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DDT > Trigger 6 > Flashcards

Trigger 6 Flashcards

1
Q

Blood pressure equation

A

Bp = Q x TPR

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2
Q

what is the mean arterial pressure regaulated by

A

baroreceptors

renin-angiotensin system

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3
Q

what is the effect of baroreceptors

A

fast neuronal response
M2AchR = decrease Q
B1AR = increase Q
a1AR = increase vasoconstriction = increase TPR

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4
Q

outline the renin angiotensin pathway

A

plasma angiotesnionogen - cleaved be renin
= angiotensin I - cleaved by ACE (in the lungs)
= angiotensin II

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5
Q

what does angiotensin II stimulate

A

release of aldosterone
release of ADH
release of ANP
vasoconstriction

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6
Q

what is the effect of aldosterone

A

released from the adrenal cortex
increase Na2+ and fluid retention (distal convulted and collecting duct)
loss K+ and H+ in the urine

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7
Q

what is the effect of ADH

A 
released from the posterior pituitray 
increases fluid retention 
aquaporins in collecting duct 
V2R (Gs) stimulates aquaporins
stimulates Na2+ K+ 2Cl- cotransporter
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8
Q

effect of angiotensin on smooth muscle contraction

A

angiotensin II At receptor is a Gs and leads to Ca2+ release
increase in intracellular Ca2+ leads to calmodulin activating the MLC kinase which phosophorylates MLC leading to contraction
Gs - leads to cAMP, which inhibts MLC leading to relaxtion

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9
Q

what is ANP

A

released from the atria
due to stretch/distension
binds to natriuetic peptide receptor resulting in guanylate cyclase activity - increase cAMP
smooth muscle relaxation, vasodilation of affertent

causes a decrease in renin and subsequently angiotensin and aldostrone

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10
Q

what is the glomerus filtration rate

A

rate of fluid filtered through the kidneys

estimates how much blood passes through the glomeruli each minute

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11
Q

normal GFR rates

A

males - 125ml/min

females - 105ml/min

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12
Q

GFR equation

A

urine conc x urine flow/plasma conc

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13
Q

what is urine flow

A

amount of urine produced in a given time

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14
Q

what is plasma conc

A

conc of urine in blood after a IV injection

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15
Q

how is the GFR regulated

A

intrinsic mechanisms
- renal autoregualtion - vasocontrsiction/dilation

extrinsic mechaisms

  • neural/endocrine control - ANP = increase GFR
  • tubulogolmular feedback - specialised cells within the distal tubule monitor Na2+
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16
Q

what happens if K+ conc decreases

A

if it reduces by a 1/3 leads to paralysis as nerves unable to generate AP

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17
Q

what happens if Ca2+ conc decrease

A

if it reduces by 1/2 leads to tetanic skeletal muscle contractions

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18
Q

what are the 3 types of dehydration

A

hypotonic/hyponatremic - primarily loss of electrolytes
hypertonic/hypernatremic - primarily loss of water
isotonic/isonatremic - equal loss of water and electrolytes

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19
Q

where is Na largely loacted

A

extracellularly

primary determinent of extracellular fluid volume

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20
Q

where is K+ largely located

A

intracellularly

primary determinent of extracellular fluid volume

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21
Q

what is hypokalemia and why does it occur

A

low K+
caused by directics, diarrhoea
leads to intracellular hyperpolarization
RMP further from resting membrane potential

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22
Q

what is hyperkalemia and why does it occur

A

caused by renal failure, tissue damage and acidosis
depolarisation of excitable cells - high K+ outside

causes an increase in voltage gated Na channel opening in the first instance, which depolarises the cell, then the channels are inactivated once it reaches a certain voltage leading to overall inhibition of the cell

23
Q

role of principle cells

A

secrets K+

exchanger with Na2+

24
Q

what stimulates principle cells

A

aldosterone
K+ increase
alkalosis

25
Q

role of intercalacted cells

A

reabsorbs K+

exchanger with H+

26
Q

what stimulates intercalated cells

A

acidiosis

K+ decrease

27
Q

what is the bodys pH range

A

6.8-8

28
Q

what is the pH of acidosis and the result

A

pH < 7.35
results in depression of the CNS

  • increase in H+ secretions and excitation
29
Q

what is the pH of alkasis and the result

A

pH >7.45
overexcitabilty of the CNS and PNS
- sensory neurones fire in absence of stimuli
- motor neurons casues muscle twitches/spasm

  • decrease in H+ secretion and excrtion
30
Q

risk factors for UTIs

A

females - poor hygine, unprotected sex, diaphragm and spermicide use, antibiotics
anatomincal structure and functional abnormalities

31
Q

what are the different classifications of UTIs

A

Urethritis - infection of urthera
Cystisis - infection of the bladder
Acute pyelonephritis - baterical infection of the kidney parenchyma

32
Q

describe the follcular phase

A 
O and P levels low = signals to piturtary gland to produce FSH 
FSH = maturing folicle 
levels of FSH start to decrease 
casues folicle to produce more O 
suppress development of other follicles 
postive feeback 
lasts about 14 days
33
Q

descirbe the ovulation phase

A

increased O causes an LH surge
ovulation
stimulated enzymes in the follicel release an egg
ovulatiory phases lasts about 16-32 hours
eggs travels down the fallopian tube

34
Q

decribe the luteal phases

A 
corpus lutem secretes large amount of O&amp;P 
prepares uterus for fertilsation 
P causes 
 - endothelium to thicken 
 - fill with fluid and nutrients 
 - mucus in the cervix to thicken 
 - slight increase in body temp

LH & FSH fall
if the eggs is not fertilised the corpus lutem shrinks an degenerates, unfertlised egg dies
O&P levels fall
uterus lining is shed

35
Q

where is the thyroid gland

A

located in the neck just below the layrnx and in front of the trechea

36
Q

structure of the thyroid

A

bufferfly shaped with two lobes connected by the isthmus
made up of many sphericle thyroid follicles
follicles contain colloid, which stores the glycoprotien = thryrogloblin

37
Q

how are T3 and T4 made

A

tyrosine molecules are iodinased

38
Q

role of T3

A

responsible for almost all thyroid activity

half life - 1 day

39
Q

role of T4

A

largely converted to T3 intracellulary

half life - 7 days

40
Q

effect of thyroid hormones on the nucleus

A

stimulate nuclear receptors to activate DNA transcritpion

receptors are normally occupied by inhibitory repressors which are displaced by T3 to start activation

41
Q

effect of thyroid hormones on the mitochondria

A

direct action to increase oxidative phosphorylation

stimulates mitochondiral DNA transcription

42
Q

effect of thyroid hormones on the cell membrane

A

may also be a cell surface GPCR receptor which has an indirect function to stimulate nuclear DNA transcription

43
Q

thyroid hormones act to enchance

A

basal metabolism
cardiac muscle activity
sympathetic NS activity
protein synthesis and growth

44
Q

hypothalmus location and role

A

part of the dicephalon
between the cerebral hemisphere and brain stem
ventral to the thalamus

regulates

  • body temp
  • food intake
  • water balance
45
Q

endocrine gland location and role

A

releases hormones into hypophysical portal blood that causes release or inhibition of hormones from the anterior pituitary
also contains cell bodies of neurones of the posterior pituitary

46
Q

pituitary gland

A

size of a pea, situated in a bony hollow just behind the bridge of your nose
controls several other hormones glands

47
Q

anterior pituitray gland

A

surronded by a capillary network which extends from the hypothalamus
the hypophyseal portal system allows hormoes prodcued by the thalamus to be carried directly to the posterior pituitray without entering the blood

48
Q

thyroid abnormalities

A

hypothroidism - not enough thyroxine is produced

hyperthroidism - too much thyroxine produced

49
Q

what is hyperaldosterone

A

excessive levels of aldosterone which may be independant of the RAAS axis (primary) or due to high renin levels (secondary)

50
Q

primary hyperaldosterone

A

at the gland
renin independant increase in the secretion of aldosterone
disease of adult hood

causes

  • adrenal adenoma
    • usually benign encapsulated adenoma
  • tumours
51
Q

levels for primary hyperaldosterone

A

aldosterone - high
renin - low
cortisol - normal

52
Q

secondary hyperaldosterone

A

occurs at the previous site or further up the system

occurs in the kidney 
decrease in 
- blood flow 
- blood pressure 
- Na2+ levels in the blood

more renin, more signals to adrenal gland so more aldosterone

53
Q

levels for secondary hyperaldosterone

A

aldosterone - high
renin - high
cortisol - normal

DDT (10 decks)

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