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154 Cards in this Set

  • Front
  • Back
What is present on the RBC plasma membrane?
Antigens - Agglutinogens
What are genetically determined Glycoproteins present on the RBC membrane?
Antigens - Agglutinogens
Which two Antigens (agglutinogens) are present in a large proportion of human beings? These Antigens cause most blood transfusion reactions.
Type A and Type B
How many blood type combinations exist?
6 total.
OO, OA, OB, AA, BB, AB
If a persons blood type produces no Agglutinogens, what is the blood type?
OO
A person with blood type OA or AA produces what type of Agglutinogens and what type of Agglutinins?
Agglutinogens: Type A
Agglutinins: anti-B
A person with blood type O produces what type of Agglutinogens and what type of Agglutinins?
Agglutinogens: None
Agglutinins: anti-A and anti-B
A person with blood type AB produces what type of Agglutinogens and what type of Agglutinins?
Agglutinogens: Type A and Type B
Agglutinins: None
The Antibodies found in the plasma in response to the Antigens found on the RBC plasma membrane, are called?
Agglutinins
What is the reason for the agglutination seen with a blood type mismatch?
The Agglutinins attaching themselves to the RBCs.
How to Agglutinins work in Agglutination?
Agglutinins have multiple binding sites so a single Agglutinin can attach to two or more RBCs at the same time, thereby causing the cells to clump.
These clumps can plug small blood vessels throughout the circulatory system.
What destroys the membranes of Agglutinated cells?
Physical distortion of the cells or attack from WBCs destroys the membranes of the Agglutinated cells, releasing Hemoglobin into the plasma, which is termed Hemolysis of RBCs.
How do plasma Agglutinins (antibodies) develop for the ABO blood type system?
Spontaneously
How do Agglutinins develop for the Rh blood type system?
Never spontaneously.
The person must be exposed to large amounts of Rh antigen by for example, a transfusion of blood containing Rh antigen, before enough Agglutinins are able to cause a significant transfusion reaction to develop.
How many types of Rh antigens exist?
6. Each of which are called an Rh Factor.
C, D, E, c, d, and e.
If a person has Rh factor: C antigen, do they also have the c?
No, if a person expresses C this means they do not have the c antigen.
If a person is missing Rh Factor: C antigen, do they also have the c?
Yes. A person will still express the c antigen despite missing the C antigen.

This is the same for D-d and E-e.
Which Rh factor is widely prevalent in the population and considerably more antigenic than other Rh antigens?
Rh Factor: D
What makes a person Rh+ or Rh- ?
If a person has the Rh factor: D, they are said to be Rh+
If a person does not have Rh factor: D, they are said to be Rh-
What is the "universal" donor and recipient blood types?
Universal Donor: O-
Universal Recipient: AB+
What is the average arterial pressure during a single cardiac cycle?
Mean Arterial Pressure
What is the amount of pressure required to create a pulse?
Pulse Pressure
What is the condition that is caused when the mother and fetus have differing blood types, and Antibodies from the mother attack the fetus' RBCs?
Erythroblastosis Fatalis
What are the two main incompatibilities seen in Erythroblastosis Fatalis?
ABO Incompatibility: Most common
Rh Incompatibility: Most severe. Causes severe anemia. Mother must take RhoGAM to prevent Erythroblastosis Fatalis.
Blood Type: A+
Agglutination with anti-A:
Agglutination with anti-B:
Agglutination with Rh:
Agglutination with anti-A: +
Agglutination with anti-B: -
Agglutination with Rh: +
Blood Type: B+
Agglutination with anti-A:
Agglutination with anti-B:
Agglutination with Rh:
Agglutination with anti-A: -
Agglutination with anti-B: +
Agglutination with Rh: +
Blood Type: AB-
Agglutination with anti-A:
Agglutination with anti-B:
Agglutination with Rh:
Agglutination with anti-A: +
Agglutination with anti-B: +
Agglutination with Rh: -
Blood Type: AB+
Agglutination with anti-A:
Agglutination with anti-B:
Agglutination with Rh:
Agglutination with anti-A: +
Agglutination with anti-B: +
Agglutination with Rh: +
Blood Type: O-
Agglutination with anti-A:
Agglutination with anti-B:
Agglutination with Rh:
Agglutination with anti-A: -
Agglutination with anti-B: -
Agglutination with Rh: -
Blood Type: B-
Agglutination with anti-A:
Agglutination with anti-B:
Agglutination with Rh:
Agglutination with anti-A: -
Agglutination with anti-B: +
Agglutination with Rh: -
Which 6 things do the kidneys regulate in hopes to maintain homeostasis in the body?
1) Plasma Osmolarity ( Osmoles of solute / L of solvent )
2) Plasma Volume
3) Acid-Base Balance
4) Electrolyte Balance
5) Excretion of metabolic wastes and foreign materials.
6) Production and secretion of hormones that regulate Osmolarity and electrolyte balance.
What is the precise location of the Kidneys?
Between the Posterior Abdominal wall and the Abdominal Peritoneum.
Which kidney is slightly lower than the other?
The right kidney is slightly lower than the left.
What is the functional unit of the Kidney and how does it exist?
Nephron, exists in about 1.2 million for each kidney.
What part of the Nephron consists of a tuft of capillaries called the Glomerulus, which is enclosed by a fluid filled capsule called the Bowan's Capsule?
The Renal Corpuscle
What part of the Nephron supplies blood to the Glomerulus?
Afferent Arteriole
What is this process called: As blood flows through the Glomerular Capillaries, Protein-free plasma filters into the Bowman's Capsule.
Glomerular Filtration
What part of the Nephron drains the Glomerulus of the remaining blood?
Efferent Arteriole
What is the sequence of flow of the filtrate at the end of Glomerular Filtration?
Filtrate flow:
Bowman's Capsule > start of Renal tubule called the Proximal Convoluted Tubule > Proximal Straight Tubule > Loop of Henle > Distal Convoluted Tubule > Connecting Tubule > Collecting Ducts.
Where does urine collect in the Nephron?
At the Collecting Ducts
Where in the Nephron do we find Principle Cells and Intercalated Cells ?
Distal Convoluted Tubule and the Collecting Duct.
What are the functions of Principle Cells?
Reabsorb Na+
Secrete K+
What are the functions of Intercalated Cells?
Secrete: H+ or HCO3-
Therefore very important in the regulation of acid-base balance.
What aids the blood filtration from the Glomerular Capillaries into the Bowman's Capsule?
Starling Forces (Hydrostatic and Osmotic pressure gradients) drives protein-free plasma from blood across the walls of the Glomerular Capillaries and into the Bowman's capsule.
What is a good index of Kidney function?
GFR - Glomerular Filtration Rate
What is the range of the typical GFR in humans?
Normal Human GFR Range: 80-140 ml/min.

So that in 24 hours, as much as 180L of plasma is filtered by the Glomeruli.
What is the formed Glomerular Filtrate devoid of?
Devoid of cellular debris and it is protein-free.
How does the Glomerular Filtrate concentration of salt and organic molecules compare to that of blood?
Similar
What is the normal Liters/24 hours of urine output?
1-1.5L / 24 hours
Normally, what percentage of blood is filtered in the nephron? What is this due to?
20% of entering blood is actually filtered.
This is due to the Osmotic pressure of the blood (Oncotic pressure), and the Hydrostatic Pressure from the fluids in the Bowman's Capsule.
What are the 4 main ways to alter the GFR?
1) Changing Afferent Arteriole Resistance
2) Changing Efferent Arteriole Pressure
3) Changing the size of the filtration surface
4) Renal Autoregulation
Once Filtrate is formed, what does the Nephron do?
It must reabsorb materials that the body needs and excrete unneeded materials from the body.
Where in the Nephron does more than 67% of reabsorption take place?
Proximal Convoluted Tubule
Where in the Nephron does about 7% of the reabsorption of NaCl take place, and a variable amount of secretion occur?
Distal Convoluted Tubule and Collecting Duct.
~7% of NaCl is Reabsorbed
K+ and H+ is Secreted variably
Water is Reabsorbed variably
Where do hormones act to reabsorb water and electrolytes in the Nephron?
In the Distal part of the Nephron
What is the function of Aldosterone?
Regulates the reabsorption of NaCl (and thus its excretion also)
What is the function of ADH?
Causes the permeability of the Distal Convoluted Tubule and Collecting Duct to increase = Promoting the water reabsorption from the Filtrate.
Which hormone is considered the most important in regulating water balance?
ADH
How can we reduce GFR?
By constricting Afferent Arterioles and/or dilating Efferent Arterioles.
How can we increase GFR?
By dilating Afferent Arterioles and/or constricting Efferent Arterioles.
What two types of cells are physiological mechanisms to regulate Afferent and Efferent Arteriole radius?
Juxtaglomerular Cells
Macula Densa Cells
How do Macula Densa cells work?
In response to low Na+, Cl-, Water in filtrate in distal part of Nephron. This triggers the dilation of Afferent Arterioles to increase Glomerular Blood Flow.
How to Juxtaglomerular Cells work?
Able to constrict or dilate mostly the Afferent Arterioles, but also Efferent Arterioles in order to regulate Glomerular Blood Flow.
If low Glomerular Blood Flow: Juxtaglomerular Cells secrete Renin.
If you increase blood pressure, how does this effect the pressure in the Glomerulus?
Increased
If you increase blood pressure, how does this affect GFR?
Increased
If you increase blood pressure, how does this affect urine formation?
Increased
What is the movement of filtered solutes and water from the lumen of the renal tubules back into the plasma called?
Reabsorption
List all functions of the Kidney
1) Excretion of metabolic wastes and foreign chemicals
2) Regulation of water and electrolytes
3) Regulation of body fluid Osmolarity and Electrolyte Concentrations.
4) Regulation of Acid/Base Balance
5) Secretion, metabolism, and excretion of hormones
6) Gluconeogenesis
What three processes aid in clearing the filtrate from unneeded products?
1) Glomerular Filtration
2) Reabsorption from Renal Tubules into the blood
3) Secretion of substances from blood into the Renal Tubules.
How does urine formation begin?
When a large amount of fluid that is virtually free of protein is filtered from the Glomerular Capillaries into the Bowman's Capsule.
Most substances except for proteins are freely filtered, so that their concentration in the Glomerular Filtrate in the Bowman's Capsule is almost the same as in the Plasma.
Which substances must be cleared from the blood?
Urea, Creatinine, Uric Acid, Urates, and drugs.
What is the pH of urine?
~6
But can vary between 4.5-8 during changes in the body's metabolism.
What is specific gravity?
The ratio of a mass of a substance to the same mass of distilled water. Since urine has a greater concentration of solutes than water, it will therefore have a greater mass.
Specific gravity of urine ranges from 1.01-1.025
How could you explain the appearance of Bilirubin in Urine?
It is supposed to be removed from the blood and become part of Bile.
If found in urine, it indicates liver damage or liver disease.
How could you explain the appearance of Blood in Urine?
Hemoglobin raises basicity, along with myoglobin.
The pH would be high if blood was found in urine.
If found in urine, it indicates Kidney damage or infection, or kidney and bladder stones.
How could you explain the appearance of Protein in Urine?
Low pH would signify high protein levels in urine.
It indicates Kidney problems.
List all the factors that could potentially contribute to low pH urine?
Exercise, drugs, eating acidic foods, eating a high sodium diet.
List all the factors that could potentially contribute to a high glucose concentration in urine?
Diabetes, Kidney damage, Kidney Infection --> UTI
What are the problems associated with a high urine Specific Gravity?
Dehydration, heart failure, shock, Glucosuria.
What are the problems associated with a low urine Specific Gravity?
Diabetes, Kidney failure, Kidney infections, Excessive fluid intake.
What measurement helps evaluate your body's water balance and urine concentration?
Specific Gravity of urine
What are the major functions of Respiration?
Pulmonary Ventilation
Diffusion of Oxygen and CO2 between the Alveoli and blood.
Transport of Oxygen and CO2 in the blood and fluids from the tissue cells.
Regulation of Ventilation and other facts of Respiration.
Define Pulmonary Ventilation
The inflow and outflow of air between the atmosphere and the lung Alveoli
How is Ventilation produced in the Human Lung?
By muscular contraction in two ways,
1) By Downward and upward movement of the diaphragm to lengthen and shorted the chest cavity.
2) By elevation and depression of the ribs by the Intercoastal muscles to increase or decrease the anteroposterior diameter of the chest cavity.
What is a simple method for studying Pulmonary Ventilation?
Spirometry
Define Spirometry
The recording of the volume of air moving into and out of the lungs.
What two things does the Spirometer measure?
1) Records the volume of air that you inhale and exhale over a period of time.

2) Measures the rate of movement of air into and out of your lungs.
What are the 4 Pulmonary Volumes?
Tidal Volume
Inspiratory Reserve Volume
Expiratory Reserve Volume
Residual Volume
Term the measurement: The volume of air inspired or expired with each normal breath; it amounts to about 500 ml in the average-sized adult male.
Tidal Volume
Term the measurement: The extra volume of air that can be inspired beyond the normal tidal volume when the person inspires with full force; it is usually about 3000 ml.
Inspiratory Reserve Volume
Term the measurement: The extra volume of air that can be expired by forceful expiration after the end of a normal tidal expiration; this normally amounts to 1200 ml.
Expiratory Reserve Volume
Term the measurement: The volume of air remaining in the lungs after the most forceful expiration; this volume averages about 1200 ml.
Residual Volume
What is the average amount of volume expected in: Tidal Volume?
500ml
What is the average amount of volume expected in: Inspiratory Reserve Volume?
3000ml
What is the average amount of volume expected in: Expiratory Reserve Volume?
1200ml
What is the average amount of volume expected in: Residual Volume?
1200ml
List the 4 Pulmonary Capacities?
Inspiratory Capacity
Functional Residual Capacity
Vital Capacity
Total Lung Capacity
Term the measurement: The Tidal Volume plus the Inspiratory Reserve Volume. This is the amount of air (about 3500 ml) a person can breathe in, beginning at the normal expiratory level and distending the lungs to the maximum amount.
Inspiratory Capacity
Term the measurement: The Expiratory Reserve Volume plus the Residual Volume. This is the amount of air that remains in the lungs at the end of normal expiration (about 2400 ml).
Functional Residual Capacity
Term the measurement: The Inspiratory Reserve Volume plus the Tidal Volume plus the Expiratory Reserve Volume. This is the maximum amount of air a person can expel from the lungs after first filling the lungs to their maximum extent and then expiring to the maximum extent (about 4700 ml).
Vital Capacity
Term the measurement: The maximum volume to which the lungs can be expanded with the greatest possible effort (about 5900 ml); it is equal to the Vital Capacity plus the Residual Volume.
Total Lung Capacity
What is the average amount of volume expected in: Inspiratory Capacity?
3500ml
What is the average amount of volume expected in: Functional Residual Capacity?
2400ml
What is the average amount of volume expected in: Vital Capacity?
4700ml
What is the average amount of volume expected in: Total Lung Capacity?
5900ml
What are both equations to find the Vital Capacity?
VC = IRV + TV + ERV

VC = IC + ERV
What are both equations to find the Total Lung Capacity?
TLC = VC + RV
TLC = IC + FRC
What is the equation to find the Functional Residual Capacity?
FRC = ERV + RV
All pulmonary volumes and capacities are about __ - __% less in women than in men, and they are greater in people with __________ and __________ than in individuals with ____________.
20-25%
Larger physical builds and athletes
Smaller builds
How do the Pulmonary Volumes compare during Normal Breathing, Hyperventilation and Hypoventilation?
Normal Breathing:
Hyperventilation:
Hypoventilation:
After a brief period of Hyperventilation, Apnea Vera occurs. Why?
The cessation of breathing allows the blood CO2 levels to return to normal, and with it the desire to resume breathing. The temporary cessation of breathing following a brief period of voluntary Hyperventilation is known as Apnea Vera (apnea–without breath, vera–true).

A person may also voluntarily hold their breath and experience a voluntary Apnea for a short period of time.
However, the cessation of breathing results in hypercapnia, a condition in which blood CO2 levels rise above normal, producing a stronger chemical stimulus to the respiratory centers that overcomes the cerebral breath-holding input and initiates breathing.
Thus, the child who holds his breath to spite his parents will, if ignored, begin to breathe anyway. Immediately after voluntary apnea ends, breathing resumes at a higher than resting rate and depth, producing an involuntary Hyperventilation to quickly rid the body of excess carbon dioxide. As blood CO2 levels are returned to normal, breathing frequency and depth decrease to normal resting values.
If you start Hyperventilating, the goal is to?
Lower the CO2 levels in your blood
What may Hyperventilation be a marker of?
Bleeding
Heart or Lung disorder
Infection
Anxiety
What physiological changes occur in the body during Hyperventilation?
Respiratory Alkalosis
Cerebral Vasoconstriction because of Hypocalcemia (caused by high pH)
Hypoxia

Expiring more CO2 than what is being produced in the body, thereby raising the blood's pH value (making it more alkaline), initiating constriction of the blood vessels which supply the brain, and preventing the transport of oxygen and other molecules necessary for the function of the nervous system.
What physiological changes occur in the body during Hypoventilation?
Increased concentration of CO2 (hypercapnia)
Respiratory Acidosis
Secondary Hypoxemia (low oxygen levels - SECONDARY)

Early symptoms may include fatigue, daytime sleepiness, anxiety, and shortness of breath.
As the condition worsens, cyanosis (blue lips, fingers, and toes) or paleness may occur.
Severe disease may cause confusion, extreme fatigue, seizures, and mental status changes, and may ultimately lead to impairment of other organs, including pulmonary hypertension and cor pulmonale, a form of heart failure.
What are Pulmonary function tests are routinely used to determine the presence of?
Restrictive or Obstructive Pulmonary defects
Respiratory health prior to surgery
Lung and chest wall compliance
Response to therapies
Readiness to wean from a ventilator
What do Obstructive defects impede?
Impedes the movement of respiratory gases through the respiratory passages and alveoli. Airway resistance is increased and it is very difficult to exhale air.
During physical exertion, an increased breathing rate results in abnormally large volume of air remaining in the lungs, owing to the fact that a very small volume of air is exhaled with each breathing cycle.
What are Obstructive diseases are characterized by?
Elevated total lung capacity (TLC)
Elevated forced residual capacity (FRC)
Elevated residual volume (RV)
What are examples of Obstructive Pulmonary Diseases?
Asthma
Emphysema
What may Restrictive (constrictive) defects be caused by?
Restriction of the Chest wall or loss of functional Lung Parenchyma.
Because lung distension is impaired, the lungs cannot maximally fill with air.
What are Restrictive pulmonary defects are characterized by?
Reduced vital capacity (VC) - less than 80% of predicted
Reduced TLC
Reduced RV
What are examples of Restrictive Pulmonary Diseases?
(Pulmonary causes of Restrictive Pulmonary Defects)
Pulmonary Fibrosis
Tuberculosis
Massive Pneumonia
What are Non-pulmonary causes of Restrictive Pulmonary Defects?
Conditions that cause Chest wall restriction:
Massive obesity
Scoliosis
Pregnancy
Cardiomegaly
How do you perform the FVC maneuver?
The person inspires maximally and then exhales into the spirometer with maximum expiratory effort as rapidly and as completely as possible.
What represents the FVC on the spirometry graph?
The total vertical distance of the downward slope.
Why is it customary to measure the the forced expiratory volume (FEV) during the first second (FEV1) and third second (FEV3)?
Because there is a considerable difference in the amount of air that is expired each second.

In the normal person, the percentage of the FVC that is expired in the first second divided by the total FVC is about 80% and in the third second is 92%.

FEV% = (FEV/FVC) X 100
How is FEV% affected in Obstructive Pulmonary Defects vs. Restrictive Pulmonary Defects?
Obstructive Pulmonary Defects: This value can decrease to less than 20%, often seen in acute Asthma.
Restrictive Pulmonary Defects: Normal or elevated FEV%.
Why is determination of FEV% important?
The FEV% is a valuable and relatively sensitive index of airway obstruction, and therefore is very useful in evaluation of a patient’s response to a bronchodilator.
Term the measurement: The volume of air moved through the pulmonary system in one minute when breathing as quickly and deeply as possible (hyperventilation).
Maximal Voluntary Ventilation (MVV)
How do you perform a Maximal Voluntary Ventilation?
The subject inspires as deeply and as rapidly as possible (>1 breath/sec) while the tidal volume and the respiratory rate are measured.
Because the maximal breathing is difficult to maintain, the subject hyperventilates for 15 seconds.
How do you calculate the MVV?
The average volume per respiratory cycle is multiplied by the number of cycles per minute (liters/min).
What is the MVV an indicator of?
MVV is an indicator of the peak performance of the ventilatory apparatus (respiratory muscles, chest wall, airways, and lung parenchyma).
It limits how much oxygen is available to the tissues of the body during strenuous exercise and work.
MVV is rarely exceeded and normal values vary with sex, age, and body size.
What are the normal values for MVV for males and females?
Males: 140 - 180 L/min
Females: 80 - 120 L/min
Up to what percentage can a person's MVV be used for exercise beyond 10 minutes?
50%
Most people have trouble breathing when only using the available 30 - 40%.
How is MVV affected in Obstructive Pulmonary Defects vs. Restrictive Pulmonary Defects?
MVV tends to be reduced in both Restrictive and Obstructive Defects.
What are the equations to predict the Vital Capacity in both Males and Females?
Male VC = 0.052H – 0.022A – 3.60
Female VC = 0.041H – 0.018A – 2.69
[H – Height in cm, A – Age in years]
Asthmatics tend to have smaller airways. What are they narrowed by?
Smooth muscle contraction
Thickening of the walls
Excess mucous secretion
How would the FEV% of an asthmatic person compare to that of an athlete?
Asthmatic FEV%: Reduced
Athlete FEV%:
How do Obstructive Pulmonary conditions affect:
TLC, RV, FVC, FEV and MVV values?
TLC: Increased
RV: Increased
FVC:
FEV:
MVV: Reduced
How do Restrictive Pulmonary conditions affect:
TLC, RV, FVC, FEV and MVV values?
TLC: Reduced
RV: Reduced
FVC: Reduced
FEV: Reduced
MVV: Reduced
What is the clinical importance of the FEV and FVC values?
FEV:
FVC:
What is ventilation a result of?
Muscle Contraction
What reduces the pressure within the thoracic cavity, allowing the atmospheric gas to enter the lungs (inspiration)?
The contraction of the diaphragm
What's the difference between inspiration and expiration processes during normal breathing and during strenuous exercise?
Normal: Inspiration = Active / Expiration = Passive
Exercise: Inspiration = Active / Expiration = Active

During exercise: External intercoastal muscles contract during inspiration and diaphragm contraction. Expiration involves internal intercoastal muscle contraction
How is Ventilation measured?
As the frequency of breathing multiplied by the volume of each breath, called the tidal volume.
How do Oxygen and CO2 travel around the body?
Down their concentration gradients
Define Minute Respiratory Volume and state the equation
The amount of air that passes in and out of the lungs in 1 minute.

Equation: Tidal Volume x Breaths/min
How is the adequacy of alveolar ventilation measured?
In terms of the partial pressure of CO2.
What is the major component for regulating breathing rate?
CO2
What maintains normal partial pressures of oxygen and carbon dioxide in the lungs and blood?
Ventilation
How are breathing patterns of an individual tightly regulated?
By breathing centers of the brain so that the respiratory and circulatory systems can work together effectively.
What condition would result in a significant loss of intrinsic elastic recoil in the lung tissue?
Emphysema
How does a person with Emphysema breath?
Slow exhalations, requiring great effort.
What is the difference in the way in which Asthma increases airway resistance compared to Emphysema?
Airway resistance is increased in Asthma because of bronchiole smooth muscle spasms causing airways to constrict, in addition to thick mucous secretion clogging them.

Elastic recoil is not diminished in an acute asthma attack.