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AP2 > AP2 Exam 3 > Flashcards

AP2 Exam 3 Flashcards

1
Q

Some mediators can be both a neurotransmitter and a hormone: what are some examples?

A

NE

Epi

Oxytocin: as a neurotransmitter, released throughout the brain and expressed by neurons

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2
Q

Exocrine glands secrete their product into ______ that release into body cavities, lumen of organs, or to outer surface.

A

ducts

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3
Q

Local hormones:

A
  • act on neighboring cells or the same cell without entering the bloodstream
  • paracrine: act on neighboring cell
  • autocrine: act on same cell
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4
Q

Amino acids:

A
  • amines
  • peptides
  • proteins
    *
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5
Q

Amino acid hormones:

A
  • water soluble
    • unbound in the blood
    • cannot bass through cell membrane
    • bind to receptors on the outside/surface of the cell
    • second messenger
  • derived from modification of one or multiple AAs
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6
Q

Steroid/cholesterol hormones:

A
  • lipid soluble
    • must be bound to transport proteins in the blood
    • provide a ready reserve of hormone in the blood
    • can freely pass through cell membrane
    • binds to receptors on the inside of the cell
  • derived from cholesterol
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7
Q

Steroid hormones

A

calcitriol

aldosterone

cortisol/corticosterone/cortisone

androgens: test., androstenedione, dihydrotestosterone (DHT), dehydroepiandrosterone (DHEA), DHEA sulfate

estrogen/progesterone

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8
Q

Synthetic thyroid hormone is ______.

A

lipid soluble

taken orally; easily absorbed through intestinal wall

bioavailability is drastically reduced when transdermal/INJ (because all the membranes it has to travel through)

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9
Q

Insulin is ______.

A

water soluble

cannot survive acidic environment in the stomach (destroys peptide bonds)

must be INJ SQ

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10
Q

Hypothalamus (picture):

A
  • controls the ANS through neural and hormonal approaches
  • connected to the pituitary via the infundibulum:
    • infundibular stalk + pars tuberalis = indundibulum
      • hypothalamus and posterior pituitary connected via infundibular stalk
      • pars tuberalis of the anterior pituitary wraps up the infundibular stalk
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11
Q

Hypothalamic Axes:

A
  • Adrenal Axis
  • Gonadal Axis
  • Thyroid Axis
  • Others are not a part of an axis but rather controlled by circulating levels of other hormones
    • Example: PTH, calcitonin, calcitriol
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12
Q

Releasing and inhibiting hormones of the hypothalamus:

A

The Pretty Dressed Girl Got Some Courage

  • Thyrotropin releasing hormone (TRH)
  • Prolactin releasing hormone (PRH)
  • Dopamine; Prolactin inhibiting hormone (PIH)
  • Growth hormone releasing hormone (GHRH)
  • Gonadotropin releasing hormone (GnRH)
  • Somatostatin: Growth hormone inhibiting hormone (GHIH)
  • Corticotropin releasing hormone (CRH)
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13
Q

The pituitary gland:

A
  • aka hypophysis
  • sits in the sella turcica of the sphenoid bone
  • anterior pituitary aka adenohypophysis aka pars distalis (the gland)
    • pars tuberalis partially covers the infundibulum like a sheath
  • posterior pituitary aka neurohypophysis aka pars nervosa
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14
Q

Posterior pituitary:

A
  • Antidiuretic hormone (ADH) and oxytocin are stored and released here
    • these two hormones are produced in the hypothalamus and sent via the axons (infundibular stalk) to the terminal ends (posterior pituitary) where they are stored
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15
Q

Antidiuretic hormone (ADH)

A
  • aka vasopressin
  • effects:
    • anti diuresis (U/O can increase to 20L/day without ADH)
      • increased reabsorption in collecting ducts
    • inhibits sweat production>decreased water loss
    • systemic vasoconstriction of arterioles (smooth muscle)
  • amount secreted varies with blood osmotic pressure and blood volume
    • monitored by osmoreceptors in hypothalamus
    • osmotic pressure increases with “thicker fluid”
  • may also be secreted in response to: pain, stress, anxiety, morphine, tranquilizers, anesthetics, nicotine
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16
Q

Diabetes Insipidus

A
  • defects of ADH receptors or inability to produce/secrete ADH
    • neurogenic DI: reduction/cessation of production/secretion of ADH (tumor, trauma, surgery)
    • nephrogenic DI: kidneys don’t respond to the ADH
      • non functional receptors in kidneys or kidney damage

*can die in a day from dehydration

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17
Q

Oxytocin

A
  • childbirth (stretching of uterus stimulated secretion)>pos. feedback
  • stimulates milk ejection (let down) in response to suckling
  • may be involved with:
    • emotional/social bonding with others
    • parenting (levels increased in new moms/dads)
    • autism (many have low oxytocin levels but not all)
    • sexual pleasure during/after (length/strength of orgasm and post coital)
      • no affect on sexual arousal, erection, sex drive
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18
Q

Anterior pituitary:

A
  • aka adenohypophysis aka pars distalis
  • secretes hormones from 5 types of cells:
    • somatotrophs: human growth hormone (hGH) aka somatropin
    • thyrotrophs: thyroid stimulating hormone (TSH) aka thyrotropin
    • gonadotrophs: follicle stimulating hormone (FSH); luteinizing hormone LH)
    • lactotrophs: prolactin (PRL)
    • corticotrophs: melanocyte stimulating hormone (MSH); adrenocorticotropic hormone (ACTH) aka corticotropin
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19
Q

Human growth hormone (hGH)

A
  • aka somatotropin (secreted by somatotrophs)
  • most abundant anterior hormone
  • targets most cells in the body rather than a particular gland/organ
  • produced and released in a pulsatile/diurnal manner (increase during first 2hrs of sleep)
  • main function is to promote synthesis/secretion of insulin-like growth factors (IGFs aka somatomedins) by cells in the body (liver, muscle, bones, etc)
    • (believed) most changes seen in body are due to IGFs rather than hGH directly
      • someone can have nml hGH but low IGFs>abnormalities
    • IFG functions of note:
      • adipose tissue: lypolysis> increased fatty acids released> used over glucose (more so during fasted state)
      • skeletal muscle: suppresses protein catabolism; favors fatty acid use over glucose
      • immune: stimulates B and T cell function
      • metabolism: can cause beta cell burnout from extended insulin production (diabetogenic)
  • secretion decreases with age
    • muscle wasting, unwanted fat
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20
Q

Disorders of human growth hormone (hGH):

A
  • Hypersecretion
    • giantism (gigantism)
      • hypersecretion in childhood stimulates chondrogenesis in epiphyseal plates
        • results in very tall with normal body proportions
      • will also normally experience:
        • hyperglycemia leading to insulin burnout (diabetes)
        • panhypopituitarism: hypertrophy of somatotrophs which eventually render the whole gland dysfunctional
    • acromegaly
      • hypersecretion in adulthood
        • enlargement of many internal organs (liver, kidneys)
        • thickened skin
        • bone thickening (enlarged facial features, feet, fingers)
  • Hyposecretion
    • dwarfism
      • hyposecretion in childhood
        • epiphyseal plates close before nml heigh is attained
        • some keep child like characteristics whereas others can develop some adult characteristics with the addition of androgens
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21
Q

Prolactin (PRL)

A
  • pregnancy:
    • stimulates growth/development of mammary glands
    • synthesis of milk
  • PRH stimulated by high levels of estrogen and suckling
  • dopamine/PIH stimulated by low-moderate levels of estrogen
  • Disorders:
    • hypersecretion most commonly caused by a prolactinoma (benign pituitary adenoma)
      • non pregnant, non breastfeeding female complaining of milky discharge
      • male with milky breast discharge or ED with no obvious cause
22
Q

Follicle stimulating hormone (FSH)

A
  • females:
    • stimulates follicle production in women monthly
    • stimulates ovarian follicular cells to produce estrogen
  • males:
    • stimulates production of sperm cells
  • regulated by neg. feedback by estrogen and testosterone
23
Q

Luteinizing hormone (LH)

A
  • females:
    • triggers ovulation
    • triggers formation of corpus luteum>secretion of progesterone
    • triggers secretion of estrogen by ovarian follicular cells (along with FSH)
  • males:
    • stimulates testes to produce testosterone
24
Q

MSH

A
  • peptide hormone produced not only in the anterior pituitary but also in the skin itself
  • exact role of anterior pituitary produced MSH in humans unknown
    • possible appetite suppression
  • MSH is produced locally in the skin>pigmentation of skin (melanin)
  • dopamine (PIH) inhibits MSH release
25
Q

Thyroid gland and thyroid hormone:

A
  • largest of “pure” endocrine glands (very extensive blood supply)
  • only endocrine gland that stores its hormones in large quantities (~100day supply)
  • follicles are the functional unit
  • parafollicular cells reside in between follicles
    • produce calcitonin (not considered “thyroid hormone”)
      • inhibits calcium breakdown in bone and absorption in the intestines (closes certain channels)
      • increases calcium loss in urine (DCT)
  • Thyroid hormones
    • production stimulated by TSH (inhibited via neg. feedback)
    • anything that increases cellular energy demand causes increase in T3/T4 production (cold, hypoglycemia, altitude, pregnancy)
    • Tetraiodothyronine (Thyroxine, T4)
      • inactive form of thyroid hormone
      • more abundant but less potent
    • Triiodothyronine (T3)
      • active form of thyroid hormone
      • less abundant but more potent
26
Q

Resorption vs. Reabsorption/Absorption

A
  • Resorption: back into the blood
  • Reabsorption/Absorption: out of the blood
27
Q

Synthesis and transport of T3/T4 (picture with steps):

A
  • Follicular cells trap and pull iodide ions into the cytosol.
  • Follicular cells are simultaneously producing the glycoprotein, thyroglobulin (TGB):
    • TGB is produced in the RER, modified in the Golgi body, and secreted into the colloid via exocytosis
  • Iodide is oxidized into iodine by perioxidase then move into the colloid
  • Iodine binds to the tyrosines that are part of the TGB
    • Monoiodotyrosine (MIT, T1): one iodine binds
    • Diiodotyrosine (DIT, T2): two iodines bind
  • Coupling of T1 and T2:
    • T1+T2=T3 or T2+T2=T4
  • Pinocytosis and digestion of colloid; lysosomes cleave off T3 and T4 molecules
    • Left over T1 and T2 are deiodinated and recycled
  • Secretion of T3 and T4
  • Transported in the blood via proteins produced in the liver
    • Thyroxine binding globulin (TBG) (70%)
    • Albumin (20%): generic transport protein
    • Transthyretin (10%): releases T3/4 into the CSF
28
Q

T3/T4

A
  • transported by one of these proteins (all made in liver)
    • thyroxine binding globulin (TBG) (70%)
    • albumin (20%)
    • transthyretin (10%): releases thyroid hormone into CSF
  • actions
    • increases BMR
      • rate of O2 consumption under normal conditions
    • stimulates synthesis of additional Na+/K+ pumps
      • increased ATP production and consumption>increased heat>maintain body temp
    • regulate metabolism
      • stimulates protein synthesis, lipolysis, cholesterol secretion
        • increases glucose and fatty acid use for ATP production
    • enhances actions of some catecholamines
      • T3/T4 upregulate beta receptors> increased HR, BP
    • works with hGH and insulin to accelerate body growth
      • nervous and skeletal
      • deficiency can result in mental retardation and stunted bone growth (fetal growth)>cretinism
29
Q

Hypothyroidism

A
  • myxedema:
    • accumulation of negatively charged mucopolysaccharides in connective tissues (attracts sodium>fluid follows)
    • puffy features, enlarged tongue, hoarseness, joint stiffness
    • increased chance for effusions (serous cavities)
  • cretinism (untreated congenital hypothyroidism)
    • associated with stunted growth, mental retardation, impaired motor neuron dysfunction, constipation (severe)
    • usually caused by severe lack of iodine or immune dysfunction
  • Hashimoto’s disease
    • autoimmune
    • Ab attack TSH receptors and thyroglobulin
    • apoptosis of follicular cells
    • thyroid tissue becomes infiltrated with B and T cells
    • goiter
30
Q

Hyperthyroidism

A
  • Grave’s disease
    • autoimmune
    • caused by production of thyroid stimulating Ig (autoantibody)
      • mimics TSH at TSH receptors excessively>overstimulation of thyroid gland
    • goiter
    • exophthalmos and periorbital edema (bug eyes)
      • orbital fibrocytes have TSH receptors>autoantibody stimulates these causing edema
    • thyroid will burn itself out if TSH receptors are constantly stimulated by autoantibody>becomes hypothyroidism
    • Tx: removal of thyroid tissue and supplementation with T4

Hyper can turn to hypothyroidism quickly (its rare for it to go the other way)

31
Q

Parathyroid glands:

A
  • chief cells are the functional cell
    • produce and secrete parathyroid hormone (PTH)
      • resorb calcium from bone
32
Q

Adrenal glands:

A
  • covered by connective tissue capsule
  • adrenal cortex:
  • adrenal medulla:
33
Q

Adrenal cortex:

A
  • zona glomerulosa
    • mineralocorticoids
      • ACTH can stimulate however angiotensin2 and hyperkalemia stimulate to greater degree
      • aldosterone targets nephron
        • promotes filtration of K+ and H+ in urine
        • promotes reabsorption of Na+ in urine
  • zona fasciculata
    • glucocorticoids
      • stress management (overreaction if stressor not removed)
      • cortisol (95%), corticosterone, cortisone
      • normal levels>stimulate:
        • gluconeogenesis
        • protein catabolism
        • lipolysis
      • excess levels cause:
        • inhibits bone formation
        • inhibits connective tissue formation
        • suppress immune response
          • suppress Ab formation, cell mediated immunity, kills immature T cells and B cells
          • anti-inflammatory
            • inhibits inflammatory cytokines>delays healing
            • stimulates anti-inflammatory cytokines (good under normal stress conditions)
  • zona reticularis
    • androgens (weak variety)
      • dehydroepiandrosterone (DHEA)
        • precursor to numerous hormones: androstenedione, testosterone, dihydrotestosterone (DHT), estrogen
      • androstenedione
        • can be converted to: testosterone or estrone (precursor to estradiol)
34
Q

Disorders of adrenal cortex:

A
  • Addison’s disease:
    • autoimmune attacks ACTH receptors
      • hyposecretion of gluco/mineralcorticoids
    • symptoms don’t present until 90% of cortex is destroyed
      • low aldosterone: hypoglycemia, anorexia>weight loss
      • low cortisol: hyperkalemia, acidosis, hypotension
      • low androgens: more noticeable in women>loss of pubic/axillary hair, decreased libido
      • increased circulating ACTH and MSH
        • distinct bronzing of the skin
        • hyperpigmentation of gums
  • Cushing’s
    • Disease: increased ACTH from pituitary>increased cortisol
    • Syndrome: increased cortisol from adrenal glands without increased ACTH (or even exogenous corticosteroids>organ transplant, chronic inflammatory conditions)
    • Both result in:
      • muscle breakdown
      • redistribution of body fat
      • moon face
      • HTN (80%), hyperglycemia, osteoporosis, immunodeficiency, mood swings
35
Q

Adrenal medulla:

A
  • functional cells are Chromaffin cells
    • considered modified sympathetic ganglion
      • signal received through splanchnic nerves>Ach binds to nicotinic receptors
    • produce/secrete catecholamines
      • epinephrine (more numerous and potent) and NE
      • intensify sympathetic responses throughout the body
        • stimulates glycogenolysis
36
Q

Disorders of adrenal medulla:

A
  • pheochromocytoma
    • usually caused by a benign tumor of the chromaffin cells
      • most often arise in adrenal medulla however they can arise anywhere along sympathetic ganglia
    • prolonged “fight or flight” response
37
Q

Pancreas

A
  • both exocrine and endocrine gland
  • head, body and tail
  • Islets of Langerhans (pancreatic islets)
    • 4 types of islet cells
      • alpha (20% of cells): glucagon
        • raise blood glucose levels (receptors in pancreas)
          • glycogenolysis and lipolysis
          • regulated by neg. feedback
          • short lived (liver deactivates very fast> first pass of portal blood)
      • beta (75% of cells): insulin
        • presence of food in small intestine triggers release of glucose-dependent insulinotropic peptide (GDIP)
        • lowers blood glucose levels
          • facilitates glucose uptake into cells
          • stimulates glycolysis and glycogenesis
          • neg. feedback
          • little longer lasting than glucagon (liver deactivates> first pass of portal blood)
  • delta: somatostatin (GHIH)>actions concentration based
    • acts in paracrine manner by inhibiting both insulin/glucagon
  • F: pancreatic polypeptide> actions concentration based
    • inhibits: somatostatin release, gallbladder contraction, secretion of enzymes and bicarb from pancreas
    • possible role in appetite suppression
38
Q

Disorders of pancreas:

A
  • Growth:
  • Diabetes mellitus: inability to produce or use insulin
    • type 1: autoimmune attacks beta cells>no insulin
      • symptoms do not show until 80-90% destruction
        • 3 P’s and possible DKA
    • type 2:
      • cells have less insulin receptors>insulin levels increased, increased blood glucose
      • usually obese
      • more mild symptoms (usually found with labs)
  • Hyperinsulinism
    • usually occurs when diabetic injects too much insulin> results in hypoglycemia> causes secretion of epi, glucagon, hGH
      • symptoms: AMS
  • Hyper and hypoglycemia can present similarly
39
Q

Gonads

A
  • Ovaries
    • synthesize/secrete:
      • estrogen, progesterone: along with LH/FSH regulate menstrual cycle, maintain pregnancy, lactation
      • inhibin, relaxin>only produced in large qty in pregnancy
        • inhibin: inhibits FSH>deters follicle development
        • relaxin: relaxes cartilage of pubic symphysis, widen cervix>prepare for delivery
  • Testes
    • synthesize/secrete:
      • testosterone
        • stimulates decent of testes before birth
        • regulates production of sperm and secondary sex characteristics
      • inhibin
        • high concentration: inhibits spermatogenesis
        • low concentration: reduces rate of spermatogenesis
40
Q

Pineal gland

A
  • secretes melatonin
    • sets biological clock
      • more secreted in dark light>promotes sleepiness
  • seasonal affective disorder (SAD)
    • type of depression worse in winter months and in areas that have more darkness (Alaska very long periods of darkness)
      • increased melatonin levels
    • Tx: bright light therapy
41
Q

Atrial natriuretic peptide/hormone (ANP/ANH)

A
  • secreted by the heart when atria are stretched>reduces blood pressure
42
Q

Kidney hormones

A

Renin: stimulates the release of aldosterone

Calcitriol: increased Ca2+ absorption in the GI

Erythropoietin: stimulates RBC synthesis in bone marrow

43
Q

Adipose tissue hormones:

A

Leptin: promotes satiety signal to brain

Adiponectin: helps to reduce insulin resistance

44
Q

Cholecalciferol is produced by the ______.

A

skin

modified from of Vit. D

45
Q

Thymus hormones:

A
  • atrophies with age
  • produces multiple hormones that promote maturation of T cells
    • thymosin
    • thymic humoral factor
    • thymic factor
    • thymopoietin
46
Q

Misc. liver hormones:

A
  • IGF
  • angiotensiongen
  • thrombopoietin: PLT’s
  • Hepcidin: blocks release of iron into body fluids
47
Q

Digestive tract hormones

A
  • gastrin:
    • promotes H+ section from parietal cells and growth of gastric mucosa
  • cholecystokinin:
    • gallbladder contraction
    • slows gastric emptying
    • stimulates pancreatic enzyme release
  • Glucose dependent insulinotropic peptide (GDIP/GIP):
    • stimulates insulin release
    • inhibits H+ ion secretion in gastric mucosa
  • Secretin:
    • stimulates secretion of: pancreatic and biliary bicarb
    • inhibits effects of gastrin
48
Q

Eicosanoids

A
  • found everywhere except RBC
  • act as paracrine/autocrine
  • very short lived (rapid deactivation)
  • prostaglandins: smooth muscle, glands, blood flow, PLTs, TAGs, immune
  • leukotrienes: mediates inflammation and chemotaxis of WBC
49
Q

Histamine

A
  • synthesized in mast cells and platelets (most tissues)
    • from trauma (burns)
    • immune response
  • functions
    • contraction of smooth muscle in lungs, uterus, stomach
    • vasodilation
    • stimulates gastric acid secretion
    • iflammation>increases permeability (immune)
50
Q

Serotonin

A
  • synthesized by cells in the intestines (90%; bacterial colonies), brain, CNS
  • platelets take up and store free serotonin until its needed (no production)
  • stimulated by:
    • mood, anxiety, sleep
    • general body mvmt
    • GI motility
    • can acts as vasocontrictor/dilator depending on concentration
51
Q

General Adaptation Syndrome

A
  • Alarm stage:
    • min-hrs
    • initiated by any stressor
    • cortisol release (impairs immune response)
    • SNS stimulated
  • Resistance reaction (“recovery phase”)
    • hrs-weeks
    • stressor removed but dealing with psychological aftermath
      • cortisol levels should decline (immune system back to nml)
      • SNS stimulation is reduced
      • increased parasympathetic (rest and digest)
  • Exhaustion response
    • if stressor is not removed or when resistance reaction not sufficient
    • depletion of physical/psychological energy levels
      • physical and mental illnesses begin to surface (ulcers, immunocompromise, depression, fatigue)
    • prolonged cortisol (immunocompromise)
    • prolonged SNS stimulation

*view body as a complete, integrated system>treat the whole person/body> treat underlying root causes of disease

52
Q

Aging

A
  • general reduction in hormone production and response
    • decreased hGH, thyroid hormones (worn out thyroid)>but increased TRH and TSH (no negative feedback)
    • adrenal cortex becomes fibrous (medulla usually unaffected)> decrease cortex hormones
    • pancreas>releases insulin more slowly (glucose receptors less sensitive)
    • gonads
      • ovaries> decreased estrogen>osteoporosis, hyperlipidemia, atherosclerosis, menopause
      • testes>decrease in size but still produce test.; sperm are decreased quality
  • bone injury
    • increased PTH likely due to decreased dietary calcium
    • calcitriol and calcitonin levels reduced
      *

AP2 (4 decks)

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