Respiratory Flashcards
(437 cards)
1
Q
what is the functional unit of the kidney
A
the nephron
2
Q
deoxyhemoglobin
A
hemoglobin that is less that fully saturated with O2
3
Q
what stops the filtration of very large anionic molecules (proteins) through the filtration barrier
A
expression of negatively charged glycoproteins on the endothelial cells
4
Q
respiratory driving force equation
A
driving force = Patm - Palv
5
Q
surface tension
A
the force acting at an air/water interface resulting from water having a greater attraction itself that air
6
Q
which of the following is NOT a partial compensation for fluid loss
a. A retention of water from the kidney that can actually in some case cause a hypo-osmotic plasma (< 290 mOsm/kg H 2 O)
b. The increase in sympathetic nervous stimulation of the kidney acting on Beta receptors on the JG cells increase the release of rennin and thus angiotensin II
c. An increase in the permeability of the collecting duct to urea to facilitate the osmotic gradient in the interstitial fluid of the kidney
d. A massive vasoconstriction occurs that essentially block blood flow to the kidneys in order to shunt blood to more important organs such as heart and brain.
A
d, A massive vasoconstriction occurs that essentially block blood flow to the kidneys in order to shunt blood to more important organs such as heart and brain.
7
Q
describe the process of ventilatory feedback from hypoventiliation
A
hypoventilation increases PCO2, decreases pH and PO2 (indirectly)
chemoreceptors detect change
stimulate CPG to increase ventilation
increased ventilation
8
Q
what enzymes are responsible for the movement of Na and K out of the tubule in the ascending loop of henle
A
Na and K move with Na/K/2Cl symporter
Na alone is by Na/H antiporter
9
Q
nearly all of what two substances is reabsorbed in the PCT
A
glucose and AA
10
Q
what are the three main parts of inspiration and expiration
A
action on the chest wall
change in intrapleural pressure
change in alveoli
11
Q
what diuretics work on the collecting duct
A
amiloride and triamterene
12
Q
how many oxygen binding sites are present in hemoglobin
A
4
13
Q
what is the action of hydrochlorothiazide that helps control blood pressure
A
decrease in intravascular fluid that will decrease the amount of preload to the heart to decrease stroke volume and cardiac out put
14
Q
decreasing surface tension has what effect on collapsing pressure
A
it increases it
15
Q
what forces control the production of ultrafiltration
A
starling forces
16
Q
what would a creatinine plasma level of = 1.2 indicate
1.3-1.6
>/= 1.7
A
normal
borderline or increased creatinine due to muscle mass
renal disease
17
Q
what are mesangial cells
A
smooth muscle cells that remove proteins and trapped residues from the basement membrane to keep the filter from getting clogged
18
Q
what will stimulate the release of natriuretic peptide
what will the effect be on GFR and RBF
A
increase GFR, no effect on RBF
19
Q
three main ways the pressure in the glomerular capsule (PGC) can be altered
A
changing the resistance in the afferent arteriole
changing the efferent arteriole resistance
changing the renal arteriole pressure
20
Q
what is the typical GFR
how much of that volume is reabsorbed
A
125 mL/min
99%
21
Q
how does PCO2 effect pH
A
increasing PCO2 will increase the amount of HCO3 in the blood and increase pH
decreasing PCO2 will increase the amount of H+ in blood, decreasing pH
22
Q
where is the juxaglomerular apparatus found
what are three cells found there
A
between the distal tubule and the afferent arteriole
macula densa
extraglomerular messangial cells
renin/angiotensin producing cells
23
Q
what is the action of intercalated cells and principle cells on K
A
principle cells uptake K from the BL via Na/K, then it is secreted through passive diffusion
Intercalated cells reabsorb K from the tubule via H+/K ATPase
24
Q
solubility coefficient of O2 in water is inversely proportional to what
A
temperature
25
why is innervation of the kidney necessary
to regulate RBF, GFR, salt and H2O reabsorption
26
wha stimulus with stimulate the release of endothelian
what is the effect on GFR and RBF
how does it accomplish this
increased tensions in the vessel wall, angiotensin, decreased ECFV
decrease in both
constriction of the efferent and afferent arterioles
27
what are the starling forces
hydrostatic pressure in the artery
osmotic pressure in the artery
hydrostatic pressure in the tubule
osmotic pressure in the tubule
28
five specific functions of mesangial cells
provides structural support to the glomerular capillaries
secretes extracellular matrix
acts as a phagocyte
secretes prostaglandins and pro-inflammatory cytokines
influences GFR by regulating blood floow
29
descrive how PP CO2 changes throughout the body
alveolar PP CO2 40mmHg
maintains alveoli --\> pulmonary veins --\> systemic arteries
increases to around 46mmHg at the cells
maintains through systemic veins and pulmonary arteries
30
what makes up the pleural sac
the visceral and parietal pleural with the intrapleural space between
31
of the three nerves that control respiration (phrenic, external intercostal, internal intercostal) which one is active only during active expiration
the internal intercostal nerve
32
by what means of cellular transport are proteins reabsorbed
what happens to them once they are reabsorbed
endocytotis
they are digested and leave the cell via the basolateral membrane
33
what is the normal VT
what is a normal number of breaths/minute
based on this what is a normal tidal volume
500mL
12
6000mL/minute
34
what is the difference between lung volume and lung capacities
volume can not be broken into more parts
capacity is the sum of two volumes
35
minute volume VE defintion and equation
the amount of air that flows in and out of the ventilatory system in one minute
VE = VT x number of breaths
36
what are the four static lung capacities
inspiratory
vital
functional residual capacity
total lung capacty
37
inulin clearance is equal to what
GFR
38
what is the functional difference between the respiratory and conducting zones
the conducting zone is a passage for air, the respiratory zone is where gas exchange happens
39
what provides sympathetic innervation to the kidnets
the celiac plexus through the aorticorenal ganglia
40
what is the function of renalase
why is this important
degrade catecholamines and allow them to be removed from the kidney
it stops vasocontrictions from dopamine and NE
41
why is the osmotic pressure of the bowmans capusle typically a nonfactor in filtration
because there should be relatively little protein the space
42
what is the difference in ANP and BNP, aside from where they are produced
ANP has a higher affinity, BNP is longer lived
43
where temm-horsfall proteins are secreted
thick loop of henle
44
What happens at the chest wall during expiration
negative feedback from increased Palv decreases neural drive
inspiratory muscles relax
chest wall collapses
45
explain this formula
clearance ratio = Cx/Cinulin
the clearance ratio of substance x is equal to the clearance ratio over clearance of inulin
46
describe the indirect effects of increasing PO2
increased PO2 will cause Hb that is bound protons or CO2 at the tissues to release CO2 at the lungs (haldane)
carbaminohemoglobin formed at the tissues by the relative lack of oxygen will dissociate with increased PO2
both increase the Hb affinity for O2, which will increase O2 loading
47
content formula
content = capacity(percent saturation)
48
how can mesangial cells influence filtration
by changing the surface area for diffusion
49
normal tidal volume
500
50
what is the function of a podocytes
they wrap around capillaries and glomerular capsule to produce filtration slits that filter blood
51
four vasodilators of the kidney
prostaglandins
NO
bradykinin
natriuretic peptides
52
what happens at the alveoli during inspiration after the intrapleural space changes volume
increased volume of the alveoli
decreased Palv
increased driving force (Patm - Palv)
increased air flow into alveoli
increase Palv
53
what is the negative feedback mechanism that stops increased ventilation in reponse to hypoventilation
increased PCO2, decreased pH, increase PO2
54
hypoventilation will result in what
decreased pH, leading to respiratory acidosis
55
how are lung volumes measured
spirometry
56
where are the most of the proteins absorbed in the kidney
PCT
57
_which of the following about aldosterone is NOT true_
## Footnote
* *a**. High serum K+ levels increase the secretion of aldosterone by _action on adrenal cells_
* *b**. Low sodium in the tubular fluid increases indirectly stimulate _aldosterone by the secretion of renin_
* *c**. Aldosterone stimulates the secretion of hydrogen ion by _intercalated cells in the collecting ducts_
* *d**. None of the above, all are true about aldosterone.
d, all of the above are true
58
what effect will increased PCO2 and decreased PO2 have on pulmonary arteries
what will be the effect of the action at the arteries
increased smooth muscle contraction, causing vasoconstriction
increases vascular resistnace, decreasing perfusion
59
where are the rate-limiting enzymes in the process of organic cation secretion
on apical membrane (OC/H and MDR1)
60
four functions of ANP/BNP
decreased vascular resistance
decreased central venous pressure
increased natriuresis
decreased cardiac output
61
what effect will a right shift have on SO2 of hemoglobin
there will be a lower SO2 at the same PO2
62
what will cause a right shift on a O2 affinity curve
increased temp
decreased pH
increased PCO2
increased 2,3 - BPG
63
why would a failing kidney change the theraputic window of a drug
because unless the kidneys can excrete the drug it can stay in the blood and increase the amount circulating
64
explain this equation
Q = deltaP/R
renal blood flow equals the mean arterial-venous pressure to the organ divided by the resistance through the organ
65
how can VA be increased/decreased without changing minute ventilation
taking few, deeper breaths will allow for high alveolar ventiliation than many shallow breaths
66
what is the direct effect of increased PCO2
increased CO2 loading
67
two ways to alter afferent arteriole resistance with their effects
decreased resistance through dilation: increase PGC and GFR
increased resistance through constriction: decreased PGC and GFR
68
what will the effect of sympathetic innervation be on renin producing cells
what are two consequences of that
increases renin secretion
increase in systemic BP
increase in K secretion in urine
69
what effect will a left shift have on SO2
there will be higher SO2 at the same PO2
70
what is the effect of theraputic doses of glucocorticoids have on GFR and RBF
increases both
71
what is the function of NO in the capillaries
what about endothelian 1
NO is a vasodilator
endothelian is a vasoconstrictor
72
what is the main symporter found at the BL membrane in the first half of the PCT
why is it important
Na/K
it maintains the Na gradient
73
what is absorbed in the intial distal loop of henle
what is this strucutre impermable to
Na, Cl, and Ca
impermeable to H2O
74
four important factors in determining GFR
Starling forces
permability of the glomerular capilary
surface area of the capilaries
plasma flow rate
75
what percent of CO2 is bound to plasma
Hb
HCO3
5%
5%
90%
76
what surrounds the nephron
peritubular capillaries
77
what structure is effected by mygoenic and tubuloglomerular feed back
the radius of the afferent tubules
78
what is the effect of stimulation on central and peripheral chemoreceptors
increasing ventilation due to increased PCO2 or decreased PO2
79
describe the process of tubuloglomerular feedback in repsonse to high GFR
NaCl increase is detected by the macula densa
macula releases ATP and adenosine
signaling to the afferent arterioles to constrict
constriction decreases GFR
80
T/F VA and blood flow to the pulmonary capilliaries (Q) a inversely correlated
false, Q is directly related to VA
81
what is the action of the surface tension of pure water on alveoli
what does the body do to combat this
it has an inward force that will collapse alveoli
produces surfactant to decrease surface tension
82
what does EPO do
increases red blood cell production
83
how does the sympathetic innervation of tubular cells create "natures little IV"
this is important in what speficic disese process
by increasing NaCl absorption
shock
84
how is clearance corrected for body size
clearnance \* 1.73m2/body surface area in m2
85
what is the driving force behind the absorption of water in the descending loop of henle
the gradient created by absorption of NaCl in the ascending loop
86
Where is most of the glucose absorbed
PCT
87
what happens to the osmolality of the tubular fluid as it moves towards the macula densa
what morphological feature allow for this to happen
it decreases and NaCl is actively pumped out
the loop of henle gets thicker to accomodate more mitochondria to fuel Na/K pumps
88
what diuretic would mimic liddle syndrome
what would the pathologcial effects be
amiloride (inhibits ENaC)
metabolic acidosis
89
two ways altering renal arteriolar pressure will change PGC
increased BP leads to a transient increase in PGC and GFR
decreased BP leads to transient decrase in PGC and GFR
90
what is the effect of histamine on RBF
increase RBF through decreasing resistance in the afferent and efferent arterioles
91
what do peripheral chemoreceptors repsond to
central?
peripheral: direct and indirectly to changes in PCO2
Central: only indirect response to changes in PCO2
92
male and female Hb concentration ranges
males 130-160 g/L
femailes 120-150 g/L
93
which of the following are potential sites for K+ secretion in the nephron
## Footnote
a. Proximal tubule
b. Ascending loop of Henle
c. Distal convoluted tubule and collecting duct
d. Proximal convoluted tubule and distal convoluted tubule
c. Distal convoluted tubule and collecting duct
94
ELIF carbamino effect
carbaminehemoglobin is formed with Hb and CO2 in low PO2 conditions. It will hold on to CO2 as long as the PCO2 is high (such as around cells) and release it in areas of low PCO2 (such as in the alveoli)
95
capacity vs content
capacity is the amount that something can hold
content is the actualy amount something is holding
96
what happens during hypoventilation
what is the result
the amount of CO2 produced exceed the amount blown off
arterial PCO2 increases (hypercapnia)
97
what are the primary respiratory muscles
diaphragm
internal and external intercostals
98
what is measured by dyanmic lung volumes
rate of air flow
99
what pump on the basolateral membrane is the primary actor for reabsorption in the PCT
Na K pump
100
why do intercalated cells have a lot fo mitochrondria
the need lots of ATP the run the H+ ATPase that they use to fuel cell transport and regulate acid-base balance
101
what is the Pip found at FCR
what is the force created
-4 relative to atm (756 mmHg)
inward forces from the chest wall and lung
102
what is the boht effect in relation to O2 unloading with increased PCO2
increasing PCO2 will increase the amount of H+ and decrease pH
decreasing pH decreases Hb O2 affinity
increases O2 offloading
103
what would albumin in the urine indicate
high pressure, kidney failure
104
lung compliance is inversely related to what
what is the significance
elasticity
as the lung loses compliance the inward elastic force also increases
105
solubility coefficient formula
C = kP
C molar concentration of gas
k henrys law constatnt at specific temp
P partial pressure of gas
106
what is the function of vagus nerve fibers in the kidney
unknown, possibly afferent fibers
107
how does VA effect Alveolar PO2 and PCO2
what about RER
increased VA will bring more oxygen into the alveoli
RER will determine how much oxygen is taken up and how much CO2 is produced
108
given the Hb concentration, arterial and venous O2 saturation, and O2 consumption how would you determine...
cardiac output
ficks principle
VO2 = CO(SO2Arterial - SO2Venous)
109
FEV1.0/FVC x 100
indirect measure of the rate of air flow through the ventilitory system
110
why does transpulmonary pressure increase when the chest wall expands
what is the result
the intrapleural space increases in volume, decreasing the PIP and increasing the outward force on the lungs
the visceral pleural will pull on the alveoli
111
where are the renin/angiotensin cells in the juxtaglomerular apparatus
what is their function
near the afferent tubule
secretion of hormones into the blood based on renal blood pressure
112
what does it mean to say the VRG causes nerve stimulation to respiratory muscles to "ramp up"
as inspiration continues the frequency of nerve impulses increases
113
when measure static lung volume what is not taken into account
the time it takes to move air in or out
114
internal respiration
what is the byproduct
use of O2 in mitchondria to generate ATP
CO2
115
what enzymes are responsible for pumping Na out of the blood in the ascending loop of henle
what about Cl
Na/K pump
Cl/K symporter
116
patient presents with chronic kidney disease. What lab value would indicate the greatest absolute decrease in GFR?
a rise in plasma creatinine levels from 1mg/dl to 2mg/dl
117
four lung volumes
Tidal volume
inspiratory reserve volume
expiratory reserve volume
residual volume
118
what will the effect increased PO2 have on the bronchioles
pulmonary arterioles
weak constriction of the bronchioles
dialation of the arteries
119
what enzymes are repsonsible for moving OAs into tubular cells from blood
what enzymes are responsible for moving OAs into tubular fluid
what is the common factor in each
OAT1, 2, 3
MRP2 and OAT4
OAT enzymes are ketogluterate antiporters
120
what is the primary function of intercalated cells
two types of intercalated cells and their function
regulation of acid base balance
alpha (reabsorbs HCO3 in acidosis)
beta (reabsobs H+ in alkalosis)
121
what is the effect of the haldane effect and carbamino effect on O2 unloading with decreased PO2
both will decrease Hb affinity for O2
122
two types of ventilation as they relate to neural control
quiet and active ventilation
123
what effect will increased PCO2 and decreased PO2 have on bronchioles
what effect will the action of the bronchioles have
decreased smooth muscle activity, leading to brochodilation
decreased resistance and increased ventiliation
124
T/F the descending limb of henle is impermable to water
false, the ascending limb is impermeable
125
Haldane effect
because deoxygenated Hb has a higher affinty for CO2 than oxygenated Hb, it will accept more CO2 and allow for CO2 to be transported from the cells to the lungs, where the CO2 will be released as Hb becomes oxygenated
126
what is the function of the DRG during quiet and active expiration
inhibition of inspiratory neurons
127
what is the function of phosphate that is filtered and remains in urine
buffering pH
128
how does BNP/ANP increase GRF
dilation of the afferent arterioles
constriction of the efferent arterioles
increase in glomerular hydrostatic prssure
129
why is PIP usually negative
because the elastic recoil of the chest wall and the lungs pull the viseceral and parietal pleura in different directions, increasing volume and decreasing pressure
130
what does the bohr effect mean in practical terms
at the cells there is a higher concentration of CO2
high CO2 produces more carbonic acid
more acid means lower pH
lower pH forces O2 to dissassociate from Hb
allows for offloading O2 at cells
131
PAH clearance is equal to what
RPF
132
how would RER changed if metabolism was primarily anaerobic?
aerobic?
anaerobic = glycolysis = increased RER
aerobic = fatty acid oxidation = decreased RER
133
define clearance of a solute
the virtual volume of blood plasma volume per unit of time inflow needed to supply the amount of solute that appears in the renal veins or in the urine
134
what types of waste products are excreted by the kidneys
urea
uric acid
creatinine
metabolites of hormones (vitamins)
bilirubin
135
normal FRC
2200
136
explain this forula
PUF = PGC - (PBS + πGC)
the pressure of ultra filtrate is equal to the hydrostatic pressure of the glomerular capilaries minus the sum of the pressure in bowmans space and the osmotic pressure of the glomerular capillary
137
what GFR value would be considered kidney failure
kidney disease
normal
0-15 ml/min
15-60
60-120
138
why is the amount of O2 dissolved in plasma largely ignored
because it is very small compared to the amount bound to hemoglobin
139
what would increased levels or atrial and brain natruiretic peptide be indicative of
congestive heart failure
140
what type of hemoglobin has oxygen bound at almost all binding sites
oxyhemoglobin
141
what is the gold standard substance to determine GFR
is it commonly used in clinic? why?
inulin
because it has to be IV injected
142
mechanics of ventilation formula
movement = Driving force/resistance
143
what are the bones of the chest cavity
rib cage, sternum, thoracic vertebrae
144
why is there a brush boarder in nephron cels
to increase surface area and allow for more Na/K pumps
145
when proteins are allowed to pass through holes in capillaries, what stops them from passing through the basement membrane
the fact that fenistrations in the basement membrane are too small to allow them to pass (25-65 nm)
146
where does most of the action happen in the kidney
in the PCT
147
what substances are absorbed in the distal tubule and collecting duct
NaCl (8%)
variable amounts of H, K, and H2O inreaction to dehydration, alkalosis, or acidosis
148
is Palv normally positive or negative?
what is the PIP in comparison
what does this do to PTP
alveolar pressure is positive
intraplural pressure is less that Palv
that means that at baseline PTP will be positive
149
what is is the effect of renal artery stenosis due to atherosclerosis on renal function and blood pressure
1. An increase in blood pressure due to stimulation of the rennin-angiotensin-aldosterone system which in turn will initially cause a transient increase in GFR
2. reabsorption of sodium and water resulting in an increase in preload that can increase BP
3. After the initial period, a further increased constriction of the afferent andefferent arterioles ensues which results in the retention of fluid and an increase blood pressure
4. all of the above results from renal artery stenosis
4, all of the above
150
what mediates H2O absorption in the later DCT
the effect of ADH on APQ2 on the apical and APQ3 and 4 on the BL membrane
151
what are the gradients that are at work in CO2/O2 loading
what about off loading
alveoli --\> plasma
plasma --\> RBCs
RBCs --\> Hb
it is the same, CO2/O2 will desaturate in plasma first
152
how would the lung react to decreased blood pH?
how would the kidneys
increasing respirations to blow off CO2
decreasing secretion of HCO3
153
what is the carbamino effect as it related to decreased PO2 and Hb affinity
deoxygenated Hb will form carbaminohemoglobin, which has a low affinity for oxygen but doesn;t hold on to CO2 well
154
describe the bohr effect (reddit)
in areas of high PCO2, increased H+ will make it more likely for Hb to release O2
in areas of low PCO2, decreased H+ will make it more likely for Hb to pick up O2
155
what is the effect of PCO2 on smooth muscle during venitliation
stimulates smooth muscle to dilate or constrict brochial diamter
156
functional reserve capacty equation and defintion
the amount of air remaining in the lungs after normal expiration
FRC = ERV + RV
157
what are the two effects of dopamine in the kidney
naturesis
vasodilation
158
what are the SNS hormones that will vasoconstrict
what wll reverse their effect
Epi and NE
renalase
159
what is the direct effect of increased PO2 on Hb loading
direct: increased O2 loading due to increased PO2
160
T/F there are no cellular elements and very little protein typically found in ultrafiltrate
true
161
what much O2 can be bound to 1g of Hb when saturated
1.34 mL O2
162
wjhat is the function of angiotensinogen
regulated BP and Na/K balance
163
what happens during hyperventillation
what is the result
ventilation exceeds cellular PCO2
arterial PCO2 drops (hypocapnia)
164
what stops the process of expiration
negative feed back from decreased Palv
165
what would glucose in the urine indicate
hyperglycemia, failure of glucose reabsorption
166
external respiration
exchange of O2 and Co2 between the atmopshere and the body
167
what is the direct effect of decreased PCO2 on Hb O2 loading
decreased PCO2 will cause more CO2 to be offloaded to allow for more O2 binding
168
what stimulus will cause the secretion of ANP and BNP
stretch in the atria
169
name three structures that are not normally allowed through the filtration barrier of the nephron
RBCs
WBCs
platelets
170
expiratory reserve volume (ERV)
the amount of air greater than tidal volume that is expelled during forceful expriation
171
what does the SNS respond to produce vasoconstriction of the kidney
what is the effect on GFR and RBF
decreased extracellular fluid volume
both will decrease
172
what is normal resting renal blood flow
what is that in percent of cardiac output
1.2L/min
around 20-25%
173
What are the generalized functions of the kidney
excretion of waste
regulation of fluid volume and content
balance electrolytes
react to changes in pH along with resp
Produce and secrete hormones
174
what type of cellular transport is used for NaCl reabsorption in the ascending loop
what happens to NaCl in the tubule as it approaches the macula densa
passive transport
it diffuses out of the tubule into the interstitium
175
which of the following will cause a decrease in renin secretion from the kidney
## Footnote
a. Decreased fluid and solute delivery to the macula densa
b. Hemorrhage
c. Intervenous infusion of isotonic saline
d. Narrowing of the renal artery
c. Intervenous infusion of isotonic saline
176
ventiliation
breathing
177
Dorsal respiratory group (DRG)
a medullary respiratory center with mostly inspiratory neurons and few expiratory
178
what is the direct effect of decreased PO2 on O2 unloading
decreased PO2 in tissues increases the chance that O2 will unload
179
what structures are contained in the nephron
renal capsule
proximal tubule
loop of henle (distal, ascending, thick)
distal tubule
collecting system
180
four factors that will increase GFR
increase in arterial BP
vasodilation of the afferent arteriole
vasoconstriction of the efferenet arteriole
increase renal blood flow
181
why do JM nephrons have a long loop of Henle
to take advantage of countercurrent ion regulatioin
182
hypercapnia
PCO2 is greater than normal in blood
183
FEV1.0
the amount of air that can be expired in one second from total lung capacity
184
describe the process of ventilatory feed back from hyperventiliation
decreased PCO2, increased pH, increased PO2
chemoreceptors detect
CPG decreases ventilation
185
where are the extraglomerular messnagial cells found in the juxtaglomerular apparatus
what is their function
near the macula densa
their function is unknown
186
what diuretics act on the PCT
acetazolamide
manitol
187
what is the PP of O2 in the pulmonary veins?
CO2
when and does that change, and by how much
100 mmHg
40 mmHg
at the cells
O2 down to 40mmHg, CO2 upto 46mmHG
188
what would albumen or glucose in the urine indicate
diabetic neuropathy
189
bohr effect
the presence high levels of CO2 in blood will produce more H+ ions and decrease pH, decreasing O2 affinity and allowing for CO2 uptake
190
what stimulus will release angiotensin II
what will the efect be on GFR and RBF
decreased extracellular volume
decreased GFR and RBF
191
why is the solubilty of CO2 relevant clincially
because CO2 is very soluble our bodies are very good at getting rid of it
192
what will the effect of angiotensin II be on BP and ECFV
will constrcit the afferent and efferent arterioles to increase them both
193
tidal volume
the amount of air moved during one normal breath
194
what would happen to blood flow (Q) when VA decreases
what happens to VA if Q decreases
nothing, they don't effect one another
195
what is the function of the renal corpuscle
produces ultra-filtrate from blood in the glomerular capilaries that ends up in the glomerular space
196
how are Na and Cl transported across the cell membrane in the 2nd PCT
transcellular and paracellularly
197
what is the process for excretion of organic cations
OCT enzymes transport OC from blood
OC/H+ antiporter and MDR1 transport them out
198
what two neurotransimitters are secreted by the sympathetic neurons of the kidney
norepinephrine and dopamine
199
what is the correct order of blood flow through vessels inside the kidney
afferent arterioles
glomerulus
efferent arterioles
pertubular capiliarries
200
laplace law for airway resistance
air flow = (Patm - Palv)πr4/8nl
201
what determines the amount of O2 dissolved in plasma
alveolar PO2
202
what is the effect of NO on the action of angiotensin II, NE, and Epi
it will decrease the amount of vasoconstriction
203
where is are the macula densa found
what is their function
superior border of the thick loop of henle
detects NaCl concentration in the distal tubule
204
when PTP increases, what will be the ultimate end result at normal physiologic conditon
increase in alveolar volume
205
what will the effect of ATP in the interstitial fluid be
in tubuloglomerular feedback it constricts afferent arterioles to decrease GFR and RBF
in some conditions it can stimulate NO and increase GFR and RBF
206
Daltons law
the total prssure exerted by a gas on the walls of its container is equal to the sum of partial pressure from each gas
207
explain this formula
Ex = Fx - Rx + Sx
excretion rate of a substance is equal it is filtration rate minus the reabsorption rate plus the secretion rate
208
what effect will the increase of bradykinin have on the release of NO and prostaglandins
it will stimulate the release of both, which will further incrased GFR and RBF
209
inspiratory reserve volume (IRV)
the amount of air greater than tidal volume taken in during forced inspiration
210
what are ions that can be excreted into urine
Na
K
Cl
HCO3
H+
Ca
P
211
why is the Na/K pump necessary to the reabsorption of solute in the thick loop of henle
it maintains a low intracellular Na gradient to fuel transport from the tubule
212
where does H2O reabsorption happen in the loop of henle
what cellular protein is responsible for this
exclusively in the thin descending loop of henle
aquaporin 1
213
normal total lung capacity
5700
214
what is the location of dysfunction in Gitelman syndrome
what is the mechaniism
intitla DCT
failure of the Na/CL symporter
215
why would hyperventilation cause syncope
as PCO2 drops the neural drive to breathe is decreased
216
what is the transcellular route of Na reabsorption in the 2nd PCT
parallel operation of Na/H antiporter and Cl anion antiporter
217
describe the haldane effect (reddit)
deoxygenated Hb will be more likely to bind to CO2, which allows it to pick up CO2 at the cells
oxygenated Hb will be less likely to pick up CO2 to encourage full O2 loading
218
can yhou determine the SO2 from PO2
use the graph
219
three dyanmic lung volumes
FEV1.0
FVC
FEV
220
inspiratory capacity definition and equation
the amount of air taken into the lungs from FRC on maximum inspiration
VT + IRV
221
what are three factors that can stimulate the action of rate-limiting enzymes in secretion of organic cations
PKA, PKC, androgens
222
what is the effect of ADH on the later DCT
decreased ADH will down regulate APQ's on the apical and Bl membranes, causing decreased H2O reabsorptiond and diuresis
223
67% of what substances filtered by the nephron are reabsorbed in the PCT
H2O, Na, Cl, K, others
224
what provides negative feed back during inspiration
increasing Palv will inhibit inspiration
225
what enzyme is active in the intital segment of the DCT at the apical membrane
BL membrane
Na/Cl symport
Na/k pumps, Cl passive transport channels
226
what is the driving force for ventilation
the pressure difference between the atmosphere and the alveoli
227
three differences between superficial and juxtamedullay nephrons
JM nephrons have a long loop of henle
their primary job is to concentrate or dilute urine
has vasa recta
228
what is the relationship between RBF and RPF
RBF = RPF/1-hematocrit
229
what are normal GFR values for males and females
125 ml/min
110 ml/min
230
what amount of O2 will dissolve in plasma at sea level
3mL O2 per liter of blood at alveolar PO2 100mmHg
231
what is the normal pH of urine
what causes this
5.5
H+/K ATPase antiport excnages H in the tubule for K in the cell
232
what is the indirect effect of decreased PCO2 on O2 loading
decreased PCO2 means thre will be less H+ produced, raising pH
increased pH increases O2 binding
233
what condition would you expect to be present in a patient with the following symptoms
pH 7.34, PCO2 46mmHg, Resp Rate 15, HCO3 25 meq/L
respiratory acidosis that is being compensated by the renal system
234
five examples of sensory inputs that feed into the central pattern generator
central chemoreceptors
peripheral chemoreceptors
pulmonary stretch receptors
irritant receptors
proprioceptors
235
what differentiates principle cells from intercalated cells
moderate invaginations of the basolateral membrane
main function is the the reabsorption of NaCl and secretion of K
236
where are central chemoreceptors
peripheral
central in the central nervous system
peripheral in blood vessels
237
what is the RPF in a normal adult
600-700ml/min
238
functional residual capacity (FRC)
the amount of air present in the lungs after passive expiration
239
what are two things that can modulate autoregulation
sympathetic tone and hormones
240
what does a left shift on an O2 affinity curve represent
right shift?
increased Hb O2 affinity
decreased affinity
241
if a drug causes _vasoconstriction_ of the _efferent arteriole_ _with no effec_t on the _afferent arteriole_, what is the expected trend in GFR and RBF compared to normal
GFR will increase and RBF will decrease
242
quiet ventiliation
inspiration is active, expiration is passive
243
what is the ventilation/perfusion ratio
the amount of alveolar ventilation related to the amount of blood in the pulmonary capiliaries
244
normal IRV
3000
245
what is the basic process of urine formation
ultrafilatration of plasma
reabsorption of water and solutes
secretion
excretion
246
why is Cl transported instead of organic anions or HCO3
because most of the proteins and HCO3 have already be reabsorbed
247
what would be the result of decreased renal blood flow from cardiogenic shock
acute tubular necrosis if enough cells are destroyed which can escalate into renal failure
248
What is the equation used to determine fuel source
%VO2FAT = 1 - RER/0.3
249
what forces are working to expand the chest wall at functional residual capacity
elastic recoil of the chest wall
250
normal RV
1200
251
what are two cell types in the DCT
what are their functions
principle and intercalated
principle reabsorb NaCl and H2O, secrete K into tubule
incalated cells secrete H+ or HCO3 for acid base balance
252
what is the location of dysfunction barter syndrome
what is the mechanism
ascending loop of henle
problems withthe Na/K/2Cl pump
253
what will the kidney do in response to hypotension
decrease GFR to conserve water
254
what is the haldane effect as it related to decreased PO2
Once O2 has been offloaded and PO2 is decreased, Hb has an increased affinity for CO2
255
why can urinalysis detect certain drugs
because some substances are secrete into the PCT and not reabsorbed
256
what is the structure of the renal corpuscle
fenestrated capillaries surrounded by podocytes
257
how is Na pumped cross the basolateral membrane in the 2nd PCT
CL
Na K pump
Cl/K symporter
258
total lung capacity equation
VT + ERV + IRV + RV
259
describe the equation
GFR = Kf \* PUF
the glomerular filtration rate is equal to the product of hydraulic conductivity and surface area (Kf) times the pressure of ultrafiltrate
260
why is creatinine used to determine GFR
freely filtered at a reletively stead concentration of 1mg/dL
almonst non is reabsorbed, secreted, or metabolized by the nephron
261
normal ERV
1000
262
which is more soluble in water, O2 or CO2
CO2, x20 more soluble
263
what happens at the intrapleural space during expiration
collapsing chest wall decreases pull on parietal pleura
increased PIP
decrease in transpulmonary pressure (decrease driving force)
264
transchest wall formula
PCW = PIP - Patm
265
what covers the epithelial cells of the renal corpuscle
what disease process might effect this layer and how
a basement membrane
can be thickened by DM
266
how is CO2 transported in blood
dissolved in plasma
bound to Hb
HCO3
267
what is the direct effect of peripheral chemorecptors
they detect changes in PCO2 and in pH and send signals to the CPG
268
active ventilation
inspiration and expiration are both active
269
what percent of total O2 in blood is dissolved in plasma
1.5%
270
what are the starling forces that oppose filtration
hydrostatic pressure in the tubule
osmotic pressure in the the capillary
271
what determines the composition of ultrafiltrate
the characteristics of the glomerular filtration barrier (endothelium, basement membrane, podocytes)
272
transpulmonary pressure formula
PTP = Palv - PIP
273
how does changes in PCO2 arterial effect central chemoreceptors
it will increase PCO2 in the CSF, increasin pH and causing a repsonse to be sent to the CPG
274
what will the effect increased PCO2 have on the bronchioles
pulmonary arterioles
dialtion (increased VA)
weak constriction (decreasedQ)
275
what percent of the VT doesn't make it to the alveoli
30%
276
if protein is filtered where is it reabsorbed in the kidney
the proximal tubule
277
what is the role of the kidneys in regulating pH
during acidosis the kidneys will hold on to HCO3
during alkalosis the kidneys will excrete HCO3
278
what are four apical symporters found in the 1st PCT
Na/glucose
Na/AA
Na/Pi
Na/Lactate
279
what would be consequence of lost surfactant in the lungs
be specific
small alveoli would have a higher collapsing pressure
higher pressure in the small alveoli would drive air out into larger alveoli with a lower pressure
280
what stimulus will produce bradykinin
what will the effect be on GFR and RBF
increased prostafglandins and decreased acetylchloline
increase in both
281
what happens to PGC and πGC as the ultrafiltrate passes through the nephron
why is this relevant
PGC decreases
pi GC increases
promotes reabsorption in the peritubular capillaries
282
hypoxia
P02 is lower than normal in tissue
283
three vasoconstrictors in the kidney
SNS
angiotensin II
endothelian
284
what substance is not absorbed in the DCT
what is the consequence of this
Na contentration decreases
285
what is the effect of dopamine on RBF
increases
286
FVC
the amount of air that can be expelled from TLC
287
four criteria to determine if a substance can be used to calculate GFR
freely filtered
no absorbed or secreted
not metabolized or produced by the kidney
does not alter GFR
288
what will the effect decreased PO2 have on the bronchioles
pulmonary arterioles
weak dilation
constriction
289
why would BNP be a good test for CHF
increased stretch on the vessel walll will increase BNP production
BNP as a long half life
290
why would renal failure cause anemia
because mesangial cells in the kidney produce EPO, and as the kidneys fail those cells loose their secretory capacity
291
what is the function of calcitrol
where is it produced
allows for normal absorption of Ca from the GI tract and deposiiton of Ca in bone
it is converted from vitamin D in the proximal tubules
292
what is the function of atrial natriuretic peptide
it attempts to decrease fluid volume in response to excessive stretch in the atria
293
what will the effect decreased PCO2 have on the bronchioles
pulmonary arterioles
constriction
weak dilation
294
molecules below what size are freely filtered in the nephon
what size will prohibit free filtration
\<20 angstroms
\>42 angstroms
295
what starts the process of expiration after inspiration
negative feedback from increased Palv
296
what is the inspiratory functino of the VRG
Expiratory
ramp up the frequency of action potentials
stimulate motor neurons to expiratroy muscles
297
what is the cut off of FEV1.0/FVC that would indicate ventilatory obstruction
+80%, no obstruction
\<80%, possible obstruction
298
how can hypersecetion of PTH effect other systems
hyperseceretion of PTH can increase the amount of PTH produced, which can cause more calcium to be released
299
anatomical dead space VD
the conduction region, where gas exchange doesn;t occur
300
surface tension formula
P = 2T/r
collapsing pressure, surface tension, radius
301
which of the following is NOT a component of the filtration barriers in the glomerulus
1. podocytes
2. basement membrane
3. capillary endothelium
4. all of the above are part of the filtration barrier of the glomerulus
4, they are all barriers
302
what is the function of the pontine respiratory center
possibly to facilitate transition between inspiration and expiration
303
where in the PCT is Na absorbed
HCO3
CL
the first 1/2
first 1/2
last 1/2
304
what is the effect of norepinehprine and dopamine on the kidney
what will be the effect
vasoconstrcitons through alpha adenoreceptors on the afferent arterioloe
dcreased in RBF and GFR
305
how does the effect of gravity effect the perfusion to those alveoli
alveoli with a low VA need less perfusion and have a lower Q to maintain a raio of 1
306
T/F there is significant parasympathetic innervaion to the kidney
false, there is none
307
what two substance are reabsrbed in the loop of henle, along with the percent of what is in filtrate
25% of filtered NaCl
15% of filtered H2O
308
aside from production of hormones, what other important endocrine function does the kidney play
ir regulates clearance of hormones which can indirectly influence endocrine function
309
hypooxemia
PO2 is lower than normal in arterial blood
310
what influences smooth muscle contractility in the lungs
PO2 and PCO2
311
what will increase RBF
what will decrease RBF
which of the two trumps the other
vasodilation
vasoconstriction
vasoconstriction
312
why is the amount of solute in the renal veins less important than the amount removed from blood
because solute in the veins is recycled
313
where is most of the H2O absorbed
PCT
314
what is the effect of decreasing temperature on Hb O2 affinity
decreasing temperature increases Hb affinty for O2
315
explain this formula
Cx = (Ux \* V)/Pax
clearance of a substance is equal to the amount in urine times the volume of urine per day divided by the arterial concentration
316
what stops cesllls in the PCT from brust
Na K pump
317
Hypocapnia
PCO2 is lower than normal in blood
318
what will caused a left shift of an O2 affinty curve
decreased temp
increased pH
decreased PCO2
decreased 2,3 - BPG
319
what happens at the intrapleural space after the chest wall expands during inspiration
chest all pulls on the parietal pleura
PIP decreases because volume increases
Transpulmonary pressure increases
320
what force is collapsing the lung at FRC
elastic recoil of the lungs
321
what is the effect of sympathetic tone if the content of the extracellular fluid is nomal
there is minimal effect
322
why is high compliance in lung tissue important
because low compliance means that it will take greater force to expand the alveoli
323
what happens to the the charge of tubular fluid as it passes through the thick loop of Henle
why is this important
it acquires a positive charge
the voltage is important for the reabsorption of cations like magnesium
324
what is the conducting zone
the airway from the larynx down to the terminal bronchioles
325
how much O2 is used by the body each day
how much CO2
90 gallons
72 gallons
326
what diuretics act on the thick asceening loop of henle
furosemide and bumetanide
327
what percent of the ventilatory system is the conducting zone
the respiratory zone
30%
70%
328
two types of collecting tubule cells
principle cells
intercalated cells
329
transchest wall prssure
the inward force of elastic lung recoil and force due to negative intrapleural pressure that decreases lung volume
330
what happens after the central pattern generator processes sensory, pontine, and cortical repsonses
it inhibits or stimulates neurons in the DRG and VRG to regulate breathhin rhythem
331
what is the filtration fraction
how is it calculated
the portion of blood that is shunted away from the glomerulus
GFR/RBF
332
what is a condition that will allow GFR and RBF to not be related in parallel
renal response to atrial natruetic peptide
333
explain this equation
RPF = CPAH/EPAH
renal plasma flow
334
given the Hb concentration, arterial and venous O2 saturation, and O2 consumption how would you determine...
Arterial and venous O2 capacity
capacity = [Hb g/L](1.34mLO2/g)
convert 0.00134 L/g
multiply by the concentration of hemoglobin
335
what will happen if there is a decrease in ATP and adenosine
how does this change in the presence of NO
what about angiotensin II
vasodilation of the afferent arteriole
NO will decrease vasoconstriction caused by ATP and adenosie
Angiotensin II will increase the vasoconstrictive effects of adenosine
336
what is the primary function of the juxaglomerular apparatus
regulation of filtration rate and renal blood flow by detecting the amount of NaCl in filtrate and changes in renal blood pressure
337
what determines the O2 capacity of blood
the concentration of hemoglobin
338
three factors that determine alveolar PO2 and PCO2
partial pressures in the ambient air
alveolar ventilation
RER
339
hyperventilation will cause what response in regard to pH
increased pH, leading to respiratory alkalosis
340
what does tubuloglomerular feed back respond to
changes in NaCl in the intertubular fluid
341
ventral respiratory group (VRG)
a medullary respiratory center with expiratory and inspiratory neurons
342
why is important that the peritubular capillaries be have low hydrostatic pressure compared to the glomerular capilaries
because the peritubular capilaries need to reabsorb and then secrete substances based on need
343
four factors that influence Hb affinity for O2
temperature
pH
PCO2
2,3 - BPG
344
what is the function of the peritubular capillaries
deliver substances and O2 to the nephron and allow for reabsorption
345
given the Hb concentration, arterial and venous O2 saturation, and O2 consumption how would you determine...
arterial and venous O2 content
capacity = [Hb](.00134)
content = capacity(SO2)
346
what to tamm horsfall proteins do
normally they are a defense against bacteria in the nephron, but the also form casts that can trap substances
347
of the starling forces, which is the primary driving force behind filtration
hydrostatic pressure in the arteries
348
what stimulus will increase NO production
what is the effect
increased shear stress, histamine, bradykinin
increased in GFR, increase in RBF
349
what would it mean if a substance had clearance ratio of 1
less that one
greater than one
the substance is filtered and not reabsorbed
the substance could not be filtered or is filtered then reabsorbed
the substances is filtered and secreted
350
Partial pressure of a gas
PP = %gas(Patm)
351
how do chemoreceptors regulate ventilation
they send signals to the central pattern generator which regulates rate and depth
352
why is the clearance of P-aminohippurate of note
clearance of PAH almost equals renal plamsa flow, and RPF = RBF
353
what effect does gravity have on air flow to alveoli
some alveoli are more completely ventilated than others
354
how does Na move out of the later segments of the DCT
what is the driving force behind this movement
what other ion does the effect
diffusion through ENaC channel
negative charge inside the DCT cell
it sets up a gradient for Cl paracellular transport
355
when loading or unloading O2/CO2, what gradient will become saturated first
Hb, then RBCs, then plasma
356
the solubility of oxygen in water is directly proportional to what
the partial pressure of oxygen in the air
357
normal IC
3500
358
where does 70% of the absorption in the nephron happen
the proximal tubule
359
what happens to the lung if transpulmonary pressure is 0
the lungs will collapse because of the elastic recoil of the lungs
360
compare and contrast carbaminohemoglobin to carboxyhemoglobin
both have compounds other than O2 bound in significant quantities
Carbaminohemoglobin has CO2
Carboxyhemoglobin has CO
361
what is the inspiratory function of the DRG
produces a firing pattern based on stretch of the lungs
inhibits inspiratory muscles
362
five reasons why RBF is important
Indirectly determines GFR
modifies the rate of solute and water reabsorption be proximal tubule
participates in the concentration and dilution of urine
delivers O2, nutrients, and hormones to renal cells
delivers substrates for excretion
363
in what ways is autoregulation of renal blood flow maintained
changes in vascular resistance in the afferent and efferent arterioles
364
what diuretic would mimic gitelman syndrome
what would be the pathlogical effects of this
thaizaide
hypocaluria
365
what is the primary ventilatory stimulus
systemic arterial and pulmonary vein PCO2
366
two types of nephrons
superficial
juxamedullary
367
what is the only factor that will change to alter airway resistance
increasing or decreasing radius
368
how is the kidney a source of drug interaction
give an example
certain drugs can cause the preferential secretion of acids or bases
diuretics can increase the secretion of aspirin, an acid, and decrease secretion of basic drugs like amphetamines
369
what diuretic would mimc barter syndrome
what would the pathologic effects be
lasix (inhibition of Na/K/2Cl symporter)
salt wasting, metabolic acidosis
370
normal resting plasma flow
650 mL/min
371
what is the relationship between Palv, PIP, and PTP
Palv is higher than PTP
both decrease during inspiration and increase during expiration
graphically the space between them is the PTP
372
hyperoxia
PO2 is greater than normal in tissue
373
what causes a detrimental accumulation of fluid by the kidneys in response to decreased ejection fraction in kidney faiilure
heart failure will cause a decrease in BP, which will trigger baroreceptors in the vasculature and kidneys, resulting in a decreased RBF and GFR to increase BP
this overrides the signals from the kidney that would elimiinate fliud
374
what does the haldane effect mean in practical terms
binding O2 to Hb decreases its affinity for CO2
375
what hormone opposes the function of calcitrol
PTH
376
what three organs work to maintain blood pH
lungs, kidneys, liver
377
where is the location of dysfunctionin liddle syndrome
what is the mechanism
later DCT
hyperactive ENaC
378
what would cause increase in ventiliation/perfusion ratio (Example)
decrease (example)
a decrease in perfusion (Q) with no increase in VA (PE)
A decrease in VA with no increase in Q (airway obstruction)
379
where is the central pattern generator
what does it do?
in the medulla
control the firing pattern of inspiratory neurons in the VRG and DRG similar to pacemaker cells
380
four types of hemoglobin
oxyhemoglobin
deoxyhemoglobin
carbaminohemoglobin
carboxyhemoglobin
381
which of the following is NOT true in regards to atrial and brain natruretic peptide
1. produced in the ventricles
2. increases cardiac output
3. serum BNP is a valuable index of cardiac stretch
4. promotes sodium extretion
2, increases cardiac output
382
two mechanisms responsible for autoregulation of renal blood flow
myogenic response to arterial pressure
tubuloglomerular feedback
383
two respiratory centerns in the medulla
one in the pons
ventral and dorsal respiratory groups
pontine respiratoey group
384
what does sympathetic innervation of the kidneys react to the produce vasoconstriction of renal blood vessels
if vasoconstriction is excessive, what can happen
decrease in renal blood flow
acute tubular necrosis
385
why are cations more likely to be filtered than anions
because the glycoproteins on the basement membrane are negatively charged, so anions would be repelled and cations would be attracted
386
describe the sequence of autoregulation inresponse to increased GFR (8)
1. GRF increase
2. increase flow through the tubule
3. flow past the macula densa increases
4. paracrine stimulation from macula to afferent arteriole
5. afferent arteriole constricts
6. increased resistnace
7. decreased hydrostatic pressure in the glomerulus
8. decreased GFR
387
what percent of plasma is shunted and not filtered through the glomerulus
15-20%
388
what structures are innervated by sympathetic nerves in the kidney
renin producing glandular cells
389
what are three functions of norepinephrine on the kidney
increase in renin production (beta adrenergic receptors)
increase in NaCl and water reabsorption
vasoconstriction via alpha adrenergic pathways
390
what do chemoreceptors that regulate breathing respond to
pH, PCO2, PO2
391
residual capacity (RV)
the amount of air left in the lungs after ERV
392
how is a positve ion balance maintained in the body
negative
positive = excretion \< intake
negative = excretion \> intake
393
lung elasticity is dependant on what two factors
elastin fibers in the alveolar wall
alveolar surface tension
394
respiratory structures in the chest cavity
lungs
chest wall
intrapleural space
395
what pump reabsorbs Na in the 1st 1/2 of the PCT
What is a secondary effect of this
Na/H+
places HCO3 into the interstitium
396
two ways altering efferent arteriole resistance can effect PGC
decreased resistance throght dialtion: decreased PGC and GFR
increased resistnace through constriction: increased PGC and GFR
397
since atmospheric pressure doesn't change drastically how is the driving force of respiration changed during ventilation
the alveolar pressure is altered by altering the alveolar volume
398
RER definition and equation
the ratio of CO2 priduced to O2 consumed during the process of mitochondrial respiration
RER = VCO2/VO2
399
what happens at the alveoli during expiration
decreased PTP decreases outward force on visceral pleura
alveolar volume increases
Palv decreases
decreased driving force (Patm - Palv)
decreased air flow into the alveoli
400
where is the majority of Cl reabsorbed in the PCT
the DCT
401
what happens to ventillation as PCO2 increases?
decreases?
increasing PCO2 increase minute ventilation
decreasing PCO2 decreases minute ventilation
402
what three factors feed into the central pattern generator
sensory input
pontine regulation
voluntary control from the cortex
403
what is the function of adenosine in the kidneys
what is its effect on GFR and RBF
vasoconstriction
decrease in both
404
where is atrial natriuetic peptide produced
BNP?
the atria
the ventricles
405
how is PAH used to test renal blood flow
PAH IV is given
PAH is filtered almost completely bt the kidney
the clearance of PAH divided by the extraction of PAH is an indirect measure of the RPF
406
what are the three hormones secreted by the kidneys
renin, calcitrol, erythropoietin
407
normal vital capacity
4500
408
T/F O2 binding to hemoglobin is non-reversible
false
409
lung compliance formula
lung compliance = deltaV/delta(Palv - PIP)
410
Alveolar ventilation (VA) defintion and equation
the amount of air that reaches the alveoli in one minute
VA = *f*(VT - VD)
411
what is the purpose of gas exchange
to take CO2 out of blood and replace it with O2
to collect CO2 from cells and replace it with O2
412
between what MAP does renal blood flow remain constant
what happens to GFR in this range
80-180
it remains basically the same
413
Henry's Law
the quantity of gas that will dissolve in a liquid is proportional to the the partial pressure of the gas above the liquid and its solubilty coefficient
414
how can the kidneys regulate blood pressure
regulate water and Na reabsorption
producing renin for the RAA cycle
415
how does 2,3 - BPG(DPG) affect Hb affinty for O2
it binds to deoxygenated Hb to stop O2 from rebinding at the cells to allow for more O2 delivery tocells
416
vital capacity defintion and equation
the total amount of air moved during forced inspiration or expiration
VT + ERV +IRV
417
what are some buffered forms of hydrogen formed in the renal tubules that are in urine
## Footnote
_**a**. Titratable acid such as phosphate (monobasic)_
**b**. Water a byproduct of the addition of hydrogen and biocarbonate _through action with carbonic anhydrase_
**c**. Ammonium ion by the addition of the hydrogen ion to ammonia _generated by the catabolism of glutamine_
_**d**. All of the above are forms of the hydrogen ion in excreted urine_
_**d**. All of the above are forms of the hydrogen ion in excreted urine_
418
collapsing pressure
the pressure needed to collapse alveoli
419
what diuretics act on the DCT
thiazides
420
partial pressure
the pressure exerted by one gas in a mixture
421
what is the respiratory zone
respiratory broncioles and alveli
422
glycosylation
how would you assess this in a patient
a reaction in the glycoproteins on the basement membrane that decreases their ability to repel anionic proteins
HbA1c levels or fasting glucose, along with albumin in the urine
423
Transpulmonary pressure
the combined force fo negative intrapleural pressure and elastic chest wall recoil that acts to expand the chest wall
424
describe how PP O2 changes throughout the body
air starts at 160mmHg
alveoli --\> pulmonary veins --\> systemic arteries steady at 100 mmHg
decreases to around 40 mmHg at cells
maintains 40mmHg through venous circulation back to heart
425
where does reabsorpton of NaCl happen in the loop of henle
where does it not occur
the thick and thin loops
no the descending limb
426
why does there need to be high hydrostatic pressure in the glomerular capillaries
because there need to be pressure to push all the filtrates out of blood
427
what are the three anatomical strucutures of the filtration barrier in the renal corpus
fenestrated epithelium
basement membrane
podocyte from bowmans capsule
428
what happens in the chest wall during inspiration
motor neuron stimulation
inspiratory muscles contract
chest wall expands
429
what is the function of renin
renin promotes the production of angiotensinogen from the liver, which is converted to angiotensin in the kidneys
430
what is the indirect effect of peripheral chemo receptors
detects decreased PO2 (below 60mmHg) and sends signals to CPG
431
what is the effect of PO2 on smooth muscle in the lungs
it will act on the pulmonary arterioles to regulate Q
432
by what two methods is oxygen transported in blood
dissolved in plasma
bound to hemoglobin
433
where would a right shift (decreased oxygen affinity) be useful
why
what about left shift
at the cells
so O2 will dissociate from Hb
at the lungs, because you want to maximize O2 saturation
434
boyles law equation and meaning
P1V1 = P2V2
as volume increases, pressure decreases, and vice versa
435
T/F obstruction doesn;t change vital capacity
true
436
what is the process of exretion of organic anions into the tubules
intracellular ketogluterate is exchanged into the tubular fluid for OA with OAT1, 2, 3
ketoglutarate in the tubule fluid is exchanged with OA by OAT4 and MRP2
437
Gitelman’s syndrome is a genetic defect that affects the thiazide sensitive Na + /Cl - symporter in the distal convoluted tubule.
## Footnote
Which of the following would be observed in these patients?
a. Salt wasting
b. Hypokalemia
c. Hypocalcuria
d. All of the above would be observed in a patient with Gitelman’s syndrome
d. All of the above would be observed in a patient with Gitelman’s syndrome
