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MSK > Physiology and pharmacology > Flashcards

Physiology and pharmacology Flashcards

1
Q

What is the difference between skeletal muscle and the other two types?

A

Skeletal is under voluntary control

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2
Q

The motor-neurones supplying skeletal muscle ar myelinated/non-myelinated

A

Myelinated

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3
Q

The cell bodies of neurones innervating skeletal muscle are located in the ______ and _______

A

Spinal cord

Brain stem

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4
Q

The motor neurone axon divides into many myelinated/unmyelinated branches near the muscle

A

Unmyelinated

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5
Q

Each branch of the motor neurone supplies multiple fibres - true/false

A

False - single muscle fibres

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6
Q

The neurone and the number of fibres it supplies is the same throughout the body - true/false

A

False - it is highly variable

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7
Q

define a motor unit

A

One alpha motor neurone and all of the muscle fibres it supplies

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8
Q

How does the neurone:fibre ratio vary with precision and strength

A

Neurone:fibre ratio is less when needing more precision; more precision, less fibres per neurone
it is higher in strength but therefore has less precision - more strength, more fibres innervated by one alpha neurone

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9
Q

Each branch of an alpha motor neurone then further divide to give fine branches ending in a _____ ______

A

terminal bouton

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10
Q

The terminal bouton forms a chemical synapse - true/false

A

True

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11
Q

What is the transmitter substance in the neuromuscular junction?

A

Acetylcholine

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12
Q

What receptor does acetylcholine activate in the sarcolemma at the neuromuscular junction?

A

Nicotinic acetylcholine receptors

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13
Q

Cell body can be located in the ____ ____ of the spinal cord of the brain stem

A

ventral horn

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14
Q

The alpha neurones can have a very long axon, ranging up to approximately ____meter in length

A

one meter

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15
Q

The very fine branch of the neurone spreads out to form the terminal bouton - true/false

A

True

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16
Q

The terminal bouton contains many/few mitochondria

A

Many

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17
Q

The terminal bouton contains lots of _______ containing _______

A

Vesicles containing acetylcholine

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18
Q

The vesicles are concentrated in which part of the bouton?

A

Near to the areas they are released from

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19
Q

the synaptic cleft in a muscle is very large/small to facilitate very rapid twitch

A

Small (20-50nm)

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20
Q

What is a junctional fold?

A

A fold in the sarcolemma immediately below the presynaptic membrane which contain the nicotinic ACh receptors

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21
Q

The junctional folds are arranged in what way?

A

They are arranged so that the nicotinic receptors are facing the areas of maximum ACh release.

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22
Q

For every action potential that passes through the presynaptic membrane there may or may not be a muscle twitch - true or false

A

False - if an action potential reaches the synapse, it will always invoke a muscle contraction - always

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23
Q

Acetylcholine is formed from choline and acetate. How is the choline taken up by the presynaptic membrane?

A

Via a choline-sodium transporter - using the sodium electrochemical gradient energy

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24
Q

What enzyme combines choline and acetate?

A

Choline-acetyl-transferase

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25
Q

Where is the acetate group taken from?

A

Acetyl Co-A produced in the mitochondria

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26
Q

What channels are opened by the action potential?

A

Voltage activated calcium channels

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27
Q

Calcium channels opening can stimulate release of vesicles in itself true/false

A

True - they are clustered round the vesicles

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28
Q

The acetylcholine-containing vesicles can dock to the membrane, without fusing with it using proteins, this increases faster release. True/false

A

True

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29
Q

When ____ molecules of ACh bind to the receptor on the postsynaptic membrane, the channel opens

A

2

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30
Q

the ACh receptor when open conducts sodium more effectively than potassium - true/false

A

False - they are equal

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31
Q

Sodium influx occurs faster than potassium efflux due to the relatively higher driving force - true/false

A

true

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32
Q

The higher efflux of sodium than potassium influx generates the end plate potential

A

False - the higher INflux of sodium than potassium EFflux generates the EPP

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33
Q

You can lose 30% of your ACh receptors in the postsynaptic membrane before experiencing any paralysis - true/false

A

False - you can lose up to 70-80% and still function reasonably well

34
Q

The end plate potential stimulates contraction - true/false

A

False

35
Q

The end plate potential triggers a muscle action potential - true/false

A

True

36
Q

The muscle action potential does not stimulate contraction - true/false

A

False

37
Q

A threshold end plate potential causes the opening of _____ ______ ______ channels.

A

Voltage-activated sodium channels

38
Q

Normally one action potential in the motor neurone causes ____ muscle action potential(s) and twitch

A

1

39
Q

How do drugs or toxins suppress muscle twitch?

A

they reduce the amplitude of the EPP so that it is below threshold, no muscle action potential can be generated

40
Q

Name the enzyme that degrades acetylcholine into acetate and choline

A

Acetylcholinesterase

41
Q

How efficient is acetylcholinesterase?

A

Extremely - some ACh is hydrolysed before reaching the post synaptic membrane

42
Q

All transmission has been ceased within a few milliseconds via the action of AChE - true/false

A

True

43
Q

Define pain

A

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

44
Q

What is meant by pain being an “unpleasant sensory and emotional response…”

A

While pain is a sensory response it also has an emotional component; the same damage may cause less pain/more pain depending on your emotional status,

45
Q

State the three types of pain

A

Nociceptive pain
Inflammatory pain
Pathological pain

46
Q

Nociceptive pain is adaptive true/false

A

True

47
Q

What is the purpose of nociceptive pain?

A

It is an unpleasant adaptive pain which is present to deter you from further injury.

48
Q

Inflammatory pain is maladaptive - true/false

A

False - it is adaptive

49
Q

Inflammatory pain exceeds the duration of the injury but completely resolves when the injury is completely resolved - true/false

A

True

50
Q

Pathological pain is adaptive/maladaptive

A

Maladaptive

51
Q

There is always a clear cause of pathological pain - true/false

A

False - it may arise out of the blue or outlast its cause.

52
Q

is it easy to treat pathological pain? Why/why not?

A

No it is not easy to treat - it doesn’t response well to common analgesics.

53
Q

Nociceptors are specific receptors activated by intense stimuli including ______, ______ and _________ or noxious stimuli.

A

Chemical
thermal
Mechanical.

54
Q

Where are nociceptor cell bodies located?

A

The sensory ganglia

55
Q

Nociceptors are first order neurones which deliver the nervous impulse to the higher pain centres - true/false

A

False - they synapse with second order neurones which carry the impulse to the higher pain sensors.

56
Q

Nociceptive pain is a warning system telling you to avoid this stimulus in future - true/false

A

True

57
Q

Nociceptive pain is triggered by both minor and intense stimuli - true/false

A

False - only triggered by intense stimuli

58
Q

Give 3 (of 4) stimuli that can provoke nociceptive pain

A

Severe mechanical stress
Chemical irritants
Extreme heat
Extreme cold

59
Q

Much of the voluntary system can be overridden by nociceptive pain to prevent further injury - true/false

A

True - nociceptive pain can cause an override in the voluntary system to cause you to, for example drop the pot that burned you

60
Q

There is only a minor emotional response in nociceptive pain - true/false

A

False - there is a major emotional response in nociceptive pain.

61
Q

What is the purpose of the emotional response in nociceptive pain?

A

It will inscribe a strong memory association with that stimulus and you’ll be more careful to avoid it next time.

62
Q

Inflammatory pain is adaptive and protective - true/false

A

True

63
Q

the inflammatory pain response involves many cellular and humoral components of which system?

A

The immune system.

64
Q

The inflammatory pain response causes _____ ______ to noxious stimuli

A

Pain hypersensitivity

65
Q

What immune cells are already present in tissue when acute injury or infection occurs?

A

Mast cells

66
Q

the purpose of inflammatory pain is to promote healing - how does it achieve this?

A

It immobilises the wound as you are reluctant to move it due to pain and discourages you from making contact with stimuli that may cause you pain.

67
Q

If the pain seriously impacts on the patient’s QOL we can prescribe which type of drug to alleviate it to some degree?

A

NSAIDs

68
Q

Pathological pain is adaptive/maladaptive and serves a protective/no function.

A

Maladaptive

has no function

69
Q

Pathological pain is often a disruption of function to ___ _______ ______

A

the nervous system

70
Q

Pathological pain can be divided into two categories based on their cause - name and define each

A

Neuropathic pain - caused by previous nerve damage

Dysfunctional - it comes from any other injury

71
Q

Neuropathic pain can be caused by lesions/strokes etc. true/false

A

True

72
Q

Nociceptors are primary afferent/efferent neurones

A

Afferent

73
Q

There are two type of nociceptor fibre - name them

A

Alpha-delta and C-fibres

74
Q

Alpha-delta fibres are mechanical and thermal fibres which are unmyelinated

A

False - they are mechanical and thermal fibres but are myelinated.

75
Q

Myelinated alpha-delta fibres conduct at what speed?

A

6-30m/s

76
Q

Alpha delta fibres mediate first/secondary pain

A

First (fast) pain.

77
Q

C-fibres are myelinated and can conduct at 0.5-10m/s

A

false - they are unmyelinated and conduct at 0.5-2m/s

78
Q

C-fibres mediated first/secondary or fast/slow pain

A

Secondary

slow

79
Q

First (fast) pain can be described as _____

A

Pricking, stabbing pain

80
Q

Secondary (slow) pain can be described as ______

A

Burning, throbbing, cramping, aching

81
Q

Thermal channels include a channel called ______ which is activated normal by temperatures of _______

A

TRPV1

43+ degrees

82
Q

in the inflammatory pain response the TRPV1 channel becomes more/less sensitised to heat and increases/reduces the activating temperature

A

more sensitised

Reduces - below core body temperature

MSK (7 decks)

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