PHYSIOLOGY Flashcards

1
Q

what is the endometrium and what happens to it at the end of the menstrual period?

A
  • layer of tissue lining the inside of the uterus

- the endometrium lining breaks down and leaves via the vagina (menstrual period)

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2
Q

how long is the average menstrual cycle, what day does ovulation usually occur?

A
  • 28 days

- ovulation usually occurs at day 14

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3
Q

what is the pre-ovulatory period of the menstrual cycle called and what is the post-ovulatory period of the menstrual cycle called, and what hormones are at their highest in each of the phases?

A
  • follicular phase (oestrogen at highest)

- luteal phase / secretory phase (progesterone at highest)

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4
Q

describe the process of the menstrual cycle (pre-ovulation, day 10-14, post-ovulation(up to day 15), after day 15)

A

PRE-OVULATION:

  • hypothalamus releases gonadotropin-releasing hormone (GnRH)
  • this stimulates the pituitary gland to release FSH and LH

DAY 10-14:

  • positive feedback loop due to the follicle stimulating lots of oestrogen which acts on the pituitary gland making it more responsive to GnRH and therefore releases lots of FSH and LH
  • this increase in FSH and LH occurs 1-2 days before ovulation and this stimulates ovulation

POST-OVULATION (up to day 15):

  • increase in progesterone which acts as a negative feedback signal on the pituitary so less FSH and LH released
  • also, inhibin is released by luteinised granulosa cells which inhibits FSH and LH production
  • oestrogen levels decrease, progesterone increases

AFTER DAY 15:

  • hormones are gradually stopped being produced
  • oestrogen and progesterone levels decrease
  • cervical mucus thickens (less hospitable for sperm)
  • endometrium layer breaks down
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5
Q

when is the optimal chance for fertilisation period in the average menstrual cycle and what effect does an increase in oestrogen levels have on cervical mucus?

A
  • day 11 to day 15

- increased oestrogen levels make the cervical mucus more hospitable for sperm

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6
Q

Describe in detail the physiological pathway of pain transmission from a joint to the brain

A
  • Inflammatory markers (cytokines, histamine, prostaglandins etc.) released locally as a result of injury/inflammation
  • Initial pain is sensed by nociceptors (free nerve endings in skin, muscle, other tissues)
  • Pain is transmitted by primary sensory neurons to the dorsal horn of the spinal cord
  • Type A-delta fibres (myelinated) for fast, acute pain and type C fibres (unmyelinated) for slow, throbbing/dull pain
  • In the dorsal horn, the primary sensory neuron will synapse with a second neuron of the spinothalamic tract
  • This second order neuron immediately decussates and passes up the spinothalamic tract to the thalamus
  • In the thalamus, second order neurons synapse with third order neurons leading to the sensory cortex to register pain and mediate emotional components
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7
Q

Briefly describe the physiological pathway in the brain thought to be involved in nicotine addiction

A
  • Nearly all dependence-producing drugs activate the mesolimbic and/or mesocortical dopaminergic pathways
  • Nicotine, via attachment to nicotinic receptors, enhances the synthesis and release of dopamine from dopamine-containing neurons in the ventral tegmental area (VTA) of the hypothalamic region
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8
Q

Describe the physiology behind the mechanism of action of the oral contraceptive pill

A
  • Synthetic oestrogens inhibit FSH release by negative feedback, suppressing follicular development
  • Synthetic progesterone like compounds (progestins) block the oestrogen-mediated positive feedback surge in LH release, preventing ovulation, also changes the properties of cervical mucous so that it is hostile to sperm
  • Endometrial layer development is less and not favourable for implantation
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9
Q

The sleep-wake cycle is an example of a circadian rhythm, describe the role of the Suprachiasmatic Nucleus (SCN) and the Pineal gland in the sleep-wake cycle

A
  • The SCN becomes activated by changes in light levels detected via the optic chiasm
  • In turn, the SCN sends a signal to the pineal gland
  • Once activated, the pineal gland produces melatonin (sleep hormone) which reduces arousal in the brain and leads to sleep
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10
Q

Describe one other type of biorhythm and provide an example

A
  • Infradian rhythms: where each cycle happens less frequently than every 24 hours (eg. Menstrual cycle)
  • Ultradian rhythms: where each cycle happens more than once in 24 hours (eg. Hormone release, heart rate, bowel activity)
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11
Q

Describe how calcium is removed from the muscle cell to start muscle relaxation

A
  • Calcium needs to be removed from sarcoplasm (cytoplasm of striated muscle cells)
  • Sarco Endoplasmic Reticulum Calcium ATPase (SERCA) pumps two calcium ions out of sarcoplasmic reticulum via active transport
  • Plasma Membrane Associated Calcium ATPase (PMACA) actively transports calcium ions across sarcolemma membrane into extracellular space
  • Calcium is also removed via Na/Ca pump by facilitated diffusion across the sarcolemma membrane into extracellular space
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12
Q

what are long muscle fibers good for and what are short muscle fibers good for? (in terms of type of movement)

A
  • long fibers good for rapid movement

- short fibers good for large forces

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13
Q

what are the 3 types of muscle fiber, what colour do they stain with myosin ATPase, and what are they used for?

A
  • SLOW TWITCH (type 1): oxidative, stain red, prolonged endurance activity
  • FAST TWITCH (type 2a): stain red, either endurance or rapid force, quickly fatigue
  • FAST TWICTH (type 2b): stain white, rapid force production, quickly fatigue
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14
Q

what are the 2 main types of muscle contraction?

A

ISOMETRIC: contraction against resistance where length of muscle remains the same

ISOTONIC: contraction against resistance where length of muscle changes

  • concentric: in direction of contraction
  • eccentric: opposite to direction of contraction
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15
Q

what effect does the muscle fiber cross-sectional area have on maximal force generated?

A
  • the larger the fiber CSA, the larger the force generated
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16
Q

what effects does endurance exercise training have at a cellular level?

A
  • increased mitochondrial function
  • hypoxia inducible factors (HIFs) involved in gene control of red muscle cell production and regulation of glycolytic enzymes
  • increased Haemoglobin concentration
17
Q

what type of fibers do marathon runners (endurance activity) have more of and what type of fibers do sprinters (short intense activity) have more of?

A
  • marathon runners (endurance activity) have more slow fibers, these do not fatigue as quick as fast fibers
  • sprinters (short intense activity) have more fast fibers, these fatigue quickly
18
Q

how does smoking effect muscle fibers?

A
  • reduces cross-sectional area (and therefore force generated is lower)
  • less type 2 fibers (fast twitch fibers)
19
Q

how is creatine phosphate produced and what is produced when resting muscle becomes active muscle?

A
  • ATP + creatine = creatine phosphate + ADP
  • when resting muscle is becoming active muscle, creatine kinase acts on creatine phosphate and ADP and turns it into creatine and ATP (energy for muscle contraction)
20
Q

in the first step of glycolysis what is the starting compound and what is produced?

A
  • starts with glucose

- 2 pyruvate molecules and 2 ATP produced

21
Q

where is nicotine metabolised?

A
  • in the liver
22
Q

how is nicotine excreted ?

A
  • 50% in urine

- also excreted by faeces, saliva, bile, sweat

23
Q

what are the physiological effects of nicotine?

A
  • increased HR, BP, cardiac contractility, blood sugar, FFA (free fatty acids), adrenaline, arousal or relaxation
  • decreased skin temperature
  • inhibits effects of parasympathetic activation
  • (parasympathetic endings release acetylcholine)
  • activates sympathetic activity
  • (sympathetic endings release noradrenaline)
24
Q

what diseases are smokers of more risk of?

A
  • coronary heart disease
  • peripheral vascular disease (hypertension)
  • chronic lung disease (bronchitis and emphysema)
  • abnormal foetal development
  • lung cancer (more because of carcinogens not the nicotine)
25
Q

what are the UK recommendations for alcohol intake per week?

A
  • 14 units per week
26
Q

how is ethanol metabolised?

A
  • metabolised in the liver (90%)

- the rest is excreted

27
Q

what effects does alcohol have on the body?

A

CARDIOVASCULAR SYSTEM:
- cutaneous vasodilation and makes you feel warm but you lose heat
- cardiomyopathy
ENDOCRINE:
- diuresis: ethanol inhibits ADH release
GI:
- increased salivary and gastric secretions
- peptic ulcers
- pancreatitis
LIVER:
- increased fat accumulation: leads to hepatitis and hepatic necrosis and fibrosis
- also affects lipid metabolism, platelet function, and atherosclerosis (narrowing of arteries, and they become rigid and unresponsive)
FOETUS:
- fetal alcohol syndrome and neuro-developmental disorder
CNS:
- acute intoxication: slurred speech, affects motor function (lose coordination)
- chronic intoxication: irreversible neurological effects, peripheral neuropathy, and dementia (chronic effects due to ethanol or thymine deficiency)

28
Q

what is the mechanism by which ethanol acts?

A
  • enhances GABA mediated inhibition

- inhibits transmitter release by inhibiting voltage-gated calcium channels

29
Q

describe components of a simple reflex arc

A
receptor 
afferent neuron
interneuron ( in spine )
efferent neuron
effector eg muscle
30
Q

how can analysis of synovial fluid be useful in management of disease ?

A

can do microscopy ( cells - infection or inflammation, crystals - gout or pseudogout )
protein level - raised in infection or inflammation
also glucose, uric acid level, lactate - inflammation , gout
send for culture of organisms - infection
do a gram stain - infection

31
Q

what are the effects of old age on prescribing ?

A

liver enzyme systems slower
medications not excreted by kidneys as quickly
polypharmacy due to multiple diseases / interactions of medications
medications have different effects eg need lower dose of diazepam in elderly

32
Q

physiological changes with ageing ?

A

atherosclerosis ( hardening arteries, hypertension, heart disease )
osteoporosis ( fractures )
frailty ( falls )
longer exposure to disease process changes ( diabetes, inflammation )
deteriorating vision and hearing

33
Q

what are the mechanisms for homeostasis of temperature ?

A

cooling : vasodilation, sweating
heating : shivering, vasoconstriction
mediated by hypothalamus ( afferent, efferent neurons )