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Unit 1 > Biomedical > Flashcards

Biomedical Flashcards

1
Q

trace the path of an RBC from vena cava to vena cava

A

vena cava, right atrium, tricuspid, right ventricle, pulmonary valve, pulmonary artery, pulm. circulation pulmonary vein, left atrium, bicuspid valve, left ventricle, aortic valve, aorta, systemic circulation, vena cava

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2
Q

what are the main functions of the cardiovascular system?

A

deliver O2 and nutrients, remove waist

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3
Q

What are the components of cardiac output

A

heart rate and stroke volume (CO = HR * SV)

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4
Q

what is automaticity

A

ability of the heart to beat on its own without input from the brain due to unstable resting membrane potential of the SA node

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5
Q

why is the sinoatrial note the pacemaker of the heart

A

the SA node has the highest intrinsic rate of the conducting cells there fore it takes president in setting the pace, this is known as overdrive suppression

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6
Q

what is an ectopic foci

A

other conducting cells can become pacemakers in pathological stress

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7
Q

what are the components of normal sinus rhythm

A

regular rhythm, rate between 60-100bpm, normal shape of wave formation (ECG)

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8
Q

what does the signal that makes the heart beat result from?

A

depolarization of cardiac myocytes

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9
Q

what is the ion response during contraction/systole

A

Ca++ influx during action potential triggers release of Ca++ from scaroplasmic reticulum; Ca++ bonds to troponin, causing it to shift and allowing myosin-actin interaction and contraction

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10
Q

what is the ion response during relaxation/diastole

A

[Ca++] falls as it is transported (into SR via SERCA pump, out of cell by membrane CA++ pump and Na=Ca exchanger); fall in [Ca++] causes troponin to shift, blocking actin-myosin interaction and contraction

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11
Q

What is the prominent ion in excitation-contraction coupling

A

CALCIUM

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12
Q

what is stroke volume

A

the volume of blood ejected by the heart each beat (SV=EDV-ESV)

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13
Q

what is ejection fraction

A

the fraction of the end diastolic volume ejected each beat (EF = SV/EDV)

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14
Q

your patient’s end diastolic volume is 140ml, end systolic volume is 70ml, HR is 75.

What is stroke volume?

A

70ml

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15
Q

your patient’s end diastolic volume is 140ml, end systolic volume is 70ml, HR is 75.

What is ejection fraction?

A

50%

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16
Q

your patient’s end diastolic volume is 140ml, end systolic volume is 70ml, HR is 75.

What is cardiac output?

A

5250ml/minute

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17
Q

what is stenosis?

A

narrowing of the valve opening

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18
Q

what is regurgitation?

A

valve allows backflow of blood

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19
Q

what can go wrong with the heart beat

A

valve disease, systolic disfunction, diastolic dysfunction

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20
Q

what is systolic disfunction

A

decreased contractility during systole

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21
Q

what is diastolic disfunction

A

decreased relaxation during diastole

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22
Q

what are the phases of the cardiac cycle

A

atrial systole, isovolumetric ventricular contraction, ejection, isovolumetric ventricular relaxation, passive ventricular filling

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23
Q

what phases of the cardiac cycle are ventricular systole

A

aka contraction; isovolumetric contraction & ejection of blood into aorta

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24
Q

what phases of the cardiac cycle are ventricular diastole

A

aka relaxation; isovolumetric relaxation, passive filling of ventricle, active filling of ventricle (atrial systole)

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25
Q

What is the first principle of flow

A

fluids flow from high to low pressure

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26
Q

what factors affect resistance

A

viscosity, vessel length, vessel radius - radius is the most important!

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27
Q

what is the second principle of flow

A

anytime there is flow, there is resistance to flow

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28
Q

what is the third principle of flow

A

flow in = flow out

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29
Q

what is the forth principle of resistance

A

for resistances in a series, total R=R1+R2+R3..

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30
Q

what is the 5th principle of resistance

A

total flow equals the sum of the flow through the parallel segments Qin=Qout= Q1+Q2+Q3…

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31
Q

what is the 6th principle of resistance

A

for resistances in parallel, 1/Rtotal = 1/R1 + 1/R2 + 1/R3; total resistances is less than any of the individual resistances

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32
Q

what has the biggest contributions to peripheral resistance

A

arterioles

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33
Q

how does vasculature regulate flow?

A 
local mechanisms (tissue metabolites, myogenic, endothelial factors)
distant mechanisms (neural & hormonal)
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34
Q

What valve closes at the beginning of isovolumetric contraction?

A

Bicuspid on the left, tricuspid on the right

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35
Q

what valve opens at the end of isovolumetric contraction

A

aortic valve, because the pressure in the ventricle exceeds that in the aorta

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36
Q

what causes the aortic valve to close

A

the aortic valve closed when ventricular pressure falls below that of aortic pressure, marking the beginning of isovolumetric relaxation

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37
Q

what electrical event most closely corresponds to the closing of the mitral(bicuspid) valve

A

QRS complex

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38
Q

what are the components of cardiac output

A

heart rate and stroke volume

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39
Q

what are the components fo blood pressure

A

cardiac output and total peripheral pressure

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40
Q

what is mean arterial pressure

A

diastolic pressure + 1/3(pulse pressure)

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41
Q

what is pulse pressure

A

the difference between systolic and diastolic pressure

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42
Q

what is directly proportional to pulse pressure

A

stroke volume

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43
Q

what is inversely proportional to pulse pressure

A

vessel compliance (ex: decreased compliance due arteriosclerosis = increased pulse pressure)

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44
Q

which has a high pressure gradient, systemic or pulmonary circulation

A

systemic

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45
Q

how do tissue metabolites regulate flow

A

dilation of vessels

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46
Q

how does the myogenic response regulate flow

A

both dilation and constriction

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47
Q

how do endothelial factors regulate flow

A

both dilation and constriction

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48
Q

how does the sympathetic NS regulate flow

A

veddel constriction

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49
Q

what is reactive hyperemia

A

an increase in blood flow in response to a period of occlusion

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50
Q

what tissue metabolites are responsible for vasodilatation

A

K+, phosphate, adenosine, prostaglandins, etc

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51
Q

what is active hyperemia

A

increase in blood flow in response to increase in a tissues metabolic activity (exercise)

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52
Q

describe the myogenic auto-regulation of blood vessels

A

smooth muscle in the vessels respond to changing pressure; dilates to maintain flow when pressure decreases, constricts to maintain flow when pressure increases

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53
Q

how does the sympathetic NS control PB

A

blood vessels innervated by the SymNS vasoconstrict in response to norepi acting on alpha1 receptors; also stimulates adrenal cortex to release epi

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54
Q

explain the renin-angiotensin-aldosterone system

A

a decrease MAP leads to decrease in renal perfusion -> incresae in renin ->increase in angiotensinogen -> angiotensin I -> angiotensin II -> aldosterone & ADH
- KEY for long term management of BP

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55
Q

what are the effects of angiotensin II

A

increased sympathetic activity; increased tubular Na+ and Cl+ reabsorption, K+ excretion, water retention; stimulates adrenal cortex to release aldosterone; stimulates arteriolar vasoconstriction; stimulates antidiuretic hormone(ADH) release

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56
Q

what are pharmacologic management methods of HTN

A
  • decrease cardiac output via calcium channel blockers and beta blockers; decrease TPR via angiotensin converting enzyme inhibitors; decrease volume via diuretics
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57
Q

discribe the baroreceptor reflex

A

sensors detect change, processors develop response, effectors carry out response. in BP decreases: CO increased via parasympathetic withdraw and sym. activation; TPR increases via sym. mediated vasoconstriction; sympatheric constriction of veins to increase venous return.

KEY for short them management of BP

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58
Q

what are the two branches of autonomic nervous system

A

sympathetic and parasympathetic

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59
Q

what used to be thought of as the 3rd division of the of the ANS

A

enteric

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60
Q

where are the SyNS pre ganglionic neurons located

A

in the spinal cord T1-L3 - lateral horn. “thoracolumbar”

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61
Q

Where are the SyNS post ganglionic neurons located

A

pre and paravertebral chain of ganglia

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62
Q

where are the PsNS preganglionic neurons located

A

brainstem nuclei, spinal cord S2-S4; “craniosaccral”

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63
Q

where are the PsNS post ganglionic neurons located

A

close to the effector in parasympathetic ganglia

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64
Q

what is different about the autonomic nervous system circuit structure as apposed to the somatic

A

the ANS circuit has 2 neurons in series while somatic has 1 neuron

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65
Q

What is released from all preganglionic neurons in the ANS

A

acetylcholine (Ach)

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66
Q

where do the axons of the preganglionic neurons exit the spinal cord in the SyNS

A

through the ventral root

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67
Q

what are the prevertebral sympathetic ganglion

A

celiac ganglion, superior mesenteric ganglion, inferior mesenteric

68
Q

where do the majority of PsNS neurons originate

A

cranial nerve X (Vagus nerve)

69
Q

what are the PsNS cranial preganglion neuron regions

A

edinger-westphal nucleus (CN III); salivatory nucleus (CN VII and IX); dorsal motor nucleus of vagus (CN X)

70
Q

what are the 3 trajectories of a preganglionic neuron in the SyNS

A

enter the paravertebral chain & synapse at same level then exit to effector; enter the paravertebral chain and travel up or down the chain before synapsing; enter the paravertebral chain, travel, exit and synapses in prevertebral ganglion

71
Q

what are some examples of parasympathetic ganglia

A

ciliary ganglion, pterygopalatine ganglion, submaxiliary ganglion, otic ganglion, etc.

72
Q

what are the holes of the hypothalamus

A

the five Fs and one S: Food metabolism, Furnace (body temp), fight response, flight response, fuck (sex behaviors), sleep-wake cycles

73
Q

describe food metabolism as controlled by the hypothalmus

A

controls hunger/feeding behavior; autonomic control of digestion; hormone release

74
Q

describe regulation of body temperature controlled by the hypothalamus

A

thermoregulatory behavior; autonomic control of heat conservation/loss; hormone secretion controlling metabolic rate

75
Q

how does the hypothalamus play a roll in sexual behavior

A

autonomic modulation of reproductive organs and endocrine regulation of gonads

76
Q

what role does the hypothalamus plat in sleep wake cycles

A

controls the sleep cycle and levels of arousal when awake

77
Q

whaat are the main ANS neurotransmitters

A

norepinephrine, epinephrine, acetylcholine

78
Q

what types of receptors respond to Ach

A

cholinergic

79
Q

what are the 2 types of cholinergic receptors

A

nicotinic - autonomic ganglia

muscarinic - heart, sm, glands

80
Q

what types of receptors respond to NE and Epi

A

adrenergic

81
Q

what are the 5 types of adrenergic receptors

A

alpha 1 &2, Beta 1,2&3
alpha 1- smooth muscle
Beta 1 - heart

82
Q

give examples of muscarinic receptors that react to Ach

A

sweat glands and blood vessels (SyNS)

glands, SM, heart (PnSN)

83
Q

give examples of androgenic receptors for norepinephrine and epinephrine

A

heart & blood vessels

84
Q

what is the major example of Ach acting on a nicotinic receptor

A

SyNS and PsNS pre-post ganglion synapse

85
Q

what are examples of autonomic reflexes

A

baroreceptors, micturition, pupillary response, peristalsis, respiratory

86
Q

what are the phases of an autonomic reflex arc

A

afferent pathways (input); integration/processing; efferent pathways (output) - > back to afferent to maintain control constantly

87
Q

what are the types of sensory receptors

A

mechanoreceptors, chemoreceptors, nociceptors, thermoreceptors

88
Q

give examples/locations of mechanoreceptors

A

aortic baroreceptors, carotid sinuses, lungs, bladder, veine, intestines

89
Q

give examples/locations of chemoreceptors

A

carotid/aortic bodies, medulla, hypothalamus, stomach, taste buds, olfactory bulbs

90
Q

where are nociceptors located

A

throughout viscera, arterial walls

91
Q

where are thermoreceptors located

A

hypothalamus, cutaneous

92
Q

give an example of a negative feedback loop

A

baroreceptor reflex to control BP - baroreceptors sense decrease in pressure, relay to hypothalamus, signal sent to increase heart activity and peripheral resistance

93
Q

what is ventilation

A

the bulk flow of air into and out of the lungs

94
Q

what are the main principles of ventilation

A

air flows from high to low pressure; for air to flow into the lungs PinPout

95
Q

how does air get into the lungs?

A

contraction of inspiratory muscles increases thoracic volume therefore decreasing thoracic pressure making creating the pressure gradient needed

96
Q

how does air get out of the lungs?

A

muscles relax decreasing thoracic volume and compressing the lungs and alveoli reversing the pressure gradient and expelling air

97
Q

what is spirometry

A

measures that allow us to look at lung volumes and capacity

98
Q

what is functional residual capacity

A

the point where the collapsing force of the ling is balanced by the expanding force of the thorax

99
Q

what is minute ventilation

A

tidal volume * respiratory rate

100
Q

what is the conducting zone?

A

anatomic dead space that does not participate in gas exchange (~150mL)

101
Q

what is alveolar ventilation

A

(tidal volume-dead space)*respiratory rate; accounts for dead space; basically how much air per minute participated in gas exchange

102
Q

how does gravity affect ventilation

A

gravity causes a gradient in internal pressure; upper regions are more stretched and there for less compliant. therefore base of lungs are more compliant and can expand more

103
Q

what is a pheumothorax

A

collapsed lung; results from the decoupling of the lung and chest wall

104
Q

how is ventilation affected with a SCI at C3 or above

A

diaphragm is paralyzed; requires mechanical ventilation

105
Q

how is ventilation affected with a low cervical SCI

A

diaphragm remains innervated, but accessory muscles not. contraction of diaphragm collapses thoracic cage, loss of abs leads to diaphragm flattening and expansion of abdomen during inspiration

106
Q

how does asthma affect ventilation

A

vasospasms causes narrowing of airway which increased resistance; therefore a greater pressure gradient is required to maintain flow executed by an increase in muscle effort/ work of breathing

107
Q

what is dynamic compression

A

changing of airway diameter during ventilation phases to aid in controlling air flow - expands during inspiration and compresses during expiration

108
Q

what disease can increase compliance in the lungs

A

emphysema - increases compliance by destroying elastic fibers in lung

109
Q

what diseases can decrease compliance in the lungs

A

pulmonary fibrosis & chest wall disorders

110
Q

what are the consequences of decreased compliance of the lung

A

increased muscle effort for inspiration, increased work of breathing, lower functional residual capacity

111
Q

what are the consequences of increased compliance of the lung

A

decreased elastic recoil, elevated functional residual capacity, increased work of breathing

112
Q

what is the roll of surfactant in the lungs

A

reduce surface tension on the alveoli walls to keep alveoli from collapsing

113
Q

what is respiratory distress syndrome

A

loss of surfactant that leads to alveolar collapse; this gives rise to decreased lung compliance and decreased area for gas exchange

114
Q

what is the driving force for diffusion of gases

A

partial pressure

115
Q

what is the PO2 of dry air

A

160mmHg

116
Q

what is the PO2 of tracheal air

A

150mmHg; because you have to account for water vapor in the trachea

117
Q

What is PAO2

A

100mmHg; reflects balance between O2 entry to and exit from alveoli

118
Q

what is PACO2

A

40mmHg; due to CO2 diffusing into alveoli from venous blood

119
Q

why are partial pressures of O2 and CO2 equal in the alveolus and arterial blood

A

arterial blood “equilibrates” with alveolar air under normal circumstances

120
Q

what determines the rate of gas diffusion

A

pressure gradient, thickness of the membrane, surface area

121
Q

how much of blood oxygen is pound to hemoglobin

A

98% - Measured by % saturation (SaO2)

122
Q

how many oxygen binding sites are on hemoglobin

A

4

123
Q

how much of blood oxygen is dissolved in plasma

A

2% - measured by PO2

124
Q

what are the 3 modes fo CO2 transport

A
  • dissolved in plasma (5%)
  • bound to hemoglobin (3%)
  • chemically modified as H+ and HCO3- (92%)
125
Q

what does changing oxygen affinity do?

A

decreasing affinity facilitates O2 unloading in tissues by making it harder for hemoglobin to hold on to oxygen

126
Q

what is hypoxemia

A

decreased arterial PO2 (<80mmHg)

127
Q

what is hypercapnia

A

increased PaCO2 (>45mmHg)

128
Q

how is hypercapnia sensed

A

central chemoreceptors in the brainstem - VERY SENSITIVE to pCO2 and pH of cerebrospinal fluid

129
Q

how is hypoxemia sensed

A

by peripheral chemoreceptors in carotid and aortic bodies,

130
Q

where are hypoxia and hypercapnia processed

A

respiratory centers in medulla and pons

131
Q

what is the effect of hypoxia and hypercapnia

A

increased ventilatory drive to expel more CO2 or inhale more O2

132
Q

causes of hypoxemia

A

breathing hypoxic gas, hypoventilation, diffusion limitation, ventilation-perfusion matching

133
Q

what is the normal ventilation perfusion ratio

A

0.8

134
Q

what is gravities affect on ventilation

A

ventilation at base> apex; alveoli at apex pulled open at rest, at base much larger increase during inspiration

135
Q

what is gravities affect on perfusion

A

perfusion at base> apex; caps in apex are underperfused while those at base are overperfused

136
Q

what happens when V/Q is high

A

ventilation&raquo_space; perfusion; blood coming out of lung looks more like atmospheric air

137
Q

what happens when V/Q is low

A

ventilation &laquo_space;perfusion; blood coming out of lungs looks more like venous blood

138
Q

how does ventilation change with exercise

A

ventilation increases in proportion to VO2 and VCO2

139
Q

what are the 3 phases of ventilation with exercise

A

phase I - fast
Phase II- Primary
Phase III - steady state

140
Q

what is pharmacokinetics

A

how the body processes the drug

141
Q

what is pharmacodynamics

A

how the body interacts with the drug

142
Q

what is the therapeutic index

A

the ratio of median toxic dose to median beneficial dose; the greater the ratio the more safe the drug is

143
Q

what are the routes of administration of a drug

A

enteral (GI tract) & parenteral

144
Q

give examples of enteral drug administration

A

oral, buccal, sublingual, rectal

145
Q

give examples of parenteral drug administration

A

inhalation, intranasal, injection, topical, transdermal

146
Q

what is the issue with oral drug administration

A

subject to first pass effect - liver removes some before it gets to target

147
Q

what are the main ways drugs move across the cell membrane

A

passive diffusion and active transport

148
Q

what is bioavailability

A

how much of the drug is available for use

149
Q

what factors affect absorption and distribution

A

route of administration, prosperities of the drug, endogenous carriers, endogenous barriers, PT (heat and ice)

150
Q

what are the drug storage sites

A

adipose (most common), bone, muscle, organs

151
Q

what is biotransformation

A

metabolic process of breaking down lipid soluble drugs into water soluble parts

152
Q

how are drugs excreted

A

Renal (pee), respiratory, other uncommon paths include - GI, sweat, saliva and lactation

153
Q

what are the energy pathways available for muscle

A

phosphocreatine, anaerobic glycolysis, oxidative phosphorylation

154
Q

describe phosphocreatine ATP generation

A

high power, low capacity; makes ATP from ADP and nearby PCr

155
Q

describe anaerobic glycolysis

A

moderate power and capacity; associated with acidosis makes ATP from glycogen

156
Q

describe oxidative phosphorylation

A

Low power, high capacity, aerobic, makes ATP from lipids, carbs, and proteins; occurs in mitochondria

157
Q

what are the yields of the substrates for oxidative phosphorylation

A

glucose - 36 ATP
lipids - 130 ATP
proteins - somewhere between

158
Q

when is each substrate primarily used in oxidative phosphorolyation

A

lipids - at rest
carbs - during heavy exercise
proteins - disease states and starvation

159
Q

when is each method of ATP production primarily used

A

phosphocreatine - temporal and spatial buffer for high power activity and transition from rest to exercise
glycolysis- transition from rest to exercise, heavy exercise and when O2 is lacking
oxidative phosphorylation - primary means always

160
Q

what are the aerobic changes with training

A

high intensity, short duration activity increases anaerobic substrates, increases quantity and activity of key glycolytic enzymes

161
Q

what are the aerobic energy changes with training

A

mod intensity long duration activity increases # of mitochondria in use, increases oxidation of fats at rest and submax exercise; increased ability to oxidize carbs at max exercise

162
Q

what are the changes with aerobic training to cardiovascular system

A

increases stroke volume via increased left ventricle volume
decreased HR at rest and submax exercise
increased peripheral vasodilation capacity

163
Q

what are the ventilatory changes with aerobic training

A

increased tidal volume and RR at submax exercise, greater time for O2 diffusion, lower energy cost of breathing

164
Q

what mechanisms control blood pressure

A

heart rate, stroke volume, peripheral resistance

165
Q

what is the affect of sympathetic activation to the heart

A

increased heart rate,
increased contractility
(increased BP)

166
Q

what is the affect of parasympathetic activation to the heart

A

decreased HR, decreased contractility

decreased BP

167
Q

what are the autonomic higher level cardiac regulation regions

A

cardiac accelerator center, cardiac inhibitory center; both in medulla

Unit 1 (3 decks)

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