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Bioscience II > Quiz 2 > Flashcards

Quiz 2 Flashcards

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1
Q

Major centers of respiratory control in the brainstem

A

pneumotaxic
apneustic
Dorsal Respiratory Group (DRG)
Ventral Respiratory Group

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2
Q

Pneumotaxic center

A

provides inhibition to the dorsal respiratory group

acts as the “offswitch” for DRG

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3
Q

apneustic cneter

A

signals to the DRG that override the inhibition of the pneumotaxic center
therefore they prolong inspiration
- examples: sighing, yawning

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4
Q

Ventral respiratory group

A

active during FORCED respiratory efforts

-examples: coughing and sneezing

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5
Q

Dorsal Respiratory Group

A

group of active neurons during inSpiration

makes connection with the phreneric and intercostal nerves

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6
Q

Stretch receptors (Hering-Breur reflex)

A

lung receptor that sends inhibitory signals to the DRG

keeps you from taking too large of a breath

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7
Q

Irritant receptors

A

lung receptors that are stimulated by inhaled irritants
this protective mechanism increases respiratory rate and decreases the tidal volume (depth of breath) which causes you to pant.
-shallow, rapid breathing limits exposure to irritants

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8
Q

Juxtacapiallary receptors (J receptors)

A

lung receptors that are next to pulmonary capillaries
they are sensitive to congestion and excess fluid
decreases tidal volume (depth of breath)
reflex causes an increase in rapid breathing

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9
Q

How is breathing coordinated?

A

this autonomic and voluntary action had integration of afferent inputs to CNS respiratory centers and efferent output to repspiratory muscles

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10
Q

Peripheral chemoreceptors

A

found in the peripheral circulation in the aortic and carotid bodies
known as the O2 monitoring system and arterial H+ concentration

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11
Q

What is the negative feedback loop for peripheral chemoreceptors?

A

decreased in PO2 causes increased rate/depth of ventilation
vice-versa

increased PO2 causes decreased rate/depth of ventilation

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12
Q

central chemoreceptors

A

located near respiratory centers in the brainstem
responds directly to changes in arterial PCO2 only
directly sensitive to CSF [H+]
if PCO2 increases so does CSF [H+]
very sensitive to small changes in aterial PCO2
if you have increased [H+] then you have decreased pH
more CO2=more [H+} = more acidity

breathe more rapidly to get rid of CO2

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13
Q

Is CO2 lipid soluble?

A

YES, this allows it to cross the blood-brain barrier

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14
Q

What happens with obstructive lung disease?

A

the respiratory drive can be repressed therefore these individuals have trouble getting air out and so CO2 acccumulates
they have low O2 levels (hypoxcemic)
giving them supplemental O2 can help but we must be careful with creating the gradient

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15
Q

relationship between ventilation and arterial effects

A

greater ventilation when there is less arterial PO2

As PCO2 increases, ventilation INCREASES (linear)

ventilation increases as [H+] levels increase (linear)

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16
Q

Effect of progressively increasing exercise intensity

A

minute ventilation: linear increase until it reaches a break point for a larger slope during maximal effort

arterial PO2: a healthy person has sufficient O2 so there is no change during progressive increased in exercise

Arterial PCO2: constant decrease at low loads until it reaches a break point where it steeply decreases with increasing efforts; more ventilation to get rid of CO2

Arterial [H+]: increase only seen at high levels of work. As a result there is an increase of LA in the blood and an increased respiratory effort (hyperventilation)

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17
Q

Cheyne-Stokes breathing

A

seen in severe heart failure

gradual increase and decrease in depth of ventilation with a period of no breathing in between (apnea)

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18
Q

Apneustic breathing

A

pattern of deep sighs

brainstem damage produces this pattern of bigger, deeper and longer breaths

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19
Q

obstructive sleep apnea

A

structural issue; the soft tissue around the neck puts pressure on the upper airways and causes compression and loss of breath
apnea=”not breathing”
closing of the pharynx during inspiration and arousal by respiratory drive
associated with obesity
treatment of a breathing apparatus which uses positive pressure to splint the airways open
-Continuous Positive Airway Pressure

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20
Q

Restrictive disease

A

VOLUME limitation
“belt around the lungs”
decreased FVC and FEV1

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21
Q

Obstructive disease

A

FLOW limitation
decreased airway diameter
problematic during expiration
normal or decreased FVC and extremely decreased FEV1

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22
Q

Obstructive Flow-Volume Loop

A

limitation of FLOW so that the peak flow rate drops rapidly

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23
Q

Restrictive Flow-Volume Loop

A

shape of the loop is the same but much smaller

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24
Q

Obstructive diseases

A

obstruction to FLOW
COPD-chronic obstructive pulmonary disease
includes chronic bronchitis, emphysema, asthma

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25
symptoms of obstructive diseases
chronic cough coughing out of mucus wheexing dyspnea with exertion
26
Pathology in obstructive disease
inflammation of lining of smaller airways increased mucus production or impaired clearance impaired cilia in conducting zone leads to less filtration mucosal thickening bronchial smooth muscle spasm leads to further narrowing of the airways and increased resistance seen in people with asthma tissue destruction; the elastic tissue is lost which decreases SA and gas exchange seen in people with empheysema
27
effects on lung function with obstructive
loss of elastic recoil; overly compliant airways that can inflate but can't deflate this causes hyperinflation(air trapping) and "barrel chest" tendency for airway collapse from dynamic compression loss of alveolar surface area poor oxygen delivery and CO2 clearance(hypercapnia) creates vasoconstriction with poor ventilation resulting in right sided heart failure=cor pulmonale
28
chronic bronchitis
inflammation of bronchi caused by irritants such as smoking sputum-producing cough ciliary dysfunction with increased mucous glands
29
Emphysema
destruction of alveoli results in poor gas exchange feels like taking sips of air on full inhaled lungs expends a lot of energy to breath they have a mechanically inefficient diaphragm that can't generate enough force for breathing
30
Emphysema treatment
``` smoking cessation medications- inhaled corticosteroids, anticholinergics, B2 agonsits oxygen therapy surgery pulmonary rehab- helps manage symptoms ```
31
Asthma
reversible obstruction excess mucus, edema and inappropriate activation of bronchiole SM creating a narrowed airway worse with environmental factors -dust, pollen, cold air
32
three kinds of COPD
emphysema chronic bronchitits airway hyperactivity (constricts and further creates obstruction)
33
Corticosteroids
useful in asthma powerful anti-inflammatories flovent
34
sympathomimetics
epinephrine adn ephedrine are non-selective peripheral vasoconstriction and tachycardia in addition to bronchodilation selective B2 agonists are ideal Albuterol
35
parasympatholytics
anticholinergics usually used in COPD; emphysema Spiriva
36
bronchiectasis
result of infection
37
cystic fibrosis
``` occurs int he pancreas lung consequences occurs in much younger- teens to 20s OBSTRUCTIVE lung disorder inherited autosomal recessive pulmonary secretions are thick ```
38
Restrictive Lung Dysfunction
VOLUME limitation disorder of compliance; issues with inflating all lung volumes and capacities are decreased harder to breath
39
Causes of RLD
``` pregnancy- difficulty inspiring with limited diaphargm movement stroke- causes neuromuscular weakness obesity arthritis- limited lung volume capacity immunologic nutritional and metabolic issues trauma connective tissues issues cardiovascular/pulmonary issues ```
40
long bone structure
periosteum ---> endosteum ---> bone marrow
41
diaphysis
the shaft of the long bone
42
yellow bone marrow
contains fat | no RBC production
43
epiphysis
end of the bones | made up of spongy bone (callcaneous)
44
metaphysis
region between the shaft and the epiphyses contains the epiphyseal growth plate widens as it approaches the epiphysis
45
what does the marrow cavity contain?
found in the center of the shaft it contains marrow
46
what is the diaphysis composed of?
a peripheral layer of compact bone called the bone collar | the central part is hollow and called the medullary cavity
47
what does the medullary cavity contain?
either red or yellow bone marrow that contains hematopoetic tissue capable of producing red and white blood cells
48
where is cancellous (spongy bone) found?
in the epiphysis and distal portions of the shaft of the long bones
49
properties of spongy bone
consists of numerous interwoven thin plates of bone= trabeculae it is the inner layer of bone can be called cancellous or trabecular highly dominant in the metaphysis and epiphysis found in flat bones such as the skull, pelvis, ribs and vertebrae as well role is to provide reinforcement and strength for weight bearing
50
compact bone
``` also known as cortical bone forms the outer, protective shell of the bone is very dense and rigid found in the diaphysis (shaft) contains the marrow cavity differs in long bones and flat bones major component of tubular bones ```
51
Where is spongy bone found?
in the metaphysis and epiphysis
52
What does the diaphysis of the long bones contain?
RED bone marrow which is hematopoietically active but gradually becomes yellow as the cavity fills with fat
53
What does the diaphysis of flat bones contain?
flat bones= sternum, vertebrae, pelvic | red bone marrow of hematopoeitic activity only
54
what is the periosteum?
membrane covering the outer surface of bone
55
What is the endosteum?
membrane that lines the marrow cavity
56
What is the functional unit of bone
the osteon
57
What is the osteon comprised of?
mature bone cells (osteocytes) which are arranged in concentric layers called lamellae
58
What are the lacunae and what do they contain?
they are small extracellular fluid filled spaces "lakes" that contain osteocytes
59
What connects the lacunae?
canaliculi; small channels that branchout into the matrix
60
Role of the canaliculi
``` function to allow nutrient exchange between osteocytes and blood vessels on the surface of the bone extracts waste and acts as a storage unit ```
61
How does the Haversian canal run?
runs PARALLEL to the long axis bone | contains blood vessels that carry nutrients and wastes to and from canaliculi
62
How does the Volkmann's canal run
runs PERPENDICULAR to the long axis bone | blood vessels enter through here to connect with the haversian system
63
What are the trabecular of spongy bone lacking?
they do not have blood vessels therefore they use diffusion as a means of nourishment
64
What cells make up the organic component of bone?
osteogenic (osteoprogenitor) osteoblasts osteocytes osteoclasts
65
What are osteogenic cells
also known as osteoprogenitor cells they are found in endosteal and periosteal membranes differentiate into osteoblasts active in growing bones may become activated in adults after a fracture or inury to replace 'worn out' bone
66
What are osteoblasts
"bone builders" - make the bone modified fibroblasts (secrete collagen) involved in ossification (cartilage ---> bone) and mineralization ( calcification of the matrix)
67
What is ossification
the synthesis and secretion of the organic matrix | transformation of cartilage to bone
68
what are osteocytes
mature bone cells active in transfer of minerals from interior of the bone to growth surfaces and the maintainence mode arise from osteogenic cells active in the transfer of Ca2+ and other minerals back and forth between the blood and organic matter
69
what are osteoclasts
``` derived from monocytes (WBC) break down the organic matrix in the process of bone resorption can do this by phagocytosis function to release calcium into the blood from the matrix ```
70
Where do the mature cells (osteocytes) reside?
in the lacunae
71
what is cancellous (spongy bone) lacking?
it does not have osteons (which resist bend) | it contains the trabeculae for its network
72
What is the extracellular matrix made up of?
collagen (mostly type 1), proteoglycans water(glycoproteins) these components in its unmineralized state are called the OSTEOID they determine the structure and function of the bone
73
What is the INorganic component of the matrix
inorganic mineral salts= hydroxyapatites combination of calcium phospates (main component) calcium flouride calcium hydroxide
74
What is the role of osteoblasts in the inorganic component
they secrete enzyme-containing vesicles that promote crystallization of the minerals
75
What is the skeleton of a developing fetus made of?
hyaline cartilage | this is very bendy and flexible
76
What is ossification?
the process of conversion of hyaline cartilage to bone
77
where does endochondreal ossification occur?
within the cartilage | occurs mainly in long bones and has 5 steps
78
Step 1 of ossification
formation of the bone collar round hyaline cartilage model the periosteum forms and contains many osteogenic cells which turn into osteoblasts the osteoblasts secreate osteoid
79
Step 2 of ossification
cavitation of hyaline cartilage occurs in middle of diaphysis (primary ossification center) chrondrocytes hypertrophy here and secrete alkaline phosphatase (enzyme for mineralizaton) diffusion is then inhibited--> chrondrocytes die= cavity
80
Step 3 of ossification
invasion of the periosteal bud in the primary ossification center the bud is made of blood vessels, lymphatic vessels and nerves vascularization allows for delivery of hematopoietic cells, osteoblasts and osteoclasts
81
Step 4 of ossification
continuation of ossification | trabeculae are formed by osteoblasts but then broken down by osteoclasts to form the marrow cavity
82
Where do the secondary ossification centers appear?
in the epiphyses
83
Step 5 of ossification
ossification of the epiphyses | the only layer of cartilage that remains is the growth plate
84
What is the epiphyseal plate?
the site of long bone growth and ossification during growth | they promote longitudinal growth until young adulthood
85
Where is the only area that is not replaced by bone after growth
the articular surfaces
86
completion of the ossification process is marked by...
the closure of the epiphyseal plate
87
describe the process of the ossification at the growth plate
chondrocytes undergo mitosis while the older chondrocytes enlargen and the matrix is calcified this calcification causes the cells to die and matrix to deteriorate osteoblasts secrete osteoid which is mineralized to form bone
88
what receptor do osteoclasts express on surface
RANK | receptor activator of nuclear factor KB
89
What is RANKL?
protein secreted by osteoblasts | receptor activator of nuclear factor KB ligand
90
What is osteoprotegerin
a protein secreted by osteoblasts that inhibits RANKL
91
what occurs with the binding of RANKL to RANK
activation of osteoclasts and continued interaction of the two receptors for survival of this "bone chewer"
92
menopause and RANKL
estrogen limits RANKL produced by the osteoblasts therefore osteoprotegerin dominates and inhibits RANKL postmenopausal women have an increased RANKL since they have less estrogen. osteoclast function is increased
93
What is the primary reservoir of calcium
the bone!!! holds 99% of body's calcium Ca2+ is the most abundant mineral in the body its homeostasis is tightly regulated about 50% is free as ions in the plasma and is able to regulate calcium metabolism
94
what is free calcium necessary for?
blood clotting muscle contraction of all types nerve signal transmission
95
Where is calcitonin produced?
by the parafollicular cells of the thryoid
96
What is phosphate homeostasis?
important part of ATP tied to Ca2+ homeostatsis less closely regulated fluctuates with diet more
97
calcium regulation by the parathryoid hormone (PTH)
calcium receptors found on the parathryoid gland | stimulated by calcium levels
98
What happens when there are LOW plasma Ca2+ levels?
increased levels of PTH
99
PTH and bone
receptors for PTH are found on osteoblasts (boss of the osteoclasts) when bound signals increase activity of bone chewers which release inorganic minerals such as Ca2+ salts into the plasma which increases Ca2+ and phosphate plasma concentrations
100
PTH and the kidneys
causes increased ca2+ reabsorption and decreased Ca2+ exretion in the urine results in increased plasma Ca2+ concentration there is also less phosphate reabsorption and more phosphate excretion
101
PTH and the intestines
actively regulates Ca2+ and iron absorption PTH does not directly affect the small intestine promotes synthesis of another hormone necessary for Ca2+ absorption from the gut (active Vitamin D)
102
What is the active form of Vitamin D
vitamin D3 or 1,25 dihydroxy D3
103
PTH and Vitamin D
PTH converts inactive to active vitamin d by action of the enzyme in the kidney
104
effects of calcitonin on calcium
secreted by the parafollicular cells of the thryoid stimulus for synthesis is high Ca2+ levels inhibits the release of Ca2+ from bone and reduces renal reabsorption of calcium and phosphate
105
Where do we get Vitamin D in our diet?
``` fish liver oils has the greatest amount fatty fish leafy greens fruit juices added to dairy vitamin d is a steroid hormone ```
106
hypocalcemia
increase in neuronal excitability (lowered threshold) neuromuscular instability signs/symptoms - parasthesia of hands and feet -perioral tingling -bronchospasm=wheezing -carpopedal spasm (trousseau's sign)=contraction of muscles -chvostek sign tapping over facial nerve brings on twitch in face fatigue, siexures, anxiety, muscle cramps, confusion, skin and dental problems death occurs with values below 35% of normal
107
What is trousseau's sign
inflation of a BP cuff above SBP elicits carpal spasm
108
hypercalemia
depressed neuronal excitability signs/symptoms nausea vomiting polyuria (large amounts of urine) polydipsia (great thirst) depression, coma, bradycardia, constipation, kidney stones, weakness
109
most common causes of hypercalcemia
primary PTH dysfunction and malignancy
110
In the setting of chronic heart failure, what does the renin-angiotensin aldosterone system do to increase preload?
promotes salt and water retention in order to increase (venous return)
111
What symptom will a 78 year old male with LEFT ventricular ejection fraction of 18% and a LEFT MI show?
dyspnea with exertion
112
What does digitalis do?
improves symptoms but not mortality in patients with heart failure
113
Hypovolemic shock often results in what?
renal failure | -low blood volume causes less urine output
114
What occurs with the pressures during normal, quiet breathing?
the intrapleural pressure (Pip) is always negative | -this keeps the alveoli inflated
115
When does dynamic compression possibly occur?
when transmural pressure is less than or equal to 0 | Palv --- Pip = Tp
116
Bronchiolar diameter would be expected to decrease in response to:
poor blood flow through pulmonary capillaries causes constriction
117
the volume left in the lungs at the end of a maximal expiration is known as the;
residual volume
118
The forced expiratory volume (FEV1) will be interpreted as normal if it is what percentage of the FVC?
80%
119
Analysis of the partial pressures of O2 and CO2 in the blood returning to the left atrium via the pulmonary veins would be most likely to reveal?
PO2= 100 PCO2= 40
120
The V/Q ratio in the upright position is lowest when?
there is more perfusion which occurs at the base of the lungs
121
Hemoglobin will release oxygen more readily under which circumstances?
Increased CO2, Acidity, 2,3 Diepg protein, Exercise, Temp

Bioscience II (10 decks)

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