Alexis Shared "PHYS PHINAL" - 54 Picmonics

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PHYS PHINAL

Alveolar Gas Equation
Equation
Partial Pressure of Alveolar Oxygen (PAO2)
Partial Pressure of Oxygen in the Inspired Air (PIO2)
PIO2 Normally Approximated = 150 mmHg
Arterial Partial Pressure of CO2 (PaCO2)
Respiratory Quotient (R)
R Normally Approximated = 0.8
PAO2 = PIO2 - (PaCO2/R)
1 min
Physiologic Dead Space (VD)
Tidal Volume (VT)
Partial pressure of arterial CO2 (PaCO2)
Partial pressure of CO2 in expired air (PECO2)
VD = TV x (PaCO2-PECO2) / PaCO2
2 mins
Exercise pulmonary
Overview:
increased oxygen DEMAND
increased respiratory rate (hyperventilation)
increased Tidal volume
minute ventilation
Arterial
Arterial Partial Pressure of CO2 (PaCO2) the same
Partial pressure of arterial O2 (PaO2) the same
Arterial Partial Pressure of CO2 (PaCO2) the same
Arterioles
venous
Veins
Skeletal muscle adds CO2 to veins
pulmonary blood flow
Increased cardiac output
increased pulmonary blood flow
decreased pulmonary resistance
High Blood Pressure Response
Characteristics
Atria Release Atrial Natriuretic Peptide
Vasodilation
Antagonizes Aldosterone
Na+ and Water Excreted
1 min
Pulmonary pressures
Pleural Pressure
Alveolar Pressure
Transpulmonary Pressure
Volume Pressure Curves for Lungs/Chest
5 cm H2O
Low Blood Pressure Response
Characteristics
Posterior Pituitary Releases Vasopressin
Vasoconstriction
Adrenal Cortex Releases Aldosterone
Increased Na+ and H2O Reabsorption
1 min
Renal Clearance
Characteristics
Estimates Volume of Substance Cleared by Kidney Per Unit Time
Creatinine Clearance Used to Estimate GFR
Equation
Cx = (Ux/Px) * V
Variables
Urine Concentration of Substance X (Ux)
Plasma Concentration of Substance X (Px)
Urine Flow Rate (V)
2 mins
Stages of Renal Disease
Stage 1-GFR > 90ml/min with proteinuria and microalbuminuria
Stage 2-GFR between 60-89 ml/min
Stage 3-GFR between 30-59
Stage 4-GFR between 15-29 (Severe)
Stage 5-GRF
Chronic Kidney Disease Begins at stage 3 or higher
Hypertension is directly correlated with stage
Increased Risk of Death from Cardiovascular disease stage 3 and higher
Erythropoietin is low beginning at stage 4
Hypocalcemia is seen in stage 4 and 5
Vitamin D Deficiency
Hyperkalemia seen in stage 4 and 5
Hyperphosphatemia and Hypocalcemia
Gadolinium Contrast should be avoided
Neuron Action Potential Initiation
Characteristics
Summation of Signals
-50 mV Threshold Value Reached
Voltage-Gated Sodium Channels Open
Local Depolarization
Na+ Influx
Potassium Channels open
Repolarization
2 mins
Neuron Action Potential Propagation
Characteristics
Unidirectional Depolarization
Absolute Refractory Period In Preceding Na+ Channels
Neighboring Voltage Gate Channels Open
Nodes of Ranvier
Myelination Increases Propagation Speed
Saltatory Conduction
3 mins
Neuron Resting Potential
Characteristics
More Na+ Outside
Sodium-Potassium Pump
K+ Leaks Out
More K+ Inside
About -70mV
Voltage-Gated Sodium Channels are Closed
2 mins
Motor Neuron Signs UMN and LMN
Upper Motor Neuron (Increases)
Increased DTRs
Positive Babinski
Spastic Paralysis
Clasp-Knife Reaction
Lower Motor Neuron (Decreases)
Decreased DTRs
Negative Babinski
Flaccid Paralysis
Muscle Atrophy
Fasciculations
2 mins
Skeletal Muscle Contraction Action
Characteristics
Calcium Binds Troponin
Active Site Exposed
Many Mitochondria Produce ATP
Myosin Head Binds
Power Stroke
Myosin Head Releases Active Site
ATP Consumed
1 min
cardiac action potentials
sodium channels open
upstroke
Repolarization
Voltage-Gated Sodium Channels close
calcium influx
Smooth Muscle Contraction
Repolarization
closure of calcium channels
Resting Potential
potassium efflux
potassium efflux
Somatic Reflex Arc
Spinal Cord
Sensory (Afferent) Neuron
Interneurons Transmit
Motor (Efferent) Neuron
Effector Targets
1 min
Pressure-volume loop
Phases—left ventricle
Isovolumetric contraction: period between mitral valve closing (S1 sound is heard) and aortic valve opening. Period of highest O2 consumption
Systolic ejection: period between aortic valve opening and closing
Isovolumetric relaxation: period between aortic valve closing (S2 can be heard) and mitral valve opening
Rapid filling: period just after mitral valve opening (S3 occurs)
Reduced filling: period just before mitral valve closing
CHANGES
Increased Preload (Moves to the right like the letter P)
Increased Afterload (Tall and Skinny like the letter A)
Increased Contractility (Moves to the left like the letter C)
Coagulation Cascade
Secondary Hemostasis
Intrinsic Pathway
Partial Thromboplastin Time (PTT)
Heparin
Extrinsic Pathway
Prothrombin Time (PT)
Warfarin
Common Pathway
Thrombin
Convert Fibrinogen to Fibrin
Stabilizes the Platelet Plug
2 mins
Types of Blood Products
Types
Whole Blood
Packed Red Blood Cells
Fresh Frozen Plasma
Immunoglobulins
Clotting Factors
Albumin
Platelets
Considerations
Use within 24 Hours
Washing Removes Antibodies
Irradiation Destroys WBCs
2 mins
PHASES OF WOUND HEALING
Inflammatory (up to 3 days after wound) Platelets, neutrophils, macrophages Clot formation,  vessel permeability and neutrophil migration into tissue; macrophages clear debris 2 days later
Proliferative (day 3–weeks after wound) Fibroblasts, myofibroblasts, endothelial cells, keratinocytes, macrophages Deposition of granulation tissue and type III collagen, angiogenesis, epithelial cell proliferation, dissolution of clot, and wound contract
Remodeling (1 week–6+ months after wound) Fibroblasts Type III collagen replaced by type I collagen,  tensile strength of tissue
Vitamin K
Sources
Dark Green Leafy Vegetables
Synthesized by Intestinal Flora
Mechanism
Activated by Epoxide Reductase
Gamma Carboxylation of Glutamate
Activation of Clotting Factors II, VII, IX, X, Protein C and S
Considerations
Deficiency with Broad Spectrum Antibiotics
Neonatal Hemorrhage with Increased PT and aPTT
Warfarin is a Vitamin K Antagonist
4 mins

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