Respiratory, Urinary Flashcards
Muscles used during a breathing cycle with Forceful inhalation
Sternocleidomastoids, scalene, pectoralis minor
Muscles used during a breathing cycle with Forceful exhalation
Abdominal muscles, internal intercostals
The muscles that are recruited to increase ventilation by patients with laboured breathing, are called
Accessory muscles
What should the oxygen saturation be in an uncompromised, healthy individual?
> 95%
What is the expected rate of respirations for a 30 y/o?
12-20
In a person with a chronic lung disease (emphysema) you may see?
nasal flaring, accessory muscle use, barrel chest, hunched over position
What is the inhalation (inflow) and exhalation (outflow) of air. This involves the exchange of air between the atmosphere and the alveoli of the lungs
Pulmonary ventilation
What can be broken down into external (pulmonary) and internal (tissue) respiration?
Respiration
(Internal or External) respiration is the exchange of gases between the alveoli of the lungs and the blood in pulmonary capillaries across the respiratory membrane.
External respiration
(Internal or External) respiration is the exchange of gases between blood in system in capillaries and tissue cells. In this step, blood loses O2 and gains CO2.
Internal respiration
What is emphysema
Chronic respiratory disease, causes extensive damage to the alveoli, reducing the surface area of the respiratory membrane. Oxygen can be provided to help with oxygenation; however, individuals can still feel like they are not getting enough air.
Between the Ribs
Intercostal
Adventitious
Abnormal
Voicebox
Larynx
The movement of air in and out of the lungs
Ventilation
A decreased concentration of oxygen in the air
Hypoxia
Normal lung sound
Vesicular
A substance that lowers surface tension in the alveoli
Surfactant
A decreased concentration of oxygen in the blood
Hypoxemia
What are the 3 steps of urine formation?
Glomerular filtration, Tubular reabsorption, Tubular secretion
Filtration of blood plasma from the glomerulus into Bowman’s capsule, and then into the renal tubule
Glomerular FIltration
Secretion of wastes, drugs, and excess ions, into the fluid flowing through the tubules. Removes substance from the blood
Tubular Secretion
Reabsorption of solutes and 99% of water from the tubular system (PCT, loop of Henle, DCT, collecting ducts). The water and solutes return to the blood as it flows through the peritubular capillaries and vasa recta
Tubular Reabsorption
Where does the majority of reabsorption occur along?
Proximal convoluted tubule (PCT)
What is the normal filtration rate for male and female (ml/min)
125 male
105 female
There are built-in mechanisms for regulation of GFR. Which is the main method of regulation?
Renal autoregulation, Neural regulation, Hormone regulation
The effects of the 2 hormones involved with regulation of GFR are:
Angiotensin II will (increase/decrease) GFR
ANP will (increase/decrease) GFR
decrease, increase
3 mechanisms that help maintain H+ within normal levels
buffer systems: raise ph, do not remove H+
Exhalation of carbon dioxide: increase rate and depth of respiration. Reduces levels of carbonic acid in blood, reduces blood H+ levels, increase pH levels
Kidney excretion: excretion of acids in the urine in the slowest mechanisms
What is edema?
fluid accumulating in the intercellular spaces
Refers to the ratio of weight of volume of substances of weight of equal volume of distilled water. Normal range: 1.001-1.035 - the higher the concentration of solutes, the higher the number
Specific gravity
Mildly aromatic; becomes ammonia-like on standing. May depend on dietary intake. Urine of diabetics may be fruity due to presence of ketone bodies
Odour
Yellow or amber, varies with urine concentration and diet. Concentrated urine, darker. Kidney stones may produce blood in urine
Colour
Between 4.6-8.0, average 6.0. Varies with diet
pH
Transparent when freshly voided; becomes cloudy on standing
Turbidity
The following is a list of common electrolyte levels you will come across in your clinical practice and in particular - NA+, Cl-, K+, HCO3- additionally Mg2+, HPO4 2-, Ca2+
Mg2+ : 1.3-2.1 mEq/l
HCO3- : 22-26 mEq/l
Cl- : 95-105 mEq/l
Na+ : 136-148 mEq/l
HPO4 2-: 1.7-2.6 mEq/l
K+ : 3.5-5 mEq/l
Ca2+ : 4.5-5.5 mEq/l
PTH, calcitriol and calcitonin are:
The main regulators of
- magnesium in the blood
- phosphate in the blood
- calcium in the blood
- NaCl in the blood
The main regulators of calcium in the blood
Metabolic reactions can produce
- H+
- HCO3-
- Nonvolatile acids
- Volatile bases
- Ca+
Nonvolatile acids
In extracellular fluid the most abundant anion is:
Na+, Cl-, K+, HPO42-, HCO3-
Cl- the primary anion in the extracellular fluid, helping to maintain osmotic pressure, acid-base balance, and fluid balance. It works in conjunction with sodium (the most abundant cation) to regulate these processes.
What is Natriuresis
The process of excreting sodium (Na⁺) in the urine. The kidneys regulate the amount of sodium in the body, typically in response to changes in blood volume, blood pressure, or the osmotic balance.
Helps in maintaining the balance of sodium in the body, contributing to overall fluid and electrolyte homeostasis.
In intracellular fluid the most abundant cation is:
Na+, Cl-, K+, HPO42-, HCO3-
K+ It plays a crucial role in maintaining cell function, including regulating the resting membrane potential, nerve transmission, and muscle contraction. It is maintained at high concentrations inside cells compared to the extracellular fluid, where sodium (Na⁺) is the predominant cation.
In intracellular fluid the most abundant anion is: Na+ Cl- K+ HPO42-, HCO3-
HPO42- various cellular processes, including energy metabolism (as part of ATP), signalling, and the formation of cell membranes. The concentration of phosphate is much higher inside cells compared to the extracellular fluid.
In extracellular fluid, the most abundant cation is: Na+ Cl- K+ HPO42- HCO3-
Na+ primary cation in the extracellular fluid and plays a key role in maintaining fluid balance, osmotic pressure, and proper nerve and muscle function. It is critical for regulating blood volume and blood pressure, as well as in the movement of fluids between compartments in the body.
Which is used to promote Na reabsorption by the kidneys?
Aldosterone
This imbalance results when systemic arterial blood HCO3- levels drop significantly (below 22 mEq/l):
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
In partial compensation:
- pH is brought into the normal range
- systemic arterial blood is lower than 7.35
- systemic arterial blood is higher than 9.5
- pH >5.5
- pH <2.5
Systemic arterial blood is lower than 7.35 - the body’s compensatory mechanisms (respiratory or renal) try to bring the pH to normal, but the pH remains outside the normal range. Still either acidic or alkaline, depending on the initial disturbance, but not yet normal
The response of the body to decreasing blood pressure will not cause:
- Dehydration
- Formation of angiotensin II
- Stimulate the kidneys to secrete rennin
- Formation of ADH
- Increased vasoconstriction
Dehydration - result in inadequate fluid intake or excessive fluid loss, not direct consequence of low blood pressure
Which of the following is a way angiotensin II affects the kidneys?
- increases GFR
- decrease GFR
- enhance reabsorption of certain ions
- stimulates the release of aldosterone
It can increase GFR
The proximal convoluted tubules reabsorb what percentage of filtered water?
- 25%
- 50%
- 65%
- 80%
- 90%
65%
This is a nephron process that results in a substance in blood entering the already formed filtrate:
- reabsorption
- filtration
- secretion
- excretion
Secretion - process by which substances are actively transported from the blood into the already formed filtrate in the renal tubules, leading to their excretion in urine
What is the correct order of blood flow?
Renal artery-Segmental artery- Interlobular artery- Peritubular capillaries-Afferent arterioles
(Blood flow through the kidney begins at RA, which branches into SA, then the IA, which further branches into smaller arterioles that lead to the AA. The blood then flows through the glomerulus and into the peritubular capillaries)
How much of the total volume of body fluid is intracellular fluid?
- 10%, 50%, 1/3, 2/3, 99%
2/3
This is the formation of a new glucose molecule
- glycolysis
- gluconeogenesis
- glucosamine
- glucose
- calcitriol
Glucogenesis
This is when a substance passes from the fluid in the tubular lumen through the apical membrane then across the cytosol into the interstitial fluid:
- paracellular reabsorption
- transcellular reabsorption
- apical reabsorption
- basolateral reabsorption
- active transport
Transcellular reabsorption
An analysis of physical, chemical and microscopic properties of urine is called
Urinalysis
What is the waste product normally excreted by the kidneys?
urea
Which structure of the nephron reabsorbs the most substances?
- glomerular capsule, loop of henle, ascending limb, collecting duct, proximal convoluted tubule
Proximal convoluted tubule
What is not a major function of the kidneys?
Regulation of - blood ionic composition, blood cell size, blood volume, blood pressure, blood pH
Regulation of blood cell size
Increased secretion of Hydrogen ions would result in a - of blood -?
- increase, pressure
- decrease, volume
- increase, sodium level s
- decrease, pH
- increase, urea
Decrease, pH
This transports urine from the kidney to the bladder
Ureter
This term means entry of substances into the body from the filtrate
Reabsorption
Once fluid enter the proximal convoluted tubule:
- less dense
- higher [K+]
- called tubular fluid
- all Na+ is removed
- headed to the ascending loop
Called Tubular fluid
Main organic urine component
Urea
Tube from the bladder
Urethra
Artery to the kidney
Renal
Ion in urine
Potassium
Water reabsorption force
Osmosis
Stores Urine
Bladder
Loop between tubules
Henle
Urine excess in diabetics
Glucose
Convoluted Tubule
Proximal
Functional unit of Kidney
Nephron
Urine expulsion
Micturition
Capillary knot in kidney
Glomerulus
Portion of kidney
Medulla
Tube from the kidney
Ureter
Departing arteriole
Efferent
PCT Histology
Simple cuboidal epithelial cells with prominent microvillus-borders
Nephron loop; descending limb and thin ascending limb Histology
Simple squamous epithelial cells
Nephron loop; thick ascending limb Histology
Simple cuboidal to low columnar epithelial cells
Distal convoluted tubule (DCT) Histology
Simple cuboidal epithelial cells
Last part of DCT and all collecting ducts Histology
Simple cuboidal epithelium consisting of principal cells and intercalated cells
Countercurrent Multiplication Graph
- Symporters in thick ascending limb cause buildup of Na+ and Cl- in renal medulla
- Countercurrent flow through nephron loop establishes osmotic gradient
- Principal cells in collecting duct reabsorb more water when ADH is present
- Urea recycling causes buildup of urea in renal medulla
