Respiratory Sytem Flashcards

Question

What is the cribiform plate?

Answer 1

Perforations in the ethmoid bone

Answer 2

Neurons in the olfactory bulb which interact with other neurons for olfaction

Answer 3

Pseudostratified columnar epithelia

Answer 4

Superior, middle and inferior Conchae which project medially from the lateral wall of the nasal cavity

Answer 5

Superior, middle and inferior meatus inferior to the conchae.

Answer 6

Frontal, ethmoid, sphenoid and maxillary sinus.

Answer 7

Unknown but may assist in air filtration

Answer 8

Sphenoid sinus

Answer 9

Posterior ethmoidal sinus

Answer 10

Frontal sinus, maxillary sinus and anterior and inferior ethmoidal sinus

Answer 11

nasolacrimal duct to drain excess fluid- crying causes runny nose

Answer 12

Kiessalbeck's plexus of the anastomosis of 5 arteries Superior ethmoidal- near the frontal bone Inferior ethmoidal- near the middle ethmoidal bone Sphenopalantine artery- near the sphenoid bone Greater palantine- near the teeth Superior labia- near the lips

Answer 13

Nose is highly vascularised, damage of one blood vessel leads to quick and severe bleeding from all blood vessels.

Answer 14

Nasopharynx- base of skull to the soft palate and uvula Oropharynx- Soft palate to epiglottis Laryngopharynx- superior margin epiglottis to the circoid cartilage

Answer 15

Nasal cavity, oral cavity and larynx.

Answer 16

Protect and aerate middle ear and equalise pressure in the middle ear in response to external pressure

Answer 17

Children- narrower tubes prone to inflammation Smokers- damaged cilia that allows mucus to enter and cause blockage and inflammation Overweight people- fatty deposits may block the eustachian tube

Answer 18

Collections of lumphoid tissue containing dendritic cells and lymphocytes for pathogen defense

Answer 19

Conchae, meatus, eustachian tube and two tonsils: Adenoid/Pharyngeal tonsil-connective tissue attaches it to the ethmoid bone and is lined with pseudostratified epithelia Tubal tonsils- inferior to the eustachian tube

Answer 20

Superiorly- hard palate --> soft palate Uvula attached to soft palate Palatine tonsil- superior to the tongue. It invaginates to form crypts. Lined with stratified squamous non keratinising epithelia Tongue Lingual tonsil on posterior tongue that invaginates to form crypts filled with bacteria. Stratified squamous non keratinising epithelia

Answer 21

The opening in the pharynx for the beginning of the larynx. It is posterior to the epiglottis and superior to the arytenoid cartilage (vocal folds). Bordered laterally by the aryepiglottic folds.

Answer 22

Anterior- Thyroid cartilage Posterior- Oesophagus Superior- Laryngeal inlet Inferior- Cricoid cartilage

Answer 23

Muscular tube from C3 to C6/7 for phonation.

Answer 24

Supraglottis- Above the vocal folds, contains epiglottis to regulate food movement Aryepiglottic folds- connects epiglottis and arytenoids Arytenoids- joint for movement of vocal folds False vocal folds- protection of the vocal folds Glottis- contains vocal folds for phonation Infraglottis- adjusts vocal fold tension

Answer 25

Applying pressure to the cricoid cartilage

Answer 26

Superior and inferior laryngeal artery Superior and inferior laryngeal veins

Answer 27

Adduction (closure) of the vocal folds

Answer 28

Contains vocal folds for phonation. The opening is the rima glottidis

Answer 29

Support the vocal folds and the epiglottis

Answer 30

Lateral cricoarytenoid muscle

Answer 31

Posterior cricoarytenoid muscle Oblique arytenoid muscle Transverse arytenoid muscle

Answer 32

Origin: Posterior lamina of cricoid cartilage Insertion: Posterior muscular process of cricoid cartilage Innervation: recurrent laryngeal nerve (branch of vagus)

Answer 33

Origin: Upper margin of cricoid cartilage Insertion: Anterior muscular process of cricoid cartilage Innervation: recurrent laryngeal nerve (branch of vagus)

Answer 34

Origin: Muscular process of arytrnoif Insertion: Adjacent contralateral muscular process Innervation: reccurrent laryngeal nerve

Answer 35

Origin: posterior muscular process of the arytenoid cartilage Insertion: Adjacent lateral Innervation: reccurrent laryngeal nerve

Answer 36

Cricothyroid muscle- only tesnor muscle involved in phonation

Answer 37

Thyroarytenoid which includes vocalis

Answer 38

Origin: Anterior lateral cricoid cartilage Insertion: Inferior lamina of cricoid cartilage Innervation: Superior external laryngeal nerve

Answer 39

Origin: Inferior surface of thyroid cartilage Insertion: Anterolateral arytenoid cartilage Innervation: recurrent laryngeal nerve

Answer 40

Abnormal voice -> tumour ->damage to the recurrent laryngeal nerve during surgery that can cause unilateral paralysis of a hoarse voice or bilateral paralysis of no voice

Answer 41

10-15cm airway tract from C6- T4/T5. Outermost layer is the adventitia formed of connective tissue containing fibroblasts.

Answer 42

Sternal angle at T4/T5

Answer 43

Swallowing in the posterior oesophagus, achieved by the trachealis muscle and the cartilaginous rings.

Answer 44

Pleura- Lungs Pericardium- Heart Peritoneal- Abdominal Cavity

Answer 45

Mesothelium- simple squamous epithelia for filtration

Answer 46

Precursor to the cardiac muscle for heart formation on the cranial end. Due to ventral folding, it moves towards the midline.

Answer 47

Precursor to the diaphragm and lies laterally to the cardiogenic mesoderm on the cranial end

Answer 48

Dorsally incomplete that creates pericardioperitoneal canals to allow communication between the cavities.

Answer 49

Anus precursor- Ectoderm and mesoderm that forms a ring on the caudal end.

Answer 50

Mouth precursory- ectoderm and mesoderm that lies on cranial end

Answer 51

Precursor to the brain and spinal cord, formed from invagination of the mesoderm medially.

Answer 52

In the yolk sac, ventral folding like a drawstring creates cranial end foregut, medial midgut and caudal end hindgut.

Answer 53

Outpouch of the yolk sac for urinary waste and gas exchange

Answer 54

Creates attachment for the peritoneal cavity to the abdominal wall dorsally(posterior)

Answer 55

Inner- Aligns with yolk sac

Answer 56

Outer mesoderm- Continous with inner amnion membrane of the amniotic cavity

Answer 57

Initially at C3-C5, along with phrenic nerve but moves inferiorly to end at L3 and the level of ribs 7-12

Answer 58

The Lungs and GI tract

Answer 59

Lined with pericardium Ventrally attached to gut wall Cranial position to septum transversum

Answer 60

Fusion of the pleuroperitoneal membrane with the septum transversum transversely. Myoblast cells in the mesoderm migrate.

Answer 61

Week 5-7 W5: Medial folding of the pleuropericardial folds along with the phrenic nerve contained in the walls. W6: Continues to fold medially and lungs extend ventrally W7: Pleuropericardial folds fuse to create distinct pleural cavity and pericardial cavity

Answer 62

Incomplete closure of the pleuroperitoneal membrane. Herniation (opening) creates an opening in the diaphragm Insufficient migration of myoblast cells creates easily palpable diaphragm.

Answer 63

Lung hypoplasia- underdeveloped lungs. Due to pressure from abdominal organs.

Answer 64

maintain po2 and pCO2 levels and maintain ph of the plasmaa

Answer 65

Gas exchange across metabolising tissues

Answer 66

Decreases from 100 mmHg to 40mmHg

Answer 67

Increases from 40mmHg to 45mmHg

Answer 68

Gas exchange across lung membrane

Answer 69

Decreases from 45mmHg to 40mmHg

Answer 70

Increases from 40mmHg to 100mmHg

Answer 71

Gas exchange.

Answer 72

High CO2 caused by Hypoventilation

Answer 73

Low CO2 caused by Hyperventilation

Answer 74

Kidneys through HCO3- in the carbonate acid buffer system

Answer 75

Nucleus tractus solitaris in the medulla

Answer 76

Carotid body- bifurcation of the capillaries in the neck- innervated by the glossopharyngeal nerve Aortic body- near the aortic arch- innervated by the vagus nerve

Answer 77

Flow dependent and are in areas rich in high flowing blood to detect pO2 levels and minimally pCO2

Answer 78

Each side of the neck, at the bifurcation of the common carotid artery

Answer 79

Neurons found in the airways and the lungs -Myelinated Rapidly adapting stretch receptors -Myelinated Slow adapting stretch receptors -Unmyelinated C fibres

Answer 80

Along aortic arch

Answer 81

Airways to lungs respond to changes in lung or airway volume, possibly caused by tumours or inflation

Answer 82

Smooth muscle of airways -> lungs responds to changes in lung or airway volume possibly caused by tumours or inflation

Answer 83

RAR respond briefly but quickly to stimuli SAR maintain firing rate of impulses in response to stimuli.

Answer 84

Airways-> alveolar walls Chemosensitive to inflammatory mediators like cytokines or bradykinins in the airways -> lungs

Answer 85

Changes in pCO2 levels in the ECF of the blood brain barrier between arterial blood supply and cerebral spinal fluid

Answer 86

Movement of CO2 through ECF into the CSF is detect by chemoreceptors which send impulses to the nucleus tractus solitaris in the medulla increase ventilation during hypercapnia decrease ventilation during hypocapnia

Answer 87

Central chemoreceptors

Answer 88

Chloroid plexus cells that increase the movement of HCO3- to decrease ph of CSF.

Answer 89

Irritation of Chemoreceptors/Mechanoreceptors Impulse down vagus afferent nerve to the nucleus tractus solitaris in the medulla Contraction of lateral arytenoid muscle for adduction of vocal folds for air entry Elevation of ribs- scalene and external intercostal muscle Elevation of sternum- sternocleoidomastoid muscle Diaphragm contracts and flattens Decrease in intrathoracic pressure

Answer 90

Abductor muscles posterior cricoarytenoid, transverse/oblique arytenoid contract to close vocal folds Expiration occurs against closed glottis which increases intrathoracic pressure

Answer 91

Thyroarytenoid contracts to release vocal fold tension Internal intercostal muscle contracts to depress ribs Abdominal muscles contracts to force diaphragm more superiorly to increase intrathoracic pressure Posterior cricoarytenoid contracts briefly to abduct vocal folds Lateral cricoarytenoid contracts to adduct vocal folds wider Air containing irritant is expelled

Answer 92

Inhibits cough reflex by targeting the central control pathway and the vagal efferent nerves.

Answer 93

Endorphin ligands bind and induce calming and analgesic effect, part of the reward system

Answer 94

Mu, kappa and delta

Answer 95

Mood, pain and reward

Answer 96

Mood, reward and pain

Answer 97

Occupy opioid receptor site longer and continuously attaches to produces slower long lasting effect

Answer 98

The opening in the pharynx for the beginning of the larynx

Answer 99

Opening at the back of the oropharynx

Answer 100

Vestibular fold

Answer 101

Most anterior of the nasal cavity enclosed by cartilage. Lined with stratified squamous keratinising epithelia like the skin

Answer 102

An attempt to mitigate pain or distress, actively seeking help if it affects their physical or mental capabilities

Answer 103

1) Awareness of problem 2) Expressing need for support 3) Gaining understanding of resources and availability of support 4)Willingness to seek and disclose help

Answer 104

Occupation, literacy level, history of serious illness in family and suicidal ideation

Answer 105

Communication diffculty in expressing distress shame culture of stigma self-reliance anticipation that help is inaccessible

Answer 106

Going to a social worker, going to see a GP.

Answer 107

Assymetrical distriubtion around the mean

Answer 108

More values on the left- positive value Higher mean than median IQR and mode is unafffected Box plot- line in the middle representing median favours the left 1st quartile

Answer 109

More values on the right- negative value Higher median, lower mean IQR and mode is unaffected Box plot- line in the middle representing the median favours the right 3rd quartile

Answer 110

Spread of data around the mean, mu

Answer 111

Wider curve- higher standard deviation Narrower curve- lower standard deviation Area under the graph does not change

Answer 112

Probability that parameter (a number in a population) will fall within the set of values

Answer 113

G protein coupled receptor with 7 transmembrane alpha helices, stimulated by binding of artificial or endogenous opioid

Answer 114

Medulla, pons, pulmonary mucosa in the lungs, smooth muscle of the trachea and bronchi and the gut.

Answer 115

Inhibit central sympathetic outflow to the vagus nerve, decreasing inspiration rate and peristalsis.

Answer 116

Nausea, vomiting, lower heart rate, blood pressure and lower respiration. Lower blood pressure in use with opioids leads to increased intracranial pressure

Answer 117

Respiratory failure, bradycardia, comatose patients

Answer 118

Myocardial infarction, tacycardia, chronic and severe pain

Answer 119

Opioid antagonist

Answer 120

Competitive inhibition and blockage of mu receptors with opioids

Answer 121

Opioid analgesic

Answer 122

Volume of air entering and leaving the lungs in one minute

Answer 123

Air taken in and out with each breath in the lungs

Answer 124

Movement of air in and out of the lungs

Answer 125

Pulmonary ventilation and Alveolar ventilation

Answer 126

Spirometer

Answer 127

No of breaths per minute

Answer 128

Decreases; infant 30-50, child 20-30 adult 12-20

Answer 129

Conducting and respiratory

Answer 130

Filter, warm and humidify air to prevent airway damage. Includes nose -> terminal bronchioles

Answer 131

Gas exchange. Includes respiratory bronchioles, alveolar ducts, alveolar sacs and the alveoli

Answer 132

Air in the airways that does not participate in gas exchange

Answer 133

Area in the aiways that does not participate in gas exchange

Answer 134

Damage to the respiratory airways involved in gas exchange such as emphysema where damaged alveolar areas become dead space

Answer 135

Residual volume and FRV. Patient breathes in a closed air circuit mixture of helium and oxygen conc(C1). Helium should be 12-14% and O2 30% to prevent respiratory distress- and allow resting state breathing to be measured. Helium enters the lungs and is insoluble so eventually helium in spirometer tank and lungs equilibriate to produce C2.

Answer 136

C1 X V1= C2 (V1 + V2) C1 is the initial tank conc. V1 is the initial lung volume. C2 is the equilibrated tank conc. V2 is the equilibrated lung volume.

Answer 137

Record pressure of organs like the functional residual volume. Patient sits in a container and pants through an external tube while open and once while shut. This creates oscillations in the airways and pressure which is recorded by signal transducers. it can diagnose emphysema and COPD and asthma due to higher residual volume as an indicator

Answer 138

Inefficient respiratory movement More work needed for breathing Respiratory muscles have longer resting length

Answer 139

Chronic obstructive pulmonary disorder which is lung conditions that cause breathing difficulties. Emphysema- damage to alveolar air sacs Chronic bronchitis- 8+ weeks of airway inflammation associated with breathlessness, wheezing, mucusal chesty cough and frequent infections

Answer 140

Damage to the lungs, such as a genetic susceptibility or smoking

Answer 141

Exercise tolerance or underlying pulmonary disease like asthma

Answer 142

No, it measures airflow obstruction generally which may be associated with other conditions

Answer 143

Total vital capacity only identifies moderate and severe lung obstruction. Residual volume distinguishes between mild to moderate lung obstruction.

Answer 144

Residual volume and FRV of high values using helium dilation method or plethysmography.

Answer 145

Helium dilation method or plethysmography

Answer 146

Peak flow meter

Answer 147

Higher weight, male sex

Answer 148

No effect on total lung capacity but decrease in ERV and Vt After age 30, elastic recoil is weaker. More hyperinflation so RV and FRV increases

Answer 149

Damages cilia and lung cells and suppress immune response which protect lungs

Answer 150

Forced expiratory volume of air in one breath. Should be at least 75%. Decreases with COPD.

Answer 151

Difficulty in expelling air containing CO2 due to obstruction. This causes low FEV1 (forced expiratory volume in one second).Because air can't be expelled, lung hyperinflation so high residual and FRV.

Answer 152

Emphysema: degeneration of the alveolar air sac which increases dead space in the lungs and reduces release of air. Asthma: chronic inflammatory disease where constricted bronchi smooth muscle reduces airflow. It is a overactive th2 centered response by T helper cell 2 that may recruit eosinophils and may be allergy induced sometimes. 1.1% of respiratory mortality Cystic fibrosis: mucus build-up restricts airways Bronchiectasis- scarring of the bronchi caused by damaged that causes inability to clear mucus which builds up

Answer 153

Build up of non-expelled CO2 will cause acidosis to occur. Acidosis results in rapid short breaths, dyspnea, headache and fatigue (due to hypoxia) and hyperreflexia (muscle cramping due to hyperkalemia.)

Answer 154

->Dyspnea -> Slow exhalation which is wheezy and shallow because airflow is limited.

Answer 155

Difficulty expanding the lungs either intrinsically or extrinsically which limits the volume of air inhaled.

Answer 156

Difficulty expanding the lungs intrinsically. Pulmonary fibrosis- Irritants like smoke, metal dust or asbestos damage the lungs and cause scar tissue formation by overproduction of fibroblasts by epithelia 4.6% of mortality of respiratory disease Pneumonia- infection of alveoli which fill with fluid/pus and reduces O2 uptake. 25.3% of respiratory mortality. Tuberculosis: Bacterial infection which creates lung lesions that may induce fibrosis or rupture the pleura.

Answer 157

Difficulty expanding the lungs externally. Tumors- infection which breaks down lung tissue. 31% of respiratory mortality Pleurisy- inflammation of pleura membrane Rib fractures Obesity- fatty deposits prevent full inhalation

Answer 158

Lower FEV1 than FVC Volume lower than normal Expiration is limited more than inspiration.

Answer 159

Significantly lowest FVC than normal and obstructive disease. It decreases in proprotion to FEV1 because inspiration is limited more than expiration

Answer 160

Obstructive: Expiration and FEV1 is significantly lower. Higher Vc and inspiratory flow. Less air flows. Restrictive: Inspiration and Vc is significantly lower. Higher air flow.

Answer 161

Indicator for diagnosis and treatment efficacy

Answer 162

Not decreased in purely obstructive disease

Answer 163

Volume of air taken in and out in one breath.

Answer 164

Flow of air in and out of the lungs

Answer 165

No. of breaths per minute

Answer 166

Volume of air moving in and out of the longs in one minute

Answer 167

Maximum volume of air in and out of the lungs in one breath.

Answer 168

Volume of air that can be inspired beyond resting breathing.

Answer 169

Volume of air that can be expired beyond resting breathing.

Answer 170

Volume in the lungs remaining after maximum expiration to keep alveoli inflated

Answer 171

Volume of air remaining in the lungs after passive expiration

Answer 172

Volume of air inspired during resting breathing

Answer 173

Spirometer measures most lung volumes like tidal volume, inspiratory reserve volume and exspiratory reserve volume. It cannot measure residual volume or functional reserve volume

Answer 174

Patient breathes into a tube which increases air volume in the drum. This alters the counterbalance weight attached to the pen that records reading.

Answer 175

It is impossible to fully empty the lungs of air

Answer 176

Plethysmography measures the residual volume and the functional reserve volume.

Answer 177

Peak flow meter measures airflow obstruction. Green zone: 80 to 100 percent of your usual flow rate. Yellow zone: 50 to 80 percent of your usual flow rate. Airways starting to narrow. Red: less than 50 percent- severe narrowing

Answer 178

Higher lung capacity means the lungs are hyperinflated, which is indicative of pulmonary disease. Hyperinflation means there is a greater Residual Volume and Functional Reserve volume.

Answer 179

Lungs are hyperinflated because the respiratory movements are inefficient at fully expelling air or taking it in and resting length between breathing is longer.

Answer 180

Smoking is an irritant ->stimulates overproduction of fibroblasts by alveoli that leads to fibrosis which limits gas exchange in the lungs. ->acts on macrophages to recruit monocytes, neutrophils and T cells. ->Causes emphysema: Smoking induced neutrophil recruitment will release proteases that cause hypersecretion of mucus from goblet cells and damage cilia cells to prevent movement of mucus. ->The proteases secreted by neutrophils and T killer cells will cause destruction of the alveolar wall due to the cigarette smoke present. Causes emphysema

Answer 181

Smoking is an irritant ->stimulates overproduction of fibroblasts by alveoli that leads to fibrosis which limits gas exchange in the lungs. ->acts on macrophages to recruit monocytes, neutrophils and T cells. ->Causes emphysema: Smoking induced neutrophil recruitment will release proteases that cause hypersecretion of mucus from goblet cells and damage cilia cells to prevent movement of mucus. ->The proteases secreted by neutrophils and T killer cells will cause destruction of the alveolar wall due to the cigarette smoke present. Causes emphysema

Answer 182

Pressure gradient

Answer 183

Intrathoracic pressure

Answer 184

Volume and pressure are inversely proportional.

Answer 185

Gases at the same pressure and temp have same number of moles at 6.02 x 10(23)

Answer 186

Diffusion rate decreases with higher molecular weight

Answer 187

Mass of dissolved substance = Solubility coefficient x partial pressure

Answer 188

Temperature and Pressure are proportional

Answer 189

Total partial pressure is the sum of the individual partial pressures

Answer 190

Total Arterial O2 levels

Answer 191

Amount of O2 bound to haemoglobin

Answer 192

CO2 has a higher affinity to deoxyhaemoglobin than oxyhaemoglobin. This facilitates CO2 uptake in tissues

Answer 193

Oxygen leaves arteries; uptake by veins

Answer 194

CO2 uptake by arteries; leaves veins

Answer 195

Closed circuit blood circulation between the heart and the lungs. Includes the pulmonary artery and the pulmonary vein

Answer 196

Low temp, Low H+, Low CO2, Low BPG

Answer 197

High Temp, high H+, high CO2, high BPG

Answer 198

Endogenously: Haemolysis of RBC because haem group contains endogenous CO Environmental: smoking, vehicle exhaust, pollution, asbestos, gas fire

Answer 199

In order: Carbonic Acid H2CO3, Carboxaminohaemoglobin and Dissolved CO2

Answer 200

CO2 decreases haemoglobin's affinity for O2

Answer 201

HCO3- is exchanged for CL- intracellularly to maintain electrolyte balance

Answer 202

CO2 Increases from 0.3 mmHg to 40mmHg O2 decreases from 159mmhg to 105mmhg N2 decreases from 607 mmhg to 568mmhg H20 is variable but in the alveolar it is 47mmHg

Answer 203

It is insoluble and exerts pressure to keep alveoli inflated

Answer 204

Decreases from the arteries; Increases in the veins 40mmHg> 105mmg

Answer 205

Increases into the arteries; decreases from the veins 47 mmHg / 40 mmhG

Answer 206

Hallucinations, tiredness, fatigue, headaches

Answer 207

pH should be maintained at 7.4 7.35 is low ph 7.45 is high pH

Answer 208

Enzyme which increases cell uptake of H+ via ATP hydrolysis to exudate K+ into the interstitial space

Answer 209

pH below 7.35 Respiratory acidosis: CO2 Hypercapnia; retention of CO2 due to problems expelling like restrictive disease or retaining in obstructive Metabolic acidosis: High H+ Diabetic ketoacidosis: Insulin amount is insufficient to free glycogen stores. Acidic Ketone bodies in excess. Renal failure

Answer 210

Bradycardia and hyperreflexia: Hyperkalaemia due to high H+ uptake /high K+ exudation to tissue which impacts 3Na+ out/ 2K+ in. Hyperkalaemia reduces Na+ activation, increases refractory period of AP and lowers neuron resting potential. Bradycardia Rapid short breaths, wheezing, dysnpea, respiratory distress

Answer 211

Increasing ventilation or increasing renal excretion. It can use buffers like HCO3-.

Answer 212

pH is above 7.45. Respiratory: loss of CO2 Hypocapnia: excessive ventilation, associated with hypoxia. Metabolic: loss of H+ Vomiting Increased urinary loss of H+ via vomiting, diuretics, overactive kidneys

Answer 213

Tacycardia, normal to high BP and muscle weakness and Paraesthesia (pins and needles) -> Hypokalemia as H+ is too low for H+/K+ ATPase to exudate K into tissue fluid. Resting potential increases. Low extracellular K+ disrupts muscle contraction

Answer 214

Decreasing renal excretion of H+, increasing excretion of HCO3-, decreasing ventilation.

Answer 215

-Lamina propia- below the epithelia and conncts it to smooth muscle to regulate contraction. It has immune cells for pathogen defense such as leukocytes, lymphocytes and mast cells -Pseudostratified columnar epithelia Olfactory- for olfaction Bowman's gland- secretions keep the olfactory moist

Answer 216

Goblet cells- secretes mucus. Cilia cells- coordinated beating of the cilia transports mucus down the airways Basal cells- for adhesion and cell renewal

Answer 217

-Smoking damages cilia which prevent cilia beating, leading to mucus build-up in the airways -Cystic fibrosis causes mucus build-up due to deficiency in CFTR gene which encodes for CL- transport that affects water content of mucus. This causes it to harden and damage airways.

Answer 218

In the terminal bronchioles from columnar epithelia containing goblet cells to the cuboidal epithelia containing clara cells

Answer 219

They secrete non mucous secretions and are non-ciliated. Involved in pathogen defence and proliferation of epithelia.

Answer 220

pseudostratified columnar epithelia. Hyaline cartilage and smooth muscle with a thin lamina propia. Lamina propia connects the epithelia to the smooth muscle for regulation of contraction. It contains immune cells like macrophages and mast cells but mostly connective tissue like fibroblasts

Answer 221

Pseudostratified ciliated columnar epithelia. Plates of hyaline cartilage and no smooth muscle. It is smaller than primary bronchi.

Answer 222

Tall pseudostratified Columnar epithelia containing goblet cells. Contains smooth muscle which causes mucosa to fold and has seromucous glands to facilitate movement.

Answer 223

Ciliated columnar epithelia which transitions to cuboidal epithelia with clara cells. Clara cells secrete substances for pathogen defence like goblet cells, but it is not ciliated and not mucus. It is the progenitor for ciliated epithelia. Vagus nerve stimulates contraction of terminal bronchioles to constrict.

Answer 224

Sacs extending from the wall of the terminal bronchioles. Beginning of the respiratory airways. It contains cuboidal epithelia with clara cells.

Answer 225

Collect air from the respiratory bronchioles and disperse it throughout the alvoelar sacs

Answer 226

Collections of multiple alveoli

Answer 227

Macrophages, and pneumocytes (alveolar epithelia)

Answer 228

Simple squamous epithelia which cover most of the pulmonary surface. It fuses with pulmonary endothelium to form occluding junctions to control barrier for substance exchange.

Answer 229

Simple cuboidal epithelia which is most numerous. It secretes the pulmonary surfactant phosphatidylcholine that reduces surface pressure of alveoli to prevent bursting due to varying size

Answer 230

->low ph of the skin, gastric acid and vagina. This either denatures pathogen proteins or creates a hostile environment. ->Lysozymes- fungicidal and bactericidal properties present in sebum perspiration and urine, mucus. ->Mucus ->Defensins produced by epithelial cells. Alpha defensins are found in macrophages, neutrophils and intestinal paneth cells. Beta defensins create channels that disrupt the microbial membrane

Answer 231

Cough reflex and sneezing reflex

Answer 232

Irritation of nasal mucous membrane. Detected by olfactory receptor/trigeminal nerve terminals in nasal mucosa. Transmits impulse down trigeminal/olfactory nerve to the nucleus tractus solitaris in the medulla and the reticular formation in the brainstem. This acts on efferent fibres like the trigeminal and facial efferent to contort face, vagus and intercostal nerves for forced expiration and glossopharyngeal to elevate the pharynx and larynx. Activates tracheal muscle for constriction of trachea and internal intercostal muscles Initially glottis is closed but sneezing is with an open glottis to expel air through the mouth and the nose, containing the mucosal debris

Answer 233

Microbes present in the nasopharynx, vagina, GI tract, skin and mouth. They outcompete pathogens for attachment sites, nutrients, stimulate the immune system, or may perform direct antagonism like microbes in the vagina, secrete lactic acid, an antimicrobial peptide to inhibit pathogenic activity

Answer 234

The lung is located in the thoracic cavity, lateral to the mediastinum, and enclosed within a pleural cavity.

Answer 235

Visceral pleura

Answer 236

Hilum is the lung root where anatomical structures enter the lungs. It is the reflection of the parietal pleura off different directions in the thoracic cavity that joins with the visceral pleura to form the hilum.

Answer 237

Middle mediastinum. It runs inferolateral towards the left with 1/3 of the lying to the right and 2/3 lying to the left.

Answer 238

Artery: aortic arch-> brachiocephalic artery, left and right common carotid and left and right subclavian artery Veins: Brachiocephalic vein which gives rise to the right subclavian vein left subclavian vein which drains the left superior intercostal and the left and right supreme intercostal Thoracic duct, oesophagus, trachea

Answer 239

Lymph nodes, sternopericardial ligaments, Connective tissue, thymus (in infants) and Fibrofatty (adults) Artery: aortic arch-> brachiocephalic artery, left and right common carotid and left and right subclavian artery Veins: Brachiocephalic vein which gives rise to the right subclavian vein left subclavian vein which drains the left superior intercostal and the left and right supreme intercostal

Answer 240

Veins: Deep cardiac plexus of vagal nerve, phrenic nerve and recurrent laryngeal nerve cardiac branches

Answer 241

Thoracic duct, lymph nodes, oesophagus Veins: vagal nerve of oesophagi

Answer 242

At clavicle between ant ribs 1-2/post 2/3

Answer 243

Sternal line ant ribs 2-3/ post ribs 3-4

Answer 244

midclavicular line ant between 3rd and 4th rib

Answer 245

Mid axillary line between the 5th and 6th rib

Answer 246

Between Ant ribs 7 and 8/ post ribs 8 and 9

Answer 247

Costomediastinal recess and the costadiaphragmatic recess

Answer 248

Bronchus anterior to pulmonary artery. Bronchus superior to pulmonary artery

Answer 249

Thin walled chambers that establish cardiac pace at 40bpm.

Answer 250

Atria are thin walled chambers which establish cardiac pace at 60bpm and primarily fill the ventricles with blood

Answer 251

Atrioventricular valve between the L atria and L ventricle

Answer 252

Atrioventricular valve between R atria and R ventricle.

Answer 253

Thick-walled chambers which establish cardiac pace at 40bpm. Contains papillary muscles close to the valves which contract chordae tendinae to prevent backflow of blood.

Answer 254

Right ventricle contains a muscular column called the moderator band associated with papillary muscles to prevent overdistension of the ventricles with blood. Left ventricle has more prominent trabeculae carnae

Answer 255

Inner endocardium- simple endothelial cells with a subendocardial layer continuous with the myocardium Myocardium- thickest layer formed of cardiac myocytes with intercalated discs for electrical conduction, synchronised contraction and scaffolding Visceral epicardium- adipose, mesocardium and connective tissue layer to cushion the heart. Reflections of this form the parietal pericardium which

Answer 256

There are two heavy polypeptide chains which coil to form an alpha double helix 4 light polypeptide chains in total. Two light polypeptide chains on each myosin head. One is the regulatory light chain which regulates myosin head movement. There is an alkali light chain.

Answer 257

It increases Ca2+ conc for muscle contraction

Answer 258

The heads of myosin contain myosin ATPase for the hydrolysis of ATP during muscle contraction to break actin-myosin cross bridge The hinge region is the lever to transduce force generated by myosin head to the entire molecule The double helix tail connects to other myosin molecules and regulate motor activity

Answer 259

Two helical strands of spherical a-globular protein. Between the strands is the tube-shaped protein tropomyosin which regulates the interaction between actin and myosin by covering the myosin binding site on actin filament which shortens the muscle. It unmasks the binding site when it moves deeper into the actin grove Attached to tropomyosin at regular intervals is the troponin regulatory complex which is the Ca2+ binding site. It has 3 isoforms Troponin T- connects and binds troponin complex to tropmyosin Troponin C- Ca2+ binding site for contraction Troponin I: regulates and inhibits actin interaction with myosin

Answer 260

Troponin complex regulates muscle contraction and has 3 isoforms: Troponin T- connects and binds troponin complex to tropomyosin Troponin C- Ca2+ binding site for contraction Troponin I: regulates and inhibits actin interaction with myosin

Answer 261

Ca2+ binds to troponin C of the troponin regulatory complex. The troponin complex triggers a conformational change to undergo in tropomyosin which unmasks the region in actin globular protein where myosin head will bind Myosin head is in the cocked position prior to cross bridge formation. It releases ADP and Pi and binds to active site on actin globular protein. In a power stroke it pulls actin inward to cause muscle contraction. To release from actin and break the cross bridge, ATP binds to myosin and is hydrolysed by ATPase.

Answer 262

Lusitropy is rate of muscle relaxation following muscle contraction

Answer 263

Lusitropy uses two transporters: Na+/Ca2+ exchanger which exudates Ca2+ for the high influx EC Na+ SERCA (sarcoendoplasmic reticulum calcium ATPase) which regulates Ca2+ release from sarcoplasmic reticulum

Answer 264

The rate of impulse conduction through the AV node

Answer 265

Heart rate/ number of times the heart beats per minute (bpm)

Answer 266

Treat heart failure by increasing inotropy and chronotropy and prolong refractory period

Answer 267

It directly inhibits the Na+/K+ pump in cardiac myocytes. Accumulation of intracellular Na+ disrupts the Na+/Ca2+ exchanger. This causes accumulation of intracellular Na+ which disrupts Na+/Ca2+ exchanger which exudates Ca2+ for EC Na+. Ca2+ accumulates in the cell and binds to troponin C complex for heart muscle contraction.

Answer 268

Action potential triggers synchronised contraction of the atrial and ventricular myocytes via intercalated discs.

Answer 269

Induces secretion of adrenaline/noradrenaline for calcium-induced-calcium release

Answer 270

SAN generates action potentials, induced by the sympathetic release of noradrenaline. This binds to B1/B2 adrenergic g protein coupled receptor on the SAN. Activates adenyl cyclase -> cAMP formation-> protein kinase activation for phosphorylation-activation of Funny channels: allow influx of Na+ T-type calcium channels- low voltage activated Ca2+ channels which allow entry of Ca2+. The influx of Na+ and Ca2+ causes depolarisation of SAN which fires impulses that travel to the sarcolemma of cardiac myocytes.

Answer 271

Ca2+ is contained in Sarcoplasmic reticulum, regulated by the pump SERCA. SERCA may be inhibited by the enzyme phspholamban.

Answer 272

Ca2+ is contained in Sarcoplasmic reticulum, regulated by the pump SERCA. SERCA may be inhibited by the enzyme phospholamban.

Answer 273

Acetylcholine binds to muscarinic M2 receptors on the SAN node. These cause disassociation of alpha subunit bound to GTP. This associates with the G protein inwardly rectifier channel which allows influx of K+ into the SAN. This repolarises the membrane to become more negative and inactivates T-type calcium channels that become activate at 50mV. Blocked entry of Ca2+ prevents heart contraction. Leads to reduce dromotropy, inotropy, chronotropy, lusitropy.

Answer 274

Cardiac cycle is initiated by SAN impulses. It lasts 0.8s at 75bpm.

Answer 275

Mitral valve is open. AV is open. Passive ventricular filling and atria contract to eject final amount of blood..

Answer 276

EDV is amount of blood 135ml before the ventricles contract. Ventricular pressure builds for 50 m/s

Answer 277

EDV is 135ml. Mitral valves close so both SL valves are closed. Ventricular pressure builds for 50 m/s

Answer 278

Initial ventricular contraction causes left ventricular pressure to rise about the right ventricular pressure which closes the mitral valve.

Answer 279

R ventricle pressure of 25mmHg exceeds pulmonary artery of 10mmHg; pulmonary valve opens, and pulmonary artery fills with blood. Pressure builds in pulmonary artery to 25mmHg. Left side: L ventricle pressure of 120mmHg exceeds aorta of 80mmhg; aortic valve opens, and aorta fills with blood. Aortic pressure builds to 120mmHg. Blood is ejected through outflow tracks

Answer 280

Volume in blood at the end of systole which is 65ml

Answer 281

R ventricle pressure decreases as it relaxes L ventricle pressure decreases as it relaxes This causes blood to leak back into ventricles so the semilunar valve to close as blood leaks though

Answer 282

Mitral valve is open during passive ventricular diastole and filling and atrial contraction. It closes at the end diastolic volume. During isovolumic contraction, both semilunar valves are closed. During ventricular ejection, aortic valve opens. It closes during isovolumic relaxation when ventricles relax.

Answer 283

Cardiac output is the amount of blood pumped out of the heart per minute. Cardiac output= stroke volume x heart rate.

Answer 284

Initial increase in CO is due to both higher stroke volume and heart rate. However, there is a limitation to stroke volume so extreme increase in CO is due to heart rate increase.

Answer 285

Stroke volume is the volume of blood pumped out of the ventricles. It is calculated by Stroke volume= end diastolic volume - end systolic volume Stroke volume is proprotional to end diastolic volume.

Answer 286

Parasympathetic stimulation -> slower heart rate and inotropy -> Longer filling time, more venuous filling

Answer 287

Sympathetic stimulation which increases heart rate -> less venous filling- lower filling time Associated with higher stroke volume Higher stroke volume

Answer 288

Ejection fraction is how much end diastolic volume blood is pumped out of the ventricles. It is a measure of ventricular performance as a percentage: Stroke volume / end diastolic volume

Answer 289

Normal ejection fraction is between 55%-75%. Below this indicates issues with ventricular performance that is insufficient to supply the body with oxygenated blood. May cause hypoxia and is a indicator of heart disease of myopathy.

Answer 290

More Ca2+ decreases length of sarcomere Less Ca2+ increases sarcomere length

Answer 291

End systolic volume increases with afterload- peripheral vascular resistance in the heart against ventricular contraction. parasympathetic stimulation shorter filling time less venous return

Answer 292

Atrial reflex is when atrial pressure causes heart rate to increase.

Answer 293

Heart rate increases with more venous return, atrial reflex and sympathetic stimulation.

Answer 294

An action potential is the change in membrane potential that travels as an impulse across the membrane of a cell. In ventricular cells such as cardiac myocytes, it triggers release of Ca2+ intracellular vesicles to cause heart contraction.

Answer 295

Electrical coupling ensures heart electrical activity is synchronised with a unidirectional spread. The gap junctions allow adjacent cells to share a cytosol to facillitate ion movement down the electrochemical gradient.

Answer 296

Equlibrium potential is the membrane potential diference in exact equilibrium with an ion conc gradient. It has the symbol Ek.

Answer 297

Equilibrium potential is the membrane potential difference in exact equilibrium with an ion conc gradient. It has the symbol Ek.

Answer 298

Phase 4: Baseline at -70 to -90mv driven by opening of rectifier K+channels and some influx of Na+ Brings membrane potential closer to the negative K+ equilibrium potential (Ek). There is some influx of Na+. Rectifier channels are channels rectifier that passes current into the cell more easily than outwards by allowing K+ to move more easily into the cell.) Phase 0-Depolarisation/Rapid upstroke driven by opening of Na+ channels Depolarisation occurs. This triggers voltage gated Na+ channels to open. Influx of Na+ depolarises the cell and triggers opening of more Na+ channels and influx of Na+ in a positive feedback cycle. This increases membrane potential. Opened Na+ channels during depolarisation inactivate and close almost instantly after opening due to negative membrane potential. The current produced is toward the electrode. Phase 1- Notch/ Early rapid repolarisation/depolarisation Na+ channels inactivate. Transient (temporarily) open K+ channels repolarise the cell and K+ is exudated from the cell to establish a new membrane potential for the plateau phase. More K+ current repolarise moreand exude K+ to estbalish lower membrane potential during the plateau. Less K+ repolarise less and exudate less K+ which means there is a higher membrane potential during the plateu Phase 2- Plateau caused by balance between Ca2+ entry and K+ exudation. Ca2+ channels in T-tubules are close to sarcoplasmic reticulum and move through a channel inside ryanodine receptors on sarcoplasmic reticulum membrane to bind to ryandoine receptors. This triggers Voltage gated Ca2+ channels to open and influx of CA2+ that binds to ryanodine receptors on sarcoplasmic reticulum. This triggers further release of Ca2+ which binds to troponin C that initates movement of tropomyosin away from mysoin binding site to cause cell contraction. Ca2+ enters the cell. There is a balance between entry of C2+ and exudation of K+ Phase 3- Final Repolarisation driven by Ca+ activation Ca2+ channels close and there is delayed K+ effluxs to repolarise the cell back towards a negative membrane potential via K+ exudation. Na+ channels recover as this occurs.

Answer 299

Atrial pathways have a speed of 0.3m/s AV node is 0.05m/s Purkinje fibres have veolcity of 4.m/s Ventircles have volcity of 1 m/s

Answer 300

R atria 0.07s-> left atria 0.09s Reaches AV node at 0.03 but travels down at 0.16s due to delay Ventircles 0.19-0.22s

Answer 301

Impulses are generated by pacemaker cells in the SAN of the upper right atria that stimulate atrial contraction. This impulse travels down the atrial septum to the AVN node . -> AV Bundle of His -> Bundle branches --> Purkinje fibres. At the Purkinje fibres, it activates the myocardium of the left and right ventircles to cause ventricular contraction from the apex.

Answer 302

SAN is located in the right atria and contains pacemaker cells. Pacemaker cells are located mainly in the SAN, which is in the upper wall of the right atria. They have natural automaticity to generate own AP spontaneously because of their unstable membrane potential. The rate of depolarisation of pacemaker cells determines heart rhythm. Usually there is a slow depolarisation to reach the threshold potential to establish a slow heart rhythm. There is no plateau phase with equal Ca2+ and K+ influx.

Answer 303

Phase 4- Resting potential/ slow depolarisaton This occurs between the end of an AP and the start of the new. The resting is transient as there is an immediate slow depolarisation of pacemaker cells by hyperpolarisation activated cyclic nucleotide gated channels (HCN) These channels are permeable to both K+ and Na+. It allows entery of Na+ entry into the cells when memrbane potential is lower than -50mv to increase it. Phase 0- Spontaneous depolarisation Depolarisaton raises membrane pontential to -40mv, causing voltage gated Ca2+ chnnaels to open and influx of Ca2+ to create rapid upstroke. HCN inactivates and at the peak of the upstroke, CA2+ inactivates and K+ opens Phase 3- Exudation of K+ by open K+ channels which repolarises the membrane to cause downstroke. No plateau stake because Ca2+ channel opening is not sustained. When downstroke reaches -50mv, HCN is reactivated

Answer 304

Noradrenaline acts on B1 adrenoreceptors in the SAN and AVN of the cardiac myocytes.. Afferent vagal fibres transmit this to the Cardioaccelaratory centre in the medulla. This innervates sympathetic fibres in the sympathetic chain ganglioon of the spinal cord. The ganglion is a collection of neuronal cell bodies with sympathetic chains that have a cardiac fibre to accelerate inotropy and chronotropy in the SAN.

Answer 305

Acetlycholine acts on M2 muscarinic receptors in the SAN, This travels via afferent vagal nerve to the cardioinhibiory centre in the medulla. It responds by innervating efferent parasympathetic fibres to decrease chronotropy and inotropy.

Answer 306

the parasympathetic system dominates to produce rrsting rate of 60bpm. Initial increase in heat rate is caused by reductionin parasympathetic flow. Further increase is caused by increase in sympathetic outflow.

Answer 307

Adrenaline is synthesised in the chromaffin cells in the medulla of the adrenal gland. It increases chronotropy and inotropy and acts on B1 adrenergic receptors in the heart. It is competitively inhibited by Beta blockers like adrenolol.

Answer 308

Adrenaline is synthesised in the chromaffin cells in the medulla of the adrenal gland. It increases chronotropy and inotropy and acts on B1 adrenergic receptors in the heart. It is competitively inhibited by Beta blockers like adrenolol.

Answer 309

Baseline- SAN activity and atrial activation at 80-100 AP per min at rest P wave- atrial depolarisation caused by stimuli from fibres spreading across atrial surfaces to reach AV node. This is towards the chest lead that causes upward inflection PR interval- Time taken for excitation to spread from SA to the ventricles Delay at the AV node to cause atrial contraction. Then, there is conduction of AV node and AV bundle of His QRS complex- impulse spreads through ventricles to cause ventricular contraction and begin atrial contraction Q wave initial ventricular depolarisation caused by stimuli impulse spreading along interventricular septum-> AV bundle -> Bundle of Purkinje -> moderator band -> papillary muscles in R ventricular from the Bundle of His. This is away from the chest electrode R wave ventricular depolarisation towards Lead II which creates upwards positive wave S wave depolarisation spreads from ventricular apex to go superiorly away from lead II to generate a small downward inflection T wave ventricular repolarisation which creates small, curved inflection

Answer 310

Normal ECG PR interval is 0.12-0.20 . Normal QRS interval is 0.12s

Answer 311

ECG is used to trace electrical activity of impulses in cardiac tissue through various angles. We can use it to identify and locate pathology. Commonly, ECG is measured using 3 leads or 12 leads.

Answer 312

An ECG lead is a graphical description/image of electrical activity in the heart, generated by analysing the electrical currents produced by electrodes

Answer 313

V1- 4th intercostal space on right sternal margin- Septal view V2-4th intercostal space on left sternal margin V3- midway betwen V2 and V4 V4- mid clavicular line V5 anterior axillary line V6- mid axillary line

Answer 314

avL lead is on the left arm to provide a superolateral view of left heart such as the left ventricle outflow tract. Variable polarity of the p wave.

Answer 315

aVR is on the right arm to provide a lead with a superlateral view of the heart, such as the right ventricle outflow tract and basal interventricular septum. P wave is always negative.

Answer 316

Lead I is an exploring electrode which records the electrical difference between the right and left. It produces a high lateral view of the heart. Current towards the avR produces negative deflection, current towards the avL produces a positive upward.

Answer 317

avF is on the left leg to produce lead of the inferior view of the heart such as the left ventricle. P wave is always negative.

Answer 318

Measure of ventricular performance- healthy is 5L/min Heart rate x stroke volume

Answer 319

Flow is synonymous with cardiac output. Flow is the volume of fluid passing in a given time period. (Cm3/s)

Answer 320

Velocity is the rate of particle flow.

Answer 321

Radius is half the diameter of the vessel. We can use radius to determine the area of a vessel. pi x r2

Answer 322

Flow(cm3/s)= cross sectional area (cm) x velocity (cm/s) Flow= pressure/resistance

Answer 323

Velocity of blood flow is highest in the centre of each section in the vessel. Velocity decreases more superiorly/inferiorly closer to the vessel walls due to the resistance.

Answer 324

Bruit is the audible turbulent flow of blood within arteries clogged with atherosclerotic plaque.

Answer 325

Resistance is the opposition to flow.

Answer 326

Difference between mean arterial pressure - central venous pressure?

Answer 327

Flow increases non-linearly with higher pressure. They have a non-linear relationship due to this equation. Pressure is= cardiac output x resistance

Answer 328

Pouiselle's Law? Flow= Change in pressure x radius (to the power of 4)/ 8 x viscosity x length

Answer 329

Radius: Increases flow by a factor of 4 Viscosity- Decreases flow. In hypoxic conditions, more RBC produced called polycythaemia to carry more O2 which will decrease flow. Length- longer vessel will have a greater resistance -> higher BP-> low flow/ high velocity Shorter vessel will have less resistance-> low BP-> higher flow/ low velocity

Answer 330

Resistance decreases flow however resistance increaases blood pressure which increases flow.

Answer 331

Average HR is average 70bpm

Answer 332

Vascular tone controls local flow. This is affected by metabolic products.

Answer 333

-acidity such as H+ and hypercapnia (CO2) is harmful so increased blood flow removes it -> Nitric oxidate. Triggers vasodilation in response to blood vessel damage to increase blood flow of inflammatory mediators ->K+ is a vasodilator for repolarisation of the membrane

Answer 334

hypoxia- direct blood to important organs Alkaline/ high Ph above 7.7 HCO3- increases vasoconstriction

Answer 335

Nerve endings called baroreceptors respond to high BP that causes stretch in the myocardium via stretch-triggered opening of voltage gated Na+ channels which transmit impulses to the medulla.

Answer 336

->Cardioacceleratory centre ->Cardioinhibitory centre Vasomotor centre has two divisions which acts on the tunica media of the smooth muscle C1: stimulates vasoconstrciton A1: stimulates vasodilation

Answer 337

Aortic sinus-> innervates vagus nerve Carotid sinus-> innervates glossopharyngeal nerve

Answer 338

Baroreceptors increase firing of the afferent sympathetic vagus/glossopharyngeal fibres to the vasomotor centre. Cardioinhibitory centre reduces sympathetic innervation of adrenaline and noradrenaline release to act on B1 and B2 receptors. It stimulates the A1 segment of the vasomotor to act on the tunica media of blood vessels to decrease afterload. It prevents renin release for Na+ and Cl- reabsorption for water retention, therefore more urinary loss. Increase vasodilation Decreases vascular resistance, cardiac output, stroke volume (inotropy)

Answer 339

Little firing by baroreceptors down the afferent fibres to the medulla oblaganta. This triggers the cardioacceleratory centre to inhibit the cardioinhibitory centre and increases release of adrenaline and noradrenaline to act on B1 and B2 receptors to increase SAN and AVN depolarisation. It also stimulates the vasomotor motor C1 segment to act on the systemic blood vessels of the tunica media and cause vasoconstriction. Renin also acts on B1 receptors in the kidney to cause release of angiotensin for vasoconstriction. This causes vasoconstriction, cardiac output, and angiotensin promotes release of aldosterone and ADH which increases Na+ and CL- reabsorption for water retention to increase blood volume and therefore blood pressure.

Answer 340

It is three components: ->vascular component of the afferent and efferent arterioles and the extraglomerular mesangial cells. Extraglomerular mesangial cells are pericytes present in the arterioles outside glomerulus that regulate blood flow. ->A plaque of epithelial tissue called macula densa in the DCT which detect Na+ conc.

Answer 341

Cells present in the vasculature that regulate blood flow through vascular tone

Answer 342

Macula Densa detects low Na+ and Cl- and in response releases paracrine signals to release renin. It is released into the bloodstream and binds to B1 receptors of the kidneys and cleaves angiotensinogen-> angiotensin I. Angiotensin I travels in the bloodstream and is a potent vasoconstrictor by acting on the tunica media of the blood vessels. It reaches the lungs where ACE and causes angiotensin I-> Angiotensin II. Angiotensin II moves through the heart aorta throughout the body to act on the adrenal medulla. It stimulates release of aldosterone which binds to renal receptors in the DCT. DCT has principal cells which are stimulated by aldosterone to increase expression of Na+ channels and K+ channels present in the luminal side. This allows influx of Na+ into the principal cells which establishes a gradient for Na+/K+ ATPase to move Na+ into the bloodstream and K+ into the lumen of the cell for excretion into the urine. Hydrostatic pressure decreases. ADH binds to G protein coupled receptors and alters expression of insertion of aquaporin receptors for water absorption. This increases blood volume, BP and heart rate.

Answer 343

Detects Na+/Cl- levels in the body and releases renin in response.

Answer 344

Increases Na+/Cl- reabsorption by binding to principal cells in the DCT. It causes insertion of Na+ and K+ channels in the laminal surface which establishes a gradient via Na+/K+ ATPase for Na+ out into the bloodstream and K+ into the lumen. This increases osmolality which reduces hydrostatic pressure.

Answer 345

ADH binds to G protein coupled receptors and alters expression of insertion of aquaporin receptors for water absorption.

Answer 346

Natriuretic peptide system.

Answer 347

Renin-angiotensin-aldosterone system.

Answer 348

Natriuretic peptide system is the secretion of peptide hormones by the cardiac myocytes when the myocardium is stretched. There are two types of natriuretic peptide cells in the heart: ->Atrial natriuretic peptide (ANP) that respond to atrial stretch. In the inactive state, it is pro-ANP and when there is atrial stretch, releases the CORIN protein to transfer the N-terminal and become ANP. ->B-type natriuretic (BNP) peptide cells that respond to ventricular stretch. In the inactive state, it is pro-BNP which releases FURIN enzyme to become active BNP. Both ANP and BNP cause the release of the natriuretic peptide cGMP/cyclic guanosine monophosphate. cGMP causes vasodilation and is a diuretic which increases urinary secretion of water and Na+ and CL- via increasing GFR rate. Therefore, cGMP inhibits aldosterone secretion and renin. . cGMP inhibits aldosterone and ADH. Aldosterone causes fibrosis of myocardium; natriuretic peptides cause antifibrosis which is helpful for patients with heart failure that have difficulty contracting.

Answer 349

cGMP causes vasodilation and is a diuretic which increases urinary secretion of water and Na+ and CL- via increasing GFR rate. Therefore, cGMP inhibits aldosterone secretion and renin. . cGMP inhibits aldosterone and ADH. Aldosterone causes fibrosis of myocardium; natriuretic peptides cause antifibrosis which is helpful for patients with heart failure that have difficulty contracting.

Answer 350

Beta blockers are antagonists for beta receptors activated by the sympathetic system. Therefore, it reduces vasoconstriction and lowers BP and HR. It ends i the suffix -lol eg atenolol. It is not widely used because of its inability to lower central arterial pressure in the heart, brain and kidneys.

Answer 351

Pericardial effusion is when extra fluid gathers in the space between the pericardial sac and the heart which generates pressure ON the heart that limits its ablity to contract.

Answer 352

The coronary sulcus is the atrioventricular groove.

Answer 353

Right coronary artery arises from the right cusp of the aortic sinus. Right marginal artery- supplies right ventricle and heart septum Right posterior interventricular artery- supplies the posteiror 1/3 of the interventricular septum and inferior part of the heart The right PIV artery may anastomose with the left anterior descending artery in some people

Answer 354

Left coronary artery arises from the space between the left cusp of the aortic sinus. Circumflex artery- supplies the left atria and posterior-lateral ventricle. Left marginal artery supplies the apex of the left ventricle Left anterior descending artery- supplies Left atrium and ventricle, part of the right ventricle anterior 2/3 of the interventricular septum, atrioventricular bundle and SAN in (40%) -> diagonal branch supplies anterior surface of left ventricle

Answer 355

The funnel leading to the pulmonary artery

Answer 356

Dominance in the heart is determined by the posterior descending artery. Most people are right dominant with a right posterior interventricular artery. Left dominance is less common but where the left circumflex artery will give a posterior descending artery. Codominance is when both the right coronary artery and left circumflex artery supply the posterior interventricular artery.

Answer 357

Sinoatrial nodal artery- supplies SAN and originates either directly from right coronary artery or left circumflex

Answer 358

Atrioventricular nodal artery- supplies AVN- in 80-90% of people it is the right coronary artery and less commonly it is the left circumflex

Answer 359

Briefly has zero blood flow.

Answer 360

Atherosclerosis is when there is build-up of fat in the coronary arteries which reduces blood flow. This can lead to a blood clot forming becomes stuck in this plaque and forms a thrombosis.

Answer 361

Cardiac muscle is shorter, branched via intercalated discs and is uninucleate or

Answer 362

Both are striated.

Answer 363

During contraction, I band and H zone shorten significantly. There is no change in A band

Answer 364

Pacemaker cells are cells that depolarise to generate electrical impulses. They are present in the SAN, AVN, Bundle of His and purkinje which form the electrical condcution system in the heart to induce contraction

Answer 365

Bachmann's bundle is the interatrial pathway for conduction from the SAN.

Answer 366

Phase 0 is Pre-potential is slow depolarisation caused by slow Na+ influx. Phase 1- Ca2+ inflx for depolarisation Phase 3 exudation of K+n for repolarisation

Answer 367

Cardiac cells have a longer duration of action potentials than neurons. Neurons take 1ms; cardiac myocytes is 2-5ms.

Answer 368

Arteries carry blood away from the heart Veins carry blood to the heart.

Answer 369

A capillary bed is an interconnecting network of capillaries which is the main site of exchange of substances occurs between the capillary blood stream and tissue fluid.

Answer 370

Capillaries have a larger cross-sectional area due to their branching and larger radius which decreases flow. This is beneficial for the exchange of substances in perfusion.

Answer 371

Tunica intima is the innermost layer formed of endothelial cells. It has a subendothelial layer below formed of elastic fibres and connective tissue such as fibroblasts and collagen. This can be the site to cause thrombogenesis. The internal elastic lamina is the elastic fibre sheet which separates the tunica intima from the tunica media.

Answer 372

Ehlers Danlos syndrome will affect the internal elastic lamina of the tunica intima.

Answer 373

Damage to the endothelial lining and exposure of blood to the collagenous lining in the tunica intima leads to thrombogenesis

Answer 374

Tunica media is the middle layer of mainly elastic fibres, connective tissue, ground substance and smooth muscle. It is sympathetically innervated to influence hypertension or hypotension of the blood vasodilation and constriction.External elastic lamina is a sheet which separates the tunica media and tunica externa.

Answer 375

Issues with sympathetic innervation can lead to neurogenic shock.

Answer 376

The tunica externa/adventitia is the outer sheath of the vessels consisting of macrophages, collagen and elastic fibres, nerva vasorum and vasa vasorum. It supports and holds the vessel in place

Answer 377

There are two types of vasa vasorum: vasa vasorum internae-> directly from the main branch vasa vasorum externae-> branch of the main artery which is within the main vessel wall

Answer 378

Veins have a wider lumen than arteries, despite having the same diameter. This means the vasa vasorum in the tunica adventitia is closer and able to supply more nutrients. This explains why arterial diseases are more common

Answer 379

These are small arteries in the outer tunica adventitia layer that remove metabolic waste and supply nutrients. The tunica intima and tunica media layer contain connective tissue and other cells which require nutrient supply and waste removal. This role is supplied by the vasa vasorum.

Answer 380

There are two different types of arteries: Elastic conducting arteries and muscular arteries?

Answer 381

Elastic conducting arteries- largest artery with a diameter of 1.5cm and length of 1cm. They are directly branching from the outflow tract of the aorta and the pulmonary artery. Therefore, they have a lot of elastic fibre and collagen in their tunica media layer to expand and absorb systolic pressure. It also recoils to release it and maintain a constant pressure gradient with the constant pumping of the heart.

Answer 382

It has a diameter of 0.6cm/6mm and receives blood from elastic conducting arteries to suppply to tissues and organs. They have a lot of smooth muscle in their tunica media layer to regulate blood flow to the supplied tissue/organs via vasodilation and vasoconstriction. Examples of this includes the brachial artery and the femoral.

Answer 383

Arterioles connect arteries to the capillary bed and have a wider lumen which greatly reduces blood pressure in order to direct flow. They have the same layers as arteries however, they have much thinner layers. Both arteries and arterioles have the thickest layers to withstand pressure

Answer 384

Metarterioles are branches from the terminal arteriole which directly supply blood from arterioles to capillaries. They have the same layers however, smooth muscle in the tunica media layer is arranged in rings called sphincter muscles to regulate blood flow into the capillary bed to decrease pressure.

Answer 385

Rings of circular smooth muscle called the pre-capillary sphincters surround the opening of the metarteriole to the capillary bed. Pre-capillary sphincters regulate blood flow in and out of the capillaries by opening and closing.

Answer 386

When surrounding tissue requires O2, pre-capillary sphincters open to allow blood to enter the capillary bed for exchange. When capillary beds in other parts of the body require gas exchange such as the muscles during exercise, the pre-capillary sphincters will close. Blood supply from the metarterioles will flow directly through thoroughfare channels to the venules. This is known as vascular shunt- the redirection of blood flow.

Answer 387

Channel which directly connects the metarterioles to the postcapillary venules

Answer 388

Vasomotion is blood flow in the capillaries; this is generally irregular and pulsating. Vasomotion is regulated in response to levels of O2 vs CO2, H+ and lactic acid. When O2 levels are low, and CO2, Lactic acid and H+ levels are high, there will be a greater rate of vasomotion for exchange to occur

Answer 389

Pinocytosis is cell drinking-uptake fluid containing proteins, lipids and white blood cells for pathogen defence via vesicle budding

Answer 390

Capillaries contain invaginations in the endothelial layer called caveolae which they can uptake substanes through via transcytosis. Capillaries have only a tunica intima layer for a short diffusion path.

Answer 391

Continuous, fenestrated and sinusoid

Answer 392

It has an intact basement membrane with tight junctions in the endothelial layers. Depending on location, the tight junctions may have intercellular clefts/gaps that allow small molecules to pass through. Continuous capillaries in the brain do not have any intercellular gaps; they highly restrict exchange via astrocyte extensions of end feet Outside the brain, continuous capillaries have intercellular celfts for movement of water, glucose and other hydrophobic molecules for endocytosis and exocytosis.

Respiratory Sytem Flashcards

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