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138 Cards in this Set

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components of the conducting zone
trachia, bronchi, bronchioles, terminal bronchioles. No gas exchange here
components of the respiratory zone
respiratory bronchioles, alveolar ducts, alveolar sacs Gas exchange here
components of the upper airway
nostril, nasal cavity, pharynx, mouth, larynx
what walls of the respiratory system have cartilage
trachea, bronchi
what parts of the respiratory system contain protective structures for particulate matter
respiratory bronchioles and higher
what are the structures that are located on airway epithelium for protection
5
cilia, glands, cell that secrete mucus, watery fluid secreters, macrophages
what is the cause of cystic fibrosis
defect in CL- channels that effects the water secretory cell. Allows the mucus to become thick.
what are the components of the respiratory membrane
alveolar wall (epithelium), interstitial space, capillary wall (endothelium)
"entire pathway which CO2, O2 must travel"
Type I alveolar cell
majority of the lining of the alveoli, monolayer
Type II alveolar cell
interspersed in the monolayer and secrete surfactant that acts like a detergent
Plueral sac
thin sheet of cells that surrounds each lung. consists of two membranes that lie adjacent to each other.
what are the components of the plueral sac
inner membrane(attached to the lung), outer membrane (attached to the thoraxic wall and diaphragm)
what is the function of the interplueral fluid
lubrication of the plueral surfaces, changes in this hydrostatic pressure are directly related to lung and thoracic wall changes
what is the equation for bulk flow
F=Patm-Palv/R
what is the most important factor in determining resistance
radius inversely proportional to the 4th power of the radius
Boyles law
at constant temp, pressure varies inversely with the volume of the container
what is transpulmonary pressure
measure of pressure between the inside and outside of the lungs. Not outside the body Palv-Pip
what is the effect of transpulmonary pressure change
change the lung vol and result in air movement,
Lung compliance equation
change in vol/change(Palv-Pip)
what does increased compliance mean
you have greater expansion than normal
what does decreased compliance mean?
you have less than normal expansion
what is the cause of respiratory distress syndrome in infants
lack of ability to produce surfactant
what are the 2 determinants of compliance
elasticity, and surface tension
what does surfactant do and where is it produced
reduces surface tension which increases compliance
what are the three factors that effect resistance
chemical, physical, neuronal
what are the physical factors that effect resistance
transpulmonary pressure, lateral traction(for distention of airways)
what are the neural factors that effect resistance
Epinephrine (relaxation), leukotrienes (contraction)
what is the cause of asthma
airway smooth m. strongly contracting
how would you treat asthma
give anti-inflammatory drugs glucocorticoids or bronchodilaters albuterol, theophylline
what is COPD
chronic obstructive pulmonary disease
causes difficulty in ventilation and oxygenation of the blood (not a smooth m. condition)
what is emhysema
COPD that results in the loss of alveoli and pulmonary capillaries
what is chronic bronchitis
COPD that is characterized by over production of mucus and inflammation in the airways
what is FEV1
forced expiratory volume. amount expired in 1 second after full inspiration. measured as a % of vital capacity
what is obstructive lung disease
when FEV1 is less than 80%, get barrel chested becuase airways are narrowed
what is restrictive lung disease
when FEV1 is normal but vital capicity is lowered
what is minute ventilation
total amount of air moved into and out of the lungs in 1 min
Min ventilation(ml/min)=Tidal vol(ml/breath)xrespiratory rate(breath/min)
what is alveolar ventilation
the fresh air that moves into the alveoli in one min. AV=TV-dead space x RR
what is physiological dead space
anatomical+alveolar

alveolar=air in the alveoli with no blood suplly
anatomic dead space=air in the conducting zone
what is the respiratory quotient
CO2 prod/ O2 cons = RQ
Dalton's law
in a mixture of gases the pressure of one gas is indepentent of all the other gases
henry's law
the amount of a gas dissolved in a liquid is proportional to the partial pressure of the gas above the liquid.
what are the normal atm pressure of the four main gases
o2=160 co2=.3 h2o=0 n2=600
what are the normal alveolar pressures for the four main gases
o2=105 co2=40 h2o=46 n2=569
what is hypoventilation
when there is an increase in Co2 production to Co2 ventilation. above 40
what is hyperventilation
when there is an decrease in co2 production to ventilation below 40
what is a ventilation-perfusion abnormality
a mismatch of blood supply and ventilation in the alveoli. usually has lower o2 in systemic blood and raised co2 in systemic blood
what two ways is o2 found in the blood
bound to hemiglobin and dissolved in the blood plasma
how do you calculate the % saturation of o2
o2 bound to Hb/capacity of Hb to bind x 100
what factors contribute to the decreased affinity for o2 in hemiglobin
DPG, H+, temp, Po2
what are the 3 ways in which co2 is transported in the blood
10% dissolved
30% carbamino compound
60% bicarbonate
what is the enzyme that catalyzes the conversion from co2 to bicarbonate
carbonic anhydrase
what happens to the bicarbonate ion formed by carbonic anhydrase
leaves the red blood cell in exchange for a one CL-
what happens to the H+ ion produced by the production of HCO3- in gas exchange
the deoxyhemoglobin bind the H+ and act as a buffer
what is respiratory acidosis
increased aterial H+ due to retained Co2
what is respiratory alkalosis
decrease in aterial H+ due to hyperventilation
what neurons provide the rythmic input to inspiratory muscles
medullary inspiratory neurons
what controls the medullary inspiratory neurons
medulla oblongata
from what source are inspiratory neurons modulated
low pons (apneustic center) INHIBITION
what modulates the apneustic center
upper pons ( pneumotaxic center )
during excercise what protects the lungs from over inspiration
pulmonary strecth receptors
what are the most important inspiratory inputs at rest to the medullary inspiratory neurons
central chemoreceptors and peripheral chemoreceptors
what is the stimulus for peripheral chemorecpetors
1. decrease in arterial O2
2. increase in arterial H+
what is the stimulus for central chemorecpetors
increase in H+ in the brains extracellular fluid
what is the major player in stimulation of respiration when arterial CO2 levels rise slightly
central chemoreceptors 70% of response
what are the the causes of arterial H+ changes
metabollic acidosis and metabolic alkalosis
in metabollic acidosis and alkalosis what receptors cause a change in ventilation
peripheral chemoreceptors only. Co2 from the metabollic process can't cross the blood brain barrier
what is the only factor we know about that causes increase in ventilation
H+ from lactic acid producton. Not o2 or Co2
what is hypoxia
a deficiency of oxygen at the tissue level
what is hypoxic hypoxia
reduced arterial Po2
what is anemic hypoxia
reduction in o2 content of arterial blood
ischemic hypoxia
inadequate oxygen at the tissue level due to inadequte blood flow to the tissue
histotoxic hypoxia
o2 to cells is normal but toxic agent doesn't allow the cell to utilize the o2
what is hypo/hyperkalemia
inability to regulate K+
what is hypo/hypercalcemia
inability to regulate Ca++
what is the result of renin secretion
aldosterone secretion and Na+ conservation
what is hemodialysis
blood is removed from the body to be filtered and then returned
what is peritoneal dialysis
fluid is injected into the peritoneal cavity
what are the components of the renal corpuscle
glomerulus, bowman's capsule, bowmans space
what are the components of the nephron
renal corpuscle, renal tubule
what are the components of the renal tubule
proximal tubule all the way to the collecting duct
what is ultra filtrate
plasma without protein
what is the function of the juxtaglomerular apparatus
regulation of the processes ocurring in the nephron
what is the differance in cortical nephron and a juxtamedullary nephron
cortical=renal corpuscle is near the surface of the kidney, loop only slightly in the medulla

juxtamedullary nephron=renal corpuscle is near but not in the medulla and loop penetrates deeply
what is the sequance of arteries to the afferent arteriole
renal-interlobar-arcuate-interlobular-afferent ateriol
what is the source of the peritubular capillaries
efferent arteriole
what are vasa recta capillaries
part of the paratubular capillaries that are parellel to the loop of henle
what are the 4 functions of the kidney
hormone secretion, rid the body of waste, maintain intra/extracelluar enviroment, site of gluconeogenisis
what are the components of the basement membrane between the capillary endothelium and bowmans capsule
gel (glycoprotein, laminin),thick, neg charge, barrier for proteins
what is the typical GRF of the kidneys
125 ml/day
what is the typical plasma flow through the kidneys
600ml/min
blood flow is = to what
plasma flow/ 1- hematocrit
what is autoregulation
ablility of nephrons to regulate blood flow at a constant value during changes in arterial blood pressures
in what 2 ways is autoregulation accomplished
myogenic hypothesis, tubuloglomerular feedback
what is the affect on GFR when you contrict the afferent or the efferent arterioles
afferent the GFR is decreased
efferent the GFR is increased
what cause the constriction of the afferent and efferent arterioles
sympathetics, epinephrine/norepinephrine, angiotensinogenII, ADH, cortisol
what are meangial cells
support glomerular capillary loops and can constrict to reduce GFR in response to angiotensinogen II
what is the opposition to constriction at afferent and efferent arterioles
vasodilators (prostoglandins)
what are the things that happen in the proximal tubule
1. reabsorb 2/3 of Na+ and water+60% of K+
2. reabsorbs all filtered glucose
3. secretes metabolic end products and toxins
4. preferentially reabsorption of HCO3-
how does Na+ enter the interstitial fluid in the proximal tubule
passively down electrochemical gradient
what is the purpose of Na+/K+ pump on the basolateral side of the a proximal tubule cell
to provide metabollic energy for Na+ reabsorption
how and why does water enter the interstitial fluid in the proximal tubule
water enters due to the osmotic gradient created by Na+, water enters the cell through aquaporins.
what is the driving force for movement of water and solutes from the interstial fluid to the paratubular capillaries
hydrostatic pressure in the interstitial is high relative to paratubular capillaries
how is K+ reabsorbed in the proximal tubule
concentration gradient and draged with water. not actively
what is the result of having all the cotransporters in proximal tubule saturated
products will be seen in the urine
how are glucose and amino acids reabsorbedin the proximal tubule
cotransport with Na+
what is probenicid an example of
a inhibitor of transporters to maintain plasma levels of drugs
how is H+ removed from the the plasma
coupled with Na+ in a countertransport
if plasma H+ get to high what hormone will cause rapid removal of H+ from the kidney
angiotensinogen II- increase in Na+ and water reabsorption to increase H+ countertransport
how much Na+ and K+ are reabsorbed in the loop
both 25%
what is the net active transport of solutes in the thin portions of the loop of henle
zero
what happens to water in the loop of henle
1. thin decending= very permiable
2. thin ascending= impermiable
3. thick ascending=low permiablity
what is the function of the thin ascending loop
permiable to Na+ and Cl-
what happens at the thick ascending loop
hypoosmotic situation, low water permiablilty, but Na+, K+, Cl-
what has a higher reabsorption of water in the decending loop. juxtamedullary or superficial nephrons
juxdamedullary
where is the energy supply for reabsorption of Na+ in thick ascending loop
Na+/K+ pump on basolateral side
how do K+ and CL- enter the cell in the Thick ascending loop
cotrasport with Na+
some K+ re-enters the cell to keep cycle going
what is a diuretic
substance that increases urine production, usually by keeping solutes in the lumin
what are 3 ways to increase urine production
1.diuretic
2. interfere with reabsorption-alcohol
3. ingest a loute that cannot be reabsorbed
what is furosemide
drug that blocks CL- cotransport, works as a diuretic
what is reabsorbed in the distal tubule
Na+ cotransported with CL- driven by the pump
what does thiazide do
blocks the Na+ Cl- cotrasport in distal tubule
what is the difference in Na+ and Cl- reabsorbtion in the distal tubule vs. the collecting duct
no cotransport. Cl- is through tight junctions and Na+ is associated with K+ export
what are potassium sparing diuretics
drugs that effect the luminal transport of Na+ in the collecting duct. amiloride/triamterene
how is K+ in collecting ducts when K+ is low as a result of Na+ absorption
reabsorption by intercalated cells then K+ diffuses out the basolateral side
what is the effect of aldosterone in the collecting duct
secreted in response to low Na+ from that adrenal cortex to the nucleus of luminal cells to promote new Na+ transporters
what does spironlactone do
prevents aldosterone from entering cell nucleus
what is the purpose of vasa recta loops around the loop of henle
minimize the loss of solute in the interstitial fluid
what are the steps caused by ADH
ADH-v2-G-Phosphoralaytion resluting in more aquaporins
what are the two functions of ADH
Reabsorption of NaCl in the thick ascending and aquaporins in the collecting duct
what is diabetes insipidus
ADH cannot be released into the system=
1. lower interstital osmolarity (lack of ADH at ascending loop)
2. huge urine vol
what range is ADH actively secreted
above 275 mOsm/Kg suppressed below this value
what nerves do high pressure mechanorecpetors use
vagus and glossopharyngeal
what nerve does low pressure mechanoreceptors use
vagus
what is atrial natriuretic peptide
ANP humoral signal produced by atrial distension. increases GFR by afferent dialation and efferent constriction
when is renin released
decreased NaCl to the Juxtaglomerular apparatus or decreased blood vol
what are the activation steps of renin
renin-peptide angiotensinogin-angiotensinogin I-angiotensinogenII-secretion of aldosterone
what does PTH act on when ca++ plasma levels are low
bone, kidney and intestine
how does PTH affect the intestinal absorbtion of Ca++
25 to 1,25 active form of vitamin D