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General Physiology Flashcards

1
Q

Intracellular component consists of

A
  • Water
  • K+
  • Acidic
  • intracellular organs
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2
Q

Extracellular component consists of

A
  • Na+
  • blood plasma/interstitial fluid
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3
Q

What’s the membrane potential of a cell? (NO NET MVMT)

A

(-) 90mV
- leaky K+ (flowing in and out of the cell) but exist mostly INSIDE the cell
-Na/K ATPase pump

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4
Q

Resting membrane potential

A

-70mV
- Na+ can slowly diffuse through the cell membrane causing resting membrane potential
- Na/K ATPase

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5
Q

Na+/K+ pumps

A

3 Na+ OUT
2 K+ IN

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6
Q

Depolarization

A

inside cell becomes more positive due to influx of Na+

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7
Q

Hyperpolarization

A

Inside cell becomes more negative due to efflux of Na+

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8
Q

Action potential

A

when membrane is depolarize beyond a certain threshold

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9
Q

2 directions for cellular transport

A
  1. Uphill/against graident (requires ATP)
    - Primary active tranpsport: directly uses ATP
    - Secondary active transport: indirectly uses ATP (Na+/K+ pump)
  2. Downhill/w/ gradient (does not require ATP)
    - Simple: non-electrolytes (no charge) diffuse across membrane
    - Carrier-Mediated transport: integral membrane proteins to move charged molecules across the membrane facilitated diffusion
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10
Q

2 types of secondary active transport

A
  • Cotransport: ions move SAME direction (ex. Na+/AA in PCT kidneys, Na+/K+/2Cl- in ascending loop of henlen)
  • Counter-tranpsort: ions move in OPPOSITE direction (Ex. Na+/Ca2+ transport in muscles)
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11
Q

passage of glucose, AA, and other polar molecules are mediated by..?

A

carrier protein
- maximum rate = transport maximum (carriers are saturated)

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12
Q

Which adrenoreceptors inhibits adenylyl cyclase = decr cAMP?

A

a2

“a2 is different from you”

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13
Q

B-blockers side effects

A

act on B1 and B2 receptors
- bronchoconstriction, bradycardia

ask about pulmonary sx before prescribing!

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14
Q

Which receptors are the only receptors that can open Na+ and K+ channels? Where are they located?

A

Nicotinic, other receptors alter either calcium concentration or cAMP
- causes depolarization
- located in the motor end plates of skeletal muscles on postganglionic neuron cell bodies within the ganglion of the sympathetic and parasympathetic nervous system, and adrenal medulla

these are unique

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15
Q

Muscarinic receptors Which recpetors increase intracellular Ca2+

A

alpha 1 and muscarinic

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16
Q

Which receptors increase cAMP?

A

B1 and B2

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17
Q

Where are muscarinic receptors located?

A

PNS effector organs, vascular SM, sweat glands.

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18
Q

Calculate Intracellular volume

A

Intracellular volume = Total volume - extracellular volume
- ICF is slightly more acidic
- ECF and ICF has the same osmolality

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19
Q

Diffusion

A
  • passive transport (high to low)
  • uses thermal energy, not ATP
  • stops when concentration of molecules are equal on both sides of the membrane
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20
Q

rate of diffusion increases under which condtions?

A
  • decr membrane thickness
  • incr temp
  • incr membrane permeability
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21
Q

Simple diffusion

A
  • passive transport involving mvmt of small molecules and inorganic ions
  • Na+ and K+ pass thru specific channels
  • steroids and hormones pass directly through the phospholipid bilayer
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22
Q

Osmosis

A
  • simple diffusion of water across a semipermeable membrane
  • low to high solute
  • solution with higher osmolality (more solutes) = higher osmotic pressure
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23
Q

the right and left lungs have how man lobes?

A

3 right lobes (larger and wider)
2 left lobes

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24
Q

3 surfaces of the lung

A
  • Coastal = faces sternum, costal cartilage, and ribs
  • Mediastinal = faces hilum of lungs and medial to the mediastinum
  • Dipaphragm = rest on the dome of the diaphragm
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25
Q

Each lung has 2 zones:

A
  1. Conducting zone = upper airways, trachea, bronchi, bronchioles.
    - warms and humidifies air before reaching respiratory zone
    - innervated by SNS via B2 receptor causing relaxation of smooth muscle, bronchodilation, inward flow of air
  2. Respiratory zone
    - includes respiratory bronchioles, alveolar ducts, alveolar sacs, alveoli
    - allow blood and air to interfuse
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26
Q

Inspiration

A
  • active process
  • diaphragm contracts (lowers and flattens, incr throacic volume)
  • Parasternal and external intercostal muscles contract
  • scalenes lift rib cage in ant-post position

incr thoracic volume and intrapulmonary pressure

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27
Q

Expiration

A
  • Passive process
  • diaphragm relaxes
  • decr lung volume = incr alveoli to incr above atmospheric pressure causing air to be pushed out from lungs
  • forced expiration, the internal intercostal muscles contract and squeeze rib cage and abdominal muscles force organs up against the diaphragm

decr volume of thorax

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28
Q

Tidal volume

A

air volume inspired or expired after each normal breath

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29
Q

Inspiratory Reserve Volume (IR)

A

max volume inspiration after a tidal volume (normal) inspiration

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30
Q

Expiratory Reserve Volume (ER)

A

max volume of expiration that can be pushed out after tidal volume (normal) expiration

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31
Q

Inspiratory capacity

A

total amount of air you can breathe in after taking a normal breath without straining.
- Vol is approx 3L

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32
Q

Vital capacity

A

the maximum amount of air a person can exhale forcefully after taking the deepest breath possible.
- volume is approx 4.5L

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33
Q

Residual volume

A

volume of air that remains in the lungs even after a maximal exhalation

RV = Functional residual capacity (FRC) - Expiratory reserve (ER)

FRC = it’s the amount of air left in your lungs after you’ve exhaled normally
ER = additional amount of air that you can forcibly exhale from your lungs after a normal, passive exhalation

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34
Q

Functional residual capacity

A

it’s the amount of air left in your lungs after you’ve exhaled normally

FRC = ER + RV

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35
Q

Total lung capacity

A

maximum volume of air that the lungs can hold at the end of a maximal inhalation

TLC = VC + RV

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36
Q

Forced Vital capacity

A

measure of the maximum amount of air that a person can forcefully exhale after taking the deepest breath possible

It’s similar to vital capacity (VC), but in FVC, the exhalation is done as forcefully and rapidly as possible, whereas VC can be exhaled at a more relaxed pace.

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37
Q

Forced expiratory volume (FEV1)

A

measure of the amount of air that a person can forcefully exhale in one second (FEV1)

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38
Q

Respiratory rate

A

number of breaths per min
Normal = 12 breaths per min

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39
Q

Minute ventilation

A

Tidal volume x breaths/min (TV x RR)

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40
Q

Spirogram

A

clinically used to measure lung function and dz
- ratio <80% = obstructive lung dz (COPD, chronic bronchitis, emphysema, asthma)
– reduced FEV1/FVC ratio

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41
Q

Restrictive lung dz

A
  • poor expansion of lungs with a decr in lung volume and normal to elevated FEV1/FVC ratio
  • ex. toxoplasmosis, histoplasmosis, sarcoidosis
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42
Q

Anatomic dead space

A

portion of the respiratory system where no gas exchange occurs during breathing.
- conducting zone (bronchi and bronchioles, trachea)

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43
Q

Where does gas exchange occur?

A

alveoli
- O2 and CO2 diffuse across the alveolar and capillary walls to and from blood stream

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44
Q

functional dead space

A
  • specifically refers to alveoli
  • occurs when there is ventilation of lung areas that are not effectively perfused with blood, such as areas with reduced or absent blood flow due to conditions like pulmonary embolism or areas affected by lung disease. As a result, the air that reaches these alveoli during inhalation does not participate in gas exchange with the blood.
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45
Q

Physiologic dead space

A
  • includes airways and non-functional alveoli within the lungs. This space represents the portion of each breath that doesn’t contribute to the exchange of oxygen and carbon dioxide in the blood.
  • combination of functional and anatomic dead space
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46
Q

Which part of the lung has the highest blood flow?

A

base of the lung, greatest exchange of O2

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47
Q

Hemoglobin

A
  • 98% of O2 is bound to Hb, remaining 2% dissolved in plasma
  • 4 peptide subunits
  • each subunits contains a heme group with a reduced iron core that shares elctrons with an O2 molecule
  • considered oxygenated when saturated with 4 O2 molecules
  • Hb carrying less than 4 O2 is considered deoxygenated
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48
Q

CO2

A
  • concentration is 20X greater compared to O2 in the blood stream
  • 90% of CO2 is transported to lungs in form of bicarbonate. Carbonic anhydrase (found in RBC) catalyze reversible conversion of CO2 and H2O: CO2 + H2O ⇌ H2CO3

CO2 + H2O ↔ H2CO3↔ H+ + HCO3-
- reaction occurs rapidly and facilitates transport of CO2 from tissues to lungs for elimination

In the lungs, process is reversed
- carbonic anhydrase to bicarb to CO2 and water

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49
Q

Transport of CO2

A
  1. CO2 to RBC = simple diffusion
  2. CO2 is hydrated to H2CO3 within RBCs
  3. H2CO3 is broken down into HCO3- and H+ by carbonic anhydrase
  4. Deoxyhemoglobin acts as a buffer within the bloodstream to counteract released H+ ions from the breakdown of H2CO3
  5. Cl- and HCO3 are exchanged across RBC membrane. HCO3- within the plasma is then taken to the lungs
  6. After reaching the lungs, Cl- and HCO3 are exchanged across the RBC membrane in the veins of the lungs. HCO3 then combines with H+ to form H2CO3
  7. H2CO3 dissociates into CO2 and H2O which are expired by the lungs
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50
Q

Atmospheric pressure

A

760mmHg

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51
Q

Partial pressure of O2 (PO2)

A

160 mmHg

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52
Q

Partial pressure of CO2

A

0

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53
Q

What happens to PO2 when air enters the trachea/lungs?

A

Decr b/c of vaporization of water as it travels into the blood stream

54
Q

What happens to PCO2 within the lungs

A

incr as CO2 diffuses from bloodstream into the alveoli

55
Q

What conditions decr the surface area of the lungs?

A

emphysema, causing decr exchange of CO2 and O2

56
Q

Which one is more soluble CO2 or O2?

A

CO2 20x more soluble than O2

57
Q

Partial pressure will always flow from

A

high to low pressure

58
Q

How will thickness and SA affect diffusion rate?

A

increase thickness = decr diffusion rate, they are inversely proportional

incr SA = incr diffusion rate

59
Q

Oxygen dissociation curve

A

The oxygen dissociation curve shows how easily hemoglobin in red blood cells binds to and releases oxygen molecules depending on the partial pressure of oxygen in the blood

  • the higher the PO2 = the higher the O2, vice versa
  • sigmoid shape curve

Imagine the oxygen dissociation curve as a rollercoaster ride. The x-axis represents the partial pressure of oxygen (how much oxygen is available), and the y-axis represents the saturation of hemoglobin with oxygen (how much oxygen hemoglobin is carrying).

At lower partial pressures of oxygen, like what we have in tissues where oxygen is needed, the rollercoaster is steep. This means that even small changes in oxygen levels lead to significant changes in how much oxygen hemoglobin carries. This steep part of the curve indicates that hemoglobin eagerly grabs onto oxygen when it’s available.

At higher partial pressures of oxygen, like what we have in the lungs, the rollercoaster levels off. This means that even when there’s a lot of oxygen around, hemoglobin doesn’t hold onto it tightly. Instead, it releases oxygen more readily, making it available for tissues that need it.

So, the oxygen dissociation curve helps us understand how efficiently hemoglobin picks up oxygen in the lungs and delivers it to tissues throughout the body.

60
Q

Oxygen dissociation curve

  • Right shift indicates?
  • Left shift indicates?
A

Right = decr affinity for O2
- Increased acidity (decreased pH)
- Increased temperature
- incr CO2

Left = incr affinity for O2
- decr acidity
- decr temp
- decr CO2

61
Q

Carbon monoxide

A
  • binds to hb more readily than CO2
  • decr ability of hb to release O2 into the bloodstream
62
Q

Respiration is controlled through..

A

Neural and chemical regulators

63
Q

Part of the brain that activates neurons that control respiratory muscles to produce an automatic breathing cycle? What is it influenced by?

A

Medulla oblongata
- influenced by apneustic and pneumotaxic centers of the pons in pons, as well as feedback info
- pulmonary stretch receptors in the bronchioles leads to negative inhibition, helping to prevent lung over-inflation
- conscious breathing includes direct control by cerebral cortex via the corticospinal tracts

64
Q

Chemical control

A
  1. Peripheral chemoreceptors
  2. Central receptors
65
Q

Peripheral chemoreceptors

A
  • located within the walls of the carotid and aorta, sensitive to CO2 changes
  • Monitor O2 and CO2 levels within arterial blood and provide feedback to the medullary centers
  • they detect CO2 changes via increase acidity in the plasma and incr levels of carbonic anhydrase
  • decr O2 = incr CO2 (affect sensitivity or carotid and aortic bodies)
66
Q

Central receptors

A
  • sensitive to H+ changes
  • H+ CANNOT enter BBB but CO2 can
  • High CO2 = High H+ = increase acidity and ventilation
  • buffering ability of CSF is very limited, so it is very sensitive to changes in CO2 and H+

Ex. Change in PCO2 from 40 to 44 within the bloodstream cause respiration rate to double

67
Q

Increased acidity in the blood leads to ….

A

increased ventilation

68
Q

Respiratory acidosis

A

“Problem with breathing”

  • caused by hypoventilation
  • incr CO2 = incr H+ = incr acidity
  • Kidneys compensate by holding HCO3 - incr HCO3 in the plasma
69
Q

Respiratory alkalosis

A

“excessive breathing”

  • hyperventilation
  • decrease CO2 = decr H+ = increase alkaline
  • kidneys compensate by increasing HCO3 excretion which incr CO2 and returns pH to normal
70
Q

Metabolic acidosis

A
  • LOSE HCO3 = increase H+ and incr acidity
  • diarrhea
  • Compensate by hyperventilation, decr CO2, incr alkalinity, kidneys excrete H+
71
Q

Metabolic alkalosis

A
  • incr HCO3, lose H+
  • vomiting
  • Compensate: hypoventilation, kidney excrete HCO3 (increase H+ and CO2), incr acidity
72
Q

Atrium

A

recieves venous blood from the body

73
Q

Right ventricle

A

Largest part of the anterior and inferior surface of the heart
- goes through the pulmonary valve > pulmonary artery > lungs

74
Q

Left atrium

A
  • forms the base of the heart
  • site for the four pulmonary veins
75
Q

Left ventricle

A
  • forms apex of the heart
  • blood from this area is pumped to the aorta
76
Q

What supplies the heart muscle/myocardium

A

left and right coronary arteries

77
Q

Deoxygenated blood comes through the body through ____ to reach the atrium.

A

vena cava

78
Q

Blood flow to the heart

A

vena cava > tricuspid > right ventrical > pulmonary valve > pulmonary artery > left atrium > left ventricle > aorta (to the rest of the body)

79
Q

Systole

A

Contraction of the heart
- first lub sound

80
Q

What makes the lub sound?

A

During systole, closing of mitral and tricuspid valves

81
Q

on the EKG where is systole located?

A

Q-T

82
Q

Diastole

A
  • relaxation of the ventricles
  • second dub sound
  • aortic and pulmonary valves close
  • contraction of the atria forces tricuspid and mitral valves open
  • ventricles relax and atria contracts
83
Q

Where is Diastole located on the EKG complex?

A

T-R

84
Q

Mechanical events of the heart

A

Isovolumic contraction
- Ventricular contraction (after mitral valve closure, before aortic valve opens)
- doesn’t force blood out of the heart so volume stays the same

Ventrical (Systolic) Ejection:
- pressure in the ventricles exceeds the aorta, the aortic valve opens

Isovolumic Relaxation
- ventricles relax

Ventricular filling
- immediately after the mitral valve opens, ventricles fill with blood
- during diastole
- NO change in pressure in ventricles

85
Q

Systole vs Diastole

A

systole is the contraction phase of the heartbeat, where blood is pumped out of the heart, while diastole is the relaxation phase, where the heart fills with blood.

86
Q

Lub dub sound

A

(S1) lub = closing of the tricuspid and mitral valves/bicuspid

(S2)dub = closing of the aortic and pulmonary valves

87
Q

Electrical cycle of the heart

A

SA node > AV node > Purkinje of HIS

**spread of depolarization through atria and ventricles **

88
Q

pacemaker of the heart

A

SA node, self generates action potentials and spread to other cells

89
Q

Arrhythmias

A
  • abnormal electrical depolarization in the heart
  • abnormal stimuli of action potential or abnormal (drug-induced or myocardial cell death) conduction pathways( Ex. A-fib or heart block)
90
Q

Describe this EKG complex

A

P = atrial depolarization

QRS = ventricular depolarization, atrial repolarization

T = ventricular repolarization

QT = systole
T-R = diastole

91
Q

Fast myocardial AP

Phase 0
Phase 1
Phase 2
Phase 3
Phase 4

A

Phase 0 = Depolarization/AP causes Na+ channels to open

Phase 1 = K+ channels open

Phase 2 = Ca2+ channels open

Phase 3 = K+ cells open further, allowing K+ to leave the cell

Phase 4 = returns to resting membrane potential via Na/K pump

important for generating impulses that coordinate contraction of the heart

92
Q

Slow myocardial Action potentials: SA and AV nodes

Phase 0
Phase 1 and 2: absent
Phase 3
Phase 4

A
  • so slow they do not have phase 1 or 2

Phase 0 = depolarization, Ca2+ channels open cause Ca2+ influx (THEY DO NOT HAVE Na+ channels)
- slow conduction from AV node (allow time for ventricles to fill)

Phase 3: Repolarization, Ca2+ leaves the cell
Phase 4: slow diastolic depolarization. membrane potential spontaneously depolarizes as Na+ conductance incr. This causes SA and AV nodes to fire spontaneously
- When the heart is resting, its cells slowly start to become more positively charged inside, mainly because sodium ions start to flow in more. This makes the SA and AV nodes in the heart start firing on their own

93
Q

What determines the heart rate?

A

speed of SA node

94
Q

Blood flow through a vessel is determined by what 2 factors?

A
  1. resistance to blood flow through the vessel
  2. The pressure differences at the beginning and end of the vessels
95
Q

Arterioles have high or low resistance to blood flow?

A

high resistance due to smaller diameter

While veins have a larger diameter = low resistant to blood flow

96
Q

Poiseuille’s Law

A

Rate of blood flow

Flow (Q) = r^4/nL

nL = vessel length and vessel viscosity

Change in pressure

Flow (Q) = change in pressure/ resistance

97
Q

Total peripheral resistance

A
  • Sum of all vascular resistances within the systemic circulation is the total peripheral resistance
  • Vasodilation can decr the total peripheral resistance
98
Q

Starling forces

A

Starling forces refer to the balance between hydrostatic pressure and oncotic pressure across the walls of capillaries.

Hydrostatic Pressure (Outward Force): Pushes fluid out of the capillaries into the surrounding tissues.

Oncotic Pressure (Inward Force): Pulls fluid back into the capillaries from the surrounding tissues.

These forces regulate the movement of fluids across capillary walls, maintaining a balance between fluid inside and outside the blood vessels.

99
Q

Starlings equation

A

0 = no fluid mvmt
+10 = vessel to tissue
-10 = tissue to vessel

100
Q

Oncotic vs hydrostatic pressure

A

Oncotic = dependent on protein content
Hydrostatic = fluid pressure that is generated from the heart

101
Q

Where are Baroreceptors found and what is their function?

A
  • These are found in the walls of carotid artery (neck) and Aortic arch
  • SNS
  • Senses blood pressure changes
102
Q

Where does baroreceptors send their signal?

A

medulla oblongata (where the cardiovascular control center is located) via vagus (CN X) and glossopharyngeal nerve (CN IX)

103
Q

What hormones elevate BP?

A

ADH (released by posterior pit)
Angiotensin 2 (potent vasoconstrictor)
Aldosterone (released by adrenal glands)
Epinephrine/Norepinephrine

104
Q

ejection fraction (EF)

A

amt of blood pumped out of a ventricle with each heart beat

105
Q

end-diastolic volume

A

blood within ventricles before it contracts

106
Q

end-systolic volume

A

blood left in ventricle after it contracts

107
Q

Stroke volume

A

Stroke volume = end-diastolic - end-systolic

108
Q

What’s a normal ejection refraction?

A

normal EF is 50% or greater

less than this means the pt has heart damage from heart attack or congestive heart failure

109
Q

A healthy man with a SV of 72 ml and EDV of 120 ml, what’s the ejection fraction EF?

A

60% (normal EF)

110
Q

Cardiac output (CO)

A
  • how much blood the heart pumps in a minute
  • incr as a result of increase stroke volume
  • heart rate is too high = diastolic filling is incomplete (not enough time to fill the ventricles) = decr CO
111
Q

Cardiac output equation

A

CO = heart rate x stroke volume

112
Q

stroke volume increases when..

A
  • preload increases
  • after load decrease (less pressure needed to pump blood out, making it easier)
  • contractility incr
113
Q

Factors that increase stroke volume and contractility

A
  • increased intracellular Ca2+
  • Decreased extracellular Na+
  • Digitalis (incr intracellular Na+)
  • sympathetic stimulus
114
Q

Factors that decrease stroke volume and contractility

A
  • Heart failure
  • Loss of heart cells due to infarction
  • Acidosis and hypoxia
115
Q

How does the sympathetic system affect the kidney?

A
  • decr GFR and urine production
  • increase blood volume
  • increase cardiac output and total peripheral resistance so blood flow can be direct toward the heart and muscles
116
Q

Angiotensin 2

A

potent vasoconstrictor

induces the following mechanisms
- incr ADH levels
- incr aldosterone levels
- incr Na+ levels
- incr water reabsorption in the collecting duct of kidneys

117
Q

ADH (Vasopressin)

A
  • regulates reabsorption of water
  • incr osmolality due to dehydration or salt intake
  • released in the posterior pituitary
  • works in the collecting duct to reabsorb water
118
Q

Aldosterone

A
  • decr blood volume
  • decr blood flow to kidneys and incr K+ concentration cause the juxtaglomerular cells to release renin ( converts angiotensinogen to angiotensin I)
  • acts on kidneys to increase salt and water retention
119
Q

Renin

A
  • converts angiotensinogen and angiotensin I
  • the ACE enzyme then converts angiotensin I to angiotensin II which stimulates the adrenal cortex to release aldosterone
120
Q

ACE enzyme

A
  • the ACE enzyme then converts angiotensin I to angiotensin II which stimulates the adrenal cortex to release aldosterone
121
Q

Function of the kidney

A
  • eliminates drugs (along with liver)
  • Excretes waste products and toxic materials from protein metabolism
  • Maintains extracellular volume and ionic concentration
  • Maintains blood plasma volume
  • Regulates BP
  • Produces and secretes erythropoietin
122
Q

Hilum

A

where renal artery enters and retinal vein and ureter exits

123
Q
A
124
Q

Describe the blood flow of kidneys

A
125
Q

How many nephrons are in a one kidney?

A

1 million

126
Q

2 types of nephron based on location:

A
  1. Cortical nephron (80%): outer 2/3 of renal cortex (MOST COMMON)
  2. juxtamedullary (20%): inner 2/3 next to the medulla (long loops)
127
Q

Which kidney is lower and why? Where is the kidney located?

A

Retroperitoneal
- right kidney lower due to liver

128
Q

Bowman’s capsule

A

Bowman’s capsule, also known as the renal corpuscular capsule, is a cup-shaped structure located at the beginning of each nephron in the kidney. It is part of the renal corpuscle, which is the initial site of blood filtration in the process of urine formation.
- afferent and efferent arteriole
- vascular pole and urinary pole
- parietal layer and inner visceral layer

129
Q

Glomerular filtrate

A

fluid that filters through the glomerular membrane

130
Q

Glomerular Filtration Rate

A
  • how much blood is filtered per minute in both kidneys
  • want hydrostatic pressure to be high so that it filters more

KMK (18 decks)

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