PHYSIOLOGY Flashcards
(206 cards)
1
Q
An increase in the heart rate increases the force of contraction generated by the myocardial cells with each heartbeat refers to
A
Treppe phenomenon
2
Q
What phases are NOT present in the SA node action potential?
A
Phases 1 and 2
3
Q
The rapid diffusion of ions that result in propagation of the action potential in cardiac muscle fibers is due to the presence of
A
Gap junctions
4
Q
A carotid pulse called pulsus parvus et tardus is seen in what disease?
A
Aortic stenosis
5
Q
What ion is responsible for the self-excitation of the sinus nodal fibers?
A
Sodium
6
Q
An accentuated decrease in systolic arterial pressure of >10 mmHg during inspiration
A
Pulsus paradoxus
7
Q
Wide, fixed splitting of the second heart sound is characteristically seen in what condition
A
Atrial septal defect
8
Q
Pt: ventricular tachycardia
PE: hyperkeratosis of his hands and feet and that he had thick, wool-like hair.
A
Naxos disease
9
Q
infero-posterior infarction and hypotension. What reflex?
A
Bezold- Jarish reflex
10
Q
In what phase of the cardiac volume-pressure curve are the atrioventricular valves open while the semilunar valves are closed?
A
Period of filling
11
Q
A beat to beat alternation of one or more components of the ECG signal, together with sinus tachycardia is a relatively specific sign of what condition
A
Pericardial effusion with tamponade
12
Q
What ions are responsible for the plateau phase in the ventricular action potential
A
Calcium
13
Q
Brain waves found in those who are awake (eyes closed)
A
Alpha waves
8-12 Hz
(Awake and relaxed)
<4- delta
<8 - theta
>12 - beta
14
Q
Brain waves found in those who are awake (eyes open)
A
Beta waves
>12 Hz
15
Q
Brain waves found in those who are alert
A
Beta wave
16
Q
Brain waves found in those who are awake and relaxed
A
Alpha wave
17
Q
Brain waves found in those who are soundly sleeping
A
Delta/ slow waves
Deep sleep
18
Q
Brain waves found in those who have hepatic/ uremic encephalopathy
A
Delta / slow waves
(Requirement on those who have hepatic encephalopathy + asterixis/negative myoclonus)
19
Q
Brain waves found in those who are in REM sleep
A
Beta wave
20
Q
Brain waves found in those who are in stage 4 slow wave sleep
A
Delta wave
21
Q
Brain waves that are strong and of low frequency
Most sleep during each night
A
Slow wave or non REM Sleep
22
Q
Eyes undergo rapid movements even though the person is still asleep
25% of sleep time
Recurs about every 90 mins
A
Rapid eye movement (REM Sleep)
23
Q
Not so restful
Associated with vivid dreams?
REM or Non REM?
A
REM sleep
24
Q
Deep, restful sleep during first hour of sleep after having been awake for many hours
A
Non-REM sleep
25
Paradoxical, desynchronized sleep
REM Sleep
26
Raphe nuclei produce what neurotransmitter?
Serotonin
27
Lesion in raphe nuclei
Bilateral lesion in the medial rostral suprachiasmal area in the anterior hypothalamus
high state of wakefullness
28
Important neurons in arousal and wakefulness
Orexin neuron/ hypocretin
Produced in the hypothalamus
29
Loss or destruction of Orexin Producing neurons cause?
Narcolepsy
30
Weight of kidney
150 g
31
Most common injured organs in blunt abdominal trauma
Liver and spleen
32
Position of kidneys
Retroperitoneal
Right kidneys more CAUDAL
33
What is the most common kidney chosen for renal transplant?
LEFT kidney
Left renal vein in Longer
34
All chronic kidney disease has atrophied kidney except?
HIV
DM nephropathy
Amyloidosis
35
Functional unit of kidney
Nephron
36
Juxtaglomerular apparatus (3)
JG cells
Macula densa
Mesangial cells
37
Cell that secretes Renin
JG cells
38
Senses changes in volume and decrease in NaCl concentration
“Na sensor”
Macula densa
39
Basic renal processes
Glomerular Filtration
Tubular Reabsorption
Tubular Secretion
40
Normal protein content of urine
Zero
41
Usual daily urine output
720 - 1440mL
(700-1500)
42
Bladder muscle responsible for urination
Detrusor muscle
43
Effect of sympathetic nervous system in the bladder
Fill the bladder
(Sympathy is Feeling)
44
Effect of parasympathetic nervous system in the bladder
Emptying of bladder
(No pera - empty)
45
Erection
Para or sympa?
Parasympathetic
(point)
46
Ejaculation
Para or sympa?
Sympathetic
(Shoot)
47
Parasite that causes urinary bladder cancer
Schistosoma haematobium
48
Chemical notorious for causing urinary bladder cancer
Aniline dye
49
Chemical notorious for causing hemorrhagic cystitis
Toxin?
Cyclophosphamide/ ifosphamide
Toxin: acrolein
50
First urge to void is felt at a bladder volume of about?
150 mL
51
Marked fullness of bladder at about?
400 mL
52
Normal capacity of adult urinary bladder
500 mL
53
Rx for post-op urinary retention
Bethanecol
Parasympathetic effect = emptying
54
Effect of parasympathetic nervous system on the cardiovascular system
Inhibit
55
Substance secreted in response to changes in Bp by the JG cells of the afferent arteriole
Renin
56
Action of renin?
Converts angiotensinogen (from liver) to angiotensin I
57
Angiotensin I
vasodilator or vasoconstrictor?
Potent vasoconstrictor
Angiotensin II is a more potent vasoconstrictor than angiotensin I
58
Hormone that promotes WATER REABSORPTION in distal collecting ducts
Location?
Vasopressin/ ADH
Supraoptic nuclei of posterior pituitary gland
59
Drug used to treat bipolar disorder that causes nephrogenic Diabetes Insipidus
Lithium carbonate
60
Hormone produced by the adrenal cortex (z. Glomerulosa); promotes NA REABSORPTION in the collecting ducts
Aldosterone
61
Drug used to treat volume overload in liver cirrhosis of congestive heart failure which is an aldosterone antagonist
Spirinolactone
Side effect: gynecomastia and small balls
62
Produced by atrial cardiac cells and promote NA EXCRETION in the collecting ducts
Natriuretic peptides (NPs)
63
Action of parathyroid hormone
Phosphate EXcretion
Calcium reAbsorption
Vit D Production
64
Hormone that will decrease calcium
Calcitonin from C cells of thyroid
65
Thyroid cancer that is calcitonin producing
Medullary thyroid CA
(Bad prognosis)
66
Where is erythropoietin (EPO) produced
Peritubular capillaries of the kidney
67
Two erythropoietin Vit B
Vitamin B9 (folic acid) and B12 (cyanocobalamin)
68
Strict vegetarians
Vit B12 (cyanocobalamin)
69
Recently underwent a gastrectomy
Intrinsic factor deficiency
—-Removal of parietal cells
70
Promotes Calcium and Phosphate Absorption from the gut as a principal action
Vitamin D
1, 25 dihydroxycholecalciferol (active)
71
Enzyme present in kidney that converts Vit D to its active form
1 alpha hydroxylase
72
Case:
- infant
- hypogonadism
- syndactyly
- (-) 7 dehydrocholesterol reductase
Dx?
Smith Lemli Opitz Syndrome (SLOS)
73
Vitamin D deficiency in children
Rickets
74
Vitamin D deficiency in adults
Osteomalacia
75
High permeability of the Thin Descending limb to WATER is because of?
Aquaporin 1 channels
76
Specific action of ADH on the kidney
Causes insertion of aquaporin/ water channels on the distal tubules
77
Where is aldosterone produced specifically?
Zona glomerulosa of adrenal cortex
78
Clearance of this substance is used to estimate renal blood flow and renal plasma flow
Para aminohipuric acid (PAH)
79
Clearance of this substance is used to estimate GFR
Inulin
80
Renal threshold for glucose
180 ml/dL
81
3 urinary buffers
NaHCO3 - sodium bicarbonate
NaHPO4 - sodium phosphate
NH4 - ammonium
82
Most important ECF buffer
Bicarbonate buffers
83
Most powerful buffer because pK of proteins (amino acids)
Protein buffer
84
Causes of normal anion gap metabolic acidosis (NAGMA)
Diarrhea or
Renal tubular acidosis
“USEDCAR”
Ureteral diversion
Saline infusion
Exogenous acid
Diarrhea
Carbonic anhydrase inhibitors
Adrenal insufficiency
Renal tubular acidosis
85
Carbonic anhydrase inhibitor that is used to treat glaucoma, hydrocephalus and acute mountain sickness
Acetazolamide
86
Cofactor for carbonic anhydrase
Zinc
87
Mammary myoepithelial cells are contractile epithelial cells that express _____________________
Smooth muscle a-actin (ACTA2)
88
The primary function of mammary myoepithelial cells is to contract in response to _________ release by posterior pituitary gland upon sucking of nipple
Oxytocin
89
Milk letdown reflex
Milk ejection reflex
Uterine contraction
Oxytocin
90
Specific part of hypothalamus that synthesizes oxytocin
Paraventricular or magnocellular nuclei
91
Galactorrhea causes
Nipple stimulation
Prolactinoma of anterior pituitary
Drugs (anti-psychotic, anti-depressant, digitalis, reserpine, estrogen, dopamine 2, methyldopa)
92
Pressure of the fluid in the pleural space; slightly negative
Pleural pressure
93
Major muscle of inspiration
Diaphragm
----phrenic nerve
94
Air pressure inside alveoli
Alveolar pressure
95
Difference between alveolar and pleural pressure
Transpulmonary pressure
96
Measures lung DISTENSIBILITY
Compliance
"Compliant lungs are easy to distend"
97
Property of matter to resist DEFORMATION
Elastance
"Highly elastic structures are difficult to deform"
98
Compliance work is ____ in emphysema (obstructive) and ____ in lung fibrosis (restrictive)
Compliance work is INCREASED in emphysema and REDUCED in lung fibrosis
99
Obstructive lung diseases
- destruction of lung tissue and the loss of elastin and collagen
Emphysema
Asthma
Normal aging lung
100
Restrictive lung diseases
Pulmonary fibrosis
Alveolar edema
Atelectasis
Increased surface tension
101
Created by attractive forces between water molecules
Produces a collapsing pressure
Surface tension
102
Decreases alveolar surface tension to decrease the work of breathing
Surfactant
103
Collapsing pressure = 2(surface tension)/ alveolar radius
Law of laplace
104
ARDS in newborn due to
Prematurity
(-) surfactant
105
ARDS in adult due to
Sepsis/ infection
Diffuse Alveolar Damage (DAD)
106
Air Flow Resistance = (air viscosity)(airway length)/ airway radius
Poiseuille's Equation
107
Volume inspired or expired with each normal breath
Tidal volume
500ml
108
Extra volume that can be Inspired over and above the tidal volume
Inspiratory Reserve Volume (IRV)
3000ml
109
Maximum extra volume that can be Expired by forceful expiration after the end of a normal tidal expiration
Expiratory Reserve Volume (ERV)
1100ml
110
Volume that Remains in the lungs after maximal expiration
Residual Volume (RV)
1200ml
111
TV + IRV = ?
Inspiratory Capacity
TV + IRV = IC
500 + 3000 = 3500ml
112
ERV + RV = ?
Functional Residual Volume (FRV)
1100 + 1200 = 2300 ml
113
TV + IRV + ERV =
Vital Capacity (VC)
500 + 3000 + 1100 = 4600ml
114
TV + IRV + ERV + RV =
Total Lung Capacity (TLC)
500 + 3000 + 1100 + 1200 = 5800ml
115
Lung Volumes
___ in RESTRICTIVE
___ in OBSTRUCTIVE
DECREASE in RESTRICTIVE disease
INCREASE in OBSTRUCTIVE disease
116
Total Lung Capacity
___ in RESTRICTIVE
___ in OBSTRUCTIVE
DECREASED in RESTRICTIVE
INCREASED in OBSTRUCTIVE
117
Maximum amount of air that can be exhaled in 1 sec after a maximal inspiration
Forced Expiratory Volume (FEV1)
118
FEV1/FVC Ratio
___ in RESTRICTIVE
___ in OBSTRUCTIVE
0.8
Normal or increased in RESTRICTIVE
Decreased in OBSTRUCTIVE
119
Reversibility is demonstrated....
12% and 200ml increase in FEV1 15mins after an inhaled Beta 2 agonist
Or
2-4 week trial of oral corticosteroids (OCS) (Prednisolone or Prednisone 30-40mg daily)
120
Portions of the lungs that are VENTILATED but in which NO GAS EXCHANGE occurs
Pulmonary Dead Space
121
Volume of conducting airways NOT involved in gas exchange
(Approx. 150ml)
Anatomic dead space
122
Ventilated alveoli that are NOT PERFUSED
Negligible amount
Alveolar dead space
123
SUM of anatomic and alveolar dead spaces
Physiologic dead space
124
Increases anatomic dead space
Mechanical ventilator (extra tubes)
125
Respiratory centers of the brain
Pons and Medulla
126
Controls basic RHYTHM of respiration
Dorsal Respiratory Group of Medulla
127
Stimulates EXPIRATORY MUSCLES as in forced expiration
Ventral Respiratory Group of Medulla
128
INHIBITS INSPIRATION thus decreasing lung filling and increases respiratory rate
Pneumotaxic of Pons
129
INCREASES DURATION of inspiration thus increases lung filling and decreases respiratory rate
Apneustic of Pons
130
Lung overinflation stimulates stretch receptors and transmits signal through vagus nerve to the Dorsal Respiratory Group switching off inspiration
Tidal volume 3x normal (>1.5L)
Hering-Breuer Inflation Reflex
131
Lung overinflation stimulates the Dorsal Respiratory Group switching off inspiration
VT 3x normal (>1.5L)
132
Best oxygenated (ventilated) lung zone
Zone 1 - apices
No blood flow during cardiac cycle
133
Best perfused lung zone
Zone 3 - bases
Continues with cardiac cycle
134
Maximum amount of O2 that can combine with Hemoglobin of the blood
1g Hgb + 1.34ml of O2
135
Major form of CO2 in the blood
Bicarbonate
136
Phenomenon where bicarbonate ions diffuse from RBC into plasma and chloride ions diffuse into RBC to take their place
Chloride shift
137
Phenomenon associated with unloading of carbon dioxide secondary to increased OXYGEN
Haldane effect
138
Phenomenon associted with unloading of oxygen secondary to increased H+
Bohr effect
139
Major forms of CO2 transported as..
Bicarbonate (*)
Carbaminohemoglobin
Dissolved CO2
140
Nerve supply for the anterior 2/3 of the tongue
CN 7 - facial nerve
141
Diseases that presents ectopia lentis (2)
Marfans
Homocystinuria
142
Transparent and avascular part of the eye
Only human tissue that can be transplanted without fear of rejection
Cornea
143
Findings of cornea with wilsons disease?
Tx?
Keyser fleischer rings
Penicillamine
144
Layer of the retina converts 11-cis retinal to all-trans retinal
Pigment epithelial cells
- to absorb stray light and prevent scatter of light
145
Vitamin necessary for the regeneration of 11-cis retinal
Vitamin A
Earliest manifestation: Nyctalopia (night blindness)
146
Allow dim light vision and peripheral vision
Rods or cones?
Rods
147
Area of the retina which only has cones
Fovea centralis
148
Day vision
High visual aCuity
Color vision
Will adapt first
Rods or cones?
Cones
149
Unit of measure of the refractive power of a lens
Diopters
150
Normal and correct focus
Normal vision
Emmetropia
151
Farsighted
Light focus BEHIND retina
CONVEX lens correction
Hyperopia
152
Nearsighted
Light focus in FRONT of retina
BiCONCAVE LENS
Myopia
153
Curvature of lens not uniform
CYLINDRICAL LENS
Astigmatism
154
Condition with increase intraocular pressure?
Gold standard to diagnose?
Rx?
Glaucoma
Tonometry
Acetazolamide, timolol, pilocarpine, bimatoprost
155
Mast cell stabilizer used in a form of eyedrops
For conjunctivitis
Ketotifen
156
Loss of accomodation power of lens (aging)
CONCAVE LENS
Presbyopia
157
Pie in the sky lesion
Meyer's loop
158
If cut, will result to homonymous hemianopia with macular sparing
Geniculocalcarine tract
159
Free nerve ending
Pain
Cold
Warmth
160
Pacinian corpuscles
Pressure
161
Meissner's corpuscles
Touch
162
Muscle Spindle
Stretch
163
Golgi tendon receptor
Tension
164
Simultaneous neuronal discharge
Summation
165
Summation by activating multiple terminals on widely-spaced areas
Spatial
166
Rapidly successive discharges from a single presynaptic terminal
Increasing the frequency of nerve impulse in each fiber
Temporal
167
Occurs when membrane potential is NEARER TO TRESHOLD FOR FIRING than normal but is not yet at the firing level
Facilitation
168
Potential that OPPOSES MOVEMENT of an ion
Nernst potential
169
Receptor: pain and temperature
Free nerve ending
170
Receptor: light touch
Merkel's tactile disks
171
Receptor: fine touch
Meissner corpuscles
172
Receptor: Pressure and vibration
Pacinian corpuscles
173
Receptor: cold temp
Krause's corpuscles
174
Receptor: warm temp
Ruffini's endings
175
Receptor: muscle Tension
Golgi Tendon organs
176
Receptor: muscle Length
Muscle Spindle
177
Bending of light rays at angulated interface
Refraction
178
Ratio of velocity of light in air to the velocity in the substance
Refractive index
179
Optics of the eye (3)
Lens
Pupil
Retina
180
Emmetropia
Normal eye
181
Eyeball that is too short or lens too weak
Corrected with Concave lens
Hyperopia
182
Eyeball that is too long or lens that is too strong
Corrected by convex lens
Myopia
183
Refractive errorthat causes visual image one plane to focus at a different distance from that of the plane at right angles
Corrected with SPHERICAL LENS & CYLINDRICAL LENS
Astigmatism
184
The ability to determine distance of an object from the eye
Depth perception
185
Interneurons that help analyze visual signals before leaving the retina
Amacrine cells
186
Cell type for fine details and color vision
Parvocellular
187
Cell type for rapidly moving visual signals and low-contrast stimuli
Magnocellular
188
Area lack of rods and cones in the retina over the area of the **optic disk 15°lateral to the central point of vision°**
Blind spot
189
Rapid jerk-like "jumping" movement of the eyes to shift the focus on a visual scene
Saccades
190
Rapid smooth movement of the eye
Pursuit movement
191
Responsible for rapid head and eye turning movements
Superior colliculi
192
Refers to lack of fusion of the eyes
Strabismus
193
Total body water measurement
Antipyrine
194
Clearance of this substance used to estimate GFR
Inulin
195
Plasma or Intravascular volume measured
Evan's blue dye
196
Most important ECF buffers
Bicarbonate buffer
197
Most powerful buffer because pK of proteins (amino acids)
Protein buffer
198
Clearance of substance is used to estimate Renal Blood Flow and Renal Plasma Flow
PAH / Paraaminohippuric
199
Highest % of glomerular filgrate reabsorption occurs in
Proximal tubules at brush border and microvilli
200
Filling nerve
Sympathetic nerve
201
Will cause emptying of bladder
Parasympathetic
202
Normal protein content of urine
0 (zero)
203
Usual daily urine output
720-1440mL
204
Bladder muscle responsible for urination
Detrussor muscle
205
Urinary buffers
Sodium bicarb (NaHCO3)
Sodium phosphate (NaHPO4)
Ammonium (NH4)
206
Cofactor of carbonic anhydrase
Zinc
