Patho Exam 3 Flashcards
Where are the ganglia of the sympathetic nervous system located
Outside of the CNS in the paravertebral ganglia, bead like structures
Where are the ganglia of the parasympathetic nervous system located
on or near the target tissue
What does the parasympathetic system control
rest digest
What does the sympathetic system control
Fight of flight
What is the main goal of the autonomic nervous system
maintain homeostasis
What is the neuroeffector junction and how does it function
site where motor neurons release neurotransmitters to affect muscle cells
neurotransmitters are released into interstitial fluid and diffuses until reaches a target cell
What is released by preganglionic parasympathetic and sympathetic fibers fibers
acetylcholine
What is released by postsynaptic sympathetic fibers
norepinephrine
What is released by postsynaptic parasympathetic fibers
acetylcholine
What are some major organs or tissues controlled by the autonomic nervous system
Smooth muscle, cardiac muscle, exocrine glands, some endocrine glands, lymphoid tissues, the liver, adipose tissue
Why is the adrenal medulla called a modified sympathetic ganglion
It secretes neurohormone directly into the blood
What is the working of the somatic motor division of the efferent pathway of the PNS
Single neuron from CNS to target tissue, always excitatory
What is a NMJ
the synapse between the alpha motor neuron and the muscle fibers
What is a motor unit
The motor neuron and the muscles it innervates
What is myasthenia gravis
Most common disorder of NMJ, results from lack of acetylcholine receptors on post synaptic side
What is the motor end plate
postsynaptic side of NMJ, has acetylcholine receptors
What breaks down acetylcholine
Acetylcholinesterase
What is calcium ineduced release
When calcium from pre synapse binds to SR to release even more calcium
What is syncytium
When muscles next to each other signal each other to contract in unison
What is an Isometric contraction
Same length, same tone
What is an Isotonic contraction
Same tone, different length
What is a Concentric contraction
Force greater than load
What is an Eccentric contraction
Force less than load
What are the zones of the Sarcomere
Z disk - ends, thin filaments I band - thin actin filaments only A band - thin and thick filament H zone - thick myosin only M line - middle, attachment for thick filament
What is the function of the SR
Contain and control calcium
What is the function of the T-tubules
Help with electrical conduction within muscle fiber
What do nebulin and titin do
Nebulin - structure for actin
Titin - structure for Myosin
What are the layers of connective tissue for a muscle
epimysium - around muscle
perimysium - around fascicle
endomysium - around fiber
Describe osteoporosis
low bone density
more in females
most common metabolic bone disease
Describe Paget’s disease
Osteoclastic and osteoblastic activity
deformity of the skull and bowing of femur and tibia
second most common metabolic bone disease
Describe osteomalacia
Softening of bones as a result of vitamin D deficiency
Describe Gout
uric acid crystalizes in foot most often, very painful
What is a monosynaptic reflex
single synapse between neurons in reflex pathway, often afferent and efferent
What is a polysynaptic reflex
More than one synapse, more complex
Where are Autonomic neural reflexes integrated
hypothalamus, thalamus and brainstem
Describe GTOs
found near tendons
provides information on muscle tension
prevent too much tension by relaxing muscle
Describe muscle spindles
found in muscle
provides information on muscle stretch
Intrafusal fibers are innervated by gamma neurons
prevent too much length by contracting muscle
What is alpha – gamma coactivation
Excitation of alpha and gamma motor neurons at the same time to maintain spindle activation during muscle contraction
What is Stretch reflex
when spindles prompts muscle contraction to prevent the muscle from being damaged by excessive stretch
What is Crossed Extensor reflex
extension of the opposite leg to support sudden shift in weight
What is Reciprocal inhibition
When antagonist muscles relax so agonist muscle can contract
What is reflex movement and where is it integrated
least complex
integrated by spinal cord
What is voluntary movement and where is it integrated, what are the types
most complex integrated at cerebral cortex Decision making and planning Initiating movement Executing movement
What is Rhythmic movement
combination of reflex and voluntary, like walking or running
What are the aerobic and anaerobic yields of ATP production
Aerobic 30-32
Anaerobic 2
Describe the corticospinal tract
Controls voluntary movement
runs from motor cortex to the spinal cord
descending pathways cross to other side of the body in a region of the medulla called the pyramids
What hormones increase in concentration with exercise
Glucagon
Cortisol
Catecholamines (epinephrine/norepinephrine)
What hormones promote conservation of triglycerides
Glaucon
Cortisol
Catecholamines (epinephrine/norepinephrine)
What happens to insulin with exercise
Secretion decreases, probably due to sympathetic inhibition
What does GLUT4 transporter do
performs the function of insulin but in muscle only
What is EPOC
Excess postexercise oxygen consumption, represents oxygen being used to metabolize lactate and restore ATP and phosphocreatine levels
What are the energy yields of the macronutrients
Carbs and proteins - 4 cal
Fat - 9 cal
How does exercise affect immunity
It affects it like a J curve
What are all the steps of actin in contraction
Ca increase in cytosol Ca binds to troponin Troponin-Ca complex pulls tropomyosin away from actin’s myosin-binding site Myosin binds to actin and power strokes Actin moves
What is the role of tropomyosin
Blocks the myosin binding sites on action, moves when calcium binds to troponin
What is ECC and SFT
ECC - action potentials are converted into calcium signals
SFT - actin and myosin slide past one another
What are the healthy vital sign responses to exercise
HR - goes up with intensity
SPB - goes up with intensity
DPB - may go up or down by 10 degrees
What are some vital sign red flags
If HR or BP goes down with increased intensity
If HR or BP goes up with constant intensity
What is osteomyelitis
bacterial inflammation of the bone, makes bones weak and open to fracture
What is exogenous osteomyelitis
organism enters from outside, possibly from a surgical procedure
What is hematogenous osteomyelitis
spreads from inside the body from a preexisting infection
Why is it of concern when children develop osteomyelitis
If periosteum is displaced-blood supply is compromised- bone infarct
How do you diagnose osteomyelitis
Children present with acute pain and high fever
If the process is unattended for a week or 10 days, permanent bone structure damage
almost always occurs
early diagnosis is crucial
What is Myositis offificans
abnormal bone deposits in muscle
can be caused by trauma or repeated trauma
Describe prosthesis and implant fever
Painful joint, fever, risk of implant failure, possibly death
70% locally introduced
What are the stages if implant/ prosthesis infection
early - < 3 months
Delayed 3 - 24 months
Late > 24 months
Describe the 4 types of fractures
Traumatic - sudden impact
Stress fatigue - partial break as a result of repeated rhythmic stress
Insufficiency - result from normal force as a result of weakened bone
pathologic - fracture that occurs in a bone that is fragile by pathological means
What is a sprain and a strain
sprain - ligamentous tear
Strain - muscular tear
What are the sprain and strain classifications
first degree - minor tearing, no integrity loss
second degree - partial tearing, clear loss of function
Third degree - severe tear, complete loss of function
What is osteoarthritis and how do you rule out rheumatoid arthritis
wear and tear of cartilage on joints
Rule out RH by RH factor, proteins outside of RBC
Describe degenerative disk disease
wear down if IV disks
repeated loading, repetitive injury
Describe the plateau phase of heart excitation
Open calcium channels remaining open and potassium channels not opening right away are responsible for cardiac action potential repolarization plateau
What is the conduction pathway in the heart
SA node Internodal Pathway Atrioventricular node AV bundle left and right bundle branches
What are the ions in cardiac impulse generation
Depolarization - sodium entry
Repolarization - potassium exit
What do the waves on an EKG correspond to
P - atrial depolarization
QRS - ventricular depolarization, also atrial repolarization happens here
T - ventricular repolarization
What are the 5 stages of the cardiac cycle
Atrial and ventricular diastole, atria are filling, AV valves open, blood flows via gravity
Atrial systole, atrias contract to fill ventricles, EDV is observed here as the ventricles hold their largest amount of blood
Early ventricular contraction, isovolumetric ventricular contraction, atria begin to fill again, first heart sound as the AV valves close
Ventricular ejection, pressure overcomes the semilunar valves and blood is ejected into the arteries, EDV is observed here as these is a small amount of blood left in the heart
Ventricular relaxation, second heart sound
What causes the heart sounds
S1 -Closure of Mitral and Tricuspid
S2- closure of semilunar valves
What is cardiac output
Volume of blood pumped by one ventricle in a given time, (heart rate x stroke volume)
What is stroke volume
The amount of blood per systole
What are some factors that affect venous return
Contraction or compression of veins returning blood to the heart
Pressure changes in the abdomen and thorax during breathing
Sympathetic innervation of veins
What causes congenital heart defects
Environmental factors - Infections, medication, alcohol, smoking drugs
Genetic - Heredity, mutations, linked with other issue
Differentiate between arteriosclerosis and atherosclerosis
Art
Thickening of the middle layers of small arteries, loss of elasticity, arterial hardening
Ath
Lipids and calcium deposit below the medium and large vascular endothelium
Caused by elevated cholesterol and triglycerides
Large contributor to cardiovascular disease in US
Risk factors for atherosclerosis
High cholesterol and triglycerides
Types Angina
Chronic stable - predictable level of physical activity
Unstable - unpredictable with exercise
Vasospastic - occurs at rest, vasospasm of coronary arteries
Healing process for MI and medications
Surgical options to re vascularize the area of infarct
Nitroglycerine, beta blockers, anticoagulants
S/s of Myocardial infarction and healing duration
Chest pain, heavy arms, shortness of breath, coughing, nausea, vomiting, dizziness, clammy and sweaty
5-6 weeks
What is Heart failure: s/s of heart failure – left heart failure, right sided heart failure
Left
Shortness of breath, coughing, especially during exercise, most common
Right
Buildup of fluid in legs, genitals and abdomen, also cyanosis, enlargement of jugular veins, hepatomegaly and elevated venous pressure
Action of the medications used to treat heart failure
Diuretics - ACE inhibitors
Vasodilators - inotropes
describe Orthostatic hypotension
Low blood pressure when going from sitting down to standing up
What is Active hyperemia, reactive hyperemia
Locally mediated increased blood flow to organs
