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AP255
Final guide for AP255
| Question | Answer |
|---|---|
| What are Formed Elements | (3) platelets, leukocytes, erythrocytes |
| What is normal PH | 7.35-7.45 |
| If PH is over 7.45 | Alkali |
| If PH is lower than 7.35 | Acidic (more carbonic acid) |
| Do Erythrocytes need oxygen | No, erythrocytes do not need oxygen |
| What are Erythrocytes | sacs of hemoglobin; 97% hemoglobin; dedicated to oxygen transport |
| What consist of a Heme molecule | 4 heme groups with 1 bound oxygen molecule |
| What types of Leukocytes are there | 1) granulocytes – basophils, eosinophils & neutrophils 2) Agranulocytes – Monocytes & lymphocytes |
| What is Blood type AB | no A or B antibodies; O never has antibodies at all; RH has no antibodies |
| Other than veins what other system has valves | Lymph vessels & nodes have valves |
| What 4 distinct processes for respiration to occur | Ventilation, external respiration, transport, internal respiration |
| What do conchae do | Increase mucosal area and enhance air turbulence |
| What are the 3 layers of the trachea | Adventitia (outer), submucosa & mucous membrane |
| Respiratory Zone consists of | Respiratory Bronchioles (first ones with alveoli), alveolar ducts to alveolar sacs to alveoli. |
| What are type I pneumocytes | The cell responsible for the gas (oxygen and carbon dioxide) exchange that takes place in the alveoli. It is a very large thin cell stretched over a very large area. Gas exchange by simple diffusion |
| What are type II pneumocytes | Secrete surfactant that coats alveolar surface reducing surface tension |
| What is the root of the lung | Vascular & bronchiole attachments |
| What is costal surface | Ribs anterior, posterior & lateral surface lie in close contact with ribs |
| What is Apex | Near clavicle, narrow superior tip of lung |
| What is hilus of lung | Mediastinal surface; indentation where pulmonary & systemic blood enter & leave lungs. |
| What is cardiac notch | Left lung has concavity in its medial aspect to accommodate heart |
| How many lobes does each lung have | Right has 3 lungs portioned by 3 fissures (oblique & horizontal fissures); left has two lobes separated only by oblique fissure. |
| What is intrapulmonary pressure | Pressure in alveoli; rises and falls with breathing BUT it always equalizes with atmospheric pressure |
| What is intraplueral pressure | Pressure in pleural cavity; fluctuates w/breathing but it is always about 4mmHG LESS than intrapulmonary & Atmospheric pressures. |
| Why is transpulmonary pressure so important | Due to the importance of negative pressure in the intrapleural space; the difference in the two pressures keeps air spaces open and not collapsed, so negative pressure must be maintained. |
| What is Boyle’s law | P1V1=P2V2; at constant temperature, the pressure of a gas varies inversely with its volume. When volume is reduced, the pressure goes up |
| Why is airway resistance important | flow of gas in & out of alveoli is directly proportional to the change in pressure; the diff in pressure or the pressure gradient between ext enviro. & alveoli. Gas flow changes inversely – it decreases as resistance due to friction increases |
| What is lung compliance | Refers to the stretch of the lungs; the more the lung expands for a given rise in transpulmonary pressure the greater the lung compliance. |
| What is surface tension | Liq molecules stronger attraction than other gas molecules. This unequal attraction produces state of tension at liquid surface. draws liq molecules closer together & reduces theier contact w/gas molecules & resists force that increase surface area of liq |
| What is surfactant | Produced by Type II cells; decreases cohesiveness of water molecules. As a result the surface tension of alveolar fluid is reduced and less energy needed to overcome forces to expand lungs and prevent collapse. |
| How does quiet inspiration work | Action of the diaphragm (moves inferiorly & flattens) and action of the intercostal muscles. |
| What are the four respiratory volumes | Tidal, Inspiratory reserve, expiratory reserve & residual |
| What is Tidal volume | Normal quiet breathing; about 500ml |
| What is Inspiratory reserve volume | Amount of air that can be inspired forcibly (2100-3100ml) |
| What is Expiratory reserve volume | Amount of air (1000-1200ml) that can be evacuated from lungs AFTER tidal expiration |
| What is residual volume | Amount of air that remains in lungs after expiration (1200ml) |
| What are the respiratory capacities | Inspiratory, functional residual, vital, & total lung |
| What is Inspiratory Capacity | Total amount of air that can be inspired after tidal expiration (sum of TV + IV) |
| What is functional reserve Capacity | Combined RV & ERV and represents the amount of air in lungs after tidal expiration |
| What is Vital Capacity | Total amount of exchangeable air; sum of TV, IRV, & ERV |
| What is Total Lung Capacity | Sum of all lung volumes: TV, IRV, ERV, RV |
| What is minute ventilation | Total amount of gas that flows in or out of respiratory tract in one minute. |
| What is alveolar ventilation | Better indicator of effective ventilation; includes volume of air wasted in dead space and measures flow of fresh gases in and out of alveoli during a particular time interval (avr=freq or breaths per min X (TV-dead space {ml/breath}) |
| What is Dalton’s law of partial pressures | Total pressure exerted by a mixture of gas is the sum of the pressures exerted independently by each gas in the mixture. The pressure exerted by each gas, its partial pressure, is directly proportional to the % of gas in the gas mixture |
| What is Henry’s law | When a mixture of gasses is in contact with a liquid, each gas will dissolve in the liquid in proportion to its partial pressure. The greater the concentration of a gas the more & faster the gas will go into the solution in the liquid. Also influenced by |
| What is most soluable gas | CO2, then O2 and N2 is nearly insoluble. |
| What are non-respiratory air movements | Cough, sneeze, crying, laughing, hiccup, yawn |
| What 3 factors influence movement of O2 & Co2 across respiratory membrane in external respiration | 1) Partial pressure gradients & gas solubilities; 2) matching alveolar ventilation & pulmonary blood perfusion; 3) structural characteristics of resp. membrane. |
| What is partial pressure gradients & gas solubilities | Steep oxygen partial pressure gradient exists between alveoli (104mmHG) and venous blood (40mmHG) the O2 diffuses rapidly from the alveoli into the capillary blood. CO2 is expelled gradually because CO2 is 20 times more soluble than O2 so equal amounts |
| How does blood transport CO2 | 1) Dissolved in plasma (7-10%), 2) Chemically bound to hemoglobin (20%) 3) bicarbonate ion in plasma (70%). |
| How is bicarbonate ion in plasma transported | CO2 diffuses into RBC’s and combines with water forming carbonic acid. H2CO3 (carbonic acid) is unstable and quickly dissociates into hydrogen ions and bicarb ions. RBC’s contain carbonic anhydrase an enzyme that reversibly catalyzes the conversion of CO |
| What is chloride shift | Bicarb ions diffuses quickly from RBC into plasma where it is carried to the lungs; to counterbalance the rapid outrush of these ions from the RBCs, Chloride ions move from plasma into RBC’s |
| How is the chloride shift process reversed in the lungs | PCO2 declines in the pulmonary capillaries. The CO2 must be freed from the bicarb ion. Bicarb reenters the RBC and chloride moves into plasma and binds with H+ to form carbonic acid which is then split by carbonic anhydrase to release CO2 and water |
| What neural mechanisms control breathing rhythm | Medullary Response centers & Pons respiratory centers |
| What comprises medullary Response center | Dorsal respiratory Group (DRG) and Ventral respiratory group |
| What does the Dorsal resp. group do | Pacesetting respiratory center or Inspiratory center |
| What does the VRG do | Involved in forced breathing |
| What is the Pontine respiratory group | Transmits inhibitory impulses to the Inspiratory center of the medulla. This fine tunes the breathing rhythm and prevent lung over inflation |
| What are Alveoli | Actual site of gas exchange |
| What are Bronchioles | Smallest respiratory passageways |
| What are conchae | Fleshy lobes in nasal cavity that increase its surface area & helps improve air turbulence |
| What is Epiglottis | Closes of the larynx during swallowing |
| What is the Esophagus | Food passageway posterior to the trachea |
| What is the Glottis | Lumen of the larynx |
| What is the palate | Separates the oral & nasal cavities |
| What are the parietal pleura | Pleural layer covering thorax walls |
| What is the phrenic nerve | Major nerve stimulating the diaphragm |
| What are the primary bronchi | Cilia of its mucosa beat upward toward the larynx |
| What is the trachea | Windpipe |
| What is the vagus nerve | Autonomic nervous system nerve serving the thorax |
| What is the Uvula | Closes the nasopharynx during swallowing |
| What are the vocal folds | Closes the glottis during the valsalva maneuver |
| What respiratory structures have simple squamous cells | Walls of alveoli |
| What respiratory structures have stratified squamous cells | Laryngopharynx |
| What respiratory structures have simple cuboidal cells | Bronchioles |
| What respiratory structures have psuedostratified ciliated columnar cells | Nasal cavity, nasopharynx, trachea & primary bronchi |
| What is External respiration | Exchange of gasses between alveolar & pulmonary capillary blood |
| What is Expiration | Period of breathing when air leaves the lungs |
| What is Inspiration | Period of breathing when air enters lungs |
| What is internal respiration | Exchange of gases between blood & tissue cells. |
| What is pulmonary ventilation | Alternate flushing of air into and out of lungs |
| T or F -Concerning transport of CO2, the level of bicarbonate ion is higher than resting values | False |
| T or F -Concerning transport of CO2, the amount of carbaminohemoglobin is increased | True |
| T or F -Concerning transport of CO2, the PH of the blood is higher | True |
| T or F -Concerning transport of CO2, the ph of the blood will be closer to 7.45 than 7.35 | True |
| What are Hassall’s corpuscles | Thymus medullary cells |
| What is type II allergy | Antigen contact |
| What is acquired immunity | Active and passive |
| What are interferons | Chemical Messengers |
| What is specific immunity | Innate or acquired |
| What are mast cells | Non specific immune response |
| What is the specific defense | Immune response |
| What are Monocytes | Macrophages |
| What is fever’s patch | Lymph nodule in small intestine |
| What is passive immunity | Transfer of antibodies |
| What are microphages | Neutrophils & eosinophils |
| What is humoral immunity | B Cells |
| What are lymphokines | Resistance to viral infections |
| What are cytotoxic reactions | Activation of T cells |
| What is activation of B cells | Decreased thymic hormones |
| What are cytotoxic T Cells | Lyse cells directly |
| What is active immunity | Direct exposure to an antigen |
| What are T lymphocytes | Cell mediated immunity |
| What is the coating on antibodies | Opsonization |
| What does interferons do | Enhances non specific defenses |
| What is an antibody | Two parallel pairs of polypeptide chains |
| What are IgG antibodies | Accompany fetal-maternal RH incompatibility |
| What do memory T cells do | Immediate response |
| What happens with advancing age to the thymus | Involution of the thymus |
| What’s involved in the anti-inflammatory effect | Glucocorticoids & interleukins |
| What happens in endocytosis | Antigen presentation |
| What is a bacteriophage involved in | agglutination |
| The ability to resist infection and disease through the activation of specific defenses constitute | Immunity |
| The cells that provide a specific defense known as the immune response are | Lymphocytes |
| The special lymphatic vessels that line the small intestine are | Lacteals |
| Lymphocytes that attack foreign cells or body cells infected by viruses are called | Cytotoxic T cells |
| Plasma cells are responsible for the production and secretion of what | Antibodies |
| Cells that represent the first line of cellular defense against pathogenic invasion are | Phagocytes |
| The process during which macrophages move through adjacent endothelial cells of capillary walls is called | Diapedesis |
| The small proteins released by activated lymphocytes and macrophages and by tissue cells infected with viruses are called | Interferons |
| Immunization where antibodies are administered to fight infection or prevent disease is called | Passive immunity |
| Cytotoxic T cells are responsible for the type of immunity referred to as | Cell mediated immunity |
| What is immunity that is present at birth and has no relation to previous exposure to a pathogen | Innate immunity |
| Immunity that appears following exposure to an antigen as a consequence of the immune response is called | Active immunity |
| What are the types of cells that inhibit the response of T cells and B cells | Suppressor T cells |
| Before B cells can respond to an antigen, they must receive a signal from what cells | Helper T cells |
| When an inactive cytotoxic T cell is activated and divides it produces active T cells and what other cell | Memory T cells |
| When an activated B cell divides it produces cells that differentiate in plasma and what other cell | Memory B cells |
| Antibodies are produced and secreted by what | Plasma cells |
| The ability to demonstrate an immune response upon exposure to an antigen is called | Immunological competence |
| The only antibodies that cross the placenta from the maternal blood stream are | IgG antibodies |
| The system responsible for providing the body with specific defenses against infections is called | Lymphatic |
| When glucocorticoids reduce permeability of capillaries they reduce the possibility of what | Inflammation |
| Chemical messengers secreted by the lymphocytes are called | Lymphokines |
| As a person ages their T cells become less responsive to what | Antigens |
| Name some processes in tissue damage | Inflammation of site, mast cells release histamine/heparin, attraction of phagocytes (neutrophils) and then release of cytokines. |
| Name some processes in tissue repair | Clot formation, removal of debris by neutrophils & macrophages, stimulation of fibroblasts, activation of specific defenses. Pathogen removed clot erosion & scar tissue formation. |
| Where does right lymphatic duct drain into | Right subclavian vein |
| Where does the thoracic duct drain into | left subclavian veins |
| After a hemocytoblast is made from red bone marrow, what is combined with the lymphoid stem cells to make B cells & natural killer cells | Interleukin 7 |
| True or False - Lymph nodes have many vessels entering node but only one exiting | True |
| What are the processes that make up our defenses | Physical barriers, phagocytes, immunological surveillance, interferons, compliment system, inflammatory response, fever |
| What are physical barriers | Prevents approach ^& access of pathogens; skin, hair, sweat |
| What are phagocytes | Remove debris and pathogens |
| What is immunological surveillance | Destroys abnormal cells |
| What are interferons | Increase resistance of cells to viral infections; slows spread of disease |
| What is complement system | Attaches and breaks down cell walls; attracts phagocytes |
| What is inflammatory response | Mast cells; increased blood flow, capillary permeability increased, clotting reaction walls off area, regional temp increased & specific defenses activated |
| What is fever | Mobilizes defenses, accelerates repair, inhibits pathogens |
| How does a NK cell work | Recognition & adhesion; realignment of golgi apparatus; secretion of perforin; lysis of abnormal cell |
| What is the lymphatic system | Includes cells, tissues, organs responsible for defending the body against environmental hazards such as pathogens and internal threats such as cancer cells |
| What is a nonspecific defense | Body forms anatomical barrier & defense mechanisms to prevent, slow or attack infectious organisms without discriminating one threat from another. |
| What is a specific defense or the immune response | Lymphocytes respond specifically to a pathogen or bacteria. Ability of lymphocyte to provide specific defense |
| What does the lymphatic system consist of | Lymph (fluid), lymphatic vessels, lymph tissue, lymphoid organs |
| What is primary function of lymphatic system | Production, maintenance and distribution of lymphocytes to provide defense against infection |
| What does a Lymphatic vessel do | Carry lymph from peripheral tissue to venous system; lymphatic capillaries branch to peripheral tissue; small vessels have valves |
| What are major lymph collecting vessels | Superficial lymphatics and deep lymphatics. These merge to form lymphatic trunks. Then empty into thoracic duct & right lymphatic duct |
| What is cisterna Chyli | Base of thoracic duct; expanded sac like chamber |
| Which collects more, the right lymphatic duct or thoracic | Thoracic |
| What forms the right lymphatic duct | Right jugular, right subclavian & bronchiomediastinal trunks |
| The thoracic duct collects from what parts of the body | Below diaphrahm and left side of body superior to diaphragm |
| Lymphocytes account for how much of the circulating leukocyte population | 20-30 |
| What are the three classes of Lymphcytes | T cells (thymus dependent, B cells (bone marrow derived), and NK (natural killer cells. |
| What are the primary types of T cells | Comprise 80% of circulating lymphocytes; cytotoxic cells, helper T cells & suppressor T cells |
| What is a cytotoxic T cell | Attack foreign cells; primary cells involved in production of cell mediated immunity or cellular immunity |
| What is a Helper T Cell | Stimulate activation and function of both T & B cells |
| Suppressor T Cells | Inhibit activation & function of T & B cells |
| What are B cells | Comprise 10-15% of lymphocytes; B cells differentiate into plasma cells & are responsible for production & secretion of antibodies (soluable proteins/immunoglobulins which bind to antigens) |
| What are NK Cells | Remaining 5-10%; large granular lymphocytes attack foreign cells, normal cells infected with viruses & cancer cells that appear in normal tissue; immunological surveillance |
| B & NK cell production key points | Hemocytoblasts remain in bone marrow; stromal cells produce immune system hormone interleukin-7 to promote differentiation of B cells. |
| T cell production key points | Migrate from bone marrow into Thymus; isolated by the blood-thymus barrier; when done migrate back to marrow or peripheral/lymph tissue. |
| What is lymph tissue | Connective tissues dominated by lymphocytes; nodules are densely packed in an area of areolar tissue. |
| What is a germinal center in a lymph nodule | Central zone which contains dividing lymphocytes |
| What are tonsils | Nodules in pharynx; palatine, pharyngeal (adenoid), lingual tonsils. |
| Lymph Organs | Lymph nodes, thymus & spleen; covered by fibrous connective tissue capsule. |
| What are lymph nodes | Covered by connective tissue; collagen fibers extend into node to form trabeculae (walls). Function as a filter for lymph. Macrophages in walls; provide early warning system; antigen presentation is first step in activation of immune response |
| What is the hilus of the lymph node | Blood vessels and nerves reach the node via the hilus, a shallow indentation |
| What are afferent lymphatics | Carry lymph to the lymph node from peripheral tissues. Many coming into node |
| What are efferent lymphatics | Leave lymph node at hilus and carry lymph away to venous circulation. Only ONE efferent out of node. |
| What is thymus | Pink grainy organ in mediastinum. Large in children, small in adults. |
| What do reticular epithelial cells do | Maintain blood-thymus barrier and secrete thymic hormones to stimulate stem cell divisions & T cell differentiation |
| What is the spleen | Largest lymphoid tissue in body. Performs same functions for blood that lymph nodes perform for lymph. |
| What are functions of spleen | 1) Removal of abnormal blood cells & other components by phagocytosis; 2) storage of iron recycled from RBC’s; 2) initiation of immune response by B & T cells in response to antigens in blood. |
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