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Hubs192 > 14-some of 29 lectures > Flashcards

14-some of 29 lectures Flashcards

1
Q

what are the 3 main things that the respiratory do?

A

moisten, warms and cleans the air

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2
Q

what does the respiratory need to be effective?

A

a surface for gas exchange

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3
Q

what happens at the surface of gas exchange?

A

where blood and air are brought close together

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4
Q

what does URT mean?

A

upper respiratory tract

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5
Q

what does LRT mean?

A

lower respiratory tract

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6
Q

what does the respiratory zone consist of?

A

bronchioles to alveoli

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7
Q

what happens at the respiratory zone?

A

where gas exchange occurs

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8
Q

what does the conduction zone consist of?

A

nose to the bronchioles

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9
Q

what does the conduction zone do?

A

ensures warm, clean and moisten the air

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10
Q

what happens at the oral cavity?

A

passage for food and air

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11
Q

what happens in the nasal cavity?

A

where officiation happens

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12
Q

what epithelia lines the respiratory tract?

A

mucosa that is attached to the basement membrane to lamina propria

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13
Q

what epithelium is in most of the conducting region?

A

respiratory epithelium

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14
Q

what is the epithelium where air and food travels?

A

stratified squamous cells

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15
Q

what cells line the sites of the gas exchange?

A

simple squamous cells

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16
Q

what epithelium lines areas of olfaction?

A

olfactory mucosa

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17
Q

what does the mucosa of the reparatory tract do?

A

clean, warms and moistens the air

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18
Q

what is the lamina propria?

A

connective tissue and may contain glands

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19
Q

what is below the lamina propria?

A

the submucosal layer

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20
Q

what is the submucosa layer?

A

connective tissue and depending on the region it may contain glands

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21
Q

what is respiratory epithelium known as?

A

pseudostratified ciliated columnar epithelium

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22
Q

what does respiratory epithelium contain?

A

goblet cells

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23
Q

where is respiratory epithelium found?

A

nasal cavity, part of the pharynx, larynx, trachea and bronchi

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24
Q

what do goblet cells do?

A

produce mucus to trap debris and moistens the air

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25
Q

what are ciliated cells?

A

a patterned movement that pushes the mucus towards the pharynx to be swallowed and digested in the stomach acid

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26
Q

what are some components of the URT?

A

nose, nasal cavity, paranasal sinuses, pharynx

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27
Q

what is the noses job?

A

primary passageway for air

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28
Q

what does the cartilage of the nose do?

A

maintains patent which keeps it open

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29
Q

what are nosetrils?

A

the external nares

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30
Q

what are the vestibule?

A

line the skin and has sebaceous and sweat glands as well as hair follicles

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31
Q

what are vibrissae?

A

hairs that line the nasal cavity which filter the air

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32
Q

what is the nasal septum?

A

the bone down the midline that separates the nostrils

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33
Q

what forms the roof cavity?

A

ethmoid and sphenoid bones

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34
Q

what forms the floor cavity?

A

the hard and soft palates

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35
Q

what are the conchae?

A

the lateral walls of the nasal cavity

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36
Q

what are the 3 projections of the conchae?

A

superior, middle and inferior conchae

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37
Q

what do the conchae do?

A

spin the air around (turbinate)

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38
Q

what covers the conchae?

A

respiratory epithelium

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39
Q

what does spinning the air in the conchae do?

A

gives it more time to clean, warm and moisten the air

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40
Q

where is nasal epithelium?

A

in the nasal cavity

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41
Q

what is another name for smell receptors?

A

olfactory receptors

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42
Q

where are smell receptors found?

A

on the roof of the nasal cavity

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43
Q

what is the vascular plexus?

A

a thin wall that has nasal epithelium sitting on the lamina propria

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44
Q

what does the vascular plexus do?

A

when cold air enters the nasal cavity it dilates and brings the air closer to the blood to warm it up more

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45
Q

what is a sinus?

A

a cavity in the bone

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46
Q

what does paranasal mean?

A

surrounding the nose

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47
Q

where are the paranasal sinuses found?

A

the frontal sphenoid, ethmoid and the maxillary bones

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48
Q

what lines the paranasal sinuses?

A

respiratory muscosa

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49
Q

what do the paranasal sinuses drain into?

A

the pharynx

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50
Q

what does clearing the paranasal sinuses do?

A

stops the blockage with interferes with the resonance so we sound different

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51
Q

what is the pharynx?

A

a muscular funnel-shaped tube shared by the respiratory and digestive system

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52
Q

what are the 3 regions of the pharynx?

A

nasopharynx, oropharynx, laryngopharynx

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53
Q

what is the nasopharynx?

A

air passage only

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54
Q

what blocks the nasopharynx during swallowing?

A

the soft palate and the uvala

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55
Q

what does blocking the nasopharynx?

A

prevents food from entering the nasal cavity

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56
Q

what does the oropharynx do?

A

allows food and air and enters

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57
Q

what does the laryngopharynx do?

A

allows food and air to pass but has a food has right of way during swallowing

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58
Q

what are the components of LRT?

A

larynx, trachea, bronchi, bronchioles and alveoli

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59
Q

what does the LRT do?

A

conducts air to the site of gas exchange and completes cleaning, warming, and humidifying the air

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60
Q

what is the only passage that sits Infront of the esophagus?

A

the larynx

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61
Q

what does the cartilage of the larynx do?

A

protects it and keeps the airway open

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62
Q

what is the thyroid cartilage?

A

the biggest piece of cartilage of the throat

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63
Q

what is the laryngeal prominance?

A

the medial part of the thyroid cartilage ad is also referred to as the apples apple

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64
Q

what is the cricoid cartilage?

A

a solid peice of cartilage that wraps the larynx

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65
Q

what is the epiglottis?

A

a piece of cartilage that closes over the airway when swallowing so no food goes down the larynx

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66
Q

what does Epi mean?

A

ontop of

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67
Q

what does Glottis mean?

A

voice box

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68
Q

what are the true vocal cords?

A

passing air causes vibrations which makes sound waves

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69
Q

what causes a deeper voice?

A

testosterone which affects the cartilage and muscle

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70
Q

what are vestibular folds called?

A

false vocal cords

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71
Q

what are vocal folds called?

A

true vocal cords

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72
Q

where is the trachea?

A

anterior to the esophagus and is between the larynx and primary bronchi

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73
Q

how are sounds produced?

A

air plucks the strings and makes vibrations

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74
Q

what is the function of the trachea?

A

to keep the throat patent

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75
Q

what is the structure of the trachea?

A

C-shaped cartilage rings that end are connected by a band of muscles called the trachealis

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76
Q

what are the trachealis?

A

the muscle that connects the c shaped cartilage

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77
Q

what happens when the trachealis contracts?

A

causes a cough

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78
Q

what epithelium lines the the trachea?

A

respiratory epithelium

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79
Q

are there goblet cells in the trachea?

A

yes

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80
Q

what is the mucosillary escalator do?

A

has cilia that beat in unicen to move the mucus with the debris up the trachea to the pharynx

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81
Q

how many lobes are in the right side of the lung?

A

3

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82
Q

how many lobes are in the left side of the lung?

A

2

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83
Q

why does the left side of the lungs have 1 less lobe?

A

to accommodate for the heart

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84
Q

what is the top of the lung called?

A

the apex

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85
Q

what is the bottom of the lung?

A

base

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86
Q

what does the base of the lungs sit ontop?

A

the diaphragm

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87
Q

what is the hilum?

A

where the bronchi and the blood vessels enter

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88
Q

what is the costal surface of the lungs touch?

A

the ribs

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89
Q

explain the bronchial tree?

A

the trachea branches into 2 primary bronchi, which split into the lobar branches and go in different lobes.
once in the lobes, they separate into the segmental bronchi within the lobes
these continue to split into the terminal bronchioles

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90
Q

is the trachealis muscle posterior or anterior?

A

posterior

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91
Q

structure of the primary bronchi?

A

respiratory epithelium, cartilage and smooth muscle rings are complete

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92
Q

structure of the secondary and tertiary bronchi?

A

respiratory epithelium starts to decrease in height, goblet cell numbers are reduced and cartilage is not in plates

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93
Q

what is the structure of the bronchioles?

A

cuboidal epithelium, no cartilage but thicker smooth muscles

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94
Q

what is the function of the terminal bronchioles?

A

each supplies a pulmonary lobule

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95
Q

what are pulmonary lobules?

A

many alveoli arranged in bunches like grapes

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96
Q

structure of the alveoli?

A

thins walls of simple squamous epithelium on a thin basement membrane
the external surface is covered in a fine network of pulmonary capillaries

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97
Q

what is the alveolus?

A

pocket like open at one side covered by a dense capillary network

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98
Q

what is the name for lung epithelium called?

A

pneumocytes

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99
Q

what is the respiratory membrane?

A

a wall of the capillary and the alveoli that share the same basement membrane

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100
Q

how does oxygen get into our blood?

A

O2 travels through the alveoli wall, across the basement membrane and pass the capillary wall

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101
Q

how does C02 get into our lungs?

A

CO2 travels through the capillary wall, across the basement membrane and pass the alveoli wall

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102
Q

what is the gas exchange?

A

O2 goes into the blood and CO2 goes into the lungs

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103
Q

what is the mediastinum?

A

the region that contains the heart, vessels, pericardium

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104
Q

whats in the pleural cavity?

A

contains the lungs

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105
Q

what does the pleural cavity do?

A

keeps the lungs separate so if one stops functioning you can have another stop the spread of infections between the two lungs

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106
Q

what are the 2 layers of the pleural cavity?

A

the visceral and parietal layer

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107
Q

where is the visceral layer of the pleural cavity?

A

closer to the lungs

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108
Q

where is the parietal layer of the pleural cavity?

A

the layer further from the lungs

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109
Q

what happens to the volume if the pressure increases?

A

the volume decreases

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110
Q

what happens to the volume if the pressure decreases?

A

the volume increases

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111
Q

what happens if we change the volume of the thorax?

A

we change the pressure of the thorax

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112
Q

how do we measure pressure?

A

collisions

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113
Q

what does smaller spaces have in relation to pressure?

A

more collisions
increased pressure

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114
Q

what does larger space have in relation to pressure?

A

less collisions
decreased pressure

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115
Q

what is Boyles law mean when it comes to breathing?

A

we need to establish a pressure gradient to make air move

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116
Q

what binds ribs to ribs?

A

costal cartilage

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117
Q

what are the joints of the ribs?

A

they are all synovial except the first sternocostal are cartilaginous joints

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118
Q

what is the coastal chondral?

A

is the cartilage binding to the ribs via cartilaginous joints

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119
Q

what are interchondral?

A

where the cartilage is attached to help allow more individual movement yet keeps the structure whole

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120
Q

how many points are there between the ribs and the vertebrae?

A

2

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121
Q

what is the costotransverse mean?

A

between the rib and the transverse process of the vertebrae

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122
Q

what is costalvertebral mean?

A

between ribs and the body of vertebrae
these help lift the ribcage up

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123
Q

what are the primary muscles required in respiratory?

A

diaphragm and intercoastal

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124
Q

what are accessory muscles?

A

only active when they are needed

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125
Q

what is the diaphragm?

A

a sheet of skeletal muscle that separates the thorax from the abdomen?
It has a dome shape when relaxed and flattens when contracted

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126
Q

what are the 3 openings in the diaphragm that contraction expands?

A

the aorta, inferior vena cava and the esophagus

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127
Q

where are intercoastal muscles?

A

attached diagonally between neighbouring ribs

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128
Q

what does the external intercoastals do?

A

lift the ribcage and expands the cavity

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129
Q

what does the internal intercostals do?

A

depress the ribcage and decrease the cavity

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130
Q

where are accessory muscles?

A

many muscles that attach to the thoratic cage
some increase and some decrease cavity volume

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131
Q

what is inspiration?

A

diaphragm contracts and external intercostals contract in ‘quiet’
accessory muscles contract to further expand the thoracic cavity in ‘forced’

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132
Q

what is expiration?

A

passive process, diaphragm relaxes and external intercoastal relax in ‘quiet’
internal intercoastal contract and accessory muscles contract to further decrease cavity volume in ‘forced’

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133
Q

what is good about lung tissue being elastic?

A

allows lungs to take up air and recoil afterwards

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134
Q

what does plueral do?

A

makes the lungs stick to the thoracic wall

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135
Q

why do we want the lungs to stick to the thoracic wall

A

so when the wall expands the lungs expand and vise versa

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136
Q

where does the parietal pleura stick?

A

to the wall

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137
Q

where is the pleural fluid?

A

between the visceral pleura and the parietal pleura and allows frictionless movement

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138
Q

what is respiratory?

A

taking the air from the atmosphere into the lungs to be used in cell around the bopdy

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139
Q

what is needed to get oxygen into the lungs?

A

a pressure gradient to move air from the atmosphere to the lungs

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140
Q

what happens if we expand the lungs?

A

we decrease the pressure of the lungs and draws the air from the environment

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141
Q

how much of a change in pressure is sufficient for taking in and out air between 0.5- 3 liter of air from the enviroment.

A

1 mmhg

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142
Q

what are the 2 forces that must be overcome to take a breath?

A

stiffness of the lungs
resistance of the airways to the lungs

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143
Q

what determines stiffness?

A

relationship of pressure and volume

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144
Q

what happens to people with pulmonary fibrosis?

A

they struggle to breath as there is less compliance so high pressure is needed to take up a small volume compared to a normal lung

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145
Q

what lines the alveoli?

A

fluid that exerts surface tension
the thin wall of the alveoli enhances this effect

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146
Q

why do we need to overcome surface tension?

A

to expand the lung

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147
Q

what does sufactant do?

A

reduces surface tension in alveoli which makes it easier to expand the lungs

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148
Q

what produces surfactant?

A

type 2 pneumocytes in the alveoli

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149
Q

what is the result of lack of surfactant?

A

stiff lungs

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150
Q

what is resistance of the airways?

A

is like friction of the airways must be overcome to help compliance

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151
Q

what is important for resistance?

A

vessel diameter

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152
Q

where does most of the resistance airflow arises from?

A

the bronchi

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153
Q

what is the spirometry test?

A

how we can measure volume inspired/exhaled and also how fast you can breathe

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154
Q

what is the symbol for tidal volume?

A

Vt

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155
Q

what is the tidal volume?

A

volume of air moved in and out during normal quiet breath

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156
Q

what is the symbol for expiratory reserve volume?

A

ERV

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157
Q

what is expiratory reserve volume?

A

extra volume that can be exhaled voluntarily after completion of a normal, quiet respiratory cycle

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158
Q

what is the symbol for inspiratory reserve volume?

A

IRV

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159
Q

what is inspiratory reserve volume?

A

extra volume that can be inhaled over and above the tidal volume

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160
Q

what is the symbol for residual volume?

A

Rv

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161
Q

what is residual volume?

A

volume remaining in lungs after maximal exhalation

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161
Q

what is the symbol for minimal volume?

A

Mv

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161
Q

what is minimal volume?

A

volume remaining in the lungs if they have collapsed

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161
Q

what is the small amount of air that is always in the lungs called?

A

the residual volume

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161
Q

what is an indication of our lung resistance?

A

depends on our breathing rate

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161
Q

what is obstructive breathing?

A

resistance to airways

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162
Q

what is restrictive breathing?

A

reduced lung capacity

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162
Q

what is the dead space?

A

some of the inhaled air that never gets to the alveoli so it cant gas exchange

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162
Q

how do we calculate how much we breathe in and out?

A

respiratory minute volume = tidal volume (times) respiratory rate

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162
Q

what is alveolar ventilation?

A

the volume of gas per unit time that reaches the alveoli

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162
Q

how do we calculate alveolar ventilation?

A

(tidal volume - dead space) (times) respiratory rate

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162
Q

symbol for dead space?

A

Vd

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162
Q

symbol for respiratory rate?

A

f

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163
Q

what is partial pressure?

A

each gas exerts its own individual pressure in a gas mixture (air)

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163
Q

what is the pressure of a mixture of gases?

A

the sum total of the pressures of each individual gas

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163
Q

what happens to air as we breathe it in?

A

it becomes saturated so now we have nitrogen, oxygen and water vapour

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163
Q

what happens to the partial pressure of the air when it reaches the alveoli?

A

it drops from 160 to 100

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163
Q

what does oxygen do when it reaches the alveoli?

A

it dissolves into a solution until the pressure of the air and solution are in equilibrium

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163
Q

what is ficks law?

A

the rate of diffusion is determined by the surface area of which a gas is diffused across

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163
Q

what determines ficks law?

A

the soluablity of gas as well as a pressure gradient

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164
Q

what is the diffusion constant?

A

the solubility of gas

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164
Q

how do we calculate the diffusion?

A

surface area/thickness (times) diffusion constant (times) pressure difference

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165
Q

what is the partial pressure when the haemoglobin is 50% saturated?

A

p50

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165
Q

what pressure does the sigmoidal curve starts to platue?

A

p60

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165
Q

what can cause a large desaturation of oxygen of the haemoglobin?

A

a small drop in partial pressure

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165
Q

can nitrogen be dissolved?

A

no, because the diffusion constant is so low

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165
Q

what happens to oxygen if the curve shifts to the right?

A

the oxygen is released as a higher amount of partial pressure is required

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165
Q

what helps the rate of diffusion in the lungs?

A

the high surface area of the alveoli

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165
Q

how much faster does carbon dioxide diffuse compared to oxygen?

A

20 times because CO2 has a higher solubility

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166
Q

what drives the gas across the membrane?

A

the pressure gradient

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166
Q

what is the thickness of the membranes that gas has to cross?

A

3 microns thick

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166
Q

why does oxygen move down the gradient when crossing the membrane?

A

because the partial pressure in the capillaries is higher

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166
Q

what is the partial pressure of the alveoli and the capillary?

A

150 mmhg

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166
Q

what determines the rate of oxygen in our venous blood which comes back to the lungs?

A

metabolism

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166
Q

what happens to the partial pressure of the air and oxygen in the alveoli?

A

mixes with water vapour so the partial pressure decreases

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166
Q

what lowers the level of oxygen in the venous blood?

A

exercise as we use more oxygen in the blood

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167
Q

how many oxygens can bind to the haemoglobin?

A

4

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167
Q

what happens to the oxygen as soon as it enters the blood?

A

it is taken up by the haemoglobin

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167
Q

what binding to haemoglobin is the hardest?

A

the first binding

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167
Q

what does the first binding of haemoglobin do?

A

unmasks the other binding sites to make it easier to bind to more oxygen

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167
Q

what happens to the haemoglobin as the partial pressure increases?

A

the haemoglobin becomes more saturated oxygen

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168
Q

what does a decrease in partial pressure do to the saturation of haemoglobin?

A

the saturation of the haemoglobin decreases

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168
Q

what happens to oxygen if the curve shifts to the left?

A

the oxygen is loaded to the haemoglobin as less pressure is required to bind to the oxygen

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168
Q

what happens during metabolism to do with respiration?

A

CO2 is produced, O2 is needed

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168
Q

what are the 3 forms the carbon dioxide is transported in?

A

dissolved in plasma 7%
dicarbonate 70%
combined with proteins as carbamino compounds 23%

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169
Q

what carbonic anhydrase?

A

an enzyme in the RBC which converts 70% of the carbon dioxide into carbonic acid

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170
Q

what happens to carbonic acid?

A

it dissosiates into a hydrogen ion and bicarbonate ion

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171
Q

how does haemoglobin transport C02?

A

binds to the hydrogen ion formed by carbonic acid

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172
Q

what forces the C02 across the membrane?

A

a decrease of CO2 in the plasma which increases the pressure

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173
Q

where is respiratory controlled?

A

in the brainstem

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173
Q

how do the chemical chemoreceptors in the medulla pick up on PCO2?

A

CO2 diffuses out of the cerebral capillaries which changes the pH of the cerebrospinal fluid

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173
Q

what does the respiratory rhythmicity center do?

A

generates cycles of contraction and relaxations in the diaphragm
it also establishes a pace of respiration
modifies activity in response to chemical and pressure signals

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173
Q

what do central chemoreceptors respond to?

A

pH change

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173
Q

what is the purpose of the GI tract?

A

to injest food and break it up

173
Q

what do peripheral chemoreceptors respond to?

A

changes in the arterial PO2

173
Q

where are the peripheral chemoreceptors located?

A

in the carotid and aortic bodies

174
Q

what re the 4 main ways that nutrients /water are brought into the internal enviroment to be used by the body?

A

motility, secretion, digestion, absorbtion

175
Q

what is motility?

A

transport food into and through the body, mixing luminal contents and transport waste out

175
Q

what is secretions?

A

synthesised and released enzymes, mucus and serous fluids into the lumen

175
Q

what is digestion?

A

breaking of nutrients into smaller peices

175
Q

what is absorbtion?

A

bring nutrients/water from the lumen to internal enviroment

175
Q

what is the entire GI tract lined with?

A

epithelium

175
Q

what do sphincters do?

A

close off ends and separate sections of a tube
separates the enviroments of the tube

175
Q

what are sphicters made of?

A

thick rings of muscles that when contract it closes and when it dilates it lets things pass

175
Q

what epithelium lines the mouth, pharynx and esophagus?

A

stratified squamous epithilium to protect it from abrasion

175
Q

what epithelium lines the stomach and the intestines?

A

simple columnar to help with secretions and absorbtion

176
Q

what epithelium lines the anus?

A

stratified squamous to protect it from abrasion

176
Q

what are unicellular glands?

A

goblet cells which are columinar and goblet shaped

176
Q

what do goblet cells have?

A

they have apical mucus granules and a basal nucleus

177
Q

what are multicellular glands?

A

they have epithelium that can invaginate to form glands

177
Q

what are simple glands?

A

glands with a single duct

178
Q

what are the 4 layers of the gut from inner most to outer?

A

mucosa, submucosa, muscularis and adventitia

178
Q

what are compound glands?

A

have 2 or more ducts

178
Q

what does the mucosa consist of?

A

epithelium, basement membrane, lamina propria and mucularis mucosae

178
Q

what is the muscularis mucosae?

A

a small muscle to help move the mucosa a little bit

178
Q

does the mucosa have glands?

A

sometimes

178
Q

what does the submucosa plexus do?

A

regulates the secretions and is part of the enteric nervous system

178
Q

what are the 2 layers of the muscularis?

A

inner circular
outer longitudinal

178
Q

where is the submucosa?

A

below the mucosa

178
Q

what does the submucosa consist of?

A

FCT, glands and blood vessels

178
Q

what does the adventitia consist of?

A

FCT

178
Q

what is the muscularis made up of?

A

smooth muscle

178
Q

what is the lumen?

A

the middle of the tube where everything happens

178
Q

why is the mouth and oral cavity lined with stratified squamous epithelium?

A

as food may be rigid and hard so the epithelium protects against abrasion

179
Q

what are the 3 pairs of the salivary glands?

A

paratoid glands
sublingual glands
submandibular glands

179
Q

what do salivary glands secrete?

A

mucus and enzymes to help lubricate our food

179
Q

what do the paratoid glands do?

A

secretes serous fluid with amylase to help with the break down of carbohydrates

179
Q

what do sublingual glands do?

A

secretes from multiple ducts from under the tounge and secretes a mixture of mucus and serous fluids

179
Q

what type of glands are salivary glands?

A

copound glands

180
Q

what is the job of the esophagous?

A

to bring food to the stomach

180
Q

why is the mucosa and submucosa highly folded in the esophagus?

A

to expand to have the capacity for the passage of the food bolus

180
Q

what do acinar cells do?

A

secrete a number of things such as bicarbonate to be used as a pH buffer

180
Q

explain the muscles in the esophagus?

A

the first third is skeletal muscle, the last third is smooth muscle and the middle third is a mixture of both

180
Q

what do the muscles in the esophagus do?

A

helps to move the food bolus to the stomach

180
Q

what is the peritoneum?

A

a serous membrane that consist of 2 layers

180
Q

what does the parietal layer of the peritoneum line?

A

it lines the body wall

181
Q

what is between the 2 layers of the peritoneum?

A

serous fluid

181
Q

what does the visceral wall of the peritoneum line?

A

covers and lines the organs

181
Q

What is the retroperitoneal?

A

posterior to the peritoneum

181
Q

what are the areas that are tethered to the visceral wall to the parietal layer?

A

mesentary

181
Q

what are organs that sit outside the peritonuem cavity called?

A

retroperitoneal organs

181
Q

what is the mesentary?

A

a double layer of visceral peritonium that connects organs to the body wall

181
Q

what is another name for an omenta?

A

a ‘sing’

181
Q

what shape is the stomach?

A

‘J’ shaped

181
Q

What is the omenta?

A

a double layer of visceral peritonium that connects organ to organ

181
Q

what is the main function of the stomach?

A

holds food and has chemicals that break it down

181
Q

what are the 4 main parts of the stomach?

A

cardia, fundus, body and pylorus

181
Q

what does the omenta do?

A

keeps the organs in place aswell as lets then expand and have a little movement

181
Q

what is the area that the esophagus passes through the diaphragm called?

A

the esophageal hiatus

181
Q

where is the stomach located?

A

at the base of the esophagus

181
Q

what does the LES do?

A

prevents reflux from the stomach

181
Q

what does the fundus do?

A

where gases collect during the digestion process at the superior end of the stomach

182
Q

what is the sphincter at the base of the esophagus called?

A

the lower esophageal sphincter (LES)

182
Q

what does the cardia do?

A

passes food into the stomach

182
Q

what does the body of the stomach do?

A

where the main functions of the stomach happen

182
Q

what does the pylorus do?

A

allows small bits of food called chyme to pass through into the instestine

182
Q

where is the greater omentum?

A

goes from the stomach to the trasverse colon

182
Q

what is chyme?

A

small digested food that is allowed to pass into the intestine from the stomach

182
Q

where is the lesser omentum?

A

between the stomach and liver

183
Q

what is the job of the greater omentum?

A

to keep the intestinal tract clean

184
Q

what are the 3 layers to the muscularis?

A

oblique (inner)
circular (middle)
longitudinal (outer)

184
Q

what are rugae?

A

temporary folds that allow for expansion of the stomach which doesnt stretch the tissue

185
Q

what is a modification of the submucosa?

A

rugae

186
Q

what is the core of submucosa do?

A

used for structure and support

187
Q

what are modifications in the mucosa?

A

simple columinar epithelium

188
Q

what does the stomach need?

A

acid and enzymes for digestion
mucus for protection
hormones for regulation

188
Q

what do gastric glands do?

A

secrete mucus for protection
these are also called goblet cells which are around the surface of the glands

188
Q

are gastric glands temporary or not temporary?

A

not temporary

188
Q

what are the 3 glands that are deeper within the gastric glands?

A

G cells, cheif cells and parietal cells

188
Q

what do G-cells secretes?

A

hormones

188
Q

what do cheif cells secrete?

A

pepsinogen

189
Q

what does pepsinogen do?

A

inactive form of pepsin ad helps with digestions

189
Q

what do parietal cells secrete?

A

acid and intrincic factors

189
Q

cheif cells consist of alot of what?

A

rough ER
they also have a nucleus

190
Q

how do parietal cells produce acid?

A

they pump hydrogen across the gradient

190
Q

what do parietal cells consist of?

A

alot of mitochondria to make energy to pump hydrogen across the gradient
it also has a central nucleus

191
Q

what are canaliculi?

A

channels between the microvilli

192
Q

what is the sphincter that connects the stomach to the small intestine?

A

the pyloric sphincter

193
Q

what does the pyloric sphicter do?

A

controls the release of chyme into the small intestine

194
Q

what is the duodenum?

A

the entrance of the small intestine

195
Q

is the pancreas retroperitoneal?

A

yes

196
Q

what shape is the pancreas?

A

C-shaped

196
Q

where is the pancreas located?

A

posterior to the stomach

196
Q

what is the duct called that the pancreas secretes into the duodenum?

A

pancreatic duct

197
Q

what is the endocrine functions of the pancreas?

A

pancreatic islet alpha cells secrete glycagon
pancreatic islet beta cells secrete insulin

197
Q

what are the exocrine functions of the pancreas?

A

acinar cells secrete digesive enzymes
duct cells secrete bicarbonate

197
Q

what does the pancreatic acinar cells consists of?

A

apical zymogen granules and a basal nucleus with an abundant of rough ER

197
Q

why do the pancreatic cells have so much rough ER?

A

to secrete enzymes

198
Q

where does the bile duct meet the pancreatic duct?

A

at the entrance of the hepatopancreatic ampulla

198
Q

what does the hepatopancreatic ampulla do?

A

collects and mixes the secretions of the pancrease and live/gallbladder

198
Q

what does the duodenal papilla do?

A

projects into the duodenal lumen and mixes with the chyme of the stomach

199
Q

what controls the release from the hepatopancreatic ampulla?

A

the hepatopancreatic sphincter

200
Q

how do we protect the small intestines from the acid chyme when it enters the duodenum?

A

we have goblet cells that produce mucus

200
Q

how do we neutralize the acidic chyme when it enters the duodenum?

A

we secrete bicarbonate which comes from the pancreas through a duct

201
Q

what are the 3 areas of the intestine called?

A

the duodenum
jejunum
ileum

201
Q

what does the duodenum recieve?

A

the chyme from the stomach
bicarbonate from the pancreas
bile from the liver

202
Q

what is the main function of the jejunum and ileum?

A

to digest and absorb

203
Q

what keeps our intestines from tangling?

A

mesentery which anchors the intestines in place

203
Q

is the jejunum retro or intro peritoneal?

A

intro

203
Q

is the ileum retro or intro peritoneal?

A

intro

203
Q

is the duodenum retro or intro peritoneal?

A

retro

203
Q

what does the mesentary protect between the 2 layers?

A

arteries, veins, nerves and lymphatics

203
Q

what parts of the intestinal tract require mesentary?

A

jejunum and ileum

203
Q

what do the mesenteric arteries and veins do?

A

bypass the muscularis and can go to the mucosa layer and is important for carrying away nutrients absorbed into the small intestine

204
Q

what is the blood that leaves the small intestines?

A

deoxygenated but full of nutrients

204
Q

where do the mesentary veins go?

A

to the hepatic portal vein

205
Q

where does fats from the small intestines go?

A

to the lymphatic lacteals which breaks it down
it then goes through the lymph into the cisterna chyli, into the thoracic duct and into the subclavian vein.

206
Q

what happens to the blood in the hepatic portal vein?

A

goes to the liver to be detoxified

206
Q

why do we want the small intestine to have alot of surface area?

A

for efficient absorbtion

207
Q

what is plicae circularis?

A

permanent folding of the submucosa of the intestinal wall

207
Q

what are villi?

A

on the surface of the plicae circularis
made of mucosa

208
Q

what does muscularis mucosa do to villi?

A

allow it to wiggle back and forth to allow contact digestion and allows chyme to come in contact with the villi

209
Q

what is inside each villi?

A

a singular lymph lacteal for digestion of fats
A capillary network wraps around the lacteals to take nutrients into the bloodstream

210
Q

what are enterocytes of the small intestine?

A

epithelium simple columnar cells which can fit goblet cells with each one touching the basement membrane
they have microvilli on the apical surface of the enterocytes to form a brush border

211
Q

what do glycocalyx do?

A

tether localized enzymes to the surface of a cell
these help with contact digestion which involves enzymes that are attached to the brush border

211
Q

what is glycocalyx?

A

a meshwork of glycoproteins which are a bit sticky and form a branchy network and are good at anchoring things in place

211
Q

what is the plasma membrane?

A

a semi-permeable barrier that is selective to lipid soluables

212
Q

what are 5 things that the epithelial of the small intestines consist of?

A

enterocytes
goblet cells
paneth cells
endocrine cells
stem cells

212
Q

what controls paracellular pathway?

A

tight junctions

213
Q

what are intestinal crypts?

A

in the mucosa but dip down and kept away from the outer most surface for protection

213
Q

what are in the intestinal crypts?

A

endocrine cells, paneth cells, stem cells

214
Q

what do paneth cells do?

A

protects us from anything that does damage such asbacteria getting out of control an paneth secrete antibacterial enzymes

215
Q

where are paneth cells located?

A

usually at the base of the intestinal crypts

215
Q

what is the ileocecal valve do?

A

connects the ileum to the cecum and acts as a sphincter

215
Q

what can stem cells do?

A

they can become any sort of cell to replicate and replace damaged cells

215
Q

what areas of the large intestine are introperitoneal?

A

transverse and sigmoid colon

215
Q

what areas of the large intestine are retroperitoneal?

A

ascending and decending colon

215
Q

why do we have an intestine?

A

so we do not have to go to the bathroom all the time and to have regulatory absorption of sodium and waters

215
Q

what are the 4 parts of the large intestine?

A

ascending, transverse, descending and sigmoidal

216
Q

what is the cecum?

A

a blind-end pouch which means it doesnt continue on
it is the beginning of the large intestine

217
Q

where is the appendix found?

A

in the cecum

217
Q

what happens in appendicitis?

A

when the appendix ruptures and bacteria floods the body

217
Q

what are some modifications of the large intestine?

A

stores faeces, expells faeces during defication, be lubricated and allows absorption of water

217
Q

what is the appendix?

A

a worm shaped structure that is an important location of bacteria for the large intestine

217
Q

what does the bumpy appearance of the large intestinal wall do?

A

help stores faeces

218
Q

what are the haustra?

A

a series of pouches to allow more area for storage

218
Q

what are tenia coli?

A

bands of longitudinal muscles that holds the haustras together

218
Q

what are the omental appendices?

A

sacs of fats that attach to the outer layer of the large intestine

219
Q

what is the gallbladder?

A

a hollow sac below the liver and concetrates the bile

219
Q

how are gall stones made?

A

if the gallbladder concetrates the bile too much

219
Q

what percentage of caridac output does the liver recieve cardiac?

A

25%

219
Q

how does 2/3 of the blood supply get to the liver?

A

the hepatic vein

219
Q

how does 1/3 of the blood supply to the liver get there?

A

through the hepatic artery

219
Q

what are hepatocytes?

A

cells that process anything toxic that enters our blood such as alcohol or drugs

220
Q

what does the lesser omentum contain?

A

hepatic portal vein, hepatic artery and the bile duct

220
Q

what are the sinusoids?

A

they run between rows of the liver cells

220
Q

what is the structure of the liver?

A

the liver is made of lobules

221
Q

what runs between the cells in the liver?

A

the bile canaliculi

222
Q

what produces the bile?

A

rows of hepatocytes

223
Q

what do hepatic portal veins do?

A

they take the blood for the GI tract to the liver to be cleaned

223
Q

how many sphincters control defication?

A

2

223
Q

what are the 2 main types of cells in the large intestine?

A

absorptive cells for water and salts
goblet cells to produce mucus for protection and lubrication

223
Q

what happens in the anal canal?

A

where the epithelium switches simple columinar and stratified squamous epithelium

223
Q

what is the internal anal sphincter?

A

the inner anal sphincter made of smooth muscles and is involuntary control

224
Q

what is the portal traid of the liver?

A

branch of hepatic artery
branch of hepatic portal vein
a bile duct

224
Q

what does the anal canal connect?

A

the anus to the colon

224
Q

what are the 2 anal sphincters?

A

internal anal sphincter
external anal sphincter

225
Q

what sends a signal to the brain before defication?

A

stretch receptors in the anus of the internal sphincters

225
Q

how do we relax the external anal sphincter?

A

sends a signal to the brain to relax the skeletal muscles

225
Q

what is the external anal sphincter?

A

the outer anal sphincter made of skeletal muscles and is voluntary control

226
Q

where is the liver located?

A

superior right quadrant of abdominopelvic cavity and is attached to the stomach by the the lesser omentum

227
Q

what is the shape of the liver?

A

a wedged shape organ

228
Q

what are the main functions of the liver?

A

metabolic processes
detoxifies blood
produce bile

229
Q

what is the central nervous system?

A

long distance controller and is good for external inputs

230
Q

what is the parasympathetic nervous system?

A

the rest and digest system which wakes the GI tract while the rest of the body is still asleep

230
Q

what is the sympathetic nervous system?

A

the fight and flight system which puts of GI tract to sleep

230
Q

what is the submucosa plexus?

A

regulates secretions

230
Q

what does the enteric nervous system have?

A

submucosa plexus and myenteric plexus

230
Q

what are paracrine effect?

A

effects the next-door endocrine cells

230
Q

what is the myentric plexus?

A

controls motility

230
Q

what is tonic contractions?

A

sustain contractions for minutes to hours

230
Q

what is the point of the enteric nervous system?

A

to respond to internal stimuli with receptors to detect conditions in the GI tract

231
Q

what do enteroendocrine cells do?

A

secrete hormones and detect luminal contents

231
Q

what is phasic contractions?

A

waves of contractions and relaxation, each wave lasting seconds (peristalsis)

231
Q

what is motility/motility patterns?

A

any pattern of contraction or relaxation of GI tract smooth muscle

231
Q

what is movement/propulsion?

A

motility patterns that specifically move/propel GI contents along the tract

232
Q

what does the intestine work on its own?

A

uses pace maker cells just like the ones in the heart
slows down for absorption
speeds up for mixing with digestive enzymes

233
Q

what is the peristalsis?

A

the propulsion of food bolus along the intestinal tract

234
Q

what happens in peristalsis?

A

muscles relax ahead of the food bolus and contracts behind the food bolus forward in a propulsion muscle

235
Q

what happens in the stomach when the stretch receptors are activated?

A

the rugae unfold to not change the pressure of the stomach

235
Q

what is segmentation?

A

circular muscle that pinches and makes unturnatives segments and exposes the food to alternative segments as well as mixes the food with the serous fluids and enzymes to help breakdown

235
Q

what does chewing do?

A

breaks large food boluses with mechanical breakdown and reduces the size of the food before its swallowed aswell as mixes it with saliva and enzymes

235
Q

what is swallowing?

A

a complex reflex when the tounge pushes the food to the back of the mouth and the epiglottis closes as the food bolus travels done to the stomach

235
Q

how is chyme forced through the pylorus sphincter?

A

the chyme is forced and slowly builds up pressure until it gets through the sphincter

236
Q

what salivary gland contributes the most to saliva secretion?

A

submandibular glands

236
Q

what does the intrinsic factor do?

A

stabilizes vitamin B12 and facilitates its absorbtion in the small intestine

236
Q

what is the motility patterns between meals?

A

migrating motor complexes

236
Q

what happens when the pylorus sphincter is closed?

A

retropulsion happens and the chyme is mixed around in the acid and enzymes of the stomach

236
Q

what does saliva contain?

A

lubrication, dilute solution of NaHCO3/NaCl and digestive enzymes such as lingual lipase and a-amylase

236
Q

what is the motility patterns after meals?

A

segmentation and some peristalsis

236
Q

what is secretions?

A

the movements of solutes and water from the body to the lumen across an epithelial layer

236
Q

what is absorption?

A

movements of solutes and water from the lumen into the body across the epithelial layer

236
Q

why do we need to irrigate our mouths?

A

it can lead to dental issues

236
Q

what does basal secretions do?

A

helps with talking aswell a respiratory tract moistening

236
Q

what are stimulated secretions?

A

when we stimulate the glands ourselves

236
Q

what does pepsin do?

A

digests proteins

236
Q

how much does the gastric system secrete per day?

A

2-3 liters

236
Q

how do we activate pepsinogen?

A

comes in contact with the acids

237
Q

what amount of secretions happen in the cephalic phase (head phase)

A

20% of secretions

237
Q

what do gastric acids do?

A

dilute food, denature protein, activates pepsinogen, protection and is also a good antimicrobial protection

237
Q

what are carbonic-anhydrase do?

A

takes CO2 and water to make bicarbonate and hydrogen
so its catalyses the reaction

237
Q

where does the chloride come from in the production of the HCl?

A

a bicarbonate chloride exchanger
the chlorides are channeled out and binds to the hydrogen

237
Q

what does bicarbonate dissociate into?

A

H+ and HCO3-

237
Q

what are the 3 phases of regulation?

A

head phase
stomach phase
intestinal phase

237
Q

what signals does the head send to the stomach when the food enters the mouth?

A

signals to start making pepsinogen

237
Q

what percentage of the secretions happens in the gastric phase?

A

70% of secretions

237
Q

what percentage of secretions are in the intestinal phase?

A

10% of secretions

237
Q

what hormones are secreted in response to nutrients in the chyme?

A

GIP, CCK and secretin

237
Q

what do GIP and CCK do?

A

travel through the bloodstream to the chief and parietal cells to stimulate the production of acid within the stomach

238
Q

what does secretin do?

A

diffuses into the chief and parietal cells and is the hormone that decreases pH

238
Q

what makes lipolytic?

A

lipase and phospholipase

238
Q

what is amylytic?

A

pancreatic amylase which digests starches

238
Q

what is proteolytic?

A

trypsin

238
Q

what digestive enzymes does the pancreas secrete?

A

lipolytic, amylytic, protoelytic, chymotrypsin, carboxypeptidase, nucleolytoic and deoxyribonuclease

239
Q

what is nucleolytic?

A

ribonuclease

239
Q

what secretes pancreatic enzymes?

A

acinar cells

239
Q

what is CCK?
and what does it do?

A

cholestokinin
a hormone that gets released by nutrients getting released into the duodenum which tells the pancreas to secrete enzymes to digest the food to make nutrients

240
Q

what does trypsin do?

A

is on the brush border and enzymes activated

240
Q

what do bile salts do?

A

stablize lipids

240
Q

what is enterokinase?

A

bound to the duodenal membrane and converts trypsinogen into trypsin

240
Q

what is enterohepatic circulation?

A

big release of CCK which releases alot of bile salt

240
Q

how much bile is reabsorbed?

A

around 90%

240
Q

how are the bile salts reabsorbed into the liver?

A

the liver recognises the bile in the blood stream and reabsorbs it

240
Q

what is our main source of energy?

A

carbohydrates

240
Q

what hormone forces bile into the intestinal tract?

A

CCK

241
Q

what are carbohydrates?

A

a long complex chains tht are monosaccharides such as glucose

242
Q

what bonds glucose together?

A

glycosidic bonds

243
Q

what is an example of disaccharides that we ingest?

A

sugars such as sucrose

243
Q

what do proteins require?

A

amino acids

243
Q

how many amino acids can be synthesised?

A

12

244
Q

what links long chains of amino acids together?

A

peptide bonds

244
Q

why do we need chemical digetion?

A

to dijest food into monosaccharides and amino acids

245
Q

what is mechanical digestion?

A

breaks food up to increases surface area available for chemical digestion

246
Q

what do organic catalysts do?

A

enzymes which take substrates and makes a ES complex and then it seperates to return back to the enzymes but the substrate goes to a product

246
Q

what is contact digestion?

A

the border enzymes absorb into the body

246
Q

whjat are 2 types of chemical digestion?

A

luminal and contact digestion

246
Q

what is luminal digestion?

A

enzymes that are secreted into our GI tract and are free floating

247
Q

what does amylase break?

A

alpha bonds of the poly saccharides into disaccharides

247
Q

what do the brush border enzymes do?

A

takes disaccharides and breaks them into monosaccharides

248
Q

what enzymes break the peptide bonds in the small intestine?

A

trypsin and chymotrypsin

249
Q

what enzymes chops the amino acids off in the peptides in the small intestine?

A

carboxypeptidase

250
Q

what does peptidase do?

A

converts polypeptides into amino acids onn the brush border

251
Q

what digestion does lipids go through?

A

luminal not contact digestion

252
Q

what is emulsifaction?

A

the first stage of lipid digestion
retroplusion breaking lipids into smaller droplets to increase surface area

253
Q

what is stabilization?

A

the second step of lipid digestion
bile salts stabilize the emusion in the small intestine

254
Q

what is hydrolysis?

A

the third stage of lipid digestion
lipase is secreted from the pancreas and breaks the lipids into smaller lipid molecules

255
Q

what is the formation of michelles?

A

the fourth stage of lipid digestion
michelles allow enzymes to get close to the hydrophillic lipid molecules so that they can be absorbed easier into the body

256
Q

how do we maximise absorption into the blood stream in the small intestines?

A

villi which have a brush border of micro villi to maximise surface area

257
Q

what is transcellular pathway?

A

passing the epithelium through the cell through transporters and cytoplasm

258
Q

how do we get solutes through transcellular pathway if it has a bilayer that is impermeable to solutes?

A

we can use protein transporters to change shape and allow solutes to pass

259
Q

what do we need to help move solutes across the celles membrane?

A

ATP synthesis to occur

260
Q

how much water are we meant to drink a day to keep up with how much we have lost?

A

1.5 liters

261
Q

how do we lose water?

A

sweat, urine, faeces and as we breathe out

262
Q

what are sodium potassium channels?

A

pumps sodium out of a cell and potassium in with the help of ATP
this is active transport

263
Q

what does the active absorbtion of carbohydrates involve?

A

a co-transport of sodium

264
Q

how do amino acids diffuse through the epithelial?

A

through the paracellular pathway

265
Q

what does sodium ATPase do?

A

move sodium against to gradient and the amino acids are moved out of the cell

266
Q

what does the amino acids pass through to leave the cell?

A

basolateral membrane through an amino acids carrier

267
Q

what pulls tripeptides into the cell?

A

the hydrogen going into the cell through a co-transporter due to the sodium exchange being a negative potential

268
Q

what happens to the tripeptides in the cell?

A

they are broken down into amino acids and are pushed out of the cell

269
Q

what are chylomicrons?

A

small vesicles that package the lipids which then get exocytosis

269
Q

what removes the lipids?

A

lacteals

270
Q

what stabilises the fats?

A

bile salts

271
Q

what happens to majority of the bile salts when they have been used?

A

they get reabsorbed

271
Q

what do intrinsic factors do?

A

binds to the vitamins which protects them from being absorbed until they reach the ileum where there are receptors that the factor binds to and allows the vitamin to be internalized through an endocytosis process

271
Q

what helps the absorbtion of vitamins?

A

intrinsic factors

272
Q

how are fat soluable vitamins tended to be absorbed into cells?

A

they are carried by lipid droplets and michelles to diffuse across the cell membrane for fat soluable vitamins

272
Q

what do they do in weight loss surgery?

A

they get rid of theintrinsic factor so there needs to be injections of B12 to get in the blood stream

273
Q

how are water soluable vitamins tended to be absorbed into cells?

A

similar to amino acid absorbtion and are absorbed by a sodium dependant driving force to move into the cell

273
Q

what happens to the vitamins that we dont absorb?

A

it is expelled through the elimination process of defication

274
Q

how much water is women (%)?

A

55%

274
Q

how much of males are water (%)?

A

60%

275
Q

why are men more water than women?

A

because men are more muscle and women are more fat

276
Q

what amount of the TBW is extracellular fluid?

A

1/3

276
Q

what is TBW??

A

total body water

276
Q

what is ECF?

A

extracellular fluid

277
Q

what amount of TBW is intracellular fluid?

A

2/3

278
Q

wat is ICF?

A

intracellular fluids

279
Q

what is the main function of the urinary system?

A

maintain the balance in blood by filtering and expelling things like excess water, salts, wastes and many toxins and drugs

280
Q

what is urine?

A

a waste product which is excreted from the body to maintain waste

281
Q

what does urine consist of normally?

A

water, salts, urea, metabolites, hormones and small proteins

282
Q

what is different about the pH in urine?

A

it is not tightly regulated and is influenced by what was excreted

283
Q

what does abnormal urine consist of?

A

large proteins, red blood cells and glucose

284
Q

what are the main components of the urinary system?

A

2 kidneys, 2 ureters, urinary bladder and a urethra

285
Q

what are the structure of the kidneys?

A

allows the blood to be brought into close proximity of the nephrons for filtering

286
Q

where are the kidneys located on the body?

A

between the T12-L3 vertebrae

287
Q

what superiorly protects the kidneys?

A

the 11th and 12th ribs

288
Q

where is the convex side of the kidney facing?

A

laterally

289
Q

what si the medial side of the kidney?

A

the concave side and is called the hilum

290
Q

are the kidneys peritoneal or retroperitoneal?

A

retroperitoneal

291
Q

what are the 3 regions of the kidney called?

A

the cortex, medulla and the pelvis

292
Q

what are the regions o0f the kidneys surrounded in?

A

a fibourus capsule

293
Q

what is the inner medullary divided into?

A

medullary pyramids with papilla at the ends

294
Q

what is the outer cortex?

A

a continuos layer that has renal columns

295
Q

how many functional lobes are in each kidney?

A

between 5-11

296
Q

what defines a kidney lobe?

A

one medullary pyramid surrounded by a cortex

297
Q

what are nephrons?

A

tiny tubes that filter blood and produce urine in each lobe of the kidney

297
Q

what does the urine drain from and where does it go?

A

it drains through the papilla and collects in the caylx
calyces join to form a renal pelvis
the pelvis narrows and exits the hilum through the ureter

297
Q

what does the afferent arterioles do?

A

deliovers blood from the arteries to the glomerlus

297
Q

where does filtration occur in the lobe?

A

in the cortex

297
Q

where does the renal artery arise from?

A

the abdominal artery
branching arteries get smaller and smaller until they reach the cortex

298
Q

what dio veins do in the renal area of the body?

A

return filtered blood from the cortex to the renal vein and then to the inferior vena cava

298
Q

what ios the globmerlus made of?

A

glomerular cappillaries and is where the filtration occurs

299
Q

what does the efferent arterioles do?

A

carries blood from the glomerlus to the peritubule capillaries

299
Q

what does the peritubules capillaries do?

A

carries blood to the veins

300
Q

what percentage of our nephrons are cortical?

A

85%

300
Q

where does the nerve supply to the kidneys come from?

A

a network of autonomic nerves and ganglia called the renal pelvis

300
Q

what do sympathetic nerves of the renal system do?

A

acts to adjust diameter of renal arterioles and thus regulate blood flow

301
Q

what percentage of our nephrons are juxtamedullary?

A

15%

301
Q

what are nephrons?

A

short and long loops that extend down into the medulla and are responsible for urine formation

301
Q

what are the 2 types of nephrons?

A

cortical and juxtamedullary

302
Q

what nephrons are shorter?

A

cortical

303
Q

what nephrons are longer?

A

juxtamedullary

303
Q

how fa do the longer nephron loops extend to?

A

almost the papilla

Hubs192 (4 decks)

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