S4.txt

• Sympathethic post synaptic (post ganglia) of sweat glands and some blood vessels
• Parasympathetic post ganglion/synamptic Heart smooth muscle and glands
• Muscarinic are G-protein linked while nicotinic are ion channels

Usually quarternary ammonium compounds (CATIONS)

• Heteropentameric ligand gated ion channel with 2 alpha subunits which both must be bound. All or none 70% must be blocked and 90% for full paralysis
• Most receptors in muscles of respiration then for coarse movement
• Least occurs in the facial expression and eyes

• Blocks ganglia (no BP control)
• Affects muscarinic ( no parasymp to heart-> tachycardia)
• Releases histamine (bronchoconstriction & hypotension)
• 30 minute long duration

• Competitive antagonist (70% for effect, 90% for full)
• Vercuronium
• Rocuronium- most popular
• Cistacurium- Hoffman elimination (good for medically compromised)
• Onium = aminosteriod

• Succinylcholine
• Rapidly stimulates and leaves Na channel inactive to prevent repolarization and is not broken down by Achesterase (plasma cholinesterase must break down)
• Phase 1 block for short 5 minute duration (except with plasma cholinesterase defficincies)
• Could lead to bradycardia and Hyperkalemia and malignant hyperthermia

Variation in RYANODINE receptor in the sarcoplasmic reticulum can result in uncontrolled Ca2+ rls and a hypermetabolic response when triggered by succinylcholine and some volatile inhaled anesthetics like sevofluorane

Surgery, intubation, tetnus (non), join, bone maniupulation, electroconvulsant (dep) and laryngospasm (dep)

• GABA (valium, lioresal)
• Alpha 2 agonist (zanaflex)
• Tricyclic (flexeril)
• Ach rls blocker (botox)

Hair loss

• Raised lesion > .5 cm wit water, no pus
• Sometimes autoimmune

• Plug of sebaceous and dead skin in opening of hair follicle
• Open=blackhead
• Closed = whitehead

Inanimate disease carrying object

Itching

Basal cell carcinoma

• Change in skin color
• Flat not palpated

• Elevated small, no depth
• Nodule= papule w depth/elevation
• Pustule = pus-filled papule

Fluid-filled lesions less than .5 cm (sun blisters)

• Blood plasma leaks
• Allergic degranulation of mast cells
• Wheals=circumscribed rounded, slightly elevated lesions of hives

• Type I: slow, mitochondria/lipid rich (acid)
• Type II: fast, glycogen (alkaline)
• What types of stains used to observe mitochondria in muscles?
• OXIDATIVE found in inner mitochondrial membrane
• 1. NADH (more mit, darker)
• 2. SDH (complex II)
• 3. COX2
• Gmori will have purple spots if ragged red

• HYDROLYTIC
• 1. NSE non-specific esterase: shows NMJ, dark = not well innervated
• 2. Alkaline phosphatase: regenerated, dermatomyositis (dark perimyosium
• 3. Acid phosphatase: lysosomal activity: macrophages

• Genetic tests available: dystrophinopathies,
• Myasthenia gravis:Abs blocking Ach receptors and NMJ
• Endocrine myopathies

• Neuromuscular disease: myopathy, neuropathic
• Ststemic disorders: dermatomyositis
• Repeat or treatment related

• Fiber size variation
• ANGULAR atrophy
• Nuclear clumps
• Loss of mosaic pattern
• Eg diabetes, ALS, spinal muscular atrophy

• Random myofiber size
• ROUND atrophy
• Nuclear/cytoplasmic changes: regeneration/degeneration (bluer and mononucleated)
• Inflammatory cells: myositis
• Eg. Dystrophy

• Facial, head, neck muscles
• Teeth don’t meet
• Problems with TMJ checwing, headaches tenderness
• OH problems

• Non-infective inflammatory myopathy CD4 & MAC expression
• Rash, periorbital edema, proximal muscle weakness
• High serum creatine kinase
• PERIFASICULAR ATROPHY: (black) regenerated myofibers along edge of fascicle
• Often seen w alkaline phosphatase rxn