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Physiology > Ch 16: The Endocrine System > Flashcards

Ch 16: The Endocrine System Flashcards

1
Q

What is the basic characteristics of the endocrine?

A
  1. Acts with the nervous system
  2. Hormones are transported in the blood
  3. Response slower but longer lasting
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2
Q

What is endocrinology?

A

The study of hormones and endocrine organs

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3
Q

What does the endocrine control and integrates?

A
  1. Reproduction
  2. Growth and development
  3. Maintenance of electrolyte, water, and nutrient balance of blood
  4. Regulation of cellular metabolism and energy balance
  5. Mobilization of body defenses
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4
Q

What the difference between exocrine and endocrine glands?

A
  1. Exo: Nonhormal such as sweat and saliva have ducts

2. Endo: Produces hormone and lack 🦆

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5
Q

List the major endocrine organs and describe their body locations.

A
  1. Pituitary
  2. Thyroid
  3. Parathyroid
  4. Adrenal
  5. Pineal
  6. Hypothalalus
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6
Q

What is a hormone?

A

Long-distance chemical signals that travel in blood or lymph

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7
Q

What are autocrines?

A

Chemicals that exert effects on same cells that secrete them

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8
Q

What are paracrines?

A

Locally acting chemicals that affect cells other than those that secrete them

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9
Q

Out of hormones, autocrines, and paracrines, which are not part of the endocrine system?

A

Autocrine and paracrine are local chemical messengers

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10
Q

What are the 2 classes of hormones?

A
  1. Amino acid-based hormones

2. Steroids

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11
Q

What are examples of amino acid-based hormones?

A

Amino acid derivatives, peptides, and proteins

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12
Q

What are example of steroid hormones?

A
  1. Produced from cholestrol

2. Gonadal and adrenocortical hormones

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13
Q

What are target cells?

A

Tissues with receptors for specific hormone

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14
Q

Hormone action on target cells can cause?

A
  1. Alterations in plasma membrane permeability
  2. Membrane potential by oening or closing ion channels
  3. Stimulate synthesis of enzymes or other proteins
  4. Activate or deactivate enzymes
  5. Indoce secretory activity
  6. Stimulate mitosis
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15
Q

What would water soluble hormones achieve?

A
  1. Consist of all amino acid based hormones other than thyroid)
  2. Act on plasma membrane receptors via G proteins and secondary messengers
  3. Can’t enter the cell
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16
Q

What are some secondary messengers?

A
  1. cAMP
  2. cGMP
  3. PIP2
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17
Q

What is an example of a hormone acting on a receptor without the help of secondary messengers?

A

Insulin receptor is tyrosine kinase enzyme that autophosphorylates upon insulin binding.

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18
Q

What would lipid-soluble hormones achieve?

A
  1. Act on intracellular receptors that directly activate genes.
  2. Require a transport protein for transport in the watery environment of the blood.
  3. Can enter cell
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19
Q

Explain how hormone release is regulated.

A
  1. Blood levels of hormones are controlled by negative feedback system
  2. Blood levels have a narrow and desirable range
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20
Q

What are the 3 factors of target cell activation?

A
  1. Blood levels of hormones
  2. Relative number of receptors on or in target cells
  3. Affinity of binding between recpetor and hormone
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21
Q

What is up-regulation?

A

Target cells form more receptors in response to low hormone levels

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22
Q

What is down-regulation?

A

Target cells lose receptors in response to high hormone levels

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23
Q

Where are ACTH receptors found?

A

Certain cells of the adrenal cortex

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24
Q

Where are thyroxin receptors found?

A

Nearly all cells of body

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25
Q

What kind of stimulus would stimulate hormone release?

A
  1. Humoral
  2. Neural
  3. Hormonal
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26
Q

What happens as a result oh humoral stimuli?

A

Changing blood levels of ions and nutrients directly stimulating hormonal secretion

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27
Q

What is an example of humoral stimuli?

A
  1. Declining blood Ca2+ concentration stimulates parathyroid glands to secrete PTH.
  2. PTH causes Ca2+ concentrations to rise and stimulus is removed
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28
Q

What happens as a result of neural stimuli?

A

Nerve fibers stimulate hormone release

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29
Q

What is an example of neural stimuli?

A

Sympathetic nervous system fibers stimulate adrenal medulla to secrete catecholamines

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30
Q

What happens as a result of hormonal stimuli?

A

Hormones stimulate other endocrine organs to release hormones

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31
Q

What is an example of hormonal stimuli?

A
  1. Hypothalamic hormones stimulate release of anterior pituitary hormones.
  2. Anterior pituitary hormones stimulate targets to secrete still more hormones.
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32
Q

Describe the Hypothalamic-pituitary-target endocrine organ feedback loop

A

Hormones from final target organs inhibit release of anterior pituitary hormones

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33
Q

What overrides normal endocrine controls?

A

The nervous system

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34
Q

Where are hormones found?

A
  1. Circulating in the blood free or bound

2. Steroid and thyroid hormones are attached to the plasma membrane

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35
Q

How is a reflection of the concentration of circulating hormones?

A
  1. Rate of release

2. Speed of inactivation and remval from the body

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36
Q

How are hormones removed from the blood?

A
  1. Degrading enzymes
  2. Kidneys
  3. Liver
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37
Q

What is a half-life?

A

Time required for hormone’s blood level to decrease by half

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38
Q

What are the different types of onset action of hormone activity?

A
  1. Some responses are immediate
  2. Some (steroid) are hours to days
  3. Some are activated by target cells
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39
Q

What happens when there is limited duration of action?

A
  1. 10 seconds to several hours
  2. Effects may diasppear as blood levels drop
  3. Some persist at low blood levels
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40
Q

What are the 3 interactions of hormones with target cells?

A
  1. Permissiveness
  2. Synergism
  3. Antagonism
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41
Q

What does it mean for a hormone to be permissible?

A

One hormone can’t exert its effects without another hormone being present

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42
Q

What does it mean for a hormone to be synergized?

A

More than one hormone produces same effects on target cells causing amplification

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43
Q

What does it mean for a hormone to be antagonistic?

A

One or more hormones oppose action of another hormone

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44
Q

What are the 2 lobes of the pituitary?

A
  1. Posterior: neural tissue

2. Anterior: glandular tissue

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45
Q

Describe the structure of the posterior pituitary

A
  1. Posterior pituitary and hypothalumus are neurally connected by the hypothalamic-hypophyseal tract
  2. Hypothalamus synthesizes oxytocin and antidiuretic hormone
  3. These hormones are stored in posterior pituitary
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46
Q

What are the functions of oxytocin release?

A
  1. Strong stimulant of uterine contraction
  2. Released during childbirth
  3. Hormonal trigger for milk ejection
  4. Acts as neurotransmitter in brain
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47
Q

What are the functions of ADH release?

A
  1. Inhibits or prevents uring formation
  2. Regulates water balance
  3. High concentrations of ADH cause vasocontriction
  4. Targets kidney tubules → reabsorb more water.
  5. Release also triggered by pain, low blood pressure, and drugs.
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48
Q

What occurs during diabetes insipidus?

A

ADH deficiency due to hypothalamus or posterior pituitary damage

Must keep well-hydrated

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49
Q

What occurs during syndrome of inappropriate ADH secretion (SIADH)?

A
  1. Retention of fluid, headache, disorientation

2. Fluid restriction, blood sodium level monitoring

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50
Q

How does the hypothalamus connect to the anterior pituitary?

A

Hypophyseal portal system

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51
Q

What is the purpose of the Hypophyseal portal system?

A

Carries releasing and inhibiting hormones to anterior pituitary to regulate hormone secretion

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52
Q

How is the anterior pituitary secretion regulated?

A
  1. 5 releasing and 2 inhibiting hormones in the hypothalamus stimulate/inhibit their secretion.
  2. Negative feedback via hormones released by target glands decreases secretion of three types of hormones
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53
Q

What are the hormones found in the anterior pituitary gland?

A
  1. Growth hormone (GH)
  2. Thyroid-stimulating hormone (TSH)
  3. Adrenocorticotropic hormone (ACTH)
  4. Follicle-stimulating hormone (FSH)
  5. Lutenizing hormone (LH)
  6. Prolactin (PRL)
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54
Q

Which hormone of the anterior pituitary gland does not activate cAMP?

A

GH

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55
Q

Which of the anterior pituitary hormone are tropic?

A
  1. TSH
  2. ACTH
  3. FSH
  4. LH
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56
Q

What is a tropic hormone?

A

Regulate secretory action of other endocrine glands

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57
Q

What is the function of GH?

A

Stimulates secretion of insulin-like growth factors (IGFs) that promote growth

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58
Q

How does GH directly affect metabolism?

A

Increases blood levels of fatty acids and glucose by glycogen breakdown (anti-insulin)

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59
Q

How does GH indirectly affect growth?

A

Mediates growth via growth-promoting proteins insulin-like growth factors (IGFs)

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60
Q

How are IGFs stimulated?

A
  1. Increased protein synthesis; cell growth and proliferation.
  2. Formation of collagen and deposition of bone matrix.
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61
Q

What are the target cells for GH?

A

Bone and skeletal muscle

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62
Q

How are GH chiefly regulated?

A

Hypothalamic hormones

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63
Q

What stimulates the release of GH?

A

GHRH

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64
Q

What inhibits the release of GH?

A

GHIH

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65
Q

What is ghrelin?

A

The hunger hormone that also stimulates GH release

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66
Q

What caused by the hypersecretion of GH?

A
  1. Adults: acromegaly

2. Children: gigantism

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67
Q

What caused by the hyposecretion of GH?

A

Pituitary dwarfism

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68
Q

What is the function of TSH?

A

Stimulates synthesis and secretion of thyroid hormones by the thyroid gland

69
Q

What hormone activates the release of TSH?

A

Thyrotropin-releasing hormone

70
Q

How is TSH inhibited?

A

Rising blood levels of thyroid hormon that act on pituitary and hypothalamus

71
Q

What is the function of FSH?

A

Stimulates gamete production and Ovaries initiate development of oocytes; testes initiate development of spermatozoa

72
Q

What is the function of LH?

A

Promotes production of gonadal hormones

73
Q

How are gonadotropin release regulated?

A
  1. Triggered by gonadotropin-releasing hormone (GnRH) during and after puberty.
  2. Suppressed by gonadal hormones (feedback).
74
Q

What is the function of PRL?

A

Stimulates breast growth, and development of the mammary glands

74
Q

What regulates PRL release?

A

Prolactin-inhibting hormone (PIH) dopamine

75
Q

What is caused when PRL is hypersecreted?

A

Causes inappropriate lactation, lack of menses, infertility in females, and impotence in males

76
Q

What is the function of ACTH?

A

Stimulates release of mineralocorticoid, glucocorticoid, and androgen hormones from the adrenal cortex

77
Q

What hormone regulates ACTH release?

A

Hypothalamic corticotropin-releasing hormone (CRH)

78
Q

What is the function of MSH?

A

Stimulate the production and release of melanin by melanocytes in skin and hair. MSH signals to the brain have effects on appetite and sexual arousal

79
Q

What is the isthmus?

A

Two lateral lobes connected by median mass

80
Q

What types of glycoprotein is produced by follicles?

A

Thyroglobulin

81
Q

What is a colloid?

A

Fills lumen of follicles and is precursor of thyroid hormone

82
Q

What do parafollicular cells produce?

A

Calcitonin

83
Q

What is the difference between T4 and T3?

A
  1. T4 (thyroxine); has 2 tyrosine molecules + 4 bound iodine atoms
  2. T3 (triiodothyronine); has 2 tyrosines + 3 bound iodine atoms
84
Q

What element is essential for TH synthesis?

A

Iodine

85
Q

What are the functions of thyroid hormones?

A
  1. Major metabolic hormone
  2. Increases metabolic rate and heat production
  3. Regulation of tissue growth and development
  4. Maintenance of blood pressure
86
Q

How are T3 and T4 transported?

A

Thyroxine-binding globulins (TBGs)

87
Q

Describe the negative feedback regulation of TH release

A
  1. Rising TH levels provide negative feedback inhibition on release of TSH
  2. Hypothalamic thyrotropin-releasing hormone (TRH) can overcome negative feedback during pregnancy or exposure to cold
88
Q

What is hyposecretion of TH in adults?

A

Myxedema, goiter if due to lack of iodinie

89
Q

What is hyposecretion of TH in children?

A

Cretinism

90
Q

What is hypersecretion of TH?

A

Grave’s disease

91
Q

What cells would produce calcitonin?

A

Parafollicular (C) cells

92
Q

What is the antagonist of PTH?

A

Calcitonin

93
Q

What occurs when someone has high levels of calcitonin?

A
  1. Inhibits osteoclast activity and release of Ca2+ from bone matrix.
  2. Stimulates Ca2+ uptake and incorporation into bone matrix.
94
Q

What is the most important hormone in Ca2+ homeostasis?

A

PTH

95
Q

What cells secrete PTH?

A

Parathyroid cells

96
Q

What are the functions of PTH?

A
  1. Stimulates osteoclasts to digest bone matrix and release Ca2+ to blood.
  2. Enhances reabsorption of Ca2+ by kidneys.
  3. Promotes activation of vitamin D (by kidneys); increases absorption of Ca2+ by intestinal mucosa.
97
Q

Describe the negative feedback control of PTH?

A
  1. Hypocalcemia
  2. PTH increase from parathyroid gland causing osteoclast, Ca2+, and activation of Vitamin D increase
  3. Increase in Ca2+ in blood
98
Q

What occurs during hyperparathyroidism?

A
  1. Caused by tumors
  2. Bones soften and deform
  3. Elevated Ca2+ depresses nervous system and contributes to formation of kidney stones
99
Q

What occurs during hypoparathyroidism?

A
  1. Caused by gland trauma or removal, or dietary magnesium deficiency
  2. Tetany, respiratory paralysis, death
100
Q

What is the difference between adrenal cortex and medulla?

A

Medulla: nervous tissue; part of sympathetic nervous system

Cortex: 3 layers of glandular tissue that synthesize and secrete corticosteroids

101
Q

What are 3 layers of the adrenal cortex and what do they produce?

A
  1. Zona glomerulosa: mineralocorticoids
  2. Zona fasciculata: glucocorticoids
  3. Zona reticularis: gonadocorticoids
102
Q

What is the primary functions of mineralocorticoids?

A
  1. Regulare electrolytes in ECF
  2. Importance of Na+: affects ECF volume, blood volume, blood pressure, levels of other ions
  3. Importance of K+: sets RMP of cells
103
Q

What is considered the most potent mineralocorticoid?

A

Aldosterone

104
Q

What does aldosterone stimulate?

A

Stimulates Na+ reabsorption and water retention by kidneys; elimination of K+.

105
Q

What triggers aldosterone release?

A
  1. Decreasing blood volume and blood pressure.

2. Rising blood levels of K+.

106
Q

Describe the Renin-Angiotensin-Aldosterone System (RAAS)

A
  1. Dehydration Na+ deficiency or hemmorhage
  2. Decreases in blood volume
  3. Decrease in blood pressure
  4. Juxtaglomerular cells of kidneys
  5. Increased renin
  6. Angiotensin is released by liver
  7. Renin converts angiotensin into Angiotensin II
  8. Angiotensin II is transferred to ACE
  9. ACE increases angiotensin II thats directed to the arterioles or adrenal cortex
  10. In the adrenal cortex increased aldosterone
  11. Increase Na+ and water reabsorption and increased secretion of K+ and H+ into urine
  12. Increased blood volume
  13. Vasoconstriction of arterioles and increased blood volume causes blood pressure increases
107
Q

When would renin be released?

A

Low BP stimulates renal juxtaglomerular (JG) cells

108
Q

What converts Angiotensin I to II?

A

Angiotensin converting enzyme (ACE)

109
Q

What is the product for Angiotensin II?

A

Stimulates the adrenal cortex to secrete aldosterone

110
Q

What are the mechanisms that influence aldosterone secretion?

A
  1. Renin-angiotensin-aldosterone mechanism: Decreased blood pressure stimulates kidneys to release renin → triggers formation of angiotensin II, a potent stimulator of aldosterone release
  2. Plasma concentration of K+: directly causes aldosterone release.
  3. ACTH: directly increases aldosterone during stress.
  4. Atrial natriuretic peptide (ANP): blocks renin and aldosterone secretion to decrease blood pressure.
111
Q

What is aldosteronism?

A
  1. Hypersecretion due to adrenal tumors
  2. Hypertension and edema due to excessive Na+
  3. Excretion of K+ leading to abnormal function of neurones and muscles
112
Q

What is the primary function of glucocorticoids?

A
  1. Keep blood glucose levels relatively constant

2. Maintain blood pressure by increasign action of vasoconstrictors

113
Q

What are the glucocorticoid hormones?

A
  1. Cortisol
  2. Cortisone
  3. Corticosterone
114
Q

What are the prime functions of cortisol?

A
  1. Prime metabolic effect is gluconeogenesis promoting the rise of blood glucose, fatty acids, and amino acids
  2. Enhances vasoconstriction → rise in blood pressure to quickly distribute nutrients to cells.
115
Q

What is caused by hypersecretion of glucocorticoid?

A

Cushing’s syndrome

116
Q

What is Cushing’s syndrome?

A
  1. Depresses cartilage and bone formation
  2. Inhibits inflammation
  3. Depresses immune system
  4. Disrupts cardiovascular, neural, and gastrointestinal function
117
Q

What is caused by hyposecretion of glucocorticoid?

A

Addison’s disease

118
Q

What is Addison’s disease?

A
  1. A deficiency in mineralocorticoids that causes decreases in glucose and Na+ levels
  2. Causes weight loss, sever dehydration, and hypotension
119
Q

What are the contribution of gonadocorticoids?

A
  1. Onset of puberty.
  2. Appearance of secondary sex characteristics.
  3. Sex drive in women.
  4. Estrogens in postmenopausal women.
120
Q

What is caused by hypersecrtion of gonadocorticoids?

A

Adrenogenital syndrome

121
Q

How could adrenogenital syndrome effect males?

A

Reproductive organs mature; secondary sex characteristics emerge early.

122
Q

How could adrenogenital syndrome effect females?

A

Beard, masculine pattern of body hair; clitoris resembles small penis

123
Q

What are the effects of the adrenal medulla?

A
  1. Vasoconstriction
  2. Increased heart rate
  3. Increase blood glucose levels
  4. Blood diverted to brain, heart, and skeletal muscle
124
Q

What cells synthesize epinephrine and norepinephrine?

A

Medullary chromaffin cells

125
Q

What does epinephrine stimulate?

A

Metabolic activities, bronchial dilation, and blood flow to skeletal muscles and heart

126
Q

What does the norepinephrine stimulate?

A

Peripheral vasoconstriction and blood pressure

127
Q

What occur from the hypersecretion of adrenal catecholamines?

A

Hyperglycemia

128
Q

What occur from the hyposecretion of adrenal catecholamines?

A

Nothing, adrenal catecholamines are not essential

129
Q

What is the importance of the pineal gland?

A

Secretes melatonin

130
Q

What does melatonin initiate?

A
  1. Timing of sexual maturation and puberty.
  2. Day/night cycles.
  3. Physiological processes that show rhythmic variations (body temperature, sleep, appetite).
  4. Production of antioxidant and detoxification molecules in cells.
131
Q

Explain the differences between the exocrine and endocrine pancreas

A
  1. Acinar cells (exocrine) produce enzyme-rich juice for digestion.
  2. Pancreatic islets (islets of Langerhans) contain endocrine cells.
132
Q

What is the difference between alpha and beta cells of the pancreas?

A
  1. Alpha: produce glucagon (hyperglycemic)

2. Beta: produce insulin (hypoglycemic)

133
Q

What is the target cell for glucagon?

A

Liver

134
Q

What are the effects of glucogon?

A
  1. Glycogenolysis – breakdown of glycogen to glucose.
  2. Gluconeogenesis – synthesis of glucose from lactic acid and noncarbohydrates.
  3. Release of glucose to blood
135
Q

What are the effects of insulin?

A
  1. Lowers blood glucose levels by enhancing transport of glucose into fat and muscle cells and inhibiting glycogenolysis and gluconeogenesis
  2. Participates in neuronal development and learning and memory
136
Q

How does insulin trigger enzymes in the cells?

A
  1. Increase glucose uptake (stored as glycogen in muscle).
  2. Catalyze glucose oxidation and ATP production.
  3. Convert glucose to fat (particularly in adipose tissue).
137
Q

What factors inhibit insulin release?

A
  1. Elevated blood glucose levels.

2. Rising blood levels of amino acids and fatty acids. Acetylcholine/PNS

138
Q

What factors inhibit insulin release?

A

Glucagon, epinephrine/SNS, growth hormone, thyroxine, glucocorticoids

139
Q

What is caused from diabetes mellitus?

A
  1. Due to hyposecretion (type 1) or hypoactivity (type 2) of insulin.
  2. Glycosuria – glucose spilled into urine. Fats used for cellular fuel → lipidemia; if severe → ketones (ketone bodies) from fatty acid metabolism → ketonuria and ketoacidosis.
  3. Untreated ketoacidosis → hyperpnea; disrupted heart activity and O2 transport; depression of nervous system → coma and death possible.
140
Q

What are the 3 cardinal signs of DM?

A
  1. Polyuria: huge urine output
  2. Polydipsia: excessive thirst
  3. Polyphagia: excessive hunger
141
Q

What occurs during hyperinsulism?

A
  1. Excessive insulin secretion.
  2. Causes hypoglycemia.
  3. Low blood glucose levels.
  4. Anxiety, nervousness, disorientation, unconsciousness, even death.
  5. Treated by sugar ingestion
142
Q

What produces steroid sex hormones?

A

Gonads

143
Q

What do the ovaries produce?

A

Estrogen and progesterone

144
Q

What is the purpose for estrogen?

A
  1. Maturation of reproductive organs.
  2. Appearance of secondary sexual characteristics.
  3. With progesterone, causes breast development and cyclic changes in uterine mucosa.
145
Q

What does the placenta produce?

A

Estogen, progesterone, hCG

146
Q

What is the purpose of testosterone?

A
  1. Initiates maturation of male reproductive organs.
  2. Causes appearance of male secondary sexual characteristics and sex drive.
  3. Necessary for normal sperm production.
  4. Maintains reproductive organs in functional state.
147
Q

What is atrial natriuretic peptide (ANP)?

A

Decreases blood Na+ concentration therefore BP and blood volume

148
Q

State the location of enteroendocrine cells.

A

GI tract

149
Q

What kind of hormones are secreted by the enteroendocrine cells in the GI tract?

A
  1. Gastrin
  2. Secretin
  3. Cholecystokinin
  4. Serotonin
150
Q

What is gastrin?

A

Stimulates the release of HCl

151
Q

What is secretin?

A

Stimulates live and pancreas

152
Q

What is cholecystokinin?

A

Stimulates pancreas, gallbladdeer, and hepatopancreatic sphincter

153
Q

What is serotonin?

A

Acts as paracrine

154
Q

What kind of hormones are secreted by the adipose tissue?

A
  1. Leptin
  2. Resistin
  3. Adiponectin
155
Q

What does leptin secretion achieve?

A

Appetite control stimulating increased energy expenditure

156
Q

What does resistin secretion achieve?

A

Insulin antagonist

157
Q

What does adiponectin secretion achieve?

A

Enhances sensitivity to insulin

158
Q

What kind of hormones are secreted by the kidney tissue?

A
  1. Erythropoietin: signals production of RBCs

2. Renin: initiates the renin-angiotensin-aldosterone mechanism

159
Q

What kind of hormones are secreted by the thymus?

A
  1. Thymulin, thymopoietins, and thymosins.
  2. Involved in normal development of T lymphocytes in immune response.
  3. Classified as hormones; act as paracrines
160
Q

What kind of hormones are secreted by the skeleton?

A

Osteocalcin: activates insulin

161
Q

What kind of hormones are secreted by the skin?

A

Cholecalciferol: precursor of vitamin D

162
Q

Describe the effects of aging on endocrine system function.

A
  1. GH levels decline: muscle atrophy
  2. TH levels decline: lowers basal metabolic rate increasing body weight
  3. PTH levels remain fairly constant with age
  4. Cortisol and aldosterone decline with age.
  5. Adrenal glands produce less cortisol and aldosterone.
  6. Pancreases releases insulin more slowly, and sensitivity to glucose declines
  7. Ovaries become unresponsive to gonadotropins
  8. Testosterone diminishes with age
163
Q

Describe the general adaptation syndrome (GAS)

A

If stress is extreme, unusual, or long-lasting, normal mechanisms may not be enough

164
Q

What is a stressor?

A

Any stimulus that produces a stress response

165
Q

What is the alarm reaction?

A
  1. Short-lives “fight or flight” response of SNS
  2. Brings glucose and oxygen to the brain, lungs, and skeletal muscles.
  3. The RAAS is also activated to maintain blood volume and BP
166
Q

What is the resistance reaction?

A
  1. Longer-lasting response initiated by hypothalamic releasing hormones
  2. High levels of cortisol and thyroid hormone assures that body tissues can sustain necessary metabolic needs.
167
Q

What the exhaustion phase?

A

Body reserves become so depleted that they cannot sustain the resistance stage.

Physiology (22 decks)

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