Immunity, Digestive, And Urinary Flashcards
1
Q
Describe the process of clonal selection
A
B cells all have different antigen docking sites, and only the one that binds with the invading antigen will proliferate and divide (clonal selection)
2
Q
What is the outcome of clonal selection?
A
A lot of plasma cells and a few B cells that become memory cells for when that antigen is encountered again
3
Q
In B cells, which cells are the actual effectors?
A
Plasma cells
4
Q
How long does a primary response in B cells take to start and peak?
A
It takes three to four days to begin to respond, and antibody production doesn’t peak until 10 days or so later
5
Q
How long does secondary response in B cells take to begin and peak?
A
It begins pretty much immediately and peaks after three days
6
Q
In second exposure responses from B cells, how long are antibodies produced?
A
For weeks or even months
7
Q
What is the difference between active and passive humoral immunity?
A
In active immunity, a person’s body generates the antibodies to fight the antigen.
In passive immunity, the antibodies are given to a person, not produced by them.
8
Q
Natural active immunity
A
When a person gets sick and their body mounts an immune response
9
Q
Artificial active immunity
A
Gaining immunity through vaccinations
10
Q
Passive natural immunity
A
Antibodies being shared through placenta or breast milk
11
Q
Passive artificial immunity
A
Antibodies are given in a serum (like with anti venom)
12
Q
What are the four types of T cells?
A
Cytotoxic T cells
Helper T cells
Regulatory T cells
Memory T cells
13
Q
Which T cells are direct attack cells?
A
Cytotoxic T cells
14
Q
What are the targets of cytotoxic T cells?
A
Cancer cells, viruses, and other foreign cells
15
Q
How do cytotoxic T cells kill their targets?
A
They perforate the cell using perforins, and then insert granzymes into them that kill the cells
16
Q
What do helper T cells do?
A
Direct the immune response
Activate and amplify immune response
Cause B and T cells to proliferate
Activate macrophages
17
Q
What are cytokines?
A
Chemicals that help to stimulate or enhance cellular immunity
18
Q
What are some examples of cytokines?
A
Interferons
Colony stimulating factor
Interleukins
19
Q
Deglutition
A
Swallowing
20
Q
What are the three phases of swallowing?
A
Voluntary phase
Pharyngeal phase
Esophageal phase
21
Q
Where does the voluntary swallowing phase take place and what aids it?
A
It takes place in the mouth and the tongue presses up to push the food back into the pharynx
22
Q
In the pharyngeal phase, what structures block the other openings to make the food go down the esophagus?
A
The tongue blocks the mouth
The uvula blocks the nasopharynx
The epiglottis blocks the trachea when the larynx pushes up and folds it over
23
Q
What happens in the esophageal phase?
A
Peristalsis pushes food down, and the gastroesophageal sphincter opens for food to enter stomach
24
Q
What four types of cells are found in gastric pits?
A
Mucous neck cells
Parietal cells
Chief cells
Enteroendocrine cells
25
Mucous neck cells
Secrete mucous to protect stomach lining
26
What two things are secreted by parietal cells?
Intrinsic factor
| Hydrochloric acid
27
What does intrinsic factor do?
Aid in B12 absorption
28
What does hydrochloric acid do in the stomach?
Kills bacteria
Denatures proteins
Activates pepsinogen into pepsin
29
What do chief cells secrete? What is unique about this?
Pepsinogen, which doesn’t turn into pepsin until it gets up to the HCl
30
What is the pH of HCl?
3.0
31
Enteroendocrine cells
Secrete hormones into the blood that target the small and large intestine
32
What are the three phases in the regulation of gastric secretion?
Cephalic
Gastric
Intestinal
33
What stimulates gastric secretions in the cephalic phase?
Smelling food
| Thinking about food
34
What can inhibit the cephalic phase of gastric secretion?
Depression
35
What stimulates gastric secretions during the gastric phase?
The stomach being stretched by food and food and chemicals being sensed by the stomach
36
What can emotional upset/sympathetic nervous system input do to the gastric phase?
Inhibit gastric secretions
37
Under what conditions in the intestinal phase will gastric secretions be stimulated?
Gastric secretions will be stimulated/continued when the first bits of food enter the intestines, because most of the food is still in the stomach
38
In the intestinal phase, what will cause the inhibition of gastric secretions?
Intestinal stretching and acidity in the intestines
39
Where in the stomach does grinding take place and what does it entail?
Pyloric region, and the grinding motion pushes the food towards the small intestine
40
Retropulsion
Part of gastric motility in which a small amount of chyme squirts into the small intestine when the sphincter opens, but most most of it squirts back in the stomach to continue mixing
41
What is propulsion as pertains to the stomach?
The basic electrical rhythm of the stomach, which stimulates it to contract about 3 times per minute
42
What primarily controls the emptying of the stomach?
Signals from the small intestine
43
What kind of things will signal the stomach to empty faster?
The presence of carbohydrates in the small intestine
44
What sort of things will signal the stomach to empty slower?
Protein, fat, or acid presence in the small intestine, as well as stretch being sensed in the small intestine
45
In order, what are the three sections of the small intestine?
Duodenum
Jejunum
Ileum
46
What are three modifications that increase the surface area of the small intestine?
Circular folds
Villi
Microvilli
47
What is another name for circular folds?
Plicae circularis
48
How big are circular folds?
Up to 1 cm
49
What are villi?
Finger like projections that are about 1 mm in length
50
What are microvilli?
Finger like projections on each individual cell
51
What cell types are found in the small intestine micro anatomy?
Secretory cells
Enteroendocrine cells
Stem cells
Immune cells
52
What types of immune cells are present in the small intestine?
Intraepithelial lymphocytes and granular (paneth) cells
53
What do bound enzymes in the microvilli do?
Help to break down proteins and carbohydrates
54
What is the digestive function of the liver?
Creation of bile, to help break down lipids
55
How does bile help in fat breakdown?
Bile salts have a polar end and a non polar end, so they get between fat globs and break them into smaller bits so that enzymes can handle them better
56
How many times can bile salts be reused in one meal?
Up to five
57
How are bile salts recycled?
Through the enterohepatic circulatory route that takes blood from the intestines to the liver
58
What does the gallbladder do?
Store and concentrate bile
59
What are the endocrine secretions of the pancreas?
Insulin and glucagon
60
What are the exocrine secretions of the pancreas and where do they secrete into?
It secrete enzymes to break down all macromolecules, and the pancreas secretes them into the duodenum
61
Give examples of the enzymes of the pancreas for each type of macromolecule
Carbs: pancreatic amylase
Protein: proteases
Lipids: lipase
Nucleic acid: nucleases
62
How does the pancreas help regulate intestinal pH?
Pancreatic juice also includes lots of bicarbonate ions to neutralize stomach acid
63
What are the main functions of the large intestine?
Elimination of waste and absorption of water
64
What do bacterial flora in the large intestine do?
Digest carbs we cannot digest and synthesize vitamins B and K
65
Haustral contractions
Contraction of the individual segments of the large intestine
66
Gastrocolic reflex
The full stomach signaling the large intestine to empty (usually 20-30 minutes after a meal) to make room for more food
67
How often do mass movements occur?
3-4 times a day
68
What are the three general roles of the kidneys?
Removal, regulation, and endocrine function
69
What do the kidneys remove?
Metabolic wastes, toxins, excess water, excess ions
70
What is regulated by the kidneys?
Blood volume, blood pressure, pH, chemical composition of blood
71
What hormones are made by the kidneys?
Erythropoietin, renin, and PTH
72
When is PTH released and what does it do?
It is released when blood calcium is low, and it draws calcium from the bones that is then reabsorbed at the kidneys. The kidneys also activate vitamin D to cause the digestive system to absorb more calcium
73
Trace a drop of creatinine through the kidney
```
Glomerulus
Filtration membrane
Glomerular space
Proximal convoluted tubule
Loop of henle (descending then ascending)
Distal convoluted tubule
Collecting duct
Calyx
Renal pelvis
Ureter
Urinary bladder
Urethra
```
74
List three possible urine color abnormalities and possible causes
Cloudy: possible UTI
Dark: dehydration
Pink/red: red foods or blood in the urine
75
What could fruity smelling urine indicate?
Diabetes
76
What is the normal pH of urine?
Around 6.0
77
What could make urine alkaline?
vegetarian diet, UTI, or prolonged bleeding
78
What is the normal specific gravity range for urine?
1.001 to 1.035
79
What is the normal urine range for leukocytes and what could it indicate if out of range?
Zero
| If present, UTI
80
Normal amount of nitrites in urine
Zero
81
What does it mean if there are nitrites in the urine?
Probably a UTI, because some bacteria can turn nitrates into nitrites
82
Under what circumstances would there be protein in the urine?
Pregnancy, extreme exertion, heart failure, hypertension, renal disease, glomerulonephritis
83
Will glucose normally be present in urine? Why or why not?
No, it should all be reabsorbed
84
What does it mean if glucose is present in the urine?
Likely diabetes
85
Under what circumstances would ketones be present in the urine?
Diabetes or starvation
86
Where are urobilinogen and bilirubin normally found (leaving the body)?
In the stool
87
What does it mean if bilirubin or urobilinogen is present in urine?
Possible liver disease or blockage of bile flow from the liver
88
What could it indicate if blood is present in the urine?
Trauma, infection, kidney stones, or cancer
89
What would be potential causes for hemoglobin presence in the urine?
Transfusion reaction, hemolytic anemia, or severe burns
90
What are kidney stones?
Hard crystallized calcium salts that are between 2 and 3 mm in size
91
Where do kidney stones usually form and why are they painful?
They usually form in the renal pelvis and they cause pain when passing through the ureter and the smooth muscle contracts
92
Of men and women, who has an internal and external urethral sphincter?
Men only
93
How does the micturation reflex work?
The micturation reflex gets the detrusor muscle in the bladder to contract, signaling that urination is needed. However, the external sphincter muscles will stay contracted until there is a convenient time.
94
Why cant infants control when they urinate?
The nerves involved are not fully myelinated, so the micturation reflex cannot be inhibited
95
proximal convoluted tubule tissue
simple cuboidal epithelium
96
loop of henle descending limb tissue
simple squamous epithelium
97
loop of henle ascending limb tissue
simple cuboidal epithelium
98
what is reabsorbed at the proximal convoluted tubule?
amino acids and glucose
99
what is reabsorbed in the descending limb of LOH?
water but not sodium
100
what is reabsorbed in the ascending limb of the LOH?
sodium, but not water
101
collecting duct tissue type?
simple cuboidal epithelium
102
what is reabsorbed at the collecting duct?
some sodium but mostly water
103
what can be secreted at the collecting duct?
some water and other electrolytes for fine tuning urine concentration
104
what are toxins and drugs secreted?
proximal convoluted tubule
105
what is the tissue type(s) of the calyces?
simple cuboidal becoming transitional as it goes down
106
renal pelvis tissue type
transitional epithelium
107
ureter tissue type
transitional epithelium, lamina propria, smooth muscle
108
urinary bladder tissue type
transitional epithelium, lamina propria, and smooth muscle
109
urethra tissue type
smooth/skeletal muscle and stratified squamous epithelium
110
what are the three main steps of urine formation?
glomerular filtration
tubular reabsorption
tubular secretion
111
what drives glomerular filtration and by what mechanism?
driven by hydrostatic pressure and it's a passive mechanical process
112
what substances are filtered at the glomerulus?
glucose, ions, small toxins, urea/nitrogenous waste, amino acids, water
113
what substances are not filtered at the glomerulus?
all formed elements and proteins, large toxins
114
what is reabsorbed at the distal convoluted tubule?
calcium and sodium, other electrolytes
115
what is tubular reabsorption?
selective transepithelial process that can be active or passive (stuff from nephron back into blood)
116
what is tubular secretion?
things moving from the bloodstream into the urinary tubules (opposite direction of tubular reabsorption)
117
what types of pressures move substances into the glomerular space?
hydrostatic pressure of the glomerulus and osmotic pressure of the capsule
118
what pressures give opposition to the movement of substances into the capsule?
hydrostatic pressure of the capsule and osmotic pressure of the glomerulus
119
which pressure in the glomerulus is usually the driving/dominant?
hydrostatic pressure of the glomerulus
120
which pressure in the glomerular capsule is zero (or should be)?
osmotic pressure of the capsule
121
how do you find net filtration pressure at the glomerulus?
(HPg + OPcaps) - (HPcaps + OPg)=net filtration pressure
122
what is normal GFR?
about 125 mL/min
123
what two general categories control GFR?
intrinsic and extrinsic methods
124
what are the two intrinsic methods of GFR control?
myogenic mechanism and tubuloglomerular mechanism
125
how does the myogenic mechanism work to control GFR?
if LOCAL BP is high, afferent arteriole will constrict to slow blood flow to glomerulus. If local BP is low, afferent arteriole will dilate to increase blood flow to glomerulus
126
what triggers the myogenic mechanism?
baroreceptors in the granular cells of the distal convoluted tubule, which touches the afferent arteriole
127
how does the tubuloglomerular mechanism work?
the end of the tubule (DCT) talks to the beginning (afferent arteriole). The DCT senses sodium level and tells afferent tubule to constrict or dilate accordingly
128
what is it called where the distal convoluted tubule meets the afferent arteriole?
juxtaposition apparatus
129
what specifically senses the sodium levels in the distal convoluted tubule?
chemoreceptors called the macula densa cells
130
how does GFR affect blood sodium and how will the body adjust accordingly?
If GFR is too high, blood will be too salty and afferent arteriole will constrict
If GFR is too low, blood will not be salty enough and afferent arteriole will vasodilate
131
what are the extrinsic methods for controlling GFR?
neural and hormonal
132
how does the nervous system influence GFR?
in stressful situations where the sympathetic nervous system is stimulated, GRF will decrease because blood will be routed to other areas where its needed more. the nervous system overrides any local controls
133
if blood pressure drops, what endocrine controls do the kidneys have?
the granular cells release renin, which triggers the formation of angiotensin II
134
what functions does angiotensin II have in the endocrine/vascular system? (4 things)
```
causes vasoconstriction
ADH formation
aldosterone formation
glomerular cells contract
**all of these lead to increase in BP**
```
135
what does ADH do?
decreases urination
136
what does aldosterone do?
increases sodium reabsorption at the kidneys, leading to water retention and increasing BP
137
what is the purpose of tubular reabsorption?
Tubular reabsorption helps the body to keep as much water and as many nutrients as possible, instead of most of them leaving the body as waste products
138
what does it mean to say that tubular reabsorption is a selective transepithelial process?
it means that some substances make it across the epithelial membrane of the tubule while others do not
139
by what two routes can substances be reabsorbed?
transcellular and paracellular routes
140
transcellular route
substances go through the epithelial cells of the DCT and into the bloodstream
141
paracellular route
substances go between the epithelial cells of the DCT and into the bloodstream
142
Describe the primary active transport of sodium across the DCT membrane
Sodium passes from the inside of the PCT cell through the basolateral membrane and into the capillary using primary active transport (ATP is used to move the sodium)
143
how does the secondary active transport of sodium work?
the sodium leaving the epithelial cell creates a gradient with the intracellular space, and the sodium goes through the luminal membrane using a channel that has been opened without ATP being used
144
what is the benefit to the secondary active transport mechanism?
sodium takes glucose and amino acids through the channel with it, so those molecules are transported without energy being expended
145
what is the transport maximum?
there are only so many of those channels that sodium/glucose/ATP can go through, so if someone's blood has too much glucose (diabetes) not all of it will be reabsorbed
146
why are lipids hard for the body to get rid of?
they can slide between the phospholipid bilayer of the cell membrane and back into the bloodstream, meaning they cycle around and are rarely expelled from the body
147
how do ions like chloride and potassium usually move from the tubules to the blood?
either by the paracellular route or through a channel in exchange for sodium
148
how does water get through the membrane of the tubules?
osmosis or aquaporins (water channels)
149
why are lipid soluble environmental toxins dangerous to the body?
because like lipids, they slide through the phospholipid bilayer and back into the bloodstream, so they build up in the body instead of being filtered out
150
what is the purpose of tubular secretions?
get rid of unwanted things in the body
151
in a counter current multiplier, what is the direction of the flow in the tubes?
they flow in opposite directions of one another
152
how does the gradient function (give number too) to establish maximum water reclamation at the collecting duct?
Entering nephron, osmolarity of filtrate is 300. At top of collecting duct, it is 100, and at the bottom it is 1200. Because the papilla gets saltier the lower you go, the more water is pulled out of the collecting duct (maximum reclamation)
153
What is the role of ADH in regulating urine concentration?
ADH inserts and removed aquaporins, so if ADH removes the aquaporins, the urine will be very dilute
154
How does aldosterone work in regulating urine concentration?
Aldosterone causes the kidneys to reabsorb more salt, which also causes more water retention, so urine will be more concentrate
155
By what mechanism do osmotic diuretics, alcohol and caffeine affect urine volume?
Alcohol inhibits ADH, so you pee a lot
Caffeine inhibits sodium reabsorption, so you pee a lot
Glucose is an osmotic diuretic, meaning the water follows the glucose so you pee more
156
What is renal clearance?
Renal clearance is the volume of blood plasma cleared of a particular substance in a given time (mL/min)
157
What does it mean if renal clearance is less than normal as pertains to a drug in the system?
some is being filtered and some is being reabsorbed
158
what does it mean if renal clearance is normal?
all is being cleared/filtered
159
what does it mean if renal clearance is zero?
nothing is being filtered, or its being filtered but completely reabsorbed
160
What is the percentage of body fluids in the different compartments?
8% of body fluid is in the plasma
30% of body fluids are interstitial fluids
62% of body fluids are intracellular fluids
161
What are the most abundant interstitial solutes? (give charges as well)
Positively charged sodium
| Negatively charged chloride
162
What are the most abundant intracellular solutes? (with charges)
Positively charged potassium
| Negatively charged protein and phosphate
163
What are some non-organic solutes in the body?
Glucose
Lipids
Urea
164
what happens to a cell in a hypotonic solution?
it swells
165
what happens to a cell in a hypertonic solution?
it shrinks
166
What do electrolytes do in the presence of water?
Disassociate into ions
167
What do non-electrolytes do in the presence of water?
Stay the same, no disassociation
