Final Flashcards
weeks 1-15
Ventilation
Movement of air through the pulmonary airways
Perfusion
movement of blood through the pulmonary circulation
Diffusion
the exchange of oxygen and carbon dioxide
Oxygenation
providing cells with oxygen
Ventilation+ perfusion+ diffusion= ?
Oxygenation
Perfusion without ventilation
blood goes to parts of the lung that DO NOT have oxygen to give
ex. pneumonia
ventilation without perfusion
Blood does NOT go to parts of the lung that have oxygen to give
ex. pulmonary embolism
Atelectasis
Alveoli collapse
Hypercapnia means
high carbon dioxide level in the blood
The lungs help regulate…..
carbon dioxide which is an acid
The kidney help regulate….
Bicarbonate which is a base
Low pH = what concentration of hydrogen ions & High pH= ?
high concentration= low pH
Low concentration high pH
Acidic lungs
increase ventilation, elimate CO2, and raise pH
Alkalotic lung
decrease ventilation, retain CO2, and lower pH
Alkalotic kidney
increase excretion, lower pH
Acidic kidney
increase reabsorption, raise pH
pH: 7.20
CO2: 38
HCO3: 3.17
uncompensated metabolic acidosis
pH: 7.5
CO2: 47
HCO3: 27
partially compensated metabolic alkalosis
pH: 7.42
CO2: 32
HCO3: 18
Fully compensated resp. alkalosis
what lung disease increases in resistance to airflow from the trachea and larger bronchi to the terminal and respiratory bronchioles
obstructive lung disease
COPD, emphysema, chronic bronchitis, asthma are what lung disease
obstructive
What lung disease is characterized by reduced expansion and stiff lungs
restrictive lung disease
pneumonia, pulmonary edema, atelectasis are what type of lung disease
restrictive
______ is difficulty getting air out and ______ is difficulty getting air in
obstructive, restrictive
COPD pts drive to breathe
hypoxia instead of carbon dioxide
Hypoxia
low O2 in the tissues
- persistant airway inflammation bronchial hyperreactivty causing obstruction
- often hereditary
Asthma
cause of COPD
chronic bronchitis, emphysema, or both
Severe COPD leads to chronic…..
hypercapnia> stimulus to breathe is now hypxoia
Blue bloater is characterized with what disease
chronic bronchitis
- cyanosis, clubbing, hypoxia
pink puffer is characterized with what disease
emphysema
- barrel chest, chronic hypercapnia, excess air in lungs
Air in pleural space
- caused by trauma or infection
treatment: chest tube, needle decompression
Pneumothorax
Excess fluid within pleural space
- HF, renal failure, liver failure, infections
- treatment thoracentesis
Pleural Effusion
Roles of kidney
- metabolism
- waste elimination
- control Blood pressure
- regulate RBCs
- vit D synthesis
- manage electrolytes
Diagnostics for kidney dysfunction
- urinalysis
- BUN
- Serum Creatine> gold standard
- imaging studies
Treatments for kidney disease
- medications (bicarb, beta blockers, epogen, diuretics)
- dialysis (HD, PD, CRRT)
AKI four phases
- initial> injury to manifestation
- oliguria> retention of fluid
- diuresis> increased urine output
- recovery> final repair of damage
AKI: pre/ intra/post
pre: decreased perfusion> CHF, Shock, blood loss
intra: injury in the kidney itself
post: obstruction> stone, tumor
GFR (test used with kidneys)
how much blood is filtering through kidneys per minute
Clinical presentation of AKI
- anemia
- hypokalemia> bone breakdown & fracture
- kidney can’t activate vit D
- encephalopathy> confusion
- thrombocytopenia> bleeding/ bruising
UTI 3 primary symptoms
- urgency
- frequency
- burning sensation
untreated UTI can lead to….
Urosepsis
Risk factors for developing UTI
- female> urethra closer to anus
- incontinence
- dehydration
- obesity
- being older
Risk factor for kidney stones
(nephrolithiasis)
- depends on what stone is made out of
- dehydration
- gout
- diet(high sodium)
- hyperkalemia
treatment of kidney stones
- pain medication> priority
- hydrate> flush out
- lithotripsy> sound waves breakup stone
- prevent reoccurance
diagnosis of kidney stones
- urinalysis
- infection, hematuria, urine pH, presence of crystals
- protein in urine
how does kidney stones lead to hydronephrosis
- complete obstruction of bloodflow
- urine backup into renal pelvis and destroys kidney
- extra fluid in kidneys from obstruction
- found during ultrasound
Metabolism
refers to the chemical processes involved in converting carbs, fats, and proteins from the foods we eat into the energy needed for cell function
small intestine villi contain…
goblet cells> secret mucous and absorb nutrients
PUD risk factors
- NSAIDs and H. pylori
NSAIDs inhibit….
prostaglandin E leading to decreased mucosa
H. pylori releases….
-enzyme urease which breaks down urea leading to CO2 and ammonia(acid)
- ammonia then destroys mucosal lining
PUD s/s
- pain with eating
- pain- burning, gnawing stomach pain
- perforation- sudden pain, pale skin, cold sweat
What is gliadin
protein form gluten
- HLA molecule activates helper T cells causing autoimmune inflammatory process
- can cause malabsorption
Celiac s/s
- Vit A, E, and K deficiency
- malabsorption
- steatorrhea
- impared muscle mass
low immune function> high infection rates
If GFR is high the kidneys are…
More at risk
A medication for kidney dysfunction includes
Beta blocker
Kidneys excrete what
Hydrogen and bicarbonate
Urosepsis intervention
antibiotics and bolus fluids
Ulcerative colitis s/s
- Pseudo polyps
- frequent bowel movements
- blood stolls
- urgency
- rectum extending to large bowel
- wt loss
Chron’s Disease
- skip lesions
- cobblestoning
- mouth to anus
- toxic megacolon
-1 Hematemesis
- 2 Hematochezia
- 3 Melena
1- blood in vomit
2- blood in stool
3- black and tarry stool
If bleed is closer to source of going out of body blood is
bright red
If bleed is further from the source of going out blood is
brown and coffee ground appearance
Liver dysfunction s/s
- ascites/ edema
- jaundice, spider angiomata, finger clubbing
- steatorrhea
- fatigue, anorexia, wt loss
Liver function
- vit k synthesis
- detoxes
- metabolism
- coagulation and metabolize bilirubin
High unconjugated bilirubin is what hepatic injury
intrahepatic injury
Calculous cholecystitis versus acalculous
Calculous: gallstones that lodge in the cystic ducts
Acalculous: caused w/ out evidence of obstruction
Spasmodic pain is known as _______ after decrease in distention
biliary colic
Cholecystitis is
the gallbladder becomes thickened, rigid, and fibrotic
- function begins to function poorly
Signs to check which lead to cholecystitis
- CRP
- Murphy
- RUQ pain
Pancreas endocrine versus exocrine function
endocrine: produces insulin, glucagon
Exocrine: excrete/ secretes digestive enzymes lipase, amylase, trypsin and bicarb
Intrinsic factor is vital for absorption of ?
Vit B12
Biliary Tract Disease
- obstruction of the flow of enzyme from the pancreas
- autodigestion on the gland tissue and destroy the pancreatic cell
Unconjugated versus conjugated bilirubin
Uncon: not water soluble
Con: Water soluble
- For body to excrete bilirubin in the bile, it has to be water-soluble
Hyperbilirubinemia can lead to
jaundice
Greatest risk(key event) for atherosclerosis
Endothelial injury
LDL is
BAD CHOLESTROL
- HDL can help out by reverse transport
-high levels of LDL and low levels of HDL predispose to CVA
Free radials are
- attracted to things they shouldn’t be
- create inflammation
- can cause damage to the endothelium
Effect of these Blood compositions can alter heart of arteries
- lipids
- glucose
- free radicals
- nicotine
- homocysteine
3 elements that regulate blood flow through the arteries
- volume
- pressure
- resistance
Blood pressure regulation systems
- Baroreceptors> raise BP
- RAAS > raise BP
- ADH> raise BP
- Natriuresis> lower BP
Cardiac Output
The amount of blood the heart pumps out of the ventricle each minute
- CO= HRxSV, about 5L per minute
Process of atherosclerosis
- formation of foam cells
- formation of fatty streaks and plaque
- Plaque rupture
STEMI vs NSTEMI
STEMI: infarction is completely through the cardiac wall
NSTEMI: infarction is subendocardial and not completely through the heart wall
Preload
The volume of blood in the heart at the end of diastole
- precontraction
- loading of a sling shot
- beginning of cardiac cycle
Afterload
The amount of resistance the ventricle must overcome to pump blood out of the heart
- high resistance= higher afterload resistance
- pressure that the left ventricle has to pump against(resistance)
Left ventricular failure backflow
- lungs
- creates build up of hydrostatic pressure in LA, pulmonary vein
Left ventricular forward effect
- causes decreased perfusion to brain, kidneys, and other organs
Right Ventricular failure backward effect
creates backup within the right heart chambers and eventually into superior and inferior vena cava
- causes fluid leakage and edema and ascites and enlarged organs
Shock
severe hypotension
- inability of heart and lungs to satisfy the metabolic and oxygen requirements
- blood pressure drops 40 below pts normal pH
Shock stages
- initial
- sudden BP drop and SNS & RAAS kick in! - Progressive
- blood conserved for heart and brain - Irreversible
- blood loss in heart and brain and leads to ischemia
Normal cell cycle has
checkpoints to repair, recycle, and destroy apoptosis during the cell cycle
Cancer eitology
Cell DNA Error+ Failure to detect and stop error= cancer
Tumor suppressor gene
- normally function to restrain cells growth and become defective
- lose ability to inhibit cell growth and division
- TP53
- BRCA1 &2
Proto-oncogenes
normal cells that stimulate and regulate the cell cycle
Mutated/ defective oncogenes can lead to
constant cell proliferation and cell cycling
Benign
- cells are well differentiated
- growth is slow
- genetic stability
- tumor is localized
- edges are smooth
Malignant
- cells poorly differentiated
- tumor is invasive and disrupting surrounding cells
- growth is erratic
- cells have unlimited lifespan
- easily break free and spread
Grading
- looking at differentiation
- well differentiated vs poorly differentiated
Staging
- classifies the size, invasiveness, and the spread of the tumors
- TNM System
- how advanced cancer is
Blast cells
premature precursor cells
In leukemia the WBCs over produce and take over RBCs T or F
TRUE
Acute vaso-occlusive crisiscaused by…
more likely with illness, stress, heat/cold, dehydration, or by high altitude, but can also have no trigger at all
Sickle Cell Anemia
- RBCs take on an S shape
- These get stuck in vessel and create obstructions
- Obstructions create ischemia and can lead to tissue damage and possible infarction
RBC break > hyperbilirubinemia> _______
Jaundice
Hemophilia A
Deficiency in coag factor VII
Hemophilia B
Deficiency in coag factor IX
In hemophilia does vasoconstriction and platelet activation still happen
Yes, dysfunction doesn’t occur until coagulation cascade
Fibrinogen changes into ______
which strengthens the platelet plug into a blood clot
Fibrin
Cellular regulation
Any process that controls the series of events by which a cell goes through the cell cycle
Perfusion
Perfusion is the passage of bodily fluids, such as blood, through the circulatory or lymphatic system to an organ or tissue.
