Med Phys unit 4 Word Association Flashcards Preview

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Flashcards in Med Phys unit 4 Word Association Deck (110):
1

Filtration

Movement of fluid and its components from the capillaries into Bowman's space

2

Reabsorption

Movement from the nephron tubule back into peritubular capillaries

3

Secretion

Movement of fluid and its components from peritubular capillaries to the nephron tubules

4

GFR

125mL/min
180 L/day

5

Filtration fraction

GFR/renal plasma flow
Should be 20% (20% of renal plasma flow is filtered)

6

Fenestration

Small hole in endothelium in the glomerular filtration membrane that allows water, ions, and glucose through

7

Podocytes

Cells that cover the capillaries

8

Filterability

Compares how easily a substance is filtered compared to water

9

Minimal change nephropathy

Lose negative charge in the basement membrane due to a variety of disease processes. Small proteins show up in the urine.

10

Diabetic nephropathy

A common side effect of diabetes, start spilling proteins in the urine, leads to renal failure

11

Gestational proteinuric HTN

Pre-eclampsia, HTN and spilling protein in the urine during 3rd trimester of pregnancy

12

Polycystic kidney disease

Autosomal dominant in adults, autosomal recessive in infants... can't filter adequately due to cysts all over the kidneys

13

Microalbuminuria

Excretion of greater than 25-30 but less than 150 mg albumin per 24 hours

14

Kf

Filtration coefficient (12.5 mL/min/mmHg), a measure of hydraulic conductivity and surface area of the glomerular capillaries

15

NFP

Net Filtration Pressure (10 mmHg)

16

Hydronephrosis

Excess fluid in the kidney... still filtering but fluid gathers in the calices and increases hydrostatic pressure in Bowman's space

17

Aminoglycosides

Antibiotics that are filtered in the kidneys and are directly nephrotoxic. Epithelial cells are killed and slough off, obstructing the flow of urine.

18

Gentomycin

An aminoglycoside, an antibiotic filtered in the kidney and is directly nephrotoxic.

19

Malignant HTN

Systolic > 240 or Diastolic > 120
The arterioles can't function to decrease the blood flow at that high pressure, capillaries rupture, end up with end organ failure

20

Macula densa

Cells in the distal tubule that can sense the amount of Na+ in the tubule

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Juxtaglomerular cells

Cells around the afferent/efferent arterioles that respond to cytokines from the macula densa to either release renin or change the diameter of the arterioles.

22

Transport maximum

All transporter proteins are saturated

23

Threshold

The tubular load that exceeds transport maximum in some nephrons and the substance starts appearing in the urine

24

Furosemide

AKA Lasix, loop diuretic that blocks the Na+/Cl-/K+ cotransporter in the thick ascending loop of Henle to prevent formation of an osmotic gradient

25

Ethacrynic acid, Bumetanide

Loop diuretics that affect the thick ascending loop of Henle similar to Furosemide

26

Thiazide diuretics

A mild diuretic that blocks the Na+/Cl- cotransporter in the early distal tubule to keep Na+ and H2O in the tubule to increase their excretion

27

Polyuria

The inability to concentrate urine

28

Principal cells

Located in the late distal tubule and collecting duct, play big role in reabsorption of Na+/Cl- and the secretion of K+... under the influence of aldosterone

29

Intercalated cells

Located in the late distal tubule and collecting duct, play role in acid/base balance

30

Alpha cells

Type of intercalated cell that secretes H+ to get rid of acid

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Beta cells

Type of intercalated cell that reabsorbs HCO3-

32

Spironolactone, Eplerenone

Aldosterone agonists that cause principle cells in the late distal tubule and collecting duct to make more Na+/K+ ATPase pumps to reabsorb less Na+ to excrete more Na+ and H2O

33

Amiloride, Triamterene

Na+ channel blockers that block the Na+ channel on the luminal side of principal cells in the late distal tubule or collecting duct so Na+ can't diffuse into the cells and out of the lumen

34

PAH

A substance monitored for measuring GFR

35

Clearance

The rate at which substances are removed from the plasma

36

Renal clearance

The volume of plasma completely cleared of a substance by the kidneys per minute

37

Upper respiratory tract

Nasal cavity, oral cavity, pharynx, vocal cords, larynx

38

Lower respiratory tract

From the trachea on down

39

Conductive zone

Warms and humidifies inspired air, filters and cleans mucus by moving mucus up to be expectorated

40

Goblet cell

Unicellular mucus-producing cells in the conductive zone

41

Columnar epithelium cells

Located between goblet cells in the conductive zone

42

Cystic fibrosis

Lack the watery layer in the conductive zone and can't bring up mucus, the Cl- pump is deficient

43

Respiratory zone

Gas exchange between air and blood takes place in the respiratory bronchioles and alveolar sacs

44

Alveolar Type I cells

Structural cells in the alveoli

45

Alveolar Type II cells

Make surfactant

46

Surfactant

Covers the alveoli on the inside to prevent collapse

47

Pore of Kohn

A very short duct between adjacent alveoli which allows for collateral ventilation

48

Elastic fibers

Needed to expand alveoli without popping during inspiration and constrict without collapsing during exhalation

49

Boyle's law

Changes in intrapulmonary pressure occur as a result of changes in lung volume (the two are inversely related)

50

Distensibility

The ease with which the lungs can expand

51

Elastase

The enzyme that destroys elastin

52

Alpha-1 anti-trypsin deficiency

Elastase goes unchecked by lack of alpha-1 anti-trypsin and can destroy too much elastin, can cause a type of emphysema that affects all the airways

53

Emphysema

Elastin fibers destroyed, alveoli hyper-inflate during inspiration, collapse during expiration causing air trapping

54

Inspiratory muscles

Diaphragm
External intercostals
SCM
Serratus anterior
Scalenes

55

Expiratory muscles

Internal intercostals
Abdominals

56

Polio

Causes spinal deformities, difficult to expand the chest wall, decreased compliance

57

Pink puffer

A patient with emphysema, constantly in the respiration cycle, overinflate to dilute old trapped air to keep up PO2

58

Blue bloater

A patient with chronic bronchitis, has lower PO2 due to air trapping without being able to overinflate, can't dilute the old air

59

Surface tension

Force exerted by fluid in alveoli to resist distension

60

ARDS

Acute Respiratory Distress Syndrome... break in capillary endothelial cells, fluid collects in interstitial space and alveoli, washes out surfactant, difficult to expand lungs

61

Reactive airway disease

Type of obstructive disease involving spasms, decreased airway diameter, hard to get in and VERY hard to get air out

62

Inspiratory reserve volume

Inspiring air beyond normal inspiration

63

Expiratory reserve volume

That air which we expel beyond tidal volume

64

Tidal volume

The normal volume which we inhale and expel with resting ventilation (about 500mL)

65

Residual volume

The air that always stays in the lungs

66

Inspiratory capacity

Tidal volume inspiration plus the inspiratory reserve

67

Vital capacity

All of the air that we have access to: tidal volume plus inspiratory reserve plus expiratory reserve

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Functional residual capacity

Expiratory reserve plus residual volume

69

Total lung capacity

Functional residual capacity plus inspiratory capacity

70

Restrictive lung disease

A disease (like fibrotic lung disease) that makes it hard to inhale, causes decreased vital capacity

71

Obstructive lung disease

A disease (like emphysema, chronic bronchitis) that makes it hard to exhale

72

Dalton's Law

The total pressure of a gas mixture is equal to the sum of the pressures that each gas would exert independently

73

Henry's Law

The amount of gas dissolved in fluid reaches a maximum value

74

Thalassemia

A mutation in the beta chain of hemoglobin causes inadequate oxygen transport

75

Oxyhemoglobin

Normal heme that contains iron in the reduced form that shared electrons and bonds with O2

76

Deoxyhemoglobin

Oxyhemoglobin that dissociates to release O2 with iron still in reduced form

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Methemoglobin

Contains iron in the oxidized form, lacks electrons and can't bind with O2

78

Carboxyhemoglobin

Reduced heme bound to CO, which impairs O2 transport to tissues

79

Anemia

[hemoglobin] below normal or does not function well (<14 in males)

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Polycythemia

[hemoglobin] above normal, blood becomes viscous

81

Renal artery stenosis

Decreased blood flow to kidneys due to atherosclerosis, decreased O2 delivery, stimulates release of erythropoietin

82

Shift to the right

Hgb unloads O2 easier at higher PO2
Decreased pH
Increased temp
Increased 2,3 DPG/BPG

83

Shift to the left

Hgb hangs onto the O2, unloads O2 at lower PO2
Increased pH
Decreased temp
Decreased 2,3 DPG/BPG

84

Fetal hemoglobin

Has 2 gamma chains instead of beta chains, can't bind to 2,3 DPG, higher affinity for O2, shift to the left

85

Bohr Effect

When H+ or CO2 increases, causing a shift to the right, Hgb unloads O2 easier at higher PO2... H+ binds to hgb and changes how O2 binds to hub, decreasing hgb's affinity for O2

86

Cyanosis

Blue appearance only seen with at least 5 grams of unsaturated hemoglobin

87

Carbonic anhydrase

The enzyme in the RBC that converts CO2 and H2O to H2CO3

88

Respiratory Exchange Ratio (RQ)

The amount of CO2 produced compared to the amount of O2 that you use (normally 0.8)

89

Chloride shift

HCO3- leaves the cell, which makes the cell membrane more positive, so Cl- moves into the RBC

90

Dorsal respiratory group

Influenced by the pneumotaxic center and apneustic center to cause inspiration

91

Ventral respiratory group

Mainly causes active expiration by sending signals to abdominal muscles

92

Pneumotaxic center

Influences the dorsal respiratory group to control rate and depth of breathing, controls the switch-off of the inspiratory ramp to limit inspiration

93

Apneustic breathing

Occurs when you damage the pons... breathe in, hold it for a long time before exhaling... not regulated by CO2

94

J receptors

Located in alveolar walls, sense pressure in capillaries to increase ventilation rate and initiate sense of dyspnea

95

"Ramp" signal

Intrinsic APs to the diaphragm increase for 2 seconds and cease for 3 seconds

96

Stretch receptors

Located in walls of airways in bronchi and bronchioles that switch off inspiratory ramp to inhibit inhalation and increase frequency

97

Irritant receptors

Located between airway epithelial cells, cause bronchoconstriction and increased ventilation

98

Chemosensitive area

Located bilaterally under ventral medulla, stimulated by H+ ions or CO2

99

Kussmaul respirations

Deep labored breathing usually associated with diabetic ketosis (lots of fat breakdown)

100

Glomus cells

Part of the carotid body that are thought to be the sensory unit to sense gases

101

Glomus tumors

Grow under fingernails and become painful due to compression, the cells sense temperature and pain

102

Hexokinase

The enzyme that stimulates the uptake of glucose into liver cells

102

CO2 retention

Chemoreceptors desensitized to CO2, respiratory drive only responds to O2, develop hypoxemia and hypercapnia

103

Glucose-6-phosphatase

The enzyme that stimulates the release of glucose from liver cells

104

Hormone-sensitive lipase

The enzyme that stimulates the release of alpha-glycerol from adipose cells as glucose

105

C-peptide

A substance tested for in a glucose-tolerance test, is cleaved off of an insulin precursor

106

Liver phosphorylase

An enzyme in the liver that stimulates the conversion from glycogen to glucose

107

Hexokinase/Glucokinase

An enzyme in the liver that phosphorylates glucose to trap it in the liver cells

108

Glucose-dependent insulinotropic peptide (GLIP)

A hormone released from the duodenal mucosa in response to fats AND carbs

109

Cholecystokinin (CCK)

A hormone released from the duodenal mucosa in response to fats