Test 5 Study Guide Part 4

Question 1

right shift in oxygen dissociation curve due to low pH is called:

Answer 1

A Bohr Effect

Question 2

temperature effect on hemaglobin oxygen unloading:

Answer 2

High temperature right shift

Low temperature left shift

Question 3

Sickle Cell Anemia:

• Population at risk:
• Alternative Hemoglobin:

Answer 3

• Population at risk:
• Alternative Hemoglobin:
  Hemoglobin S instead of hemoglobin A

Question 4

Sickle Cell Anemia:

• Hemoglobin S differs in what regard:
• Physiological effect:

Answer 4

• Hemoglobin S differs in what regard:
  Single amino acid shift within beta chains
• Physiological effect:
  in low Po2 hemaglobin S polymerizes, causing extended, sickle shaped cells

Question 5

Sickle Cell Anemia:

• Impact of elongated cells:
• Treatment:

Answer 5

• Impact of elongated cells:
  Reduced flexibility causes infarcts
  Damaged plasma membrane = hemolysis
  damaged RBCs injure vascular endothelium
• Treatment:
  Hydroxyurea -> gamma chains instead of beta chains -> fetal hemaglobin is used
  Bone marrow transplant

Question 6

Thalassemia:

- Define:

Answer 6

• Define:

Hemoglobinopathy (like sickle cell anemia), unusual shaped RBCs

Question 7

Myoglobin:

• Number of hemes:
• Dissociation curve difference:

Answer 7

• Number of hemes:
  1 heme (1 O2 molecule)
• Dissociation curve difference:
  Very left shifted.

Question 8

Myoglobin:

• Function:
• CO poisoning:

Answer 8

• Function:
  Oxygen storage
  Oxygen release during oxygen deprivation (left shifted curve)
• CO poisoning:
  CO binds to myoglobin with more affinity then it binds to hemaglobin

Question 9

CO2 composition in the blood stream:

Answer 9

10% dissolved in plasma
20% bound to hemaglobin (carbaminohemeglobin)
70% as bicarbonate ion (HCO3-)

Question 10

Law of mass action:

Answer 10

Enzymes can drive the equation either way, increased reagents drive it one way, increased reactants drive it the other way

Question 11

Why is the pH of deoxygenated blood lower than the pH of oxygenated blood?

Answer 11

Increased CO2 in deoxygenated, drives the enzyme carbonic anhydrase to make increase H2CO3 -> H+ + HCO3-

Question 12

Where is carbonic anhydrase located?

Answer 12

In the RBCs

Question 13

Chloride shift:

• Story:
• Where does it occur:

Answer 13

• Story:
  carbonic anhydrase -> HCO3- -> diffuses out of cell -> Cl- replaces it
• Where does it occur:
  Systemic capillaries (where CO2 is produced)

Question 14

How is the bohr effect achieved?

Answer 14

H+ binds to Oxyhemaglobin, increasing the chance it will release O2

Question 15

Deoxyhemaglobin and H+:

Answer 15

Binds with greater affinity then oxyhemaglobin. Slows loss of oxygen

Question 16

Carbonic anhydrase, the lungs, and the law mass activation:

Answer 16

low Pco2 in lungs will cause HCO3- -> H20 + CO2

Question 17

Reverse Cl- shift:

• Define:
• Occurs where:

Answer 17

• Define:
  Low Pco2 in lungs -> HCO3- -> H20 + CO2 -> Cl- replaces HCO3- in RBC
• Occurs where:
  The pulmonary capillaries

Question 18

Blood pH:

Answer 18

7.4 (slightly alkaline)

Question 19

Types of acids:
Can be converted to a gas (HCO3- -> CO2 + H20)
Cannot be converted to gas
Lactic acid, fatty acid, ketone bodies

Answer 19

• Volatile Acid:

- Non-Volatile acid:

Question 20

Why does non-volatile/metabolic acids not normally effect pH?

Answer 20

bicarbonate buffers pH changes

Question 21

Respiratory acidosis:

Respiratory alkalosis:

Answer 21

Hypoventilation -> CO2 -> decreased pH

Hyperventilation -> CO2 -> increased pH

Question 22

Metabolic acidosis:

- Causes:

Answer 22

• Causes:
  Volatile fatty acid increase
  Lower levels of bicarbonate (diarhea, loss of bicarbonate from pancreatic juices)

Question 23

Vomiting and metabolic alkalosis:

Answer 23

Vomiting loses stomach acid, loss of acid produces metabolic alkalosis

Question 24

Kidney roll in acid regulation:

Answer 24

Regulates long term levels of various acids

Question 25

Respiratory compensation for metabolic acidosis: | Respiratory compensation for metabolic alkalosis:

Answer 25

Hyperventilate (breath off CO2, decrease acid levels) Hypoventilate (keep CO2, increase acid levels)

Question 26

During exercise what happens to arterial blood Po2 and Pco2 levels?

Answer 26

Pco2 and Po2 stay constant. | Not mediated by normal H+ increase due to CO2 increase

Question 27

Despite high hemaglobin saturation levels what may reduce O2 transfer to tissues?

Answer 27

Linear decrease in plasma pO2, which dictates how much pO2 can be in the plasma at any given time

Question 28

Hypoxic ventilatory response: - Define: - Compensation mechanism:

Answer 28

- Define: entering higher altitudes lowers plasma Po2 causes hyperventilation. Decreases Pco2 causing respiratory alkalosis. - Compensation mechanism: Kidney's excrete bicarbonate, causing more to be made, normalizing pH

Question 29

How can ventilation directly try to compensate for high altitude? What is the limit to this?

Answer 29

- Increase tidal volume, breath out more air, removes dead air with lower O2 - PO2 of arterial blood can never be greater then atmospheric P02

Question 30

Lung and NO in high altitude:

Answer 30

NO is produced by lungs. Vasodilatation of pulmonary arteries NO also binds to hemaglobin, and contributes to hypoxic drive in the medulla oblongata

Question 31

What happens to the affinity of oxygen at high altitudes:

Answer 31

it shifts right, increased oxygen unloading in tissues (but a small decrease in O2 loading in lungs)

Question 32

Acetazolamide:

Answer 32

In the family of Carbonic anhydrase inhibitor Causes excretion of HCO3- -> More to be made -> increases pH -> increases ventilation -> helps compensate for high altitude sickness

Question 33

What is the ideal way to prepare for high altitude?

Answer 33

Acclimatize at progressively higher and higher base camps

Question 34

What stimuli causes increased EPO production in the kidneys?

Answer 34

Decreased O2 levels are detected

Question 35

Increased RBC counts have what downside?

Answer 35

Polycythemia produces increased vascular resistance (the blood is more viscous) Can cause pulmonary hypertension -> ventricular hypertrophy -> heart failure

Question 36

Ideal hemaglobin level: | Level in those with chronic mountain sickness:

Answer 36

18g/dL | 21 to 23 g/dl

Question 37

Change in chest associated with whole life spent at high altitude:

Answer 37

Larger chest, larger lungs

Question 38

Effect of chronic life at altitude on pulmonary capillaries:

Answer 38

More capillaries develop

Question 39

Renal pelvis:

Answer 39

All urine made enters the renal pelvis, which is a hollow cavity. Flow from here to ureter

Question 40

Filtrate vs urine:

Answer 40

Filtrate: exists in the renal cortex and renal medulla. This fluid is still being processed. Urine: exists once the filtrate enters the renal pelvis, no more processing.

Question 41

Renal Cortex:

Answer 41

Outermost layer of the kidney. | Granular in appearance due to many capillaries

Question 42

Renal Medulla:

Answer 42

Inner from the renal cortex Striped appearance due to microscopic tubules Composed of 8 - 15 renal pyramids separated by renal columns

Question 43

Renal Pyramid:

Answer 43

Located within the renal medulla

Question 44

Minor Calyces: | Major Calyces:

Answer 44

Renal pyramids drain into this hollow structure | It becomes this hollow structure, which leads to the renal pelvis

Question 45

Ureters, calyces and renal pelvis exhibit what type of movement?

Answer 45

Peristalsis

Question 46

Where are the pacemakers for the ureters peristalsis located?

Answer 46

Renal calyces and pelvis

Question 47

Flow of urine from minor calyces onward:

Answer 47

Minor calyces -> major calyces -> renal pelvis -> ureter -> bladder -> urethra -> outside

Question 48

Urethra: - Define: - Female: - Male:

Answer 48

- Define: Where the urine exits the bladder - Female: shorter, wider urethra. More likely to get urinary tract infections - Male: Longer narrower, prostate gland enlargement can cause problems

Question 49

Why does an enlarged prostate compress the urethra?

Answer 49

Because it flows through the prostate gland

Question 50

Muscular wall of the bladder: - Name: - Parasympathetic axons:

Answer 50

- Name: Detrusor muscle - Parasympathetic axons: ACh parasympathetic innervation causes urination

Question 51

``` bladder control: Smooth muscle (not consciously controlled) Skeletal muscle (consciously controlled) ```

Answer 51

Internal Urethral Sphincter: | External Urethral Sphincter:

Question 52

Exercises to strengthen external sphincter

Answer 52

Kegel exercises:

Question 53

CO2 bound to hemoglobin:

Answer 53

Carbaminohemeglobin