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Cardiorespiratory (MEDI301) > Weeks 1-2 > Flashcards

Weeks 1-2 Flashcards

(70 cards)

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1
Q

Normal PO2 in arterial blood

A

~95mmHg

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2
Q

Normal PO2 in venous blood

A

40mmHg

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3
Q

Normal PCO2 in arterial blood

A

~40mmHg

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4
Q

Normal PCO2 in venous blood

A

46mmHg

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5
Q

Normal arterial blood pH

A

7.38-7.42

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6
Q

Normal venous blood pH

A

7.37

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7
Q

What is the result on breathing of a lesion between the medulla and pons?

A

Breathing is erratic, but spontaneous

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8
Q

What are the 4 centres in the brainstem controlling breathing?

A

Pons: pneumotaxic centre and apneustic centre
Medulla: dorsal respiratory group and ventral respiratory group

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9
Q

What is the purpose the inspiratory ramp signal?

A

To ensure gradual inspiration, which is then turned off to allow passive expiration

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10
Q

What is the role of the dorsal group of the medulla?

A

Inspiratory centre, creating the basic rhythm

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11
Q

What are the inputs to the dorsal group of the medulla?

A

Peripheral chemoreceptors
Baroreceptors
Stretch receptors

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12
Q

What nucleus is part of the dorsal group of the medulla?

A

NTS

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13
Q

The NTS is part of which respiratory group?

A

Dorsal group of the medulla

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14
Q

What is the role of the ventral group of the medulla?

A

Forced breathing, creating large tidal volumes

E.g. during exercise, result of pathology

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15
Q

Which nuclei are part of the ventral group of the medulla?

A

Nucleus ambiguus

Nucleus retro-ambiguus

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16
Q

The NA and NRA are part of which respiratory group?

A

Ventral group of the medulla

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17
Q

What is the role of the pneumotaxis centre of the pons?

A

Turn the ramp signals off

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18
Q

Which nucleus is part of the pneumotaxis centre of the pons?

A

Nucleus parabrachialis

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19
Q

What is the role of the apneustic centre of the pons?

A

Decreases the depth of inspiration by acting on inspiratory centre

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20
Q

Along which nerves do impulses from the peripheral chemoreceptors and baroreceptors travel to the respiratory centre?

A

Glossopharyngeal

Vagus

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21
Q

What is the efferent pathway from the respiratory centre?

A

Descending in anterior part of lateral column of spinal cord

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22
Q

What is the Hering-Breuer reflex?

A

Limits lung inflation.
Inspiratory centre -> phrenic nerve -> diaphragm contracts -> stretch receptor in lung -> vagus nerve.
Vagus nerve inhibits the inspiratory centre

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23
Q

What are J receptors of the lung?

A

Juxtacapillary receptors present in the wall of the alveoli, close in contact with pulmonary capillaries.

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24
Q

What conditions can stimulate J receptors?

A

Pulmonary edema
Pulmonary congestion
Pneumonia
Exposure to chemicals

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25
What response is produced by stimulation of J receptors?
Reflex: apnoea
26
What is apnoea?
Temporary cessation of breathing
27
J receptors have an effect on...
The respiratory centre
28
What factors affect the respiratory centre?
Impulses from higher centres, stretch receptors, J receptors, irritant receptors, proprioceptors, thermoreceptors and pain receptors. Cough, sneeze and deglutition reflexes
29
What is hypercapnea?
Increased CO2 in blood
30
Where are the central chemoreceptors situated?
In the deep parts of the medulla. | Close contact with blood and CSF
31
What is the action of the central chemoreceptors?
Detecting pH and PCO2
32
What are the carotid bodies specifically sensitive to?
pO2, pCO2 and pH
33
Where are the carotid body afferents?
Glossopharyngeal nerve
34
What are the aortic bodies specifically sensitive to?
pO2 and pCO2
35
Where are the aortic body afferents?
Vagus nerve
36
What are the 2 COPD phenotypes/stereotypes?
Pink puffer - thin | Blue bloater - fat
37
Explain the pink puffer presentation of COPD
Hyperventilates to blow off CO2. | Skinny because breathing is hard work
38
Explain the blue bloater presentation of COPD
Has lost sensitivity to CO2, so breathing is driven by hypoxemia. Don't give oxygen!
39
What are Cheyne Stokes?
An abnormal cycle of breathing, the result of a failure of control of respiration.
40
What is bronchial thermoplasty?
Radiofrequency energy is delivered by bronchoscope, and causes atrophy of airway smooth muscle. Helps with conditions like extremely severe asthma
41
What is obstructive sleep apnoea?
The soft palate collapses during sleep, and wakes the person up to restart their breathing.
42
What is central sleep apnoea, and what can cause it?
When there is no signal from the brain to breathe. | Tumour, stroke, cardiac failure
43
What is the Frank-Starling mechanism of the heart?
An increase in the return of blood from the venous system causes a greater cardiac output.
44
Function of norepinephrine
Vasoconstrictor
45
Where is the vasoconstrictor area in the brain?
Anterolateral portions of the upper medulla
46
Where is the vasodilator area in the brain?
Anterolateral portions of the lower medulla
47
Where is the sensory area in the brain, regarding sympathetic and parasympathetic innervation?
NTS - posterolateral portions of medulla and lower pons
48
How is a rapid rise in blood pressure invoked?
Constriction of arterioles (increase peripheral resistance) Constriction of veins (Frank-Starling mechanism) Direct stimulation of the heart (increasing heart rate and heart muscle fibre contractility)
49
What is vasovagal syncope?
A large vagal cardioinhibitory response to emotional stress, physical stress, sometimes in response to blood flow changes during urination, bowel movement, coughing, swallowing. Heart rate is reduced, vasodilation occurs -> blood pressure drops.
50
What is the Valsalva manoeuvre?
Moderately forceful exhalation against a closed airway
51
What is orthostatic hypotension?
AKA postural hypotension | When a person's blood pressure suddenly drops after standing up
52
What is the Bainbridge reflex?
An atrial reflex that regulates heart rate. | Increased venous return -> increased atrial pressure -> increased cardiac contractility -> increased heart rate
53
What is the volume reflex?
An atrial reflex that activates the kidneys. Stretched atria -> decreased kidney afferent arteriolar resistance -> decreased ADH -> decreased reabsorption of water from tubules -> increased fluid loss -> decreased blood volume
54
Where is ADH produced?
Hypothalamus (brain) -> pituitary gland -> bloodstream
55
What stimulates ADH production?
Hypovolemia Hypotension Angiotensin II increase
56
What is ANP (atrial natriuetic peptide) and what does it do?
Released by atrial cells in response to distension of atrial myocytes. Causes vasolidation, promotes loss of salt and water through kidneys, reducing blood volume
57
What is the Cushing reflex?
A reflex to restore blood flow to the brain, when occluded by increased intracranial pressure
58
What is transmural pressure (regarding arteries)?
The difference between pressure outside an artery and that inside.
59
What is the significance of the baroreflex, chemoreceptor and Cushing reflexes being closed-circuit feedback systems?
They sense the thing they control, so are prone to oscillations
60
What is the function of the kidneys?
Regulation of blood ionic composition Regulation of blood volume Regulation of blood pressure (volume, secreting renin) Regulation of blood pH (excreting H+, conserving bicarbonate ions) Regulate RBC production (release erythropoietin) Synthesise vitamin D Filter waste produces in blood
61
What is the renin-angiotensin system?
Drop in blood flow -> renin secreted -> angiotensin II (vasoconstrictor) -> increased pressure Angiotensin II -> aldosterone secretion -> Na+ and water reabsorption -> increased blood volume -> increased blood pressure
62
Examples of drugs for hypertension therapy
``` Diuretics Beta-blockers ACE inhibitors Angiotensin antagonists Ca+ channel blockers Alpha-blockers ```
63
What is the definition of resistant hypertension
Treatment with 3+ antihypertensive drugs including a diuretic Brachial blood pressure >140/90mmHg Secondary causes of hypertension have been ruled out
64
How do diuretics work to reduce hypertension?
Increased water excretion -> reduced blood volume -> reduced blood pressure
65
How do beta-blockers work to reduce hypertension?
Slow heart-rate -> reduce cardiac output -> reduce blood pressure
66
How do ACE inhibitors reduce hypertension?
Vasodilate peripheral arteries -> reduced resistance -> reduced blood pressure
67
How do angiotensin antagonists reduce hypertension?
Vasodilate peripheral arteries
68
How do Ca+ channel blockers reduce hypertension?
Prevent Ca+ enter smooth muscle cells of peripheral arteries -> reduced vessel stiffness -> reduced blood pressure
69
How do alpha-blockers reduce hypertension?
Reduce sympathetic nerve signal to arteries -> vasodilation -> reduced blood pressure
70
Does atherosclerosis reduce the windkessel effect?
No

Cardiorespiratory (MEDI301) (3 decks)

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