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Medical Physiology I > Block 8 Exam > Flashcards

Block 8 Exam Flashcards

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USMLE® Step 1 flashcards
1
Q

Flailing injuries

A

Injuries sustained due to lack of arm or leg restraints or ejection at high air speed

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2
Q

Skeleton G suit

A

abdomen down

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3
Q

Full coverage G suit

A

Feet up

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4
Q

Maximum daily exposure without Active noise reduction

A

Can be exceeded in as little as half an hour

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5
Q

Why can’t sunscreen be used in the cockpit

A

Can’t apply frequently enough
Can degrade the mask
Can be flammable

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6
Q

Three shunts in fetal circulation

A

Ductus Arteriosus
Foramen Ovale
Ductus Venosus

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7
Q

Ductus Arteriosus

A

Pulmonary artery => aorta

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8
Q

Foramen ovale

A

Right atrium => left atrium

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9
Q

Ductus Venosus

A

Bypasses liver

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10
Q

Organogenesis time

A

4-16 weeks

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11
Q

Organogenesis

A

Formation of major airways
Formation of bronchial tree and portions of respiratory parenchyma
Birth of the acinus

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12
Q

Differentiation time

A

16 weeks - birth

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13
Q

Airway liquid clearance

A

Na+ reabsorption before birth
Mechanical forces During vaginal delivery
Pressure gradients of first breaths after delivery

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14
Q

Pulmonary complications for preterms

A

Smaller diameter airways
Reduced airway surface area
Lack of effective surfactant

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15
Q

Surfactant production

A

Begins around 26 weeks

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16
Q

Manifestations/symptoms of neonatal respiratory distress syndrome

A 
Tachypnnea
Grunting
Nasal flaring
Chest wall retractions
Increasing FiO2 requirement
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17
Q

How do infants maintain thermoregulation?

A

Non-shivering thermogenesis
Vasoconstriction
Sweating

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18
Q

Risks for hypothermia in neonates

A

Larger surface area relative to body mass
Little white fat for insulation
Thin skin
Extended posture
Increased oxygen consumption to maintain thermic stability
Limited stores of BAT

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19
Q

Periventricular leukomalacia

A

Major form of cerebral white matter injury affecting preterm infants
White matter damage due to hypoxic-ischemic injury

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20
Q

Percent of time spent wave riding

A

3-5%

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21
Q

Percent of time spent paddling

A

40%

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22
Q

Percent of time spent stationary

A

50%

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23
Q

Percent of time spent miscellaneous

A

10%

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24
Q

Role of wetsuits

A 
Insulation
Injury prevention
Performance
Proprioception
Energy expenditure
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25
Q

Access points of wetsuits

A

Neck
Zipper
Cuff regions of arms
Ankle

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26
Q

Fluid loss during surfing results

A

Surf duration and body composition significantly correlated with fluid loss

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27
Q

Body weight lost in costa rica

A

0.98%

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28
Q

Body weight lost in Australia

A

0.94%

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29
Q

Body weight lost in San Diego

A

0.48%

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30
Q

Utilization of Surf apparel to dissipate heat during surfing

A

No significant difference found in skin temperature between wearing surf shirt, rash guard, or no shirt

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31
Q

Where in the body do surfers lose heat?

A

Thigh, calf, and abdomen

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32
Q

Where did surfers feel coldest

A

Calf, forearm, and chest

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33
Q

Where did surfers feel most uncomfortable

A

Chest

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34
Q

Where did surfers feel wettest

A

Lower legs, chest, upper back, lower back, and wrist

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35
Q

Smoothskin in the field

A

Upper chest, back, and lower back were significantly warmer

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36
Q

Smoothskin in the lab

A

Upper chest and lower back were found to be significantly warmer

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37
Q

Silicone in the field

A

No statistical significance in upper chest, upper back, and lower back
Abdomen was statistically significantly colder

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38
Q

Silicone in lab

A

Significantly warmer in upper back

Colder in abdomen

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39
Q

Thermo light

A

No statistical significance

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40
Q

Graphene

A

Significantly colder than standard fleece in lower back

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41
Q

Thermoplastic Elastomer (TPE)

A

Significantly colder in upper chest, lower arm, lower abdomen, upper leg, lower back, lower leg compared to polychloroprene foam

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42
Q

Class A Mishaps

A 
Spatial Disorientation/Illusions/Misperceptions
Fatigue
Medications/Illnesses
Loss of consciousness
Diet/Nutrition
Hypoxia
Heat/Cold/Dehydration
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43
Q

G force

A

Measure of acceleration where 1 G is the force of gravity on the body
Gravitational force experienced during acceleration and/or change in direction

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44
Q

Gy axis

A

Left to right

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45
Q

Gx axis

A

Front to back

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46
Q

Gz axis

A

Top to bottom

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47
Q

Air plane turns right G force

A

+Gy

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48
Q

Air plane pitches up

A

+Gz

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49
Q

Air plane accelerates on runway

A

+Gx

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50
Q

For every 1G BP above heart decreases by

A

22 mmHg

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51
Q

FiO2

A

0.21

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52
Q

Patm at sea level

A

760 mmHg

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53
Q

PH2O at sea level

A

47 mmHg

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54
Q

PaCO2 at sea level

A

40 mmHg

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55
Q

RQ value

A

0.8

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56
Q

For every ___ m dive absolute pressure increases by ___ atm

A

10

1

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57
Q

Nitrogen Narcosis

A

Increase PN2 causes N2 to dissolve into blood and tissues

Causes effects resembling alcohol intoxication

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58
Q

Martini’s Law

A

15m of descent = 1 martini

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59
Q

Decompression sickness

A

Happens when diver returns to surface too quickly after deep dive

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60
Q

Treatment for decompression sickness

A

Recompress in hyperbaric chamber

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61
Q

PB falls by ___ for each ____ of ascent

A

1/2

~5500m

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62
Q

Acute adaptations to hypoxia

A 
HVR
Hyperventilation
Increased HR and CO
Decreased food intake
Increased bicarb excretion
Decreased H+/acid excretion
Right shift begins
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63
Q

Long term adaptations to hypoxia

A 
Increased ventilation
Bicarb excretion
Oxidative enzymes increased
Increased pulmonary diffusing capacity
Increased HIF-1
Increased HCT
Right shift
Weight loss
Decreased core temperature
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64
Q

HVR PAO2

A

Enhanced by 10-12 mmHg

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65
Q

Tibetans

A

Show HVR

Similar to “pink puffer”

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66
Q

Bolivians

A

Do not show HVR
Polycythemia
Similar to “blue bloater”

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67
Q

Acute mountain sickness symptoms

A

Nausea
Headache
Sleep disturbance
Lassitude

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68
Q

Acute mountain sickness treatment

A 
Descent
CO2
Acetazolamide
O2
Dexamethasone
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69
Q

High-altitude cerebral edema treatment

A

Descent

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70
Q

Chronic mountain sickness symptoms

A 
Headache 
Confusion
Sleeplessness
Cyanosis
Erythemic conjunctivae due to excessive polycythemia
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71
Q

Chronic mountain sickness treatment

A

Descent

Phlebotomy

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72
Q

Gray out

A

Loss of blood flow to retina
No loss of consciousness
Orthostatic hypotension

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73
Q

Black out

A

Loss of blood flow to brain

Loss of consciousness

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74
Q

White out

A

Hypoxia

No loss of consciousless

75
Q

Red out

A

Red vision

Loss of consciousness

76
Q

Body temperature 40-44

A

Heat stroke with multiple organ failure and brain lesions

77
Q

Body temperature 38-40

A

Hyperthermia (as a result of fever or exercise)

78
Q

Body temperature 36-38

A

Normal range

79
Q

Body temperature 34-36

A

Mild hypothermia

80
Q

Body temperature 30-34

A

Impairment of temperature regulation

81
Q

Body temperature 27-29

A

Cardiac fibrillation

82
Q

Diagnosis of CO poisoning

A

CO-oximetry

Arterial blood gas

83
Q

Treatment of CO poisoning

A

High-flow O2 to increase PAO2

Hyperbaric chamber to increase PaO2

84
Q

Endotherms

A

Generate the heat they need internally

85
Q

Ectotherms

A

Body temperature depends on external heat sources

86
Q

Homeotherms

A

Maintain stable body temperature by generation heat generally above external temperature

87
Q

Mesotherms

A

Express characteristics and both endotherms and ectotherms

88
Q

Poikilotherms

A

Do not regulate internal body temperature and rely on external environment

89
Q

Large S:V ratio

A

Small animal
Lose a lot of heat
Increased metabolism

90
Q

Bergmann’s rule

A

Bigger animals are better for a colder environment

91
Q

Core body temp varies based on:

A

Time of day
Physical activity
Time in menstrual cycle
Age

92
Q

Anterior hypothalamus regulation of body temperature

A

Responds to increased core temp

Sweating and increased skin blood flow

93
Q

Posterior hypothalamus regulation of body temperature

A

Responds to decreased core temp

Shivering, decreased skin blood flow, nonshivering thermogenesis

94
Q

Resting metabolic rate influenced by

A 
Sex
Body size
Fat
Age
Hormones
Fitness level
Temperature
95
Q

Positive S value heat balance equation

A

raises core temp

96
Q

Negative S value heat balance equation

A

Lowers core temp

97
Q

Radiation

A

Transfer heat via infrared rays

98
Q

Conduction

A

Heat loss due to contact with a surface

99
Q

Convection

A

Heat transferred to air or water

100
Q

Evaporation

A

Heat from skin converts water to water vapor

101
Q

Motor unit

A

A single alpha motor neuron and all muscle fibers that it innervates

102
Q

Motor neuron pool

A

All alpha motor neurons that innervate a single muscle

103
Q

Innervation ration

A

alpha motor neurons: # muscle fibers
Smaller ratio in fingers
Larger ratio in gastroc muscle

104
Q

Type I (slow twitch)

A

Membrane resistance is high
Small diameter neurons
Smaller motor units

105
Q

Type II (fast twitch)

A

Membrane resistance is low
Large diameter neurons
Larger motor units

106
Q

Force of contraction depends on:

A

of motor units recruited
Size of motor units
Frequency of motor neuron firing
Muscle and sarcomere stretch

107
Q

Henneman’s Size Principle

A

Type I -> Type IIa -> Type IIx

108
Q

of mitochondria Type I

A

High

109
Q

of mitochondria Type IIa

A

High/moderate

110
Q

of mitochondria Type IIx

A

Low

111
Q

Fatigue resistance Type I

A

High

112
Q

Fatigue resistance Type IIa

A

High/moderate

113
Q

Fatigue resistance Type IIx

A

Low

114
Q

Major energy source Type I

A

Aerobic

115
Q

Major energy source Type IIa

A

Combination

116
Q

Major energy source Type IIx

A

Anaerobic

117
Q

ATPase activity Type I

A

Low

118
Q

ATPase activity Type IIa

A

High

119
Q

ATPase activity Type IIx

A

Highest

120
Q

Speed of fiber shortening Type I

A

Low

121
Q

Speed of fiber shortening Type IIa

A

High

122
Q

Speed of fiber shortening Type IIx

A

Highest

123
Q

Efficiency Type I

A

High

124
Q

Efficiency Type IIa

A

Moderate

125
Q

Efficiency Type IIx

A

Low

126
Q

Specific tension Type I

A

Moderate

127
Q

Specific tension Type IIa

A

High

128
Q

Specific tension Type IIx

A

High

129
Q

Innervation ratio Type I

A

Small

130
Q

Innervation ratio Type IIa

A

Large

131
Q

Innervation ratio Type IIx

A

Largest

132
Q

Concentric contraction

A

Sarcomeres shortened
Force generated
Positive work

133
Q

Eccentric contraction

A

Sarcomeres lengthened
Deceleration of force
Negative work

134
Q

Instant Energy

A

10-15 seconds
Stored ATP and creatine phosphate
Type IIx

135
Q

Short-term energy

A

15 seconds - 2-3 minutes
Anaerobic metabolism of glucose
Type IIa

136
Q

Long-term energy

A

2-3 minutes and beyond
Aerobic metabolism of glucose, fatty acids, and some protein
Type I

137
Q

VO2 max is dependent on:

A

Cardiac output
Oxygen delivery
Oxygen diffusion

138
Q

Factors contributing to fatigue

A

Motivations
Physical fitness
Nutritional status
Types of motor units recruited

139
Q

Recovery after exercise affected by

A

Fitness level
Temperature and humidity
Intensity and duration

140
Q

Central fatigue

A

Changes in CNS

141
Q

Peripheral fatigue

A

At the level of the muscle fiber

142
Q

Apocrine sweat glands

A

Produce viscous secretions

No role in temperature regulation

143
Q

Eccrine sweat glands

A

Innervated by cholinergic sympathetic nerves
Secrete and reabsorb water and solutes
Regulate temperature

144
Q

Senescence/Aging

A

Progressive changes during adult life that underline an increasing vulnerability to challenges faced by the organism

145
Q

Primary aging

A

Intrinsic changes occurring with age, unrelated to disease or environmental influences

146
Q

Secondary aging

A

Changes caused by the interaction of primary aging with environmental influences or disease processes

147
Q

Frailty

A

A pathologic geriatric syndrome characterized by high susceptibility, impending decline in physical function and high risk of death

148
Q

Hypotheses of aging mechanisms

A

Mutation-accumulation mechanism
Antagonistic pleiotropy
Disposable Soma theory

149
Q

Mutation-accumulation mechanism

A

Mutated genes that don’t have deleterious effects until advanced ages

150
Q

Antagonistic pleiotropy

A

Genes with deleterious actions late in life increase evolutionary fitness in early adulthood
Aging is a byproduct of natural selection

151
Q

Disposable Soma theory

A

Purpose of an organism is to procreate

152
Q

Cellular and molecular mechanisms of aging

A

Damage caused by oxidative stress and other factors
Inadequate repair of damage
Dysregulation of cell number

153
Q

Dysregulation of homeostasis of cell number

A

Hyperplasia, Neoplasia, or atrophy

May be caused by decreased telomere length

154
Q

Hyperplasia

A

Increased number of cells

155
Q

Hypertrophy

A

Increased size of cells

156
Q

Neoplasia

A

New cell/mass growth

157
Q

Atrophy

A

Decline/shrinkage of tissue

158
Q

Oxidative stress theory

A

Free oxygen radicals damage important molecules

159
Q

Glycation theory

A

Formation of advanced glycation end products which can induce DNA damage

160
Q

Mitochondrial theory

A

Damage to mitochondrial DNA form ROS => Less ATP generation => Loss of cell function => aging

161
Q

DNA Damage theory

A

DNA damage is produced by radiation, ROS, making it lose the ability to repair itself

162
Q

Necrosis

A

Response to severe cell trauma

Unregulated

163
Q

Apoptosis pathways

A

Extrinsic
Mitochondrial
Nuclear

164
Q

Extrinsic apoptosis pathway

A

Extracellular signals activated internal caspase cascade => proteolysis

165
Q

Mitochondrial apoptosis pathway

A

Damage to mitochondria => release cytochrome-c => cell committed to apoptosis

166
Q

Nuclear apoptosis pathway

A

Activation of P53 => increased ratio of bax:bcl-2 => apoptosis

167
Q

Gelsolin

A

Breaks down actin marking cell for death

168
Q

MPTP

A

Mitochondrial permeability transition pore

169
Q

BAX

A

Pro-apoptosis

170
Q

BCL-2

A

Prevents apoptosis

171
Q

GFR in aging

A

Decreases in some older adults

172
Q

Bladder in aging

A

Increase in urgency, frequency, and nocturia

173
Q

Pulmonary function in aging

A

Loss of collagen and elastin structure

174
Q

Exercise capacity in aging

A

Decreased VO2 max

175
Q

Cardiovascular system in aging

A

Decreased arterial compliance

176
Q

Bone in aging

A

Resorption > formation

177
Q

Skin in aging

A

Thins and becomes less elastic

178
Q

Endocrine system in aging

A

Decline in many hormone levels (exception = PTH)

179
Q

Body mass in aging

A

Loss of lean mass

Increased fat mass

180
Q

Brain in aging

A

White matter loss

181
Q

Sarcopenia definition

A

Age-associated loss of skeletal muscle mass and function

182
Q

Sarcopenia

A

Loss of number and size of muscle fibers

Progressive loss of innervation of motor units

183
Q

Slowing aging process in animals

A

Eat less food (caloric restriction)

Medical Physiology I (8 decks)

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