fibrinogen, von willebrand factors (VWF), prothrombin, clotting factors
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Sequence when you get a wound
1. wound VWF binds to collagen, 2. platelets bind to collagen via VWF, 3. Binding to collagen activates platelets, 4. A thrombus is formed (platelet plug), does not need thrombin
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Thrombin
used for clotting
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Thrombus
many platelets piled up
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Prothrombin (Xa)
→ thrombin
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Fibrinogen (thrombin)
→ Fibrin
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Fibrin (XIII)
→ crosslinked fibrin (clot)
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Xa
Need to clot
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Intrinsic pathways
negative charged surface (platelet lipids), clotting factors, calcium, vitamin K
Blood accumulates in the legs and venous return decreases. This drops EDV (preload) and SV decreases. Decrease in SV results in decrease in CO and drop in BP, You turn on the sympathetic to counter the drip in BP.
Why does BP drop when you suddenly stand up
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Pooling blood in lower extremities, decrease in cardiac output
decrease in BP when you stand up
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MAP
mean of blood pressure
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What could cause a drop in MAP
drop in SV by drop in venous return, drop in heart rate caused by drop in CO (parasympathetic), drop in TPR
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P wave
depolarization of atria in response to SA node triggering
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T wave
ventricular repolarization
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PR interval
delay of AV node to allow filling of ventricles
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QRS complex
depolarization of ventricles, triggers main pumping contractions
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ST segment
beginning of ventricular repolarization, should be flat
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Sympathetic
activates Gs phosphorylate the sodium channel and they open faster
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Parasympathetic
activate Gi inhibits adenylate cyclase and cAMP production and beta gammas bind to K channels and slow the closing of these channels
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High BP, low albumin, leakage of protein into interstitial fluid
What causes edema in legs?
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High BP
hydrostatic pressure
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Low albumin
which is decrease in plasma protein which decreases osmotic pressure
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BP measurement
first sound systolic pressure, hear sound until you drop below diastolic pressure (no sound)
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systolic pressure
first sound (top)
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diastolic pressure
no sound (bottom)
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A metabolic
no cause relaxation
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Stretch responds to either stretch of smooth muscle or lack of stretch smooth muscle contraction
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MAP = (SP+2DP)/3
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86=(110+2x75)/3
MAP BP 110/75
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Conducting zones
bronchi, regulate air flow to alveoli smooth muscle
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Conducting zone
Cleans with ciliated cells and mucous cells
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Respiratory zone
alveoli, where gas exchange takes place
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Partial pressure
% of gas X total pressure
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120 = .2 X 600
Total pressure 600 and O2 = 20% find Partial pressure
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Take a breath
intrapleural space expands and pressure drops, lungs expand, lung volume increases so alveolar pressure drops relative to Atm pressure and air moves into the lungs
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Diaphragm contracts and external intercostal muscles contract
Muscles that move while quiet breathing
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Opposite
Muscles that move when you quiet expire
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Prevents collapse of lungs, decreases surface tension
What is the role of surfactant
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In type 2 cells in the alveoli
Where is surfactant made
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Surfactant
does not increase elasticity, increases compliance
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Inspiratory reserve volume
when you take deep breath volume taken in
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Expiratory reserve volume
blowing air out forcefully
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Vital capacity
Title Volume + Inspiratory Reserve Volume + Expiratory Reserve Volume
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Inspiratory capacity
Title Volume + IRV + maxim air you can take in
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Passive diffusion
Both O2 and CO2 move across membranes by
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CO2 flows from
high pressure to low
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Normal conditions of CO2
high in capillaries and flow from capillaries to alveoli
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O2 flows from
high pressure to low
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Chloride shift
1.CO2 is released to alveoli and exhaled, 2. CO2 is converted to HCO3 at tissues to be carried by blood, 3. Shift allows for conversion of CO2 to HCO3 at tissue in tissue 4. Shift of HCO3 to CO2 in lungs
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Tissue to lungs (70% HCO3, 20% carbamino HB, 10% dissolved in blood)
How is CO2 transported
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Decreased affinity
HB/O2 binding and release increased temp
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Increased CO2
decreased affinity
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Decreased pH
decrease affinity
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Shift graph to the left
increase affinity
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Lungs
Want high oxygen affinity in the
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Hemoglobin wants
less affinity
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Acid, CO2, DPG
shifts to the right, decrease affinity
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Immediately O2 levels drop, hyperventilate and lower CO2 so affinity for O2 increases, gives better O2 loading, after a few days DPG levels increase and O2 affinity decreases
What happens if you go up to altitude
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If aveouls is poorly ventilated
O2 down, CO2 high then constrict this capillary blood vessle to limit blood flow to this alveolus
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If no blood flow to alveoli
O2 high, CO2 low, constrict the smooth muscle of the alvelous that is not perfused and relax the other
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Stay unchanged bc increased ventilation
During exercise O2 levels
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Lungs are not functioning
you hyperventilate, CO2 builds up and move to right get more H+ acidosis
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Metabolic acidosis
lungs are fine if acidic, lungs want to hyperventilate to lower H+ so PCO2 levels are low