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Bioscience II > Quiz 2 > Flashcards

Quiz 2 Flashcards

1
Q

Major centers of respiratory control in the brainstem

A

pneumotaxic
apneustic
Dorsal Respiratory Group (DRG)
Ventral Respiratory Group

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2
Q

Pneumotaxic center

A

provides inhibition to the dorsal respiratory group

acts as the “offswitch” for DRG

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3
Q

apneustic cneter

A

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

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4
Q

Ventral respiratory group

A

active during FORCED respiratory efforts

-examples: coughing and sneezing

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5
Q

Dorsal Respiratory Group

A

group of active neurons during inSpiration

makes connection with the phreneric and intercostal nerves

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6
Q

Stretch receptors (Hering-Breur reflex)

A

lung receptor that sends inhibitory signals to the DRG

keeps you from taking too large of a breath

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7
Q

Irritant receptors

A

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

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8
Q

Juxtacapiallary receptors (J receptors)

A

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

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9
Q

How is breathing coordinated?

A

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

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10
Q

Peripheral chemoreceptors

A

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

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11
Q

What is the negative feedback loop for peripheral chemoreceptors?

A

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

increased PO2 causes decreased rate/depth of ventilation

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12
Q

central chemoreceptors

A

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

breathe more rapidly to get rid of CO2

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13
Q

Is CO2 lipid soluble?

A

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

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14
Q

What happens with obstructive lung disease?

A

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

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15
Q

relationship between ventilation and arterial effects

A

greater ventilation when there is less arterial PO2

As PCO2 increases, ventilation INCREASES (linear)

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

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16
Q

Effect of progressively increasing exercise intensity

A

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

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

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

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

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17
Q

Cheyne-Stokes breathing

A

seen in severe heart failure

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

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18
Q

Apneustic breathing

A

pattern of deep sighs

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

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19
Q

obstructive sleep apnea

A

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

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20
Q

Restrictive disease

A

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

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21
Q

Obstructive disease

A

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

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22
Q

Obstructive Flow-Volume Loop

A

limitation of FLOW so that the peak flow rate drops rapidly

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23
Q

Restrictive Flow-Volume Loop

A

shape of the loop is the same but much smaller

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24
Q

Obstructive diseases

A

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

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25
Q

symptoms of obstructive diseases

A

chronic cough
coughing out of mucus
wheexing
dyspnea with exertion

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26
Q

Pathology in obstructive disease

A

inflammation of lining of smaller airways
increased mucus production or impaired clearance
impaired cilia in conducting zone leads to less filtration
mucosal thickening
bronchial smooth muscle spasm leads to further narrowing of the airways and increased resistance
seen in people with asthma
tissue destruction; the elastic tissue is lost which decreases SA and gas exchange
seen in people with empheysema

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27
Q

effects on lung function with obstructive

A

loss of elastic recoil; overly compliant airways that can inflate but can’t deflate
this causes hyperinflation(air trapping) and “barrel chest”
tendency for airway collapse from dynamic compression
loss of alveolar surface area
poor oxygen delivery and CO2 clearance(hypercapnia)
creates vasoconstriction with poor ventilation
resulting in right sided heart failure=cor pulmonale

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28
Q

chronic bronchitis

A

inflammation of bronchi
caused by irritants such as smoking
sputum-producing cough
ciliary dysfunction with increased mucous glands

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29
Q

Emphysema

A

destruction of alveoli
results in poor gas exchange
feels like taking sips of air on full inhaled lungs
expends a lot of energy to breath
they have a mechanically inefficient diaphragm that can’t generate enough force for breathing

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30
Q

Emphysema treatment

A 
smoking cessation
medications-      
       inhaled corticosteroids, anticholinergics, B2 agonsits
oxygen therapy
surgery
pulmonary rehab- helps manage symptoms
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31
Q

Asthma

A

reversible obstruction
excess mucus, edema and inappropriate activation of bronchiole SM creating a narrowed airway
worse with environmental factors
-dust, pollen, cold air

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32
Q

three kinds of COPD

A

emphysema
chronic bronchitits
airway hyperactivity (constricts and further creates obstruction)

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33
Q

Corticosteroids

A

useful in asthma
powerful anti-inflammatories
flovent

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34
Q

sympathomimetics

A

epinephrine adn ephedrine are non-selective
peripheral vasoconstriction and tachycardia in addition to bronchodilation
selective B2 agonists are ideal
Albuterol

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35
Q

parasympatholytics

A

anticholinergics
usually used in COPD; emphysema
Spiriva

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36
Q

bronchiectasis

A

result of infection

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37
Q

cystic fibrosis

A 
occurs int he pancreas
lung consequences
occurs in much younger- teens to 20s
OBSTRUCTIVE lung disorder
inherited
autosomal recessive
pulmonary secretions are thick
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38
Q

Restrictive Lung Dysfunction

A

VOLUME limitation
disorder of compliance; issues with inflating
all lung volumes and capacities are decreased
harder to breath

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39
Q

Causes of RLD

A 
pregnancy- difficulty inspiring with limited diaphargm movement
stroke- causes neuromuscular weakness
obesity
arthritis- limited lung volume capacity
immunologic
nutritional and metabolic issues
trauma
connective tissues issues
cardiovascular/pulmonary issues
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40
Q

long bone structure

A

periosteum —> endosteum —> bone marrow

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41
Q

diaphysis

A

the shaft of the long bone

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42
Q

yellow bone marrow

A

contains fat

no RBC production

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43
Q

epiphysis

A

end of the bones

made up of spongy bone (callcaneous)

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44
Q

metaphysis

A

region between the shaft and the epiphyses
contains the epiphyseal growth plate
widens as it approaches the epiphysis

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45
Q

what does the marrow cavity contain?

A

found in the center of the shaft it contains marrow

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46
Q

what is the diaphysis composed of?

A

a peripheral layer of compact bone called the bone collar

the central part is hollow and called the medullary cavity

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47
Q

what does the medullary cavity contain?

A

either red or yellow bone marrow that contains hematopoetic tissue capable of producing red and white blood cells

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48
Q

where is cancellous (spongy bone) found?

A

in the epiphysis and distal portions of the shaft of the long bones

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49
Q

properties of spongy bone

A

consists of numerous interwoven thin plates of bone= trabeculae
it is the inner layer of bone
can be called cancellous or trabecular
highly dominant in the metaphysis and epiphysis
found in flat bones such as the skull, pelvis, ribs and vertebrae as well
role is to provide reinforcement and strength for weight bearing

50
Q

compact bone

A 
also known as cortical bone
forms the outer, protective shell of the bone
is very dense and rigid
found in the diaphysis (shaft)
contains the marrow cavity
differs in long bones and flat bones
major component of tubular bones
51
Q

Where is spongy bone found?

A

in the metaphysis and epiphysis

52
Q

What does the diaphysis of the long bones contain?

A

RED bone marrow which is hematopoietically active but gradually becomes yellow as the cavity fills with fat

53
Q

What does the diaphysis of flat bones contain?

A

flat bones= sternum, vertebrae, pelvic

red bone marrow of hematopoeitic activity only

54
Q

what is the periosteum?

A

membrane covering the outer surface of bone

55
Q

What is the endosteum?

A

membrane that lines the marrow cavity

56
Q

What is the functional unit of bone

A

the osteon

57
Q

What is the osteon comprised of?

A

mature bone cells (osteocytes) which are arranged in concentric layers called lamellae

58
Q

What are the lacunae and what do they contain?

A

they are small extracellular fluid filled spaces “lakes” that contain osteocytes

59
Q

What connects the lacunae?

A

canaliculi; small channels that branchout into the matrix

60
Q

Role of the canaliculi

A 
function to allow nutrient exchange between osteocytes and blood vessels on the surface of the bone
extracts waste and acts as a storage unit
61
Q

How does the Haversian canal run?

A

runs PARALLEL to the long axis bone

contains blood vessels that carry nutrients and wastes to and from canaliculi

62
Q

How does the Volkmann’s canal run

A

runs PERPENDICULAR to the long axis bone

blood vessels enter through here to connect with the haversian system

63
Q

What are the trabecular of spongy bone lacking?

A

they do not have blood vessels therefore they use diffusion as a means of nourishment

64
Q

What cells make up the organic component of bone?

A

osteogenic (osteoprogenitor)
osteoblasts
osteocytes
osteoclasts

65
Q

What are osteogenic cells

A

also known as osteoprogenitor cells
they are found in endosteal and periosteal membranes
differentiate into osteoblasts
active in growing bones
may become activated in adults after a fracture or inury to replace ‘worn out’ bone

66
Q

What are osteoblasts

A

“bone builders” - make the bone
modified fibroblasts (secrete collagen)
involved in ossification (cartilage —> bone) and mineralization ( calcification of the matrix)

67
Q

What is ossification

A

the synthesis and secretion of the organic matrix

transformation of cartilage to bone

68
Q

what are osteocytes

A

mature bone cells
active in transfer of minerals from interior of the bone to growth surfaces and the maintainence mode
arise from osteogenic cells
active in the transfer of Ca2+ and other minerals back and forth between the blood and organic matter

69
Q

what are osteoclasts

A 
derived from monocytes (WBC)
break down the organic matrix in the process of bone resorption
     can do this by phagocytosis
function to release calcium into the blood from the matrix
70
Q

Where do the mature cells (osteocytes) reside?

A

in the lacunae

71
Q

what is cancellous (spongy bone) lacking?

A

it does not have osteons (which resist bend)

it contains the trabeculae for its network

72
Q

What is the extracellular matrix made up of?

A

collagen (mostly type 1),
proteoglycans
water(glycoproteins)
these components in its unmineralized state are called the OSTEOID
they determine the structure and function of the bone

73
Q

What is the INorganic component of the matrix

A

inorganic mineral salts= hydroxyapatites
combination of calcium phospates (main component)
calcium flouride
calcium hydroxide

74
Q

What is the role of osteoblasts in the inorganic component

A

they secrete enzyme-containing vesicles that promote crystallization of the minerals

75
Q

What is the skeleton of a developing fetus made of?

A

hyaline cartilage

this is very bendy and flexible

76
Q

What is ossification?

A

the process of conversion of hyaline cartilage to bone

77
Q

where does endochondreal ossification occur?

A

within the cartilage

occurs mainly in long bones and has 5 steps

78
Q

Step 1 of ossification

A

formation of the bone collar round hyaline cartilage model
the periosteum forms and contains many osteogenic cells which turn into osteoblasts
the osteoblasts secreate osteoid

79
Q

Step 2 of ossification

A

cavitation of hyaline cartilage
occurs in middle of diaphysis (primary ossification center)
chrondrocytes hypertrophy here and secrete alkaline phosphatase (enzyme for mineralizaton)

 diffusion is then inhibited--> chrondrocytes die= cavity
80
Q

Step 3 of ossification

A

invasion of the periosteal bud in the primary ossification center
the bud is made of blood vessels, lymphatic vessels and nerves
vascularization allows for delivery of hematopoietic cells, osteoblasts and osteoclasts

81
Q

Step 4 of ossification

A

continuation of ossification

trabeculae are formed by osteoblasts but then broken down by osteoclasts to form the marrow cavity

82
Q

Where do the secondary ossification centers appear?

A

in the epiphyses

83
Q

Step 5 of ossification

A

ossification of the epiphyses

the only layer of cartilage that remains is the growth plate

84
Q

What is the epiphyseal plate?

A

the site of long bone growth and ossification during growth

they promote longitudinal growth until young adulthood

85
Q

Where is the only area that is not replaced by bone after growth

A

the articular surfaces

86
Q

completion of the ossification process is marked by…

A

the closure of the epiphyseal plate

87
Q

describe the process of the ossification at the growth plate

A

chondrocytes undergo mitosis while the older chondrocytes enlargen and the matrix is calcified
this calcification causes the cells to die and matrix to deteriorate
osteoblasts secrete osteoid which is mineralized to form bone

88
Q

what receptor do osteoclasts express on surface

A

RANK

receptor activator of nuclear factor KB

89
Q

What is RANKL?

A

protein secreted by osteoblasts

receptor activator of nuclear factor KB ligand

90
Q

What is osteoprotegerin

A

a protein secreted by osteoblasts that inhibits RANKL

91
Q

what occurs with the binding of RANKL to RANK

A

activation of osteoclasts and continued interaction of the two receptors for survival of this “bone chewer”

92
Q

menopause and RANKL

A

estrogen limits RANKL produced by the osteoblasts therefore osteoprotegerin dominates and inhibits RANKL

postmenopausal women have an increased RANKL since they have less estrogen. osteoclast function is increased

93
Q

What is the primary reservoir of calcium

A

the bone!!!
holds 99% of body’s calcium
Ca2+ is the most abundant mineral in the body
its homeostasis is tightly regulated
about 50% is free as ions in the plasma and is able to regulate calcium metabolism

94
Q

what is free calcium necessary for?

A

blood clotting
muscle contraction of all types
nerve signal transmission

95
Q

Where is calcitonin produced?

A

by the parafollicular cells of the thryoid

96
Q

What is phosphate homeostasis?

A

important part of ATP
tied to Ca2+ homeostatsis
less closely regulated
fluctuates with diet more

97
Q

calcium regulation by the parathryoid hormone (PTH)

A

calcium receptors found on the parathryoid gland

stimulated by calcium levels

98
Q

What happens when there are LOW plasma Ca2+ levels?

A

increased levels of PTH

99
Q

PTH and bone

A

receptors for PTH are found on osteoblasts
(boss of the osteoclasts)
when bound signals increase activity of bone chewers which release inorganic minerals such as Ca2+ salts into the plasma which increases Ca2+ and phosphate plasma concentrations

100
Q

PTH and the kidneys

A

causes increased ca2+ reabsorption and
decreased Ca2+ exretion in the urine
results in increased plasma Ca2+ concentration

there is also less phosphate reabsorption and more phosphate excretion

101
Q

PTH and the intestines

A

actively regulates Ca2+ and iron absorption
PTH does not directly affect the small intestine
promotes synthesis of another hormone necessary for Ca2+ absorption from the gut (active Vitamin D)

102
Q

What is the active form of Vitamin D

A

vitamin D3 or 1,25 dihydroxy D3

103
Q

PTH and Vitamin D

A

PTH converts inactive to active vitamin d by action of the enzyme in the kidney

104
Q

effects of calcitonin on calcium

A

secreted by the parafollicular cells of the thryoid
stimulus for synthesis is high Ca2+ levels
inhibits the release of Ca2+ from bone and reduces renal reabsorption of calcium and phosphate

105
Q

Where do we get Vitamin D in our diet?

A 
fish liver oils has the greatest amount
fatty fish
leafy greens
fruit juices
added to dairy
vitamin d is a steroid hormone
106
Q

hypocalcemia

A

increase in neuronal excitability (lowered threshold)
neuromuscular instability
signs/symptoms
- parasthesia of hands and feet
-perioral tingling
-bronchospasm=wheezing
-carpopedal spasm (trousseau’s sign)=contraction of muscles
-chvostek sign
tapping over facial nerve brings on twitch in face
fatigue, siexures, anxiety, muscle cramps, confusion, skin and dental problems
death occurs with values below 35% of normal

107
Q

What is trousseau’s sign

A

inflation of a BP cuff above SBP elicits carpal spasm

108
Q

hypercalemia

A

depressed neuronal excitability
signs/symptoms
nausea vomiting
polyuria (large amounts of urine) polydipsia (great thirst)
depression, coma, bradycardia, constipation, kidney stones, weakness

109
Q

most common causes of hypercalcemia

A

primary PTH dysfunction and malignancy

110
Q

In the setting of chronic heart failure, what does the renin-angiotensin aldosterone system do to increase preload?

A

promotes salt and water retention in order to increase (venous return)

111
Q

What symptom will a 78 year old male with LEFT ventricular ejection fraction of 18% and a LEFT MI show?

A

dyspnea with exertion

112
Q

What does digitalis do?

A

improves symptoms but not mortality in patients with heart failure

113
Q

Hypovolemic shock often results in what?

A

renal failure

-low blood volume causes less urine output

114
Q

What occurs with the pressures during normal, quiet breathing?

A

the intrapleural pressure (Pip) is always negative

-this keeps the alveoli inflated

115
Q

When does dynamic compression possibly occur?

A

when transmural pressure is less than or equal to 0

Palv — Pip = Tp

116
Q

Bronchiolar diameter would be expected to decrease in response to:

A

poor blood flow through pulmonary capillaries causes constriction

117
Q

the volume left in the lungs at the end of a maximal expiration is known as the;

A

residual volume

118
Q

The forced expiratory volume (FEV1) will be interpreted as normal if it is what percentage of the FVC?

A

80%

119
Q

Analysis of the partial pressures of O2 and CO2 in the blood returning to the left atrium via the pulmonary veins would be most likely to reveal?

A

PO2= 100

PCO2= 40

120
Q

The V/Q ratio in the upright position is lowest when?

A

there is more perfusion which occurs at the base of the lungs

121
Q

Hemoglobin will release oxygen more readily under which circumstances?

A

Increased CO2, Acidity, 2,3 Diepg protein, Exercise, Temp

Bioscience II (10 decks)

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