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Term 2 > Physiology Post-Midterm > Flashcards

Physiology Post-Midterm Flashcards

1
Q

How thin is the blood-gas barrier?

A

1/3 micron

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2
Q

What is the major principle of gas diffusion?

A

[pressure gradient]area/thicknessdiffusion coefficient

  • diffusion coefficient = solubility/ sq(MW)
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3
Q

Which main stem bronchus is more vertical?

A

right

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4
Q

Type 1 alveolar cells

A

Main structural cell of alveoli

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5
Q

Type 2 alveolar cells

A

Produce surfactant

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6
Q

Alveolar macrophage

A

Ameboid motion, phagocytose

* No mucociliary elevator in the respiratory zone

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7
Q

What is an acinus?

A

Group of alveoli branching from a terminal bronchiole

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8
Q

What is the bronchial circulation?

A

Supplies blood to the conducting airways. Delivers deoxygenated blood into the pulmonary vein

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9
Q

What is a normal tidal volume?

A

500 mL

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10
Q

What is total ventilation?

A

Tidal volume x Respiratory frequency

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11
Q

How do you calculate alveolar ventilation?

A

P(expired CO2)/Arterial PCO2

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12
Q

Why does the partial pressure of oxygen decrease once inspired?

A

We humdify the air with gaseous water, thus PO2 becomes 149

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13
Q

Where is there convection vs. diffusion?

A

Convection: bulk flow
Diffusion: across capillary and into tissue

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14
Q

Where is there greater ventilation of the lung? Lower or upper region?

A

Lower region because of gravity

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15
Q

What is the relationship between anatomic dead space, breathing rate and alveolar ventilation?

A

Slower breathing rate combined with larger tidal volumes will maximize alveolar ventilation.

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16
Q

What is the equation for He-dilution FRC testing?

A

V1*(He in/He out -1)

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17
Q

What is the Band 3 protein?

A

Cl-HCO3 exchange transporter; takes place in peripheral RBC’s; offloading of HCO3 from Hb

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18
Q

Differentiate between Bohr and Haldane effects.

A

Bohr: reduced Hb affinity for O2 because high H+/CO2
Haldane: reduced Hb affinity for H+ because of high O2 partial pressure

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19
Q

A V/Q > 0.8

A

Results from “wasted” ventilation, or a PE; PCO2 drops

Bronchi constrict

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20
Q

A V/Q < 0.8

A

Results from an obstructed airway, or “wasted” perfusion.

Hypoxia-induced vasoconstriction

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21
Q

Where in the lung is there better ventilation and perfusion?

A

At the base of the lung; perfusion affect is stronger

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22
Q

Where in the lung are alveoli biggest at rest?

A

At the apex of the lung

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23
Q

What determines the rate of ventilation: size of alveoli or change in size of alveoli?

A

Change in size

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24
Q

Where in the lung is there both decreased pressure and increased resistance?

A

Upper zone; decreased pressure because of gravity; resistance in the lung is increased because capillaries are compressed by the large alveoli

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25
Q

What is LaPlace’s law?

A

P = 2T/R

  • T = surface tension
  • P = collapsing pressure
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26
Q

Surface tension in alveoli can cause 3 major problems

A
  1. Alveoli tend to collapse
  2. Large/small alveoli; small become underventilated, large become hyperventilated
  3. As alveoli collapse, they pull water in from blood – pulmonary edema
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27
Q

A high surface tension in the lungs leads to…

A

Stiff lungs, decreased compliance

* Atelectasis

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28
Q

At what week does synthesis of surfactant begin?

A

24th week

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29
Q

If a baby is born before 35th week, what might be a problem?

A

IRDS – not enough surfactant

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30
Q

What are 3 roles of surfactant?

A
  1. Reduce work of breathing
  2. Keep alveoli dry
  3. Opsonization
  4. Equalizes ventilation in adjacent alveoli
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31
Q

Smaller alveoli have more/less surfactant than larger alveoli?

A

More

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32
Q

Intracellular K+ will build up when what happens at the carotid body.

A

PO2 lower than normal

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33
Q

Cells at the carotid body depolarize with what type of ion influx: Na or Ca

A

Ca2+

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34
Q

What is the Herring Bruer reflex?

A

Lung stretch reflex

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35
Q

Where are the lung stretch receptors?

A

Smooth muscles in bronchi and bronchioles

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36
Q

Irritation receptors in the mucosal lining of the airways cause bronchodilation or constriction?

A

Constriction

Particularly with histamine

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37
Q

Pulmonary edema irritates what types of cells in the lung?

A 
J cells (juxta-capillary) specially activated by pulmonary edema --> rapid shallow breathing
* Dyspnea
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38
Q

What is the definition of “dynamic lung compliance”?

* A higher/lower airway resistance results in higher/lower dynamic lung compliance

A

For a given pressure, the change in volume

* Thus, a higher airway resistance, lower dynamic lung compliance

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39
Q

Which are perfusion-limited and diffusion-limited gases?

A

Perfusion: CO2, O2, N2O
Diffusion: CO

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40
Q

Under what conditions is CO diffusion capacity increased/decreased?

A

Decreased in PE, emphysema, fibrosis, anemia

Increased in exercise, polycythemia

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41
Q

Describe the 3 different zones of the lungs.

A

Zone 1: PA > Pa > Pv
Zone 2: Pa > PA > Pv - intermittent
Zone 3: Pa > Pv > PA - continuous

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42
Q

The exercising lung has increased/decreased resistance to blood flow. How does the lung increase/decrease its resistance?

A

Decreased; capillary recruitment & distension

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43
Q

O2 content is …

A

the actual amount of oxygen in ml per volume dissolved in blood; includes dissolved O2 and O2 in Hb

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44
Q

Differentiate between tense and relaxed Hb

A

Tense: de-oxy
Relaxed: oxy

45
Q

2,3 BPG is increased in…

A

COPD, high altitude, anemia, shunts, emphysema

46
Q

Where does the formation of bicarbonate take place?

A

In the RBC

47
Q

How does bicarbonate leave the RBC?

A

Cl-shift

48
Q

What is the Haldane effect?

A

Increasing Hb O2 saaturation reduces the CO2 concentration in the blood (opposite of Bohr effect)

49
Q

What is pickwickian syndrome?

A

Chronic hypo ventilation and respiratory acidosis

49
Q

T/F Deoxy-Hb is a good buffer

A

True

50
Q

What is base excess?

A

Respiratory acidosis, compensated with bicarbonate excess

52
Q

At a high altitude, is there compensatory base excess or base deficit?

A

Base excess

53
Q

What is the equation for determining % of supplemental oxygen?

A

PAO2 = FIO2 - PACO2/0.8

54
Q

How can you determine an anatomical shunt from other forms of hypoxemia?

A

Breathe 100% O2

55
Q

Under what circumstances is the difference between PA o2 and Pa o2 increased?

A

Shunt, V/Q inequality, diffusion impairment

56
Q

Dorsal/Ventral respiratory group neurons in MO

A

Dorsal: inspiration
Ventral: inspiration + expiration

57
Q

Primary and secondary sensitivity of the glomus cell

A

Primary: low PO2
Secondary: PCO2, pH

58
Q

The main driver of respiration centrally… (PO2 or PCO2)

A

PCO2

59
Q

During the Valsalva maneuver,

A

Alveolar pressure > intrapleural pressure

60
Q

An increased respiratory rate inc/dec dead space breathing

A

Increases (hence a decrease in alveolar ventilation)

61
Q

Where in the lung is the intrapleural pressure most negative: apex or base?

A

Apex

62
Q

Differentiate between Hb’s carrying capacity and affinity

A

Carrying capacity: anemia/polycythemia

Affinity: right/left shift

63
Q

What is the alveolar ventilation equation (that doesn’t use CO2)

A

(TV-DS)*RR

64
Q

Define proximal/distal with respect to the equal pressure point.

A

Proximal: mouth
Distal: towards alveoli
* EPP = PA = PIP

65
Q

Which of the following is the correct spirometric term for the largest tidal volume that this patient can generate during the course of pulmonary function testing?

A

FVC

66
Q

DKA, central/peripheral chemoreceptors, H+ or O2 or CO2

A

Peripheral; H+

67
Q

Glucose, fat, protein digestion in the small intestine

A

Glucose, fat, protein –> Duodenum, jejenum, ileum

68
Q

This feature of ____________ smooth muscle in the GIT enables tonic contractions.

A

Unitary; gap junctions

69
Q

Differentiate between the submucosal and muscular plexuses in the GIT

A

Submocosal: Meisner’s plexus
Muscle: Myenteric (Auerbach’s)

70
Q

Differentiate between absorption and secretion

A

Abs: apical Na in – Cl paracellular in
Sec: apical Cl out – Na paracellular in

71
Q

The digestive enzymes (exocrine) of the mouth

A

Lingual lipase, alpha-amylase

72
Q

The digestive enzymes (exocrine) of the stomach

A

Gastric lipase, pepsin

73
Q

The digestive enzymes (exocrine) of the duodenum

A

Enterokinase, maltase, lactase

74
Q

The digestive enzymes (exocrine) of the pancreas

A

Amylase, trypsin, chymotrypsin, PLA2, cholesterol esterase

75
Q

The 4 layers of the GIT (histological)

A

Mucosa, submucosa, muscularis, serosa

76
Q

Muscle contraction of smooth muscle is dependent on this enzyme….

A

Ca2+

77
Q

Endocrine secretions of the stomach

A

Gastrin (G cells), somatostatin (D cells)

78
Q

Exocrine secretions of the stomach

A

Pepsin, gastric lipase

79
Q

Exocrine secretions of the mouth

A

Alpha-amylase, lingual lipase

80
Q

Describe the 4 different types of exocrine cells in the stomach

A

Mucus surface/neck (mucus, HCO3, water)
Parietal/oxyntic (H+, Cl-, IF, H20) (only in body)
Cheif/peptic (lipase, pepsinogen)

81
Q

Parietal cells are found only in this part of the stomach

A

Body

82
Q

Where are the endocrine cells of the stomach?

A

Antrum (G+D)

83
Q

What are the 4 stages of gastric motility?

A
  1. Fasting/MMC
  2. Meal –> vago-vagal reflex of fundus
  3. peristalsis (increased pressure)
  4. antral systole (retropulsion)
84
Q

Describe gastric acid secretion

A 
Na/K ATP-ase
H+ proton pump
Cl-HCO3 shift (alkaline tide)
CO2 diffusion / carbonic anhydrase
Na/H exchanger
85
Q

The majority of gastric stimulation: interdigestion, cephalic, gastric, intestinal

A

Cephalic (30%) & gastric (50%)

86
Q

Parietal cells are stimulated by …

A

Histamine (ECL cells), which are stimulated by gastrin and ACh (Gq, Gq)

87
Q

Where are ECL cells found in the stomach?

A

Body

88
Q

What receptors are present on parietal cells (4)?

A

H2, gastrin, ACh, SST

89
Q

Oxyntic secretion of parietal cells is high in…

A

HCl

90
Q

Describe the negative feedback of the stomach

A

1/2. Body/Antrum (H+ –> D cells –> SST –> parietal and ECL) ** parietal are not in antrum **
3. Small intestine (enterogastrones – secretin, CCK, GIP, VIP, pep YY, SST)

91
Q

Chief cells are stimulated by…

A

ACh (neural and H+), secretin

92
Q

Describe several aggressive factors against the integrity of the gastro-mucuosal barrier.

A

H+, pepsins, ETOH, NSAIDS, bile acids, ischemia

93
Q

Endocrine/Exocrine panceras

A

Endocrine: insulin
Exocrine: trypsinogen, chymotrypsinogen

94
Q

Describe the acinus/ductal aspects of a pancreatic exocrine gland

A

Acinus: low volume, enzymes
Ductal: high volume bicarb

95
Q

The pancreas doesn’t digest itself because…

A
  1. Zymogen granules
  2. Enterokinase requirement
  3. Trypsin inhibitor
96
Q

Is there an acid tide or alkaline tide in the exocrine pancreas?

A

Acid

97
Q

CCK/Secretin/M3 on exocrine panceras

A

CCK: acinar
Secretin: ductal
M3: both acinar and ductal

98
Q

Majority of pancreatic regulation occurs during this period of digestion

A

Intestinal (CCK, secretin, vagus)

99
Q

What type of cells secrete secretin and bicarbonate?

A

S cells

100
Q

Cells in zone 1 or 3 are more prone to ischemia in the liver?

A

Zone 3

101
Q

The major regulator of the digestive phase of the gallbladder

A

CCK (20% ACh)

102
Q

The bile flow rate changes based on: bile-dependent or bile-independent flow?

A

Bile-acid dependent

103
Q

Components of bile

A

Bile salts, cholesterol, phospholipids, bilrubin, HCO3-

104
Q

Function of bile

A

Emulsify fat, elimination of cholesterol, neutralize acid in duodenum

105
Q

What duct delivers bile to/fro gallbladder?

A

Cystic duct

106
Q

In a hepatocyte, which side is apical vs. basolateral

A

Apical: central vein

107
Q

Differentiate between bile acid and salt

A

Salt more soluble (conjugated)

108
Q

Differentiate between primary and secondary bile salts

A

Secondary are dehydroxylated by bacteria in intestines

109
Q

Functions of liver

A 
Bile/bilrubin
Metabolism (vitamin D, t4-->t3)
Proteins
Immune (Kupfer)
Endocrine (angiotensinogen)
Detoxify

Term 2 (8 decks)

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