Quiz 3 Neurology and Pulmonology Flashcards

Question

4 Types of Neroglia in CNS

Answer 1

1. Apendymal Cells 2. Astrocytes 3. Oligodendricytes 4. Micro Glia

Answer 2

1. Schwann Cells 2. Satellite Cells

Answer 3

* Belongs to CNS * Forms lining of central canal and ventricles where CSF is found

Answer 4

* Found in CNS * surround capillaries responsible for blood-brain barrier * regulate passage of "stuff" crossing into interstitial fluid between neurons * regulate ion concentrations in interstitial fluid

Answer 5

* Blongs to CNS * Forms Mylein Sheath that is rolled around axon; flattened out like a pancake squeezing out cytoplasm * Membrane is primarily lipid that creates insulation * **Internodes** are the myelin sheath between **Nodes of Ranvier** - the space between oligodendrocytes

Answer 6

* Belong to CNS * Engulf cell debris and waste products

Answer 7

* Belongs to **PNS** * PNS version of Oligodendrocytes * Myelin sheath that wraps peripherial axons

Answer 8

* Belongs to PNS * PNS version of Astrocytes * Surround cellbodies of neurons and regulate exchange with interstitial environment

Answer 9

* Concentration Gradient based on the # of ions of a particular kind * each chemical has its own gradient and will look to equalize it own concentration

Answer 10

* Allow free movement of a particular ion in/out of a cell * Usually specific to one type of ion

Answer 11

* Exists alongside Chemical gradient * Electrical gradient may move chemical in/out based on charge of ECF vs ICF environment

Answer 12

* movement of charges to eliminate the potential difference * ie fixing the electrical or chemical gradients

Answer 13

* Becomes a barrier that creates **resistance** by restricting the flow of current

Answer 14

* how much the barrier restricts the flow of current

Answer 15

Sum of all Electrical and Chemical factors that determine the direction of ion flow For example: * K+ wants to move out of the cell due to concentration gradient from Hi to Low; however because the presence of the Protein Anion and the overall negative charge inside the cell, the K+ is attracted, and wants to pass back into the cell. * Na+ wants to move into the cell due to concentration gradient between ECF and ICF; and the electrical gradient which is negative inside cell and attractive to Na+

Answer 16

meaning with charge

Answer 17

* adding positive charge * Becoming less negative * moving toward zero * change in ion flow ⇒ becoming more more positive

Answer 18

* When cell moves more negative towards resting potential *

Answer 19

* Na+K+ Pump maintains the resting membrane potential across by pumping sodium out of the cell and potassium into cell against concentration gradients. * Enables cells ability to depolarize and propogate an electrical impule to the synapse

Answer 20

* **propogated** in a **graded** and **decremental** fashion * Propogated - Charge spreads outward in all directions * Graded - Vary in size in relation to size of chemical input * Decremental - decreases in size as it moves further from point of orgin

Answer 21

* Propogated changes in transmembrane potential * once initiated it will affect the entire excitable membrane * All or nothing, must meet threshold @ axon hillock to initiate Action Potential all the way to Synapse * **Not decremental or graded**

Answer 22

minimum stimulus required to form an action potential

Answer 23

1. The presynaptic neuron sends neurotransmitters to postsynaptic neuron. (A chemical message) 2. Once the threshold of excitation is reached (Axon Hillock) the neuron will fire an action potential. 3. Na+ channels open and Na+ is forced into the cell by the concentration gradient and the electrical gradient. depolarizing the neuron. 4. K+ channels open (@ -30mV) and K+ is forced out of the cell by the concentration gradient and the electrical gradient. The neuron continues to depolarize. 5. The Na+ channels close at the peak of the action potential (+30mV). The neuron starts to repolarize. The K+ channels close, but they close slowly and K+ leaks out. 6. The neurotransmitter is released to the postsynaptic neuron 7. The resting potential(-70mV) is overshot and the neuron falls to a -90mV (hyperpolarized) 8. The Na+/K+ pump then starts to pump 3Na+ ions out for every 2K+ ions it pumps in, some K+ leaks out synapse. 9. The neuron returns to resting potential

Answer 24

* period of time when neuron is unavailable to refire * From time it leaves it's resting potential -70mV, depolarizes yo +30mV and returns to -70mV * Like Toilet - the time when toilet is flushed until it has minimum amt. of water necessary to flush again.

Answer 25

* Period of time after cell has depolarized and returned to initial resting potential; however cell is now in hyperpolarization phase and is not best suited for reconduction * Analogous to being able to flush the toilet before it is optimal to do so.

Answer 26

* Continuously Propogatate - local current depolarizes adjacent membrane * Can't travel backwards (True for all AP's)

Answer 27

* Oligodendrocytes/Schwanns Cells that wrap around axon, * Produces salutatory conduction/propogation as nerve impulse jumps from node to node along signal path

Answer 28

* Electrical - does not require chemical nerotransmitter * Chemical - common in cardiac cells, requires use of nerotransmitter; \*makes up majority of synapses

Answer 29

* is a special kind of effect of a hormone on its target. * The hormone activates or deactivates ionotropic receptors (ligand-gated ion channels). * The effect can be either positive or negative, whether the effect is a depolarization or a hyperpolarization respectively.

Answer 30

* effects some sort of metabolic activity inside the cell * ie. second messengers are molecules that relay signals from receptors on the cell surface to target molecules inside the cell

Answer 31

1. AP arrives at synaptic knob 2. Voltage changes allow opening of Ca²⁺ voltage gated chanels entry of Ca²⁺ions 3. Entry of Ca²⁺ ions allows vessicles containing nerotransmitters to fuse with membrane and excytosis of neurotransmetters into synaptic clef 4. Neurotransmitter binds to ligand gated channel on post synaptic membrane, inhibitory/excititory transmission follows 5. Neurotransmitter broken down or taken up into presynaptic membrane

Answer 32

are 3 layers of specialized membranes that Surround brain and spinal cord Provides protection, stability, shock absorption to CNS Tissue

Answer 33

Spinal Meninges contain adipose tissue in epidural space where local anesthia can be administered. vs. Cranial meninges have no epidural space.

Answer 34

**Dura Matter** - Outermost membrane just under bone, responsible Subdural Space - Lymphatic fluid **Arachnoid matter** - Subarachnoid space - Blood Vessels and CSF **Pia Matter** - Follows contours of the brain tissue; has blood vessels Cerebral Cortex - Brain - Gray matter

Answer 35

Epidural Subdural Subarachnoid Interparenchymal

Answer 36

Relay between body and brain Sends/receives messages to/from Brain & Sends/recieves messages from Periphery **Includes SPINAL & CRANIAL Nerves**

Answer 37

Cervical Spine C1-C7 Thoracic Spine T1-T12 Lumbar L1-L5 Sacral S1-S5 Coccyx 3-5 Fused

Answer 38

L1 or L2 Cauda Equina - looks like horses tail extends from bottom of spinal cord

Answer 39

31 Pairs of spinal nerves Spinal Nerves #'s correspond to adjacent just lower vertebrae for everything T1 and below. ie. Just below the T1 Vertebrae is the T1 Spinal Nerve Cervical Spinal Nerves are ontop of corresponding vertebrae ie Spinal nerve C7 is just ontop of C7 and Just under the C7 Vertebrae is the C8 Spinal nerve

Answer 40

Central Canal - Contains CSF Dorsal (posterior) Root Ganglia - carries sensory information Ventral Root Ganglia (Anterior) - Carries motor information Two ganglia join to form mixed (motor/sensory) for innervation of periphery

Answer 41

Cerebrum Diencephaion Mid-Brain Pons Medulla Oblongata Cerebellum

Answer 42

Outter Shell - kind of provides protection for basal functions located in mid-brain Responsible for all higher order functions ie: sensation, learning, thinking and memory, storage and retrival, speech

Answer 43

Bridge between L&R Hemispheres of Brain Plasticity - ability of brain to compensate for left or right hemisphere damage; ability is better as you are younger

Answer 44

kind of subdivision of cerebrum, buried in that portion of the brain Comprised of: Epithalamus/Thalamus/Hypothalamus integration of conscious and unconcious sensory information and motor commands Hypothalamus is responsible for temperature regulation

Answer 45

Brain Stem - responsible for basal functions * **Mid Brain** - processing visual and auditory information; generates involuntary motor response; contains Reticular activating system (RAS) = has affect on level of conciousness ie. being hit in the face * Pons - Rate and Depth of Respiration; functions as relay center; pontine pupils (pons pupils) - severely constricted pupils * Medulla Oblongata - **connects brain to spinal cord**; contains the cardiac, respiratory, vomiting and vasomotor centers and deals with autonomic, involuntary functions, such as breathing, heart rate and blood pressure.

Answer 46

Responsible for balance and gait Ataxia - impairment in balance; controls positive muscles which aid in balance

Answer 47

Identified by regions of skull that they are adjacent to * Frontal - conscious thought; damage can result in mood changes, social differences, etc. The frontal lobes are the most uniquely human of all the brain structures. * Parietal - integrating sensory information from various senses, and in the manipulation of objects * Temporal - senses of smell and sound, as well as processing of complex stimuli like faces and scenes * occipital -sense of sight; lesions can produce hallucinations

Answer 48

Motor Cortex sits in Anterior Sensory Cortex is Posterior Hands and Face have largest amount of sensory and motor function dedicated to them specifically.

Answer 49

**Speech and language** areas sometimes affected in stoke deficits Broca's - Area linked to speech production Wernicke's - Area linked to understanding of written and spoken language

Answer 50

Part of Peripherial Nervous System 12 pairs Things that control the face, eyes, what you see, expressions, saliva, tears etc

Answer 51

Vagus Nerve Longest nerve in human body Responsible for both sensory and motor function Parasympathetic innervation stimulatory & inhibitory innervates soft palate, esophagus, pharanx, cardiac muscle, smooth muscle,

Answer 52

``` Corticospinal Pathway (Pyrimidal System) - Voluntary control over skeletal muscle ``` Medial & Lateral Motor Pathways(Extra-Pyrimidal System) - Involuntary/subconcious control ⇒ muscle tone ⇒ trunk and limbs Nervous System/PNS/Efferent/

Answer 53

involuntary muscle movements or spasms that usually occur in the face and neck. An individual may suffer from this syndrome as a result of a head injury or Parkinson's disease, though the primary cause is an adverse reaction to antipsychotic drugs. Some forms can be treated with Benedryl **Dystonia** or dystonic reation is a disorder characterized by involuntary muscle contractions that cause slow repetitive movements or abnormal postures.

Answer 54

Prevalent in Autonomic nervous system Where both Sympathetic and Parasympathetic Nervous Systems bring nerves to the same peripheral organs actions oppose each other but can be either stimulatory or inhibitory ie digestive system - Stimulation is initiated by parasympathetic division vs decreased activitiy initiated by sympathetic Cardiovascular system - Stimulation is initiated by Sympathetic division; decrease in activity initiated by parasympathetic division

Answer 55

1. Provides and extensive surface for gas exchange 2. Move air to/from lungs 3. Protection of respiratory surfaces from changes temperature and exposure to pathogens 4. Production of Sound 5. Facilitate olfactory

Answer 56

see diagram

Answer 57

See Diagram

Answer 58

* Nasopharynx * Oropharynx * Laryngopharynx Chamber that is shared by respiratory and digestive tracts

Answer 59

* main entrance to lungs * C-shaped cartilage protects airway * **Trachealis muscle** bridges the gap between free ends of C-shaped cartilages at the posterior border of the trachea, adjacent to the esophagus. * Trachealis muscle is comprised of smooth muscle and can be relaxed via sympathetic stimulation(+air flow, +diameter, -resistance) in the event of food bolus with glucagon (ß₂ agonist) * When Trachealis Muscle contracts it plumps (gets fatter) reducing the diameter of the trachea * **Food Bolus** - large food particle stuck in esophagus * descends from larynx @ C6 to carina @ T5

Answer 60

includes: * epiglottis - blocks food from trachea * thyroid cartilage * cricothyroid cartilage found between C4-C6 Seperates upper and lower airways

Answer 61

Entrance to lung from bronchi Where pleural membranes attach

Answer 62

base of trachea Splits into Left & Right mainstem Bronchi Right mainstem is wider and more anatomically straight down Sits around T5 Left Bronchi is off to the side at an angle Right lung has 3 lobes Left lung has 2 lobes

Answer 63

* Primary Bronchi * Secondary Bronchi * The tertiary bronchi (also known as the segmental bronchi * Bronchioles - first structures without cartilage terminate at alveoli

Answer 64

* Bronchioles - first structures without cartilage or glands in their submucosa * Wrapped in increasing amounts of smooth muscle as it descends respiratory tract * Smooth muscle cells have ß₂ receptors on them which when sympathetically stimulated cause relaxation = bronchodialation, more space * Asthma - broncoconstriction and inflammation decreases airflow

Answer 65

epithelium - lining of respiratory tract and mucous membrane plus connective tissue nutrients must be provided by diffusion - ie from basal lamina or lumen (or airway = O²) \*\*will not be asked- cells of respiratory tract are primarily pseudo stratified columnar epithelium

Answer 66

is a thin layer of loose connective tissue which lies beneath the epithelium and together with the epithelium constitutes the mucosa contains smooth muscle cells which increase in number as it descends down respiratory tract The lamina propria is also rich in immune cells known as lymphocytes

Answer 67

glands that secreet mucus onto surface of epithelium of respiratory tract where cilia sweep away contaminants/pathogens towards the throat for elimination of pathogens from respiratory tract

Answer 68

External Nare is what you see Internal Nares are highly vascular to warmand humidify the air entering respiratory system; blood vessesls dialate when they need to warm the air and contrict when unnecessary Epistaxis potential due to vasculature; HTN can cause nosebleeds Nares are seperated by septum Lateral surfaces of the nares contain turninates which cause turbulance in air flow aiding in warming and removal of debris

Answer 69

Separates oropharnyx from nasal cavity & nasopharynx

Answer 70

The opening between the vocal cords at the upper part of the larynx * glottis is the vocal apparatus of the larynx * flase vocal cords (vestibular folds) sit on eiter side of the vocal cords and glottic opening * Vocal cords (vocal folds) - ligaments covered by folds of epithelium * responsible for **cough reflex** hypersensitive to foreign matter; causes increase in intercranial pressure

Answer 71

enclosed in pleural cavity right has three lobes, left has two primary/secondary/tertiary bronchi followed by **Bronchioles and alveoli -** are part of respiratory system but not respiratory tract

Answer 72

Alveoli - plural; Alveolis - singular the sac where bronchioles terminate and gas exchange takes place alveolar membrane is the gas-exchange surface

Answer 73

* develops in last four weeks of fetal development * air/water boundary which creates surface tension in aveoli and prevents lung from collapsing at end of expiration * an increase in interstitial fluid can cause alveoli to collapse and not reopen preventing gas exchange * responsible for lung compliance

Answer 74

Acute Respiratory Distress Syndrome attacks and destroys avaliability/production of surfactant creates poor lung compliance

Answer 75

Pt's with Emphysema have **increased lung compliance** because the elastic tissue has been damaged, usually due to their being overstretched by chronic overinflation there is no problem inflating the lungs there is extreme difficulty exhaling air. In this condition extra work is required to get air out of the lungs

Answer 76

Angiotensin Converting Enzyme * enzyme that participates in the conversion of Angiotensin I into Angiotensin I, which is responsible for maintaining bloodvolume and blood pressure * **produced in the lungs**

Answer 77

Without oxygen the is no ATP needed for * Ventilation - getting air IN/OUT of Lungs * Difussion - getting O₂ into the blood and CO₂ out of the lungs * Perfusion - avaliability for blood supply to all tissues

Answer 78

* External - **exchange** of O₂/CO₂ between environment and body fluid * Internal - exchange between fluids(blood) and peripheral tissues (individular cells) * cells ie cellular respiration * glycolysis * krebs cycle * **oxidative phosphorylation** (requires O₂) \*\*\*bottom line need O2 for oxidative phosphorylation and production of ATP ⇒ energy ⇒ life

Answer 79

* Pulmonary Ventilation -Air In/Out of Lungs * Alveolar Ventilation -Air In/Out of the Alveoli

Answer 80

* Boyle's Law * Dalton's Law * Henry's Law

Answer 81

P = 1/V Pressure and volume are inversely related The greater the volume the smaller the pressure; The smaller the volume the greater the pressure

Answer 82

Respiratory cycle = 1 Inhalation + 1 Expiration 1. **Lungs @ rest** ie. P in lungs = P in Environment 2. **Inhalation**: * Diaphram contracts, ribcage expands increasing volume decreasing pressure in lungs * Creation of pressure gradient causes air to flow **into** lungs until equalized 3. **Exhalation**: * Diaphram relaxes, Ribcage contracts increasing pressure in lungs * Creation of pressure gradient causes air to flow **out** of lungs until equalized

Answer 83

How easily lungs expand and contract ie how easily someone is bag or ventilate Poor Compliance = Difficult to move air, increase in amount of force Decreased compliance = inability to move the thoracic cage

Answer 84

Problem with equiptment ie. pt clenching on tube, vomit in BVM indicates a mechanical problem not a compliance problem

Answer 85

increases the size of the pressure gradient allows more air in and out of lungs to provide more O₂ to the body tissues ie exercising Hyperventilation is breathing faster than normal for sake of increasing O₂ and decreasing CO₂ Preoxygenation - no increase in rate, used to properly saturate O₂ levels before intubation

Answer 86

* Rate (f)- frequency * Tidal Volume (V_T) - Average volume of Inspiration (5-7ml/kg of avg body weight) * Minute Volume (V_E) - Amount of air in/out of lungs per minute f x V_T= V_E Example: f = 12 Breaths per minute; V_T = 500mL 12 x 500 = 6000mL = 6L of air/minute

Answer 87

* Anatomic Dead Space (V_D) = amount of inhaled air that does not come into contact with alveolar surface ie unable to participate in gas exchange * Average Adult 150mL * Aveolar Ventilation (V_A) - amount of air able to participate in gas exchange (V_T - V_D) f = V_A Example: (500mL - 150mL) 12 = 4200mL = 4. 2L of Alveolar ventilation ie. an increase in Shallow respirations = decreased tidal volume = less exchanged air Asthma patients have trouble getting rid of air Normally 1 sec In / 2 Sec out; asthma 1 sec in/ 4-5 out

Answer 88

* **TV = Tidal Volume**: Normal air movement in/out of lungs in one breath * **ERV = Expiratory reserve volume:** the maximal volume of air that can be exhaled from the end-expiratory position * **IRV = Inspiratory reserve volume:** the maximal volume that can be inhaled from the end-inspiratory level important ***allows for increased air intake during exercise*** * **IC = Inspiratory capacity:** the sum of IRV and Tidal volume * IRV + ERV + TV = **Vital Capacity VC** * **RV = Residual volume**: the volume of air remaining in the lungs after a maximal exhalation * **TLC = Total lung capacity:** the volume in the lungs at maximal inflation * **Functional Residual Capacity:** Important flight/critical care = Expiratory Reserve Volume + Residual volume (remaining air left in lungs) after maximum exhalation * **Minimum Volume** - still has 30-120mL when collapsed

Answer 89

each gas contributes to the total pressure based on the relative abundance (partial pressure) contributed by single gas Atmosphere: 78% Nitrogen, 21% Oxygen, 1% Trace Elements P_N2 + _O2 + P_CO2 = 760 Hgmm

Answer 90

* At given temperature, the amount of a particular gas that is disolved in solution is directly proportional to the partial pressure of theat gas The way I understand it: * ***More gas molecules are soluble at a higher pressure*** ie CO2 is disolved when a can of soda is closed; when opened pressure decreases and CO2 equalizes to that of the partial pressure in environment

Answer 91

Partial pressures of O2 and CO2 in Blood returning from Body are: * P_CO2 = 45mmHg * P_O2 = 40mmHg In Alveolar Partial Pressures of Inhaled Air are: * P_CO2= 40mmHg * P_O2 = 100mmHg \*\*\*The _PO2is higher in alveoli and wants to move across to the blood; like wise the P_CO2 is higher in blood and wants to move into alveoli to be exhaled by the lungs.

Answer 92

Partial pressures of O₂and CO₂in Blood ariving from lungs * P_CO2= 40mmHg * P_O2 =100mmHg Partial pressures of O₂ and CO₂ of blood leaving tissues * P_CO2= 45mmHg * P_O2= 40mmHg \*\*\*Because the arriving blood has higer concentration of O₂ in than cell, it moves down concentration gradient into tissues; like wise the higher levels of CO₂in cell moves into blood to be transported back to lungs for exhalation

Answer 93

* Genetic blood disorder in which globin protein does not fold up correctly and cannot carry the maximum number of O2 * Is a medica

Answer 94

* carries oxygen from the respiratory organs to the rest of the body\ * Optimally can carry 4 O2 molecules * carbaminohemoglobin is when CO2 is bound to the globin protein Hb + O2 \<-\> HbO2 Hb = efficency of O2 transport reversible action of Oxygen binding and releasing to Hemoglobin \*\*Oxygen can only travel in bloodstream bound to Hemeglobin or disolved (ie Henry's Law)

Answer 95

is a Relationship of Partial Pressure of O₂ and SpO₂ * PO₂ \> 60 = SpO₂ \> 90% * ***if*** PO₂ \< 60 = SpO₂ ***drops rapidly*** SpO₂ = % Oxygen saturation = % of Heme Units that have bound O₂ \*100% only means that all avaliable Hemeoglobin is saturated, there may be more free O2 circulating in blood stream. Conditions change dissociation points: Increases in temperature/pH shifts to right ie disassociates earlier, Decreases in pH and Temperature disassociates later \*\*Trend to give less O2 if Pulse Ox

Answer 96

1. Bound to Heme ie **Carbaminohaemoglobin** 2. Disolved 3. converted to carbonic acid **H⁺ + CO₃^- \<\> H₂CO₃ \<\> H₂O + CO₂** * When CO2 leaves tissues one of its options is to combine with water and make carbonic acid where it can be: transported that way and be converted back upon arrival at alveoli, or converted to H ions

Quiz 3 Neurology and Pulmonology Flashcards

(121 cards)