QP Test 2 Flashcards

1
Q

Name four things involved in excitation-contraction coupling in skeletal muscle

A

Generation of end plate potential, formation of cross-linkages between actin and myosin, depolarization

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2
Q

What is a feature common to skeletal, cardiac, and smooth muscle?

A

Increase in cytoplasmic free calcium concentration

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3
Q

How is skeletal muscle innervated?

A

Motor neurons exclusively

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4
Q

What is the result of a ryanodine receptor knockout?

A

no Ca release into cytosol from sarcoplasmic reticulum

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5
Q

Name four things that increase intracellular calcium in smooth muscle.

A
  1. activation of voltage gated calcium channels
  2. activation of gap junctions
  3. activation of IP3 receptor channel
  4. activation of ligand gated calcium channel
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6
Q

What is the purpose of gap junctions between smooth muscle cells?

A

electrical communication between neighboring cells

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7
Q

What happens in latch state (smooth muscle)?

A

(incomplete) dephosphorylation of myosin light chain

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8
Q

What is a pancreatic hormone with a strong hypoglycemic effect?

A

Insulin

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9
Q

What does a shift in the hormone response curve to the left of the control indicate?

A

An up-regulation and the receptors are more sensitive to hormone action.

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10
Q

Give an example of a hormone that acts mainly through a membrane receptor.

A

Growth hormone

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11
Q

Circadian rhythms fluctuate _________.

A

Daily

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12
Q

Give an example of a hormone released from the pituitary.

A

Adrenocorticotropic hormone (ACTH)

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13
Q

What pituitary peptide stimulates the thyroid gland?

A

Thyroid stimulating hormone (TSH)

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14
Q

What is the condition called when the hypothalmus hypersecretes a particular hormone.

A

Tertiary hypersecretion

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15
Q

In the negative feedback of complex neuroendocrine systems, what happens if negative feedback from the primary gland hormone decreases?

A

The secondary glad increases secretion of its tropic hormone

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16
Q

What is the pacemaker of the heart?

A

The sinoatrial node

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17
Q

In an EKG, what causes the P wave?

A

Atrial depolarization

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18
Q

Where is conduction of cardiac impulse the slowest?

A

AV nodal fibers

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19
Q

The plateau of cardiac action potential is maintained by what?

A

Both calcium and potassium channels

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20
Q

What is the most important factor in influencing the amount of blood pumped by the ventricles of the heart?

A

preload (venous return)

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21
Q

What is another name for the bicuspid valve?

A

The mitral valve

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22
Q

Beta Blockers are commonly used as what?

A

Anti-hypertensive drugs

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23
Q

According to starlings law, what happens if the interstitial osmotic pressure decreases?

A

Less filtration

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24
Q

What is the most important factor in determining vascular resistance?

A

Vascular diameter

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25
Q

If the diameter changes by a factor of 2, how will the flow change?

A

Flow will change by a factor of 16

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26
Q

During hemorrhage, activation of baroreceptor reflex causes what?

A

Increase in heart rate (look up baroreceptor reflex)

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27
Q

What is flow autoregulation?

A

Maintaining blood flow nearly constant in the face of pressure change

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28
Q

Gases inspired in the tidal volume are thoroughly and rapidly mixed in the alveolar space by ________.

A

simple diffusion

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29
Q

What disease causes the lungs to become more compliant?

A

Emphysema

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30
Q

“For a fixed amount of gas kept at a fixed temperature, pressure and volume are proportional” is what law?

A

Boyle’s law

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31
Q

Lungs are wrapped by two layers of pleura membranes. What is the relationship between the pressure in the space between the membranes and the alveolar pressure?

A

The space in between the membranes is always more negative than the alveolar pressure.

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32
Q

How is CO2 carried in the blood?

A

As bicarbonate in plasma

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33
Q

Which way would the oxyhemoglobin dissociation curve move with an increase in PCO?

A

It would move to the left (learn all of these)

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34
Q

Both peripheral and central chemoreceptors will contribute to increased ventilation as the result of _________.

A

Increased arterial partial pressure of carbon dioxide.

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35
Q

What is the function of ryanodine receptors?

A

The release Ca into the cytosol from sarcoplasmic reticulum in skeletal muscle cells

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36
Q

What happens in myosin/actin’s location during activation of skeletal muscle contraction?

A

Actin filaments slide past myosin filaments shortening the Z discs.

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37
Q

Tetanic skeletal muscle tension is resulted from the sustained elevation of which molecule’s concentration in myocytes?

A

Calcium

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38
Q

What does the pre-stimulation length of the muscle represent in terms of myosin-actin interaction?

A

Number of myosin cross-bridges interacting with actin.

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39
Q

What are the differences between Type I (slow, red) human skeletal muscle fibers and Type II (fast, white) muscle fibers?

A

The type I have more mitochondrias, smaller fiber diameter, more myoglobins, harder to get tired, lower glycolytic enzyme activity than the type II.

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40
Q

What is the primary function of gap junctions between smooth muscle cells?

A

Allows them to communicate electronically.

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41
Q

What happens if the level of myosin light chain phosphorylation increases in smooth muscle?

A

The rate of the actin-myosin cross-bridge cycle increases. The maximum contraction force increases.

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42
Q

What is the “latch state” in smooth muscle?

A

The cross bridge cycle is slowed down due to the myosin light chain dephosphorylation but not completely stopped.

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43
Q

What are the similarities between smooth muscle and skeletal muscle contraction?

A

Both involve voltage dependent calcium channels, ATP consumption, myosin-actin interaction and Ca release from the SR

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44
Q

What four factors modulate smooth muscle contraction?

A
  1. autonomic nerves
  2. circulating hormones
  3. local signals from other cells
  4. electrical signals from other smooth muscle cells
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45
Q

Why does the force of smooth muscle in blood vessels continually increase after (longer than) the optimal length?

A

Because passive stress from other tissues continually increases

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46
Q

What are the 5 sequential events during smooth muscle cell contraction?

A
  1. rising intracellular Ca
  2. binding of Ca to calmodulin
  3. Activation of MLCK by Ca/calmodulin complex
  4. phosphorylation of myosin light chain
  5. activation of myosin ATPase
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47
Q

What 4 factors regulate intracellular calcium of skeletal muscle?

A

L-type Ca channel, calcium pump, ryanodine receptor, Na/Cl exchanger

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48
Q

What are the differences among skeletal, cardiac, and smooth muscle in terms of nucleus?

A

Skeletal muscle has many nuclei, smooth muscle is mononuclear, cardiac muscle is a mixture of the two

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49
Q

What are the differences among skeletal, cardiac, and smooth muscle in terms of performing autonomic phase contraction?

A

Only smooth muscle performs autonomic phase contraction

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50
Q

What are the differences among skeletal, cardiac, and smooth muscle in terms of fatigue?

A

Only white (fast twitch) muscle fibers get fatigued

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51
Q

Is skeletal muscle innervated by sympathetic nervous system?

A

No. Diaphram and facial muscles are exceptions though

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52
Q

What type of contraction is happens when myosin heads bind to the same F-actin monomer during cross-bridge cycling?

A

Isometric contraction

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53
Q

Why can airway allergies be treated with epinephrine?

A

Epinephrine activates Beta2 adrenergic receptors, which then activate the cAMP signaling pathway which causes smooth muscle cell relaxation

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54
Q

Can nerve stimulation induce smooth muscle relaxtion?

A

Yes, smooth muscle innervation regulates both contraction and relaxation.

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55
Q

In a single stimulated isotonic contraction, what 4 things change in the shortness-time relationship while load is increasing?

A
  1. latency of contraction increases
  2. total shortening duration decreases
  3. speed of contraction decreases
  4. maximal shortening distance decreases
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56
Q

Where is adrenocorticotropic hormone (ACTH) secteted from?

A

pituitary gland

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57
Q

Where is progesterone secreted from?

A

The ovaries

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58
Q

Which hormones regulate calcium absorption?

A

Vitamin D increases calcium absorption, parathyroid hormone (PTH) increases Vitamin D synthesis

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59
Q

Where is insulin secreted from?

A

Pacreatic Beta Cells

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60
Q

What class of receptors does testosterone belong to?

A

Nuclear receptors

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61
Q

Compare the endocrine and exocrine systems.

A

Both are essential communicating systems. The nervous system uses neurons to target specific cells and the endocrine system send hormones through the body affecting cells nonspecifically. Endocrine system’s action is much slower and longer compared to the nervous system.

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62
Q

What is the hormone secreted from the adipose tissue that controls food intake?

A

Leptin

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63
Q

What is the pituitary peptide that stimulates the thyroid gland?

A

Thyroid stimulating hormone

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64
Q

What is the largest class of hormones?

A

The proteins (peptide) hormones

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65
Q

How are steroid hormones made?

A

The enzymatic conversion from cholesterol

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66
Q

What type of chronotropic control observed within the endocrine system that occurs with a pulse every 24 hours?

A

Circadian rhythm

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67
Q

Name 2 types of hormones that come from amino acids

A
  1. Thyroid hormones are basically a double tyrosine with three or four iodine atoms.
  2. catecholamines including epinephrine, norepinephrine, dopamine
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68
Q

What is the receptor for catecholamine?

A

Adrenergic receptor that is a 7-trans-membrane spanning protein

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69
Q

What does a shift of the hormone dose response cure to the right from the control indicate?

A

An ED50 dose of hormone that is greater than before the shift occurred. The response of receptor (binding, activity, etc.) is reduced for the same concentration of hormonal stimulation.

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70
Q

What is the relationship between metabolic clearance of a hormone and its half-life?

A

The shorter the half life, the higher the metabolic clearance number

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71
Q

Give 4 examples of the way that the nervous system integrates its control with the classical endocrine system?

A
  1. hypothalamus secretion of releasing hormones
  2. hypothalamus secretion of posterior pituitary hormones
  3. adrenal medulla secretion of catecholamines
  4. autonomic nervous system control of endocrine secretion
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72
Q

In a complex control system with three hormones, where is the tertiary endocrine gland?

A

At the hypothalamus

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73
Q

In a negative feedback system of complex control, what happens if negative feedback from the primary glad hormone decreases for some reason?

A

The secondary glad increases secretion of its tropic hormone

74
Q

There is a primary hyposecretion of a hormone. What will happen?

A

The tropic hormone will be high because there is no negative feedback by the primary gland hormone which is low.

75
Q

Where is corticotropin releasing hormone secreted from?

A

Hypothalamus

76
Q

What is the peptide hormone secreted by the pancreas alpha-cells that raises plasma glucose its action in the liver?

A

Glucagon

77
Q

What is the relationship among insulin, glucagon, and somatostatin?

A

All inhibit each other except glucagon stimulates the other two

78
Q

What is the critical step by which 25-OH-D is converted to the activated form 1,25-(OH) D?

A

In the kidney, the enzyme 1-alpha-hydraxalase converts 25-OH-D to the 1,25-(OH)D.

79
Q

How many hormones are included in the class of steroids?

A

Intermediate (less than peptides)

80
Q

What is the function of T3 thyroid hormone?

A

Decreases TSH from anterior pituitary, increases basal metabolism all over the body, plays a significant role in brain growth and development.

81
Q

What indole hormone is secreted by the pineal gland?

A

Melatonin, which is a tryptamine derivative

82
Q

Give 8 (or so) examples of hormones that act through a nuclear receptor.

A

T3, T4, testosterone, Vit D, estradiol, cotrisol, progesterone, aldosterone

83
Q

What is ultradian rhythm?

A

like a circadian rhythm but it’s less than 24 hours and greater than 1

84
Q

What is the steroid hormone secreted by the adrenal that regulates Na reabsorption by the kidney?

A

Aldosterone, which is secreted by Zona glomerulosa

85
Q

Where are the receptors for protein hormones?

A

Cell membrane

86
Q

What is the hormone that specifically inhibits the pituitary secretion of ACTH?

A

cortisol

87
Q

In complex control, where is the primary endocrine gland located?

A

Periphery (away from the brain)

88
Q

What is another name for vasopressin?

A

ADH (antidiuretic hormone)

89
Q

What is Cushing syndrome?

A

Hypersecretion of cortisol

90
Q

What is Addison’s disease?

A

Hyposecretion of cortisol

91
Q

What is the effect of plasma thyroid hormone on TSH and TRH secretion?

A

inhibition

92
Q

How many hormones are released from the pituitary? (anterior and posterior)

A

Anterior: FSH, LH, GH, TSH, Prolactin, ACTH
Posterior: Oxytocin, vasopressin

93
Q

What hormones are released by the hypothalmus?

A

GnRH, GHRH, SS, TRH, DA, CRH

94
Q

What are the common stimulators for the insulin release from human pancreatic beta-cells?

A

Glucagon, Potassium, Glucose, Amino acids, Fatty acids

95
Q

What are the common inhibitors for insulin release from human pancreatic beta-cells?

A

Somatostatin, epinephrine, norepinephrine

96
Q

What are the hormones secreted from the adrenal gland?

A

aldosterone, cortisol, androgen, epinephrine, norepinephrine

97
Q

What are the major differences between diabetes I and II?

A

Type I is a defect in Beta cells.

Type II is a defect in non-beta-cells where the insulin receptor is damaged

98
Q

Name three major functions of glucocorticoid

A
  1. anti-inflamitory
  2. suppress immune system
  3. increase blood glucose
99
Q

Where is the bicuspid valve (mitral valve) located?

A

The bicuspid valve is located between the left atrium and left ventricle

100
Q

What is the P wave of the EKG?

A

Depolarization of the atrial muscle fibers

101
Q

In the EKG, when does repolarization occur?

A

The T wave

102
Q

Can EKG be useful for determining a patient’s cardiac output?

A

No. EKG is useful for heart rate

103
Q

What is responsible for the plateau of cardiac action potential?

A

Both Ca and Na channels

104
Q

Which cells have the pacemaker potential?

A

The SA node

105
Q

What determines cardiac output?

A

Stroke volume x heart rate

106
Q

What is the ratio of stroke volume and end-diastolic volume?

A

Ejection fraction

107
Q

What is the most important factor determining how much blood is pumped by the ventricle?

A

Venous return

108
Q

Which two great vessels bring deoxygenated blood back to the heart?

A

The superior and inferior venae cavae

109
Q

When does the first heart sound occur?

A

isovolumetric contraction

110
Q

What is the sequence for the propagation of cardiac impulse? (4)

A
  1. SA node
  2. AV node
  3. bundle of His
  4. Purkinje fibers
111
Q

Where are the bundle of His and its branches located?

A

In the intraventricular septum

112
Q

What are most responsible for phase 0 of a cardiac action potential?

A

Na channels

113
Q

What causes cardiomyocyte repolarization?

A

Ca channels begin to close while more K channels open. K leaves the cell

114
Q

What relationship is defined by the Frank-Starling Lab?

A

End-diastolic volume and stroke volume

115
Q

The opening of which channel in the autorhythmic cell (pace maker cells) is responsible for huge positive spike in membrane potential?

A

L-type calcium channel

116
Q

What is the typical stroke volume of an adult at rest?

A

70mL

117
Q

When does atrial systole occur?

A

Towards the end of ventricular diastole

118
Q

Due to what even does the second heart sound occur?

A

Closing of the semilunar valves

119
Q

What does heart rate depend on?

A

Rate of pacemaker potential

120
Q

Which structure has the slowest conduction velocity of the cardiac impulse?

A

AV nodal fibers

121
Q

What is the correct sequence for blood flow in the heart?

A

right atria, tricuspid, right ventricle, pulmonic, left atria, mitral, left ventricle, aortic, aorta

122
Q

Why does the electrical activation from the atria to the ventricles need to delay?

A

The delay allows atrial contraction to push and additional amount of blood into the ventricle before it contracts

123
Q

Which heart valves open or close during diastole and systole of the heart cycle?

A

In diastole, AV valves (bicuspid, tricuspid) poen and semilunar valves close. In systole, opposite occurs

124
Q

What changes in the ventricular pressure occur during the isovolumetric contraction phase?

A

The beginning of ventricular contraction causes leaflets of the mitral valve to close, continuation of ventricular muscle contraction will increase ventricular pressure very rapidly until it exceeds aortic pressure

125
Q

What is the Beta adrenergic effect on ventricular myocyte function?

A

It increases cAMP/PKA signal pathway which activates L-type calcium channels. It also causes release of free calcium from SR. Results in more muscle contractility.

126
Q

What is the effect of activation of baroreceptor reflex during hemorrhage?

A

Increase heart rate due to activation of sympathetic tone on the vasculature.

127
Q

What is the effect of NO on smooth muscle?

A

NO causes arteriolar vasodilation.

128
Q

What is active hyperemia?

A

Increasing blood flow of an organ when its metabolic activity increases.

129
Q

Where does the slowest blood flow occur?

A

In the capillaries

130
Q

What happens to the capillary hydrostatic pressure during arteriolar constriction?

A

Decreases

131
Q

Where does the highest vascular resistance occur?

A

Arterioles, there is a large decrease in pressure

132
Q

What is the effect of the heart when parasympathetic stimulation decreases?

A

Heart rate increases

133
Q

How do lipid soluble substances (CO2 O2) cross the capillary membrane?

A

Diffusion

134
Q

What will cause decreases hematocrit in the microcirculation?

A

Velocity profiles in higher vessels, few RBCs near the walls

135
Q

Where is NO released?

A

Arteriolar endothelial cells

136
Q

What does Starling’s law of filtration predict?

A

Write this the fuck down and know it.

137
Q

What percentage of blood is RBCs?

A

45% of blood volume.

WBCs are less than 1%

138
Q

What are the myogenic and metabolic vasodilator hypotheses of autoregulation?

A

Myogenic autoregulation depends of the stretch activated channels in VSM that, when stretched allow Ca2+ ions to enter and induce contraction. Metabolic is thought to be due to substances produced in the tissue

139
Q

What is the Fahraeus effect?

A

More RBCs in arterioles than capillaries

140
Q

What percent of blood is in capillaries?

A

At any given time, only 5%

141
Q

What is the relationship between the arteriolar vasodilators production and local oxygen level?

A

The production of vasodilators is inversely proportional to local oxygen levels

142
Q

What causes ECs to produce more NO?

A

Shear stress

143
Q

What is the effect of sympathetic stimulation of hydrostatic pressure?

A

Decrease

144
Q

What factors determine the changes in mean arterial pressure?

A

Cardiac output and peripheral resistance

145
Q

Does parasympathetic stimulation control arteriolar resistance?

A

No

146
Q

What is flow autoregulation?

A

Maintaining blood flow constant in the face of pressure changes

147
Q

What vascular region has the least amount of smooth muscle?

A

Capillaries

148
Q

What is the most important factor in determining vascular resistance?

A

Diameter

149
Q

Where is the most blood in the cardiovascular system?

A

Veins

150
Q

How does a vasodilator relate to oxygen level?

A

Reversely proportional toit

151
Q

Are enodthelial cells involved in the myogenic response?

A

Nope

152
Q

What is the vital capacity?

A

The maximum volume that can be inspired after a maximum expiration

153
Q

In which form is most CO2 in arterial blood carried?

A

Bicarbonate in plasma

154
Q

What is normal aterial oxygen carrying capacity?

A

1.34 mL O2/gHb

155
Q

What happens to the O2 binding on hemoglobin when blood temperature increases?

A

Less oxygen is chemically bound to hemoglobin at the same PO2

156
Q

When the respiratory muscles are relaxed in a normal person with open airways, what is the volume of the lungs?

A

Functional residual capacity

157
Q

How is lung movement controlled?

A

Not by muscle. Lungs are wrapped by two layers of pleura membranes and the pressure in the space between the membranes is always more negative than the alveolar pressure

158
Q

During normal inspiration, what will happ to the intrapleural pressure?

A

It will become even more negative

159
Q

How are inspired gases mixed in the alveolar space?

A

Simple diffusion

160
Q

What is the relationship between body weight and conducting dead space?

A

1 mL/pound

161
Q

What is the effect of pH on the oxyhemoglobin dissociation curve?

A

Increasing pH (becoming more basic) moves it to the left

162
Q

As mixed venous blood enters and travels through capillaries in well ventilated areas of the lung, what happens to pH?

A

The pH increase (becomes more basic)

163
Q

What is the effect of an increase in aterial CO2 on ventilation?

A

It will stimulate both peripheral and central chemoreceptors and increase ventilation

164
Q

What do you expect on the CO2 response curve with an acclimation to altitude?

A

Shift to the left (that is, increase the respiratory response to a given arterial PCO2)

165
Q

What is the effect of hydrogen ion concentration on perhipheral chemoreceptor activity?

A

The activity increases linearly with hydrogen ion in the range 40-45 mEq/L

166
Q

What is the vital capactity?

A

Maximum volume that can be inspired after a maximal expiration

167
Q

Do the terminal bronchioles belong to the respiratory zone?

A

Nope. The respiratory zone consists of respiratory bronchioles, alveolar ducts, and alveoar sacs

168
Q

What type of flow is movement into the airways?

A

Bulk flow

169
Q

In the absence of surfactant, what pressures would you see in two different sized alveoli?

A

Psmall»Plarge

170
Q

What is the percentage of total volume that can be expired in the first second of exhalation?

A

80%

171
Q

According to Fick’s law, how is membrane thickness related to diffusion?

A

Flow is inversely proportional to thickness

172
Q

How is COPD different from Asthma?

A

In COPD patients, the inflammation is not triggered by allergies and cannot be treated with anti-inflamitory medications

173
Q

What change in diphosphoglycerate (DPG) will shift the oxygen saturation curve to the left?

A

A decrease

174
Q

What is the effect of CO on the oxygen saturation curve?

A

Shift to the left

175
Q

How is most O2 transported in the blood?

A

Bound to hemoglobin

176
Q

What enzyme is used in CO2 transportation?

A

Carbonic anhydrase

177
Q

How do different pathologies affect lung compliance?

A

Emphysema increases compliance, decreases with fibrosis, no change or decrease with asthma

178
Q

What is tidal volume?

A

The lung volume change during normal breathing

179
Q

How is CO2 carried in the blood?

A

60% is bicarbonate
30% HbCO2
10% dissolved in plasma

180
Q

What is the effect of PO2 on the oxygen saturation of hemoglobin?

A

O2 binding increases with pressure to a point and then there is no significant change

181
Q

What does carbonic anhydrase do?

A

Converts back and forth between CO2 and bicarbonate