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
|
|
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
|
|
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
|
|
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
|
|
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
|
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
|
Definition
| surfactant decreases surface tension to prevent alveoli from closing |
|
|
Term
|
Definition
| surfactant consists of phospholipid (phosphatidylcholine), surfactant apoproteins, and Ca2+ |
|
|
Term
| when does surfactant production begin during pregancy? |
|
Definition
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
Term
|
Definition
| change in V / Change in P |
|
|
Term
| 65% of the work of breathing is overcoming ? |
|
Definition
|
|
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
|
|
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
|
|
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
|
|
Term
| if alveolar pressure is high then what happens to blood flow at capillaries |
|
Definition
|
|
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
|
|
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
|
|
Term
| Is O2 or CO2 more soluble? |
|
Definition
|
|
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
|
|
Term
| normal oxygen absorption / uptake rate per minute is? |
|
Definition
|
|
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
|
|
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
|
|
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
|
|
Term
| A high or low V/Q ratio decreases paCO2 and increases paO2. |
|
Definition
|
|
Term
| a pulmonary embolism results in a high or low V/Q ratio? |
|
Definition
|
|
Term
| in emphysema is there a high or low V/Q ratio |
|
Definition
|
|
Term
| in acute pulmonary edema is there high or low V/Q ratio |
|
Definition
|
|
Term
| In asthma is there a high or low V/Q ratio |
|
Definition
|
|
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
|
|
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
|
|
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
|
|
Term
| High affinity = __________ shift |
|
Definition
|
|
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
|
|
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
|
|
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
|
|
Term
| The second largest component to plasma is? |
|
Definition
|
|
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
|
|
Term
| Proteins such as albumin and globulin are a component of plasma or formed elements in whole blood? |
|
Definition
|
|
Term
| Plasma is mostly made up of? |
|
Definition
|
|
Term
| The second largest component to plasma is? |
|
Definition
|
|
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
|
|
Term
| Proteins such as albumin and globulin are a component of plasma or formed elements in whole blood? |
|
Definition
|
|
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
|
|
Term
| second most abundant leukocytes are |
|
Definition
|
|
Term
| red blood cells also known as |
|
Definition
|
|
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
|
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
|
|
Term
| compliance work equation is? |
|
Definition
| (change in pressure X change in volume) / 2 |
|
|
Term
|
Definition
|
|
Term
| the left atria pressure is similar to the pressure of the? |
|
Definition
|
|
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
|
|
Term
| Whats the total volume of blood normally in the lungs |
|
Definition
|
|
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
|
|
Term
|
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
|
|
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
|
|
Term
| what is the intracellular PCO2 |
|
Definition
|
|
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
|
|
Term
| partial pressure of dissolved gases = |
|
Definition
concentration of dissolved gas /
solubility coefficient. also known as Henry's law. |
|
|
Term
|
Definition
|
|
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
|
|
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
|
|
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
|
|
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
|
|
Term
| What actually digest the fibrins threads of the clot? |
|
Definition
|
|
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
|
|
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. |
|
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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. |
|
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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? |
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Definition
|
|
Term
| negative interstitial lung pressure is created by? What is it? |
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Definition
|
|
Term
| at what left atrial pressure is it too high and pulmonary edema develops |
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Definition
|
|
Term
| What type of immune component are located in alveoli to help with preventing bacteria and debris buildup |
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Definition
|
|
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. |
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Term
| the vagal and glosopharyngeal nerves communicate with which part of the medulla...the ventral or dorsal? |
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Definition
| They communicate with the dorsal |
|
|
Term
| alveolar ventilation responds more strongly to increase CO2 or H+? |
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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? |
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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! |
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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) |
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Definition
|
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Term
| what causes stimulus to brain to feel like you aren't breathing enough? |
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Definition
| J (juxtacapillary) receptors: Although their functional role is unclear, J-receptors respond to events such as pulmonary edema, pulmonary emboli, pneumonia, congestive 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 |
|
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Term
| women hematocrit compared to men |
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Definition
|
|
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 |
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Definition
|
|
Term
| decrease PO2 will cause primary or secondary polycythemia? |
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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? |
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Definition
|
|
Term
| primary or secondary polycysthemia can lead to granulocytic leukemia |
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Definition
| primary. Cell reproduction over and over again. |
|
|
Term
| can IgM or IgG cross the placenta? |
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Definition
|
|
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 |
|
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Term
|
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) |
|
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Term
| what substance is used to thread and to interlace the platelet aggregation to form a clot. |
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Definition
|
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Term
| what converts fibrinogen to fibrin |
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Definition
|
|
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. |
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Definition
|
|
Term
| what phase in hemeostasis is focused on forming a stable clot? |
|
Definition
|
|
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
|
|
Term
| hemophilia B is a lack of factor____ |
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Definition
|
|
Term
| coagulation and clot lysis in uncontrolled manner resulting in depletions of all clotting factors is? |
|
Definition
|
|
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
|
|
Term
| Phagocytic cells that remove foreign substances from liver are called? |
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Definition
|
|
Term
| liver cells are also known as? |
|
Definition
|
|
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. |
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|
Term
| the liver cell plates excrete bile which travels down the _________ to the bile duct and then gall bladder. |
|
Definition
|
|
Term
| the gallbladder is composed of what three things? |
|
Definition
| the body, fundus and neck |
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|
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
|
|
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
|
|
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
|
|
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
|
|
Term
| which lung is more broad? Right or Left |
|
Definition
|
|
Term
| which lung is more short? Right or Left |
|
Definition
|
|
Term
| which lung is longer? Right or Left |
|
Definition
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
|
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
|
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
|
|
Term
| pulmonary edema increases compliance or decreases |
|
Definition
|
|
Term
| increase venous pressure increases or decreases compliance |
|
Definition
|
|
Term
| increased residual volume results from poor elastic recoil and High or Low compliance? |
|
Definition
|
|
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
|
|
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
|
|
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
|
|
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
|
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
|
|
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
|
|
Term
| to determine O2 carrying capacity of the blood we need to measure? |
|
Definition
|
|
Term
| to determine the percent of blood that is RBC we need to measure |
|
Definition
|
|
Term
| metabolites of bilirubin removed by the? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| decrease capacity to carry blood |
|
|
Term
| an example of hypochromic microcytic anemia is? |
|
Definition
|
|
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 |
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Definition
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Term
| gastric bypass / resection can cause ____ anemia |
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Definition
| pernicious anemia since no intrinsic factor since those cells that secrete them in the stomach are destroyed. |
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Term
| what type of anemia is from damage to bone marrow from drugs chemicals or autoimmune diseases |
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Definition
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Term
| In this type of anemia lysine is substituted instead of glutamine |
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Definition
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Term
| in this type of disease valine is substituted instead of glutamine |
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Definition
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Term
| red blood cells destroyed by mechanical trauma are called ____ hemolytic anemia |
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Definition
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Term
| two complications of polycythemia |
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Definition
1. increased blood viscosity
2. increase risk for thromboses |
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Term
| what is rhogam treatment for? |
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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. |
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Term
| platelets are fragments from megakaryocyctes formed where? |
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Definition
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Term
| normal concentration of platelets in blood |
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Definition
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Term
| whats unique about the structure of platelets that help in hemostasis |
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Definition
| contain actin and myosin filatments to help in contraction. |
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Term
| What other components do platelets have/composed of that are important in their role in the body |
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Definition
| large amounts of Ca, can make ADP and ATP, and prostaglandins |
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Term
| What type of thrombocytopenia is autoimmune |
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Definition
| idiopathic thrombocytopenia |
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Term
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Definition
| plasmin made from plasminogen |
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Term
| whats on the surface of the endothelium that helps prevent platelet adhesion |
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Definition
| charged glycocalyx repels plaetelets |
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Term
| how does heparin help prevent clotting? |
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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. |
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Term
| what two things do endothelial cells release that prevent clotting/platelet aggregation |
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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. |
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Term
| what drugs convert plasminogen to plasmin to lyse clots? |
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Definition
| streptokinase and urokinase |
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Term
| How does the citrate in stored blood not clot? |
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Definition
| prevents clotting in blood samples by binding to Ca++ |
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Term
| Vitamin K is necessary for clotting factors.... |
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Definition
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Term
| what is vonwillebrand disease? |
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Definition
| Decrease Factor VIII as a result of deficiency of vonWillebrand factor. |
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Term
| umbilical arteries branch off the ____ of the fetus and travel to the _____ |
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Definition
| umbilical arteries branch off the common iliac arteries and travel with de-oxygenated blood to the placenta |
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Term
| umbilical vein travel from the _____ to the _____ via what duct? |
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Definition
| umbilical vein from placenta to inferior vein via ductus venosus |
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Term
| whats the purpose of the venosus duct? |
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Definition
| to bypass liver since its not used much and take blood from placenta and portal vein directly to heart |
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Term
| what percentage of blood flow goes to liver |
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Definition
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Term
| what percentages does the liver receive its blood supply from? |
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Definition
25% from hepatic artery
75% from portal system |
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Term
| small and large intestine supplied with blood from |
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Definition
| superior and inferior mesenteric arteries |
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Term
| celiac trunk is large and supplies what three organs |
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Definition
| liver, spleen and stomach |
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Term
| most permeable capillary in the body is found? |
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Definition
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Term
| liver sinusoids drain in what capillary bed of the liver? Where does stomach, spleen, pancreas drain into which capillary bed of the liver? |
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Definition
| Liver sinusoids drain into the 2nd capillary bed while the others drain into the 1st capillary bed. |
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Term
| The hepatic artery is around ___ mm Hg |
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Definition
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Term
| the bile canaliculi empty into the? |
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Definition
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Term
| 7 main functions of hepatocytes |
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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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