Term
| Turning injury into an electrical stimulus is known as? |
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Definition
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Term
| Carrying the electrical stimulus is known as? |
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Definition
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Term
| what are the three main steps needed to deliver pain information |
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Definition
1. transduction
2. transmission
3. signaling |
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Term
| how does the sensory information of pain then illicit a muscle movement |
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Definition
| via a interneuron that activates a alpha lower motor neuron |
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Term
| what are the body's natural pain suppressors |
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Definition
1. enkephalin
2. endorphins |
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Term
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Definition
| G protein and K channel opening that results in further repolarization away from threshold therefore blunting response to pain by preventing transmission to brain. |
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Term
| site of action of local anesthetics is |
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Definition
| voltage gates sodium channels |
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Term
| what are the three parts of a local anesthetic |
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Definition
1. liphilic end
2. middle region (Ester or amide)
3. nitrogen end |
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Term
| Which type of local under go metabolism by esterase |
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Definition
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Term
| which local undergoes metabolism via liver? What type of metabolism is this called |
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Definition
| amides undergo conjugation via liver |
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Term
| Are all LA equally weak bases? |
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Definition
| NO. All LA are weak bases but they are NOT equally weak. |
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Term
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Definition
| pH at which there are equal amounts of the lone pair. THe closer the pKa is to Ph then the faster the drug onset. |
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Term
| thin filament of the muscle is known as? |
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Definition
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Term
| thick filament of the muscle is known as |
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Definition
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Term
| muscle relaxants results in the myosin being left in what position |
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Definition
| a locked, cocked ready position. |
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Term
| during cardiac plegia what happens? |
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Definition
| during cardiac plegia – flood heart with K+ so it goes into suspended animation (bypass) - heart will die if don’t give enough plegia |
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Term
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Definition
| cardioplegia is intentional and temporary cessation of cardiac activity, primarily for cardiac surgery. |
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Term
| without __ and ___ nicotinic receptors may migrate out and form into extrajunctional receptors |
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Definition
| need agrin and musc to anchor nicotinic receptors to lipid bilayer. |
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Term
| extrajunctional recpetors can occur in what patient populations |
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Definition
| Can occur with: muscular dystrophy, spinal cord injury, myotonia, ALS, MS, major burns, ICU pts., muscle breakdown |
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Term
| why does myathesia gravis do patients need less Sux? |
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Definition
| MG – auto Ab against nicotinic receptors – will not have extra junctional receptors. They just have less receptors, so adjust sux dose. |
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Term
| 5 criteria that make General Anesthesia |
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Definition
1. Loss of all reflexes
2. Hypnosis
3. Amnesia
4. Analgesia
5. Paralysis |
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Term
| ICE used to describe issues with diabetes such as? |
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Definition
| ICE - Inflammation, Coagulation, Endothelial dysfunction |
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Term
| suendothelium injury stimulates what coagulation pathway resulting in what? |
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Definition
| Innate immunity: Subendothelium expresses TF, not in contact with blood unless there is an injury factor 10X factor 10a. Creates a short burst of thrombin production called priming thrombin |
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Term
| 7a activates what at injury site |
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Definition
| o 7a activates platelets at injury site |
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Term
| In _____________, don’t get thrombin burst or mature platelet plug formed at injury site. Only have loose fibrinogen. |
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Definition
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Term
| normal endothelium expresses natural anticoagulants such as___ and ________ |
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Definition
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Term
| endothelial cells turns ____ into nitric oxide (NO) |
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Definition
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Term
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Definition
| NO finds guanykate cyclase cGMP, activates protein kinase G phosphorylates myosin heads of smooth muscle cells wrapped around blood vessels |
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Term
| when drugs bind to mu receptor what type of channel is opened |
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Definition
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Term
| what type of Na channel is the site of Local anesthetics |
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Definition
| VOLTAGE GATED Na Channels |
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Term
| If the pka of a LA is close to or furhter away from the body's pH will the drug act fastest |
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Definition
| the closer the pKa is to the pH the faster the LA will work |
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Term
| what extreme pH would locals not work well in? |
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Definition
| Extreme acid pH would effect LA from working well since it would be totally bounded by H+ ions. |
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Term
| in a skeletal muscle what are the two filaments |
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Definition
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Term
| for cross bridging to work in our muscles what steps need to happen. |
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Definition
| The myosin head needs to be in the ready state, cocked back. To get there an ATP binds to myosin head. In the head it undergoes hydrolysis resulting in a phosphate molecule and ADP left on the head. The head is now cocked back. Neck the sarcoplasmic reticulum needs to release Ca. Ca needs to bind to troponin on the thin filament. Once this occurs the troponin will tell the tropomyosin to move over and expose the binding sites. As soon as the binding sites are exposed the mysoin head fires and binds to the binding site which then causes the release of the phosphate. then the power stroke occurs causing the ADP to be released. Then cross bridge detachment occurs only after ATP binds to it causing the myosin to release. Cannot go back to cocked position until ATP is hydrolyzed again. |
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Term
| • Extra junctional nicotinic receptors happens with disease states of |
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Definition
| • Extra junctional nicotinic receptors happens with disease states of muscular dystrophy, spinal cord injury, major burns, ALS, MS, myotonia, ICU pts, muscle breakdown. These people are exposed to risk of massive K+ release that causes cardiac arrest. They should not get sux. |
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Term
| MG patients have what abnormalities with their AcH receptors |
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Definition
| • MG have LESS receptors, adjust sux dose but can still give. (autoimmune disorder that eats away at nicotinic receptors and destroys them. No extrajunctional nicotinic receptors here because nothing wrong with neuro or muscle. So they just have less receptors) |
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Term
| explain the physiology of why despite giving NMB drugs that stimulation of the larynx can still cause profound parasympathetic responses? So what exactly does NMB do to the larynx? |
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Definition
| NMB drugs can only block alpha motor neurons. So when you stimulate larynx with intubation it sends signal to the medulla which sends a effector signal to the throat via the recurrent vagus nerve to close airway but can't get there because you blocked it. HOWEVER the medulla can also send vagus signals via non-motor pathways and result in bradycardia ect... |
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Term
| what does the mnumonic ICE stands for relating to DM |
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Definition
ICE
I: Inflammation
C: Coagulation
E: Endothelial dysfunction |
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Term
| which coagulation pathway is the priming pathway? |
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Definition
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Term
| when endothelium is exposed to injury what is released from the subendothelium and what does it incite |
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Definition
| Tissue factor is released and turns 10 into activated 10a. (PRIMING THROMBIN BURST) |
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Term
| prothrombinase complex involves??? |
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Definition
1. Factor 9
2. factor 8
3. factor 10
4. factor 5 |
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Term
| NO works to cause relaxation of smooth muscle around vessels by? |
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Definition
| it phosphorylates myosin heads |
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Term
| the nemesis of NO is ? It works by? |
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Definition
| Nemesis of NO is angiotensin 2 which works by desroying the co-factors for NO |
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Term
| NOS needs ___ cofactors for it to be made |
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Definition
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