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1 - FINALS > Metabolism > Flashcards

Metabolism Flashcards

1
Q

Where does the parotid gland open out?

A

Opposite the second upper molar

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2
Q

Where does the submandibular gland open out?

A

Either side of the frenulum

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3
Q

Where does the sublingual gland open out?

A

Plica sublingualis - fold between tongue and body of the mandible

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4
Q

Nerve supply to the parotid gland

A

Via auriculo-temporal nerve
Sensory fibres from V3
Parasympathetic fibres from the lesser petrosal nerve from CN IX

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5
Q

Nerve supply to the submandibular and sublingual glands

A

Chorda tympani

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6
Q

Derivatives of body and root of the tongue

A 
Body = ectoderm
Root = endoderm
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7
Q

4 extrinsic muscles of the tongue and their innervation

A

Styloglossus - CN XII - to styloid process
Genioglossus - CN XII - to mandible
Palatoglossus - CN X - to palate
Hypoglossus - CN XII - to hyoid bone

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8
Q

Nerve supply to the anterior 2/3 of the tongue

A

General sensory = V3

Special sensory = CN VII

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9
Q

Nerve supply to posterior 1/3 of the tongue

A

General and special sensory = Cn IX

Patch at the root = internal laryngeal CN X

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10
Q

Pharyngeal constrictor muscles

A

Superior - from medial pterygoid plate
Middle - from angle between hyoid horns
Inferior - from lateral thyroid cartilage

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11
Q

Muscles of mastication and actions

A

Temporalis - closes mouth
Masseter - closes mouth
Medial pterygoid - closes mouth
Lateral pterygoid - opens mouth

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12
Q

Innervation of muscles of mastication

A

V3

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13
Q

Extent of oesophagus

A

C6–>T10

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14
Q

What muscle is found around the UOS

A

Cricopharyngeal

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15
Q

Sites of oesophageal constrictions

A

In the pharynx
Behind aortic arch
Diaphragmatic

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16
Q

3 layers of stomach muscle

A

Inner oblique
Middle circular
Outer longitudinal

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17
Q

4 parts of duodenum

A

Superior
Descending
Horizontal
Ascending

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18
Q

Jejunum vs ileum

A 
Jejunum darker
Jejunum more vascular 
Jejunum more folds 
Jejunum thicker walls
Jejunum less fat
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19
Q

Quantity of jejunum vs iluem

A 
Jejunum = 2/5 of gut 
Ileum = 3/5
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20
Q

Where is the bare area of the liver?

A

Superior and posterior surfaces

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21
Q

Arterial arcades in jejunum vs iluem

A

Longer but fewer in jejunum

More but shorter in ileum

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22
Q

Portal venous system

A

Splenic and inferior mesenteric veins join
Then join superior mesenteric vein
Forms hepatic portal vein

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23
Q

Coeliac trunk branches

A

Left gastric
Splenic
Common hepatic

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24
Q

Splenic artery branches

A

Left gastroepiploic

Short gastrics

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25
Q

Common hepatic artery branches

A

Hepatic artery proper –> left and right hepatic, cystic, right gastric
Gastroduodenal –> right gastroepiploic, superior pancreaticoduodenal

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26
Q

Superior mesenteric artery branches

A

Jejunal and ileal
Iliocolic
Right colic
Middle colic

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27
Q

Inferior mesenteric artery branches

A

Left colic
Sigmoidal
Superior rectal

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28
Q

Falciform ligament

A

Anterior abdominal wall –> liver

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29
Q

Lesser omentum

A

Liver –> lesser curvature of the stomach

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30
Q

Greater omentum

A

Greater curvature of the stomach –> transverse colon

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31
Q

Transverse mesocolon

A

Transverse colon –> posterior body wall

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32
Q

Mesentery

A

Small intestine –> posterior body wall

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33
Q

Immune systems in the gut

A

MALT

Secretory IgA

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34
Q

Gut layers

A

Mucosa
Submucosa
Muscularis propria
Adventitia

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35
Q

Oesophageal epithelium

A

Stratified squamous

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36
Q

What is secreted by the cardia of the stomach?

A

Mainly mucous from mucous neck cells

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37
Q

What is secreted by the fundus of the stomach?

A

Mucous from mucous neck cells
HCL and intrinsic factor from parietal cells
Pepsin from chief cells
Gut hormones from endocrine cells

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38
Q

What is secreted by the pylorus of the stomach?

A

Mainly mucous from mucous neck cells

Gut hormones from endocrine cells

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39
Q

Cells of intestinal crypts

A

Enterocyte - secretion of watery intestinal juice
Endocrine cell - regulation of gut function
Stem cell - regeneration of epithelium
Paneth cell - antimicrobial agent release such as lysozyme

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40
Q

Where are Peyer’s patches found?

A

Lamina propria of the ileum

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41
Q

What are taenia coli?

A

Bands of longitudinal muscle in the colon

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42
Q

Where are Brunner’s glands found?

A

Submucosa of the duodenum

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43
Q

Brunner’s gland function

A

Alkaline mucous secretion for neutralisation of acidic chyme

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44
Q

Which enzyme has a calmodulin subunit that is activated during enzyme and what is its function?

A

Phosphorylase kinase A
Phosphorylated glycogen phosphatase
Activates glycogen breakdown

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45
Q

What does calcium activate during exercise?

A

PDC phosphatase to activate PDC to promote entry in TCA cycle
Dehydrogenase enzymes of the TCA cycle

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46
Q

What does AMP do in exercise?

A 
Increases GLUT4 channels  
Enzymes at the start of glycolysis 
Glycogen phosphorylase
AMPK which turns on PFK2
Inactivates ACC to prevent malonyl CoA formation which would inhibit fatty acid breakdown for energy
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47
Q

What is hormone sensitive lipase controlled by?

A

Promoted by glucagon and adrenaline

Inhibited by insulin

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48
Q

Process of fatty acid breakdown

A

Activation by ATP to form fatty acyl CoA
Transport into mitochondria via carnitine shuttle
Beta oxidation to produce acetyl CoA, NADH and FADH2

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49
Q

How is CPT1 (carnitine shuttle) controlled?

A

Promoted by cAMP and glucagon

Inhibited by malonyl CoA

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50
Q

Lipogenesis steps

A

Formation of malonyl CoA by acetyl CoA carboxylase

Fatty acid synthetase adding 2 carbons at a time

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51
Q

Ketone body formation

A

acetyl CoA –> acetoacetyl CoA –> HMG CoA –> acetoacetate

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52
Q

Effect on insulin on ketone body production

A

Insulin inhibits ketone body production by inhibiting HSL and CPTI
Ketoacidosis common in diabetics

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53
Q

What enzyme is used to overcome glucokinase?

A

Glucose-6-phosphatase

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54
Q

What enzyme is used to overcome PFK?

A

Fructuse-1,6-phosphatase

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55
Q

What enzyme is used to overcome pyruvate kinase?

A

Pyruvate carboxylase
Malate dehydrogenase
PEP carboxykinase

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56
Q

Where does glycerol enter respiration?

A

Dihydroxyacetone phosphate in glycolysis

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57
Q

Where does glutamine/glutamate enter the TCA cycle?

A

As a-ketoglutarate

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58
Q

Hows does alanine enter respiration?

A

Converted to pyruvate

59
Q

Primer for glycogen synthesis

A

Glycogenin - modified tyrosine

60
Q

Von Giurke’s disease

A

Type I glucogen storage disease
Deficiency of glucose-6-phophatase
Glucose from glycogolysis or gluconeogenesis cannot be exported from the liver
Hypoglycaemia and lactic acidaemia

61
Q

McArdle’s disease

A

Type 5 glycogen storage disease
Deficiency of muscle phosphorylase
Exercise induced fatigue and cramps

62
Q

Her’s disease

A

Type 6 glycogen storage disease
Deficiency of liver phosphorylase
Hypoglycaemia

63
Q

GLUT transporters

A

GLUT1 - constitutive
GLUT2 - liver and pancreas
GLUT4 - muscle and adipose tissue - controlled by insulin

64
Q

Hexokinase

A

Sensitive to feedback inhibition

Wide specificity

65
Q

Glucokinase

A

Only in liver and pancreas
Specific to glucose
Not sensitive to feedback inhibition

66
Q

PFK1 control

A

Promoted by F2,6P2
Indreictly promoted by high ADP and AMP levels
Inhibited by citrate, high ATP

67
Q

Where does fructose enter glycolysis?

A

As fructose-6-phosphate

Converted by hexokinase or fructokinase

68
Q

What do chylomicrons carry?

A

Dietary TAGs

69
Q

What do VLDLs carry?

A

Liver derived TAGs

70
Q

What do IDLs carry?

A

TAGs and cholesterol

71
Q

What do LDLs carry?

A

Cholesterol

72
Q

What do HDLs carry?

A

Reverse cholesterol transport

73
Q

Where is apoB48 found?

A

Chylomicrons

74
Q

Where is apoB100 found?

A

VLDLs, IDL, LDLs

75
Q

What does apoE do?

A

Controls receptor binding of remnant particles

76
Q

What does apoC do?

A

Acts as an enzyme inhibitor of lipoprotein lipase

77
Q

What apoproteins do chylomicrons contain?

A

B48, A, C, E

78
Q

What apoproteins do VLDLs contain?

A

B100, A, C, E

79
Q

What apoproteins do IDLs contain?

80
Q

What apoproteins do LDLs contain?

81
Q

What apoproteins do HDLs contain?

A

AI, AII, C, E

82
Q

Galactose intolerance

A

Deficiency of galactose-1-phosphate uridyl transferase
Galactose cannot be converted to glucose in the liver
Accumulation of galactose

83
Q

Fructose intolerance

A

Fructose aldolase deficiency

84
Q

PKU

A

Deficiency of phenylalanine hydroxylase

No conversion to tyrosine

85
Q

Maple syrup urine disease

A

Unable to break down branched amino acids
Build up of keto acids
Sweet urine

86
Q

MCADD

A

Can’t break down medium or long chain fatty acids

87
Q

Familial hypercholesterolaemia

A

Reduced number of functional LDL receptors

More LDL in circulation so more cholesterol deposition

88
Q

What is tyrosine used to make?

A

Melanin, dopamine, adrenaline, noradrenaline, thyroxine

89
Q

What is tryptophan used to make?

A

Serotonin, melatonin

90
Q

What is arginine used to make?

A

Nitric oxide

91
Q

What is histadine used to make?

92
Q

What can alanine be converted to by transamination?

93
Q

What can glutamate be converted to by transamination?

A

a-ketoglutarate

94
Q

What can aspartate be converted to by transamination?

A

Oxaloacetate

95
Q

Urea cycle

A 
CO2 + NH4 + ornithine
Cabamoyl phosphate 
Citrulline
Arginosuccinate
Arginine 
Urea + ornithine
96
Q

Control of PDC

A

Controlled by feedback inhibition from acetyl CoA and NADH

97
Q

ETC complex I

A

NADH –> UQ

98
Q

ETC complex II

A

FADH2 –> UQ

Unable to pump proton into IM space

99
Q

ETC complex II

A

UQ –> cytochrome C

100
Q

ETC complex IV

A

Cytochrome C –> oxygen

101
Q

What do carbon monoxide and cyanide inhibit?

A

Complex IV - cytochrome C oxidase

102
Q

Natural antibiotics that can uncouple?

A

Gramicidin
Nigericin
Valinomycin

103
Q

What does dinitrophenol do?

A

Can carry H+ ions across membrane

Avoids ATP synthase

104
Q

What happens to HIF-1 in hypoxia

A

Beta subunit stabilised
Can bind to regulatory sections of genes
Promotes gene transcription of genes involved in glycogen breakdown and glycolysis
Induces transcription of EPO and VEGF
Promotes mitochondrial autophagy and suppresses fission

105
Q

Difference in saliva secretions from glands

A 
Parotid = serous and rich in amylase
SubML = serous and mucous rich in proline rich proteins
106
Q

Control of salivary secretions

A

M3 receptors

Vasoactive intestinal protein

107
Q

Function of intrinsic factor

A

Critical for vitamin B12 absorption

108
Q

Where is gastrin secreted from?

A

G cells in the antrum

109
Q

Where is somatostatin secreted from?

A

D cells in the antrum

110
Q

What is the action of gastrin

A

Stimulates parietal cells to secrete acid via CCKB receptors

Stimulates ECL cells to release histamine which stimulates parietal cells via H2 receptors

111
Q

When is somatostatin released and what does it do?

A

Released in presence of acid

Inhibits G cells, ECL cells and parietal cells

112
Q

Where is secretin produced

A

S cells of the duodenum

113
Q

What stimulates pepsin release?

A

Gastrin from G cells
Secretin from duodenal S cells
ACh via M3 receptor
Acid is gastric mucosa

114
Q

What cleaves pepsinogen to pepsin?

A

Acid and pepsin

115
Q

What promotes pancreatic secretions?

A

VIP and secretin promote secretion of aqueous component

CCK promotes secretion of enzymatic content

116
Q

Where is CCK released from and when?

A

From duodenal I cells

In response to fat and peptide presence

117
Q

Pancreatic zymogens

A

Trypsinogen
Chymotrypsinogen
Procarboxypeptidase
Proelastase

118
Q

What converts trypsinogen?

A

Enteropeptidase

119
Q

Active pancreatic enzymes

A

Glycerol ester hydrolase
Cholesterol ester hydrolase
Phospholipase A2

120
Q

Bile salts

A

Synthesised from cholic acid originally from cholesterol

121
Q

What stimulates bile release?

A

CCK, ACh, gastrin

122
Q

Effect of secretin on bile?

A

Stimulates bicarbonate and water release into bile

123
Q

Lipid absorption

A

Form micelles than can diffuse through membrane
Remade into TAGs by smooth ER
Packaged into chylomicrons
Secreted into IC space
Taken up by lacteals and join lymphatic circulation

124
Q

Components of saliva

A 
Amylase 
Lysozyme
Bicarbonate 
Growth factors
Transcoblamin II
125
Q

Gastric secretions

A 
Mucous
Acid 
Proteases
Lipase 
Intrinsic factor
126
Q

Gastric acid secretion

A

Carbon dioxide in
Converted to bicarbonate and protons by CA
Bicarbonate pumped out into plasma and exchnaged for Cl-
H+ pumped out by H+/K+ ATPase
Cl- and K+ pumped out into lumen

127
Q

How H2 receptor activation leads to gastric acid secretion

A

Activates adenylyl cyclase
ATP –> cAMP
Activates protein kinase
Activates H+/K+ ATPase

128
Q

Interstitial cells of Cajal

A

Create rhythm of electrical slow waves

Cause phasic contractions

129
Q

Migrating motor complexes

A

3 phases every 90-120 minutes
Create sensation of hunger
Clear undigested material
Prevent bacterial overgrowth

130
Q

Cephalic phase

A

Triggered by sight, smell, taste of food

Prepares GI tract by stimulating gastric, salivary, pancreatic and gastrin secretions

131
Q

Gastric phase

A

Triggered by stomach distension

Stimulates gastric acid secretion

132
Q

Intestinal phase

A

Triggered by chemoreceptor activation in the small bowel

Inhibits further gastric secretions

133
Q

Waves of peristalsis in the oesophagus

A 
Primary = occurs on swallowing 
Secondary = pushes bolus into stomach
134
Q

Graph of liquid gastric emptying

A

Exponential

135
Q

Graph of solids gastric emptying

A

Lag period

Then linear

136
Q

Duodenal and jejunal brake

A

HCl, LCFAs, AAs, glucose, peptides in these regions
Reduces pyloric sphincter opening
Reduces antral contraction
Enhanced relaxation and storage of fundus

137
Q

Ileal brake

A

Peptide YY, GLP-1, oxntomodulin
Fats in ileum
Slows gastric emptying and induces satiety

138
Q

Vomiting centre

A

Nucleus of the solitary tract

Dorsal motor nucleus of vagus

139
Q

What communicates with the vomiting centre?

A

Area postrema

140
Q

Motion type anti-emetics

A

Muscarinic antagonists - hyoscine

141
Q

Old type anti-emetics

A

D2 receptor antagonists - act on area postrema to block vomiting induced by blood borne agents
H1 receptor antagonists
Cannabinoid derivatives

142
Q

New type anti-emetics

A

5-HT3 receptor antagonists

NK1 receptor antagonists

143
Q

Corticosteroids as anti-emetics

A

Anti-inflammatory
Enhances anti-emetic effects of other drugs
Anti-nausea effects

1 - FINALS (6 decks)

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