Final Flashcards
Pathway of blood through the heart
Deoxygenated blood -> superior vena cava/ inferior vena cava -> right atrium -> tricuspid valve -> right ventricle -> pulmonary valve -> pulmonary artery -> lungs to collect O2/ dump CO2 -> pulmonary veins -> left atrium -> bicuspid valve -> left ventricle -> aortic valve -> aorta -> body
Role of pons in respiratory
Coordinates actions of medulla for a smooth breathing center that has stimulating neurons and inhibitory neurons to start/ block actions to increase/decrease the rate and depth of inspiration based on chemical/pressure levels
Homeostatic balance of rate and depth of respirations
Broca’s area
Motor/ expressive speech area that controls the output of words (verbal/written) to ensure they are coordinated/ appropriate
Base of the frontal lobe
Left ventricular failure
Most commonly damaged during an MI
Happens when the left side of the heart can’t pump blood from the pulmonary vessels so blood backs up behind the left side causing increased pressure in the left atrium and pulmonary veins and serum to be forced from pulmonary capillaries and into alveoli.
Endocrine glands
Secrete or release chemicals/hormones that are used in the body directly into the blood stream to be carried to target tissues
The hormones are messengers that are responsible for telling one part of the body to start/stop doing something and coordinates bodily functions like regulation of mood, growth and development, metabolism, tissue function, sexual development and function.
Examples: pineal gland, ovaries/testes, pituitary gland, hypothalamus
Exocrine glands
Secretes hormones/products into ducts to the surface of the skin or body cavity to excrete chemicals for elimination
Examples: sweat glands, salivary glands, liver
Wernicke’s area
Integration center that comprehends language receive (written/spoken) with connective fibers to visual/ auditory areas
Located in the posterior temporal lobe
Role of medulla in respiratory
Controls rhythmic nature of breathing
Inspiratory center is the pacemaker of the respiratory control center that depolarizes and send impulses via phrenic nerve in diaphragm and intercostal nerves to the intercostal muscles
Expiratory center is when deeper expiration is needed that is not involved during normal breathing and impulses are sent to intercostals and abdominal muscles to aid in the expiration
Right side heart failure
A result of left sided heart failure where when blood is pumped back into the lungs the right side must work harder to pump blood back into the pulmonary arteries and eventually the right side cannot keep up and fails
Role of cerebral cortex in respiratory
Impulses from motor area of the brain to respiratory center can increase/decrease respirations voluntarily but eventually the automaticity of the system will take over when CO2 levels rise in the blood and involuntary breathing is resumed
Diencephalon
Contains thalamus/ hypothalamus
Thalamus- nerve bodies serve to sort/relay incoming sensory impulses
Hypothalamus- maintains homeostasis- regulates temp, intake of food/fluids, regulates sleep cycle, regulates libido
Mixed glands
Both endocrine and exocrine functions
Ex. Pancreas insulin production (endocrine) and digestive enzymes (exocrine)
Double gland
Glands that secrete different and two different functions
Growth hormone
Regulates metabolic process related to growth/adaption to physical/ emotional stressors
Aplastic anemia
Failure of bone marrow to function causing a loss of stem cells and a decreased number of RBCs, leukocytes, and platelets
PO2
The amount of blood diffused into the blood each minute
Depends on the alveolar pressure gradient, functional surface area of the resp. membrane, the respiratory minute volume, and alveolar ventilation
Brainstem
Pons: contains afferent (incoming) and efferent (outgoing) fibers
Medulla: vital control to regulate respiratory and cardiovascular function
RAS (reticular activating system): determines degree, arousal, awareness of cerebral cortex (decides what sensory impulses brain ignores/notices)
Sickel cell anemia
Altered hemoglobin changes to a sickle cell shape and crystalizes, changing the life span to 20 days from 120. The altered shape causes less oxygen to be carried and a risk of thrombi and necrosis
How BP is controlled
An increase causes stimulation of aortic/carotid baroreceptors stimulates cardiac control center to lower HR and more impulses per second go from parasympathetic fibers to slow HR and dilate blood reservoirs
A decrease causes baroreceptors to stimulate causing cardiac control center to increase HR and send more impulses to medulla to stimulate vasoconstriction raising Bp to normal
Cerebellum
Coordinates movement, maintain posture and equilibrium from taking impulses from visual pathways, vestibular pathways, and proprioceptors in joints and muscles
Frontal lobe functions
Conscious thought and voluntary motor action
How PCO2 changes affect resp system
Medulla has sensors in the nervous system to detect changes in PO2, PCO2, and pH
PCO2 acts on chemoreceptors that are sensitive to CO2 changes in arterial blood and when stimulated from increased PCO2 results in faster breathing and greater volumes of air moving in and out of the lungs. When stimulated for decreased PCO2 it results in inhibition of medulla rhythmicity and slows respirations
Thyroid-stimulating hormone (TSH)
Increases production/ secretion of thyroid hormone
Hemolytic anemia
Premature destruction of RBCs that is inherited of acquired. May not appear as anemia if bone marrow can produce enough RBCs
Adrenocorticotropic hormone (ACTH)
Stimulate adrenal gland to secrete cortisol and adrenal proteins that contribute to the maintenance of adrenal gland
Polycythemia
Primary: increased production of RBCs in bone marrow for no reason
Secondary: increased RBC secondary to hypoxia (needs more RBCs for o2 carrying capacity)
Temporal lobe function
Hearing
P wave
precedes QRS, less than 110ms, amplitude <2.5mm
Luteinizing hormone (LH)
In women ovulation and progesterone production
In men regulates spermatogenesis and testosterone production
PR interval
normally between 0.12 seconds and 0.20 seconds, shorter= wolff, longer= 1st degree block
QRS complex
less than 0.12 sec
TP segment
isoelectric line (baseline) that is flat, straight, horizontal that begins at T and ends at P
J point-
QRS ends, and ST segment begins
ST segment
line between QRS and t wave
T wave
asymmetric, less than half the height of QRS and in the same direction, faster downstroke than upstroke
QT interval
0.36s- 0.44s
Parietal lobe function
Body awareness
Follicle-stimulating hormone (FSH)
In women: follicle maturation and estrogen production
In men: spermatogenesis
Baroreceptors
Sense pressure changes
Aortic and carotid receptors and aortic and carotid bodies
Occipital lobe function
Vision
Prolactin
Milk production
First cranial nerve
Olfactory- sensory, smell
Chemoreceptors
Impulses sent via receptors to medulla when excess CO2 or low O2 levels are in the blood
Third cranial nerve
Oculomotor- motor, eye movements including eyelids
Second cranial nerve
Optic- sensory, vision
Fourth cranial nerve
Trochlear- motor, eye movements
Eighth cranial nerve
Vestibulocochlear- sensory, hearing and balance
Fifth cranial nerve
Trigeminal- sensory/motor, general sensory- eye, nose, face or oral cavity, teeth, speech muscles
Sixth cranial nerve
Abducens- motor, eye movement
Seventh cranial nerve
Facial- sensory/motor, taste, muscles of facial expression, scalp muscles
Ninth cranial nerve
Glossopharyngeal- sensory/motor, taste, gag reflux
Tenth cranial nerve
Vagus- sensory/motor, external ear, parts of taste, heart and lung smooth muscle, glands of GI system, diaphragm
Twelfth cranial nerve
Hypoglossal- motor, muscles of the tongue
Eleventh cranial nerve
Spinal accessory- motor, voluntary muscle of pharynx, head movements
Antidiuretic hormone (ADH)
Controls plasma osmolality and increases permeability of distal renal tubules and collecting ducts leading to an increased water reabsorption
Conduction system- SA node
SA node- 60-100
Atrial cells- 55-60
SA node activity and atrial activation begin
Inter cranial pressure (ICP)
5-15 mmHg
Type 1 diabetes
Insulin dependent with a juvenile onset that’s more severe. Results from destruction of the pancreatic beta cells in an autoimmune reaction resulting in an absolute insulin deficit requiring replacement therapy.
Oxytocin
Contracts the uterus during childbirth and stimulates milk production
Conduction system- AV node
40-60
Stimulus reaches the AV node and delays for 100msec, and atrial contraction begins (atrial depolarization)
Cerebral perfusion pressure (CPP)
70-80 mmHg with no less of 60mmHg
Conduction system- bundle of his and bundle branches
His- 40-45
Bundle branch- 40-45
Impulse travels down bundle of his and branches to the Purkinje fibers
Mean arterial pressure (MAP)
70-100 mmHg, <60mmHg can be deadly to organs
Type 2 diabetes
Non-insulin dependent diabetes with a mature onset that is based on decreased effectiveness of insulin from decreased beta cell production, increased resistance to insulin and increased production of glucose by the liver
Can be managed by a diet and exercise
Types of seizures
Generalized- no definable origin where the entire brain is involved
Partial- known focus
Hypoglycemia
Excess insulin that causes a deficit of glucose in the blood usually after vomiting, exercise, skipping a meal after insulin, or medication dosing errors
Lack of gluxose affects nervous system as it requires glucose to function
S&S: signs related to impaired nervous function, signs related to stimulation of nervous system , LOC, seizures, possibly death
Conduction system- Purkinje fibers
20-40
Impulse is distributed/ relayed through ventricular myocardium completing atrial contraction and starting ventricular contraction
Stroke volume
the volume of blood pumped out of the left ventricle of the heart during each systolic cardiac contraction.
Petit mal
Generalized
Absence seizures around kids 4-12 with a lapse of consciousness, no loss of posture or motor activity, isolated clonic activity for a short period then return to normal.
DKA
Insufficient insulin resulting in high BS that occurs over several days that could be from infection, stress, overindulgence of food/alcohol, or medication errors
S&S: dehydration, low BP, deep/rapid respirations, acetone breath, decreased LOC, imbalances of sodium/potassium/chloride
Insulin
From beta cells to uptake glucose and allows for storage of glycogen, fats, and proteins and removal of glucose from blood for storage, secreted when blood glucose levels are elevated
Decreases blood sugar levels
Grand mal
Preceded by an aura with a sudden onset with loss of organized muscle tone
Tonic phase: extensor muscle tone, apnea, tongue biting, incontinence, short duration
Clonic phase: rigidity, convulsions, ANS discharge, hyperventilation, salivation, tachycardia, 1-3 min
Postictal phase: drowsiness, unconsciousness, min to hours, confusion, fatigue, transient neurological deficits
Status epilepticus: prolonged seizure activity that is reoccurring seizures before regained consciousness
Simple partial seizures
Motor seizures clonic activity to one specific body part and sensory seizures are tingling, numbness, visual, auditory, and taste symptoms
Jacksonian seizure: seizure activity involving a brief alteration in movement, sensation or nerve function
Nitroglycerine
A vasodilator that works by relaxing the blood vessels to increase the blood supply and oxygen to the heart while reducing the workload (BP also)
ASA
A platelet aggregating inhibitor (anticlotting) that interferes with the production of clotting factor
Complex partial seizure
Arise from focal seizures in the temporal lobe (psychomotor) that manifest as changes in behavior and present as abnormal repetitive motor behavior and a period of amnesia with a brief duration
Glucagon
Produced by alpha cells when body’s blood glucose levels fall to stimulate the liver to change glycogen into sugar
Glycogenesis- conversion of glycogen into glucose from stores in the liver
Glucogenesis- conversion of nutrients into glucose from use of fat and amino acids for energy production
Release causes higher blood sugar level
COPD
Progressive tissue degeneration and obstruction of the airways causing irreversible damage to the lungs, and debilitating conditions like asthma, emphysema, and bronchitis
Asthma
Periodic episodes of severe bronchial obstruction that can be acute or chronic and triggered by an inhaled antigen (extrinsic) or respiratory infections, exposure to cold, exercise, drugs, and stress (intrinsic)
Somatostatin
Produced in delta cells of pancreas, nervous system and GI tract to inhibit the release of other hormones including insulin and glucagon
Release causes higher blood sugar levels
Emphysema
Destruction of alveolar walls leading to large permanently inflated alveolar spaces that is contributed by factors like genetic deficiency or smoking
Syncope
Fainting spell positional with lightheadedness with a sudden onset and short duration
Bradycardia with vagal stimulation
CVA
Sudden alteration in LOC, sensation, and voluntary movement due to an obstruction or rupture of an artery in the brain causing temporary or permanent effects
Hyperosmolar hyperglycemic nonketotic coma (HHNC)
Metabolic derangement in patients with type two diabetes characterized by hyperglycemia, hyperosmolarity, absence of ketosis, and glucosuria
Most common cause is infection (pneumonia/UTI) due to a stress response that increases cortisol, epi, norepi (elevated glucose)
Treatment: airway management is top priority
Neuropathy
Common with diabetics causing impaired sensation, numbness, tingling, weakness, and muscle wasting, and nerve degeneration like bladder incontinence, impotence, diarrhea
Chronic bronchitis
Significant changes to bronchi from constant irritation, smoking, or exposure to pollutants with irreversible effects resulting in inflammation and obstruction to bronchi, repeated infections, and chronic coughing
TIA
Focal cerebral dysfunction that is a temporary reduction in blood flow casing no permanent damage and the patient returns to normal within minutes to hours
S&S: weakness, paralysis, face numbness, and speech disturbances
Graves disease
Hyperthyroidism
Immune system attacks the thyroid gland and thyroid reacts by producing/secreting thyroid hormone causing an increase in HR, sweating, nervousness, and weight loss
Bronchodilators
Beta 2 agonist that works on the cells in the lungs and stimulates beta cells to relax smooth muscles in the air ways to treat bronchoconstriction for asthma, COPD, and emphysema
Most common is Ventolin
Ischemic strokes
Occlusions of an artery from plaque buildup or an embolus causing sudden obstruction
S&s: hemiparesis/hemiplegia, contralateral numbness/ facial drooping, aphasia, confusion/coma, convulsions, incontinence, diplopia, dysarthria, headache, dizziness
Croup (Layngotracheobronchitis)
Viral infection common between children ages 1-2 that begins as an upper resp condition with nasal congestion and cough. The larynx and subglottic area become inflamed with swelling and exudate causing a braking cough, hoarse voice, and stridor
Treat with cool, moist air
Hypothyroidism
Caused from inflammation of thyroid glands resulting in altered levels of thyroid hormones produced or autoimmune destruction of thyroid, or goiters/ cancer
Mild can be treated with thyroid hormone replacement
S&S: fatigue, weakness, difficulty gaining/ losing weight, dry hair, dry skin, cold intolerance, cramps, constipation, depression
Cushing’s syndrome
Excessive amount of corticosteroids released (cortisol, hydrocortisone) causing round/puffy faces, heavy trunk, fat at the back of the neck, wasting of muscles of the limbs
Hemorrhagic stroke
Hemorrhage in cranial vault from aneurysms, malformations, hypertension, stress/ exertion, cocaine with a sudden onset accompanied by headache, nausea, vomiting, quick deterioration
Long-acting bronchodilators
Has long-acting beta 2 agonist and some steroids either in them or used in conjunction to provide control not relief
Most common puffers are Advair and Symbicort
Addisons disease
Deficit of adrenocortical steroid secretions causing effects like decreased BS levels, poor stress response, fatigue, weight loss, frequent infections, decreased blood volumes/hypotension, hyperkalemia
Primary head injury
Initial damage from direct injuries that’s a result of a force applied to the head causing tissue and nerve damage
Anticholinergics
Blocks parasympathetic response as sympathetic increases HR and causes bronchodilation, parasympathetic decreases HR and causes bronchoconstriction
Most common is ipratropium (Atrovent)
Secondary head injury
Result of hypoxia and decreased perfusion, cerebral edema, infection or hemorrhage causing the brain to respond by swelling, decreasing perfusion, and hypoxia
Corticosteroids
Reduce bronchial swelling through IV or inhalation with long term negative effects like high BS, decreased immune system, and generalized edema
Most common are dexamethasone, prednisone, hydrocortisone, betamethasone
What is ICP
The pressure inside the cranium from brain tissue, blood, and CSF
Increased ICP is one of the three components that has a greater volume than normal causing more pressure to build up at the expense of the rest.
Presents as hypoxia, severe headache, projectile vomiting, papilledema, seizures
Diuretics
Maintain BP and remove fluid from the body and beneficial to patients with pulmonary edema but a negative side effect is the lost potassium
Most common is Lasix (Furosemide)
Cushing’s reflex
Caused from cerebral ischemia, where to increase blood supply to the brain, the heart will increase systolic pressure to widen pulse pressure, decreasing pulse, and irregular respirations.
Sympathomimetics
Stimulate beta 2 receptors and assist with bronchodilation given IM
Most common is Epinephrine
Shunt
Alveoli are perfused with blood normally but ventilation (supply of air) fails to supply the perfused region
Low VQ (0.5)
Very rarely a true shunt because then they are not breathing
Hypovolemic shock
Tachycardic response, pale/cool/clammy skin, diaphoretic, evident blood loss, not associated with paralysis
Neurogenic shock
Bradycardic response, swink is warm and dry, no significant blood loss, paralysis and loss of spinal reflexes
Dead space
Alveoli are ventilated but not perfused
High VQ (2.0)
