Exam III Flashcards
An increase in which of the following factors will result in a decrease in glomuruler hydrostatic pressure?
a) arterial pressure
b) afferent arteriolar resistance
c) efferent arteriolar resistance
d) both b and c
e) all of the above
b
Almost 90% of glucose reabsorption occurs in the early proximal tubule. Which of the following mechanisms is responsible for moving glucose from the tubular lumen into the cytoplasmic compartment?
a) primary active transport via glucose ATPase pump
b) secondary active transport via sodium/glucose cotransporter
c) secondary active transport via sodium/glucose antiporter
d) diffusion due to conc. differences between tubular fluid and cytoplasm
b
Which of the following, in liters/day, represents the GFR in the average adult?
a) 3
b) 125
c) 180
d) 360
c
Most K+ reabsorption occurs at which of the following sites?
a) ascending LoH
b) distal convoluted tubule
c) proximal convoluted tubule
d) collecting duct
c
Which of the following cells play a maj role in the secretion of K+?
a) intercalated cells
b) principal cells
c) chief cells
d) podocytes
b
Which of the following plays a major role in stimulating K+ excretion by the kidney tubules?
a) aldosterone
b) angiotensin II
c) Na+
d) PTH
a
Approximately how much of the body’s supply of Ca+2 is stored in the bone?
a) 1%
b) 47%
c) 78%
d) 99%
d
How much filtered calcium is stored in the kidneys?
1%
Which of the following cells reabsorb potassium during potassium depletion?
a) intercalated cells
b) principal cells
c) chief cells
d) podocytes
a
A high potassium intake would have which of the following effects on potassium excretion associated with increased renal tubular flow rate?
a) potassium excretion would increase with increased tubular flow
b) potassium excretion would decrease with increased tubular flow
c) there would be little effect
d) tubular flow rate would be decreased
a
Which of the following describes a valid change in K+ distribution due to an acid-base abnormality?
a) metabolic acidosis decreases extracellular K+ conc
b) metabolic alkalosis increase extracellular K+ conc
c) metabolic acidosis increase extracellular K+ conc
d) both A and B are valid
c
Which of the following buffer systems is most important in buffering renal tubular fluid?
a) phosphate buffer system
b) carbonate buffer system
c) bicarbonate buffer system
d) hemoglobin buffer system
a
Compounds that dissociate incompletely into hydrogen ions and a conjugate base are members of which of the following compounds?
a) strong acid
b) weak acids
c) strong bases
d) weak bases
b
The bicarbonate buffer system consists of a bicarbonate salt and which of the following?
a) weak acid
b) strong acid
c) weak base
d) strong base
a
Primary active hydrogen secretion involves a hydrogen-transporting ATPase. It occurs in which of the following parts of the renal tubules?
a) descending limb
b) ascending limb
c) late distal tubules in intercalated cells
d) early collecting tubules in principal cells
c
Most bicarbonate reabsorption occurs in which of the following parts of the renal tubule?
a) proximal tubule
b) descending limb
c) ascending limb
d) distal tubule
a
Which of the following occurs when a decrease in bicarbonate ion results in a decrease in the ratio of bicarbonate ion to CO2 in the extracellular fluid?
a) respiratory acidosis
b) respiratory alkalosis
c) metabolic acidosis
d) metabolic alkalosis
c
Respiratory alkalosis to a decrease in CO2 conc caused by hyperventilation is compensated for by which of the following mechanisms?
a) increased ventilation rate
b) decreased ventilation rate
c) renal excretion of bicarbonate ion
d) renal addition of new bicarbonate ion to extracellular fluid
c
Respiratory epithelium of the nasal cavity
pseudostratified ciliated coliumnar with goblet cells
Structure in nasal cavity
conchae
structure in nasopharynx
uvula
structure in larynx
glottis
Histology of trachea
- pseudostratified ciliated columnar epithelium
- incomplete cartilaginous rings
- trachaelis muscle
What is the carina?
- inside trachea at point of branching primary bronchi
- produces cough reflex
What are the inspiratory muscles?
- respiratory diaphragm
- external intercostal muscles
- sternomastoids
- serratus anterior
- scalene
What are the expiratory muscles?
- abdominal muscles
- internal intercostals
What is the total lung capacity?
-the max volume of gas the lungs can hold
+composed of compartments called lung volumes
What is the tidal volume?
-volume of air that is inspired or expired with each breath at rest
+500mL
What is the inspiratory reserve volume?
-volume of air that can be inspired in addition to tidal volume with forceful inspiration
+300mL(for average young adult male, reduce by 20-25% for females)
What is the expiratory reserve volume?
-additional volume of air that can be expired at end of tidal volume by forceful expiration
+1100mL
What is the residual volume?
-volume of air remaining in lungs after forceful expiration
+1200mL
What is the vital capacity?
-the sum of all the volumes that can be inspired or exhaled
-inspiration to the maximum extent plus expiration to maximum extent
+4600mL
What is the total lung capacity?
-the sum of all the volumes = vital capacity plus residual volume
+5800mL
What is the inspiratory capacity?
-the sum of volumes above resting capacity = tidal volume plus inspiratory reserve volume
+3500mL
What is the functional capacity?
-the sum of volumes below resting capacity = expiratory reserve volume + residual volume
+2300mL
What is minute ventilation?
-total volume of gases moved into or out of the lungs per minute
-calculated as:
=(breaths per minute)(tidal volume)
What is alveolar ventilation?
-total volume of gases that enter spaces participating in gas exchange per minute
-calculated as:
=(breaths per minute)(tidal volume-dead space)
What is the difference between anatomical and physiological dead space?
anatomic:
-trachea, bronchi, bronchioles (.15L)
physiological:
-anatomic dead space + ventilated alveoli with poor or absent perfusion (.35L)
How does one calculate dead space?
Vd=Vtot(PaCO2-PeCO2)/PaCO2
\+PaCO2 = amount of CO2 in arterial blood \+PeCO2 = amount of CO2 in expired ait
What is transpulmonary pressure?
-pressures resulting in the movement in and out of the lungs
pleural pressure)-(alveolar pressure
What is pleural pressure?
- pressure of fluid in the space between the visceral and parietal pleura
- measured in cm
- during inspiration: -5 to -7.5cm H2O
- during expiration: -7.5 to -5cm H2O
What is alveolar pressure?
- pressure of air inside the alveoli
- measured in cm H2O
- during inspiration: 0 to -1cm H2O
- during expiration: 0 to +1cm H2O
What is the definition of compliance for the lungs?
-the extent (volume) to which lungs will expand for each unit increase in the transpulmonary pressure
-expansibility of the lungs and trachea
+normal: 200mL
How do you calculate compliance?
-(increase in volume)/(increase in pressure)
+distensibility volume
+distensibilityVorig
Compliance vs elastance
- compliance is measure of the ease with which a hollow viscous may be distended, reciprocal of elastance
- elastance is a measure of the tendency of a hollow viscus to recoil toward its original dimensions upon removal of a distending or collapsing force
What are the components of surfactant?
- dipalmitoylphosphatidylcholine
- surfactant apoproteins
- calcium ions
What produces surfactant?
type II alveolar cells
What is the purpose of surfactant?
-prevents surface tension to collapse alveoli
+with surfactant 4cm of water pressure
+no surfactant 18cm of water pressure
What are the two lung circulations?
-high pressure, low flow
+thoracic aorta -> bronchial arteries -> trachea, bronchial tree, adventitia, CT
-low pressure, high flow
+pulmonary artery and branches -> alveoli (higher compliance)
Pressures in lungs
- pulmonary artery systolic (24-25)
- pulmonary artery diastolic(8-9)
- mean pulmonary arterial(15)
- mean pulmonary capillary(7)
What are the factors that determine how rapidly a gas will pass through a repiratory membrane?
- membrane thickness
- membrane SA
- diffusion coefficient of gas in the substance of the mambrane
- partial pressure difference of gas between the two sides of the membrane
What does Va/Q refer to?
- ventilation-perfusion ratio
- alveolar ventilation/blood flow
What are normal Va/Q values?
Va/Q = 0.8
pulmonary= 5L/min
ventilation= 4L/min
What happens when Va/Q is 0?
-Va is 0, but there is still perfusion
+due to airway constriction
+blood/gas composition remains unchanged
What happens when Q=0?
- Va/Q is equal to infinity
- there is still ventilation, but no gas exchange due to vascular obstruction
- alveolar gas composition remains unchanged because there is no blood contact -> physiologic shunt
- partial pressure of CO2 is 0mm Hg and O2 must compensate
What is a physiological shunt?
- when Va/Q falls below a normal value, a fraction of the venous blood passing through the pulmonary capillaries does not become oxygenated
- shunted through alveolar capillaries
What is physiologic dead space?
-the sum of alveoli that have large amounts of available oxygen due to poor blood flow + the sum of the anatomic dead space
The thin LoH is highly permeable to which of the following?
a) sodium
b) water
c) urea
d) aa
b
Aldosterone is an important regulator of sodium reabsorption and potassium secretion, one of its main targets is…?
a) podocytes
b) principal cells
c) intercalated cells
d) cells of the macula densa
b
The macula densa is found in which of the following parts of the renal tubule?
a) proximal tubule
b) thin descending LoH
c) thick ascending LoH
d) distal tubule
d
Increased levels of angiotension II results in what?
increased vasoconstriction
What is normal PO2 in the alveoli and PO2 in the venous blood? Pressure difference that causes oxygen to diffuse into the pulmonary capillary?
PO2= 104 (close to alveolar air) PO2= 40 -difference= 64 mm Hg
What compensates to result in increased amount of O2 uptake during exercise?
- increased SA of capillaries participating in diffusion
- nearly ideal Va/Q ratio in the upper parts of the lungs
What is the required PO2 for normal cellular respiration?
1-3 mm Hg
What are he factors that determine tissue PO2?
- rate of oxygen transport to tissues
- rate of oxygen consumption by the tissues
What is normal intracellular PCO2 vs interstitial PCO2?
intra: 46 mm Hg
inter: 45 mm Hg
- arterial blood: 40 mm Hg
- venous blood: 45 mm Hg
PO2 in arterioles vs PO2 in venous end capillary?
arteriole: 95 mm Hg
venous: 40 mm Hg
What percentage of blood gives up its oxygen? During strenuous exercise?
normal: 25%
exercise: 75-85%
In order to release 5mL of oxygen/dL of blood, PO2 must fall above ______ mm Hg. _________ PO2 cannot rise above this level.
- 40
- tissue
When PO2 is _________, oxygen binds with __________. When hemoglobin is _______ oxygen is released from _________.
- high, hemoglobin
- low, hemoglobin
What is the Bohr effect?
-increase in blood CO2 conc and H+ ions
+shifts O2-hemoglobin curve to right
+enhances release of O2 from blood to tissues
+enhances oxygenation of blood in lungs
-decrease in blood CO2 and H+ ions:
+shifts O2-hemoglobin curve to left
+occurs in lungs
Relationship between ADP and PO2 of oxygen.
-as ADP levels increase, the PO2 will increase (but plateau)
What is 70% of carbon dioxide transported as?
carbonic acid, remainder is transported as carbamino hemoglobin
- requires carbonic anhydrase
- also employs a bicarbonate/chloride transporter
Bohr vs Haldane effect
Bohr: increase in blood CO2 causes O2 to be displaced from hemoglobin
Haldane: binding of O2 with hemoglobin displaces CO2 from blood
+binding of O2 causes hemoglobin to be a stronger acid
+more acidic hemoglobin has less of a tendency to bind with CO2
+causes it to release H+
Why is CO so dangerous?
-it displaces O2 on the hemoglobin because it has greater affintiy
Why would blood be bright red with CO poisoning?
-oxygen content of blood is greatly reduced, but PO2 blood is normal
Acidosis occurs when the ratio of bicarbonate ion to CO2 in the extracellular fluid decrease. When this change is due to a decrease in bicarbonate ion, it is called respiratory acidosis. (T or F)
false, metabolic acidosis
The volume in which the lungs and thorax increase for each unit of pressure change in the transpulmonary pressure is referred to as:
a) tidal volume
b) inspiratory volume
c) compliance
d) transpulmonary volume
e) elasticity
c
During heavy exercise blood flow through the lungs increases four to seven times that at rest. This is due to which of the following?
a) increase in the number of open caPILLARIES
b) distension of capillaries and a doubling in flow rate
c) increase in pulmonary arterial pressure
d) all of the above
e) a and b only
d
The Va/Q ratio is 0 under which of the following conditions?
a) Va = infinity, but Q = 1
b) Va = infinity, but Q =0
c) Va = 0, but perfusion greater than 0
d) Va greater than 0, but Q = 0
c
According to the oxygen-hemoglobin dissociation curve, an increase in blood partial oxygen pressure will have which of the following effects?
a) a decrease in bound oxygen
b) an increase in bound oxygen
c) no change in bound oxygen
d) no correlation between the two variables
b
Reduction of blood flow to a portion of the lung has which of the following effects?
a) alveolar pCO2 is lowered, resulting in a constriction of the bronchi supplying the portion of the lung
b) alveolar pCo2 is elevated, resulting in a constriction of the bronchi supplying the lung
c) alveolar pCo2 is lowered, resulting in dilation of the bronchi
d) alveolar pCO2 is elevated, resulting in a constriction of the bronchi
a
One gram of hemoglobin can bind how much oxygen?
a) 19.4 mL
b) 15.4 mL
c) 3.25 mL
d) 1.34 mL
d