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MSN 570 PROFESSORS NOTES MIDTERM
PATHOPHYSIOLOGY 2026 EXAM SCRIPT
COMPLETE SOLUTIONS
โ What does the migration of WBCs to the bronchials do. Answer: increases inflammation of the cite and causes fibrosis in the bronchial wall โ How does the thickening and rigidity of bronchial basement membranes effect the lungs. Answer: leads to further narrowing of the bronchial passageways โ What acid-base disorder is seen in chronic bronchitis. Answer: respiratory acidosis โ how does chronic bronchitis lead to respiratory acidosis?. Answer: hyperinflation of the alveoli causes CO2 retention โ Where does air enter the body?. Answer: naso and oropharynx (mouth and nose) โ Where does air go after it passes through the nose and mouth?. Answer: it passes through the trachea
โ After air passes through the trachea where does it go?. Answer: goes into the left or right bronchi โ Where does air flow after the bronchi?. Answer: into the smaller bronchioles โ Where does air flow after the bronchioles?. Answer: into the alveoli โ Describe how blood flows to become oxygenated. Answer: - deoxygenated systemic blood flows from the vena cava to R atrium
- Tricuspid valve opens to flow to R ventricle
- Pulmonary semilunar valve opens and blood flows to the alveolar capillaries for gas exchange from the pulmonary trunk and L & R pulmonary arteries
- blood goes from alveolar capillaries to pulmonary veins to return oxygenated blood to the left atrium
- bicuspid valve opens to allow blood to go to left ventricle
- aortic semilunar valve opens and blood goes to the aorta
- aorta pushes oxygenated blood out to the body โ What is the formula for cardiac output. Answer: CO = HR x SV
โ What can cause decreased preload. Answer: cardiac tamponade and hypovolemia โ What are two common causes of hypovolemia. Answer: dehydration and hemorrhage โ Afterload. Answer: the amount of resistance to open the semilunar valves and eject of blood from the ventricle โ what influences afterload (3). Answer: ventricle wall thickness (muscle strength) arterial pressure (resistance to ejection) ventricle chamber size (blood volume capacity) โ what can cause an increase in afterload. Answer: systemic hypertension valve disease COPD (pulmonary hypertension) โ what can decrease afterload. Answer: hypotension or vasodilation
โ what influences cardiac contractility (inotropic state). Answer: levels of electrolytes High levels of ATP level of oxygen available synchronous muscle contraction โ What electrolytes are used for cardiac muscle contraction?. Answer: sodium potassium and calcium โ What increases cardiac muscle contraction. Answer: sympathetic stimulation; fear anxiety and increased thyroxine โ what decreases cardiac muscle contraction. Answer: low ATP levels; ischemia hypoxia or acidosis โ Stimulation of what set a resting HR (chronotropic state). Answer: parasympathetic system โ what stimulates the parasympathetic system. Answer: the vagus nerve โ What does the parasympathetic system do?. Answer: It releases acetycholine which decreases heart rate and causes vasodilation
โ What are the semilunar valves?. Answer: pulmonary and aortic valves โ What causes the semilunar valves to open?. Answer: As ventricles contract and intraventricular pressure rises, blood is pushed up against the SL valves, forcing them to open โ ejection fraction. Answer: measurement of the volume percentage of left ventricular contents ejected with each contraction โ What causes the semilunar valves to close?. Answer: ventricles relax and intraventricular pressure falls, blood flows back from the arteries, and fill the cusps of the semilunar valves โ What causes the S2 heart sound?. Answer: closing of semilunar (aortic and pulmonary) valves โ What prevents the backflow into the ventricles. Answer: semilunar valves โ Stenosis of heart valve. Answer: A narrowing of the valve opening, causing turbulent flow and enlargement of the emptying chamber
โ Stenosis of a heart valve, may result in what?. Answer: Narrowing of the heart valves means that blood moves with difficulty out of the heart. Results may include chest pain, edema in the feet or ankles, and irregular heartbeat. and hypertrophy โ heart failure. Answer: cardiac dysfunction caused by the inability of the heart to provide adequate CO resulting in inadequate tissue perfusion โ Left sided heart failure characteristic. Answer: inability of the left ventricle to provide adequate blood flow into systemic circulation โ Causes of left sided heart failure. Answer: systemic hypertension left ventricle MI LV hypertrophy Aortic SL valve or bicuspid valve damage Secondary to right heart failure โ How does LV hypertrophy lead to left sided heart failure. Answer: The hypertrophy is secondary to cardiac damage resulting in an enlarged by weaker structure that holds more blood
โ What does fluid in the pulmonary tissue result in. Answer: the areas are flooded and results in pulmonary edema and dyspnea โ cor pulmonale. Answer: right-sided heart failure โ right sided heart failure. Answer: inability of the right ventricle to provide adequate blood flow into the pulmonary circulation โ Causes of right sided heart failure. Answer: - pulmonary disease
- pulmonary hypertension
- RV MI
- RV Hypertrophy
- pulmonary SLV or tricuspid valve damage
- secondary to left heart failure โ What is the most common cause of right sided heart failure. Answer: pulmonary hypertension โ Progression of right sided heart failure. Answer: - damage causes the right ventricle to increase contraction force to eject/unload the blood
- over time EF is reduced and right ventricle us unable to eject the normal amount of blood
- the blood remaining in the RV increases and RA preload increases until the RA is unable to eject the normal amount of blood into the RA
- the amount of blood remaining in the right atrium increases causing an increase in RA preload
- blood volum enad pressure then backs up into the vena cava and systemic veins โ signs and symptoms of right sided heart failure. Answer: jugular vein distension hepatosplenomegaly peripheral edema โ Why does hepatosplenomegaly develop in right sided heart failure. Answer: the large volume of blood flow through the liver and spleen causes these areas to be engorged
โ sliding filament theory. Answer: theory that actin filaments slide toward each other during muscle contraction, while the myosin filaments are still โ Hematopoiesis. Answer: formation of blood cells โ Where does blood cell formation occur in a fetus. Answer: 3 weeks - yolk week 8 - fetal liver and spleen 5th month - bone marrow โ Blood cell formation in chidren 0-5 years old. Answer: red marrow of all bones to make blood cells โ blood cell formation in adults over 20. Answer: red marrow in large bones
- illium, vertebrae, cranium, jaw, sternum, ribs, humerus, and femur โ Erythropietin. Answer: Produce: Kidney (small amount in liver) Released: Kidney Target: Bone Marrow Functions: Stimulates bone marrow to produce more red blood cells
โ hematopoietic stem cells. Answer: The stem cells that give rise to RBC WBC and platelets through the process of haematopoiesis. โ How does a hematopoietic stem cell produce a red blood cell. Answer: hematopoietic stem cells produces an unndifferentiated hemocytoblast
- erythropoietin binds to it and createsa a proerythroblast
- cell develops into an erythrocyte 7 days later โ Erythrocyte function. Answer: transport oxygen and carbon dioxide โ Erythrocyte life span. Answer: 120 days โ anemia risk factors. Answer: acute or chronic blood loss, increased hemolysis, inadequate dietary intake or malabsorption, bone marrow suppression, age โ function of hemoglobin. Answer: In red blood cells, carries oxygen from the lungs to body's tissues and returns carbon dioxide from tissues back to lungs. It also maintains the shape of red blood cells.
โ hemolytic anemia is what kind of anemia. Answer: normocytic normochromic anemia โ polycythemia vera. Answer: condition characterized by too many erythrocytes; blood becomes too thick to flow easily through blood vessels โ Kidney Anatomy. Answer: renal artery renal vein cortex, medulla, renal pelvis ureter renal pyramid nephron โ Nephron Anatomy. Answer: 1. glomerulus
- bowman's capsule
- collecting duct
- tubule
- capillary โ Bladder anatomy. Answer: - ureter
- bladder
- urethra โ reabsorption (kidney). Answer: movement of solutes from filtrate to blood
things taken back that were secreted of filtered by the kidney โ what solutes are typically reabsorbed. Answer: glucose, ions, amino acids and urea โ Where is most of the solute reabsorbed?. Answer: proximal convoluted tubule โ What effects amount of water and solute reabsorption. Answer: ADH and aldosterone โ secretion (kidney). Answer: movement of solutes from blood to filtrate anywhere besides bowman's capsule able to secrete salts, acids, bases and urea directly into the tubule via active or passive transport what is secreted into the tubule depends on what the body needs at that time ex. eating a lot of protein nitrogen waste is a product of protein metabolism (ammonia)
hydrostatic pressure is greater so there will be movement into bowman's capsule usually favors the filtrate to go into the bowman's capsule each persons full body is filtered about every 40 minutes โ Conditions associated with renal failure. Answer: - congenital abnormalities in the urethral tract development
- kidney and bladder cancer
- infections
- glomerulonephritis
- acute/ tubular necrosis
- AKI โ vesicoureteral reflux. Answer: Abnormal ureter-bladder connection allowing retrograde flow of urine from bladder to ureters and/or kidneys โ renal agenesis. Answer: unilatral or bilateral failure of the kidneys to develop in utero
โ Potter syndrome. Answer: Syndrome characterized by bilateral renal agenesis and incompatibility of live birth โ Wilms tumor. Answer: - Embryonal kidney tumor associated with defective tumor (WT) genes
- Tumors are typically not clinically diagnosable until age 1-5 even though they are present at birth โ polycystic kidney disease. Answer: - Mutant PKD genes cause fluid accumulation in kidney tubules "cysts"
- The cysts can be the size of grapes or oranges and compress and destroy nephrons โ Why are kidneys and bladders at high risk for cancer. Answer: - UT is the route of excretion for many toxins and contains highly mitotic cells โ Descending infection. Answer: The blood can carry bacteria from a focus of infection in another part of the body to the kidneys. The bacteria then pass with the urine down the ureters to the bladder. โ Ascending infection. Answer: - urethra to bladder, and then to kidney
- due to: bacteria from residual fecal contamination
