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peer teaching Flashcards

1
Q

what are the 2 main causes of V/Q mismatch

A
  1. ventilated alveoli but lack of blood supply (ie blood clot)
  2. adequate blood flow but lack of ventilation (ie collapsed alveoli)
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2
Q

what is the local homeostatic response to a V/Q mismatch caused by a decrease in ventilation

A

vasoconstriction of vessels so that blood is diverted away from poorly ventilated areas

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3
Q

what is the local homeostatic response to a V/Q mismatch caused by a decrease in blood supply

A

bronchoconstriction to areas of poor blood flow so that air is diverted to areas of better blood supply

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4
Q

if FEV1 is less than … it is abnormal

A

<80% of expected value

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5
Q

if FVC is less than … it is abnormal

A

<80% of expected value

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6
Q

define FEV1

A

forced expiratory volume in one second

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7
Q

define FVC

A

forced vital capacity - volume of air that can be forcebily exhaled after maximum inspiration

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8
Q

what values would indicate airway obstruction

A

FEV1/FVC is below 0.7

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9
Q

what values would indicate airway restriction

A

FEV1/FVC is normal but FVC is low (<80%)

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10
Q

what are the two parts of the medullary respiratory group

A

dorsal resp group and ventral resp group

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11
Q

what is the dorsal respiratory group responsible for

A
  • fires during inspiration

- activates muscles involved in inspirationn (diaphragm and external intercostal muscles)

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12
Q

what is the ventral respiratory group responsible for

A
  • contains the respiratory rhythm generator
  • contains pacemaker cells that set the basal resp rate
  • contains expiratory neurons that are most important when active expiration occurs
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13
Q

what are the two parts of the pontine area involved in respiration and where are they located

A

pneumotaxic centre - upper pons

apneustic centre - lower pons

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14
Q

what is the pneumotaxic centre of the pons responsible for

A

smooths the transition between inspiration and expiration

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15
Q

what is the apneustic centre of the pons responsible for

A
  • fine tunes the output of the inspiratory neurons of the medulla
  • continues activating inspiratory neurons to inhibit expiration
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16
Q

define: inspiratory reserve volume

A

amount of in excess tidal inspiration that can be inhaled with maximum effort

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17
Q

define: expiratory reserve volume

A

amount of air in excess tidal expiration that can be exhaled with maximum effort

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18
Q

define: residual volume

A

amount of air remaining in the lungs after maximal expiration

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19
Q

define: vital capacity

A

amount of air that can be exhaled with maximum effort after maximum inspiration

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20
Q

define: functional residual capacity

A

amount of air remaining in the lungs after a normal tidal expiration

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21
Q

define: total lung capacity

A

the maximum amount of air that the lungs can hold

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22
Q

define: tidal volume

A

amount of air inhaled or exhaled in a normal breath (500ml)

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23
Q

what is Dalton’s law

A

pressure exerted by each gas in a mixture of gases is independent of the pressure exerted by other gases

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24
Q

what is Boyle’s law

A

pressure of a fixed amount of gas in a container is inversely proportional to the container’s volume (P1V1=P2V2)

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25
Q

what is Henry’s law

A

amount of gas dissolved in a liquid is proportional to the partial pressure of gas which which the liquid is in equilibrium with

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26
Q

what is the alveolar gas equation

A

PAO2 = PiO2 - PaCO2/R

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27
Q

what is the Law of Laplace and give the relevant equation

A

describes the relationship between pressure (P), surface tension (T) and radius of an alveolus (r)

P = 2T/r

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28
Q

what are the 5 types of antibodies

A 
IgG
IgA
IgM
IgE
IgD
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29
Q

which antibody is produced first at the beginning of an infection

A

IgM

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30
Q

which type of antibody is the most abundant

A

IgG

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31
Q

which type of antibody is made in response to allergies

A

IgE

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32
Q

what is hypersensitivtiy and which antibody is involved in this

A

the overreaction of the immune system to things it doesn’t need to react to (IgE involved in this)

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33
Q

what are the 4 types of hypersensitivity reactions

A

type I = ALLERGIC (IgE mediated, quick onset after exposure)

type II = CYTOTOXIC/ANTIBODY MEDIATED

type III = IMMUNE COMPLEX (IgG and IgM mediated)

type IV = DELAYED / CELL MEDIATED

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34
Q

which type of nerve fibres are sensory

A

afferent neurons

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35
Q

which type of nerve fibres are motor

A

efferent neurons

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36
Q

what are efferent neurons subdivided into

A

somatic (voluntary) and autonomic (involuntary) nervous system

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37
Q

what does the somatic NS innervate

A

skeletal muscle

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38
Q

how many somatic neurons are found between the CNS and an effector muscle

A

one

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39
Q

is the somatic NS excitatory, inhibitory or both

A

ONLY excitatory

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40
Q

what neurotransmitter(s) does the somatic NS use

A

only ACh

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41
Q

what does the autonomic NS innervate

A

cardiac muscle, glands, neurons in the GI tract and other tissues (not skeletal)

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42
Q

how many autonomic neurons are found between the CNS and its innervation

A

2 neurons synapse

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43
Q

where would 2 neurons in the autonomic NS synapse

A

in a cell cluster outside of the CNS called the autonomic ganglion

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44
Q

is the autonomic NS excitatory, inhibitory or both

A

both

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45
Q

what neurotransmitter(s) does the preganglionic neuron in the autonomic NS use

A

ACh

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46
Q

what neurotransmitter(s) does the postganglionic neuron in the autonomic NS use

A

ACh (excitatory)

Noradrenaline (inhibitory)

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47
Q

what can the autonomic NS be divided into

A

sympathetic and parasympathetic divisions

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48
Q

describe the neurotransmitters involved in pre/postganglionic in the sympathetic NS and what receptors they act on

A

Preganglionic synapse → ACh acts on nicotinic receptors

Postganglionic synapse → noradrenaline acts on adrenergic receptors

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49
Q

what are the effects of the sympathetic NS

A 
Increase HR
Increases force of contraction of heart
Vasoconstriction
bronchoDILATION
Sphincter contraction
DECREASED GASTRIC SECRETIONS
REDUCED GASTRIC MOTILITY
Male ejaculation
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50
Q

describe the neurotransmitters involved in pre/postganglionic in the parasympathetic NS and what receptors they act on

A

Preganglionic synapse:
ACh acts on nicotinic receptors

Effector cell synapse:
ACh acts on muscarinic receptor

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51
Q

describe the effects/innervations of the parasympathetic cranial nerves

A 
Decrease HR
Decrease force of contraction of the heart
bronchoCONSTRICTION
Sphincter relaxation
INCREASED GASTRIC SECRETIONS
INCREASED GASTRIC MOTILITY
Male erection
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52
Q

what are upper motor neurons and where do they synapse

A

they are the descending pathways and neurons of the motor cortex

they synapse on LMN in the brainstem or the spinal cord

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53
Q

what are the signs of an UMN lesion

A

paralysis/weakness of movements on the affected side

Baninski sign is present - big toe is dorsiflexed and other toes fan outwards

Loss of fine-skilled voluntary movements (especially at distal ends of the limbs

Spasticity or hypertonicity of the muscles

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54
Q

what are lower motor neurons

A

alpha motor neurons that connect UMNs to effectors

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55
Q

define: single motor unit

A

the muscle fibres distributed in one muscle

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56
Q

what are the signs of a LMN lesion

A

Flaccid paralysis of muscles supplied

Atrophy of muscles supplied

Loss of reflexes of muscles supplied

Muscle wasting

Muscle contracture

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57
Q

which part of the primary motor cortex is supplied by the anterior cerebral artery

A

medial aspect (legs)

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58
Q

which part of the primary motor cortex is supplied by the middle cerebral artery

A

lateral aspect (all except legs)

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59
Q

what are the 7 layers of gas exchange in the lungs

A

fluid lining epithelium

layer of alveolar epithelium (type 1 pneumocytes)

basement membrane of epithelial cells (type 1 pneumocytes)

interstitial fluid

basement membrane off capillary endothelium

capillary endothelium

red blood cells

FABIBER (feeling are bad instead be emotionally reserved)

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60
Q

what is the henderson hasselbach equation

A

pH = 6.1 + log ([HCO3-]/(0.03[PCO2])

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61
Q

what are the 3 proteins produced in the liver

A
  1. plasma proteins (albumin)
  2. clotting proteins (except VII (vWF) and IV (calcium))
  3. complement proteins
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62
Q

what are the 2 main functions of albumin

A
  1. maintain colloid oncotic pressure

2. binding and transport of hydrophobic/large molecules

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63
Q

describe phase 1 detoxification in the liver

A
  • oxidation/hydrolysis reactions
  • often involved in adding -OH or -SH
  • use cytochrome P450 enzyme
  • using mainly microsomal enzymes
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64
Q

describe phase 2 detoxification reactions in the liver

A
  • conjugation
  • often involves adding glucuronic acid
  • excretion in bile/urine/faeces
  • using mainly non-microsomal enzymes
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65
Q

what is stored in the liver

A
  • iron is stored in the form of ferritin
  • glycogen (100g)
  • minerals (Cu)
  • fat soluble vitamins (A,D,E,K)
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66
Q

where is vit A stored

A

stored in Ito cells in the the space of Disse

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67
Q

what does vit D do

A

increases Ca and P reabsorption in the GI tract

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68
Q

which clotting factors are vit K dependent

A

10, 9, 7, 2

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69
Q

describe the process of fat metabolism

A
  • bile salts emulsify fats in the small intestine and form micelles
  • intestinal lipase degrades triglycerides
  • triglycerides are incorporated with cholesterol into chylomicrons
  • hepatic lipase releases fatty acids and glycerol and allow fatty acid uptake into hepatocytes
  • fatty acids are then oxidised or esterified to triglycerides for storage
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70
Q

where are LDLs formed and what do they do

A
  • formed in the plasma

- deliver cholesterol to cells throughout the body

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71
Q

where are HDLs formed and what do they do

A
  • formed in the liver

- remove excess cholesterol from blood and tissues

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72
Q

where are VLDLs formed and what do they do

A
  • synthesised in hepatocytes

- carry triglycerides from glucose in liver to adipocytes

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73
Q

describe the urea cycle

A

Arginine –(-urea)–>ornitihine –(+ ammonia and CO2)–> citrulline –(+ammonia)–>Arginine

Urea is the only product made

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74
Q

what is the innervation and and artery supply to the foregut

A
  • coeliac trunk

- greater splanchnic (T5-T9)

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75
Q

what is the innervation and artery supply to the midgut

A
  • superior mesenteric artery

- lesser splanchnic (T10-T11)

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76
Q

what is the innervation and artery supply to the hindgut

A
  • inferior mesenteric artery

- least splanchnic (T12)

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77
Q

what forms the ampulla of Vater and where does this enter the duodenum

A
  • bile duct and pancreatic duct

- ampulla of vater enters the 2nd part of the duodenum at the major papilla

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78
Q

which part(s) of the duodenum is smooth muscle and what does the rest contain

A
  • the first part of the duodenum is smooth

- the rest contains plicae circularis

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79
Q

what are the differences between the jejunum and the ileum

A

LENGTH - J=2/5, I=3/5
DIAMETER - J=wider
WALL - J=thicker
COLOUR - J=deep red, I=pale pink
PEYER’S PATCHES - J=fewer, I=more
BLOOD SUPPLY - J=longer vasa recta, fewer arcades
MESENTERY - J=transparent (less fat), I= more fat

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80
Q

what are peyer’s patches

A

small masses of lymphatic tissue found throughout the ileum

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81
Q

what is the porta hepatis

A

where the neurovascular vessels (EXCEPT VEINS) enter and leave the liver

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82
Q

describe the billary tree

A

left + right hepatic duct = common hepatic duct
common hepatic duct + cystic duct = common bile duct
common bile duct + pancreatic duct = ampulla of vater

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83
Q

what are the 4 layers of the GI tract

A
  1. mucosa
  2. submucosa
  3. muscularis externa
  4. serosa
    Ms & Ms
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84
Q

which embryological layer forms the foregut, midgut and hindgut

A

endoderm

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85
Q

describe the phases of swallowing

A

Stage 1 - voluntary

  • Food compressed against the roof of the mouth and pushed towards the oropharynx by the action of the tongue
  • Buccinator and suprahyoid muscles manipulate food

Stage 2 - involuntary:
-Nasopharynx closed off by the soft palate
pharynx shortened/widened by elevation of the hyoid bone

Stage 3 - involuntary

  • Sequential contractions of the constrictor muscles followed by the depression of the hyoid bone and pharynx
  • Peristalsis
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86
Q

name the afferent and efferent nerves involved in the gag reflex

A 
afferent = glossopharyngeal
efferent = vagus
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87
Q

what are the main functions of the saliva

A
  • lubrication for mastication
  • maintains oral pH of 6.2-7.4 (bicarbonate/carbonate)
  • digestive enzymes = salivary alpha amylase
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88
Q

name the salivary glands and what type of saliva it produces

A

PAROTID
- serous saliva
main source of saliva when activated

SUBMANDIBULAR
- serous and mucous saliva

SUBLINGUAL
- mucous saliva

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89
Q

what is the effect of sympathetic and parasympathetic effect on salivary glands

A

sympathetic - inhibits

parasympathetic - stimulates

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90
Q

describe serous acini

A
  • dark staining nucleus
  • small central duct
    secrete water and alpha amylase
  • found mainly in parotid gland
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91
Q

describe mucous acini

A
  • pale staining
  • nucleus at the base
  • large central duct
  • secrete mucous (water and glycoprotein)
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92
Q

what connects acini to striated ducts and what is the function

A
  • intercalated ducts

- NaCl

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93
Q

what do parietal cells produce and what do they do

A

HCl - digestion, activation of pepsinogen, host defense

Intrinsic factor - involved in the absorption of B12 in the terminal ileum

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94
Q

what do chief cells produce and what does it do

A

Pepsinogen - inactive form of pepsin which breaks down proteins

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95
Q

what do enterochromaffin (ECL) cells produce and what does it do

A 
Enterochromaffin cells (ECL cells)
Histamine - upregulates HCl secretion from parietal cells
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96
Q

what do G cells produce and what does it do

A

Gastrin - upregulates HCl secretion

binds to parietal and ECL cells

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97
Q

what do D cells produces and what does it do

A

Somatostatin - inhibits gastrin secretion

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98
Q

ACh

  • site of production
  • site of action
  • action
A

neurons

ECL cells and parietal cells

stimulates histamine and HCl secretion

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99
Q

Gastrin

  • site of production
  • site of action
  • action
A

G cells

ECL cells and parietal cells

stimulate histamine and HCl secretion

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100
Q

histamine

  • site of production
  • site of action
  • action
A

ECL cells and mast cells

H2 receptors on parietal cells

stimulates HCl secretion and increases response to gastrin/HCl

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101
Q

somatostatin

  • site of production
  • site of action
  • action
A

D cells

parietal cells

inhibits HCl secretion

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102
Q

secretin

  • site of production
  • site of action
  • action
A

S cells (small intestine)

G cells

inhibits gastrin secretion

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103
Q

CCK

  • site of production
  • site of action
  • action
A

I cells (small intestine)

parietal cells and pancreas

inhibits HCl secretion and promotes flow of digestive enzymes from pancreas/ bile salts

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104
Q

what is the volume of an empty stomach vs when it is full

A 
empty = 50ml
full = 1.5 litres
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105
Q

what is receptive relaxation WRT the stomach and what is it mediated by

A
  • dilation of the body/fundus just before food arrives

- mediated by parasympathetic NS (vagus nerve)

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106
Q

describe peristalsis in the stomach

A
  • peristaltic waves begin in the body of the stomach which are weak and cause little mixing
  • more powerful contractions occurin the gastric antrum
  • pyloric sphincter closes as the peristaltic wave reaches it
  • little chime will enter the duodenum
  • the majority rebounds to the antrum and is forced backwards towards the body to be mixed
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107
Q

what are the 4 gastric mucosal defences

A
  1. alkaline mucous on luminal surface
  2. tight junctions between epithelial cells
  3. rapid replacement of damaged cells by stem cells present at the base of pits
  4. feedback loops for regulation of gastric acid secretion
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108
Q

which are the fat soluble vitamins and where are they absorbed

A
  • A, D, E, K

- absorbed in micelles the same way as fat in the ileum

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109
Q

which are the water soluble vitamin and where are they absorbed

A

-B, C
- jejunum
(exception is B12)

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110
Q

describe the process of B12 absorption

A
  1. B12 bonds with R-protein in the mouth
  2. R-protein protects B12 from the HCl in the stomach
  3. protease in the duodenum releases B12 from R-protein
  4. intrinsic factor produced by parietal cells in the stomach help B12 to be absorbed
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111
Q

describe the digestion of starch

A
  1. begins in the mouth with alpha-amylase (pH 6.7)
  2. 95% of digestion is done by pancreatic amylase in the small intestine
  3. this produces maltose and a mixture of other chains
  4. the products are broken down into monosaccharides by oligosaccharide and disaccharide enzymes of the luminal membranes of the small intestine
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112
Q

what are the 3 monosaccharides

A

glucose
fructose
galactose

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113
Q

describe the digestion of proteins

A

STOMACH
- partially broken down to peptide fragments in the stomach by pepsin

SMALL INTESTINE
- peptide fragments are further broken down by proteolytic pancreatic e enzymes (trypsin and chymotrypsin)

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114
Q

what are the proteolytic pancreatic enzymes

A

trypsin and chymotrypsin

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115
Q

describe the process of protein absorption

A
  • most of the products of protein digestion are absorbed in short chains of 2/3 A.As by secondary active transport coupled to the H+ gradient
  • free A.As enter the epithelial cells by secondary active transport coupled to Na+ facilitated by an increase in luminal Na+ concentration
  • these A.As then leave the cell and enter the interstitial fluid via facilatated diffusion
  • diffuse passively into the blood
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116
Q

describe the digestion of fat

A
  • major digestive enzyme is lipase which is synthesised in the pancreas
  • catalyses the splitting of bonds linking fatty acids to the 1st and 3rd carbon atoms of glycerol producing two free fatty acids and a monoglyceride
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117
Q

what are the classifications of BMI

A 
BMI > 40 = morbidly obese
30 < BMI < 40 = obese
25 < BMI < 30 = overweight
18.5 < BMI < 25 = normal
BMI < 18.5 = underweight
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118
Q

what is BMI measure in

A

weight (Kg) / height^2 (m)

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119
Q

how much excess glycogen can be stored and how long does it last

A
  • 15 kg

- 12 hours

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120
Q

how much excess lipid can be stored and how long does it last

A
  • 350 g (200g in liver, 150g in skeletal muscle)

- 3 months

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121
Q

how much excess protein can be stored and how long does it last

A
  • 6kg
  • 10 days
    (only used in periods prolonged starvation)
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122
Q

briefly describe the 2 functions of the pancreas

A

EXOCRINE
- acini of pancreas produce digestive enzymes that are released via the pancreatic duct

ENDOCRINE
- islets of langerhans produce insulin and glucagon which regulate blood glucose levels

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123
Q

what do alpha cells secrete and what is its function

A
  • glucagon

- raised blood glucose

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124
Q

what do beta cells secrete and what is its function

A
  • insulin

- lowers blood glucose

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125
Q

what do delta cells secrete and what is its function

A
  • somatostatin

- inhibits glucagon and insulin secretion

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126
Q

what is the function of the gallbladder

A

the site where bile is stored and concentrated

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127
Q

describe how bile is secreted from the gallbladder

A
  1. CCK triggers the gallbladder to contract and release bile into the cystic duct
  2. this emptys into the common bile duct which joins with the pancreatic duct to form the ampulla of vater
  3. this enters into the duodenum where bile emulsifys fat
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128
Q

define hormone

A

signalling molecule produced in a gland which travels to a target organ to regulate physiology and behaviour

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129
Q

define endocrine

A

secrete hoemones into the blood to regulate distant target organs

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130
Q

define exocrine

A

secrete substances via a duct

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131
Q

define paracrine

A

cell to cell communication to induce changes in nearby cells

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132
Q

describe the three types of hormones

A

AMINE
- derived from A.As (catecholamines, thyroxine)

PEPTIDE

  • made from peptide
  • stored in secretory granules
  • rapid release and short action

STEROID

  • made from lipids
  • travel in the plasma bound to proteins
  • slow release and long action ie cortisol
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133
Q

what hormones does the anterior pituitary gland produce

A
  1. TSH (thyroid stimulating hormone)
  2. FSH
  3. LH
  4. ACTH (adrenocorticotropic hormone)
  5. Growth hormone
  6. prolactin
134
Q

where does FSH act in males and females and what does it do

A

FEMALES
- stimulates the growth of ovarian follicles in the ovary before ovulation

MALES
- acts on SERTOLI cells to stimulate spermatogenesis

135
Q

where does LH act in males and females and what does it do

A

WOMEN

  • in weeks 1 and 2 of the menstrual cycle it stimulates ovarian follicles to release estrogen
  • around day 14 a surge in LH causes ovulation

MALES
- acts on LEYDIG cells to produce testosterone (which acts locally to support sperm cell production)

136
Q

what is another name for the anterior pituitary and where is it derived from embryologically

A
  • anterior pituitary = adenohypothesis

- derived from the GI tract

137
Q

what is another name for the posterior pituitary gland and where is it derived from

A

posterior pituitary = neurohypothesis

- neural tissue

138
Q

name the major hormones secreted by the posterior pituitary gland and which nucleus they are released from

A

PARAVENTRICULAR NUCLEUS

  • located in the hypothalamus
  • releases oxytocin

SUPRAOPTIC NUCLEUS

  • located in the hypothalamus
  • releases ADH (vasopressin)
139
Q

what are the layers of the adrenal cortex and what do they produce

A

zona glomerulosa - mineralcorticoids (aldosterone)

zona fasiculata - glucocortiocoids (cortisol)

zonal reticularis - androgens (DHEA)

140
Q

what is produced in the adrenal medulla

A

catecholamines

- adrenaline, noradrenaline and some dopamine

141
Q

what activates the zona glomerulosa and what does it act on

A

activated by:

  1. Angiotensin II (RAAS)
  2. hperkalaemia

acts on:
1. DCT
2. CD
(increases water and Na+ reabsorption, increases K+ secretion

142
Q

what activates the zona fasiculata and what does it do

A
  • secretes glucocorticoids in response to ACTH secretion from the anterior pituitary gland
  • negative feeback on the anterior pituitary
  • results in giht or flight response
143
Q

describe the action of cortisol

A
  1. increases metabolism by:
    - protein breakdown
    - gluconeogenesis
    - insulin resistance
  2. circulation:
    - increases vasoconstriction
  3. decreases inflammation and specific immune responses
  4. decrease of non-essential functions (ie reproduction/growth)
144
Q

how many lobes are there of the thyroid gland and what connects them

A
  • 2 lobes

- connected by the isthmus

145
Q

describe the vasculature of the thyroid gland

A

ARTERIAL SUPPLY
- superior and inferior thyroid artery

external carotid artery –> superior thyroid artery
subclavian –> thyrocervical trunk –> inferior thyroid artery

VENOUS DRAINAGE
- superior, middle and inferior thyroid veins

146
Q

describe the synthesis of T3/4

A
  • Thyroglobulin produced in ER of follicle cell travels to the lumen
  • Iodide travels from plasma, through the cell, into the lumen.
  • Peroxidase converts Iodide to Iodine
  • Iodine replaces OH groups on Tyrosine rings making MIT + DIT
  • MIT + DIT combine via ester bonds to make T3 + T4
  • T3/T4/MIT/DIT travel from lumen into follicle cells, packaged in endosomes
  • Lysosomes cleave T3/T4 as required from endosomes
  • T3/T4 diffuse freely through the apical membrane
147
Q

what is the action of T3/4

A
  • increased metabolic rate
  • growth and development
  • increased catecholamine effect (symp NS)
148
Q

how is T3/4 transported in the blood

A

bound to thyroid binding protein

149
Q

out of T3 and T4 which is the more active form and which is more prevelant

A

T3 - more active form

T4 - more prevalent

150
Q

what are the 3 hormones that regulate Ca2+ uptake and what effect do they have

A
  1. vit D - increases Ca2+
  2. PTH - increases Ca2+
  3. calcitonin - decreases Ca2+
151
Q

what cells produce and release PTH from PTH glands

A

chief cells

152
Q

what are the actions of parathyroid hormone

A
  1. osteoclast proliferation/differentiation
  2. reabsorption of Ca2+ in the DCT
  3. increases production of activated vit D (via increase in action of 1 alpha hydroxylase)
153
Q

describe the synthesis of vit D

A

7-dehydrocholesterol in skin is converted to cholecalciferol (vitD3) by UV B

this is converted to 25(OH)vit D in the liver

this is converted to 1,25(OH)2 vit D in the kidneys via 1 ALPHA HYDROXYLASE

(activity of this enzyme is increased by PTH)

154
Q

where is calcitonin released and what are its actions

A

released from the thyroid gland when Ca2+ levels are too high

activity:

  • promotes bone deposition
  • inhibits Ca2+ resorption in the kidneys

opposite effect of PTH

155
Q

where are the receptors for peptide and steroid hormones located

A

peptide - cell membrane

steroid - intracellular

156
Q

how do you calculate the anion gap

A

anion gap = (Na+ + K+) - (Cl- + HCO3-)

157
Q

what are the 4 main energy sources for catabolism

A

carbohydrates
lipids
proteins
alcohol

158
Q

does hyperthyroidism or hypothyroidism INCREASE BMR

A

hyperthyroidism

159
Q

approx how much of excess energy intake is stored as protein

A

6kg

160
Q

what are the bonds between phosphate groups on ATP called and are they strong or weak

A
  • phosphoanhydride bonds

- relatively weak

161
Q

what is the overall equation for aerobic glycolysis

A

glucose –> 2 pyruvate + 2 ATP + 2 NADH

162
Q

what is the overall equation for anaerobic glycolysis

A

glucose –> 2 lactate + 2 ATP

163
Q

what inhibits krebs cycle

A

Succinyl CoA
ATP
NADH

164
Q

what activates krebs cycle

A

ADP

165
Q

what is the total number of ATP produced in aerobic respiration

A

34

166
Q

what enzyme converts acyl carnitine to acyl CoA and where does this take place

A

carnitine acyltransferase 2

mitochondria

167
Q

which ion has little effect on the anion gap

A

K+

168
Q

how is total body water distributed in a healthy 70kg man

A

intracellular 28L
extracellular 14L
–> intravascular 3L
–> interstitial 11L

169
Q

what is the main cation in extracellular fluid

A

Na+

170
Q

what is the main cation in intracellular fluid

A

K+

171
Q

define osmolarity

A

conc of solutes in plasma per:
KILOGRAM of SOLVENT
LITRE of SOLUTION

172
Q

what does the right coronary artery supply

A

right ventricle
right atrium
SA and AV nodes

173
Q

define fasciculi

A

nerve axons that run up and down the spinal cord in bundles

174
Q

Dorsal/medial lemniscal column

  • function
  • decussation
  • lateral vs medial
A

FUNCTION
- proprioception, vibration and discriminative touch

DECUSSATION
- medulla

LATERAL
- fasciculus cuneatus - carries info from the upper body to the cuneate tubercle in the medulla

MEDIAL
- fasciculus gracilis -carries info from the lowerr body to the gracile tubercle in the medulla

175
Q

lateral and medial spinothalamic tract

  • function of lateral and medial
  • decussation
  • where the tracts join
A

FUNCTION
LATERAL - pain and temp
MEDIAL - crude touch

DECUSSATION
- ascends on the same side for 1 to 2 levels then descussates before ascending to the thalamus

JOIN
- the tracts join at the medulla and carries on to the thalamus

176
Q

corticospinal tract

  • function
  • decussation
  • lateral vs medial
A

FUNCTION
- transmits control of voluntary muscles (motor)
DECUSSATION
LATERAL (75%) - pyramidal medulla decussation (limbs)
MEDIAL (25%) - decussates as it leaves the spinal cord via the anterior white commissure (axial muscles)

177
Q

what sensory nerve endings may sense fine touch

A
  1. meissner’s corpuscle
  2. pacinian corpuscle
  3. ruffini endings
  4. mekels endings
178
Q

how many nerves are involved in the DMLC tract

A

3 neurons:

  1. in the dorsal root ganglion
  2. in the cuneate and gracile nuclei
  3. in the ventral posterolateral nucleus of the thalamus
179
Q

describe the effect of brown-sequard syndrome

A
  1. ipsilateral weakness (due to DMLC)
  2. ipsilateral loss of dorsal column proprioception
  3. CONTRALATERAL loss of spinothalamic pain and temperature

overall:
ipsilateral loss of: proprioception, motor and fine touch
contraleteral oss od: pain, temp and crude touch

180
Q

what are the parasympathetic effects of CN III

A
  1. pupil constriction

2. accommodation (focusing near to far objects)

181
Q

what muscle controls movement of the eyelid

A

levator palpebrae superioris muscle

182
Q

what would damage to the trochlear nerve cause

A

double vision as the patient looks down

183
Q

where do the afferent branches of the trigeminal nerve meet

A

meckel’s cave

184
Q

what are the parasympathetic functions of the facial nerve

A
  • submandibular and sublingual salivary glands
  • nasal, palatine and pharyngeal mucous glands
  • lacrimal glands
185
Q

where does the facial nerve begin to branch and what are the branches

A
  • within the parotid gland
  • temporal branch
  • zygomatic branch
  • buccal branch
  • marginal mandibular branch
  • cervical branch
186
Q

what are the parasympathetic, motor and sensory functions of glossopharyngeal nerve

A 
PARASYMPATHETIC
- parotid gland
MOTOR
-elevates the pharynx
- stylopharyngeal
SENSORY
- external ear
posterior 1/3 of tongue
- pharynx (touch/pain/temp)
- Eustachian tube (touch/pain/temp)
- carotid sinus &amp; body (baro/chemoreceptor)
187
Q

describe the innervation of the tongue

A

POSTERIOR 1/3
sensory and taste - glossopharyngeal

ANTERIOR 2/3
sensory - lingual branch of V3
taste - chorda tympani branch of facial

MOTOR
hypoglossal except palatoglossus (pharyngeal branch of vagus)

188
Q

what passes through the cavernous sinus

A

CN III, IV, V1, V2, VI

internal carotid artery

189
Q

where is wernicke’s area located

A

temporal lobe

190
Q

where is the most common location of a berry anuersym and what does it cause

A

anterior cerebral artery and anterior communicating artery junction

subarachnoid heaemorrage

191
Q

how is fibrin broken down

A

plasminogen –> plasmin which breaks down fibrin

192
Q

what is the function of titin

A

maintains the alignment of thick filaments in the middle of each sarcomere

193
Q

describe cardiac action potentials

A

0 - rapid depolarisation (Na+ influx)
1 - partial repolarisation (Na+ stops, K+ efflux)
2. plateau (slow inflow of Ca2+)
3. repolarisation (Ca2+ stops, K+ efflux)
4. rest,

194
Q

what is the function of intercalated discs

A
  • they are junctions that contain desmosomes and adherent junctions that binds cells together
  • contain gap junctions that allow cells to become electrically coupled
195
Q

differentiate between action potentials in cardiac myocytes vs skeletal muscles

A

CARDIAC MYOCYTES

  • long plateau due to the influx of calcium
  • extended refractory period allows the cell t fully contract before another electrical event can occur
  • AUTORHYTMICITY - cardiac muscles can initiate its own electrical impulse that trigger the mechanical contraction
196
Q

which component of the heart conduction system would have the slowest firing rate

A

purkinje fibres

197
Q

what would the heart rate be if the SA node was blocked

A

40-60 bmp

198
Q

describe the order of valves opening/closing in the cardiac cycle in the left side of the heart

A

mitral valve closes
aortic valve opens
aortic valve closes
mitral valve opens

COCO MAAM

199
Q

list 5 constituents of plasma

A

salts, nutrients, antibodies, hormones and other bio-active constituents

200
Q

n some cases however immature red cells still containing some visible ribosome remnants may be released into the blood stream. What are these cells called?

A

Reticulocytes

201
Q

what layer do veins not have

A

external elastic lamina

202
Q

what 3 layers do all arteries and veins contain

A

external to innermost

  • tunica adventitia
  • tunica media
  • tunica intima
203
Q

what are the 4 ways in which the structure of arteries and veins differs

A
  1. outline - A=circular, V=irregular
  2. musclular wall - A=thick, V=thin
  3. diameter - A=smaller, V=larger
  4. Valves - A=none, V=present
204
Q

what are the 4 starling forces that determine net filtration pressure (NFP)

A
  1. hydrostatic pressure in the capillary
  2. hydrostatic pressure in the interstitium
  3. oncotic pressure in the capillaries
  4. oncotic pressure in the interstitum
205
Q

how does the kidney detect changes in blood pressure

A

strech receptors in the vascular walls or by macula densa cells (NaCl)

206
Q

describe the changes to foetal circulation that occur at birth

A

First breaths of life -> lungs expand -> the alveoli in the lungs are cleared of fluid.

An increase in the baby’s BP and a significant reduction in the pulmonary pressures reduces the need for the ductus arteriosus to shunt blood -> closure of the shunt.

These changes increase the pressure in the left atrium of the heart -> decrease the pressure in the right atrium -> foramen ovale closes -> newborn circulation.

207
Q

name the local constrictors of blood vessels

A

endothilin -1

local BP

208
Q

name the local dilators of blood vessels

A 
NO
bradykinin 
prostacyclin
H+, K+, H20
hypoxia
adenosine 
tissue breakdown products
209
Q

name the hormonal constrictors of blood vessels

A

adrenaline
vasopressin
angiotensin II

210
Q

name the hormonal dilators of blood vessels

A

adrenal

atrial natriuetic peptide (ANP)

211
Q

name the neural vasoconstrictor/dilator on blood vessels

A

noradrenaline

212
Q

what is the main determinant of population health

A

the extent of income division

213
Q

what is the Gini coefficient

A

statistical representation of national income distribution

lower Gini coefficient = greater equality

214
Q

2 responses to health inequality (reports)

A 
black report (1980)
acheson report (1988)
215
Q

what is proportionate universalism

A

Proportionate universalism is the resourcing and delivering of universal services at a scale and intensity proportionate to the degree of need.

Services are therefore universally available, not only for the most disadvantaged, and are able to respond to the level of presenting need.

216
Q

give 3 theories of causation of health inequality

A
  1. psychosocial - stress, impact on blood pressure, cortisol levels, inflammatory response
  2. neo-material - heirarchial societies invest less in public goods
  3. life course - combination of above, critcal periods and accumulation
217
Q

what are the 4 domains of public health

A
  1. health protection
  2. improving services
  3. health improvements
  4. addressing wider determinants of health

WISP

218
Q

what are the 3 ethical levels

A
  1. meta-ethics
  2. ethical theory
  3. applied theory
219
Q

explain a deductive ethical argument

A

one general ethical theory applies to all medical ethics

220
Q

explain a inductive ethical argument

A

use settled medical cases to generate ethical theory

221
Q

explain the 4 parts of the biomedical model of health

A
  1. mind and body are separate
  2. body, like a machine, can be repaired
  3. privilages use of technological interventions
  4. neglets social and psychological dimensions of disease
222
Q

give the 5 structural determinants of illness

A
  1. social class
  2. poverty
  3. unemployment
  4. discrimination
  5. gender and health
223
Q

when is a breach of confidentiality allowed

A
  1. required by law
  2. public interest
  3. patient consents
224
Q

what is the criteria for disclosure of patient information

A
  1. anonymous if practical
  2. patients consent
  3. minimum amount of info possible
  4. meets law
225
Q

what are the 3 main notifiable diseases for breach of consent

A

cholera
yellow fever
plague

226
Q

explain consequentialism

A

an act is evaluated on its consequences

227
Q

what is the difference between rule consequentialism and act consequentialism

A

rule - belief that rules are in place for the good of society

act - belief that you should evaluate actions based on outcome not on rules

228
Q

explain the doctrine of double effect and give an example

A

This doctrine says that if doing something morally good has a morally bad side-effect it’s ethically OK to do it providing the bad side-effect wasn’t intended. This is true even if you foresaw that the bad effect would probably happen.

ie euthanasia, giving drugs to ease pain even if it may shorten life

229
Q

what is deontology

A

evaluating inherent worthiness of action, not outcome

duty based ethics

230
Q

explain a virtue

A

the trait of a character manifested in a habitual action

231
Q

give the 4 ethical principles

A
  1. autonomy
  2. beneficence
  3. non-maleficence
  4. justice
232
Q

what is a health behaviour

A

a behaviour aimed to prevent disease

233
Q

what is an illness behaviour

A

behaviour aimed to seek remedy

234
Q

what is a sick role behaviour

A

a behaviour aimed at getting well

235
Q

give three examples of preventative medicine / disease prevention

A

screening
immunisation
child health protection

236
Q

explain the health belief model (how people change their behaviour)

A
  1. believe they are susceptible to a disease
  2. believe it has serious consequences
  3. believe taking action reduces risk
  4. benefits outweigh costs
237
Q

give the 6 stages of the transtheoretical model (quitting smoking)

A
  1. pre-contemplation
  2. contemplation
  3. preparation
  4. action
  5. maintenance
  6. relapse
238
Q

define morality

A

the concern with distinction between good and evil

239
Q

what is the ABC list for HIV safety

A

abstain
be faithful
condom use

240
Q

what is the WHO definition of obesity

A

Abnormal or excessive fat accumulation resulting from chronic imbalance between energy intake and energy expenditure that presents a risk to health. It is a state of positive energy balance.

241
Q

what are the 7 key domains of energy balance

A
  1. food environment
  2. food consumption
  3. individual activity
  4. activity of the environment
  5. societial influences
  6. individual psychology
  7. individual biology
242
Q

what is the sacral outflow of the parasympathetic NS

A

S2-4

243
Q

which oif the pre/post ganglionic fibres in the sympathetic NS is short and which is long

A

short preganglionic

long postganglionic

244
Q

describe the order of flow of CSF

A

lateral ventricles
foramen of monro
3rd ventricle
cerenbral aqueduct
4th ventricle
laterally - foramen of Luschka (superior)
medially - foramen of magendie (inferior)

245
Q

what makes up the striatum

A

caudate nucleus

putamen

246
Q

what is the function of the limbic system

A

emotion, memory, drive related behaviour (thirst/hunger)

247
Q

what makes up the limbic system

A 
Cingulate gyrus
corpus callosum
mammillary bodies
fornix
hippocampus
amygdala
hypothalamus

(cant control my feelings, HAH)

248
Q

what it found at either end of the fornix

A

mammillary bodies

amygdala

249
Q

what are the 3 areas of the midbrain

A

crus cerebri
tegmentum
tectum

250
Q

what does the tegmentum contain

A

substantia nigra
red nuclei
cerebral aqueduct
oculomotor and trochlear nuclei

251
Q

what does the tectum contain

A

inferior and superior colliculi

252
Q

where does the spinal cord start and finish

A

between foramen magnum and cauda equna

C1-L1/2

253
Q

how many pairs of spinal nerves are there

A

31

254
Q

what substances are found in the substansia nigra

A

melanin (dark pigment)

dopamine (causes parkinsons if deficient)

255
Q

what is the effect of decreased dopamine in the substansia nigra

A

parkinsons

256
Q

where are ureteric stones likely to stop

A

renal pelvis
where it crosses the pelvic brim
pelviuretitic junction
uretero-vesical junction

257
Q

describe the testicular vein drainage and its clincial relevance

A
  • pampiniform plexus
  • right drains directly into IVC
  • left drains into renal vein

clinical relevance - can cause swelling of the left testes

258
Q

name the branches of the abdominal aorta

A
  • coeliac trunk ,SMA, IMA
  • renal, gonadal, middle suprarenal
  • median sacral and 2x femoral iliac
  • inferior phrenic and 4 lumbar
259
Q

what cells are responsible for the production of catecholamines

A

chromaffin cells

260
Q

name the arteries supplying the kidneys from large to small

A 
aorta
renal
segmental
interlobar
arcuate 
interlobular
afferent 
glomerular
efferent

all really sexy interns are imprisoned after general elections

261
Q

what are the contents of the spermatic cord

A
  • pampiniform plexus
  • ductus deferens
  • cremasteric artery
  • testicular artery
  • artery of ductus deferens
  • genital branch of the genitofemoral nerve
  • sympathetic nerve fibres
  • lymphatic vessels

pills dont contribute to a good sex life

262
Q

what are the layers of the glomelular filtration

A

fenestrated capillary endothelium
basement membrane
foot processes of podocytes

263
Q

describe the descending limb of LOH

A

thin descending
permeable to water
not perrmeable to salt

264
Q

describe the ascending limb of LOH

A

thick ascending
permeable to salt
impermeable to water

265
Q

what are the 5 ligaments of the liver

A

flaciform
teres
2 triangular
coronary

266
Q

what is the ligamentum teres a remenant of

A

the umbilical vein

267
Q

describe the 3 types of cells in the liver

A

hepatocytes - functional cells (store glycogen and triglycerides)

stellate cells - supporting cells

kupffer cells - specialised macrophages (breakdown of RBCs)

268
Q

what is the cause of jaundice

A

excess of bilirubin in the blood

269
Q

what is the equation to calculate transpulmonary pressure

A

alveolar pressure - intrapleural pressure

270
Q

what is the difference between retrospective cohort studies and case control studies

A

RETROSPECTIVE COHORT

  • know outcome
  • compare the risk of ALREADY KNOWN exposure factors on disease outcome

CASE CONTROL

  • know outcome
  • tries to determine possible exposure factors
271
Q

what is the difference between retrospective and prospective cohort studies

A

RETROSPECTIVE

  • know outcome
  • compare the risk of ALREADY KNOWN exposure factors on the disease outcome

PROSPECTIVE

  • dont know outcome
  • compare the effects of high and low risk factors on if a disease is developed
272
Q

what is the gold standard of evidence evidence based medicine

A

randomized control trial

273
Q

what is prevelance

A

how much a disease exists in an entire population in a point in time

274
Q

what is incidence

A

number of NEW CASES in a population in a point in time

275
Q

define evidence

A

a pattern of results that make you think something

276
Q

where are peripheral chemoreceptors found

A

aortic and carotid bodies

277
Q

where are central chemoreceptors found

A

medulla

278
Q

what causes the oxygen dissociation curve to shift left

A
  • increase in pH
  • decrease in CO2
  • decrease in Temp
  • decrease in 2,3 - DPG (reduces oxygen affinity of Hb)
279
Q

what causes the oxygen dissociation curve to shift right

A
  • decrease in pH
  • increase in CO2
  • increase in temp
  • increase in 2,3 - DPG (reduces oxygen affinity of Hb)
280
Q

what is the role of 2,3 - DPG

A

it decreases the oxygen affinity of Hb

281
Q

is venous or arteriole blood more acidic and why?

A

venous blood is slightly more acidic because there is more CO2

282
Q

what are the 4 types of hypoxia

A
  • hypoxic hypoxia
  • anemic hypoxia
  • circulatory hypoxia
  • histoxic hypoxia
283
Q

what is the main drive to breathe

A

hypercapnia (too much CO2 in blood)

284
Q

what is the effect of type 1 resp failure

A
  • hypoxia (pO2 is low)

- no hypercapnia (pCO2 normal or low)

285
Q

what is the effect of type 2 resp failure

A
  • hypoxia (pO2 is low)

- hypercapnia (pCO2 is high)

286
Q

what is the cause of type 2 respiratory failure

A

hypoventilation

287
Q

what is the cause of type 1 respiratory failure

A

pulmonary embolism

288
Q

what is peak expiratory flow (PEF)

A

a person’s maximum speed of expiration

289
Q

in what order does air move through the resp system

A 
trachea
main bronchus
lobar bronchi
segmental bronchi
terminal bronchioles
respiratory bronchioles
alveolar ducts
290
Q

how many segmental branches are present in each lung

A

LEFT - 8

RIGHT - 10

291
Q

what is dead space and how much is there in the lungs

A

the volume of air not contributing to ventilation

- 175mls

292
Q

which ECG leads are anterior

A

V3

V4

293
Q

which ECG leads are inferior

A

II
III
AVF

294
Q

which ECG leads are septal

A

V1

V2

295
Q

which ECG leads are lateral

A

I
AVL
V5
V6

296
Q

what is a confounder

A

something that influences both the independent and dependent variable

CAUSE OF DISEASE ie smoking

297
Q

where does significant (95%) of the data lie on a normal distribution curve

A

95% of data lies within +/- 2 standard deviations

298
Q

what is a p value

A

probability of an event occuring given that a null hypothesis is true

299
Q

what is the difference netween primary, secondary and tertiary prevention of disease

A

PRIMARY
prevents disease occuring (lifestyle changes, fluoridation of water, childhood vaccinations)

SECONDARY
detects disease earlier (screening)
intervention that prevents recurrence of a disease

TERTIARY
minimize complications after diagnosis of disease

300
Q

what is the prevention paradox

A

interventions can achieve large overall health gains for whole populations but might offer only small advantages to each individual

301
Q

what are Wilson and Junger’s screening rules

A

CONDITION

  • important health problem
  • well understood
  • detectable at early stage

TREATMENT

  • accepted treatment
  • facilities for diagnosis/treatment available
  • adequate health service provision available

TEST

  • suitable test
  • test should be acceptable to population
  • should be repeated at regular intervals

RISKS/BENEFITS

  • agreed policy
  • costs should be balanced
  • psychological/physiolgical risks should be less than the benefit
302
Q

define sensitivity

A

proportion of people who are correctly identified with a disease (true positive)

303
Q

define specificity

A

proportion of people correctly identified without the disease

304
Q

how to calc positive predictive value

A

proportion of CORRECTLY identified with disease / proportion of people identified with the disease

305
Q

how to calc neg predictive value

A

proportion of people CORRECTLY identified without the disease / prop of people identified without the disease

306
Q

what is screening length-time bias

A

screenings happen at regular intervals, may miss those with short term disease/ only pick up those with long, slow growing tumours

307
Q

what is screening lead-time bias

A

if a disease affects 2 people (A and B) at the same and they die at the same time but A had a screening earlier, it appears A survived longer with the disease when they didn’t

308
Q

what is the difference between risk and odds

A

RISK
new cases in a period of time / total at risk at the start of the time period

ODDS
cases vs non-cases

309
Q

how do you calculate the number needed to treat for one person to benefit

A

1/absolute risk reduction

310
Q

how do you calculate the absolute risk reduction

A

absolute risk of control group - absolute risk of effected group

311
Q

define utilitarianism

A

concerned with the most benefit for the most people

“actions are right in proportion as they tend to promote happiness, wrong as they tend to produce the reverse of happiness.”

312
Q

describe the process of fertilisation

A
  • in the fallopian tubes sperm penetrates the ZONA PELLUCIDA
  • acrosome reaction occurs
  • this causes the zona pellucida to harden to prevent other sperm entering
  • meiosis 2 of secondary OOCYTE occurs to produce OVUM
  • fusion of nuclei leads to ZYGOTE
313
Q

describe blastocyte formation from a zygote to implantation

A
  • zygote
  • divisions occur - cleavage + compaction
  • morula = 16 cells
  • cells fuse to form blastocyst with inner cell mass and trophoblast
  • ‘hatching’ occurs
  • implantation
314
Q

what is the difference between morula and blastocyst

A

MORULA

  • 3-4 days after fertilisation
  • mass of 16 totipotent cells

BLASTOCYST

  • 4-5 days after fertilisation
  • has a cavity inside the zona pellucida along with an inner cell mass
315
Q

what forms from the inner cell mass

A

bilaminar disc

316
Q

what makes up the bilaminar disc

A

epiblast and hypoblast

317
Q

when and where does the mesoderm form from

A

forms from the ectoderm during gastrulation

318
Q

what do the 3 germ layers form from

A

epiblast –> ectoderm
Hypoblast –> endoderm
Ectoderm –> mesoderm

319
Q

what does the ectoderm develop into

A
  • epidermis of skin/hair/nails
  • mammary, sweat and sebaceous glands
  • CNS nd PNS
  • posterior pituitary gland
  • enamel of teeth
  • lens of the eye and parts of the inner ear
  • sensory epithelium of nose/eye/ear
320
Q

what does the endoderm develop into

A

epithelial lining of the gastrointestinal tract, resp tract and urinarry bladder

  • parenchyma of the thyroid gland, parathyroid glas, liver and pancreas
  • epithelia lining of the tympanic cavity and auditory tube
  • plays a part in the development of the notochord
321
Q

what does the mesoderm develop into

A
  • all of the musculoskeletal system
  • deep layers of the skin
  • abdominal and chest wall lining
  • the WALLS of the bowel
  • the urogenital system
322
Q

describe the embryology of the heart

A

MESODERM

  • 2 tubes fuse to form 1 primitive heart tube
  • longitudinal and lateral folding
  • tube undergoes SEPTATION (seperating left/right sides of the heart)
  • atrial septation - primary and secondary septum (foramen ovale –> fossa ovalis) and ventricular septation
  • 6 aortic arches
  • ductus arteriosus –> ligamentum arteriosus
323
Q

describe the embryology of the resp system

A

ENDODERM

  • trachea buds off oesophagus (pharyngeal foregut)
  • epithelial layer forms from endoderm
  • lung buds rapidly divide (branching morphiogenesis)
  • asymmetry (2 lobes vs 3 lobes)
  • cartilage, smooth muscle, pleura derived from MESODERM
  • cuboidal epithelium converted to simple squamous in the alveoli
324
Q

describe the embryology of the GI tract

A

ENDODERM
foregut = lower oesophagus –> ampulla of vater
midgut = ampulla of vater –> 2/3 along transverse colon
hindgut = 2/3 along transverse colon dentate line

  • midgut leaves through umbilicus, loop rtates out of abdomen then reenters
  • smooth muscle, connective tissue and visceral peritoneum dervived from MESODERM
325
Q

what is the telecephalon

A

cerebral cortex

326
Q

what is the diencephalon

A

thalamus and hypothalamus

327
Q

what is the metencephalon

A

pons and cerebellum

328
Q

what is the myelencephalon

A

medulla oblongata

329
Q

what is the prosencephalon

A

forebrain

330
Q

what is the mesencephalon

A

midbrain

331
Q

what is the rhombencephalon

A

hindbrain

332
Q

what marks the start of gastrulation and which day does this occur

A

formation of the primitive streak on day 15

essentials (1 decks)

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