Pathology Lesson 2 Flashcards

2
Q

In myopathy, what three things are affected?

A

strength tone and bulk

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3
Q

Weakness in myopathy is usually ______ and _____ ?

A

symmetrical and proximal

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4
Q

In myopathy, what is decreased?

A

tone and reflexes

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5
Q

Atrophy and hypertophy is associated with what disease?

A

myopathy

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6
Q

After a binge, there is an acute attack of what three things?

A

Muscle weakness
Pain
and swelling

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7
Q

What is myopathy?

A

disease of muscle

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8
Q

Alcoholic myopathy can have what three kinds of weakness?

A

chronic
progressive
proximal

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9
Q

Necrosis of individual muscle fibers is associated with what disease?

A

toxic myopathy

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10
Q

What two drugs cause toxic myopathy?

A

ipecac

vincristine

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11
Q

What three kinds of pathogens are the etiology of myositis?

A

viral
bacterial
parasitic

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12
Q

What four pathogens cause myositis?

A
Influenza
Staph aureus
Tuberclosis
Trichinosis
 AKA -> SITT
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13
Q

What is the most common toxic myopathy?

A

alcoholic

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14
Q

What two forms of myositis are there?

A

polymyositis

dermatomyositis

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15
Q

Myoglobinuria means what other condition happen to the muscle?

A

rhabdomyolysis

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16
Q

Which myositis causes heliotrope discoloration around the eyes and periorbital edema?

A

dermatomyositis

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17
Q

What is an electromyography?

A

studies activation of motor units

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18
Q

What does an electromyography record?

A

electrical activity of a muscle

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19
Q

What is the mechanism of Duschenne Muscle Dystrophy?

A

1) defective cell membrane protein
2) failure of contractile protein attachment
3) necrosis of muscle fibers

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20
Q

What does an electromyography measure?

A

recruitment of voluntary muscle

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21
Q

What is Duchenne Muscular Dystrophy?

A

recessive, X-linked single gene defect

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22
Q

Muscles account for what percentage of body weight?

A

50%

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23
Q

What are three basic muscle types?

A

skeletal, smooth, cardiac

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24
Q

Give 4 characteristics of skeletal muscle

A

voluntary
striated
multinucleated
large

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25
Q

Give 5 characteristics of cardiac muscle

A
striated
involuntary
branching
one location
uninucleate
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26
Q

What are 8 functions of the muscular system?

A
  • movement-
  • maintenance of posture-
  • stabilization joints
  • respiration
  • production of body heat
  • constriction of organs-vessels
  • heart beat
  • “guard” orifices

MMSRPCG

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27
Q

Give 4 characteristics of smooth muscle

A

nonstriated
involuntary
sheets
uninucleate

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28
Q

At what age do the size and number of muscle fibers begin to decrease?

A

40

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29
Q

What is contractility?

A

ability of a muscle to shorten with force

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30
Q

What is excitability?

A

capacity of muscle to respond to a stimulus

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31
Q

What is extensibility?

A

muscle can be stretched

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32
Q

What is elasticity?

A

ability of muscle to recoil back to original resting length after being stretched

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33
Q

What is the shape of a skeletal muscle?

A

long and cylindrical

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34
Q

What kind of contractions does a skeletal muscle have?

A

rapid

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35
Q

Name the opposing movement:flexion

A

extension

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36
Q

Contraction of skeletal muscle occurs in response to what?

A

nerve impulse

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37
Q

What happens to the skeletal muscle when the nerve impulse is removed?

A

relaxes

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38
Q

Muscle tissue is constructed how?

A

bundles of fibers

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39
Q

Higher demand of muscle work requires what?

A

increased blood supply for increased oxygen need

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40
Q

How is the color of a muscle affected by blood supply?

A

the greater the blood supply, the darker the color

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41
Q

What is myoglobin similar to?

A

hemoglobin

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42
Q

Where is myoglobin found?

A

skeletal and cardiac muscle

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43
Q

What three things happen when myoglobin is released into circulation with muscle damage?

A

leaks potentially toxic cellular content
renal toxicity
acute renal failure

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44
Q

What does myoglobin transport?

A

oxygen

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45
Q

If a patient has rhabdomyolysis, what 5 symptoms may he/she present with?

A

MUSCLE pain
MUSCLE Cramping

Fever
Flu like symptomes

Dark urine

( M2, F2, D1 )

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46
Q

What are six select causes of rhabdomyolysis?

A
trauma
exercise
(status) asmaticus
mult drugs
(Status) epilepticus
substance abuse

mneumonic:
TEAMES

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47
Q

What isoforms are specific for myocardial damage?

A

troponin

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48
Q

What is status epilepticus?

A

continuous seizure activity without pause

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49
Q

What is status asthmaticus?

A

persistent and intractable asthma

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50
Q

Name the opposing movement:1) flexion2) supination3) rotation to right4) eversion5) abduction

A

1) extension2) pronation3) rotation to left4) inversion5) adduction

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51
Q

Compartment syndrome can result in sequela of what? What is this?

A

1) Volkmann ischemic contracture
2) Volkmann ischemic contracture is decreased perfusion to organ which results in hypoxia and contraction of muscles (rigidity)

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52
Q

Increased venous pressure leads to what two things?

A

1) decreased arterial pressure (Ischemia)

2) Edema

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53
Q

What kind of skeletal muscle contraction maintains posture?

A

continuous contractions

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54
Q

What is compartment syndrome?

A

local muscle damage

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55
Q

What provides support for the weight of visceral organs?

A

layers of skeletal muscle tissue located in abdominal wall and pelvic cavity

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56
Q

Sphincters provide 3 somewhat kinds of voluntary control. What are they

A

swallowing
defecation
urination

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57
Q

What kind of skeletal muscle encircles openings to digestive and urinary tracts?

A

sphincters

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58
Q

Following a muscle contraction, how much of the energy is released as body heat?

A

about 3/4

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59
Q

What are two important skeletal muscle properties?

A

irritability and contractility

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60
Q

What is irritability?

A

ability to receive and respond to stimulus

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61
Q

What seven things are used in naming skeletal muscles?

A

SA LANDS

SHAPE
ACTION PERFORMED
LOCATION
ADJACENT BONES
NUMBER OF HEADS
DIRECTION OF MUSCLE FIBERS
SIZE
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62
Q

What is contractility?

A

ability to contract when adequate stimulus is received

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63
Q

What are three functions of fascia?

A

COVERS
supports
and separates muscles

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64
Q

Each muscle is wrapped in a thin, fibrous membrane of connective tissue called what?

A

fascia

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65
Q

What do tendons connect?

A

muscle to bone

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66
Q

What system do tendons belong to?

A

muscular system

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67
Q

What do ligaments connect?

A

bone to bone

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68
Q

What are the three layers of connective tissue?

A

epimysium
perimysium
endomysium

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69
Q

What layer of connective tissue is made of fibrous connective tissue, is composed of a layer of collagen fibers, surrounds entire muscle, separates muscle from surrounding tissues/organs, and extends into muscle attachments?

A

epimysium

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70
Q

What system do ligaments belong to?

A

skeletal system

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71
Q

The epimysium extends into one of what to muscle attachments/

A

tendon or aponeurosis

72
Q

What layer is an invagination of the epimysium?

A

perimysium

73
Q

What is the perimysium composed of and what does it contain?

A

collagen and muscle fibers

74
Q

What does the perimysium wrap around?

A

bundle of muscle fibers (fascicles)

75
Q

What layer is an invagination of the perimysium?

A

endomysium

76
Q

What does the endomysium wrap around?

A

individual muscle fibers

77
Q

What are three sites of skeletal muscle attachments?

A

bones
cartilage
connective tissue covering of anotha muscle

78
Q

What does the endomysium connect?

A

adjacent muscle fibers

79
Q

What are tendons comprised of?

A

bands of collagen fibers

80
Q

The fibers of tendons are interwoven into what?

A

periosteum of the bone

81
Q

What is an aponeurosis?

A

broad sheet comprised of bands of collagen fibers

82
Q

What does an aponeurosis connect?

A

different skeletal muscles to each other

83
Q

Name a tendon

A

Achilles
or
hamstring

84
Q

give an example of aponeuroses

A

palmar
or
epicranial

85
Q

What do skeletal muscles require to initiate muscle contraction?

A

CNS stimulation

86
Q

What are skeletal muscle cells called?

A

myocytes

87
Q

What are myofibrils?

A

fine contractile threads that make up muscle fibers

88
Q

True or False:Skeletal muscle cells are uninucleate.

A

FALSE

89
Q

What is the sarcolemma?

A

specialized plasma membran for skeletal myocytes

90
Q

What is cytoplasm in muscle called?

A

sarcoplasm

91
Q

What are T-tubules?

A

narrow tubules filled with extracellular fluid

92
Q
Myosin= thin
Actin = Thick

Right or Wrong?

A

WRONG! THAT is ABSOLUTELY WRONG!!!!

93
Q

What two proteins are myofibrils composed of?

A

myosin and actin

94
Q

Myosin and actin are responsible for what?

A

muscle fiber contraction

95
Q

What are sarcomeres?

A

myofibrils sectioned into repeating segments

96
Q

What are the dark bands and what are they made of?

A

A bands

made up of myosin

97
Q

What are the light bands and what are they made of?

A

I bands

made up of actIn

98
Q

What do sarcomeres extend between?

A

two Z lines

99
Q

What forms a triad?

A

one T-tubule and two terminal cisternae

100
Q

Skeletal muscle requires stimulation from where to initiate muscle contraction?

A

CNS

101
Q

What is a motor unit comprised of?

A

one motor unit + muscle fibers being stimulated by that motor unit

102
Q

What is the neuromuscular junction?

A

junction of axon terminal of the motor neuron and sarcolemma

103
Q

What is the gap between motor neuron and muscle fibers?

A

synaptic cleft

104
Q

The terminal cisternae contain a high concentration of what?

A

calcium ions

105
Q

Is the concentration of calcium in the sarcoplasm very high or low?

A

low

106
Q

Calcium is required to regulate what?

A

muscle contraction

107
Q

What two things need to happen to initiate muscle contraction?

A

NAME?

108
Q

What is an action potential?

A

fast transient change in membrane potential of an excitable cell due to increased permeability of ion selective channels

109
Q

What is depolarization?

A

change in polarity

110
Q

What is repolarization?

A

back to normal resting state

111
Q

What is needed to carry signal through neuromuscular junction?

A

ACh

112
Q

Where does the motor neuron release ACh?

A

synaptic cleft

113
Q

ACh binds to receptors where?

A

sarcolemma

114
Q

ACh makes sarcolemma more permeable to what?

A

NA+

115
Q

What generates action potential?

A

NA+ influx

116
Q

What is Acetylcholinesterase?

A

Enzyme needed to break down (inactivate) ACh before it can bind to ACh receptors on sarcolemma

117
Q

Where is AChE found?

A

synaptic cleft

118
Q

ACh plays a significant role in what disease?

A

myasthenia gravis

119
Q

What is myasthenia gravis?

A

chronic autoimmune neuromuscular disease

120
Q

explain biochemistry behind myasthenia gravis?

A

antibodies to ach block alter or destroy ach receptors at the neuromuscular junction

121
Q

What is myasthenia gravis characterized by?

A

fluctuating skeletal muscle weakness

122
Q

What are seven topical symptoms of myasthenia gravis?

A

Drooping eyelid
blurred/double vision

slurred speech
difficulty chewing/swallowing

weakness in arms/legs
Chronic muscle fatigue

difficulty breathing

Way to remember:
Eyes - 2
Mouth - 2
Muscles - 2
Chest -1
123
Q

What is the hallmark of myasthenia gravis?

A

muscle weakness that increases during periods of activity and improves with rest

124
Q

What are the five symptomatic treatments for myasthenia gravis?

A

1) AChE Inhibitor agents to reduce act breakdown
2) Steroids/ immunosuppressants
3) Immunoglobulins - alters antibody function
4) Thymectomy to suppress immune rxn
5) plamaphoresis to temporarily remove antibodies

125
Q

How does myasthenia gravis affect the thymus?

A

causes a thymoma

126
Q

How do AChE inhibitor agents help?

A

reduce breakdown of ACh

127
Q

How do steroids/immunosuppressants help myasthenia gravis?

A

suppress immune reaction

128
Q

How do immunoglobulins help myasthenia gravis?

A

alter function of antibodies

129
Q

How does thymectomy help myasthenia gravis?

A

suppress immune reaction

130
Q

How does plasmaphoresis help myasthenia gravis?

A

temporary removal of antibodies

131
Q

What is the name of the bacterium in botulism

A

Clostridium Botulinum

132
Q

What is botulism?

A

toxin which inhibits ACh release which equals paralysis

133
Q

What is tropomyosin?

A

strands of protein that binds with actin

134
Q

What is troponin?

A

hold tropomyosin in position

135
Q

Troponin leaks into cells with what kind of injury?

A

skeletal and cardiac muscle injury

136
Q

What are the effects of exercise? 4

A

increases muscle
size
strength
efficiency

and increases resistance to muscle fatigue

137
Q

What does aerobic exercise increase?

A

increases cappillaries, mitochondia, enzymes, myglobin, VO2 Max, SV

138
Q

Troponin levels are used for what?

A

biomarkers for AMI

139
Q

What does resistance exercise increase?

A

muscle mass and more glycogen

140
Q

What is the reaction for direct phosphorylation?

A

creatine phosphate + ADP –> Creatine + ATP

141
Q

What happens in oxidative phosphorylation?

A

38 ATP / Glucose uses O2

142
Q

What happens in glycolysis?

A

decreased O2, forms lactic acid

143
Q

How many ATP are used up during skeletal muscle contraction per second?

A

up to 600 trillion

144
Q

What is creatine?

A

small molecules assembled from amino acid fragments in muscle cells

145
Q

What are three gradations of contraction?

A

frequency of stimulation
intensity of stimulation
length of fibers before contraction

FIL

146
Q

What is summation? 3 things

A

second twitch stronger than the first
addition Ca+ from SR released
Additional shortening of sarcomere

147
Q

What is tetanus?

A

little or no muscle relaxation

148
Q

What is the surplus energy stored as?

A

creatine phosphate (CP)

149
Q

What are slow oxidative muscle fibers characterized by?

A

SMALL diameter
aerobic
fatigue resistant

150
Q

What are fast oxidative muscle fibers characterized by?

A

INTERMEDIATE diameter
aerobic
moderate fatigue resistance

151
Q

What are fast glycolytic muscle fibers characterized by?

A

LARGE diametere
anaerobic
fatiguable

152
Q

What is staircase effect?

A

successive increase in amplitude

153
Q

What does skeletal muscle atrophy cause?

A

immobilization
and
loss of neural stimulate

154
Q

What is skeletal muscle atrophy?

A

weakening and shrinking of muscle

155
Q

What is the function of smooth muscle?

A

propels “stuff” along internal passageways such as food bolus, urine, and baby

156
Q

What are nine examples of where smooth muscle is located?

A
lining of BV
lymphatic vessels
urinary bladder
uterus,
reproductive tract
GI
pili of skin
eye muscles
157
Q

What are myofilaments of smooth muscle attached to and what do these replace?

A

dense bodies replacing z disk

158
Q

Where is smooth muscle located?

A

primary walls of hollow organs

159
Q

True or False:Smooth muscle has the ability to stretch/maintain tension for extended periods of time.

A

TRUE

160
Q

True or False:Smooth muscle is under voluntary control.

A

FALSE

161
Q

Smooth muscle is grouped into sheets with how many layers? What do these layers participate in?

A

2 layers

participate in peristalsis

162
Q

Smooth muscle is innervated by what kind of terminal?

A

single axon terminal

163
Q

What is the longitudinal layer?

A

fibers run parallel to organ’s long axis

164
Q

What is the circular layer?

A

fibers run around circumference of organ

165
Q

Smooth muscle is innervate by what part of the nervous system?

A

ANS

166
Q

What are the two neurotransmitters used in smooth muscle innervation?

A

ACh and NE

167
Q

What hormones are used in smooth muscle innervation?

A

epinephrine and oxytocin (in some cases)

168
Q

How can contractions of smooth muscle be characterized as?

A

slow wave-like

169
Q

What kind of tension do smooth muscles have?

A

relatively constant tension

170
Q

What can smooth muscle contract in response to?

A

sudden stretch

171
Q

How many nuclei do cardiac muscles usually have?

A

one

172
Q

What are intercalated discs?

A

finer-like interlocking of cells at specialized junctions

173
Q

What kind of contractions do cardiac muscles have?

A

intermediate

174
Q

How many locations can cardiac muscle be found?

A

one

175
Q

What innervates cardiac muscle?

A

ANS