1
Q
What nerve innervates the thenar eminence and can easily be injured?
A
Recurrent branch of median N
2
Q
Which nerve can be compressed while traveling under the flexor retinaculum (also called the transverse carpal ligament) aka carpal tunnel syndrome
A
Median nerve
3
Q
What are the three muscles that make up the thenar eminence?
What are the three muscles that make up the hypothenar eminence?
A
FPB (flexor pollicis brevis), APB (abductor pollicis brevis), and opponens pollicis
Flexor digiti minim brevisi, abductor digiti minimi, opponens digiti minimi
4
Q
What attaches to the extensor expansion?
A
Lumbricals
5
Q
The long tendons of __ and __ enter a common flexor sheath (called the ulnar bursa) beneath the flexor retinaculum. Each of their 4 tendons then enter its own separate synovial sheath, except for digit __, which is continuous with the ulnar bursa.
The long tendon of __ has a synovial sheath that is separate from the ulnar burssa
A
FDS (flexor digitorum superficialis) and FDP (Flexor digitorum profundus), 5
FPL (Flexor Pollicis longus)
6
Q
Flexion occurs primarily at the __ joint and what is a fracture called that involves flexion at the wrist?
Extension occurs primarily at the __ joint and what is a fracture called that involves extension at the wrist?
Abduction and Adduction occur mainly at the __ joint
The joint between the proximal carpal row (scaphoid and lunate) and the radius is the ___ joint.
The joint between the distal carpal row and proximal carpal row is the __ joint
The joint between the distal carpal bones and the metacarpal bones is the __ joint
Joints between carpal bones are called ___
A
Midcarpal joint, smiths fracture
Radiocarpal joint (*Note that radiocarpal joint is the same thing as wrist joints), Colle’s fracture
Midcarpal joint
Radiocarpal joint
Midcarpal joint
Carpometacarpal joint
Intercarpal joints
7
Q
In a __ fracture, the carpals of ones hands could be injured
On the other hand, in a __ fracture the radius and ulna could be injured
A
Smiths (Inward aka flexion)
Colles (Outward aka extension)
** COULD BE A TEST QUESTION
8
Q
What four ligaments strengthen the wrist joint?
A
Palmar radiocarpal, dorsal radiocarpal, radial collateral, and ulnar collateral ligaments
9
Q
What muscles allow flexion at the MP joints but extension at the IP joints?
A
Lumbricals
10
Q
Failure of formation for vertebra, failure of segmentation of vertebra, or a combination of both results in __
A
Congenital scoliosis (abnormal lateral curvature of spine)
11
Q
If cartilage overgrows and pushes the sternum posteriorly (inward), the disease is called __. If the cartilage pushes the sternum anteriorly (forward), it is called ___. If the sternum did not fuse in the midline, although it looks like the sternum is sucked inwards, this is actually a __ disease.
A
Pectus excavatum, Pectus carinatum, sternal cleft
12
Q
A patient was receiving an acupuncture. However, the puncture kept on going because the patient had a __, a whole in the sternum right above the heat, and this killed the patient.
A
Sternal foramen
13
Q
Positioning of limbs along the axis is due to the expression of __ genes.
Once those limbs are there, you want to specify whether you are a forelimb or hindlimb. __ is specific to forelimb and __ is specific to hindlim… Both also have TBX10 included
Now once all these are in place,you need the limbs to grow. ___ genes, expressed in ventral ectoderm induce the formation of the __
A
HOX
TBX5, TBX4
BMPs, AER (Apical Ectodermal Ridge)
14
Q
Types of reduction defects are when there is an arrest or failure of development. If a child were to have a limb that is completely missing, it’s called __, if they were to have part of a limb that stopped developing it is called __. If the hands and feet arise close to the trunk, it’s called __. If a limb is shortened it is called ___
A
Amelia, Meromelia, phocomelia, mesomelia
15
Q
Two important genes tell the limb bud exactly where the AER is suppose to go. __ is expressed in the dorsal part of the ectoderm and __ is expressed in the ventral part of the ectoderm.
A
Radical fringe, Engrailed-1
16
Q
In a developing limb bud, there are different zones that have their own specific roles. The two zones receive __ signals from AERs
Name them
1) Zone that simply continues to divide to give you the length that you want
2) Gives the instruction to lay out the pattern (ulna, radius etc.)
A
FGFs
1) Progress zone
2) ZPA (Zone of polarizing activity)
** If no FGFs then progress zone can’t allow the growth from proximal to distal
17
Q
The ZPA zone itself makes it own signals, which determine preaxial/potaxial growth. What signal is this?
*Note that preaxial/postaxial is the same thing as anterior/posterior
If to __ of this signal is sent out you can get an entire new limb**
A
SHH and Retinoic acid
much
18
Q
Match the things that create each axis
1) Ventral and Dorsal
2) Proximal and Distal
3) Anterior and Posterior (aka Preaxial and Postaxial)
A
1) AER
2) AER which sends signals (FGFs) to progress zone
3) SHH and Retinoic acid (which receive signals from ZPA which received signals from AER)
19
Q
Complete absence of a limb could be due to __ missing. However, multiple limbs is when you have multiple __
A
AER, AERs
20
Q
Polydactyly is what?
Syndactyly (webbing between fingers and toes) occurs from what?
What is brachydactyly?
A
Extra digits
Failure of programmed apoptosis
Short digits
21
Q
___ limb rotates 90 degrees laterally during growth and the __ limb rotates 90 degrees medially during growth
A
Upper, Lower
22
Q
What two muscles allow the power grip?
A
FDP and FPL
23
Q
The superficial branch off of the ulnar nerve innervates the skin, and what muscle not listed in the slides?
A
Palmaris Brevis
23
Q
Sirenomelia is also refered to as mermaid syndrome
Achondroplasia is also referred to as as dwarfism and affects the long bones
A
Just some stuff to look at
24
__ muscle is a type of striated muscle that is multinucleated, also these cells are very large (myotubes)
__ muscle is a type of striated muscle that is uninucleated and branched
Smooth muscle cells compared to striated muscle cells are ___ at contraction and ___nucleated
Skeletal muscle
Cardiac muscle
weaker, uni
25
The cardiac muscle fibers attach into the fibrous __
cardiac skeleton
26
Intercallated discs are found in which muscle? Also these discs are where all of the __ junctions are located to allow QUICK ionic communication between cells which leads to synchronous muscle contraction
Cardiac muscle
Gap
27
What muscle lines blood vessels and can help restrict the amount of blood going to a certain area by constricting
Smooth muscle
28
___ act as the sarcoplasmic reticulum (a specialized type of smooth ER that regulates the Ca2+ ion concentration in the cytoplasm of striated muscle cells) in smooth muscle
Caveolae
29
You can identify the axon by locating an absence of __ (where that does not exist, it is the start of the ___)
Nissl bodies (or nissl substance)
Axon hillock
30
Golgi type __ has a long axon and Golgi type __ has a short axon
1, 2
31
Motor neurons, pyramidal neurons, and purkinje cells are all __ neurons
Retinal neurons and olfactory neurons are __ neurons
Touch and pain sensory neurons are __ neurons
Multipolar
Bipolar
Unipolar (now called pseudounipolar)
32
__ neurium wraps around myelin and axons to form peripheral nerve fibers, __neurium wraps up fascicles and __neurium wraps up bundles of fascicles to make the peripheral nerve
Endo, Peri, Epi
33
Brain and spinal cord = __ and everything else is __
In the PNS you are myelinated by a __ cell
In the CNS you are myelinated by a __ cell
CNS, PNS
Schwan cell (new term is called Neurolemma)
Oligodendrocyte (also called oligodendroglia)
34
Which myelinated cell can myelinate multiple axons?
Oligodendrocytes (schwann cells can only do one)
35
Which cell makes white matter white in the brain and spinal cord?
Oligodendrocytes
**aka white matter is myelinated and gray matter is not myelinated
36
In redox reactions, the reducing-equivalent transfer involves the transfer of a __ AND a __, compared to electron only transfer which consists of electrons being transferred between two metal ions
Proton AND electron
37
The __ is always on the side of the reaction with the electrons
Oxidant
38
For the formation of ROS and RNS, oxygen is converted to __, which can be converted to __ by __.
This can then be broken down into water by __ of hydroxyl radical by __
If ___ of ROS occurs, excess oxidation can occur such as oxidation of lipids which destroys the cell's membrane and causes cell to commit apoptosis
Superoxide anion, hydrogen peroxide, SOD (superoxide dismutase)
Catalase, GSH peroxydase (glutathione peroxidase)
Overproduction
39
OxPhos aims to transfer electrons from NADH and FADH2 to __. It also establishes a proton gradient across the __ membrane and synthesizes __
O2, inner mitochondrial, ATP
40
Since ___ is a peripheral part of the respiratory chain, if the mitochondria's membrane becomes leaky then it can be easily released to the cytosol
Cytochrome - C (So you could measure this to analyze mitochondrial diseases since it's like a marker for the membrane well-being)
41
The electron flows from molecules with __ standard redox potential (E0') to that with the __ aka NADH to O2
Lowest, Highest
42
Name the ETC complexes affected with the disorder
1) MELAS
2) LHON
3) MERRF
4) Hypertrophic cardiomyopathy (excercise intolerance)
1) Complex 1 and 4
2) Complex 1 and 3
3) Complex 1 and 4
4) Complex 3 and 4
**All others are complex 1 and 4
43
Name the disorder associated with these symptoms
1) Degenerated optic nerve, continued loss of central vision and occurs in early adulthood
2) Muscles spasms, hearing loss, and dementia
3) Muscle weakness and pain, accumulation of lactic acid, vomiting, loss of appetite, seizures, stroke like episodes and occurs in infancy to early childhood
1) LHON
2) MERRF
3) MELAS
44
What are the two factors that constitute a proton-motive force (pmf) to drive ATP synthesis by Complex 5?
Ph gradient and membrane potential
45
Agents such as DNP (2,4-Dinitrophenol) can cause uncoupling, which causes a disruption of the __ and therefore leads to P and ADP being uncoupled. This causes __ to not be synthesized and protons entering the mitochondrial matrix since they aren't being converted to ATP and this causes an __ in the TCA cycle since no ATP is being produced
protein gradient, ATP, increase
46
The malate-Aspartate shuttle operates in the __ and helps NADH enter the ETC at __
The glycerophosphate shuttle operates in the __ and helps FADH2 donate its electrons to the ETC at __
Heart, liver, and kidney, Complex 1
Skeletal muscle and brain, CoQ
47
For bears to hibernate, they can activate __, which causes heat to be release by providing a pathway fro electrons to be leaked back into the matrix (the energy stored in the proton gradient is dissipated as heat rather than being used to produce ATP
** Note that aspirin is one of these
Uncoupling agents
48
1) Rotenone inhibits complex __, which prevents the electron transfer from the Fe-S centers to ubiquinone
2) Cyanide poisoning inhibits complex __, which prevents O2 reduction (the terminal step of electron transport) causing mitochondrial respiration and ATP production to stop
3) CO (carbon monoxide) and H2S (Hydrogen sulfide) inhibit complex __
4) Oligomycin inhibits complex __
5) Antimycin inhibits complex __
6) Malonate inhibits complex __
1) 1
2) 4
3) 4
4) 5
5) 3
6) 2
49
The chemiosmotic hypothesis states that most ATP synthesis comes from the __
Proton gradient
51
Making the membrane potential more positive is called __ and making it more negative is called __
Depolarization, Hyperpolarization
52
Lipophilic and non-polar substances such as steroids __ (will or will not) cross the plasma membrane
Hydrophilic and polar substances such as water __ (will or will not) cross the plasma membrane
Will
will not
53
Intracellular proteins can not leave the cell, and are stuck with a __ charge. Also, which two ions have some permeability to the cell membrane?
Negative
K+ and Cl-
54
The sodium potassium pump, an electrogenic pump, pushes __ potassium in and __ sodium out
2, 3
55
For neurons and muscle cells, what is the most important thing the sodium potassium pump does?
Creates a concentration gradient (more important than an electronegative gradient)
56
If you poison the sodium potassium pump, the cell will begin to __
Depolarize
57
After an action potential occurs, what re-establishes the resting membrane gradients?
Sodium potassium pump
58
The __ refractory period is during the depolarization phase and some of the repolarization phase and is when a second action potential CAN NOT be initiated
The __ refractory period is during the repolarization and hyperpolarization phase is when it's harder, but a second action potential can be initiated
Absolute (This is because either all sodium channels are open, or inactive)
Relative (This is because some of the sodium channels are closed and therefore can be activated again, but some are still inactive)
59
In a depolarization block, what stage is the cell stuck in?
Inactive stage
60
Unlike action potentials which are all or none, sub-threshold responses are __ aka they get larger with stronger stimuli
graded
61
__ is one type of communication where you can have one cell do pretty much the exact same thing as the other cell very quickly. This would be good to have in heart muscle, but not so much skeletal muscle.
Gap junctions
62
Extensive surface area and greater densities (for NT receptors) indicate which side of the cell?
What about high mitochondria, vesicles, and increased surface area?
Postsynpatic
Presynaptic
63
```
Name if chemical is a cholinergic, adrenergic (monoamine), excitatory amino acid, or inhibitory amino acid
1) Histamine
2) Glutamate
3) Acetylcholine
4) Dopamine
5) Gaba
6) Serotonin
7) Aspartate
8) Glycine
9) Norepinephrine
10 Epinephrine
```
1) MOA
2) Excitatory AA
3) Cholinergic
4) MOA
5) Inhibitory
6) MOA
7) Excitatory AA
8) Inhibitory
9) MOA
10) MOA
64
From an action potential, sodium travels down the length of the axon and eventually causes __ channels to open which fuses with a protein complex causing vesicles and membrane to fuse together
Calcium
65
What toxin cleaves the SNARE complex (which is the complex that helps vesicles bind to the membrane) at the neuromuscular junction (or end of the axon) and therefore blocks ACh release
What toxin has a similar affect, but acts in a retrograde fashion by traveling up the action?
```
Botulinium (leads to paralysis and complete weakness)
Tetanus toxin (lock jaw and contraction of muscles)
```
66
What drug can increase ACh levels?
Any drug that blocks AChE
67
Which ACh receptor is a g-protein coupled receptor?
Which is a ligand gated ion channel?
Also, which channel is fastest and which channel is found ONLY on skeletal muscle?
Muscarinic
Nicotinic
Nicotinic and nicotinic
68
Nicotinic ACh receptros are found on __, UNLIKE muscarinic which is found on smooth muscle like the GI track
Skeletal muscle
** AKA this is the only receptor found on skeletal muscle
69
Tetrodotoxin and local anesthetics are drugs that affect __ by inhibiting voltage gated Na+ channels
Nerve action potential (no conduction can travel along the length of the axon)
70
___ activate the receptor to signal as a direct result of binding to it and ___ bind to receptors but do not activate generation of a signal
Curare alkaloids is a __-gonist and compete with ACh at the synapse for nAChR, which causes a defect in __
Succinylcholine has the same end effect, but is a __-gonist and works by keeping the channels open longer since it takes longer to break it down, and therefore the channels can not become closed and are stuck in an open (aka the cell can not ___) state.
Agonists, antagonists
antagonist
depolarization (since ACh cant activate the receptor, which causes no sodium to go into the muscle cell, so you can't activate an action potential, and then you get paralysis)
Agonist, repolarize
71
Dantrolene affects __ and Tetrodotoxin affects muscle AND nerve __
Muscle contraction, action potential
72
Snyaptotagmin and synaptobrevin, a __-SNARE, is located on the vesicle and moves towards SNAP-25 and syntaxin, which are __-SNAREs to bind the vesicle to the membrane
What three SNAREs fuse to form membrane and vesicle fusion?
V-SNARE
T-SNAREs
Snyaptobrevin, syntaxin, and SNAP-25
** Synaptotagmin is involved in calcium censoring for vesicle fusion to initiate
73
__ filaments are stuck to the Z-disk
Thin (Actin)
74
ATP affects the __ molecule which causes the head groups to start moving the thin filaments and Z discs together.
Once mysoin is hydrolyzed, ADP and Pi are bound to the mysoin, however ___ is causing contraction to not start yet.
When calcium enters the cell, it binds to troponin complex C and this causes a conformation change which causes tropomyosin to stop blocking and mysoin and actin bind and the ADP dissociates with Pi to cause the powerstroke
Myosin
Tropomyosin
75
A ___ negative point mutation in the gene for the myosin chain can occur, which causes the heavy chain to be all messed up
dominant
76
Myosin exists as a hexameric protein composed of two myosin __ chain subunits and 4 light chain subunits.
The heavy chains dimerize through a coiled-coil interaction which provide the motor and filament-forming functions
Heavy
77
Name the gene involved and muscle fiber type
1) MyHC IIx/d
2) MyHC IIa
3) MyHC 1
** Remember that Type 1 muscles are slow twitch used for endurance such as a marathon and Type 2 muscle fibers (which can be either 2A or 2B) are fast twitched and used for quick exercise like a sprint
1) MYH1 - Type 2B
2) MYH2 - Type 2A
3) MYH7 - Type 1
78
The __ end is attached to the Z disc and is capped by the protein __
Also, what protein is responsible to make sure ALL filaments are 1mM in length?
Plus end (aka barbed end), CapZ
Nebulin
79
The troponin complex is made up of three small molecules that sit on tropomyosin. Name which part is associated with the function
1) Binds tropomyosin and positions the complex on the filament
2) Binds actin and inhibits myosin binding
3) Binds calcium and relieves inhibition
Which complex is found in both cardiac and skeletal muscle?
1) Troponin T
2) Troponin I
3) Troponin C
Troponin I
80
___ is a protein that attatches actin filaments to the Z-discs
__ is a protein that ties multiple myofibirls to one another
The point at which the Z-disc is anchored to the sarcolemma (plasma membrane of the muscle fiber) is called __
Actinin
Desmin
Costamere
81
The protein that allows for passive elasticity (during stretching) and acts as a molecular ruler for the entire sacromere is __
Titin
82
Hypocalcemic tetany occurs due to the fact that when the concentration of calcium falls below normal, the NS is more excitable and if the concentration is so low, spontaneous firing of action potentials or muscle contractions occur.
Just know the mechanism...
83
In smooth muscle contraction, ___ binds to calcium which binds to the myosin light-chain kinase. This complex allows for the "golf club looking head things" to become phosphorylated and active
Calmodulin
84
___ tethers the outer bundle of the myofibrils to the surface membrane (Sacrolemma)
Dystrophin
85
Duchenne muscular dystrophy is due to no detectable ___ and Becker muscular dystrophy is due to dystrophins of various size
Dystrophin
86
If there is a mutation in dystrophin, the __ rips and causes a huge intake of calclium and various other problems
Surface membrane
** so remember, dystrophin helps maintain the integrity of the of the surface membrane during the shear stress of muscle contraction
87
In skeletal muscle contraction, calcium binds to the Troponin __ complex and causes a change in the protein conformation. This change is transmitted to __, which allows myosin to bind to actin filaments and cause muscle contraction
c, tropomyosin
88
If someone were to have a heart attack or some heart muscle problem, troponin I and T could be used as markers due to their __ levels in the body
Increased
** Also note myoglobin and creatkine kinase (CK-MB and CK) would be increased
89
Glycogen is broken down into glucose when muscles need to to produce energy. This occurs by calcium induced activation of glycogen ___ which breaks down glycogen into glucose 1-phosphate and then glucose-6 phosphate (in muscle cells) and then metabolizes the glucose to CO2 via TCA cycle to generate ATP
phosphorylase kinase
90
GSD __ also called McArdle disease is an autosomal recessive disorder marked by a deficiency in muscle ____ **(the rate limiting enzyme of glycogenolysis). Since this is absent, glycogen can not be degraded into glucose 1-phosphate and patients have muscle fatigue, cramping, and muscle breakdown marked by increased ___ in urine
5 (V), glycogen phosphorylase, myoglobin
91
Glycogen is broken down by the activation of glycogen phosphorylase kinase (also called phosphorylase kinase or PK or PhK.. all the same thing) by ___. Then, active phosphorylase kinase goes on to activate glycogen phosphorylase by increasing __ levels. Then glycogen phosphorylase produces glucose-1 P and then glucose-6 P which turns into pyruvate via ___ and then CO2 and lactate to produce ATP
Calcium, AMP, glycolysis
92
Dantrolene can be given to patients as a muscle relaxant to prevent the excess mobilization of __ that can occur when patients with mutations to the ryanodine receptor (which is found in skeletal muscle located on the sarcoplasmic reticulum) are give anesthetics. If dantrolene was not given, calcium would continue to be reabsorbed and this requires a large expenditure of ATP
In other words, Dantrolene inhibits calcium release from the ___
Calcium
sarcoplasmic reticulum
93
When a NT diffuses into the synaptic cleft, there are 3 ways that the NT action can be limited. Name an example for each way
1) Natural degradation
2) Enzymatic destruction
3) Re-uptake
Also, the NT travels across the cleft by ____
1) NO
2) AChE
3) Epinephrine or norepinephrine
Diffusion
94
If the NT (stimulatory) has opened a sodium or calcium channel at the postsynaptic membrane (+ ions), ___ occurs and this is called a ___
If the NT (inhibitory like GABA or glycine) has opened a chloride channel at the postsynaptic membrane (-ions), ___ occurs and this is called a __
depolarization, Excitatory post-synaptic potential (EPSP)
Hyperpolarization, IPSP
95
Because IPSPs and EPSPs are graded, they can add together and this is called __.
___ summation has simultaneous stimulation from several presynaptic neurons and ___ (can or can not??) have both IPSPS and EPSPs.
__ summation has high frequency stimulation by ONE presynaptic neuron and __ (can or can not??) have both IPSPs and EPSPs
summation,
Spatial, can
Temporal, can not
96
The ___ receptor is on the T-tubule membrane and ___ receptor on the SR membrane
DHP (Dihydropyridine)
Ryanodine
97
Depolarization of __ results in the release of calcium from the SR membrane
T-tubules
98
Binding of __ to the myosin head must occur for myosin and actin to dissociate
ATP
99
When ATP is hydrolyzed to ADP and Pi, the ADP is recycled and meets up with ___ which then donates one of its phosphates to ADP to make more ATP
CrP (creatine phosphate)
100
3 sources can be used to create ATP for muscle contraction. CrP, Aerobic, and Anaerobic. Name which one is associated with what
1) Occurs at the mitochondria
2) Occurs at the myofibril
3) Occurs at the cytosol
4) ATP production is 1:1
5) 2 ATPs are produced
6) 38+ ATP is produced
7) Used during intense activity
8) Used at rest
9) Used during exercise
1) Aerobic
2) CrP
3) Anaerobic
4) CrP
5) Anaerobic
6) Aerobic
7) Anaerobic
8) Aerobic
9) CrP
101
If the muscle is stretched out to much, the contraction strength is __. However it the muscle is short already, then contraction strength is __
Therefore the number of myosin and actin filaments is __ proportional to strength of muscle contraction
Weakened for both
directly
** In better terms, force is directly proportional to the number of cross-bridge heads
102
___ contractions are used to overcome gravity aka they have an increase in tension/force but do not change length
__ contractions means you have the same force but you get a change in the length of the muscle
Isometric (like when you push your hands together )
Isotonic (when you see motion aka move...)
103
When you squeeze your hands together to perform an isometric contraction (no shortening of muscle) you still see some bulging in your biceps... This isn't due to muscle contraction however, it is due to ___ which are tendons and other tissues in series with the muscle. They are __ by the contraction and essentially are the slack the muscle contraction takes up
Series elastic elements, stretched
104
In order to contract a muscle you must first pick up the slack of the muscle before it begins to stretch. The slack is due to the ___ which is a verrrrrry slight isotonic contraction. Next you must generate the force to pick up the object so this contraction is a __ contraction. Finally a __ contraction occurs to lift the load
series elastic element, isometric, isotonic
105
At ___ (short or long?) lengths of muscle, you do not have any Passive tension. However once the muscle length increases you start to get some tension by the tendons and membranes and this is passive tension (the rubber band effect)
__ tension is what the cross bridges do
So in other words, when the muscle is at the correct length, active tension is ___ (maximal or minimal?) because the cross bridges are maximal. If you make it to short or to long, the cross bridges decline so then active tension declines as well.
Short
Active
maximal
** Just note total tension is sum of passive and active tension
106
In a __load, the load affects the muscles before the beginning of the contraction such as carrying around a briefcase
In a __load, the load does not affect the muscle until contraction begins such as having your briefcase resting on a table and about to pick it up
*** In other words, if the muscle is stretched by the weight prior to the beginning of contraction it is __load, if not it is ___load
Pre
After
Pre
After
107
In a preload, the muscle is already stretched by the load before beginning of the contraction, so this leads to a __ contraction force
weaker (since it is stretched, less myosin/actin overlap and less cross bridge interaction)
108
One disease that affects nAChRs are myathenia gravis which causes a decrease in action potentials since this disease destroys the receptors. What could be used to inhibit it?
AChE inhibitors because that increases ACh in the synapse
109
What drug causes muscle fasciculations (muscle twitch)
Succinylcholine
110
A ___blockade prevents access of ACh to its receptor (AKA it competes with it) and blocks depolarization by keeping the receptor from opening
A __ blockade results from excess depolarizing agonist by keeping the receptor open and prevents re-polarization
Nondepolarizing (like d-tubocurarine and curare alkaloids)
Depolarizing (like succinylcholine)
111
Dantrolene can be used to counteract ___ induced by general anesthesia in genetically susceptible patients. Susceptibility is enhanced by mutations in ryanodine receptors (RYR1), which causes an increase in the reabsorption of __ and therefore ATP is used up which produces heat
Furthermore, if left untreated what is the consequence?
malignant hyperthermia, calcium
** some symptoms are increased CO2 production, acidosis, and ATP depletion
Rhabdomyolysis aka kidney failure
112
On x-rays, air shows up ___
Fat shows up ___ and water/blood/pus shows up ___
Bones show up as ___
Metal or some foreign substance shows up as ___
Black
Dark gray, light gray
white
much whiter
113
An initial exam of choice in patients with trauma, foreign bodies, or pain-acute/chronic is ___
To assess for joint fluids, administer steroids, look at rotator cuff muscles or the **achilles tendon** you can use ___
What is great to look at bone fractures?
What is best for soft tissue imaging (muscular, ligamentous, or tendinous) and has no radiation?
What is used for real time ** labral pathology (acetabular) **or arthrography (looking at a joint space)?
What is used for metastases?
radiographs
ultrasonography
CT scans (Can give you axial acquisition)
MRI
Fluoroscopy
Nuclear medicine
114
BBQ*
____ contracture is a disease if the palmar fascia that results in the shortening and thickening of the fascia to pull the __ digits into partial flexion. It also tends to be hereditary
Dupuytren, 4th and 5th
115
BBQ*
Infections in the digital synovial sheaths can commonly occur and cause inflammation of the tendon and sheath. This can become a larger problem when the infection occurs in the __ digit because this digit is continuous with the ___ bursa and therefore the infection can spread into the carpal tunnel and then forearm
5th, ulnar
116
BBQ*
In carpal tunnel syndrome, the median nerve can be messed up due to compression and this results in losing the ability to oppose the thumb due to __ and __ muscles that are innervated by the recurrent branch of the median nerve being affected.
** However, sensation in the central palm does not become defective since the palmar cutaneous branch of the median nerve splits before the carpal tunnel
Abductor pollicis brevis and opponens pollicis (flexor pollicis brevis is also innervated by the recurrent branch of the median nerve, but since it is involved in flexion it doesnt matter for this case if it is not working or not)
117
BBQ*
Handlebar neuropathy can occur in people who ride bikes for extended periods of time. This compresses the guyon tunnel which has __ artery and nerve running through it which leads to medial side of hand sensory loss
Ulnar nerve and artery
118
The ___ bone does not participate in the wrist joint
Ulna
119
Metacarpophalangeal joints are a type of synovial joint that permit movement in __ planes. THe interphalangeal joints are a hinge joint that permit movement in __ planes.
The carpometacarpal and intermetacarpal joints are __ joints, except for the carpometacarpal joint of the thumb which is a __ joint
2 (flexion/extension and abduction/adduction), 1(flexion/extension)
plane, saddle
120
For CT densities, the Hounsfield unit is set to middle gray and numbers __ the width are black and numebrs __ the width are white
A __ width is used for bones and a __ width is used for soft tissue
Below, above
Wide, Narrow
Msk
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