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Physiology Exam 4

front 1

Kidney Functions

back 1

 Regulate ECF volume & blood pressure
 Regulate osmolarity
 Maintain ion balance
 Regulate pH
 Excrete wastes
 Regulate hormone production

filter, reabsorb, secrete

front 2

nephron anatomy (picture)

back 2

 Normally highly twisted
 Blood flows out of the nephrons into the efferent arterioles

front 3

Kidney portal system (picture)

back 3

 blood flows from the renal artery then into the cortex, then from the afferent arteriole into the glomerulus (ball-like network of capillaries). Then blood flows into the efferent arteriole then into the peritubular capillaries, then into the renal vein and out of the kidneys
 In juxtamedullary nephrons, long peritubular capillaries that dip into the medulla are vasa recta.
 Function: filter fluid out of the blood and into the lumen of the nephron at the glomerular capillaries, then to reabsorb fluid from the tubule back into the blood at the peritubular capillaries

front 4

kidney filtration (picture)

back 4

o Happens in glomerulus
o 300 mOsmol
o Filter fluid from plasma
o Leave behind plasma proteins & RBCs
o only 20% of the plasma that passes through the glomerulus is filtered and less than 1% of the filtered fluid is excreted (the other 99% return to systemic circulation
o takes place in the renal corpsule
net driving pressure causes filtration

front 5

renal corpuscle filtration

back 5

o first barrier is the capillary endothelium which contains glomerular fenestrated capillaries (large pores- RBC and most proteins still cannot pass)
o second filtration barrier is the basal lamina (Extensive extracellular matrix to exclude plasma proteins from the fluid)
o third filtration barrier is the epithelium of the bowmans capsule (podocyte foot processes leave narrow slits through which filtration takes place

front 6

3 pressure components acting within the renal corpuscle

back 6

 Blood pressure – blood moving into glomerulus (provides hydrostatic pressure) forces fluid through leaky fenestrated capillaries
 Osmotic pressure – Fluid moving back due to protein concentration differences
 Capsule fluid pressure – hydrostatic fluid pressure of the enclosed space opposes fluid movement in and is in competition with blood and osmotic pressure

front 7

Glomerular filtration rate (GFR)

back 7

 volume of liquid that filters into bowman's capsule that depends on 2 things: filtration pressure and the filtration coefficient (which depends on surface area of capillaries, permeability of membranes)
 stays relatively constant even across ranges in blood pressure
 regulated by blood flow in the renal arterioles or by autonomic regulation (sympathetic control changes the resistance in arterioles bu using NE to vasoconstrict as necessary)

front 8

regulation of the GFR by blood flow in the renal arterioles (picture)

back 8

 Increase in blood pressure= vasoconstriction to keep GFR constant
• Myogenic response: Vascular smooth muscle responds to pressure changes (Increase in blood pressure causes vasoconstriction, decreases causes vasodilation)
• Tubuloglomerular feedback: Paracrine signaling to change fluid flow through the loop of Henle
 Passes by afferent and efferent arterioles which get direct feedback and twisting causes ascending limb to pass between afferent & efferent arterioles

front 9

nephron absorption (picture)

back 9

 70% gets reabsorbed almost immediately
 Loop of Henle is where solutes change concentrations
• About 100mOsmol at the end of the loop of Henle
• Must remove stuff without removing water
• Only 18L/day reaches the end of the loop
• Excrete about 1.5 L/day at the end of the tube
pressure gradient favors reabsorption

front 10

Nephron secretion (picture)

back 10

o After filtration, to adjust concentrations
o Happens via aided transport
o transfers solutes from the ECF to the lumen
o Na+ is the driving molecule with the sodium potassium pump
o uses transport molecules (active transport) and concentration gradients to fine scale adjust the concentrations in the lumen

front 11

nephron excretion (picture)

back 11

o about 1.5 L/day
o Amount Filtered- Amount reabsorbed+ amount secreted= amount of solute excreted
o most useful metabolites have been removed at this point
o ion and water concentration is highly variable depending on needs

front 12

Sodium (Na+) in kidney reabsorption

back 12

o Na+ is the main player because it sets up the electrical gradient (active transport)
o water equalizes concentrations by moving to the nephron from the lumen
o ECF has higher Na+ concentration than the ICF so Na+ follows its concentration gradient into cells and is actively pumped out of cells via the sodium-potassium pump

front 13

urea reabsorption in the kidneys (picture)

back 13

transports proteins into the epithelium and breaks them down

front 14

solute transport in the kidneys (picture)

back 14

 Saturation – Maximum rate of transport due to maximum carrier use (receptors and channels)
 Filtration has a linear increase in the amount of glucose in the plasma and the glucose filtration rate
 you can reabsorb up to 300 mg/mL and everything else gets excreted

front 15

clearance

back 15

 easiest method to determine the Rate at which a solute disappears from the body due to excretion or metabolism
 Provides a method for estimating GFR as well
 Determines how well a nephron handles a filtered solute

front 16

Micturition

back 16

 urination
 what leaves the collecting duct must be excreted and the concentrations cannot be adjusted any further
 Normal conditions: Motor neuron is leading to tonic contraction of the external sphincter
 When you have to urinate
• Spinal reflex tells stretch receptors to fire-As you gain control of your bladder, more stretch receptors are present so that you can notice how full your bladder is instead of just whether you have to urinate or not

front 17

primary goal of the digestive system

back 17

 move nutrients, water, and solutes from the external environment to the internal evironment
 4 Basic Processes: Digestion- breaking down of food particles, Absorption, Motility, Secretion

front 18

gastrointestinal tract and secretion

back 18

 hollow tube (lumen) passing through the body
 the primary way pathogens can get into the body
• Secretions come from enzymes
• Substantial amount of fluid from secretions enter the digestive system
• 7.5/9 L of liquid is reabsorbed, the rest is excreted

front 19

Gastrointestinal tract anatomy

back 19

 mouth/ salivary glands- chewing and the secretion of saliva
 stomach- mixes food with acid and enzymes to create a soupy mixture called chyme
 small intestine- Ducts pour in enzymes from the liver to help break down and absorb the fluid and particles and nearly all the digested nutrients and secreted fluids are absorbed here

front 20

GI tract wall structure (picture)

back 20

 The stomach and wall function very similarly (only a few small differences)
 Basic structure is similar in stomach and small intestine
• Mucosa- interfacing with the food and lumen
• Submucosa
• Muscularis externa
• Serosa

front 21

Mucosa (picture)

back 21

• layer of the GI Tract wall
o Gastric glands- Deep folds in mucosa
o Single epithelial tissue layer (enterocytes)
o Lots of goblet calls and other paracrine cells than excrete
o Makes up part of the intestinal space
o First line of defense by having many immune cells on the inside of the interstitial space
o villi- play a big role in absorption and mobility
o epithelial cell layer- function depends on their location in the tract (Transporting – enterocytes in small intestine, Secreting – endocrine & exocrine, Stem cells)

front 22

Muscularis externa

back 22

• layer of the GI Tract wall
- muscle layer
• Muscle rings- change the diameter of the lumen
• Longitudinal muscle- changes the length of the tube
o Longitudinal and muscle rings do not always agree
• Innervation for smooth muscle tissue is directly next to the layer

front 23

Submucosa

back 23

• layer of the GI Tract wall
- convergence of smaller vessels into larger muscles
•Basically the same for stomach and small intestine

front 24

Serosa

back 24

• layer of the GI Tract wall
- outermost layer
• Anchors the intestine and other organs within the abdominal cavity
o Must be anchored because the 2 muscle layers (muscle rings and longitudinal) must be working together so if they can move, then the muscles would just get tied into a knot

front 25

purpose of motility in the GI tract

back 25

o Two main purposes:
 Move food through the GI tract
 Mix food and break down into small pieces
• Food moves around a lot to absorb as many enzymes as possible to get broken down

front 26

GI smooth muscle contraction- migrating motor complex

back 26

• Normal pattern of contraction between meals
• Contraction begins in stomach and ends in large intestine
o Keeps things moving all in one direction
o Important in preventing infection
• Sweeps remnants to large intestine

front 27

GI smooth muscle contraction- peristalsis

back 27

• smooth muscle in the bottom 1/3 of the esophagus (the top 2/3 is skeletal muscle)
• peristaltic contraction pushed the food (bolus) into the receiving segment which pushes it forward more down the esophagus and into the stomach
• segmental contractions are responsible for mixing by alternating contracting segments so that there is little or no net forward movement and the bolus is exposed to as much intestinal wall (where enzymes are located) as possible

front 28

single unit smooth muscle in the GI tract (picture)

back 28

o Groups of cells connected by gap junctions
o Signal passes quickly through gap junctions
o Tonic or phasic contractions

front 29

GI tract contraction- slow wave potential

back 29

• Dependent on Ca2+ signaling
• Graded contractions
• More Ca2+ àstronger and/or longer contraction

front 30

Things the digestive system secretes

back 30

 Ions & Water, Digestive enzymes, Mucus, Saliva, Bile
• Wherever we move ions, water wants to follow (osmotic equilibrium)

front 31

acid secretion in digestion

back 31

 Parietal cells secrete acid
 1-3 L of acid per day
 Lumen of stomach can reach pH of 1(very acidic)
 Parietal cell cytoplasm has pH=7.2 (pretty normal)
• Pumping out H+ extremely against its concentration gradient to transition from a pH of 1 to 7.2
• Very active process (uses ATP)
o Lumen net gain is a lot of chloride
o Bicarbonate goes into the interstitial fluid and eventually into the blood
o pancreas secretes bicarbonate to neutralize the acid that gets pumped into the lumen and enters the small intestine because we don't want a very acid fluid going into other tissues

front 32

bicarbonate secretion in digestion

back 32

 Bicarbonate, water, Na+ & Cl- move into the lumen
 H+ moves into ECF à blood
 Sets up electrical gradient due to pumping of negative ions into the lumen
• Causes Na+ and water to pump through too

front 33

NaCl secretion in digestion

back 33

• Cryp cells from the small intestine and colon secrete salt solution
• Creates gradient for water to follow which creates an isotonic salt solution

front 34

enzyme secretion in digestion

back 34

o secreted by exocrine glands (Salivary glands and pancreas) or by epithelial cells in the mucosa of the stomach and small intestine
o Stored as proenzyemes

front 35

mucus secretion for digestion

back 35

o Made up of glycoproteins
o Forms protective coating over the GI mucosa and lubricates the contents of the gut
o Secreted by mucous cells (stomach), serous cells (salivary glands), and goblet cells (intestine)
o Also secretes salt solution

front 36

bile secretion for digestion

back 36

o Secreted by the liver (hepatocytes)
o Made up of:
o Bile salts – facilitate fat digestion (main goal)
o Bile pigments like bilirubin
o Cholesterol
o Drugs & other waste products

front 37

locations of digestive secretions

back 37

• Ions (acid, bicarbonate, salt)
• Digestive enyzmes (salivary glands & pancreas)
• Mucus (stomach, salivary glands, & intestine)
• Saliva (salivary glands)
• Bile (liver)

front 38

digestion and absorption

back 38

• Villi increase surface area for absorption
• Brush Border creates a border for protection
 Not directly regulated
• Regulated by motility, feelings of hunger, etc.
 3 major nutrients: carbohydrates, proteins, fats

front 39

Carbohydrates

back 39

• Starch, sucrose, glycogen, cellulose, lactose, maltose, glucose, fructose
o Must break giant polymers into smaller pieces (monosaccharides) before you can move it across a cellular border
o Amylase- breaks polymers into simpler molecules
 Found in the saliva and gets secreted by the pancreas
o Enterocytes don’t use glucose (they use glucogen) so they don’t mess up the gradient

front 40

Proteins

back 40

• Most ingested protein are large molecules
• Not all proteins are processed equally (80% of protein is absorbed from eggs, only 30-40% absorbed from beans
• 30-60% of protein in lumen comes from dead cells & secretion
• endopeptidases and exopeptidases

front 41

endopeptidases vs exopeptidases

back 41

• Endopeptidases- breaks up initial peptide bonds
o Proteases are a more common name
o Proenzymes
o Ex: pepsin, trypsin
• Exopeptidases- break off amino acids from the amino or carboxyl ends of smaller proteins that have been broken up
o Carboxypeptidases are most important

front 42

protein transport in digestion

back 42

• Many different transport systems for the different amino acids
• Large proteins can be brought in via transcytosis
o Stimulates immune response and allergy responses
o Larger peptides are that are transported through the cell are more likely to cause an immune response so if you wait until a baby has more mature villi then they are less likely to transport those larger molecules and cause an allergic response

front 43

fats

back 43

• Triglycerides
• Cholesterol
• Phospholipids
• Long-chain fatty acids
• Fat-soluble vitamins
• Not water soluble
o Fat groups into large droplets
o Need to break up the droplets into smaller ones via Bile salts

front 44

bile salts

back 44

 break up fats into smaller pieces
 Bile salts interact with water
 Fat droplets alone are relatively unstable (break into smaller ones)
• Bile salt ringed fat droplets are relatively stable
• Broken into smaller and smaller pieces
• Secreted into the lumen

front 45

micelles

back 45

combination of all the things that have been broken up into the lumen
• Small, disk-shaped droplets
• Diglycerides & monoglycerides, Phospholipids, Fatty acids, Cholesterol
• Migrate towards the microvilli and brush border for secretion
• Water soluble
o Does not need transport protein and will go through the membrane without a problem
• Once they pieces get through the membrane into the cytoplasm they reform into larger molecules that get secreted by the golgi apparatus
• Too big to go into the capillaries or normally secrete (A few fatty acids can pass to the capillaries but it is fairly infrequent)

front 46

fat digestion and absorption (picture)

back 46

front 47

nucleic acid digestion

back 47

• DNA & RNA polymers are small part of diet
• Broken down into nitrogenous bases & monosaccharides
• Nitrogenous bases require active transport for absorption

front 48

vitamin digestion

back 48

• Fat-soluble vs. water-soluble
• Fat-soluble vitamins are packaged into micelles and absorbed (vitamins A, D, and K)
• Water-soluble are absorbed by mediated transport (all B and C vitamins)
• Olestra- fat that cannot be absorbed
o Was added to chips but caused negative side effects when too much was ingested

front 49

mineral digestion

back 49

• Generally occurs via active transport
• Iron & calcium are actively regulated

front 50

ion and water digestion

back 50

• Most absorption occurs in small intestine
• Na+ & Cl- absorbed by multiple pathways
• K+ & water absorbed via paracellular transport

front 51

digestive system regulation signaling

back 51

o Neural, endocrine & local signals
 Long reflexes (integrated in CNS)
 Short reflexes (integrated within GI tract)
 Peptide hormones & reflexes
• Paracrine system (stomach)

front 52

integration of digestive reflexes

back 52

 Everything is happening within GI tract\same responses we would normally see just input from the CNS is not required

front 53

Function of components of the GI tract in digestive signaling

back 53

 Muscularis are in charge of secretion and regulates motility and control
o Peptides are a major class of signaling molecule
o Act as hormones or paracrine signals
 Could affect other hormones as well
o Inhibit or excite secretion & motility
o Can work on either side of epithelial layer

front 54

enteric nervous system

back 54

 Acts as an independent integrating center like the brain or spinal cord
 Does not have a specific bundle or ganglia of nerve cells like the CNS for processing specific signals
 Nerve network responds to sensory stimuli and initiates reflex
• Everything is reflex responses since there is no integrating center

front 55

shared characteristics between the enteric nervous system and the CNS

back 55

• Intrinsic neurons à interneurons
• Neurocrine molecules
• Glial support cells
• Tight capillaries around ganglia à blood-brain barrier
• Acts as an integrating center

front 56

digestive system summary (picture)

back 56

front 57

cephalic phase of digestion

back 57

 Feedforward response
• Smelling, seeing, or thinking about food triggers digestion
 Anticipation or stimulus of food in mouth causes stimulation via medulla
 Food in mouth causes: Salivary response (Lubricates, Digests - salivary amylase (starts breaking down carbohydrates), Protects – Lysozyme), Mastication = chewing, Deglutition= swallowing

front 58

steps of swallowing

back 58

 tongue pushes bolus against soft palate
 breathing is inhibited as the bolus passes the closed airway (epiglottis folds down to help keep swallowed material out of the airways and upper esophagael sphincter relaxes)
 food moves downward into the esophagus propelled by peristaltic waves and

front 59

gastric phase reflex (picture)

back 59

front 60

Stomach function- storage

back 60

o Bring in 3.5L of food, liquid, & saliva per day
 Relaxed stomach holds 45mL of liquid, after a normal meal it expands to 1.5L, after a large meal it can stretch to 2.5-3L
o Regulates amount of food that goes into small intestine for digestion
o Upper stomach (fundus) stores food

front 61

stomach function- digestion

back 61

o Lower stomach (antrum) continues digestion
o Peristalsis mixes food with enzymes & acid to break down food
 Only 10% of digestion happens in the stomach, the rest happens in bile, etc.

front 62

secretory cells of the gastric mucosa

back 62

front 63

integration of cephalic and gastric phase secretion

back 63

front 64

stomach function- protection

back 64

o Mucous neck cells secrete mucuous- bicarbonate barrier
o Gastric juice pH = 2
o Enterocyte cell surface pH = 7

front 65

intestinal phase

back 65

 Chyme enters small intestine
 Started to break down proteins by pepsin in stomach
 Rate of entry of chyme determines intestinal response (secretion, motility, nutrient use)

front 66

intestinal phase secretion

back 66

• Bicarbonate (pancreas)- Neutralizes stomach acid
• Mucus (goblet cells)- Lubricates & protects epithelium
• Bile (gallbladder)- Fat digestion
• Digestive enzymes (enterocytes & pancreas)- Break down food particles
• 5.5L of total stuff in the lumen after secretion

front 67

hepatic portal system (picture)

back 67

• after the transport of organic nutrients and ions through the duodenum and jejunum most absorbed nutrients move into the capillaries in the villi and then into the hepatic portal system.
• specialized region of the circulation that has 2 sets of capillary beds: one that picks up absorbed nutrients in the intestine and another that delivers the nutrients to the liver

front 68

absorption in the small intestine

back 68

 7.5L of 9L reabsorbed
 Most happens in duodenum & jejunum
 Move into capillaries & then the hepatic portal system
 As you move solutes water will follow

front 69

digestion in the intestines

back 69

• most digestion occurs in the small intestine
• Protein -Broken down by many peptidases & proteases à small peptides & amino acids
• Carbs- Digestible polysaccharides broken down into monosaccharides & absorbed
• Fats- Bile salts enter at the duodenum to allow digestion & absorption
• By large intestine down to 1.5 L of stuff

front 70

differences between large intestine and small intestine walls

back 70

Large intestine has:
 Colonocytes
 Mucosa (Smooth, no villi)
 Muscularis (Discontinuous longitudinal layer)

front 71

large intestine digestion and absorption

back 71

o Traditionally thought that little to no digestion/absorption occurs here
o Recent research increasingly points to importance of gut bacteria for digestion

front 72

gut microbiome

back 72

o Around 500 species of bacteria in your gut
o Key for breaking down nutrients
o Three main categories: Prevotella (Carbs & simple sugars), Bacteroides (Proteins),Ruminococcus
 Absorption of nutrients is dramatically affected if these bacteria are missing
o Byproduct: gas production
o babies develop a gut microbiome which varies depending on the way the birth was given, how much the baby is interacted with (exposure) and whether the baby drank breast milk ir formula
o stool transplant

front 73

large intestine motility

back 73

o Chyme enters colon & mixes via segmental contractions
o Forward movement is minimal
o Occurs via mass movement
 Decreases diameter of colon
 Pushes bolus forward
 Gastrolic reflex
o Pushes bolus into rectum

front 74

defecation

back 74

• Distension of rectal wall initiates
• Internal anal sphincter relaxes
• Peristalsis pushes material forward
• External anal sphincter relaxes & feces move out of anus
• Emotions and the limbic system can affect defecation

front 75

diarrhea

back 75

• Abnormal water absorption causes watery feces
o Osmotic-Unabsorbed solutes pull water into feces (Ex: Lactose, sorbitol, Olestra, polyethylene glycol)
o Secretory-Bacterial toxins enhance Cl- secretion, Increased fluid secretion causes increased motility

front 76

M cells

back 76

• Specialized epithelial cells
• Sample gut content
• Transport content to interstitial fluid
• If bad stuff present, launch immune response
o Cytokines are released and trigger an immune response
• Irritable bowel syndrome- M cells can misrecognize normal foods and cause an immune response to normal food

front 77

vomit reflex

back 77

 Protective reflex
 Force contents out of stomach and duodenum
 Regulated by medulla
 Caused by: Cytokines, drugs, pain, disturbed equilibrium
 Reverse peristalsis- smooth muscle wave moves from small intestine, through the stomach, up the esophagus, and out the mouth

front 78

appetite vs. satiety

back 78

 Regulated by two hypothalamic centers
• Feeding center
o Tonically active
o Removal results in stopping eating
• Satiety center
o Inhibits feeding center
o Removal results in overeating which causes obesity

front 79

glucostatic theory

back 79

o a theory about how food uptake is regulated
o Glucose metabolism regulates food intake
o Low blood glucose levels causes a suppression of satiety center which causes hunger

front 80

lipostatic theory

back 80

o Lipid level regulates food intake
o Body seeks to maintain an “ideal” weight
o Low lipid level à hunger
o Some research support for this theory
 Leptin – protein hormone made in adipocytes that indirectly regulates food intake
 Neuropeptide Y directly regulates food intake

front 81

energy output

back 81

• Transport work- Moving molecules between compartments, moving materials into/out of body, Includes gradients for solutes
• Mechanical work, Muscle contraction, movement of vesicles down filaments
• Chemical work, Growth, maintenance, & storage

front 82

metabolic rate

back 82

o Oxygen consumption (indirect calorimetry)
 Easiest way to measure
 Measure O2 used and convert that into glucose using the glucose pathway
o Estimate of glucose metabolism indirectly
o Glucose metabolism is most efficient using aerobic pathways
• Metabolic rate (kcal/day)= L O2 consumed/day * kcal/L O2

front 83

energy storage

back 83

• Get energy from proteins, carbohydrates & fats
• Store energy for immediate use primarily as glycogen (Glycogen is more compact for storage than glucose)
• Long term storage as fat

front 84

metabolism

back 84

o Sum of all chemical reactions in the body
 Extract energy from nutrients
 Use energy for work
 Store energy for later work
 anabolism (small to larger molecules) vs. catabolism (larger to smaller molecules)
 fed state vs. fasted state

front 85

Fed State vs Fasted State

back 85

o Fed state
 AKA absorptive state
 Following a meal
 Anabolic pathways (smaller to larger molecules) active
 most glucose is stored as glycogen in fats

o Fasted state
 AKA postabsorptive state
 Used up nutrients from food already
 Catabolic pathways active (larger to smaller molecules)
 most glucose is used right away (in the form of glycogen)

o Body turns incoming proteins into amino acids that can be used where they are needed
 If there is too much protein the proteins can be turned into glucose and used for energy

front 86

hormone regulation of metabolism

back 86

insulin drives the production of glycogen from glucose

front 87

fed-state metabolism- carbohydrates

back 87

• Absorbed by intestine as monosaccarides (glucose mostly)
o About 30% of the glucose that goes through the liver is immediately metabolized
o The remaining 70% is sent out to the blood and circulated to the areas where it is needed
o If it is not needed it is stored as glycogen

front 88

fed-state metabolism- protein

back 88

• Absorbed by intestine as amino acids
• Diffuse into blood via hepatic portal vein
• Sent to the liver
• Excess amino acids get stored as fat

front 89

fed-state metabolism- fats

back 89

o Triglycerides + phospholipids + cholesterol + lipid-binding proteins
o More protein = heavier
o Range from VLDL (very low density lipoproteins) to HDL (high density lipoproteins)
o Protein bound with lipids makes them more soluble to cell membranes
o cholesterol

front 90

cholesterol

back 90

o Range from VLDL (very low density lipoproteins) to HDL (high density lipoproteins)
 Cholesterol levels are determined by the number of lipoproteins in the lipoprotein-cholesterol complex
o Most found as low-density lipoprotein cholesterol (LDL-C)
 “Lethal cholesterol”
 Uses apoprotein B to diffuse through membranes
o Second most common is high-density lipoprotein cholesterol (HDL-C)
 “Healthy cholesterol”
 Uses apoprotein A to diffuse through membranes
o Elevated LDL-C level is largest risk factor associated with heart disease
 Can manage through diet, exercise, drugs

front 91

nutrient disorders

back 91

• Diabetes mellitus – abnormal glucose metabolism
• Kidney & liver disorders – abnormal plasma protein levels
• Heart disease – abnormal cholesterol levels
o No studies that show causation between high dietary cholesterol and blood cholesterol levels
o Is a correlation between high blood cholesterol and heart disease

front 92

fasted vs fed state metabolism nutrients (picture)

back 92

front 93

fasted state metabolism

back 93

 After all nutrients from a meal have been cleared from digestive tract & plasma glucose concentrations start to fall
• After a meal blood glucose rises and fasted state begins when the glucose begins to fall
 Plasma glucose level a key regulator
 Catabolism hallmark of postabsorptive state

front 94

glycogenolysis (carbohydrate fasted state metabolism)

back 94

 glycogen can be converted directly to glucose 6-phosphate by the addition of a phosphate
 glycogen that is broken down first to glucose then phosphorylated "costs" the cell an extra ATP
 most glycogen is found in the liver

front 95

amino acid catabolism (protein fasted state metabolism)

back 95

 deamination- removal of the amino group from an amino acid creates ammonia and an organic acid
 body does not like ammonia (toxic) so it gets secreted
 free amino acid pool used for energy production
 creates pyruvate, acetyl CoA, etc. that can be used in glycolysis and the citric acid cycle

front 96

lipolysis (fat fasted state metabolism)

back 96

• Primary fuel-storage molecule
• Excess acetyl CoA production à ketones
o Useful in the citric acid cycle
• Basis for fad diets (Atkins, South Beach)

front 97

metabolism regulation (picture)

back 97

o Primarily regulated by endocrine cells
o Pancreas secretes insulin & glucagon
o Ratio of two hormones is what drives metabolism
o Insulin and glucagon are both always present so the ratios of them are what matter
o Short half lives, so they need to be replaced regularly

front 98

GLucose, glucagon, and insulin levels before and after a meal (picture)

back 98

front 99

insulin

back 99

 Peptide hormone
 Stimuli for insulin secretion:
• Increased plasma glucose
• Increased plasma amino acids
• Feedforward effects of other hormones involved in digestion
• Autonomic division activity
o “rest and digest”

front 100

glucagon

back 100

o Secreted by alpha cells in pancreas
o Whatever insulin does, glucagon does the opposite
o Low plasma glucose causes glucagon release
o Triggers catabolism
o Glycogenolysis & gluconeogenesis to generate new glucose
o Liver is primary target

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metabolism regulation dysfunction

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o Diabetes mellitus- Abnormally elevated plasma glucose levels (AKA hyperglycemia)
o Type 1 – insulin deficiency due to beta cell destruction
Fasted state: in the absence of insulin, there are no GLUT4 transporters in the membrane, Fed state: insulin signals the cell to insert GLUT 4 transporters into the membrane, allowing glucose to enter the cell
 Damaging to blood vessels, eyes, kidneys & nervous system
 8.3% of the U.S. population
o Type 2 – insulin resistant
 Variety of problems: Atherosclerosis, Neurological changes, Renal failure, Blindness

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heat loss

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conduction, radiation, convection, evaporation

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thermoregulation

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 Thermoneutral zone (82-86°F)
 Normal metabolism generates enough heat to maintain body temperature
 above that range causes gain of heat and the need to cool down, likewise for below that range
 sweating

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sweating

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• Evaporative cooling
• Use 2-3 million sweat glands in skin
• Sympathetic control
• Secretion of hypotonic solution
• Dependent on humidity

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cutaneous blood flow

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• Use convection by passing blood close to surface
• Sympathetic control
• Heat conservation- Close to zero blood flow through cutaneous layer
• Heat loss- 1/3 of cardiac output to cutaneous layer

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thermogenesis

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• Shivering
o Skeletal muscle contraction generates heat
• Non-shivering
o Brown fat- fat found in babies between the shoulder blades which is just now being discovered in adults
o More pronounced in babies and non-humans

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variation in temperature regulation

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• Circadian patterns: Daily, menstrual cycle
• Postmenopausal hot flashes
• Fever-Pyrogens
 Cytokines produced by immunocytes
 Increase body temperature
 Enhances activity of WBCs

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major functions

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 Recognize and remove foreign invaders
 Recognize and remove abnormal body cells
 Remove dead or damaged cells

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immune system dysfunction

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• Incorrect response- Fail to recognize self from non-self (Ex: Autoimmune diseases)
• Overactive response- Respond at a greater level than threat posed (Ex: Allergies)
• Lack of response- Failure of immune system to respond (Ex: Acquired immunodeficiency syndrome (AIDS))

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bacteria

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• Divides by self replicating
• Circular DNA, Unicellular, Small, Cell wall
• Prokayoric (no nucleus)
• No membrane bound organelles
• Antibiotics work well to kill bacteria

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virus

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• Needs a host to reproduce
• DNA or RNA
• Use host cell machinery
• Small genomes
• Integration of DNA

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lymphoid tissue

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• Found throughout body
• Thymus gland
• Bone marrow
• Lymph nodes
• Diffuse tissues

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Cells of the immune system

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Neutrophils

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• Phagocytes
• Most abundant WBC- 50-70% of white blood cells
• Release pyrogens
o Fever response

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Basophils

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• Important for inflammatory & allergic responses
• Granulocytes
o Histamine, Heparin

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eosinophils

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• Rare
• Allergic & parasitic response
• Granulocytes
o Cytotoxins

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Monocytes and Macrophages

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• Monocytes à macrophages
• Trash cans of immune system
o Pick up and take out mostly everything
o Anything abnormal, aging
• Antigen-presenting cells

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lymphocytes

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• Key part of acquired immunity
• B lymphocytes
• T lymphocytes and Natural killer (NK) cells- play important roles in defense against intracellular pathogens, such as viruses

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dendritic cells

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• Non-circulating
• Antigen-presenting cells
• Found in skin

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immunogen, antigen, antibody

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• Immunogen- Anything that triggers the body’s immune response
• Antigen- Immunogen that reacts with immune response
• Antibody- Proteins secreted by immune cells that bind to antigens to make them more visible to immune response

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goals of an immune response

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• Detection and identification of foreign substances
• Communication to other immune cells
• Coordination of response
• Suppression of target

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types of immunity

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• Innate Immunity- Present from birth, Nonspecific, immediate response
• Acquired Immunity- Specific response, Slower response

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lymphoid tissue

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 Found throughout body
 Thymus gland
 Bone marrow
 Lymph nodes
 Diffuse tissues

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immune response

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 Epithelium- the protective barrier of skin and mucous membrane is the body's first line of defense
 Secretions- salivary glands and the glands in airways secrete mucus and immunoglobulins to trap and disable inhaled or ingested pathogens
 Stomach acid- the low pH of the stomach helps destroy swallowed pathogens

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phagocytes

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• Innate immunity
• Attracted by chemotaxins
• Secrete own chemotaxins (cytokines) to attract more phagocytes
• Chemotaxins bind to PRRs
• Secrete inflammatory cytokines
• Ingest pathogen

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natural killer cells

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• Innate immunity
• Key for viral infections and cancer cells
• Rapid response
• Trigger apoptosis in infected cells

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inflammatory response for innate immunity

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• inflammatory response is key for innate immunity
• Attracts immune cells
• Produces physical barrier to prevent spread of infection
• Promotes tissue repair

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B lymphocytes

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• antibody production and antigen presentation, become plasma cells
• memory cells: coordinate immune response much more quickly and strongly when exposed to the same antigen a second time
• effector cells: short lived plasma cells that carry out the immediate immune response and secrete antibodies

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T lymphocytes

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o Cytotoxic – Attack & destroy
o Helper – Coordinate immune response

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major histocompatibility complex (MHC)

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• tissue rejection- want similar HLA antigens for tissue transplant (blood groups)

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Active and Passive immunity

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 Active immunity
• Body responds to pathogen & creates antibodies
• Ex: chicken pox, vaccines
 Passive immunity
• Receive antibodies made from another organism
• Ex: Motheràfetus, breast milk

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Antibodies (AKA immunoglobulins) (picture)

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o Activate B lymphocytes
o Act as opsonins
o Enhance phagocytosis
o Trigger cytotoxic responses
o Activate complement proteins
o Activate mast cells

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Bacteria Immune Response (picture)

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virus immune response (picture)

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allergen immune response (picture)

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 Inflammatory immune response to a non-pathogenic antigen
 Wide range of triggers and severity
 Key player: Histamine

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vaccination immune response (picture)

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