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Physiology Flashcards

1
Q

Apparatus used in determining hemoglobin content

A

Sahli which has 2 readings (gram/100 or % of normal)

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2
Q

Sahli is used in

A

Determination of Hb content

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3
Q

Material/principle used in determining hemoglobin content

A

0.1 HCl to 10% in Sahli tube + 0.02 ml anti-coagulated blood using pipette

Add distilled H2O to acid hematin and match colors

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4
Q

What is the role of HCl in the hemoglobin content experiment

A

Blood + diluted HCl (hypotonic) ——> Repture of RBC’s (hemolysis) + formation of acid hematin (dark brown color)

Intensity of color alpha Hb content

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5
Q

Can HCL be replaced with sulphuric acid (H2SO4)?

A

No, gives another color

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6
Q

Precautions in determining Hb content

A

Sterilization, No air bubbles in blood column, avoid compression of finger

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7
Q

Normal value of Hb content for males?

A

15-16 gm/100ml

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8
Q

Normal Hb value for females?

A

13-14 gm/100 ml

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9
Q

Why is Hb content lower in females?

A

male androgen (increases erythropoietin) in males. Also females have periods

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10
Q

As one ages, Hb content…….

A

decreases

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11
Q

State the variation in Hb% could happen due

A

Chronic bleeding: ↓due to iron loss—> microcytic hypochromic anemia

Newborn: ↑due to relative intra-uterine hypoxia—-> stimulate erythropoietin release—–> ↑ RBC’s

High altitude: ↑ due to hypoxia—>stimulate erythropoietin release—> ↑RBC’s

Renal failure: anemia (↓ erythropoietin)

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12
Q

Hb above physiological level is called

A

polcythemia

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13
Q

Functions of Hb

A

gas transport, buffer (maintaining PH at 7.4)

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14
Q

blood ph?

A

7.4

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15
Q

Each 1 gm of Hb carries _____ml of O2

A

1.34 ml

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16
Q

Apparatus used in ESR

A

Westergren tube

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17
Q

Clinical significance of ESR?

A

Prognostic not diagnostic test (used in follow up)

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18
Q

Materials used in ESR

A

Anticoagulant = (0.5 ml Na citrate → Deionization of ca++ ion) + 2ml blood (ratio 1:4) in tube to 0

Read plasma on top of RBCs after 1 & 2 hours

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19
Q

ESR possible mechanism

A
  • Plasma proteins neutralize charges on RBCs →↓ repulsion forces→ favors adhesion, sedimentation.
  • specific gravity of RBC’s 1090 > plasma 1030
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20
Q

Rate of sedimentation depends on…..

A

number of RBC’s, repulsion force between RBC’s, specific gravity of RBC’s, plasma

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21
Q

ESR normal values for male and females at 1st hour and 2nd hour

A
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22
Q

Factors that increase ESR

A

Pregnancy, menstruation, infection, inflammation, malignant and anemia

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23
Q

Factors that decrease ESR

A

Afibrinogenemia and Polycythemia

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24
Q

Why ESR is increased in inflammatory conditions:

A

↑ plasma antibodies (proteins) neutralize charges on RBCs→↓ repulsion forces→ favors adhesion, sedimentation.

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25
Q

Agglutination is

A

antigen antibody reaction →hemolysis of RBC’s

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26
Q

Rouleaux formation

A

adhesion of RBC’s together

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27
Q

Hematocrite ratio (PCV) apparatus

A

capillary tube ( contains heparin as anticoagulant) and centrifuge

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28
Q

What is hematocrite ratio (PCV) ?

A

% of RBCs volume to total blood volume

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29
Q

Specific gravity of RBC’s is

A

1090

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30
Q

Specific gravity of plasma

A

1030

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31
Q

Specific gravity of blood

A

1060

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32
Q

Normal hematocrit values (PCV) for male is_____and for females is _____

A

46%, 42%

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33
Q

High PCV is caused by

A

Polycythemia (as in high altitude), dehydration, and venous blood

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34
Q

Low PCV is caused by

A

Anemia, overhydration, arterial blood

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35
Q

Why hematocrit value of venous blood more than arterial blood?

A

Due to chloride shift phenomenon

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36
Q

Mean corpuscular volume (MCV) is

A

volume of single RBC. Normal is normocytic, low is microcytic (80) and high is macrocytic (95)

(PCV x 10)/RBC count

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37
Q

Mean corpuscular Hemoglobin (MCH) is _________.Normal is called _______and it is considered low if less than ____. The formula for this is?

A

Hb concentration in single RBC. normochromic. 25.

(Hb contentx10) / RBCs count

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38
Q

Mean corpuscular hemoglobin concentration (MCHC) is ________, the formula is ________ and the range is _______

A

Hb concentration in 100 ml PCV, (Hb contentx 100)/PCV, 32-38

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39
Q

Osmotic fragility test apparatus is

A

test tubes

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40
Q

materials in osmotic fragility test

A

5ml NaCl with different concentration in test tubes + 1ml blood in each tube

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41
Q

RBCs in NaCl is 0.9%, this is a _______solution

A

isotonic solution

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42
Q

RBC’s in NaCl greater than 0.9% is a _______solution

A

hypertonic/hyperosmotic solution

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43
Q

RBC’s in NaCl is less than 0.9%, this a ______solution

A

hypotonic

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44
Q

If RBC’s in 0.3% or less it is _______

A

not detected, completely hemolyzed

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45
Q

Hemolysis begins at ____, hemolysis completes at _____

A

0.45, 0.3

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46
Q

Why is there a range of hemolysis

A

Older hemolyze before new ones

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47
Q

Fragility of RBC’s is increased in

A

Hereditary spherocytosis

higher saline concentration

G6PD

drugs

infections

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48
Q

fragility decrease in

A

Thalassemia, iron deficiency anemia

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49
Q

Causes of hemolysis of RBC’s

A

malaria
Incompatible blood transfusion
Snake venom
Hypotonic solution

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50
Q

Osmosis is:

A

Diffusion of H2O according to conc. gradient

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51
Q

Osmotic pressure is

A

pressure needed to stop osmosis

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52
Q

Hemostasis is

A

stoppage of bleeding from injured vessels

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53
Q

Bleeding time is about

A

1-3 min

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54
Q

Coagulation time is

A

3-10 min

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55
Q

Bleeding time depends on

A

VC, number and functions of platelets

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56
Q

Coagulation depends on

A

clotting factors (liver function, Vit K)

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57
Q

Bleeding time prolonged in

A

purpura, which is caused by vascular disorders (vitamin C deficiency) , thrombocytopenia and thrombasthenia

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58
Q

Coagulation time prolonged in

A 
Hemophilia ( A ↓8 factor or B ↓IX or C ↓XI )
Liver disease 
↓ vit K as in new born, prolonged 
antibiotic
use of anticoagulant
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59
Q

In Purpura, bleeding time is ______ while clotting time is ______

A

prolonged, normal

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59
Q

In Purpura, bleeding time is ______ while clotting time is ______

A

prolonged, normal

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60
Q

In hemophilia , bleeding time is ______ while clotting time is ______

A

normal and prolonged

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61
Q

In Vitamin K deficiency, bleeding time is ______ while clotting time is ______

A

normal. prolonged

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62
Q

Average thrombocytes is

A

300000/mm3

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63
Q

Thrombocytopenia means you have fewer than ______ platelets

A

150000

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64
Q

Thrombocytosis is defined as a platelet count above ________

A

350,000

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65
Q

Vivo anticoagulant

A

heparin, dicumarol

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66
Q

In vitro anticoagulant

A

Na citrate, oxalate and heparin

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67
Q

Sources of heparin in body?

A

Mast cell and basophil

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68
Q

Prothrombin is a test for the

A

extrinsic pathway, 15 second in vitamin k deficiency

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69
Q

Activated partial thromboplastin time is a test for

A

intrinsic pathway

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70
Q

Blood types rarest to most common are

A

AB, B, A and O

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71
Q

A type blood can donate to ______and receive from ______

A

A, AB A, O

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72
Q

B type blood can donate to ________and receive from _______

A

B, AB B,O

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73
Q

AB type blood can donate to ______and receive from _______

A

AB, all (universal recipient)

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74
Q

O blood can donate to ________and receive from________

A

All, O

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75
Q

Rh positive is about ____% of population while RH negative is ____%

A

85, 15

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76
Q

RH positive can receive from _______ while RH negative can receive from _________

A

RH negative or positive, ONLY RH negative

77
Q

Indications of blood transfusion

A

Hemorrhage, erythroblastosis, fetalis, severe anemia

78
Q

Complications of incompatible blood transfusion includes

A

Agglutination of RBC,s which results in:

-Blockage of capillaries

-Intravascular Hemolysis ( which releases)—>
Histamine
K—>cardiac arrhythmia
Hb—> hemolytic jaundice

79
Q

Erythroblastosis fetalis is

A

hemolytic disease of Rh+ve newborn. It is caused by development of anti-D (IgG) following delivery of first baby

80
Q

Conditions in which erythroblastosis fetalis is possible?

A
  • 2nd baby for RH –ve female married RH+ male

* 1 st baby may be affected in previously sensitized female

81
Q

Erythroblastosis fetalis manifestation

A

Anemia, jaundice, born dead

82
Q

How to prevent Erythroblastosis fetalis

A

Anti-D injection within 48 hours of delivery

83
Q

A fibers are ______fibers for _______muscles. They are blocked by_________

A

Thick somatic, skeletal muscles, pressure

84
Q

B fiber are ________, blocked by _________

A

Thin autonomic, hypoxia

85
Q

C fibers are _______nerve, and are _______. They are blocked by ____________

A

Unmyelinated thin, postganglionic, anesthesia

86
Q

Nerve conduction velocity is

A

Distance between stimulating and recording electrodes/ latent period

87
Q

The firing level is _____mv. depolarization is caused by ________, repolarization is caused by _______ and hyperpolarization is caused by _______

A

-65, Na inflow, K outflow, slow closure of K channels

88
Q

Compound action potential is

A

sum of all action potentials recorded from nerve trunk. It has many peaks and doesn’t obey the all or none law.

89
Q

Two tests for carpal tunnel syndrome

A

Phalen or wrist flexion test (tingly or numbness after 1 minute is abnormal)

Tinel test: Tap or press on median nerve (abnormal if its shock or tingly)

90
Q

Causes of Normocyte normochromic anemia`

A

Acute blood loss

Bone marrow depression

91
Q

Causes of microcytic hypochromic anemia

A

Deficiency of iron in diet
deficient iron absorption
Chronic blood loss

92
Q

Causes of macrocytic anemia

A

Folic acid and vitamin B12 deficiency

93
Q

Causes of Iron deficiency

A

Lower Iron intake as in growing children and during pregnancy

deficiency of iron absorption as in partial gastrectomy, vitamin C deficiency, and disease of small intestines.

94
Q

Causes of vitamin B12 deficiency

A

Defective absorption as after gastrectomy, absence of intrinsic factors and small intestine disease

Deficiency in diet in cause of vegetarians

95
Q

Pernicious anemia

A

Autoimmune disease that attacks the intrinsic factor that absorbs vitamin B12

96
Q

Items used in frog leg experiment

A

Gastrocnemius and sciatic nerve
Ringer’s solution poured on them (0.6% NaCl)
Stimulus: single maximal electric stimulus
Transducer, computer system for recording

97
Q

The single muscle twitched (SMT) is represented on the graph as……..

A

a curve

98
Q

what is a single muscle twitch (SMT)

A

single maximal stimulus → results in isotonic contraction followed by relaxation.

99
Q

Is SMT a physiological event

A

No, as muscle receives train of action potentials

→cause tetanic contraction→ useful work

100
Q

What are the phases of SMT

A
  • Latent period (0.01)
  • Contraction period (0.04)
  • Relaxation period (0.05)
101
Q

causes of latent period

A
  • Conduction through nerve

* Neuromuscular transmission

102
Q

To shorten latent period, you must

A
  • Shorten distance between applied electrode & muscle
  • Put electrodes directly on muscle
  • Use warm ringer
103
Q

Effect of warming on SMT?

A

↓duration of all phases (shortened) &
↑force (amplitude) (height) of contraction
↑ enzymes activity, ↓muscle viscosity

104
Q

Effect on SMT cooling?

A

↑ duration of all phases (prolonged) &
↓force of contraction
↓enzymes activity, ↑ muscle viscosity

105
Q

true or false? Nerves fatigue

A

False

106
Q

Effect of fatigue on SMT

A
  • ↑Duration of all phases
  • ↓Force (height) of contraction
  • Incomplete relaxation (contracture)
107
Q

Causes of SMT fatigue

A
  • Neuromuscular fatigue: ↓acetyl choline
  • Muscle fatigue (chemicals accumulated): ↑ lactic acid, CO2, K, adenosine, ↓ATP

➢ Intact animal: fatigue is caused mainly due to muscle fatigue

➢ in the experiment: neuromuscular fatigue

108
Q

To differentiate between Neuromuscular fatigue & Muscle fatigue:

A

• Put electrode directly on muscle

➢ If there is Response→ Neuromuscular fatigue
➢ No response→ Muscle fatigue

109
Q

Why muscle shows normal contraction on direct stimulation after being fatigued:

A

direct stimulation→ bypass neuromuscular fatigue

110
Q

How could we obtain forcible contraction?

A 
Increase intensity of stimulus
Increase frequency of stimulus
Increase temperature (warm ringer)
111
Q

Structures that obey all or none law

A

Nerve fiber
Muscle fiber
Visceral smooth muscle
Atria and venricles

112
Q

What structures DONT obey the all or nothing law?

A

nerve trunk

Skeletal muscle

113
Q

Clonus when warmed results in

A

separated twitches

114
Q

Clonus when cooled/fatigued result in

A

tetanus (no relaxation)

115
Q

Tetanus when warmed results in

A

clonus

116
Q

Separated twitches when cooled results in

A

clonus

117
Q

chemicals in fatigued muscles are

A

CO2, lactic acid, K, adenosine

118
Q

Low frequency of stimulation result in

A

separate twitches

119
Q

A moderate stimulations result in

A

clonus

120
Q

High frequency stimulation results in

A

tetanus

121
Q

Stair case phenomenon

A

multiple sperate twitches (contractions followed by complete relaxation)

122
Q

clonus definition

A

contraction followed by incomplete relaxation

123
Q

why does multiple stimuli increase peak of contraction?

A

accumulation of calcium

124
Q

Diastolic pulse pressure is

A

Minimum pressure during diastole (60-90)

125
Q

Pulse pressure formula

A

Difference between systolic and diastolic pressure

126
Q

MAP (Mean systemic arterial pressure) 2 formulas are

A

MAP=Diastolic pressure+ 1/3Pulse pressure

MAP= CO X resistance

127
Q

Gravity affect on ABP

A

each 1 cm below heart → ↑ABP by 0.77 mmHg.

Each 1 cm above heart → ↓ ABP by 0.77 mmHg

128
Q

Types of blood flow:

A

✓ Laminar (streamline): flow in layers (fastest in center, slowest at periphery) → no sound

✓ Turbulent flow: → Korotkoff sounds

129
Q

Why sounds are heard just between systolic and diastolic pressures?

A

a. Above systolic: closed artery→ no flow → no sound.
b. Between systolic and diastolic: partially opened artery→ turbulent flow →sound.
c. Below the Diastolic: opened artery→ laminar flow →no sound

130
Q

Why blood flow in artery normally soundless:

A

Laminar flow

131
Q

Korotkoff’s sounds:

A

Sounds heard over brachial artery during deflation of cuff due to turbulent blood flow

a. Phase1: sharp clear sound → systolic pressure. systolic pressure when sound first appears
b. Phaes2: soft
c. Phase3: louder sound
d. Phase4: ↓ intensity
e. Phase5: sound disappear → diastolic. Diastolic pressure when sounds disappear.

132
Q

Effect of exercise on ABP

A

↑systolic pressure due to ↑SV (due to ↑EDV, VR) , ↓diastolic pressure (due to
peripheral VD→↓ resistance)

133
Q

HESS (tourniquet) TEST (determination of capillary fragility)

A

• Mark one inch circle on forearm

• Apply cuff on upper arm → ↑pressure to 60 mmHg for 15 min (interfere with venous return)→↑
capillary pressure

  • Count number of red spot (petichea) in the circular area
  • Petichea >8= + ve test→ purpura
134
Q

in frogs: pacemaker is

A

sinus venosus

135
Q

Factors affecting HR (Chronotropic state):

✓ in frog experiment

A

warming , cooling

136
Q

Very slow conduction at AV node:

A

allow sufficient time for ventricular filling before ventricular contraction

137
Q

Very fast conduction in purkinje fiber:

A

allow ventricular muscle to contract at same time→ work as one unit

138
Q

Vagal tone importance

A

under rest, parasympathetic effect on SAN is stronger than sympathetic (↓ SAN to 70)

139
Q

Physiological significance of the long ARP of the cardiac muscle:

A

prevent cardiac tetanus

140
Q

Effect of stimulus while heart in systole:

A

no effect due to ARP

141
Q

Effect of stimulus while heart in diastole:

A

Premature Ventricular Beat (ventricular extrasystole) due to RRP

142
Q

Ascending

(Anacrotic) limb

A 
↑  reach  120 
mmHg (Systolic 
Blood Pressure) 
Due to rapid 
ejection of blood coincides with Maximum 
ejection phase
143
Q

Diacrotic Notch=

Incisura

A

Sharp small drop Of pressure Due to small back

flow of blood from aorta to left ventricle coincides with End of reduced ejection phase

144
Q

Diacrotic wave

A

↑ pressure (Due to bouncing of blood up by closed valve & elastic recoil). coincides with Isovolumetric
relaxation phase

145
Q

water hammer pulse

A

wide pulse pressure as in anemia, pregnancy, hyperthyroidism

146
Q

pulsus alternans

A

: alternating strong & weak pulse in heart failure

147
Q

Positive A wave

A

high atrial pressure, atrial contraction during atrial systole

148
Q

Negative X wave

A

Low atrial pressure, escape of blood from atria to ventricle

149
Q

Positive C wave

A

increase of atrial pressure , due to bulge of tricuspid valve cups into atria

150
Q

Negative X wave

A

decrease in atrial pressure and downward pull of Av cusps

151
Q

Positive Y wave

A

Increase atrial pressure, accumulation of VR in atrium while tricuspid is closed

152
Q

Negative Y wave

A

decrease in atrial pressure, blood flow from atria to ventricle

153
Q

Ventricular systole is between __________and _______

A

begging of positive C wave and peak of positive v wave

154
Q

First heart sound is caused from

A

closure of A-V valves

155
Q

First heart sound is timed with

A

isometric contraction phase and early rapid ejection phase

156
Q

First heart sound has a ______pitch and a duration of _____seconds

A

low, 0.15 seconds

157
Q

Mitral component of first heart sound is at

A

left of 5th intercostal space (apex of heart)

158
Q

Third heart sound is caused from ________. It coincides with________and is normally ________

A

Rapid flow from atria to ventricles, rapid filling phase, non-audible

159
Q

Fourth heart sound (S4) is caused by _________, and coincides with ________. It is ________

A

rapid flow of blood from atria to ventricles, atrial systole, very faint.

160
Q

Causes of Autonomic dysfunction

A 
Diabetes mellitus:
Vitamin B12 deficiency 
Metabolic
Central cause
Idiopathic cause
161
Q

During inspiration HR _______, and in expiration HR________

A

Increase, decrease

162
Q

Respiratory sinus arrhythmia

A

HR doesnt increas during inspiration

163
Q

Why HR increase during inspiration?

A

Stretch receptors in alveoli inhibit vagus N

Respiratory center inhibits Vagus N

increase VR, causes stretch in heart wall, activate stretch Receptors which inhibits vagus N

164
Q

HR during respiratory cycle normal, borderline and Abnormal

A

15 or greater, 11-14 , 10 or less

165
Q

Valsalva maneuver is __________. when preformed correctly you can see_______

A

Forced expiration against closed glottis for 15 seconds. distend jugular vein

166
Q

Phase 1 of heart in Valsalva maneuver

A

increase BP and decrease HR

167
Q

Phase 2 of heart cycle during Valsalva maneuver

A

BP decrease, HR increase

168
Q

Phase 3 of heart cycle during Valsalva maneuver

A

BP decrease and HR increase

169
Q

Phase 4 of heart cycle during Valsalva maneuver

A

BP increase, HR decrease

170
Q

Atrial fibrillation

A

P wave absent, irregular beats

171
Q

Heart block

A

PR interval is longer than normal. Makes QRS late

172
Q

Premature beat

A

An extra beat due to premature electric impulse.

173
Q

ST elevation in ECG is caused by

A

Myocardial infarction

174
Q

ST depressed caused by ischemia

A

Ischemia

175
Q

Effects of hypokalemia on ECG

A

Flat T wave
Prominent U wave
Depressed S-T segment
Prolonged PR intreval

176
Q

Effects of hyperkalemia on ECG

A

Tall, peaked, narrow T wave
P wave diminishes in size
Shortened Q-T interval

177
Q

Tidal volume

A

volume of air inspired or expired during rest. About 500 ml

178
Q

Inspiratory reserve volume (IRV)

A

max volume of air inspired after normal inspiration (3000ml)

179
Q

Expiratory reserve volume

A

Max volume of air expired after normal expiration (1100)

180
Q

Residual volume

A

volume that remains in lungs unless punctured, 1200 ml

181
Q

Total lung capacity is

A

volume of air in the lungs after maximum inspiration

TLC= IRV + TV + ERV + RV = 5800 ml

182
Q

Inspiratory capacity

A

max volume of air inspired after normal expiration

= IRV + TV + ERV = 4600

183
Q

Functional residual capacity

A

Volume of air between breathes when respiratory muscles relaxes

= ERV + RV = 2300 ml

184
Q

Pathological decrease in vital capacity

A 
Paralysis of respiratory muscles
Bone deformities
Obstructive lung disease
Restrictive lung disease
Loss of lung elasticity 
Abdominal tumor
185
Q

Forced vital capacity (FVC)

A

rapid forced expiration after max inspiration

186
Q

Respiratory rate is normally

A

12-16 cycles per minute

187
Q

Pulmonary ventilation

A

Respiratory rates X tidal volume

188
Q

Alveolar ventilation

A

(TV-DS) X respiratory rate

189
Q

Dead space

A

TV X ((PCO2 artery -PCO2 air)/ PCO2 arterial blood))

190
Q

Measurement of maximal voluntary ventilation

A

Maximum amount of air subject can respire in 1 minute. Use nasal clips.

191
Q

Where to preform auscultation

A

➢ Anteriorly

  • Apex of the lung: above middle 1/3 of the clavicle
  • Upper lobe: 2nd space MCL
  • Middle lobe: 4th space MCL
  • Lower lobe: 6th space MAL

➢ On the back of the chest:
• Upper lobe: C7 – T3
• Lower lobe: T3- T10

Practical (13 decks)

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