PHYSIO LAB QUIZ Exam 3

Aldosterone

"salt-retaining hormone" which promotes the retention of Na+ by the kidneys. na+ retention promotes water retention, which promotes a higher blood volume and pressure

Which of the following are true regarding cardiac output? Select all that apply.

- Increased potassium (K+) will decrease CO - CO will increase if stroke volume (SV) increases - CO output will decrease with increased vagal stimulation - CO output will decrease is heart rate (HR) decreases - Increased sodium (Na+) decreases CO

Which of the following is true regarding neurogenic syncope? Select all that apply. Define the term dysautonomia

- characterized by an intermittent drop in blood pressure that results in fainting (syncope) - neurogenic syncope is a form of dysautonomia - Emotional stress or pain may trigger an episode

Which of the following are true regarding the baroreceptor reflex?

- increased BP causes increased parasympathetic stimulation - baroreceptors are mechanoreceptors - negative feedback occurs to decrease the baroreceptor reflex response - increased BP causes vasodilation - HR increases in response to decreased stretch detected by baroreptors - decreased firing barorecptors increases sympathetic stimulation

Given what you learned about blood types and the blood typing procedure, which of the following are true regarding Blood types and transfusions

Agglutinins = antibodies, RBC's that have A antigen will have B antibodies.

Which of the following are true regarding the effect of a change in stroke volume on cardiac output? Select all that apply.

An increase in stroke volume increases cardiac output.

Which of the following are true regarding the Frank-Starling law of the heart? Select all that apply.

An increase in venous return increases myocardial stretching. This increases contractility and thus stroke volume increases. This is a built-in mechanism that makes sure that cardiac output keeps up with venous return to the heart.

Explain the effect of a increased blood pressure on the 3 regions of the cardiovascular center: - Cardioinhibitory center - Cardioacceleratory center - Vasomotor center Describe the overall effect of these changes.

The cardiovascular center in the medulla oblongata responds to many stimuli detected by chemoreceptors and baroreceptors. After receptors detect a pH fluctuation or secretion of epinephrine, the region functions in changing heart rate and stroke volume in order to increase blood pressure and flow. Baroreceptors in blood vessels detect increased blood pressure from the amount of stretch in blood and stimulate the cardiovascular center. The cardiovascular center of the brain alters and controls cardiac output through its 3 regions: cardio-inhibitory center, cardio-acceleratory center, and vasomotor center. Increased BP An increase in the stretch of the walls of the carotid artery and aorta, which is detected by the baroreceptors. The activated receptors send impulses to the cardiovascular center, resulting in: - Stimulation of the cardioinhibitory center- increases parasympathetic input to the heart and slowing of the heart rate. - Inhibition of the cardioacceleratory center- decreasing sympathetic input to the heart. - Inhibition of the vasomotor center- causing vasodilation and a decrease in total peripheral resistance. - The decrease in cardiac output coupled with the decrease in total peripheral resistance results in a decrease in blood pressure towards normal.

Match the ECG Abnormality with the possible cause.

atrial enlargement - enlarged P wave ventricular enlargement - enlarged QRS complex hypokalemia - flat T wave AV node abnormality - prolonged P-R interval

AV valves are open; Semilunar valves are closed

atrial systole and ventricular diastole or atrial diastole and ventricular diastole

What are 2nd line of defense innate immunity

complement, interferons, inflammatory response

Eosinophilia

elevated numbers of eosinophils

amount of blood in each ventricle at the end of ventricular filling

end diastolic volume

amount of blood remaining in each ventricle after ventricular contraction

end systolic volume

Renin

hormone secreted by the kidney; it raises blood pressure by influencing vasoconstriction (narrowing of blood vessels)

A moderate increase in body temperature will generally have the following effects on cardiac function? Select all that apply. there is no effect on heart rate decrease Heart Rate increase Heart Rate

increase Heart Rate

Basophilia

increased basophils

Leukocytosis

increased total white blood cell count

Angiotensin II

increases blood pressure by stimulating kidneys to reabsorb more water and by releasing aldosterone

ADH

increases water reabsorption by the kidneys by increasing aquaporin channels, STIMULATED BY increase in osmolality, sensed at the hypothalamus

AV valves closed; Semilunar valves closed; ventricular systole

isovolumetric isolation

Which of the following organs can be targeted with medications to control hypertension? Select all that apply

lungs, blood vessels, kidneys, heart

Which of the following, if increased, will decrease cardiac contractility (negative inotrope)? Select all that apply. potassium (K+) epinephrine/norepinephrine parasympathetic stimulation increased temperature calcium (Ca++)

parasympathetic stimulation, potassium (K+)

A normal BP is __________________ or below.

120/80

Which of the following are likely causes of lymphocytosis? Select all that apply.

Autoimmune disease, cancer, infection

Describe in detail how to use a sphygmomanometer to measure blood pressure. During the process of taking a blood pressure, describe what is happening to the brachial artery and how that relates to the sounds being heard through the stethoscope.

Blood pressure is measured in the arm using a sphygmomanometer instrument and stethoscope. The cuff of the sphygmomanometer goes over the arm and over the brachial artery. The patient getting their blood pressure measured should be sitting down and their arm should sit at chest level on a table or arm chair. The cuff will be wrapped around their arm over their brachial artery and constrict over it until blood flow to the artery is cut off. The technician measuring BP will inflate the cuff with air until it reaches a pressure of 160/80 or when the pressure is higher than systolic pressure (no sound is heard through the stethoscope). While keeping the stethoscope on the patient's antebrachial area, the technician will release the cuff gauge and the decrease pressure in the cuff. During the release, sound is produced when blood pressure in the blood vessel during ventricular systole is higher than the cuff's pressure. The sound is the Korotkoff sound that can be heard from the stethoscope. Blood flows at a high velocity during systole and there is no sound at diastole. The first sounds are recorded as systolic pressure and soft sounds or when sounds disappear are recorded as diastolic pressure. There is a normal flow of blood if the blood vessel pressure is higher than the cuff's pressure.

Which of the following are true regarding the mechanism by which NCS occurs? Select all that apply.

Cardiac output decreases, decreased blood pressure results in vagal stimulation, decreased O2 to brain and fainting

Match the causes of iron deficiency anemia with the mechanism. Excessive blood loss, Decreased absorption of iron, Decreased dietary intake of iron, Relative increased need of iron - hemorrhage - Crohn's disease - GI bleeding - pregnancy - parasites - vegan diet - hemolysis - menstruation - gastric bypass - inflammatory bowel disease

Excessive blood loss: hemorrhage, GI bleeding, parasites, hemolysis, menstruation Decreased absorption of iron: Crohn's disease, gastric bypass, inflammatory bowel disease Decreased dietary intake of iron: vegan diet Relative increased need of iron: pregnancy

Which of the following could contribute to iron deficiency anemia?

GI blood loss, blood borne parasites, GI inflammation, thalassemia, pregnancy

Which of the following are true regarding iron transport and storage? Select all that apply.

Hemosiderin is a storage form of Fe. Iron may be stored in the liver and bone marrow

Which of the following are true regarding hemoglobin? Select all that apply.

Hgb is a quaternary protein, low hemoglobin decreases oxygen carry capacity, carbon dioxide is carried by hemoglobin

What are 3rd line of defense adaptive immunity

IgM antibodies, B Cells, T helper cells

Match the description with the correct effect on blood pressure. increase in resistance increase in cardiac output (CO) decreased heart rate (HR) decreased vessel diameter increased blood viscosity increased vessel length

Increase BP: increase in resistance, increase in cardiac output (CO), decreased vessel diameter, increased blood viscosity, increased vessel length Decrease BP: decreased heart rate (HR), vasodilation

Match the condition with the possible cause for anemia and Polycythemia - Iron deficiency - Smoking - high altitude - COPD - lack of intrinsic factor - increased HCT - excessive blood cell destruction

Iron deficiency, lack of intrinsic factor, excessive blood cell destruction - Anemic Smoking, high altitude, COPD, increased HCT - Polycythemia

Which of the following are true regarding cell mediated immunity. Select all that apply.

MHC I receptors with antigen are recognized, memory cells are produced, cancer cells are targeted, cytotoxic T cells destroy abnormal cells, virus infected cells are targeted

Which of the following may be employed to treat NCS? Select all that apply.

Non-pharmaceutical methods - counter-maneuvers which are performed at the beginning of presyncopal signs and are intended to increase BP and prevent fainting. These maneuvers include isometric arm counter-pressure maneuvers by gripping one hand with the other and pushing both arms away from the chest, leg crossing combined with muscle tensing, and sitting with the head between the knees. - counseling the patient to avoid dehydration, prolonged periods of standing motionless, and situations known to trigger syncope. - Compression stockings Pharmacologic: Medications that may help to prevent NCS include the following: - Alpha agonists increase vasomotor tone - Disopryramide decreases ventricular contractility and counteracts parasympathetic activity - Mineralocorticoids may be helpful in augmenting salt retention, plasma volume, and therefore, BP - Beta-adrenergic blockers may prevent activation of ventricular mechanoreceptors that initiates NCS- no longer reccommended.

Match the events occurring in the cardiac cycle to the correct wave of an ECG

P wave: atrial depolarization, atrial contraction begins during this wave QRS Complex: atrial repolarization, ventricular depolarization, ventricular contraction begins toward the end of this wave, Atrial contraction end at the beginning of this wave, First heart sound occurs T Wave: ventricular repolarization, ventricular contraction ends, Second heart sound occurs

Which of the following are true regarding iron deficiency anemia? Select all that apply.

RBCs are typically smaller, RBC numbers are typically lower, oxygen carrying capacity is decreased, decreased hemoglobin levels

Which of the following is NOT a symptom associated with neurogenic syncope?

The onset may be abrupt or associated with warning signs (prodromal symptoms) such as fatigue, weakness, nausea, sweating, visual disturbances, headache, or lightheadedness. Hypertension is NOT a symptom

Describe the renin-angiotensin-aldosterone pathway.

The renin-angiotensin-aldosterone pathway functions in increasing systemic blood pressure and regulating blood flow in the kidneys. The functions occur through the creation of aldosterone and angiotensin II from renin. The pathway begins when systemic blood pressure and blood volume decreases, stimulating juxtaglomerular cells to release renin and form angiotensin II. Renin is able to convert angiotensinogen to angiotensin-I. Then ACE converts angiotensin-I to angiotensin-II, which carries out the remaining functions of the pathway. The formation of active angiotensin-II promotes vasoconstriction of efferent arterioles return the glomerular filtration rate to normal in the measuring kidney function. Angiotensin II also promotes vasoconstriction of systemic blood vessels, causing blood pressure to increase as the blood vessels have less space for blood flow. Systemic blood pressure is also increased from Angiotensin-II as it promotes the reabsorption of sodium and chloride ions from the proximal tubule in the nephron of the kidneys. Na+ ions and water absorption is increased from aldosterone release, leading to an increase in systemic blood pressure. The hypothalamus's thirst center is also stimulated by Angiotensin II and increases fluid intake and blood pressure. Overall, the renin-angiotensin-aldosterone pathway restores water, blood pressure, blood volume, Na + concentration, osmolarity of ECF, and pH ALL back to a normal range.

Which vitamin or mineral , when taken with iron, can increase absorption of iron from the diet?

Vitamin C

AV valves closed; Semilunar valves open

atrial diastole and ventricular systole

renin-angiotensin-aldosterone system

a hormone cascade pathway that helps regulate blood pressure and blood volume

Angiotensin

a peptide hormone that constricts blood vessels, causes the retention of sodium and water, and produces thirst and a salt appetite, increases BP

the force exerted by blood on the walls of the vessels

blood pressure

Which of the following, if increased, will increase heart rate? Select all that apply. calcium (Ca++) potassium (K+) vagal stimulation sympathetic stimulation

calcium (Ca++) sympathetic stimulation

Stroke volume times heart rate equals

cardiac output

volume of blood pumped from the left ventricle into the aorta and the systemic circuit per minute

cardiac output

sympathetic neurons that increase the heart rate and strength of contraction

cardioacceleratory center

parasympathetic neurons that slow the heart rate

cardioinhibitory center

Match the pharmacological agent with the correct effect on blood pressure. thiazide diuretics ACE inhibitors Angiotensin receptor blockers Calcium Channel blockers

decrease volume overload by increasing urine output - thiazide diuretics block the conversion of angiotensin I to angiotensin II - ACE inhibitors blocking the effects of angiotensin II at target sites - Angiotensin receptor blockers decrease cardiac contractility - Calcium Channel blockers

Neutropenia

decreased neutrophils

ANP (atrial natriuretic peptide)

dilates the juxtamedullary afferent-arterioles, vasodilation of systemic blood vessels, STIMULATED BY increased pressure sensed by baroreceptors in the RT atrium

The difference between systolic pressure and diastolic pressure is

pulse pressure

Match the effect on cardiovascular activity or hormone release with the correct receptors of autonomic Nervous System (ANS).

release of epinephrine and norepinephrine from the adrenal medulla act on: - beta-1 adrenergic receptors in the SA node and the ventricular myocardium; increasing heart rate and contractility, increasing SV and CO. - alpha-1 adrenergic receptors in veins of GI, urinary, and reproductive; increasing vasoconstriction, BP, and increasing venous return to the heart - beta-2 adrenergic receptors in the vascular smooth muscle to the heart and skeletal muscles; causes vasodilation- this decreases blood pressure to a small degree compared to alpha-1 effects. - release of norepinephrine by postganglionic sympathetic neurons act on the SA node and the ventricular myocardium; increasing hear rate and contractility, increasing SV and CO.

closing of the Semilunar valves

second heart sound

What are 1st line of defense innate immunity

skin, stomach acid, stratified squamous epithelium

Aldosterone

stimulus is increased Angiotensin II (AGII) or increased ACTH, increases both sodium reabsorption and potassium excretion at the renal level

volume of blood ejected from each ventricle each time it contracts

stroke volume

Based on your understanding of normal ranges for hematocrit values, which if the following are true regarding a hematocrit result of 30% for a 25 year old female?

the plasma volume is approximately 69-70% and the person would generally be considered anemic

sum of all the factors that inhibit blood flow through the arterial system

total peripheral resistance

sympathetic neurons that control the smooth muscle in the walls of arterioles

vasomotor center