Physio Handout Flashcards by Aileen Crystel D. Abueva

Powerhouse of the cell.

Mitochondria

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Organelle for Protein synthesis.

Rough Endoplasmic Reticulum

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Organelle for synthesis of lipids; contains oxidades, catalases; for detoxification.

Smooth Endoplastic Reticulum

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Contains lysozyme, lysoferritin, and acud hydrolase.

Lysosomes

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Only substance modified in the RER, not in the Golgi.

Collagen

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Moves substances from center to periphery of the cell; involved in Anterograde axonal transport.

Kinesin

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Moves substance from the periphery to the cebter of the cell; involved in Retrograde axonal transport.

Dynein

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Provides structural support component for the cell movement.

F-actin

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Substances that passes throught the water clefts/pores in the membranes.

Water
Glucose
Amino acids

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Junctional complex that is disk-shaped for firm intercellular adhesions.

Macula adherens a.k.a. Desmosomes

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Junctional complex for communication that serve as regulated cytoplasmic bridge for sharing of small molecules between cells.

Gap junctions

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Ring shaped junctional complex that increases surface area contact, in epithelial cells & endothelial cells; intercalated disks of cardiac muscles.

Zonula Adherens

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Functional unit of a gap junction.

Connexon

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Subunit of connexon.

Connexin

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Connexin disorder involving Cx32.

Charcot-Marie-Tooth disease

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Main cation in ECF.

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Main cation in ICF.

K+

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Hallmark of carrier mediated transport.

✔Stereospecificity
✔Saturation
✔Competetion

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Passive, Downhill, Non carrier mediated transport.

Simple diffusion

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Passive, Downhill, Carrier mediated

Facilitated diffusion

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Active, Uphill, Carrier mediated, uses atp

Primary Active Transport

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Active, Uphill, Carrier mediated, uses Na gradient

Secondary Active Transport

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Gases, Alcohol, Steroid hormones transport.

Simple diffusion

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Transport process of GLUT-1,2,3,4,5

Facilitated diffusion

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Transport process of SGLT-1, SGLT-2, Na-K-2Cl

Secondary Active Transport

Transport Na-K-ATPase Pump, Proton Pump

Primary Active Transport

Exhibited only by excitable cells (neurons, muscle cells).

Action potential

Cells that produces CSF

Ependymal cells

Macrophage of the brain

Microglia

Regulates ECF ions and NTs; gives mechanical support; forms BBB

Astrocytes

Creates myelin in the CNS

Oligodendrocytes

Creates myelin in the PNS

Schwann cells

Brain tumors from non-mature neurons

Neuroblastoma | Retinoblastoma

"Receiving" portion of the neuron for NTs

Dendrites

Where action potential in a neuron actually starts

Axon hillock | initial segment

Function of myelin sheath

Insulator

Unmyelinated portion of the axon with highest concentration of Na channels

Node of Ranvier

Branches of the axons

Neural fibrils

Terminal portion of a neural fibril that contains NT-containing vesicles

Axon Terminal / Boutons / End-Feet

Space between 2 neurons

Synaps

Opening of Na-ACtivation Gates (Na influx)

Depolarization

Closure of Na-Inactivation Gates + Opening of K Channels (K Efflux)

Repolarization

Membrane potential where AP is inevitable

Threshold

Portion of AP where MP is Positive

Overshoot

Portion of AP where MP is

Undershoot

No AP can be elicited despite increased stimulus

Absolute Refractory Period

More inward current needed to generate AP

Relative Refractory Period

Causes activation of Synaptic vesicles

Ca Voltage Gated Channels

Death of Axon Distal to the site of injury

Anterograde degeneration

Changes to soma after axon is transected

Axonal reaction / Chromatolysis

Principle that in spinal cord the dorsal roots are sensory and ventral roots are motor.

Bell-Magendie law

Found in NMJ, Sympa and Para preganglionic neurons; Para and some Sympa Post-ganglionic neurons

Acetylcholine * Decreased in Alzheimer's and Huntington * Found in basal ganglia, large pyramidal cells of motor cortex, giganto cellular neurons of the REA * maybe excitatory or inhibitory

Triggers REM sleep

Acetylcholine

Found in locus ceruleus of pons, pre ganglionic of sympa; for arousal/wakefulness

Norepinephrine

Secreted mainly by the adrenal medulla

Epinephrine

Found in substantia nigra, known as PIF in the hypothalamus; for fine tuning movements

Dopamine D1 receptors: activates adenylate cyclase using Gs proteins; D2 receptors: inhibits adenlylate cyclase using Gi protein * decreased in Parkinson * increased in Schizoprenia

Found in the median raphe of the brainstem, from tryptophan, converted to melatonin; low levels association with depression

Serotonin

From Arginine, not pre-formed; inhibitory NT

Nitric oxide

Found in spinal interneurons; main inhibitory NT

Glycine * Increase Cl influx

Found in the brain (e.g. spiny neurons of the striatum, Purkinje cells of the cerebellum)

GABA * main inhibitory NT, from glutamate * inc Cl influx (GABA-A) or K Efflux (GABA-B) * responsible for coordinated movements

Excitatory NT in the CNS; activate NMDA receptors

Glutamate * involved in fast pain * activate Kainate, AMPA receptors

Inhibits neurons in the brain involved in pain receptors

Opioid peptides *enkephalins, endorphins, dynorphins

Involved in slow pain

Substance P

Originates in te superior colliculus of the midbrain, projects to the contralateral cervical spinal cord to control the head and eye movements

Tectospinal Tract

Corticospinal tract neurons that innervates spinal motor neurons, but they can also include brainstem neurons that control spinal motor neurons

Upper motor neuron

Area in the brain for hearing and balance

Temporal lobe

Area in the brain for vision

Occipital lobe

Area in the brain for judgement, calculation, personality

Frontal lobe

Area in the brain for motor

Frontal lobe

Area in the brain for somatosensory

Parietal lobe

Area in the brain for Sex, Thirst, Appetite, Body clock, Temperature

Hypothalamus

Area in the brain for Coughing, Vomiting, Swallowing; Respiratory and Vasomotor center

Medulla

Area where Apneustic and Pneumotaxic center is located

Pons

Micturition center is located

Pons

Area in the brain for Behavior, Emotions, Motivation

Limbic system

Location: Broca's Area?

Opercular / Triangular part of the Inferior Frontal lobe | BA 45

Location: Wernicke's Area?

Superior temporal lobe | BA 21, 22

Contributes to balance; Silent area of the brain

Cerebellum

Communication between corresponding areas of the cerebral hemispheres.

Corpus callosum

Where memory is stored

Throughout the brain | esp TEMPORAL lobe

Conversion of short term memory to long term memory.

Consolidation

Cerebral cortex order neurons.

1st order: Initiation 2nd order: Interpretation 3rd order: Integration

Output pathway from reward and punishment centers; Lesions here will produce ANTEROGRADE amnesia

Hippocampus * create memory based on experience * processor

Help search memory storehouses; lesions will produce RETROGRADE amnesia

Thalamus *relay station for almost all sensations

Can see words but readily grasp meaning despite normal intelligence.

Dyslexia

Site of Pathology of Dyslexia

Dominant Temporoparietal area *secondary visual area

Disease caused by a lesion on the arcuate fasciculus connecting the broca's and wernicke's area.

Conduction aphasia

Sympathectomy effect

Orthostatic hypotension

Person punched in the epigastric area developing hypotension, bradycardia, weak pulses, what reflex is seen?

Vasovagal reflex

Decrease in HR upon compression of the eyeballs due to connection between CN VI and CN X.

Oculocardic reflex

EEG wave: alert; REM

Beta wave * active dreaming * 1st 90 minutes of sleeps * difficult to arouse

EEG wave: relaxed

Alpha wave

EEG wave: deep sleep

Delta wave

Substance suspected to induce sleep

Muramyl peptide

Percentage of REM sleep in newborns

50% * 25% in adults

Master clock

Suprachiasmatic nucleus

Regulates master clock

Pineal gland

Superior cervical ganglia, Tryptophan, Epinephrine, Pineal Hydroxyidole-O-methyltransferase would increase

Melatonin secretion

Bilateral synchronous symmetric "spike-and-wave" discharge on EEG.

Absence seizure

Lesion on this area of the brain will result to Narcolepsy.

Hippocampus

Hypothalamic nucleus associated with temperature regulation.

Anterior nucleus

Synthesizes Vasopressin

Supraoptic nuclei in Hypothalamus

Synthesizes Oxytocin

Paraventricular nuclei (Magnocellular cells)

Responsible for Appetite

Lateral nuclei

Responsible for Satiety

Ventromedial nuclei

Responsible for Dissipation of heat

Anterior nuclei

Responsible for Conservation of heat

Posterior nuclei

Reward center

Medial Forebrain Bundle

Punishment center

Central Gray Area or Aqueduct of Sylvius

Responsible for social inhibition

Amygdala

CSF produced per day

500 mL *150 mL in the brain

Acute effect of hypoxia begin at ___ ft.

12, 000 feet

Seizures begin at ____ ft.

18, 000 feet

Death at ____ ft.

23, 000 feet

5 Mechanism of Acclimatization of Low PO2.

1) Increased RR-> RAL->Renal compensation-> normal pH 2) Polycythemia via EPO-> Inc 2,3 BPG-> shift to R of O2-Hgb dissociation curve 3) Inc diffusing capacity for O2 4) Angiogenesis via VEGF 5) inc mitochondria

What is the cardiac reserve?

400% - 600%

Effects of testosterone on athletic performance.

* increase muscle size * muscle strength * muscle aggression

Maximum allowable negative G force

- 20G | * positive: +6G to +10G

Most common symptom of decompression sickness.

"Bends"

First symptom at 120 feet below sea level.

Joviality

Capillary network in Cortical nephrons

Peritubular arteries *contains interstitial cells that produce EPO

Capillary network in Juxtamedullary nephrons

Vasa recta * counter-current exchanger * maintain the gradient * remove waste

Normal capacity of urinary bladder

600 mL Urge to urinates: >150 mL (25% filled) Reflex contraction: >300 mL (50% filled) Detrussor muscle: responsible for contraction, triggered by distention

Two major parts of nephron

1) Renal or Malphigian Corpuscle | 2) Renal tubular system: PCT, LH, DT, CD

Modified cells capable of phagocytosis in between glomerulus.

Mesangial cells

"Counter current multiplier"

Loop of Henle

Directly proportional to pressure difference between renal artery and renal vein; inversely proportional to resistance of renal vasculature.

Renal blood flow *22% of CO vasodilation: Increase RBF vasoconstriction: Decrease RBF

Estimated by PAH clearance

Renal plasma flow RPF= [RBF x (1-Hemtocrit)]

Normal GFR

125 ml/min or 180L/day ``` GFR= Filtration fraction x RPF GFR= Filtration fraction x [RBF x (1-Hemtocrit)] ```

Filtered; NOT reabsorbed; secreted Highest clearance Estimates RPF & RBF

Paraamino-hippuric acid (PAH)

Filtered; NOT reabsorbed; NOT secreted | Estimates GFR

Inulin

Filtered; Reabsorbed; NOT secreted

Glucose

Activated before RAAS

Baroreceptor reflex

Sense BP changes

Macula densa *detects changes in sodium concentration

JG (granular cells) cells secrete

Renin

Maintains (preserves) normal GFR

Angiotensin II

Inc Na reabsorption Inc K secretion Inc H secretion

Aldosterone

Side effects of High aldosterone levels.

* HPN * Hypokalemia * Metabolic alkalosis (Conn syndrome)

Substances start to appear in the urine.

Renal threshold * some nephrons exhibit saturation * 200mg/dL for glucose

All excess substance appear in the urine.

Renal Transport Maximum * all nephrons exhibit saturation * 375 mg/dl for glucose

3 urinary buffers

NaHCO3 NaHPO4 NH4

Location of Thirst center

ANteroventral wall of the 3rd Ventricle and Pre-optic nuclei

Causes 0.5F increase in temp during ovulation

Progesterone

Reabsorb Na; Secrete K

Principal cells in late DT

Reabsorb K; Secrete H

Intercalated cells in late DT

First step in urine formation

Glomerular filtration

Effect on GFR: Afferent Vasodilation

Increase

Effect on GFR: Efferent Vasodilation

Decrease

Effect on GFR: Afferent Vasoconstriction

Decrease GFR

Effect on GFR: Moderate Efferent Vasoconstriction

Increase

Effect on GFR: Severe Efferent Vasoconstriction

Decrease

Detects movement of objects and low frequency vibration; found in glabrous skin

Meissner's corpuscle | Fast adapting Type 1

For continuous touch; grouped into Iggo dome receptors

Merkel's disk | Slow adapting Type 1

Detects movement of object in skin

Hair-end organ

For pressure; for heavy and prolonged touch; found in deep skin, internal tissues and joint capsules

Ruffini's end organs | Slow adapting Type 2

For high frequency vibration; onion-like structure

Pacinian corpuscle | Fast adapting Type 2

2 point discrimination

Merkel's disk (SA 1): stationary | Meissner's corpuscle (FA1): moving

Order neuron of sensory pathways location

1st: dorsal root / cranial nerve ganglia 2nd: spinal cord / brainstem 3rd: thalamus 4th: sensory cortex

Action potential in retina is due to:

Hyper-polarization

How is color blindness transmitted?

X-linked recessive | 20x more common in males

Substance that directly stimulates the rods

Metarhodopsin II

Receptors connected to bipolar cells

Center of Receptive field

Receptors connected to horizontal cells

Surround of Receptive field

Respond to Bars of Light with correct position & orientation

Simple Cells

Respond to moving bars or edges of light

Complex cells

Respond to lines with particular length and curves/angles

Hypercomplex cells

Absorb stray light and prevent them from scattering; | Site for Macular Degeneration & Retinal Detachment

Pigment epithelium

Retinal Glial cells that maintain internal geometry

Mueller cells

Interneurons that connects rods & cones; | Contrast Detectors

Bipolar cells

Retinal output cells whose axons from the optic nerve

Ganglion cells P cells: Color, Form, Fine details M cells: Illumination, Movement W cells: Unknown function

Cutting of this structure causes ipsilateral total blindness.

optic nerve

Cutting of this structure causes bitemporal hemianopsia.

optic chiasm

Cutting of this structure causes contralateral homonymous hemianopsia.

optic tract | geniculocalcarine tract

Cutting of this structure causes contralateral superior homonymous quadrantinopsia.

Meyer's loop (temporal lobe); | Inferior calcarine fissure (with macular sparing)

Cutting of this structure causes contralateral inferior homonymous quadrantinopsia.

Parietal lobe | Superior calcarine fissure (with macular sparing)

Most common occupational related disease

Occupational Hearing loss *85dB-maximum tolerable loudness

Causes pain, and triggers attenuation reflex

>120dB *stapedius and tensor tympani contract respectively

Respond to high-frequency sounds;

Hair cells near BASE (oval and round windows)

Respond to low-frequency sounds;

Hair cells near APEX (helicotrema)

Frequency analyzer; | Membrane that separates scala tympani and media.

Basilar membrane *where Organ of Corti is

Function of Pinna

Sound collection & localization

Function of Middle ear

Impedance matching

Connects Outer ear and Middle ear that equalizes pressure.

Eustachian tube

For linear & sometimes Angular acceleration/Deceleration

Utricle & Saccule

For Angular acceleration/Deceleration alone

Semicircular canals

For Vertical Acceleration

Saccule *tip links in hair cell: involved in regulation of disotrition-activated ion channels

For Horizontal Acceleration

Utricle

Caused by continued movement of endolymph in the semicircular canals, with consequent bending of the cupula and stimulation of hair cells.

Post rotatory Nystagmus

Masks Background noise

Attenuation / Auditory reflex

Max allowable workplace loudness x 8hours

85-90 dB

Loudness causing pain

120 dB

Location: Sweet

Tip of the Tongue

Location: Umami

Tip of the Tongue

Location: Bitter

Back of the Tongue

Location: Salty, Sour

Sides of the Tongue

Nerve fiber used by Smell

Typa C (slow)

Taste with lowest stimulation threshold

Bitter

Unpleasant perception of taste (metallic, salty, foul, rancid).

Dysgeusia / Parageusia

Produces ptyalin

Parotid gland (serous)

Sites of production of RBCs in order.

1) Yolk sac / AGM (3rd week): 1st trimester 2) Liver (3rd month), Spleen: 2nd-3rd 3) Bone marrow: after birth Main site: liver

Condition when liver still produce RBCs even after birth.

Extramedullary hematopoiesis

Derived from megkaryocytes that lasts for 7-10 days; | forms initial thrombus

Platelets

Lasts for 120 days; relies on ANAEROBIC glycolysis.

RBC *biconcave due to spectrin

Derived from B-cells, secrete Ig

Plasma cells

Cells involved in INNATE Immunity ("security of the cell").

``` Neutrophils Macrophages Dendritic cells Natural Killer cells Complement proteins: C3b, C3a, C5a, C5b-C9 ```

Involved in ADAPTIVE Immunity; specific

T-cells B-cells Antibodies Complement proteins: C3b, C3a, C5a, C5b-C9

Most common blood cell; | Highly lobulated nucleus;

Neutrophils

Least common blood cell; | Bilobulated/trilobulated, blue

Basophils

Cell that is bilobulated, pink

Eosinophils

Largest blood cell; | Eccentricaly placed nucleus

Monocytes

Involved in adaptive immunity; | round, densely stained nucleus with a pale basophilic, non-granular cytoplasm

Lymphocytes

Most abundant immunoglobulin; Predominant antibody in secondary responses; only able to cross the placenta

IgG * dimeric * smallest

Main immunoglobulin concerned with primary immune response; present in uncommitted B cells

IgM * pentameric * largest, with 10 binding sites

Main immunoglobulin in secretions including EXOCRINE secretions

IgA

Antibody mediated allergies and hypersensitivity

IgE

Acts as an antigen receptor when present on the surface of certain B lymphocytes

IgD

Complement protein that acts as "molecular vetsin" (Opsonization).

C3b

Complement protein that induces inflammation (Anaphylatoxin).

C3a, C4a, C5a

Complement protein chemotactic to WBCs

C5a

Complement protein in membrane attack complex (form holes in the cell membranes)

C5b-C9

Causes increased bone marrow RBC production in response to hypoxia.

EPO

Last cell capable of mitosis

Polychromatic erythroblast / Pro rubricyte

Sign due to reduced hemoglobin concentration of the blood in the capillaries >5g/dL.

Cyanosis

Lifespan of: * Reticulocyte * Adult RBC * Fetal RBC

* Reticulocyte: 2 days * Adult RBC: 120 days * Fetal RBC: 90 days

Lifespan of * Granulocytes * Monocytes * Lymphocytes

* Granulocytes: 4-8 hrs in blood; 4-5 days in tissues * Monocytes: 10-20 hrs in blood; months in tissues * Lymphocytes: weeks to months

Movement of neutrophils and macrophages towards a CHEMICAL signal.

Chemotaxis

Movement out of the circulatory system and into the site of injury.

Diapedesis

Most common type of Graft.

Allograft Autograft: same person = 0% risk of rejection Isograft / Syngeneic: among identical twins = 0% risk of rejection Allograft: same species; imminent risk of rejection Xenograft: between species

Endothelial molecule for Rolling.

P Selectin: Neutrophils, Monocytes, T-lymphocytes | Glycam-1: Neutrophils, Monocytes

Endothelial molecule for Adhesion.

VCAM-1: Eosinophils, Monocytes, Lymphocytes

Endothelial molecule for Rolling & Adhesion.

E Selectin: Neutrophils, Monocytes, Lymphocytes

Endothelial molecule for Adhesion, Arrest, and Transmigration.

ICAM-1: Neutrophils, Monocytes, Lymphocytes

Mediated by local myogenic spasm and endothelin 1.

Vascular constriction

Primary Hemostasis / Formation of Loose Platelet Plug

Platelet ADHESION: mediated by vWF (bv) and Gpb1 (platelets) Platelet ACTIVATION: change shape Platelet AGGREGATION: mediated by fibrinogen and Gp2b-3a of platelets

Vasodilate in response to hypoxia to provide O2.

Systemic arterioles

Lowest pressure; 0-4 mmHg

Right Atrium

Shunts in Fetus

Ductus venosus: liver Ductus arteriosus: PA and aorta Foramen ovale: RA & LA

Control conduits; main determinant of TPR

Arterioles * may rapidly dilate or constrict * (+) greatest resistance a1: constriction b2: dilation (relax) * predominant contributor of TPR

Highest pressure individual basis; stressed volume

Arteries

Highest total cross sectional area in the body; endothelial cell only

Capillaries

A.k.a. Capacitance vessels;with one way valves; | reservoir of blood

Veins

Reynold's number for Laminar flow

<2000 Laminar flow: streamlined; highest at the center, lower at the walls

Reynold's number for Turbulent flow

>2000 Turbulent flow: disorderly; vessel narrowing, anemia

Marker for Cardiac function

Ejection Fraction EF= SV/EDV

Amount of blood per heart beat

Stroke volume

Pressure at the level of arterioles and arteries that opposes blood coming out of the heart.

Total peripheral resistance *predominant component of diastolic pressure

Amount of blood in the ventricle immediately before systole.

End Diastolic Volume (EDV)

Amount of blood in the ventricle immediately before diastole.

End Systolic Volume (ESV)

Ventricular Contraction

Systole

Ventricular Relaxation

Diastole

LVEDV

Cardiac Preload

Aortic Pressure

Cardiac Afterload

Stroke volume/Arterial Compliance

Pulse pressure

Used to estimate L atrial Pressure

Pulmonary Capillary Wedge Pressure

Prolonged QT interval

Hypocalcemia

Prolonged PR interval

Heart blocks

Peak or Tall T waves, reduction of size of P waves, widened QRS, evolution to sinusoidal shape

Hyperkalemia

Isoelectric portion of ECG where ventricles are completely depolarized.

ST segment

ECG: Atrial Depolarization

P wave

ECG: Ventricular Depolarization

QRS

ECG: Ventricular Repolarization

T wave

ECG: Initial Repolarization of Ventricles

P-R interval

ECG: Intraventricular Conduction Time

QRS duration

ECG: Duration of Ventricular Action Potential

Q-T interval

Reflex: An increase in venous return will increase HEART RATE.

Bainbridge reflex *volume receptors of atria

An increase in venous return will increase STROKE VOLUME.

Frank-Starling Mechanism

Set point of MAP in Vasomotor center

100 mmHG

Respond in low BP

Carotid Sinus * low and high * 50 mmHg - 180 mmHg

Respond in high BP >80mmHg

Aortic Arch

Branch of CN IX that carries signals from carotid sinus to NTS.

Hering's nerve

Volume equilibrium between brain tissue, blood, and CSF.

Monroe-Kelly Doctrine

Triad: HPN, Irregular respiration and Bradycardia

Cushing Reflex | increased ICP

Phase of cardiac cycle where Aortic pressure is highest.

Reduced Ventricular Ejection

Phase of cardiac cycle where Ventricular pressure is lowest.

Isovolumic Relaxation * closure of SL valves * v wave (atrial filling)

Closure of aortic valve in aortic pressure curve

Dicrotic notch

The aortic valve closure marks the beginning of which phase in cardiac cycle?

Isovolumic Relaxation

Closure of AV valves

S1 | Isovolumic contraction

Closure of SL valves

S2 (split during inspiration) | Isovolumic relaxation

Rapid ventricular filling

Stiff ventricles | Atrial Contraction/Systole

Where blood velocity is fastest

Aorta

Main fuel of the Heart

fatty acids

Disappearance of Korotkoff sounds at the level above diastolic pressure

Auscultatory gap

Prolonged PR interval (>200ms); | Conduction is slow but not completely interrupted

1st degree AV Block

Ventricular rate lower than atrial rate; PR interval increases then ventricular beat is dropped; Wenckeback phenomenon)

2nd degree AV Block

Conduction to ventricles completely interrupted and ventricles beat at low rate; idioventricular rhythm

3rd degree (Complete) AV Block

Describes fluid movement into (absorption) or out (filtration) the capillary

Starling Forces

Normal net filtration

2mL/min

Most potent vasoconstrictor

Vasopressin

Most important controller of coronary blood flow.

Adenosine

Favors filtration; | Determined by pressure & resistance in arteries & veins

Capillary Hydrostatic Pressure | NV: 25 mmHg

``` Opposes filtration (favors absorption); Slightly negative due to lymphatic pump ```

Interstitial Hydrostatic Pressure | NV: -3 mmHg

Favors filtration; | Increased by increases in plasma protein concentration

Capillary Oncotic Pressure | NV: 28 mmHg

Favors filtration; | Determined by interstitial protein concentration

Interstitial Oncotic Pressure | NV: 8 mmHg

Hydraulic conductance of capillary wall.

Filtration coefficient

Counteracts TXA2

Prostacyclin (PGI2)

Most important factor in the closure of Ductus arteriosus.

Increased O2 tension

Organ with greatest blood flow per 100g of tissue

Kidneys

Functional anatomic unit of the Lung

Segmental Bronchi to Alveoli

Respiratory unit of the Lung

Respiratory bronchiole Alveolar ducts Alveoli

Anatomic deadspace

Nose to Terminal Bronchiole

Produces mucus

Goblet cell

May secrete protective GAGS and metabolize air-borne toxins

Clara cells | club cells

Largest circumference in the tracheobronchial tree.

Trachea

Law implying that an increase in Lung Volume will decrease pressure.

Boyle's Law

Law for transfer of gases through simple diffusion in cell membranes or capillary walls.

Fick's Law of Diffusion

Maintains oxygenation in between breaths; Prevents lung collapse after max exhalation; Cannot be measured directly by spirometry.

Residual volume

Amount of air inspired/expired during quiet breathing.

Tidal volume

Marker for Lung function; | Equilibrium/Resting volume of the Lung

Functional Residual Capacity *air left in the lungs after a regular exhalation

Directly measured in spirometry.

Vital capacity

Anatomic Dead Space + Alveolar Dead Space

Physiologic Dead SPace

Minute ventilation corrected for physiologic dead space.

Alveolar Ventilation

Total rate of air movement in/out of the lungs.

Minute Ventilation

Connects alveoli to another alveoli; enable stability of alveoli

Pores of Kohn

Ability of the respiratory membrane to exchange gas between alveoli & pulmonary blood.

Diffusing capacity

Percentage of dissolved O2

Percentage of O2 bound to Hgb

98%

Hgb with attached O2

Oxyhemoglobin

Hgb without attached O2

Deoxyhemoglobin

Hgb with Fe+3, doesnt bind O2

Methemoglobin

a2y2, higher affinity for O2

Fetal hemoglobin

sickled RBCs, less affinity to O2

Hemoglobin S

% of blood that gives up to its O2 as it passes through the tissues

Utilization coefficient

O2 affecting affinity of CO2/H+ to Hgb

Chloride shift

O2/H+ affecting affinity of O2 to Hgb

Haldane effect

V/Q = infinity

Dead space

V/Q = zero

Shunt

Zone with no blood flow

Zone 1

Zone with Intermittent blood flow

Zone 2

Zone with complete blood flow

Zone 3 * Lungs in supine position * Lung during exercise

For normal inspiration; Main center that sends inspiratory ramp signal

DRG (medulla)

For Forced inspiration and passive expiration; overdrive mechanism in exercise

VRG | supplements

Located in upper pons that modify the DRG; | Limits duration of inspiration and increases RR

Pneumotaxic Center

Located in lower pons; | Prolongs duration of inspiration and decreases RR

Apneustic Center

Located in ventral medulla; | excited by CSF H+ from plasma CO2

Central Chemoreceptor *adapt within 1-2 days

Stimulated by Lung distention; | Initiated Hering-Breuer reflex

Lung Stretch receptors

Stimulated by noxious chemicals

Irritant receptor

Strongest layer of the esophagus.

Submucosa

Periodic contractions due to spike potentials (ture AP).

Phasic Contraction

Constant level of contraction without regular rest due to sub threshold slow waves.

Tonic Contractions

Source of CCK in duodenum.

I cells

Secretes Mucus in GIT.

Mucous Neck Cell

Secretes HCl in GIT.

Parietal / Oxyntic Cell

Secretes Pepsinogen in GIT.

Chief / Peptic Cell

Secretes IF in GIT.

Parietal / Oxyntic Cell

Secretes Serotonin in GIT.

Enterochromaffin

Secretes Bicarbonate in GIT.

Mucous Neck Cell

Secretes Gastrin in GIT.

G Cells

Secretes Histmine in GIT.

ECL cells

Inhibits appetite

Satiety Center

Stimulates appetite

Hunger Center

Releases POMC to decrease appetite

Anorixegenic Neurons

Releases Neuropeptide Y to increase appetite

Orexigenic Neurons

Stimulates Anorexigenic neurons

Leptin (Fat cells) | Insulin , GLP-1

Inhibits Anorexigenic neurons

Ghrelin

Inhibits Ghrelin

Peptide YY

Substance responsible for activation of zymogen secretion.

Gastrin

Inhibits pancreatic HCO3- & enzymes.

Pancreatic Polypeptide

Secreted by intestinal cells in response to hypoglycemia.

Enteroglucagon

Secreted by L cells; stimulates insulin secretion

GLP-1

Inhibits all GI hormones

Somatostatin

Potentiates gastrin & ACh action on the parietal cells.

Histamine

Hunger pangs are strongest when?

3rd to 4th day

Myenteric Reflex + Anal Direction of Peristalsis

Law of the GUT

Causes receptive relaxation of the stomach.

VIP

Storage capacity of the stomach.

1.5L

Gastric emptying is faster in which condition?

Food is isotonic & liquid

Deactivated by Gastric pH

Salivary amylase

3 structures found in the Large intestines but not in the Small intestine

Haustra Appedices epiplocae Taenia coli

Defecation following a meal among infants is due to?

Gastrocolic reflex

Stimulates HCl secretion

Histamine (paracrine): H2 receptors Ach (neurocrine): M3 recepetors Gastrin (GI hormone): CCKb receptors

Inhibits HCl secretion

Low pH (<3.0) of the stomach Somatostatin Prostaglandins

Type of CHO absorbed

Monosaccharides *gluc, galac, fruc

Activates Trypsinogen

Enterokinase

Glu, Gal absorption from Lumen to SI

SGLT-1

Fru absorption form lumen to SI

GLUT-5

Glu, Gal, Fru absorption form SI to blood

GLUT-2

Lingual lipase, Gastric Lipase

Acid-Stable

Pancreatic lipase

Acid-Labile

Fat absorption from lumen to SI

Micelles

Fat absorption from SI to LActeals

Chylomicrons

Tether Myosin to Z lines; | Binds Z lines to M lines

Titin

Stabilizes Sarcolemma and prevents contraction-induced rupture

Dystrophin

Binds Actin to Z lines

Actinin and CapZ protein

Binds Z lines to Sarcolemma

Desmin

Molecular ruler, sets actin length

Nebulin

Type of muscle with slow onset, low energy expenditure. greater and prolonged force of contraction.

Smooth muscle * 4-6 kg/cm2

Blocks release of ACh from presynaptic terminals.

Botulinum toxin

Competes with ACh for receptors on motor end plate

Curare

Inhibits acetylcholinesterase

Neostigmine

Blocks reuptake of choline into presynaptic terminal

Hemicholinium

Ab directed against the ACh receptor

Myasthenia gravis

Ach binds to ____ in the motor end plate

Nm Rceptor/Ligand-Gated Ion Channel

Activated at the T-Tubules

DHPR

Calcium channels in the SR activated by DHPR

Ryanodine receptors

Binds to Trop C

Calcium

Happens when Ca binds with Trop C

Displaced Tropomyosin --> Exposure of binding sites in Actin

Happens when ATP binds with Myosin

Myosin detaches from Actin

Partial ATP hydrolysis

Recocking of Myosin heads

Complete ATP hydrolysis

Powerstroke