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Organ Systems Exam 4 > Chamberlin Study Guide > Flashcards

Chamberlin Study Guide Flashcards

0
Q

What is the set point reached between glucagon and insulin?

A

70-100 mg/dl

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1
Q

What is the relationship between glucagon and insulin?

A

When one goes up — The other goes down

and a set point is reached

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2
Q

If there were a reduction in insulin levels across all levels of blood glucose levels, how would this change the glucose equilibrium point?

A

Blood glucose levels would rise and a new, higher set point will be established.

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3
Q

How are decreased insulin levels and insulin resistance related?

A

Both do the same thing - blood glucose levels rise

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4
Q

What organ has both endocrine and exocrine function?

A

Pancreas

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5
Q

Which cells produce insulin?

A

beta (B) cells

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6
Q

Which cells produce glucagon?

A

Alpha cells

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7
Q

Which cells produce somatostatin?

A

D cells in the stomach

Delta cells in the pancreas

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8
Q

What is the difference between D cells and delta cells?

A

Both secrete somatostatin into the blood stream

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9
Q

What are the two mechanisms glucagon employs to increase blood glucose?

A

Glycogenolysis and gluconeogenesis

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10
Q

What 3 things stimulate glucagon secretion?

A
  • Low glucose
  • Amino acids
  • ACh, Epinephrine, Norepinephrine
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11
Q

What 3 things inhibit glucagon secretion?

A
  • High glucose
  • Insulin
  • Fatty acids
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12
Q

Why does activation of the sympathetic nervous system stimulate glucagon release?

A

Fight or flight - you need to put as much immediately usable fuel into the circulatory system to provide for the needs of the muscles.

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13
Q

What is paracrine secretion?

A

Secretion into the local area only

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14
Q

Which pancreatic hormone utilizes paracrine secretion?

A

Somatostatin

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15
Q

What is the purpose of somatostatin?

A

Down regulate both insulin and glucagon secretion so that levels of both don’t get out of control

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16
Q

Why is calming things down important?

A

So you don’t exhaust nutrients too quickly

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17
Q

What stimulates somatostatin release?

A
  • Glucagon
  • Insulin
  • Amino Acids
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18
Q

What is the most effective and most immediate treatment for hypoglycemia?

A

Glucagon

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19
Q

Why does glucagon reduce the uptake of glucose into adipose cells?

A

To keep as much glucose as possible in the circulatory system.

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20
Q

What are the multiple ways insulin is expressed to cells?

A
  • insulin receptors
  • tyrosine kinase
  • other enzymes (IRS, insulin receptor substrates)
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21
Q

What is insulin’s action on glucose in relation to cells?

A

It stimulates glucose uptake into cells.

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22
Q

What synthetic processes are a result of insulin?

A

Synthesis of…

  • Protein
  • Fat
  • Glycogen
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23
Q

What expressions does insulin facilitate?

A

Growth and gene expression

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24
Q

What signals are stimulated by insulin?

A

Satiety signal

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25
Q

What is IRS?

A

The receptor that binds with insulin

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26
Q

What doe the IRS cause?

A

Glucose channels to increase in number on the cell membrane

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27
Q

What is the benefit of IRS increasing the number of glucose channels on the cell membrane?

A

It increases glucose uptake into the cell

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28
Q

What does the IRS trigger?

A

Translocation of GLUT 4 (glucose transporter) into the cell membrane to facilitate glucose absorption

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29
Q

What are the old antiquated classifications of diabetes?

A

Insulin and non-insulin dependent

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30
Q

Why was it important to change the old classification of diabetes?

A

Eventually most non-insulin dependent diabetics will require insulin

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31
Q

How do the autoimmune processes of type I and type II diabetics differ?

A

Type I: involves destruction of the beta cells in the pancreas
Type II: alteration of the IRS and/or GLUT 4 receptors in the target adipose tissue

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32
Q

If the body chooses to store glucose, what are the 2 primary forms that it is stored as?

A

Glycogen and TAG

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33
Q

Where is glycogen normally stored?

A

Liver and muscle

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34
Q

Where are TAG normally stored?

A

Adipose tissue

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35
Q

Do myocytes normally store fat for later use as energy?

A

NO. They store glycogen

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36
Q

Does insulin cause lipogenesis or lypolysis?

A

In adipose tissue and liver - STIMULATES lipogenesis

It INHIBITS lipolysis of TAG

37
Q

Where are GLUT 2 receptors found?

A

Beta cells in the pancreas

38
Q

What is the effect of the activation of GLUT 2 receptors?

A

Insulin is released from the pancreas

39
Q

Does insulin travel through the pancreatic duct to the duodenum?

A

NO. Only the exocrine products (lipase, HCO- etc.) hormones are secreted in the vascular system

40
Q

In what phase does parasympathetic activity stimulate beta cells?

A

Cephalic phase

41
Q

What is the ultimate function of the interaction between glucagon and insulin?

A

Keep blood glucose levels within a very narrow range during fasting.

42
Q

When a person gets hypoglycemia, why does the sympathetic nervous system activate?

A

To keep the person conscious. The brain relies on glucose alone for energy on a second to second basis.

43
Q

If stress is causing continuous sympathetic activation, what will happen to the equilibrium point of glucose?

A

The ANS will cause constant glucagon release, the point will shift upward, resulting in a higher concentration of fasting glucose levels. (Stress can lead to diabetes)

44
Q

Where is iron specifically absorbed?

A

Duodenum

45
Q

Which 6 nutrients are absorbed in the duodenum?

A

Cl-, SO4-, iron, calcium, magnesium, zinc

46
Q

Where is B-12 absorbed specifically?

A

Terminal ileum

47
Q

Which 7 nutrients are absorbed in the jejunum?

A

glucose, galactose, fructose, Vit. C, Thiamin, Riboflavin, Pyridoxine (water soluble vitamins)

48
Q

What are 7 nutrients absorbed in the ileum?

A

Folic acid, amino acids, di-and tri-peptides, Vitamins A, D, E, K, Fat, cholesterol, bile salts and Vit. B-12

49
Q

What nutrients are absorbed in the colon?

A

Na+, K+, Vitamin K (formed by bacterial action), and H2O

50
Q

True/False: Fat soluble vitamins avoid the first pass effect.

A

True

51
Q

What is the first pass effect?

A

Substances with a high fat content avoid being degraded by the liver by bypassing it and going to the peripheral tissues first.

52
Q

Where does intestinal absorption occur, where does intestinal secretion occur?

A

Enterocytes; secretion occurs in the crypts of Lieberkuhn

53
Q

Daily secretion and absorption of fluid are massive. About how much fluid is secreted a day by the stomach alone? Entire GI system?

A

Stomach: 2L

GI System: 9L

54
Q

Both small and large intestine absorb water, but do entirely different things with K+, what are they?

A

Small intestine: absorbs K+

Large intestine: secretes K+

55
Q

Why does most NaCl and water absorption occur in the duodenum and jejunum and less absorbed in the ileum and colon?

A

The tight junctions in the duodenum and jejunum are more permeable to water and solutes than in the ileum and colon

56
Q

Na+ follows Cl- movement and H2O follows both. If by controlling Cl- and thus controlling Na+, how does controlling just one molecule control all other things?

A

Mechanisms have developed so that every time a Na+ enters a cell, it drags an glucose with it and expels a H+ at the same time.

57
Q

Where is Na+ co-transported with glucose?

A

Jejunum

58
Q

In which part of the small intestines does Cl- diffuse into and around the cell for absorption? Which part contains a pump for absorption via exchange with HCO3-

A

duodenum and jejunum; ileum and colon

THIS IS NOT THE SAME AS THE CFTR PUMP!

59
Q

What is the difference between the way Cl- is absorbed and secreted?

A

It is absorbed by diffusion through gap junctions.

60
Q

What method is used when Cl- needs to be secreted into a lumen?

A

CFTR (cystic fibrosis transmembrane regulator)

61
Q

Approximately how much water is secreted and reabsorbed into the intestines in a 24 hour period?

A

8900-9000ml

62
Q

How much water is lost a day?

A

about 100ml

63
Q

Why is secretory diarrhea so deadly?

A

It causes the CFTR to endlessly secrete Cl- (thus, water) down low below the duodenum and jejunum where water would normally be reabsorbed. (instead of 100ml a day being lost, it would be liters)

64
Q

How does secretory diarrhea differ from osmotic diarrhea?

A

Osmotic diarrhea doesn’t involve the CFTR - this results in a “water drag” situation where overall water losses are much smaller.

65
Q

How can losing just 2 BMI points lead to a vast change in health?

A
  • The visceral fat “dissolves” first, lessening intrabdominal mass effects (i.e. hiatal hernia).
  • Decreases the likelihood of an autoimmune reaction in the peripheral fat.
66
Q

How does fat storage differ in men and women?

A

Men: store visceral fat first
Women: store peripheral fat first

67
Q

Which cytokines are thought to cause damage of peripheral fat cell receptors as a result of type II diabetes mellitus?

A

TNF, IL-6, and excess free fatty acids

68
Q

What is the consequence of damaging the IRS?

A

GLUT 4 receptors cannot translocate to the cell membrane and thus the adipocyte cannot uptake glucose

69
Q

Why are these IRS damaging cytokines thought to be released?

A

Because of an immune reaction occurring between visceral fat and bacterial agents in the GI system

70
Q

TNF secreted from visceral fat causes _______ _________ in what other tissues?

A

insulin resistance; subQ fat and muscle

71
Q

TNF secretion and insulin resistance interferes with ___ ________ in cell signaling of what?

A

IRS protein; GLUT-4 translocation

72
Q

A similar mechanism can be responsible for atherosclerosis that is seen in insulin resistance. What is the mechanism in the heart?

A

Cytokines (adipokines) attack the coronary arteries instead of the IRS and causes atherosclerosis

73
Q

How is the amount of fat a person has normally determined?

A

Body weight (adiposity) is normally stabilized by balancing energy intake and energy expenditure (homeostasis)

74
Q

How does homeostasis occur?

A

Neural & endocrine afferent pathways provide feedback for regulating neural and behavioral aspects of eating

75
Q

What is homeostatic regulation of energy uptake?

A

The result of feedback regulation from the internal milieu on hypothalamic/brain stem actions on eating.

76
Q

What is non-homeostatic regulation of energy uptake?

A

Involves cognition, motivation, drive, stress (the limbic system’s processing of environment, early life events, predisposition etc.)

77
Q

How does the “ileal brake” work?

A

Inhibition of glucagon release, GI motility, and secretion

78
Q

How can the “ileal brake” be used clinically for weight loss?

A

Slower eating permits activation of the satiety signals to reduce meal size.

79
Q

What are the basic gastric cell types?

A
  • Mucous Cells
  • Parietal Cells
  • Peptic Cells
  • Enterochromaffin-like Cells
80
Q

What stimulates the production of HCL?

A
  • Peptides stimulate gastrin release - stimulating acid secretion
  • Vagus nerve stimulates acid secretion and inhibits somatostatin release
81
Q

What inhibits HCL production?

A

Acid stimulates somatostatin (SS) release which inhibits gastrin release

82
Q

What does Vit B12 absorption depend upon?

A
  • Secretion of intrinsic factor from gastric parietal cells

- Uptake by ileal cells

83
Q

Gastric R-proteins are dissociated by _______, and dependent on acid

A

pepsin

84
Q

Intrinsic factor is released from _______ cells and combines with vitamin ____

A

parietal; B12

85
Q

Vit B12 absorption requires what 3 factors?

A
  • Dissociation from R-proteins by pepsin
  • Binding with intrinsic factor
  • Absorption by ileal cells and transport into portal vein
86
Q

Decreased parietal cell activity, (eg. ulcers), causes diminished release of:

A
  • Acid (hypochlorhydria or achlorhydria)

- Intrinsic factor (B12 deficiency, pernicious anemia)

87
Q

What is the function of gastric mucus

A

All areas of the stomach secrete mucus because all areas of the stomach need protection from HCl

88
Q

Protein digestion depends on secretions from which cell types?

A

Parietal, peptic, and enteroendocrine cells (ECL, G and D cells)

89
Q

Parietal cells secrete intrinsic factor for what purpose?

A

for vit B12 absorption

90
Q

Parietal cells secrete acid via which mechanism?

A

carbonic acid

91
Q

Acid initiates protein digestion in the stomach by converting pepsinogen to ___________, which is a _________.

A

pepsin: a protease

Organ Systems Exam 4 (4 decks)

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