Exam 5- GI Flashcards

Question

Excitatory GI Motor Neurons

Answer 1

Excitatory Junctional Potential - Ach - Substance P

Answer 2

Inhibitory Junctional Potential - VIP= vasoactive intestinal peptide - NO when activated= physiological ileus (lack of contraction)

Answer 3

circular muscle

Answer 4

longitudinal muscle

Answer 5

specialized rapid long distance movement -normal in large intestine, pathologic in sm. intestine

Answer 6

-used when there is an irritant we want to get out

Answer 7

in duodnum and colon - mixing in enzymes - food is not forward movemtn just moving back and forth

Answer 8

=physiological valve - ring of smooth uscle - normally in a contractie state

Answer 9

stops us from swallowing air =striated muscle

Answer 10

protects esoph. from H3O+ =smooth muscle

Answer 11

put diagram here pg 4 of gi secretiosn

Answer 12

=contractie -\>more saliva into ducts

Answer 13

=\>amylase from zymogen granules -found in mouth and esophagus

Answer 14

HCO3- and K+

Answer 15

starts digestions of carbs

Answer 16

metabolizes some fat | (in saliva)

Answer 17

in saliva lubrication for swallowing

Answer 18

digestion (minor) lubrication neutralize acid (HCO3-) solvent for taste aids in speech water balance (dry mouth (+) thirst)

Answer 19

longitudinal folds in stomach allow it to exapand

Answer 20

- reservoir for food - antral pump= mixes and propulses food

Answer 21

in stomach =backwards jet of contents towards the corpus -a few of these a minut during digestion breaks up food

Answer 22

semifluid substace that exits the stomach

Answer 23

=mucous cells - near lower esoph. sphincter - protective

Answer 24

=Gcells -secrete gastrin --(+)--\>stomach activity and secretion

Answer 25

mucous cells =\>mucus parietal cells =\> HCl and intrinsic factor chief cells =\> pepsinogen

Answer 26

=secreting H+ to stomach HCO3- to blood

Answer 27

PSNS ---(+)----\> secretion ACh, gastrin, and histamine all (+) gastric secretions

Answer 28

thoughts, smell, taste, chewing, swallowing increase HCl and pepsinogen (preparing to eat, but no food in stomach)

Answer 29

-food is in the stomach protien and stretching of stomach --(+)--\> increase in HCl, pepsinogen and gastric secretion

Answer 30

**decreased** HCL, pepsinogen **increased** secretion of enterogastrones (HCO3-, and enzymes)

Answer 31

digestion-pepsinogen bacteriocidal- low pH supplies intrinsic factor

Answer 32

needed to absorb vit. B12 -without B12 pernicious anemia

Answer 33

in liver ~macrophages

Answer 34

highly permeable discontinuous capillaries

Answer 35

bile salts =detergents for fat digestion phospholipids bicarbonate cholesterol (an way to excrete extra) bilirubin (product of heme metabolism)

Answer 36

detergents keep fat in emulsion-surround droplet of fat -cholesterol nonpolar/polar... polar is outside, nonpolar faces lipases

Answer 37

mostly exocrine only 1-2% endocrine

Answer 38

CCK ---(+)---\> relaxation of sphincter =release of pancreatic juice

Answer 39

bicarbonate - neutralizes stomach H3O+ proteases - protien metabolism pancreatic amylase - carbohydrate metabolism pancreatic lipase - fat metabolism

Answer 40

small increase in secretion

Answer 41

large increases in secretions -contents are entering duodenum

Answer 42

=house keeping function - propagating wave of contraction that moves form antrum to ileum in ~90-120 min - clears out anything left in stomach/intestines - activity repeatively sweeps through sm intestine and continues to move to colon

Answer 43

from the crypts of lieberkuhn =gastric glands contain: goblet cells epithelial stem cell paneth cells

Answer 44

mucus in the SMALL intestine

Answer 45

found in SMALL intestine - high turnover of cells in GI, need to be replaced - also easily affected by radiation

Answer 46

in small intestine secrete anti-microbial peptides

Answer 47

food only stays for a short amount of time

Answer 48

food stays here for a while and dehydrates

Answer 49

short transit time

Answer 50

mixing movements similar to sm. intestine but slower

Answer 51

can be pathological, but usually normal 3-4 times a day, associated with defication

Answer 52

increased activity in colon associated wiht eating

Answer 53

for 24-48 hrs trying to dehydrate it

Answer 54

rectal disention triggers mechanoreceptors **defecation reflex:** contraction of rectum -\> relaxation of internal anal sphincter -\> peristalsis in sigmoid colon

Answer 55

mucus bicarbonate (neutralize H+ from fermentation)

Answer 56

water and electrolytes (Na+ and Cl-)

Answer 57

nitrogen from swallowed air bacterial fermation of undigested poly saccharides= CO2, CH4, H+, H2S,

Answer 58

1. congential malformations - agenesis (absence) or atresia 2. stenosis (narrowing)

Answer 59

-a form of functional obstruction =incmplete relaxation and increased tone in the lower esophageal sphincter and esophagel aperistalsis primary= congenital secondary= from something else like diabetes

Answer 60

veins in the lower third of the esophagus drain into the hepatic portal vein - w/ hypertension = channels between the portal system and venous circulation - varices=swollen, associated with serosis can rupure -\>hematemesis (vomiting blood)

Answer 61

**1. Mallory-Weiss tears** = esophagus is overly relaxed and then vomiting causes tears 2. chemicals (heavy alcohol/hot liquids) 3. infections

Answer 62

- esophageal sphincter doesnt work as it should- acid from stomach afects lower esophagus - middle aged people most commonly - causes esophageal ulceration, hematemesis, strictures, and barrett esophagus

Answer 63

premalignant condition associated with GERD - leads to adenocarcinoma - reddish patches or tongue-like projections of mucosa, above the gastroesophageal junctiona nd metaplastic gastric mucosa - start getting goblet cells

Answer 64

usually in distal 1/3 of esophagus - flat lesions or large invasive masses - clinical features=pain difficulty swallowing, weight loss, vomiting - 5 year outlook is not good

Answer 65

- affects more men than women - associated with hot beveridges, smoking and alcohol - half occur in the middle third of the esophagus - can become large masses that may obstruct the loumen or invade surround tissues (lungs aorta) clinical features=pain difficulty swallowing, obstruction, weight loss -5-year survival =10%... due to late detection

Answer 66

inflamation of stomach - casues temporary pain, nausea, and hematemsis (vomiting blood) - melena= black, tar-like feces from blood - proctective mechanisms (HCO3- and mucus) have been overwhelmed, usually from drugs (NSAIDS)

Answer 67

- penetrating mucosal layer from long term NSAID use and stress - causes pain, nausea, and vomiting - pain releaved when eating

Answer 68

with a head injury = excessive vagal stimulation and too much gastric acid secretion =\> ulcer

Answer 69

ulcers usually caused from helicobacter pylori that colonize the stomach and cause excessive acid secretions - in stomach and duodenum - can find Ab to h. pylori in pts

Answer 70

Ab to parietal cells normally parietal cells =\> HCl and IF ∴ disease = low acid and pesinogen secretion

Answer 71

due to H. pylori, and NSAIDS - worsens with stress, smoking, and alcohol abuse - 4X more common i nduodenum - could cause hemmoraging - "coffee ground vommitting"- from blood and tissue being brokend down - perforration (from acid/pepsin) and scarring

Answer 72

=nodlule that projects to surrounding tissue ## Footnote types: _1. inflammatory polyps_ _2. gastric adenomas_ -both related to gastritis (∴ in mid. aged ppl) _3. gastric adenocarcinomas_- chronic risk of chronic gastritis (delayed discovery = \<30% survival)

Answer 73

scar tissue btw two loops of GI tubes causes them to not move as they should -usually after surgery

Answer 74

twisting of intestine cause a section to be cut off from the rest (loop)

Answer 75

part of intestine "telescoped" in on itself

Answer 76

-from herniation, adhesions, volvus or intussusception =loss of bloodflow =EMERGENCY... needs surgery

Answer 77

="congenital aganglionic megacolon" - from improper development of enteric NS - starts in rectum and affects a variable amount of colon - MEGAcolon can't move well! =obstructive constipation

Answer 78

=dilated anal and perianal blood vessels - painful - often during pregnancy ~\> excessive straining or portal hypertensive = bright read blood (blood wasn't digested)

Answer 79

=gluten intolerance - immune reaction to gluten -with gluten = loss of villi= less absorption surface =diarrhea and weight loss

Answer 80

=ballooning pouches/diverticula form in colon - weaker tube btw tenia coli is stressed w/stool - occurs in \>60 yrs w/ low fiber diet - could rupture ...=papatenitus

Answer 81

-from mucosal immune system reacting inapropriately (probably involves intestinal flora)

Answer 82

need to expose kids to pathogents to build immune system -aims to prevent inflammatory bowel disease

Answer 83

a form of inflammatory bowel disease - can be found anywhere in GI - "skip lesions" and transmural lesions - causes diarrhea, fever, abd. pain, intermittent stress and diet can cause relapse

Answer 84

a form of inflammatory bowel disease - limited to rectum and colon - always involves colon causes diarrhea, and pain -smoking can release symptoms

Answer 85

= increased risk of cancer in colon

Answer 86

pts. \>50 yrs no malignant potential in colon

Answer 87

common above age 50 - can turn into adenocarcinoma ∴ we want to remove it - high fat diet contributes to this - can occur anywhere in the colon

Answer 88

most common GI tract malignancy #2 cancer killer (second to lung cancer) - happens anywhere in colon - causes anemia, bloody stool and cramping - if metastisized \<5% yr survival but, if lower stage could be 75% survival

Answer 89

a neuroendocrine tumor can release serotonin

Answer 90

effects caused by carcinoid tumor in colon -causes flushing/sweating effects of NT

Answer 91

from an obstruction of the appendix -inflammation and pain in right lower quadrant with fever

Answer 92

most common = carcinoid tumor

Answer 93

=80-90% fxn lost chronic =most common

Answer 94

most common - jaundice, hypoalbuminemia, hyperammonemia, hypogonadism - fatal in weeks to months due to accumulation of toxins affecting multiple organ systems and impaired coagulation - nees a transplant

Answer 95

1. emulsification of afat 2. elimination of bilirubin, cholesterola nd highly lipid soluble foriegn substances (ie. drugs)

Answer 96

=impaired flow of bile

Answer 97

-in newborns liver's ability to excrete biliruben hasn't been developed ∴ put babies uner ligts that breakdown biliruben in skin

Answer 98

=CNS effects form liver failure due to high NH3 "amenemia" -mild brain dysfunction all the way to confusion, stupor, coma and death

Answer 99

=fibrosis of the liver and abdominal changes in liver architecture =death of hepatocytes, deposition of ECM and vasculature changes =resistance to filtration = accuumulation in sinusoids =portal hypertension -initially may be asymptomatic, or cause weight loss, and weakness death is usually from liver failure, portal hypertension, or hepatocellulr carcinoma

Answer 100

cirrosis is the most common cause increases resistance to filatration causes the hypertension

Answer 101

=build-up of paritoneal fluid, jauncice, potbelly and esophogeal varicocities Pathogenesis 1. excess filtration through sinusiods due to sinusiodal hypertension and hypoalbuminia 2. increased hepatic lymph flow 3. Na+ and H2O retention by the kidneys due to high plasma aldosterone

Answer 102

enlargement of spleen -culd rupture= hemorrhaging

Answer 103

=a build up of Fe in body \>1/3 accumulates in the liver common in men \>50 hemosiderin in organs triad: 1. abnormal brown color to skin 2. cirrosis 3. diabetes mellitus due to damaged beta cells

Answer 104

a complex of iron and protiens

Answer 105

= caverous hemangioma (most common) =adenoma =hepatocellular carcinoma

Answer 106

=benign hepatic tumor -soft nodules full of blood

Answer 107

benign hepatic tumor that may have malignant tumor

Answer 108

- benign hepatic tumor - associated with HBV or HCV infection, alcoholic cirrhosis, and exposure to aflatoxin - may be unifocal but usually massive tumor, multiocal tumor of diffuse infiltrating cancer - usually in pts with cirrhosis

Answer 109

=gallstones -may not have symptoms but pts have an "attack"= upper right quadrant pain types 1. cholesterol 2. pigmented

Answer 110

=most common -form with excessive secretion of cholestrol and bile

Answer 111

gall stones that contain billiruben form with excessive secretion of biliruben -dark color and radiopaque

Answer 112

=inflammation of gal bladder -needs to be rmoved

Answer 113

a form of acute cholecystitis gall bladder filled with puss

Answer 114

a form of acute cholecystitis gall bladder is necrotic

Answer 115

=blockage of gall bladder duct leads to inflammation of gall bladder

Answer 116

acute= pain in UR quadrant, cant digest fatty foods chronic= same as acute but less pronounced

Answer 117

-adenocarcinoma pathogenesis= gall stones (+) blockage (+) inflammation =predisposed to cancer dismal 5 yr outlook

Answer 118

reversible inflammatory disorder - alcoholism or other inflammatory disorder causes this - morphology= microvascular leakage and edema, fat necrosis via lipases acute inflamation protelytic destrction and blood vessel damage... hemorrhage pathogenesis =activation of pancreatic enzymes causeing autodigestiion

Answer 119

most common cause = alcoholism morphology- fibrosis and acinar loss pathogenesis- unclear (maybe ductal obstruction from increased AA, toxic effects of alcohol acinar cells or oxidative stress) may be asymptomatic, or cause jaundice

Answer 120

serous cystadenoma mucinous cystic pancreatic adenocarcinoma

Answer 121

pancreatic neoplasms fluid filled cysts most common after age 60 almos always benign abdominal pain

Answer 122

pancreatic neoplasm mucous secreting cell adenoma 95% in women may lead to adenocarcinoma

Answer 123

pancreatic neoplasm 4th leading cancer killer 5 yr survival rate \<5% most pts over \>60 yrs usually silent until it impenge son another structure

Answer 124

circular folds X 3 vili X 30 microvili X 600

Answer 125

polysaccharide form plants most abundant carb in typical human diet

Answer 126

polysaccharide from meat

Answer 127

polysaccharide fromplant cell walls indigestible but provides fiber (keeps contents moving along)

Answer 128

glucose-fructose

Answer 129

glucose-galactose milk sugar

Answer 130

glucose-glucose from malt

Answer 131

glucose fructose galactose

Answer 132

via salivary amylase -just starts digaestion

Answer 133

fsalivary amylase is deactivated by low stomach pH so no digestion just mixing

Answer 134

does most of the carbohydrate digestion - pancreatic amylase =carb digestion - epithelial disaccharidases= break down disaccharrides in gut epithelium

Answer 135

triglycerides (90%) cholesterol phospholipids

Answer 136

via lingual lipase -just minor digestion

Answer 137

via pancreatic lipase -emulsification then lipase has major role in metablolism

Answer 138

protiens (\<100 AA) peptides amino acids

Answer 139

VIA PEPSIN

Answer 140

**pancreatic enzymes** 1. trypsinogen 2. endopeptidases 3. exopeptidases **epithelial enzymes**

Answer 141

activated by enteropeptidase to **trypsin** trypsin then activates other proenzymes

Answer 142

cleave **internal** peptide bonds =trypsin, chymotrypsin and elastase

Answer 143

-cleaves **terminal** peptide bonds =procarboxypeptidases A & B

Answer 144

in the wall of the duodenum cleave polypeptides to dipeptides, tripeptides, or amino acids

Answer 145

needs transpeptidases cant cross membrane

Answer 146

absorbed more efficiently thatn AA sometimes so these are "taken up" as well

Answer 147

usually don't want to absorb a straight protien it could cause an allergic rxn

Answer 148

A, D, E, and K

Answer 149

easily cross cell membranes ∴ passively absorbed in the small intestine -can be toxic

Answer 150

passive and active processes in small intestine

Answer 151

via intrinsic factor (secreted by parietal cells) -IF binds B12 an then is absorbed in ileum via transporter complex

Answer 152

pernicious anemia =smooth shiny tongue

Answer 153

1/3 is absorbed in the gut -transported by Ca2+ channels calbindin (Ca2+ binding protien) -stores Ca2+ and then is pumped out via ATPase

Answer 154

more of a hormone than a vitima -turns on gene expression of calbindin and Ca2+ ATPase

Answer 155

important for heme - free Fe 3+ wil oxidize membranes - \>4,000 Fe 3+ stored in ferritin ∴ stays in epithelial cells - free Fe 3+ is transported out of enterocyte to blood by transport protien to transferin (binding protien in blood)

Answer 156

Fe binding protien in epithelial cells a way of excreting Fe bc enterocyts are often sloughed off =PRIMARY form of Fe regulation

Answer 157

less ferritin (less excretion) more DMT (more absorption) (Bohr effect is DPG)

Answer 158

O2 from air and CO2 from cell sback out

Answer 159

no gas exchange =dead space -warms, humidifies, and removes junk from air trachea-\>bronchi-\>bronchiole

Answer 160

-does gas exchange respiratory bronchiole-\>alveolus

Answer 161

=ALWAYS NEATIVE -chest wall wants to expand, and lungs want to shrink =keeps the lungs inflated

Answer 162

negative = air fows in positive= air flows out

Answer 163

hole in chest wall =air in pleural space Ppl goes to zero ∴ lungs collapsse and wall exapnds outward

Answer 164

increase | (boyle's law)

Answer 165

contract diaphragm= it pulls down = increased volume of chest cavity = decreased P = air in

Answer 166

contract external intercostal muscles adn accessory muscles in the neck =chest wall moves up and out =increased volum =decreased pressure

Answer 167

=passive diaphragm relaxation

Answer 168

= contract intercostals -\> pushes chest wall down and in = contract abdominals -\>pushes intestines up

Answer 169

pleural pressure= getting more negative alveolar pressure= negative flow= negative total volume= increases

Answer 170

pleural pressure= less negative alveolar pressure= positiv flow = positive (air out) tidal volume = decreasing

Answer 171

normal breath 0.5 L

Answer 172

amount of air that can be inspire after normal inspiration

Answer 173

amount yo can breathe out after expiration

Answer 174

= air you cant expire from lungs 1L

Answer 175

=total amount of air that can be moved = 5 L =TV+IRV+ERV

Answer 176

vital capacity as fast as possible normal =5L

Answer 177

FVC=3L RV= 3L (cant get air out) total =6L (ie emphysema - loss of alvoli and elastic recoil)

Answer 178

FVC= 3L RV= 1L total = 4L (cant get air in) -edema/fibrous tissue in lungs causes disorder

Answer 179

=episodes of reversible bronchial narrowig =primarily obstructive types 1. intrinsic (non-allergic/non-atopic)- due to stress/exercise 2. extrinsic (allergic/atopic)- due to inflammation, usually develops at a young age

Answer 180

airway obstruction

Answer 181

WBC accumulation =edema = increased mucus =hypersensitivity

Answer 182

=chronic obstructive pulmonary disease =5th leading cause of disease 1. chronic bronchitis 2. emphysema

Answer 183

="pink puffers" =normal O2 with increased breathing loss of alveoli adn elastic recoil =airways collapse (obstructive disorders) -proteases released

Answer 184

1. elastase - destroys tissue 2. alpha 1 anti-trypsin- inhibits proteases (protects lungs)

Answer 185

(+) elastase (-) alpha1 anti-trypsin

Answer 186

a genitic disease ---\>pts develop emphysema

Answer 187

="blue bloaters" involves inflammation excess mucus-\> blocks airways = chronic cough

Answer 188

=mucus coating and airway blockage =bacterial infection!

Answer 189

1. antibiotics and O2 for symptoms 2. gene therapy - hasn't been successfull - in 2012 therapy opens Cl- channel with a gating problem (4%)

Answer 190

inspired air not involved in gas exchange ## Footnote 1. anatomic= air in conducting space 2. alveolar= air in alveoli but no gas exchange

Answer 191

amount of air moved/minute VT= (tidal volume)(frequency of breathing) (500)(12)= **6,000 mL/min**

Answer 192

amount of air moved that is involved in gas exchange/min V_a=(tidal vol.-anatomic dead space)(freq. of breathing) =(500-150)(12) =**4200 mL/min**

Answer 193

deep and slow

Answer 194

decrease (BIG TIME)

Answer 195

large bronchi bc there are so few of them

Answer 196

bronchioles!

Answer 197

ACh (+) muscarinc R = AIRWAY CONSTRICTION at rest you dont need lots of O2

Answer 198

Epi (+) **B**₂Receptor =AIRWAY DILATION

Answer 199

=B2 agonist

Answer 200

with decreased CO2 = airway constriction

Answer 201

=large change in V for a change in P =easy to inflate -emphysema- cant get air out

Answer 202

small change in volume for a change in pressure =hard to inflate - happens wiht restrictive disorders - work of lungs is increased

Answer 203

a lipoprotien decreases surface tension (-) alveoli from collapsing from type II alveolar cells made late in fetal development

Answer 204

higher ST in smaller radii ∴ surfactant is more important and also works better in smaller radii lumens

Answer 205

O2= P_Bx FO2 Barrometric P x Force of O2 =(760 mmHg)(0.21) =160 mmHg

Answer 206

P_O2= (P_B-P_H2O) x FO2 =(760-47) x (0.21) =150mmHg

Answer 207

decreases it bc there's a decrease in total pressure P_O2= (380-47)(0.21) P_O2= 69.93

Answer 208

its partial pressure A LINEAR RELATIONSHIP

Answer 209

1. increased surface area of membrane 2. increased diffusion coefficient - for gasses this is the amout dissolved 3. increasing the concentration gradient - for gasses this is the partial pressure difference 4. membrane thickness

Answer 210

=the amount of gas the lungs can transfer to the blood

Answer 211

1. **perfustion limited**- diffusion capacity is limited by blood flow 2. **diffusion limited**- diffusion capacity is limited by the rate of diffusion ∴ to increase O2 in blood you need to increase bloodflow or increase the rate of diffusion

Answer 212

perfussion limited - becasue we reach equiliibrium always even if we increase the rate of diffussion so we should increase the rate of blood flow instead

Answer 213

1. recruitment= open more capillaries 2. distension= increase radius of capillaries

Answer 214

1. decreased resistance =no edema 2. decreased velocity of blood floow= more time for gass exchange 3. increased SA for gas exchange

Answer 215

hypoxia NOT autonomic NS

Answer 216

constricts

Answer 217

-decreased P_O2 everywhere =general vasoconstriction =increased BP and work of heart

Answer 218

1. H20 (humidifies) 2. its mixed with dead space air 3. its mixed with residual volume air PO2 160 to 105mmHg

Answer 219

shunting- some of the blood doesn't pass by alveoli, it passes other airways and it is at P_O2 40 this mixed with P_O2 105 yields P_O2 100

Answer 220

160 105 100 100 \<40 40 40

Answer 221

0. 3ml O2/100ml of blood - this is a small amount

Answer 222

20.1 =vast majority of O2 in blood is bound to Hb -doesnt contribute to PO2

Answer 223

dissolved O2, not bound to Hb

Answer 224

- this is what is seen by the lungs - increasing PO2 doesn't saturate more Hb

Answer 225

If PO2 drops to here... Hb is still nearly saturated

Answer 226

this is what's seen near normal tissue O2 IS COMMING OFF Hb Hb is at 75% saturation

Answer 227

what is seen near ACTIVE tissue =50% saturated Hb

Answer 228

as O2 unbinds to Hb= Hb's affinity for O2 decreases as O2 binds to Hb= its easier to add O2

Answer 229

Left shift when P5O decreased (in an environment of high pH and low CO2 like lungs) =more O2 binds to Hg at a given PO2 ∴ we decrease DPG, CO2, temp and H+ (DPG is made by RBC during hypoxia/exercise)

Answer 230

P50 increases (in an environment of low pH and high CO2 like muscles) =more O2 comes off Hb at a give PO2 -we want this in active tissue ∴ increase PCO2, H+, temp, and DPG

Answer 231

insuficient O2 in the tissues

Answer 232

edema in the lungs

Answer 233

decreased O2 in arterial blood which is detected by chemoreceptors whic the (+) increased respriatory rate

Answer 234

less Hg ∴ less O2 -THIS IS NOT DETECTED BY CHEMORECEPTORS because amountof dissolved O2 is normal ∴ no stress is experienced

Answer 235

-causes less O2 to bind to Hb CHEMORECEPTORS WILL NOT DETECT THIS!! bc dissolved O2 levels are normal ∴ no stress is exprienced

Answer 236

1. 10% dissolved in plasma 2. 30% bound to carbamino protiens (Hb) 3. 60% bicarbonate ions CO₂+ H₂O \<=**CA**⇒ H₂CO₃⇔ H⁺ HCO₃^- ^{(via carbonic anhydrase)}

Answer 237

when O2 binds to Hb ∴ less CO2 binds to Hb and is expired

Answer 238

near active tissue there is high CO2 and H+ ∴more CO2 binds to Hb ∴ less O2 bound to Hb ∴ more O2 to muscles

Answer 239

**sensors:** detect changes - chemoreceptors - pulm. receptors in lungs **central controller:** region of brain that interprets sensory and directs resp. activity -in medulla (not well understood) **effectors:** -respiratory muscles (mostly the diapragm)

Answer 240

1. chemoreceptors detect high CO2, and H+ and low O2 2. pulmonary iritant receptors

Answer 241

DO NOT inhibit normal inspiration (other brain centers do this) they ONLY protect against over inflation

Answer 242

**PO2-** has to drop from 100 to 60 t stimulate breathing **PCO2-** any increase wil (+) breathing

Answer 243

decreases CO2 in blood ∴ you can hold your breath longer

Answer 244

in medla of brain ## Footnote **_stimulated by:_** 1. high CO2 in blood 2 high H+ in interstitial fluid **_NOT stimulated by:_** 1. high H+ in blood 2. low O2

Answer 245

found in carotid and aortic bodies - measure arteiole blood - no BBB ∴ they detect blood's: high CO2 and H2O low O2

Answer 246

in lung bronchiole smooth muscle have the **Hering-Breuer reflex** =stops overinflation of lungs

Answer 247

=irritant receptors respond to injury, inflammatin, touch, chemicals - complex effects (+) cough and some inspiration

Answer 248

deep-rapid breathing (over ventilation) then inhibits breathing ∴ (+) slower/stopped breathing ∴ (+) increased CO2 ∴ (+) deep rapid breathing again ="waxing and waning"

Answer 249

**1. 70% of people in heart failure** because: - not enough blood to chemoreceptors - (+) stimulation of pulmonary irritant receptors **2. people with brain damage** -respiratory centers damaged

Answer 250

inflammation of the epiglottis -it swells and blocks to trachea =from injury or BACTERIAL infection tx: O2, antibiotics

Answer 251

= inflammation of the vocal cords =from overuse or VIRAL infection tx: rest, maybe corticosteroids to reduce inflammation

Answer 252

1. "vocal cord nodules" or "singers nodules" - fibromas on vocal cords tx: surgery or rest 2. HPV oral lesions= benign mouth tumors - sugically removed BUT 30%of oral carcinomas have HPV

Answer 253

HPV= a cofactor for carcinoma

Answer 254

carcinoma - 90% seem to involve smoking - poor survival bc it ofte metastisizes symptoms= coughing, short of breath , fatigue... less suicide than COPD tx: surgery, radiation, chemotherapy

Answer 255

inflammation of lungs -usually due to bact/viral infection but also can be autoimmune and fungal symptoms=difficulty breathing, fever and cough tx: vaccination for viral antibiotics for bacterial (or with viral to prevent onset of bacterial)

Answer 256

occupational lung diseases -inhalation of dust **coal workers** =black lung disease -\>inflammation -\>fibrosis and necrosis **asbestos** -\>inflammation -\> fibrosis and lots of MESOTHELIOMA (lung cancer)

Answer 257

blood clot blocking an artery in the lungs -15% of unexpected deaths usually from DVT caused by: 1. immobility 2. hypercoagulative blood 3. blood vessel wall inflammation

Answer 258

**symptoms**= chest pain, shortness of breath, caughing up blood may also be asymptomatic **treatment** = = O2 =antigoagulant \*prevention= compression stockings and mobilizing patients

Answer 259

distruption of alveolar capillary memb = pulmonary edema causes= sepsis, trauma, and pneumonia =releases inflammatory cytokines = increased PMNs =\> oxidative stress and proteases =\> CELL DAMAGE =40% death rate!

Exam 5- GI Flashcards

(300 cards)