Last min memorization stuff Flashcards
What is the most common cause of metabolic acidosis
Diarrhea, Ketone bodies from starvation or diabetes mellitus
Most common causes of Metabolic alkalosis
Vomitting, Diuretics
Roles and location of Granular cells
Granular cells are Mechanoreceptors
- Line Blood affeent arterioles
- Release renin when Low BP
Location and role of Macula Densa cells
Located in DCT
Chemoreceptors to moniter solute concentration (NA) of filtrate
Which cells secrete renin
Lacis cells and granulare cells
What structures are in the cortex
Bowman’s capsule, PCT and DCT, Glomerulus, peritubular capillaries
What structures are in the medulla
Vasa recta, loop of henle, collecting duct
Main function of renorenal reflex
Increased pressure of one kidney decreases efferent nerve activity to cause Vasodialation, increase excretion of Na and water
Which parts of filtration are highly innervated, and what does SNS act on/function of this
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
Primary function of juxtamedullary nephron vs cortical nephron
Juxtamedullary concentrates urine since it has such long loops of henle (w countercurrent mecahnism)
Cortical nephrons - Na and H2O reabsorbtion
What is reabsorbed/ secreted in the PCT and via which channels
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
What is reabsorbed/ secreted in the DCT and via which channels
Na and Water are reabsorbed via aldosterone increases or decreases
K is exchanged with Na
H as needed
Which limb secretes Urea
Descending limb- concentrates interstitial space
Where are P cells and I cells
In collecting duct
- P cells reabsorb Na
- I cells sense H or HCO3
If GFR=RC, what substances test for this?
Inulin, creatanine
neither reabsorbed nor secreted, just filtered
If GFR>RC, what substances have this?
Reabsorbed into the body–> Na or Glucose, Amino Acids
If RC> GFR what happens and which substances are like this
The substances are secreted from the body
Drug metabolites, H+ as needed, K
Steps on urination
- Receptors on bladder wall detect stretch
- Pelvic Afferent nerves receive signal
- Send to sacral region of spinal cord
- 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).
What are Aldosterone’s 3 mecahnisms
- Increase ENAcs in DCT
- Increase Na/K exchange
- Increase H/Na exchange
Lasix does what
Blocks salt reabsorbtion in Ascending loop ( hurts countercurrent mechanism)
Hypoxemia (hypoxic hypoxemia)
Not enough O2 in blood
Anemic Hypoxia
Low Hemoglobin levels
Ischemic hypoxia (stagnant)
Not enough blood flow
Histotoxic hypoxia
Toxin impairs O2 usage
Why is there an increase of ventilation at high atltitude
Because the O2 levels are lower
Causes a decline in CO2 and H, which increases pH (more basic)
Left shift or Right shift at high altitude
Left shift- easier unloading of O2 at lungs, harder to unload at tissues because blood is desaturated
Low O2 stimulates EPO to increase hematocrit
in ASD, what is the concern
R atrium to L atrium (foramen ovale)
In AVSD what is the problem
No septum– 2 chamber heart, no top or bottom, just left and right
In VSD what is the problem
Hole in ventricle
In PDA what occurs
vessel from pulm artery to aorta stays open
Cervical portion of respiration
Connect to phrenic nerve, control diaphragm
What is thoracic portion of respiration
Control intercostal muscles–> still automatic control via prebotzinger complex, just intercostals
What ion has the strongest impact on Chemoreceptors
CO2
Where is the central chemoreceptor sensing CO2
Senses CO2 in medulla in CSF
Where are peripheral chemoreceptors sensing CO2
In periphery– blood– carotid and aortic bodies (sinusoidal capillaries)
What is the medullary chemoreceptor activation
CO2 can’t enter blood brain barrier, H+ can. H+ stimulates chemoreceptors in medulla
Describe the C- fiber activation and non-chemical reflexive action on ventilation
Found next to pulmonary capillaries (Juxtamedullary receptors)
Stimulatd by hyperinflation or capsaicin
Caused the pulmonary reflex–> Apnea causes rapid breathing, bradycardia, hypotension
What causes the pulmonary reflex
Apnea–>bradycardia, hypotension, rapid breathing
Ending of C-fibers causes it
Describe the differences between Sneezing and Coughing
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
Describe afferent neuron sensitivity to CO2 and exercise
Afferent neurons become more sensitive to CO2, so it takes less cO2 to activate them (causing increased ventilation)
What are the 2 angiotensin receptors and their purpose
- AT1a– blood vessels, brain
- AT1B– anterior pituitary and adrenal cortex
What are the 3 receptors of vasopressin/ADH
V2–> ADH impacts (Increase aquaporin 2 channels on collecting duct)
V1a–> Vasoconstriction
V1b–> Anterior pituitary–> ACTH release
