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Pathophysiology after midterm
just stuff after midterm
122
Nursing
Undergraduate 2
10/31/2011

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Term
Memories of events, experiences, information, facts are what kind of memory?
Definition
Declarative
Term
Declarative memory is processed and retrieved where?
Definition
Basal ganglia
Term
Your behaviors, skills, motor memory and actions are included in what type of memory?
Definition
Non-declarative
Term
Memories about how to do things, how to get things done and things you can do without alot of thought are part of declarative or non-declarative?
Definition
non-declarative
Term
non-declarative memories are processed where?
Definition
cerebellum
Term
dysmensia means?
Definition
memory is not normal
Term
What is anterograde amnesia?
Definition
Can't remember things that happened after accident or injury, such as they may not remember walking into the classroom and sitting down today, but they do remember things from long ago, such as where they were born.
Term
What is retrograde amnesia?
Definition
Cannot remember what happened previously. Can learn new skills but don't remember old things like who their parents are.
Term
If a person has both retrograde and anterograde amnesia it is called?
Definition
global amnesia
Term
What areas of the brain are impacted in an acute confusional state?
Definition
Reticular activating system
Thalamus
Basal ganglia
Term
Signs of acute confusional state?
Definition
attention deficits
difficulty understanding thoughts or actions
delirium
confusion
signs come on all of a sudden
Term
What can cause an acute confusional state?
Definition
drugs such as cocaine, sedatives, alcohol/drug withdrawl
metabolic disorders
diseases affecting the NS
Term
What is cerebral hemodynamics?
Definition
Blood flow and oxygen supply to the brain
Term
What is cerebral perfusion pressure and its equation?
Definition
Pressure needed to get blood to brain cells.
CPP = MAP - ICP
Term
What vessels are involved with cerebral blood flow?
Definition
Carotids
Vertebral arteries
Circle of Willis
Term
When the levels of CO2 and H+ go up, what happens to the blood amounts in the brain and the blood vessels?
Definition
Blood amount goes up and blood vessels dialate
Term
What is the consequence on cerebral blood flow when O2 in the brain is decreasing?
Definition
Blood vessels dialate
Term
What is the purpose of astroglia in cerebral blood flow?
Definition
Contribute substances so that when O2 goes down BVs are stimulated to dialate
Term
How does the brain compensate for changes in amount of blood flow?
Definition
Through amount of CSF and brain tissue
Term
The amount of CSF being absorbed through the arachnoid villi increases in what stage of compensation?
Definition
Stage 1
Term
What happens in stage 2 of compensation?
Definition
Arterioles constrict because of build up in the brain, this causes hypoxia
& hypercapnea (inc. CO2)
Term
Loss of autoregulation, further hypoxia and acidosis is seen in what stage of compensation?
Definition
Stage 3
Term
When does cerebral blood flow finally cease in compensation?
Definition
when Intracranial pressure equals Mean systolic arterial pressure
(ICP = MAP)
Term
What are the serious consequences of stage 4 compensation?
Definition
Hemorrhage, hernia, hydrocephalus, brain tissue pushing into all spaces including tentorium(?), brain stem and foremen magnum
Term
What are the first clinical signs of compensation/altered cerebral blood flow?
Definition
Confusion
Drowsy
Pupils change
Respirations altered
Term
Cheyne-Stokes breathing, bradycardia, Central Neurogenic Hyperventilation & Increased pulse pressure (SBP-DBP)manifest in what stage?
Definition
Stage 2
Term
What could increased ICP be a sign of in the brain, CSF and blood?
Definition
Neoplasia, hydrocephalus, hematoma
Term
What type of supratentorial herniation compresses CN III? and what are the signs of the compression?
Definition
Uncal
Signs are sluggish pupil response, which starts ipsilaterally and then contralaterally as CN serving the other side also gets compressed
Term
Uncal supratentorial herniation puts pressure on what parts of the brain?
Definition
brainstem and midbrain,
Term
What can be compressed in Cingulate gyrus
supratentorial herniation?
Definition
frontal lobe and vessels
Term
What type of supratentorial herniation is shown by the downward shift of diencephalon & going from conscious to unconscious quickly?
Definition
Central
Term
Put the following in order from the inside of a muscle to the outside:
epimysium, fascicle, Muscle fiber cell, perimysium, endomysium
Definition
Muscle fiber cell, endomysium, fascicle, perimysium, epimysium
Term
Fascia
Definition
Connective tissue surrounding each muscle
Term
epimysium
Definition
Outermost surface of muscles
Connective tissue
Tapers to form tendons
Fascia is around it
Term
Tendon
Definition
Connects muscle to bone
Extension of the connective tissue
Term
Perimysium
Definition
Divides fibers into fascicles
Surrounds different muscle fibers (fascicle)
Term
Fasicles
Definition
Groups of muscle fibers
Surrounded by perimysium
Term
endomysium
Definition
Surrounds individual muscle fibers
Term
Motor unit
Definition
Muscle + nerve
An axon (motor nerve) comes out of the anterior horn of the spinal column
the axon connects with a muscle fiber
axon + muscle fiber = neuromuscular junction
Term
innervation ratio
Definition
motor units per muscle
Lower innervation ratios allow for precision of movement
high innervation ratio prevents fatigue
Term
Muscle spindle fibers are types of:
Definition
Afferent nerves
Mechanoreceptors
intrafusal muscle fibers
Term
What to muscle spindle fibers respond to?
Definition
length & change of length
Term
What message does muscle spindle fibers send and why?
Definition
They send a message of how extended a muscle is up the spinal cord
it keeps us from overstretching a muscle
Term
Characteristics of actin
Definition
• Light bands
• Thin fiber
• I bands
Term
Characteristics of myosin
Definition
Dark bands
Thicker
A bands
Term
What is a sarcomere?
Definition
Z-disc to Z-disc
1 muscle cell
Term
How does muscle contraction happen with actin, myosin, troponin and tropomyosin?
Definition
Actin in surrounded by tropomyosin with some troponin stuck on
Underneath the troponin is an active site the myosin's head can attach to
When the myosin head attaches to the active site, it pulls actin filament forward towards the center of the sarcomere
this pulling toward the center causes contraction
Term
Sarcoplasmic reticulum
Definition
very specialized E.R. that contains lots of calcium
part of sarcotubular system and muscle fibers
Term
T. tubules
Definition
An extension of muscle cell membrane.
Allow action potential to move up in muscle fibers.
Part of sacrotubular system in muscle fibers
Term
Where does stimulation for a muscle contraction come from? (type of nerve and location)
Definition
Efferent nerve of the anterior horn of the spinal cord
Term
What substance does the efferent nerve in the anterior horn of the spinal cord release to generate action potentials?
Definition
Acetylcholine
Term
What substance does the efferent nerve in the anterior horn of the spinal cord release to generate action potentials?
Definition
Acetylcholine
Term
Where does stimulation for a muscle contraction come from? (type of nerve and location)
Definition
Efferent nerve of the anterior horn of the spinal cord
Term
What happens after a muscle fiber action potential is generated?
Definition
Action potential runs through T Tubules & T Tubules are depolarized
Term
What happens after depolarization of T Tubules?
Definition
Calcium is released from the S.R. & Calcium binds with troponin
Term
What happens when calcium binds with troponin?
Definition
The active site on the actin is uncovered
Allows myosin head to bind to actin & pull actin forward
Term
What is coupling?
Definition
Calcium is released from the S.R. and allows muscles to contract
Term
What substances are released during contraction?
Definition
Acetylcholine, sodium, calcium
Term
What is the process of calcium during contraction?
Definition
Ca+ is released from the S.R.
Ca+ allows actin and myosin filaments to slide past each other
Ca+ is removed & pumped back into the S.R.
Term
What causes rigor mortis?
Definition
ATP is not available, myosin does not detach from actin head when contracted.
Term
What is isometric contraction?
Definition
Muscle held at constant length & the Load on the muscle is greater than the force the muscle can generate
Term
What are some examples of isometric contraction?
Definition
Push or pull an immovable object
Pushing up against a wall
Term
What are the two types of isotonic contraction?
Definition
eccentric & concentric
Term
In eccentric isotonic contraction tension ___ and muscle length ___?
Definition
In eccentric isotonic contraction tension increases and muscle length increases
Term
In concentric isotonic contraction tension ___ & muscle length ___?
Definition
In concentric isotonic tension increases & muscle length shortens.
Term
Characteristics of an agonist muscle
Definition
o Generate specific movement
o Provide normal range of motion
o Prime mover
Term
Characteristics of an antagonist
Definition
o Opposition to agonist
o Return body part to original position
Term
What is sacropenia?
Definition
o Decrease in muscle strength and bulk that happens with aging
Term
___ rupture more in younger people, but ___ rupture more in older people
Definition
Muscles rupture more in younger people, but tendons rupture more in older people
Term
Myoglobin is released from damaged muscle, urine turns red-brown, kidneys become damaged. What disease is this describing?
Definition
Rhabdomyolysis
Term
What are some causes of rhabdomyolysis?
Definition
Crush syndrome, compartment syndrome, snake bites, cocaine use, seizures, overuse of muscles (marathon runners)
Term
What disorder is characterized by Chronic widespread joint and muscle pain, fatigue, sleep disturbances but is absent of inflammation?
Definition
Fibromyalgia
Term
Who is at greatest risk for fibromyalgia?
Definition
Women 30-50, those who are depressed or anxious, with a low pain threshold
Term
4 major functions of bones?
Definition
Structure, mineral storage, hematopoeisis, protection
Term
Ligaments connect?
Definition
bones to bones
Term
tendons connect?
Definition
muscle to bone
Term
What substance gives bones tensile strength and makes them less brittle and more stretchable?
Definition
Collagen
Term
What are the main salts/minerals of bone?
Definition
Magnesium
Sodium
Potassium
Carbonate
***Calcium salts - hydroxyapetite
Term
What are the two types of lamellar bone?
Definition
Cancellous & compact
Term
Characteristics of cancellous bone
Definition
o Spongey
o Contains bone marrow
o High Tensile strength
o Light weight
Term
What is the name of the structure that allows blood vessels to run through bones?
Definition
Haversian canals
Term
Osteoblasts
Definition
Form bone based on shape and structure
Term
Osteocytes
Definition
Control what osteoblasts and osteoclasts do
Term
Osteoclasts
Definition
Dissolves boney matrix
Term
Epiphyseal areas
Definition
Bones actively grow from these areas until about 1 year after sexual maturity
Term
Immovable joints
Definition
synarthrosis
Term
Slightly movable joints
Definition
Amphiarthrosis
Term
freely movable joints
Definition
diarthrosis
Term
What kind of connective tissue is synarthroses made up of? and what parts of the body are they seen in?
Definition
Fibrous.
Skull & teeth where they hook into the jawbone
Term
Where would you see cartilaginous joints?
Definition
Intervertebral discs & symphysis pubis
Term
Example of a pivot or rotary joint movement
Definition
Atlas and axis of neck that allow you to nod your head “no”
Term
hinge joint movement
Definition
Elbow, knee
Term
Gliding joint movement
Definition
hand bones
Term
ball & socket joint movements
Definition
shoulder, hip
Term
Saddle joint movements
Definition
thumb
Term
Condyloid joint movement
Definition
Knuckles
Term
3 phases of bone remodeling
Definition
Activation
Resorption
Formation
Term
Stage 1 of non-REM sleep
Definition
• Transition between awake and asleep
Person doesn’t think they’re actually asleep
• Theta waves
• 5-10 minutes
Term
Stage 2 of non-REM sleep
Definition
• Rapid, rhythmic brain waves
• Body temperature decreases
• Heart rate decreases
• ≈ 20 minutes
Term
Stage 3 of non-REM sleep
Definition
• Delta waves
• Transition to deep sleep
Term
Stage 4 non-REM sleep
Definition
• Delta sleep
• Deep sleep
• Lasts ≈ 30 minutes
Parasomnias:
• Bed-wetting
• Sleep-walking
Term
When does REM sleep begin?
Definition
1-2 hours into sleep and then every 90 minutes
Term
Stage 5 - REM sleep
Definition
• Rapid eye movement
• Increased respirations
• Increased brain activity
• Dreaming – not sure why this happens
• Voluntary muscles inactive
Term
Myopia
Definition
Near sighted
Term
Hyperopia
Definition
Far sighted
Term
How do you corrected farsightedness?
Definition
Using a convex lens.
Term
Astigmatism
Definition
The cornea is wobbly, lens has to correct. Can co-exist with myopia and hyperopia.
Term
A man has sustained a contusion. He has changes in attention, memory, affect, and emotion. In which region of the brain is the contusion most likely located?
Definition
Frontal
Term
An older adult alcoholic man has fallen and is told he has a hematoma that is on the top of his brain. What type of hematoma is this?
Definition
Subdural
Term
Does edema occur in white or grey matter?
Definition
white
Term
Transtentorial
Definition
herniation goes through the tentorium
Term
supratentorial
Definition
above the tentorium, bad but not as horrendous unless there is enough pressure like a herniation of temporal lobe
Term
intratentorial
Definition
parts of cerebellum shift and go down into the spinal cord; putting pressure on the brainstem because it controls vital functions
Term
Which brain lobe takes information and interprets in the brain as to the particular sounds you hear?
Definition
temporal lobe
Term
WNT protein signals?
Definition
Bone formation, mass, remodeling, and healing of fractures
Term
Gout
Definition
-Disorder of uric acid metabolism (monosodium urate crystals deposited in soft tissues)

-Leads to joint destruction and renal damage
Term
Chemicals of depression
Definition
Decreased norepinephrine or serotonin
Term
Chemicals of bipolar
Definition
imbalance between acetylcholine (or cholinergic stimulation) and Epinephrine or norepinephrine (adrenergic stimulation)
Term
chemicals of the manic phase of bipolar
Definition
Increased norepinephrine and serotonin receptors
Term
Chemicals of anxiety
Definition
Dopamine and Serotonin
Term
vasogenic cerebral edema
Definition
-Capillary endothelium is more permeable

-Alterations in blood-brain barrier

-Proteins in intracellular spaces
Term
interstitial cerebral edema
Definition
-CSF into brain tissue

-Increased pressure in white matter

-Associated with hydrocephalus
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