Ear External- Auricle and external acoustic meatus * tympanic membrane* Middle- tympanic cavity and auditory ossicles (malleus, incus, stapes) Stapedius and tensor tympanic muscle, intervated by CN 7 *oval window* Inner Ear- Vestibococular organs, bony/osseous labyrinth, perilymph (cochlea, vestibule [ membranous labyrinth- endolympth, ulticle and saccula- linear, dolls eye] semicicrcular canals [ angular, eye movement in the opposite direct as head movement]) innervated by CN 8 Heart- Tricuspid- AV valve Pulmonary valve- semi-lunar Mitral- AV valve, biscuspid Aortic- S and I VC- R Atrium- pectinate muscle Right Ventricle- less likely to cause pulmonary adema- Pulm A 4 Pulm Veins- Left atrium- base, smooth inside Left ventricle- thickest- aorta SA node (pacemaker in RA) to AV node (delay) to Bundle of His to Purkinji fibers Liver- On the right of the body, two lobes (R2/L1), separated by the falciform (round/ umbilical cord reminant) and coronary ligament Kupffer cells- phagocytic, stores BEAK (12) Portal Triad- HA, PV, Biliary duct Spleen- upper left side of the ab, 9th-11th rib, nodular within a BV (modified tunica adventia) central A. White pulp- lymphocytes initiated immune response. Red pulp- outside white pulp, has splenic cords, blood is filtered here before reentering circulation. Splenic V foes to inferior VC Pancrease- in front of left kidney Plasma Membrane 7-10 nm thick, amphipathic, polar heads, nonpolar (hydrophobic tails) Unicellular- one nuclei, most cells Binuclear- Cardiac muscles, hepatocytes, urinary epith Multicellular- skeletal muscle, osteroclasts Anuclear- RBC Ribosome- site of protein synthesis, no lipid bilayer, cytoplasmic basophilia, nissel substance, free float (cell growth) and bound (make proteins for export, rER) sER- detoxify drugs and make steroids, muscle cells Sarcoplasmic renticulum (store Ca) Mitochondria- Own DNA, resp center, maternial inher, Krebs in Matrix, LHON Microfilaments Microvilli (actin) absorb, SI, epididymis Microtubules Cilia & flagella (tubulin), movement, trachea and resp tract, fallopian tubes, sperm cells Epithelium- Simple Squamous- Diffusion, alveolar, corneal endo, loop of Henle, Bowmans, vasc endo Simple cuboidal- Secrete, PCT/DCT/CD, thyroid, salvary glands Simple columnar- Absorb, colon, GI (except esophagus) Pseudostratified columnar ciliated- Resp Stratified Squamous NK- cornea epith, conj, esophagus, vagina Stratified squamous K- (made by golgi, rER and rib- karolysis) thick skin Stratified cuboidal- 2 layers, large ducts Stratified columnar- 2 layers, large ducts, anus Transitional epithelium- 3-7 layers in bladder Communication or gap juctions- thur channels, connexons, allow ions to flow, cardia and neurous tissue, ZO- very tight, like a belt, lipids fuse, B/A barrier, Schlemms canal, iris vessels, NPCE ZA- structural support, interweave fibers use tonofilaments and mucoproteins MA (desm)- spot weld for reienforcement Hemi- connects cell to BM Endocrine *NO ducts*, invaginations in epith: pancrease, thyroid, adrenal, pit Exocrine- use ducts based on # cells- uni (goblet) Shape- simple (LI, sebaceous gland, Brunners) vs compound (cardia region of stomach, salivary, pancrease) Mechanism- holocrine- secrete whole cell (sebaceous, Zeiss) apocrine- just a piece in a PM (sweat, Moll, odor) and merocrine- exocytose out (temp regulating, salivary, pancrease) Salvary glands- Parotid- less mucus, drain lateral orbit, largest Submandibular- more mucus drain medial orbit Sublingual- most mucus, smallest CT- all from Mesenchyme- tendons, ligaments, muscle, cartilage, bone, blood, fat Loose (more cells) Dense (less cells) elastic, reticular Fibroblasts, Mast cells, Plasma cells, Macrophages, pericytes, endothelial Collagen- Most abundant protein in body, 8 types, 1/3 glycine, chain of 3 disulfide bonds formed extracellularly, need Vit C (Scurvy), fibrous- water insoluable *osteogenesis Imperfecta G replaces by A, blue sclera* Elastic fibers, reticular GAGs- keratin sulfate (66) chondro sulfate (33) hyaluronic acid, heparine sulfate Diasccharids, AA, uronic acid Blood- RBC- 45%, Plasma 55%, WBC 1% Plasma 55%- water, albumin RBC 45%- biconcave, 280 hemoglobin (2 alpha and 2 beta chains, with Fe, binds 4 oxygen when relaxed) located on WBC 1%- gran- BEN Agran- M, L Basophils- gran, <1%, anaphylaxis, like mast cells, bilob Eosinophils- gran 1-6%, phag, parasite and stop allergic rxn, bilob Neutrophils- gran 50-70%, phag, nonspec single immunity, pus, multlob Monocytes (macrophages in tissue) 2-10%, largest 20um, phagocytic, APC Lymphocytes (T and B) 20-40%, specific, fight viral T- cell mediated response, Helper T (CD4, Class 2), Cytotoxic (CD8, Class 1), suppressor T, does type IV reactions, Natural Killer cells- tumor fighters, don’t need APC B- humoral immunity, plasma cell makes Ab Platelets <1%, smallest 3um, anulcear, megokeryocytes, used in the clotting pathway Clotting factor IX converts Prothrombin to Thrombin and then Thrombin turns Fibrinogen (in blood stream) to Fibrin Blood cells formed in Bone Marrow by Hemopoiesis from stem cells Woven bone- primary immature, fractures Lamellar bone- secondary, mature Osteocytes (no division), osteoblasts (product matrix) osteoclasts (remodeling, multinucleates) Haversian system- rings of lamella, osteons, canaliculi within, volkman canal, lots of gap junctions Types of ossification: Intramembranous ossification- flat bones, no cartilage precursor, apposition growth, widen Endochrondrial ossification- long bones, begins as cartilage, appositional and interstitial growth, widen and lenghten Cartilage- type II cartilage, chondrosulfate GAG Chondrogenic cells- chondroblasts- chondrocytes (can divide) Types: Hyaline- fetal, type II Elastic- Type II Fibrocartilage- interveterbal disks, type I and hyaline- No periochonrium Types of Growth- Appositional- chondrogenic cells add to edges, widen Insterstitial- chondrocytes undergo mitosis and increase from within Fat- Unilocular and multilocular Muscle- mesoderm Z- M to M A- Actin and Myosin I- only Actin (double helix) H- only myosin When contract, only A stays same, I shrinks Skeletal Muscle- voluntary, striated, multinucleated, t-tubules at A/I jxn, when depolized Ca released from SR, tropomysin has myosin binding site, actin binding site and Ca binding site. When Ca binds, shift exposes Myosin binding site, and myosin binds actin, thin over thick. Cardiac muscle- binucleated, striated, intercalated disks, gap jxns, purkinji used for conduction not contraction Smooth muscle- nonstraied, involuntary, central nuclei, use calumodule instead of tropomysin, when Ca binds get MLPK and then pho to get cross bridges. Substained contractions. Nervous tissue- all from ectoderm Myelin- oligodendrocytes and schwann cells, nodes of Ranvier, salutatory conduction Epidermis- Melanocytes (tanning increases melanosome) Malignant melanoma eye to liver, from breast or lung Layers corneum (ZO) lucidum (thick) Spinosum (desm) and basal (mitotic) *Squamous cell carcinoma is the most common metastatic tumor of eyelid* *Basal cell carcinoma is the most common malignant tumor of the eye* Dermis- Pars papillaris, Par Reticularis (cutaneous and suprapillary plexus), hypodermis (cutaneous glands, receptors- open (RUffini/merkle, nocioreceptors) and encapsuled (panician) Blood Vessel- Endothelium- Simple Squ (expect in lymphnods where cuboidal) Tunica Intima- more prominent in Arteries, elastic fibers, *atherosclerosis* Tunica Media- collagen 3, middle SM in circular, thickest in arteries, thin in veins, not in capillaries Tunica Adventia- outer, mainly in veins Vaso Vasorum- blood vessels in the adventia supply outer layer, DM effects Capillaries- single layer of simp squam and thin adventia Continuous- ZO in iris and retina, lungs, muscle, nervous tissue Fenestrated- Ciliary body, Choroid, kidneys, GI Sinusoidal- liver, spleen, bone marrow Lymph- MALT- Mucous associated lymphatic tissue Peyers Patches in SI Thymus- decreases after puberty, reticular cells form Hassal corpuscles as they degenerate. Respiratory system- Conduction- terminal bronchi and up Respiratory- respiratory bronchi and down Nasal cavity- Pharyn- Laryna (Simple Squamous) Trachea (Trachealis muscle- SM) Bronchi (1 R3L2, 2 R10L8) Broncho- pulmonary Segment (smallest independent unit of the lung)- Respiratory bronchioles (no hyaline cartlage) – terminal bronchioles Respiratory Bronchioles- alveolar ducts- sacs- alveoli 300 million (type 1 gas exchange and type 2 surfactant, release surface tension) Digestive system- Lumen Mucosa- epithelium, lamina propria, muscularis mucosa (inner circ, outer long) Submucosa- glands- Brunners in SI (neutralize HCL, controlled by Meissner’s plexus) Muscular Externa- inner circular and outer long, Auerbauch’s plexus- Hirschsprung’s disease Adventia Stomach- 1- 1.5 Cardiac- branched mucus Fundus- straight, HCl (parietal) pepsinogen (chief) Body- straight, HCl (parietal) pepsinogen (chief) Phyloric- branched, mucus SI- microvilli, Crypts of Lieberkuhn, enterocytes, lamina propria (peyers patches) Duodenum- sphincter of Oddi Jejunum Ileum- No Brunners Large intestines- Water absorption, no villi, Cecum (lower right) Appendix Asending Transverse Descending Sigmoid Rectum Thyroid gland- Follicular cell- simple cuboidal cells Colloid- modified to mature hormones T3 T4 Parafollicular Cells- produce calcitonin Parathyroid gland- 4 on back on thyroid Chief- PTH Oxyphils- ? Adrenal gland- on top of kidney Medulla- NCC Chromaffin- ep and NE Cortex- Diencephalon ZG- Aldosteron ZF- Corticol ZR- Adregens Pituitary Glands Anterior- edtodermal pouch, Rathke’s Acidophiles GH, Prolactin Basophiles- FSH, LH, TSH, ACTH, Chromophobes- ? Posterior- diencephalons Herring Bodies, Pituicytes Stores- Oxytoxin, ADH NEUROSCIENCE- Resting potential- -60 mV K higher inside GABA, glycine- inhibitor Glutamate- excitory Gastrulation- ectoderm (CNS) mesoderm (notochord) endoderm Neurulation Neural fold- groove- tube Ependymal- innermost layer Mantle- alar- sensory, basal- motor Marginal- outer (white) Procephalon- Telecephalon- cerebral (lateral) Diencephalon- Thalamus, eye (third- interventricular Monroe) Midbrain- Mesencephalon- Rhombinceph- Metencephalon- Pons (4th b/w Sylvian aqueduct, CSF in chorid plexus. Myencephalon- Medulla Gray Matter- cell bodies in butterfly region of center White matter- myelinated tracts Spinal nerves 31 Vertebral 33 8 Cervial 7 12 Thoratic 12 5 Lumbar 5 5 Sacral 5 1 Cocci 4 Pyramidal tract- Descending Precentral motor gyrus internal capsule in forbrain cerebral peduncles, pons, form medulla pyramids (break away of the Corticobulbar tract to CN) crosses in the pyr decussation in caudal medulla 85% cross Lateral corticospinal 15% uncrossed Anterior corticospinal Anterolateral/ Spinothalamic pathway- ascending pain and temp Nerves synapse in the substantia gelatinosa cross b/c lateral spinothalamic VPLT Trigeminothalamic- Ascending pain and temp from face Trigeminal ganglia to BS at level of the pons medulla (Spinal tract of CN V) syn in trigeminal complex cross in the medulla and remain contralateral to VPMT Medial Leminiscus- Ascending, touch, pressure, vibration. Upper body to cuneate (lateral) and lower body from gracilis (medial) cervical lumbar regions to nuclei in caudal medulla cross midline in medulla Internal arcuate fibers contra to VPLT. Visual Pathway- Fibers nasal cross in chiasm LGN- lateral upper VF, medial lower VF, parvo dorsal 3-6, mango ventral 1-2, C I I C I C (isp 2, 3, 5; contra 1, 4, 6) meyers loop, temporal superior VF (pie in sky) , parietal lobe- inferior VF(pie on the floor)) V1, Area 17 (binocularity) Calcarine Fissure top- cuneus (inferior VF) bottom lingual (superior VF), receptive fields: simple elongated stimulus in certain orientation make up complex cells specific to certain direction (also hypercomplex deal with length) Higher cortical areas (V2, V3, V4 Area 18, 19 Anopsias- large VF defect Scotoma- smaller VF defect Pupillary Pathways- Light response- Tectotegmentom nucleus, Near response- FEF 1. Fibers from temporal brain go to ips pretectum, nasal fibers to contra pretectum Edinger- Westphal Necleus ciliary ganglia iris sphincter and ciliary body (Para) 2. Fibers to reticular formation in midbrain lateral horn of the spinal cord iris dilator. Blood supply to the Brain- Mainly from Vertebral and Internal Carotid (b/c anterior and middle) Circle of Willis BIOCHEMISTRY Protein (4 cal/g)- AA covalently bound by peptide bounds, amino group and carboxyl group, made in ribosome Amino Acid- 20 types, coded by mRNA, degenerative Primary (sequence) Secondary (beta sheets, helix) Tertiary (globular (water sol) and fibrous (insoluable) 3D) quandary (subunits hemoglobin, insulin) Antibodies IgM- made first, blood IgA- saliva, tears, breast milk IgD- ? IgE- allergic IgG- Girth, most, cross placenta Energenonic- require energy (so these reactions need to be coupled with other exergoinc (give off energy) in order to proceed. Want: Exergonic, - G - H Enthalph (give off heat) + Entropy (disorder) Oxidative- reduction rxn- transfer of e- Greater difference in redox potentions reaction favorable NADH, NADPH and FAHD (coenzymes) are reducing agents, RED: Reducers are E- Donors. Give up electrons in CAC pH= - log (H+) Ka= measure of acid strength, high Ka= strong acid, wants to give up H+ pKa is inverse of Ka pKa= - log (Ka) Henderson Hasselbalch pH= pKa + log (A-/HA) Michaelis-Menten Equation= Vo= V max (s) / Km + (s) Km is substrate concentration at ½ Vmax A large Km means low affinity, if the substrate has a high affinity (more tightly bound), you do not need a lot of substrate, thus a low Km. Lineweaver Burke Plot m=Km/Vmax, linear MM, Allosterism- binding changes things + or – Competetive inhibition- bind and prevents substate from binding, get no change in Vmax, increase in Km (need more substrate) , crossed Non-Competetive inhibitor- bind separate site, no effect on affinity, no change in Km (don’t need more), but Vmax is lowered, does Not cross Feedback Moderation- series of reaction that may effect later step. Carbohydrates- 4cal/g Monosaccharides- glucose, fructose, galactose Di- sucrose (G and F) Lactose (G and Gl) Maltose (G and G) Poly- 3 or more, starch, glycogen, GAG, proteoglycan Glycolysis- breakdown of glucose to 2 pyruvate 2 ATP and 2 NADH Located in cytoplasm Rate Limited step: Phos Fruc Kinase, - feedback on PFK, + NADH Glucose into cell (can’t cross lipid membrane) use GLUT 4 channels (don’t use ATP) No Oxygen b/c lactic acid Oxygen TCA in mitochondria Matrix, Acetyl CoA to Citrate (oxaloacetic acid), makes 6 NADH, 2 FADH, and 2 GTP these then go to the electron transport chain in the inner mit matrix for Oxidative Phosphorylation (protons move from inside to outside, O2 is final e- receptor, makes 30 ATP. Pentose Phosphate Shunt- in cytosol, make NADPH used for syn of nucleotides, fatty acid, reduce glutathione and steroids. Gluconeogenesis- in liver and kidneys (not in muscle), make glucose from proteins, sugars, lactose, pyruvate, AA, glycerol. (NOT from FAT!) increased by glucagon Glycogenesis- in muscles and liver, storage of glucose as glycogen (b/c can’t store glucose b/c osmotic P), Glucose is stored everywhere in body, but mostly in the liver, increased by insulin, inhibited by stress hormones Glycogenolysis- muscle and liver, breakdown of glycogen into glucose, increased by glucagons. Brain uses glucose but can use ketone bodies (NOT FAT) Lipids (9 cal/g) - Non polar, nonionized, insul in water. Fatty acids are required in diet Shorter are usually liquid, longer are solid Saturated are usually solid (all single bonds) Unsaturated are usually liquid (double bonds- lower melting point) Triglyceride- 3 FA and glycerol Phospholipids- polar head (electrostatic and H bond), non polar tail (hydrophobic and Van der walls) Fluid Mosaic , Sphingomyelins- type of phospholipids in nerve cells, myelin sheath Isoprenoids- lipids in plants animals and bacteria Cholesterol- precursor for steroids and major structural comp on the membrane. Made in the cytosol from Acetyl CoA, uses NADPH, rate limiting step is HMG-CoA reductase (blocked by –statins) Lipid Digestion- bile salts emulsify, pancrease lipase, chylomicrons, lipoprotein lipase into liver broken down into FA and Trig (insol) VLDL leave and recognized by adipose tissue LDL HDL- healthy, transfere and scav of free chol, returns it to liver FA metabolism- Beta Oxidation- bkdw of lipids- Done in mitochondria FA Acetyl CoA and generate NADH and FADH Move fatty acid in the blood, Albumin in cells Ketone Bodies- made in liver when excess Acetyl CoA 2 Acetyl CoA 1 Ketone Body. Make more when DM crisis, Adkins diet, starvation. (end up with acidosis) Used by all cells (except liver) for energy FA Synthesis- when you have enough energy, body stores fat Done in cytosol, 4 step process, uses NADPH 4 CCondenstation, reduction, dehydration, reduction X4= 16 C Minerals needed: Na Ca, Mg, K> Fe, CU, I, Zn Water soluable- B1 Thiamine (coenxyme in glycolysis) BeriBeri alcohols= Wernick-Kor, Neuro dis. B2 Riboflavin anemia, cracking of skin C Ascorbic Acid- Anti-oxidant, collagen syn (scurvy), cofactor DO and NE B12 Folic Acid, bkbone of DNA and RNA, intrinsic factor, maintain myelin pernicious anemia, most common disorder B3 Niacin, needed for NADPH Fat Soluable- DEAK D- increase Ca and P abso (UV light) rickers, osteomalacia, pagents + E- antioxidant, protect RBC hemolysis, no if + A- beta carotene, anti-oxidant, vision/wrinkles nightblindness, xerophtalmia, toxic+ K- blood clotting, needed for syn of prothrombin hem, no if + DNA- Pyridimines C, T (U in DNA) Purines G A 5 carbons, has 2 or 3 H bonds RNA- mRNA (largest) rRNA (most, made in nucleous), tRNA (smallest) Protein syn is done in the ribosome, 64 possible codons, degerate b/c only 20 AA Transcription- nucleus, make mRNA modified GTP cap on 5, poly A tail, remove introns, semi-conservative Translation- in cytosol (on ribosome) tRNA anticodon accepts mRNA, makes protein chain. DNA polymerase- extends DNA 5-3 (must have primer) DNA ligase- connects 2 strands together Primase (RNA P) makes primer for the DNA Helicases- unwind DNA Cell Cycle- G1 (growth) S (DNA synthesized and DNA replication occurs) G2 Mitosis- Prophase (condense) metaphase (align) anaphase (split) and telophase (cytokinesis) Mutations- mis-sense (different AA, sickle cell), non-sense (stop codon, none fxn protein), no effect, frame shift PCR- amplify DNA Southern Blot- see if DNA present GENERAL PHYSIOLOGY Body 60% water Intracellular 25 L, main one is K 120 Extracellular- main one is Na 140 Interstitial 12 L Plasma 3 L Transcellular 3 L B/c ions charge of cell is more – inside = -65 to -80 mV, need Na/K pump to maintain 3 Na out, 2 K in Transport- Uphill- requires energy, Primary uses ATP directly, secondary uses indirectly co-transport- same direction (Na/AA, Na/K/2CL) Counter-transport- opposite (Na/Ca) Downhill- no energy, simple or carrier (facilitated- glucose, AA and other polar) Receptors- Adrenergic- increase sym and decrease para Alpha 1 Gq increase IP3, increase Ca dilate radial, VC Alpha 2 Gi decrease AC, decrease cAMP Beta 1 Gs increase AC, increase cAMP, increase heart contraction Beta 2 Gs increase AC, increase cAMP, BC, increase heart contraction Cholinoreceptors- increase para M1 Gq increase IP3, increase Ca M2 Gi inhibitor cAMP M3 Gq increase IP3, increase Ca Nicotinic- open K and Na channels Diffusion- move from higher concentration to lower concentration Higher diffusion at: lower thickness, lower velocity, higher perm, higher temp Osmosis- diffusion of water Breathing- Inspitation- contract external intercostals and diaphragm, increase V Expiration- passive, contract internal intercostals and relax diph, decrease V Lung Volume- about 6 L, measure with Spirogram, FEV/FLC, if less then 70%, COPD Tidal Volume- in and out each breath 0.5 L Inspiratory Reserve volume- amount in (over TV) when deep breath Expiratory RV- amount out (over TV) when deep breath 1.2 L Inspiratory capacity- total in with deep breath (TV + IRV) 3 L Vital Capacity- total out after deep breath (TV + IRV + ERV) 4.5 L Residual volume- amount always left in lungs 1.2 L Function residual volume- left after normal breath out ERV+ RV 2.4 Total lung capacity- entire volume lungs can exchange VC + RV Forced lung capacity- volume out after max in, 4.8 L 7.5% air changes with one breath Anatomic Dead space- in conduction zone Functional dead space- in alveoli Physiological Dead space – both of above O2 in body- 98% bound to hemoglobin (prop to PP), 2% in plasma CO2 in body- 20X more then O2, 90% HCO3(uses CA) 5% carbominohemoglobin, and 5% dissolved. Air in at 760 mmHG, 21% O2 (160 mmHg) , none CO2, in arteries PP is 100, in veins is 40 mmHG because passed throughout body.
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