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My Phase 1 > suger wrap up > Flashcards

suger wrap up Flashcards

1
Q

Layers of the skin

A

Epidermis
Dermis
Subcutaneous fatty tissue

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2
Q

Layers of the epidermis

A 
Stratum corneum
Stratum lucidum
Stratum granulosum
Stratum spinosum
Stratum basale
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3
Q

Features of the stratum corneum/lucidum

A

Annulated keratinocytes.

Corneodesmosomes hold corneocytes together.

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4
Q

Features of the stratum granulosum

A

Contains granules:

  • keratohyaline granules
  • lysosomal enzyme
  • odland bodies (lipids - prevent water loss)
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5
Q

Features of the stratum spinosum

A

‘prickle layer’
5-10 layers
plump polygonal keratinocytes
contains Langerhans and Merkels cells

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6
Q

Features of the stratum basale

A

single layer
Basal epithelial cells and melanocytes
Columnar and perpendicular to basement membrane.
Mitotically active.

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7
Q

How is the epidermis separated from the dermis?

A

By a ridges basement membrane which forms ‘rete ridges’

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8
Q

Describe the papillary dermis

A

Closer to the basement membrane.
Loose meshwork, poorly organised type 3 collagen and elastic fibres
Abundant in small blood vessels, fibroblasts and ground substance

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9
Q

Describe the reticular dermis

A

Thick bundles of well organised type 1 collagen with thick elastic fibres
Also contains vessels and ground substance, plus macrophages and mast cells

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10
Q

what is the subcutaneous layer of the skin composed of?

functions?

A

Lobules of mature adipocytes with intervening fibrous tissue septae.
Functions: insulation, food store, shock absorber

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11
Q

Compare Pacinian and Meissner’s corpuscle in relation to:

  • size
  • location
  • function
  • appearance
A 
Pacinian:
large
deep dermis and subcutis
coarse touch, vibration, tension
onion appearance
Meissner's:
small
dermal papillae
light touch
spiral appearance
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12
Q

Describe the protective function of the skin

A

Strong physical barrier protects from trauma, dehydration and invasion by pathogens, UV light protection via melanin

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13
Q

Describe the sensory function of the skin

A

Somatic sensory receptors allow transmission of signals regarding pain, temperature and light touch

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14
Q

Describe the function of the skin in temperature regulation

A

Regulation of blood flow, erection of hairs, release of sweat

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15
Q

Describe the immune function of the skin

A 
Specialised cells (e.g. Langerhans, phagocytes destroy microorganisms and interact with rest of immune system.
Acidic environment.
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16
Q

How is the skin adapted to allow movement and growth?

A

elastic and recoil properties

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17
Q

Role of the skin in excretion

A

Waste products removed from surface of the skin e.g. water, urea, ammonia, uric acid – regulated by sweat composition

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18
Q

Endocrine function of the skin

A

synthesis of vitamin D from sunlight

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19
Q

why does the R kidney lie lower than the left?

A

liver is on the R - has to accomodate

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20
Q

At which vertebral level do the kidneys lie at?

A

T12-L3

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21
Q

ARe the renal arteries above or below the coeliac trunk?

A

Below - near sup. mesenteric

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22
Q

3 coverings of the kidneys

A

Gerota’s fascia, perinephric fat, renal capsule

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23
Q

How many arteries supply adrenals?

A

3:

aorta, renal artery, inferior phrenic artery

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24
Q

Where does the urogenital sinus originate? what will it eventually form?

A

From cloaca.

Forms bladder and urethra.

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25
Q

Where does the ureteric bud originate? What does it eventually form?

A

From mesonephric duct.

Forms ureters, calices and collecting ducts.

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26
Q

3 stages of kidney development

A
  1. pronephros
  2. mesonephros
  3. metanephros
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27
Q

which embryological kidney forms the permanent kidney? when does it start functioning?

A

Metanephros

Functions at 12 weeks

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28
Q

Which stage of developing kidney gives rise to the mesonephric duct (Wolffian duct)?
When does this kidney form disappear?

A

mesonephros

disappears 2nd month

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29
Q

what does the Wolffian duct go on to form?

A

vas deferens, epididymis, seminal vesicles, ejaculatory duct

30
Q

what week does sex differentiation occur?

A

week 7

31
Q

4 functions of kidney

A

water/acid-base/ion balance
waste removal
gluconeogenesis
hormone production

32
Q

How much of the cardiac output is to kidneys?

A

20%

33
Q

Normal GFR

A

100ml/min

34
Q

Normal rate of urine production

A

1ml/min

35
Q

Sodium channel present on the ascending limb of the nephron

A

NKCC2

Limb is impermeable to water, sodium actively pumped out

36
Q

Describe sodium reabsorption in the ascending limb

A

NKCC2 channels (reabsorption of sodium, K+ and 2Cl-)

37
Q

Describe sodium reabsorption in the PCT

A

sodium channels exchange sodium for H+ (most reabsorption occurs here) and water follows passively

38
Q

Describe sodium reabsorption in the DCT

A

NCC channels transport Na+ and Cl-

39
Q

Describe sodium reabsorption in the collecting duct

regulation of ion channels

A

ENaC (epithelial sodium) channels transport sodium in from tubular fluid. Water follows passively. K+ enters tubular fluid from blood (exchanged with Na+ by Na/K ATPase).
Aldosterone regulates ENaC and Na+/K+ channels.

40
Q

Describe the permeability of the descending limb of the nephron

A

Impermeable to sodium.

Water out via aquaporins.

41
Q

What happens to hypertonicity as you move further into the medulla?

A

Increases

42
Q

What detects decrease in renal perfusion?

A
  • renal sympathetic nerves
  • intrarenal baroreceptors in the afferent arteriole
  • cells of the macula dense
43
Q

In response to a decrease in renal perfusion, which cells will produce Renin?

A

Juxtaglomerular cells of the afferent arteriole of the kidney
(juxtaglomerular apparatus)

44
Q

What produces angiotensinogen?

A

the liver

45
Q

what does angiotensinogen do?

A

Inactive, circulates in blood and is converted by renin to angiotensin 1

46
Q

What produces ACE?

A

lungs - surface of pulmonary (and renal) epithelium

47
Q

What does ACE do?

A

Converts angiotensin 1 to angiotensin 2 in the blood vessels

48
Q

Describe the actions of angiotensin 2

what do all of these factors cause?

A
  • increases sympathetic activity
  • increases tubular Na+Cl- reabsorption, K+ excretion and H2O retention
  • causes secretion of aldosterone from adrenal gland cortex
  • increases arteriolar vasoconstriction
  • increases ADH secretion from the posterior pituitary gland, leading to H2O absorption in the collecting duct

EFFECT: increased effective circulating volume (increased blood pressure)

49
Q

What does aldosterone producted by the kidney cortex in response to angiotensin 2 cause?
How does it work?

A

Increases tubular Na+Cl- reabsorption, K+ excretion and H2O retention.
It does this by: binding to a cytoplasmic receptor which is transported to the nucleus.
This increases action of ENaC and Na/K ATPase channels.

50
Q

What triggers ADH release?
How is this detected?
How does ADH work?

A

Triggers: increased plasma osmolality and reduced blood volume
Detected by: hypothalamic osmoreceptors
How does it work: aquaporin insertion in collecting duct

51
Q

Continence and micturition - nerve supply

A

Sympathetic: hypogastric nerve
Parasympathetic: pelvic nerve
VoluntaryL pudendal nerve
(S2,3,4 keeps the piss off the floor…)

52
Q

Storage of urine:

  • control?
  • muscles/sphincter
  • nerve
A
  • Sympathetic
  • Internal urethra sphincter contracted
  • detrusor muscle relaxed
  • hypogastric nerve T10-L2
53
Q

Voiding:

  • control
  • sequence of events
  • nerves
A
  • Parasympathetic
    1. Internal urethral sphincter relaxes
      1. Bladder neck funnels
      2. Detrusor contracts
  • Pelvic nerve, S3-5 from sacral plexus

AND
voluntary control:
pudendal nerve controls external urethral sphincter

54
Q

Layers of the bladder wall

A
  1. Urothelium (also called transitional epithelium)
  2. Lamina propria
  3. Muscularis detrusor
  4. Adventitia
55
Q

Arterial supply of the thyroid

A

Superior thyroid artery (branch of external carotid)

Inferior thyroid artery (branch of subclavian)

56
Q

Venous drainage of the thyroid - why is this significant?

A

Superior and middle veins, drain into internal jugular.
Inferior vein drains into brachiocephalic vein.
Significant for hormone release.

57
Q

2 proteins which bind thyroxine in the blood

A

Albumin and thyroxine binding globulin

58
Q

How is T4/T3 excreted?

A

Deiodinated by liver and kidneys

59
Q

effects of thyroxine

A
  • increases oxygen consumption at tissues
  • increased metabolism
  • excess causes muscle breakdown
  • brain maturation
  • growth
60
Q

Thyroid histology:

  • C cells
  • follicular cells
  • follicle
A
  • C cells: produce calcitonin, are alongside the follicles
  • follicular cells: form a cuboidal epithelium
  • follicle: hollow spheres containing inert thyroxine
61
Q

Brief steps of spermatogenesis

A
  1. Spermatogonia forms a spermatocyte
  2. Meiosis 1: the spermatocyte forms 2 spermatocytes
  3. Meiosis 2: 2 spermatocytes form 4 spermatids
  4. Spermiogenesis: spermatids forms spermatozoa which adapts to move: sprouts tail, discards excess cytoplasm, acrosome forms
62
Q

Factors affecting puberty

A
  • nutrition
  • genetic
  • exercise
  • socio-cultural
  • hormones
63
Q

Hormonal changes in puberty

A
  • ↑ amplitude of hypothalamic endocrine secretions
  • ↑ levels of FSH, LH and sex steroids
  • ↑ growth hormone
    Centrally driven and depends on hypothalamic-pituitary-gonadal (H-P-G) axis
64
Q

OOgenesis

meiosis 1 and 2

A 
Meiosis 1:
Begins in uetero, before 12 weeks
Homologous recombination and crossover > variation
46 XX > 23X + 23X
Arrested in metaphase 1 until puberty.
Meiosis 2:
LH surge at puberty > resumation
Equatorial division
23X > 23X + 23X
Arrested in metaphase 2 until fertilisation.
65
Q

Endometrial phases:

describe the proliferative phase

A

oestrogen stimulation causes straight glands so show mitotic activity and become tortuous glands.
No luminal secretions.
Stromal cells: spindled, compact, show mitotic activity.

66
Q 
Endometrial phases:
describe the secretory phase
- early
- mid
- late
A 
EARLY: 
sub-nuclear vacuoles
MID: 
Vacuoles above and below nucleus
Intraluminal secretions (pink)
Rounded glands
Stromal oedema
LATE:
Spiral arterioles in stroma
Elongated, saw-tooth glands with ↑ luminal secretions
67
Q

Describe pre-implantation:

from pertilisation to hatching

A
  1. Fertilisation – day 1
    Spermatozoon penetrates zona pellucida surrounding oocyte and gametes fuse to form zygote
  2. Cleavage – day 2-3
    Ooplasm divides into two equal halves and successive cleavages > ↑ cell no.
  3. Compaction – day 4
    Cells flatten and tight junctions form, max. intracellular contacts
  4. Cavitation and differentiation – day 5
    Fluid filled cavity expands to form blastocyst
  5. Expansion – day 5-6
    Cavity expands further and diameter of blastocyst ↑, zona pellucida thins
  6. Hatching – day 6+
    Blastocyst expansion + enzymes > hatching of embryo from zona pellucida
    Necessary for implantation…
68
Q

Describe the implantation of the blastocyst, startinf with apposition

A

Apposition – starts ~ 9 days after fertilisation
Hatched blastocyst orientates via embryonic pole and synchronises with receptive endometrium (day 19-22 of cycle)

Attachment
Endometrial epithelial cells and trophoblastic cells express integrins which connect with one another

Differentiation of trophoblast
Trophoblast > cytotrophoblast + syncitiotrophoblast (erodes endometrial blood vessels)

Invasion
Enzymatic degradation of basal lamina

Decidual reaction
Differentiation of stromal cells adjacent to blastocyst

Maternal recognition
Secretion of interleukin-2 prevents antigenic rejection of embryo

69
Q

Skin changes during prgnancy

A

Linea nigra: dark central line on abdo
Striae gravidarum: strech marks in lumbar/lower abdo regions
Darkened areolar of breast

70
Q

Spinal changes in pregnancy

A

increased lumbar lordosis

71
Q

stages of labour

A
  • latent phase: little cervical dilation
  • active phases - organised uterine contractions and dilation:
    stronger, higher frequency contractions
    full dilatation –> foetal expulsion
    placental expulsion
  • post partum phase

My Phase 1 (14 decks)

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