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Study Guide #1 Chapters 1-4 1) How many milliliters are in: a) 1 cc - 1 b) 5 cc - 5 c) 1 ounce - 30 d) 1 teaspoon - 5 e) 1 cup - 240 f) 1 pint - 480 2) How many millimeters are in : a) 1 cm - 10 b) 1 meter - 1,000 c) 1 km - 1,000,000 3) The autoclave temperature reads 270F. what is the temperature in Celsius? 132.2 4) What do the following prefixes refer to: a) dys- bad, or difficult b) chole- gall, or bile 5) What do the following suffixes refer to: a) oscopy- viewing b) otomy- incision c) ectomy- excision d) plasty- Repair or surgical reconstruction of. e) lysis- loosening, dissolution, separating. f) synostosis- Articulation of osseous tissue of adjacent bones. g) ostomy- Creation of a new opening for drainage. 6) Starting at the mouth and ending with the anus, describe the path a bite of food takes. Include all divisions of organs, names of sphincters, and what happens to the food in each structure. Use the back of this page, if necessary. Mouth- food is mechanically broken down by the teeth. Deciduous (baby teeth) are shed and replaced. 20 by age 2 ½. Permanent 32 total. Salivary gland secretions begin the chemical breakdown. Tongue- moves the food around in the mouth and aids in swallowing Pharynx- food travels through the oropharynx and laryngopharynx, pastuvula and the epiglottis. Esophagus- 10 inches long. food travels through by peristalsis and gravity (liquids about 1 second, solids or semi solids about 4 to 8 seconds). Stomach- food enters the cardiac portion of the stomach by the cardiac sphincter, moves through the fundus and body to the pylorus, where it leaves via the pyloric sphincter. Folds in the stomach are called rugae. While in the stomach peristaltic movements mix the food with gastric secretions. Absorption of some water, electrolytes, certain drugs (especially aspirin) and alcohol occur here. Small intestine- food (now called chyme) travels by peristalsis through: the duodenumapproximately 10 inches long, the billiary system empties into it ; the jejunumapproximately 8 feet long; and the ileum- approximately 12 feet long. Handles about 90% of all absorption of nutrients. Villi and microvilli are minute projections of the intestinal mucosa which increase surface area and contain a capillary network for absorption. Large intestine- food enters through the ileocecal valve (or sphincter) into the cecum (from which hangs the appendix), ascending colon, right colic (or hepatic) flexure, transverse colon, left colic (or splenic) flexure, descending colon, sigmoid colon, rectum, anal canal, then the anus with both internal and external anal sphincters. Pouches along the large intestine are called haustra. Unlike other parts of the digestive tract, portions of the longitudinal muscles are thickened, forming 3 conspicuous longitudinal bands referred to as taeniae coli. Each band runs most of the length of the large intestine. The large intestine primarily absorbs water. chyme is prepared for elimination by bacteria, which ferment the remaining carbohydrates and release hydrogen, carbon dioxide, and methane gas. Vitamins K and some B are synthesized by bacterial action and absorbed. 7) Define the following terms: a) anabolism- Constructive metabolism characterized by the conversion of simple substances into more complex compounds of living matter. b) catabolism- A complex, metabolic process in which energy is liberated for use in work, energy storage, or heat production by the destruction of complex substances by living cells to form simple compounds. Carbon dioxide and water are produced, as well as energy. c) metabolism- The aggregate of all chemical processes that take place in living organisms, resulting in growth, generation of energy, elimination of wastes, and other bodily functions as they relate to the distribution of nutrients in the blood after digestion. Metabolism takes place in two steps: anabolism, the constructive phase, in which smaller molecules (such as amino acids) are converted to larger molecules (such as proteins); and catabolism, the destructive phase, in which larger molecules (such as glycogen) are converted to smaller molecules (such as pyruvic acid). Exercise, elevated body temperature, hormonal activity, and digestion can increase the metabolic rate, which is the rate determined when a person is at complete rest, physically and mentally. The metabolic rate is customarily expressed (in calories) as the heat liberated in the course of metabolism. d) glycogenesis- The synthesis of glycogen from glucose. e) hemolysis- The rupture of red blood cells. f) hilus- Depression or recess at exit or entrance of a duct in a gland are of nerves and vessels into an organ. g) oncology- The study of tumors. h) metastasis- The spread of cancerous cells to other parts of the body. 8) Define the following terms: a) peritoneum- an extensive serous membrane that covers the entire abdominal wall of the body and is reflected over the contained viscera. b) mesentery- a broad, fan shaped fold of peritoneum connecting the jejunum and ileum with the dorsal wall of the abdomen c) omentum- Greater omentum is an extension of the peritoneum that drapes from the greater curvature of the stomach to the transverse colon and coils of the small intestine. The lesser omentum drapes from the lesser curvature of the stomach towards the liver. Contains blood vessels and fat pads. 9) Place in order the layers of the GI tract, from the inner lining to the outer: ___3__A) muscularis ___4__B) serosa ___1__C) mucosa ___2__D) submucosa 10) Place in order the route air will take on inspiration: ___3__A) larynx ___5__B) bronchus ___7__C) alveoli ___1__D) nose ___6__E) bronchioles ___2__F) pharynx ___4__G) trachea 11) Match the terms at left with their place in the ear: ___2__A) malleus ___2__B) eustachian tube orifice ___3__C) cochlea ___1__D) auricle ___2__E) incus ___2__F) oval window ___3__G) semicircular canals ___2__H) stapes 1) outer ear 2) middle ear 3) inner ear 12) Make a chart of the 12 cranial nerves. Include names, numbers, and specific functions. Use the back of this page, if necessary. number name function I Olfactory sense of smell II Optic sense of sight III Oculomotor controls movement of the intrinsic muscles of the eye and 4 pairs of the extrinsic eye muscles IV Trochlear controls the superior oblique eye muscle V Trigeminal three branches supply the cornea, and conjunctiva, upper portion of the face, ear, lower lip, teeth and gums, and muscles for chewing VI Abducens controls lateral eye movement (lateral rectus) VII Facial supplies facial muscles, middle ear, and taste VIII IX Auditory sense of hearing and balance (aka vestibulocochlear) Glossopharyngeal taste, swallowing X Vagus swallowing, hunger, speech muscles, breathing, heart rate, peristalsis, and control of the glands in the stomach and pancreas XI Spinal accessory controls muscles of neck and upper back XII Hypoglossal controls tongue muscles 13) Define the following terms: a) diffusion- the process in which there is a greater movement of molecules or ions from an area of high concentration to an area of low concentration b) osmosis- the passage of solvent through a semipermeable membrane separating solutions of different concentrations. The solvent, usually water, passes through the membrane tending to equalize the concentration of the two solvents c) filtration- the process of removing particles from a solution by allowing the liquid portion to pass through a membrane or other partial barrier, which contains holes trough which small particles may pass, but larger ones can’t 14) Give the characteristics of the following types of muscle tissue: a) skeletal- attached to the bones. is striated, voluntary, and cells have more than one nucleus b) cardiac- forms the bulk of the wall of the heart. is striated, involuntary, and cells have only one nucleus. c) smooth- located in the walls of hollow internal structures such as blood vessels, the stomach, intestines, and urinary bladder. Is non-striated involuntary, and each spindle shaped cell contains a single, centrally located nucleus. 15) Describe the structure and function of the following terms related to the eye: a) retina- innermost layer, or third tunic of the eye. receives image formed by the lens. Light sensitive structure on which light rays come to a focus. Contains rods and cones. b) Macula lutea- small oval yellowish spot in the center of the retina approximately 2mm lateral to the optic disc. It contains a pit, the fovea centralis, which contains only cones and is the region of most acute vision. c) Optic disc- aka blind spot- area where the optic nerve leaves the eye d) choroid- middle layer or second tunic of the eye. is highly vascularized and provides nutrients to the posterior surface of the retina e) sclera- outer layer, or first tunic of the eye. white of the eye. gives shape to the eyeball and makes it more rigid. f) cornea- non-vascular, transparent, covers the iris. is continuous with the sclera g) iris- The colored portion of the eye, it regulates the amount of light entering the eye and assists in obtaining a clear image. h) pupil- the contractile opening at the center of the iris of the eye. contracts when exposed to strong light. dilates in the dark. regulates the amount of light that enters the eye i) lens- AKA Crystalline lens. transparent, colorless structure, biconvex in shape, enclosed in a capsule, and held in place by the suspensory ligament. Function is to focus light rays so that they make a perfect image on the retina. The shape is altered by the cilliary muscle. j) Extrinsic eye muscles- six pairs of muscles which hold the globe in place and provide for movement. Medial, lateral, superior and inferior rectus; superior and inferior oblique. k) Intrinsic eye muscles- muscles inside of the globe (iris and cilliary body) l) aqueous humor- transparent liquid contained in the anterior and posterior chambers of the eye. Produced by the cilliary processes, it passes from the posterior to the anterior chamber and then to the venous system by way of the canal of Schlemm. m) vitreous humor- (AKA- vitreous body) – fills the posterior cavity of the globe (posterior to lens). Glasslike, transparent, gelatinous mass, 99% water, 1% collagen and hyalurinic acid, which fills 4/5ths of the eyeball 16) (T or F) Vitamin C is essential to the synthesis of prothrombin by the liver and is a valuable hemostatic agent. False, Vitamin K 17) A _glomerulus____ is a capillary network of blood vessels within the renal cortex that functions as a filter. 18) Place in order (1-13) the route blood takes as it approaches the heart: __7__A) lungs __11_B) left ventricle __4__C) right ventricle __13_D) aorta __1__E) superior and inferior vena cava __2__F) right atrium __9__G) left atrium __12_H) aortic semilunar valve __3__I) tricuspid valve __10_J) bicuspid (mitral) valve __5__K) pulmonary semilunar valve __8__L) pulmonary veins __6__M) pulmonary arteries 19) What is estimated in each of the following counts? What is the normal range for each? a) red blood count- percentage of RBC’s in a given volume of blood Norm- 4.55.5- million/cu. Ml (45%) b) white blood count- number of leukocytes (WBC’s) Norm- 5-10,000/cu. ml c) differential blood count- varieties of leukocytes (WBC’s) and their percentages. Norm- Neutrophils- 40-70% ; Eosinophils- 1-4% ; Basophils- 0-1% ; Lymphocytes- 20-45% ; Monocytes- 4-8% d) hematocrit- percentage of total blood volume composed of RBC’s. Normmen- 42-50% ; women- 40-48% 20) Define the following terms: a) hypotonic- having a lower osmotic pressure than a compared solution. Low salt concentration as related to blood- cells placed in it would swell and burst (lysed) b) hypertonic- a solution of higher osmotic pressure than another. High salt concentration as related to blood- cells placed in it would shrivel up (crenated) c) isotonic- a solution in which the concentration of water molecules are the came as in blood. Under normal circumstances 0.9%NACL is isotonic. 21) Describe the following terms related to bones: a) epiphysis- end of a bone. Where growth occurs. also referred to as the growth plate. b) diaphysis- shaft, or long main part of a bone. c) endosteum- membrane lining the medullary cavity of a bone. d) periosteum- dense, white, fibrous covering around bone. Serves as a supporting structure for blood vessels. e) malleolus- The protuberance on both sides of the ankle joint; the lower extremity of the fibula being known as the lateral malleolus and the lower end of the tibia as the medial malleolus. f) trochanter- either of the two bony processes below the neck of the femur g) condyle- a rounded protuberance at the end of a bone forming an articulation. h) acetabulum- The rounded cavity on the external surface of the inominate bone (or os coxae) that receives the head of the femur. i) cortical- hard, dense bone, generally found in the shaft or main portion of the bone. j) cancellous- spongy bone, usually found at ends of bones 22) Review the location and names of the bones of the skeleton. Be prepared to name them in class. 23) Review the location and names of the muscles. Be prepared to name them in class. 24) The inner layer of the uterus is the _endometrium______________; the outer layer is the _perimetrium___; and the middle layer is the _myometrium______. 25) Number, in order of sequence, the placement of each mater of the meninges (1 being outermost): __3__A) pia mater __1__B) dura mater __2__C) arachnoid mater 26) Describe the characteristics and functions of the following portions of the following portions of the nervous system: a) cerebrum- The largest part of the brain, consisting of two hemispheres separated by a deep longitudinal fissure. The surface of each hemisphere is thrown into numerous folds or convolutions called gyri, separated by furrows called fissures or sulci. Within the cerebrum are two cavities, the right and the left lateral ventricles. Concerned with sensations or the interpretation of sensory impulses; and all voluntary muscular activities. It is the seat of consciousness and the center of the higher mental facilities, such as memory, learning, reasoning, judgment, intelligence, and the emotions. b) cerebellum- Lies dorsal to the pons and medulla oblongata, overhanging the later. Occupies most of the posterior fossa, and forms the roof of the fourth ventricle. principally concerned with balance and coordination of movement c) pons- a rounded eminence on the ventral surface of the brainstem. It lies between the medulla and cerebrum, and contains fiber tracts which connect the two. Is the upper portion of the brainstem. Relays messages between the cerebrum and cerebellum, and the cerebrum and medulla oblongata. Is the site of cranial nerves V, VI, VII, and VIII. d) medulla oblongata- Enlarged portion of the spinal cord in the cranium after it enters the foramen magnum of the occipital bone; the lower potion of the brainstem. Controls vital functions such as breathing, heart rate, blood pressure, and coughing. Is the site of cranial nerves IX through XII. e) hypothalamus- Lies between the hemispheres of the cerebrum in an area known as the diencephalon. Controls body temperature, water balance, sleep, appetite, some emotions such as fear and pleasure, and both divisions of the autonomic nervous system. f) neuron- A nerve cell, the structural and functional unit of the nervous system. Consists of a cell body and its processes, an axon and one or more dendrites. Neurons function in initiation and conduction of impulses. g) autonomic nervous system- The part of the nervous system that is concerned with control of involuntary bodily functions. Is divided into the sympathetic (or thoracolumbar) system and the parasympathetic (or craniosacral) system. h) sympathetic nervous system- Also called the thoracolumbar, or fight or flight. Stimulation usually produces vasoconstriction, rise in blood pressure, depression of gastrointestinal activity, and acceleration of the heart. i) neurotransmitters- Substance such as norepinephrine, acetylcholine, and dopamine that is released when the axon terminal of a presynaptic neuron is excited. The substance then travels across the synapse to act on the target cell to either inhibit or excite it. j) synapse- Junction of an axon and one or more dendrites, which transmits nerve impulses in one direction only. k) Tentorium cerebelli- a fold or extension of dura mater that separates the cerebellum from the occipital lobe of the cerebrum. 27) Explain portal circulation. The hepatic portal vein drains blood from the pancreas, spleen, stomach, intestines and gall bladder and delivers it to the liver for detoxification. 28) Review the location and names of the major arteries and veins. Be prepared to name them in class. 29) About bile: a) Where is bile produced? Liver b) Where does “A” drain that bile to? Via? Gallbladder; Hepatic duct c) What happens to bile in “B”? Its stored and concentrated d) What stimulates “B” to release bile? Gastric juice, fatty foods, and the hormone cholecystokinin. e) What route does bile take leaving “B”? Cystic duct, common bile duct, sphincter of Oddi, duodenum 30) What is the name given to the dense connective tissue that forms the external covering of the liver? Glissons capsule. 31) Define the following terms: a) commensalism- the symbiotic relationship of two organisms of different species in which neither is harmful to the other and one gains some benefit such as protection or nourishment. b) parasitism- a relationship in which an organism benefits at the expense of the host organism c) mutualism- a form of symbiosis in which organisms of two different species live in close association to the mutual benefit of each 32) Give the characteristics of the following microorganisms. Include whether they are gram positive or gram negative and what diseases they cause. a) Clostridium perfringes- anaerobic gram-positive bacteria (bacilli). Capable of causing gas gangrene in humans b) Neisseria- gram negative cocci. N. gonorrhea is the causative organism of gonorrhea. N. meningitidis is the causative organism of meningitis. c) Escherichia coli- gram negative bacilli. Normally present in the intestines. Most frequent cause of urinary tract infections. d) Staphylococcus aureus- gram positive cocci. Normally found on the skin, it produces a golden pigment with some color variations. Responsible for a number of infections, such as boils, carbuncles, and abscesses. Most common cause of surgical site infections. 33) What major contribution did the following people make to aseptic technique: a) Ignaz Semmelweis- advanced the theory that hand washing greatly reduces infection in patients (1818-1865) (B&K 107) b) Louis Pasteur- taught his germ theory, laying the foundation for bacteriology as a science. Found that heat could halt organisms (in wine) growth. Developed the vaccine for rabies. (B&K 107, 406) c) Robert Koch- isolated the tubercle bacillus, advocated the use of bichloride of mercury as an antiseptic (B&K 107) d) Joseph Lister- became known as the father of modern surgery; pursued Pasteur’s work. He was the first to use carbolic acid on dressings; he also used it on articles that came in contact with the wound and on the hands of the OR team. (B&K 107) 34) Define the following terms: a) Aerobic- with oxygen. Living only in the presence of oxygen. b) Anaerobic- without oxygen. Able to live without oxygen. 35) Describe the function of the following parts of the cell: a) Nucleus- spherical or oval organelle and the largest structure in the cell. Contains genetic material, consisting primarily of DNA. b) Ribosomes- sites of protein synthesis c) Endoplasmic reticulum- contributes to the mechanical support and distribution of the cytoplasm. Also involved in intracellular exchange of materials, and serves as a storage area for synthesized molecules. d) Golgi complex- is generally near the nucleus. Principal function is to process, sort, and deliver proteins to various parts of the cell. e) Mitochondria- “powerhouses of the cell”, they are the sites for the production of ATP. Active cells, such as muscle, liver, and kidney have a large number of mitochondria because of their high-energy expenditure. f) Lysosomes- contain powerful digestive enzymes capable of breaking down many kinds of molecules, including bacteria that enter the cell. White blood cells, which ingest bacteria by phagocytosis, contain large numbers of lysosomes. 36) Describe the following drugs and their common usage’s: a) Oxytocics- agent that stimulates uterine contractions. Also acts on the mammary gland to stimulate the release of milk; pitocin b) Epinephrine- a hormone secreted by the adrenal medulla. Vasoconstrictor, cardiac stimulant, relaxes bronchioles, constricts blood vessels to prolong action of local anesthetics. c) Mannitol- used as an osmotic diuretic to increase urinary output and to reduce cerebrospinal fluid pressure. d) Sodium bicarbonate- used intravenously to treat metabolic acidosis. Mixed with local anesthetic is takes the sting out of injection e) Protamine sulfate- used to neutralize the anticoagulant action of heparin f) Heparin sodium- Interferes with clotting, given IV during vascular surgery, and effects may be reversed prior to wound closure; may be given in smaller doses preoperatively or postoperatively to prevent the formation of blood clots. Neutralized by protamine sulfate. g) Topical thrombin- a topical powder that may be mixed with a solution, and may be used with Gelfoam to control bleeding during surgery. It is NEVER injected. h) Thiopental (Pentothal)- Older agent and is rarely used. Rapid, smooth and pleasant anesthesia induction; quick recovery and causes respiratory depression. i) Fentanyl citrate (Sublimaze)- potent IV narcotic used for rapid, smooth induction; metabolizes slowly and may cause respiratory distress. j) Lidocaine- Popular short-acting anesthetic. Major advantages are rapid onset of anesthesia and lack of local irritant effect, Used in the management of ventricular arrhythmias during and after cardiac procedures. k) Keflin (cephalothin)- a first generation cephalosporin. Broad spectrum antibiotic active against many gram-positive and some gram-negative microbes. l) Solu-medrol- steroidal anti-inflammatory drug used to decrease edema and prevent swelling. 37) Circle the hemostatic agents: surgicel cocaine avitene heparin bone wax gelfoam