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Term 2 > Physiology Post-Midterm > Flashcards

Physiology Post-Midterm Flashcards

(109 cards)

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1
Q

How thin is the blood-gas barrier?

A

1/3 micron

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2
Q

What is the major principle of gas diffusion?

A

[pressure gradient]area/thicknessdiffusion coefficient

  • diffusion coefficient = solubility/ sq(MW)
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3
Q

Which main stem bronchus is more vertical?

A

right

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4
Q

Type 1 alveolar cells

A

Main structural cell of alveoli

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5
Q

Type 2 alveolar cells

A

Produce surfactant

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6
Q

Alveolar macrophage

A

Ameboid motion, phagocytose

* No mucociliary elevator in the respiratory zone

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7
Q

What is an acinus?

A

Group of alveoli branching from a terminal bronchiole

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8
Q

What is the bronchial circulation?

A

Supplies blood to the conducting airways. Delivers deoxygenated blood into the pulmonary vein

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9
Q

What is a normal tidal volume?

A

500 mL

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10
Q

What is total ventilation?

A

Tidal volume x Respiratory frequency

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11
Q

How do you calculate alveolar ventilation?

A

P(expired CO2)/Arterial PCO2

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12
Q

Why does the partial pressure of oxygen decrease once inspired?

A

We humdify the air with gaseous water, thus PO2 becomes 149

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13
Q

Where is there convection vs. diffusion?

A

Convection: bulk flow
Diffusion: across capillary and into tissue

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14
Q

Where is there greater ventilation of the lung? Lower or upper region?

A

Lower region because of gravity

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15
Q

What is the relationship between anatomic dead space, breathing rate and alveolar ventilation?

A

Slower breathing rate combined with larger tidal volumes will maximize alveolar ventilation.

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16
Q

What is the equation for He-dilution FRC testing?

A

V1*(He in/He out -1)

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17
Q

What is the Band 3 protein?

A

Cl-HCO3 exchange transporter; takes place in peripheral RBC’s; offloading of HCO3 from Hb

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18
Q

Differentiate between Bohr and Haldane effects.

A

Bohr: reduced Hb affinity for O2 because high H+/CO2
Haldane: reduced Hb affinity for H+ because of high O2 partial pressure

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19
Q

A V/Q > 0.8

A

Results from “wasted” ventilation, or a PE; PCO2 drops

Bronchi constrict

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20
Q

A V/Q < 0.8

A

Results from an obstructed airway, or “wasted” perfusion.

Hypoxia-induced vasoconstriction

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21
Q

Where in the lung is there better ventilation and perfusion?

A

At the base of the lung; perfusion affect is stronger

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22
Q

Where in the lung are alveoli biggest at rest?

A

At the apex of the lung

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23
Q

What determines the rate of ventilation: size of alveoli or change in size of alveoli?

A

Change in size

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24
Q

Where in the lung is there both decreased pressure and increased resistance?

A

Upper zone; decreased pressure because of gravity; resistance in the lung is increased because capillaries are compressed by the large alveoli

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25
What is LaPlace's law?
P = 2T/R * T = surface tension * P = collapsing pressure
26
Surface tension in alveoli can cause 3 major problems
1. Alveoli tend to collapse 2. Large/small alveoli; small become underventilated, large become hyperventilated 3. As alveoli collapse, they pull water in from blood -- pulmonary edema
27
A high surface tension in the lungs leads to...
Stiff lungs, decreased compliance | * Atelectasis
28
At what week does synthesis of surfactant begin?
24th week
29
If a baby is born before 35th week, what might be a problem?
IRDS -- not enough surfactant
30
What are 3 roles of surfactant?
1. Reduce work of breathing 2. Keep alveoli dry 3. Opsonization 4. Equalizes ventilation in adjacent alveoli
31
Smaller alveoli have more/less surfactant than larger alveoli?
More
32
Intracellular K+ will build up when what happens at the carotid body.
PO2 lower than normal
33
Cells at the carotid body depolarize with what type of ion influx: Na or Ca
Ca2+
34
What is the Herring Bruer reflex?
Lung stretch reflex
35
Where are the lung stretch receptors?
Smooth muscles in bronchi and bronchioles
36
Irritation receptors in the mucosal lining of the airways cause bronchodilation or constriction?
Constriction | Particularly with histamine
37
Pulmonary edema irritates what types of cells in the lung?
``` J cells (juxta-capillary) specially activated by pulmonary edema --> rapid shallow breathing * Dyspnea ```
38
What is the definition of "dynamic lung compliance"? | * A higher/lower airway resistance results in higher/lower dynamic lung compliance
For a given pressure, the change in volume | * Thus, a higher airway resistance, lower dynamic lung compliance
39
Which are perfusion-limited and diffusion-limited gases?
Perfusion: CO2, O2, N2O Diffusion: CO
40
Under what conditions is CO diffusion capacity increased/decreased?
Decreased in PE, emphysema, fibrosis, anemia | Increased in exercise, polycythemia
41
Describe the 3 different zones of the lungs.
Zone 1: PA > Pa > Pv Zone 2: Pa > PA > Pv - intermittent Zone 3: Pa > Pv > PA - continuous
42
The exercising lung has increased/decreased resistance to blood flow. How does the lung increase/decrease its resistance?
Decreased; capillary recruitment & distension
43
O2 content is ...
the actual amount of oxygen in ml per volume dissolved in blood; includes dissolved O2 and O2 in Hb
44
Differentiate between tense and relaxed Hb
Tense: de-oxy Relaxed: oxy
45
2,3 BPG is increased in...
COPD, high altitude, anemia, shunts, emphysema
46
Where does the formation of bicarbonate take place?
In the RBC
47
How does bicarbonate leave the RBC?
Cl-shift
48
What is the Haldane effect?
Increasing Hb O2 saaturation reduces the CO2 concentration in the blood (opposite of Bohr effect)
49
What is pickwickian syndrome?
Chronic hypo ventilation and respiratory acidosis
49
T/F Deoxy-Hb is a good buffer
True
50
What is base excess?
Respiratory acidosis, compensated with bicarbonate excess
52
At a high altitude, is there compensatory base excess or base deficit?
Base excess
53
What is the equation for determining % of supplemental oxygen?
PAO2 = FIO2 - PACO2/0.8
54
How can you determine an anatomical shunt from other forms of hypoxemia?
Breathe 100% O2
55
Under what circumstances is the difference between PA o2 and Pa o2 increased?
Shunt, V/Q inequality, diffusion impairment
56
Dorsal/Ventral respiratory group neurons in MO
Dorsal: inspiration Ventral: inspiration + expiration
57
Primary and secondary sensitivity of the glomus cell
Primary: low PO2 Secondary: PCO2, pH
58
The main driver of respiration centrally... (PO2 or PCO2)
PCO2
59
During the Valsalva maneuver,
Alveolar pressure > intrapleural pressure
60
An increased respiratory rate inc/dec dead space breathing
Increases (hence a decrease in alveolar ventilation)
61
Where in the lung is the intrapleural pressure most negative: apex or base?
Apex
62
Differentiate between Hb's carrying capacity and affinity
Carrying capacity: anemia/polycythemia | Affinity: right/left shift
63
What is the alveolar ventilation equation (that doesn't use CO2)
(TV-DS)*RR
64
Define proximal/distal with respect to the equal pressure point.
Proximal: mouth Distal: towards alveoli * EPP = PA = PIP
65
Which of the following is the correct spirometric term for the largest tidal volume that this patient can generate during the course of pulmonary function testing?
FVC
66
DKA, central/peripheral chemoreceptors, H+ or O2 or CO2
Peripheral; H+
67
Glucose, fat, protein digestion in the small intestine
Glucose, fat, protein --> Duodenum, jejenum, ileum
68
This feature of ____________ smooth muscle in the GIT enables tonic contractions.
Unitary; gap junctions
69
Differentiate between the submucosal and muscular plexuses in the GIT
Submocosal: Meisner's plexus Muscle: Myenteric (Auerbach's)
70
Differentiate between absorption and secretion
Abs: apical Na in -- Cl paracellular in Sec: apical Cl out -- Na paracellular in
71
The digestive enzymes (exocrine) of the mouth
Lingual lipase, alpha-amylase
72
The digestive enzymes (exocrine) of the stomach
Gastric lipase, pepsin
73
The digestive enzymes (exocrine) of the duodenum
Enterokinase, maltase, lactase
74
The digestive enzymes (exocrine) of the pancreas
Amylase, trypsin, chymotrypsin, PLA2, cholesterol esterase
75
The 4 layers of the GIT (histological)
Mucosa, submucosa, muscularis, serosa
76
Muscle contraction of smooth muscle is dependent on this enzyme....
Ca2+
77
Endocrine secretions of the stomach
Gastrin (G cells), somatostatin (D cells)
78
Exocrine secretions of the stomach
Pepsin, gastric lipase
79
Exocrine secretions of the mouth
Alpha-amylase, lingual lipase
80
Describe the 4 different types of exocrine cells in the stomach
Mucus surface/neck (mucus, HCO3, water) Parietal/oxyntic (H+, Cl-, IF, H20) (only in body) Cheif/peptic (lipase, pepsinogen)
81
Parietal cells are found only in this part of the stomach
Body
82
Where are the endocrine cells of the stomach?
Antrum (G+D)
83
What are the 4 stages of gastric motility?
1. Fasting/MMC 2. Meal --> vago-vagal reflex of fundus 3. peristalsis (increased pressure) 4. antral systole (retropulsion)
84
Describe gastric acid secretion
``` Na/K ATP-ase H+ proton pump Cl-HCO3 shift (alkaline tide) CO2 diffusion / carbonic anhydrase Na/H exchanger ```
85
The majority of gastric stimulation: interdigestion, cephalic, gastric, intestinal
Cephalic (30%) & gastric (50%)
86
Parietal cells are stimulated by ...
Histamine (ECL cells), which are stimulated by gastrin and ACh (Gq, Gq)
87
Where are ECL cells found in the stomach?
Body
88
What receptors are present on parietal cells (4)?
H2, gastrin, ACh, SST
89
Oxyntic secretion of parietal cells is high in...
HCl
90
Describe the negative feedback of the stomach
1/2. Body/Antrum (H+ --> D cells --> SST --> parietal and ECL) ** parietal are not in antrum ** 3. Small intestine (enterogastrones -- secretin, CCK, GIP, VIP, pep YY, SST)
91
Chief cells are stimulated by...
ACh (neural and H+), secretin
92
Describe several aggressive factors against the integrity of the gastro-mucuosal barrier.
H+, pepsins, ETOH, NSAIDS, bile acids, ischemia
93
Endocrine/Exocrine panceras
Endocrine: insulin Exocrine: trypsinogen, chymotrypsinogen
94
Describe the acinus/ductal aspects of a pancreatic exocrine gland
Acinus: low volume, enzymes Ductal: high volume bicarb
95
The pancreas doesn't digest itself because...
1. Zymogen granules 2. Enterokinase requirement 3. Trypsin inhibitor
96
Is there an acid tide or alkaline tide in the exocrine pancreas?
Acid
97
CCK/Secretin/M3 on exocrine panceras
CCK: acinar Secretin: ductal M3: both acinar and ductal
98
Majority of pancreatic regulation occurs during this period of digestion
Intestinal (CCK, secretin, vagus)
99
What type of cells secrete secretin and bicarbonate?
S cells
100
Cells in zone 1 or 3 are more prone to ischemia in the liver?
Zone 3
101
The major regulator of the digestive phase of the gallbladder
CCK (20% ACh)
102
The bile flow rate changes based on: bile-dependent or bile-independent flow?
Bile-acid dependent
103
Components of bile
Bile salts, cholesterol, phospholipids, bilrubin, HCO3-
104
Function of bile
Emulsify fat, elimination of cholesterol, neutralize acid in duodenum
105
What duct delivers bile to/fro gallbladder?
Cystic duct
106
In a hepatocyte, which side is apical vs. basolateral
Apical: central vein
107
Differentiate between bile acid and salt
Salt more soluble (conjugated)
108
Differentiate between primary and secondary bile salts
Secondary are dehydroxylated by bacteria in intestines
109
Functions of liver
``` Bile/bilrubin Metabolism (vitamin D, t4-->t3) Proteins Immune (Kupfer) Endocrine (angiotensinogen) Detoxify ```

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