• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/444

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

444 Cards in this Set

  • Front
  • Back
___ innervates cardiac & smooth muscle, most exocrine glands, & the adrenal medulla. (part of the Efferent division)
a. Somatic Nervous System
b. Autonomic Nervous System
c. Sympathetic Nervous System
d. Parasympathetic Nervous System
b. Autonomic Nervous System
___ innervates skeletal Muscle. (part of the Efferent division)
a. Somatic Nervous System
b. Autonomic Nervous System
c. Sympathetic Nervous System
d. Parasympathetic Nervous System
a. Somatic Nervous System
Which of these is the pathway from the CNS to an organ?
a. Somatic NS
b. Autonomic NS
b. Autonomic NS
What are the 2 fibers of the Autonomic Nervous System?

a. Sympathetic & parasympathetic
b. Preganglionic & Postganglionic
c. Preganglionic & Parasympathetic
d. None of the above
b. Preganglionic & Postganglionic
Which of these is the fiber after the ganglion?

a. Preganglion
b. Postganglion
b. Postganglion
What are the 2 divisions of the Autonomic Nervous System?
Sympathetic & Parasympathetic
The sympathetic NS controls:

a. Rest & Digest
b. Fight or Digest
c. Fight or flight
d. Rest & Flight
c. Fight or Flight
The Sympathetic NS controls the:
a. Sacral & Cranial Regions of the Spinal Cord
b. the Terminal Ganglia
c. the Thoracic-Lumbar region
c. Thoracic Lumbar region
In the Sympathetic NS, the Preganglionic fibers are ____, & the Postganglionic fibers are ___.
Preganglionic=short
Postganglionic=long
In the Sympathetic NS, the Preganglionic Fibers synapse with ______ of postganglionic fibers in the sympathetic trunk ganglion chain.
a. Cell bodies
b. Cells
c. Terminal Ganglia
a. cell bodies of Postganglionic fibers
In the Parasympathetic NS, the Preganglionic Fibers synapse with ___ of postganglionic fibers.
a. Cell bodies
b. Cells
c. Terminal Ganglia
b. Cells
(These are actually called Terminal Ganglia so C. is right too)
In the Parasympathetic NS, Preganglionic fibers are ___, and Postganglionic fibers are _____.
Pre=long
Post-short
___- cell bodies of postganglionic fibers or neurons.

a. Ganglion Chain
b. Terminal Ganglia
c. sympathetic Ganglia
b. Terminal Ganglia
What is Acetylcholine?
ACh
Fibers that release ____ are cholinergic.
ACh (Acetycholine)
Parasympathetic & Sympathetic Preganglionic fibers release ___.

a. ACh
b. NE (norepinephrine)
c. E (Epinephrine)
a. ACh
Parasympathetic Postganglionic fibers release__.
a. ACh
b. NE (norepinephrine)
c. E (epinephrine)
a. ACh
Sympathetic Postganglionic fibers release____.
a. ACh
b. NE
c. E
b. NE Norepinephrine
Sympathetic Preganglionic fibers release ___.
a. ACh
b. NE
c. E
a. ACh
The function of the Autonomic NS is to ____.
Regulate Unconscious Activities
Usually ___ subdivision(s) are active in controlling the activity of an internal organ.
a. Sympathetic
b. Parasympathetic
c. Both
d. Neither
c. Both

This ongoing activity is called sympathetic or parasympathetic tone activity.
"Dilation of pupils; increased sweating; increased HR; Dilation of Bronchiles; most of digestion inhibited." Are all examples of

a. Active Parasympathetic NS
b. Active Sympathetic NS
b. Active Sympathetic NS

Fight or Flight
___ allows precise control over the activity of a visceral organ.

a. Dual Innervation
b. Dual Reciprocal innervation
c. Reciprocal Innervation
d. None
b. Dual reciprocal Innervation
What are the 4 exceptions of Dual Innervation of organs?
1-Innervated Blood Vessels
2-Sweat Glands
3. Salivary Glands
4-Adrenal gland (modified part of the sympathetic nervous system)
What type of Receptors bind to ACh?
Cholinergic Receptors
What are the 2 types of Cholinergic Receptors?
1 Nicotinic
2 Muscurinic
____ Cholinergic receptors are found on the Postganglionic cell bodies of ALL autonomic Ganglia.

a. Nicotinic
b. Muscurinic
a. nicotinic
___ Cholinergic receptors are found where the Preganglionic neuron signals the postganglionic neuron.
a. Nicotinic
b. Muscurinic
a. Nicotinic
___ Cholinergic receptors bind to ACh from Parasympathetic Postganglionic nerve fibers.
a. Nicotinic
b. Muscurinic
b. muscurinic
___ receptors bind to norepinephrine & epinephrine.

a. Cholinergic Receptors
b. Adrenergic
b. Adrenergic
What are the 4 types of Adrenergic Receptors? (and are they excitatory or inhibitory?)
1-Alpha 1 (a1)~Excitatory
2-Alpha 2 (a2)~Inhibitory
3-Beta 1 (b1)~Excitatory
4-Beta 2 (b2)~Inhibitory
____ Adrenergic Receptors have greater affinities for Norepinephrine.

a. A1 & B1
b. A1 & B2
c. A1 & A2
d. B2 & B1
a. A1 & A2
____Receptors have equal affinities for Norepinephrine & Epinephrine.

a. A1
b. A2
c. B1
d. B2
c. B1 (Excitatory Response)
____ Receptors bind primarily with epinephrine.

a. A1
b. A2
c. B1
d. B2
d. B2

(Inhibitory Response)
___ mimic/enhance autonomic responses.

a. Antagonist
b. Agonist
c. Caricosities
b. Agonist
___ blocks autonomic responses.

a. Antagonist
b. Agonist
c. Caricosities
a. Antagonist
___-Ending of the Postganglionic Neuron in the ANS.
Varicosities

"terminals"
List the 7 steps in Exciting Skeletal Muscle Fibers:
1-Action Potential @ axon terminal opens voltage-gated Ca channels in Terminal button.
-Ca ions diffuse into terminal button from ECF
2-by this Ca influx, ACh released by exocytosis from vesicles in terminal button
3-ACh diffuses through Neuromuscular Junction (between nerve & muscle cells)
4-This neurotransmitter binds to receptor sites on motor end plate of Muscle Cell membrane
5-The binding opens channels for Na influx into ICF of muscle cell
6-This produces a Local Current Flow, opening adjacent Na channels in Motor End Plate (spread occurs in both directions)
7-An Action Potential is initiated through the muscle fiber.
The End-Plate Potential occurs as a result of ____ opening in the Motor-End-Plate.
Sodium Channels
An End-Plate potential is ___ than an EPSP because _______.
Bigger; because the Terminal Button releases more neurotransmitter
The End-Plate potential is bigger than an EPSP because the Terminal Button releases more neurotransmitter. This permits ____.
A greater net influx of positive ions and a larger depolarization.
An EPP (End-Plate Potential) is a ____, whose magnitude depends on the ___ & ___ of ACh at the motor end-plate.
Graded Potential; Amount & Duration
____ destroys Acetycholine.
Acetylcholinesterase.

Found in the motor-end plate
____- Terminates the action potential & response of the muscle cell by breaking Acetycholine into Acetate & Choline.
Acetycholinesterase
Acetylcholinesterase in the motor end-plate destroys acetylcholine by:
Terminates the action potential & response of the muscle cell (breaks acetylcholine into acetate and choline)
3 types of Muscle
Smooth
Cardiac
Skeletal
What are the 5 levels of organization of a muscle?
Organ
Cell (Fiber)
Specialized intracellular structures (Myofibrils)
Cytoskeletal Elements
Contractile Proteins
What are the 2 Bands of a Myofibril?
I band
A band
What are the 2 lines of a myofibril?
Z line
M line
What is the zone of the Myofibril that contains the M line?
H zone
What is the line that holds the myosin?
M line
What is the band that holds the z line and Actin? (the white band)
I band
Which line is the end of a sarcomere?
Z line
____ in a Myofibril is everything between the Z lines.
Sarcomere
Which of these is the Thick filament?
-Myosin
-Actin
Myosin
Which of these is the Thin filament?
-Myosin
-Actin
Actin
___ binds to ATP and actin in the Myosin filament of a Myofibril.
Cross Bridges
____ and ___ are on the heads of the cross bridges. (in Myosin of a Myofibril)
Actin Binding sites; Myosin ATPase site
Actin contains ___ and ___ proteins
Tropomysin
Troponin
____ covers over myosin binding sites.
-Troponin
-Tropomyosin
Tropomyosin
____ is the hinge that moves the other which covers over the myosin binding sites.
-Troponin
-Tropomyosin
Troponin
Troponin contains 3 binding sites:
Tropomyosin
Actin
Calcium
Sliding-Filament Theory-Molecular basis of Skeletal Muscle Contraction: (5points that happen)
1 A band width is unchanged
2 The actin filament is unchanged
3 The sarcomere width shortens
4 The H zone shortens
5 The width of the I band decreases
Contraction is accomplished by the ____ sliding closer together between the ____.

(SKELETAL MUSCLE)
Thin filaments (Actin)
Thick Filaments (Myosin)
___- the ATP powered cross-bridge binding and bending that pulls the thin filaments in closer together between the thick filaments during contraction of a muscle fiber.
Power Stroke
What are the STEPS of the CONTRACTION of a Muscle Fiber?
1-ATP hydrolyzed by myosin ATPase, ADP and Pi remain attached to myosin, energy stored in the crossbridge
2- Ca is released from Sarcoplamic Reticulum upon excitation of T-Tubule by an action potential, binds to the Ca binding site on troponin enabling actin to bind with the crossbridge.
- Or No excitation, No calcium is released, Actin and myosin are prevented from binding, No crossbridge cycle occurs and Muscle fiber remains at rest
3-Power stroke of crossbridge triggered upon contact between myosin & actin, ADP and Pi released
4- Linkage between actin & myosin broken as fresh ATP binds to myosin crossbridge; Crossbridge assumes original conformation; ATP hydrolyzed & cycle starts again
-Or No fresh ATP & actin & myosin remain attached (Rigor Mortis)
9 steps of Excitation-Contraction Coupling:
1-ACh released from the terminal button & binds to receptors on motor end-plate
2-Action Potential propagated across surface membrane & down T-tubules of muscle cells
3-Action potential triggers Ca release from Sarcoplasmic Reticulum
4-Ca+ released bind to troponin on actin filaments; Tropomyosin physically moved aside to uncover cross-bridge binding sties on actin
5-Myosin Crossbridges attach to actin & bend, pulling actin filaments toward center of sarcomere, releasing ADP & Pi (the stored energy)
6-Attachment of a new ATP permits detachment of the crossbridges
7-Ca actively taken up by sarcoplasmin reticulum when there isn't a local action potential
8-Troopomyosin slips back over binding sites of actin (Contraction Ends)
9-RELAXATION: ACh removed by Acetylcholinesterase. Ca back into sarcoplasmic Reticulum by the Ca+-ATPase Pump & muscle Relaxes.
___- one cell contracting
Twitch
What are the 3 Phases/Periods of a Twitch?
1 Latent Period
2 Contraction Phase
3 Relaxation Phase
___ is the time the signal travels during a twitch (the very first part of the twitch).
Latent Period
____ is an alpha motor neuron & all the muscle cells (fibers) it innervates.
Motor Unit
What are the 2 determinants of the whole muscle cell tension?
1 Number of fibers contracting
2 Tension developed by each contracting fiber
Determinants of whole muscle tension:
1 Number of fibers contracting
(3points)
a. Number of Motor units contracting
b. Number of muscle fibers per motor unit
c. Number of muscle fibers available to contract
Determinants of whole muscle tension:
2. Tension developed by each contracting fiber (4points)
a. Frequency of stimulation
b. Length of fiber at the onset of contraction
c. extent of fatigue
d. thickness of fiber
Asynchronous Recruitment of Motor Units.
"Everything doesn't work at the same time" as it recruits more motor units.
What are the 2 types of Asynchronous Recruitment of Motor units?
1 Submaximal Contractions
2 Maximal Contractions
Asynchronous Recruitment of Motor Units:
-____- Recruits more & more or switches units.

-Submaximal
-Maximal
-Neither
-Submaximal Contractions
Asynchronous Recruitment of Motor Units:
-____- Fires everything at one time (All muscle units recruited)

-Submaximal
-Maximal
-Neither
Maximal Contractions
___- Maximal Contractions without relaxation
Tetanus
What are the 2 types of muscle contractions?
1 Isotonic
2 Isometric
___ type of muscle contraction is where the tone stays the same.
Isotonic
___ type of muscle contraction is where the length of the muscle stays the same (Burning energy).
Isometric
Velocity of shortening is related to load.
The ___ the load, the lower the velocity at which a single muscle fiber ___ during an isotonic tetanic contraction.
Greater; Shortens
The velocity of shortening is ___ when there is no external load, and falls to zero when the load cannot be overcome by maximal tetanic tension.
Maximal
Although muscles can accomplish work, much of the energy is converted to ___.
heat
The amount of work accomplished by a contracting muscle depends on how much an object ___ & _________________.
Weighs; How far it is moved
In an Isotonic contraction, of the energy consumed by the muscle during contraction, ___% is realized as external work whereas ____% is converted to heat.
-50;50
-75;25
-25-75
-60;40
-40;60
25;75
In an Isotonic contraction: ___% is external work, but ___% of all energy consumed by the muscle during contraction is converted to heat.
-0;100
-50;50
-75;25
-25-75
0;100
What are the 3 Alternative pathways for forming ATP?
1 Creatine Phosphate
2 Oxidative Phosphorylation
3 Glycolysis
Alternative Pathways for forming ATP:
___- takes place within the muscle mitochondria if sufficient oxygen is present.

___- is the first energy source
Oxidative Phosphorylation; Creatine Phosphate
___- a glucose molecule is broken down into 2 pyruvic acid molecules, yielding 2 ATP molecules in the process
Glycolysis
___- end product, cannot be further processed, and implicated in muscle soreness
Lactic Acid
What are the 3 types of Fatigue?
1 Muscular
2 Neuromuscular
3 Central
____ Fatigue is in the brain or spinal cord

-Muscular
-Neuromuscular
-Central
central
___ Fatigue is in the Neuromuscular Junction

-Muscular
-Neuromuscular
-Central
Neuromuscular Fatigue
___- fatigue is inside the muscle cells

-Muscular
-Neuromuscular
-Central
Muscluar
Increased O2 consumptionis necessary to recover from exercise: (5points)
1 Repayment of O2 debt
2 Fresh Supplies of ATP are formed by Oxidative Phosphorylation
3. Creatine Phosphate system is restored
4. Lactic Acid is removed
5. Gycogen Stores are at least partially replenished
What are the 3 types of Muscle Fibers?
1. Slow Oxidative Fibers (Type I)
2. Fast Oxidative Fibers (Type IIa)
3. Fast Gycolytic Fibers (Type IIb)
Which of these fiber types is Red?
- Slow oxidative
-Fast Oxidative
-Fast Gycolytic
-Slow & Fast Oxidative Fibers are red
What are the 2 major differences between the 3 Types of muscle fibers?
1. Speed of contraction
2. Type of enzymatic machinery for ATP production
Muscle fibers adapt considerably in response to the demands placed on them: (6points)
1. Endurance-Aerobic exercise induces metabolic changes with oxidative fibers to use O2 more efficiently
2. Hypertrophy & Hyperplasia
3. Testosterone
4. Interconversion between fast muscle fiber types
5. Atrophy
6. Limited repair of muscle (Myoblast)
Multiple Neural Inputs influence Motor Unit Output (3points):
1. Input from Afferent Neurons
2. Input form the Primary Motor Complex
3. Input from the Brain Stem
___- descend directly without synaptic interruption to terminate on motor neurons to mediate performance of fine, discrete, voluntary movements of the hands & fingers.

- Brain Stem
-Primary Motor Complex
-Afferent Neurons
-All of the above
-Primary Motor Complex

(Corticospinal Motor Systems)
___- includes a number of synapses that involve many regions of the brain which are concerned with regulation of overall body posture involving involuntary movements of large muscle groups of the trunk & limbs.

-Brain stem
-Primary Motor Complex
-Afferent neurons
-All of the above
Brain Stem
Muscle receptors provide afferent info. needed to control skeletal muscle activity through:
-Muscle Spindles
-Golgi Tendon Organs
____- In the muscle; Detects length & excites the muscle to oppose.

-Muscle Spindles
-Golgi Tendon Organs
-Afferent neurons
-None
Muscle Spindles
___ - in the tendon; Detect muscle tension; Inhibit the muscle.

-Muscle spindles
-Golgi Tendon Organs
-Afferent Neurons
-None
Golgi Tendon Organs
SMOOTH MUSCLE:
____ shaped cells.
It is _____.
Have ___, ___, & ____ filaments.
It has ____ but no ____.
Spindle shaped cells
Unstriated
Thick, Thin & Intermediate cells
No Z-line(or sarcomeres) Has dense bodies.
Cells can replace itself
SMOOTH MUSCLE:
is turned on by ______ of myosin.
Calcium-Dependent Phosphorylation
SMOOTH MUSCLE:
Steps when it is turned on by Ca-depedent Phosphorylation of Myosin.

(4 points)
1. Ca binds with Calmodulin
2. Ca-Calmodulin activates Myosin Kinase
3. Active Myosin Kinase Phosphorylates Myosin
4. Phosphorylated Myosin then binds with actin so that cross-bridge cycling can begin.

-Ca comes from the ECF
-No T-Tubules
-No Troponin & Tropomyosin doesn't cover actins' crossbridge binding sites
What are the 2 types of Smooth Muscle?
1. Multiunit
2. Single-unit
Which type of smooth muscle?

___- multiple discrete units that function independently of each other & must be separately stimulated by nerves to contract.
Multiunit
Which type of smooth muscle?

-Becomes excited & contracts as a unit (many gap junctions)
-Self excitable: clusters of specialized cells display spontaneous electrical activity without any external stimulation (contains pacemaker cells)
Single-unit
Gradiation of single-unit smooth muscle contraction is accomplished by varying the ______.
Cytosolic Calcium Concentration
___- many single-unit smooth muscle cells have sufficient levels of cytosolic Calcium to maintain a low level of tension even in the absence of action potentials.
(Always some level of contraction)
Tone
Modification of smooth muscle activity is by the ____ NS.
Autonomic

(doesn't initiate but can modify the rate & strength of contraction)
What is the relationship between length & tension for smooth muscle?
It can still develop tension yet inherently relaxes when stretched.

Stretch fast=Builds tension (Contraction)
Stretch slow= Doesn't build pressure (Relaxation)
Smooth muscle is ___ & ___.
Slow & Economical
How is Smooth muscle slow?
Contractions last for 3seconds due to slower rate of Ca removal
How is smooth muscle Economical?
Because of the low rate of cross-bridge cycling, crossbridges are maintained in the attached state for a longer period of time therefore maintain tension with comparatively less ATP consumption
Cardiac muscle has characteristics of:
-Smooth muscle
-Skeletal muscle
-Both
-Neither
Both
Cardiac muscle is:

(5points)
1. Striated: highly organized into a regular banding pattern
2. Abundance of mitochondria (myoglobin=red)
3. Have T-tubules & sarcoplasmic reticulum
4. Pacemaker activity
5. Influenced by autonomic Nervous system

(Gets Ca from inside & outside the cell)
What are the 3 basic components of the circulatory system?
1. Blood (transport medium)
2. Heart (Establishes pressure gradient)
3. Blood vessels (Passageways)
___- A loop of blood vessels between the heart & the lungs.

-Pulmonary Circulation
-Systemic Circulation
Pulmonary Circulation
___- a loop of blood vessels carrying blood between the heart & the body systems

-Pulmonary Circulation
-Systemic Circulation
Systemic Circuation
What is the pathway of blood flow?
1. Superior & inferior Vena Cava
2. Right Atrium
-Bicuspid Valve
3. Right Ventricle
-Semilunar Pulmonary Valve
4. Pulmonary Trunk
5. Right & Left Pulmonary Arteries
6. Lungs
7. Right & Left Pulmonary Veins
8. Left Atrium
-Tricuspid Valve
9. Left Ventricle
-Semilunar Aortic Valve
10. Aorta
The Right Heart Circulation is ____.

-Pulmonary
-Systemic
Pulmonary
The Left heart Circulation is _____.

-Pulmonary
- Systemic
Systemic
What are the 3 layers of the heart wall?
Endocardium
Myocardium
Epicardium
___- (connectors) join cardiac muscle cells together which allows the action potential to spread to neighboring cells.
Intercalated Disks
___- Pathway of all disks (Connection across the whole top)
Syncytium
What are the 4 layers of the Pericardial Sac?
-Visceral Pericardium
-Parietal Pericardium
-Pericardial Cavity
-Pericardial Fluid
What are the 2 types of cardiac cells?
-Contractile cells
-Autorhythmic cells
Which of these are 99% of Cardiac Cells?

-Contractile
-Autorhythmic
Contractile
The Pacemaker Potential of an Autorhythmic cardiac cell is triggered by ____.
the Pacemaker (the cell beating the fastest)
What are the 5 types of Autorhythmic Cardiac Cells?
1. Sinoatrial Node (SA)
2. Atrioventricular Node (AV)
3. Bundle of His
4. Left & Right Bundle Branches
5. Purkinje Fibers
What is the 1st degree of heart block?
Extended AV node delay
(PR segment is too long)
What is the 2nd degree of heart block?
Every other signal from the AV node goes through
What is the 3rd degree of heart block?
Atria & Ventricles are off sync because the AV node is not working
Ectopic Focus
Abnormal Location
what is the 3 criteria that needs to be satisfied for efficient spread of excitation?
1. Atrial excitation & contraction complete before start of ventricle contraction
2. Excitation of cardiac muscle fibers should be coordinated to assure each heart chamber contracts as a unit (for efficient pumping)
3. Pair of atria & ventricles should be functionally coordinated so both members of each pair contract simultaneously
How is the Cardiac Impulse spread through the heart?
1. originates @ SA node
2. Spreads through atria
3. delayed at AV nodal region
4. Bundle of His (intermodal pathway)
5. Purkinje fibers (into endocardium)
6. Spreads through ventricular muscle (to epicardial surface)
How long does the AV nodal delay last?
100msec
What is the purpose of the AV nodal delay?
To let the Atria be completely depolarized & contract, empty their contents into the ventricles before ventricular depolarization & contraction occurs. (also keeps the heart form tetanus)
Action potential in the cardiac contractile muscle cells shows a ______.
Characteristic Plateau
IN CARDIAC MUSCLE:
Calcium entry from the ___ induces a much larger Calcium release from the _____.
ECF: Sarcoplasmic Reticulum

Extra supply of Ca from the Sarcoplasmic Reticulum is responsible for the long period of cardiac contraction
The role of calcium in cardiac muscle is like skeletal muscle because:
Calcium binds with Troponin
The role of calcium in cardiac muscle is unlike skeletal muscle because:
The extent of cross-bridge activity varies with the amount of cystolic calcium
CARDIAC MUSCLE:
Increase in ECF __ results in the _____ in the resting membrane potential.
K+ ; Reduction

The membrane is less negative on the inside than normal because less K+ leaves. As a result of this ectopic foci & cardiac arrhythmias develop.
CARDIAC MUSCLE:
Increase in ECF ___ increases the strength of the contraction.
Ca+2

Ca channel blockers
Digitalis induces an increases in cytosolic Ca
About how long does the refractory period last in the cardiac muscle?
about 250msec
Pwave
Atrial Depolarization
P-R Segment
AV node delay
QRS segment
Ventricles Depolarization
S-T Segment
Ventricles Contracting (emptying)
Twave
Ventricle Repolarization
T-P Segment
Ventricles Relax & Refilld
What are the 2 abnormalities in heart rates?
-Tachycardia
-Bradycardia
___-Fast; over 100beats/min
Tachycardia
___- Slow; under 60beats/min
Bradycardia
What are the 5 abnormalities in heart rhythm?
-Arrhythmia
-Atrial & Ventricular Flutter
-Atrial & Ventricular Fibrillation
-Pulse Deficit
-Heart Block
Which is this?

__-Without Rhythm

a. Atrial Flutter
b. Heart Block
c. Arrhythmia
d. Pulse Deficit
c. Arrhythmia
What is this?
__- Faster heart rate than pulse rate

a. Atrial Flutter
b. Heart Block
c. Arrhythmia
d. Pulse Deficit
d. Pulse Deficit
What is this?
___- Atrial is out of sync

a. Atrial Flutter
b. Atrial Fibrillation
c. Pulse Deficit
Atrial Fibrillation
what is this?
___-Ventrical is contracting extremely fast.

a. Ventricle Flutter
b. Ventricle Fibrillation
c. Pulse Deficit
c. Arrhythmia
Ventricle Flutter
What are 3 Cardiac Myopathies?
1. Myocardial Ischemia
2. Necrosis
3. Acute Myocardial Infarction
____- the period from the end of one cardiac contraction to the end of the next (1 heartbeat)
Cardiac Cycle
What are the 2 periods of time in the Cardiac Cycle?
Diastole & Systole
___- Resting of ventricles

-Systole
-Diastole
-Neither
Diastole
____- Contraction phase (contraction of ventricles)

-Systole
-Diastole
-Neither
Systole
____- Volume of blood in the ventricle at the end of diastole.
- Isovolumetric Ventricular relaxation
-End-diastolic Volume
- Stroke volume
End-Diastolic Volume
____- All valves closed, no blood can enter or leave the ventricle during this time. It is after closing of the AV valve and before the opening of the aortic valve.

Isovolumetric Ventricular contraction
-End-diastolic Volume
- Stroke volume
Isovolumetric Ventricular Contraction
___- Amount of blood left in the ventricle at the end of systole when ejection is complete.

-Isovolumetric Ventricular Relaxation
-End-Systolic Volume
-Stroke Volume
-End-Diastolic Volume
End-Systolic Volume
___- when ventricular pressure exceed aortic pressure, the aortic valve is forced open & rapid ejection of blood begins.

-Stroke Volume
-End-Diastolic Volume
- Ventricular Ejection
-Isovolumetric Ventricular Contraction
Rapid ventricular Ejection
___- All valves closed. After the Aortic valve closes, before the AV valve opens (ventricular pressure still exceeds atrial pressure)

-Isovolumetric Ventricular Contraction
-Stroke Volume
-End-Systolic Volume
-Isovolumetric Ventricular Relaxation
Isovolumetric Ventricular Relaxation
__- the amount of blood pumped out of each ventricle with each contraction.

-Isovolumetric Ventricular Contraction
-Stroke Volume
-End Systolic Volume
-Isovolumetric Ventricular Relaxation
Stroke Volume
____- How much blood you move in 1 minute.

-Isovolumetric Ventricular Contraction
-Stroke Volume
-Cardiac Output
-Cardiac Input
-Cardiac Reserve
Cardiac Output
Stroke volume equation is ____________.
End-Diastolic Volume (EDV) - End-Systolic Volume (ESV) = Stroke Volume (SV)

EDV - ESV = SV
Calculate the Stroke volume:

The total End-Systolic Volume was 65ml. The End-Diastolic Volume was 135ml. What is the stroke volume?
70ml

EDV(135ml) - ESV(65ml) = 70ml
Calculate the Stroke Volume:

The total End-diastolic Volume was 85ml. The End-Systolic Volume was 25ml. The patient has 100beats per minute.
60ml

EDV(85ml) - ESV(25ml) = 60ml
____- how many heart beats per minute.
Heart Rate
What is the Cardiac Output equation?
Heart Rate (HR) x Stroke Volume (SV)= Cardiac Output (CO)

HR(SV)=CO
Calculate the Cardiac Output:

the patients heart beats 150 per minute. and the Stroke volume is 70ml.
150(70ml)=10500ml/minute
Calculate the Cardiac Output:

The total End-diastolic Volume was 85ml. The End-Systolic Volume was 25ml. The patient has 100beats per minute.
Stroke Volume: 85-25=60ml

60(100)=6000ml/minute
The amount of blood to be ejected depends on what 3 things?
1. Preload
2. Contractility
3. Afterload
___-Strength of a (cardiac) contraction at any given End-Diastolic Volume.

-Preload
-Contractility
-Afterload
Contractility
___- (arterial blood pressure) workload imposed on the heart after the contraction has begun.

-Preload
-Contractility
-Afterload
Afterload
Which of these is the 1st sound?

-Dub
-Lub
Lub
Softer, Longer, Louder.... it is the sound of the AV valves closing

-Lub
-Dub
Lub
The 2nd sound

-Lub
-Dub
Dub
Quick, Sharp, Brief.... Sound of the semilunar valves closing.

-Dub
-Lub
Dub
___- abnormal heart sounds
Murmurs
___- doesn't create sound; Smooth flow

(blood flow)
Laminar Flow
____- creates sound: Anything creating obstruction (Blood Pressure cuff)
Turbulent Flow
____- Slows flow down: is pinched off a little bit & does not open completely.

-Insufficient Valves
-Stenotic Valves
- Laminar Valves
Stenotic Valves
___- Opens wide, but doesn't close completely.

-Insufficient Valves
-Stenotic Valves
-Laminar Valves
Insufficient valves
___- sound of blood going backwards through valves
Regurgitation
___- between Lub & Dub sounds.

-Systolic Murmur
-Diastolic Murmur
Systolic Murmur

Because it happens during systole
___- after Dub, before next Lub sound.

-Systolic Murmur
-Diastolic Murmur
Diastolic Murmur

Because it happens during diastole
What are the steps of blood flow (in physiological detail) starting from the atria & ventricles in diastole.
1. Atrial pressure exceeds ventricle pressure
2. AV valve opens
3. Blood flows into ventricle
4. Ventricle volume increases (before atria contracts)
5. Late in ventricular diastole, SA node fires
6. Impulses spread through atria (Pwave)
7. Atria contracts (AV valve still open)
8. Impulse passes to AV node
9. Atrial contraction done (before ventricle contraction)
10. Ventricle excitation (^vent. pressure) (QRSwave)
11.Start of ventricle contraction: ^ventricle pressure closes AV valve
12. Ventricular pressure continues to ^ before exceeding aortic pressure
- AV & aortic valves closed (Isovolumeric contraction)
13.Ventricular pressure exceeds Aortic pressure (Aortic valve opens)
-Ventricular pressure > Aortic: valve stays open
14. Ventricular pressure < Aortic: Aortic valve closes
- Ventricle repolarization (Twave)
15. Ventricle continues to relax & pressure steadily falls (Isovolumetric Relaxation)
16. Ventricle pressure < Atrial pressure, AV valve opens & ventricular filling
What are the effects of the parasympathetic stimulation on the heart?

(3 things)
- Decreases heart rate by keeping K+ channels open, decreasing the rate at which an action potential is created.
- Time between atrial & ventricular contraction stretched out
- Atrial contraction is weaker
What are the effects of the sympathetic stimulation on the heart?

(4things)
- Increases heart rate; decreasing K+ permeability (faster time to depolarize)
-Decreases delay between atrial & ventricular contractions
-Decreases contraction time throughout heart
-Increases Ca in ventricles (Increase in contractility strength)
____- is determined by the extent of venous return (intrinsic control) & by sympathetic activity (extrinsic control).
Stroke volume
What are 2 points about intrinsic control of Stroke Volume?
(Frank Starling Law of the Heart)
-Heart pumps all blood returned to it
-Increased End-Diastolic volume results in increased stroke volume
What are the 2 concepts of the Frank Starling Law of the Heart?
-Heart pumps all blood returned to it
-Increased End-Diastolic volume results in increased stroke volume
What is Arterial Blood pressure known as?
Afterload

(BP of arteries pushing back)
Preload:

Afterload:
Veins

Arteries
What is the primary defect in heart failure?
Decrease in cardiac contractility ( Decreased Stroke Volume)
What are the Compensatory measures for heart failure?

(2)
- Increases sympathetic activity
-Kidneys retain salt & water to expand Blood Volume
What are 2 types of heart failure?
-Decompensated Heart Failure
-Congestive Heart Failure
___- The heart reaches a point at which it is no longer able to pump out a normal SV despite compensatory measures.

-Decompensated Heart Failure
-Congestive Heart Failure
Decompensated heart failure
___- Blood cannot enter the heart & backs up into the venous system

-Decompensated Heart Failure
-Congestive Heart Failure
Congestive heart failure
How is the heart nourished?
Coronary Circulation
____ blockage in arteries (build-up).

-Atherosclerosis
-Agina Pectoris
-Thrombosis
-Embolus
-Collateral Circulation
Artherosclerosis
___- The pain you feel from blockage in the arteries (it starts at about 60% blockage)

-Atherosclerosis
-Agina Pectoris
-Thrombosis
-Embolus
-Collateral Circulation
Agina Pectoris
___- Accumulation of a blood clot.

-Atherosclerosis
-Agina Pectoris
-Thrombosis
-Embolus
-Collateral Circulation
Thrombosis
___- when a blood clot blocks the vessel completely

-Atherosclerosis
-Agina Pectoris
-Thrombosis
-Embolus
-Collateral Circulation
Embolus
___- the blood supply through the heart

-Atherosclerosis
-Agina Pectoris
-Thrombosis
-Embolus
-Collateral Circulation
Collateral Circulation
What is the organization of the blood vessels?

Starting from the heart (Oxygenated blood) to coming back to the heart (Unoxygenated blood)
Arteries
Arterioles
Capillaries
Venules
Veins
What is the formula for blood flow?
Pressure gradient/ Resistance

(these are proportional; Double the pressure=double the flow)
___- the difference in pressure between the beginning and end of a vessel.

-Pressure gradient
-Resistance
Pressure gradient
___- A measure of hindrance to blood flow through a vessel caused by friction between the moving fluid & stationary walls.
Resistance

Resistance ^= Blood Flow v
What are 3 factors determining resistance to blood flow?
1. Viscosity
2. vessel length
3. Vessel radius
____ - the overall thickness of the blood.
Viscosity
Viscosity is determined by what 2 things?
1. Plasma proteins
2. Number of Red Blood Cells circulating
What is the formula for resistance?
1/radius^4
What does Poiseuille's Law describe?
The factors affecting blood flow.

(Thicker & longer vessels = slower blood flow)
____- rapid-transit passage-ways to the tissues and as a pressure reservoir.
Arteries

(they push the blood away from the heart... hence the "pressure reservoir")
The continual flow through the capillaries during cardiac relaxation is provided by: (3 things)
1. Elastic properties in arterial walls
2. Endothelial cells
3. smooth muscle
___- the force exerted by the blood against a vessel wall
Blood pressure
____- how easily the vessel wall can be stretched
Compliance
___- the max pressure exerted in the arteries when blood is ejected into them.

-Systolic pressure
- Diastolic pressure
-Pulse pressure
Systolic pressure
__- the min. pressure within the arteries when blood is draining off into the remainder of the vessels.

-Systolic pressure
- Diastolic pressure
-Pulse pressure
Diastolic pressure
___ the pulse felt in an artery lying close to the surface of the skin due to the difference between systolic & diastolic pressures

-Systolic pressure
- Diastolic pressure
-Mean Arterial Pressure
-Pulse pressure
Pulse pressure
What is the equation for Pulse pressure?
Systolic Pressure - Diastolic Pressure = Pulse Pressure
____- the average pressure responsible for driving the blood forward throughout the whole cardiac cycle

-Systolic pressure
- Diastolic pressure
-Mean Arterial Pressure
-Pulse pressure
Mean Arterial Pressure

(measured with baroreceptors in your body)
What is the equation for the Mean Arterial Pressure (MAP)?
Diastolic Pressure + 1/3(Pulse Pressure) = MAP
_____- major resistance vessels.

-relatively inelastic
- More smooth muscle than elastin
-Innervated by Sympathetic NS & hormones
Arterioles
ARTERIOLES:
_____; Turned on by the sympathetic NS. (caused when exposed to cold)

____; Turned down by the sympathetic NS. (caused when exposed to hot)
Vasoconstriction; Vasodilation
____- state of partial constriction
Vascular Tone
Vascular tone is controlled by what 2 things?
1. Myogenic Activity (intrinsic)
2. Sympathetic Innervation (extrinsic)
What are 7 facters that cause vasoconstriction?
1. Increased myogenic activity
2. Increased oxygen
3. decreased CO2
4. increased Endothelin (most powerful vasoconstriction)
5. Increased Sympathetic stimulation
6. Increased Vasopressin & Angiotensin II
7. Cold
What are 7 factors that cause Vasodilation?
1. Decreased myogenic activity
2. Decreased Oxygen
3. Increased CO2
4. Increased Nitric Oxide (gas to cause vasodilation)
5. Decreased Sympathetic Stimulation
6. Increased Histamine Release
7. Heat
___- refers to changes within a tissue that alter the radii of the arteriole which will determine the distribution of cardiac output.
Local Control
___- a Local Arteriolar Vasodilation subsequently increases blood flow to that particular area that is metabolically active.
Active Hypermia
VASODILATION & VASOCONSTRICTION:
What are the Local Chemical Influences?

(2)
1. Local metabolic changes
2. histamine release (mast cells release=dilation)
VASODILATION & VASOCONSTRICTION:
what are the Local Physical Influences?

(2)
1. Local application of heat or cold
2. Myogenic response to stretch
What are 2 Extrinsic Controls of Arteriolar Radius?
1. Sympathetic (except in the brain)
2. Hormonal Influences (vasopressin, angiotensin II, epinephrine)
EXTRINSIC CONTROL OF ARTERIOLAR RADIUS:
What type of hormones affect the Arteriolar Radius?

(3)
1. Vasopressin
2. Angiotensin II
3. Epinephrine
What is the formula for blood flow after a change in pressure?
Flow= change in pressure/resistance
What is the formula for Cardiac Output?
Mean Arterial Pressure/ Total Peripheral Resistance

MAP/TPR = CO
____ are the only vessels that are regulated intensely & because of that determine flow, or Cardiac Output.
Arterioles
____- site of exchange & diffusion.

-arterioles
-arteries
-capillaries
-venuoles
Capillaries
Capillaries are ideal for diffusion because:

(2 things)
- Short distance to travel between blood & surrounding cells
(because thin capillary wall & small capillary diameter coupled with close proximity of every cell to a capillary)
- Large surface area (^surface area = ^ diffusion)
___- channel that runs between an arteriole & venule. They have capillary branches but are not open during resting conditions due to precapillary sphincters closed.
Metarterioles
Capillaries do not have ______ or ____, so blood flow through a tissue is regulated by other things.
No nervous supply or smooth muscle
Capillary blood flow is regulated by:

(2)
1. Degree of resistance of arterioles in organ; controlled by sympathetic activity & local factors
2. The number of open capillaries controlled by action of same local metabolic factors on precapillary sphincters
CAPILLARIES:
Exchange between blood & surrounding tissue is accomplished by:

(2)
1. Bulk flow (ECF distribution) - a volume of protein-free plasma filters out of the capillary mixes with surrounding interstitial fluid & is reabsorbed
2. Passive Diffusion (solute exchange)
___- when the pressure inside the capillary is greater than outside- fluid is pushed out through the pores.

-Reabsorption
-Ultrafilteration
Ultrafilteration (arteriole end)

(-) because it takes away from blood
___- when the pressure outside the capillary is greater than inside- fluid moves inside the cell.

-Reabsorption
-Ultrafilteration
Reabsorption (Venule end)

(+) because it adds to blood
What are the 2 pressures (inside & outside) of the capillary wall?
Ultrafiltration (arteriole end)
Reabsorption (venule end)
What are the 4 pressures that influence fluid movement across the capillary wall?
-Capillary Blood Pressure (CBP)
-Blood-Colloid Osmotic Pressure (BCOP)
-Interstitial-fluid hydrostatic pressure (IFHP)
-Interstitial-fluid-colloid osmotic pressure (IFCOP)
Of the 4 pressures that influence fluid movement across the capillary wall... which 2 are Inward Pressures? (+)
BCOP & IFHP

Blood-Colloid Osmotic PRessure & Interstitial-fluid Hydrostatic Pressure
Of the 4 pressures that influence fluid movement across the capillary wall...which 2 are Outward Pressures? (-)
CBP & IFCOP

Capillary Blood Pressure & Interstitial-Fluid-Colloid Osmotic PRessure
What is the formula for the net exchange of fluid movement across the capillary wall?
Total Outward Pressure - Total Inward Pressure = Net exchange
____- is an accessory route by which interstitial fluid can be returned to the blood. (Low pressure)
Lymphatic System
___- small, blind-ended terminal lymph vessels (weaves between capillaries)

-Lymph
-Lymph Vessels
-Initial Lymphatics
- Lymph Nodes
Initial Lymphatics
What are the 4 functions of the lymphatic system?
1. Return of excess filtered fluid
2. Defense against disease
3. transport of absorbed fat
4. return of filtered protein
____- swelling of the tissues because of excess interstitial fluid.
Edema
What are the 4 causes of edema?
1. Reduced concentration of plasma proteins
2. increased permeability of the capillary walls (histamine does this)
3. Increased venous pressure
4. Blockage of lymph vessels
___ & ___- Capacitance vessels (blood reservoir). Passageways bringing blood to the heart.

-Large Radii & very little resistance.
Veins & Venules
___- volume of blood that the veins can accommodate.
Venous capacity
___- volume of blood entering each atrium/min from the veins
Venous return
Venous return is affected by what 6 things?
1. Sympathetic stimulation
2. skeletal muscle activity
3. effects of gravity
4. venous valves
5. respiratory activity
6. cardiac suction
VEINS & VENULES:
Blood pressure is regulated by controlling ___, ___, & ___.
Cardiac output: Total peripheral Resistance: & Blood volume
What are 2 characteristics of blood pressure for veins & venules?
1. has to have high enough pressure to assure a sufficient driving force
2. Can't be so high that it creates extra work for the heart
What is the short-term regulation for veins and venules?
the nervous system (baroreceptors)
What 2 places are baroreceptors found?
1. Carotid Sinus
2. Aortic Arch
What happens (with baroreceptors) when BP increases?

(4)
1. Increased firing of baroreceptors; increased action potentials
2. cardiovascular control center sends messages to increase parasympathetics & decrease sympathetics
3. causes decreased HR, SV, & dilation of arteriolar & venous vessels
4. You get decreased Cardiac Output, Total Peripheral Resistance, & BP until it gets normal
What are other reflexes & responses that influence BP?

(6)
1. L. Atrial volume receptors & hypothalamic osmoreceptors
2. chemoreceptors: (Central & Peripheral)
3. Cardiovascular responses associated with certain behaviors & emotions
4. Pronounced cardiovascular changes accompany exercise
5. Hypothalamic control over cutaneous arterioles
6. Vasoactive substances release from the endothelial cells play a role in regulating BP
Hypertension...

Hypotension...
High BP

Low BP
___-when BP falls so low that there is inadequate blood flow to the tissues.
Circulatory shock
What are 4 types of Circulatory shock?
1. Hypovolemic Shock
2. Cardiogenic Shock
3. Vasogenic Shock
4. Neurogenic Shock
___- a fall in blood through loss of fluids (low blood volume.)
1. Hypovolemic Shock
2. Cardiogenic Shock
3. Vasogenic Shock
4. Neurogenic Shock
Hypovolemic Shock
___- Due to a weakened heart failure.
1. Hypovolemic Shock
2. Cardiogenic Shock
3. Vasogenic Shock
4. Neurogenic Shock
Cardiogenic Shock
___- widespread vasodilation, triggered by the presence of vasodilator substances (Infection {septic shock}, increased histamine in allergic reaction {anaphylactic shock})

1. Hypovolemic Shock
2. Cardiogenic Shock
3. Vasogenic Shock
4. Neurogenic Shock
Vasogenic Shock
___- Loss of sympathetic tone-deep excruciating pain inhibits sympathetic vasoconstriction
1. Hypovolemic Shock
2. Cardiogenic Shock
3. Vasogenic Shock
4. Neurogenic Shock
Neurogenic shock
What are the Consequences & Compensations of Shock?
-Increased sympathetics due to decreased baroreceptor firing (decreased parasympathetics)
-Not for longterm: fluid volume must be replaced from the outside through drinking, transfusion or combination of both
___- the point at which BP continues to drop rapidly because of tissue damage, despite vigorous therapy
Irreversible Shock
Blood is:
__% of total body weight
there are __L in women
there are ___L in men
8%
5L in women
5.5L in men
What is the 4 components of blood?
1. Erythrocytes (RBC)
2. Leukocytes (WBC)
3. Platelets
4. Plasma (55%)
Plasma Proteins: ___-___% of the total plasma weight.
6-8%
What are 2 characteristics of Plasma Proteins?
1. They create Osmotic Gradient
2. They are partially responsible for plasma's capacity to buffer changes in pH
What are the 3 groups of plasma proteins?
1. Albumins
2. Globulins
3. Fibrinogen
PLASMA PROTEINS:
____- binds substances (most abundant)

1. Albumins
2. Globulins
3. Fibrinogen
Albumins
PLASMA PROTEINS:
___- Binds substances & blood clotting, & are immunoglobulin (antibodies)
1. Albumins
2. Globulins
3. Fibrinogen
Globulins
PLASMA PROTEINS:
What are the 3 types of Globulins?
Alpha
Beta
Gamma
PLASMA PROTEINS:
___- Blood clotting.

1. Albumins
2. Globulins
3. Fibrinogen
Fibrinogen
PLASMA PROTEINS: GLOBULINS:
___- Binds substances & Blood clotting.

-Alpha
-Beta
-Gamma
Both Alpha & Beta
PLASMA PROTEINS: GLOBULINS:
____ are immunoglobulin (antibodies)

-Alpha
-Beta
-Gamma
Gamma
What is the shape of Red Blood Cells?
Bioconcave
What does Hemoglobin contain?
4 Iron molecules:

Can combine with O2 & also CO2, Hydrogen ions, Carbon Monoxide, & Nitrogen Oxide.
What are Key Erythrocyte Enzymes?
(2)
-Glycolytic Enzymes
-Carbonic Anhydrase
ERYTHROCYTE ENZYMES:
____- For glycolosis to make ATP & Lactic Acid.

-Carbonic Anhydrase
-Glycolytic Anhydrase
-Glycolytic Enzymes
Glycolytic Enzymes
ERYTHROCYTE ENZYMES:
___- Takes Acid & Transforms it into CO2.

-Carbonic Anhydrase
-Glycolytic Anhydrase
-Carbonic Enzymes
-Glycolytic Enzymes
Carbonic Anhydrase
What does Bone marrow do?
Generates new Red Blood Cells
How many new RBC does Bone Marrow generate per second?
2-3million/second
What is the life span for a RBC?
120days (cannot repair because it has no nucleus)
What do the Liver & Spleen do with RBC?
Break Down & recycle old RBC
_____- RBC (erythrocyte) production by the red bone marrow.
Erythropoesis
____- hormone that stimulates bone marrow to increase erythrocyte production
Erythropoietin
___- a reduction below normal in the oxygen-carrying capacity of the blood and is characterized by a low hematocrit.
Anemia
What are 6 types of Anemia?
1. Nutritional Anemia
2. Pernicious Anemia
3. Aplastic Anemia
4. Renal Anemia
5. Hemorrhagic Anemia
6. Hemolytic Anemia
___- Not enough Iron.

1. Nutritional Anemia
2. Pernicious Anemia
3. Aplastic Anemia
4. Renal Anemia
5. Hemorrhagic Anemia
6. Hemolytic Anemia
Nutritional Anemia
___- Too little Vitamin B12: Not absorbing it.
1. Nutritional Anemia
2. Pernicious Anemia
3. Aplastic Anemia
4. Renal Anemia
5. Hemorrhagic Anemia
6. Hemolytic Anemia
Pernicious Anemia

(Intrinsic Factor is needed to absorb vitamin B12)
___-Cannot grow new Blood Cells from bone marrow.
1. Nutritional Anemia
2. Pernicious Anemia
3. Aplastic Anemia
4. Renal Anemia
5. Hemorrhagic Anemia
6. Hemolytic Anemia
Aplastic Anemia
___- Kidney doesn't make erythropoietin (to stimulate creation of RBC)
1. Nutritional Anemia
2. Pernicious Anemia
3. Aplastic Anemia
4. Renal Anemia
5. Hemorrhagic Anemia
6. Hemolytic Anemia
Renal Anemia
___-Bleeding: Not making erythropoietin in reticulocytes.
1. Nutritional Anemia
2. Pernicious Anemia
3. Aplastic Anemia
4. Renal Anemia
5. Hemorrhagic Anemia
6. Hemolytic Anemia
Hemorrhagic Anemia
___- Bursting Red Blood Cells.
1. Nutritional Anemia
2. Pernicious Anemia
3. Aplastic Anemia
4. Renal Anemia
5. Hemorrhagic Anemia
6. Hemolytic Anemia
Hemolytic Anemia

(Hemolysis:"breaking apart of RBC". & Sickle Cell Disease)
What is the characteristics of Sickle Cell Disease? (genetic disorder)
- 1 out of 650 African Americans
- Defective Hemoglobin
-RBC is stiff & crescent shaped
-RBC clump together & block blood flow
-Prone to rupture/spleen can get rid of more than being made
___- excessive circulating erythrocytes (too many RBC)
Polycythemia
What are the 2 types of Polycythemia?
Primary & Secondary
POLYCYTHEMIA:
__- tumor like condition in bone marrow.
-Primary
-Secondary
Primary
POLYCYTHEMIA:
___-occurs in people who live at high altitude where less oxygen is available.

-Primary
-Secondary
Secondary
What are the 3 functions of Leukocytes?
1. Defend against invasion by pathogens
2. Identify & destroy cancer cells that arise within the body
3. cleanup crew (phagocytizing)
What are the 2 types of Leukocytes?
1. Polymorphonuclear Granulocytes
2. Mononuclear Agranulocytes
What are the 3 types of Polymorphonuclear Granulocytes?
1. Neutrophils
2. Eosinophils
3. Basophils
GRANULOCYTES:
___- Phagocytic Specialists: 1st defenders on the scene of bacterial invasion, elevated in bacterial infection.
1. Neutrophils
2. Eosinophils
3. Basophils
neutrophils
GRANULOCYTES:
___- allergic conditions & internal parasite infection (attacks parasites)
1. Neutrophils
2. Eosinophils
3. Basophils
Eosinophils
GRANULOCYTES:
__-synthesize & stores histamine (released in allergic reaction) & heparin
1. Neutrophils
2. Eosinophils
3. Basophils
Basophils
What are the 2 types of Mononuclear Agranulocytes?
1. Lymphocytes
2. Monocytes
AGRANULOCYTES:
___- Phagocytize differentiate into macrophages, life span months to years.
1. Lymphocytes
2. Monocytes
Monocytes
AGRANULOCYTES:
___- Life span 100-300 days found in blood, lymph & lymphoid tissue.
1. Lymphocytes
2. Monocytes
Lymphocytes
AGRANULOCYTES:
What are the 2 types of Lymphocytes?
1. B-Lymphocytes
2. T-Lymphocytes
AGRANULOCYTES: LYMPHOCYTES
___- Plasma cells, makes Antibodies.
1. B-Lymphocytes
2. T-Lymphocytes
B-Lymphocytes
AGRANULOCYTES: LYMPHOCYTES
___-Directly destroy their specific target cells by releasing chemicals that punch holes in the victim's cell.
1. B-Lymphocytes
2. T-lymphocytes
T-Lymphocytes
____- Cell fragments derived from megakaryocytes.
Platelets (thrombocytes)
___- makes platelets: Huge with a big nucleus
Megakaryocytes
___- hormone made by the liver to increase megakaryocytes.
Thrombopoietin
___- stopping of bleeding from a broke blood vessel
Hemostasis
What are the 3 parts of hemostasis? (in order)
-Vascular spasm
-Formation of a platelet plug
-Blood Coagulation (clotting)
____- Reduces blood flow by constricting in response to an injury.
-Vascular spasm
-Formation of a platelet plug
-Blood Coagulation (clotting)
Vascular Spasm
___- blood from a liquid into a solid gel.
-Vascular spasm
-Formation of a platelet plug
-Blood Coagulation (clotting)
Blood Coagulation
___- when a damaged vessel exposes collagen platelets adhere & form a clot
-Vascular spasm
-Formation of a platelet plug
-Blood Coagulation (clotting)
Formation of a platelet plug
What are the 5 proteins/enzymes/substances involved in blood coagulation (clotting)?
-Fibrinogen
-Fibrin
-Thrombin
-Factor XIII (fibrin-stabilizing factor)
-Prothrombin
___- Insoluble thread-like molecule.
-Fibrinogen
-Fibrin
-Thrombin
-Factor XIII (fibrin-stabilizing factor)
-Prothrombin
Fibrin
___- soluble plasma protein produced by the liver (inactive: cut activates it to make a web)
-Fibrinogen
-Fibrin
-Thrombin
-Factor XIII (fibrin-stabilizing factor)
-Prothrombin
Fibrinogen
___-Enzyme that catalyzes fibrinogen into fibrin (causes everything in blood to clump)
-Fibrinogen
-Fibrin
-Thrombin
-Factor XIII (fibrin-stabilizing factor)
-Prothrombin
Thrombin
___- Inactive precursor to thrombin
-Fibrinogen
-Fibrin
-Thrombin
-Factor XIII (fibrin-stabilizing factor)
-Prothrombin
Prothrombin
___- Strengthens & stabilizes the clot : turns mesh into concrete
-Fibrinogen
-Fibrin
-Thrombin
-Factor XIII (fibrin-stabilizing factor)
-Prothrombin
Factor XIII (fibrin-stabilizing factor)
___ dissolves clots.
Fibrinolytic Plasmin

-Plasminogen:inactive precursor
___- primary condition responsible for excessive bleeding due to a deficiency in one of the factors in the clotting cascade.
Hemophilia
What are the 4 steps in respiration?
1. Exchange of air between the external env. & the alveoli
2. Exchange of CO2 & O2 between air in the alveoli & blood within the pulmonary capillaries by diffusion (Ventilation & Profusion)
3. O2 & CO2 are transported by the blood between the lungs & tissues
4. Exchange of O2 & CO2 between the tissues & blood by diffusion across the systemic capillaries
What are the 6 NONrespiratory functions of the respiratory system?
1. provides a route for water loss & heat elimination
2. enhances venous return
3. contributes to the maintenance of normal acid-base balance (help reg. pH)
4. Enable speech, singing & other vocalization
5. Defends against inhaled foreign material
6. removes, modifies, activates or inactivates various materials passing through the pulmonary circulation
What are the 3 types of cells that make up the alveoli?
-Type I
-Type II
-Macrophages
The lungs consist of (4things):
1. Several branching airways
2. alveoli
3. pulmonary vasculature
4. large quantities of elastic connective tissue

(only smooth muscle in walls of arterioles & bronchioles for control)
___- Inflammation in pleural cavity.
Pleurisy
What are 3 pressures important for ventilation?
1. Atmospheric pressure
2. Intra-alveolar pressure
3. Intra-pleural pressure
What are the 2 reasons the lungs follow the movements of the chest wall?
1. Intrapleural-fluid surface tension (cohesiveness)
2. Transmural pressure gradient
a. Across the wall of the lung
b. across the thoracic wall
Atmospheric pressure = ___
or
Alveolar pressure = ____
Intrapleural pressure
Intra-Alveolar pressure MUST be ____ atmospheric pressure for air to flow into the lungs during inspiration.
Less than
Intra-Alveolar pressure MUST be ___ atmospheric pressure for air to flow out of the lungs during expiration.
greater than
What is boyles law?
Increase in volume = decrease in pressure
What are the 4 steps in 1 respiratory cycle?
1. Before inspiration: muscle are relaxed, no airflow (intra-alveolar = atmospheric pressure)
2. Inpiratory muscles stimulated to contract (phrenic nerve & intercostal nerves), resulting in enlargement of thoracic cavity & expansion of lungs (v intra-alveolar pressure) Air flows in & pressure drops more.
3. End Inspiration: muscles relax, intra-alveolar pressure ^
4. Expiration: Intra-alveolar pressure ^, outward flow stops when pressures equilibrate
What muscles are used for forced expiration?
Internal Intercostals & abdominal muscles
Which muscles are used for forced inspiration?
Sternocleidomastoid & Scalenes
Which muscles are used for inspiration?
Diaphragm & external intercostals
What is the equation for air flow?
Flow=pressure gradient/resistance of airways
Regulation of airway resistance depends upon what 2 body needs?
1. Carbon Dioxide levels
2. Autonomic Nervous System
High CO2 ___ airways (to get CO2 out).

Low CO2 ___ airways (keep CO2 in).
Dilates

Constricts
How is the regulation of airway resistance regulated with the Autonomic NS?
Parasympathetic: Bronchoconstrictors
Sympathetic: Bronchodilators
What are 2 characteristics about elastic behavior of the lungs?
1. Elastic Recoil
2. Compliance
___- how easily the lungs rebound after having been stretched
Elastic Recoil
___- how easily the lungs stretch.
Compliance
What is Pulmonary Elastic Behavior due to?

(2)
1. Highly elastic connective tissue
2. Alveolar surface tension (Surfactant decreases it)
PULMONARY ELASTIC BEHAVIOR
What are the 2 functions of surfactant?
1. Reduces elastic recoil, so that the lungs don't collapse
2. Increases pulmonary compliance (reduces work of inflating the lungs)
What are the 3 forces keeping the alveoli open?
1. Transmural gradient
2. Pulmonary surfactant
3. Alveolar Interdependence (surrounding alveoli stretch to keep neighbor alveoli open)
What are the 2 forces keeping the alveoli closed?
1. Elasticity of stretched pulmonary connective tissue
2. Alveolar surface tension
What is the Law of Laplace (formula)
Collapsing pressure = 2 x surface tension/radius
what are 4 ways that increase the work of breathing?
1. Pulmonary compliance decreased (pulmonary fibrosis)
2. Airway resistance increased (Asthma; allergic r.; bronchitis)
3. Elastic recoil decreased (smoking)
4. A need for increased ventilation (during exercise)
What are the 4 lung volumes?
1. Tidal Volume (TV)
2. Inspiratory Reserve Voume (IRV)
3. Expiratory Reserve Volume (ERV)
4. Risidual Volume (RV)
___- (500ml) volume of air entering or leaving the lungs during a single breath.
1. Tidal Volume (TV)
2. Inspiratory Reserve Voume (IRV)
3. Expiratory Reserve Volume (ERV)
4. Risidual Volume (RV)
Tidal Volume (TV)
___- (3000mls) extra volume of air that can be maximally inspired over & above the tidal volume.
1. Tidal Volume (TV)
2. Inspiratory Reserve Voume (IRV)
3. Expiratory Reserve Volume (ERV)
4. Risidual Volume (RV)
Inspiratory Reserve Volume (IRV)
___- (1000mls) extra volume of air that can be maximally expired over & above the tidal volume.

1. Tidal Volume (TV)
2. Inspiratory Reserve Voume (IRV)
3. Expiratory Reserve Volume (ERV)
4. Risidual Volume (RV)
Expiratory Reserve Volume (ERV)
___-(1200mls) the min. volume of air remaining in the lungs even after a maximal expiration.
1. Tidal Volume (TV)
2. Inspiratory Reserve Voume (IRV)
3. Expiratory Reserve Volume (ERV)
4. Residual Volume (RV)
Residual Volume
What are the 4 Lung Capacities?
1. Inspiratory Capacity (IC)
2. Funtional Residual Capacity (FRC)
3. Vital Capacity (VC)
4. Total Lung capacity (TLC)
___- the maximum volume of air that can be inspired at the end of a normal expiration.
1. Inspiratory Capacity (IC)
2. Funtional Residual Capacity (FRC)
3. Vital Capacity (VC)
4. Total Lung capacity (TLC)
Inspiratory Capacity (IC)
__= IRV + TV
1. Inspiratory Capacity (IC)
2. Funtional Residual Capacity (FRC)
3. Vital Capacity (VC)
4. Total Lung capacity (TLC)
Inspiratory Capacity (IC)
___- the volume of air in the lungs at the end of a normal passive expiration
1. Inspiratory Capacity (IC)
2. Funtional Residual Capacity (FRC)
3. Vital Capacity (VC)
4. Total Lung capacity (TLC)
Functional Residual Capacity (FRC)
__=ERV + RV
1. Inspiratory Capacity (IC)
2. Funtional Residual Capacity (FRC)
3. Vital Capacity (VC)
4. Total Lung capacity (TLC)
Functional Residual capacity (FRC)
___- The max. volume of air that can be moved in & out during a single breath.
1. Inspiratory Capacity (IC)
2. Funtional Residual Capacity (FRC)
3. Vital Capacity (VC)
4. Total Lung capacity (TLC)
Vital Capacity (VC)
__=IRV + TV + ERV
1. Inspiratory Capacity (IC)
2. Funtional Residual Capacity (FRC)
3. Vital Capacity (VC)
4. Total Lung capacity (TLC)
Vital Capacity (VC)
___- The max. volume of air that the lungs can hold.
1. Inspiratory Capacity (IC)
2. Funtional Residual Capacity (FRC)
3. Vital Capacity (VC)
4. Total Lung capacity (TLC)
Total Lung Capacity (TLC)
__= VC + RV
or
__=IRV + TV + ERV + RV
1. Inspiratory Capacity (IC)
2. Funtional Residual Capacity (FRC)
3. Vital Capacity (VC)
4. Total Lung capacity (TLC)
Total Lung Capacity (TLC)
What are the 2 Respiratory Dysfunctions?
1. Obstructive Lung Disease
2. Restrictive Lung Disease
__- have more difficulty emptying the lungs than filling them.
1. Obstructive Lung Disease
2. Restrictive Lung Disease
Obstructive Lung DIsease
__- the lungs are less compliant than normal
1. Obstructive Lung Disease
2. Restrictive Lung Disease
Restrictive Lung Disease
___- determined by the amount of air breathed in & out in one minute
Pulmonary (minute) ventilation

PV = TV x Respiratory Rate
___- air in conducting passageways that doesn't reach the site of gas exchange in the alveoli (150ml).
Anatomic Dead Space

So of the 500ml moved in, only 350ml are exchanged
___- the volume of air exchanged between the atmosphere & the alveoli per minute.
Alveolar Ventilation
What is the formula for Alveolar Ventilation?
AV= (tidal Volume - Dead space volume) x RR
What is the Alveolar Ventilation?

Johns respiratory rate is 12/minute. The Tidal Volume is 500 and the Dead space volume is 150.
AV=(500 - 150) x 12
AV= 4200ml/min
___- any alveoli that are inadequately profused (nonfunctionable). [not all O2 is exchanged]
Alveolar dead space
What is Physiological or Total Dead space formula?
Alveolar Dead space + Anatomical Dead space
What are the 2 local controls that act on smooth muscle of the airways & arterioles to match airflow to blood flow?
1. Effect of CO2 on bronchiolar smooth muscle (High CO2 dilates; Low CO2 constricts)
2. Effect of O2 on Pulmonary Arteriolar smooth muscle
(High: Dilates; Low: constricts)
What is the purpose of the gas exchange of O2 & CO2?
To provide O2 to blood & to remove CO2 from blood
What are the 2 sites of gas exchange?
1. Between Alveoli & Pulmonary capillaries
2. Between Tissues & Systemic Capillaries
What is the method of Gas Exchange of O2 & CO2?
Occurs by simple passive diffusion of O2 & CO2 down partial pressure gradients
Alveolar air is not the same composition as inspired atmospheric air for what 2 reasons?
1. Alveolar air becomes saturated with water by moist airways
2. Alveolar PO2 is further reduced since fresh inspired air is mixed with the old air that remained in the lungs & dead space at end of preceding expiration
At the end of inspiration, less than __% of the air in the alveoli is fresh air.
15%
Alveolar PO2 is ___mm Hg
-200
-300
-50
-100
-1000
100

& it goes from the alveoli to blood
What is the Alveolar PO2 constant?
(2reasons)
1. Small portion of total alveolar air is exchanged with each breath
2. O2 arriving in alveoli (newly inspired air) simply replaces O2 diffusion out of the alveoli into the pulmonary capillary
the Alveolar PCO2 is ___mm Hg
-200
-300
-40
-50
-100
-1000
40

goes from blood to alveoli
Why is the Alveolar PCO2 constant?
The rate of CO2 entering the alveoli from blood balances the rate which it is removed by ventilation from the alveoli to the atmosphere
What are 2 additional factors that affect the rate of gas transfer?
1. Surface Area (^SA=^gas transfer)
2. Thickness of the membrane (thinner=^diffusion; Thicker=v diffusion)
What are the 2 ways of Gas Transport?
1. Oxygen Transport
2. CO2 Transport
Oxygen Transport:
- Physically dissolved- ___%
- Chemically bound to Hemoglobin ___%
1.5%

98.5%
What are the 2 ways of Oxygen Transport?
1. Physically dissolved
2. Chemically bound to Hemoglobin
What are the 3 ways of CO2 Transport?
1. Physically dissolved
2. Bound to Hemoglobin
3. As bicarbonate
CO2 Transport:
- Physically dissolved __%
- Bound to Hemoglobin __%
- As Bicarbonate ___%
10%
30%
60%
___- No oxygen is bound

-Reduced Hemoglobin
-Oxyhemoglobin
-Hemoglobin Saturation
Reduced Hemoglobin
___- Occurs if 4 O2 Molecules are attached to it.
-Reduced Hemoglobin
-Oxyhemoglobin
-Hemoglobin Saturation
Hemoglobin Saturation
____- Oxygen is bound to Hemoglobin
-Reduced Hemoglobin
-Oxyhemoglobin
-Hemoglobin Saturation
Oxyhemoglobin
What is the Law of Mass Action?
If the concentration of one substance involved in a reversible reaction is increased, the reaction is driven toward the opposite side.

"bath tub": Hb + O2 = HbO2
const. ^ ^
const. v v
Oxygen-Hemoglobin (saturation) curve:
Relationship between PO2 & % Hb saturation is not directly linear (not 1:1)
-It is an S-shaped (sigmoid) curve
What are the factors that shift the O2-Hb saturation curve to the right?
(4)
-Increased PCO2 (pushes O2 into tissue)
-Increased H+ (Pushes O2 out)
-Increased Temp. (Speeds O2; into tissue)
-Increased 2,3-bisphosphoglycerate (placenta; pushes O2 out of blood into Placenta)
What are the factors that shift the O2-Hb saturation curve to the left?
(1)
-Increased Carbon Monoxide (CO)

CO + Hb = HbCO
___- as bicarbonate comes out of the RBC to buffer acids, Cl goes in to maintain electrical neutrality
Chloride Shift
What is the Bohr Effect?

(explain it)
Increased CO2 & Hydrogen ion levels cause an increase relase of O2 from hemoglobin.
What is the Haldane Effect?

(explain it)
Oxygen removed from Hemoglobin increases the ability of hemoglobin to pickup CO2 & Hydrogen ions
What are the 2 Respiratory Control Centers in the Brain Stem?
1. Medulla (Medullary Respiratory Group)
2. Pons
RESPIRATORY CONTROL CENTERS IN BRAIN STEM:
What are the 3 parts/centers in the Medulla that make up the Medullary Respiratory Group?
1. Dorsal Respiratory Group
2. Ventral Respiratory Group
3. preBotzinger Complex
RESP. CONTROL CENTERS IN BRAIN STEM: MEDULLA
____- allows inspiration to take place.
1. Dorsal Respiratory Group
2. Ventral Respiratory Group
3. preBotzinger Complex
Dorsal Respiratory Group
RESP. CONTROL CENTERS IN BRAIN STEM: MEDULLA
___- generates the respiratory rhythem (pacemaker activity)
1. Dorsal Respiratory Group
2. Ventral Respiratory Group
3. preBotzinger Complex
preBotzinger Complex
RESP. CONTROL CENTERS IN BRAIN STEM: MEDULLA
____- stimulated when there is an increased demand of ventilation
1. Dorsal Respiratory Group
2. Ventral Respiratory Group
3. preBotzinger Complex
Ventral Respiratory Group
What are the 2 Respiratory centers of the Pons?

What is their job/ what do they influence?
1. Apneustic Center
2. Pneumotaxic Center

Both influence output from the medullary Respiratory center for "fine tuning" influences.
What are the 2 Inspiratory Neuron Pacemaker Activities? (2 nerves) And what do they innervate?
1. Phrenic - Thoracic Diaphragm
2. Intercostal - External Intercostal Muscles
What is the Hering-Breuer Reflex?
When does it occur?
Prevents the Tidal Volume from expanding greater than 1 Liter to prevent over-inflation of the lungs.

(Occurs during exercise)
____- located within the smooth-muscle layer of the airways are activated by the stretching of the lungs at large tidal volumes.
-send an afferent nerve fiber to the medullar dorsal respiratory group & inhibits the inspiratory neurons
Pulmonary Stretch Receptors
What are the 2 types of Chemoreceptors in the Respiratory System?

What are they most sensitive to?
1. Peripheral chemoreceptors (O2, CO2, & acid)
2. Central Chemoreceptors (Acid & CO2)
What are the 3 signals to increase ventilation? (chemical)
1. Decreased PO2 in arterial blood
2. Increased arterial PCO2
3. Increased H+ in arterial blood
-Decreased PO2 in arterial blood stimulates ____ chemoreceptors.

-Increase arterial PCO2 strongly stimulates ____ chemoreceptors.

-Increased H+ in the arterial blood stimulates _____ chemoreceptors.
Peripheral

Central

Peripheral & Central
What are the 4 mechanisms involved when exercise increases ventilation?
1. Reflexes originating from body movements
2. Increase in body temp.
3. Epinephrine Release
4. Impulses from the Cerebral Cortex
Voluntary control of breathing is accomplished by the ____.
Cerebral Cortex