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MSKJaz > Physiology > Flashcards

Physiology Flashcards

1
Q

a _____ supplies all the fibres of one motor unit

A

single alpha motor neuron

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2
Q

muscles that have fine movements have more/fewer fibres per motor unit
roughly = ___ fibres

A

fewer

10

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3
Q

muscles that are for power have __fibres per motor unit

A

100-1000s

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4
Q

organisation of muscle:

sarcomere>____>muscle fibre> ____>whole muscle

A

myofibril

motor unit

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5
Q

skeletal muscle:
___ initiation and propagation involves ___+neuromuscular junction with ____
excitation contraction coupling by ___ entirely from ___

A

neurogenic
motor units
with Nitrogen Oxide gap junctions
Ca2+ entirely from sarcoplasmic reticulum

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6
Q

gradation of contraction in skeletal muscle is due to ___+___

A

motor unit recruitment and summation of contractions

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7
Q

in skeletal muscle Ca2+ is released from ___ of ____ when surface AP spreads down ____ => ______

A

lateral sacs of sarcoplasmic reticulum
T/transverse tubules
excitation-contraction coupling

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8
Q

in skeletal muscle:

Ca2+ binds to ___ which causes ___ to be pulled away from actin binding site so it can bind to myosin

A

troponin

tropomyosin

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9
Q

Z line to next Z line =

A

sacromere

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10
Q

skeletal muscle:
ATP in contraction is for ___
in relaxation it ___

A 
contraction = power cross bridges
relaxation = release cross bridge and pump Ca2+ into sarcoplasmic reticulum
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11
Q

____ muscle unit recruitment during ___ contractions help prevent skeletal muscle fatigue

A

asynchronous

submaximal

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12
Q

gradation of tension in skeletal muscle fibres depends on __+__

A

number of muscle fibres contracting

tension developed by each muscle fibre

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13
Q

tension developed by one skeletal muscle fibre depends on … (4)

A

thickness of fibre
length of fibre
freq of stimulation
summation of contractions

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14
Q

The AP in skeletal muscle is __+___ meaning it is possible to summate twitches to bring about __ contraction through ___ stimulation of fibres

A

shorter than resulting twitch + no refractory period
stronger
repetitive fast

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15
Q

if a skeletal muscle is constantly stimulated before it can relax = ___ = ____ contraction

A

tetanu

maximal sustained contraction

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16
Q

optimum length of skeletal muscle =

at this length ___ can be acheived

A

resting length of the muscle

maximal tetanic contraction

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17
Q

2 types of skeletal muscle contraction

A

isotonic

isometric

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18
Q

isotonic contraction in skeletal muscle =

used for:

A

tension constant as length changes

body movement + moving objects

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19
Q

isometric contraction in skeletal muscle =

used for:

A

tension develops at constant muscle length

support objects in fixed position + maintain body posture

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20
Q

velocity of skeletal muscle shortening ____ as load increases

A

decreases

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21
Q

3 types of skeletal muscle fibre

most motor units contain more than one kind

A

slow oxidative type 1/slow twitch
fast oxidative type IIa / intermediate twitch
fast glycolytic type IIx / fast twitch

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22
Q

Metabolic pathways that supply ATP in skeletal muscle fibre = (3)

A

transfer of high E phosphate from creatinine phosphate to ATP - immediate ATP source
oxidative phosphorylation (main aerobic source)
glycolysis (main anaerobic source)

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23
Q

main differences between the 3 types of skeletal muscle fibres

A

enzymatic pathways for ATP synthesis
resistance to fatigue
activity of myosin ATPase

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24
Q

activity of myosin ATPase determines ______ in skeletal muscle fibres

A

the speed of energy availability for cross bridge formation ie speed of contraction

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25
Q

resistance to fatigue in skeletal muscle fibres is increased if ____

A

they have a greater capacity for ATP synthesis

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26
Q

slow oxidative type 1 (slow twitch) fibres are for ___

A

prolonged low-work aerobic activity eg. walking/posture

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27
Q

fast-oxidative type IIa (intermediate twitch) fibres have ___+__ metabolism for ___

A

aerobic and anaerobic

prolonged moderate work eg. jogging

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28
Q

fast glycolytic type IIx (fast-twitch) fibres have __ metabolism for ___

A

anaerobic

short term high intensity activity eg. jumping

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29
Q

myosin ATPase activity in the 3 types of skeletal muscle fibres =

A

slow = low

intermediate and fast = high

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30
Q

speed of contraction in the 3 types of skeletal muscle fibres =

A

slow = slow

int + fast = fast

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31
Q

resistance to fatigue in the 3 types of skeletal muscle fibres =

A 
slow = high
int = int
fast = low
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32
Q

oxidative phosphorylation capacity in the 3 types of skeletal muscle fibres =

A 
slow = high
int = high
fast = low
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33
Q

enzymes for anaerobic glycolysis in the 3 types of skeletal muscle fibres =

A

slow = low
int =int
fast = high

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34
Q

number of mitochondria and capillaries in the 3 types of skeletal muscle fibres =

A 
slow = many 
int = many
fast = few
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35
Q

myoglobin content in the 3 types of skeletal muscle fibres =

A 
slow = high
int = high
fast = low
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36
Q

color of fibre in the 3 types of skeletal muscle fibres =

A

slow + int = red

fast = white

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37
Q

glycogen content in the 3 types of skeletal muscle fibres =

A 
slow = low
int = int
fast = high
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38
Q

simplest form of coordinated movement

a stereotyped response to specific stimulus

A

reflex

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39
Q

simplest monosynaptic spinal reflex =

describe it

A

stretch reflex

-ve feedback to resist stretch and maintain optimum skeletal muscle length

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40
Q

in stretch reflex:
___ stretched causing increased __ in ___ > synapse at ___ > __
coordinated by simultaneous __

A 
muscle spindle
firing in afferent neurons
alpha motor neurons
muscle
simultaneous relaxation of antagonistic muscle
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41
Q

in knee reflex:
spinal segment =
peripheral nerve =

A

L3 +4

femoral

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42
Q

in ankle reflex:
spinal segment =
peripheral nerve =

A

S1 +2

tibial

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43
Q

in biceps reflex:
spinal segment =
peripheral nerve =

A

C5+6

musculocutaneous

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44
Q

in brachioradialis reflex:
spinal segment =
peripheral nerve =

A

C5+6

radial

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45
Q

in triceps reflex:
spinal segment =
peripheral nerve =

A

C6+7

radial

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46
Q

sensory receptors for stretch reflex

A

muscle spindle

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47
Q

muscle spindle = ___ collection

A

specialised muscle fibre

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48
Q

muscle spindles are made up of __ fibres

normal fibres in skeletal muscle =

A

intrafusal

normal = extrafusal

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49
Q

muscle spindles are found in ___ and parallel to __

A

muscle belly

extrafusal fibres

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50
Q

sensory nerve endings in muscle spindles are know as

A

annulospiral fibres

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51
Q

discharge from ___ in muscle spindles ___ as muscle is stretched

A

annulospiral fibres increases

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52
Q

efferent supply to muscle spindles =

adjust level of __ in spindles so ___ when muscle shortens during contraction

A

gamma motor neurons
tension
maintain sensitivity

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53
Q

the contraction of intrafusal fibres does/doesn’t contribute to the overall strength of muscle contraction

A

doesn’t

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54
Q

in congenital myopathies: ___ changes => decreased ___

A

microscopic

contractile ability

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55
Q

muscular dystrophy = ____ of contractile elements

A

chronic degeneration

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56
Q

myotonia is an example of an abnormality in ___

A

muscle membrane ion channels

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57
Q

4 broad types of acquired myopathies

A

inflammatory
toxic
endocrine
non-inflam

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58
Q

delayed relaxation after voluntary contraction =

A

myotonia

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59
Q

EMG aka
detects ___
differentiates ___ from ___
usually do __ at same time as this test is not pathognomic

A

electromyography
presence of muscle activity - freq and amplitude of APs
primary muscle disease from weakness due to neurological disease
nerve conduction study

60
Q

5 useful tests in neuromuscular disease

A 
muscle biopsy
EMG
inflam markers
muscle enzymes
nerve conduction studies
61
Q

motor neuron branches end in a ___ at NMJ

A

terminal bouton

62
Q

the cell body of motor neurons is in ____

A

the ventral horn of the spinal cord (or brain stem)

63
Q

motor neurones release ___ at NMJ which activates ___ a ___ of glycoprotein subunits ((α1)2β1δε) - in embryonic muscle ε is replaced by _

A

ACh
Nicotinic ACh post-synaptic receptors
pentamer
γ

64
Q

Nicotinic ACh post-synaptic receptors in muscles are closed unless ____ and then they are ___ selective

A

2ACh bind

cation selective

65
Q

Nicotinic ACh post-synaptic receptors in muscles are roughly equally permeable to __+__
direction of movement?
which one has a larger driving force and causes depolarisation (___)

A

Na+ in to muscle cell + K+ out

Na+ > driving force => end plate potential / epp

66
Q

each ACh vesicle contains one ___ of ACh

the electrical response to one vesicle’s ACh =>___

A

quantum

mepp (miniature end plate potential)

67
Q 
End plate in muscles have \_\_\_ adjacent to Nicotinic ACh post-synaptic receptors
function = \_\_\_
A

voltage-activated Na+ channel

AP propagates from the endplate over the length of the muscle fibre without deteriorating

68
Q

bouton synapse at the ____ of skeletal muscle fibre

A

endplate region

69
Q

APs propagate over the surface membrane (____) of skeletal muscle fibre and enters ____
this causes _____ from ___

A

sarcolemma
transverse (T) tubules
Ca2+ from the sarcoplasmic reticulum

70
Q

termination of AP in muscle cells:

___ hydrolyses __>choline(__) + acetate (___)

A

AChE - ACh
taken up into transporter
diffuses from cleft

71
Q

terminal bouton is surrounded by ___

A

Schwann cell

72
Q

ACh vesicles at NMJ await release at “___”

A

active zones

73
Q

choline is recycled in the pre synaptic bouton:

choline + ___ > (enzyme) > ACh

A

acetyl Co-A

CAT

74
Q

the location of nicotinic ACh receptors in muscle cells

A

end plate

75
Q

neuromyotonia aka __/_
s+s
usually acquired = ___ against ____ in motor neurone => ____

A

NMT/ Isaac’s syndrome
cramps, stiffness, myotonia (slow relaxation), fasciculations (twitches)
AI Ig - voltage activated K+ channels - hyperexcitability

76
Q

Rx for neuromyotonia/Isaac’s syndrome

A

anticonvulsants - eg carbamazepine, phenytoin

they block Na+ channels and may also increase inhibitory GABA

77
Q

v rare and ass with small cell lung ca => muscle weakness

A

Lambert-Eaton Myasthenic Syndrome (LEMS)

78
Q

AI process in Lambert-Eaton Myasthenic Syndrome (LEMS)

A

Ig against Ca2+ channels in neurone terminal => decreased Ca2+ entry and ACh release

79
Q

Rx of Lambert-Eaton Myasthenic Syndrome (LEMS)

A

anticholestinesterases (pyridostigmine)

K+ channel blockers (3,4 - diaminopyridine)

80
Q

___ muscle weakness can transiently improve on exertion, ____ is progressive muscle weakness during activity

A 
Lambert-Eaton Myasthenic Syndrome (LEMS)
Myasthenia Gravis (MG)
81
Q

AI mechanism behind Myasthenia Gravis

A

Ig against nicotinic ACh receptors => decreased epp amplitude

82
Q

Rx for myasthenia gravis =

A

antichloniesterases - edrophonium (to diagnose), pyridostigmine (long term)
IS eg azathioprine

83
Q

very potent toxin that irreversibly inhibits ACh release at NMJ
no Rx, just time, v high mortality rate

A

Botulinum Toxin

84
Q

low dose botulinum haemoglutin complex IM is used for ___ eg __+__

A

dystonias - strabismus/blepharospasm

85
Q

To induce reversible paralysis in Sx = ___ compounds eg __/__
they interfere with ____ as antagonise ____ and decrease ___

A 
curare-like
vecuronium
atracurium
post-synaptic ACh
nicotinic ACh receptors
epp amplitude
86
Q

synarthosis =

A

fibrous joints

87
Q

amphiarthrosis =

egs (4)

A

cartilaginous joints

IV discs, pubic symphysis, part of SIJ, costochondra

88
Q

diarthrosis =

A

synovial joint

89
Q

synovial membrane lines ____

it is a __ CT with ___ networks and ___ ; they contain ___ that produce ___

A 
fibrous capsule in synovial joints
vascular CT
capillary networks
lymphatics
synovial cells (fibroblasts) => synovial fluid
90
Q

> 1 pair of articular surfaces in a synovial joint = a ___ joint

A

compound

91
Q

most of the stress across a synovial joint is taken up by __+__

A

tendons and muscles across the joint

92
Q

joint lubrication at diarthroses = (3)

A

cartilage interstitial fluid
synovium
synovium-derived lubricin-glycoprotein

93
Q

synovium is derived from ___(__) a polymer of __

A 
hyaluronic acid (mucin)
disaccharides
94
Q

function of synovial fluid

A

lubrication
supplies chondrocytes with O2 and nutrients
removes CO2 and waste

95
Q

high viscosity of synovial fluid is due to ___

viscosity varies with ___ as does elasticity

A

mucin

joint movement

96
Q

other constituents of synovial fluid eg. uric acid are derived by ___

A

dialysis of blood plasma

97
Q

normally synovial fluid contains a few cells - mainly ___

A

mononuclear luecocytes

98
Q

rapid movement at a synovial joint => synovial fluid viscosity ___ and elasticity ____
is defective in ___

A

viscosity decreases
elasticity increases
diseased joint eg OA

99
Q

colour of synovial fluid in trauma

A

red

100
Q

colour of normal synovial fluid and in an inflammatory joint

A 
norm = colourless
inflam = straw yellow
101
Q

clarity of synovial fluid normally, in inflammation and in septic joint

A 
norm = transparent
inflam = translucent
septic = opaque
102
Q

WBC count (/mm^3) in synovial fluid normally, in inflammation and in septic joint

A 
norm = <200
inflam = 2000-75000
septic = >100,000
103
Q

PMN leucocytes (/mm^3) in synovial fluid normally, in inflammation and in septic joint

A 
norm = <25
inflam = >50
septic = >75
104
Q

zones in articular cartilage superficial to deep =

differ in their ___ and ___

A

superficial > middle > deep(all chondrocytes) > calcified zone
organisation of collagen fibres
content of cartilage components

105
Q

usually articular cartilage is __ cartilage

A

hyaline

106
Q

articular cartilage has special ___ : 70% ___, 20% ___, 10% ___

A

ECM
70 water
20 type II collagen
10 proteoglycans

107
Q

properties of water in articular cartilage (3)

A 
uneven distribution (80% near art. surface)
decreases with age
maintains tissue resilience
108
Q

properties of type 2 collagen in articular cartilage (2)

A

decreases with age

provides stiffness and strength

109
Q 
proteoglycan in articular cartilage:
high concn in \_\_+\_\_ zone
composed mainly of \_\_ eg \_\_\_
\_\_ changes with age eg decreased amount of \_\_\_
function =
A

middle and deep
glycosaminoglycan eg chondroitin sulfate
composition - condroitin decreases
compression for load bearing

110
Q

degradation of ECM in articular cartilage is by ___ from chondrocytes eg __+__

A

metalloproteinase proteolytics

collagenase + stromelysin

111
Q

98% of articular cartilage volume =

maintained degraded, synthesised and organised by __

A

ECM

chondrocytes

112
Q

chondrocytes get nutrients and O2 from __

A

synovial fluid

113
Q

catabolic factors in articular cartilage matrix turnover (2)

A

TNFα + IL-1

=> stimulate proteolytic enzymes and inhibit proteoglycan synthesis

114
Q

anabolic factors in articular cartilage matrix turnover (2)

A

TGF-β and IGF-1

=>stimulate proteoglycan synthesis and counteract IL-1 effects

115
Q

markers of articular cartilage degradation = increased __+___
____ in synovial fluid

A

serum and synovial keratin sulfate (^ in age and OA)

type 2 collagen (RA + OA)

116
Q

pain definition =

A

an unpleasant sensory and emotional experience associated with actual tissue damage or described in terms of such damage

117
Q

nociceptive pain is ___ (early warning sign) and ___ (only to intense stimuli)

A

adaptive

high threshold

118
Q

___ overrides other nervous system activities eg. => withdrawal reflex

A

nociceptive pain

119
Q

nociceptors = specific _____ activated by ___ stimuli.
are ___ order and relay to ___ at __ synapse
stimuli =__/__/__

A

peripheral primary sensory afferent neurones
intense noxious
1st order - 2nd order - CNS
temp / mechanical force / chemical irritants

120
Q

inflammatory pain is __(early warning system) +__
caused by activation of ___
=> ___+___

A

adaptive + protective
immune system to injury/infection
pain hypersensitivity and allodynia

121
Q

inflammatory pain discourages __+___ so aids healing

A

physical contact and movement

122
Q

maladaptive pain = ___ pain
due to _____
2 types =
=> __/___

A 
pathological
abnormal nervous system functioning
neuropathic (neural lesion +/- symptoms)
dysfunctional (no neural lesion but +ve symptoms)
spontaneous pain/pain hypersensitivity
123
Q

Congenital insensitivity to pain (CIP) is caused by which mutation? that encodes __ which is highly expressed in nociceptive neurones

A

loss of function (missense/inframe deletions) in SCN9A

voltage gated activated Na+ channel (NaV1.7)

124
Q

nociceptors are comprised of __+__ fibres

A

Aδ + C

125
Q

Aδ fibres = __/___ nociceptors - ___ myelinated

mediate __/__ pain

A

mechanical / thermal
thinly
1st / fast

126
Q

C fibres are ___ (respond to all noxious stimuli) and ___ so mediate __/__ pain

A

polymodal

unmyelinated - 2nd/slow

127
Q

thermal stimuli to C fibres activate ____ esp. ___ - it is greatly sensitised in inflammation and so becomes active at ___

A

Transient receptor potential family (TRP)
esp. TRPV1
body temperature

128
Q

in chemical stimulation of C fibres:
H+ activates ___
Atp activates ___
bradykinin activates ____

A

ASIC (acid sensing ion channels)
P2X+ P2Y receptors
B2 receptors

129
Q

possible receptor to mechanical stimuli in C fibres

A

Piezo2

130
Q

all stimulation of c fibre receptors cause __/__ influx > graded ___ > ___ activated > aP to CNS

A

Na+ Ca2+
depolarisation
voltage gated Na+ channels

131
Q

amplitude of depolarising receptor/generator potential in C fibres is __ and proportional to ___

A

graded

stimulus intensity

132
Q

local current flow (___) in c fibres trigger all/none APs at frequency proportional to ___

A

Hermann currents

receptor potential

133
Q

axon of 1st order neurone nociceptor synapses in _____
its soma is in ____/____
axon of 2nd order neurone > ___+___ > pain
ducussation via ____ occurs at all levels of the spinal cord

A

dorsal/posterior horn of spinal cord
dorsal root ganglion (DRG) / trigeminal ganglion (TG)
spinothalmic + spinoreticulothalmic tracts
ventral white commisure

134
Q

subset of C fibres = ___ polymodal nociceptors
afferent - release __+__ to CNS at dorsal horn synapse
efferent - releases ____ and contributes to ___

A

peptidergic
glutamate + peptides (substance P and neurokinin A)
pro-inflam mediators (eg calcitonin gene related peptide (CGRP) and substance P)
neurogenic inflam

135
Q

neurogenic inflam:

___(__+__) from peptidergic nociceptor free nerve endings are released due to __/____

A

peptides (substance P and CGRP -calcitonin gene related peptide)
inflammatory mediators/tissue damage

136
Q

role of substance P released in neurogenic inflammation (3)

A

vasodilation and extravasation of plasma proteins (promotes formation of bradykinin and PGs)
histamine released from mast cells
sensitises surrounding nociceptors

137
Q

the role of CGRP released in neurogenic inflammation

A

vasodilation

138
Q

CGRP and substance P cause effects in neurogenic inflammation that ultimately lead to ___

A

primary and secondary hyeralgesia and allodynia

139
Q

in pain: primary afferent to 2nd order neurone in dorsal horn transmission =
AP > ___ influx > __ released from afferent
> __ epsp and neuronal excitation by activating ___ and some NMDA receptor involvement > depolarisation of 2nd neurone and ___ open > AP

A 
Ca2+
glutamate
fast
postsynaptic AMPA receptors
Na+ channels
140
Q

in pain: primary afferent to 2nd order neurone in dorsal horn transmission:
__+___ are also involved esp in high freq stimulation = __+__ epsp that facilitates ___ activation by relieving voltage dependent block by __

A 
substance P 
CGRP
slow and prolonged
NMDA receptor
Mg2+
141
Q

for pain: primary afferent cell bodies (except in trigeminal system) are located in the ___ - axon terminates centrally in the ___ in various ___

A

DRG
dorsal horn
lamina Rexed

142
Q

nociceptive C and Aδ mostly terminate in __+__ also + __ for Aδ

A

laminae I+II

V for Aδ too

143
Q

nociceptive specific cells synapse only with __+_

A

C and Aδ fibres

144
Q

cells that receive input from Aβ fibres are ___

A

proprioceptive

145
Q

wide dynamic range (WDR) neurones receive input from ++_

A

Aβ, C and Aδ fibres

146
Q

in nociceptive tract for 2nd order neurones:
in spinothalmic tract:
projecting neurones from ___ (fast fibre ___ pain) terminate in ___
projecting neurones from ___ (WDR) terminate in __+__
pain perception (site and intensity) need ___ firing from both pathways

A

lamina I - Aδ - posterior nucleus of thalamus
lamina V - posterior and ventroposterior nucleus of thalamus
simultaneous

147
Q

in nociceptive tract for 2nd order neurones:
in spinoreticular tract: mainly transmits ___ __ fibre pain
makes extensive connections with ___ in ___ eg periaquesductal grey (PAG) + _____
involved in ___ responses to pain, arousal, emotion and fear of pain

A

slow C
reticular nuclei in brainstem
parabrachial nucleus (PBN)
autonomic

MSKJaz (28 decks)

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