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nbde biochem > page 360-369 > Flashcards

page 360-369 Flashcards

1
Q

https://drive.google.com/open?id=0B8uJUY-tie8GUm5Zb0dwUFRLQkE

A

https://drive.google.com/open?id=0B8uJUY-tie8GcVV6R2JmN1dPRFE

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2
Q

ECG

A

Records the flow of electrical impulses through the heart.

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3
Q

To read ECG:

A

■ Remember that a single lead corresponds to an anatomic territory.

■ Look at multiple leads together for voltage abnormalities and axis

deviations.

■ Look at a single lead for arrhythmias.

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4
Q

https://drive.google.com/open?id=0B8uJUY-tie8GV0h3UGEwUUpadEk

A

https://drive.google.com/open?id=0B8uJUY-tie8GZEJRSnBnT3h6dFU

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5
Q

https://drive.google.com/open?id=0B8uJUY-tie8GYzRXOW52YWY0eGM

A

https://drive.google.com/open?id=0B8uJUY-tie8GLTJrRHMtU2lzYTA

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6
Q

https://drive.google.com/open?id=0B8uJUY-tie8GQUVQYm51djVYM1U

A

https://drive.google.com/open?id=0B8uJUY-tie8Ga3RGSHFLcV9CbHM

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7
Q

https://drive.google.com/open?id=0B8uJUY-tie8GaDFlaWhReks5ZDQ

A

https://drive.google.com/open?id=0B8uJUY-tie8GUGh6OEQ3WFhEUEE

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8
Q

Bainbridge Reflex

A

■ Stretch of atria (with ↑ blood volume) causes ↑ HR and, therefore, ↑ CO.

■ Mediated by stretch receptors in atria.

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9
Q

Receptor cells are sensitive to pressure and stretch.

■ Mediated by vagal (CN X) afferents to the medulla.

■ Efferent loop is slowing of vagal output

A

Bainbridge Reflex

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10
Q

Pumps more blood out of pulmonary system to the systemic system.

■ This helps prevent pulmonary edema.

A

Bainbridge Reflex

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11
Q

Baroreceptor

A

HR, BP

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12
Q

Chemoreceptor

A

Respiration > vasomotor

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13
Q

Baroreceptors

A

■ Modulate intravascular pressure and HR over a short time period.

■ Activated by ↑ BP.

■ Causes ↓ HR, vasodilation, ↓ BP

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14
Q

BARORECEPTOR REFLEX (VALSALVA )

A

■ ↑ BP/↑ stretch of baroreceptors → ↑ parasympathetic afferent output (CN

IX, X) → medulla → ↑ vagal efferent tone (CN X) (↓ sympathetic tone)

→↓HR, ↓ BP (vasodilation, venodilation) →↓CO.

■ Antagonist to Bainbridge reflex.

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15
Q

car sinus

A

Spindle-shaped dilation of receptors at

he common carotid artery bifurcation

(superior border of thyroid cartilage).

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16
Q

Afferent = CN IX.

A

carotid sinus

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17
Q

Afferent = CN X.

A

Aortic Arch Baroreceptora

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18
Q

Receptors in the aortic arch

A

Aortic Arch Baroreceptora

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19
Q

carotid sinus syndrome

A

Excessive stimulation of both carotid sinuses (eg, convulsive seizures) can

lead to momentary loss of consciousness because of vagal discharge, venodilation,

vasodilation.

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20
Q

RESPONSE TO SUDDEN STANDING

A

↓ BP in brain, upper body sensed by baroreceptors →

■ ↓ parasympathetic firing (CN IX, X); (sympathetic discharge → ↑HR,

↑ conduction velocity, ↑ cardiac contractility, ↑ peripheral resistance ↑

vasoconstriction), ↓ renal blood flow ↑a1 vasocontriction of afferent artery;

b1 on JGA →↑renin →↑angiotensin-II → aldosterone→↑blood back to

heart (↑preload because venoconstriction of large veins) → ↑ CO →

return/maintain BP.

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21
Q

HEMORRHAGE OR HYPOVOLEMIA

A

COMPENSATIONS :

■ Baroreceptor reflex (↑ sympathetic, ↓ parasympathetic tone).

■ ↑ epinephrine from adrenal medulla.

■ ↓ vagal output from medulla (↓ carotid sinus, ↓ aortic baroreceptor firing

22
Q

RAAS (Renin-Angiotensin-Aldosterone system). See renal also.

■ AT-II, aldosterone and increase in TPR

■ AT-II: On efferent arteriole to preserve GFR.

■ Aldosterone: On cortical collecting duct, increase Na+ reabsorption,

K+ excretion, H+ secretion by intercalated cells.

A

HEMORRHAGE OR HYPOVOLEMIA

23
Q

HEMORRHAGE OR HYPOVOLEMIA

A

ADH

■ Capillary fluid shift

■ Increases water reabsorption in CCD.

24
Q

Chemoreceptors

A

■ Detect changes in blood oxygen, carbon dioxide, and hydrogen ion

concentrations.

■ Modulate respiratory center in brain (regulate respiratory activity).

25
Q

Afferent CN IX

A

Carotid Body

26
Q

Afferent CN X

A

Aortic Body

27
Q

CHEMORECEPTOR PATHWAY

A

↑ CO2, ↑ H+, and/or ↓ O2 → stimulates chemoreceptors (carotid, aortic

bodies) → ↑ parasympathetic afferent output (CN IX, X) → medulla (respiratory
center) → ↑ ventilation (to breathe down CO2) → (↑ BP, ↑ HR

secondary to simultaneous secretion of catecholamines from the adrenal

medulla).

■ Increase in sensitivity to CO2 and pH when <60 mm Hg.

28
Q

Mechanisms to meet ↑ demand to muscles during exercise (↑ supply).

■ ↑ CO because ↑ HR and ↑SV.

A

excersize

29
Q

excersize

A

Sympathetic nervous system.

■ b2 adrenergic receptors in muscle/pulmonary tree

■ Vasodilate

■ ↑ Blood flow to muscles

30
Q

excersize

A

b1 receptors in heart

■ ↑ HR

■ ↑ Contraction force (inotropic) (phospholumbar “releasing brake”

on SERCA pump)

■ ↑ CO

31
Q

excersize

A

a1 in other parts of body

■ Vasoconstriction

■ ↑ Arterial pressure

32
Q

excersize

A

Enhanced venous return (↑ preload).

■ ↓ Venous compliance

■ Pumping effect of the skeletal muscle

■ Vasoconstriction

33
Q

excersize

A

Local metabolites (released as O2 ↓ 0).

■ Adenosine, CO2, lactic acid

■ Vasodilate: ↓vascular resistance, ↑ blood flow

34
Q

AUTOREGULATION OF BLOOD FLOW

A

As blood flow ↑ to muscles during exercise, the adenosine is washed out.

■ ↓ adenosine → arterioles and small arteries vasoconstrict → keeping blood

flow at a normal rate (in face of ↑arterial pressure).

35
Q

hematocrit

A

Percentage of RBCs in blood sample.

■ Normal:

■ Male: 44–46.

■ Female: 40–42.

36
Q

Venous Hct is typically higher than arterial Hct because of xxx

■ More yyy in comparison to plasma. CO2 from tissues gets converted

by zzz → HCO3 in RBC increases osmotic pressure

→water rushes in →RBC greater volume

A

Venous Hct is typically higher than arterial Hct because of “chloride shift.”

■ More RBC mass in comparison to plasma. CO2 from tissues gets converted

by carbonic anhydrase → HCO3 in RBC increases osmotic pressure

→water rushes in →RBC greater volume

37
Q

hb conc

A

Normal:

■ Male: 15–16 g/dL.

■ Female: 13–14 g/dL.

38
Q

Severe anemia:

A

■ <7.5 g/dL.

■ Hct = Hb °ø 3.

39
Q

anemia

A

↓ Hct.

■ ↓ RBC and/or ↓ Hb concentration

40
Q

Consequences of Anemia

A

■ ↓ oxygen transport in blood.

■ Fatigue, respiratory compensation, cardiac compensation.

■ Hypoxia in the tissues.

■ Causes small arteries and arterioles to dilate (so ↑ blood return to the

heart [preload]).

■ Hypoxia in the pulmonary circulation results in vasoconstriction of those

vessels (opposite to effect on other body tissues).

41
Q

https://drive.google.com/open?id=0B8uJUY-tie8GbHk3T2wxVnc1bmM

A

https://drive.google.com/open?id=0B8uJUY-tie8GU0JJR195MTR4QlE

42
Q

https://drive.google.com/open?id=0B8uJUY-tie8GQm9Bbnl1dXZObEE

A

https://drive.google.com/open?id=0B8uJUY-tie8GRnowaXEtQkhxT28

43
Q

Carbon Monoxide Poisoning

A

■ CO competes with oxygen for Hb-binding sites and changes allosterics;

CO has greater affinity (250°ø)

■ Normal Hb level

■ O2 content ↓

■ Cherry red cheeks

44
Q

Cyanosise

A

■ Deoxygenated hemoglobin in tissues gives the skin/mucous membranes a

blue tint.

■ Does not occur in severe anemia because you need >5 g of deoxygenated

Hb per 100 mL of blood to appreciat

45
Q

ERYTHROPOIETIN

A

■ Glycoprotein hormone produced in kidneys

■ ↑ RBC production by bone marrow

■ Acts at the hemocytoblast (pluripotent stem cell)

46
Q

erythpoetin

A

↓ Erythropoiesis → anemia

■ ↑ Erythropoiesis → polycythemia

■ ↑ Blood viscosity, sluggish blood flow, ie, polycythemia vera (JAK2

mutation downstream of Epo Receptor)

47
Q

Negative Feedback

A

■ ↓ O2 tension (anoxia/hypoxia) →↑erythropoietin (HIF)

■ ↑ O2→↓erythropoietin

48
Q

Virchow’s Triad

A

■ Endothelial injury

■ Stasis

■ Hypercoaguability

49
Q

hemostasis

A

■ Three parts:

■ Vasoconstriction

■ Platelet aggregation/plug (primary)—platelets bind wWF on damaged

endothelium

■ Coagulation (secondary)—crosslinking with fibrin meshwork

50
Q

Coagulation

Intrinsic and extrinsic pathways

A

Prothrombin is cleaved to thrombin.

■ Converted by prothrombin activator (Factor Va).

■ Fibrinogen cleaved to fibrin.

■ Converted by thrombin.

■ Fibrin forms the clot and cross-links with the platelets.

51
Q

https://drive.google.com/open?id=0B8uJUY-tie8GbWJ0Z0JSbHlCb1U

A

https://drive.google.com/open?id=0B8uJUY-tie8GdkpWdTRnN09ZT2c

52
Q
A

nbde biochem (14 decks)

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