Last min memorization stuff

Question 1

What is the most common cause of metabolic acidosis

Answer 1

Diarrhea, Ketone bodies from starvation or diabetes mellitus

Question 2

Most common causes of Metabolic alkalosis

Answer 2

Vomitting, Diuretics

Question 3

Roles and location of Granular cells

Answer 3

Granular cells are Mechanoreceptors
- Line Blood affeent arterioles
- Release renin when Low BP

Question 4

Location and role of Macula Densa cells

Answer 4

Located in DCT
Chemoreceptors to moniter solute concentration (NA) of filtrate

Question 5

Which cells secrete renin

Answer 5

Lacis cells and granulare cells

Question 6

What structures are in the cortex

Answer 6

Bowman’s capsule, PCT and DCT, Glomerulus, peritubular capillaries

Question 7

What structures are in the medulla

Answer 7

Vasa recta, loop of henle, collecting duct

Question 8

Main function of renorenal reflex

Answer 8

Increased pressure of one kidney decreases efferent nerve activity to cause Vasodialation, increase excretion of Na and water

Question 9

Which parts of filtration are highly innervated, and what does SNS act on/function of this

Answer 9

PCT, DCT,and loop of henle are stimulated by norepi on tubule cells and granular cells receptors.
1. Causes increased sensitivity of granular cells (respond to smaller decrease in pressure)
2. Increase Na reabsorbtion (Na back into blood, decrease urine production)
3. Renal vasoconstriction–>Decrease GFR and renal blood flow

Question 10

Primary function of juxtamedullary nephron vs cortical nephron

Answer 10

Juxtamedullary concentrates urine since it has such long loops of henle (w countercurrent mecahnism)
Cortical nephrons - Na and H2O reabsorbtion

Question 11

What is reabsorbed/ secreted in the PCT and via which channels

Answer 11

Na uses active transport
Glucose uses cotransport w Na Via SGLT2
Amino Acids use cotransport with Na
Water uses aquaporins

Hydrogen can be secreted if needed

Question 12

What is reabsorbed/ secreted in the DCT and via which channels

Answer 12

Na and Water are reabsorbed via aldosterone increases or decreases
K is exchanged with Na
H as needed

Question 13

Which limb secretes Urea

Answer 13

Descending limb- concentrates interstitial space

Question 14

Where are P cells and I cells

Answer 14

In collecting duct
- P cells reabsorb Na
- I cells sense H or HCO3

Question 15

If GFR=RC, what substances test for this?

Answer 15

Inulin, creatanine
neither reabsorbed nor secreted, just filtered

Question 16

If GFR>RC, what substances have this?

Answer 16

Reabsorbed into the body–> Na or Glucose, Amino Acids

Question 17

If RC> GFR what happens and which substances are like this

Answer 17

The substances are secreted from the body
Drug metabolites, H+ as needed, K

Question 18

Steps on urination

Answer 18

1. Receptors on bladder wall detect stretch
   
   2. Pelvic Afferent nerves receive signal
   3. Send to sacral region of spinal cord
   4. Efferent nerve (Sacral PNS nerves) relax internal urinary sphincter and contract detrusor muscle of bladder. We voluntarily open the external urinary sphincter (Inhibit motor neurons to relax and open bladder).

Question 19

What are Aldosterone’s 3 mecahnisms

Answer 19

1. Increase ENAcs in DCT
2. Increase Na/K exchange
3. Increase H/Na exchange

Question 20

Lasix does what

Answer 20

Blocks salt reabsorbtion in Ascending loop ( hurts countercurrent mechanism)

Question 21

Hypoxemia (hypoxic hypoxemia)

Answer 21

Not enough O2 in blood

Question 22

Anemic Hypoxia

Answer 22

Low Hemoglobin levels

Question 23

Ischemic hypoxia (stagnant)

Answer 23

Not enough blood flow

Question 24

Histotoxic hypoxia

Answer 24

Toxin impairs O2 usage

Question 25

Why is there an increase of ventilation at high atltitude

Answer 25

Because the O2 levels are lower Causes a decline in CO2 and H, which increases pH (more basic)

Question 26

Left shift or Right shift at high altitude

Answer 26

Left shift- easier unloading of O2 at lungs, harder to unload at tissues because blood is desaturated Low O2 stimulates EPO to increase hematocrit

Question 27

in ASD, what is the concern

Answer 27

R atrium to L atrium (foramen ovale)

Question 28

In AVSD what is the problem

Answer 28

No septum-- 2 chamber heart, no top or bottom, just left and right

Question 29

In VSD what is the problem

Answer 29

Hole in ventricle

Question 30

In PDA what occurs

Answer 30

vessel from pulm artery to aorta stays open

Question 31

Cervical portion of respiration

Answer 31

Connect to phrenic nerve, control diaphragm

Question 32

What is thoracic portion of respiration

Answer 32

Control intercostal muscles--> still automatic control via prebotzinger complex, just intercostals

Question 33

What ion has the strongest impact on Chemoreceptors

Answer 33

CO2

Question 34

Where is the central chemoreceptor sensing CO2

Answer 34

Senses CO2 in medulla in CSF

Question 35

Where are peripheral chemoreceptors sensing CO2

Answer 35

In periphery-- blood-- carotid and aortic bodies (sinusoidal capillaries)

Question 36

What is the medullary chemoreceptor activation

Answer 36

CO2 can't enter blood brain barrier, H+ can. H+ stimulates chemoreceptors in medulla

Question 37

Describe the C- fiber activation and non-chemical reflexive action on ventilation

Answer 37

Found next to pulmonary capillaries (Juxtamedullary receptors) Stimulatd by hyperinflation or capsaicin Caused the pulmonary reflex--> Apnea causes rapid breathing, bradycardia, hypotension

Question 38

What causes the pulmonary reflex

Answer 38

Apnea-->bradycardia, hypotension, rapid breathing Ending of C-fibers causes it

Question 39

Describe the differences between Sneezing and Coughing

Answer 39

Sneeze--> Open glottis Cough-->Closed Glottis Sneeze-->reflexive from irritatnts in nasal mucosa Cough-->reflexive from irratents in trachea/bronchi Innervation of Cough: Vagus and closopharyngeal Innervation of Sneeze: Trigeminal

Question 40

Describe afferent neuron sensitivity to CO2 and exercise

Answer 40

Afferent neurons become more sensitive to CO2, so it takes less cO2 to activate them (causing increased ventilation)

Question 41

What are the 2 angiotensin receptors and their purpose

Answer 41

1. AT1a-- blood vessels, brain 2. AT1B-- anterior pituitary and adrenal cortex

Question 42

What are the 3 receptors of vasopressin/ADH

Answer 42

V2--> ADH impacts (Increase aquaporin 2 channels on collecting duct) V1a--> Vasoconstriction V1b--> Anterior pituitary--> ACTH release