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NURS 350 > Exam 3 - Obesity & Digestive system > Flashcards

Exam 3 - Obesity & Digestive system Flashcards

1
Q

What are the 2 classifications of adipose tissue?

A
  1. brown

2. white

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2
Q

What kind of adipose comprises most adipose in the body?

A

white adipose tissue (WAT)

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3
Q

What kind of stores are involved with WAT?

A

visceral and subcutaneous

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4
Q

What kinds of cells does WAT contain?

A

macrophages, mast cells, neutrophils, fibroblasts, endothelial cells, blood vessels nerves, and precursor adipocytes

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5
Q

What does WAT store?

A

excess fat

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6
Q

What 2 things help metabolize fat in WAT?

A
  1. estrogen

2. estrogen receptors

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7
Q

What kind of adipose tissue is rich in mitochondria?

A

brown adipose tissue (BAT)

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8
Q

What makes BAT brown?

A

iron

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9
Q

What 4 things stimulate BAT to rapidly generate heat through the activation of uncoupling protein 1?

A
  1. exposure to cold
  2. activation of the sympathetic nervous system
  3. catecholamines
  4. activation of triiodothyronine
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10
Q

How do neonates generate body heat?

A

from Bat located in the inter scapular and perirenal regions

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11
Q

BAT is common in which people? in which areas?

A

lean persons in…

  1. neck
  2. supraclavicular axillary
  3. paravertebral regions
  4. perirenal regions
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12
Q

What does BAT have an inverse relationship with?

A

BMI and age

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13
Q

What emerges within WAT with chronic exposure to cold, exercise, and exposure to synthetic ligand of peroxisome proliferator-activated receptor-y

A

bAT (brown in white)

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14
Q

Excess what contributes to obesity?

A

WAT (white adipose tissue)

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15
Q

What does WAT contribute to?

A

regulation of energy homeostasis

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16
Q

define obesity

A

increase in body fat mass

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17
Q

what is a major cause of morbidity, death, and increased care costs?

A

obesity

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18
Q

What is a BMI value for adults with obesity?

A

> 30 kg/m2

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19
Q

What is a BMI value for children with obesity?

A

> or equal to age and sex-specific 95th percentile of the growth charts in children

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20
Q

What are the leading causes o death associated with obesity

A
  1. CV disease
  2. type 2 diabetes mellitus
  3. cancer
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21
Q

what is the cellular basis of obesity?

A

adipocyte

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22
Q

what are the molecules that stimulate eating?

A

orexins

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23
Q

define orexin

A

a peptide family that act as neurotransmitters for stimulating eating

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24
Q

What are molecules that inhibit eating?

A

anorexins

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25
Q

what does the arcuate nucleus regulate?

A

regulates food intake and energy metabolism in hypothalamus

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26
Q

What do neurons with the ARC promote?

A
  1. appetite
  2. stimulate eating
  3. decrease metabolism
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27
Q

What does the hypothalamus control?

A
  1. reward
  2. pleasure
  3. memory
  4. addictive behavior
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28
Q

What is visceral obesity also known as?

A

intraabdominal, central, or masculine obesity

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29
Q

What is the distribution of body fat like with visceral obesity?

A

it is localized around the abdomen and upper body.

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30
Q

What is peripheral obesity also known as?

A

glutealfemoral, feiminine, or subcutaneous obesity

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31
Q

What is the distribution of body fat like with peripheral obesity?

A

It is exztraperitoneal and distributed around the things and buttocks and through the muscle.

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32
Q

What shape is visceral obesity?

A

apple

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33
Q

What shape is peripheral obesity?

A

pear

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34
Q

What is considered overweight in terms of BMI?

A

greater than 25 kg/m2

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35
Q

What are 3 things to correct with obesity?

A
  1. metabolic abnormalities
  2. weight-reduction diets
  3. exercise programs
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36
Q

What is the most effective treatment for obesity?

A

combination of weight reduction and exercise

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37
Q

What are 2 things that are critical with obesity?

A
  1. self-motivation

2. support systems

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38
Q

What are three psychiatric disorders related to a distorted body image with a desire for thinness and a fear of fatness that results in extreme restrictions in eating habits?

A
  1. anorexia nervosa
  2. bulimia nervosa
  3. binge eating disorder
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39
Q

What are 3 short term problems associated with starvation?

A
  1. glycogenolysis
  2. gluconeogenesis
  3. leads to ketosis and acidosis
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40
Q

define glycogenolysis

A

splitting of glycogen into glucose

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41
Q

define gluconeogenesis

A

formation of glucose from noncarbohydrate molecules

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42
Q

What are 2 long term problems associated with starvation?

A
  1. marasmus

2. kwashiorkor

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43
Q

What does treatment involve with starvation?

A

adequate ingestion of appropriate nutrients

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44
Q

What is anorexia of aging?

A

decrease in appetite or food intake in older adults

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45
Q

What is anorexia of aging due to

A
  1. Reduced energy needs
  2. Waning hunger
  3. Diminished sense of taste and smell
  4. Decreased production of saliva
  5. Altered GI satiety mechanisms
  6. Co-morbidities
  7. Medications
  8. Decreased orexigenic and increased anorexigenic signals
  9. Delayed gastric emptying
  10. Decreased small intestine motility
  11. Sensory impairments
  12. Medical/psychiatric disorders
  13. Social isolation, abuse, neglect
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46
Q

What does treatment involve for anorexia of aging?

A

support strategies

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47
Q

Define adipocytes

A

fat storing cells that store excess energy (triglycerides)

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48
Q

Define adipokines

A

include all of the biologically active substances synthesized by WAT which function in a lot of regulation…

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49
Q

What is the gastrointestinal tract?

A

a hollow tube that extents from mouth to the anus (mount, esophagus, stomach, small intestine, large intestine, rectum, anus)

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50
Q

What are accessory organs of digestive system?

A
  1. liver
  2. gallbladder
  3. exocrine pancreas
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51
Q

What does the digestive system perform?

A

performs the mechanical and chemical breakdown of ingested food

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52
Q

What does the digestive system prepare?

A

prepares food for uptake by the body’s cells

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53
Q

What does the digestive system provide?

A

body water

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54
Q

What does the digestive system eliminate?

A

wastes

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55
Q

What is the digestive system controlled by?

A

controlled by hormones and the autonomic nervous system.

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56
Q

What is not controlled by hormones and the ANS?

A

chewing, swallowing, and defecation

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57
Q

What is the alimentary canal responsible for?

A
  1. ingestion of food
  2. Propulsion of food and wastes from the mouth to the anus
  3. Secretion of mucus, water, and enzymes
  4. Mechanical digestion of food particles
  5. Chemical digestion of food particles
    Absorption of digested food
    Elimination of waste by defecation
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58
Q

What is the alimentary canal responsible for?

A
  1. ingestion of food
  2. Propulsion of food and wastes from the mouth to the anus
  3. Secretion of mucus, water, and enzymes
  4. Mechanical digestion of food particles
  5. Chemical digestion of food particles
  6. Absorption of digested food
  7. Elimination of waste by defecation
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59
Q

What is the order of the histology of the GI tract?

A
  1. mucosa
  2. submucosa
  3. muscularis
  4. serosa or adventitia (esophagus only)
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60
Q

Where is the submucosal plexus located?

A

located in the muscular mucosae

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61
Q

Where is the myenteric plexus located?

A

located between the inner circular and outer longitudinal muscle layers in the muscularis

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62
Q

What is the subserosal plexus located underneath?

A

just beneath the serosa

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63
Q

What do enteric (intramural) plexus neurons regulate?

A

motility reflexes, blood flow, absorption, secretions, and immune response

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64
Q

What is the mouth a reservoir for?

A

for chewing and mixing of food and saliva

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65
Q

What kind of digestion occurs in the mouth?

A
  1. chewing

2. salivation

66
Q

What kinds of nerves are in the mouth?

A

olfactory nerves

67
Q

What are three salivary glands?

A
  1. submandibular
  2. sublingual
  3. parotid
68
Q

What is saliva composed of?

A
  1. water with mucus
  2. sodium
  3. bicarbonate
  4. chloride
  5. potassium
  6. salivary a-amylase (carb digestion)
69
Q

What is saliva controlled by?

A
  1. sympathetic fibers (increases)

2. parasympathetic fibers (decreases)

70
Q

What does saliva contain?

A

immunoglobulin A

71
Q

What is a hollow muscular tube that measures ~25 cm long and conducts substances from the oropharynx to the stomach?

72
Q

Upper esophageal sphincter prevents the entry of what into the esophagus during respiration?

73
Q

What are the two phases of swallowing

A
  1. oropharyngeal (voluntary)

2. esophageal phase (involuntary)

74
Q

What is the brain structure responsible for swallowing?

A

reticular formation of brainstem

75
Q

When the superior constrictor muscle of the pharynx contracts what does it prevent the movement of?

A

food into the nasopharynx

76
Q

What slides downward to prevent a bolus from entering larynx and trachea?

A

epiglottis

77
Q

Movements of what 2 structures propel food into the esophagus in a series of coordinated events that takes 1 or 2 seconds?

A

tongue and pharyngeal constrictors

78
Q

What 4 things is the stomach responsible for?

A
  1. storing food
  2. secreting digestive juices
  3. mixing food with the juices
  4. propelling partially digested food (chyme)
79
Q

What are the muscle layers of the stomach?

A
  1. longitudinal (outer)
  2. circular (middle)
  3. oblique (inner)
80
Q

What are the 2 sphincters of the stomach?

A
  1. lower esophageal sphincter

2. pyloric sphincter

81
Q

What does the pyloric sphincter allow?

A

allows food to exit the stomach into the duodenum

82
Q

What are the 3 functional portions of the stomach?

A
  1. fundus (upper)
  2. body (middle)
  3. Antrum (lower)
83
Q

What can the stomach absorb?

A

alcohol, aspirin, other non steroidal anti-inflammatory agents

84
Q

true or false: stomach is permeable to water

A

false; impermeable to water

85
Q

What relaxes with swallowing?

86
Q

Gantrin and cholecystokinin enhance what?

A

relaxation of the stomach

87
Q

What do gastrin and motilin and low BS?

A

peristalsis contractions of the stomach

88
Q

sympathetic activity, secretin, cholecystokinin inhibit what?

A

peristalsis contractions of the stomach

89
Q

vacus nerve stimulates what?

A

gastric secretion and motility

90
Q

gastric mixing is enhanced by what?

A

retropulsion

91
Q

Gastric emptying is the moment of what into what?

A

gastric contents into the duodenum

92
Q

When does increased gastric emptying occur?

A

with larger volumes of food

93
Q

When does delayed gastric emptying occur?

A

with solids, fats, and non-isotonic solutions

94
Q

Mucus acts as a what?

A

protective barrier

95
Q

What kind of acid is secreted by the stomach?

A

hydrochloric acid

96
Q

What enzyme is in the stomach?

A

pepsinogen

97
Q

What hormone is in the stomach?

98
Q

What does intrinsic factor do for gastric secretion?

A

intestinal absorption of vitamin B12

99
Q

What facilitates small intestinal absorption?

A

gastroferrin

100
Q

What do parietal cells secrete?

A

hydrochloric acid, gastroferrin, and intrinsic factor

101
Q

What do chief cells secrete?

A

pepsinogen converted to pepsin in the gastric environment

102
Q

What do G cells secrete?

103
Q

What do enterochromaffin-like cells secrete?

104
Q

What do D cells secrete?

A

somatostatin

105
Q

What are the 4 gastric glands in order?

A
  1. mucous neck cell
  2. chief cell
  3. parietal cell
  4. endocrine cell
106
Q

What are the 3 segments of the small intestine?

A
  1. duodenum
  2. jejunum
  3. ileum
107
Q

What does the ileocecal valve control? prevent?

A
  1. controls… the flow of digested material from the ileum into the large intestine
  2. prevents… reflux into the small intestine
108
Q

What is the peritoneum?

A

serous membrane surrounding the organs of the abdomen and lining of the abdominopelvic cavity

109
Q

What is the peritoneal cavity?

A

space between the visceral and parietal peritoneum

110
Q

What 2 muscle layers comprise the small intestine?

A

outer: longitudinal
inner: circular

111
Q

What is the function of villi in the small intestine?

A

absorption

112
Q

What is the function of microvilli in the small intestine?

A

greatly increases absorption surface area

113
Q

What is the connective tissue layer of the mucosa?

A

lamina propria

114
Q

What is contained in each villus where fat molecules are absorbed and transported?

115
Q

Carbs must be what in the intestine?

A

must be hydrolyzed to their simplest form

116
Q

pancreatic enzymes accomplish what in the small intestine?

A

major protein hydrolysis

117
Q

Fats undergo what in the small intestine?

A

emulsification

118
Q

Water and electrolytes are transported in what 2 directions in the small intestine?

A
  1. toward the capillary blood

2. toward the intestinal lumen

119
Q

What does movement of the small intestine facilitate?

A
  1. digestion

2. absorption

120
Q

What 2 movements promote motility?

A
  1. segmentation

2. peristalsis

121
Q

define segmentation

A

rhythmic contractions of the circular smooth muscles

122
Q

What does segmentation divide and mix?

A

divide and mixes chyme; puts it in contact with absorbent mucosal surface

123
Q

define peristalsis

A

short segments of longitudinal smooth muscle wave contraction

124
Q

what does peristalsis propel?

A

chyme through the intestine

125
Q

What is the function of the ileogastric reflex?

A

inhibits gastric motility when the ileum is distended

126
Q

What is the function of the intestinointestinal reflex?

A

inhibits intestinal motility when one part of the intestine is over distended

127
Q

What is the function of the gastroileal reflex?

A

Stimulates an increase in ileal motility and relaxation of the ileocecal sphincter to empty the ileum and prepares it to receive more chyme

128
Q

What is the function of the large intestine?

A
  1. messages fecal mass

2. absorbs water and electrolytes

129
Q

What is the cecum of large intestine?

A

pouch that receives chyme from the ileum

130
Q

What is the appendix attached to?

131
Q

What is the order of the colon?

A
  1. ascending
  2. transvers
  3. descending
  4. sigmoid
132
Q

What comes first the anus or rectum?

A

rectum then anus

133
Q

Is the stomach environment sterile or non-sterile? why?

A

sterile because of secreted stomach acid

134
Q

What 3 things keep bacterial numbers in the duodenum to a min?

A
  1. bile acid secretion
  2. motility
  3. antibody production
135
Q

What is there a low concentration of in the jejunum?

136
Q

What are 95% of the fecal flora in the colon?

137
Q

What is the largest solid organ in the body?

138
Q

how are the lobes of the liver attached to the anterior abdominal wall?

A

by the falciform ligament

139
Q

What 2 lobes compose the right lobe of the liver?

A
  1. caudate

2. quadrate

140
Q

define glisson capsule of the liver:

A

fibroelastic capsule covering the liver

141
Q

What are the 2 functions of the liver?

A
  1. bile secretion

2. enterohepatic circulation

142
Q

What happens in enterohepatic circulation

A

recycling of bile salts

143
Q

What is the byproduct of the destruction of aged RBCs?

144
Q

What does bilirubin give bile in terms of color?

A

a greenish black color

145
Q

Unconjugated (free) bilirubin is what kind of soluble?

A

lipid soluble

146
Q

Conjugated bilirubin is what kind of soluble?

A

water soluble

147
Q

What is responsible for giving urine its yellow color, and feces its brown color?

A

urobilinogen

148
Q

What are another 7 functions of the liver?

A
  1. vascular and hematologic functions
  2. metabolizes fats
  3. synthesizes phospholipids and cholesterol
  4. metabolizes proteins
  5. metabolizes carbs
  6. metabolic detoxification
  7. storage of minerals and vitamins
149
Q

What is a sac-like organ that lies on the inferior surface of the liver?

A

gallbladder

150
Q

what is the function of the gallbladder:

A

to store and concentrate bile between meals

151
Q

What is responsible for the hormonal regulation of gallbladder contraction?

A

cholecystokinin

152
Q

What is does the exocrine pancreas secrete? what do these do?

A
  1. secretes enzymes and alkaline fluids

2. assist in digestion

153
Q

What is the function of trypsinogen, chymotrypsinogen, and procarboxypeptidase of the pancreas?

A

inactivates proteases

154
Q

What is the function of trypsin inhibitor of the pancreas?

A

prevents the pancreas from eating itself

155
Q

what is the function of pancreatic a-amylase of pancreas?

A

digests carbs

156
Q

what is the function of pancreatic lipase of pancreas?

A

digests fat

157
Q

what is the function of pancreatic protease of pancreas?

A

digests protein

158
Q

What are 6 things that happen with aging and the digestive system?

A
  1. Tooth enamel and dentin wear down
  2. Teeth are lost
  3. Number of taste buds decline
  4. Sense of smell and taste diminishes
  5. Salivary secretion decreases
  6. Esophageal motility decreases
159
Q

What is there reduced secretions of with aging?

A

hydrochloric acid (slows gastric digestion and emptying)

160
Q

What decreases with the intestine with aging?

A

intestinal motility and absorption of carbs, proteins, fats, and minerals

161
Q

What decreases in efficiency with aging and the digestive system?

A

drug and alcohol metabolism

162
Q

What is decreased efficiency of drug and alcohol metabolism related to?

A

decreased liver perfusion and decreased liver enzymes

NURS 350 (6 decks)

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