Cardiac Function & Troponin

: What is the common name for the clavicle?
A: Collarbone Q: What is the common name for the scapula?
A: Shoulder blade Q: What bone is located in the upper arm?
A: Humerus Q: Which forearm bone is lateral (thumb side)?
A: Radius Q: Which forearm bone is medial (pinky side)?
A: Ulna Q: What structure forms the point of the elbow?
A: Olecranon process of the ulna Q: What fossa does the olecranon process fit into?
A: Olecranon fossa Carpal Bones Q: How many carpal bones are there?
A: 8 Q: Name the proximal row of carpal bones.
A: Scaphoid, Lunate, Triquetrum, Pisiform Q: Name the distal row of carpal bones.
A: Trapezium, Trapezoid, Capitate, Hamate Q: What mnemonic helps remember the carpal bones?
A: Some Lovers Try Positions That They Can't Handle Hand Bones Q: What are the hand bones called?
A: Metacarpals Q: What are the three parts of a metacarpal?
A: Base, Shaft, Head Q: How many phalanges does the thumb have?
A: 2 (Proximal and Distal) Q: How many phalanges do the other fingers have?
A: 3 (Proximal, Middle, Distal) Pelvis & Lower Extremity Q: What is the superior portion of the pelvis?
A: Ilium Q: What is the anterior pelvic bone?
A: Pubis Q: What is the posterior-inferior pelvic bone?
A: Ischium Q: What is the large opening in the pelvis called?
A: Obturator foramen Q: What is the thigh bone?
A: Femur Q: What is the medial lower leg bone?
A: Tibia Q: What is the lateral lower leg bone?
A: Fibula Q: What is the distal tibia called?
A: Medial malleolus Q: What is the distal fibula called?
A: Lateral malleolus Q: What ankle bone articulates with both malleoli?
A: Talus Q: What is the heel bone called?
A: Calcaneus Anatomy Terms Q: What is osteology?
A: Study of bones Q: What is arthrology?
A: Study of joints Q: What is kinesiology?
A: Study of body movement Q: What is another name for a joint?
A: Articulation Joints Q: What is a synarthrosis?
A: Nonmovable joint Q: Give an example of a synarthrosis.
A: Skull suture Q: What type of joint is a tooth?
A: Gomphosis Q: What is an amphiarthrosis?
A: Slightly movable joint Q: Give an example of an amphiarthrosis.
A: Pubic symphysis Q: What is a diarthrosis?
A: Freely movable joint Q: What fluid is found inside synovial joints?
A: Synovial fluid Q: What type of joint is the shoulder?
A: Ball-and-socket Q: What type of joint is the hip?
A: Ball-and-socket Q: What type of joint is the elbow?
A: Hinge joint Q: What type of joint is the knee?
A: Hinge joint Q: What type of joint is the wrist?
A: Condyloid joint Q: What type of joint is the thumb?
A: Saddle joint Q: What type of joint is found between tarsal bones?
A: Gliding joint Ligaments Q: What ligament stabilizes the medial side of the elbow?
A: Ulnar collateral ligament Q: What ligament stabilizes the lateral side of the elbow?
A: Radial collateral ligament Q: What does ACL stand for?
A: Anterior Cruciate Ligament Q: What does PCL stand for?
A: Posterior Cruciate Ligament Muscle Tissue Q: What is the muscle cell membrane called?
A: Sarcolemma Q: What is the muscle cell cytoplasm called?
A: Sarcoplasm Q: What are the contractile organelles called?
A: Myofibrils Q: What is the functional unit of muscle contraction?
A: Sarcomere Q: What is the thick filament?
A: Myosin Q: What is the thin filament?
A: Actin Q: What regulatory proteins control contraction?
A: Troponin and Tropomyosin Connective Tissue Coverings Q: What surrounds an individual muscle fiber?
A: Endomysium Q: What surrounds a fascicle?
A: Perimysium Q: What surrounds the entire muscle?
A: Epimysium Q: What surrounds groups of muscles?
A: Fascia Facial Muscles Q: What muscle closes the eye?
A: Orbicularis oculi Q: What muscle opens the eye?
A: Levator palpebrae superioris Q: What muscle wrinkles the nose?
A: Nasalis Q: What muscle closes the lips?
A: Orbicularis oris Q: What muscle is known as the "kissing muscle"?
A: Buccinator Q: What muscle causes smiling?
A: Zygomaticus major and minor Q: What muscle causes pouting?
A: Mentalis Muscle Actions Q: What are muscles that work together called?
A: Synergists Q: What are muscles that oppose each other called?
A: Antagonists Q: What are muscles that stabilize joints called?
A: Fixators (Stabilizers) Q: What is the main muscle performing an action called?
A: Prime mover Q: Where does a muscle begin?
A: Origin Q: Where does a muscle attach?
A: Insertion Q: What is the thick middle portion of a muscle?
A: Belly Mastication (Chewing) Muscles Q: What mnemonic helps remember the muscles of mastication?
A: TIME Q: What does T stand for in TIME?
A: Temporalis Q: What does M stand for in TIME?
A: Masseter Q: What does I stand for in TIME?
A: Internal (Medial) Pterygoid Q: What does E stand for in TIME?
A: External (Lateral) Pterygoid Tongue Muscles Q: What muscle sticks the tongue out?
A: Genioglossus Q: What muscle pulls the tongue in?
A: Styloglossus Q: What muscle elevates the tongue?
A: Palatoglossus Q: What muscle depresses the tongue?
A: Hyoglossus Rotator Cuff Q: What mnemonic helps remember the rotator cuff muscles?
A: SITS Q: What does S stand for?
A: Supraspinatus Q: What does I stand for?
A: Infraspinatus Q: What does T stand for?
A: Teres Minor Q: What does the second S stand for?
A: Subscapularis Q: Which rotator cuff muscle initiates abduction?
A: Supraspinatus Lower Limb Muscles Q: What muscle extends the thigh at the hip?
A: Gluteus maximus Q: What muscles flex the thigh at the hip?
A: Iliacus and Psoas muscles Q: What muscles abduct the thigh?
A: Tensor fasciae latae, Gluteus medius, Gluteus minimus Q: What muscles adduct the thigh?
A: Adductor longus, brevis, magnus, gracilis, pectineus Quadriceps Q: What is the function of the quadriceps?
A: Extend the knee Q: Name the four quadriceps muscles.
A: Rectus femoris, Vastus lateralis, Vastus intermedius, Vastus medialis Hamstrings Q: What is the function of the hamstrings?
A: Flex the knee Q: Name the hamstring muscles.
A: Biceps femoris, Semitendinosus, Semimembranosus Lower Leg Q: What muscle dorsiflexes the foot?
A: Tibialis anterior Q: What muscles plantar flex the foot?
A: Gastrocnemius and Soleus Q: What tendon is formed by gastrocnemius and soleus?
A: Achilles (Calcaneal) tendon Trunk & Breathing Q: What muscle flexes the trunk?
A: Rectus abdominis Q: What muscle extends the trunk?
A: Quadratus lumborum Q: What is the primary muscle of breathing?
A: Diaphragm Q: What muscles help with inhalation?
A: External intercostals Q: What muscles help with exhalation?
A: Internal intercostals Muscle Fiber Types Q: Which muscle fibers are best for posture?
A: Slow-twitch fibers Q: Which muscle fibers resist fatigue?
A: Slow-twitch fibers Q: Which muscle fibers are best for sprinting?
A: Fast-twitch A fibers Q: Which muscle fibers contract the fastest?
A: Fast-twitch B fibers Blood Q: What is the study of blood called?
A: Hematology Q: What is the normal blood pH?
A: 7.35–7.45 Q: What percentage of blood is plasma?
A: 55% Q: What percentage of blood is formed elements?
A: 45% Q: What are red blood cells called?
A: Erythrocytes Q: What is the function of red blood cells?
A: Transport oxygen and carbon dioxide Q: How long do red blood cells live?
A: 120 days Q: What are white blood cells called?
A: Leukocytes Q: What is the function of white blood cells?
A: Fight infection Q: What are platelets also called?
A: Thrombocytes Q: What is the function of platelets?
A: Blood clotting Q: How long do platelets live?
A: 5–9 days Blood Clotting Q: What is hemostasis?
A: Stoppage of blood loss Q: What is a thrombus?
A: A blood clot Q: What is thrombosis?
A: Formation of a clot in an unbroken vessel Q: What is an embolus?
A: A traveling clot Q: What is an embolism?
A: Blockage caused by an embolus Blood Types Q: What antigens are found on Type A blood?
A: A antigens Q: What antibodies are found in Type A blood?
A: Anti-B antibodies Q: What antigens are found on Type B blood?
A: B antigens Q: What antibodies are found in Type B blood?
A: Anti-A antibodies Q: What antigens are found on Type AB blood?
A: A and B antigens Q: What antibodies are found in Type AB blood?
A: None Q: What antigens are found on Type O blood?
A: None Q: What antibodies are found in Type O blood?
A: Anti-A and Anti-B Q: What is the universal donor?
A: O Negative Q: What is the universal receiver?
A: AB Positive Last-Minute Memorization Set Q: Radius = ?
A: Thumb side Q: Ulna = ?
A: Pinky side Q: Heel bone = ?
A: Calcaneus Q: Study of bones = ?
A: Osteology Q: Study of joints = ?
A: Arthrology Q: Study of movement = ?
A: Kinesiology Q: Rotator cuff mnemonic = ?
A: SITS Q: Chewing muscles mnemonic = ?
A: TIME Q: Universal donor = ?
A: O- Q: Universal receiver = ?
A: AB+ Q: Blood pH = ?
A: 7.35–7.45 Q: RBC lifespan = ?
A: 120 days Q: Platelet lifespan = ?
A: 5–9 days Q: Main breathing muscle = ?
A: Diaphragm Q: Knee extensors = ?
A: Quadriceps Q: Knee flexors = ?
A: Hamstrings

La cardiopatía séptica no es un diagnóstico único, sino una complicación grave de la sepsis (infección generalizada). Se refiere a la disfunción del corazón causada por la tormenta inflamatoria y el daño celular durante la sepsis. ¿Qué ocurre en el corazón? A diferencia de un infarto, las arterias suelen estar limpias. El problema es la respuesta extrema del cuerpo: · Inflamación severa: Citoquinas que deprimen la contractilidad del miocardio. · Disfunción mitocondrial: El músculo cardíaco no produce energía. · Microcirculación alterada: Capilares que no llevan oxígeno, aunque la presión arterial esté medicada. · Estrés y edema: El corazón se hincha y se vuelve rígido. Principales formas clínicas: 1. Depresión miocárdica biventricular (ventrículos dilatados y con mala contracción). 2. Disfunción diastólica (llenado alterado, más frecuente y de peor pronóstico). 3. Respuesta adrenérgica tóxica (taquicardia descontrolada que daña el músculo). Dato clave: Es reversible en los sobrevivientes. El corazón suele recuperar su función completa en 7–10 días si el paciente supera la sepsis. Sospecha clínica ante: · Insuficiencia cardíaca sin causa obstructiva/isquémica. · Necesidad de dosis altas de noradrenalina o dobutamina. · Aumento de troponinas y péptidos natriuréticos. · Ecocardiograma que descarta otras causas. Tratamiento: control de la infección, soporte circulatorio (dobutamina, vasopresores si existe hipotensión) y manejo de líquidos con cuidado para no sobrecargar. Si necesitas más detalles sobre el manejo o la fisiopatología, házmelo saber

Muscle Contraction Physiology

Three types of muscle tissue o Compare and contrast the three basic types of muscle tissue. • List four characteristics of muscle tissue. • List the functions of muscle tissue • Describe the gross structure of a skeletal muscle. o Organization of muscle, fascicle, muscle fiber, myofibril, myofilaments o Connective tissue sheaths of skeletal muscle: ▪ epimysium, perimysium, and endomysium. o Describe what origins and insertions are in a general terms • Describe the microscopic structure and functional roles of the myofibrils, sarcomere, sarcoplasmic reticulum, and T tubules of skeletal muscle fibers. o Myoglobin, glycosomes o M line, Z disc o Triad • Sliding filament model of muscle contraction • Composition of thick and thin filaments o Structure of Actin, Tropomyosin, Troponin, Myosin • AP, hyperpolarization, depolarization • Ion channel function • Refractory period • Explain how muscle fibers are stimulated to contract by describing events that occur at the neuromuscular junction. • Follow the events of excitation-contraction coupling that lead to cross bridge activity. • Describe cross bridge cycling • Define motor unit and muscle twitch, and describe the events occurring during the three phases of a muscle twitch. • Muscle Atrophy • Explain how smooth, graded contractions of a skeletal muscle are produced. o Temporal summation o Multiple motor unit summation (recruitment) ▪ Know the recruitment thresholds • Differentiate between isometric and isotonic contractions. • Describe three ways in which ATP is generated during skeletal muscle contraction. o Be able to compare and contrast the three modes of ATP generation o Know important molecules (i.e. creatine), whether oxygen is necessary, by-products (i.e. lactic acid) • Define EPOC and muscle fatigue. List possible causes of muscle fatigue. • Describe factors that influence the force, velocity, and duration of skeletal muscle contraction. • Describe the three types of skeletal muscle fibers (slow and fast oxidative, fast glycolytic) • Compare and contrast the effects of aerobic and resistance exercise on skeletal muscles • Compare the gross and microscopic anatomy of smooth muscle cells to that of skeletal muscle cells

13 A Ticket to Traponia

NURS 348 — EXAM 4 STUDY GUIDE Hypertension Definition & Overview • Persistent elevation of BP ≥130/80 mmHg (systolic at/greater than 130 OR diastolic at/greater than 80) on at least 2 separate visits, 2+ weeks apart. • Primary (Essential): No identifiable cause, most common (90–95% of cases). • Secondary: Caused by another condition or adverse effects of medications. Etiology/Pathophysiology • ↑ Peripheral resistance and/or ↑ cardiac output → ↑ blood pressure → When blood vessels get narrower (increased resistance) or the heart pumps more forcefully (increased output), pressure inside the vessels rises “like squeezing a hose while water is running” → Over time, this high pressure damages the vessel walls and heart muscle, increasing the risk for atherosclerosis, heart attack (myocardial infarction), and stroke. • ↑ Increased peripheral resistance (arteriolar constriction) → ↑ afterload → left ventricular hypertrophy → heart failure → The heart pushes against more resistance (afterload), making the heart muscle thicker (hypertrophy). Over time, it becomes weaker and can lead to heart failure. • Kidneys retain sodium and water → ↑ circulating volume → The kidneys hold onto extra salt and water, adding more fluid to the blood. More fluid means higher pressure—like overfilling a water balloon. • Activation of renin–angiotensin–aldosterone system (RAAS) = vasoconstriction + fluid retention. RAAS is like the “blood pressure booster” → When this system turns on, blood vessels tighten and the kidneys save even more salt and water, both of which raise blood pressure. Risk Factors: • Primary: family history, ↑ sodium intake, Obesity (BMI >25), African-American ethnicity, smoking, hyperlipidemia, diabetes mellitus, and stress. • Secondary: kidney disease, Cushing’s, pregnancy, pheochromocytoma, medic (steroids, OCPs). Clinical Manifestations (S/S) • Often asymptomatic (“silent killer”)!!! • Headache, dizziness, fainting, vision changes • Retinal damage on exam (cotton wool spots, papilledema). • Note: if blood pressure reading is elevated then take in both arms; pt legs uncrossed, and arms above heart; correct cuff Diagnostics (Dx)/Labs • Multiple BP readings (both arms, sitting and standing) • ECG → Left-Ventricular hypertrophy. evaluates cardiac function. • Labs → ↑ BUN/creatinine (kidney disease), lipids, glucose, cortisol (Cushing’s) Nursing Care / Nursing Interventions • Monitor pt BP regularly and accurately, check both arms/correct cuff • Put on DASH diet (Dietary Approach to Stop Hypertension) Medications • ⭐️Diuretics (first-line): excess fluids, they need to remove; increase urine • Thiazides (hydrochlorothiazide) inhibits water & sodium reabsorption and increases potassium excretion • Side effects/SE: hypokalemia; monitor potassium(K⁺) levels • Loop (furosemide) decreases sodium reabsorption & increase potassium excretion– SE: hypokalemia; monitor potassium(K⁺) levels • Potassium-sparing (spironolactone) – SE: hyperkalemia; monitor potassium levels. EKG: peaked T waves • Also watch out for muscle weakness, irregular, pulse, and dehydration. • ⭐️Calcium channel blockers (verapamil, amlodipine, and diltiazem) Calcium channel blockers relax and widen blood vessels by preventing calcium from entering muscle cells, leading to lower blood pressure (vasodilation) • SE: constipation; take fiber for verapamil, and all can ↓HR • Avoid grapefruit juice ➡️ toxicity, hypotensive effects Calcium= contract • ⭐️ACE inhibitors (lisinopril, enalapril): prevents angiotensin II → vasodilation • SE: - hypotension; monitor BP and pulse HR -hyperkalemia; monitor potassium levels -erectile dysfunction -⭐️cough linked to angioedema (swollen tissue under the skin around lips, tongue, and glottis); report swelling & discontinue med • ⭐️ARBs (valsartan, losartan): for ACE-intolerant pts from cough/hyperkalemia. ARBs lower blood pressure by blocking angiotensin II from binding to its receptors, preventing vasoconstriction, and reducing fluid retention. • SE: angioedema, heart failure, hyperkalemia • Change position, slowly, report, angioedema, edema, and avoid foods that are high in potassium (bananas, potatoes, apricots, spinach, beans); monitor potassium levels • Aldosterone-receptor antagonists (eplerenone, spironolactone): blocks aldosterone action. • SE: kidney damage, hypertriglyceridemia, hyponatremia, and hyperkalemia; monitor kidney function, triglycerides, sodium, and potassium levels • Avoid Grapefruit juice and St. John’s wort, salt substitutes, and potassium rich foods • ⭐️Beta blockers (metoprolol, atenolol): blocks beta receptors (adrenaline/epinephrine) ➡️reduces heart rate, cardiac output, and blood pressure ↓HR, ↓CO; use cautiously in diabetics • SE: -⭐️erectile dysfunction, -Fatigue, weakness, depression -hypoglycemia • Monitor heart rate (hold if HR is less than 60) and do not suddenly stop taking med (cause rebound hypertension); and don’t give to pts with asthma, airway disease (cause bronchospasms) • Central Alpha-2 agonists (clonidine): calm the nerves that raise blood pressure, letting blood vessels, relax, and BP go down, ↓SNS tone • SE: sedation, orthostatic, hypotension, and sexual dysfunction/impotence • Monitor BP and pulse • Alpha-adrenergic blockers (prazosin, doxazosin): vasodilator= relaxed BP; give at night to avoid first-dose hypotension. Start with low dose. • SE: postural hypotension; make sure patient rises slowly and caution. • Monitor BP 2 hrs after initiation Complications • Hypertensive Crisis: usually when patients do not follow the medication regimen • BP >180/120 → organ damage (encephalopathy, renal failure) • S/S: severe headache, dizziness, blurred vision, confusion, epistaxis • Treat: IV antihypertensives (nitroprusside, nicardipine, labetalol); the goal is to lower BP gradually by 20-25% in first hour. Not less than 140/90. Monitor BP every 5-15 mins Patient Education • Adhere to medication regimen, don’t abruptly stop even when you feel better • Change positions slowly • Encourage DASH diet (low sodium, high fruits/veggies, low-fat dairy) ex: grilled salmon, brown rice, steamed broccoli, and low-fat milk • Avoid high-sodium foods. Consume less than 2.3 g/day • Monitor BP at home • Report signs or symptoms of electrolyte imbalances • Encourage Weight loss, exercise 3x weekly • Encourage Smoking cessation • Encourage Limit alcohol (≤2/day men, ≤1/day women) • Manage stress • Report persistent cough or swelling (ACE inhibitor red flag) Peripheral Venous Disorders(PVD) Patho: problems with veins where Deoxygenated blood can't get back to the heart Oxygenated blood pools in the extremities. The valves are preventing backflow. • Venous Thromboembolism (VTE): blood clot that starts in a vein. -Two types: deep vein thrombosis (DVT) and pulmonary embolism (PE) • Venous insufficiency: Improper functioning of the veins. Veins aren’t able to push back blood to the heart which results in swelling, venous stasis ulcers, or cellulitis. Blood can go down into the veins just fine but cannot come back up. a. VTE ex: Deep Vein Thrombosis (DVT) Pathophysiology • Thrombus (Blood clot) forms in deep veins (usually in legs) → can embolize (travel and block vessel) its way to lungs (PE). • Caused by Virchow’s triad: venous/blood flow stasis, endothelial injury, hypercoagulability. Risk Factors • Surgery (hip, knee, prostate) • Immobility • Heart failure • Pregnancy • Family hx • Oral contraceptives or hormone therapy • Cancer • COVID-19 (elevated D-dimer) • Central venous catheters Clinical Manifestations • Note that clients can be asymptomatic • Calf/groin pain (dull/achy), tenderness, warmth, edema • Unilateral swelling • Shallow, irregular shaped wounds • Too much blood, brown/yellow discoloration • Sudden SOB and sharp chest pain → suspect PE • Positioning: “Elevate Veins”, position up in “V” shape, above heart. Worsens: if dangling, sitting/dangling for long periods of time. Diagnostics • ⭐️Venous duplex ultrasonography = gold standard; it’s an ultrasound of Leg to see blood clot/blood flow through the vessel. • ⭐️D-dimer ↑ = clot breakdown evidence • Venogram/MRI if ultrasound inconclusive Nursing Interventions • Bed rest until anticoagulation started • Elevate leg slightly above heart (no knee gatch). Positioning: “EleVate Veins”, think V as veins are up, to keep the veins open. • Warm compresses • DO NOT massage leg • Compression stockings (after swelling ↓) • Encourage early ambulation when safe • SCDS Medications/Procedures (Anticoagulants) stops blood from clotting, another nurse must be with you • Unfractionated heparin (given IV): prevents clots and growth of existing clot; monitor platelets, and aPTT (how long it takes blood to clot) (1.5–2× normal). Must be given in facility. MUST MONITOR CLOSELY • Antidote: protamine sulfate • Low-molecular-weight heparin (Lovenox/enoxaparin): given SubQ, weight-based, prevention and treatment of DVT, given twice daily, can be used in home setting. Don’t need labs. Monitor for bleeding, and take bleeding precautions (Electric razor, soft toothbrush, environment safety) • Warfarin (Coumadin): oral, inhibits vitamin K clotting factors overlaps; combined with heparin 3–4 days until INR 2–3 (takes awhile to kick in; therapeutic affect) • Antidote: vitamin K • Avoid high vitamin K foods (green leafy veggies) • Monitor PT (range: 11-13.5 secs), INR (must know range: 2–3) • Factor Xa inhibitors (fondaparinux; SubQ) (rivaroxaban, apixaban; oral): Prevents development of Thromboses; transitional medication; initial labs are PT and PTT; not routinely • Direct thrombin inhibitors (dabigatran): directly prevents growth of thrombus Formation, given sub Q ; initiate initial lab values only for PT and APTT. • Antidote: idarucizumab • Thrombolytics (tPA): for massive DVT/PE, directly infused into clot, start within 24hrs- 5 days of clot formation; monitor for bleeding, neuro status, dizziness, headache. Take bleeding precautions, pt must use electric razor and, brush teeth with a soft toothbrush. • Inferior vena cava filter: prevents embolus from reaching lungs (PE), inserted in femoral vein; catches blood clot. Used when pt is unresponsive to other treatments. Monitor: bleeding, hematoma, infection, PE (dyspnea, chest pain, tachycardia). Nursing actions: assess circulation and encourage leg exercises/ambulation early, have patient not sit for too long Anticoagulant Therapy Nurse’s Role • Verify labs,;Double-check with another RN for IV heparin, Assess for bleeding (bruises, gums, stools) and Monitor vitals, mental status (signs of intracranial bleed) Reversal Agents • Heparin → protamine sulfate • Warfarin → vitamin K • Dabigatran → idarucizumab Patient Education • Avoid contact sports • Soft toothbrush, electric razor • Avoid sudden diet changes (vitamin K) Complications (anticoagulants) • ⭐️Pulmonary embolism: sudden dyspnea, chest pain, SOB, anxiety, tachypnea → emergency; sit, patient in high Fowlers, and administer oxygen and anticoagulants • ⭐️Ulcer formation(venous): often formed over the medial malleolus, chronic, hard to heal, can reoccur. Can lead to amputation/death. Neuropathic patients might not feel this. Nursing care: Dressing is left 3–7 days; wound vacuums, diet: high in zinc, protein, iron, and vitamins A and C, debride necrotic tissue so wound can heel. Patient Education(Anticoagulants) • Bleeding precautions (soft toothbrush, electric razor) • Report bruising or black stools • Avoid prolonged sitting/crossing legs • Wear compression stockings b. Venous insufficiency Pathophysiology • Valves and legs are damaged due to prolong venous HTN Our previous blood clot Risk factors: • Sitting/standing in one position for a long period of time • Obesity • Pregnancy • Thrombophlebitis Clinical manifestations: • Status dermatitis(brown discoloration along ankles) • Edema • Stasis ulcers around ankles Labs/DX • D-dimer ↑ = clot breakdown evidence, detects clot Nursing interventions: Elevate legs to increase venous return (20 mins, 4-5/day), position: legs above heart, “Elevate Veins”, Apply stockings, and monitor for cellulitis Patient education: avoid sitting/standing still for too long, change positions often, avoid crossing legs, tight clothing. Apply stockings before getting out of bed in the morning Peripheral Arterial Disease (PAD) : affects blood vessels that carry blood away from the heart; artery carries blood away from heart but has difficulty going down to extremities. Pathophysiology • Atherosclerosis in lower extremities → decreased blood flow to tissues. Risk Factors • Smoking, DM, hypertension, hyperlipidemia, obesity, age, sedentary lifestyle. Clinical Manifestations • Intermittent claudication: leg pain with exercise, relieved by rest; not enough oxygen makes the tissue suffer = pain; ischemia • Pain(sharp) that is only relieved when resting in dependent position • Cool, pale, cyanotic skin • Loss of hair on legs, thick toenails • Weak/absent pedal pulses; dorsalis pedis; Doppler(verify), +1 • Numbness, burning at night • No blood and no edema due to an adequate blood flow • Note: think “A” in PAD as Antarctica, where it’s cold! For cold, pale skin! Diagnostics • ⭐️ABI < 0.9 = PAD; ankle pressure compared to break your pressure; expected finding is 0.9–1.3; less than is PAD • ⭐️Arteriography for visualization of occlusion/decreased arterial flow with contrast injection on a x-ray. Monitor for bleeding, hemorrhage, marked, pedal pulses • Doppler studies → decreased flow in DM patients • ⭐️Exercise tolerance testing → decreased pressure in lower limbs, read the workload of the heart/circulation, and clarification during exercise. May use treadmill or meds (dipyridamole, adenosine). Finding of a BP/pulse waveform = arterial disease. Monitor vitals before, during, and after. Stop test if chest pain or symptoms are severe. Nursing Interventions • Encourage graded exercise until pain, rest, repeat • Avoid elevating legs above heart (impairs flow) • Avoid cold, caffeine, nicotine, tight clothing • Keep extremities warm (no heating pad), they can’t feel • Foot care: inspect daily, no bare feet, toenails straight Medications • Antiplatelets: (aspirin, clopidogrel) reduces blood viscosity and increases blood flow and extremities. Monitor: bleeding, abdominal pain, black, tarry stools. • Statins: (atorvastatin, simvastatin). Relieved manifestations like intermittent claudication. • Pentoxifylline: improves RBC flexibility (claudication). Monitor for bleeding, abdominal pain, black tarry stools. Procedures • Angioplasty (balloon/stent). Opens and helps, maintain the patency of the vessel, however, laser vaporizes atherosclerosis plaque. Monitor for bleeding, vital signs, pulses, cap Refill. As patients rest limbs are straight for 2-6 hrs before ambulation. Anticoagulant/Antiplatelet therapy given 1-3 months after. • Atherectomy rotation, device removes, arterial plaque. Monitor for bleeding and distal pulses. rest limbs are straight for 2-6 hrs. Anticoagulant/Antiplatelet therapy given 1-3 months after. • Arterial revascularization bypass surgery • Used for clients at risk for losing a limb, severe claudication, or limb pain at rest. It reroutes the circulation around the arterial occlusion. • Post-op: ⭐️ maintain adequate circulation in repaired artery, mark pedal/dorsalis pulses(compare both), monitor color/temp, pain, cap refill, blood pressure (HTN= risk for bleeding; Hypotension=clot risk). • Complications: for these notify provider first -graft occlusion: acute blockage of bypass graft within 24 hr(absent pulse, cold foot, increased pain) -compartment syndrome: tissue pressure restricting blood flow; causing ischemia (numbness, tingling, edema, worsening/passive pain) -infection: infection of site (warm, tenderness, elevated, WBC, purulent drainage, use sterile technique) Patient Education • Walk until pain → rest → walk more • Stop smoking • Avoid crossing legs • Diet low in cholesterol and fat Postoperative Care – Peripheral Bypass/Revascularization Priorities • Assess extremity: color, temperature, cap refill, sensation, pulses q15min ×1hr • Mark pedal pulses before surgery • Maintain adequate BP (avoid hypo or hypertension) • Do not flex hip/knee excessively • Encourage ambulation when ordered • Report sudden pain, loss of pulse, pale/cool extremity = graft occlusion Complications • Graft occlusion, Compartment syndrome, Wound infection Arterial vs. Venous Ulcers Feature Arterial Ulcer Venous Ulcer Location Toes, feet, lateral ankle Medial ankle Appearance Pale, dry, round “punched out”, no drainage Irregular, leaky/moist, brown discoloration Pain Severe, worse with elevation Achy, relieved with elevation Skin Cool, shiny Warm, thickened Treatment Improve arterial flow Compression therapy, elevate legs Valvular Heart Disease OVERVIEW Overview • Stenosis = narrowed opening/thickening and hardening • Regurgitation = backflow of blood • Causes: rheumatic fever, degenerative calcification, endocarditis Diagnostics • Chest X-ray → chamber enlargement • ⭐️ECG → hypertrophy • Echo → valve dysfunction • TEE → direct view of valves ⭐️ Medications overview • Diuretics [furosemide, hydrochlorothiazide, spironolactone]: reduce pulmonary congestion, by removing excessive extracellular fluid. Monitor: hypokalemia, eats foods high in potassium, and administer furosemide IV slowly over 1 – 2 minutes. • Afterload–reducing agents [Beta-blockers (-lol); calcium channel blockers (-dipine); ACE inhibitors (-pril); angiotensin–receptor blockers (-artan); vasodilators (hydralazine]): control heart rate, by lessening resistance to contraction. Monitor: hypotension. • Inotropic agents (digoxin): increases contractility, improves cardiac output. Hold medication if pulse rate (abnormal) is less than 60/min or greater than 100/min. Take medication same time every day, avoid combining with antacids (2hrs). Monitor: toxicity such as weakness, confusion, visual changes, low appetite. • Anticoagulants: reduces risk of thrombus. Monitor: stroke, PT, INR, bleeding/bruising. Procedures • Valvuloplasty (balloon dilation) • Valve replacement • Mechanical = lifelong anticoagulants • Tissue = replace every 7–10 years Patient Education • Prophylactic antibiotics before dental procedures • Good oral hygiene • Daily weights • Sodium restriction • Avoid caffeine/alcohol • Report HF signs (weight gain, edema, SOB) • Avoid alcohol, epinephrine, and ephedrine= can cause dysrhythmias THE 4 VALVULAR DISORDERS Mitral Stenosis Etiology/Pathophysiology: Narrowed mitral valve obstructs blood flow from left atrium (LA) → left ventricle (LV), increasing LA pressure and pulmonary congestion → right-sided heart failure. Often caused by rheumatic fever. Clinical Manifestations: Dyspnea on exertion, orthopnea, pitting edema, fatigue, palpitations, hemoptysis, apical diastolic murmur. Risk Factors: Rheumatic heart disease, aging, congenital malformations. Labs/Diagnostics: Echocardiogram (valve narrowing, pressure gradient), ECG (A-fib), chest X-ray (LA enlargement). Medications/Management: • Diuretics [furosemide, hydrochlorothiazide, spironolactone]: reduce pulmonary congestion, by removing excessive extracellular fluid. Monitor: hypokalemia, eats foods high in potassium, and administer furosemide IV slowly over 1 – 2 minutes. • Afterload–reducing agents [Beta-blockers (-lol); calcium channel blockers (-dipine): control heart rate, by lessening resistance to contraction. Monitor: hypotension. • Anticoagulants: reduces risk of thrombus; prevent emboli from A-fib. Monitor: stroke, PT, INR, bleeding/bruising. • Surgical: Balloon valvuloplasty or valve replacement. NCLEX Tip: Rheumatic fever is the most common cause. Mitral Insufficiency Etiology/Pathophysiology: Incomplete closure of mitral valve causes blood to leak back into LA during systole → LV dilation and hypertrophy. Clinical Manifestations: Fatigue, dyspnea, orthopnea, palpitations, holosystolic murmur at apex, pitting edema, S3 sounds Risk Factors: Mitral valve prolapse, rheumatic disease, MI, endocarditis. Labs/Diagnostics: Echocardiogram (regurgitant volume), ECG (A-fib), BNP (HF indicator). Medications/Management: • Beta-blockers (-lol); ACE inhibitors (-pril); ARBS/angiotensin–receptor blockers (-artan): reduce afterload /control heart rate, by lessening resistance to contraction. Monitor: hypotension. • Diuretics [furosemide, hydrochlorothiazide, spironolactone]: manage fluid overload. Monitor: hypokalemia, eats foods high in potassium, and administer furosemide IV slowly over 1 – 2 minutes. • Anticoagulants if A-fib present; reduces risk of thrombus; prevent emboli from A-fib. Monitor: stroke, PT, INR, bleeding/bruising. • Surgery for severe cases. NCLEX Tip: Afterload reduction decreases regurgitant flow. Aortic Stenosis Etiology/Pathophysiology: Narrowed aortic valve → obstructed LV outflow → ↑ LV pressure → hypertrophy → ↓ cardiac output. Clinical Manifestations: Triad: angina, syncope, dyspnea (heart failure); systolic murmur radiating to carotids. Risk Factors: Aging (calcification), congenital bicuspid valve, rheumatic fever. Labs/Diagnostics: Echocardiogram (valve area), ECG (LV hypertrophy), cardiac cath (pressure gradient). Medications/Management: • Avoid nitrates/vasodilators (can cause hypotension). • Use beta-blockers (-lol) cautiously. reduce afterload /control heart rate, by lessening resistance to contraction. Monitor: hypotension. • Surgical aortic valve replacement (definitive). NCLEX Tip: Do not aggressively lower preload; maintain perfusion. Aortic Insufficiency Etiology/Pathophysiology: Incomplete closure of aortic valve → backflow of blood into LV → volume overload → dilation and LV hypertrophy. Clinical Manifestations: Dyspnea, palpitations, fatigue, bounding (“water hammer”) pulse, wide pulse pressure, diastolic murmur. Risk Factors: Rheumatic fever, endocarditis, Marfan syndrome, trauma. Labs/Diagnostics: Echocardiogram (backflow volume), ECG (LV enlargement), chest X-ray (cardiomegaly). Medications/Management: • Calcium channel blockers (-dipine); ACE inhibitors (-pril); vasodilators (hydralazine]): reduce afterload /control heart rate, by lessening resistance to contraction. Monitor: hypotension. • Diuretics for volume management. • Surgical valve replacement when severe. NCLEX Tip: Bounding pulse and wide pulse pressure are hallmark findings. General Nursing & Exam Focus • Best diagnostic test: Echocardiogram (for all). • Monitor for A-fib in mitral disorders. • Valve replacement (mechanical): Lifelong anticoagulation. • Daily weights & fluid balance: Detect early HF. • Positioning: High-Fowler’s for dyspnea, low-sodium diet. Inflammatory Heart Disorders (Endocarditis, Pericarditis, Myocarditis, Rheumatic Carditis) Risk Factors • IV drug use, valve replacement, streptococcal infection, immunosuppression, lower socioeconomic status Pericarditis: inflammation of the pericardium (sac around heart) -RF: heart attack, lupus, rheumatoid arthriti -Clinical manifestations: Chest pain (relieved when leaning forward), coughing, Pericardial friction rub, fever, dysrhythmias, and SOB -Labs/DX: • High WBCs, EKG showing ST or T spiking, echocardiogram (inflamed heart) -Nursing care/Intervention: address pain/inflammation, and monitor for cardiac tamponade, position, patient upright, leaning forward, and monitor ECG - Medications: NSAIDs, corticosteroids, anti antibiotics for bacterial • Ibuprofen/NSAIDs for inflammation (pericarditis). Avoid if patient has peptic ulcer, monitor for G.I. bleeding, platelets, liver/kidney function. Must be taken with food, avoid alcohol. • Corticosteroids (prednisone) for autoimmune causes (pericarditis/myocarditis). Low-dose first, take with food, and patient must not stop abruptly. Monitor BP, glucose, electrolytes, wounds, infection, sudden weight gain. -Complication: cardiac tamponade → muffled heart sounds, paradoxical pulse, JVD, hypotension (Beck’s triad) Myocarditis: inflammation of the myocardium (heart muscle itself) -RF: viral (covid, Coxsackie), fungal, or bacterial infection; autoimmune disorder -Clinical Manifestations: Tachycardia, chest pain, murmur, friction rub, dysrhythmias, peripheral swelling, cardiomegaly. -Labs/Dx: ECG, echocardiogram, high troponin, CK – MB, ESR in CRP for inflammation/injury -Nursing Care/interventions: monitor for heart failure, and dysrhythmia’s, provide rest and activity restriction -Medication: • Amphotericin B for fungal infection (myocarditis/endocarditis). Monitor liver/kidney function for a G.I. upset. • Corticosteroids (prednisone) for autoimmune causes (pericarditis/myocarditis). Low-dose first, take with food, and patient must not stop abruptly. Monitor BP, glucose, electrolytes, wounds, infection, sudden weight gain. Endocarditis: bacterial infection that leaves inflammation of the endocardium (inner layer of the heart); bacterial or fungal Infection of endocardial tissues that leads to necrosis and embolization of growth -RF: congenital/valvular heart disease, prosthetic valve, IV drug use -Clinical Manifestations: janeway lesions, Fever, murmur, petechiae, splinter hemorrhages (red streaks under nail beds), Osler’s nodes -labs/dx: positive blood culture, echocardiogram -nursing interventions/care: administer IV antibiotics, antipyretics for fever, and anticoagulants, patient should use soft toothbrush, and prophylactic antibiotics before dental/invasive procedures -medication: • Penicillin for infection (rheumatic fever/endocarditis). Monitor for allergic reaction, kidney function/electrolytes. • Amphotericin B for fungal infection (myocarditis/endocarditis). Monitor liver/kidney function for a G.I. upset. Rheumatic Carditis/heart disease: infection of endocardium due to complication of rheumatic fever; GABHS triggers, rheumatic fever leading to inflammatory lesions in the heart -RF: children, Follows untreated strep infection -Clinical Manifestations: tachycardia, Fever, rash(trunk/extremities), joint pain, murmur, chest pain, muscle spasms, friction rub -Labs/Dx: throat culture (strep infection), positive ASO titer, echocardiogram -Nursing care/Interventions: administering antibiotics to stop strep infection, and promote rest, monitor for heart failure, and encourage life on prophylactic antibiotics. -Medications: antibiotics, valve replacement/repair • Penicillin for infection (rheumatic fever/endocarditis). Monitor for allergic reaction, kidney function/electrolytes. Nursing Interventions (Overview for Inflammatory disorders) • Monitor for tamponade & HF • Administer antibiotics (penicillin) • Pain relief (NSAIDs for pericarditis) • Bed rest • Emotional support • Auscultate heart sounds; murmur or friction rub • Collab with cardiologist and physical therapists Procedures (Overview for Inflammatory disorders) • Pericardiocentesis for fluid removal, then sent to laboratory; monitor for recurrence of cardiac tamponade. ( pericarditis.) • Valve surgery if damaged Complications (Overview for Inflammatory disorders) • Cardiac tamponade: medical emergency resulted from fluid accumulation in pericardial sac. S/S: dyspnea, dizziness, tightness in chest, restlessness. Administer IV fluids, notify the provider, obtain chest, x-ray or ECG Cardiac Diagnostics & Vascular Access (Ch. 28) Transesophageal Echocardiography (TEE) Provides clear heart images via probe in the esophagus to detect valve disease, thrombi, or heart failure. NPO 4–6 hr, monitor VS, ECG, and sedation; check gag reflex before eating post-procedure; keep HOB 45°. Stress Testing (Exercise or Pharmacologic) Assesses heart’s response to stress for angina, HF, MI, or dysrhythmia. NPO 2–4 hr, avoid caffeine/tobacco, wear comfortable clothes; stop test for chest pain, SOB, dizziness. Post: monitor ECG & BP until stable. Coronary Angiography (Cardiac Catheterization) Identifies coronary artery blockages using contrast dye via femoral, radial, or brachial artery. NPO 4–6 hr, assess renal function, allergies (iodine/shellfish), and hold metformin 48 hr before/after. Post: monitor VS and site for bleeding, hematoma, or thrombosis, keep limb straight, maintain bedrest. Complications: cardiac tamponade (↓BP, JVD, muffled heart sounds), embolism, hematoma, AKI—notify provider. Teach: report chest pain, bleeding, SOB, avoid lifting >10 lb, and take antiplatelets as prescribed if stent placed. Vascular Access Devices (VADs) Provide reliable central access for fluids, meds, TPN, or blood. Verify tip placement via x-ray before use. PICC: up to 12 mo use, insert in basilic/cephalic vein → SVC; no BP/venipuncture in that arm, keep dressing dry. Tunneled Catheter: long-term use, subcutaneous tunnel prevents infection; no dressing once healed. Implanted Port: long-term chemo access; access with Huber needle, flush with heparin after use. Complications: • Phlebitis: redness, pain, warmth—maintain sterile technique. • Occlusion: flush gently with 10 mL syringe; never force. • Mechanical issues: swelling or pain at port site = dislodgement → notify provider

Myosin & Muscle Contraction Terms: G-actin, Tropomyosin, Troponin

answers for Chapters 5, 6, and 7 based on your study guide: ⸻ ✅ Chapter 5 – Skeletal System 1. Functions of the Skeletal System • Support • Protection • Movement (with muscles) • Mineral storage (calcium, phosphorus) • Blood cell production (hematopoiesis) • Fat storage (yellow marrow) ⸻ 2. Axial vs Appendicular Skeleton Axial (80 bones) • Skull • Vertebral column • Ribs • Sternum • Hyoid Appendicular (126 bones) • Pectoral girdle (clavicle, scapula) • Upper limbs • Pelvic girdle • Lower limbs ⸻ 3. Bone Components • Compact (cortical) bone • Spongy (trabecular) bone • Periosteum • Endosteum • Bone marrow (red & yellow) • Articular cartilage ⸻ 4. Cortical vs Trabecular Bone • Cortical (compact): Dense, outer layer, strength • Trabecular (spongy): Porous, inside bone, reduces weight, houses marrow ⸻ 5. Bone Classification by Shape • Long (femur) • Short (carpals) • Flat (sternum) • Irregular (vertebrae) • Sesamoid (patella) ⸻ 6. Structure of a Long Bone • Diaphysis (shaft) • Epiphysis (ends) • Medullary cavity • Periosteum • Compact bone • Spongy bone ⸻ 7. Microscopic Bone Structure • Osteon (Haversian system) • Central canal • Lacunae (contain osteocytes) • Canaliculi (nutrient pathways) ⸻ 8. Osteoblast vs Osteoclast • Osteoblast: Builds bone • Osteoclast: Breaks down bone ⸻ 9. Three Types of Joints • Fibrous: Immovable (skull sutures) • Cartilaginous: Slight movement (intervertebral discs) • Synovial: Freely movable (knee) ⸻ 10. Osteoporosis & Arthritis • Osteoporosis: Bone thinning • Arthritis: Joint inflammation ⸻ ✅ Chapter 6 – Muscular System 1. Three Muscle Types • Skeletal: Voluntary, striated, attached to bones • Cardiac: Involuntary, heart only • Smooth: Involuntary, organs ⸻ 2. Connective Tissue Coverings • Endomysium → around muscle fiber • Perimysium → around fascicle • Epimysium → around whole muscle ⸻ 3. Fascicle Bundle of muscle fibers (covered by perimysium) ⸻ 4. Sarcomere Functional unit of muscle Boundaries: Z discs ⸻ 5. Bands • I band → thin only • A band → thick (and overlap) ⸻ 6. Filaments • Thick → Myosin • Thin → Actin, Troponin, Tropomyosin ⸻ 7. During Contraction • Sarcomere shortens • Z discs move closer • I band shortens • A band stays same ⸻ 8. Role of Calcium & ATP • Calcium: Exposes binding sites • ATP: Powers contraction & releases myosin ⸻ 9. Cross Bridge Myosin head binding to actin ⸻ 10. Neuromuscular Junction • Nerve releases acetylcholine (ACh) • ACh binds receptors • Muscle action potential starts ⸻ 11. Steps of Skeletal Muscle Contraction 1. Nerve impulse 2. ACh release 3. Muscle action potential 4. Ca²⁺ released from SR 5. Cross bridge formation 6. Power stroke 7. ATP binds & detaches 8. Relaxation when Ca²⁺ removed ⸻ 12. Three Ways Muscles Produce ATP • Direct phosphorylation (creatine phosphate) • Anaerobic glycolysis • Aerobic respiration ⸻ 13. Oxygen & Lactic Acid • Aerobic: Requires oxygen • Anaerobic glycolysis: Produces lactic acid ⸻ 14. Fastest Energy System Direct phosphorylation ⸻ 15. Isotonic vs Isometric • Isotonic: Muscle shortens (lifting weight) • Isometric: Tension, no movement (holding weight) ⸻ ✅ Chapter 7 – Nervous System 1. CNS Brain + spinal cord Function: control center ⸻ 2. PNS Cranial nerves + spinal nerves ⸻ 3. Afferent vs Efferent • Afferent: Sensory → to CNS • Efferent: Motor → from CNS ⸻ 4. Three Parts of Neuron • Dendrites (receive) • Cell body • Axon (send signal) ⸻ 5. Synapse Junction between neurons Synaptic cleft = gap between them ⸻ 6. Neurotransmitters Chemical messengers between neurons ⸻ 7. Three Neuron Types • Sensory • Motor • Interneurons ⸻ 8. CNS Neuroglia • Astrocytes • Oligodendrocytes • Microglia • Ependymal cells ⸻ 9. Action Potential Phases • Resting (-70mV) • Depolarization (Na⁺ in) • Repolarization (K⁺ out) • Hyperpolarization ⸻ 10. Myelinated Axons Faster Because Saltatory conduction (jumps between nodes) ⸻ 11. Reflex & Components Automatic response 5 parts: 1. Receptor 2. Sensory neuron 3. Integration center 4. Motor neuron 5. Effector ⸻ 12. Four Lobes of Cerebrum • Frontal → movement • Parietal → sensation • Temporal → hearing • Occipital → vision ⸻ 13. Thalamus, Hypothalamus, Epithalamus • Thalamus → sensory relay • Hypothalamus → homeostasis • Epithalamus → melatonin ⸻ 14. Brainstem Parts • Midbrain → reflexes • Pons → breathing control • Medulla → heart rate ⸻ 15. Cerebellum Balance & coordination ⸻ 16. Meninges • Dura mater • Arachnoid mater • Pia mater Protect CNS ⸻ 17. CSF Cerebrospinal fluid Found in ventricles & around brain/spinal cord ⸻ 18. Spinal Cord Structure: gray center, white outside Function: reflexes & signal pathway ⸻ 19. Sympathetic vs Parasympathetic • Sympathetic → fight or flight • Parasympathetic → rest and digest ⸻ 20. Effects on Organs Sympathetic: • ↑ heart rate • Dilates pupils • Stops digestion Parasympathetic: • ↓ heart rate • Constricts pupils • Stimulates digestion ⸻ 21

TEST DE TROPONINA DE ALTA SENSIBILIDAD (Analizador SIEMENS Healthineers)

MI Definitions, MINOCA, and Troponin Interpretation (Video Notes)

Endocrine System 1. What are hormones and what is their function in the body? Hormones are chemical messengers transported in the bloodstream that stimulate physiological responses in target cells or organs. 2. Types of hormones Endocrine System 1. What are hormones and what is their function in the body? Hormones are chemical messengers transported in the bloodstream that stimulate physiological responses in target cells or organs. 2. Types of hormones based on chemical composition and how they enter target cells: • Steroid hormones: Lipid-soluble, diffuse through cell membrane (e.g., cortisol). • Protein/Peptide hormones: Water-soluble, bind to surface receptors (e.g., insulin). • Biogenic/Monoamines: Derived from amino acids (e.g., T3/T4), may need carriers or membrane receptors. 3. Know all 6 hormones secreted by the anterior pituitary gland and their functions: • TSH: Stimulates thyroid to release T3 and T4. • ACTH: Stimulates adrenal cortex to release cortisol. • GH: Stimulates tissue growth and protein synthesis. • PRL: Stimulates milk production. • FSH: Stimulates egg maturation/sperm production. • LH: Triggers ovulation and testosterone production. 4. What is thymosin? Which gland secretes it? What is its function? Thymosin is secreted by the thymus and helps in the development and maturation of T-cells. 5. Know thyroid gland hormones, the cells that secrete them, and their functions: • T3 & T4 (follicular cells): Increase metabolism and regulate appetite. • Calcitonin (C cells): Lowers blood calcium levels. 6. Know the hormones secreted by the adrenal gland and their specific functions: • Cortex: • Aldosterone: Retains Na⁺, excretes K⁺, raises blood pressure. • Cortisol: Increases glucose, metabolism of fat/protein. • Androgens: Precursor to sex hormones. • Medulla: • Epinephrine/Norepinephrine: Increase heart rate, blood flow, and alertness. 7. Function of glucagon and insulin in maintaining homeostasis: • Insulin (beta cells): Lowers blood glucose. • Glucagon (alpha cells): Raises blood glucose. • Antagonistic: They have opposing effects to balance blood sugar levels. 8. Which cells are involved in spermatogenesis? Where does sperm production occur? • Sertoli (Sustentacular) cells support spermatogenesis. • Leydig (Interstitial) cells produce testosterone. • Occurs in the seminiferous tubules of the testes. 9. Know the hormones secreted by the testes and their functions: • Testosterone: Stimulates male development and sperm production. • Inhibin: Inhibits FSH to regulate sperm production. 10. What causes diabetes insipidus? How is it different from diabetes mellitus? • Diabetes insipidus: ADH deficiency → excessive urination. • Diabetes mellitus: Insulin issues → high blood glucose. 11. Know the 3 “P’s” of diabetes: • Polyuria: Excessive urination. • Polydipsia: Excessive thirst. • Polyphagia: Excessive hunger. 12. How are oxytocin and prolactin different? • Oxytocin: Stimulates uterine contractions and milk letdown. • Prolactin: Stimulates milk production. 13. Name the ovarian hormones and their functions: • Estrogen/Progesterone: Regulate cycle, pregnancy, and secondary sex characteristics. • Inhibin: Inhibits FSH secretion. ⸻ Muscle Physiology 14. Know 3 muscle types, their locations, and function: • Skeletal: Attached to bones; movement; voluntary. • Cardiac: Heart; pumps blood; involuntary. • Smooth: Organs/vessels; propels substances; involuntary. 15. Know the layers surrounding muscle: • Epimysium: Surrounds entire muscle. • Perimysium: Surrounds fascicle (bundle). • Endomysium: Surrounds individual fiber. 16. What is a fascicle? A bundle of muscle fibers. 17. What is a sarcomere? Name its regions: Smallest contractile unit (Z-disc to Z-disc). • Z-band, A-band (dark), I-band (light), H-zone. 18. What are actin and myosin? • Actin: Thin filament. • Myosin: Thick filament that pulls actin during contraction. 19. What is troponin and tropomyosin? • Tropomyosin blocks binding sites on actin. • Troponin binds Ca²⁺ to move tropomyosin and expose sites. 20. What is a motor unit? A motor neuron and all muscle fibers it controls. 21. Role of T-Tubule, SR, Terminal Cisternae: • T-Tubule: Conducts AP into cell. • SR: Stores calcium. • Terminal cisternae: Release calcium. 22. Which neurotransmitter is released at the neuromuscular junction? Acetylcholine (ACh). 23. What role does Ca²⁺ play in muscle physiology? Binds troponin, moves tropomyosin, exposes actin sites. 24. What happens to Ca²⁺ after action potential ends? Reabsorbed into SR by Ca²⁺ ATPase pump. 25. What is the function of ATP in muscle physiology? Powers myosin movement, detachment, and Ca²⁺ reuptake. 26. What is sliding filament theory? Myosin pulls actin filaments → sarcomere shortens → contraction. 27. What are DHP and Ryanodine receptors and their roles? • DHP: Voltage sensor in T-tubule. • Ryanodine: Releases Ca²⁺ from SR. 28. What is the function of AChE? Breaks down ACh to stop stimulation and contraction. 29. Difference between isotonic and isometric contractions: • Isotonic: Muscle changes length (shortens/lengthens). • Isometric: Muscle length stays same; tension builds. ⸻ Respiratory Physiology 30. Difference between conductive and respiratory divisions: • Conductive: Air passageways (nose to bronchioles). • Respiratory: Gas exchange (alveoli). 31. Type I & II alveolar cells and functions: • Type I: Gas exchange. • Type II: Secretes surfactant, repairs alveoli. 32. Dust cells and their functions: Alveolar macrophages that clean up particles/debris. 33. Muscles in relaxed vs. forced respiration: • Relaxed inhale: Diaphragm, external intercostals. • Forced inhale: Accessory neck muscles. • Forced exhale: Internal intercostals, abdominals. 34. What happens to pressure and volume when inhaling/exhaling? • Inhale: Volume ↑, pressure ↓. • Exhale: Volume ↓, pressure ↑. 35. Difference between systemic and pulmonary exchange: • Systemic: Gas exchange at tissues. • Pulmonary: Gas exchange in lungs. 36. What cells are involved in carrying gases? Red blood cells (RBCs). 37. Which enzyme converts CO₂ + H₂O → H₂CO₃? Carbonic anhydrase. 38. What does carbonic acid break into? H⁺ + HCO₃⁻ (bicarbonate ion). 39. What happens in hypoxia (low oxygen)? • ↓O₂, ↑CO₂, ↓pH (acidosis). 40. What happens in hypercapnia (high CO₂)? • ↑CO₂, ↓O₂, ↓pH (acidosis). 41. Receptors for blood pH and their locations: • Central (CSF pH): Medulla oblongata. • Peripheral (O₂, CO₂, pH): Carotid & aortic bodies. 42. CO₂ loading & O₂ unloading at tissues: • CO₂ enters blood → forms HCO₃⁻. • O₂ released to tissues. 43. CO₂ unloading & O₂ loading at alveoli: • CO₂ released from blood to lungs. • O₂ binds to hemoglobin. 44. Brain part for unconscious breathing: Medulla oblongata. 45. Obstructive vs. restrictive disorders + example: • Obstructive: Narrowed airways (asthma). • Restrictive: Reduced lung expansion (fibrosis). 46. Know spirometry volumes (not numbers): • Tidal volume, • Inspiratory/Expiratory reserve volume, • Residual volume, • Vital capacity, • Total lung capacity, • Inspiratory capacity, • Functional residual capacity. 47. Define eupnea, dyspnea, tachypnea, apnea, Kussmaul respiration: • Eupnea: Normal breathing. • Dyspnea: Labored breathing. • Tachypnea: Rapid, shallow breathing. • Apnea: No breathing. • Kussmaul: Deep, rapid (from acidosis Endocrine System 1. What are hormones and what is their function in the body? Hormones are chemical messengers transported in the bloodstream that stimulate physiological responses in target cells or organs. 2. Types of hormones based on chemical composition and how they enter target cells: • Steroid hormones: Lipid-soluble, diffuse through cell membrane (e.g., cortisol). • Protein/Peptide hormones: Water-soluble, bind to surface receptors (e.g., insulin). • Biogenic/Monoamines: Derived from amino acids (e.g., T3/T4), may need carriers or membrane receptors. 3. Know all 6 hormones secreted by the anterior pituitary gland and their functions: • TSH: Stimulates thyroid to release T3 and T4. • ACTH: Stimulates adrenal cortex to release cortisol. • GH: Stimulates tissue growth and protein synthesis. • PRL: Stimulates milk production. • FSH: Stimulates egg maturation/sperm production. • LH: Triggers ovulation and testosterone production. 4. What is thymosin? Which gland secretes it? What is its function? Thymosin is secreted by the thymus and helps in the development and maturation of T-cells. 5. Know thyroid gland hormones, the cells that secrete them, and their functions: • T3 & T4 (follicular cells): Increase metabolism and regulate appetite. • Calcitonin (C cells): Lowers blood calcium levels. 6. Know the hormones secreted by the adrenal gland and their specific functions: • Cortex: • Aldosterone: Retains Na⁺, excretes K⁺, raises blood pressure. • Cortisol: Increases glucose, metabolism of fat/protein. • Androgens: Precursor to sex hormones. • Medulla: • Epinephrine/Norepinephrine: Increase heart rate, blood flow, and alertness. 7. Function of glucagon and insulin in maintaining homeostasis: • Insulin (beta cells): Lowers blood glucose. • Glucagon (alpha cells): Raises blood glucose. • Antagonistic: They have opposing effects to balance blood sugar levels. 8. Which cells are involved in spermatogenesis? Where does sperm production occur? • Sertoli (Sustentacular) cells support spermatogenesis. • Leydig (Interstitial) cells produce testosterone. • Occurs in the seminiferous tubules of the testes. 9. Know the hormones secreted by the testes and their functions: • Testosterone: Stimulates male development and sperm production. • Inhibin: Inhibits FSH to regulate sperm production. 10. What causes diabetes insipidus? How is it different from diabetes mellitus? • Diabetes insipidus: ADH deficiency → excessive urination. • Diabetes mellitus: Insulin issues → high blood glucose. 11. Know the 3 “P’s” of diabetes: • Polyuria: Excessive urination. • Polydipsia: Excessive thirst. • Polyphagia: Excessive hunger. 12. How are oxytocin and prolactin different? • Oxytocin: Stimulates uterine contractions and milk letdown. • Prolactin: Stimulates milk production. 13. Name the ovarian hormones and their functions: • Estrogen/Progesterone: Regulate cycle, pregnancy, and secondary sex characteristics. • Inhibin: Inhibits FSH secretion. ⸻ Muscle Physiology 14. Know 3 muscle types, their locations, and function: • Skeletal: Attached to bones; movement; voluntary. • Cardiac: Heart; pumps blood; involuntary. • Smooth: Organs/vessels; propels substances; involuntary. 15. Know the layers surrounding muscle: • Epimysium: Surrounds entire muscle. • Perimysium: Surrounds fascicle (bundle). • Endomysium: Surrounds individual fiber. 16. What is a fascicle? A bundle of muscle fibers. 17. What is a sarcomere? Name its regions: Smallest contractile unit (Z-disc to Z-disc). • Z-band, A-band (dark), I-band (light), H-zone. 18. What are actin and myosin? • Actin: Thin filament. • Myosin: Thick filament that pulls actin during contraction. 19. What is troponin and tropomyosin? • Tropomyosin blocks binding sites on actin. • Troponin binds Ca²⁺ to move tropomyosin and expose sites. 20. What is a motor unit? A motor neuron and all muscle fibers it controls. 21. Role of T-Tubule, SR, Terminal Cisternae: • T-Tubule: Conducts AP into cell. • SR: Stores calcium. • Terminal cisternae: Release calcium. 22. Which neurotransmitter is released at the neuromuscular junction? Acetylcholine (ACh). 23. What role does Ca²⁺ play in muscle physiology? Binds troponin, moves tropomyosin, exposes actin sites. 24. What happens to Ca²⁺ after action potential ends? Reabsorbed into SR by Ca²⁺ ATPase pump. 25. What is the function of ATP in muscle physiology? Powers myosin movement, detachment, and Ca²⁺ reuptake. 26. What is sliding filament theory? Myosin pulls actin filaments → sarcomere shortens → contraction. 27. What are DHP and Ryanodine receptors and their roles? • DHP: Voltage sensor in T-tubule. • Ryanodine: Releases Ca²⁺ from SR. 28. What is the function of AChE? Breaks down ACh to stop stimulation and contraction. 29. Difference between isotonic and isometric contractions: • Isotonic: Muscle changes length (shortens/lengthens). • Isometric: Muscle length stays same; tension builds. ⸻ Respiratory Physiology 30. Difference between conductive and respiratory divisions: • Conductive: Air passageways (nose to bronchioles). • Respiratory: Gas exchange (alveoli). 31. Type I & II alveolar cells and functions: • Type I: Gas exchange. • Type II: Secretes surfactant, repairs alveoli. 32. Dust cells and their functions: Alveolar macrophages that clean up particles/debris. 33. Muscles in relaxed vs. forced respiration: • Relaxed inhale: Diaphragm, external intercostals. • Forced inhale: Accessory neck muscles. • Forced exhale: Internal intercostals, abdominals. 34. What happens to pressure and volume when inhaling/exhaling? • Inhale: Volume ↑, pressure ↓. • Exhale: Volume ↓, pressure ↑. 35. Difference between systemic and pulmonary exchange: • Systemic: Gas exchange at tissues. • Pulmonary: Gas exchange in lungs. 36. What cells are involved in carrying gases? Red blood cells (RBCs). 37. Which enzyme converts CO₂ + H₂O → H₂CO₃? Carbonic anhydrase. 38. What does carbonic acid break into? H⁺ + HCO₃⁻ (bicarbonate ion). 39. What happens in hypoxia (low oxygen)? • ↓O₂, ↑CO₂, ↓pH (acidosis). 40. What happens in hypercapnia (high CO₂)? • ↑CO₂, ↓O₂, ↓pH (acidosis). 41. Receptors for blood pH and their locations: • Central (CSF pH): Medulla oblongata. • Peripheral (O₂, CO₂, pH): Carotid & aortic bodies. 42. CO₂ loading & O₂ unloading at tissues: • CO₂ enters blood → forms HCO₃⁻. • O₂ released to tissues. 43. CO₂ unloading & O₂ loading at alveoli: • CO₂ released from blood to lungs. • O₂ binds to hemoglobin. 44. Brain part for unconscious breathing: Medulla oblongata. 45. Obstructive vs. restrictive disorders + example: • Obstructive: Narrowed airways (asthma). • Restrictive: Reduced lung expansion (fibrosis). 46. Know spirometry volumes (not numbers): • Tidal volume, • Inspiratory/Expiratory reserve volume, • Residual volume, • Vital capacity, • Total lung capacity, • Inspiratory capacity, • Functional residual capacity. 47. Define eupnea, dyspnea, tachypnea, apnea, Kussmaul respiration: • Eupnea: Normal breathing. • Dyspnea: Labored breathing. • Tachypnea: Rapid, shallow breathing. • Apnea: No breathing. • Kussmaul: Deep, rapid (from acidosis Endocrine System 1. What are hormones and what is their function in the body? Hormones are chemical messengers transported in the bloodstream that stimulate physiological responses in target cells or organs. 2. Types of hormones based on chemical composition and how they enter target cells: • Steroid hormones: Lipid-soluble, diffuse through cell membrane (e.g., cortisol). • Protein/Peptide hormones: Water-soluble, bind to surface receptors (e.g., insulin). • Biogenic/Monoamines: Derived from amino acids (e.g., T3/T4), may need carriers or membrane receptors. 3. Know all 6 hormones secreted by the anterior pituitary gland and their functions: • TSH: Stimulates thyroid to release T3 and T4. • ACTH: Stimulates adrenal cortex to release cortisol. • GH: Stimulates tissue growth and protein synthesis. • PRL: Stimulates milk production. • FSH: Stimulates egg maturation/sperm production. • LH: Triggers ovulation and testosterone production. 4. What is thymosin? Which gland secretes it? What is its function? Thymosin is secreted by the thymus and helps in the development and maturation of T-cells. 5. Know thyroid gland hormones, the cells that secrete them, and their functions: • T3 & T4 (follicular cells): Increase metabolism and regulate appetite. • Calcitonin (C cells): Lowers blood calcium levels. 6. Know the hormones secreted by the adrenal gland and their specific functions: • Cortex: • Aldosterone: Retains Na⁺, excretes K⁺, raises blood pressure. • Cortisol: Increases glucose, metabolism of fat/protein. • Androgens: Precursor to sex hormones. • Medulla: • Epinephrine/Norepinephrine: Increase heart rate, blood flow, and alertness. 7. Function of glucagon and insulin in maintaining homeostasis: • Insulin (beta cells): Lowers blood glucose. • Glucagon (alpha cells): Raises blood glucose. • Antagonistic: They have opposing effects to balance blood sugar levels. 8. Which cells are involved in spermatogenesis? Where does sperm production occur? • Sertoli (Sustentacular) cells support spermatogenesis. • Leydig (Interstitial) cells produce testosterone. • Occurs in the seminiferous tubules of the testes. 9. Know the hormones secreted by the testes and their functions: • Testosterone: Stimulates male development and sperm production. • Inhibin: Inhibits FSH to regulate sperm production. 10. What causes diabetes insipidus? How is it different from diabetes mellitus? • Diabetes insipidus: ADH deficiency → excessive urination. • Diabetes mellitus: Insulin issues → high blood glucose. 11. Know the 3 “P’s” of diabetes: • Polyuria: Excessive urination. • Polydipsia: Excessive thirst. • Polyphagia: Excessive hunger. 12. How are oxytocin and prolactin different? • Oxytocin: Stimulates uterine contractions and milk letdown. • Prolactin: Stimulates milk production. 13. Name the ovarian hormones and their functions: • Estrogen/Progesterone: Regulate cycle, pregnancy, and secondary sex characteristics. • Inhibin: Inhibits FSH secretion. ⸻ Muscle Physiology 14. Know 3 muscle types, their locations, and function: • Skeletal: Attached to bones; movement; voluntary. • Cardiac: Heart; pumps blood; involuntary. • Smooth: Organs/vessels; propels substances; involuntary. 15. Know the layers surrounding muscle: • Epimysium: Surrounds entire muscle. • Perimysium: Surrounds fascicle (bundle). • Endomysium: Surrounds individual fiber. 16. What is a fascicle? A bundle of muscle fibers. 17. What is a sarcomere? Name its regions: Smallest contractile unit (Z-disc to Z-disc). • Z-band, A-band (dark), I-band (light), H-zone. 18. What are actin and myosin? • Actin: Thin filament. • Myosin: Thick filament that pulls actin during contraction. 19. What is troponin and tropomyosin? • Tropomyosin blocks binding sites on actin. • Troponin binds Ca²⁺ to move tropomyosin and expose sites. 20. What is a motor unit? A motor neuron and all muscle fibers it controls. 21. Role of T-Tubule, SR, Terminal Cisternae: • T-Tubule: Conducts AP into cell. • SR: Stores calcium. • Terminal cisternae: Release calcium. 22. Which neurotransmitter is released at the neuromuscular junction? Acetylcholine (ACh). 23. What role does Ca²⁺ play in muscle physiology? Binds troponin, moves tropomyosin, exposes actin sites. 24. What happens to Ca²⁺ after action potential ends? Reabsorbed into SR by Ca²⁺ ATPase pump. 25. What is the function of ATP in muscle physiology? Powers myosin movement, detachment, and Ca²⁺ reuptake. 26. What is sliding filament theory? Myosin pulls actin filaments → sarcomere shortens → contraction. 27. What are DHP and Ryanodine receptors and their roles? • DHP: Voltage sensor in T-tubule. • Ryanodine: Releases Ca²⁺ from SR. 28. What is the function of AChE? Breaks down ACh to stop stimulation and contraction. 29. Difference between isotonic and isometric contractions: • Isotonic: Muscle changes length (shortens/lengthens). • Isometric: Muscle length stays same; tension builds. ⸻ Respiratory Physiology 30. Difference between conductive and respiratory divisions: • Conductive: Air passageways (nose to bronchioles). • Respiratory: Gas exchange (alveoli). 31. Type I & II alveolar cells and functions: • Type I: Gas exchange. • Type II: Secretes surfactant, repairs alveoli. 32. Dust cells and their functions: Alveolar macrophages that clean up particles/debris. 33. Muscles in relaxed vs. forced respiration: • Relaxed inhale: Diaphragm, external intercostals. • Forced inhale: Accessory neck muscles. • Forced exhale: Internal intercostals, abdominals. 34. What happens to pressure and volume when inhaling/exhaling? • Inhale: Volume ↑, pressure ↓. • Exhale: Volume ↓, pressure ↑. 35. Difference between systemic and pulmonary exchange: • Systemic: Gas exchange at tissues. • Pulmonary: Gas exchange in lungs. 36. What cells are involved in carrying gases? Red blood cells (RBCs). 37. Which enzyme converts CO₂ + H₂O → H₂CO₃? Carbonic anhydrase. 38. What does carbonic acid break into? H⁺ + HCO₃⁻ (bicarbonate ion). 39. What happens in hypoxia (low oxygen)? • ↓O₂, ↑CO₂, ↓pH (acidosis). 40. What happens in hypercapnia (high CO₂)? • ↑CO₂, ↓O₂, ↓pH (acidosis). 41. Receptors for blood pH and their locations: • Central (CSF pH): Medulla oblongata. • Peripheral (O₂, CO₂, pH): Carotid & aortic bodies. 42. CO₂ loading & O₂ unloading at tissues: • CO₂ enters blood → forms HCO₃⁻. • O₂ released to tissues. 43. CO₂ unloading & O₂ loading at alveoli: • CO₂ released from blood to lungs. • O₂ binds to hemoglobin. 44. Brain part for unconscious breathing: Medulla oblongata. 45. Obstructive vs. restrictive disorders + example: • Obstructive: Narrowed airways (asthma). • Restrictive: Reduced lung expansion (fibrosis). 46. Know spirometry volumes (not numbers): • Tidal volume, • Inspiratory/Expiratory reserve volume, • Residual volume, • Vital capacity, • Total lung capacity, • Inspiratory capacity, • Functional residual capacity. 47. Define eupnea, dyspnea, tachypnea, apnea, Kussmaul respiration: • Eupnea: Normal breathing. • Dyspnea: Labored breathing. • Tachypnea: Rapid, shallow breathing. • Apnea: No breathing. • Kussmaul: Deep, rapid (from acidosis based on chemical composition and how they enter target cells: • Steroid hormones: Lipid-soluble, diffuse through cell membrane (e.g., cortisol). • Protein/Peptide hormones: Water-soluble, bind to surface receptors (e.g., insulin). • Biogenic/Monoamines: Derived from amino acids (e.g., T3/T4), may need carriers or membrane receptors. 3. Know all 6 hormones secreted by the anterior pituitary gland and their functions: • TSH: Stimulates thyroid to release T3 and T4. • ACTH: Stimulates adrenal cortex to release cortisol. • GH: Stimulates tissue growth and protein synthesis. • PRL: Stimulates milk production. • FSH: Stimulates egg maturation/sperm production. • LH: Triggers ovulation and testosterone production. 4. What is thymosin? Which gland secretes it? What is its function? Thymosin is secreted by the thymus and helps in the development and maturation of T-cells. 5. Know thyroid gland hormones, the cells that secrete them, and their functions: • T3 & T4 (follicular cells): Increase metabolism and regulate appetite. • Calcitonin (C cells): Lowers blood calcium levels. 6. Know the hormones secreted by the adrenal gland and their specific functions: • Cortex: • Aldosterone: Retains Na⁺, excretes K⁺, raises blood pressure. • Cortisol: Increases glucose, metabolism of fat/protein. • Androgens: Precursor to sex hormones. • Medulla: • Epinephrine/Norepinephrine: Increase heart rate, blood flow, and alertness. 7. Function of glucagon and insulin in maintaining homeostasis: • Insulin (beta cells): Lowers blood glucose. • Glucagon (alpha cells): Raises blood glucose. • Antagonistic: They have opposing effects to balance blood sugar levels. 8. Which cells are involved in spermatogenesis? Where does sperm production occur? • Sertoli (Sustentacular) cells support spermatogenesis. • Leydig (Interstitial) cells produce testosterone. • Occurs in the seminiferous tubules of the testes. 9. Know the hormones secreted by the testes and their functions: • Testosterone: Stimulates male development and sperm production. • Inhibin: Inhibits FSH to regulate sperm production. 10. What causes diabetes insipidus? How is it different from diabetes mellitus? • Diabetes insipidus: ADH deficiency → excessive urination. • Diabetes mellitus: Insulin issues → high blood glucose. 11. Know the 3 “P’s” of diabetes: • Polyuria: Excessive urination. • Polydipsia: Excessive thirst. • Polyphagia: Excessive hunger. 12. How are oxytocin and prolactin different? • Oxytocin: Stimulates uterine contractions and milk letdown. • Prolactin: Stimulates milk production. 13. Name the ovarian hormones and their functions: • Estrogen/Progesterone: Regulate cycle, pregnancy, and secondary sex characteristics. • Inhibin: Inhibits FSH secretion. ⸻ Muscle Physiology 14. Know 3 muscle types, their locations, and function: • Skeletal: Attached to bones; movement; voluntary. • Cardiac: Heart; pumps blood; involuntary. • Smooth: Organs/vessels; propels substances; involuntary. 15. Know the layers surrounding muscle: • Epimysium: Surrounds entire muscle. • Perimysium: Surrounds fascicle (bundle). • Endomysium: Surrounds individual fiber. 16. What is a fascicle? A bundle of muscle fibers. 17. What is a sarcomere? Name its regions: Smallest contractile unit (Z-disc to Z-disc). • Z-band, A-band (dark), I-band (light), H-zone. 18. What are actin and myosin? • Actin: Thin filament. • Myosin: Thick filament that pulls actin during contraction. 19. What is troponin and tropomyosin? • Tropomyosin blocks binding sites on actin. • Troponin binds Ca²⁺ to move tropomyosin and expose sites. 20. What is a motor unit? A motor neuron and all muscle fibers it controls. 21. Role of T-Tubule, SR, Terminal Cisternae: • T-Tubule: Conducts AP into cell. • SR: Stores calcium. • Terminal cisternae: Release calcium. 22. Which neurotransmitter is released at the neuromuscular junction? Acetylcholine (ACh). 23. What role does Ca²⁺ play in muscle physiology? Binds troponin, moves tropomyosin, exposes actin sites. 24. What happens to Ca²⁺ after action potential ends? Reabsorbed into SR by Ca²⁺ ATPase pump. 25. What is the function of ATP in muscle physiology? Powers myosin movement, detachment, and Ca²⁺ reuptake. 26. What is sliding filament theory? Myosin pulls actin filaments → sarcomere shortens → contraction. 27. What are DHP and Ryanodine receptors and their roles? • DHP: Voltage sensor in T-tubule. • Ryanodine: Releases Ca²⁺ from SR. 28. What is the function of AChE? Breaks down ACh to stop stimulation and contraction. 29. Difference between isotonic and isometric contractions: • Isotonic: Muscle changes length (shortens/lengthens). • Isometric: Muscle length stays same; tension builds. ⸻ Respiratory Physiology 30. Difference between conductive and respiratory divisions: • Conductive: Air passageways (nose to bronchioles). • Respiratory: Gas exchange (alveoli). 31. Type I & II alveolar cells and functions: • Type I: Gas exchange. • Type II: Secretes surfactant, repairs alveoli. 32. Dust cells and their functions: Alveolar macrophages that clean up particles/debris. 33. Muscles in relaxed vs. forced respiration: • Relaxed inhale: Diaphragm, external intercostals. • Forced inhale: Accessory neck muscles. • Forced exhale: Internal intercostals, abdominals. 34. What happens to pressure and volume when inhaling/exhaling? • Inhale: Volume ↑, pressure ↓. • Exhale: Volume ↓, pressure ↑. 35. Difference between systemic and pulmonary exchange: • Systemic: Gas exchange at tissues. • Pulmonary: Gas exchange in lungs. 36. What cells are involved in carrying gases? Red blood cells (RBCs). 37. Which enzyme converts CO₂ + H₂O → H₂CO₃? Carbonic anhydrase. 38. What does carbonic acid break into? H⁺ + HCO₃⁻ (bicarbonate ion). 39. What happens in hypoxia (low oxygen)? • ↓O₂, ↑CO₂, ↓pH (acidosis). 40. What happens in hypercapnia (high CO₂)? • ↑CO₂, ↓O₂, ↓pH (acidosis). 41. Receptors for blood pH and their locations: • Central (CSF pH): Medulla oblongata. • Peripheral (O₂, CO₂, pH): Carotid & aortic bodies. 42. CO₂ loading & O₂ unloading at tissues: • CO₂ enters blood → forms HCO₃⁻. • O₂ released to tissues. 43. CO₂ unloading & O₂ loading at alveoli: • CO₂ released from blood to lungs. • O₂ binds to hemoglobin. 44. Brain part for unconscious breathing: Medulla oblongata. 45. Obstructive vs. restrictive disorders + example: • Obstructive: Narrowed airways (asthma). • Restrictive: Reduced lung expansion (fibrosis). 46. Know spirometry volumes (not numbers): • Tidal volume, • Inspiratory/Expiratory reserve volume, • Residual volume, • Vital capacity, • Total lung capacity, • Inspiratory capacity, • Functional residual capacity. 47. Define eupnea, dyspnea, tachypnea, apnea, Kussmaul respiration: • Eupnea: Normal breathing. • Dyspnea: Labored breathing. • Tachypnea: Rapid, shallow breathing. • Apnea: No breathing

1. Functions of Muscles: • Movement: Muscles contract to produce movement in the body, such as walking, running, or even facial expressions. • Posture and Stability: Muscles help maintain posture and stabilize joints, preventing falls or loss of balance. • Heat Production: Muscle contractions generate heat, which is vital for maintaining body temperature. • Protection of Internal Organs: Muscles, particularly in the abdominal region, protect internal organs from injury. • Circulation of Blood and Lymph: Cardiac and smooth muscles play roles in circulating blood and lymph throughout the body. 2. Characteristics of Muscles: • Excitability (Responsiveness): Muscles can respond to stimuli (like nerve signals). • Contractility: Muscles can contract or shorten when stimulated. • Extensibility: Muscles can be stretched without damage. • Elasticity: Muscles can return to their original shape after being stretched or contracted. 3. Locations of Smooth, Cardiac, and Skeletal Muscle: • Smooth Muscle: Found in walls of internal organs (e.g., stomach, intestines, blood vessels). • Cardiac Muscle: Found only in the heart. • Skeletal Muscle: Attached to bones and responsible for voluntary movements. 4. Events of Skeletal Muscle Contraction: 1. Nerve Impulse: A signal is sent from a motor neuron to the muscle. 2. Release of Acetylcholine: The neurotransmitter acetylcholine is released into the neuromuscular junction. 3. Muscle Fiber Activation: Acetylcholine stimulates muscle fibers, causing an action potential. 4. Calcium Release: The action potential triggers the release of calcium ions from the sarcoplasmic reticulum. 5. Cross-Bridge Formation: Calcium binds to troponin, moving tropomyosin, which allows myosin heads to attach to actin. 6. Power Stroke: Myosin heads pull actin filaments inward, causing the muscle to contract. 7. Relaxation: ATP breaks the cross-bridge, and the muscle relaxes when calcium is pumped back into the sarcoplasmic reticulum. 5. Isometric vs. Isotonic Contractions: • Isometric Contraction: The muscle generates tension without changing its length (e.g., holding a weight in a fixed position). • Isotonic Contraction: The muscle changes length while generating tension (e.g., lifting a weight). 6. Primary Functions of the Skeletal System: • Support: Provides structural support for the body. • Protection: Shields vital organs (e.g., brain, heart, lungs). • Movement: Works with muscles to allow movement. • Mineral Storage: Stores minerals like calcium and phosphorus. • Blood Cell Production: Bone marrow produces blood cells. • Energy Storage: Fat is stored in bone cavities. 7. Parts of a Long Bone: • Diaphysis: The shaft of the bone. • Epiphysis: The ends of the bone. • Metaphysis: Region between the diaphysis and epiphysis. • Medullary Cavity: Hollow cavity inside the diaphysis, containing bone marrow. • Periosteum: Outer membrane covering the bone. • Endosteum: Inner lining of the medullary cavity. 8. Inner and Outer Connective Tissue Linings of a Bone: • Outer: Periosteum. • Inner: Endosteum. 9. Structure of a Flat Bone: • Compact Bone: Dense bone found on the outside. • Spongy Bone: Lighter, less dense bone found inside, filled with red or yellow marrow. • No medullary cavity (unlike long bones). 10. Parts of the Osteon: • Central Canal (Haversian Canal): Contains blood vessels and nerves. • Lamellae: Concentric layers of bone matrix surrounding the central canal. • Lacunae: Small spaces containing osteocytes (bone cells). • Canaliculi: Small channels that connect lacunae and allow for nutrient exchange. 11. How Calcitonin, Calcitriol, and PTH Affect Blood Calcium: • Calcitonin: Lowers blood calcium levels by inhibiting osteoclast activity (bone resorption). • Calcitriol: Increases blood calcium by promoting calcium absorption in the intestines and bone resorption. • PTH (Parathyroid Hormone): Raises blood calcium by stimulating osteoclasts to break down bone and release calcium. 12. Two Forms of Ossification: • Intramembranous Ossification: Bone develops directly from mesenchymal tissue (e.g., flat bones of the skull). • Endochondral Ossification: Bone replaces a cartilage model (e.g., long bones). 13. Difference Between Appositional and Interstitial Growth: • Appositional Growth: Increase in bone diameter (growth at the surface). • Interstitial Growth: Increase in bone length (growth from within). 14. Different Joint Types: • Fibrous Joints: Connected by fibrous tissue (e.g., sutures of the skull). • Cartilaginous Joints: Connected by cartilage (e.g., intervertebral discs). • Synovial Joints: Have a fluid-filled joint cavity (e.g., knee, elbow). 15. Components of a Synovial Joint: • Articular Cartilage: Covers the ends of bones. • Synovial Membrane: Lines the joint capsule and produces synovial fluid. • Joint Capsule: Surrounds the joint, providing stability. • Ligaments: Connect bones to other bones. • Synovial Fluid: Lubricates the joint. 16. Hinge Joint Location: • Found in the elbow and knee. 17. Pivot Joint Location: • Found between the first and second cervical vertebrae (atlantoaxial joint). 18. Difference Between a Tendon and a Ligament: • Tendon: Connects muscle to bone. • Ligament: Connects bone to bone. 19. What is a Bursa? • A fluid-filled sac that reduces friction and cushions pressure points between the skin and bones or muscles and bones. 20. Three Types of Arthritis: • Osteoarthritis: Degeneration of joint cartilage and underlying bone, often due to wear and tear. • Rheumatoid Arthritis: Autoimmune disease causing inflammation in joints. • Gout: Caused by the accumulation of uric acid crystals in the joints. 21. Strain vs. Sprain: • A strain is damage to a muscle or tendon, whereas a sprain is damage to a ligament

Lecture 3 - Myoglobin and Troponin

Chapter 9 – Skeletal Muscles 1. Connective Tissue Surrounding a Skeletal Muscle: • Epimysium: Surrounds the entire muscle. • Perimysium: Surrounds bundles of muscle fibers (fascicles). • Endomysium: Surrounds individual muscle fibers. 2. Histology and Function of Sarcomeres: • Histology: Sarcomeres are the structural and functional units of skeletal muscles, composed of repeating units between two Z-lines. • Function: They enable muscle contraction through the sliding filament mechanism. 3. Main Components: • Thin Filaments: Actin, tropomyosin, and troponin. • Thick Filaments: Myosin. 4. Function of Transverse Tubules and Sarcoplasmic Reticulum: • Transverse Tubules (T-tubules): Transmit action potentials deep into the muscle fiber. • Sarcoplasmic Reticulum: Stores and releases calcium ions for muscle contraction. 5. Motor Unit: A motor neuron and all the muscle fibers it innervates. 6. Neuromuscular Junction: The synapse where a motor neuron meets a muscle fiber, allowing for signal transmission. 7. Synapse: A junction between two neurons or a neuron and a muscle cell where communication occurs. 8. Actions of Acetylcholine (ACh): • Initiates muscle contraction by binding to receptors on the sarcolemma. • Degraded by: Acetylcholinesterase. 9. Neurotransmitter Released at Motor Axon Terminals: Acetylcholine. 10. Steps in Excitation-Contraction Coupling: • Action potential travels along sarcolemma. • Calcium is released from the sarcoplasmic reticulum. • Calcium binds to troponin, causing tropomyosin to move, exposing binding sites on actin. • Myosin heads form cross-bridges and initiate contraction. 11. Order of Muscle Fiber Contraction: • Action potential → Calcium release → Cross-bridge formation → Power stroke → ATP binding → Cross-bridge detachment. 12. Mechanism of Muscle Contraction: • Sliding filament theory: Actin and myosin filaments slide past each other. 13. Interaction of Actin, Myosin, and Calcium: • Calcium binds to troponin, shifting tropomyosin to expose myosin-binding sites on actin, enabling cross-bridge cycling. 14. Cross-Bridges: Myosin heads that bind to actin during contraction. 15. Contraction Types: • Isotonic: Muscle length changes. • Eccentric: Muscle lengthens under tension. • Isometric: Muscle tension without length change. • Concentric: Muscle shortens under tension. 16. Force of Muscle Contraction: • Controlled by motor unit recruitment. • Partial Tetany: Incomplete relaxation. • Fused Tetany: Sustained contraction without relaxation. 17. Bones and Muscles as Levers: • Fulcrum: Pivot point of the lever. 18. Synergist and Antagonist: • Synergist: Assists the primary mover. • Antagonist: Opposes the primary mover. 19. Muscle Atrophy: Wasting of muscle due to disuse or disease. 20. Myasthenia Gravis: Autoimmune disorder causing muscle weakness by targeting ACh receptors. 21. Linea Alba: A fibrous structure running down the midline of the abdomen. 22. Origin, Insertion, and Actions of Specific Muscles: (Let me know which specific ones you’d like to focus on.) Chapter 17 – Digestive System 1. Alimentary Canal: A continuous muscular tube extending from the mouth to the anus. 2. Functions of the Digestive System: • Ingestion, digestion, absorption, and elimination. 3. Breakdown and Absorption: • Carbohydrates: Begin in the mouth (amylase). • Proteins: Start in the stomach (pepsin). • Fats: Start in the small intestine (lipase, bile). 4. Layers of Alimentary Canal Walls: • Mucosa, submucosa, muscularis, serosa. 5. Accessory Organs: • Liver, pancreas, gallbladder. 6. Sympathetic vs. Parasympathetic Effects: • Sympathetic: Decreases digestion. • Parasympathetic: Enhances digestion. 7. Hormones: • Gastrin: Stimulates gastric juice secretion. • Cholecystokinin (CCK): Stimulates bile and pancreatic juice. • Secretin: Stimulates bicarbonate secretion. 8. Peristalsis vs. Segmentation: • Peristalsis: Wave-like contractions. • Segmentation: Mixing movements. 9. Epiglottis Function: Prevents food from entering the trachea. 10. Heartburn: Caused by stomach acid reflux into the esophagus. 11. Stomach Parts: Fundus, body, pylorus. 12. Secretions: • Parietal Cells: Hydrochloric acid, intrinsic factor. • Chief Cells: Pepsinogen. 13. Digestive Enzymes and Substances: • Amylase: Breaks down starch. • Pepsin: Digests proteins. • Trypsin: Protein digestion. • Lipase: Fat digestion. • Bile Salts: Emulsify fats. 14. Liver, Gallbladder, Pancreas Functions: • Liver: Produces bile. • Gallbladder: Stores bile. • Pancreas: Produces enzymes and bicarbonate. 15. Anatomy of Bile Ducts: • Common hepatic, cystic, and pancreatic ducts form the common bile duct. 16. Functions of Large Intestine: • Absorption of water, vitamin production, and feces formation. 17. Defecation Reflex: Triggered by rectal wall distension. Chapter 18 – Nutrition 1. Excess Glucose Storage: As glycogen in the liver and muscles. 2. Tissue Requiring Glucose: Nervous tissue (brain). 3. Triglyceride Components: Glycerol and three fatty acids. 4. Essential Amino Acids: Cannot be synthesized by the body

Chapter 10: Muscle Tissue