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120 Cards in this Set
- Front
- Back
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The pacemaker region of the heart is the |
Sinoatrial (SA) node in the right atrium
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The conducting tissue of the heart located in the inter-ventricular septum is
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atrioventricular bundle (bundle of His)
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Indicate the electrical events that produce P wave
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depolarization of the atria
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Indicate the electrical events that produce QRS wave
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depolarization of the ventricles
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Indicate the electrical events that produce T wave
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repolarization of the ventricles
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The electrical synapses between adjacent myocardial cells are called
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gap junctions
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Abnormally fast rate of beat is called _____; an abnormally slow HR is called
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tachycardia; bradycardia
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An abnormally long P-R interval indicates a condition called
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first-degree AV block
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Leads I II and III are collectively called the _________ leads.
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limb
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Which ECG wave must occur before the ventricles can contract?
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QRS
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Which ECG wave must occur before the ventricles can relax?
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T wave [S-T segment]
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What property makes the normal pacemaker region of the heart function as a pacemaker? Explain.
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The SA node fibers serve as the pacemaker of the heart because they open special ion channels and undergo spontaneous depolarization faster than any other fibers in the heart. Consequently, the SA node sets the pace, generating action potentials that are rapidly conducted to other myocardial cells via intercalated discs (gap junctions). Although capable of spontaneous depolarization, other myocardial cells depolarize at a slower rate and thus normally follow the SA node rhythm. The depolarized cells of the atria respond first by contracting as a unit, followed shortly by the ventricles that similarly depolarize and contract. Furthermore, the SA node pace is influenced by autonomic neurotransmitters acetylcholine (slows) and norepinephrine (speeds), and by epinephrine (speeds).
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Describe the pathway of conduction from the atria to the ventricles and correlate this conduction with the ECG waves.,
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Depolarization spreads through the atria producing the P wave. After a delay at the AV node, the depolarization then spreads down the bundle of His to the Purkinje fibers and the ventricular myocardium. This produces the QRS wave. Repolarization of the ventricles in the reverse direction produces the T wave. In third-degree, or complete AV node block the ventricles are not depolarized by impulses from the atria. The atria continue to beat according to the pace set by the SA node (supraventricular) while the ventricles beat according to the pace set by an ectopic pacemaker within the ventricles, responsible for the slower rate and the lack of response to the demands of exercise that raise the atrial pacing only.
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The ECG wave that occurs at the beginning of ventricular systole is the _____ what wave?
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QRS
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The ECG wave that occurs at the end of systole and the beginning of diastole is the ______ wave?
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T
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The ECG wave completed just before the end of ventricular diastole is the ____ wave?
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P
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The nerve that increases the rate of discharge of the SA node is a ______ nerve.
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sympathetic (cardiac)
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The specific nerve that when stimulated causes a decrease in the cardiac rate is the
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parasympathetic (vagus)
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The scientific term for insufficient blood flow to the heart muscle is:
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ischemia
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Describe the regulatory mechanisms that produce an increase in cardiac rate during exercise. Explain how these changes affect the electrocardiogram (ECG)
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At the beginning of the exercise, there is a decrease in the activity of the parasympathetic (vagus) innervation of the heart. This causes an increase in cardiac rate that is further raised during greater levels of exercise by increased sympathetic nerve (cardiac) activity. As a result of the faster rate, the period of diastole is shortened so that the time between the T wave of one ECG tracing and the P wave of the next tracing is significantly reduced. At higher heart rates the increased conduction velocity shortens the period of systole as shown by a decrease in the QRS-T interval.
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The scientific term for listening carefully (as with a stethoscope is)
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auscultation
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The first heart sound is caused by
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the closing of the AV valves
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During which phase of the cardiac cycle does the first heart sound occur?
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systole
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The second heart sound is caused by
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the closing of the semilunar valves
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The second heart sound occurs at the (beginningof end) of (systole or diastole)
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end of systole
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The abnormal heart sounds are called
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murmurs
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The first heart sound is correlated with which ECG wave?
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end of the QRS
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The second heart sound is correlated with which ECG wave?
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peak of the T wave
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Using a complete cause-and-effect sequence explain the correlation of the heart sounds with the ECG wave
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The QRS wave represents ventricular depolarization. When the ventricles depolarize they are stimulated to contract, causing pressure to rise in the ventricles and the AV valves to close, with vibrations that produce the first heart sound. The T wave represents ventricular repolarization. When the ventricles repolarize electrically they begin to relax mechanically, causing the aortic and pulmonary semilunar valves to close, with vibrations that produce the second heart sound.
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Explain how the heart sounds are normally produced and describe some of the conditions that can cause heart murmurs.
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As explained above heart sounds are normally produced by pressure changes causing two valves of the heart to close simultaneously, producing vibrations that can be heard with a stethoscope. The first heart sound, “lub,” is caused by the closure of the right and left atrioventricular valves. The second heart sound, “dub,” is caused by the closure of the aortic and pulmonary semilunar valves (pulmonic valves). Heart murmurs are caused by structural defects in the valves that affect the pattern of blood flow through the heart. Abnormal patterns of blood flow produced by defective valves can cause abnormal vibrations and thus abnormal heart sounds that can be heard by auscultation. Heart murmurs may be caused by an irregularity in a valve, a septal defect, or the persistent fetal opening (foramen ovale) between the right and left atria after birth.
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When blood pressure measurements are taken the first sound of Korotkoff occurs when the cuff pressure equals the ____ pressure
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systolic
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The last Korotkoff sound occurs when the cuff pressure equals the _____ pressure.
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diastolic
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The sounds of Korotkoff are produced by
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vibrations due to the turbulent flow of blood in a partially compressed artery
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Suppose a person’s blood pressureis 168/112 What condition does the person described in question 4 have? What is systolic? What is diastolic pressure?
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What is the systolic pressure? 168 What is the diastolic pressure? 112
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What condition does the person have?
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Hypertension
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The arterial blood pressure is directly proportional to two factors: the___________ and the ________.
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cardiac output; total peripheral resistance
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The scientific name of the device used to take a blood pressure reading (hint:one word) is the
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sphygmomanometer
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As a person gets older; the max cardiac rate ____
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decreases
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Describe what is meant by “laminar flow”. Before you inflate the cuff which term more closely describes the blood flow in the brachial artery? Explain.
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Laminar or “layered” flow of blood through the arteries occurs when all parts of the fluid move smoothly in the same direction, parallel to the axis of the vessel. Blood in the central axial stream moves the fastest, and blood closer to the artery wall moves more slowly. By contrast, turbulent flow occurs when some parts of the fluid move in radial and circumferential directions, churning and mixing the blood, which may cause vibrations and sounds. Blood flow in the brachial artery before the cuff is inflated is mostly laminar, and so is smooth and silent.
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How are the Korotkoff sounds produced? When do you hear the first Korotkoff sound? When do you hear the last Korotkoff sound? Explain why this is true of the first and last sounds?
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Vibrations heard through a stethoscope due to the turbulent flow of blood through a partially compressed brachial artery cause Korotkoff sounds. The narrowing of the lumen creates turbulent blood flow and the vibrations produced are characterized as Korotkoff sounds. The first Korotkoff sound is heard when the pressure in the sphygmomanometer cuff is lowered so that the brachial artery is only partially compressed (the cuff pressure is equal to the systolic pressure) thereby permitting the initial turbulent flow out the distal portion of the cuff. The last Korotkoff sound is heard as the flow of blood through the cuff is no longer compressed by the cuff and laminar flow is restored (diastolic pressure) and no more sounds are detected .
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How is the pulse pressure calculated and how does its value relate to the pulse? Also describe how the mean arterial pressure is calculated and explain its significance.
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,The pulse pressure is systolic minus diastolic pressure. As the blood pressure rises from diastolic to systolic values within an artery, the rise in hydrostatic pressure against the artery wall causes the artery to expand somewhat. This is the “pulse” you feel when you press your fingers against the outside of an artery. In this way, the pulse pressure causes the pulse. The mean arterial pressure is equal to the diastolic pressure plus one-third of the pulse pressure. The mean arterial pressure represents the combined systolic and diastolic pressure that drives the blood from the arterial tree into the blood capillaries.
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If a person has athletes bradycardia the resting heart rate is _________ than average.
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lower
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The condition described in question 2 is caused by _______________
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endurance training – Results from higher levels of inhibitory activity by the vagus nerve.
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Define aerobic capacity
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Aerobic capacity is the maximum oxygen uptake or the maximum rate of oxygen consumption by the body.
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Define lactate threshold
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Lactate threshold is that percent of one’s aerobic capacity when the muscle’s anaerobic respiration production of lactic acid (lactate) rises significantly (normally at about 50–70% of one’s aerobic capacity).
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The primary cause of the higher aerobic capacity of endurance trained athletes is
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a higher maximum cardiac output, and thus higher rates of oxygen delivery to the muscles in endurance athletes.
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What cardiovascular adaptations are associated with endurance training? How do these changes help to improve performance?
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Endurance training increases the cardiac output through a higher blood volume and a stronger contraction of the ventricles, which thus ejects more blood per beat. The increase in oxygen demand also stimulates an increase in blood volume. The higher stroke volume and larger blood volume allow the same cardiac output to be achieved at a slower heart rate and thus endurance improves with training and training improves performance.
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How does the increase in blood pressure and pulse rate after exercise and the return of these values to baseline following exercise compare in people who are and who are not physically fit?
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Persons who are physically fit may have a higher stroke volume and, therefore, a greater cardiac output than those who are unfit. Higher cardiac output increases the rate of blood flow and the delivery of oxygen to the exercising muscles. Conditioned muscles also have an increased ability to extract oxygen from the blood because of biochemical and metabolic changes within the muscle cells. At a given level of physical exercise, therefore, the physically fit have a slower rate of increase in the cardiac rate and a faster rate of return to the resting cardiac rate after exercise. Since mean arterial blood pressure is directly related to cardiac rate and to cardiac output, the fit person will have a slower rise in blood pressure and a correspondingly faster return to resting pressures after exercise.
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Athletes not only have a higher maximal oxygen uptake they can exercise at a higher percentage of this maximum before reaching their lactate threshold. Explain what these terms mean and how they relate to the adaptations within the athlete’s cardiovascular systems.
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Maximal oxygen uptake, or aerobic capacity, measures the maximum rate of oxygen consumption by the body. The intensity of exercise can be rated by the percent of the aerobic capacity attained. In most healthy people, blood levels of lactic acid (lactate) rise significantly when exercise is performed at about 50–70% of their aerobic capacity. This is the lactate (or anaerobic) threshold. Endurance trained athletes have a higher aerobic capacity and may not reach their lactate threshold until exercising at about 80% of their maximal oxygen uptake. The primary cause of this higher aerobic capacity is their higher maximum cardiac outputs, and thus their higher rates of oxygen delivery to the muscles. In turn, this rise in cardiac output is brought about by a stronger contraction of the ventricles (thus ejecting more blood per beat) and an increase in blood volume.
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One hemoglobin molecule contains _____ heme group; each heme group normally combines with one molecule of ________.
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four, oxygen
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The hormone ______ stimulates the bone marrow to produce red blood cells; this hormone is secreted by the ____.
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erythropoietin; kidney
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Old red blood cells are destroyed by the _________ system which includes these three organs
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:,reticuloendothelial; spleen, liver, bone marrow
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Heme derived from hemoglobin minus the iron, is converted into a different pigment, known as ______; an accumulation of this pigment can cause a yellowing known as ________.
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,bilirubin; jaundice
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Define the term hematocrit ________
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Hematocrit is the ratio of the volume of packed red blood cells to the total blood volume.
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The moleculeformedby the binding of oxygen to deoxyhemoglobin
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oxyhemoglobin
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A hemoglobin molecule containing oxidized iron (Fe+3) is called
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methemoglobin
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A molecule formed from the combination of hemoglobin and carbon monoxide is ____
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carboxyhemoglobin
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A general term for an abnormally low RBC count or hemoglobin concentration:
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anemia
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The most common cause of the condition described in question 9 is…
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inadequate amounts of iron in the diet
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Describe some of the causes of anemia. Why dangerous?
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Anemia is a condition characterized by an abnormally low red blood cell count and/or hemoglobin concentration. It may be caused by a high rate of red blood cell destruction or insufficient red blood cell production. The latter situation may be due to dietary conditions such as iron deficiency, or deficiencies in vitamin B12 or folic acid; or by bone marrow disease. This condition is dangerous because the O2 carrying capacity of the blood is significantly reduced, leading to hypoxemia and cellular hypoxia.
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Newborn babies particularly premature ones often have a rapid rate of RBC destruction and have jaundice. What is the relationship between these two conditions? How is this jaundice treated? And how does this treatment work?
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During labor and delivery, a newborn undergoes a rapid rate of red blood destruction. This results in the liberation of excessive amounts of heme from newly released hemoglobin. These free heme molecules are converted by the newborn liver into bilirubin that circulates in the blood. If the liver cannot get rid of the excess bilirubin by conjugating it and excreting it in the bile, then the blood concentration of bilirubin can rise to a sufficient level to produce yellowing of the skin in visible areas of the body, such as the sclera of the eyes. Babies often develop this jaundice because their livers are not fully functional at the time of birth. Note: Since bilirubin is fragmented by ultraviolet light, newborn nurseries use a bili-light to reduce the circulating levels of bilirubin. Prudent, but brief exposure to daylight accomplishes the same result.
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Could a person have a low hematocrit yet have a normal RBC count? Explain what might cause…
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Yes. If the person’s plasma volume is larger than normal, the measurement of a lower hematocrit value would erroneously suggest that the packed red cell volume is too low, yet when evaluated, the red blood cell count may be normal. The increase in plasma volume is most likely due to iatrogenic causes (excessive fluid intake).
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If a person has blood type A the possible genotypes that a person may have are ____ and ___.
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AA or AO
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If a person who is blood type O marries a person who is blood type A what are the possible blood types their children could have? ___ or ___.
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AO or OO
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The universal blood donor is blood type ______.
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(more specifically: type O negative, packed cells)
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The rarest blood type is?
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AB (Rh negative)
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The most common Rh type is?
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(Rh positive)
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The person most in ganger of having a child who ….
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Rh negative; Rh positive
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What are the gangers of giving a person a transfusion when the blood types don’t match?
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The danger of mixing blood types that don’t match is that red blood cells may clump together, or agglutinate. This clumping will plug blood vessels and prevent the normal flow of blood to the tissues.
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Explain how hemolytic disease of the newborn is produced. How may the disease be prevented?
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Hemolytic disease of the newborn occurs only if the mother is Rh negative, with both the father and the baby are Rh positive. At delivery, the placental barrier will break thereby allowing baby’s blood to enter into mom’ s circulatory system. The mother’s blood will be exposed to the Rh antigen from the baby’s RBCs and, over time, develop antibodies against it. If a second developing child is also Rh positive, antibodies from the mother may cross the placenta and destroy the fetal red blood cells. The development of maternal antibodies against the Rh factor may be prevented by administration of Rh antibodies (RhoGAM) usually once during pregnancy and again shortly after delivery. The injected anti-Rh antibodies will seek out, agglutinate, and destroy any Rh-positive fetal red blood cells that may have entered the mother’s blood supply before her immune system could produce antibodies against them.
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Maximum amount of air that can be expired after a maximum inspiration:
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vital capacity (VC)
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Maximum amount of air that can be expired after a normal expiration:
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expiratory reserve volume (ERV)
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Maximum amount of air that can be inspired after a normal expiration:
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inspiratory capacity (IC)
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Amount of air left in the lungs after a maximum expiration:
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residual volume
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Category of pulmonary disorders in which the alveoli are normal but there is an abnormally high resistance to air flow:
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obstructive disorders
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An example of a disorder in the category described in question 2 is:
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bronchitis, asthma
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A pulmonary function test for the category of disorders named in question 2 is the ___ test.
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forced expiratory volume (FEV)
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Describe Boyle’s law and how inhalation and exhalation follow from this law. Identify the muscles involved in quiet inhalation and those additionally required for forced inhalation. Which spirometry measurements indicate the extent of quiet and forced inhalation?According to Boyle’s law
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the pressure of a gas is inversely proportional to its volume. During inhalation, therefore, air is pushed into the lungs by the greater pressure of the atmosphere. When thoracic volume decreases during exhalation, the intrapulmonary pressure rises above the atmospheric pressure and air is pushed out of the lungs. Normal (unforced) ventilation is regulated by action of the diaphragm and the external intercostal muscles. Forced inhalation recruits other muscles such as the scalenus, sternocleidomastoid, and pectoralis major muscles. Quiet inhalation is measured as tidal volume whereas forced inhalation can be measured from normal exhalation as inspiratory capacity.
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Explain how quiet exhalation is accomplished
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andcompare this to forced exhalation. Which spirometry measurements indicate quiet and forced inhalation?,Quiet exhalation is generally passive. Relaxation of the diaphragm and external intercostal muscles causes the thorax to resume its original volume and the air pressure inside the lungs rises resulting in exhalation. The amount of air inhaled or exhaled quietly is the tidal volume. During forced exhalation, the internal intercostal and abdominal muscles contract, decreasing the thoracic volume to a lower level than that achieved in normal exhalation. The amount of air forcefully exhaled is the expiratory reserve volume (ERV).
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Can you measure the residual volume and total lung volume by spirometry? Explain. Also explain how the residual volume vital capacity and total lung capacity change with age.
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No, because residual volume cannot be exhaled and total lung capacity includes the residual volume. These values can be estimated however by multiplying an age-dependent factor times the vital capacity. All of these values decline with age.
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Distinguish between obstructive and restrictive pulmonary disorders. Explain how spirometry aids in their diagnosis.
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Obstructive disorders are seen when there is an abnormally high resistance to airflow through the bronchioles due to such conditions as bronchoconstriction or mucus. In obstructive disorders, the vital capacity is normal but since airflow is affected the FEV1 is low.
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Restrictive disorders occur when the alveoli are adversely affected by disease. In restrictive disorders
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vital capacity is reduced but the FEV1 may be normal.
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Does your chest expand because your lungs inflate or do your lungs inflate because your chest expands?
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Your lungs expand because your chest inflates.
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A solution with H concentration of 10^-9 molar mass has a pH of:
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9
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Hypoventilation produces a condition called respiratory _________; hyperventilation produces a condition called _________.
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Acidosis; alkalosis
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Define acid
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Acid donates free protons to solution H+
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Define base
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Base removes free protons from solution usually by releasing OH-; which combines with H+ to form H20
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Define acidosis
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Acidosis is the condition in which the blood pH is less than 7.35
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Define alkalosis
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Alkalosis is the condition in which the blood pH is greater than 7.45
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What is the normal measurement of arterial carbon dioxide levels?
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40mmHg
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The free bicarbonate in the plasma serves as the major ____ of the blood
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Bugger
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The enzyme in RBCs that catalyzes in the formation of carbonic acid is
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Carbonic anhydrase
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Use the equation shown in question 7 to explain how hyperventilation and hypoventilation affect blood pH
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Following 10 seconds of hyperventilation, the breathing rate should have decreased significantly. Breathing rate is related to blood carbon dioxide levels and pH. Hyperventilation results in the excessive elimination of CO2, lowered carbonic acid, and a rise in pH. The rise in pH reduces the desire to breathe until the amount of CO2 in the blood again rises adequately high to restore a more normal pH. The normal pH should restore normal influence over the respiratory centers in the medulla oblongata, resulting in a more normal breathing pattern.
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Normally not filtered:
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protein
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Filtered then normally completely reabsorbed:
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glucose
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Derived from fat breakdown:
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ketone bodies
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Derived from heme groups of hemoglobin:
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bilirubin
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Common cells found in normal urine sediment are
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leukocytes, erythrocytes, or epithelial cells
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An abnormal component of urine sediment formed proteins is:
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large number of casts?
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Cause of Proteinuria:
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glomerular nephritis
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Cause of Glycosuria:
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diabetes mellitus
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Cause of Ketonuria:
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diabetes mellitus, starvation, carbohydrate deprivation
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Cause of Bulirubinuria:
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hemolysis (transfusion reaction), liver disease, or bile duct obstruction
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Explain why proteins are not normally found (above trace amounts) in urine? What could cause proteinuria? Also explain why glucose is not normally found (above trace amounts) in urine. What must happen to produce glycosuria?
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Due to their larger size and polarity, plasma proteins normally do not pass through the glomerulus and thus are not found above trace amounts in urine. As discussed in the next answer, proteinuria could be caused by leakage through inflamed glomerular capillaries or perhaps downstream if the lower urinary tract (ureter, urinary bladder, or urethra) is similarly inflamed. Glucose molecules present in the filtrate are selectively and efficiently reabsorbed by specific glucose carriers as a part of secondary active transport mechanisms located along the proximal convoluted tubules and returned to the blood. Consequently, glucose is not found in normal urine. However, in people with type 2 diabetes mellitus, the plasma concentration of glucose is abnormally high (hyperglycemia). If their blood glucose concentration rises above 200 mg/dl, the renal plasma threshold for glucose, all specific glucose carriers in the nephron will be saturated and glycosuria will occur.
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The three components of the mucosa layer of the digestive tract are the __________
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and the __________.,epithelium; lamina propria; muscularis mucosa
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Microscopic fingerlike projections of mucosa in the small intestine are called _________.
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villi
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The foldings of the plasma membrane of intestinal epithelial cells that produce the brush border are called:
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microvilli
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Blood is transported from the intestine to the liver in a large vessel known as the
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hepatic portal vein
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Once blood has reached the liver it travels through large capillaries called:
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sinusoids
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The microscopic exocrine units of the pancreas are called ________; the endocrine structures are known as the __________.
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pancreatic acini; (pancreatic) islets of Langerhans
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The glands in the duodenum that secrete and alkaline mucus;
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Brunner’s glands
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Describe the structural adaptations of the small intestine that help increase the surface area and the rate at which digestion products can be absorbed:
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The surface area of the small intestine is increased by the presence of plicae circulares, villi, and microvilli (brush border).
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Describe the composition of pancreatic juice and explain its function:
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Pancreatic juice is a blend of water, bicarbonate, and a variety of digestive enzymes, including trypsin, lipase, and amylase among others. Bicarbonate ions from the pancreatic duct cells help buffer the acidic contents from the stomach, trypsin hydrolyzes polypeptides to amino acids, dipeptides, and tripeptides, and pancreatic amylase digests starch to maltose, maltriose, and oligosaccharides. Pancreatic juices leave the pancreas and enter into the small intestine (duodenal portion) and perform their function there.
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Starch is partially digested into maltose by the action of
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amylase
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The enzyme in gastric juice that partially digests protines is_______; this enzyme has a pH optimum of:
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pepsin; 2.0
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Which food group-carbohydrates lipids or proteins – is not digested significantly until it reaches the small intestine?
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lipids
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Bile is produced by the? And stored in the?
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liver hepatocytes; gallbladder
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What is the function of bile salts?
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emulsify lipids
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The particles consisting of a combination of triglycerides and protein secreted by intestinal epithelial cells into the central lacteals of the villi are called?
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chylomicrons
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In procedure A which tube(s) contained the most starch following incubation? Which tube(s) contained the most reducing sugars? What conclusion can you draw from these results?
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Following incubation, tubes 1 and 4 in exercise “A” contained the most starch and tube 2 contained the most reducing sugar. Salivary amylase therefore, functions best at a neutral pH and is at least partially destroyed by boiling.
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