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95 Cards in this Set
- Front
- Back
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Question
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Answer
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How do you change your CO2 levels?
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Ventilation because that allows you to bring in a gradient with 0 mmHg PaCO2. Low ventilation, PACO2 rises, less of a gradient.
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In a V/Q mismatch, why can we blow off CO2 easier than O2?
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"1) CO2 has better transport properties.
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Would low Hb concentration affect PaO2?
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No. PaO2 is the dissolved oxygenin the arteriole blood, but it is not a measure of its content. O2 in Hb is not accessible by tests, only dissolved gasses.
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Would decreased overall pulmonary blood flow cause hypoxemia?
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No. If anything, it'll provide O2 more time to saturate. But remember that low CO also means low O2 perfusion (more uptake at tissues), so low PvO2.
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How are head targets innervated by the SNS?
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Lateral Horn T1-4 --> White Ramus --> Synapse Superior Cervical Ganglion --> Back Door --> Head Targets (SM and glands)
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How are cervical targets innervated by SNS?
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Lateral Horn T1-4 --> White Ramus --> Synapse any Lateral Horn T1-4 --> White Ramus --> Cervical Ganglion --> Gray Ramus --> C1-8 spinal nerves --> Cervical Targets (SM and glands)
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How are thoracic targets innervated by SNS?
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Lateral Horn T1-L2 --> Synapse Sympatehtic Ganglion T1-L2 --> Gray Ramus --> T1-L2 Spinal nerves --> Thoracic Targets (SM and glands)
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How are chromaffin cells innervated by SNS?
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Lateral Hron T5-12 --> No Synapse in Symp. Ganglionic Chain --> Back Door --> Form Thoracic Splachnic Nerves --> Chromaffin Cells (adrenal medulla) --> Blood (epinephrine) --> SM, cardiac muscle, glands
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How are L3-S5 innervated by SNS?
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Sympathetic Preganglionic (Lateral Horn) T10-L2 --> White Rami (T10-L2) --> Sympathetic chain synapse in L3-S5 ganglia --> Gray Rami L3-S5 spinal nerves
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How many thoracic symp. ganglia are there?
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12
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How many lumbar symp. ganglia are there?
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4-Feb
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How many sacral symp. ganglia are there?
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5-Apr
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Superior cervical ganglion consist of?
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C1-4
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Middle cervical ganglia consist of?
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C5-6
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Inferior cervical ganglia consist of?
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C7-8
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What does COMT do and where is it located?
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It metabolizes catecholamines in general (i.e. epi, norepi) and is located extraneuronally
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What does MOA do and where is it located?
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It metabolizes catecholamines in general (i.e. epi, norepi) and is located intraneuronally
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What are the end products of both COMT and MOA?
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VMA and MPG4-SO4
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Where does sulfation of catecholamine metabolites occur?
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sulfation is done by a generic enzyme in the liver
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Is the bronchiole innervated by the SNS?
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No. But it is innervated by the PNS.
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What does PNS innervation on bronchial smooth muscle do?
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Bronchoconstriction.
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Is the bronchiole vascular SM innervated by the PNS?
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No. But it is innervated by the SNS.
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Is there a B2 receptor on bronchiole SM cells?
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Yes. Even though there isn't a direct innervation, it is still used, especially for drug targeting (terbutaline, albuterol, circulating epinephrine).
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Is there a muscarinic receptor on vascular smooth muscles?
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No and Yes. The receptor is located on the endothelium, but it does cause vasodilation by activating muscarinic receptors --> activating cNOS --> NO release --> SM --> relaxation.
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Where are the PNS preganglionic cell bodies located in the body?`
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CN III, IV, VII and X, and S2-4.
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Which fibers do visceral sensory fibers course with?
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Both PNS and SNS. i.e. from the heart with the vagus nerve (ganglion in the nodose or inferior root ganglion) and from the head the sympathetic chains (DRG).
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What type of NT does the sympathetic preganglionic nerve release?
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ACh
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What type of NT does the parasympathetic postganglionic nerve release?
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ACh
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What kind of receptor does ACh hit in the ganglion?
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Nicotinic receptor
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What kind of receptor does ACh hit in the NMJ?
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Muscarinic
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M1, M3, M5 goes through which pathway? What does this result in?
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Inc. DAG and IP3, smooth muscle contraction.
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M2, M4 goes through which pathway?
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Decrease cAMP and generally inhibitory.
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Where is pseudocholinesterase located and what does it do?
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blah
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Can you have an a2 heteroreceptor in the CNS?
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No. An a2 heteroreceptor in the CNS would mean that there would be parasympathetic ganglion in the CNS, but they are only located in the PNS.
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Where can you find a2 receptors in the CNS?
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You can find them as a2 autoreceptors and this is where Clonidine acts.
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How many layers does the endocardium have? What are they?
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Two. The endothelium and the subendothelial layer.
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How do you distinguish between endocardium and epicardium?
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The endocardium/subepithelial layer has no adipose tissue. The supepicardial layer is thicker and contains adipose tissue, nerves, and BVs.
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If myocytes have gap junctions, do purkinje fibers have gap junctions?
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Yes.
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What fibers are contained in the tunica adventitia?
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Type I collagen and elastin fibers.
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What fibers are contained in the tunica media?
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Type III collagen and elastin fibers.
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How do you tell a vein and an artery apart?
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Arteries typically have thicker SM's, but the lumen of a Vein is proportionally larger in diameter than the walls.
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What is a glomerulus?
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The globular network of fenestrated capillaries inside the Bowman's capsule.
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Is the collecting duct considered a part of the nephron?
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No.
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Is it possible for a cortical nephron and a juxtamedullary nephron to share the same collecting duct?
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Yes.
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Are the majority of the nephrons juxtamedullary nephrons?
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No. 80-85% are cortical nephrons.
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Where does the peritubular capillary collect?
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In the interlobular veins. In the juxtamedullary nephron, the vasa recta and the peritubular capillaries collect into the interlobular and arcuate veins.
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What are the two layers of Bowman's capsule?
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Parietal and Visceral layer.
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What layer of Bowman's capsule is adjacent to the glomerulus and what cells does it consist of?
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The visceral layer and it consists of podocytes.
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What is the space inside Bowman's Space called?
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The urinary space.
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What are pedicels?
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Fingerlike projections from podocytes.
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What are mesangial cells?
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Modified smooth muscle cells with phagocytic properties, provide structural support for the glomerulus, and play a role in controlling glomerular flow via contraction.
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In a renal slide, how do you tell when you're in the medulla of the kidney?
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No glomerulus, just lots of ducts.
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Where does the kidney regulate Ca absorption? What factor mediates this effect?
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Aldosterone mediates the uptake of Ca at the distal convoluted tubule.
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Where does aldosterone act and what are its downstream effects?
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At the principal cells in the collecting duct. Increases sodium reabsorption by inserting Na channels and activating Na/K pumps. Also results in more K excretion.
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Where and how does angiotensin II act?
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Vasoconstriction at efferent arteriole and increased Na/H activity (inc. Na reabsorption) in the PCT.
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Where and how does alpha-adrenergic signal act in the kidney?
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Stimulate Na/H antiport and Na/K ATPase (inc. Na reabsorption).
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What is glomerulotubular balance?
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Increased reabsorption of solutes at the proximal tubule in response to greater filtration by kidneys.
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What are medullary rays?
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Collection of arranged collecting tubules (from various different nephrons) traveling between the cortex and the renal medulla. These later collect into collecting ducts.
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Is the peritubular capillary plexus considered a component of a nephrone?
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No.
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In the medulla of the kidney, if I find a circle of cells containing two differently stained cells what part of the nephron what that be?
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The collecting duct. Remember that there is no collecting tubule in the medulla.
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Where do the bronchial arteries branch from?
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Aorta or one of its branches, such as the third intercostal artery.
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What is the lung parenchyma?
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Fibrous connective tissue around the bronchi and blood vessels, lympatic vessels and nerves.
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Bronchial veins most often drain into which veins?
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The azygos or hemiazygos veins.
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What structure is "absent" in the histology of the nasal cavity that is present in other respiratory histologies?
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Submucosa.
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What is another name for the laryngopharynx and where is it located?
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The hypopharynx and it begins at the epiglottis, behind the larynx.
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How is the trachea unique, histologically, from other sections of the respiratory tract?
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The submucosa merges with the cartilage rings and dense fibroelastic tissue between the rings. Begin to see Kulchitsky cells. Adventitia may be unique.
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Compared to the trachea, what is special about the primary bronchi?
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PCCE is less tall and contains fewer goblet cells. Lamina propria is separated from submucosa by a thin layer of smooth muscle.
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Why does the PCCE become less pseudostratified as we get past the secondary/lobar bronchus and enter the tertiary/segmental bronchus?
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There are less goblet cells.
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At what level in the respiratory tract do goblet cells disappear?
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Bronchioles.
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At what level in the respiratory tract do seromucous glands disappear?
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Terminal bronchioles. Become replaced by Clara cells.
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Where does the respiratory zone begin?
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After terminal bronchioles (which succeeds the bronchioles), but before the respiratory bronchioles.
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At what level does the cartilage disappear in the respiratory tract? What takes its place?
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Terminal bronchioles and elastin becomes progressively present.
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At what level does the cartilage disappear in the respiratory tract?
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Terminal bronchioles.
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When does the cardiovascular system begin developing? What are the first signs of this development?
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At the end of the third week, mesenchymal cells from the splachnic mesoderm form isolated cell clusters ("blood islands") that coalesce into twin endocardial heart tubes.
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What is the Tetralogy of Fallot?
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"PROV--Pulmonary artery stenosis (obstructed right ventricular outlfow), Right ventricular hypertrophy, Over-riding aorta (dextroposition of the aorta), Ventrical septal defect
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What does rostral mean?
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Toward the head.
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What does caudal mean?
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Toward the tail/gluteus maximus.
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What is PICO?
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Patients, intervention, comparison, outcomes.
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As the intercostal nerve courses anteriorly, it becomes a pure _____ ______ nerve.
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somatic sensory
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Which are the mixed nerves?
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CN III, CN V, CN VII, CN IX, and CN X
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What can we suspect from a midsysotlic crescendo--decrescendo murmur?
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aortic or pulmonic stenosis (most likely aortic stenosis)
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What can we suspect from a holosystolic murmur?
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mitral or tricuspid regurgitant flow
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What can we suspect from a late systolic murmur?
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mitral valve prolapse and it can be proceeded by a click
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What can we suspect from an early diastolic murmur?
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regurgitant flow across semilunar valves
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What can we suspect from a middiastolic and presystolic murmur?
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turbulent flow across atrioventricular valve
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What is cardiogenic shock?
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can't keep CO high enough i.e. due to heart attack, arrhythmias, valve problems, stenoses etc.
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Where does angiotensin II in the kidney primarily act?
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Efferent arteriole.
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Where does alpha-1 adrenergic signals in the kidney primarily act?
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Afferent arteriole and proximal convoluted tubule (increases Na/K activity and Na/H activity).
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Where does the myogenic mechanism in the kidney primarily act?
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Afferent arteriole only
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Where does tubuloglomerular feedback in the kidney primarily act?
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Afferent arteriole only
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How does out of control diabetes contribute to hypokalemia?
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Osmotic diuresis from glucose overload increases urinary loss, which K is more susceptible to.
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Increased blood pressure on the cardiopulmonary receptors causes the forearm to ______ through the _______ nervous system.
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vasodilate, sympathetic
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Heat causes acral skin to _______. How is this achieved?
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vasodilate; through withdrawal of the sympathetic nervous activity.
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Sympathetic nervous activity to the forearm causes it to ______.
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vasodilate
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