MEDT200 STUDY GUIDES: Chapters 1-11
MEDT200 STUDY GUIDES: Chapters 1-11 MEDT200011
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Ch. 1 – Basic Word Structure Four words parts: 1. Prefix: attached to beginning of a medical term to modify its meaning a. Often indicated number, direction, time, negation 2. Word root: fundamental meaning of a medical term a. Core of the word 3. Combining vowel: used to ease pronunciation a. Usually an ‘o’ 4. Suffix: attached to end of a medical term to modify its meaning a. Often indicates a procedure or condition All medical terms have a suffix Hepatic Gastritis Encephalopathy Hematology Most medical terms have at least one word root Hepatic Gastritis Encephalopathy Hematology Apnea = a- (prefix) + -pnea (suffix) Anemia = an- (prefix) + -emia (suffix) Not all medical terms have a prefix or combining vowel Hepatic Gastritis Combining vowels are used to connect word roots or word root and suffix Encephalopathy Hematology When a suffix begins with a vowel, the combining vowel is usually not used Hepatic Gastritis Encephalopathy Hematology To get the definition, start at the suffix and read back to the beginning Histopathologist = specialist in the study of tissue disease Ch. 3 - Suffixes Ch. 3 – Suffixes (p. 959, p. 968 = glossary in textbook) -algia = pain -dynia = pain pleurodynia neuralgia arthralgia myalgia *Certain word roots go with certain suffixes -ectomy = excision, removal -tomy = incision, cutting into -stomy = creating a new opening nephrectomy = kidney removal nephrotomy = kidney incision nephrostomy = kidney opening -graph = instrument for recording -graphy = process of recording -gram = the recording itself -logy = process of study of -lysis = breakdown, destruction, separation -malacia = softening -megaly = enlargement -oma = tumor, mass, collection of fluid (hematoma) -opsy = to view (biopsy, necropsy) -osis = condition, usually abnormal -pathy = disease condition -penia = deficiency -phobia = fear -plasia = development, formation, growth (Plastic) -plasty = surgical repair -ptosis = drooping, sagging, prolapse (nephroptosis) Blepharoptosis = drooping of the eyelids -sclerosis = hardening (atherosclerosis, arteriosclerosis) -scope = instrument for visual examination (microscope) -scopy = process of visual examination (microscopy) Laparoscopy = visual exam of the abdomen using a laparoscope -stasis = stopping, controlling (hemostasis, homeostasis, metastasis) -therapy = treatment (chemotherapy) -trophy = development, nourishment hyperplasia = increase in number of cells hypertrophy = increase in size, not number -er = one who -or = one who -ia = condition -ist = specialist -ole = little, small Arteriole = small artery; blood vessel that carries blood away from the heart Ch. 3 - Suffixes -ule = little, small (venule = small vein) -um, -ium = structure tissue, -us = structure, substance -y = condition, process -ac, -iac = pertaining to -al= pertaining to -ar, ary = pertaining to -eal = pertaining to -ic, ical, = pertaining to -ous, = pertaining to -tic = pertaining to -ose = pertaining to, full of -genic = pertaining to producing, produced by or in -oid = resembling -phil = brother, attraction to -cele = hernia (protrusion of an organ through the cavity that normally contains it; cystocele) Hiatal hernia = involves the diaphragm Inguinal hernia = involves the groin -centesis = surgical procedure to remove fluid amniocentesis = withdrawal of fluid that surrounds the embryo for culture and karyotyping -coccus = bacteria that grow in chains or cluster Streptococcus Staphylococcus -emia = condition of the blood Anemia = reduction in the number of RBC or amount of hemoglobin in the circulating blood *Doesn’t have a word root Aplastic anemia = “not developing”, patients on chemotherapy can get this Sickle cell anemia = abnormal hemoglobin in the RBC; single AA difference in hemoglobin that causes the soluble hemoglobin to become insoluble Iron deficiency anemia = RBC don’t have much hemoglobin bc need iron to make hemog. Ischemia = loss of normal blood flow to a part of the body -plasia = Achondroplasia = a type of dwarfism characterized by short limbs, a normal- sized head and body, and normal intelligence Latin singular/plurals: -us -i -a -ae -um -a Greek singular/plurals -on -a -ex/ix -ices Ch. 3 - Suffixes -is -es Write the plural for each: 1. Psychosis = psychoses 2. Ovum = ova 3. Vertebra = vertebrae 4. Bronchus = bronchi 5. Spermatozoon = spermatozoa 6. Apex = apices Blood Cell Types Erythrocytes = RBC Made in bone marrow Carry oxygen from lungs to all body cells Hemoglobin = blood protein found in RBC Live 120 days; removed by spleen Millions per liter Leukocytes = WBC 10,000 per liter Five different kinds: Never Let Monkeys Eat Bananas o Neutrophils o Lymphocytes o Monocytes o Eosinophils o Basophils Two different families: o Granulocytes = have small granules containing molecules to help WBC function (one nucleus); Three types, named for staining properties: Neutrophils – kill bacteria Eosinophils – respond to allergies Basophils – contain natural anticoagulant (anti-clotting) o Mononuclear leukocytes = obvious one nucleus Lymphocytes – nucleus not much cytoplasm; increase with viral infection, produce antibodies Monocytes – biggest WBC Macrophages – respond to infection and engulf/remove dead cells from an area of an infection Thrombocytes = platelets Tiny fragments of blood cells formed in the marrow 200,000 per liter Necessary for blood clotting Megakaryocyte = large bone marrow cell responsible for producing thrombocytes Ch. 3 - Suffixes o “Big nucleus cell” Ch. 4 - Prefixes Ch. 4 – Prefixes ab- = away from abductor/adductor muscles ad- = toward adrenal glands = endocrine glands located above each kidney secondary source of male/female sex hormones aldosterone = control of sodium (made in adrenal cortex) cortisol = control of glucose in long term fasting (made in adrenal cortex) adrenaline = aka epinephrine; produced in medulla (core) anti- = against antibiotic = destroys or inhibits the growth of microorganisms such as bacteria penicillin = first antibiotic, 1928, Sir Richard Fleming antigen = a substance, usually foreign to the body, that stimulates production of antibodies antibodies = protein substances made by WBC (lymphocytes), usually in response to presence of foreign antigens part of immune response to foreign invaders autoimmune disease = the body makes antibodies against its own healthy cells and tissues, causing inflammation and injury Hard to diagnose Rheumatoid arthritis Lupus erythematosus = 9x as frequent in women as men; primarily 15- 45 year olds; affects kidneys, lungs, CNS, blood vessels, blood, and heart Graves’ disease = hyperthyroidism (bulging eyes, goiter) Rh condition = (Rhesus) an antigen-antibody condition that develops when there is a difference in the Rh blood factor between that of the pregnant mother (Rh negative) and that of the fetus (Rh positive) o RhoGam = injection mother receives right after delivery; giving antibody against Rh to keep her from developing an immune response con- = together, with Congenital anomaly = an irregularity in a structure or organ that an infant is born with Clinodactyly = “bent” “fingers” Albinism = lack of melanocytes Proteus syndrome = God who could change his shape; Joseph Merrick Spina bifida = herniation that can involve both the spinal cord and the membranes surrounding the spinal cord Cleft palate = nonformation of the roof of the mouth, involving lip or face Ch. 4 - Prefixes contra- = opposite contralateral = opposite side of the body Patients with a stroke (loss of blood supply) involving the left side of the brain will have contralateral symptoms para- = on the side of (paralysis) parathyroid glands = four endocrine glands located on the dorsal side of the thyroid gland the function separately from the thyroid gland dia- = complete separation dialysis = remove harmful waste products from the body with an artificial kidney machine Peritoneal dialysis ec- = outside top- = out of place ectopic pregnancy = an abnormal pregnancy when the embryo implants outside the uterus, usually in the fallopian tubes, but sometimes on an ovary or in the abdominal cavity pro- = forward prolapse = to fall or slide forward, often used to describe an organ Prolapsed uterus syn- = together syndrome = a group of signs or symptoms that commonly occur together and indicate a particular disease or abnormal condition sym- = together symbiosis = two organisms living together in close association, for mutual benefit or not Ex: Mistletoe Ch. 5 & 6 – Digestive System Ch. 5 & 6 – Digestive System Ch.5 Oral Cavity – know anatomy of a tooth EXAM QUESTION: Be able to split the word into its word parts o Ex: Periodontal – peri/odont/al Salivary Glands = where digestion starts by providing the enzyme salivary amylase to break down starches (complex carbohydrates) in the mouth o 3 Glands = parotid, sublingual, submandibular Deglutition = swallowing o Epiglottis Esophagus/Stomach o Carries food by gravity and muscular contraction (esophagus = muscle) o Stomach acid pH of 2 Pepsin = enzyme that can work at a very acidic pH o Sphincter = “bind tightly” Circular muscle that has the ability to constrict/tighten and then release; release is often govered by hormones and neural responses o Esophagus = “what carries and eats” o Fundus = “bottom” o Antrum = “cave” o Rugae = “wrinkle in the face” o Pylorus = “gate keeper” o Duodenum = “twelve” = first 12 inches of small intestine o Gastroesophageal reflux disease = GERD; the cardiac sphincter that should be closing stays open, and the stomach acid comes up into the esophagus, which doesn’t have the mucus to protect itself from the acidity o Ulcer = stomach cells can’t produce molecule to protect stomach lining from its own acidity (molecule = a glycoprotein called mucus) EXAM QUESTION: trace the path of food through the gastrointestinal tract Accesory Organs – supply molecules or environment to help intestines do their job o Liver = handles cholesterol; can convert it into bile (combo of cholesterol and the waste product bilirubin); portal circulation connecting all intestines directly to liver; major detoxifier (can remove drugs from circulation) bile salts have hydrophilic and hydrophobic parts o Gallbladder = storage site of bile o Pancreas = “all flesh”; makes enzymes in an inactive way to protect their own cells Ch. 5 & 6 – Digestive System Endocrine function = produces insulin to the bloodstream for cells Diabetes mellitis Exocrine function = produces enzymes to the duodenum for digestion Achalasia = failure of the lower esophagus sphincter muscle to relax o A- = not, -chalasis = relaxation Hiccups = diaphragm and the complete set of insiratory muscles make a sudden, very strong contration, exipratory muscles are inhibited, just after the contraction begins, the glottis clamps shut, making the “hic” sound Esophageal varices = swolen, varicose veins at lower end of the esophagus o “varix” = twisten vein o Increase possibility of blood vessels breaking, leading to hemmorage Cirrhosis of the liver = liver cells so damaged that they’re replaced by connective tissue (decreased functionality) o Cirrh- = yellow Gastric carcinoma = malignant tumor of the stomach Anal fistula = abnormal tubelike passageway near the anus Colonic polyposis = polyps protrude from the muscous membrane of the colon o Pedunculated or sessile Colorectal cancer = adenocarcinoma of the colon or rectum or both o Occult blood test = done in the feces Diverticulosis = abnormal side pockes in the intestinal muscular wall Hemorrhoids = swollen, twisted, varicose veins in the rectal region Ileus = failure of peristalsis with resulting obstruction of the intestines o Ileum = part of the intestines o Ilium = part of the hip bone Intussusception = telescoping of the intestines o intus- = within o –suscipere = to receive Volvulus = twisting of the intestines o Volvere- = to roll o Cecal volvulus Cholelithiasis = gallstones in the gallbladder (choleliTHIasis) o Cholecystolithiasis Choledocholithiasis = gallstones in the common bile duct Ch. 6 Aphthous stomatitis = canker sore; small ulcer; women more affected than men o Inflammation, but NOT caused by an infection Ch. 5 & 6 – Digestive System Biliary atresia = also known as “progressive obliterative cholangiopathy”; refers to bile ducts from the liver o Most commonly caused by a stone of some kind Celiac disease = “sprue”; autoimmune inflammation of lining of small intestine, damaged from eating gluten Cheilosis = break in the skin around the lips, especially in cold/dry conditions o Cheilos- = lip Cholangiectasis = bile duct widening o Chol/angi/ectasis Cholangiography = bile duct recording process o Chol/angi/o/graphy Cholangiopancreatography = endoscope is passed through the mouth, esophagus, and stomach into the first part of the small intestine; dye is then injected through the tube into the pancreatic and bile ducts, and an x-ray is taken o Chol/angi/o/pancreat/o/graphy Cholecystectomy = removal of the gallbladder o Chole/cyst/ectomy Cholecystojejunostomy = creation of a communication between the gallbladder and jejunum (-ostomy = create new opening) o Chole/cyst/o/jejun/o/stomy Choledochal = refers to the common bile duct Cholestasis = stoppage of bile flow Colectomy = removal of the colon itself Ch. 7 – Renal System Ch. 7 – Renal System Introduction Cyst = root word for bladder Nephr = root word for kidney Main job of kidney: FILTER o Nitrogenous waste products: Urea highest concentration in urine waste product of protein/amino acid metabolism Protein/AA metabolism -> NH3 -> (CO2) -> urea Creatinine Creatine = muscle 1-2% of all creatine from mucle goes from being an open molecule to being a closed molecule with covalent linkage (creatinine) Uric acid DNA/RNA (mainly Purines) converted to uric acid Ammonia (NH3) Toxic material in body fluid by making pH very basic o Azotemia = abnormally high concentration of nitrogenous waste products Azo = nitrogen Kidneys: o filter N waste to form urine o maintain proper balance of water, electrolytes, and acids Kidneys are also an endocrine organ o Secrete: Renin = important hormone in regulating blood pressure Erythropoietin = hormone that stimulates the production of red blood cells in the bone marrow Outermost part of kidney = Cortex; Innermost part = medulla o Medulla = urine formation (everything else in renal system to get urine OUT of body) Adrenal Glands o Located on top of each kidney o Outermost part = cortex o Innermost part = medulla How kidneys produce urine: o Blood enters kidneys through right and left renal arteries o Arterioles carry blood to capillaries (=glomeruli) o Glomeruli filter blood (located in Renal Cortex) o Blood (plasma) passes through glomeruli Afferent renal arteriole arrives at the glomerulus Ch. 7 – Renal System Efferent renal arteriole exits at the glomerulus o Bowman’s capsule surrounds each glomerulus o Renal tubule (PCT) is attached to each Bowman capsule o All collecting tubules lead to the renal pelvis (“basin”) o Calyces or calices are small, cup-like regions of the renal pelvis Singular is calyx o DIAGRAM OF ORDER OF HOW URINE GETS EXCRETED (FLOW CHART) Bloodstream Glomerulus Bowman capsule Renal tubule Loop of henle, collecting tubule, PCT, DCT Renal pelvis Ureter Bladder Urethra Urinary meatus Three Steps of Urine Production: 1. Glomerular filtration a. Water, sugar, wastes, salts b. Cortex 2. Tubular reabsorption a. Water, sugar, some salts b. Cortex and medulla 3. Tubular secreation a. Acids, potassium, drugs b. Cortex and medulla Glomerulus and a renal tubule combine to form a unit called a NEPHRON Function unit of an organ = Parenchyma Liquid blood is about half of total blood volume Urinalysis Tests included: 1. Color 2. Appearance 3. pH 4. Protein 5. Glucose 6. Specific gravity 7. Ketones a. Diabetes mellitus = increase in keytones, which can change blood pH which can be fatal (Ketoacidosis) 8. Blood Ch. 7 – Renal System 9. Leukocytes 10. Nitrite 11. Urine formed elements a. “Sediment” = cells, casts, mucus… 12. Urobilinogen a. Endproduct of hemoglobin metabolism 13. Bilirubin 14. Creatinine a. Nitrogenous waste product from muscle Renal System Organization Nephron: o Bowman Capsule o Proximal convoluted tubule Proximal b/c closest to Bowman capsule o Loop of Henle o Distal convoluted tubule o Collecting duct Blood Supply: o Renal artery o Interlobar artery o Afferent arteriole o Glomerulus o Efferent arteriole o Peritubular capillaries Vasa recta = parallel to loop of henle o Interlobar vein o Renal vein Blood pressure control: o Cooperation between blood side and tubule side of nephron o Specialized smooth muscle cells (“Macula Densa”, sensitive to Na concentrations) in AA and EA produce and release the hormone renin Renin = needed when BP decreases When BP falls, stimulates juxtaglomerular apparatus to release renin which goes into blood and looks for protein made by liver (angiotensinogen = protein that can be produced related to vessel pressure) Renin converts angiotensinogen to angiotensin I Angiotensin II = most potent vasoconstricter (increase BP) o Goes to adrenal cortex and stimulates certain cells to produce aldosterone which goes to cells in DCT and causes reabsorption of Na (and by default water), which increase blood volume to cause an increase in blood pressure o Vaso = arteries AND veins Ch. 7 – Renal System o Juxtaglomerular apparatus = next to glomerulus Organs of the Urinary System (MALE) Kidneys (L/R) Ureters (connect kidney and bladder at the trigone) Trigone (connection point at bladder) Urinary bladder Prostate gland (located at base of bladder) Urethra Urinary meatus Organs of the Urinary System (FEMALE) Kidneys Ureters Uterus Vagina Urinary bladder Urethra Urinary meatus Pathological Conditions Kidney Pyelonephritis o Inflammation of kidney and renal pelvis caused by UTI o Another name for an upper UTI Glomerulonephritis o Inflammation of the nephron and glomerulus o NOT an infection condition, just inflammation Interstitial nephritis o In connective tissue in kidney (NOT NEPHRON) in the interstitium o Allergic response to a medicine the person is on (eiosinophil # increased) Nephrolithiasis o Kidney stones Nephrotic syndrome o Single condition in which the patient is excreting large amounts of proteins Polycystic kidneys (PKD) Renal cell carcinoma (Hypernephroma) o Rare condition Urinary bladder Cystitis o Inflammation of the bladder (UTI) Ch. 7 – Renal System Bladder cancer o Snake venom example DO NOT CONFUSE: Diabetes mellitus o Mellitus = honey o Increase amount of glucose in urine Diabetes insipidus o Insipud = not sweet Both affect kidney, and are hormonally controlled Antidiuretic hormone (ADH) = made by pituitary gland o DI patients have decrease in ADH o No signal going to tubules to reabsorb water o High urine volume but very dilute Laboratory Tests and Clinical Procedures CT = computed tomography X-ray studies o Renal angiography o Retrograde pyelogram (RP) = dye injected via catheter from bladder into ureters o Intravenous pyelogram = dye injected via bloodstream -> kidneys -> ureters o Voiding cystourethrogram (VCUG) = contrast material inserted via urethra into bladder; x-rays taken while emptying Vesicoureteral reflux (VUR) = pediatric condition in which the urine flows backwards from bladder back into kidneys Vesico = root word for bladder o Cystoscopy = direct visual examination of he urinary bladder with a cystoscope Continuous ambulatory peritoneal dialysis (CAPD) = using bag to perform dialysis Lithotripsy = crushing kidney stones using ultrasound shock waves o Extracorporeal shockwave lithotripsy = person is usually reclining in a waterbath; shockwaves used to breakdown the stones which then pass through the body with normal urine flow; minimally invasive o Percutaneous nephrolithotomy = incision made to remove the stones using a hollow tube; more invasive Fanconi syndrome = an inability of the kidney to reabsorb small molecular weight molecules like glucose and amino acid; affect the tubules Ch. 8-9 – Sexual Reproduction 1 Ch. 8 & 9 – Sexual Reproduction Ch. 8 = Female Reproductive System Sexual reproduction Union of the nucleus of ovum and sperm cells Ovum and sperm cells are called gametes o Gamein = “to marry” Each gamete contains half the number of chromosomes of a normal body cell (23) Gametes are produced in the gonads o Gonad = “seed” o Female gonads are the ovaries; Male gonads are the testes (Testes = “witness”) Fertilization Ovum leaves the ovaries and travels through the fallopian tube Fertilization takes place if sperm cells are present and unite with the ovum Embryology (developmental terms) Zygote = 1 day post ovulation (not egg, not sperm, but unique individual) Morula = 2 days post ovulation (~8-10 blastomere stage [sprout + part]) Blastocyst = 4 days post ovulation (inner cell mass + trophoblast) Gastrula = 13 days post ovulation (endoderm, mesoderm, ectoderm) Embryo = called this before 8 weeks Fetus = called this after 8 weeks Organs of female reproductive system Ovary Fallopian tube Uterus Cul-de-sac Cervix Pubic bone Vagina Clitoris Bartholin glands Perineum Vulva Clitoral hood Clitoral glans Labia minora Urinary meatus Labia majora Ch. 8-9 – Sexual Reproduction 2 Vaginal opening Peritoneum Breast o Made up of fatty tissue o Glands to produce milk o Ducts leading to nipple to deliver milk o Hung on the chest wall on the pectoralis major/minor muscle o Pathology: Fibrocystic disease (non-cancerous) Carcinoma of the breast (breast cancer) Menstruation and Pregnancy ~Menstrual cycle WITHOUT pregnancy: Day 1-5 = blood cells, endometrial cells, and glandular secretions discharge from the body Day 6-12 = Follicle stimulating hormone (FSH) causes one ovum in ovary to ripen within its follicle; follicle produces estrogen; estrogen aids repair of endometrium Day 13-14 = with luteinizing hormone (LH, “to cause yellowing”) surge, egg leaves the ovary and passes into the fallopian tube (LH used to tell if ovulation has occurred; chemical used in ovulation kits) Day 15-28 = folicle becomes a corpus luteum, secreting progesterone; uterus blood rich lining builds up Menarch = First menstrual cycle ~PREGNANCY: If fertilization occurs, by day 5 the zygote becomes a blastocyst, with the trophoblast layer producing human chorionic gonadotropin (hCG; “seed nourishment") o hCG = biochemical used to tell if fertilization has occurred; comes from embryo A: Implantation in the uterus Embryo continues to divide and divide until it reaches the blood-rich lining of the endometrium and implants itself Fetal contribution to the placenta = trophoblast cells Blastocyst cells = 0.1mm Stem Cell Terminology: o Totipotent (“all strong”) o Pluripotent (“more strong”) Blastocysts contain these o Multipotent (“many strong”) B: Embryo’s relationship to the placenta (“flat cake”) Amnion = membrane closeset surrounding the fetus Ch. 8-9 – Sexual Reproduction 3 Amniotic cavity = Fluid the fetus us suspended in Chorion = farthest membrane surrounding the fetus; comes into intimate contact with the placenta, allowing the blood vessel connection between the fetus and the mother Summary: Blastocyst implants in the uterine endometrium Placenta forms within the uterine wall with embryonic and maternal tissue contributions Amnion holds the fetus in an amniotic cavity Nutrients, oxygen, and wastes exchange between fetus and mother Placenta produces progesterone for the remaining months of pregnancy Progesterone maintains placenta development Uterus expands as fetus grows Fetus reaches the epigastric region by ~28-30 weeks Normal delivery fetal position in cephalic presentation (head first) o If not head = breach delivery 3 Phases of Labor: o Dilation of the cervix o Birth of the infant o Delivery of the placenta Hormonal Interations: o Pituitary gland secretes: Follicle stimulating hormone Luteinizing hormone o Pituitary gland STOPS producing FSH and LH: During pregnancy With oral contraceptives (birth control fools the pituitary gland into thinking the body is pregnant) o Menopause Gradual ending of the menstrual cycle Normally begins between 45 and 55 Estrogen levels fall Option for estrogen replacement therapy (carful consideration of risks required) Uterus Pathology Fibroids o Benign tumors of the uterus Leiomyoma (singular) Leiomyomata “Smooth muscle tumor” Subserosal (under serous membrane) Submucosal (under mucous membrane) Intramural (within wall) Ch. 8-9 – Sexual Reproduction 4 Pendunculated (little foot) Pregnancy Pathology: Abruptio placentae o Premature separation of the implanted placenta Choriocarcinoma o Malignant tumor of the placenta Ectopic pregnancy o Misplaces implantation of the embryo (usually in fallopian tubes) Placenta previa o Placenta at the cervix rather than the uterine wall o Cause of c-section Preeclampsia and eclampsia o Eclampsia = “flash” Neurologial symptoms o Mother sees flashes of light o Preeclampsia precedes the neurologial symptoms of eclampsia o Can be life threatening o Preeclampsia symptoms: Hypertension, proteinuria, low platelets, and edema of the lower extremities CURE: delivery of the baby o Eclampsia symptoms: Very high BP, very high proteinuria, severe involuntary muscle movements Neonatal Pathology APGAR Scoring Chart o Both eponym and acronym invented by Virginia Apgar Appearance, pulse, grimace, activity, respiration o Assessment of newborn o Scoring 1 to 5 minutes after birth Clinical Tests and Procedures: Pregnancy test Pap smear o Georgios Papanikolaou MoM test = multiple of the median o 4 tests done on maternal serum to assess risk of birth defects Amniocentesis o Needle placement guided by ultrasound images Gynecological: Laparoscopic oophorectomy o Oophor = ovary root word Ch. 8-9 – Sexual Reproduction 5 o A: Ovary placed in a plastic bag o B: Ovary extracted through the laparoscope Female reproductive history: Gravida = pregnancy Para = birth G2P1 = pregnant twice, delivered once G4P3-0-1-2 o Pregnant = 4 o Full term infants = 3 o Pre term infants = 0 o Abortions = 1 o Living children = 2 Pathological Conditions of the Menstrual Cycle: Menorrhagia = “month + bursting forth”; abnormally long or heavy menses Metrorrhagia = “uterus + bursting forth”; bleeding between menses Menometrorrhagia = “month + uterus + bursting forth”; excessive uterine bleeding during and between menses Embryo continues to divide and divide until it reaches the blood-rich lining of the endometrium and implants itself Fetal contribution to the placenta = trophoblast cells Ch. 9 = Male Reproductive System Male sex cell = spermatozoon Sperm cell carries the 23 chromosomes in the head region Tail consists of flagella, which makes the sperm cell mobile 300 million sperm cells released during ejaculation Only one can fertilize a single female ovum If more than one egg is present in the fallopian tubes during ejactulation, multiple fetilizations are possible Twins *COURSE CAPTURE* Fraternal vs identical Separation to cause twins happens BEFORE trophoblast forms (day 5) Separation AFTER trophoblast forms and BEFORE amnion forms (before day 9) Conjoined twins (pagus = fixed) o Thoraco-omphalopagus = 28% of cases; share liver, heart, GI o Thoracopagus = 18% of cases, share chest, 90% share heart o Omphalopagus = 10% of cases; two hearts o Craniopagus = 6% of cases; share bones of the cranium Ch. 8-9 – Sexual Reproduction 6 o Cephalothoracopagus = share a heart and GI tract; non-viable o Xiphopagus = may share liver Male Reproductive Anatomy Pubic bone Prostate gland Urethra Vas deferens Penis Glans penis Foreskin (aka prepuce) Scrotum Testis Seminiferous tubules Perineum Seminal vesicles Ejaculatory ducts Cowper glands Epididymis Testicular parenchymal cells o Produce and release billions of sperm cells through a man’s lifetime Testosterone o 2ndary sex characteristcs of the male beard pubic hair deeper voice FSH (made by pituitary gland) and GnRH (gonadotropin releasing hormone, made by the hypothalamus) o Hormones that stimulate the production of sperm Seminal fluid (semen) o Composition of semen Seminal vesicle (~50%) Fructose (sperm energy source) Flavins (gray, opalescent color) Citric acid, potassium Prostate gland (20%) Prostate-specific antigen Testes (~5%) Mature sperm o Normal characteristics: Volume = 2-5mL Liquefaction within 20 minutes Ch. 8-9 – Sexual Reproduction 7 pH = 7.2-8.0 Occasional white blood cells Greater than 80% sperm forward motility Each ejaculation has 50-160 million sperm per milliliter Sperm morphology Passage of sperm from the seminiferous tubules to outside of body: 1. Seminiferous tubules (testes) 2. Epididymis 3. Vas deferens 4. Ejaculatory duct 5. Urethra 6. Penis Pathological Conditions Hydrocele o Abnormal sac of fluid in the scrotum that puts pressure on the testis Testicular torsion o Twisted spermatic cord Varicocele o Dilated spermatic vein Prostatic carcinoma o Cancer of the prostate Benign prostatic hyperplasia o Enlargement of the prostate b/c of an increased number of cells (BENIGN but increases risk of developing cancer) o DRE = digital rectal exam Hypospadia o Urethra should go to tip of penis to allow urine and semen to pass o Urethra doesn’t go to end of penis but instead opens on shaft of penis o Birth defect o First degree = 50-75% of cases, opening of urethra is on glans penis o Second degree = 20-30% of cases, opening of urethra is on shaft o Third degree = opening of urethra is on perineum o *Note: can also be an opening from female urethra into vagina o Treatment: Surgical repair Excise a portion of the prepuce Wrap it around a catheter Suture it to the distal part of the urethra, bringing it to end of penis Phimosis o “Muzzle” o Excessing amount of skin making up the prepuce Ch. 8-9 – Sexual Reproduction 8 o Corrected by incision and removal of the prepuce Sexually Transmitted Diseases Common Infections: Chlamydial infection Gonorrhea Herpes genitalis Syphilis Laboratory Tests and Clinical Procedures Prostate health index o Primary form in Pca tissue = p2PSA o Free PSA Semen analysis o Fertility assessment CA19-9 = pancreatic CA125 = ovarian, endometrial Alpha fetoprotein = liver Carcinoembryonic antigen = GI hCG = trophoblstic Transurethral resection of the prostate (TURP) Vasectomy o Cutting a segment of the vas deferens o Vasovasostomy = reversal of a vasectomy o Orchiectomy = removal of the testis o Aspermia = no sperm/semen being produced Ch. 8-9 – Sexual Reproduction 9 Ch. 10 – Nervous System 1 Ch. 10 – Nervous System Introduction Complex: 100 billion nerve cells Voluntary and involuntary functions Nerves carry electrochemical messages o Nerve = functional unit of the NS (parenchyma) External and internal receptors Division of the NS: o CENTRAL Brain/spinal cord o PERIPHERAL SOMATIC = cranial/spinal nerves Sensory nerves carry messages TOWARDS the brain o Smell, touch, sight, taste… o Myelinated nerve fibers (fast) Fast touch, pokes, pinpricks, pressure, vibration, spatial location Conduct message within milliseconds Processed by the somatosensory cortex o Unmyelinated nerve fibers (slow) Deep pain Temperature Pleasant touch Processed by the insular cortex Motor nerves carry messages AWAY from the brain Mixed nerves carry both types of fibers AUTONOMIC = parasympathetic/sympathetic nerves Carry impulses from the CNS to the organs Sympathetic nerves = stimulate the body under stress o Fight/flight o Fast heart rate, high blood pressure o Epinepherine/adrenaline Parasympathetic nerves = balance the sympathetic system o Not health to be stressed all the time o Rest/digest o Slow heart rate, low blood pressure Cranial nerves: 1. Olfactory 2. Optic 3. Oculomotor 4. Trochlear 5. Trigeminal 6. Abducens Ch. 10 – Nervous System 2 7. Facial 8. Vestibulocochlear 9. Glossopharyngeal 10. Vagus 11. Accessory 12. Hypoglossal Neuron structure Dendrite Cell nucleus Axon o Myelin sheath o Neurolimmea membrane Terminal end fibers (secrete neurotransmitters) o Neurotransmitters transfer impulse across synapse Ganglia = small cluser of nerve cell bodies Dendrite -> nerve cell body -> axon -> end fiber Neurotransmitters Acetycholine o Neuromuscular transmitter Dopamine o Perception of pleasurable effects o Opiods, nicotine, amphetamine, ethanol, and cocaine increase dopamine release o Dysfunction involved in parkinsons, schizophrenia Epinepherine and Norepinepherine o Fight or flight o Increased HR Serotonin o Regulation of mood, sleep/wake cycles, body temperature o Released in sunny weather, eating chocolate, taking some drugs Neurons, Nerves, and Glia Glia cells: “glue” Maintain health of NS Moderate neurotransmissions, but we don’t know how Roughly one glia for every neuron with a ratio of about 2 neurons for every 3 glia in the cerebral gray matter 3 Types of Neuroglia: 1. Astrocytes/Astroglial cells a. Transport water and salts between capillaries and neurons Ch. 10 – Nervous System 3 b. Nutrition cells 2. Microglia cells a. Phagocytic cells protecting neurons in inflammation b. Eating/removal cells 3. Oligodendroglia cells a. Form the myelin sheath around peripheral neurons 4. *Ependymal cells a. “upper garment” b. Line the membranes within the brain and spinal cord where CSF circulates Brain Structure and Function Gyri = sheets of nerve cells producing a rounded fold on the surface of the cerebrum Sulci = depressions, grooves in the surface of the cerebral cortex Lobes: Parietal o Body sensations, visual and spatioal perception Occipital o Vision Temporal o Hearing, understanding speech, language Frontal o Thought processes, behavior, personality, emotion Cerebrum: Largest section of the brain Surface = cerebral cortex Manages speech, vision, smell, movement, hearing, and though Cerebellum Coordinates voluntary movements Maintains balance “little brain” Thalamus “chamber” integrates and monitors impulses (pain) from the skin Hypothalamus Controls body temperature, sleep, appetite, sexual desire, and emotions Regulates the release of hormones from the pituitary gland Monitors sympathetic/parasympathetic NS Sella turcica = bony cup that envelops the pituitary gland Meninges = Membranes that envelop the brain and spinal cord 1. Pia mater a. Delicate membrane right on top of gray matter Ch. 10 – Nervous System 4 b. Deepest membrane 2. Arachnoid a. Has little projections that connect to the pia mater (spider-like) 3. Dura mater a. Uppermost membrane, closest to cranium Cerebrospinal fluid Produced in the ventricles of the brain Cushion/buffer to brain cortex Ultra-filtrate of plasma o Water, glucose, sodium, chloride, protein found in CSF o 20mL/hour made o Reabsorbed by arachnoic villi o Adult volume = 160 mL o Infant volume = 60 mL Blood-brain barrier is ability of cells lining ventricles to filter molecules (water/salt/protein) from blood side to spinal fluid side Collection of CSF is an invasive procedure o Needle placed between L3 and L4 Brainstem Pons o “Bridge” o Bridges cerebrum with cerebellum and medulla; circular structure at base of brain o Houses nerves for face an eyes o Generated dreams in REM sleep Medulla oblongata o “Long marrow” o Below the pons o Connects the spinal cord to the brain o Nerve tracts from side to side (L-R, R-L) o Regulates: Blood vessels (esp. arterioles) Heart Respiratory system Spinal Cord Gray matter = contain nerve cell bodies White matter = only has axons; no cell bodies Afferent neurons arrive Efferent neurons exit Congenital disorders Hydrocephalus o “Water on the brain” Ch. 10 – Nervous System 5 Spina bifida o Herniation because of a weakness in the formation of the spinal cord o Spina bifida occulta No visible herniation externally o Spina bifida cystica External protruding sac contains meninges and CSF o Meningomyelocele Degenerative, Movement, and Seizure Disorders Alzheimer disease (AD) o 26.6 million people worldwide in 2006; this number may quadruple by 2050 o Dementia is NOT the same as AD o Loss of neurons and synapses in the cerebral cortex o Pre-dementia o Progressive Amyotrophic lateral sclerosis (ALS) o “No + muscle + nourishment” o Muscle wasting from degeneration of motor neurons o “Lou Gehrig Disease” Epilepsy o Chronic, recurrent seizures o 50 million individuals in US affected o Younger patients: genetic, congenital, and developmental conditions o Over 40: tumors are more likely o Any age: head trauma, CNS infection Huntington disease o Uncontrollable movement of arms, legs, face o Chorea, choreatic movements o Etiology = study of causation of a condition Multiple sclerosis o Destruction of myelin sheath o NSC = normal serum control o CSF = cerebral spinal fluid o Blood brain barrier is defective in MS patients Myasthenia gravis o Chronic autoimmune disease o Weakness of voluntary muscles o Blepharoptosis = drooping of eyelids o Diplopia = double vision Parkinson disease o Degeneration of neurons in the basal ganglia Tourette syndrome o Similar to Huntington disease o Jerking, uncontrollable movements Ch. 10 – Nervous System 6 o Spontaneous yelling and cursing Infectious Disorders Herpes zoster o Viral infection affecting peripheral nerves o Causes shingles Meningitis o Inflammation of the meninges o Bacterial or viral o Leptomeningitis = inflammation of the subarachnoid space Human immunodeficiency virus (HIV) Traumatic Disorders Cerebral concussion o Temporary brain dysfunction after injury o Usually clears within 24 hours Cerebral contusion o Bruising of brain tissue through direct trauma to head o Neurological deficits persist longer than 24 hours Cerebrovascular accident (CVA) o Stroke o Lack of blood flow to the brain; death of brain cells due to lack of oxygen/nutrients o Can be caused by: dislodged thrombi cerebral arterial wall rupture artheromatous plaques that block cerebral arteries o Major risk for patients that have had bypass surgery Clinical Procedures X-ray tests: Cerebral angiography Computed tomography (CT) scan of the brain Myelography o process of recording the spinal cord Other procedures: Magnetic resonance imaging (MRI) Positron emission scan (PET) o Post seizure o Red/yellow = more activity o Green/blue = less activity Electroencephalography (EEG) o During seizure o Ch. 10 – Nervous System 7 Ch. 11 – Cardiovascular system 1 Ch. 11 – Cardiovascular System Introduction Function: deliver oxygen and nutrients to cells of body tissue Two Parts: 1. Heart = pump 2. Blood vessels = conduits o 3 major types of blood vessels: Arteries = lead AWAY from the heart; highest pressure; thicker walls; bring oxygen rich blood to tissues Veins = lead TOWARDS the heart; lowest pressure; thinner walls; bring deoxygenated blood back to the heart to be reoxygenated Capillaries = point of exchange between arteries and veins; smallest vessels; only point of exchange for oxygen and nutrients into body cells and waste products coming from body cells How many miles of blood vessels do we have within us? 60,000 miles Major Arteries and Veins Arteries: Carotid Pulmonary* o Takes deoxygenated (NOT oxygenated) blood to the lungs Aorta Brachial Radial Femoral Ch. 11 – Cardiovascular system 2 Tibial Dorsal pedis Veins: Pulmonary* o Carries oxygenated (NOT deoxygenated) blood Superior vena cava Inferior vena cava EXAM QUESTION: pathway of blood around the body Major Vessels Pulse points Common carotid artery Brachial artery Radial artery Femoral artery Popliteal artery Posterior tibial artery Ch. 11 – Cardiovascular system 3 Anatomy of the Heart Major Valves 1. Tricuspid valve o Between right atrium and right ventricle 2. Pulmonary valve o Between right ventricle and pulmonary artery 3. Mitral valve o Between left atrium and left ventricle 4. Aoritc valve o Between left ventricle and aorta A RBC would go through the valves in what order? Tricuspid -> pulmonary -> mitrial -> aortic EXAM QUESTION: pathway of blood through the heart 1. Superior/inferior vena cava a. Blood enters the heart 2. Right atrium 3. Tricuspid valce 4. Right ventricle 5. Pulmonary valve 6. Pulmonary arteries a. Towards lungs 7. Lung capillaries 8. Pulmonary veins Ch. 11 – Cardiovascular system 4 a. Towards heart 9. Left atrium 10. Mitral valve 11. Left ventricle 12. Aortic valve 13. Aorta a. Blood travels to all parts of the body Pulmonary Circulation Starts at right ventricle to lungs to lung capillaries back to left atrium Systemic Circulation Leaves aorta, goes to all parts of body, to tissue capillaries, to veins, back to heart Heartbeat and Heart Sounds Two Phases of the Heartbeat: 1. Diastole a. Relaxation phase i. Allows ventricles to refill b. Tricuspid and mitral open c. Pulmonary and aortic closed 2. Systole a. Contraction phase b. Tricuspid and mitral closed c. Pulmonary and aortic open d. Cardiac cycle (how many times heart contracts per minute) i. Average 70-80 times per minute for the average adult ii. Heart pumps 3 oz of blood with each contraction 1. 5 quarts per min 2. 75 gallons per hour 3. 2000 gallons per day iii. Total blood volume is about 7000mL Sounds “Lubb-dubb, lubb-dubb” Lubb = closure of the tricuspid and mitral valve at the beginning of systole Dubb = closure of the aortic and pulmonary valves at the end of systole Murmur = abnormal heart sound caused by improper valve closure Conduction System of the Heart Electrical control is INVOLUNTARY 1. Sinoatrial node (SA node) a. Pacemaker for the heart b. Starts the initial electrical signal to cause coordinated contraction 2. Atrioventricular node (AV node) Ch. 11 – Cardiovascular system 5 3. Atrioventricular bundle (Bundle of His) a. “Conduction myofibers” that extend to ventricular walls to stimulate contraction; beginning of systole b. Carry electrical signal down the wall of each of the ventricles to allow coordinated contraction 4. Left bundle branch 5. Right bundle branch Electrocardiogram (EKG) P wave = spread of excitation wave over the atria just before contraction o Just before systole QRS wave = spread of excitation waver over the ventricles as the ventricles contract o Systole T wave = electrical recovery and relaxation of ventricles o Diastole Blood Pressure Test used to measure how much pressure the arteries are under; The force that blood exerts on arterial walls Measured using sphygmomanometer Expressed as a fraction: systolic/diastolic Pathology: Heart and Blood Vessels Congenital Heart Diseases Coarctation (narrowing) of the aorta (CoA) Septal defects o Atrial septal defect (ASD) o Ventricular septal defect (VSD) Circulatory changes at birth o Fetus circulation vs. newborn circulation Blood delivererd to fetus comes through umbilical vein from placenta Ch. 11 – Cardiovascular system 6 3 different special blood vessels present in fetal circulation that aren’t present or active in newborns: Ductus arteriosus Foramen ovale Ductus venosus Patent ductus arteriosis (PDA) o Patent = open o Fetal connection between pulmonary artery and aorta does not close o Can lead to non-oxygenated blood from pulmonary artery getting out into the aorta and then out into general circulation, so child’s tissues won’t have ideal amount of oxygen “Blue baby” o Can be surgically repaired
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