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) كل العبارات أدناه صحيحة و يمكن تغيير عباراتها لتصبح (خطأ) أو إبقاؤها لتبقى (صح:مالحظة هامة أو حذف بعض كلماتها أو عباراتها علىMCQ ) و يمكن ترتيبها على شكلTrue or false (أي ) Match or short assay ( ) بل حتى يمكن عملBlanks شكل فراغات (أي First: CNS, PNS, ANS and Special sences 1. The term nucleus in CNS refers to a clearly defined mass of neuron cell bodies 2. The term substantia in CNS refers to a less distinct borders than nuclei 3. The term locus in CNS refers to a small but well defined mass of neuron cell bodies 4. The term ganglion refers to collection of neuron cell bodies found in PNS 5. Tract is a set of fibers that project from one structure and synapses on a second structure 6. The term nerve refers to PNS 7. Nerve is a bundle of axons projecting from CNS to a muscle or gland or from a sense organ to CNS 8. Bundle is a collection of axons that run together but may not share the same origin or destination 9. Commissure is any collection of axons that connect one side of the brain with the other side 10. Gyrus is a ridge on the surface of the cerebrum or cerebellum 11. Sulcus is a groove on the surface of the cerebrum or cerebellum 12. Fissure is a deep groove on the surface of the cerebrum or cerebellum 13. Central nervous system (CNS) refers to cerebellum, cerebrum, brain stem and spinal cord 14. Peripheral nervous system (PNS) is either somatic or autonomic 15. In CNS, gray matter is organized on the surface of the brain in lamina 16. In CNS, white matter is organized centrally 17. In CNS, white matter constitutes the majority of brain mass 18. In PNS, gray matter is centrally located 19. In PNS, white matter is organized on the surface 20. Motor areas are concerned with voluntary control of movement 21. Sensory areas are concerned with conscious awareness of sensation 22. Association areas are concerned with integration and emergent properties 23. Each hemisphere is concerned with the opposite of the body 24. Primary motor cortex (Brodmann 4) is located in the precentral gyrus of frontal lobe 25. Primary motor cortex (Brodmann 4) is concerned with conscious control of motor execution -1- 26. Pyramidal cells give rise to the corticospinal tracts 27. Somatotopy means that human body is mapped (motor or sensory homunculus) 28. Premotor cortex (Brodmann 6) is concerned with learned motor skills (patterned or repetitious) 29. Broca’s area (Brodmann 44/45) directs muscles of the tongue, throat and lips 30. Broca’s area (Brodmann 44/45) is concerned with motor planning for speech related activity 31. Frontal eye field (Brodmann 8) is concerned with voluntary movement of the eyes 32. Primary somatosensory cortex (Brodmann 1, 2 & 3) is located in parietal lobe (postcentral gyrus) 33. Postcentral gyrus is concerned with somatic senses: pain, temperature, touch and proprioception 34. Somatosensory association area (Brodmann 5 & 7) integrates various somatic sensory inputs 35. Primary visual cortex (Brodmann 17) is located in occipital lobe 36. Primary visual cortex (Brodmann 17) has a sensory function with largest cortical representation 37. Visual association areas (Brodmann 18 & 19) are concerned with interpretation of visual stimuli and past visual experiences 38. Primary auditory cortices (Brodmann 41) are located in superior margin of temporal lobe 39. Primary auditory cortices (Brodmann 41) are concerned with pitch, rhythm and loudness of voice 40. Auditory association area (Brodmann 42 & 43) are concerned with recognition of stimuli as specific auditory experiences (e.g., speech) 41. Olfactory cortex is located in medial aspects of temporal lobe (piriform lobe or uncus) 42. Gustatory cortex (Brodmann 43) is located in parietal lobe deep to the temporal lobe 43. Sensory association areas analyze, recognize and act on sensory in puts 44. Prefrontal cortex (Brodmann 11 & 47) is located in anterior portion of frontal lobe 45. Prefrontal cortex (Brodmann 11 & 47) is concerned with intelligence, complex learned behavior and personality 46. Prefrontal cortex (Brodmann 11 & 47) is concerned with understanding written and spoke language 47. General interpretation area encompasses parts of temporal, parietal and occipital lobes -2- 48. General interpretation area generally found on the left side 49. General interpretation area is concerned with storage of complex sensory memories 50. Language areas are bilaterally located 51. Wernicke’s area is located in posterior temporal lobe on left side 52. Wernicke’s area is concerned with sounding out unfamiliar words 53. Affective language areas are located contralateral to Broca’s and Wernicke’s areas 54. Affective language areas are concerned with nonverbal and emotional components of language 55. Molecular layer of cerebral cortex (layer I) lacks cell bodies 56. Layers II & III of cerebral cortex are pyramidal cells that project to and receive projections from other cortical regions 57. Layer IV of cerebral cortex represents stellate cells that receive most of thalamic input and project locally to other lamina 58. Layer V & VI of cerebral cortex represent pyramidal neurons that project to subcortical regions such as the thalamus, brainstem, and spinal cord, and other cortical areas 59. Basal ganglia are caudate, putamen and globus pallidus 60. Basal ganglia receive inputs from most cortical structures and project to motor cortex via the thalamus 61. Functions of basal ganglia are starting, stopping and monitoring movement and inhibition of unnecessary movement 62. Diencephalon represents the core of forebrain surrounded by cerebral hemispheres 63. Diencephalon involves three bilateral structures (thalamus, hypothalamus and epithalamus) 64. Thalamus is comprised of multiple interconnected nuclei that receive specific afferent projections and project (relay) processed information to particular cortical areas 65. Hypothalamus is located below thalamus between optic chiasm and mammillary bodies 66. Hypothalamus is connected to the pituitary via infundibulum 67. Hypothalamus is the visceral control center of the body 68. Hypothalamus is concerned with autonomic control (e.g., BP, HR) 69. Hypothalamus is concerned with emotional response (e.g., fear, sex drive) 70. Hypothalamus is concerned with regulation of body temperature 71. Hypothalamus is concerned with regulation of feeding 72. Hypothalamus is concerned with regulation of thirst 73. Hypothalamus is concerned with regulation of circadian rhythm 74. Hypothalamus is concerned with control of endocrine function -3- 75. Epithalamus represents pineal body and choroid plexus 76. Pineal body controls sleep-cycle and produces melatonin 77. Choroid plexus is concerned with production of cerebral spinal fluid (CSF) 78. Brain stem is organized into midbrain, pons and medulla oblongata 79. Brain stem functions in autonomic behavior 80. Brain stem functions as pathway for fiber tracts 81. From brain stem, cranial nerves originate 82. Midbrain structures are: cerebral peduncles, corpora quadrigemina, substantia nigra, red nucleus and reticular formation 83. Cerebral peduncles are fiber tracts connecting cerebrum with inferior structures 84. Corpora quadrigemina are superior and inferior colliculi 85. Substantia nigra is a nucleus of dopamine neurons 86. Color of substantia nigra is due to melanin (dopamine precursor) 87. Red nucleus is concerned with motor reflexes 88. Pons lies between midbrain and medulla 89. Pons is comprised mostly of conducting fibers 90. Pons is a connection between higher brain areas and spinal cord (longitudinal projections) 91. Pontine nuclei relay information between motor cortex and cerebellum 92. Pons has nuclei for several cranial nerves: trigeminal (V), abducens (VI) and facial (VII) 93. Medulla oblongata lies between pons and spinal cord 94. No obvious demarcation between medulla and spinal cord 95. Medulla oblongata is landmarked by pyramids (descending and decussating corticospinal tracts) 96. Medulla oblongata has nuclei for several cranial nerves: hypoglossal (XII), glossopharyngeal (IX), vagus (X), accessory (XI) and vestibulocochlear (VIII) 97. Medulla oblongata controls visceral motor function 98. Medulla oblongata contains the cardiovascular center: cardiac center and vasomotor center 99. Medulla oblongata controls vomiting, hiccup, swallowing, coughing and sneezing reflexes 100. Medulla oblongata contains the respiratory center that controls rate and depth of breathing 101. Cerebellum is located dorsal to pons and medulla and caudal to occipital lobe 102. Cerebellar hemispheres consists of posterior, anterior and flocolonodular lobes 103. Cerebellar hemispheres are connected by vermis -4- 104. Cerebellar peduncles are fiber tracts connecting brain stem and sensory cortices with cerebellum 105. Cerebellum functions in precise timing of skeletal contraction 106. Within cerebellum, sensory and motor information is integrated 107. Limbic system is a group of cortical structures located on medial aspect of the cerebral hemisphere and diencephalon with complex connectivity 108. Structures of limbic system are: upper part of brainstem, rhinencephalon, septal nuclei, cingulate gyrus, parahippocampal gyrus (hippocampus), amygdale, diencephalon structures (hypothalamus and anterior nucleus of the thalamus) and fiber tracts (fornix and fimbria) 109. Limbic system functions in emotional and affective state 110. Reticular formation is a complex of nuclei and white matter 111. Reticular formation has disperse and widespread connectivity 112. Reticular formation is located in central core of medulla, pons and midbrain 113. Reticular formation functions in maintenance of wakefulness and attention by coordination of all afferent sensory information 114. Reticular formation functions in coordination of muscle activity by modulation of efferent motor information 115. Cerebrospinal fluid (CSF) is found in cerebral ventricles and central canal of spinal cord 116. Cerebrospinal fluid (CSF) is produced by choroid plexuses 117. Gray matter in spinal cord lies centrally 118. In spinal cord, lateral horn of gray matter is found in thoracic and superior lumbar regions only 119. Posterior (dorsal) and anterior (ventral) horns are found in all regions of spinal cord 120. Anterior horn of spinal cord contains cell bodies of somatic motor neurons 121. Lateral horn of spinal cord contains cell bodies for autonomic (sympathetic) motor neurons 122. Somatic and autonomic (sympathetic) motor neurons leave via ventral root of spinal cord 123. Dorsal root ganglion contains cell bodies of sensory neurons 124. Sensory neurons project to spinal cord via dorsal root 125. Some sensory neurons enter white matter tracks of spinal cord and ascend, others synapse with interneuron located in posterior horn 126. Spinal nerves are lateral fusion of ventral and dorsal roots 127. Most of spinal pathways decussate 128. Most of spinal pathways are poly-synaptic (two or three neurons) 129. Most of spinal pathways are mapped (position in cord reflects location on body) 130. All of spinal pathways are paired -5- 131. Dorsal column (fasciculi cuneatus and gracilis) is an ascending (sensory) pathway which conveys senses of touch and proprioception 132. Spinothalamic (anterior and lateral) tracts are ascending (sensory) pathway which convey senses of pain and temperature 133. Upper motor neurons are descending (motor) pathways having their cell bodies in the brain 134. Lower motor neurons are descending (motor) pathways having their cell bodies in anterior horn of spinal cord 135. Direct upper motor neurons are anterior and lateral (pyramidal) corticospinal tracts 136. Indirect upper motor neurons are multi-neuronal as rubrospinal, vestibulospinal, reticulospinal and tectospinal tracts 137. Structural components of peripheral nervous system are: sensory receptors, peripheral nerves and ganglia and efferent motor endings 138. Mechanoreceptors are sensory receptors detecting touch, vibration, pressure or stretch 139. Thermoreceptors are sensory receptors detecting temperature changes 140. Photoreceptors, which are sensory receptors detecting light energy, are exclusively found in the retina 141. Chemoreceptors are sensory receptors detecting chemical in solution 142. Nociceptors are sensory receptors detecting pain 143. Proprioceptors are sensory receptors located in musculoskeletal organs 144. Most sensory receptors are simple (generalized) 145. Complex sensory receptors act as special senses as vision, audition, olfaction or gestation 146. Free dendritic endings are unencapsulated sensory receptors as Merkel discs and root hair plexus 147. Meisner’s corpuscles are encapsulated sensory receptors detecting low frequency vibrations 148. Pacinian corpuscles are encapsulated sensory receptors detecting high frequency vibrations 149. Ruffini’s corpuscles are encapsulated sensory receptors detecting deep pressure 150. Muscle spindles are encapsulated sensory receptors detecting muscle stretch 151. Golgi tendon organs are encapsulated sensory receptors detecting tendon stretch 152. Varicosities are contacts between autonomic motor endings and visceral effectors and organs, smooth and cardiac muscle 153. Cranial nerves that perform sensory functions only are: I, II and VIII (olfactory, optic and vestibulocochlear) nerves -6- 154. Cranial nerves that perform motor functions only are: III, IV, VI, XI and XII (oculomotor, trochlear, abducens, accessory and hypoglossal) nerves 155. Cranial nerves that perform sensory and motor functions are V, VII, IX and X (trigeminal, facial, glossopharyngeal and vagus) nerves 156. Human being has 31 spinal nerves: 8 cervical, 12 Thoracic, 5 Lumbar, 5 Sacral and 1 Coccygeal 157. Spinal nerves are named for the level of the vertebral column from which the nerves exits 158. Dermatomes are areas of skin innervated by the cutaneous branch of a single spinal nerve 159. All spinal nerves (except C1) have dermatomes 160. Dermatomes overlap 161. Reflex activity is a stimulus-response sequence that is unlearned, unpremeditated and involuntary 162. Components of a reflex arc are: receptor, sensory neuron, integration center, motor neuron and effector 163. Autonomi neurons are postganglionic driven by preganglionic neurons whose cell bodies are in the spinal cord or brainstem 164. Preganglionic parasympathetic neurotransmitter is acetylcholine 165. Preganglionic sympathetic neurotransmitter is acetylcholine 166. Postganglionic parasympathetic neurotransmitter is acetylcholine 167. Postganglionic sympathetic neurotransmitter is nor epinephrine 168. Acetylcholine acts locally and it always has a stimulatory effect 169. Nor epinephrine spreads far and can exert its effects over long distances when circulated in the blood 170. Adrenergic receptors are alpha (stimulatory) and beta (inhibitory, except in the heart when it is excitatory) 171. Parasympathetic neuron has long preganglionic and short postganglionic fibers 172. Sympathetic neuron has short preganglionic and long postganglionic fibers 173. Parasympathetic ganglion is located in visceral organ 174. Sympathetic ganglia lie close to spinal cord (sympathetic chain ganglia) 175. Parasympathetic division function in maintenance of function and energy conservation 176. Sympathetic division functions in emergence and intense muscular activity 177. Pupil dilatation is a sympathetic response 178. Secretory inhibition is a sympathetic response 179. Stimulation of sweating is a sympathetic response 180. Increased heart rate is a sympathetic response 181. Dilatation of coronary vessels is a sympathetic response 182. Increased blood pressure is a sympathetic response -7- 183. 184. 185. 186. 187. 188. 189. 190. 191. 192. 193. 194. 195. 196. 197. 198. 199. 200. 201. 202. 203. 204. 205. 206. 207. 208. 209. 210. 211. 212. 213. 214. 215. 216. 217. 218. 219. 220. 221. 222. 223. Constriction of most vessels is a sympathetic response Bronchiolar dilatation is a sympathetic response Decreased activity of digestive system is a sympathetic response Piloerection is a sympathetic response Increased metabolic rate is a sympathetic response Glucose is released into blood as a sympathetic response Lipolysis is a sympathetic response Increased alertness is a sympathetic response Ejaculation is a sympathetic response Vaginal reverse peristalsis is a sympathetic response Pupils constriction is a parasympathetic response Stimulation of secretory activity is a parasympathetic response Increased salivation is a parasympathetic response Decreased heart rate is a parasympathetic response Constriction of coronary vessels is a parasympathetic response Bronchiolar constriction is a parasympathetic response Increased activity of digestive system is a parasympathetic response Erection of penis or clitoris is a parasympathetic response Vasodilatation is a parasympathetic response Retina of the eye converts light energy into neuronal activity Axons of the retinal neurons are bundled to form the optic nerves Pupil is an opening that allows light to reach the retina Iris is a circular muscle that controls the diameter of the pupil Aqueous humor is the fluid behind the cornea Sclera is the outermost layer that forms the eyeball Extraocular muscles are attached to the eye and skull and allow movement Conjunctiva is a membrane inside the eyelid attached to the sclera Optic nerve is formed by axons of the retina leaving the eye Cornea is a transparent surface covering the iris and pupil Macula is the area of retina responsible for central vision Fovea is the center of retina where most of the cones are present Lens is a transparent surface that contributes to the formation of images Ciliary muscles change the shape of the lens and allow focusing Vitreous humor is more viscous than the aqueous humor Vitreous humor lies between the lens and the retina Retina is the inner most layer of cells at the back of the eye Audition is a sense of hearing Sound is an audible variation in air pressure (compressions) Amplitude or intensity of sound is perceived as differences in loudness Pitch of sound is the frequency of compressions per second Unit of sound pitch is hertz (1 cycle/second) -8- 224. Pinna is a funnel shaped outer ear made of skin and cartilage 225. Auditory canal is a channel leading from the pinna to the tympanic membrane 226. Ossicles of middle ear transfer the movement of the tympanic membrane into the oval window 227. Bones of middle ear are malleus (hammer), incus (anvil) and stapes (stirrup) 228. Cochlea is filled with an incompressible fluid 229. More force is required to displace cochlear fluid than air 230. Bones in the middle ear amplify the pressure 231. Malleus is displaced in response to the movement of the tympanic membrane 232. Bottom of tympanic membrane moves towards the inner ear and the top moves towards the outer ear 233. Movement of malleus pulls the top of the incus towards the outer ear and pushes the bottom towards the inner ear 234. Oval window is smaller than tympanic membrane and the same pressure across a smaller area results in a greater force (like a spiked high heel) 235. Eustachian tube connects the air-filled middle ear to the mouth 236. Cochlea of inner ear converts the physical movement of the oval window into neural signal 237. Vestibular apparatus is not part of the auditory system 238. Vestibular apparatus is involved in balance 239. Taste (Gustation) and smell (olfaction) have similar tasks 240. Taste (Gustation) and smell (olfaction) function in detection of environmental chemicals 241. Taste (Gustation) and smell (olfaction) are required to perceive flavor 242. Taste (Gustation) and smell (olfaction) have strong and direct connections to our most basic needs like thirst, hunger, emotion, sex, and certain forms of memory 243. Taste (Gustation) and smell (olfaction) systems are separate and different and only merge at higher levels of cortical function 244. Taste (Gustation) and smell (olfaction) have different chemoreceptors 245. Taste (Gustation) and smell (olfaction) use different transduction pathways 246. Taste (Gustation) and smell (olfaction) have separate connections to the brain 247. Taste (Gustation) and smell (olfaction) have different effects on behavior 248. Basic gustation categories are salty, sour, sweet and bitter 249. Most foods have a distinctive flavor as a result of their taste and smell occurring simultaneously -9- 250. Sensory modalities like food texture, temperature and pain sensitivity may also contribute to a unique food-tasting experience 251. Organs of taste are tongue, pharynx, palate and epiglottis 252. Bitter taste is perceived across the back of tongue 253. Sour taste is perceived on side closest to the back of tongue 254. Salty taste is perceived on side of tongue more rostral than sour 255. Sweet taste is perceived across front of tongue 256. Odors perceived to be noxious are often deleterious 257. Taste and sour taste stimuli may pass directly through an ion channel 258. Sour and bitter taste stimuli may bind to (and block) ion channels 259. Some sweet amino acids bind to (and open) ion channels 260. Sweet and bitter taste stimuli may bind to membrane receptors that activate 2nd messenger systems that in turn open or close ion channels 261. In salt receptor cells, Na+ increase within the cell depolarizes the membrane and opens a voltage dependent Ca++ channel 262. In sour receptor cells, H+ ions block K+ channels 263. In sweet receptor cells, G-protein activates an effector enzyme adenylate cyclase (cAMP produced) 264. In sweet receptor cells, cAMP causes K+ channels to be blocked 265. In sweet receptor cells, G-protein activates an effector enzymephospholipase C 266. In sweet receptor cells, Ca++ is released from intracellular storage 267. In olfactory receptor cells, 2nd messenger (cAMP or IP3) opens a Ca++ channel 268. In olfactory receptor cells, Ca++ influx does not cause NT release. It opens a Cl- channel Second: Cardiovascular system 269. Left ventricle is much larger and thicker than right one 270. Atrioventricular (AV) valves are closed during ventricular contraction (systole) 271. Right AV valve is tricuspid 272. Left AV valve is bicuspid (mitral valve) 273. Chordae tendineae (heart strings) are collagen cords anchoring cusps to papillary muscles 274. Semilunar (SL) valves open during ventricular contraction (systole) 275. There are no valves between atria and venae cavae and pulmonary veins 276. Atrial contraction compresses venous entry points (valve action) 277. Blood flow to myocardium occurs only during diastole - 10 - 278. Angina pectoris is temporary deficient blood flow to the myocardium 279. Myocardial infarction (MI) is cardiac cell necrosis (cell death) due to O2 deficiency 280. Cardiac muscle initiates action potentials independent of nervous innervation 281. Long refractory period in cardiac AP prevents tetanic contractions 282. Pace maker cells depolarize spontaneously 283. Autorhythmic cells have unstable resting membrane potential that drift towards threshold 284. Ca2+ influx from extracellular space causes rising phase of AP in pace maker cells 285. Sinoatrial (SA) node has the fastest rate of depolarization 286. Sinoatrial (SA) node causes the characteristic rhythm of the heart (sinus rhythm) 287. Sinoatrial (SA) node is located in right atrial wall 288. Atrioventricular (AV) node is located in interatrial septum near tricuspid valve 289. Diameter of fibers in AV node is smaller than SA node 290. Atrioventricular (AV) node slows impulse conduction 0.1 sec 291. AV node permits completion of atrial contraction 292. Impulse passes from AV node to bundle of His 293. Atrioventricular bundle is the bundle of His 294. Atrioventricular bundle (bundle of His) is located in inferior interatrial septum 295. Bundle of His transmits impulse from atria to ventricles 296. Bundle of His is very short 297. Bundle of His branches to form bundle branches 298. Bundle branches course interventricular septum toward apex of heart 299. Purkinje fibers reach apex then branch superiorly into ventricular walls 300. Impulses in purkinje fibers move faster than cell to cell contact 301. Purkinje fibers ensures greater pumping efficacy 302. Arrhythmias are uncoordinated contractions of atria and ventricles 303. Fibrillation means rapid, irregular contractions 304. Ectopic focus is excitable tissue other than SA node controls heart contractions 305. Heart block is damage to AV node 306. In heart block, impulse cannot reach ventricles 307. Cardioaccelatory center in medulla is sympathetic NS control that innervate SA and AV nodes 308. Cardioinhibitory center sends PS innervation to SA and AV nodes via X nerve to slow HR - 11 - 309. In ECG, P wave represents depolarization moving from SA node through atria 310. QRS complex represents ventricular depolarization that precedes contraction 311. T wave represents ventricular repolarization 312. T wave spreads out more than QRS complex because repolarization is slower than depolarization 313. P-R interval lasts from beginning of atrial excitation to ventricular excitation 314. P-R interval includes atrial depolarization and contraction 315. P-R interval represents passage of impulse through intrinsic conduction system 316. P-R interval lasts 0.16 sec. 317. Q-T interval lasts from ventricular depolarization through repolarization 318. Q-T interval includes time of ventricular contraction 319. Total time of cardiac cycle is 0.8 sec. 320. Time of atrial systole is 0.1 sec. 321. Time of ventricular systole is 0.3 sec. 322. Time of quiescent period is 0.4 sec. 323. 70% of ventriclular filling occurs prior to atrial contraction 324. Ventricular filling occurs during mid-to-late diastole 325. During ventricular filling, AV valves are open and semilunar valves are closed 326. Atrial systole occurs during ventricular filling 327. Ventriclular depolarization (QRS wave) occurs during ventricular filling 328. During ventricular systole, AV valves close and semilunar valves are also closed 329. In isovolumetric contraction phase, BP in aorta and pulmonary trunk exceeds intraventricular pressure 330. In isovolumetric contraction phase, pressure in ventricles increases without volume changing 331. In ventricular ejection phase, intraventricular pressure exceeds pressure in large vessels 332. In ventricular ejection phase, semilunar valves open 333. In ventricular ejection phase, blood is propelled out of ventricles 334. In ventricular ejection phase, atria begin to fill with blood 335. Isovolumetric relaxation occurs during early diastole 336. T wave occurs during isovolumetric relaxation 337. During isovolumetric relaxation, intraventricular pressure drops 338. During isovolumetric relaxation, blood in vessels outside heart begins to flow back into ventricles - 12 - 339. During isovolumetric relaxation, semilunar valves close and aortic pressure increases resulting in dicrotic notch 340. During isovolumetric relaxation, semilunar valves close and AV valves still closed 341. In sound 1 of heart sounds, AV valves close 342. Sound 1 of heart sounds refers to the onset of systole 343. Sound 1 of heart sounds is louder and longer than sound 2 344. In sound 2 of heart sounds, semilunar valves close 345. Sound 2 of heart sounds refers to the beginning of ventricular diastole 346. Sound 2 of heart sounds is short and sharp sound 347. The pause after sound 1 sound 2 of heart sounds refers to the quiescent period 348. Sounds of separate heart valves can be differentiated 349. Timing of heart valves' sounds is: mitral, tricuspid, aortic semilunar and then pulmonary semilunar in succession 350. Cardiac Output (CO) is the amount of blood pumped by each ventricle per minute 351. Cardiac Output (CO) = Stroke volume X Heart rate 352. Stroke volume is the volume of blood pumped out of each ventricle per beat 353. Stroke volume is the difference between EDV and ESV 354. EDV is determined by length of ventricular diastole and amount of venous pressure 355. Normal EDV is about 120 ml 356. ESV is determined by arterial pressure and force of ventricular contraction 357. Normal ESV is about 50 ml 358. Preload is the degree of stretch prior to ventricular contraction 359. Preload is the most important factor affecting EDV 360. The greater the stretch of cardiac fibers, the greater the force of contraction 361. Volume and speed of venous return increase stretch of cardiac fibers 362. Slow heart rate increases stretch of cardiac fibers by providing much time for filling 363. Contractility is increased independent of muscle stretch 364. Increased Ca2+ into cardiac cells, increases contractility and volume ejected from heart 365. Increased contractility decreases ESV 366. Afterload refers to arterial blood pressure 367. Normal pressure in aorta is 80 mm Hg and in pulmonary trunk 10 mm Hg 368. Afterload is not normally a factor in healthy individuals 369. Afterload may have an adverse effect in individuals with hypertension 370. Sympathetic postganglionic neurons release NE at cardiac targets - 13 - 371. Action of NE at cardiac targets is mediated by ß1 adrenergic receptors 372. Upon stimulation of ß1 adrenergic receptors, pacemaker RMP is brought closer to threshold (depolarized) 373. Stimulation of ß1 adrenergic receptors increases heart rate 374. Stimulation of ß1 adrenergic receptors increases Ca2+ influx into contractile cells 375. Stimulation of ß1 adrenergic receptors increases ESV 376. Parasympathetic division decreases heart rate 377. Parasympathetic activity is mediated by acetycholine 378. Acetycholine hyperpolarizes (inhibits) SA node 379. Vagal tone means that the effect of parasympathetic division predominates on AV node 380. Dominant parasympathetic effect is to reduce activity of AV node by 25 beats/min 381. Hormones of adrenal medulla increases HR and contractility 382. Decreased Ca2+ concentrations causes depressed heart function 383. Increased Ca2+ concentrations causes heart irritability 384. Age has inverse relation with heart rate 385. Female has faster heart rate 386. Heart rate is increased during exercise 387. SV and muscle mass are increased in athlete 388. Heart rate is lowered when body temperature is cold 389. Blood flow is the volume of blood flowing through a given structure per unit time (ml/min) 390. Blood pressure is the force per unit area (mm Hg) 391. Resistance is the opposition to flow 392. Resistance to blood flow is generally encountered in the systemic circuit (peripheral resistance) 393. Resistance to blood flow is increased with increase in blood viscosity 394. Blood viscosity is the thickness related to formed elements 395. Resistance to blood flow is increased with increase in the total blood vessels length 396. Resistance to blood flow is increased with decrease in blood vessel diameter 397. Resistance to blood flow = 1/r4 398. In healthy humans, diameter is the greatest source of resistance 399. Blood Flow (F) = ∆P/PR (Difference in blood pressure between two points/peripheral resistance) 400. Blood pressure results when flow opposed by resistance 401. Blood pressure is the highest in aorta and the lowest in right atrium - 14 - 402. Blood pressure is affected by compliance, distensibility and volume of blood forced into the arteries near heart 403. Systolic pressure is about 120 mm Hg 404. Diastolic pressure is about 70 - 80 mm Hg 405. Pulse pressure is the difference between systolic and diastolic pressure 406. Mean arterial pressure (MAP) = diastolic pressure + 1/3 pulse pressure 407. Venous return is aided by respiratory pump and muscular pump 408. For venous return, muscular pump is more important than respiratory pump 409. During venous return, contraction of skeletal muscle surrounding veins compress vein and backflow is prevented by valves 410. During venous return, blood moves in direction of heart 411. Blood pressure = Cardiac output X Peripheral resistance 412. Cardiac output is directly related to blood volume 413. Reduced parasympathetic control increases HR and enhances cardiac output 414. Increased sympathetic activity increases contractility of heart 415. Increased sympathetic activity reduces ESV and increases stroke volume 416. Increased sympathetic activity releases epinephrine into blood stream from adrenal medulla which increases heart rate 417. Increased sympathetic activity increases activity of respiratory and muscular pumps 418. Increased sympathetic activity increases venous return by increasing EDV and stroke volume 419. Vasomotor fibers are sympathetic efferents that innervate smooth muscle of arterioles resulting in vasoconstriction 420. Vasomotor center regulates blood vessel diameter 421. Baroreceptors located in carotid sinuses, aortic arch and walls of all large vessels 422. Baroreceptors stretching inhibits vasomotor center 423. Baroreceptors stretching causes dilation of arteries and veins 424. Arteriole dilation reduces peripheral resistance 425. Venodilation shifts blood to venous reservoirs, decreases venous return and cardiac output 426. Baroreceptors inhibit sympathetic NS and stimulate parasympathetic NS 427. Stimulation of baroreceptors decreases HR and contractile force 428. Carotid sinus reflex protects blood supply to brain 429. Aortic reflex maintains supply to systemic circuit 430. Chemoreceptors respond to changes in O2 and CO2 concentrations and pH 431. Chemoreceptors are located in carotid and aortic arch and carotid sinus 432. Chemoreceptors are primarily involved in control of respiratory rate and depth - 15 - 433. Adrenal medulla hormone NE is a vasoconstrictor 434. Adrenal medulla hormone EPI increase cardiac output by increasing cardiac muscle contractility 435. Atrial natriuretic peptide (ANP) reduces blood pressure by antagonizing aldosterone 436. Atrial natriuretic peptide (ANP) reduces blood pressure by increasing water excretion from kidney 437. Antidiuretic hormone (ADH) increases blood pressure by increasing water absorption 438. Antidiuretic hormone (ADH) at high concentrations, causes vasoconstriction 439. Angiotensin II causes vasoconstriction of systemic arterioles 440. Angiotensin II causes release of aldosterone from adrenal cortex 441. Endothelium-derived factors endothelin is vasoconstrictor 442. Endothelium-derived factors prostaglandin-derived growth factor (PDGF) is vasoconstrictor 443. Endothelium-derived factors Nitrous oxide (NO) is fast acting local vasodilator 444. Histamine is an inflammatory chemical causes vasodilatation by increasing capillary permeability 445. Alcohol reduces blood pressure 446. Alcohol inhibits ADH release and increases loss of water in urine 447. Alcohol increases vasodilation (skin) by depressing vasomotor center 448. Increased BP increases amount of filtrate entering tubules 449. Direct action of the kidney in BP is by regulation of blood volume Third: Muscle and Nerve I. Muscle 450. 451. 452. 453. 454. 455. 456. 457. 458. 459. 460. 461. One function of skeletal muscle is temperature homeostasis Sarcomere is the functional unit of skeletal muscle A-band is composed of thick filaments I-band is composed of the light isotropic bands H-band is visible only in relaxed muscle M-line bisects H-band Z-disc is connecting thin filaments together Myosin is composed of tail and two globular heads Tropomyosin blocks binding sites on actin Troponin is composed of three subunits TnT, TnC and TnI TnI is the inhibitory protein that binds actin Sarcotubular system means sarcolemma and sarcoplasmic reticulum - 16 - 462. 463. 464. 465. 466. 467. 468. 469. 470. 471. 472. 473. 474. 475. 476. 477. 478. 479. 480. 481. 482. 483. 484. 485. 486. 487. 488. 489. 490. 491. Sarcoplasmic reticulum is the Ca2+ stores in skeletal muscle Motor end plate is the neuromuscular junction Rigor mortis occurs due to absence of ATP after death Contraction and relaxation of skeletal muscles requires ATP Motor units in human beings are either slow oxidative or fast glycolytic Red muscles response is slow with long latency White muscles response is quick with short latency Gross movement requires few large size motor units Fine and graded movement requires numerous small size motor units In isotonic contraction, muscle changes in length and moves load In isometric contraction, tension increases and muscle length is constant Fatty acids are the major source of energy at rest Oxygen debt gives an explanation of pant Exhaustion is a state of fatigue Lmax is an optimum resting sarcomere length To is a maximum active isometric tension Sarcolemma is the plasma membrane of muscle fiber Syncytium of cardiac muscle is due to intercalated discs and gap junctions Presence of plateau phase is due to influx of Ca2+ ions Late rapid repolarization phase is due to closure of Ca2+ channels Myogenic contraction is originated inside the muscle Prepotential is the pacemaker potential Calmodulin in smooth muscle replaces troponin Contraction in response to stretch is a unique property of smooth muscle Plasticity of smooth muscle means stress-relaxation Tone (tonus) means a continuous state of partial contraction Single-unit smooth muscle is found in the wall of hollow viscera Multi-unit smooth muscle is found in the iris of eye Muscle fiber is the muscle cell Cardiac muscle source of energy is only aerobic II. Nerve 492. Neurons confer the unique functions of the nervous system while glia are the supporting elements 493. Glia are 10 times as many as neurons. 494. Astrocytes are the glial cells that also participate in information processing in the brain 495. Astrocytes are the most abundant, most versatile glial cells in CNS. 496. Astrocytes have a role in making exchange between capillaries and neurons in CNS - 17 - 497. Astrocytes have a role in guiding migration of young neurons and in synapse formation in CNS 498. Astrocytes regulate extracellular space in CNS 499. Mopping up leaked potassium ions is a function of astrocytes 500. Restricting and recycling neurotransmitters is a function of astrocytes 501. Microglia migrate toward injured CNS neurons and transform into special type of macrophages 502. Microglia are the scavenger cells that get rid of microorganisms or neural debris in CNS. 503. Ependymal cells line the central cavities of brain and spinal cord. 504. Oligodendrocytes are the myelinating glia in CNS that form myelin sheath 505. Schwann cells produce myelin sheath and neurilemma in peripheral neurons 506. Satellite cells surround cell bodies in PNS and have many functions as astrocytes in CNS 507. Nerve type Aα has the largest diameter and fastest conduction velocity 508. Somatic motor and proprioceptive nerve fibers are of Aα nerve type. 509. Sensory fibers of fine touch and fine pressure are of Aβ nerve type 510. Motor fibers to muscle spindle are of Aγ nerve type. 511. Sensory fibers of acute pain are of Aδ nerve type. 512. Sensory fibers of crude touch are of Aδ nerve type. 513. Sensory fibers of cold are of Aδ nerve type. 514. Preganglionic autonomic nerve fibers are of B nerve type. 515. Nerve type C has the smallest diameter unmyelinated fibers 516. Sensory fibers of chronic pain are of C nerve type . 517. Sensory fibers heat are of C nerve type . 518. Sensory fibers of gross pressure are of C nerve type . 519. Sensory fibers of postganglionic sympathetic fibers are of C nerve type 520. The membrane interior of all living cells is negative in relation to the membrane exterior 521. Resting membrane potential present in muscle, nerve and all living cells 522. Action potential present only in excitable tissues 523. RMP of nerve cell is –70 mV 524. RMP of skeletal muscle is –90 mV 525. RMP of cardiac muscle is –85 mV 526. RMP of smooth muscle is variable but nearly about –50 mV. 527. Na+ ions are much abundant extracellularly than intracellularly 528. Cl– ions are much abundant extracellularly than intracellularly 529. K+ ions are much abundant intracellularly than extracellularly 530. Phosphates and proteins are much abundant intracellularly than extracellularly - 18 - 531. Na+-K+ ATPase pump extrudes 3 Na+ions outside and intrudes 2 K+ ions inside the cell 532. Fast sodium channels are inactive at rest. 533. Fast sodium channels are voltage gated channels 534. K+ efflux results in diffusion potential which is the major factor responsible for RMP 535. Local responses are not "all or none" responses 536. Action potentials in neurons are "all or none" responses 537. Threshold stimuli induce action potential. 538. Subthreshold stimuli may not affect the membrane potential or cause only local responses 539. Supramaximal stimuli induce the same effects as threshold stimuli 540. Depolarization phase is due to activation of all fast Na+ channels 541. Repolarization phase in neuron is mainly due to fast inactivation of Na+ channels 542. Hyperpolarization phase is due to slow closure of K+ channels 543. In absolute refractory period, Na+ channels cannot be reactivated immediately after previous activation 544. In relative refractory period, stronger stimulus is needed to induce new, but weaker, action potential 545. Ca++ ions stabilize the membrane by increasing threshold potential toward more positive position 546. Lack of Ca++ results in tetanus 547. Action potential is triggered in axon hillock and transmitted along the axon 548. Myelin sheath provides insulation and, hence, increases conduction velocity 549. Electrotonic flow of current is very fast but, in neurons, gradually subsides 550. Successive action potentials are time consuming (0.1 millisecond for each) 551. Saltatory conduction is quicker because it is jumping from node to node 552. Orthodromic conduction is one of the benefits of absolute refractory period 553. Synaptic vesicles store neurotransmitter substance in the presynaptic membrane 554. Post synaptic membrane contains no synaptic vesicles. 555. Neurotransmitters bind their specific receptors on the postsynaptic membrane. 556. Within the synaptic cleft, neurotransmitters must be inactivated by degradation, reuptake, diffusion, or bioconversion. 557. One-way conduction from pre- to post-synaptic neurons is one of properties of synapses 558. Neurotransduction from electrical to chemical signal.is one of properties of synapses 559. About 0.5 ms synaptic delay is one of properties of synapses - 19 - 560. All-or-none rule is not one of the properties of synaptic potentials. 561. Spatiotemporal summation is one of properties of synapses 562. Arrival of impulses from numerous synaptic knobs on the same neuron at the same time is called spatial summation 563. Arrival of multiple successive impulses at the same synaptic knob is called temporal summation. 564. Occlusion means that the sum of activities of several neurons working together is less than the sum of their activities when they work separately 565. Continuous recurrent weak synaptic potentials may cause habituation of postsynaptic neuron 566. Continuous recurrent strong stimulations accompanied by other weak stimulations may cause sensitization of postsynaptic neuron 567. Acetylcholine is one of small molecule, rapidly acting transmitters 568. Adrenaline is one of small molecule, rapidly acting transmitters 569. Serotonine is one of small molecule, rapidly acting transmitters 570. Dopamine is one of small molecule, rapidly acting transmitters 571. Histamine is one of small molecule, rapidly acting transmitters 572. Noradrenaline is one of small molecule, rapidly acting transmitters 573. γ-aminobutyric acid "GABA" is one of small molecule, rapidly acting transmitters 574. Glycine is one of small molecule, rapidly acting transmitters 575. Glutamate is one of small molecule, rapidly acting transmitters 576. Aspartate is one of small molecule, rapidly acting transmitters 577. Nitric oxide "NO is one of small molecule, rapidly acting transmitters 578. Hypothalamic-releasing hormones are of neuropeptide, slowly acting transmitters 579. Pituitary peptides are of neuropeptide, slowly acting transmitters 580. Peptides that act on gut and brain are of neuropeptide, slowly acting transmitters. 581. Neurotransmitter molecule must be synthesized and stored in the presynaptic neuron 582. Neurotransmitter molecule must be released by the presynaptic neuron upon stimulation 583. ACh is the neurotransmitter for neuromuscular junction 584. ACh is the neurotransmitter for preganglionic neurons of the sympathetic and parasympathetic PNS 585. ACh is the neurotransmitter for postganglionic neuron of the parasympathetic PNS 586. ACh is the neurotransmitter for basal forebrain and brain stem complexes 587. ACh synthesis is catalyzed by choline acetyl transferase enzyme (CAT). 588. Acetylcholine degradation is by acetylcholinesterase enzyme (ACE). - 20 - 589. ACh nicotinic receptors are present in neuromuscular junction 590. ACh nicotinic receptors are present in sympathetic ganglia and many parts of CNS 591. ACh muscarinic receptors are present in smooth muscles and glands. Fourth: Renal 592. About 25% of the resting cardiac output ﴾1.25 L\min﴿ supplies the renal tissue 593. Much greater blood flow to the renal cortex ﴾97%﴿ than to its medulla 594. The structural and functional unit of kidney is called nephron 595. proteins can not exit the glomerular basement membrane 596. Production of erythropoietin hormone is a function of kidney 597. One functions of kidney is regulation of bone metabolism 598. Renal clearance = GFR – tubular reabsorption + tubular secretion 599. Glomerular filtration is passive non-selective process 600. About 20% of renal plasma flow is filtered by glomerular filtration 601. Normal GFR = 125 ml\min 602. Out of the 180 L of filtered plasma, about 179 L are reabsorbed by renal tubules 603. A substance used to measure GFR must not be stored, or metabolized by kidney. 604. A substance used to measure GFR must not be produced, secreted or reabsorbed by renal tubules. 605. A substance used to measure GFR must not affect GFR or RBF by itself 606. Endogenous substance like creatinine can be used to measure GFR 607. Renal blood flow = renal plasma flow / (1-hematocrit) 608. Renal blood flow = CPAH \ EPAH X (1-hematocrit) 609. Juxtaglomerular apparatus aid in autoregulation of GFR 610. Podocytes represent the visceral layer of Bowman’s capsule 611. Glomerular filtration rate = clearance of inulin 612. GFR = Kf * (PG + ΠB – PB - ΠG) 613. When RBF increases, GFR also increases 614. When filtration fraction increases, GFR also increases 615. Vasoconstriction of afferent arterioles decreases GFR 616. Slight vasoconstriction of efferent arterioles increases GFR 617. Severe vasoconstriction of efferent arterioles decreases GFR 618. Strong sympathetic activity decreases GFR 619. Severe hemorrhage decreases GFR 620. Cerebral ischemia decreases GFR 621. Adrenaline decreases GFR - 21 - 622. Nor-adrenaline decreases GFR 623. Angiotensin II decreases GFR 624. Aspirin decreases GFR 625. Endothelin decreases GFR 626. Nitric oxide increases GFR 627. Prostaglandin increases GFR 628. Bradykinin increases GFR 629. Macula densa contains osmoreceptors that are sensitive to changes in concentration of NaCl 630. Juxtaglomerular cells are specific smooth muscle cells in the wall of afferent arterioles 631. Renin is produced by juxtaglomerular cells in response to any increase in GFR or RBF 632. Tubular reabsorption is a highly selective process that may be passive or active 633. Some substances are completely reabsorbed like amino acids and glucose 634. Some substances are mostly reabsorbed like bicarbonates and some other electrolytes 635. Some substances (like water ..) are mostly reabsorbed in the presence of specific hormones 636. Some substances (like sodium ions..) are mostly reabsorbed in the presence of specific hormones 637. Some substances are 50% reabsorbed (and 50% excreted) like urea 638. Some substances are about completely excreted like creatinine 639. Some substances are about completely excreted like some drugs and poisons 640. Renal threshold of a substance equals its transport maximum over GFR (=Tm\GFR) 641. Transport maximum of glucose is about 325 mg\min 642. Ideal renal threshold of glucose is about 260 mg\100 ml 643. the actual renal threshold for glucose is about 180 mg\100 ml 644. Sympathetic activity leads to increase in tubular reabsorption of sodium ions 645. Aldosterone increases reabsorption of sodium ions and excretion of potassium ions 646. Adrenal insufficiency (Addison's disease) results in excessive sodium loss and potassium retention 647. Adrenal hyperactivity (Cushing syndrome) results in sodium retention and potassium depletion 648. Angiotensin acts directly (or indirectly) to increase sodium ions reabsorption - 22 - 649. Vasopressin increases water reabsorption and urine concentration 650. Atrial natriuretic peptide decreases sodium and water reabsorption 651. Parathyroid hormone increases calcium and magnesium ions reabsorption 652. Parathyroid hormone decreases phosphate reabsorption 653. Normal ECF osmolarity is about 280-300 mosm\L 654. When Posm decreases; kidneys excrete large amounts of diluted urine 655. When Posm increases; kidneys excrete small amounts of highly concentrated urine 656. Net ultrafiltration pressure = + 10 mmHg 657. The human body must get rid of not less than 600 mosm of metabolic wastes per day 658. The minimum obligatory urine volume is 0.5 L\day 659. Diabetes insipidus occurs when kidney losses its ability to produce concentrated urine. 660. Descending limbs of Henle's loop are called countercurrent multipliers 661. Ascending vasa recta are the countercurrent exchangers 662. The major bulk of tubular reabsorption of water and solutes (about 65%) occurs in proximal tubules 663. The major active reabsorption occurs in thick ascending Henle’s loop 664. About 15% of water reabsorption occurs in thin descending Henle’s loop 665. The thin descending Henle’s loop is impermeable to solutes 666. About 5% of reabsorption processes of electrolytes occur in distal segments. 667. Recirculation of urea is responsible for about 40% of the process of urine concentration 668. Vasopressin secretion is stimulated by decreased blood volume 669. Vasopressin secretion is stimulated by decreased blood pressure 670. Vasopressin secretion is stimulated by nausea and vomiting 671. Vasopressin secretion is stimulated by morphine 672. Vasopressin secretion is stimulated by nicotine. 673. Vasopressin secretion is inhibited by increased blood volume 674. Vasopressin secretion is inhibited by increased blood pressure 675. Vasopressin secretion is inhibited by alcohol intake 676. Increased osmolarity stimulates the thirst center in brain stem 677. Thirst center is stimulated by decreased ECF volume 678. Thirst center is stimulated by decreased blood pressure 679. Thirst center is stimulated by angiotensin II 680. Thirst center is stimulated by dryness of mouth, pharynx and esophagus 681. Thirst center is inhibited by decreased ECF osmolarity 682. Thirst center is inhibited by increased ECF volume 683. Thirst center is inhibited by increased blood pressure - 23 - 684. Thirst center is inhibited by gastric distension 685. Decreased osmolarity stimulates salt appetite center in the brain stem 686. Pressure induced increase in Na+ excretion is called pressure natriuresis 687. Normal [H+] in ECF is only 0.00000004 mol\L 688. Bicarbonate buffer system is the most important buffer system in ECF 689. When HCO3¯ decreases; pH is decreased and there will be metabolic acidosis 690. When PCO2 increases; pH is decreased and there will be respiratory acidosis 691. When HCO3¯ increases; pH is increased and there will be metabolic alkalosis 692. When PCO2 decreases; pH is increased and there will be respiratory alkalosis 693. Phosphate buffer system is important buffer system in intracellular and renal tubular fluids 694. Protein buffer systems are the most available intracellular buffer systems but also work extracellularly 695. Ammonium buffer system is the last choice buffer system in renal tubules 696. Ammonium is formed from metabolism of glutamine inside renal tubular cells 697. Osmotic diuretics act basically on proximal tubules by increasing tubular fluid osmolarity 698. Urea is an example of osmotic diuretics 699. Mannitol is an example of osmotic diuretics 700. Sucrose is an example of osmotic diuretics 701. Loop diuretics are strong diuretics acting on thick ascending Hemle’s loop 702. Loop diuretics are strong diuretics acting by blocking 1Na+2Cl¯1K+ secondary active transport 703. Furosemide is an example of loop diuretics 704. Ethacrynic acid is an example of loop diuretics 705. Bumetanide is an example of loop diuretics 706. Thiazides act on early distal tubules 707. Thiazides act by blocking Na+-Cl¯ cotransport 708. Chlorothiazide is an example of thiazides 709. Carbonic anhydrase inhibitors act on proximal tubules and intercalated cells of distal tubules 710. Carbonic anhydrase inhibitors act by inhibition of enzyme carbonic anhydrase 711. An example of carbonic anhydrase inhibitors is acetazolamide (diamox) 712. Competitive aldosterone inhibitors act on cortical collecting tubules - 24 - 713. Competitive aldosterone inhibitors act by competing with aldosterone and blocking its receptors 714. Example of competitive aldosterone inhibitors is spironolactone (K+ sparing) 715. Na+ channels blockers act on collecting tubules 716. Na+ channels blockers act by blocking Na+ channels 717. An example of Na+ channels blockers is amiloride 718. An example of Na+ channels blockers is triametrene - 25 -