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SBM > Week 1 > Flashcards

Week 1 Flashcards

1
Q

Weight-bearing vs. non-weight-bearing x-rays

A

if the X-ray

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2
Q

What is a sign of osteoarthritis?

A

narrow joint space

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3
Q

Which place can the hips refer pain?

A

To the back

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4
Q

What happens to intervertebral discs as we get older?

A

The disks dehydrate and compress [thinner on x-ray]

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5
Q

What does increased brightness in bones mean?

A

s

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6
Q

True or False prostate cancer can often go to bone

A

True

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7
Q

List the red flags for lower back pain

A

trauma, age over 50, fever, weight loss, night/rest pain, history of cancer, _____

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8
Q

natural history of back pain

A

___

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9
Q

What is the nucleus propulsus mainly made of?

A

water

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10
Q

What does it mean if intervertebral discs are darker on X-ray?

A

dehydrated

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11
Q

Describe a T1 vs. T2 signal on X-ray

A

T1: T2:

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12
Q

In the LAIDback study what was the most important predictor in having future back pain?

A

self-reported depression

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13
Q

How should we treat benign back pain?

A

conservative [bedrest, meds, PT, exercise, manipulation, alternative treatments, minimally invasive [injections], invasive [surgery -decompression to relieve pressure on a nerve root and decompression to remove fusion]

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14
Q

What is functional restoration?

A

It’s a treatment approach to restore functional capacity [based on PT and sports medicine in the 80s]. It interrupts disability process, returns patient to more productive lifestyle, and _______

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15
Q

Biomedical vs. Biopsychosocial model of osteoarthritis

A

__ While we addr

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16
Q

True or False. Is bedrest the best treatment for back pain? What’s the best?

A

False. It’s worse! The best is exercise [functional restoration; relatively aggressive - cannot have complete avoidance of pain]

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17
Q

passive physical therapy

A

the results don’t last

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18
Q

Which type of exercises are appropriate for back pain?

A

resistance exercises

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19
Q

Explain the MA for acetylcholine

A

-

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20
Q

Explain the MA for nicotine

A

-

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21
Q

Explain the MA for succinylcholine

A

d

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22
Q

Explain the MA for rocuronium

A

d

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23
Q

Explain the MA for varenicline

A

d

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24
Q

Explain the MA for trimethaphan

A

d

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25
Q

Explain the MA for botulium toxin A [botox]

A

d

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26
Q

Explain the MA for edrophonium

A

a

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27
Q

Explain the MA for neostigmine

A

d

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28
Q

Explain the MA for pyridostigmine

A

d

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29
Q

Explain the MA for sarin

A

d

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30
Q

Explain the MA for malathion

A

d

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31
Q

Explain the MA for pralidoxime

A

d

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32
Q

Explain the MA for atropine

A

s

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33
Q

Which neurotransmitter is used by somatic nerves?

A

acetylcholine at the neuromuscular junction

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34
Q

Which neurotransmitter is used by sympathetic nerves? Preganglionic and postganglionic

A

pre: NE post: ACh

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35
Q

Which neurotransmitter is used by parasympathetic nerves? Preganglionic and postganglionic

A

pre: ACh post: ACh

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36
Q

Which neurotransmitter is used by adrenal medulla? Preganglionic and to circulation

A

Pre: ACh To Circulation: epinephrine and norepinephrine

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37
Q

What is the innervated region of the muscle called?

A

The end plate

38
Q

Which type of ACh receptor is at neuromuscular junctions?

A

nicotinic ACh receptors

39
Q

In addition to nicotinic ACh receptors, what is the other type of receptor that recognizes ACh

A

muscarinic receptor

40
Q

Describe the nicotinic receptor

A

Binds two molecules of ACh; ligand-gated ion channel; non-selective cation channel [sodium going in, but a little potassium also leaks out]

41
Q

Describe the muscarinic receptor

A

d

42
Q

Define non-depolarizing blocks of nicotinic receptors. Which drugs are included in this group?

A

competitive antagonists of nicotinic receptors AT NEUROMUSCULAR JUNCTION ONLY; sometimes called “curare-like” drugs; roscuronium [one of the most commonly used] and cisatracurium [best for people with liver problems] more are also used these are just two examples; effect: not enough stimulation to cause depolarization

43
Q

Define depolarizing blocks of nicotinic receptors. Which drug is included in this group?

A

agonist for nicotinic receptor at NMJ; use succinylcholine [faster onset of action compared to other drugs; structurally two ACh molecules together]; cannot be degraded the same way; because of prolonged action - will have sustained depolarization; “endplate depolarization prevents resetting of voltage-gated Na+ channels this blocks the action potential generation in muscle [no [propagation]

44
Q
A
45
Q

Which drug should be used for muscle paralysis if a patient has severe burns or hemiparalysis?

A

You should use rocuronium since you don’t want to increase the risk of hyperkalemia [this would happen if you used succinylcholine]. Denvervation super-sensitivity

46
Q

Define denervation super-sensitivity

A

is the sharp increase of sensitivity of post-synaptic membranes to a chemical transmitter after denervation. It is a compensatory change.

It can cause hyperkalemia in the case of NMJ.

47
Q

True or false there is redundancy at neuromuscular junctions [aka “safety factor”]

A

True. More ACh is produced than needed to make sure the muscle contracts

48
Q

What percent of receptors need to be blocked at the NMJ to prevent/decrease muscle contraction?

A

about 75% of the receptors

49
Q

myasthenia gravis

A

auto-antibodies destroy nAChR on the muscle endplate

50
Q

lambert-eaton myasthenic syndrome

A

auto-antibodies block calcium channels and lower ACh release

51
Q

Drug targets related to neurotransmission

A

synthesis, vesicular packaging, vesicular release, receptors [pre or post synapse], and degradation/removal

52
Q

Which enzyme is always present with ACh?

A

acetylcholineesterase

53
Q

Which drug cleaves SNARE proteins in cholinergic nerves? How is function restored?

A

botulium toxins [specific for cholinergic nerves and will destroy the signal] so the localization of the injection is very important]; the nerve sprouts [forms a new connection to the motor end plate]

54
Q

Describe acetylcholinesterase

A
  • this is thee “true” cholinesterase
  • it’s selective for ACh
  • it’s abundant at synpatic cleft, and present on RBCs
  • it’s inactivated by by anti-cholinesterases
55
Q

Describe butyryl or plasma cholinesterase

A
  • family of related enzymes to acetylcholinesteraes
  • extensive distribution in the body - liver, brain, plasma
  • relatively nonselective - metabolize ester containing drugs
  • inactivated by anti-cholinesterases
56
Q

Describe the interaction between acetylcholine and acetylcholinesterase

A

d

57
Q

Describe the interaction between anticholineesterases and acetylcholinesterases

A

d

58
Q

Describe the MA of anticholinesterases

A

Types:

  1. very short acting [over within minutes]
    * edrophonium [tensilon]
  2. intermediate acting [several overs]
  • neostigmine and pyridostigmine
  • mainstay for clinical use - treating myasthenia, reversing neuromuscular block etc.
  • DOES NOT cross the blood-brain barrier [if it were to cross you’d be at risk for seizures]
  1. irreversible [need to synthesize new enzyme]
  • sarin and other chemical warfare agents
  • lipophilic and readily absorbed
59
Q

Describe thiphosphate insecticides

A

,

60
Q

When should we infuse acetylcholine verus using anticholinesterase?

A

Review the symptoms from lecture

61
Q

If an X-ray says upright on it, why is this significant?

A

If an X-ray says upright it means the image is weight-bearing. Weight-bearing images may make it difficult to determine whether or not the joint space is actually narrowed

62
Q

True or false: facet joint arthritis can cause back pain

A

true

63
Q

Define myelopathy

A

a myelopathy is a disease of the spinal cord [diseases that affect the anterior horn - motor neuron disease]

64
Q

Define radiculopathy

A

disease of spinal nerves

65
Q

Define paresthesias

A

Pins and needles (paraesthesia) is a pricking, burning, tingling or numbing sensation that’s usually felt in the arms, legs, hands or feet.

66
Q

What is the difference between propioception and kinesthesia

A

propioception = sense of body position

kinesthesia = sense of body movement

check over again

67
Q

Define tendon

A

tendon is connective tissue [collagen] that [usually] connects muscle to bone

68
Q

Define ligament

A

ligaments are connective tissue [collagen] that connect bone to bone

69
Q

How can we differentiate between a UMN and LMN problem on physical exam?

A

UMN: increased muscle contraction [spascicity], increased reflexes [hyperreflexia], no atrophy

LMN: decreased muscle contraction [flaccid], decreased reflexes [hyporeflexia], localized atrophy

70
Q

Define UMN and LMN

A

UMN: central ns [brain and spinal cord]

LMN: peripheral ns

Mixed Central and Peripheral [UMN and LMN]: motor neuron disease [patients will have hyperreflexia and localized atrophy]

71
Q
A
72
Q

Define plexopathy

A

problems with plexus [brachial or LS]

73
Q

Define neuropathy or polyneuropathy

A

problem/disease of nerves

74
Q

define NMJ disorder

A

problem at NMJ

75
Q

Define myopathy

A

problem/disease of the muscle

76
Q

True or false: both nerves and muscle are excitable

A

true

77
Q

true or false: sensory and motor neurons are meters long

A

true

78
Q

true or false every muscle has a NMJ?

A

true

79
Q

Do the nerves have a mix of afferent and efferent nerve fibers?

A

Yes

80
Q

define muscle spindle fiber organ

A

specialized group of muscle fibers [intrafusal]

81
Q

Intrafusal vs. extrafusal

A

intrafusal: muscle fibers within the muscle spindle fiber organ
extrafusal: contacticle muscle fibers

82
Q

The larger the diameter of a nerve fiber, the faster they are. True or false?

A

true

83
Q

Define trophic interactions

A

Trophic interactions are the interactions between the producers and consumers in an ecosystem

84
Q

Define dermatome

A

area of skin innervated by a bilateral pair of spinal nerves and their spinal ganglia

85
Q

Which type of neurons innervate the dermatome?

A

sensory neurons

86
Q

Which type of neurons innervate the myotome?

A

motor neurons

87
Q

Define myotome

A
88
Q

CNS

A

brain and spinal cord

89
Q

PNS

A
  • Cranial nerves [12 pairs]
  • Spinal nerves [31 pairs; includes D/V rootlets and roots]
  • Sensory Ganglia [8 cervical pairs and 31 spinal pairs [DRG]
  • Autonomic ganglia [sympathetic, parasympathetic, and enteric]
90
Q

What is the difference between cranial nerves and spinal nerves?

A

Cranial nerves come from the brain stem [there are 12 pairs of cranial nerves]. Spinal nerves come from the spinal cord [there are 31 pairs of spinal nerves: 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal]

91
Q
A

SBM (2 decks)

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