CAP Exam 1 Review

What are the structural components of the breast?

Suspensory ligaments, lobes, lactiferous ducts.

How is the breast drained?

Mammary branches to axillary and parasternal nodes.

What are the roles of intercostal muscles in respiration?

External intercostals: inspiration; Internal intercostals: expiration.

What are the cell types in olfactory epithelium?

Olfactory neurons, support cells, basal cells; thicker apical membrane.

What are the cell types in nasal epithelium?

Goblet cells, small granule cells, brush cells.

Where does the conducting zone end?

At the terminal bronchiole; no gas exchange occurs.

Where does the respiratory zone begin?

At the alveoli; gas exchange occurs.

What are the functions of alveolar cells?

Type I: gas exchange; Type II: surfactant production and progenitor for Type I.

What are club cells?

Secrete surfactant-like substance; found in bronchioles.

What are the layers of the trachea?

Mucosa → Submucosa → Hyaline cartilage → Adventitia.

What is the trachealis muscle?

Smooth muscle closing the open part of the C-shaped cartilage ring.

How does airway structure change as you descend?

Cartilage and glands decrease; smooth muscle increases; cilia last to disappear.

What is the respiratory membrane composed of?

Alveolar epithelium, basement membrane, capillary endothelium.

What is Dalton’s Law?

Total pressure = sum of partial pressures of gases.

What is Henry’s Law?

Gas dissolves in liquid proportional to its partial pressure.

What is Fick’s Law?

Gas transfer across membrane depends on surface area, thickness, and gradient.

Why does CO2 diffuse more easily than O2?

CO2 is 20x more soluble than O2.

What is the bronchial circuit?

Thoracic aorta → bronchial artery → bronchial vein; results in slightly less oxygenated blood.

What is the pulmonary circuit?

Pulmonary artery → capillary → pulmonary vein; primary site of gas exchange.

What causes a left shift in the Hb-O2 curve?

↓ temp, ↓ CO2, ↓ 2,3-BPG, ↑ pH, ↑ fetal Hb; increased affinity, decreased p50.

What causes a right shift in the Hb-O2 curve?

↑ temp, ↑ CO2, ↑ 2,3-BPG, ↓ pH, ↓ fetal Hb; decreased affinity, increased p50.

What are the types of hypoxia?

Anemic (low Hb), histotoxic (low O2 use), ischemic (poor circulation), hypoxemia (low O2 pickup).

How is CO2 transported?

Bicarbonate, bound to Hb (NH2), dissolved in plasma.

What is the carbonic anhydrase reaction?

CO2 + H2O ↔ H2CO3 ↔ H+ + HCO3−.

What is the chloride shift?

Exchange of Cl− and HCO3− to maintain ionic balance during CO2 transport.

What is the Bohr effect?

↓ pH → right shift → O2 unloading; ↑ pH → left shift → O2 retention.

What is the Haldane effect?

O2 binding to Hb reduces Hb affinity for CO2, promoting CO2 release.

How does respiratory compensation work?

Acidosis: hypoventilation → renal H+ secretion; Alkalosis: hyperventilation → renal HCO3− secretion.

How does metabolic compensation work?

Acidosis: hyperventilation; Alkalosis: hypoventilation.

How does CO affect Hb?

CO binds Hb competitively, decreases p50, causes left shift and prevents O2 release.

What is the V/Q ratio?

0.8; ventilation and perfusion are matched to optimize gas exchange.

What happens during voluntary hyperventilation?

↓ CO2 → alkalosis → cerebral vasoconstriction → syncope.

How does the diaphragm form?

Septum transversum + pleuroperitoneal folds fuse to separate thoracic and abdominal cavities.

What is congenital diaphragmatic hernia (CDH)?

Failure of pleuroperitoneal fold fusion; abdominal organs herniate into thorax.

What is ectopia cordis?

Heart located partially or completely outside the thoracic cavity.

What is bladder exstrophy?

Bladder develops outside the body; associated with pelvic/genital defects.

What is gastroschisis?

Intestines protrude through abdominal wall near umbilicus.

When do alveoli form?

After 36 weeks gestation.

What are the pleural reflections?

Costomediastinal (2nd–6th ribs); Costodiaphragmatic (8th–10th ribs midaxillary).

Where is thoracocentesis performed?

Needle inserted at 9th intercostal space, midaxillary line.

What is atelectasis?

Lung collapse due to loss of negative pressure.

What is the surface anatomy of lung lobes?

Right: upper (2nd rib), middle (4th/5th), lower (posterior); Left: upper (2nd), lower (posterior).

What is the sternal angle?

At 2nd rib, T4–T5; site of tracheal bifurcation.

What is the lymphatic drainage of the lungs?

Pulmonary → bronchopulmonary → tracheobronchial → paratracheal → thoracic duct or right lymphatic duct.

What is pulmonary edema?

Left-sided CHF; fluid in lungs; Kerley B lines on radiograph.

What is COPD?

Chronic bronchitis and asthma.

What is emphysema?

Destruction of alveoli beyond terminal bronchiole; enlarged airspaces.

What are the layers of blood vessels?

Tunica intima (endothelium), media (SMC, elastic), externa (support).

What are types of anastomosis?

Artery-vein (temp regulation), artery-artery (collateral flow), vein-vein (drainage).

What are the types of capillaries?

Continuous (nutrients), fenestrated (small proteins), sinusoid (RBCs, large proteins).

What is the conduction pathway of the heart?

SA node → AV node → Bundle of His → Purkinje fibers.

Why is there a delay at the AV node?

Allows full atrial contraction before ventricular contraction.

What are the effects of T3/T4?

Genomic: ↑ contractile proteins; Non-genomic: ↑ ATPase cycling.

What is isovolumetric contraction?

All valves closed; pressure builds until semilunar valves open.

What causes S1 and S2 heart sounds?

S1: AV valves close; S2: semilunar valves close.

What is S2 splitting?

Aortic valve closes before pulmonary during inspiration.

What are systolic murmurs?

Mitral/tricuspid regurgitation; aortic/pulmonary stenosis.

What are diastolic murmurs?

Mitral/tricuspid stenosis; aortic/pulmonary regurgitation.

What is the PR interval?

Time between atrial and ventricular depolarization.

What is the QT interval?

Time between full ventricular depolarization and repolarization.

What is stroke volume (SV)?

EDV - ESV; amount of blood ejected per beat.

What is cardiac output (CO)?

CO = HR × SV.

What increases EDV?

Blood volume, venous return, skeletal muscle activity.

What increases ESV?

↓ contractility, ↑ afterload.

What is mean arterial pressure (MAP)?

MAP = ⅓ systolic + ⅔ diastolic pressure.

What is pulse pressure?

Systolic - diastolic pressure.

What is preload?

Stretch of ventricles before contraction; influenced by EDV.

What is afterload?