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Cardiorespiratory (MEDI301) > Weeks 1-2 > Flashcards

Weeks 1-2 Flashcards

1
Q

Normal PO2 in arterial blood

A

~95mmHg

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2
Q

Normal PO2 in venous blood

A

40mmHg

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3
Q

Normal PCO2 in arterial blood

A

~40mmHg

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4
Q

Normal PCO2 in venous blood

A

46mmHg

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5
Q

Normal arterial blood pH

A

7.38-7.42

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6
Q

Normal venous blood pH

A

7.37

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7
Q

What is the result on breathing of a lesion between the medulla and pons?

A

Breathing is erratic, but spontaneous

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8
Q

What are the 4 centres in the brainstem controlling breathing?

A

Pons: pneumotaxic centre and apneustic centre
Medulla: dorsal respiratory group and ventral respiratory group

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9
Q

What is the purpose the inspiratory ramp signal?

A

To ensure gradual inspiration, which is then turned off to allow passive expiration

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10
Q

What is the role of the dorsal group of the medulla?

A

Inspiratory centre, creating the basic rhythm

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11
Q

What are the inputs to the dorsal group of the medulla?

A

Peripheral chemoreceptors
Baroreceptors
Stretch receptors

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12
Q

What nucleus is part of the dorsal group of the medulla?

A

NTS

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13
Q

The NTS is part of which respiratory group?

A

Dorsal group of the medulla

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14
Q

What is the role of the ventral group of the medulla?

A

Forced breathing, creating large tidal volumes

E.g. during exercise, result of pathology

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15
Q

Which nuclei are part of the ventral group of the medulla?

A

Nucleus ambiguus

Nucleus retro-ambiguus

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16
Q

The NA and NRA are part of which respiratory group?

A

Ventral group of the medulla

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17
Q

What is the role of the pneumotaxis centre of the pons?

A

Turn the ramp signals off

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18
Q

Which nucleus is part of the pneumotaxis centre of the pons?

A

Nucleus parabrachialis

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19
Q

What is the role of the apneustic centre of the pons?

A

Decreases the depth of inspiration by acting on inspiratory centre

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20
Q

Along which nerves do impulses from the peripheral chemoreceptors and baroreceptors travel to the respiratory centre?

A

Glossopharyngeal

Vagus

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21
Q

What is the efferent pathway from the respiratory centre?

A

Descending in anterior part of lateral column of spinal cord

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22
Q

What is the Hering-Breuer reflex?

A

Limits lung inflation.
Inspiratory centre -> phrenic nerve -> diaphragm contracts -> stretch receptor in lung -> vagus nerve.
Vagus nerve inhibits the inspiratory centre

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23
Q

What are J receptors of the lung?

A

Juxtacapillary receptors present in the wall of the alveoli, close in contact with pulmonary capillaries.

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24
Q

What conditions can stimulate J receptors?

A

Pulmonary edema
Pulmonary congestion
Pneumonia
Exposure to chemicals

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25
Q

What response is produced by stimulation of J receptors?

A

Reflex: apnoea

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26
Q

What is apnoea?

A

Temporary cessation of breathing

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27
Q

J receptors have an effect on…

A

The respiratory centre

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28
Q

What factors affect the respiratory centre?

A

Impulses from higher centres, stretch receptors, J receptors, irritant receptors, proprioceptors, thermoreceptors and pain receptors.
Cough, sneeze and deglutition reflexes

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29
Q

What is hypercapnea?

A

Increased CO2 in blood

30
Q

Where are the central chemoreceptors situated?

A

In the deep parts of the medulla.

Close contact with blood and CSF

31
Q

What is the action of the central chemoreceptors?

A

Detecting pH and PCO2

32
Q

What are the carotid bodies specifically sensitive to?

A

pO2, pCO2 and pH

33
Q

Where are the carotid body afferents?

A

Glossopharyngeal nerve

34
Q

What are the aortic bodies specifically sensitive to?

A

pO2 and pCO2

35
Q

Where are the aortic body afferents?

A

Vagus nerve

36
Q

What are the 2 COPD phenotypes/stereotypes?

A

Pink puffer - thin

Blue bloater - fat

37
Q

Explain the pink puffer presentation of COPD

A

Hyperventilates to blow off CO2.

Skinny because breathing is hard work

38
Q

Explain the blue bloater presentation of COPD

A

Has lost sensitivity to CO2, so breathing is driven by hypoxemia. Don’t give oxygen!

39
Q

What are Cheyne Stokes?

A

An abnormal cycle of breathing, the result of a failure of control of respiration.

40
Q

What is bronchial thermoplasty?

A

Radiofrequency energy is delivered by bronchoscope, and causes atrophy of airway smooth muscle. Helps with conditions like extremely severe asthma

41
Q

What is obstructive sleep apnoea?

A

The soft palate collapses during sleep, and wakes the person up to restart their breathing.

42
Q

What is central sleep apnoea, and what can cause it?

A

When there is no signal from the brain to breathe.

Tumour, stroke, cardiac failure

43
Q

What is the Frank-Starling mechanism of the heart?

A

An increase in the return of blood from the venous system causes a greater cardiac output.

44
Q

Function of norepinephrine

A

Vasoconstrictor

45
Q

Where is the vasoconstrictor area in the brain?

A

Anterolateral portions of the upper medulla

46
Q

Where is the vasodilator area in the brain?

A

Anterolateral portions of the lower medulla

47
Q

Where is the sensory area in the brain, regarding sympathetic and parasympathetic innervation?

A

NTS - posterolateral portions of medulla and lower pons

48
Q

How is a rapid rise in blood pressure invoked?

A

Constriction of arterioles (increase peripheral resistance)
Constriction of veins (Frank-Starling mechanism)
Direct stimulation of the heart (increasing heart rate and heart muscle fibre contractility)

49
Q

What is vasovagal syncope?

A

A large vagal cardioinhibitory response to emotional stress, physical stress, sometimes in response to blood flow changes during urination, bowel movement, coughing, swallowing.
Heart rate is reduced, vasodilation occurs -> blood pressure drops.

50
Q

What is the Valsalva manoeuvre?

A

Moderately forceful exhalation against a closed airway

51
Q

What is orthostatic hypotension?

A

AKA postural hypotension

When a person’s blood pressure suddenly drops after standing up

52
Q

What is the Bainbridge reflex?

A

An atrial reflex that regulates heart rate.

Increased venous return -> increased atrial pressure -> increased cardiac contractility -> increased heart rate

53
Q

What is the volume reflex?

A

An atrial reflex that activates the kidneys.
Stretched atria -> decreased kidney afferent arteriolar resistance -> decreased ADH -> decreased reabsorption of water from tubules -> increased fluid loss -> decreased blood volume

54
Q

Where is ADH produced?

A

Hypothalamus (brain) -> pituitary gland -> bloodstream

55
Q

What stimulates ADH production?

A

Hypovolemia
Hypotension
Angiotensin II increase

56
Q

What is ANP (atrial natriuetic peptide) and what does it do?

A

Released by atrial cells in response to distension of atrial myocytes.
Causes vasolidation, promotes loss of salt and water through kidneys, reducing blood volume

57
Q

What is the Cushing reflex?

A

A reflex to restore blood flow to the brain, when occluded by increased intracranial pressure

58
Q

What is transmural pressure (regarding arteries)?

A

The difference between pressure outside an artery and that inside.

59
Q

What is the significance of the baroreflex, chemoreceptor and Cushing reflexes being closed-circuit feedback systems?

A

They sense the thing they control, so are prone to oscillations

60
Q

What is the function of the kidneys?

A

Regulation of blood ionic composition
Regulation of blood volume
Regulation of blood pressure (volume, secreting renin)
Regulation of blood pH (excreting H+, conserving bicarbonate ions)
Regulate RBC production (release erythropoietin)
Synthesise vitamin D
Filter waste produces in blood

61
Q

What is the renin-angiotensin system?

A

Drop in blood flow -> renin secreted -> angiotensin II (vasoconstrictor) -> increased pressure
Angiotensin II -> aldosterone secretion -> Na+ and water reabsorption -> increased blood volume -> increased blood pressure

62
Q

Examples of drugs for hypertension therapy

A 
Diuretics
Beta-blockers
ACE inhibitors
Angiotensin antagonists
Ca+ channel blockers
Alpha-blockers
63
Q

What is the definition of resistant hypertension

A

Treatment with 3+ antihypertensive drugs including a diuretic
Brachial blood pressure >140/90mmHg
Secondary causes of hypertension have been ruled out

64
Q

How do diuretics work to reduce hypertension?

A

Increased water excretion -> reduced blood volume -> reduced blood pressure

65
Q

How do beta-blockers work to reduce hypertension?

A

Slow heart-rate -> reduce cardiac output -> reduce blood pressure

66
Q

How do ACE inhibitors reduce hypertension?

A

Vasodilate peripheral arteries -> reduced resistance -> reduced blood pressure

67
Q

How do angiotensin antagonists reduce hypertension?

A

Vasodilate peripheral arteries

68
Q

How do Ca+ channel blockers reduce hypertension?

A

Prevent Ca+ enter smooth muscle cells of peripheral arteries -> reduced vessel stiffness -> reduced blood pressure

69
Q

How do alpha-blockers reduce hypertension?

A

Reduce sympathetic nerve signal to arteries -> vasodilation -> reduced blood pressure

70
Q

Does atherosclerosis reduce the windkessel effect?

A

No

Cardiorespiratory (MEDI301) (3 decks)

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