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PAM Semester 1 > Physiology Exam 4 > Flashcards

Physiology Exam 4 Flashcards

1
Q

How do sphincters work

A

They are aones of resting pressure that relax with stimulus

Smooth muscle sphincters are closed when their inhibitory innervation is inactive.

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2
Q

Where does the vast majority of digestion and absorption take places

A

The small intestine

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3
Q

What does testosterone exert negative feedback loop on

A

LH

FSH

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4
Q

Main gastric enzyme in protein digestion

A

Pepsin

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5
Q

Liver blood supply

A

splanchnic circulation
25% form hepatic artery (oxy)
75% from portal vein (deoxy)

High flow, high compliance, low resistance system

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6
Q

What forms does CA2+ exist in plasma

A

45% free ionized Ca2+
45% bound to plasma proteins (ie albumin)
10% complexed with anions

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7
Q

most abundant female hormone

A

estradiol

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8
Q

Lipoproteins starting with more chloesterol and less protein

A

Chylomicrons
VLDL
LDL
HDL

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9
Q

PTH and Phosphate feed back

A

PTH causes excretion of phosphate

Vitamin D causes reabsorbtion of phosphate

Balances out

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10
Q

describe chloride shift in pancreas

A

As rate of secretion increases in pancreas the rate of bicarb increases as well

A chloride shift occurs to keep ionic balance

Bicarb goes out as chloride goes back in

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11
Q

Vitamin E

A

Acts as an antioxidant to protect cell membranes

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12
Q

Phases of gastric stimulation

cephalic

A

Cephalic (feed forward mechanism)

Stimulus = Thought of food

Pathway = Vagus nerve → parietal cells → G cells

Stimulate gastric secretions even before food is swallowed

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13
Q

What is precursor to glycogen

A

Uridine diphosphate glucose

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14
Q

5 enzymes that help control pancreatic secretion

A 
Secretin
Gastrin (GRP)
ACh
CCK
Substance P
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15
Q

What induces the urge to defecate

A

Distention of rectum

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16
Q

Factors affecting gastric emptying

A 
Type of food
Temp of food
Body position
Stomach PH
Emotional state
Diseases
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17
Q

When does menses occur

A

day 28 around to day 4 ish

beginning and end of cycle

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18
Q

Menopause

A

Age 45-55
decline in estrogen
increase in LH and FSH

osteoporosis

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19
Q

why doesnt menstrual flow clot

A

fibrinolysin

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20
Q

Chemical digestion

A

Series of hydrolysis (break bonds) reactions that break dietary macromolecules (polymers) into their monomers (residues)

Carried out by digestive enzymes produced by salivary glands, stomach, pancreas, and small intestine

Polysaccharides → monosaccharides
Proteins → Amino Acids
Fats → Monoglycerides and fatty acids
Nucleic acids → Nucleotides

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21
Q

4 major receptor types

A

Ligand gated ion channels
g coupled protein receptors (secondary messengers)
catalytic recpetors
intrcellular receptors

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22
Q

Liver sinusoids

A

Very porous

Allow large flux of fluid and proteins into the perisinusoidal space

Sinusoidal epithelia form large quantities of lymph
Make up more than half of lymph

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23
Q

What inhibits insulin

A

Somatostatin
Nor epi
Epi

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24
Q

What is trypsinogen

A

it activates pancreatic enzymes once they are in the duodenum

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25
Q

What cells line bile ducts

A

Choliangiocytes

These secrete bicarbonate rich fluid into the billiary tree

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26
Q

What does the bulbourethral gland in males do

A

pre lubrication of urethra

neutralize the acidity of urethra

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27
Q

lingual lipase

A

Breaks down fat but does not get activated until it reaches the stomach

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28
Q

Describe process epi helps with in liver

A

Glycogenolyis

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29
Q

GnRH

A

Gonadotropin releasing hormone

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30
Q

phases of secretion after a meal in pancreas

Gastric

A

Gastric (feed forward)

Gastric distention release of gastrin and Ach cause increase secretion form pancreas

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31
Q

Describe compaction in the 5 stages of digestion

A

Absorption of water and consolidating the indigestible into feces

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32
Q

Types of nutrients that can be absorbed directly in their usable form

A 
Vitamins
Amino acids
Minerals
Cholesterols
water
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33
Q

peristalsis contraction

A

Circular muscle contracts behind bolus

relaxation of cicular muscle in front of bolus

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34
Q

Describe Vitamin B12

A

Vitamin B12 is one of the eight water-soluble B vitamins.

The intestinal absorption of B12 depends on an intrinsic factor secreted from the stomach parietal cell.

Vitamins are water or fat soluble

Vitamin B12 comes from eggs, liver animal products (cobalamins)

Highly involved in helping us from healthy hemoglobin and red blood cells

B12 deficiency can result in anemia (pernicious anemia)

Must have intrinsic factor to absorb B12

Intrinsic factor comes from parietal cells in stomach

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35
Q

What effect does progesterone have on endometrium

A

as progesterone remains high, endometrial lining remains

As progesterone levels fall, you lose endometrial lining (menstruation)

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36
Q

What does insulin do in liver

A

Glycogen synthesis
Converts glucose to triglycerides
Protein synthesis

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37
Q

Where is majority of glycogen stored

A

Liver is the mainstorage site for glucose and glycogen

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38
Q

blood testes barrier

A

seperates sperm from immune system
sertoli cells form tight junctions

germ cells are differnet so immun system will attack them

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39
Q

What do RBC’s and the renal medulla depend on for energy

A

totallt dependant on blood glucose

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40
Q

Increased blood flow after a meal is called

A

postprandial hyperemeia

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41
Q

Sertoli cells (nurse cells)

A

in semineferous tubules
FSH binds to these cells
produce estradiol

regulate release of FSH through “inhibin” to stop sperm produciton but continue testosterone production

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42
Q

what happens in follicular phase

A

rise in FSH
follicle grows
Estradiol increases
ends in ovulation

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43
Q

Corpus cavernosa

A

2 columns of erectile tissue

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44
Q

What does insulin do in adipose tissue

A

Increases glucose uptake via (glut 4)

Storage of triglycerides

Allows the fatty acids into cell to become triglycerides

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45
Q

Ortho colic reflex

A

Urge to defecate upon standing

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46
Q

Describe Glucagon in liver

A

It is catabolic

Glycogenolysis

(also gluconeogenesis)

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47
Q

Primary vs secondary peristalsis in esophageal motility

A

Primary is act of swallowing

Secondary is involuntary peristalsis (food lodged)

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48
Q

What are gastric agonists

A

ACh
(Vagus nerve stimulation results in the release of Ach)

Histamine
(hormone)

Gastrin
(Hormone)

Works through secondary messenger system (Ca+, cAMP)

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49
Q

Granulosa cells

A

receptors for follicle stimulating hormone (FSH)
causes follicle to mature

produces estradiol with testosterone from theca cells
Produces progesterone

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50
Q

What does the enteric nervous system do

A

Gi tract own nervous system which is independent of the rest of the autonomic nervous system

Responsible for much of the moment-to-moment control of gut motility and secretion.

The myenteric plexus is mainly involved with control of gut motility and innervates the inner circular and outer longitudinal smooth muscle layers.

The submucosal plexus coordinates intestinal absorption and secretion through its innervation of the glandular epithelium, intestinal endocrine cells, and submucosal blood vessels.

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51
Q

What stimulate GnRH in females

A

kisspeptin (neurotransmitter)
Leptni simulates kisspeptin

GnRH stimulate FSH/LH
Estradiol

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52
Q

phases of secretion after a meal in pancreas

Cephalic

A

Cephalic (feed forward)

Increases secretion of pancreatic juice

Occurs through the release of Ach, gastrin and by vagal stimulation

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53
Q

Long term stress Response

A

Pituitary

Retention of sodium
increase blood volume and pressure
increased BGL
Immune system suppression
fatigue
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54
Q

What are Paneth Cells, where are they and what do they do

A

They are cells in the intestinal crypt

They function like neutrophils and produce antimicrobial substances that provide a protective barrier

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55
Q

Gastric enzymes

A

Pepsin
Gastric amylase
Gastric Lipase
Intrinsic factor

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56
Q

What is transferrin

A

Transferrin is the molecule that can move iron through the blood

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57
Q

What happens to the follicle

A

most go to atresia
the chosen one goes on to mature

After rupturing, the follicle becomes a corpus luteum.

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58
Q

What is motilin

A

GI hormone

Stimulates Motility of Gi tract

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59
Q

Sperm and mitochondria

A

Sperm has no mitochondria

all mitochondria comes from the mother

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60
Q

Describe insulin effect on potassium

A

action of insulin is increased cellular uptake of potassium

Also used to treat hyperkalemia

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61
Q

How are ketones formed

A

Beta oxidation

During prolonged starvation and in diabetes it is highly elevated (ketosis)

Long term fat metabolism

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62
Q 
Cells of Gastric secretion
G cells (enteroendocrine cells)
A

Secretes Gastrin

Gastrin secretion is a trigger for secretion from the parietal cells and the chief cells

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63
Q

Preferred substrate of brai

A

Glucose

• Brain and CNS rely on using glucose

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64
Q

What do H2 blockers do

A

H2 blockers are commonly used for the treatment of peptic ulcer disease and GERD

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65
Q

What happens in luteal phase

A

progesterone increases

corpus luteum matures

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66
Q

What happens in ovulatory phase

A

day 14 ish
LH surges causes ovulation
estradiol decreases
positive feedback

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67
Q

Egg stages

A 
oogonia
pirmary oocyte
-------------(meiosis)
secondary oocyte (& polar body)
(meiosis II) if fertilized,
If not it dies
zygote
embryo
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68
Q

Describe Parasympathetic salivation

A

Parasympathetic salivation

Rich in electrolytes
Rich in amylase
Increased salivation

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69
Q

Testosterone effect on hypothlamus and anterior pituitary

A

Inhibits

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70
Q

Secretion in which of the following tissues or glands is dependent mainly on parasympathetic nerve stimulation and not hormones?

A. Exocrine pancreas
B. Parotid gland
C. Small intestine
D. Stomach

A

B. Parotid gland

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71
Q

What forms does phosphate occur in the plsama

A

80% alkaline phosphate HPO4 2-

20% acid phosphateH2PO4-

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72
Q

Mechanical digestion

A

Physical break down of food
cutting, grinding, churning
teeth, small intestiners, stomach

exposes more surface area to digestive enzymes

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73
Q

What is ghrelin

A

GI hormone

Stomach grumbles, ghrelin is secreted
Hunger hormone

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74
Q

What is C peptide

A

Is a product of pro insulin
is a 1 to 1 ratio of insulin
can be used as a marker of insulin production

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75
Q

Ways the stomach inhibits Acid in stomach

A

If pH falls below 3, endocrine cells (D cells) in the antrum, secrete somatostatin
Somatostatin inhibits the release of gastrin and thus HCL

Acidification of the duodenal lumen
Acidification stimulates the release of secretin which in turn inhibits the release of gastrin

HCL secretion is important only during digestion of food
Excess HCL can damage mucosal surfaces

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76
Q

Process of pepsin secretion

A

Food ingested

pH of gastric acid changes (pH goes up, more basic)

The increase in pH stimulates G cells to produce gastrin

Gastrin then stimulates parietal and chief cells

Chief cells secrete pepsinogen

Pepsinogen then gets cleaved into Pepsin by HCL from parietal cell

Pepsin then can go break peptide bonds of amino acids in proteins

The short chain broken down amino acids can also activate the G cells

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77
Q

Sinusoidal epithelial cells (SEC) function

A

results in large drop in blood pressure and blood flow

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78
Q

what are 3 phases of secretion after a meal in pancreas

A

Cephalic (feed forward)
Increases secretion of pancreatic juice
Occurs through the release of Ach, gastrin and by vagal stimulation

Gastric (feed forward)
Gastric distention release of gastrin and Ach cause increase secretion form pancreas

Intestinal (feedback mechanism)
Secretin inhibits further movement of chyme from stomach
CCK causes increased secretion of pancreatic juice

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79
Q

Type 1 vs type 2 diabetes

A

Type 1 insulin dependant
pancreas does not produce insulin

Type 2 is desensitization of insulin receptors
No bonding, no glut transporters,

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80
Q

What do the intestinal crypts secrete

A

Mucous, H2O and electrolytes

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81
Q

How are Fats/Lipids digested and absorbed

A

Lipase that activates once in the stomach (gastric, lingual, pancreatic lipase)

Break down into micelles

Micelles then cross brush border

The micelles break down into chylomicrons

Then goes into the lymphatic system

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82
Q

Acid prodcution rate of gastric secretion

A

Acid production in the stomach parallels rates of gastric secretion

Sodium and Hydrogen ions are inverse

The faster the rate of secretion, the more H+ ions and less sodium ions and the more HCL

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83
Q

What are hydroxyapatite crystals

A

Components of bone

contain CA2+ and phosphate

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84
Q

Pancreatic enzymes

A

Enzymes are inactive in pancreas

Trypsin
Chymotrypsin
Lipase
Carboxypeptidase
Elastases
Nucleases
Pancreatic enzymes

Also secrets sodium bicarbonate which neutralizes the acidity of the chyme

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85
Q

scrotal mechanisms to regulat temp

A

cremaster muscle
retracts scrotum

Dartos fascia
sub cutaneaou smooth muscle
shrinks scrotum

Pampiniform plexus
network of veins and arteries to remove heat

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86
Q

What are inhibitory neurotransmitters of the enteric nervous system

A

ATP

Nitric oxide

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87
Q

Leydig cells

A

interstitum (between seminepherous tubules)
produce testosterone
LH bonds to these cells

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88
Q

Epi cascade

A 
Tyrosine
DOPA
Dopamine
Norepi
Epi
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89
Q

How is the enteric nervous system linked to the CNS

A

The ENS is linked to the central nervous system (CNS) via the sensory and motor nerves of the parasympathetic nervous system (PNS) and the sympathetic nervous system (SNS).

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90
Q

In a study in which the volume of the gastric reservoir was recorded with an intragastric barostat in a normal subject, the volume of the reservoir increased and the wall compliance increased simultaneously at the onset of a swallow. This form of relaxation in the gastric reservoir is best described as

A. receptive relaxation.
B. gastric distension.
C. adaptive relaxation.
D. feedback relaxation.

A

A. receptive relaxation.

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91
Q

What is Haustration

A

Haustration is reminiscent of the mixing (segmentation) movements in the small intestine

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92
Q

How is sodium absorbed in the gut

A

Sodium absorption in the gut depends on the sodium potassium pump

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93
Q

2 layers of endometrium

A

funtional layer (sheds during menstruation)

basal layer (produces the new functional layer)

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94
Q

What causes splanchnic vasodilation

A

Hormones (high levels of cholecystokinin

Action of enteric nerves (VIPergic)

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95
Q

Gastro ileal reflex

A

Feed forward mechanism
Food in stomach
increases motility of ileum

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96
Q

Islets of langerhans cells

A

Have alpha, beta and delta cells

Alpha = glucagon
Beta = insulin
Delta = Somatostatin
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97
Q

What stimulates insulin

A

Hyperglycemia

AA
Fatty acids
GI hormones
ACh

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98
Q

What are the major regulated processes of the enteric nervous system

A

Gut motility
epithelial secretion
blood flow

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99
Q

What are the pacemaker cells of the enteric nervous system

A

Interstitual cells of Cajal (ICC)

enteric nervous systems own pacemaker cells

located in the myenteric plexus

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100
Q

Gastro colic reflex

A

Feed forward

Gastric distention increases colonic motility

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101
Q

Where is bile concentrated

A

the gallbladder

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102
Q

Stages of follicle

A 
Primordial follicle
Primary
Secondary
Early tertiary
Graffian follicle

Ovulation

Egg is free from follicle
now corpus luteum
corpus albicans
Breaks down unless pregnancy (becomes placenta)

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103
Q

What does ovary produce

A

Mature ovum
progestins
androgens
estrogens

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104
Q

where does majority of semen come from

A

seminal vesicles
75%
fructose
coagulation of semen

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105
Q

How does penis dialate

A

Nitric oxide

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106
Q

pheochromocytoma

A

hypersecretion of catecholamines
epi / norepi

increased temp, sweating, HR RR BGL

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107
Q

What color is corpus albicans

A

white

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108
Q

What do goblet cells do

A

Secrete various mucins

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109
Q

Describe defecation in the 5 stages of digestion

A

Elimination of feces

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110
Q

Process of testosterone production

A

LH binds to Leydig cell receptors
g protein secondary messenger cascade (cAMP)
Cholesterol + STAR protein
make stestosterone

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111
Q

How is Iron absorbed

A

Must be ferrous iron to be absorbed
Fe2+

Enterocytes absorb iron in duodenum

Then gets transported across brush border and binds to transferrin

Transferrin is the molecule that can move iron through the blood

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112
Q

Ileo - gastric reflex

A

Feed back mechanism
Ileal distention
causes inhibition of gastric motility

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113
Q

Describe Muscularis externa

A

3rd layer from inside of 4

smooth muscle layer
2 types
inner circular layer
outer longitudinal layer

mechanically churns food

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114
Q

Most potent form of testosterone

A

DHT

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115
Q

Major functions of liver

A

Detoxification of hormones, drugs, waste products

Metabolism of carbs proteins and fats

Storage of iron and vitamins

Hormone production

Innate and adaptive immunity

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116
Q

What are inhibitory gastric hormones

A

Somastatin

secretin

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117
Q

What is glucagons pupose

A

break down adipose tissue, break downglycogen

to increase blood glucose levels

Secretion is stimulated by hypoglycemia, epi, vagal, AA

Inhibited by Hyperglycemia, insulin, somatostatin

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118
Q

Basic unit of salivary gland

A

Salivon

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119
Q

Define paracrine hormone

A

Hormone that is direct cell to cell

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120
Q

what are 2 secondary messengers for release of secretions

A

Ca+

cAMP

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121
Q

Calcitonin

A

Comes from the parafollicular cells (thyroid)

Has the opposite effect of PTH

if calcium levels go up, calcitonin trys to reduce the calcium levels

bone ca2+ reabsorption, urinary excretion of phosphate and calcium

Phosphate and calcium levels decrease

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122
Q

Adrenal Cortex GFR Medulla

A 
G = Mineral corticoids = aldosterone
F = Glucocorticoids = Cortisol
R = Androgens = DHEA
Medulla = EPI/NorEPI (chromaffin cells)
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123
Q

5 stages of digestion

A 
Ingestion
Digestion
Absorption
Compaction
Defecation
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124
Q

When does GH peak

A

during sleep

during adolescence

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125
Q

Describe thyroid

A

rich blood supply

delivery of thyroid-stimulating hormone (TSH), iodide, and substrates to the thyroid gland.

adrenergic system have direct effects on cells

Follicular cells and colloid produce T3 and T4

Parafollicular cells produce calcitonin

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126
Q

What is the action of cortisol

A

anti insulin
pressor
anitinflammatory immune functions

moved via albumin

Is circadian, peaks during day, low at night

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127
Q

How are non essential amino acids formed

A

The liver can form nonessential amino acids from the essential amino acids.

The liver is the body’s only source of nonessential amino acids

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128
Q

Stellate cell function

A

Store fat in distinct cytoplasmic lipid droplets containing vitamin A

Vitamin A storage

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129
Q

Which of the following is not a physiologic effect of CCK?

A. Gallbladder contraction
B. Stimulation of bile acid synthesis
C. Stimulation of pancreatic enzyme secretion
D. Relaxation of the sphincter of Oddi

A

B. Stimulation of bile acid synthesis

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130
Q

How much of electrolytes are absorbed in the gut

A

Approximately 98% of the electrolytes in the gut are reabsorbed.

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131
Q

During an experiment elucidating control of gastric acid secretion, you determine that the stomach releases a paracrine substance that inhibits gastrin release whenever the pH of the gastric mucosa drops below 3. This peptide is most likely:

A. Histamine
B. ACh
C. Gastrin
D. somatostatin.

A

D. somatostatin.

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132
Q

What does the graffian follicle do

A

Mature graffian follicle contains the oocyte and is surrounded by granulosa cells

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133
Q

What is secretin

A

GI hormone

Comes from s cells in duodenum

Stimulus is increase in acid (H+) in small intestine

Increases pancreatic enzyme secretion
inhibts gastric acid secretion

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134
Q

What is the main neurotransmitter in stimulation of Enteric nervous system

A

ACh

for secretion and motility

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135
Q

phases of secretion after a meal in pancreas

Intestinal

A

Intestinal (feedback mechanism)

Secretin inhibits further movement of chyme from stomach

CCK causes increased secretion of pancreatic juice

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136
Q

How do nucleic acids breakdown

A

Nucleases of pancreatic juice hydrolyze DNA and RNA to nucleotides

Nucleosidases and phosphatases of brush border split them into phosphate ions, ribose or deoxyribose sugar, and nitrogenous bases

Membrane carriers allow absorption

Nucleotides can then cross into the blood stream

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137
Q

What anatomical features increase the surface area of small intestine

A

Cylindrical shape
Circular folds
Microvilli
Villi

Nutrient absorption does not occur without contacting the microvilli brush border

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138
Q

Average female cycle

A

28 days

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139
Q

What kind of control is gastric secretion under

A

neural

hormonal

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140
Q

What secrets leptin

A

Adipocytes

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141
Q

What happens if you lack iodide

A

this limits T3 and T4 synthesis

This causes chronic stimulation of TSH secretion

This produces goiter

Low iodine, low T3/T4, increased TSH, goiter

142
Q

What are the regions sympthetic nerves influence

A

Thoracolumbar region

Celiac
superior and inferior mesenteric

Fight or flight, inhibits digestive functions

143
Q

Two types of hormones (solubility)

A

water soluble (protein based)
Receptor is on plasma membrane (can’t cross)
secondary messenger process after that (ie insulin)

fat/lipid soluble (direct gene expression)
Needs proteins to transport it through blood (albumin)
can diffuse through plasma membrane
receptor is in nucleus, then affects gene expression

144
Q

What hormones regulate CA2+ and phosphate

A 
Parthyroid hormone (PTH)
Vitamin D
145
Q

DEscribe the islets of langerhans make up

A

Blood flows through the islets of Langerhans from the center toward the periphery so that the α-cells receive a high concentration of insulin;

insulin suppresses glucagon secretion

Alpha cells surround islets
Beta cells are in the center
Delta cells are mixed in randomly

146
Q

Phases of gastric stimulation

intestinal

A

Stimulus = Protein digestion products in duodenum, distention

Amino acids in blood → intestinal endocrine cells

Gastrin briefly stimulate stomach, but then secretin,
CCK and enterogastric reflex inhibit gastric secretion and motility

Gives us a chance to digest what is already in the intestine

Sympathetic nervous system will also inhibit digestion

Parasympathetic activates digestion (rest and digest)
Sympathetic inhibits digestion (fight or flight)

147
Q

What are the regions parasympthetic nerves influence

A

Cranio sacral

pelvic nerves
vagus nerve

Vagus is most of the gi tract
Sacral pelvic nerves i the latter half of large intestine

Rest and digest, stimulate digestion

148
Q

Describe Submucosa layer

A

Connective tissue
second innermost layer of 4
Extensive vasculature and nerves
Lots of regulation and secretion

149
Q

What is the main target organ of glucagon

A

the liver

150
Q

What are Choliangiocytes

A

Cells that line the bile ducts

They secrete bicarbonate rich fluid into the billiary tree

151
Q

What happens if the amount of secretions surpass the absorption rate of the small intestine

A

watery diarrhea

152
Q

Where does most of lymph come from

A

Sinusoidal epithelia form large quantities of lymph

Make up more than half of lymph

153
Q

Drug metabolism in liver

A

Hepatocytes are involved in metabolism of xenobiotics (foreign substances)

Hydrophobic substances are converted to hydrophilic to be eliminated

• Cytochrome p-450 breaks down drugs

154
Q

What is the functional unit of the small intestine

A

The crypt villous unit

155
Q

How does the body store glucose

A

Glycogen and triglycerides

Glycogen is short term storage

156
Q

Corpus luteum vs Albicans

A

Corpus luteum (yellow)
becomes
Corpus albicans (white)
no more progesterone production

157
Q

Cells of Gastric secretion

Chief Cells

A

Secretes pepsinogen and lipase

158
Q

How are Proteins digested and absorbed

A

Protein breakdown does not start till stomach

Pepsin in stomach

Protease’s from pancreas (activated in small intestine)

Brush border enzymes breakdown into amino acids

Then absorbed into blood

159
Q

Cells of Gastric secretion

A

Mucosa of stomach is lined by various cells

Surface mucous cells
Mucous neck cells
Parietal Cells
Chief Cells
G cells
160
Q

Explain GI motility in relation to slow waves, contraciton and spike potential

A

Interstitual cells of cajal stimulate

Slow waves are smooth muscle oscillations

Must have spike potentials to push it past the threshold

Once at threshold, mucle contraction occurs

Ca2+ trigger excitation
K+ inhibits

161
Q

What causes the secretion of secretin

A

Acidic Chyme in duodenum

Secretin also enchances the the flow of bile rich bicarb from the liver

162
Q

what is the functional structure in which the oocyte develops

A

Follicle

163
Q

The parents of a 5-year-old male received a diagnosis of hypertrophic pyloric stenosis, which is characterized by an absence of electrical slow waves at the gastroduodenal junction. In describing the pathophysiology, the pediatric gastroenterologist explained that a specialized population of cells is missing from the child’s intestine. Which of the following kind of cells is most likely missing?

A. Parietal cells
B. Interstitial cells of Cajal
C. Enteroendocrine cells
D. Kuffer cells

A

B. Interstitial cells of Cajal

164
Q

What is somatostatin action on glucagon

A

inhibits glucagon

165
Q

Glycogenlysis is

A

Breakdown of glycogen to release glucose

166
Q

Down regulation

A

Cells decrese their receptors for a weaker response

167
Q

What is albumin function

A

Albumin helps to preserve plasma volume and tissue fluid balance by maintaining the colloid osmotic pressure of plasma.

168
Q

Choliangiocyte function

A

Modulate bile flow through the bile ducts

169
Q

Disorders of defective bone mineralization

A

Rickets and osteomalacia

Paget disease is a chronic disorder leading to enlarged and deformed bones

170
Q

Important plasma proteins synthesized in the liver

A

Albumin
Transferrin
Fibrinogen
Others

171
Q

What are the main endocrine functions of the liver

Hormone degredations

A

Insulin degradation

Glucagon degradation

hGH degradation

GI hormone degradation

172
Q

What is addisons disease

A

absence of cortisol

hypoglycemia
weakness, fatigue
aldosterone deficiency
hypotension
hypovolemia

hyperkalemia

173
Q

How often is the epithelial lining of small intestine replaced

A

every 3 days

174
Q

Colono gastric reflex

A

Feedback mechanism

Colonic distention decreases gastric motility

175
Q

What helps prevent osteoporosis

A

testosterone

176
Q

what is cut in vasectomy

A

vas deferens

177
Q

2 methods of digestion

A

Chemical (enzymes)

mechanical

178
Q

How is B12 absorbed

A

Intrinsic factor from parietal cells of stomach

179
Q

GH disorders

A

Gigantism, tumor before plates close
acromegaly excess secretion after puberty

acondroplasia defect in FGF
Cretinism = hypothyroidism

180
Q

Describe absorption in the 5 stages of digestion

A

uptake of nutrien moleculs into the epithelial cells of the digestive tract and then into the blood and lymph

181
Q

What do the pancreatic duct cells secrete into the pancreatic fluid?

A

electrolytes

h20

182
Q

Hyperthyroidism

A

increased thyroid hormones and decreased TSH

Primary is uncontrolled secretion of thyroid hormones from thyroid gland

secondary is uncontrolled secretion of TSH from Ant. Pituitary

Graves, goiter, autoimmune

183
Q

Cells of Gastric secretion

Surface mucous cells

A

Secretes mucin in an alkaline fluid

184
Q

Where are pancreatic enzymes created

A

Acinar cells of the exocrine pancreas

185
Q

What kind of disorder is it in the anterior pituitary

A

secondary disorder

186
Q

What does exercise do for Glut 4

A

GLUT4 is directly stimulated by increased muscle work via AMP kinase due to exercise

exercise is a mechanism to decrease blood sugar

187
Q

What is detoxification pathway in liver

A

Toxins
phase 1
phase 2
elimination

188
Q

What does the submucosal plexus of the enteric nervous system do

A

The submucosal plexus coordinates intestinal absorption and secretion through its innervation of the glandular epithelium, intestinal endocrine cells, and submucosal blood vessels.

in th submucosa layer

secretion, absorption, blood flow, and endocrine cell activity

189
Q

Cells of Gastric secretion

Parietal Cells

A

Secretes HCL and intrinsic factor

190
Q

How are bile and bilirubin related

A

Bile helps with bilirubin excretion

191
Q

Prime temp fro sprem production

A

35 celsius

192
Q

Five inhibitory motor neurons to the circular muscle of the colon are shown in association with the formation of haustra. Which of the five numbered neurons is/are most likely to be silent (inhibited)?

A.	2 
B.	4 
C.	2 and 4 
D.	5 
E.	1, 3, and 5
A

C. 2 and 4

the two depressions

193
Q

What are the main endocrine functions of the liver

Hormone activations

A

VItamin D activation

T4 to T3 conversion

IGF modification

194
Q

How are fatty acids transported through the blood

A

Albumin

195
Q

What is ejaculation

A

Contraction of urethra

expulsion of semen

196
Q

What is potentiation

A

Occurs when the effect of two stimulants is greater than the effect of either stimulant alone

The agonists potentiate one another

• Potentiation also occurs for pancreas

197
Q

Describe Mucosa layer

A

inner layer

Epithelium
Lamina propria
Muscularis mucosae

198
Q

What do intestinal secretions do

A

provide lubrication and protective functions

199
Q

What does oxytocin do?

A

Contraction of uterus (smooth muscle)
Stimulates milk ejection/production (let down reflex)
Dialate cervix
social bond, climax, arousal

200
Q

Frequency of slow waves

A

3 waves per minute in pylorum

12 waves per minute in duodenum

2-13 waves per minute in colon

201
Q

Large intestine motility

A

Distention of the colon can also act as a strong stimulus.

Power propulsion is unique to the large intestine.

Gastro colic reflex (feed forward)

Chemoreceptors and mechanoreceptors in cecum provide feeback

Occasional giant migrating contractions (mass movements) propel fecal material into the rectum.

202
Q

Amylase

A

Breask down carbs and starches

203
Q

How does T4 convert to T3

A

deiodination reactions occur in tissues

Conversion from T4 to T3 in the peripheral tissues using enzymes

can be inactivated as well

204
Q

salivary secretions

A

amylase
lingual lipase

Parasympathetic salivation

Sympathetic salivation

Antibodies as well as antimicrobial secretions in saliva

205
Q

Describe digestion in the 5 stages of digestion

A

mechanical and chemical breakdown of food into a form usable by the body

206
Q

Is insulin anabolic or catabolic

A

anabolic

207
Q

What does the myenteric plexus of the enteric nervous system do

A

The myenteric plexus is mainly involved with control of gut motility and innervates the inner circular and outer longitudinal smooth muscle layers.

in the muscularis propria layer

controls sphincter activity.

regulates peristalisis

208
Q

What are the 3 types of bile

A

Primary Bile acids
Secondary Bile Acids
Bile salts

209
Q

What is unique about liver blood supply

A

It has a dual blood supply

210
Q

How do the pancreatic enzymes get to the duodenum

A

through the duct of wirsung

through the sphincter of oddi

211
Q

Male reproductive hormone cascade

A 
Brain
Hypothalamus (GnRH)
Anterior pituitary
FSH & LH
Testes
Testosterone (stimulated)
212
Q

What does insulin do in skeletal muscle

A

Increases glucose uptake via (glut 4)
Glycogen & glycolysis synthesis

decreases fat breakdown

213
Q

What do parietal cells secrete

A 
HCL
Intrinsic factor (for b12)
214
Q

hypothyroidism

A

lower than normal thyroid hormone
1% of population

primary high TSH
Thyroid gland issue

secondary Low TSH
Ant pituitary issue (low TSH)

hashimoto, autoimmune

215
Q

What is fibrinolysin

A

Prostate secretion
thin milky secretion
breaks down / liquifies coagulated sperm 15-30 minutes later

216
Q

Food in duodenum is called

A

chyme

food before duodenum is bolus

217
Q

Hepatocyte function

A

Metabolism

218
Q

Main digestive gland of the body

A

Pancreas

219
Q

What is the main carbohydrate stored in liver

A

Glycogen

220
Q

What is the catcholamine response to hypoglycemia

A

inhibits insulin
gluconeogenysisglucose formation
glycogenolysis (glycogen breakdown for glucose)
triglyceride lipolysis for glucose

221
Q

how are renein and aldosterone related

A

They are proportional

the more renin secretion results in more aldosterone secretion

222
Q

Process of defecation and nervous system

A 
Feces enters rectum
stretch receptors activate
signals sent to CNS s2-s4
parasympathetic nerve impulses are sent back (pelvic)
smooth muscles relax in sphincter
recto angle straightens out
peristalsis forces feces out
223
Q

What is cushings

A

Too much cortisol

hyperglycemia
muscle wasting
 weakness
obesity
moon face
hypertension
224
Q

Precursor to testosterone

A

Cholesterol

225
Q

Most potent female hormone

A

estradiol

226
Q

Short term stress response

A

Hypothalamus

HR increase
BP increase
glycogenolysis (glycogen breakdown for glucose)
metabolic rate increases

227
Q

What is ammonias role in liver

A

Ammonia, derived from protein and nucleic acid catabolism, plays a pivotal role in nitrogen metabolism, and is needed in the biosynthesis of nonessential amino acids and nucleic acids.

228
Q

Which of the following will stimulate bile acid secretion by primary hepatocytes?

A. Fat in the duodenum
B. Gastric distension
C. Malabsorption of lipids by the ileum
D. Secretin

A

A. Fat in the duodenum

229
Q

What do you need to begin with toe get Epi

A

Tyrosine

230
Q

3 structures of defecation

A

Internal anal sphincter
external anal sphincter
pelvic diaphragm

231
Q

What kind of disorder is it in the hypothalamus

A

Tertiary disorder

232
Q

What class are epi and nor epi

A

Catchecholemines

come from chromaffin cells

233
Q
  1. Insulin deficiency will cause

A. decreased hepatic glycogenolysis.
B. decreased hepatic glycogenesis.
C. decreased hepatic gluconeogenesis.

A

B. decreased hepatic glycogenesis.

234
Q

What stimulates the release of pancreatic enzymes

A

Calcium released from intracellular stores

Works through secondary messenger system (Ca+, cAMP)

235
Q

Is glucagon anabolic or catabolic

A

catabolic

236
Q

What stimulates bile production

A

Bile is prodcued in the liver

It is stimulated by parasympathetic impulses from the vagus

237
Q

Liver regeneration

A

The liver is the only organ capable of regenerating ist own tissue

Can fully regenerate with as little as 25%

Hepatocytes make this possible due to mitosis

238
Q

What are inhibitory precursor hormones from hypothalamus

A

Dopamine

somatostatin

239
Q

What is emulsification

A

Emulsifies or breaks down lipids into smaller parts or droplets

The lipases can then act on those smaller droplets

240
Q

What is gastrin

A

GI hormone

Comes from G cells (stomach)

Increases stomach motility and H+ secretion

Stimulus is distention of stomach, vagus nerve or AA in stomach

241
Q

2 segments of small intestine motility

A

propulsion

receiving

242
Q

What are slow waves

A

They are smooth muscle oscillations

Must have spike potentials to push it past the threshold

Once at threshold, mucle contraction occurs

No slow waves in esophagus

243
Q

What is first pass emtabolism

A

muspass through thte portal venous system and the liver before entering the systemic circulation

244
Q

3 phases of gastric stimulation

A

cephalic
gastric
intestinal

245
Q

What is a lack of contraction called in small intestine

A

physiological ileus

246
Q

What does porinsulin become

A

Insulin and c peptide

247
Q

What are 3 types of relaxation of stomach as food enters

A

Receptive
Adaptive
Feedback

248
Q

up regulation

A

cells increase their receptors for a stronger response

249
Q

What kind of disorder is it in the endocrine gland

A

Primary disorder

250
Q

How does vitmain D increase calcium levels

A

The liver and kidneys convert vitamin D to the active hormone 1,25-dihydroxycholecalciferol.

Also need UV light to convert Vitamin D

This hormone stimulates intestinal calcium absorption .

251
Q

3 phases of esophageal motility

A 
Oral phase (voluntary)
Pharyngeal phase (involuntary)
Esophageal phase (involuntary)
252
Q

Fat soluble vitamins stored in liver

A

A, D, E, K

253
Q

Corpus spongiosum

A

one column that surrounds the urethra

254
Q

What is emission

A

sperm moves into the urethra

bladder sphincter closes

255
Q

what kind of receptors are on parietal cells

A

Histamine receptors

H2

256
Q

What stimulates the secretion of CCK

A

Fatty acids and amino acids in chyme entering the duodenum stimulate secretion of CCK.

257
Q

Glucose to glycogen is called

A

Glycogenesis

258
Q

Phases of gastric stimulation

gastric

A

Gastric (feed forward)

Stimulus = Stomach distention

Local reflexes and vasovagal reflexes → parietal cells → G cells

Histamine and gastrin stimulate acid production

259
Q

Kufpper cell function

A

Production of bilirubin

macrophages of liver

260
Q

What is stress hormone

A

Cortisol

261
Q

Blocking H2 histamine receptors in the stomach reduces gastric acid secretion during the cephalic phase of digestion because histamine:

A. directly stimulates pepsin secretion.
B. potentiates the actions of secretin in the stomach.
C. potentiates the acid-stimulating action of vagal stimulation on the stomach.
D. mimics the actions of Cholecystokinin (CCK).

A

C. potentiates the acid-stimulating action of vagal stimulation on the stomach.

262
Q

Which bone cells are more active if there is a drop in blood calcium

A

Osteoclasts

breaks down bone to release more calcium into blood

263
Q

What is the process of bilirubin breakdown and excretion

A

o Bilirubin is a byproduct of hemoglobin metabolism
o Macrophages break it down into biliverdin (green color)
o Biliverdin reductase converts biliverdin into bilirubin (yellow color)
o Bilirubin leaves the macrophage now called unconjugated bilirubin
o Albumin in blood binds unconjugated bilirubin and transports to hepatocytes.
o Hepatocytes convert it to conjugated bilirubin.
o This makes bilirubin more soluble so can it be secreted into bile
o In intestines, bacteria hydrolyze bilirubin into colorless urobilinogen.
o Normal urine contains urobilinogen.
o Most of the urobilinogen, becomes oxidized by gut bacteria to form stercobilin.
o Stercobilin is what makes feces brown in color.
o enterohepatic circulation Is another way bilirubin and bile acids get recycled

264
Q

Hormone defenition

A

secreted into blood stream (endocrine)
distant target cell
some also do cell to cell communication
and diffusionin intersitual fluid

Hormones initiate a cell response by binding to specific receptors.

265
Q

Goal of digestion

A

absorption

266
Q

What does CCK do

A

CCK causes the contraction of the gall bladder

whcih causes the release of bile

as well as the relaxation of the sphincter of Oddi

267
Q

Liver cell types

A 
Hepatocytes
Kupffer cells
Choliangiocytes
Sinusoidal epithelial cells (SEC)
Stellate cells (Ito cells)
268
Q

What is key organ in carbohydrate metabolism

A

Liver

269
Q

What do delta cells do

A

in the islets of langerhans
of pancreas
produce somatostatin

270
Q

5 steps to making tyroid hormone

A

Iodide trapping
Thyroglobulin is synthesized & secreted
Iodination and conjugation (T3/T4 created)
Endocytocis of thyroid colloid
Secretion by exocytosis (T3/T4 secreted into blood)
90% T4, 10% T3,

271
Q

Spermatogenesis

A 
1 - Germ cell
1 - spermatagonium
2 - spermatagonia
1 - primary spermatocyte
2 - secondary spermatocytes (2 per)
4 - spermatids (1 each)
4 - mature spermatozoa
272
Q

Where does B12 come from

A

Vitamin B12 comes from eggs, liver animal products (cobalamins)

273
Q

Define endocrine hormone

A

hormone that enters the blood stream

274
Q

Describe Serosa

A

outer layer

connective tissue

Areolar tissue
Mesothelium
Reduces friction with other structures

275
Q

Describe insulin in the liver

A

It is anabolic
Takes glucose and builds it into glycogen

regulates glycogenesis

276
Q

Vitamin D

A

Builds strong bones and teeth

277
Q

Cells of Gastric secretion

Mucous neck cells

A

Secrete mucin in an acidic fluid

278
Q

What exerts control over CA2+ and phosphate homeostasis

A

PTH

Parathyroid hormone

279
Q

Vitamin A

A

Healthy skin, mucous membranes, prevents night blindness, Promotes growth

280
Q

How is water absorbed in the gut

A

osmosis

GI tract is extremely efficient in absorbing H2O

o Lots of water added, (i.e. 8900ml)
o lots of water then reabsorbed (i.e. 8900ml),
o small amount lost in feces (i.e. 100ml)

281
Q

3 main salivary glands

A

submandibular
sublingual
parotid

282
Q

Testosterone potency

A

DHT
Testosterone
Androstenedione
DHEA

283
Q

What is CCK

A

Cholecystokinin

GI hormone

comes form I cells in duodenum

works on all GI organs

increases gastric secretion, contraction
inhibits gastric emptying

284
Q

Where is bile produced

A

The liver

In hepatocytes

285
Q

3 classes of hormones

A

amine based
peptide based
Steroids

286
Q

What is a lacteal

A

Lymphatic capillary

287
Q

Describe ingestion in the 5 stages of digestion

A

selective food intake

288
Q

Where do gall stones occur

A

Can occur anywhere in biliary tree

Can cause pancreatitis and jaundice

289
Q

Number of oocytes in female by age

A

birth - 1 million
puberty - 200,000
30 - 25,000
menopause - 0

290
Q

What are pancreatic secretions rich in?

A

Bicarbonate ions

Happens through bicarbonate anhydrase reaction

291
Q

PTH calcium feed back

A

decrease in blood calcium
induces the secretion of parthyroid hormone
PTH goes into blood stream

PTH causes 
bone to release CA2+, 
the kidneys to conserve and keep CA2+
Kidneys to activate Vitamin D
Vitmamin D causes Intestines to absorb more CA2+
CA2+ increases
PTH secretion is inhibited
292
Q

How are carbohydrates digested and absorbed

A

Starts in mouth with saliva

Then pancreatic juices

Brush borders enzymes break the sugars down to simple sugars

Simple sugars go across brush border of small intestine

Then absorbed into blood

293
Q

Where does bile origante

A

Bile canaliculus

294
Q

What stimulates glucagon

A

Hypoglycemia

AA
ACh
Nor epi
epi

295
Q

Where is bile stored

A

the gallbladder

296
Q

Pancreas enzymes

Endocrine vs exocrine

A

Has both
endocrine (insulin)
exocrine (digestive enzymes) functions

297
Q

Describe Sympathetic salivation

A

Sympathetic salivation

Rich in mucous
Reduced salivation

298
Q

What stimulate prolactin porduciton

A

Dopamine

299
Q

Intersitutal cells of cajal

A

pacemaker cells of GI tract

generate slow waves

300
Q

Immune functions of liver cells

A

Ideal site for the clearance of blood-borne antigens and pathogens.

Hepatocytes, SECs, Kupper cells act as APCs

Stellate cells release interferons and cytokines

301
Q

Other ways gluconeogenesis can occur

A

Through lactate
fats
amino acids

302
Q

What inhibits glucagon

A

Fatty acids
somatostatin
insulin

303
Q

What do T3 and T4 do

A

Regulate metabolism
T3 is more physiologically active

T3 
affects transcription
increases metabolic rate
increases Na+ / K+ pump
increases Beta adrenergic receptors
304
Q

Migrating motor complex (MMC)

A

Bouts of contraction occur 2-3 hours after meal

used to flush the system

occurs about every 90 minutes between meals

intervals of strong then propulsive contractions

Under the influence of hormone motilin

305
Q

salivon structure

A

All connected

Acinus
intercalated duct
striated duct
excretory duct

306
Q

How are PTH, Vitamin D, and calcium related

A

Parathyroid hormone and vitamin D are required for calcium absorption

PTH activates vitamin D, makes gut more permeable to calcium

PTH = more calcium absorption

307
Q

Vitamin K

A

Helps blood clotting

308
Q

What must happen for nutrient absorption to occur

A

Nutrient absorption does not occur without contacting the microvilli brush border

309
Q

What cells secrete CCK and secretin

A

I cells
or
enteroendocrine cells

310
Q

What does AVP (ADH) do

A

Humoral stimulus

increases reabsorption of water by kidneys

311
Q

What is bilirubin

A

Bilirubin is a waste product of hemoglobin breakdown

It is the end product of hemoglobin degradation

312
Q

How do the parasympathetic and sympathetic nervous systems effect the enteric nervous system

A

PNS stimulates (rest/digest)

SNS inhibits (fight/flight)

313
Q

where are sperm stored and matured

A

epidiymis

314
Q

major secondary messengers

A 
cAMP
IP3/DAG
Eicosanoids
Guanylyl cylase
Tyrosine kinase
315
Q

Define autocrine hormone

A

Horomne that is secreted and works on itself

316
Q

What color is corpus luteum

A

yellow

317
Q

What does the adrenal cortex do

A

Synthesizes and secrets steroid hormones

Highly vascular
secretes on demand, not stored

318
Q

What happens in stomach as food enters

A

Stomach relaxes

319
Q

Folliculogenesis

A

production and maturation of follicle

320
Q

What do theca cells do

A

LH binds to these cells

produce testosterone and is then sent to granulosa cell where it is converted into estradiol (FSH helps)

321
Q

How do gall stones form

A

When cholesterol becomes too saturated

Can cause pancreatitis and jaundice

322
Q

Things that effect drug metabolism in liver

A 
	Age
	Nutrition
	Genetics
	Sex
	Hormones
323
Q

What role does liver play in iron tranpsort, storage, and metabolism

A

Kupffer cells breakdown damaged red blood cells through phagocytosis

Iron released from heme becomes part of free iron pool in blood

Transferrin is the molecule that can move iron through the blood

Must be ferrous iron Fe2+

324
Q

What is the precursor molecule for all of the hormones and steroids of the adrenal cortex

ie. aldosterone, cortisol, DHEA

A

Cholesterol

Secondary messenger system (cAMP)

Star proteins move cholesterol into the mitochondria

325
Q

What is atresia

A

follicles do not continue to develop

326
Q

Hormones from the posterior pituitary

A

ADH

Oxytocin

327
Q

Hormones form anterior pituitary

A

FLAT GP

FSH
LH
ACTH
TSH
GH
Prolactin

ALl are tropic from hypothalamus

328
Q

What is the role of the parasympathetic nerve activity after a meal

A

It stimulates GI secretion and motility, which also indirectly increases splanchnic blood flow as a result of increased local metabolism

(increase blood flow, parasympathetic, rest/digest)

329
Q

What causes intestinal fluid hyper secretion

A

Toxins and other luminal stimuli

330
Q

Transporter to bring glucose into liver

A

GLUT 2

facilitated transporter

331
Q

4 layers of digestive system

A

Mucosa (inner layer)
Submucosa (connective tissue)
Muscularis externa (smooth muscle layer)
Serosa (outer layer)

332
Q

What are fatty acids used for

A

Citric acid cycle

333
Q

How are gametes transported within the female genital tract

A

Cilia and smooth muscle

334
Q

how long is egg viable after ovulation

A

24 hours

335
Q

how long is sperm viable for after ejaculation

A

48 hours

336
Q

How long is fertilization window

A

2 days

337
Q

fertilization process

A

sperm passes follicular cells (binds)
Acrosomal reaction occurs
acrosomal enzyme breaks down zona pellucida
sperm penetrates
causes rise in Ca2+ (cortical rxn)
this blocks off any other sperm from entering
this also triggers 2nd meiosis division
male sperm head then enlarges and fuses with female nucleus

338
Q

Process of implantation

A 
zygote (fertilized egg)
4 cell stage (day 2)
morula (day 3) (16 cells)
early blastocyte (day 4)
Implanting blastocyte (day 7)
339
Q

Amnion

A

Transparent sac filled with amniotic fluid

340
Q

What is chorion

A

fetal portion of placenta
Encloses the embrionic body
provides gas and nutrient exchange

341
Q

Yolk sac

A

forms part of digestive tube

earliest blood vessels

342
Q

Allantois

A

small outpocket on yolk sac
umbilical cord
urinary bladder

343
Q

intervillous space

A

acts like a big capillary

gas exchange

344
Q

When does the placenta assume produciton of progesterone

A

week 9

345
Q

What saves the corpus luteum from being brokendown

A

the early production of HCG in embryo

346
Q

When is HCG detectable

A

Dectectable in urine 8-9 days after conception

347
Q

What is hCS

A

human chorionic somatomammotropin (hCS)

hCS is the primary hormone in pregnancy that induces a state of insulin resistance in the mother

Causes gestational diabetes

348
Q

Parturition

A

Process of delivery

349
Q

Lactation

A

sucking inhibits GnRH
which suppresses FSH and LH
also suppresses the menstrual cycle (while breast feeding)

350
Q

When does menstruation resume after breast feeding

A

Usually resume menstrual cycles about 2 months after giving end of breast-feeding.

351
Q

Importatn hormones of birth delivery

A

Estrogen
induces oxytocin

Oxytocin
stimulates contractions and production of prostoglandins

Prostoglandins
help to soften the cervix

PAM Semester 1 (16 decks)

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