Pink sheets from last year Flashcards

1
Q

The Hering-Bruer reflex responds

A

to excessive stressing of the lung

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2
Q

J receptors (C fibers) are sensitive to

A

pulmonary edema such as occurs in congestive heart failure.

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3
Q

A repeated breathing cycle consisting o f a period of apnea replaced by a period of increasing rapid and deep breathing is referred to as:

A

Cheyne-Stokes breathing, associated with cardiac arrest.

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4
Q

The Ventral respiratory group is responsible for

A

forced expiration

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5
Q

The dorsal respiratory group is responsible for

A

establishing a ramp signal during normal breathing.

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6
Q

The pneumotaxic center controls

A

the switch off point of the inspiratory ramp signal

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7
Q

What monitors carbon dioxide levels via pH? and therefore controls the rate of respiration?

A

Central chemosensitive receptors located in the brain stem

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8
Q

The peripheral chemosensitive receptors

A

are involved in controlling the rate of respiration mostly monitor oxygen partial pressure in arterial blood.

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9
Q

what do you call the peripheral chemosensitive receptors?

A

carotid and aromatic receptors

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10
Q

The pneumotaxic center is the primary controller of the

A

rate and depth of breathing.

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11
Q

One gram of hemoglobin can transport

A

1.34 ml of oxygen

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12
Q

At rest, arterial blood carries _____ml oxygen per deciliter, and returning venous blood carries about _______ ml of oxygen per deciliter.

A

19.4, and 14.4

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13
Q

At rest, the oxygen utilization coefficient is

A

about 25%

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14
Q

Factors that shift the oxygen-hemoglobin curve to the right and downward, causing more oxygen to be released from the hemoglobin include:

A

a decrease in pH and an increase in carbon dioxide, and increase in BPG and and increase in temperature.

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15
Q

Bohr effect occurs when there is an increase in blood carbon dioxide causing oxygen to be displaced from hemoglobin. What happens to the curve?

A

Shifts oxygen-hemoglobin dissociation curve to the right

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16
Q

The displacement of carbon dioxide that occurs when hemoglobin binds with oxygen in the lungs is called

A

haldane effect

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17
Q

In carbon monoxide poising the p02 of the blood may be normal and the blood may be

A

BRIGHT RED

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18
Q

When intracellular pO2 is above 1mmHg the limiting factor for cellular chemical reactions is

A

ADP

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19
Q

In order to maintain electrical neutrality, red blood cells utilize what?

A

bicarbonate/ chloride ion co-transporter in opposite directions

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20
Q

Pulmonary edema occurs when

A

pulmonary capillary pressure exceeds 25 mmHg

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21
Q

The most common causes of pulmonary edema are:

A

left heart failure, mitral valve diseases, breathing noxious substances.

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22
Q

At sea level, the partial pressure of a specific gas in air can be determined by multiplying the percent of gas in the air mixture by

A

760 mmHg.

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23
Q

Henry’s law states that the amount of a given gas that dissolves in a given type and

A

volume of liquid is directly proportional to the partial pressure of that gas at equilibrium

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24
Q

Daltons law states that

A

the total pressure exerted by the mixture of a non-reactive gasses is equal to the sum of the partial pressure of the individual gasses.

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25
Q

Boyle’s law

A

states that for a fixed amount of an ideal gas kept at a fixed temperature, pressure and volume are inversely proportional

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26
Q

The addition of water vapor to the mixture of air in the alveoli decreases the partial pressures of all the other

A

gasses in the mixture.

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27
Q

alveolar pressure at the end f a normal quiet inspiration cycle is

A

0 mmHg

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28
Q

Normally, Va/Q= 0.8

A

pulmonary= 5L/min; Ventilation is approx 4 L/min

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29
Q

Va/Q=0 when

A

Va=0 but there is still perfusion; this is due to airway obstruction (mucous plug). the blood gas composition remains unchanged.

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30
Q

Va/Q= infinity when Q=0, but there is

A

still ventilation (no gas exchange) this is due to vascular obstruction (pulmonary embolism) alveolar gas composition remains unchanged because there is no blood contact. This creates a physiologic shunt.

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31
Q

How much blood volume is found in the lungs?

A

9% or 450 ml

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32
Q

The pulmonary artery and its branches can be described as

A

low pressure/ high flow system while the bronchial arteries (supplying the lung tissue itself) can be described as high pressure / low flow system.

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33
Q

The difference between the mean pulmonary arterial pressure and the diastolic pressure in the left atrium is

A

the pressure gradient in the pulmonary system. This gradient is approximately 7 mmHg

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34
Q

The mean normal pressure in the left atrium is

A

2mmHg

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35
Q

In order to increase blood flow to the lungs during exercise, the

A

number of open capillaries increases as much as 3 x normal, the capillaries become more descended and there is an increase in pulmonary arterial pressure.

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36
Q

Normally at rest, the apices of the lungs show a zone 2 pattern of blood flow while the remainder for the lungs shows what?

A

zone 3 pattern

37
Q

Because of a physiologic shunt,

A

blood in the systemic arteries contains less oxygen per deciliter than blood that has equilibrated with the alveolar air.

38
Q

Reduction f blood flow to a portion o the lung

A

lowers the alveolar pCO2 and results in a constriction of the bronchi supplying that portion of the lung.

39
Q

What is compliance

A

the volume by which the lungs and thorax increase for each unit pressure change in the transplumonary pressure

40
Q

What is the carina?

A

located at the bifurcation of the trachea into the 2 primary bronchi, produces a strong cough reflex.

41
Q

What is the difference between the bronchi and bronchioles?

A

bronchioles lack cartilaginous plates

42
Q

What is the vital lung capacity?

A

the sum of the inspiratory reserve volume, tidal volume and expiratory reserve volume.

43
Q

What is tidal volume?

A

500 ml, the volume of air that is inspired or expired with each breath at rest.

44
Q

Inspiratory reserve volume

A

3000 ml is the volume of air that can be inspired in addition tot eh tidal volume with forceful inspiration

45
Q

expiratory reserve volume

A

1100 ml is the additional volume of air that can e expired at the end of tidal volume by forceful expiration.

46
Q

Residual volume

A

1200 ml is the volume of air remaining in lungs after forceful expiration.

47
Q

Vital capacity

A

4600 is the sum of all the volumes that can be inspired or exhaled.

48
Q

total lung capacity

A

5800 is the sum of all the volumes= vital capacity plus residual volume

49
Q

Total volume of gases that enter the spaces participating in gas exchange per minute =

A

alveolar ventilation

50
Q

What is anatomic dead space?

A

Space in the trachea, bronchi, and bronchioles

51
Q

What is physiological dead space?

A

includes the anatomic dead space + ventilated alveoli with poor or absent perfusion

52
Q

Alveolar ventilation:

A

(tidal volume - dead space) x breathing rate= .35 x breathing rate

53
Q

Total dead space in normal individual?

A

.15 Liters

54
Q

What is alveolar pressure?

A

pressure of the air inside the alveoli

55
Q

What is transpulmonary pressure?

A

difference between the alveolar pressure and the pleural pressure.

56
Q

During inspiration, pleural pressure

A

-5 to -7.5 cm H2O

57
Q

During expiration pleural pressure

A

-7.5 to -5 cm H2O

58
Q

During inspiration alveolar pressure:

A

0 to -1 cm H2O

59
Q

During expiration alveolar pressure:

A

0 to 1 cm H2O

60
Q

Minute ventilation

A

is equal to tidal volume x respiration rate.

61
Q

For the average size alveolus, what is the tension pressure

A

4 cm H20 pressure with surfactant and 18 cm H2O without surfactant.

62
Q

Compliance is directly proportional to

A

distensibility and volume and indirectly proportional to pressure.

63
Q

What is the most important extracellular buffer?

A

bicarbonate buffer

64
Q

Carbonic anhydrase is important for…

A

forming carbonic acid from carbon dioxide and water

65
Q

In a rubber system, what happens if you add a strong acid?

A

it forms a weak acid and addition of a strong base leads to the formation of a weak base

66
Q

How does bicarb excreted by the kidney help?

A

decreases blood carbon dioxide levels resulting in decrease in respiration rate.

67
Q

What is the most important buffer system for the renal tubular fluid and intracellular fluids?

A

the phosphate buffer system

68
Q

How do we remove nonvolatile acids

A

renal excretion

69
Q

How does hydrogen ion secretion happen?

A

via secondary active transport (sodium) occurs in all the parts except the descending and ascending thin limbs of the loop of henle

70
Q

where is primary active hydrogen secretion done?

A

late distal tubules in intercalated cells. Involves Hydrogen transporting ATPase

71
Q

How much bicarb is reabsorbed in the proximal tubule?

A

80-90%

72
Q

what is metabolic acidosis/alkalosis

A

change in pH due to an increase or decrease of bicarb ion

73
Q

what happened in metabolic acidosis:

A

new bicarb ion is added to the ex fluid

74
Q

what happens in metabolic alkalosis:

A

bicarb ions are removed from EC fluid by renal excretion

75
Q

what is the lower ph limit of the kidney?

A

4.5

76
Q

What is respiratory alkalosis/acidosis?

A

change in plasma pH due to an increase or decrease in carbon dioxide

77
Q

Kidneys respond to respiratory acidosis by

A

adding new bicarb ion to the ecf

78
Q

Decreased ventilation is compensation for what?

A

metabolic alkalosis.

79
Q

what is the normal intracellular concentration of potassium ion?

A

140 mEQ/l

80
Q

What does aldosterone react to?

A

increase in extracellular potassium

81
Q

Reabsorption of potassium ion occurs where?

A

proximal tubule and the ascending limb of henle

82
Q

secretion of potassium occurs where?

A

late tubule and collecting duct

83
Q

Small changes in potassium concentration cause

A

large changes in aldosterone secretion by adrenals

84
Q

increased sodium intake decreases aldosterone secretion and therefore

A

potassium excretion however, increased sodium intake also increases GFR and decreases proximal tubular reabsorption of sodium

85
Q

Increased levels of PTH, plasma concentration of phosphate and metabolic acidosis decrease what?

A

calcium excretion

86
Q

Insulin and aldosterone both work to

A

increase uptake of potassium by cells

87
Q

hypokalemia results from excess secretion of Aldosterone

A

Conn’s syndrome

88
Q

hyperkalemia results from efficiency in aldosterone secretion

A

addison disease

89
Q

almost all the filtered calcium is reabsorbed by what?

A

the kidney.