscle
excess is stored as fat
glycogen polymers breakdown to glucose in liver of glucose 6 phosphate for use in glycolysis
what is the state of proteins in a fasted and fed state
amino acids go to protein synthesis
excess converted to fat
break down into amino acids
proteins consumed for ATP or converted into glucose
what is the state of fats in a fed and fasted state`
stored as triglycerides in liver and adipose tissue
cholesterol used for steroid synthesis or membrane component
fatty acids used for lipoprotein and eicosanoid synthesis
triglycerides broken down into fatty acids and glycerol
fatty acids used for ATP production in beta oxidation
what is beta oxidation
when protein chains are turned into acetyl CoA for ATP production and may lead to the rise of ketone bodies as a byproduct
what are the differences between type 1 and 2 diabetes
type 1
- autoimmune disease resulting in beta cell destruction where insulin cant be secreted by the pancreas because they were destroyed by white blood cells
type 2
- known as insulin resistant diabetes, lifestyle disease
what is the difference between diabetes mellitus and diabetes insipidus
mellitus is common diabetes but insipidus has to do with fluid levels and water also vasopressin and ADH by posterior pituitary
How is Diabetes tested for
Blood glucose tests
2 hour oral glucose tolerance test (above 200mg/dl after 2 hours )
what are the levels of a prediabetic
hemoglobin A1c - 5.7% - 6.4%
Fasting glucose - 100-125 ml/dl
two hour random plasma - 140-199 mg/dl glucose
what are the levels of a diabetic
hemoglobin A1c - > 6.5%
Fasting glucose - > 126 mg/dl
two hour random plasma - 200 mg/dl glucose
how do you diagnose metabolic syndrome
3 of the following 5 - serum triglycerides - > 150 mg/dl - Serum HDL - M < 40mg/dl, F 50mg/dl BP - > 130/85 mmHg fasting blood glucose - > 100mg/dl
what can metabolic syndrome progress to and how can you change it
type 2 DM
lifestyle changes like diet and exercise
if there is ketosis in blood or urine of a diabetic what does this mean
not to exercise a diabetic because they are not managing their diabetes
exercise precautions with hypoglycemia
Avoid exercise at peak insulin time, avoid injection in exercising muscle
exercise precautions with autonomic neuropathy
exaggerated HR and blood pressure with exercise
orthostatic and postural hypotension
exercise precautions with peripheral neuropathy
regular self exam of feet proper footwear, alternate never soak feet strait cut toe nails no tape on feet
exercise precautions with Diabetic retinopathy
avoid anaerobic exercise
avoid straining and Valsalva like maneuvers
what are signs and symptoms of hypoglycemia
`
describe an endocrine gland
ductless
secretions carried in blood to distant target cells
what type of feedback pathway controls blood glucose
negative, with insulin
what type of feedback pathway controls oxytocin
positive
how does aging affect hormone function
loss of regulation can lead to autoimmune disorders
altered hormone metabolism
secretory responses
what do releasing hormones do
stimulate synthesis and secretion
what do inhibiting hormones do
prevent synthesis and secretion
what is primary pathology
last gland in pathway
what is secondary pathology
anterior pituitary
what is tertiary pathology
hypothalamus
What are the three types of hypercortisolism
1 - primary - adrenal tumor secretes cortisol autonomously
2 - secondary - Cushing’s disease - pituitary tumor secretes ACTH
3 - Cushing syndrome - physician caused, cortisol from the outside
Describe Cushing’s disease
excessive cortisol hyperglycemia hypertension muscle wasting osteoporosis poor wound healing moon face and red cheeks
describe Addison’s diseasegluconeogenesisop
adrenal insufficiency, hyposecretion of steroid hormones
hypoglycemia
autoimmune destruction of adrenal cortex
results in widespread metabolic disturbances
what is pheochromocytoma
a rare tumor that usually starts in the cells of one of your adrenal glands that can cause the adrenal gland to make too many hormones.
What are the 3 types of divisions of the nervous system
CNS - brain spinal cord / PNS - afferent and efferent nerves
Efferent
- Somatic - voluntary
- visceral - involuntary
Visceral / autonomic - parasympathetic vs sympathetic
What are the parts of the nerve cell and their function
Dendrites - receive information Axons - carry outgoing info Cell Bodies - contain nucleus Collaterals - terminal branches of axon Axon terminals - where synapse occurs
What is the flow of information in the CNS
Stimulus sensor input signal integrating center output signal target response
Production of myelin in CNS and PNS. Difference in transmission of nerve impulse in myelinated versus nonmyelinated fibers
CNS - oligodendrocytes
PNS - Schwan cells
myelinated is fast
Generation of Action potential- absolute or relative refractory period, know electrolyte values that trigger depolarization, repolarization. Which ions contributes to the resting membrane potential
Absolute - time required for NA channel to reset to resting positions
Relative - some but not all Na channels have reset, K channels still open
depolarization -55
repolarization +30
K contributes most to resting potential
Saltatory conduction- role of myelin
when action potential jumps from node to node
convergence, divergence, fast and slow postsynaptic responses, excitatory and inhibitory postsynaptic potentials, temporal and spatial summation, and synaptic inhibition
convergence - more presynaptic neurons into less post synaptic neurons
Divergence - branches pf presynaptic neuron synapse with multiple targets
Fast - opens channels directly and quickly, but last milliseconds
Slow - activate second messengers
excitatory - depolarizing
Inhibitory - hyperpolarizing
temporal - overlapping in time
spatial - several nearly simultaneous potentials
inhibition - when a neuron is modulated resulting in inhibited neurotransmitter release
What is UMN and LMN disease, how to distinguish?
UMN - increased muscle tone - hyper reflexes - no atrophy LMN - reduced muscle tone - reduced deep tendon reflexes - atrophy
What is neuropraxia, axonotmesis, Wallerian degeneration, neurotmesis?
Wallerian degeneration - when the terminal dies
neuropraxia - demyelination, compression
axonotmesis - demyelination and axon loss, crash injuries and displacements
Wallerian degeneration - when the axon terminal dies due to proximal injury
neurotmesis - demyelination, axon loss as well as damage to endoneurium, perineurium or epineurium
Characteristics of polyneuropathy
diffuse disfunction of nerves
- lower motor neuron, somatosensory or autonomic abnormalities
Demyelination or Axonal loss
tends to start low and move up
may be caused by
- Charcot-Marie-Tooth disease, Guillain-Barre Syndrome or Diabetes Mellitus
What is lateral inhibition
when sensors sensitive to a stimulus close to make the stimulus more intense
Characteristics of Gillian Barre
immune system attacks myelin of peripheral nerves
caused by infectious illness stomach flu or lung infection
weakness that progresses to the upper body, pins and needles, difficulty with eye or facial movements, balance is challenged, pain, cramps, difficulty retaining urine and sluggish bowel movements, tachycardia, rapid respiration rate, blood pressure fluctuations
Characteristics of Poliomyelitis
Invades intestines and attacks motor neurons in the nervous system
Where is CSF produced, circulated, absorbed, function of CSF, CSF tapping
choroid plexus on the walls of the ventricles
absorbed into blood by special villi
physical and chemical protection
Spinal tap removes fluid from subarachnoid space
Reflexes and integration of the brain- spinal reflex- integration is at the SC
spinal cord generates its own action potentials when interneurons turn sensory info into muscle action
Parts of the CNS: Cerebrum, brainstem, cerebellum, hypothalamus
Cerebrum -
Brainstem - oldest, gray and white matter
Cerebellum - second largest,
hypothalamus -
Parts of the CNS: Cerebrum, brainstem, cerebellum, hypothalamus
Cerebrum - largest part, responsible for higher functions of brain
Brainstem - oldest, gray and white matter
Cerebellum - second largest, process sensory information and control movement
hypothalamus - maintains homeostasis
thalamus- functions
relay station that receives and modifies information from below
first 6 cranial nerves name and function
Olfactory - smell
Optic - vision
Oculomotor - eye movement, pupil constriction, lens shape
Trochlear - eye movement
trigeminal - senses from face and mouth, motor signals for chewing
abducens - eye movement
last 6 cranial nerves
Facial - taste, tear and salivary glands, facial expressions
Vestibulocochlear - hearing and equilibrium
glossopharyngeal - oral sensory, baro and chemoreceptors in blood, swallowing, parotid salivary gland secretion
Vagus - sensory and efferent to organs muscles and glands
spinal accessory - muscles in shoulder and neck
hypoglossal - tongue
Describe Wernicke’s area
Speech center - junction of parietal, temporal and occipital lobes
damage to this area referred to as receptive aphasia, may result in nonsense speech and difficulty understanding com
Describe Broca’s area
Speech center - posterior frontal lobe
damage to this area referred to as expressive aphasia, difficulty understanding complex explanations
Where are spatial and verbal language skills found in the brain
Spatial - right
verbal - left
Describe spina bifida
Folic acid deficiency
Occulta -
Meningocele -
myelomeningocele -
What are the types of receptors and what do they sense
Chemo - ligands that bind to it
Mechano - pressure, vibration, gravity, acceleration and sound
Thermo - temperature
Photo - light
Baro - mechano reseptor sensitive to pressure
Polydipsia, polyphagia
polydipsia - thirst
Polyphagia - hunger
