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Session Prep 10-11

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mhewett's version from 2016-06-30 20:18

Section Prep 10

Question Answer
What is the primary innervation of hamstrings? quadriceps femoris?hamstrings - sciatic nerve L4-S3
quadriceps femoris - femoral nerve L2-4
What three muscles compose the hamstrings?semitendinosus, semimembranosus, biceps femoris
How is one's ability to move their foot affected by a peroneal nerve injury?loss of dorsiflexion
Name the major contents of the superior mediastinumsuperior - thymus, great vessels, trachea, esophagus, aortic arch
Name the major contents of the middle mediastinummiddle - heart
Name the major contents of the posterior mediastinumposterior - descending aorta, esophagus
Name the major contents of the anterior mediastinumanterior - lymph, thymus (infancy) (adult loss of the thymus)
At what point during the cycle of contraction and relaxation is the blood flow through the coronary arteries the greatest?diastole
What three major arterial trunks arise from the aorta to feed the abdominal viscera?celiac, IMA, SMA
Which trunk supplies the sigmoid colon? supplies the small intestine? the transverse colon? the stomach?sigmoid colon - IMA
-small intestine - SMA, celiac trunk to prox duodenum
-transverse colon - SMA
-stomach - celiac trunk
What are three signs of portal hypertension in terms of the portacaval shunts involved?esophageal varices, caput medusae (periumbilical vein shunt), hemorrhoids (rectal veins)
Describe McBurney's point2/3 of the way from the umbilicus to the ASIS (1/3 away) *closer to the ASIS
*location of the appendix
What is the triad for peritonitis?abdominal muscle rigidity, severe pain, rebound tenderness
Name the layers of the spermatic cord, going from the most superficial layer to the deepest layer.SECIL: superficial fascia--> external spermatic fascia (external oblique) --> cremasteric muscle and fascia (internal oblique) --> internal spermatic fascia (transversalis fascia) --> loose connective tissue
From what artery does the ovarian artery originate?aorta
Compare Broca's aphasia with Wernicke's aphasia in terms of fluency of speech and comprehension of language.Broca's = nonfluent speech with intact comprehension
Wernicke's = fluent speech with impaired comprehension (word salad)
What cerebral artery supplies the lateral cortex? the medial cortex?lateral - middle cerebral artery
medial - anterior cerebral artery
Name all 5 signs/symptoms that would be associated with transient ischemia involving the vertebrobasilar artery insufficiency.vertigo, diplopia, ataxia, facial muscle weakness, nausea
What cranial nerve(s) function for taste?VII (ant 2/3)
IX (post 1/3)
What cranial nerve(s) function for hearing? for mastication? for movement of trapezius? for facial expression? for sensory transmission from viscera?hearing - VIII
mastication - V
trapezium movement - XI
facial expression - VII
sensory transmission from viscera - X
What cranial nerve is served by the Edinger-Westphal nucleus?Edinger-Westphal - III
What cranial nerve is served by the inferior salivary nucleus? the dorsal motor nucleus?inferior salivary - IX
dorsal motor - X
What part of the striatum atrophies in Huntington's disease?caudate + putamen
What brainstem area is lost in Parkinson's?substantia nigra
What part of the basal ganglion is the site of copper accumulation in Wilson's disease? What two structures comprise this part of the basal ganglion?Lentiform nucleus
putamen + globus pallidus
The thalamus recieved ALL sensory input except for this one type of sensory input. What is it?olfactory
What part of the brainstem is destroyed in Wallenberg Syndrome, and what artery infarcts to bring this about?Lateral Medulla
PICA (posterior inferior cerebellar artery)
don't PICA hoarse that can't eat (dysphagia)
damage to nucleus ambiguus is unique to Wallenbergs
If contralateral body pain and temperature sensation is lost, what spinal tract has been injured?spinothalamic tract
What occurs to the body if the corticospinal tract is lost?spastic paralysis; *UMN lesion
What lesion tops your list of differential diagnoses if there is muscle weakness and loss of sensation in the right arm? in the left leg?right arm - (CVA) left middle cerebral artery
left leg - (stroke - right side of brain) - right anterior cerebral artery
What lesion if loss of sensation over the buttocks and perineum along with loss of bowel control?Cauda Equina syndrome
In what dermatomes do the following structures lie? anus? umbilicus? great toe?anus - S5
umbilicus - T10
great toe - L4 (medial side) (top = L5) (bottom = S1)
What disorder exists if an L5 transverse process articulates or is fused with the sacrum?sacralization
What type of gene is responsible for producing gp41 and gp120 in HIV? For producing p24? for producing reverse transcriptase in HIV?gp 41 and 120 - ENV gene
p24 - GAG gene
reverse transcriptase - pol gene
What is p24?HIV core capsid; serum marker
What comma-shaped organism is renowned for causing rice-water stool, and is transmitted via contaminated water?vibrio cholera
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Session Prep 11

Question Answer
What is the typical duration of pain associated with MI?>30 min
What nerve root is being tested tb the biceps reflex?C5
If you wanted to test ROM of the shoulder, what test would probably be best to utilize?Apley's Scratch Test
What is the most common brachial plexus injury and what nerve roots are damaged in this case?Erb-Duchenne (ie someone's arm yanked down)
C5-C6
What tests are positive or tend to be positive in thoracic outlet syndrome?Adson's test - promotes compression within thoracic outlet - impingement of neurovascular bundle
Roos Test - " " exacerbates it
Apley's Scratch Test - bc most people w shoulder patho have restricted ROM
How does adhesive capsulitis develop, from a general perspective?from immobility
What is the normal carry angle of the female? of the male?female: 10-12 degrees
male: 5 degrees
What are the 2 primary supinators of the forearm?biceps (musculocutaneous nerve)
supinator (radial nerve)
What is the technical term for tennis elbow, and strain of what group of muscles (flexors vs. extensors) causes this?lateral epicondylitis
extensors muscle strain
What are the three common tests for carpal tunnel syndrome?Tinnel's Test, Phalen's Test, Prayer Test (Reverse Phalen's)
What nerve is entrapped in carpal tunnel syndrome?median nerve
If the MCP and DIP joints are extended and the PIP is contracted, what hand deformity is present?Boutonniere Deformity
What nerve(s) can be damaged in bishop's deformity?Median Nerve Damage (seen if they go to grab something) or Ulnar nerve depending on how we see the deformity (if constantly)
Why is thromboxan a pro-coagulant?increases platelet aggregation, increases vascular tone, increases bronchial tone
aka causes platelets to be more sticky
What is the main difference in the MOA between streptokinase and TPA?streptokinase activates ALL plasminogen and also catalyzes the degradation of fibrinogen and factors V and VII
tPA is fibrin selective and only activates plasmin that is already bound to fibrin
Name the general action of each ofthe 4 classes of antiarrhythmic drugs.Class I - Na+ channel blockers
Class II - beta blockers
Class III - potassium channel blockers
Class IV - CCB
"silly bunnies punch cats"
To what class of inotropic agents do digoxin and digitoxin belong?glycosides
What is the formula for calculating mean blood pressure?ardiac output * total peripheral resistance (2/3 diastolic + 1/3 systolic)
or diastolic + 1/3 (systolic - diastolic)
A patient's BP is 150/75. What is his mean BP?100 (2/3 diastolic + 1/3 systolic)
The patient had a BP of 150/75. He goes for an ECG. The test indicates that his CO is 6000 mL/min. What is his TPR?100/6000 = 0.017
TPR = MBP/CO
A patient has a serum creatinine of 4.0 mg/dL, a urine creatinine of 200 mg/dL, and a urine flow of 1200 mL per 24 hours. What is his renal clearance?Cx= [UxV]/Px = [0.83mL/min * 200 mg/dL]/ 4 mg/dL = 41.5 mL/min
In terms of the kidney and lung, which one regulates bicarbonate and which one regulates carbon dioxide?kidney - bicarbonate
lung - carbon dioxide
What is the formula for elasticity...compliance?elasticity = change in pressure/ change in volume
compliance = change in volume/ change in pressure
What ion channel is open during the upstroke phase of the action potential?Na+ channels
Is the sodium-potassium channel an example of active, facilitated, or secondary active transport? What about the sodium-glucose carriers?sodium-potassium = active transport
sodium-glucose = facilitated active = secondary active transport
What is the major prophylactic agent for asthma?cromolyn
What 2 receptor types, if stimulated, result in increased cAMP? What three hormones/drugs described in our chapter serve to increase cGMP?cAMP = beta, H2
cGMP = ANP, NO, viagra
With regard to G proteins, which one inhibits adenylate cyclase? stimulates adenylate cyclase? activates phospholipase C?inhibits adenylate cyclase - Gi
stimulates adenylate cyclase - Gs
activates phospholipase C - Gq
What type of nerve fibers are innervates skeletal muscle? What is the diameter in comparison with other nerve fibers?A alpha
largest nerve fiber that we have
What two types of nerve fibers are involved with afferent and efferent innvervation of the muscle spindles?afferent - take info from muscle spindle to spinal cord - a alphas
efferent - a gamma
What touch receptors sense pressure? sense touch? sense pain and temperature? sense vibration?pressure - Merkel's disc
touch - hair follicle sensors and Meissners
pain and temperature - free nerve endings
vibration - Pacinian
Describe the lens elasticity in presbyopic patients.diminished ability to focus on objects close by (ie cannot read without reading glasses) = loss of elasticity
Does the fast or slow phase of eye movement determine the direction of nystagmus that we note?fast phase
Compare and contrast CONDUCTION DEAFNESS in terms of what is damaged/defective in the ear, and what the results of the Rinne and Weber tests are.problem conducting sound waves - something obstructing conduction of sound waves to our hearing apparatus *insect / wax etc
Rinne - bone conduction > air conduction
Weber - negative (abnormal) --> which side do we lateralize to - sick ear
What does sympathetic stimulation of the bronchi effect? of the GI sphincters? of the pupils? of the GI tract in general, regarding motility?bronchi - bronchodilation
GI sphincters - contraction
pupils - dilation so you can see
of the GI tract in general - decreased motility
What cholinergic receptors, in general, are in the autonomic ganglia and at neuromuscular junctions?cholinergic receptors = respond to aCH
autonomic ganglia = Nn (type I)
neuromusclar junctions = Nm (type II)
Nm - nicotinic
Which cholinergic receptors are on sweat glands? Which ones are postsynaptic parasympathetic?muscarinics === sweat glands = M3
muscarinics
Identify which adrenergic receptor fulfills postsynaptic sympathetic with vasodilatory effects + bronchodilation effects: Beta2 receptors (from epi or NE)
Identify which adrenergic receptor fulfills presynaptic sympatheticalpha 2 (on nerve itself) --> inhibit sym alpha
Identify which adrenergic receptor fulfills CNSalpha 2
Identify which adrenergic receptor fulfills postsynaptic sympathetic in heartBeta1
Identify which adrenergic receptor fulfills postsynaptic sympathetic with vasoconstrictive and GI inhibitory effectsalpha 1
What nodes in the heart are innervated by the left vs right vagus nerve. and what specific aspect of the heart function is controlled by these two different branches of the vagus?Left - AVN
Right - Sinus Node
right vagus - decreases frequency (inhibit SN) = decrease HR
left vagus = decreases conduction (decrease ability to transmit conduction) and decreases force of contraction
What component of muscle measures muscle length? When stimualted, does it activate or inhibit alpha motor neurons?muscle spindles will activate
Which has the higher glycolytic capacity: red skeletal muscle or white skeletal muscle?white skeletal muscle
What does calcium bind to intracellularly in the process of activation of contraction of skeletal muscle? smooth muscle? cardiac muscle?skeletal muscle - troponin
smooth muscle - calmodulin
cardiac muscle - troponin
In assessing cardiac pressures, what does the a wave represent?filling
In what part of the lung is perfusion the greatest? In what part is ventilation the greatest? In what part does ventilation far exceed perfusion?perfusion = base (bottom of lung) - lots of gravity
ventilation = base
ventilation >>> perfusion = apex (higher ventilation ratio) ***richest oxygen concentration here
*any o2 in apex - stays there - not easily taken away from blood bc ratio of O2 and perfusion (less profused)
At what level of the brainstem may a transection occur that will have no effect on respiration?above the pons
What adrenal disorder is characterized by overproduction of androgens? of mineralocorticoids? of glucocorticoids?androgens = virulization
mineralocorticoids = Conn's
glucocorticoids = Cushings Syndrome
What is the primary motion of T11 and T12?flexion and extension
In what gender is dysplastic sponylolisthesis most common? What type of spondylolisthesis is it? When does the initial defect occur?females - lil girls
type I
at birth because congenital - symptomatic at 7, 8, 9
In what gender is dysplastic spondylolisthesis most common? What type of spondylolisthesis is it? When does the initial defect occur?Females
Type 1
Adolescense (7-8 yoa)
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