AnP Flashcards
1
Q
A
2
Q
How many lobes are on the left side of the lungs?
A
Two lobes
3
Q
How many lobes are on the right side of the lungs?
A
Three lobes
4
Q
What does the trachea divide into?
A
Two main bronchi
5
Q
What are the smaller branches of the bronchi called?
A
Bronchioles
6
Q
What are the air sacs in the lungs called?
A
Alveoli
7
Q
What is included in the conducting airway?
A
- Nose
- Mouth
- Pharynx
- Larynx
- Trachea
- Bronchi
8
Q
What is the primary function of the respiratory airway?
A
Gas exchange
9
Q
What does the process of ventilation change about atmospheric air?
A
Warms, moistens, and filters
This process enhances the quality of air before it reaches the lungs.
10
Q
What are the structures involved in the ventilation process?
A
Nose, sinuses, nasal cavity, pharynx, larynx, bronchi
These structures work together to condition the air.
11
Q
What is the function of alveolar macrophages?
A
Phagocytosis of pathogens and debris
They are essential for maintaining lung health.
12
Q
What role do neutrophils play in lung defense?
A
Respond to infection and inflammation
They are a type of white blood cell involved in the immune response.
13
Q
True or False: The cough reflex is a defense mechanism for the lungs.
A
True
It helps expel irritants and pathogens from the airways.
14
Q
What are the components of the respiratory tract?
A
Lobules and alveoli
The respiratory tract is essential for gas exchange.
15
Q
What are the functional units of the lungs where gas exchange occurs?
A
Alveoli
Alveoli are also referred to as respiratory sacs.
16
Q
What structure separates the lungs?
A
Mediastinum
The mediastinum contains the heart, esophagus, thymus gland, and other blood vessels and nerves.
17
Q
Fill in the blank: The alveoli are the functional units of the lungs where _______ occurs.
A
gas exchange
18
Q
True or False: Surfactant is produced by type I cells in the alveoli.
A
False
Surfactant is produced by type II cells.
19
Q
What does the mediastinum contain?
A
- Heart
- Esophagus
- Thymus gland
- Blood vessels
- Nerves
20
Q
What is the mucociliary apparatus?
A
A specialized cellular mechanism within the bronchioles
It plays a crucial role in clearing mucus and pathogens from the respiratory tract.
21
Q
What types of cells are found in the mucociliary apparatus?
A
- Ciliated pseudostratified columnar epithelial cells
- Goblet cells
These cells work together to produce and move mucus.
22
Q
What is the function of the cilia in the mucociliary apparatus?
A
Moves mucus from the bronchioles to the throat
The cilia beat in a wave-like motion to facilitate this movement.
23
Q
What is the role of goblet cells in the mucociliary apparatus?
A
Produce mucus
Mucus traps dust, pathogens, and other particles.
24
Q
How does the mucociliary apparatus help in swallowing mucus?
A
Cilia move mucus upward to the throat
This process helps keep the airways clear and allows for mucus to be swallowed.
25
What factors can affect the mucociliary apparatus?
* Smoking
* Respiratory Infections
## Footnote
These factors can impair the function of the mucociliary apparatus.
26
True or False: The mucociliary apparatus is only composed of ciliated epithelial cells.
False
## Footnote
It also includes goblet cells which are essential for mucus production.
27
Fill in the blank: The wave-like movement of cilia enables the movement of mucus _______ to the throat.
[downward]
## Footnote
This downward movement is essential for clearing mucus effectively.
28
Where does gas exchange occur?
In the alveoli
## Footnote
Alveoli are tiny air sacs in the lungs where the exchange of oxygen and carbon dioxide takes place.
29
What happens to oxygen during gas exchange?
Oxygen enters the alveolus and moves across the alveolar membrane into the blood
## Footnote
This process is crucial for supplying oxygen to the body's tissues.
30
What does oxygen combine with in the blood?
The heme portion of hemoglobin
## Footnote
Hemoglobin is a protein in red blood cells responsible for transporting oxygen.
31
What is formed when oxygen combines with hemoglobin?
Oxyhemoglobin
## Footnote
Oxyhemoglobin is the compound formed when oxygen binds to hemoglobin, facilitating oxygen transport in the bloodstream.
32
What does the ventilation-perfusion ratio (V-Q Ratio) measure?
The ratio of the amount of oxygen reaching the alveoli to the amount of blood reaching the alveoli
## Footnote
This ratio is critical for effective gas exchange.
33
What is the ideal state of the ventilation-perfusion ratio?
Both ventilation and perfusion should be equal
## Footnote
An equal ratio facilitates optimal gas exchange.
34
What is dead space in the context of ventilation and perfusion?
An area where there is no perfusion
## Footnote
Dead space can occur in certain lung conditions, reducing overall efficiency of gas exchange.
35
Pulmonary function Tests (PFT's)
36
What is the effect of Erythropoietin on the bone marrow?
Stimulates the bone marrow to increase the production of Red blood cells
## Footnote
This process is essential for improving oxygen transport in the blood.
37
What types of disorders can stimulate the production of Erythropoietin?
Any disorder that causes hypoxia, such as:
* COPD
* High altitudes
* Cardiac disease
## Footnote
These conditions lead to reduced oxygen availability, triggering Erythropoietin secretion.
38
Cholesterol
| precursor to..?
1. A lipid that is an essential part of bile acid and cell membranes
2. Insoluble in blood
3. A precursor of the steroid hormone
39
Triglyceride
| made from? Acquired how? Stored where? inversely related to?
1. A lipid made from fatty acids and glycerol
2. Aquired through diet
3. Stored in adipose tissue
4. Levels corrolate with LDL and are inverse to HDL
40
Lipoproteins
| Produced by?
Carrier proteins that aid in the transportation of cholesterol and triglycerides in the blood
-produced by the liver
41
Mechanism of Action/Pathophys: Statin
| Decreaes LDLS by...? What does it inhibit?
- Block synthesis of cholesterol in the liver by competitively inhibiting HMG-CoA reductase activity
- Decreases levels of LDL by 25-65%
- reduce smooth muscle changes, reduce inflammatory cells inside plaque, stabilizes the endothelium, reduces friction in blood flow and reduces proteins associated with inflammation
42
Mechanism of Action/Pathophys: Cholesterol Absoprtion Inhibitors (CAI)
| EZETIMIBE (ZETIA)
## Footnote
Works on which organ? Lowers what? Good for which types of patients?
Works on the small intestine to inhibit the absorption of cholesterol
Helps lower LDL and triglycerides
-Indications
* Lower serum cholesterol levels
* Those who can not tolerate
statins
43
Mechanism of Action/Pathophys: Bile Acid Sequestrants (B.A.S)
Bind with the cholesterol in the intestine so it can not be absorbed and is excreted in stool
- promote an increase in bile acid excretion
- enhance the conversion of cholesterol to bile acids by the liver
## Footnote
Not routinely used but strong record of efficacy and safety
44
Mechanism of Action/Pathophys: PCSK9 Inhibitors
| Reserved for which patients?
Safe to use with?
A protein produced by the liver that plays a role in regulating LDL, decrease LDL, cholesterol, and triglycerides
- reserved for those with very high LDL, very high cholesterol, or those who cannot tolerate statins
- often given with statins (synergistic effect)
45
Mechanism of Action/Pathophys: Fibrates
* Inhibition of cholesterol synthesis
- decrease triglyceride synthesis
* Inhibition of lipolysis in adipose tissue
* lower total cholesterol, LDL
- Increase HDL
- helps remove from blood
46
What is the largest endocrine gland?
Thyroid gland
## Footnote
The thyroid is responsible for producing key hormones that regulate metabolism.
47
Name the three hormones produced by the thyroid gland.
* Thyroxine (T4)
* Triiodothyronine (T3)
* Calcitonin
48
What is the function of T4 and T3?
Needed for metabolism
49
What are the functions of thyroid hormones?
* Stimulates metabolic activity and oxygen consumption of cells
* Produces heat and thermogenesis
* Stimulates carbohydrate, fat and protein metabolism
* Increases rate of glucose absorption
* Increases erythropoiesis
* Influences mood
* Works with growth hormone, insulin, and sex steroids to promote growth
* Required for normal respiratory response to hypoxia and hypercapnia
* Critical for fetal neural and skeletal development
50
What controls the secretion of T3 and T4?
Thyroid Stimulating Hormone (TSH) from the anterior pituitary
51
How does TSH control the rate of thyroid hormone release?
Via a negative feedback mechanism
52
What happens to TSH levels when thyroid hormone levels are high?
Inhibition of TSH
53
What is the primary action of insulin?
Hormones that controls the storage and metabolism of carbohydrates, proteins, and fats
## Footnote
This activity occurs primarily in the liver, in muscle, and in adipose tissues.
54
What does insulin stimulate in the liver?
Synthesis of glycogen
55
How does insulin affect protein and fat storage?
Promotes protein synthesis and helps store fat by preventing its breakdown for energy
56
From where is insulin released?
Beta cells of the Islet of Langerhans in response to increased blood sugar
57
What happens during gluconeogenesis?
The body creates glucose from non-carbohydrate sources instead of using the Krebs cycle
58
What are counter-regulatory hormones?
Hormones that counteract the effects of insulin:
glucagon, epinephrine, cortisol, and growth hormones
## Footnote
They help increase blood glucose levels when they drop.
59
What happens to glucose in the presence of oxygen?
It breaks down to form CO2 and water
## Footnote
This process is part of cellular respiration.
60
What happens to glucose after absorption?
It is used for energy, stored as glycogen in the liver, or converted into fat
## Footnote
Excess glucose can also be excreted in urine.
61
What is glycogenolysis?
The breakdown of stored glycogen to make glucose
-This process occurs in the liver and muscle tissue when glucose levels are low. (Prolonged starvation)
-In response to Epinrephrine, glucagon, insulin
62
What is gluconeogenesis?
The synthesis of glucose by the liver from non-carbohydrate sources
## Footnote
It primarily occurs from amino acids and fats. Can lead to development of ketones
63
What role does insulin play in glucose metabolism?
Insulin stimulates the uptake, use, and storage of glucose by promoting glycogen synthesis and inhibiting gluconeogenesis
## Footnote
It is released by beta cells in the pancreas.
64
Neurotransmitters: Acetylcholine - where is it found, what type of action?
- found in the CNS, PNS, and ANS
- can be either excitatory or inhibitory (depends on neurons secreting it)
-- PNS: excitatory at neuromuscular junctions
-- ANS: inhibitory and slows heart rate
65
Neurotransmitters: Serotonin (5-hydroxytrptamine) - where is it found, what type of action?
- derived from tryptophan
- found primarily in the GI tract, platelets, and brainstem
- contributor to feeling of well being
- inhibitory
66
Neurotransmitters: Dopamine - where is it found, what type of action?
- located mainly in the substantia nigra of midbrain/basal ganglia region
- numerous functions:
-- behavior and cognition
-- voluntary motor movement
-- motivation punishment and reward
-- attention
-- working memory
-- learning
- involved in many neuropsychiatric and voluntary motor movement disorders:
-- social phobia, ADHD, drug and alcohol dependence
-- Parkinson's disease
-- Tourette's syndrome
67
How do neurons do conduction?
action potential (neuron conducts impulses)
- abrupt changes in the membrane potential permit nerve signals to be transmitted from the cell body down the axon
- stimulates sodium, potassium, and calcium ions to move across the axonal membrane
68
What are the three phases of an action potential?
- depolarization of the neuron: positively charged ion
- repolarization of neuron: return of neuron to a negative value
- resting period
69
What is glycolysis?
the step by step process of breaking down of glucose into pyruvic acid, NADH, and ATP (energy)
70
What is glycogen?
when your body does not immediately need glucose from the food you eat for energy, it stores glucose primarily in muscle and the liver as glycogen for later use
71
What is gluconeogenesis
process of glucose formation from non-carbohydrate substances
72
What is glycogenolysis
the breakdown of stored glycogen to glucose
73
What is gluconeogenesis
the synthesis of glucose from non-carbohydrate sources
- the opposite process of glycolysis
74
What is glucagon?
a hormone produced by alpha cells in the pancreas
- it is released in response to a drop in blood sugar, prolonged fasting, exercise, and protein-rich meals
75
Normal renal functions (9)
* Excretion of waste prodcts and urine
* Regulation of BP
* RBC production- erythropoietin
* Breakdown of drugs
* Metabolism of hormones
* Regulation of Electrolytes and acid-base balance
* Synthesis of Vit D
* Fluid Balance
* Balance of pH of blood stream
76
Nephrons
Adults tend to lose approximately 10% of their nephrons for each decade beginning at 40
## Footnote
by age 70- nephrons will be down 30mL/min=95mL/min
77
Elimination functions of the kidney
Removal of:
- Water
- waste products
- excess electrolytes
- unwanted substances
78
Cardiac output
Stroke Volume X HR
Normally, 4-8L /min
79
Stroke Volume
Cannot directly meausre so we measure cardiac output via: preload, afterload, and contractility
80
Preload
At the end of diastole, or when L ventricle is filled/ mitral valve closed.
More stretching = more blood which is good. But excessive stretching can lead to heart failure
| Preload = stretching
81
Normal ejection fraction
55-70%
anything below 40% is abnormal
82
Which cells produce surfactant in the alveoli?
Type II cells
## Footnote
Surfactant helps reduce surface tension in the alveoli.
83
What is the role of goblet cells in the mucociliary apparatus?
Produce mucus
## Footnote
Mucus traps dust, pathogens, and other particles.
84
What is ventilation?
The process of inspiration and expiration of air
## Footnote
Ventilation is essential for gas exchange in the lungs.
85
What controls ventilation?
The respiratory center in the brain
## Footnote
It receives input from chemoreceptors and lung receptors (stretch and irritant receptors).
86
What is Erythropoietin?
A hormone secreted by the kidneys in response to low oxygen levels
## Footnote
Erythropoietin plays a crucial role in regulating red blood cell production.
87
What stimulates the production of Erythropoietin?
Low oxygen levels
## Footnote
This response is critical for maintaining adequate oxygen levels in the body.
88
Primary functions of the GI tract
- ingestion
- digestion
- absorption
- elimination
89
What is the esophagus? What does it consist of?
- tube like structure that lies behind the trachea and extends from pharynx to the stomach (approx. 10 in long)
Consists of:
- smooth muscle layers
- mucosal and submucosal glands secrete mucus for surface protection & lubrication
- has a sphincter at either end:
-- upper (pharyngoesophageal): striated muscle; prevents air from entering esophagus during breathing
-- lower (gastroesophageal): circular muscle; passes through opening in diaphragm (hiatus); reflux prevention
Food moves through by **peristalsis**
90
Three parts of the stomach? Phases of the digestive process?
Three parts:
- fundus (upper portion)
- body
- pylorus (pyloric sphincter controls gastric emptying)
Phases of digestive process
- cephalic phase
- gastric phase
- intestinal phase
91
What are the functions of gastric acid?
- chemical breakdown
- disinfect infected food
92
What are the types of cells found in the stomach?
- gastric goblet cells (mucus secretion)
- parietal cells: HCl and intrinsic factor
- chief cells
-- pepsinogen: converts to pepsin; protein breakdown
- G cells: gastrin
93
Why are prostaglandins important in gastric acid secretion?
There are high concentrations in the gastric mucosa and secretions
- inhibit acid secretion
- stimulate mucus and bicarbonate secretion
94
Function of chief cells in the stomach?
secrete pepsinogen which converts to pepsin, the enzyme for protein digestion
95
What is the function of gastric mucosal cells?
Prostaglandin E2 (PGE2)
- protective
- stimulates gastric mucus production and pancreatic bicarb secretion
96
What is the function of G cells in the stomach?
Gastrin
- protein digestion
- increases gastric motility
- stimulates secretions from parietal and chief cells
- triggers release of bile from gallbladder and enzymes from pancreas
97
What is the middle GI tract (small intestine) composed of?
Approx 20 ft long
Consists of three parts:
- duodenum (digestion): contains opening for common bile duct and main pancreatic duct
- jejunum (absorption): amino acids, glucose, iron, calcium, fat soluble vits. (ADEK)
- ileum (reabsorption): enterohepatic circulation; reabsorb B12 and return bile acids to liver
Ileocecal valve: where small and large intestine join
Mucosal lining of the small intestine is covered with **villi**
98
Lower GI tract composition and role
Large intestine; about 4.5-5 ft
Composed of:
- cecum
- ascending
- transverse
- descending
- sigmoid colon (waste products; feces)
- rectum
- anal canal
Role: absorb water and salt; store feces until defecation
99
What are the four layers of the GI wall?
- inner mucosal layer: 1st
- submucosal layer: 2nd
- muscularis externa layer: 3rd
- serosal layer: 4th
100
First (inner mucosal) layer - composition and functions
made up of lining of epithelial tissue - lamina propria, and muscularis mucosae
Functions:
- production of mucus
- secretion of digestive enzymes
- absorption of breakdown products of digestion
- maintenance of barrier; immune defense
101
Second (submucosal) layer contains...?
contains blood vessels, nerves, and structures responsible for secreting digestive enzymes
102
Third (muscularis externa) layer consists of...?
two layers of smooth muscle cells that facilitate movement:
- inner layer: smooth muscle cells in circular pattern
- outer layer: smooth muscle cells longitudinally arranged
103
Fourth (serosal) layer is made up of...?
is a serous membrane consisting of the mesothelium:
- outer layer: visceral peritoneum
- inner layer: parietal peritoneum
104
What are the mesenteries of the abdominal cavity?
double-folded connective tissue that attaches the intestines to the posterior abdominal wall
- consists of 3 sections
- helps in supplying blood vessels, lymphatics, and nerves to the intestines
- helps in storing fat
105
Intestinal motility: Segmental mixing/kneading movements (Haustrations)
- shuffle contents back and forth among haustra
- increases contact time with mucosa for absorption of water and electrolytes
- primary type of movement
- initiated by autonomic nerves within smooth muscle cells
106
Intestinal motility: propulsions or propulsive mass movements
- usually occur after a meal
- Large segment contracts and moves contents FORWARD into sigmoid colon and rectum: stimulates defecation
107
Enteric nervous system: Myenteric (Auerbach) plexus
- located between circular and longitudinal muscle layers
- gut motility
108
Enteric nervous system: Submucosal (Meissner) plexus
- between mucosal and muscle layers
- controls secretions, absorption, contraction of segments in intestinal tract
109
What is enteric nervous system activity regulated by?
local influences (mechanoreceptors, chemoreceptors), ANS and information between plexuses
110
ANS: parasympathetic innervation
- supplied by vagus nerve
- stimulation increases motility and secretions
"rest and digest"
111
ANS: sympathetic innervation
- stimulation is inhibitory
- decreased motility and secretory activity
"fight or flight"
112
Swallowing and esophageal motility
- mastication begins digestive process
- propulsion of food from mouth to stomach
- three phases of swallowing: oral, pharyngeal, esophageal
Types of peristalsis:
- primary: controlled by swallowing center and begins when food enters stomach
- secondary: partially mediated by smooth muscle fibers in esophagus (esophageal sphincter, parasympathetic stimulation, gastrin)
113
Gastric motility
- stomach serves as food storage
- chyme: food broken down into creamy mixture
- results in mixing a solid food and emptying gastric contents into duodenum (2-3 contractions/min)
- role of antrum?
- pyloric sphincter prevents backflow of gastric contents
114
Small intestinal motility
- site of digestion and absorption of food
- type types of small intestine movement: segmentation and propulsion
115
Colonic motility and defecation
- types of movement: segmentation mixing movement (Haustral churning) and propulsive mass movement
- normal colonic transit time: 24-48 hours
- normal stool consists of 75% water and 25% solid matter
- defecation controlled by internal and anal sphincters
116
GI hormones include
- cholecystokinin
- gastrin
- ghrelin (hunger)
- GLP-1
- glucose-dependent insulinotropic polypeptide
- secretin
117
GI secretions include
- salivary
- gastric
- pancreatic
- biliary
- intestinal
118
What is digestion? What does it require?
Process of dismantling food into constituent parts
Requires:
- hydrolysis
- enzyme cleavage
- fat emulsification
119
What is hydrolysis
breakdown of a compound; involves a chemical reaction with water
120
What is fat emulsification?
breakdown of fats into free fatty acids and monoglycerides
121
What is absorption?
- process of moving nutrients and other materials
- occurs through active transport and diffusion
122
GI disorders by location - image
123
Pathways of N/V (image)
124
Mechanics of Emesis (image)
125
What is the vomiting reflex?
- relaxation of the lower esophageal sphincter
- contraction of the diaphragm and abd. muscles
- autonomic changes (increases in sweating, mouth sweats, pale)
- epiglottis closes
- then expulsion of food
