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Week 6 Respiratory
Week 6 Respiratory
433
Anatomy
Graduate
07/14/2014

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Term
During respiration what happens with the larynx and epiglottis?
Definition
the larynx moves upwards and epiglottis flaps over esophagus
Term
what type of cells in the trachea secrete mucus? What structure on the trachea moves mucus up towards pharynx
Definition
goblet cells produce mucus and cillia on trachea move mucus towards pharynx
Term
What kind of muscle is next to trachea? What's its purpose?
Definition
sympathetic stimulation will cause trachealis muscle (Smooth muscle) to contract and increase diameter for higher volume of air to flow to alveoli
Term
Difference between right and left bronchi ?
Definition
Left and right main bronchi. Right bronchi is large in diameter and steeper in descent angle. Aspiration more common in right lung due to anatomy.
Term
Cartilage in the lungs starts at the trachea and ends where in the bronchi?
Definition
at the bronchioles. AT broncholes are smooth muscle
Term
At the alveoli there is less smooth muscle and more?
Definition
squamos cells
Term
Name in order from trachea to alveoli the structures of the lungs
Definition
trachea-carina-left primary bronchus - secondary bronchi - tertiary bronchi - smaller bronchi - bronchioles - terminal bronchioles - respiratory bronchioles - alveoli in pulmonary lobule - alveolar sac - alveoli
Term
what are the two types of alveolar cells
Definition
type 1 and type 2.
type 1 epithelial cells: Most common.
type 2: secrete surfactant
Term
whats the difference between the parietal and visceral cavities?
Definition
a. parietal pleura: membrane that covers the thoracic walls and diagphram
b. visceral pleura: covering the outside of the lung.
Pleural cavity: the space between the parietal and visceral pleura.
Term
what seperates the two pleural cavities?
Definition
the mediastinium
Term
Pleural space has fluid that is negative or positive? Why?
Definition
negative. Kept negative due to lymph drainage. Space also known as "potential space" b/c normal negative and barely any fluid but this could change during pathology.
Term
which lung is shorter in length but more wide (Borad) why?
Definition
right lung is shorter because it sits on top of the liver. But it has no heart on its side so it can spread out throughout the chest and hence why its wide/broad
Term
Does bronchioles have lots of sympathetic innervations?
Definition
NO. However there are beta 2 adregernic receptors that will respond to NOREPI AND EPI secretion from adrenal medulla.
Term
What do mast cells release at the bronchioles
Definition
Mast cells release histamine and leukotrienes which cause bronchoconstriction
Term
What does parasympathetic stimulation do to the bronchioles? Via what NT
Definition
parasympathetic releases acetylcholine which causes bronchoconstriction
Term
Cough reflex does not work in what type of pt
Definition
unconscious persons
Term
whats the difference in the location of the stimulation for the sneeze reflex compared to the cough refelx
Definition
cough reflex is irritation to vocal cord area while sneeze reflex is irritation to the nasal passageways
Term
what is the similarity of how the body responds to the sneeze and cough reflex.
Definition
In both cases the stimulation causes a deep inspiration prior to a forceful expiration
Term
internal respiration refers to?
Definition
diffusion of gases at the tissue level between capillaries and cell membrane of cells. External involves movement of gases from the atmospher to alveoli and across the capillary membrane of lungs
Term
during inspiration what muscles work to do this?
Definition
diagphram moves downward and EXTERNAL intercostals moves ribs up and out. This causes an inward movement of air.
Term
what law applies to how our ventilation system works. What is the equation
Definition
boyles law p1v1=p2v2
Term
whats the difference between quiet expiration and forceful expiration?
Definition
Expiration involves ribs moving down and inward and increase pressure in the lungs to force air out to the environment. During quiet expiration the external intercostal muscles relax and diagphram relaxes. Also there is some smooth muscle recoil from bronchioles ect.. During forceful experiation the internal intercostal muscles contract to pull chest inward also abdomen contract to force diagphram up.
Term
why are alveoli elastic?
Definition
to allow for expansion and recoil
Term
what keepds alveoli from collapsing? 2x
Definition
1. surfactant from type II alveoli cells
2. the intrathoracic pressure created by pleural space and lymphatic system
Term
What is the transpulmonary pressure? Where is it derived from?
Definition
It is the difference between the alveolar pressure and pleural pressure. Indicates elasticity ability and recoil of the lung.
Term
whats the relationship of atomospheric pressures to pressures in the alveoli?
Definition
Alveoli pressure always is in relationship to atmoshperic pressure. So for inspiration to occur the pressure in the alveoli would need to be negative to get air to move in.
Term
role of surfactant?
Definition
surfactant decreases surface tension to prevent alveoli from closing
Term
surfactant consists of?
Definition
surfactant consists of phospholipid (phosphatidylcholine), surfactant apoproteins, and Ca2+
Term
when does surfactant production begin during pregancy?
Definition
6-7 months
Term
what is hylane membrane disease? also known as ?
Definition
respiratory distress syndrome - -decreased or absent surfactant results in increased surface tension and lungs may collapse or fill with fluid
Term
Explain the relationship of surfactant and surface tension
Definition
surfactant is made of Ca++, apoproteins and phospholipids which combined  are molecules that are both polar (water-like) and non-polar (oil-like) so they stay on the surface like oil and do not completely mix with water but are able to bond to water and prevent water molecules from binding as tightly to one another, thus lowering the tension or strength of the surface.
Term
what is the relationship of pressure and radius of alveoli
Definition
The smaller the radius of the alveoli the higher the pressure because more H20 attraction forces since the lining of the alveoli are closer. There is more surface tension and therefore more pressure.
Term
if alveoli become occluded what happens to the pressure in the alveoli..why?
Definition
increase pressure because of increase surface tension
Term
the collapse of alveoli is referred to as?
Definition
atelectasis
Term
how does high levels of O2 Conc cause atelectasis?
Definition
High fraction of O2 causes free radical formation in the alveoli which destroy the lining. There is also a decrease in nitrogen concentration since we increase the ratio of O2 in the overall inhaled air. Since O2 can be absorbed across the respiratory membrane and Nitrogen cannot that results in less gas remaining in the alveoli since the only gas that can't cross and must remain is nitrogen. If there say is only 50% as much nitrogen as usual then the alveoli will only remain open 50% as large as before. So now there is decrease volume of gas (nitrogen) to keep the alveoli open and increase resistance since the alveoli walls are now closer to each other. That is why high levels of O2 cause absorptive atelectasis.
Term
pneumothorax occurs as a result of?
Definition
air being let into the negative pleural space. If there is air in this space than its no longer negative. If its not negative then is can be pulled down by the elastic recoil of the lungs. This leads to collapse of the lung.
Term
during a tension pneumothorax does the heart and mediastinum move away or towards the pneumo?
Definition
AWAY. it shifts away from high pressure of the air built up in the pleural space.
Term
what is the lamina propria
Definition
it is part of the respiratory mucosa along with the epithelium. It is underneath the epithelium but above the basement membrane. It is made up of loose connective tissue that is very cell rich full of fibroblasts, lymphocytes, plasma cells, macrophages, eosinophilic leukocytes, and mast cells
Term
role of elastin on alveoli?
Definition
The elastic fibers allow the alveoli to stretch as they are filled with air during inhalation. They then spring back during exhalation in order to expel the carbon dioxide-rich air.
Term
role of macrophages on alveoli
Definition
destroy foreign material, such as bacteria.
Term
surfactant's function in the lungs?
Definition
which is a phospholipid and protein mixture that reduces surface tension in the thin fluid coating within all alveoli. The fluid coating is produced by the body in order to facilitate the transfer of gases between blood and alveolar air
Term
explain why high conc of O2 can cause absorption atelectasis
Definition
The atmosphere is composed of 78% nitrogen and 21% oxygen. Since oxygen is exchanged at the alveoli-capillary membrane, nitrogen is a major component that remains in the alveoli and keeps it inflated. If a large volume of nitrogen in the lungs is replaced with oxygen, the oxygen may subsequently be absorbed into the blood, reducing the volume of the alveoli b/c there is not as much nitrogen to keep it inflated, resulting in a form of alveolar collapse known as absorption atelectasis.
Term
explain why fibrosis of the airways can lead to pulmonary edema
Definition
Airways that suffer from fibrosis are rigid and loose their elasticity. When the air is absorbed from them they cannot decrease in size (No elastic rebound) as a result there is negative pressure generated since the volume changes but the container doesn't. Now the pressure gets lower. Negative pressure then causes the capillaries from the surrounding tissue to leak out fluid towards this vacuum space.
Term
why is there mediastinial and diaphragmatic shifts from large areas of atelectasis?
Definition
Large areas of atelectasis means collapsed alveoli and decrease surface area of the lungs. As a result this void in space is filled in by the diaphragm and mediastinum TOWARDS THE ATELECTASIS
Term
what happens to blood flow in a lung with lots of atelectasis?
Definition
Increase resistance because of collapse of the lung.
Term
Explain the difference in the mediastinal shift for atelectasis and pneumothorax
Definition
In atelectasis there is collapse of alveoli which causes an increase in free space that the mediastinum will shift TOWARDS. While in pneumothorax the collapse of the lung and free space available from the is filled in by air or blood in the pleural space so much so that it can force the mediastinum away from the area of injury.
Term
The vital capacity is the sum of?
Definition
inspiraotry reserve volume + tidal volum + expiratory reserve volume
Term
The air left in the lungs after a normal expiration is referred to as? Composed of?
Definition
functional residual capacity made up of the expiratory reserve volume + residual volume.
Term
what characteristic of the lungs will cause a lost in functional residual capacity
Definition
decrease compliance
Term
What is physiological dead space? How much in the body? What contributes to it?
Definition
Physiological dead space is equal to 150mL and mostly is composed of anatomical dead space from areas of the lung (mostly bronchus) where there is not gas exchange. However in certain chronic pathological conditions there are non-functioning alveoli which contribute another type of physiological dead space as well.
Term
force vital capacity effected by
Definition
1. strength of respiratory system
2. lung volume
3. airway resistance
Term
how do you determine the force vital capacity?
Definition
The amount of air after a large inspiration that can be forced completely out
Term
What is a normal Forced vital capacity %
Definition
80%
Term
when would the forced expiratory volume be decreased? in what condition
Definition
its decreased in obstructive conditions such as COPD and asthma
Term
lung compliance tells us what about the lungs?
Definition
expandability
Term
How do we determine compliance?
Definition
compliance is: ΔV/ΔP = change in volume for each unit increase in alveolar pressure
Term
what is the normal compliance for the lungs?
Definition
compliance of lungs alone is 0.22 liters /cm H2O pressure
Term
what two things determine compliance
Definition
compliance is determined by
1. elasticity of lungs (1/3 of elastic force)
2. surface tension inside alveoli (2/3 of elastic force)
Term
decrease in compliance causes an increase or decrease in work of compliance
Definition
increase
Term
equation for compliance
Definition
change in V / Change in P
Term
65% of the work of breathing is overcoming ?
Definition
compliance.
Term
whats associated with an increase in lung compliance. Why?
Definition
emphysema / copd due to the loss of alveolar and elastic tissue.
Term
Whats associated with a decrease in lung compliance
Definition
fibrosis.
Term
Explain importance of surfactant in compliance of the lung. Does surfactant increase or decrease compliance? Why?
Definition
Pulmonary surfactant increases compliance by decreasing the surface tension of water. The internal surface of the alveolus is covered with a thin coat of fluid. The water in this fluid has a high surface tension, and provides a force that could collapse the alveolus. The presence of surfactant in this fluid breaks up the surface tension of water, making it less likely that the alveolus can collapse inward. If the alveolus were to collapse, a great force would be required to open it, meaning that compliance would decrease drastically. Remember the surface area of the alveoli make up the largest percentage of the entire lung combined and alone equals the area of a tennis court. So any changes in their ability to open will have profound effects on the lungs compliance.
Term
why would one have low compliance?
Definition
Low compliance indicates a stiff lung and means extra work is required to bring in a normal volume of air. This occurs as the lungs in this case become fibrotic, lose their distensibility and become stiffer.
Term
why do emphysema pts have high compliance
Definition
Patients with emphysema have a very high lung compliance due to the poor elastic recoil, they have no problem inflating the lungs but have extreme difficulty exhaling air. In this condition extra work is required to get air out of the lungs. Compliance also increases with increasing age. So if you have a hyperinflation of the lungs as well as a large residual of air left after inspiration than this results in higher pressure in alveoli that compromises blood flow and affects V/Q ratio.
Term
Is the apex or the base of the lung more compliance? Why?
Definition
Lung compliance is higher at the base of the lung and lower at the apex of the lung.
This means that inspiring a tidal volume of air causes more expansion at the base of the
lung and that the lung units at the base are more susceptible to collapse.
Term
What is the relationship of elastic recoil and compliance?
Definition
Compliance vs. Elastic Recoil—If compliance is low, the elastic recoil is high. This
means that the lungs are stiffer and there is a greater tendency of the lungs to collapse.
This is seen in various fibrotic conditions. If compliance is high, the elastic recoil is low.
This is seen in the case of emphysema
Term
if there is reduced compliance in a lung then will you need more or less pressure to obtain adequate volume inflation?
Definition
more pressure.
Term
explain the physiology of obese people and compliance
Definition
decrease in the compliance of either the lungs or the thorax would require that more muscular work be done to expand the lungs. This type of situation is seen in obese individuals. When they are in a supine position, the lung compliance may be normal, but the thorax compliance may be lowered by the weight of the abdomen pushing against t he thorax. This increases the amount of work that is required to expand the lungs. This is the reason that obese people often sleep sitting up. It is simply harder for them to breathe while in a supine position b/c of the greater compressed mass
Term
at function residual capacity there is a balance between pleural pressure and ?
Definition
FRC reflects when the elastic recoil and Ppl are balanced.
Term
what causes bronchial smooth muscle relaxation to decrease resistance?
Definition
beta adregernic stimulation via norepinephrine and NO
Term
What causes bronchial smooth muscle constriction?
Definition
s acetylcholine, histamine, and prostaglandin F2α
Term
True or false: work of breathing can be increased by increased airway resistance,
reduced lung compliance, or reduced thorax compliance.
Definition
true
Term
if alveolar pressure is high then what happens to blood flow at capillaries
Definition
decrease blood flow
Term
Which zone do you have continuous capillary blood flow?
Definition
zone three. Begins 10cm above the middle of the heart to base of lung
Term
what zone of the lung is not normal.
Definition
zone 1 is not normal there is not capillary blood flow during ANY of the cardiac cycle because the alveolar pressure is greater than the capillary hydrostatic pressure.
Term
in supine or reclining position what zone is your lungs mostly in? Why
Definition
even in supine and the lungs being in a near horizontal position to the heart there is still mostly zone 3 type blood flow.
Term
pulmonary circulation holds?
Definition
450 mL of blood
Term
factors that can increase blood out of the lungs?
Definition
1. increased intrapleural pressures
2. hemorrhage
3. going from a reclining to standing position.
Term
Does hemoglobin at the capillary tissue level have more PCO2 or PO2?
Definition
the hemoglobin has twice as much PCO2 than it does PO2. More PO2 is always in the interstitial / plasma space and more PCO2 is in the hemoglobin compared to interstitial space/plasma
Term
What has the highest solubility? He, N, O2
Definition
O2
Term
Is O2 or CO2 more soluble?
Definition
CO2 by 24x more
Term
What is the Fick Equation
Definition
Fick’s law of diffusion =
ΔP x A x DC
---------------
d
Term
what is the relationship between altitude and partial pressures of o2 and co2 in blood
Definition
As you increase in altitude the outside atmospheric pressure goes down which effects the pressure gradients inside the body resulting in lower external PO2/PCO2 and therefore lower blood PO2/PCO2. Oxygen saturation then diminishes as well.
Term
if your tidal volume is 500mL how much actually gets to your alveoli? Where does the rest go?
Definition
350 mL get to your alveoli while the other 150 is lost in physiological dead space
Term
normal alveolar ventilation is?
Definition
4.2 L/min
Term
normal oxygen absorption / uptake rate per minute is?
Definition
250 mL of O2 / min
Term
what two important factors directly influence the partial pressure of O2?
Definition
1. alveolar ventilation rate
2. O2 uptake rate

The higher the O2 uptake than the more alveolar ventilation necessary to keep up with that rate to get the partial pressure high enough for appropriate diffusion later in the body for diffusion to occur.
Term
what law is the diffusion of molecules in a gaseous state are inversely proportional to √MW
Definition
Grahams law
Term
during exercise does O2 or CO2 have a markedly increase in diffusing capacity?
Definition
CO2 more than doubles its diffusing capacity during exercise. Even at rest CO2 diffusing capacity is 20 times more than O2
Term
Whats the importance/effect of humidified air on the lungs?
Definition
Lungs needs warm humidified air from the nasal passageways and trachea in order to maintain a moist environment to promote cilliary removal of mucus at an appropriate viscosity. Air from the atmosphere is typically dry and becomes nearly 95% humidified before it reaches the alveoli from the moist surfaces of the airways along the way.
Term
Utilization coefficent for O2 refers to? what is the normal at rest?
Definition
how much O2 is used at the tissue level? Its approximately 25%
Term
normal ventilation / perfusion ratio is?
Normal ventilation is?
Normal perfusion?
Definition
ratio: 0.8
ventilation 4.2 l/min
perfusion: 5.5 L/min
Term
What is the ratio for ventilation/perfusion? Whats normal?
Definition
Va/Q = 0.8 b/c Va= 4.2 L/min and Q=5.5L/min
Term
If you have a decrease in flow what happens to the ventilation/flow ratio? What happens with ventilation to that alveoli?
Definition
Decrease flow means more ventilation of the blood that is there because if ventilation remains in tact then the body has a longer time to ventilate the slow moving blood. The ventilation ratio will increase from 0.8.
Term
What kind of pathologies can cause an increase in the ventilation / perfusion ratio
Definition
increase V/Q will result from decrease flow. Such things that decrease flow will cause this. Emboli, vasoconstrictors, CPD with destruction of alveoli blood capillaries.
Term
A decrease of the V/Q will result from what pathologies. What is happening?
Definition
A decrease in the V/Q will be front ventilation problems which are most often related fibrosis, inflammation, COPD (Broncholes are blocked)Decrease ventilation to alveoli will force the body to also respond by physiological shunts to move blood flow to areas of good ventilation. Remember hypoxia will cause vasoconstriction as a local effect.
Term
How does gravity effect the lungs in relation to flow (Q)and the superior area of the lung
Definition
Superior parts of the lung have decrease flow and decrease ventilation. But there is more flow disturbance because of gravity. So the ratio of V/Q would increase to nearly 2.5 normal.
Term
does humidified air or dry air have more oxygen per liter?
Definition
dry air.
Term
how does gravity and V/Q reflect areas of the bottom of the lung?
Definition
The bottom of the lung has less ventilation than it does perfusion since blood can easily flow down to the lower bases. A decrease in ventilation causes a decrease in the v/q ratio.
Term
Does a higher V/Q ratio result in more oxygen capacity or lower?
Definition
A increase in V/Q ratio will result in higher PO2 and lower CO2 concentrations. This is a result of there being more ventilation per amount of flow. So longer time to ventilate the blood that's there and exchange CO2 for O2
Term
From the apex of the lung to the base of the lung what happens to the V/Q ratio? Why?
Definition
The ratio gets smaller as you go from the apex to the base. This is because of gravity and overall the flow increases slightly more than ventilation therefore the ratio changes due to a larger number at the bottom.
Term
a V/Q undefined though approaching infinity is termed dead space and what is happening to ventilation or perfusion?
Definition
its an area with no perfusion
Term
a V/Q of zero is termed "shunt." whats happening to ventilation and perfusion?
Definition
Its an area with no ventilation
Term
We might see high partial pressures of O2 from what kind of recreational people? What are the sx of high O2 partial pressures
Definition
divers. The "benz" sickness causes nausea and seizures.
Term
what percentage of O2 is carried in the dissolve state?
Definition
3%
Term
A high or low V/Q ratio decreases paCO2 and increases paO2.
Definition
high
Term
a pulmonary embolism results in a high or low V/Q ratio?
Definition
High
Term
in emphysema is there a high or low V/Q ratio
Definition
high
Term
in acute pulmonary edema is there high or low V/Q ratio
Definition
low
Term
In asthma is there a high or low V/Q ratio
Definition
low
Term
an area with a "shunt" will have a v/q ratio that is?
Definition
no ventilation so in a shunt the v/q ratio can be zero. LOW.
Term
oxygen disassociation curve refers to?
Definition
the oxyhemoglobin dissociation curve relates oxygen saturation (sO2) and partial pressure of oxygen in the blood (pO2), and is determined by what is called "Hemoglobin affinity for oxygen"; that is, how readily hemoglobin acquires and releases oxygen molecules into the fluid that surrounds it.
Term
To get more O2 to tissues when you've maxed out your hemoglobin saturation what can you do?
Definition
To get more oxygen to the tissue would require blood transfusions to increase the hemoglobin count (and hence the oxygen-carrying capacity), or supplemental oxygen that would increase the oxygen dissolved in plasma.
Term
What does a shift to the right or left mean with oxygen disassociation?
Definition
A shift left or right refers to the x axis of the disassociation curve. On the x axis is the partial pressure of O2. So if you shift right means there is a need for more PO2 in order to maintain the O2 saturation on the hemoglobin. If you go left on the X axis then the PO2 decreases which means you need less Partial pressure of O2 to maintain the saturation of oxygen on hemoglobin. So another way to look at it is by affinity. A shift right means there is less affinity for O2 to bind to hemoglobin so it will take more partial pressure of O2 to force more O2 onto this stubborn hemoglobin. A third way to understand this is from the tissue level. If there is more tissue demand than the partial pressure at the interstitial level will be much much lower. So diffusion will be stronger and more O2 will leave the hemoglobin. stronger force on O2 leaving means a decrease in affinity of the hemoglobin to keep its O2.
Term
What causes a shift to the right of the o2 disassociation curve?
Definition
1. increase hydrogen ions
2. increased CO2
3. increased temp
4. increased BPG
Term
What is utilization coefficent?
Definition
IT reflects how much O2 is removed and utilized at the tissue level. Normal utilization coefficent is 25%
Term
what two things can cause a 100% utilization coefficent?
Definition
Slow blood and/or high metabolic rates
Term
What does DPG do to hemoglobin affinity and why is this important to fetal hemoglobin?
Definition
Fetal hemoglobin are made up of two alpha and two gamma polypeptide chains unlike adult chains which have two alpha and two beta. Fetal babies lack DPG. DPG in materal blood shifts the diassociation curve to the right which means the hemoglobin in the mom's has a lower affinity to o2 and 02 therefore wants to leave. luckily for the baby it wants to leave to the fetal blood which lacks DPG and has a higher affinity for O2.
Term
What factors favor oxygenation of the fetal blood?
Definition
1. There is a partial pressure gradient between mom and the baby. The baby's level is lower so O2 is diffused to the baby
2. The baby has a higher hemoglobin content that is around 50% compared to mom which only has around 15% hemoglobin concen.
3. Fetal hemoglobin lacks DPG. So its affinity for O2 is higher and its disassociation curve shifts to the left.
4. baby has high PCO2 which is important because it allows it to diffuse across placenta to mom's lower levels. As a result of dumping CO2 to mom it causes mom's blood to be more acid which favors more loss of O2 to the baby
5.
Term
What is the bohr's effect?
Definition
The fetal circulation has higher CO2 concentrations than the mom's and at the placenta this higher concentration diffuses across. Increase CO2 also means increase hydration of CO2 in the baby and mom by carbonic anhydrase in the hemoglobin which results in more H ions. More H means more acid which means less affinity for mom to hold onto O2 and therefore more O2 difussion to baby.
Term
what happens to hemoglobin in sickle cell anemia
Definition
there is a mutation in the b chains of the hemoglobin which results in a change in shape at lower O2 levels. Crystals devleop on the hemoglobin that causes destruction.
Term
reduced synthesis of α and β chains of hemoglobin is known as?
Definition
thalassemia
Term
what % of CO2 transported in the hemoglobin? Whats it referred to as?
Definition
23% transported at carboaminohemoglobin.
Term
why would we want to make conditions that favor hemoglobin releasing O2 (Decrease Affinity)- also known as a shift to the right
Definition
When at the tissue level there is a strong demand for O2 for metabolism whether that is for fighting off a huge infection, exercise or even supplying O2 to the fetus the body will create conditions that will favor hemoglobin releasing O2 and thereby increasing partial pressure of O2. Remember that the partial pressure of O2 at the tissue level is what actually gets absorbed into cells to be used for active processes/energy. Its important that hemoglobin release O2 because the O2 on heme does nothing for all the INTRAcellular processes.
Term
during a shift to the left will oxygen be more likely to be released or less likely to leave
Definition
less likely to leave
Term
Bohr effect is stimulated by what four things? What does it do to affinity of o2 and the o2 disassociation curve?
Definition
During Bohr effect these four things
1. increase H ions
2. increase temp
3. Increase CO2
4. DPG
will result in an environment where there is a shift to the right and hemoglobin has a decrease in affinity for O2 therefore o2 wants to leave!
Term
Low affinity = _____ Shift
Definition
right shift
Term
High affinity = __________ shift
Definition
left shift
Term
Fetal blood has higher or lower affinity for O2 in hemoglobin? Why?
Definition
Fetal have higher affinity for O2 due to lacking or having less of DPG.
Term
mnemonic for disassociation curve and right shift:
CADET face right! C=CO2 A=acid D= DPG E= Exercise T= Tempterature
Definition
CADET face right! C=CO2 A=acid D= DPG E= Exercise T= Tempterature
Term
If there is an increase in H+ Then what happens to O2 affinity? Why? What is this called?
Definition
Decrease O2 affinity. Shift right. The reason for this is that H+ and O2 both compete for binding to the hemoglobin molecule. Therefore, with increased acidity, the hemoglobin binds less O2 for a given PO2 (and more H+). This is known as the Bohr effect
Term
Basic rhythm for inspiration is set by what part of the respirator center?
Definition
dorsal respiratory group. They have a ramp signal which means they increase their firings based on inputs from chemoreceptors, stretch receptors and baroreceptors
Term
What does the ventral group of respiratory neurons do? How do they affect dorsal respiratory neurons?
Definition
It can have some influence of inspiration and respiration. During normal respiration they are usually dormant. If they are active they usually increase RR by decreasing the ramp signal sent by the dorsal group which means decreasing duration of each inspiration in order to breath faster. These can also work increase strength of expiration by recruiting more muscles to force air out.
Term
What does the pons do? Whats in the pons that affects respiration?
Definition
The pons has the pneumotaxic center that can inhibit the dorsal respiratory center and primarily inhibit length of inspiration and some decrease in rate.
Term
How does the Hering-Breuer reflex work?
Definition
This reflex uses stretch receptors in the bronchioles and bronchi that send signals to dorsal respiratory center when lungs are over inflated from large tidal volumes. The result is inhibition at the dorsal group.
Term
the dorsal and ventral respiratory groups are located where?
Definition
Medulla
Term
Chemoreceptors that act on breathing are located where? What do they respond to in the blood?
Definition
chemoreceptors located in the ventral area of the medulla respond to H+ and PCO2 in the blood. But responds mostly to H+ after its made from CA hydrating CO2.
Term
how does PO2 effect chemoreceptors and the respiratory center in the brain?
Definition
changes in blood PO2 no direct effect on respiratory center or central chemoreceptors
Term
How long does the respiratory center respond to high levels of CO2 and H+
Definition
Only for a couple of days and then the body adjusts. So its important for kidney to begin the longer term adjustment because lungs are short term mediators.
Term
how does CO2 effect affinity of hg for O2...2x things it does
Definition
High levels of Co2 causes a shift to the right because of a decrease of affinity for O2 as a result of two things that high co2 does
1. CO2 is broken down to H+ and Bicarb in hg resulting in more acidity that takes up room in the hg that acts as a buffer. Bohr effect (Competition)
2. increase CO2 means more carbaminohemoglobin.
Term
blood CO2 effects central or peripheral chemoreceptors faster?
Definition
peripher chemoreceptors faster such as those in carotids and aorta
Term
Whats the difference between peripheral and central chemoreceptors?
Definition
Central chemoreceptors at the medulla are more repsonsive to changes in H+ since CO2 does not cross BBB as well. Peripheral chemoreceptors in carotid and aortic notch are more responsive to CO2 levels.
Term
Low levels of DPG result in higher affinity for O2 to stay bounded to Heme or lower affinity?
Definition
Higher affinity to stay bounded if low levels. Heme will attract O2. Baby's have little or now DPG and they attract mom's O2 because they have a high affinity (Attraction) for O2. While mom has higher DPG and here hemoglobin has lower affinity and therefore O2 will cross placenta to heme of fetus that wants the O2 more.
Term
Why does high temp shift dis curve to right?
Definition
Increase temp causes decrease affinity of O2 to heme bc it denatures the proteins that hold O2 to hemoglobin and causes the O2 to leave.
Term
edema in the brain will do what to resp center
Definition
depress / inactivate
Term
Why is CO poisoning a shift to the left? Whats happening?
Definition
CO has a 400x more affinity for hemoglobin than does O2. CO has only one oxygen. The problem is that this one Oxygen in CO will not leave the hemoglobin and provide O for energy at the tissue level. So technically there is a massive shift to the left because hemoglobin has an extremely high affinity for that ONE OXYGEN from CARBON MONOXIDE. The hemoglobin won't share its O2 load than tissues die from hypoxia. The hemoglobin technically be 100% saturated with oxygen from that carbon MONOXIDE but it does nothing for the body. So PO2 is terrible and pt dies.
Term
Cheynne Stokes breathing occurs why?
Definition
B/c too fast removal of CO2 tells brain to stop breathing. Then PCO2 increases and the patient begins to breath again.
Term
the fetal disassociation curve is shifted to the right or to the left in relation to the mother's curve?
Definition
LEFT!! B/c baby wants O2 and is selfish. So its hemoglobin has a stronger affinity for O2 so it can effectively steal mom's O2 at the placenta.
Term
Plasma is mostly made up of?
Definition
H2O 92&
Term
The second largest component to plasma is?
Definition
Plasma proteins
Term
Whole blood is composed of?
Definition
plasma and formed elements
Term
electrolytes and organic nutrients/wastes are a component of what part of blood? What % do they contribute to it?
Definition
Plasma and only 1% of that volume.
Term
The formed elements of blood consist of what components?
Definition
WBCs, RBCs and platelets.
Term
What percentage of formed elements are platelets and WBCs
Definition
0.1%
Term
Proteins such as albumin and globulin are a component of plasma or formed elements in whole blood?
Definition
Plasma
Term
Plasma is mostly made up of?
Definition
H2O 92&
Term
The second largest component to plasma is?
Definition
Plasma proteins
Term
Whole blood is composed of?
Definition
plasma and formed elements
Term
electrolytes and organic nutrients/wastes are a component of what part of blood? What % do they contribute to it?
Definition
Plasma and only 1% of that volume.
Term
The formed elements of blood consist of what components?
Definition
WBCs, RBCs and platelets.
Term
What percentage of formed elements are platelets and WBCs
Definition
0.1%
Term
Proteins such as albumin and globulin are a component of plasma or formed elements in whole blood?
Definition
Plasma
Term
What WBC's are referred to as granular leukocytes?
Definition
1. neutrophil
2. eosinophil
3. basophils
Term
What WBC's are referred to as agranular leukocytes?
Definition
1. monocytes
2. lymphocytes
Term
most abundant leuokocytes are
Definition
neutrophils
Term
second most abundant leukocytes are
Definition
lymphocytes
Term
red blood cells also known as
Definition
erythrocytes
Term
How does the shape of the RBC help in the body
Definition
RBC's with bi-concave structure can stack in the capillaries and also moves more freely without getting stuck. They are also slightly flexible to squeeze through things.
Term
what is hemoglobin A1c?
Definition
its a type of hemoglobin that can be glycolsated under high glucose conditions in the blood. Once this is done it cannot be undone. Hence why this version of hemoglobin is a good indicator of overall glucose control in diabetes. The only way to get rid of these glycolsisated hemoglobins is for them to be destroyed. Hemoglobins stay alive for 120 days.
Term
Where does hematopoesis occur? When?
Definition
red bone marrow around 7-8 months of gestation and after birth
Term
Explain the development / Maturation of a RBC
Definition
all red blood cells start off as non-differeniated stem cells that then undergo eryhtroblast formation which ends when the nucleus is ejected. This new form along the path of maturation is called a reticulocyte. It still contains some of the organelles such as mitochondria which are needs to finish the final steps of maturation. The final mature version of a RBC is known as a erythrocyte.
Term
Whats the difference between hematopoesis and erythropoesis?
Definition
hematopoesis is the process of producing all blood cells. So the process can go many routes and depends on colony stimulating factors to decide whether or not it will develop RBCs, platelets, or WBCs.
Term
for vitamin b12 to be absorbed what does the body need?
Definition
Need intrinsic factor for b12 to be absorbed in the ileum of the small intestine.
Term
how are RBC's cleared from the body? 2x
Definition
RBCs are either destroyed along their life span and we call this hemolysis or they live out their life span and then get eaten by hungry macrophages that recycle the old RBC's and hemolyzed RBCs.
Term
How do macrophages recycle RBC's
Definition
they conserve / recycle the ferrous and amino acids that get sent back to the site of RBC production in the bone marrow. The macrophages get rid of the waste products from old hemoglobin which is the heme group by removing it in billiverdin to billirudin.
Term
What factor influences haematopoiesis to make RBCs? Where does it come from?
Definition
erythropoietin is released from the kidney and is a stimulating factor to influence RBC production.
Term
Erythropoietin release from the kidney's is influenced by what main factor?
Definition
decrease tissue oxygen!! can be caused by:
1. low blood volume
2. anemia
3. low hemoglobin
4. poor blood flow
5. pulmonary disease
Term
During rest how much energy expenditure is spent on breathing
Definition
3-5 %
Term
compliance work equation is?
Definition
(change in pressure X change in volume) / 2
Term
normal PA pressure is?
Definition
25/8
Term
the left atria pressure is similar to the pressure of the?
Definition
pulmonary VEINS
Term
normal pulmonary CAPILLARIES pressure is? while normal pulmonary vein pressure is?
Definition
pulmonary capillary pressure = 7 mm Hg while normal pulmonary vein pressure is = 3-5 mm Hg
Term
Normal pulmonary wedge pressure is? Is it higher or lower than LA pressure?
Definition
normal = 5 and it is normally 3-5 mm Hg higher than LA
Term
describe the anatomy of pulmonary ARTERIES. are they distensible or compliant? Are pulmonary veins similar?
Definition
they are extremely distensable and compliant. They are thin and much larger than their counterparts. They need to be in order to function under the lower flow rates as compared to the systemic circulation. Pulmonary veins on the other hand act more like their systemic counterparts.
Term
what constricts and what dilates pulmonary arterioles
Definition
Acetylcholine constricts while norepi and epi vasodilates.
Term
E. coli endotoxin, histamine, and serotonin will do what to the lung vessels?
Definition
Constrict pulmonary Veins
Term
where is angiotensin converting enzyme made and located
Definition
the endothelial cells of the pulmonary CAPILLARIES secrete ACE that then converts angiotensenin to angio II
Term
what factor influences pulmonary blood flow the most?
Definition
O2 concentration has the greatest effect on blood flow in the lungs. More so than any other local mediators or even more so than nervous system and NE or EPI or acetylcholine release.
Term
Whats unique about the pulmonary circulation
Definition
The pulmonary bronchioles are supplied by a systemic system that does not empty back into the right atrium and instead empties into the oxygenated blood in the pulmonary veins that then goes directly to the left atrium via pulmonary veins.
Term
hypoxia locally in the alveoli will cause what? How is this different than systemic circulation? Why is this good?
Definition
vasoconstriction also known as hypoxic vaso-constriction shunting. The body shunts blood away from areas where it is not getting enough blood flow. In systemic circulation decrease O2 would cause increase blood flow. But in the lungs we don't want that. Think about someone chocking on food. That food obstructs a alveoli duct. Why would the body want to send blood there if its not going to be ventilated and provded with O2 in exchange for CO2 waste? B/C if it doesn't shunt blood away from these dead areas then blood will continue to return to systemic circulation with no oxygen and lots of waste. That person's tissues are going to die. So its important to shunt blood from low ventilation areas to areas where O2 and CO2 exchange (internal respiration) is likely to occur.
Term
how does exercising influence the relationship of the lung and heart?
Definition
increase exercise causes increase Cardiac Output. It takes very small increases in cardiac out / pressure to the pulmonary circulation system to have profound increases in blood flow to pulmonary capillary system since the entire vasculature of the pulmonary system is so distensible and compliant. At rest not all the capillaries are open; but when there is a large increase in ventilation and cardiac output then that opens more places for all this blood to go to and by oxygenated. Its a very low resistance system. Exercise causes a shift to the right in order to all for more O2 to be diffused to high metabolizing tissues.
Term
is there a difference in pressure of the capillaries from the top of the lungs to bottom?
Definition
yes there is a 30 cm H20 hydrostatic pressure difference
Term
when would capillaries close off blood flow in relation to alveolar pressure?
Definition
If alveolar pressure is higher than capillary hydro-static pressure than blood flow will stop.
Term
In zone 2 when would there be no blood flow in relation to alveolar pressure and the cardiac cycle
Definition
No blood flow at zone 2 when heart is in diastole because there is not enough pressure at the capillaries to overcome the higher alveolar pressures. Flow only occurs when alveolar pressure is less than hydrostatic pressure of capillaries during systole.
Term
In what zone is there always blood flow? Where is this zone located?
Definition
10cm above the heart to the base of the lungs is zone 3. At zone 3 there is always constant blood flow because capillary hydrostatic pressure is always higher than alveolar pressure.
Term
how many zones does the adult have in the upright position?
Definition
ONLY two!! Only zone 2 and 3 in health person in upright position
Term
Under what circumstances would a person have zone I in their lungs?
Definition
1. positive pressure in the alveoli that prevents blood flow
2. abnormally low blood flow from the heart to not even move blood forward.
Term
why is hydrostatic capillary pressure higher in the apex of the lungs
Definition
b/c its above the heart and circulation has to work against gravity.
Term
When would all the heart be in zone 3
Definition
nearly all of the heart would be in zone 3 when a person is supine. This position allows for all the pulmonary arteries to freely flow blood without significant resistance from gravity.
Term
how does exercise affect blood flow in lung zones?
Definition
More blood flow means more zone 3 area of the entire lung. More blood flow means higher capillary hydrostatic capillary pressure.
Term
Capillary blood flow is fast or slow?
Definition
fast 0.8 seconds
Term
Whats the total volume of blood normally in the lungs
Definition
9 % or 450 mL
Term
if there was an increase in pressure from forced expiration would that force blood out or create a vacuum and keep it there?
Definition
force blood out.
Term
lung lymphs empty where?
Definition
right lymphatic duct that dumps into thoracic duct then into subclavian veins.
Term
total filtration at the pulmonary capillaries is ____ mm Hg. This favors filtration or re-absorption?
Definition
+ 1 mm Hg. Favors filtration.
Term
What keeps the interstitial pressure between the capillaries and alveoli negative?
Definition
lymphatic system.
Term
what happens when there is pulmonary edema? Explain the basic physiology
Definition
Normally at the pulmonary capillary beds there is a +1 mm Hg of pressure that favors filtration into the interstitial space between the capillaries and the alveoli. Fluid under this condition would build up if it wasn't for the lymph system that creates a vacuum by removing free fluid at a pace that is faster than the filtration from the capillaries. If this didn't happen then there would be edema in the intersitial space that would then flow into the alveolus.
Term
why is there an oncotic pressure in the interstitial fluid of the lung?
Definition
Because the capillaries of the pulmonary are leaky and allow a large amount of protein to enter.
Term
what is the pulmonary edema factor?
Definition
The pressure in the pulmonary circulation is balanced so to avoid pulmonary edema. The hydrostatic pressure is 7 but the oncotic pressure is 28. So the hydrostatic pressure would have to change by 21 mm Hg before there would be acute pulmonary edema. There are built in safety features in the interstitium space. Lymph channels can accomodate a 10 - 50 fold increase in pressure from the capillaries. That lymph channels can also absorb and recycle proteins to decrease the interstial oncotic pressure.
Term
at what point during left heart failure will pulmonary capillary pressures be high enough to cause pulmonary edema
Definition
>30 mm Hg at pulmonary capillaries will cause edema because you have gone outside the safety factor of the lungs.
Term
why are pulmonary veins more distensible?
Definition
b/c they have less smooth muscle
Term
cardiopulmonary receptors respond to?
Definition
blood loss >10%. They're also known as stretch receptors or low pressure receptors.
Term
what is the intracellular Po2
Definition
23 mm Hg
Term
what is the intracellular PCO2
Definition
46 mm Hg
Term
what is the normal PCO2 and PO2 for venous and arterial gases
Definition
Arterial PO2 is 95 (it loose some O2 conc from the deoxygenated blood from the respiratory circulation) Arterial PCO2 is 40. The venous end of circulation the PO2 drops largerly b/c its used for energy at the cellular level and now is 40 mmHg and the PCO2 at the venous end goes up because of waste but not by a lot since most of the CO2 byproducts are converted to bicarb and H ions or stored as carbaminohemoglobin so PCO2 venous is 45 mm Hg
Term
partial pressure of dissolved gases refers to what law
Definition
Henry's law
Term
partial pressure of dissolved gases =
Definition
concentration of dissolved gas /
solubility coefficient. also known as Henry's law.
Term
1 atm = ____ mm Hg
Definition
760 mm Hg = 1 atm
Term
what law applies to the benz sickness
Definition
henry's law. There is an increase in pressure on nitrogen which makes it now soluble into the blood. When the dive rises to surface the pressure is decreased and nitrogen then wants to leave the body but if the diver rises too fast the fast removal of nitrogen causes air bubbles that can kill him.
Term
During anemia what happens to CO? Why?
Definition
Increase cardiac output because there are less O2 carrying cells. (Anemia is decrease in red blood cells). So the body compensates by increasing its flow in order to compensate.
Term
Anemia causes decrease or increase viscosity
Definition
decrease viscosity
Term
what deficiency leads to macrocytic anemia
Definition
1. folic acid deficiency
2. B-12 deficiency
Term
hyperchromic anemia is most often caused by?
Definition
iron excess
Term
where is the majority of iron stored??
Definition
75% stored in hemoglobin. That's why its so important that old red blood cells are recycled by macrophages in order to be reused to make more RBCs in the bone marrow. Otherwise we would develop an anemia.
Term
if we are iron deficient where would the body get more iron?
Definition
Either from the diet via absorption in the duodenum or from iron stores. Iron stored as ferritin. Iron is transported with transferrin.
Term
Where do we get more vitamin B-12? Why is obtaining vitamin B-12 so complicated?
Definition
Vitamin B-12 is absorbed in the small intestine but only with the help of intrinsic factor. Intrinsic factor is secreted from stomach cells that also secrete HCL. That intrinsic factor combines with B-12 to form a complex. After its absorbed its stored in the liver.
Term
Where it Vitamin B-12 stored?
Definition
Liver
Term
What is pernicious anemia?
Definition
It refers to an anemia that develops as a result of a lack of intrinsic factor. Without intrinsic factor we cannot absorb B-12. Without B-12 we have anemia. Pernicious anemia develops when cells in the stomach cannot secrete intrinsic factor either from gastric surgery or autoimmune disease.
Term
Lack of B-12 results in what?
Definition
1. neurological disturbances
2. impaired hematopoiesis
Term
What anemia is inherited and results from defective synthesis?
Definition
thalassemia. decreased/defective synthesis of alpha and beta chains. Its inherited.
Term
What blood type has no antigens?
Definition
AB Blood. This type of blood can accept blood from anyone because it has no antibodies. So its blood will not attach any blood that is given to it.
Term
What blood type has no antigens on the RBC
Definition
Type O. Hence why they're the universal donor. No matter what type of antibodies a person has they will not react with Type O since it has no antigen sites for the antibodies to attach to.
Term
What blood type for mothers is most common to causes hemolytic diseases in babies
Definition
type O ??????????
Term
What actually digest the fibrins threads of the clot?
Definition
plasmin
Term
Umbilical arteries carry oxygenated blood or de-oxygenated blood from where? To where?
Definition
De-oxygenated blood from aorta/heart to the placenta
Term
Normal hemoglobin in the blood is how much for men?
Definition
15-16 gm of Hb / 100 mL of blood
Term
what is the oxygen carrying capacity for men?
Definition
~21 ml O2/ 100 ml blood for men. Women are slightly less.
Term
Whats the difference in hemopoeitic acivity of a fetus compared to adult?
Definition
In fetuses you can have hemopoeitsis in more places than bone. The three other places are:
1. spleen
2. yolk sac
3. liver

In adults you only have hemopoietesis in bone marrow.
Term
how many days is a developing cell in its erythroblast form? Then what happens to change it?
Definition
3 days. Day 2, 3, 4. then after that it ejects its nucleus and becomes a reticulocyte
Term
Is a reticulocyte a matured RBC?
Definition
NO. It still has organelles and is not mature until it gets rid of them and forms into a form RBC known as an eryhtrocyte
Term
explain the shape of a RBC
Definition
Unlike many other cells, red blood cells have no nucleus and can easily change shape, helping them fit through the various blood vessels in your body. However, while the lack of a nucleus makes a red blood cell more flexible, it also limits the life of the cell as it travels through the smallest blood vessels, damaging the cell's membranes and depleting its energy supplies. The red blood cell survives on average only 120 days.
Term
platelets are also known as?
Definition
thrombocytes
Term
where is bilirubin excreted from?
Definition
removed from liver via bile salts into small intestine and bilirubin released from kidney's during excretion.
Term
what gas has the lowest diffusion coefficent across the alveolar membrane?
Definition
NO2. its only 0.53 while O2 is 1.0
Term
is all the air in the alveoli completely replaced with each breath?
Definition
NO. Can't forget about dead space. If each tidal volume was 500 mL then only 350 mL of air is actually being exchanged in each breath at the alveoli out of 500 mL inspired.
Term
As you climb in altitude what happens to the atmospheric pressure in general. Does it go up or down?
Definition
It goes down. So if at sea level is 1 atm then as you go up it becomes <1atm. So if PO2 at sea level is 21% of 1 atm or 21% of 760 mm Hg then it is then only 21% of the atm or mm Hg at that exact height. so higher you go the lower your PO2 goes and therefore your sat is also lower. Internally your internal respiration still works under the same conditions so it is affected gravely because for everything to work in unison you need diffusion down a gradient. If the external environment is so low then there is not much of a gradient to keep your respiratory external and internal going.
Term
what is the relationship of alveolar CO2 and ventilation. If there is more ventilation is there more or less CO2 in alveolar?
Definition
Inverse relationship of alveolar CO2 to alveolar ventilation. Think about it. The more you ventilate the more you breath off CO2. So the more alveolar ventilation the lower the PCO2 in the alveoli.
Term
normal thickness of the respiratory membrane is?
Definition
normal thickness of respiratory membrane 0.2 to 0.6 μm
Term
CO2 diffusing capacity is ___ times that of O2
Definition
CO2 diffusing capacity 20 times that of O2
Term
what is the utilization coefficent for O2?
Definition
it is 25% which means the tissues typically only use 25% of O2 from the blood every pass through the body at rest.
Term
true / false: at rest all the capillaries remain open to maintain a low pressure system
Definition
FALSE. Only areas that are perfused in a healthy person have to be ventilated with O2 other wise those areas are constricted off. NO point in sending blood somewhere for no reason.
Term
V/Q ratio is affected by what two things?
Definition
1. gravity
2. local tissue mechanisms
Term
What is the difference between obstruction and constrictive pulmonary disease in relationship to total lung capacity and expiratory flow?
Definition
In airway obstruction not all the air is ever allowed to completely be exhaled so every inspired breath after will add more volume to what’s already there and hence why airway obstruction diseases result in higher total lung capacity and barrel chests. Whether its obstruction or constriction the expiratory flow rate is significantly decreased b/c both limit airmovement in their own unique ways.
Like obstruction this disease cannot get air moving well so the flow rates are very low. Unlike obstruction air flow does not get “trapped” but it is very limited on how much can actually get through these narrow openings. So very low total lung capacity but it all empties out.
Term
Which has the highest lung capacity; normal lungs, obstruction disease or constriction disease?
Definition
obstruction b/c air gets trapped and every breath after that adds more volume onto the excess left over volume that was trapped to begin with
Term
Which of the following has the lowest total lung capacity and why? normal lung, obstruction or constrictive disease?
Definition
constrictive b/c pulmonary airways are constricted "narrowed" so air can't get in as fast so there is a decrease in volume. Then on the way out air still can't get out fast so there is a very low expiratory pressure. But since not a lot of volume got in the first place then there's no issue with getting all of the volume of air out on the expiration. It just will take time.
Term
what are the three things the body must work against to bring volume into the lungs? Which one requires the most energy?
Definition
Compliance work
Airway resistance work
Tissue Resistance
Term
interstitial osmotic pressure in lungs is?
Definition
14 mm Hg
Term
negative interstitial lung pressure is created by? What is it?
Definition
-8 from lymphatic system
Term
at what left atrial pressure is it too high and pulmonary edema develops
Definition
25 mm Hg
Term
What type of immune component are located in alveoli to help with preventing bacteria and debris buildup
Definition
macrophages
Term
At a PO2 pressure of _____ mm Hg there is a 90% saturation of hemoglobin with Oxygen. At a PCO (Carbon monoxide) of ____ mm Hg there is a 90% saturation of hemoglobin with Oxygen.
Definition
At a PO2 of 60 mm Hg there is 90% saturation of hemoglobin with Oxygen. At a PCO of 0.3 mm Hg there is a 90% saturation of hemoglobin with oxygen.
Term
the vagal and glosopharyngeal nerves communicate with which part of the medulla...the ventral or dorsal?
Definition
They communicate with the dorsal
Term
alveolar ventilation responds more strongly to increase CO2 or H+?
Definition
Three times more alveolar ventilation in response to elevated CO2 levels.
Term
what nerve sends info from the carotid chemoreceptors to the medulla? What nerve sends info from the aortic chemoreceptors to the medulla? What part of the medulla do both these nerves send data to?
Definition
Vagal nerve connects aortic chemoreceptors to dorsal medulla and glossopharyngeal sends information from carotid chemoreceptors to dorsal medulla. Both tell body to breath more!
Term
The rate of impulse firing from the carotid chemoreceptor can go up 10 fold under the presence of decrease ____. (But CO2 stays constant and normal)
Definition
decrease PO2
Term
what causes stimulus to brain to feel like you aren't breathing enough?
Definition
J (juxtacapillary) receptors:  Although their functional role is unclear, J-receptors respond to events such as pulmonary edemapulmonary embolipneumoniacongestive heart failure and barotrauma, which cause a decrease in oxygenation and thus lead to an increase in ventilation/respiration. The stimulation of the J-receptors causes areflex increase in breathing rate, and is also thought to be involved in the sensation of dyspnea, the subjective sensation of difficulty breathing
Term
women hematocrit compared to men
Definition
women 40%
men: 45%
Term
Define: normocytic anemia, macrocytic anemia, microcytic anemia, hypochromic anemia and hypochromic microcytic anemia
Definition
Normocytic anemia: appearance and size of cells is normal
Macrocytic anemia: cells larger than normal
Microcytic anemia: cells are smaller than normal
Hypochromic anemia: reduced hemoglobin content
Hypochromic microcytic anemia: smaller than normal and reduced hemoglobin content
Term

mechanical damage to a RBC causes what type of etiology anemia?

1. hostile type anemia or

2. hereditary 

Definition
hostile anemia
Term
decrease PO2 will cause primary or secondary polycythemia?
Definition
Secondary. Its a response to low PO2. So body makes more Hb to carry more O2 to correct the problem.
Term
diffuse hyperplasia of bone marrow for unk reasons is primary or secondary polycysthemia?
Definition
Primary
Term
primary or secondary polycysthemia can lead to granulocytic leukemia
Definition
primary. Cell reproduction over and over again.
Term
can IgM or IgG cross the placenta?
Definition
Only IgG
Term
Erythroblastosis fetalis is what?
Definition
Its a type of anemia for fetuses/new borns. When an rH negative mother has her first child who is rH +. She develops an immune response when she comes into contact with fetal blood from trauma during delivery. Mother's immune system responds to rH antigen invasion by attacking it with IgM antibodies. These IgM antibodies only work in mom's circulation because they can't cross through the placenta. After the fight is over the body makes memory cells and prepares an IgG ready action team in the event it happens again. Then mom has another baby that is also rH positive. This time when trauma causes mom and fetus blood to mix; mom's IgG antibodies cross the placenta and start destroying the fetuses RBCs. This is known as erythroblastosis fetalis.
Term
Erythroblastosis fetalis sx in fetus
Definition
- HF, enlarged liver (increase bilirubin from RBC destruction from IgG attacking the rH antigens.
- Bilirubin excess from fetus can also be excreted from the mom because the baby’s / fetus liver is very immature.
Term
a transfusion reaction occurs as a result of? What immune system is activated?
Definition
Agglutination of red blood cells due to antigen-antibody reaction
Activation of complement system
Term
Sx of transfusion reaction
Definition
Shock, chills, fever, shortness of breath, renal shutdown
Term
Agglutination
Definition
The clumping of cells such as bacteria or red blood cells in the presence of an antibody.
Term
what are the four chemicals released during phase 1 & 2 of hemostasis
Definition
1. ADP
2. Thromboxane
3. Ca ++ (to increase contraction of smooth muscle to stop bleeding)
4. Platelet factors (For more clotting)
Term
what substance is used to thread and to interlace the platelet aggregation to form a clot.
Definition
fibrin
Term
what converts fibrinogen to fibrin
Definition
thrombin
Term
what does thrombin do that makes it a positive feedback substance
Definition
Also initiates re-accumulation of additional tissue factors and proenzymes to facilitate more clot formation. (+ Feedback)
Term
what stimulates synthesis of plasminogen activating enzymes that will eventually change plasminogen to plasmin to lysis clots.
Definition
thrombin
Term
what phase in hemeostasis is focused on forming a stable clot?
Definition
phase 3
Term
what are the 3x pathways for clot formation?
Definition
intrinsic and extrinisic pathways which lead to one main pathway called common pathway
Term
tissue damage initiates what pathway?
Definition
extrinsic (Site of the stab wound was EXTerior. so its EXTrinsic
Term
the intrinsic pathway is started by________. The most common of these is?
Definition
Intrinsic pathway most often started from proenzyme release at the site of injury. Most often stimulated by Factor 8. VIII
Term
as a result of activating factor V and the common pathway...what happens next?
Definition
Factor X activates prothrombinase to enzymatically change prothrombin to thrombin. Thrombin changes fibrinogen to fibrin. Fibrin is the material used to layer the aggregated platelets with a good seal. Its known as a fibrin clot.
Term
lack of stable collagen can cause coagulation problems. This is often seen in what kind of patients? What do they have a deficiency in that causes this?
Definition
Lack of Vitamin C. Often seen in alcoholics and elderly
Term
is hemophilia A or B more common
Definition
A is more common. 1/10,000 compared to B which is 1/100,000.
Term
hemophilia A is a lack of factor____
Definition
Factor IIX
Term
hemophilia B is a lack of factor____
Definition
Factor IX
Term
coagulation and clot lysis in uncontrolled manner resulting in depletions of all clotting factors is?
Definition
DIC
Term
ITP- autoimmune most often causes thrombocytopenia or DIC?
Definition
most common form of thrombocytopenia.
Term
the portal vein carries approximately ____ L/min from various organs in the abdominal compartment
Definition
1.05 L/min
Term
Phagocytic cells that remove foreign substances from liver are called?
Definition
Kupffer cells
Term
liver cells are also known as?
Definition
hepatocytes
Term
whats unique about circulation in the liver in regards to venous and arterial blood?
Definition
The hepatic arterial dumps its blood in the same space as the hepatic portal vein. This common space is called the sinusoids.
Term
What is the space of disse used for?
Definition
- Proteins made from hepatocytes are released into the space of disse and can enter circulation via the leaky sinusoids or travel down the space of disse into the terminal lymphatic ducts.
Term
the liver cell plates excrete bile which travels down the _________ to the bile duct and then gall bladder.
Definition
bile canaliculi
Term
the gallbladder is composed of what three things?
Definition
the body, fundus and neck
Term
the gallbladder and the _____ drain into the __________ which empties into the small intestine
Definition
Common hepatic duct and gallbladder drain into the common bile duct
Term
what stimulates the gallbladder to release bile
Definition
food stimulates secretion of cholecystikinin which stimulates contraction of the gallbladder to release more bile into duodenum.
Term
what does bile help get the body rid of? 2x
Definition
- Bile release also helps get rid of the excess bilirubin from RBC breakdown
- Also helps get rid of excess cholesterol.
Term
how much bile is excreted by the liver daily? How much bile is actually stored in the liver at any time?
Definition
600-1200 mL/day of bile secreted by liver. Only a very small fraction is stored in the gallbladder at a time. (60mL)
Term
most abundant solute in bile is?
Definition
Most abundant solute in bile is bile salts
Term
gallbladder has the ability to conserve water from the bile before excreted it and can also save electrolytes except for?
Definition
Ca++
Term
what cartilages help to open and close the glottis
Definition
corniculate and arytenoids cartilage
Term
vocal cords are attached to what two cartilage
Definition
arytenoid and thyroid cartilage
Term
the common site for tracheotomy is at the
Definition
median cricothyroid ligament
Term
what's the difference between the intrinsic and extrinsic laryngeal muscles
Definition
intrinsic controls vocal cord length/tension while the extrinsic aids in swallowing EXTernal things.
Term
does swallowing involve both intrinsic and extrinsic ______ muscles
Definition
laryngeal muscles
Term
phonation involves use of the __________ while articulation involves use of the ______ and _________
Definition
Phonation: larynx involved
Articulation: mouth and nasal cavities
Term
whats the difference between vocal cords of males compared to females?
Definition
Males vocal cords are wider and thicker
Term
the trachea starts anterior to vertebrae ____ and ends at vertebra ___
Definition
C6 - T5.
Term
Trachea is known as having C-shaped rings of cartilage and the open portion of that "C" is facing what structure?
Definition
Faces posterior towards the esophagus because the hard cartilage rings need to face anterior towards danger to protect the airway
Term
what type of cells line terminal bronchioles compared to respiratory bronchioles
Definition
in terminal bronchioles there are cuboidal epithelium while in the respiratory bronchioles there are squamos epithelial cells
Term
Sites of gas exchange are at respiratory units. True / false
Definition
True
Term
which lung is more broad? Right or Left
Definition
Right
Term
which lung is more short? Right or Left
Definition
Right
Term
which lung is longer? Right or Left
Definition
Left
Term
what type of beta receptors stimulate bronchio-dilation? What hormone attaches to this receptor?
Definition
Beta 2 receptors stimulate bronchodilation when binding with epinephrine.
Term
mast cells can cause local bronchoconstriction by releasing 2x
Definition
1. leukotrienes
2. histamine
Term
what law states that in a closed container and at constant temp the pressure is inversely proportional to volume
Definition
Boyle's law
Term
elastic recoil of the lungs involves the elastic membranes of what three parts of the lungs
Definition
alveoli, bronchioles and alveolar ducts. (All areas that have elastin)
Term
when the ribs move down and inwards what happens to the pressure in the lungs
Definition
increases. the body is expiring air
Term
forceful expiration involves the use of what two muscle groups
Definition
intercostal muscles (To pull lungs IN) and abdominal muscles to push diagphram up.
Term
pleural pressure is sometimes referred to as intrathoracic pressure. At onset of inspiration what is the pressure? What is the pressure at the end of inspiration?
Definition
In order to inspire you need a negative pressure to pull air in from higher to lower pressure. At rest the atmosphere in the lungs is equal to the atmosphere in the air outside the body. To change this the body increases the volume of the lungs thereby decreasing the pressure to -5 cm H20. This pulls air in. At the end of inspiration the pressure is greatest and is -7.5 cm H20
Term
what does transpulmonary pressure indicated? Where is it derived from?
Definition
its the difference between alveolar pressure and intrathoracic (pleural) pressure during inspiration and expiration. Indicates elasticity and elastic recoil of the lungs
Term
whats the relative pressure in relation to talking about the lung
Definition
Its just a way to refer to lung pressures and consider lung pressures in relation to the outside atmosphere by stating the outside atmosphere is zero therefore any pressure changes in the lungs can go positive or negative from the starting point of zero.
Term
is the alveoli relationship between pressure and radius inverse or direct
Definition
inverse. More diameter of the alveoli then the decrease in pressure BC there is decrease surface tension and therefore less chance to collapse.
Term
for determining alveoli pressure the equation is pressure= X/y
Definition
2x surface tension / radius of alveoli
Term
lack of surfactant causes _____ type of atelectasis
Definition
obstructive atelectasis
Term
two potential causes of obstructive atelectasis are?
Definition
1. tumor
2. thick mucus secretions post op
Term
whats the difference between obstructive and compression atelectasis
Definition
obstructive is something directly involved with the respiratory tract/physiology that causes atelectasis while compression is outside forces causing collapse of the alveoli such as any of the pneumo/hemo thoraxes
Term
what two factors prevent alveolar collapse in healthy individuals
Definition
1. lower intrathoracic pressure of the pleural space
2. surfactant.
Term
Why is there edema associated with fribrosis of the lungs?
Definition
Fibrosis of the lungs prevents airways from closing and collapsing when there are pathologies. Then all the air the alveoli are absorbed and by removing all the air and the alveoli not collapsing from this loss of volume this results in negative pressure. What does negative pressure have to influence? the plasma in the capillaries. So edema develops.
Term
women pulmonary volumes and capacities are approximately ____ % less than men
Definition
20-25% less
Term
air remaining in the lungs after forceful expiration is known as?
Definition
residual volume. It is approx 1200 mL
Term
maximum amount of air that can be exhaled after a maximal inspiration is known as ____Capacity
Definition
vital capacity. normal 4600 mL
Term
tidal volume + inspiratory reserve volume = ________ capacity
Definition
inspiratory capacity
Term
functional residual capacity = ___ + ___
Definition
FRC= Expiratory residual volume + residual volume
Term
What disease process increases functional residual capacity and residual volume?
Definition
diseases that increase airway resistance causing air trapping. COPD. asthma, emphysema, chronic bronchitis .
Term
FRC and ERV DECREASE in diseases that increase or decrease lung compliance
Definition
decrease lung compliance
Term
Total lung capacity = ____ + _____
Definition
vital capacity + residual volume
Term
normal minute ventilation (Ve) derived from? Whats normal Ve
Definition
Tidal volume x respirator rate = 6 L /min
Term
what is Va? Whats the difference between Va and Ve?
Definition
Va is the amount of air that reaches the alveoli. Ve is the amount of air each minute that enters the respiratory tract in general. Not accounting for dead space. So the actual air that is exchanged at the alveoli is less and Va accounts for dead space. To calculate Va we minus dead space from the tidal volume. Va=(Tv-V dead space) x RR. Normal is 4,200 mL/min
Term
what are the three components of the respiratory unit
Definition
1. alveoli
2. alveolar duct
3. repsiratory bronchiole
Term
dead space can be calculated by weight. How much dead space for a 200 lb person?
Definition
1 lb = 1 mL dead space. 200 lb man = 200 mL dead space.
Term
when there are V/Q problems that lead to dead space do we call this type of dead space phsyiological or anatomical dead space
Definition
physiological dead space
Term
normal functional vital capacity is?
Definition
5 Liters and is affected by strength of the chest and abd muscles, airway resistance and lung volume. Any disease that effects these muscles will lower the FVC
Term
What is FEV1?
Definition
Healthy people can expire forcefully 80% of their total forced vital capacity in 1 second. So out of the start of volume is forced vital capacity so we divide this 80% which is 4 L by normal FVC that is 5 L and get a decimal of 0.8 which is 80%.
Term
decrease FEV1 / FVC ratio in restrictive or obstructive diseases
Definition
obstructive. The whole point of the FEV1 test is to see how fast you can get air out. Obstructive diseases inhibit the person from being able to forcefully in a timely manner remove air.
Term
why is there a maximum amount of expiration flow rate?
Definition
b/c the more you force air out then the more thoracic pressure from all the muscles and thoracic cavity bearing down the bronchi/bronchioles causes a physical impedance to flow. Therefore limiting to how much you can forcefully expire.
Term
higher volumes of air in lungs are associated with: Higher or Lower expiratory flow rate
Definition
higher expiratory flow rate b/c more elastic recoil
Term
normal compliance for the lungs is?
lungs + Thorax is?
Definition
lungs: 0.22 liters / cm H20
lungs + Thorax = 0.13 liters / cm H20.
Lungs > Compliant than Thorax+Lungs
Term
Compliance is determined more by; elasticity of the lungs or surface tension inside alveoli?
Definition
Surface tension of alveoli (2/3 of compliance) b/c alveoli surface area is the size of a tennis court so it has a profound effect on compliance.
Term
kyphosis increases or decreases compliance
Definition
decreases
Term
pulmonary edema increases compliance or decreases
Definition
decreases
Term
increase venous pressure increases or decreases compliance
Definition
decreases compliance
Term
increased residual volume results from poor elastic recoil and High or Low compliance?
Definition
High compliance
Term
how does epi effect pulmonary veins compared to pulmonary arteries
Definition
epi vasodilates arteries while is constricts veins in pulmonary circulation in order to increase volume of blood and time that blood remains in the capillaries to causes more ventilation exchange
Term
pulmonary veins can be constricted by?
Definition
ecoli, histamine, serotonin
Term
bronchiole blood vessels come from ______ circulation and empty into _______
Definition
bronchiole blood vessels come from the systemic circulation and empty into the pulmonary veins which means they dump de-oxygenated blood into oxygen rich blood of the pulmonary veins.
Term
a PO2 < _____ causes vascoconstriction of pulmonary vessels
Definition
PO2<73 mm Hg
Term
zone 1 normally occurs only in pathologies that result in what changes to blood flow and / or air flow
Definition
Remember zone 1 is no blood flow during the entire cardiac cycle. So patholgies that would lead to no blood flow would be:
1. high ventilation pressure > Capillary pressure which stops blood flow.
2. Such low blood flow there is none in that area of the lung
Term
can mitral valve failure cause pulmonary edema?
Definition
yes
Term
henry's law is partial pressure of dissolved gases = x / y
Definition
conc of dissolved gas/solubility coefficent.
Term
would slow or fast replacement of alveolar air prevent sudden changes in gas concentration in the blood?
Definition
slow replacement of air in alveoli. Hence why inspiration doesn't exchange 100% of all the air in the alveoli. There is still some air left over known as dead space.
Term
the highest amount of O2 we can be oxygenated with through increasing alveolar ventilation is decided by?
Definition
the amount of air in the atmosphere. So if atmospheric air is normally 149 mm H20 at sea level than that's all we can oxygenate our blood with.
Term
normal O2 uptake in the blood is ___ ml/min
Definition
250 mL/min
Term
in expired air the PO2, PCO2 and PH2O are __________ mm Hg
Definition
Expired air:
PO2: 120 mm Hg
PCO2: 27 mm Hg
PH2O: 47 mm Hg
Term
diffusing capacity refers to? What is O2's diffusing capacity
Definition
is the amount of O2 that can diffuse through the alveolar membrane each min for a pressure difference of 1 mm Hg. For O2 its 21 ml/min/mm Hg. CO2 is 20 times that of O2.
Term
what affects V/Q ratio?
Definition
pathology at the LOCAL LEVEL
Term
a physiological shunt is a V/Q ratio that is: Below or Above normal?
Definition
below. There is no ventilation so blood remains in venous state and bypasses lung capillaries and returns to circulation.
Term
a physiological dead space results in a V/Q ratio that is: below or above normal?
Definition
Above. Great ventilation but alveolar blood is not keeping up so there is a waste of air in the alveoli resulting in air in the alveoli equaling what's outside the body since there is not much exchange at the capillaries.
Term
two factors that decrease blood flow in V/Q.
Definition
1. emboli
2. vaso-constrictors
Term
what disease effects both V and Q
Definition
COPD
Term
Upper Lung: (Upright)
Decrease Q > Decrease Va
Some physiological dead space

Lower Lung (Upright)
Decrease Va > Decrease Q
Some physiological shunting.
Definition
just memorize previous side
Term
side effects of high partial pressures of O2 in plasma to brain
Definition
free radicals and can cause neurological side effects such as twitches, dizziness, vision problems.
Term
how many atoms of oxygen attach to one healthy hemoglobin?
Definition
8 O's for each Hb. Or 4x O2 for each Hb.
Term
when would you see a high utilization coefficent for O2?
Definition
1. slow blood
2. high metabolic needs
Term
an adult hemoglobin has two alpha and 2 beta chains while a fetal hb has?
Definition
2x alpha and 2x gamma. Gamma has significantly less DPG than does Beta chains. So higher affinity for O2
Term
haldane effect refers to?
Definition
increase PO2 in lungs will bump off CO2 from Hb. Increase PCO2 in tissues will bump O2 off Hb. More important factor is CO2.
Term
what part of the brain controls duration of inspiration? What part of the brain controls strength of expiration?
Definition
Pons via the pneumotaxic center controls duration of inspiration while the ventral respiratory group controls strength of expiration.
Term
function of hering breuer reflex
Definition
stretch receptors in wall of bronchi and bronchioles signal dorsal neurals of medulla via vagus nerve from overly large tidal volumes to inhibit inspiratory signals and prevent over inflation.
Term
primary stimulus for central chemoreceptors? Does H or CO2 cross BBB more easily?
Definition
H is primary stimulator for central chemoreceptor. But CO2 cross BBB more easily.
Term
Does the respiratory system adjust to CO2 or H?
Definition
CO2. The kidney adjust to H levels.
Term
what do peripheral chemoreceptors respond to in comparison to central chemoreceptors?
Definition
Peripheral chemoreceptors respond to more things which include PO2, PCO2 and H while central chemoreceptors only respond to H and PCO2.
Term
Explain how chronic obstruction diseases physiologically change our drive to breath in relation to central and peripheral chemoreceptors.
Definition
So normal people drive to breath is based on H and CO2 levels in the breain by central chemoreceptors. However chronic lung conditions result in large constant PCO2 and H levels to the brain central receptors adapt. That leaves all the peripheral chemoreceptors left to do all the work. They respond the fastest/strongest to PO2 levels and therefore will tell body to breath more with low PO2 and not stimulate any breathing at all with high PO2. So if we give lots of FIO2 to a patient the peripheral receptors are confused and will not sitmulate more breathing and then RR decreases.
Term
in glycol-sated HbA1c glucose binds to which chains
Definition
beta chains
Term
to determine O2 carrying capacity of the blood we need to measure?
Definition
Hb
Term
to determine the percent of blood that is RBC we need to measure
Definition
Hct
Term
metabolites of bilirubin removed by the?
Definition
intestine and kidneys
Term
hemochromacytosis is?
Definition
iron overload
Term
anemia refers to?
Definition
decrease capacity to carry blood
Term
an example of hypochromic microcytic anemia is?
Definition
iron deficiency anemia
Term
B12 is absorbed after combining with intrinsic factor in what part of the GI system? Stored where?
Definition
absorbed in the distal ileum of the small intestine and stored in the liver.
Term
lack of intrinsic factor is ____ anemia
Definition
pernicious anemia
Term
gastric bypass / resection can cause ____ anemia
Definition
pernicious anemia since no intrinsic factor since those cells that secrete them in the stomach are destroyed.
Term
what type of anemia is from damage to bone marrow from drugs chemicals or autoimmune diseases
Definition
aplastic anemia
Term
In this type of anemia lysine is substituted instead of glutamine
Definition
hemoglobin c disease
Term
in this type of disease valine is substituted instead of glutamine
Definition
sickle cell anemia
Term
red blood cells destroyed by mechanical trauma are called ____ hemolytic anemia
Definition
acquired
Term
two complications of polycythemia
Definition
1. increased blood viscosity
2. increase risk for thromboses
Term
what is rhogam treatment for?
Definition
For rH negative mothers carrying rH positive fetuses. Its a shot that introduces IgG antibodies to Rh+ blood to prevent the mother from having an immune system response in the event fetal blood crosses over during birth.
Term
platelets are fragments from megakaryocyctes formed where?
Definition
bone marrow
Term
normal concentration of platelets in blood
Definition
150,000 - 300,000
Term
whats unique about the structure of platelets that help in hemostasis
Definition
contain actin and myosin filatments to help in contraction.
Term
What other components do platelets have/composed of that are important in their role in the body
Definition
large amounts of Ca, can make ADP and ATP, and prostaglandins
Term
What type of thrombocytopenia is autoimmune
Definition
idiopathic thrombocytopenia
Term
what digest clots?
Definition
plasmin made from plasminogen
Term
whats on the surface of the endothelium that helps prevent platelet adhesion
Definition
charged glycocalyx repels plaetelets
Term
how does heparin help prevent clotting?
Definition
Heparin is released from mast and basophils. It helps in formation of antithrombin III which prevents thrombin from working which means effects common pathway.
Term
what two things do endothelial cells release that prevent clotting/platelet aggregation
Definition
1. Prostacyclin released and inhibit platelet aggregation
2. Thrombomodulin: binds to thrombin and promotes in fomraiton of plasmin to eat clots and also inhibits clotting factors.
Term
what drugs convert plasminogen to plasmin to lyse clots?
Definition
streptokinase and urokinase
Term
How does the citrate in stored blood not clot?
Definition
prevents clotting in blood samples by binding to Ca++
Term
Vitamin K is necessary for clotting factors....
Definition
II, VII, IX, X
Term
what is vonwillebrand disease?
Definition
Decrease Factor VIII as a result of deficiency of vonWillebrand factor.
Term
umbilical arteries branch off the ____ of the fetus and travel to the _____
Definition
umbilical arteries branch off the common iliac arteries and travel with de-oxygenated blood to the placenta
Term
umbilical vein travel from the _____ to the _____ via what duct?
Definition
umbilical vein from placenta to inferior vein via ductus venosus
Term
whats the purpose of the venosus duct?
Definition
to bypass liver since its not used much and take blood from placenta and portal vein directly to heart
Term
what percentage of blood flow goes to liver
Definition
27% of Cardiac Output
Term
what percentages does the liver receive its blood supply from?
Definition
25% from hepatic artery
75% from portal system
Term
small and large intestine supplied with blood from
Definition
superior and inferior mesenteric arteries
Term
celiac trunk is large and supplies what three organs
Definition
liver, spleen and stomach
Term
most permeable capillary in the body is found?
Definition
hepatic capillaries
Term
liver sinusoids drain in what capillary bed of the liver? Where does stomach, spleen, pancreas drain into which capillary bed of the liver?
Definition
Liver sinusoids drain into the 2nd capillary bed while the others drain into the 1st capillary bed.
Term
The hepatic artery is around ___ mm Hg
Definition
100 mm Hg
Term
the bile canaliculi empty into the?
Definition
bile duct
Term
7 main functions of hepatocytes
Definition
1. removes nutrients from blood
2. makes and secretes bile
3. carbohydrate metabolism
4. fat metabolism
5. synthesizes proteins
6. removes and detoxifies / excretes
7. protein metabolism
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