Exam 3 Essentials Flashcards
A physician orders Tylenol for a temperature greater than 101°F. The patient’s temperature is 100.4°F. Explain the rationale for not medicating a fever of 100.4°F and why Tylenol would be prescribed for temperatures greater than 101°F?
1) Fevers occur as a byproduct of the immune system’s response to infections. 2) Fevers raise the activity of interferons, which kill pathogens. 3) Fever also raises the body’s temperature in order to cause some protein degradation of pathogens and further fight off the infection. 4) When a fever is mild, such as one of 100.4 degrees, they are beneficial to the body. 5) The raise in body temperature, to a mild degree, inhibits reproduction of pathogens. 6) However extreme fevers do need to be treated as becoming too hot can be dangerous to homeostasis and cause edema
A patient is suffering from edema in the lower-right limb. Explain why elevation of the limb and massage helps to remove the excess fluid.
1) Elevating the limb will prevent further accumulation of fluid in the lower limb. 2) Gravity can assist in moving fluid out of the inflamed area, which helps drain fluid out faster. 3) However, elevation alone cannot fix edema by itself. 4) Massages of the inflamed area are also important to remove the fluid. 5) Massage can promote the movement of fluid out of the area, in conjunction with elevation
Gary deliberately hyperventilates for several minutes before diving into a swimming pool. Shortly after he enters the water and begins swimming, he blacks out and almost drowns. What caused him to blackout and explain why this happened (this is a form of hyperventilation – what happens to the brain when CO2 levels drop?)
1) Hyperventilation causes a drastic decrease in carbon dioxide in the blood. 2) Carbon dioxide is removed through exhalation. 3) Therefore, increased ventilation decreases the urge for exhalation as there’s less carbon dioxide that needs to be removed. 4) As a result, hyperventilation can lead to hypoventilation, or lowered ventilation. 5) This means less oxygen enters the body, so what’s in the body already gets quickly used up and causes you to faint. 6) At this point, automatic breathing cannot take over since he is underwater and doing so would lead to drowning
A person who travels to a mountainous region will experience difficulty in breathing even if he or she is in good athletic shape. Explain why a person can be breathing faster than normal yet still feel like he can’t catch his breath. How may this fast breathing affect blood pH?
1) At very high altitudes, pressure is lower than it is around sea level. 2) Pressure and pressure gradients is the main way we get air in and out of our lungs. 3) When the pressure inside our thoracic cavity is lower than the atmospheric pressure, air flows into the lungs. 4) When pressure in our thoracic cavity is higher than the atmospheric pressure, air flows out of our lungs. 5) Therefore, being at an altitude with lower than regular pressure makes breathing more difficult as the pressure gradient to inhale and exhale is not as steep. 6) This means that more breaths or deeper breaths may be necessary in order to get enough air into our lungs with the inefficient pressure gradient. 7) And as a result of faster breathing, CO2 is removed very quickly leading to a more basic blood pH
Renal failure patients constantly undergo dialysis. What is dialysis and why are they at risk of anemia and osteoporosis (think about what renal failure and ALL the functions of the kidney). What medications or supplements could you give to prevent these problems?
1) Dialysis is a procedure in which waste products are removed from the blood when a person has kidney failure and their body can’t do it on its’ own. 2) Patients are at risk for anemia because their kidneys, if failing, cannot properly produce erythropoietin to make red blood cells, which leads to anemia. 3) To counteract this, iron supplements can be given which helps the body make more blood since it’s a requirement to do so. 4) Osteoporosis may occur because the kidneys need to remove phosphorous from the body, and their ability to do so declines when failing, which leads to a buildup of phosphorous, which is associated with less calcium and the release of parathyroid hormone, which moves calcium out of the bones and into the blood, leading to osteoporosis. 5) To fix this, calcitriol can be given to counteract the parathyroid hormone.
To relax after an anatomy and physiology exam, mucho Gusto goes to a local bistro and drinks 2 quarts of low-sodium beer. What effect does this beer have on urine concentration and volume/ Explain the mechanisms involved.
1) Alcohol suppresses release of antidiuretic hormone. 2) Antidiuretic hormone suppresses urination to preserve fluid. 3) Inhibiting ADH causes fluid to be lost more quickly through urination. 4) ADH does so by making the collecting duct more permeable to water. 5) When the collecting duct is more permable to water, water will reenter tissue fluid and the bloodstream, rather than be lost in the urine
A physician orders Tylenol for a temperature greater than 101°F. The patient’s temperature is 100.4°F. Explain the rationale for not medicating a fever of 100.4°F and why Tylenol would be prescribed for temperatures greater than 101°F?
1) Fevers occur as a byproduct of the immune system’s response to infections. 2) Fevers raise the activity of interferons, which kill pathogens. 3) Fever also raises the body’s temperature in order to cause some protein degradation of pathogens and further fight off the infection. 4) When a fever is mild, such as one of 100.4 degrees, they are beneficial to the body. 5) The raise in body temperature, to a mild degree, inhibits reproduction of pathogens. 6) However extreme fevers do need to be treated as becoming too hot can be dangerous to homeostasis and cause edema
What are complement proteins?
C3, which helps us fight infections
Where is IgA (immunoglobulin A) found?
In mucus, tears, milk, saliva, and intestinal secretions
What does C3 break down into?
C3a and C3b, after binding to the complement-binding site
Function of C3a?
Binds to basophils and causes them to degranulate, secreting histamine and heparin for vasodilation and increasing capillary permeability, causing edema/inflammation
Function of C3b?
Binds antibodies with antigens, forming a complex so a macrophage can phagocytize an entire group of antigens at once
What is the membrane attack complex?
AKA MAC, the way that C3b works also forms a hole in the wall of the bacteria so fluid can rush in and cause it to burst and die
What are interferons?
Secreted by virally infected cells, they act as a distress signal to attract NK cells and macrophages to kill the infected cells before it can spawn more
What are perforins?
Released by NK cells, they form a hole in target cells’ membranes
Difference between perforins and C3b/complement proteins/MACs?
Perforin holes are from protein and made by perforins, MACs are made by C3b by complement proteins
What are granzymes?
They enter perforin holes and degrade enemy cell enzymes in order to make the enemy cell dia via apoptosis (suicide). A macrophage engulfs what’s left
Components of innate immunity?
Complement proteins, interferons, perforins, granzymes, and NK cells
Components of adaptive immunity?
T and B cells
What is a fever?
Caused by exogenous pyrogens, such as bacteria and viruses. Raises interferon activity, elevates metabolic rate and tissue repair, and can cause protein degradation
Where does inflammation occur?
In the interstitial space, caused by excess plasma fluid from vasodilation and increased capillary permeability in an injured site in order to bring more WBCs
What is margination?
A behavior of neutrophils in inflammation, when WBCs stick to the endothelial wall because it becomes sticky, trying to slow down the WBCs to make them stop here
What is diapedesis?
When leukocytes crawl through gaps in endothelial cells and enter tissue fluid, entering the wall of an infected cell
How many steps to inflammation?
- Mobilization of body defenses, containment and destruction of pathogens, and tissue cleanup and repair
4 cardinal signs of inflammation?
Redness (vasodilation), swelling (increased capillary permeability), heat (vasodilation), and pain (bradykinin)
What are the 2 categories of adaptive immunity?
Cell-mediated or cellular, and antibody-mediated or humoral
What is cell-mediated immunity?
T-lymphocytes DIRECTLY attack foreign/diseased host cells. No middleman
Function of cell-mediated immunity?
Rids body of pathogens that reside within human cells, where they are inaccessible to antibodies
What is humoral/antibody-mediated immunity?
When antibodies tag a pathogen for destruction
Function of humoral/antibody-mediated immunity?
Tag a pathogen for destruction. Specifically extracellular stages of infections by microorganisms
Divisions of T cells?
Helper T cells, cytotoxic T cells, and memory T cells
What do helper T cells do?
Replicate cells for immunity
What do cytotoxic T cells do?
Carry out attacks on enemy cells
What do memory T cells do?
Form a memory for cellular immunity
How can you remember what active immunity is?
When the body is actively making specific antibodies to fight pathogens, like B and T cells
What is natural active immunity?
Production of one’s own antibodies or T cells as a result of infection or natural exposure to antigen
What is artificial active immunity?
Production of one’s own antibodies or T cells as a result of vaccination against disease. Such as vaccines
and booster shots
What is natural passive immunity?
Temporary immunity resulting from antibodies produced by another person, like received by a baby during breastfeeding
What is artificial passive immunity?
Temporary immunity resulting from injection of immune serum or antibodies from another person or animal. Treats snake bites, botulism, rabies, tetanus, etc
First step of neutrophils in fighting infections?
Margination, sticking to the vessel wall and slowing down (which is followed by diapedesis, neutrophils entering the cell)
Granzymes and enzymes are what?
Proteins secreted by NK cells that are innate and nonspecific
Are T lymphocytes specific or nonspecific?
Specific
What do B cells differentiate into and why?
Plasma cells, to make antibodies
What organ undergoes involution?
The thymus - and it means shrinking with age
What does the thymus do?
Site of T cells maturing and becoming immunocompetent
What are lacteals?
Capillaries in the small intestine for lipid absorption
What percentage of fluid do lymphatic vessels recover daily?
15%
What do lymphatic vessels drain into?
The subclavian vein
What are pyrogens?
Endogenous or exogenous chemicals that trigger fevers and raise your temperature
Where do you find IgA?
Saliva, milk, tears, mucus, intestinal secretions
What are Peyer patches?
Patches of lymphatic tissue in the small intestine for fighting infections
4 cardinal signs of inflammation and their causes?
Heat - increased blood flow from vasodilation triggered by histamine release
Redness - due to increased blood flow from vasodilation due to histamine
Swelling - excess fluid due to increased capillary permeability from histamine
Pain - from tissue breaking down and bradykinin
What are lymphatic tissues populated by?
Lymphocytes and macrophages
What are antigen-presenting cells?
Cells that bring in an antigen, break it down, and put a tiny piece on the surface, presenting it, so the immune system can develop immunity (via B cells turning into plasma cells and making antibodies to attack them, and memory B cells)
Label the cervical, axillary, thoracic, abdominal, inguinal, and popliteal lymph nodes
Done
What are tonsillar crypts?
Cracks in the tonsils to trap bacteria to be destroyed
3 main sets of tonsils and locations?
Palatine - largest, in back of mouth
Lingual - on root of tongue
Pharyngeal - wall of nasopharynx
What side of the trachea is more vertical?
The right side, the left is more horizontal due to the heart. The right side therefore has aspiration occur more
Functions of respiratory system?
Gas exchange, smell, speech, pH of body fluids, flow of lymph and venous blood, and expelling abdominal contents
How does the respiratory system control pH?
CO2 is acidic, so more CO2 means lower pH
How does the respiratory system control the flow of lymph and venous blood?
The lungs make ACE, which acts as a vasoconstrictor and increases SVR and BP
How does the respiratory system help expel abdominal contents?
Valsalva maneuver - holding your breath and contracting your abdominal muscles expels the contents
What is the upper respiratory tract composed of?
Head and neck, the nose through the larynx
What is the lower respiratory tract composed of?
The organs of the thorax, the trachea through the lungs
What divides the upper and lower respiratory tracts?
The larynx
What is the main cartilage of the larynx?
The thyroid cartilage, which is the Adam’s apple. The largest, with growth stimulated by testosterone
What is the epiglottis?
A cartilage of the larynx, it’s a flap of tissue guarding the opening of the larynx so food and drink don’t enter the airway
What connects the upper and lower respiratory tracts, specifically?
The cricoid cartilage of the larynx
How many lobes in each lung?
Right - 3, superior, middle, inferior
Left - 2, superior and inferior. Because of the heart
What are the cells of the alveolus?
Type 1 and type 2 alveolar cells and alveolar macrophages
What do type 1 alveolar cells do?
AKA squamous alveolar cells, they are the most abundant, where gas exchange occurs
What do type 2 alveolar cells do?
AKA great alveolar cells, they make surfactant which breaks down surface tension and increases compliance
What do alveolar macrophages do?
Keep the alveoli free from debris by phagocytizing dust particles
What is Boyle’s law?
Volume is inversely related to pressure
How do you inhale?
The diaphragm contracts, increasing thoracic volume, causing pressure in the lungs to decrease below atmospheric pressure, and air flows in down the gradient
How do you exhale?
The diaphragm relaxes, decreasing thoracic volume, causing pressure in the lungs to increase above atmospheric pressure, and air flows out down the gradient
What is hypoventilation?
AKA hypercapnia, not ventilating well, having a hard time removing CO2, so CO2 levels go up and pH level goes down
What is hyperventilation?
AKA hypocapnia, ventilating excessively, removing CO2 too quickly, so CO2 levels drop low and pH levels go up
Muscles of normal inspiration?
Diaphragm and external intercostals
Muscles of forced inspiration?
Sternocleidomastoid, scalenes, pectoralis major, trapezius
Muscles of normal expiration?
Usually none, technically the internal intercostals
Muscles of forced expiration?
Abdominal and oblique muscles.
Specifically abdominis rectus, external abdominal oblique, diaphragm, internal intercostals
What is emphysema?
Alveolar walls break down, forming a lesser number of larger alveoli, which decreases the elasticity of the lungs
Effects of emphysema?
Decreased elasticity, blood becomes acidic, and can cause heart attack
What is residual volume?
Amount of air remaining in the lungs after forceful exhalation.
The difference between residual volume and functional residual capacity
What is the formula for respiratory minute volume?
Rate (breaths/minute) x tidal volume (mL)
What is the formula for vital capacity?
Expiratory reserve volume + inspiratory reserve volume + tidal volume
What is the formula for total lung capacity?
Vital capacity + residual volume
What is tidal volume?
Amount of air inhaled and exhaled in one cycle
What is inspiratory reserve volume?
Amount inhaled with force, after a normal breath
What is expiratory reserve volume?
Amount exhaled with force, after a normal breath
What is vital capacity?
Maximum ability to ventilate the lungs in one breath
What is residual volume?
Amount of air left in the lungs after maximum voluntary expiration
What is total lung capacity?
Maximum air in the lungs after full force of inspiration
What do CO2 and H2O make?
Carbonic acid, which then becomes HCO3, or bicarbonate
What is deoxyhemoglobin?
Idk it has a hydrogen ion attached tho
What is an oxyhemoglobin?
Without hydrogen ion
What is carbonic anhydrase?
AKA CAH, hydrogen ion is released from hemoglobin, upon hemoglobin picking up oxygen, carbonic acid is formed, and CAH turns it into water and CO2
What does oxygen mostly bind to?
Hemoglobin
What does carbon dioxide mostly bind to?
Bicarbonate
What receives auditory tubes?
The nasopharynx
What is a carina?
The fork of the trachea into right and left main bronchi
Organs of the urinary system?
2 kidneys, 2 ureters, urinary bladder, and urethra
What muscle is the bladder made out of?
Smooth muscle, (detrusor muscle) with transitional cells
Parts of the kidney?
Cortex, medulla, renal pyramids, minor calyces, major calyces, the renal pelvis, ureter, bladder, and urethra
What does retroperitoneal mean?
Located in the back of the peritoneum
What layer directly encloses the kidney?
The fibrous capsule. It prevents trauma and infection
What is the outer part of the kidney?
The cortex
What is the inner part of the kidney?
The medulla. Be careful with labelling, as the cortex dips into the medulla!
What is inside renal pyramids?
Nephrons
What makes urine in the bladder?
Renal pyramids (specifically, nephrons inside them)
What do renal pyramids branch into?
Minor calyx
What do minor calyces branch into?
Major calyx
What do major calyces branch into?
Renal pelvis
What does the renal pelvis branch into?
The ureter
What does the ureter lead into?
Bladder
What does the bladder lead into?
The urethra
What does the urethra lead into?
The external environment
Path of renal circulation?
Blood -> aorta -> renal artery -> smaller arteries -> afferent arteriole -> glomerulus (a capillary!) -> efferent arteriole -> peritubular capillaries OR vasa recta -> veins -> renal vein
What is the glomerulus?
A capillary!
What is the portal system of the kidneys?
The glomerulus and peritubular capillaries and vasa recta
What capillaries surround the glomerulus?
The peritubular capillaries
What capillaries surround the loop of Henle?
The vasa recta
What arterioles are thicker?
Afferent, because they have more blood in them
What are nephrons deep in the medulla?
Juxtamedullary nephrons
What are nephrons closer to the cortex?
Cortical nephrons
How is glomerular filtration rate regulated?
Renal autoregulation, sympathetic control, hormonal control
Where does the majority of reabsorption in the urinary system occur?
The proximal convoluted tubule
Nephrons are composed of what 2 major parts?
Renal corpuscles and renal tubules
What are renal corpuscles?
The glomerulus and glomerular capsule (or Bowman’s capsule)
What is the function of the renal corpuscle?
Filtering blood plasma
Anatomy of the renal corpuscle?
The visceral and parietal layers of the Bowman’s capsule cover the glomerulus
Function of the renal tubule?
Converts filtrate into urine
How is GFR control achieved?
Renal autoregulation, sympathetic control, and hormonal control
What are the mechanisms of renal autoregulation?
Myogenic mechanism and juxtaglomerular apparatus
What is the myogenic mechanism?
Smooth muscle contracts when stretched, so when BP increases, the afferent arteriole stretches and constricts, if BP decreases, the afferent arteriole relaxes and dilates
What is the juxtaglomerular apparatus?
Filtrate comes through tubule, NaCl levels are high, tubule makes ATP, gets converted to adenosine, causes afferent arteriole to constrict, lowers GFR
What is glomerular filtration rate?
Amount of filtrate formed per minute by the 2 kidneys combined. About 90-120 mL/min
What effect does the sympathetic nervous system have on GFR?
It constricts the afferent arteriole, reducing urine output
What effect does the parasympathetic nervous system have on GFR?
Increases rate of urine production
What hormones impact GFR?
ADH, aldosterone, renin, and ANP
How does ANP affect GFR?
Secreted by heart when BP is high, dilates afferent arteriole and constricts efferent arteriole, raising GFR
What is the renin-angiotensin-aldosterone mechanism?
A hormonal control over GFR, the liver makes angiotensinogen, renin turns it into angiotensin I, ACE turns it into angiotensin II, causing thirst, vasoconstriction, and release of aldosterone, all elevating blood pressure
Components of the renal tubule?
PCT, loop of Henle, DCT, and collecting duct
What happens in the PCT?
Reabsorption
What happens in the loop of Henle?
Establishes salinity gradient
What is noticeable about the thin segment of the loop of Henle?
It’s permeable to water and composed of simple squamous epithelium
What happens in the DCT?
Secretion, especially hydrogen ions
What happens in the collecting duct?
ADH makes the collecting duct more permeable to water by making aquaporin channels. Water in the tubular fluid reenters tissue fluid and the bloodstream rather than being lost in the urine, decreasing urine volume
What are ureters?
A tube from the kidney to the bladder. It passes posterior to the bladder and enters it from below
What muscle makes up the bladder?
Detrusor muscle
What is the act of urinating called?
Micturition
Flow of fluid from glomerular filtrate’s formation to exiting body?
Glomerular capsule -> proximal convoluted tubule -> nephron loop -> distal convoluted tubule -> collecting duct -> papillary duct -> minor calyx -> major calyx -> renal pelvis -> ureter -> urinary bladder -> urethra
What chemical is responsible for the yellow pigment of urine?
Urochrome
Composition of urine?
95% water and 5% solutes
What is normal to find in urine?
Urea, NaCl, KCl, creatinine, uric acid, phosphates, sulfates, some calcium, magnesium, bicarbonate, urochrome, and some bilirubin
What is NOT normal to find in urine?
Glucose, free hemoglobin, albumin, ketones, bile pigments
What is the main nitrogenous waste that gets filtered out?
Urea
Components of the urinary system?
2 kidneys, 2 ureters, bladder, and urethra
What does aldosterone do?
Targets the DCT for salt retention and therefore fluid retention
What hormone acts on the collecting duct?
ADH
Difference between diabetes insipidus and mellitus?
Mellitus - no insulin
Insipidus - can’t conserve water
What does surfactant do?
Reduce surface tension, making it easier to breathe
What is respiratory distress syndrome?
Babies born prematurely have decreased compliance due to low surfactant
What is emphysema?
Surfactant deficiency
What is the volume for normal inhaling and exhaling?
Tidal volume
What are the major cartilages?
Epiglottis, cricoid, and thyroid
What are the tracheal rings around bronchioles?
They are C-rings, which keep the airways open and from collapsing
Water and CO2 and carbonic anhydrase
Yeah idk
How much oxygen can 1 hemoglobin hold?
4 oxygen molecules
What is the volume after a deep inhalation and forceful expiration?
Vital capacity
What is a respiratory burst?
Neutrophils secrete hydrogen peroxide to kill bacteria
