Exam 3 Flashcards
What carries oxygen poor blood to the lungs and back to the heart?
Pulmonary ciruit
What carries blood from the heart to the rest of the body?
Systemic circuit
What is the right AV called?
Tricuspid
What is the left AV called?
Bicuspid
The aortic valve is also called?
Semilunar valve
Explain cardiac action potential?
1) Na+ enters (depolarization)
2) Transient K+ exit
3) Ca2+ enters and K+ exits (plateau phase)
-this doesn’t happen in skeletal muscle
4) K+ exits (re-polarization)
Explain the step in heart beat coordination?
-Pacemaker cells (generate own AP)
1) SA node Pacemaker (right atrium) depolarization of both atria
3) AV node
4) Bundle of his
5) Purkinje fibers
What occurs during atrial excitation? and what occurs on EKG
1) SA node and AV node excite
2) *** P-wave (atrial depolarization)
What occurs during ventricular excitation/ depolarization? and what occurs on EKG
1) Ventricles contract
2) QRS wave
***when this occurs it masks atrial re-polarization/ relaxation
What occurs during Ventricular re-polarization (relaxation)? and what occurs on EKG
1) Ventricles relax
2) T wave
What is the process of producing an electrocardiogram (ECG or EKG), a recording of the electrical activity of the heart using electrodes placed on the skin, represented as a graph?
Electrocadiography
What is a record or graph of a person’s heartbeat produced by electrocardiography?
Electrocardiogram (ECG or EKG)
What requires the temporary threading of a thin, flexible tube called a catheter through an artery or vein into the heart?
Cardiac angiography
What is a noninvasive technique that uses ultrasound?
Echocardiography
this is a conducting cell that takes over excitation in the conduction system?
-If the SA node is damaged the AV node can take over. This is still adequate for normal circulation.
Ectopic pacemaker
What are uncoordinated atrial and ventricular contractions caused by a defect in the conduction system?
Arrhythmias
What is a rapid and irregular (usually out of phase) where the SA node is no longer controlling heart rate:
There are 2 types?
1) Fibrillation
-Atrial fibrillation
-Ventricle Fibrillation
(these are Arrhythmias)
What is the application of an electrical stimulus to shock the heart back into a normal SA rhythm? For chronic conditions _____________ can be implanted. This is a device that delivers the electrical stimulus rather than the SA node.
1) Defibrillation
2) Pacemaker
(heart sounds)
Normal open valve
Laminar flow= quiet
(heart sounds)
Stenotic Valve
Narrow valve = Turbulent flow = murmur
(heart sounds)
Normal closed valve
No flow = quiet
(heart sounds)
Insufficient valve
Leaky valve = turbulent backflow = murmur
_______ is 90% water and carries electrolytes and nutrients (glucose, amino acids, vitamins) as well as wastes (urea, bilirubin, creatine), gases (O2 and CO2), and hormones
Plasma
__________ is plasma with fibrinogen and other proteins involved in clotting removed.
Serum
Explain Erythrocyte (or RBC) Formation
1) Kidney secretes EPO in Blood
2) EPO enters bone marrow causing (Erythropoiesis) forming erythrocytes
3) Erythrocytes travel through the blood to the spleen
4) Spleen breaks down Erythrocytes into iron and Brilirubin
5) Bilirubin enters liver and is converted into bile
6) Bile is excreted by the kidney into the urine
If there is an increase in the breakdown of Erythrocyte by the spleen this causes an increases in brilirubin which increases bile production by the liver which leads to which disease?
Jaundice/ Splenomegaly
What happens to patients who kidney have failed?
they have to little erythropoietin and need to have synthetic forms administered to maintain normal RBC count
What also enhances RBC production by increasing EPO production?
Testosterone
What is defined as a decrease in the oxygen-carrying capacity of blood?
Anemia
What are cytoplasmic fragments derived from megakaryocytes, these are cell fragments have NO ORGANELLES, but they do have GRANULES and are important in blood clotting?
Platelets also known as thrombocytes
the Granules contain secretory products:
1) ADP
2) Serotonin
3) epinephrine
What is the physiological mechanisms that stop bleeding called?
Hemostasis
What are the 3 steps in hemostasis?
1) Vasular spasm
2) Formation of platelet plug
3) Blood coagulation (clotting)
After hemostasis intact blood vessel then secretes NITRIC OXIDE (NO) and PROSTACYCLIN which causes respective:
1) Vasodilation
2) Inhibit platelet aggregation
What are anticoagulants?
Prevent clot formation
What are some anticoagulants?
1) Aspirin (inhibit prostaglandins)
2) Heparin (inhibits thrombin activity)
3) Citrate (inhibits clotting factors)
What are phagocytes, and their production and release from the bone marrow increase during infection
Neutrophils
What fights off invasions by eukaryotic parasites; they either release toxic chemicals that kill parasites, or they phagocytize parasites
Eosinophils
What secretes anti-clotting factors called heparin at the site of infection, which helps the circulation flush out the infected site; they also secrete histamine to attract infection-fighting cells and proteins to the site?
Basophils
What are phagocytes that circulate in the blood for a short time, after which they migrate into tissues and organs and develop into macrophages?
Monocytes
What are large phagocytes capable of engulfing viruses and bacteria?
Macrophages
What are composed of T- and B- lymphocytes that protect against specific pathogens?
Lymphocytes
What is the cardiac cycle?
1) Diastole
2) Systole
What is the relaxation phase of the cardiac cycle?
Diastole
What is the contraction phase of the cardiac cycle?
Systole
What is the filling phase of the cardiac cycle?
Diastole
What is the pumping phase of the cardiac cycle?
Systole
What is the volume of blood in one ventricle at the end of diastole called?
End diastolic volume (EDV)
What is the volume of blood in one ventricle at the end of systole called?
End systolic volume (ESV)
What is the volume of blood ejected from one ventricle in each cycle called?
Stroke volume
What is the stroke volume equation?
SV= EDV - ESV
What happens to the SV if EDV increases?
SV increases
What happens to the SV if ESV increases?
SV decreases
What is the ability of the VENTRICLES to STRETCH and fill with blood?
Pre-load
What is the ability of the VENTRICLE TO EMPTY (has to push against aortic pressure)?
After-load
What is considered the venous return?
a) Pre-load
b) After-load
a) pre-load
what is the amount of blood pumped out of each ventricle in one minute called?
Cardiac Output
How do you calculate cardiac output?
SV*HR=CO
What causes an increase in heart rate?
Positive chronotropic factors (Norepinephrine = Sympathetic nervous system)
What causes heart rate to decrease?
Negative chronotropic factors (Acetylcholine = parasympathetic nervous system)
What states that the critical factor controlling stroke volume is PRELOAD?
-The most important factor in causing stretch is the amount of blood in the ventricles. The amount of blood in the ventricles is controlled by venous return.
Starlings law
this is defined as the ratio of stroke volume to end-diastolic volume (SV/EDV)
Ejection fraction
If you have increase contractility what happens to the ejection fraction?
Increases
What factors increase Cardiac Output?
1) Increase in EDV
2) Increase in sympathetic activity
3) Increase in epinephrine
4) Decrease in parasympathetic activity
What has more smooth muscle veins or arteries?
Arteries
During systole what happens to the arteries?
Vasodilation
During diastole what happens to the arteries?
Vasoconstriction
If compliance increases what happens to stretch in the arteries?
It increases
What is the maximum pressure reached during the peak of ventricular contraction and ejection?
Systolic pressure (SP)
What is the minimum arterial pressure reached just prior to ventricular ejection?
Diastolic pressure (DP)
what is SP/DP?
Arterial blood pressure
what is SP-DP called?
Pulse pressure
What is the average pressure driving blood to the tissues over cardiac cycle?
Mean arterial pressure
A decrease in arterial compliance occurs in ___________________
arteriosclerosis (stiffening of the arterioles)
In arterials the changes in diameter impacts ________________
blood pressure
If there is vasoconstriction what happens to blood flow?
Less blood flow
If there is less resistance what happens to blood vessels?
Vasodilation
Increase in total peripheral resistance (TPR) what happens to BP?
Increases
What is caused by non blood flow in coronary artery causing dead tissue in the heart?
Myocardial infarction
what condition is caused because of high metabolic activity?
Hypoxic
What are the steps in active hyperemia?
1) Increase metabolic activity of organ
2) Decrease oxygen, increase metabolites in organ interstitial fluid
3) Arterial dilation in organ
4) Increase blood flow to organ
What are the steps in flow regulation?
1) Decrease in arterial pressure in organ
2) decrease in blood flow to organ
3) Decrease in oxygen, increase in metabolites, decrease in vessel wall stretch
4) Ateriolar dilation in organ
Endothelial cells secrete ________________ that diffuse to the adjacent vascular smooth muscle inducing VASODILATION
paracrine agents
Velocity is the slowest in the ______________ because they have a greater cross-sectional area.
capillary beds
Delivers oxygen and nutrients to tissue this is called?
Filtration
Takes out waste products from tissue back into the blood this is called?
Absorption
Intersitial fluid contains
ICF (intracellular fluid)
this is the force exerted by the fluid pressing against a wall in the capillaries it is the same as the capillary blood pressure
hydrostatic pressure (Pc)
In capillaries the pressure tends to force fluids out _____________, especially on the arterial end, where pressure is higher
Filtration
this is the force that opposes the hydrostatic pressure.
-It is created by large plasma proteins.
osmotic pressure (Pie c)
If the hydrostatic pressure (Pc) is larger than the osmotic pressure (Pie c) what occurs?
Filtration
If the osmotic pressure is larger than the hydrostatic pressure what occurs?
Absorption
The osmotic pressure is the ____________ in the arterial end and the venuole end
same
Excess fluid go into the lymphatic system if the lymphatic system is blocked what occurs?
Edema (swelling)
What disease is associate with veins that have become DILATED and tortuous because of incompetent (Leaky) valves
Varicose veins
What are 4 factors that influence venous pressure?
1) Increase sympathetic
2) Increase blood volume
3) Increase skeletal muscle pump
4) Increase inspiration movements
What help convey information to the motor centers in the brain causing veins to constrict: increase venous pressure —> increase EDV–> increase SV –> Increase CO
Arterial baroreceptors
If there is a hemorrhage this causes a decrease in arteriole pressure what senses the decrease and causes less firing–> this will trigger the vasomotor center to increase sympathetic discharge to the heart and decrease parasympathetic discharge?
Baroreceptor
What is the equation for mean arteriole pressure
CO * TPR
If there is an increase in arterial pressure how does your body decrease the arteriole pressure?
The kidneys release more urine (causing a decrease in blood volume)
What are the 3 causes of hypotension?
1) Hypovoiemic shock
2) Low-resistance shock
3) Cardiogenic shock
________________ is caused by a hemorrhage, severe vomiting, severe diarrhea, and extensive burns
hypovoiemic shock
_______________ is when blood volume is normal, but circulation is poor due to abnormal expansion of the vascular bed caused by extreme vasodilation (example allergic reaction)
Low resistance shock
__________ is pump failure. The heart can not sustain adequate circulation (example: myocardial infarction)
Cardiogenic shock
What is the cause of secondary hypertension?
Normally a tumor in the adrenal medulla (it can also be a sign of cushing’s disease, physical obstruction of the renal arteries, kidney disease, arteriolosclerosis, hyperthyroidism
What medication can be given to a patient with hypertension?
1) Diuretics
2) Beta blockers
3) Calcium channel blockers
4) ACE inhibitors
The airways can be divided into the _______________ (where the gas exchange happens) and the _______________ (top of the trachea to the respiratory bronchioles
1) Respiratory zone
2) Conducting zone
Most of the air-facing surfaces of the wall are lined by a continuous layer, one cell thick, of flat epithelial cells called?
Typer I alveolar cells
_______________ that produce a detergent-like substance called SURFACTANT
Typer II alveolar
The total alveolar surface area is __________ and this permits the rapid exchange of large quantities of oxygen and carbon dioxide diffusion
Large
Explain the 5 processes in respiration
1) Ventilation: exchange of air between atmosphere and alveoli by bulk flow
2) Exchange of O2 and CO2 between alveolar air and blood in the lung capillaries
3) Transport of O2 and CO2 through pulmonary and systemic circulation by bulk flow
4) Exchange of O2 and CO2 between blood in tissue capillaries and cells in tissues by diffusion
5) Cellular utilization of O2 and production of CO2
What is the equation of FLOW?
Pressure divided by resistance
F=P/R
What states that at a constant temp the pressure of a gas varies inversely with its volume
Boyles law
(P1V1=P2V2)
if pressure increase volume deceases and vise versa
When the Palv < Patm what happens?
Air flows into the lungs
Palv<Patm what is this called?
Negative pressure breathing
When Palv>Patm what happens?
Air flows out of lungs
The movement of air from the area of high pressure to low pressure is called?
Law of diffusion
If these is more space in the lungs this means?
Increase volume decrease pressure (Boyles law)
During Expiration what occurs?
1) Elasticity of lung recoils inwards
2) Passive process
3) Decrease space
4) Decrease volume
5) Increase pressure
6) Air goes out of lungs
there is a ballon surrounding the lungs what is the name of the wall of the ballon that is in contact with the lungs?
Visceral pleura
there is a ballon surrounding the lungs what is the name of the inside of the ballon that is surrounding the lungs?
intrapleural fluid
there is a ballon surrounding the lungs what is the name of the wall of the ballon on the outside (outer most layer)?
Parietal pleura
What produces fluid that remains in the in the ballon surrounding the lungs?
Pleura
What is the function of the pleura?
To lubricate the lungs to prevent friction while breathing
This is an infection or inflammation of the pleura ofter results from pneumonia. This results in a roughening of the pleura, which creates friction and a stabbing pain with each breath. this causes a build up of fluid and hinders breathing.
Pleurisy
What is the pressure in the pleural cavity called?
Intrapleural pressure (Pip)
If Pip=Palv what happens to the lungs?
They will collapse
What is the disease associate with the lungs collapsing normally due to air enters the plural space?
Pneumothorax
what is the transmural pressure that governs the static properties of the lungs?
Transpulmonary pressure
What means “across a wall” and is represented by the pressure in the inside of the structure (Pi) minus the pressure outside the structure (Po)
transmural
(inflation of a ballon-like structure like the lungs requires an increase in the transmural pressure such that Pi increases relative to Po)
Inspiration is a _____________ process
Active process (requires ATP)
-Quiet
Expiration is a _____________ process
Passive (doesn’t require ATP)
this is inverse to STIFFNESS, if this becomes high the easier it is to EXPAND the lungs at any given change in transpulmonary pressure
lung compliance
(the high the compliance the less stiff and more expansion)
The type II alveolar cells secrete the detergent-like substance known as ______________
surfactant
What is the effect of surfactant on lung compliance and surface tension?
1) Increases
2) Lowers
this is a huge problem for premature babies whose type II cells are not mature enough to produce this. This is known as infant respiratory distress syndrome (IRDS) or as respiratory distress syndrome of the newborn (RDSN)
lack of surfactant
What can cause STIFFN lung and impair compliance of the lungs?
Fibrosis or Silicosis
Asthma is a disease characterized by intermittent episodes in which airway smooth muscle contracts strongly, markedly _______________________
increasing airway resistance
The basic defect in asthma is ___________________________, the cause of which vary form person to person and include, among other: allergy, viral infections, and sensitivity to environmental factors
chronic inflammation of the airways
The underlying inflammation makes the airway smooth muscle ______________ and causes it to contract strongly in response to such things as exercise.
Hyperresponsive
what are some treatments for asthma?
1) reduce inflammation and airway hyperrespinsiceness with anti-inflammatory drugs (Leukotriene inhibitors and inhaled glucocorticoids)
2) Bronchodilator drugs
What is caused by destruction and collapse of the smaller airways?
Emphysema
What is caused by excessive mucus production in the lungs?
Chronic bronchitis
What measures different lung volumes?
Spirometer
What is the amount of air inhaled or exhaled in one breath called on a spirometer?
Tidal volume (TV)
What is the amount of air in excess of tidal inspiration can be inhaled with maximum effort called?
Inspiratory reserve volume (IRV)
This is the amount of air in excess of tidal expiration that can be exhaled with maximum effort?
Expiratory reserve volume (ERV)
What is the amount of air that can be exhaled with maximum effort after maximum inspiration (TV+IRV+ERV); used to assess strength of thoracic muscle as well as pulmonary function?
Vital capacity (VC)
This is found in conducting airways (there is a certain volume in the conducting airways that is left over from the proceeding breath) what is this called?
Anatomical Dead space
Explain local control of ventilation (V)
1) Decreased airflow to region of lung
2) Pulmonary blood decrease PO2
3) Vasoconstriction of pulmonary vessels (this is also called HYPOXIC Vaso-constriction
4) Decreased blood flow
5) Local perfusion decreased to match a local decrease in ventilation
6) Diversion of blood flow and airflow away from local area of disease to healthy area of the lungs
Explain local control of perfusion (Q)
1) Decreased blood flow to region of lung
2) Alveoli ( decrease PCO2)
3) Bronchoconstriction
4) Decreased airflow
5) Local perfusion decreased to match a local decrease in ventilation
6) Diversion of blood flow and airflow away from local area of disease to healthy area of the lungs
Hb binds to oxygen this happen at the pulmonary end what is this called?
Loading
Tissues needs oxygen for cellular respiration Hb lets go of oxygen; systemic capillaries. What is this called?
Unloading
What converts CO2 and H2O into bicarbonate and also does the reverse?
Carbon Anhydrase
1) Systemic tissue: CO2 produced
2) CO2 goes into RBCs
3) Carbon Anhydrase converts CO2+H2O into biocarbonate
4) Bicarbonate is then released into the plasma
what is this whole process called?
Chloride shift
1) Lung end: Bicarbonate moves from plasma into the RBCs
2) Bicarbonate is converted into CO2 and H2O by Carbon Anhydrase (CA)
3) CO2 is sent into alveolus for expiration
What is this process called?
Reverse Chloride shift
What is it called when the binding site on Hb is full of O2?
Saturation
As the partial pressure of O2 decreases the ….
O2 dissociates from Hb
what happen to the Hemoglobin curve there is an increase in CO2?
Increase acidity causes a shift right (which means a unloading oxygen)
what happen to the Hemoglobin curve there is an increase in Temp?
Causes a shift right (which means a unloading of oxygen)
What forms DPG and how does an increase in DPG affect the hemoglobin curve?
1) Glycolysis: Which means the tissue will need more oxygen causing a release of oxygen from hemoglobin
2) This will cause a shift right to the curve (meaning an unloading of Oxygen)
What binds to hemoglobin with a higher affinity Oxygen or CO?
Carbon monoxide (CO)
If there is an increase in CO carbon monoxide in the blood what happens to the hemoglobin curve?
Shift left (decrease release of O2)
What part of the brain help control breathing?
Medulla oblongata
(Important)
Hypoventilation can cause
respiratory acidosis
(less breathing causes more acidity in the blood)
remember this is the respiratory system
(important) Hypreventilation causes
Respiratory alkalosis (Decrease in CO2)
remember this is the respiratory system
Loss of bicarbonate ions causes?
Metabolic acidosis
(this is dealing with the kidney)
Excess of bicarbonate ions causes?
Metabolic alkalosis
(this is dealing with the kidney)
What does the kidney release to increase blood pressure?
Renin
Nephrons are associates with 2 sets of capillaries:
1) Glomerular
2) Peritubular
The glomerular capillaries are specialized for?
Filtration
The glomerulus is _______________ which allows large amount of solutes to pass (but large proteins cannot pass)
Fenestrated
The inner layer of the glomerular capsule contains highly modified branching epithelial cells called?
Podocytes
What terminates in foot processes which surround the basement membrane of the glomerulus? The cleft between the foot processes are called?
Podocytes
filtration slits
In the arteriole wall the granular cells (______________________) are enlarged smooth muscle cells that have secretory granules which contain the enzyme ________________ that raise blood pressure
1) Juxtaglomerular/ JG cells
2) Renin
Where are the Juxtaglomerular cells found?
Afferent arteriole
Where are the Macula Densa cells found?
Distal tubule (they are salt sensors)
Dysfunction in the filtration process can lead to red blood cells in the urine (______________) or protein in the urine (______________)
1) hematuria
2) Proteinuria
What is the pressure in the bowmans capsule called?
1) fluid pressure
2) osmotic pressure
What is the pressure called in the arterial forcing substances into the bowmans capsule called?
Glomerular capillary pressure
What are the 3 regulations of the GFR?
1) Autoregulation (intrinsic mechanism)
2) Sympathetic (extrinsic mechanism)
3) Hormonal regulation (extrinsic mechanism): RAS and ANP
If the efferent arteriole constricts what happens to GC and GFR?
increases
increases
If the afferent arteriole constricts what happens to GC and GFR?
Decrease
Decrease
If the efferent arteriole dilates what happens to GC and GFR?
Decreases
Decreases
If the afferent arteriole dialates what happens to GC and GFR?
Increases
increases
What is the function of aldosterone?
Increase sodium reabsorption
What is the function fo ADH?
Promotes water reabsorption
Descending loop is only permeable to?
Water
Ascending loop is only permeable to?
sodium
The _______________ is why untreated diabetic patients have glucose in there urine
Transport maximum
