Mace Final Flashcards
1
Q
first step in cardiac contractility
A
depolarization
2
Q
depolarization is when
A
ions move across the membrane of a cell and the membrane potential becomes LESS negative or SLIGHTLY positive
3
Q
each depolarization causes
A
a heart muscle contraction
4
Q
intercalated discs are located
A
along the edges of the cardiomyocyte
5
Q
intercalated discs house
A
gap junctions
6
Q
ions flow from one cell into a neighboring cell through
A
gap junctions
7
Q
the movement of calcium ions from one cardiomyocyte into a neighboring cardiomyocyte triggers
A
depolarization wave
8
Q
Invaginations or tunnels of the cardiomyocte membrane
A
T tubules
9
Q
where is intracellular calcium stored
A
sarcoplasmic reticulum
10
Q
cardiac contractility begins with
A
rapid influx of Na+ thru open fast Na+ channels
11
Q
step 2 of cardiac contraction
A
transient K+ channels open → K+ efflux → membrane potential returns to 0
12
Q
step 3 in cardiac contractility
A
influx of Ca2+ thru L-type Ca2+ channels
13
Q
Ca2+ influx through L-type Ca2+ channels is balanecd by
A
K+ efflux thru delayed rectifier K+ channels →
Ca2+ in
K+ out
14
Q
when Na+ and Ca2+ channels close, what causes the RMP to repolarize to -90mV
A
K+ rectifier channels
15
Q
where are L type Ca2+ channels located
A
T tubule
16
Q
where are ryanodine receptors located
A
sarcoplasmic reticulum
17
Q
which ions have higher concentration outside the cell
A
Na+
Ca2+
18
Q
which ion concentration is higher inside the cell
A
K+
19
Q
ryanodine receptors are __ gated
and sensitive to __
A
voltage; Ca2+
20
Q
Digoxin __ contractility of the cardiomyocyte
A
increases
21
Q
where does Digoxin work
A
blocks Na/K+ ATPase pump → causes Na+ build up inside the cell → which causes Ca2+ to build up inside the cell
22
Q
normally the Na+/K+ ATPase pump pumps out __
and pumps in __
A
3 Na+
2K+
23
Q
once extracellular Ca2+ gets inside the cell it binds to __
A
ryanodine receptors
24
Q
the binding of Ca2+ to ryanodine receptors causes
A
Ca2+ release into the cell
25
what is calcium-induced calcium release
when Ca2+ moves inside the cell → binds to ryanodine receptors on SR → causes more release of Ca2+ into the cell
26
calcium induced calcium release activates
myofilaments: actin and myosin
27
myosin attaches to __ and causes
\_\_ of the muscle fiber
actin; shortening
28
contractility is directly related to
the concentration of intracellular Ca2+
29
sympathetic neurons have a __ inotropic effect
positive
30
sympathetic stimulation releases \_\_
that bind to __ receptors
and __ contractility
catecholamines; beta 1; increase
31
phosphorylation of L-type Ca2 channels __ intracellular Ca2+
increases
32
PSNS stimulation has a __ inotropic effect and
\_\_ contractility
negative; decreases
33
increased HR __ intracellular Ca2+ and
\_\_ inotrophy
increases; increases
34
the dihydropyridine CCB are
Nifedepine
Amlodipine
35
dihhydropyridines primarily act on \_\_
to cause
smooth muscle
vasodilation
36
dihydropyridines bind to __ to
block \_\_
calcium channels; Ca2+ influx
37
reflex tachycardia is the
kidney's response to protect CO
38
the non dihydropyridines are
Verapamil
Dilitazem
39
the non dihydropyridines exhibit their primary effect on \_\_
to reduce \_\_
L-type Ca2+ channels
inotropy
40
chronotropy is __ control of HR
nodal
41
which CCB has effects both smooth muscle and inotropy
Ditiazem
42
which bv holds the majority of the blood supply
veins
43
which bv layer allows for vasodilation
tunica intima
44
which bv layer is dominated by musculature and elastic fibers
tunica media
45
which bv layer receives signals from the SNS
tunica externa
46
elastic arteries are also called \_\_
and allow for the __ effect
conducting
balloon
47
where are elastic arteries found
ascending aorta
subclavian artery
common iliac
→ high pressure arteries
48
muscular arteries are also called
distributing arteries
49
muscular/distributing arteries supply
specific organs
50
where are muscular arteries found
femoral artery
splenic artery
51
which type of bv has the biggest impact on peripheral resistance
arteriole
52
capillaries have what 2 layers
basement membrane
endothelium
53
most commonly found capillary
continuous capillary
54
continuous capillaries have __ membranes
with no \_\_
continuous
perforations
55
continuous capillaries connect \_\_
and \_\_
arteries
veins
56
fenestrated capillaries are responsible for
absorption/secretion
57
fenestrated capillaries have **\_\_**
but no **\_\_**
tight junctions
perforations
58
where are fenestrated capillaries found
where exchange needs to happen:
endocrine glands
kidneys
intestinal walls
59
fenestrated capillaries have a __ basement membrane
continuous
60
sinusoid capillaries have __ basement membranes
with \_\_
discontinuous
perforations
61
sinusoid capillaries are found in the
liver
spleen
red bone marrow
62
fenestrated capillaries allow for exchange of __ molecules
sinusoid capillaries allow for exchange of __ molecules
small
large
63
pinocytic vesicles allow for the transport of __ molecules
in __ directions
large
both
64
capillaries drain into __ venules
post capillary
65
blood moves through the body by what 2 mechanisms
rhythmic smooth muscle of bv wall
skeletal muscle as body moves
66
fluid enters interstitial space through the
capillary beds
67
blood is diverted throughout the body by
vasodilation
68
precapillary sphincters are rings made up of \_\_
and they regulate \_\_
smooth muscle
blood flow
69
when precapillary sphincters contract blood bypasses the \_\_;
this is called \_\_
capillary bed → diverted to where it needs to go
autoregulation
70
at rest \_\_% of blood is in the systemic veins
55%
71
at rest \_\_% of blood is in the heart
12
72
at rest __ % of the blood is in systemic capillaries
5
73
at rest __ % of blood is in systemic arteries
10
74
venous reserve is
the amount of blood in the veins at rest → 55%
75
total systemic circulation (veins, capillaries, arteries) accounts for \_\_% of blood distribution at rest
70
76
simple circulatory pathways have no
anastomoses
77
alternative circulatory pathways have
anastomoses
78
what are anastomses
arterial, venous, and arteriovenous pathways for supply and drainage of the brain and heart
78
what are anastomses
arterial, venous, and arteriovenous pathways for supply and drainage of the brain and heart
79
anastomses allow for __ connections
and __ blood loss
faster
decreased
80
the portal system does not receive blood from the
kidneys
gonads
81
the portal system begins and ends in
capillaries
82
in the portal system, blood flows from \_\_
to \_\_
capillary bed
capillary bed
83
4 steps of the portal system
1. digestion products absorbed into capillaries w.in villi of small intestine
2. molecules then travel thru hepatic portal veins to liver capillary bed
3. liver monitors blood content and sends blood to circulatory system via hepatic veins
84
the portal system receives both __ and
\_\_ blood
oxygenated
deoxygenated
85
as cross sectional area of capillaries increases the velocity of blood
decreases
86
blood velocity is highest in
elastic arteries
87
blood pressure =
systolic BP - diastolic BP
88
MAP =
CO x TPR
89
albumin displaces \_\_
to move them back into __ the;
this is called \_\_
water
circulatory system
oncotic pressure
90
hydrostatic pressure pushes \_\_
and small molecules out of the \_\_
and into \_\_
water
blood
interstitial space
91
when blood hydrostatic pressure \> oncotic pressure
fluid is forced out of the bv into interstitial space → filtration
92
filtration happens on the __ end
arterial
93
when oncotic pressure \> hydrostatic pressure
fluid is forced into the blood from the interstitial space → reabsorption
94
reabsorption happens on the __ end
venous
95
3 causes of edema
1. increased filtration
2. decreased reabsorption
3. lymphatic obstruction
96
2 consequences of edema
1. cell death → necrosis
2. cerebral edema → sz/coma
97
the opposite of edema is
fluid recall
98
interstitial fluid comes from
fluid leaked out of capillaries
99
hemorrhage is the loss of
interstitial fluid
100
blood pressure __ the farther you get away from the heart
decreases
101
blood pressure is highest in the \_\_
and lowest in the \_\_
aorta
vena cava
102
blood pressure at the end of the capillary bed is
~20 mmHg
103
blood pressure in the vena cava
0 mmHg
104
what would be the approximate blood pressure in a blood vessel leaving the stomach for a person lying on her back
\<20 mmHg
105
when lying down, blood is evenly distributed in the
veins
106
when lying down, central venous pressure \_\_;
end diastolic volume \_\_;
stroke volume \_\_
increases
increases
increases
107
pressure difference and resistance thru a given vessel =
P1-P2/resistance
108
elastic recoil of the arteries occurs during
ventricular relaxation
109
elastic recoil of ventricles sends blood
into the circulatory system
110
arterial end pressure
40 mmHg
111
venule end pressure
20 mmHg
112
the difference in end arterial and end venule pressure ensures
adequate perfusion (filtration)
113
venous return depends on (6 things)
1. pressure gradient from heart
2. gravity
3. skeletal muscle pump
4. thoracic pump
5. cardiac suction
6. AV valve opening
114
venous valves are __ and
move in response to \_\_
passive
pressure
115
the skeletal muscle pump __ bv
and sends blood __ the heart
compresses
towards
116
which factors affecting venous return are increased with activity level
1. pressure gradient
2. skeletal muscle pump
117
inspiration __ intrathoracic pressure,
moves blood in the intra-abdominal cavity \_\_
and __ blood flow into the thoracic veins
decreases
superiorly
increases
118
expiration __ intrathoracic pressure,
\_\_ pressure on the intraabdominal veins,
and __ blood flow into the heart
increases
decreases
increases
*blood that was forced into thoracic veins during inspiration is propelled up to the heart*
119
inspiration __ venous return
decreases
120
expiration __ venous return
increases
121
3 factors that affect blood pressue
1. cardiac output
2. blood volume
3. peripheral resistance
***think about the factors in: MAP = CO x TPR***
122
organs that influence blood pressure
1. heart
2. kidney
123
physiologic factors that affect blood pressure
1. viscosity of blood
2. length of BV
3. diameter of BV
124
total blood flow =
pressure gradient (heart) /resistance (bv)
125
a larger CO causes a __ pressure gradient
steeper
126
decrease in CO causes a __ pressure gradient
smaller
127
pressure gradient is the
difference in blood pressure between 2 points
***blood moves from high pressure to low pressure***
128
increased CO causes a steeper pressure gradient because it
increases the pressure difference in bv closer to the heart vs bv farther away from the heart
129
decreased CO causes a smaller pressure gradient because
it causes less of a pressure difference in bv closer to the heart vs bv farther from the heart
130
shorter bv __ peripheral resistance and bp
decrease
131
factors that decrease bp
1. increased arterial diameter
2. decreased stroke volume
3. decreased blood viscosity
4. increased PSNS stimulation
132
autoregulation of blood flow is regulated by
precapillary sphincters
133
systemic blood flow has \_\_
and __ components
hormonal
neural
134
5 hormones that increase bv
1. epinephrine
2. norepinephrine
3. aldosterone
4. angiotensin II
5. ADH
135
hormone that decreases bv
ANP
136
does Afib increase or decrease blood volume
decreases
137
how does Afib decrease blood volume
chaotic beats → atria stretch against one another → heart thinks there is too much bv → ANP is released
138
3 ANS reflexes that regulate blood flow
1. baroreflex
2. chemoreflex
3. medullary ischemic reflex
139
baroreceptors are located on
carotid and aortic sinuses
140
chemoreceptors are located on
carotid and aortic bodies
141
3 things chemoreceptors respond to
O2
CO2
pH
142
2 things chemoreceptors influence
1. blood flow
2. respiratory cycle
143
the medullary ischemic reflex causes
vasoconstriction
144
“ogen” infers that a compound is a
precursor
*ex angiotensinogen*
145
the cardiac center is in the
medulla oblongota
146
2 components of the cardiac center
1. cardioaccelatory center
2. cardiac inhibitory center
147
when the arteries stretch __ respond by
\_\_ firing rate, which stimulates the
\_\_ center and
and inhibits the __ center
baroreceptors
increasing
cardiac inhibitory
cardio acceleratory
148
vagal effect has __ effects on blood pressure
PSNS
149
external gas exchange occurs between the
alveoli and capillaries
150
gas transport of O2 involves what protein
hemoglobin
151
gas transport of CO2 involves what compound
bicarbonate
152
internal gas exchange occurs between
the capillaries and tissue
153
what tissue is NOT involved in internal gas exchange
lungs
154
cellular respiration is
use of O2 to make ATP
155
cellular respiration uses \_\_
and produces \_\_
O2
CO2
156
5 functions of the respiratory system
1. respiration → gas exchange
2. sound production → larynx
3. odor detection → olfactory
4. pH regulation
5. blood pressure
157
the respiratory pump is responsible for
venous return
158
ACE causes
vasoconstriction
159
components of respiratory mucosa
**deep to superficial:**
1. lamina propria
2. basement membrane
3. epithelium
4. mucus
160
goblet cells live in the
epithelium
161
goblet cells produce
mucin
162
mucin mixes with \_\_
to produce \_\_
water
mucus
163
5 types of respiratory epithelium
1. pseudostratified ciliated columnar
2. simple ciliated columnar
3. simple ciliated cuboidal
4. simple squamous
5. non-keratinized
164
respiratory epithelium thick to thin
**thick → thin**
1. pseudostratified ciliated columnar
2. simple ciliated columnar
3. simple ciliated cuboidal
4. squamous
165
the lamina propria is made of
areolar CT
166
non keratinized stratified squamous epithelium is found in the
mouth
167
goblet cells are in which type of respiratory epithelium
pseudostratified ciliated columnar
168
which type of respiratory epithelium has mobile cilia
simple ciliated columnar
169
what type of epithelium is found in the alveoli
simple squamous
170
paranasal sinuses are lined with which type of epithelium
pseudostratified ciliated columnar
171
sinus epithelium is continuous with the\_\_ mucosa
nasal cavity
172
sinus/nasal mucus is swept into the
pharynx
173
3 functions of the sinuses
1. warm, humidify, clean incoming air
2. lighten weight of skull
3. give resonance to voice
174
the mucociliary escalator starts in the \_\_
and ends in the \_\_
trachea
bronchioles
175
what type of epithelium is found in the mucociliary escalator
pseudostratified ciliated columnar
176
how are cigarettes damaging to the respiratory system
1. stop ciliary escalator movement
2. change conformation of columnar epithelia → destroy cilia
177
cilia move __ airflow
towards the \_\_
against
pharynx
178
tracheal cartilage ends at the
bronchioles
179
bronchoconstriction is controlled by the
PSNS
180
bronchodilation is controlled by the
SNS
***need lots of air to run from that tiger***
181
where do bronchioles receive blood from
systemic circulation
***they are NOT fed by pulmonary arteries and do NOT use pulmonary veins***
182
do the alveolar ducts contain smooth muscle
NO!
183
what type of blood surrounds the capillary bed
deoxygenated
184
what type of receptors are found in the elastic fibers surrounding the alveoli
baroreceptors
185
3 components of the respiratory zone
1. respiratory bronchiole
2. alveoli
3. respiratory membrane
186
what type of epithelium is found in the bronchioles
simple columnar ciliated
187
what type of epithelium is found in the bronchi
pseudostratified columnar ciliated
188
what blood vessel transports oxygenated blood to the bronchi and bronchioles
thoracic aorta
189
within the lungs, what collects pollutants and particles not cleared by the cilia
lymph drainage
190
ANS innervation of the larynx
PSNS via vagus
191
trachea and bronchial tree ANS innervation
SNS
PSNS
192
lungs: SNS exit thru
T1-T5
193
lungs PSNS innervation
vagus n
194
what type of epithelium is found in the pleural membranes
simple squamous
195
inspiration is an __ process
and involves muscle \_\_
active
contraction
196
expiration is a __ process
and involves muscle \_\_
passive
relaxation
197
eupnea according to Mace
12-15 bpm
198
gas pressure and volume are __ related
inversely
199
the lungs remain inflated because __ pressure
is \> __ pressure
intrapulmonary
intrapleural
200
2 muscles of quiet breathing
1. diaphragm
2. external intercostals
201
4 muscles of forced in**S**piration
1. **S**ternocleidomastoid
2. **S**calenes
3. **S**erratus posterior **S**uperior
4. erector **S**pinus
***SSSE***
202
5 muscles of forced expiration
1. transversus thoracis
2. serratus posterior inferior → pulling up
3. internal intercostals
4. external oblique
5. transversus abdominus
203
Boyle's Law
inverse pressure and volume → volume change leads to pressure change → ***establishes gradient for airflow***
204
max volume of air that can be inspired after reaching end of normal, quiet expiration
inspiratory capacity
205
amt of air a person can inhale forcefully after normal tidal volume
inspiratory reserve volume
206
amt of air exhaled during a forceful breath out
expiratory reserve volume
207
greatest volume of air that can be expelled form lungs after taking deepest breath possible
vital capacity
208
volume remaining in lungs after a normal passive exhalation
functional residual capacity
209
Law of Laplace
pressure in alveolus is:
**directly proportional** to surface tension
**inversely related** to radius of alveoli
210
external respiration depends on 5 things
1. pressure gradient
2. solubility
3. membrane thickness
4. total surface area
5. ventilation perfusion coupling
211
edema __ the membrane
thickens
212
emphysema __ the membrane
thins
213
increased PCO2 in bronchiole air causes
bronchodilation
***need blood flow to pick up the CO2***
214
decreased PCO2 in bronchial air causes
bronchoconstriction
215
increased PO2 in alveolar air causes
arterial dilation
***need lots of blood to transport O2***
216
decreased PO2 in alveolar air leads to
arterial dilation
217
what is the chloride shift
bicarbonate moves into RBC as Cl moves out
218
after the chloride shift, bicarbonate (HCO3) combines w. \_\_
to form \_\_
H+
H3CO3 (carbonic acid)
219
carbonic acid dissociates into
CO2
H2O
220
what enzyme facilitates the dissociation of carbonic acid into CO2 and H2O
carbonic anhydrase
221
what creates the concentration gradient for bicarbonate to move into the plasma
CO2
222
what % of O2 is bound to hemoglobin
98%
223
what percent of O2 is dissolved in plasma
2%
224
factors that decrease Hgb affinity for O2
1. increased temperature
2. increased H+
3. increased CO2
4. increased 2,3-BPG (biphosphylglycerate)
5. presence of epi, TH, GH, cortisol
225
increased O2 affinity causes a __ shift in the oxyhemoglobin dissociation curve
left
226
decreased O2 affinity on the oxyhemoglobin dissociation curve causes a
right
227
inside the RBC, CO2 combines with \_\_
to form \_\_
water
H2CO3 (carbonic acid)
228
carbonic acid (H2CO3) splits into \_\_
and \_\_
with the help of \_\_
HCO3 (bicarbonate)
H\_
carbonic anhydrase (CAH)
229
bicarbonate/carbonic anhydrase rxn equation
CO2 + H20 → ← H2CO3 → ← HCO3 + H+
230
bicarbonate is __ charged and traded for
\_\_ as it leaves the cell
negatively
Cl-
231
respiration/ventilation steps
1. pulmonary ventilation
2. alveolar gas exchange → O2 into blood
3. gas transport of O2 w.in the blood
4. systemic gas exchange → O2 into cells
5. systemic gas exchange → CO2 into blood
232
3 things alveolar gas exchange depends on
1. surface area
2. thickness of respiratory membrane
3. ventilation/perfusion coupling
233
additional O2 diffuses into systemic cells with an increase in (4 things)
1. temperature
2. H+
3. 2,3-BPG
4. CO2 bindings
234
4 sensory controls of breathing
1. proprioceptors
2. irritant receptors
3. stretch receptors
4. chemoreceptors
235
where are proprioreceptors found
muscle and joints
236
where are irritant receptors found
mucosa of conducting zone
237
irritant receptors cause
forced expiration
238
what nerve is associated w. stretch receptors
vagus
239
what effect do stretch receptors have on respiration
decrease depth
240
where are stretch receptors located
smooth muscles of airways
241
3 things chemoreceptors respond to
pH
O2
CO2
242
where are chemoreceptors located
medulla oblongota
243
what are the two components of medulla control of respiration
VRG → ventral respiratory group
DRG → dorsal respiratory group
244
fxn of the VRG
sets rhythm → 2 sec inhalation/3 sec exhalation
245
fxn of the DRG
adjust rhythm
*influenced by sensory neurons*
246
what is responsible for the override respiratory rhythm
pontine (ex crying)
247
3 higher centers of respiration
1. hypothalamus
2. limbic system
3. cerebral cortex
248
in eupnea, what is tidal volume and RR
tidal volume: 500 mL
RR: 12-15 bpm (according to Mace)
249
hyperpnea
increased rate and depth of breathing
ex. exercise, pain
250
hyperventilation causes respiratory
alkalosis
251
hypercapnia CO2 pressure
\>43 mmHg
252
hypocapnia CO2 pressure
\<37 mmHg
253
what has the greatest influence on pulmonary airflow
bronchiole diameter
254
Dalton's Law
the sum of all partial gas pressure = total gas pressure
255
partial pressure definition
the pressure that would be exerted by one of the gases in a mixture if it occupied the same volume on its own
256
range of PO2
104-40 mmHg
257
range of PCO2
40-45 mmHg
258
haldane effect
CO2 binds more readily to Hgb w. increased release of O2
259
what % of CO2 binds to the globin portion of hemoglobin
23
260
what % of CO2 dissolves in plasma
7
261
what % of CO2 is converted to HCO3 and transported in plasma
70
262
CO2 diffuses __ its concentration gradient into the alveoli
down
263
amt of CO2 that moves into the alveoli is dependent on (3)
1. total surface area
2. membrane thickness
3. V/Q coupling
264
in pulmonary ventilation the respiratory center temporarily ceases stimulation of the
respiratory muscles
265
in ventilation, intrapleural and intrapulmonary pressure \_\_
and CO2 moves __ its pressure gradient to be expired
increase
down
266
if someone is in respiratory arrest, what 2 factors allow 4 or 5 mins for CPR to begin
1. venous reserve
2. presence of myoglobin
267
what is the main regulator of ventilation rate
hydrogen/CO2
268
what are the 3 types of hypoxia
1. hypoxemic
2. ischemic (circulatory)
3. anemic
4. histotoxic
269
hypoxemic hypoxia is due to a __ problem
V/Q
270
iscshemic (circulatory) hypoxia is due to
no or low blood flow to tissue
271
anemic hypoxia is due to
low O2 carrying ability in blood
272
carbon monoxide poisoning is an example of which type of hypoxia
anemic hypoxia
273
histotoxic hypoxemia is due to
toxic agent such as cyanide or etoh → lead to decreased ATP production → tissue does not use O2
274
etoh and cyanide are which types of hypoxemia
histotoxic
275
in one passage thru a bed of systemic blood capillaries, what % of O2 does the blood release
20-25
