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Type 1 Aveolar cells

- 95% of Aveolar cells - Pneumocytes - Larger, thinner cells that allow rapid gas exchange

(Different elements & structures of intestines) Submucosa:

- Large lymph & blood vessels run through it -Contain one of the major nerve networks of the enteric nervous system, the submucosal plexus

Function of Kidneys:

- Regulate water loss and BP - Regulate osmolarity - Maintain ion balance - Regulate pH - Excrete waste - Production of hormone (Renin & EPO)

Metabolism: BMR & RMR:

- process by which body converts food into energy BMR: taken while someone is sleeping; lowest metabolic rate RMR: same idea as BMR but taken when awake and in fasted state of 12 hours.

(Different elements & structures of intestines) Muscularis externa:

-2 layers, inner & outer layer. -Myenteric plexus lies between the layers & coordinates motor activity of muscularis externa

Type 2 Aveolar cells

-5% of Aveolar cells -Cuboidal -Secrete Surfactant (decreases the surface tension and allows for expansion of the alveoli - AKA keeps lungs from collapsing)

How is O2 & CO2 transported in the blood stream?

-98% of oxygen in blood is bound to hemoglobin and transported to tissue. 2% dissolved in plasma. Hemoglobin bound O2 is HbO2 -CO2 is transported via Bicarbonate: HCO3

Pulmonary Edema

-Accumulation of interstitial fluid increases the diffusion distance and slows gas exchange. -Lymphatics are unable to remove all the fluid and the excess accumulates in the pulmonary interstitial space.

What is the role of the diaphragm?

-Active during inhalation -When the diaphragm and external intercostal muscle contract the volume in the thorax increases.

What causes UTI?

-Dehydration -Bacteria/infection -Malnourishment -Female reproductive/urinary

GERD: & most common cause:

-Gastro esophageal reflux disease The lower esophageal sphincter does not fully close allowing gastric acid to come back up into the esophagus -Most common cause: Hiatal Hernia

What facilitates forced expiration?

-Internal intercostals -Abdominals

How is water regulated in the body?

-Negative feedback loop

Role of renin:

-Released if BP is low -Converts angiotensin to angiotensin 1

what are the 4 processes of the GI unit?

-Secretion -Digestion -Absorption -Motility

Role of aldosterone:

-Steroid Controls reabsorption of Na+ in the distal tubules and collecting ducts

What happens to the volume within the thorax cavity during exhalation?

-When the diaphragm and external intercostal muscle relax the volume in the thorax decreases.

What is Surfactant?

-decreases the surface tension and allows for expansion of the alveoli -Basically, prevents lungs from collapsing

(Different elements & structures of intestines) Serosa:

-outer covering of entire digestive tract. -Continuation of the peritoneal membrane lining the abdominal cavity

(GI unit) Absorption: Where does it occur?

-uptake nutrients -Movement of substances from lumen of the GI tract to the ECF -occurs in the small intestine

Blood vessels that carry blood to and within the kidney in order:

1) Afferent arteriole 2) Glomerulus 3) Efferent arterioles 4) Peritubular capillary

4 ways the kidneys regulate the blood?

1) Filtration: water & solutes from blood to tubules 2) Reabsorption: goes back to blood 3) Secretion: removes from blood 4) Excretion: goes to bladder

Primary water regulator(s) in body?

1) Kidneys

Primary ions involved in water reabsorption?

1) Na2 2) K+ 3) Ca2+ 4) Cl

Secondary water regulator(s) in body?

1) Respiratory system 2) Cardiovascular system

What increases surface area of GI tract? (4 of them)

1) Rugae (stomach) - gut wall folds 2) Plicae (small intestine) - folds 3) Villi (small intestine) - fingerlike projections 4) Invaginations - extend down to support connective tissue

Primary Airflow Resistance?

1) Upper Respiratory system: physical obstruction 2) Bronchioles: Bronchoconstriction & bronchodilation

Main products of the kidneys?

1) Urine (urea) 2) Creatine 3) Uric acid

Secondary Airflow Resistance?

1) Viscosity (humidity & altitude may alter this)

What can we gather from a pulmonary functional test? (Spirometer)

1) Vital capacity (VC) 2) Total lung capacity (TLC) 3) Inspiratory Capacity (IC) 4) Functional residual capacity (FRC)

(GI unit) Secretion:

1) movement of water and ions from the ECF to digestive tract lumen 2) Release of substances synthesized by GI epithelial cell into either lumen or ECF

Sequence from trachea

1. Trachea 2. Primary Bronchus 3. Secondary Bronchus 4. Tertiary Bronchus 5. Brachiole 6. Alveoli

Bronchial aspiration:

AKA: Dysphasia - inability/difficulty swallowing -inhalation of gastric contents in lower respiratory tract

Tidal Volume:

Amount of air that moves in and out of the lungs with each respiratory cycle.

What would sever loss of blood volume lead to in terms of hormones?

Body immediately starts to produce: 1) Renin 2) vasopressin (Signal to hypothalamus, adrenal gland releases aldosterone to decrease BP which causes the absorption of Na).

Expiration

Breathing out

(GI unit) Digestion:

Chemical and mechanical breakdown of food into smaller units that can be taken across intestinal epithelium into the body.

(GI unit) Motility - Segmental contraction:

Contraction in segments, Role: to mix food

Role of chemoreceptors:

Detects change in arterial blood oxygen and initiates reflexes to maintain homeostasis -Responds to changes in pH via PO2 & PCO2

Alveolar ventilation

Exchange of gas between the external environment and the aveoli

(side note) Baroreceptos are located where?

Found in the heart aorta or carotid

Where are osmoreceptors located?

Found in the hypothalamus

Storage of glucose & glycogen:

Glucose: stored in the blood. Glycogen: stored in liver/muscles

How do the osmoreceptors work?

High osmolarity = dehydration -increases thirst triggered by angiotensin II -signal comes from the hypothalamus, and ADH is released to tell kidneys to retain water. Low osmolarity = hydrated state.

What is erythropoietin (EPO)?

Hormone produced in kidneys that signals bone marrow to produce RBC's

Findings for COPD in pulmonary functional test:

Increased residual volume (Pts are unable to exhale fully)

What is gastritis?

Inflammation of the stomach lining -the bacteria causing this is: helicobacter pylori

Diverticulitis:

Inflammation or injection of the pouches -Secondary to diverticulosis

Third factor for airflow resistance?

Length

What enzyme digests fats?

Lipase

The clinical definition of dehydration?

Loss of body water "with or without salt" at a greater rate than the body can replace common symptoms: vomiting/diarrhea/possible bleeding

What happens to glycogen when blood sugar is low/high?

Low blood sugar: glucagon is released, which turns glycogen into glucose high blood sugar: glucose is absorbed and stored as glycogen

Diverticulosis:

Means small pouches found in the colon -The mucosa and submucosa herniate through the muscle layer of the colon

Arterial pressure of carbon dioxide:

PCO2 = 40 mmHg (35-45); Venous = 46 mmHg

Arterial partial pressure of O2 in arterial blood:

PO2 = 95 mmHg (85-100); Venous = 40 mmHg

What facilitates expiration? (Relaxed breathing)

Passive recoil of lungs, rib cage, & diaphragm

Fibrotic lung disease and emphysema?

Physical loss of alveolar surface area -Fibrotic = hardening of lungs -emphysema = smoking cigs

What facilitates inspiration? (Primary & Secondary muscles)

Primary: -Diaphragm -External intercostals Secondary: -Sternocleidomastoid -Scalenes -Pectoralis Major

(Part of kidney) Distal tubule:

Reabsorbs & secretes: Na/K pump -Reabsorption of Na+

(Part of the kidney) Loop of Henle:

Reabsorbs: -Water

Cortex and Medulla of the kidney's do what?

Release hormones

(Part of Kidney) Collecting duct:

Secretion: (Last part of kidney) Collection of urine from nephrons and moves it to renal cavity

The main roles of small & large intestine:

Small Intestine: Most nutrient uptake Large Intestine: Water & Electrolyte absorption

How does H+ concentration influence O2?

The amount of H+ ions affect the affinity of O2 binding to the hemoglobin due to a change in protein folding

Inspiratory reserve volume:

The amount of air a person can inhale forcefully after normal tidal volume inspiration.

(Part of kidney) Glomerulus/bowman capsule:

The filter -the rate of blood filtered (GFR) -podocyte: wraps around bowman's capsule and allows filtration

The role of gastrin:

The primary function is to promote the acid release (pepsin via inactive pepsinogen secreted from chief cells in gastric glans) Stimulation of gastric acid Role: breakdown protein

Inspiratory Capacity (IC)

Tidal volume + inspiratory reserve volume

What happens to tidal volume if you have COPD?

Tidal volume decreases

What hormone controls water reabsorption in the kidneys?

Vasopressin (ADH)

(Part of kidney) Proximal Tubule:

Where reabsorption & secretion happens: -reabsorption of organic nutrients, ions, & water

Hypoglycemia:

below 60 mg/dL before eating

Ventilation

breathing

Inhalation

breathing in

Where are chemoreceptors located?

carotid and aortic bodies

angiotensin converting enzyme (ACE)

converts angiotensin 1 to angiotensin 2

Functional Residual Capacity (FRC)

expiratory reserve volume + residual volume

Hemoglobin Curve Graph: What is indicated with a shift to the right? left?

hemoglobin has decreased affinity for O2 if the curve of the graph moves to the right, which means: -Increased H+ concentration and low pH -Increased temperature -Increased PCO2 Shift to the left: -Decreased CO2

air flows from _____ pressure to _____ pressure

high to low

Clinical treatment for dehydration?

hydration through IV

Where are gastritis, peptic ulcers?

in the duodenum caused by helicobacter pylori

Angiotensin II

increases blood pressure by synthesizing aldosterone, increasing vasopressin release, increasing thirst, increasing sympathetic cardiac output, vasoconstrictor

Urinary bladder cancer

increases the chances with smoking

Appendicitis

inflammation of the appendix

Esophagitis

inflammation of the lining of the esophagus

Hepatitis

inflammation of the liver

(Different elements & structures of intestines) Mucosa Layer

inner lining; 3 layers. 1) lamina propria 2) subepithelial connective tissue 3) muscularis mucosae (controls villi movements)

Where does digestion start?

mouth

(GI unit) Motility- Peristaltic contraction:

on contraction, forward movement; Role: to push down food.

Normal blood values of pH in pulmonary medicine:

pH: -Arterial = 7.4; -Venous = 7.37

Vital capacity (VC)

sum of inspiratory reserve volume, expiratory reserve volume, and tidal volume

(GI unit) Deglutition:

swallowing

How does smoking affect the respiratory system?

tar in alveoli activates alveolar macrophages that release elastase which destroy the elastic fibers of the lung.

Respiration

the action of breathing

Expiratory reserve volume:

the amount of air a person can exhale forcefully after a normal exhalation

(GI unit) Ingestion:

to consume/bring in

Total Lung Capacity (TLC)

vital capacity + residual volume