Test 1 ⭐️ Flashcards
What is homeostasis?
Conditions inside the body that are maintained at near constant conditions
Healthy balance to keep cells happy
What is our internal environment?
Everything underneath our skin
How many cells are in our body?
35 trillion cells
How does the body maintain constant conditions?
Body has many different sensors to adapt to changing conditions
Give examples of how the body maintains homeostasis:
If the body wants to maintain temperature, there needs to be sensors around that are measuring the body temperature so that it can detect a change and then feedback into system that will adjust for the change
Give examples of how the body maintains homeostasis:
If the body wants to maintain temperature, there needs to be sensors around that are measuring the body temperature so that it can detect a change and then feedback into system that will adjust for the change
Give another example of homeostasis:
Walking out into the snow temperature decreases the body senses a decrease, and then will send a signal to bring temp up.
I.e. shivering
What is a key aspect of homeostasis?
What goes in must come out
Input yields output and waste products
Input: food and energy.
Output: work heat potential energy number of other things line
Waste products: CO2, H+, water, urea
How does the body keep things constant inside?
Body has different control mechanisms to maintain homeostasis
Organ systems
What happens to the body under anesthesia?
The control mechanisms normally present go off-line
Sensors that monitor blood gas, blood pressure and other things are impaired by the drugs
CRNA must do the work that the nervous system normally does to maintain the homeostasis
What is physiology?
The study of all the processes that make life happen
What is an example of an effect anesthesia has on the body?
When under anesthesia in the OR and paralyzed body temperature drops would need to rewarm/monitor with warming device because the nervous system is incapacitated
What are some of the processes of homeostasis?
Metabolic processes.
Specialized processes
What do cells need in their surroundings?
Energy compounds and chemicals
What kind of energy compounds are needed in extracellular fluid
Oxygen sugars fats
What are the chemicals used for in the extra cellular fluid?
They work to buffer the pH around the cells
How does the kidney maintain homeostasis in the body?
Maintains blood pressure
extracellular fluid buffer (normal pH)—electrolytes
How does G.I. system maintain homeostasis?
Replacing nutrients in the blood as they are being used by the cells
How do the lungs aid in homeostasis?
Regulate blood gas
Explain how cardiovascular system aids in homeostasis:
Think of “two hearts”
Right heart pump and left heart pump share a wall (septum)
Responsible for effective gas exchange in the lungs and supplying peripheral vascular with proper nutrients
Describe ECF:
Extra cellular fluid: the fluid between the cells.
Lots of compounds helped to keep the values in the ECF constant
-electrolytes
-energy compounds
Describe ICF
Intracellular fluid: fluid that is inside the cell
Fluid inside the cells, houses organelles and functions of the cell
Lots of compounds to help keep this fluid constant
What is another term for intracellular fluid?
Cytoplasm
How do peripheral circulatory beds, maintain homeostasis?
Use the controller, responsible for blood flow within the cardiovascular system
The amount of blood flow that goes through a tissue is determined by the metabolic demand of the tissue
Example: blood goes into the arterial, and then it has the opportunity to deliver nutrients that Cells will be using and also remove metabolic by products
How would metabolic byproducts be removed from the peripheral vascular system?
Veins
Explain what happens at peripheral circulatory beds if the cells are burning through oxygen and glucose:
Extracellular fluid composition would change because the cells are pulling those nutrients
ECF is deficient of nutrients
This deficiencies are picked up by sensors within the cardiovascular system
Cardiovascular system response by increasing blood flow to increase perfusion and bring the levels in the ECF back to normal
Venus blood flow also picks up to remove byproducts that are being produced faster because the metabolic demand are increased
If a cell has increased metabolism, how does it maintain homeostasis?
The organ systems respond just enough to meet the metabolic tissue requirements
If there is no increase metabolism, it’s difficult to get a response from the Organ systems
example: would be difficult to get prolong increase in blood flow without increasing metabolism to a peripheral circulatory bed
What is negative feedback?
Most common control system in the body
Sensor out in periphery can detect changes happen in the body, which is then sent to a controller
The controller perform tasks to counteract what’s happening in the body
Change is negative to the stimuli
Give some examples of negative feedback:
Blood pressure drops from 100 to 50:
body senses the drop, and it feeds that information to the nervous system the nervous system act to increase blood pressure
Increase CO2 in the blood:
Sensor notices increase and feeds information to the brainstem which can increase ventilation to bring it CO2 back to normal
Thermostat:
Thermometer within the thermostat senses an increase or decrease and turns on AC or heat to bring the level back to baseline
How does the body form a safety net for systems important for survival?
There are many sensors and systems involved with areas that are key to survival.
More than one change if change is detected in these areas
Example: blood pressure-very important so body has MANY mechanisms to regulate and help keep system functioning
What are some negative feedback mechanisms involved with low blood pressure?
BP drops:
1: Increase sympathetic nervous system outflow (increase norepinephrine in body increases MAP)
2: Decrease parasympathetic nervous system outflow: rest and digest limited so MAP increases
3: Circulatory compounds in the body
-Increase ADH/AVP: release from pituitary increase MAP (vasoconstriction and retain volume)
-Decrease ANP: (vasodilation)
What is a positive feedback?
Not as common
The sensor detects change in the body feeds back onto the controller and the change is amplified
Works well as long as the checkpoint is in place
What is an important aspect of positive feedback to prevent complications?
Checkpoint/safety valves to shut down process once goal is achieved
What happens if positive feedback doesn’t have a checkpoint?
The positive feedback would run out of control in a way it shouldn’t be occurring and creates a vicious cycle, causing major problems
How can you stop a vicious cycle from positive feedback?
Only thing to stop vicious cycle is usually once it reaches end organ damage or death
A mild degree of positive feedback can be overcome by the negative feedback control mechanisms and the vicious cycle fails to develop
Give examples of beneficial positive feedback:
1: oxytocin levels during labor and delivery
— uterus contracts to push the fetus to the cervix. cervix has pressure that will cause the cervix to stretch. Cervical stretch causes oxytocin to release from the brain, oxytocin acts on the smooth muscle in the uterus and causes more uterine contractions.
— checkpoint is birth: after birth, oxytocin levels should decrease and contraction stop
2: blood clotting pathways
— injury to blood vessels, endothelial cells release coagulation factors, and they promote platelet plug formation and coagulation
— checkpoint is bleeding has stopped
What is pathologic positive feedback?
Amplified change continues to occur past check point
If pathologic positive feedback continue, the system will not survive
Why do most control systems of the body operate by negative feedback rather than positive feedback?
Positive feedback leads to instability rather than stability and in some cases can cause death
What are some examples of pathologic positive feedback?
1: severe hemorrhage
— decrease blood pressure causes decrease coronary blood flow, which is insufficient to keep up demand of the heart decreases cardiac output further reduces blood pressure
2: sepsis/necrosis
— dying cells due to infection. Dying at a faster rate than body can manage. All of the toxins inside the cells are released to the environment where other cells are. Cell components can be toxic: potassium, metabolic byproducts. Healthy cells can be affected by that release and die as well
3: severe acidosis
— Severe acidosis, the CNS can be so affected that respiratory drive is reduced and further perpetuates acidosis.
4: diabetic renal insufficiency/hyper filtration
— 1 million nephron in each kidney. Nephron die with age do not regenerate in adults so as nephron die, the remaining nephron carry a larger load the larger load on the nephron makes it more likely to die keep dying. You eventually will be in renal failure.
5: athrosclerotic plaque clotting:
— clotting factors continue past checkpoint. Formation of unwanted clots. Lack of blood flow to vital organs. heart attack.
6: peripheral acidotic conditions
Describe compensated shock:
Negative feedback working
Example, hemorrhagic shock:
— can lose 20% of blood volume if totally healthy and be OK. 1 L of blood loss initial drop in blood pressure & drop in cardiac output but should be able to get cardiac put to normal within a few hours through negative feedback responses.
— Blood vessel constrict
— increase heart pumping
— massive fluid shifts
Describe decompensated shock:
Positive feedback running rampant
Example, hemorrhagic shock:2L loss
— Lose 40% blood volume difficult to survive despite defense of the body through negative feedback
— negative feedback is inadequate
— too many positive pathologic feedback cycles kick in and outweigh the negative feedback systems
How would response to anesthesia be different between healthy person and critically ill person?
Typical anesthetics will not behave the same in a sick patient compared to a healthy patient
circulation decrease in elderly person
Sick Patient has changes and physiologic systems
—ex: CHF
Describe a cell and its function:
Cells are the building blocks of the body
Smallest living unit
Capable of sustaining their own life with elements inside them: enzyme material to create energy
Cells are usually specialized for a specific task based on role and location
How many cells are in the body?
35 trillion
What type of cell is most abundant in the body?
Red blood cells – 25 trillion in the body
What is a tissue?
A group of cells – like-minded and organize together to perform a function
What is an organ?
A collection of tissues – organs maintain the internal environment of the body
What is necessary for Cells to replicate?
Most cells capable of replication – need to have DNA/normal machinery
What happens if a cell cannot replicate?
A nearby progenitor cell can aid with replication
What are some examples of cells that cannot replicate, and how do they reproduce.
1: Red blood cells: cannot replicate themselves, but bone marrow or progenitor stem cells can reproduce red blood cells
Why can’t red blood cells replicate themselves?
Red blood cells do not have genetic material (DNA)
No nucleus
Why is it important for cells to replicate?
Cells occasionally die so they need to be able to reproduce
Examples of cells that don’t replicate often:
1: neurons: problems replicating in CNS, do not replicate fast or often
2: heart cells: slow replication rate, only some new cardiac cells during lifespan
Describe the cell membrane, a.k.a. cell wall:
Keep inside components in and outside components out
Phospholipid bilayer
Lipid tails make up bulk of cell wall
Phospholipids create barrier so other charged particles can’t make it through cell wall
How does a phospholipid bilayer work?
Phosphate head—charged at cell wall, behave well in water
Lipid tail— uncharged, oily do not behave well in water
Phosphates and lipids aggregate to form bilayer if there are enough around in an aqueous solution
What is the major element inside the cell?
Water: 70 to 85%
Except for adipose cells
After water, what are the most abundant substances in the cell?
Proteins
What is cytoplasm and what occurs here in the cell?
Cytoplasm is the fluid part inside the cell
Lots of chemical reactions take place here — chemical reactions are very important to keep Cell alive
What is the nucleus and its function?
The nucleus is the control center of the cell
Holds DNA
Forms a barrier to keep DNA secure — out of reach of viruses and bacteria
Body is picky about what is allowed into the nucleus
How do allowed particles get into the nucleus?
Pores (opening in nuclear envelope)
What makes up the nuclear envelope?
Double phospholipid by layer
What is the purpose of the nuclear envelope?
Separate cytoplasm from nucleus
Prevent entry of random things into nucleus
VERY selective about what comes in
What is the endoplasmic reticulum and its function?
Extension of nuclear envelope
Important for fat and protein production
Important for calcium storage
Rough and smooth ER
What happens at the rough endoplasmic reticulum?
Takes info from the nucleus and makes proteins
Small dots on rough ER are ribosomes
Translate and packaged then sent for processing into the cytoplasm
What is the function of a ribosome? Where are they located?
Ribosomes translate instructions from the nucleus into proteins – stick amino acids together to make proteins
Located in rough ER
What happens at smooth endoplasmic reticulum?
Specialize for lipid production
No ribosomes here which is why it’s smooth
How do proteins travel around the cell?
Packaged into vesicles: transport vesicles or secretory vesicles
What is the Golgi apparatus and its function?
Protein modification
Area in cell that allows processing of proteins
Post translational processing— sent to Golgi apparatus after translated by the ribosome
It is common to have to alter proteins to work properly
Describe how a secretory vesicle works in the cell:
Used to carry a protein that is trying to go outside of the cell
Released from Golgi apparatus into cytosol
Vesicle moves to the cell wall and fuses with it, then dumps the contents into the area immediately outside Cell wall (ECF)
How can you get water soluble/charged compounds from one side of the cell to the other?
Need help of a protein: proteins can position themselves in the cell wall and permit the passage of charged compounds into cell
Working like a pore
example K+
What is cytosol?
The jelly like fluid portion of cytoplasm, where particles are dispersed
Surrounds organelles
Where does protein production occur?
95% in rough ER
5% outside rough ER in cytosol
Describe the process of protein production:
DNA instructions that encodes protein produce RNA
RNA is readily allowed out of the nucleus, comes into contact with ribosomes
Ribosomes Translate the message from the RNA and link amino acids together to form proteins
What is the purpose of ribosomes in the cytosol?
Not very concentrated
Don’t do heavy lifting
Usually don’t get packaged when made in the cytoplasm
Describe genetic translation:
Specific sequence of nucleotides (RNA) dictate which amino acids get stuck together in in which order
Ribosomes move the RNA along a sensor and grab amino acids from the cytosol, then attach them together to form a chain (protein)
What are the different organelles of a cell?
Endoplasmic reticulum
Golgi apparatus
mitochondria
lysosomes
peroxisomes
Describe protein shape:
Strings of contorted and folded amino acids
3-D
What is the purpose of mitochondria?
Produce ATP from energy compounds and oxygen
What is a lysosome?
Digest by using acidic internal environment
Breakdown proteins that are malfunctioning
— amino acids are recycled
What is a peroxisome?
Known for breaking down toxins within a cell
Use oxidative stress to destroy things
Abundant and liver – ethanol digestion (catalase enzyme)
What is an enzyme?
Catalyzes chemical reactions
Typically a protein ending in – ACE
What are structural components of the cell?
Filaments or proteins to prop open, produced inside the cell to give shape
What are sugars used for in the cell?
1: energy – when floating cytoplasm
2: Glycoprotein: structure, ID tags, anchor cells together
Where are most sugars located in the cell? UNKNOWN
Many sugars are in the cell wall stuck to a protein a.k.a. glycoprotein
How do sugars function in identification?
They take on specific shapes.
Example: human shape, bacterial shape
—immune system can attack non-human cells
How do sugars play a role in structural function of cells?
Sugars are sticky— can anchor cells together that are next to each other
Which statement about feedback control systems are is incorrect?
A) most control systems of the body act by negative feedback
B) Positive feedback usually promotes stability in a system
C) Generation of nerve action potentials involves positive feedback
D) Feed-forward control is important in regulating muscle activity
B
Which on the following organelles is responsible for producing adenosine triphosphate (ATP), the energy currency of the cell?
A) ER
B) mitochondria
C) Lysosomes
D) golgi aparatus
E) peroxisomes
F) ribosomes
B
What role does the charge have on the sugar molecule?
Negative Charge.
Plays a role in repelling negatively charged proteins
What is special about external sugars?
Sugars that have a specific shape and charge
How do external sugars work in the kidney?
Limit protein filtration
What is glycolysis?
Sugars create ATP in cytoplasm using anaerobic metabolism
Glucose is being consumed to create ATP
Where does glycolysis typically occur?
Cytoplasm
What group are glyco– and carboxy– prefixes in?
Sugars
Generate ATP
What roles do proteins have in the cell?
Structural.
Enzymes
Functional
What dictates a cells specific task?
proteins expressed in the cell dictate what the cell will be good at
How is the specialized role of a cell dictated?
Genes expressed in the proteins dictate the specialized role of a cell
Do proteins function for generalized tasks?
No. Proteins have assigned tasks and are specialized for that task.
How do proteins function structurally?
Help the Cell hold shape
Can help something get across cell wall
force something in a way it may not want to go (pump)
What is an example of lipid soluble compound?
Cholesterol
What is a arachidonic acid and where is it found in the cell?
It is a long chain fatty acid found in the cell wall
What is cholesterol used for?
Used to generate signaling compounds
Where are fats primarily located?
Cell wall
What is an example of a task that a lipid has in the cell?
Metabolism to turn larger compounds into something more useful
What is flagella?
Moves a cell around it environment
What are examples of motility structures for the cell?
Flagella
Cilia
What is Cilia?
Small projections that come out of the cell
Moving environment around cells
Wave fluid or mucus example: the airway
What is the necessary step for protein and fat production?
RNA processing
Where is majority of genetic materials found in the cell?
The nucleus
What is a mitochondrial DNA?
Separate from human/host DNA
Inherit all mitochondrial DNA from mother
How many sets of mitochondrial DNA do we have?
12 to 20 different sets: lots of variability with bodies ability to inherit energy producing organelles that are super efficient
What is mitochondrial DNA used for?
Lineage and genetic testing
What would be a negative aspect if we were to only inherit one version of mitochondrial DNA?
Probably would not be enough variety to get all the jobs done in our cells
What is a part of the cell that is important for anesthesia?
The cell wall: how the cell turned itself off and on
Majority of anesthesia drugs dictate the function at the cell wall
When giving anesthesia may want to shut down part of particular system
Why are the ECF and ICF chemistries so important?
Chemistry dictates, how drugs are going to work
Example: if the fluid is not within normal pH won’t behave normally
How do cells maintain a normal internal pH?
Compounds for internal buffers – things in place to maintain pH within normal limits
Example: phosphate compounds are buffers in the intracellular
What is hydrophilic and an example?
Hydrophilic is a particle that behaves well in water
Charged particles are hydrophilic: sodium potassium chloride – they disassociate when put into water
What happens to charged compounds when put into water?
They fall apart (hydrophillic)
example sodium chloride: sodium disassociates from chloride leaving both in the solution. This happens because salt is charged and hydrophilic but needs enough water to be dissolved
What is hydrophobic and an example?
Particles that are water fearing
Uncharged particles, oils, usually fats
What are some example of water soluble things?
Ions
Proteins (somewhat)
Gases (some like CO2)
Buffers: found in all containers of the body where it’s important to manage pH
Some drugs
How can you tell if the drug is soluble or insoluble?
Can look at container the drug is in if it’s oily and slimy then it’s probably not water soluble
Why do insoluble drugs look oily?
There is probably a carrier protein or a lipid used to get these drugs into the cardiovascular system
How do we give drugs that are water insoluble?
Need to give the drug with a carrier to help it get around the cardiovascular system
- carrier protein
-carrier lipid
What is an example of an insoluble drug?
Propofol white color is due to lipids that help carry the drug through the cardiovascular system
Need carrier since cardiovascular system is mostly water
What are some insoluble compounds?
Cholesterol
Steroids
Lipids
Gases -nitrous
Some drugs
Where are majority of lipids found in the cell?
Cell wall
Describe ICF and relation to fluid concentration:
Largest of internal body fluid compartments
The sum some total of all the water that’s inside all the cells in the body
What percent of body mass is water in a healthy person?
60% of body mass is water in a 70 kg patient
What are the compartments that make up total body water?
ICF
Interstitial fluid
Plasma
What are the two compartments of ECF?
Plasma
Interstitial fluid
How much of total body water is in the ICF?
2/3 of total body water
How much of total body water is in the ECF?
1/3 of total body water in ECF
What is interstitial fluid?
Fluid that is outside the cell and outside the cardiovascular system
What percent of ECF water Content is in the interstitial fluid?
3/4 to 4/5 of ECF fluid is the interstitial fluid
What percentage of ECF is water in the plasma?
1/4 to 1/5 of ECS is water in the plasma
What is plasma?
Fluid and cardiovascular system that doesn’t involve blood cells
What is the predicted plasma volume of a 70 kg patient?
3.5-2.8L
What is the predicted interstitial fluid volume of a 70 kg patient
10.5-11.2L
How would total body water differ in an obese patient compared to healthy patient?
Obese patient may have big cells with less water and more fat
So that would disrupt the normal water distribution
Why is it useful to have a larger portion of water in the interstitial fluid?
If there’s a loss of volume or blood from cardiovascular system, there can be a shift of interstitial fluid to make up for the volume loss
Why do the plasma and the interstitial fluid have similar fluid composition?
The capillary membrane that separates them is leaky so there’s not much difference between the two
Exception is protein
What is the function of the capillary membrane?
Barrier between the plasma and the interstitial fluid
How does a capillary membrane vary from the cell wall?
The cell wall is a tight barrier
Capillary membrane is endothelial cells that are more porous and permeable: all small charged ions can move between
— capillary membrane is tight enough to prevent proteins from leaking out of the plasma
What is an exception to normal capillary permeability?
The brain: capillaries are tight
What are some differences in ECF and ICF?
Different composition of fluid
Different processes happening
What is a steady state?
Sustained differences that are maintained that way in the body at rest
Differences, but they are tightly regulated
How is steady-state different than equilibrium?
Steady state doesn’t have to be equal.
Steady state contributes to homeostasis
EX: if sodium concentration was an equilibrium, the cell would be non-functioning
EX: if our body wasn’t equilibrium with the room temp that wouldn’t be good
ECF and ICF trends of protein
Highest in ICF
Five times higher in plasma, then in interstitial fluid
What are the protein concentrations in the plasma interstitial and intracellular?
Plasma protein: 1.2
Interstitial protein: 0.2
Intracellular protein: 4
Which organ produces plasma proteins?
Liver
What is the most major plasma protein?
Albumin
ECF and ICF trends of sodium
More sodium in ECF: 140-142 mOs/L
ICF sodium much lower: 1/10 ECF Na concentration 14mOs/L
What is the predominant cation in the ECF?
Sodium
How can we estimate overall osmolarity of the blood?
Double sodium to estimate osmolarity
ECF and ICF trends of potassium:
More potassium in the cell: 30x higher in cell