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S2 E2 KCU COB Andersen Courses > Physiology E2- Fitch > Flashcards

Physiology E2- Fitch Flashcards

1
Q

Isoosmotic

A
  • Having an osmolarity of normal ECF
  • 300 mOsmol/L
  • ECF = plasma and interstitial fluid = 300 mOsmol/L
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2
Q

Hyperomotic

A

Having an osmolarity more than normal ECF

Greater than 300 mOsmol/L

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3
Q

Hypoosmotic

A

Having an osmolarity less than normal ECF

Less than 300 mOsmol/L

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4
Q

Kidneys produce a small volume of _______ urine when ADH secretion rate is high

A

Hyperosmotic

Why? ADH removes the water from the urine and puts it back into the body. Therefore, concentrating the urine

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5
Q

The osmolarity of urine cannot exceed

A

1300 mOsmol/L

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6
Q

What is the obligatory water loss?

A

How much volume of urine that we have to lose a day: 0.46L/day

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7
Q

Where are sodium and chloride ions actively being pumped out?

A

Ascending limbs fo the loop of Henle into the interstitial fluid that surrounds the loop

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8
Q

T/F the ascending limbs of the loop of Henle are permeable to water

A

False. They are impermeable to water. This allows for the creation of hyperosmotic urine in the medullary

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9
Q

T/F the renal medullary interstitial fluid becomes more hyperosmotic as you move deeper into the renal medulla

A

True because of countercurrent multiplication

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10
Q

What contains a countercurrent that prevents the washing out of the hyperosmolarity of the interstitial fluid?

A

Vasa recta: The blood supply of the renal medulla

It will take in water and solute, but it will excrete solute as well

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11
Q

If blood ADH levels are high,

A

Water diffuses out of the medullary collecting ducts into the renal medullary interstitial fluids (Diffusion because of the hyperosmolartiy)

The water then moves from the interstial fluid into the capillaries of the renal medulla to be carried away by venous blood

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12
Q

If ADH levels are low,

A

Because both the cortical and the medullary’s COLLECTING DUCTS are impermeable to water, water is not reabsorbed as the filtrate flows through the CD and a large of HYPO osmotic urine is formed

Water stays in the urine

Osmolarity is less than 300 mOsmol/L

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13
Q

Sodium excreted =

A

Sodium filtered - sodium reabsorbed

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14
Q

What are the reflex controls of sodium?

A

Baroreceptors in the cardiovascular system and the sensors in the kidneys

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15
Q

How does low total body sodium affect:
ECF volume
Plasma volume
Blood Pressure

A

Low total body sodium –> low ECF volume –> Low plasma volume –> low blood pressure

If there is less sodium, then there is less water being reabsorbed

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16
Q

Low blood pressure will result in what actions by the kidneys?

A

Control of GFR
(How much sodium is filtered out of the blood)

(Remember that GFR is controlled by pressures)

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17
Q

Low blood pressure will result in what actions by the cardiovascular system?

A

Determining the pressure that is needed for filtration in order to control Mean arterial pressure (MAP)

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18
Q

What are the three things needed for GFR

A

Blood pressure, osmotic pressure, and interstitial pressure

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19
Q

If BP is low, then GFR is

A

low

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20
Q

If BP is high, then GFR is

A

high

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21
Q

Which is more important in the control of low blood plasma volume?
Constriction of afferent renal arterioles or decreed net glomerular filtration pressure

A

Constriction of afferent renal arterioles

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22
Q

Low blood pressure can induce two things in regards to GFR. What are those two things?

A

Decreased net glomerular filtration pressure directly
or
indirectly via increased activity in sympathetic nerves to the kidneys (Leads to constriction of afferent renal arterioles

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23
Q

How will decreasing GFR help blood pressure?

A

Decrease in GFR will decrease the amount of sodium and water being excreted. Therefore retaining fluid and plasma volume which will increase BP

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24
Q

T/F Controlling sodium reabsorption is more important than controlling filtration

A

True

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25
Q

What are the steps of hormonal release of aldosterone?

A
  1. Liver releases Angiotensin
  2. Renin from the kidneys will convert Angiotensin into Angiotensin I
  3. Angiotensin 1 will flow through the lungs where ACE will convert it into Angiotensin II
  4. Angiotensin II wills stimulate the adrenal cortex to secrete aldosterone
  5. Aldosterone will make the collecting ducts more permeable to sodium
  6. Sodium reabsorption is increased
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26
Q

In the absence of aldosterone, where is absorption of sodium occurring?

A

65% in the proximal tubules
30-32% in the Loop of Henle and the distal tubules
Totaling to 95-97% being reabsorbed without the help of aldosterone

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27
Q

What does aldosterone act upon for the reabsorption of sodium?

A

collecting ducts

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28
Q

What are the three inputs that increase renin secretion?

A
  • Sympathetic nerves (activated by baroreceptor reflex will constrict the juxtaglomerular )
  • Baroreceptors in the kidneys (Stretch: BP down = less stretch = more renin)
  • Paracrine factors from the macula densa (Response from a decreased volume and/or concentration of sodium in the tubular fluid flowing past the manual densa cells)
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29
Q

Increase sodium in the body causes water to be _____ due to _____

A

reabsorbed; osmotic considerations

This water increases the ECF to help regulate arterial blood pressure in the long term

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30
Q

What is the mechanism is used to help with long term BP?

A

Angiotensin –> Aldosterone mechanism

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31
Q

What are the effects of angiotensin II?

A

Will tell the adrenal cortex to secrete aldosterone

Will also act as as vasoconstrictor to increase total peripheral resistance

Increase in Cardiac Output via aldosterone (increase in volume)

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32
Q

What is the ANP pathway?

A
  1. High plasma volume will lead to distention of atria in the heart
  2. ANP will be released due to the stretch
  3. ANP will be placed into the blood as a hormone
  4. ANP will act on the kidneys to decrease sodium reabsorption
    AND
    It will increase GFR by dilating the afferent arteriole and constricting the efferent (increasing pressure)
  5. Increase in sodium excretion (Which will lead to lower plasma volume and decreased blood pressure)
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33
Q

What is the purpose of ANP

A

To increase sodium excretion to control cardiac output and blood pressure

Also inhibits the secretion of aldosterone (preventing the reabsorption of sodium)

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34
Q

T/F we can change water excretion rates without changing sodium excretion rates

A

True

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35
Q

Compared to sodium, where is water found?

A

Sodium is mainly found in the ECF, but water is found everhwere

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36
Q

T/F Baroreceptors are the main contributor in regulating water excretion

A

False: Because water is everywhere from interstitial fluids to within our cells, it has little affect on our baroreceptors compared to other mechanics of regulation

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37
Q

What are the main receptors that will affect water regulation of the body?

A

Osmoreceptors in the hypothalamus

They only detect ECF Osmolarity

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38
Q

What do osmoreceptors control? Via what?

A

Water retention

via the posterior pituitary’r release of ADH (vasopressin)

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39
Q

What happens to osmoreceptors when there is a decrease in water?

A

They would shrink and they would increase their frequency
Because mechanical gated ion channels in neurons will open
Which will stimulate the release of ADH by the posterior pituitary

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40
Q

What happens to osmoreceptor shine there is excess water?

A

They swell up and the mechanical gates will close: decreasing the frequency of firing/action potential
Which will decrease the stimulation on the posterior pituitary. Thus, leading to less ADH secretion

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41
Q

Name an example in which arterial baroreceptors and cardiovascular baroreceptors are involved in influencing ADH secretion

A

Hemorrhages

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42
Q

What are the three factors needed in order to keep water excretion separate from sodium excretion?

A
  1. A way to detect changes in osmolarity (osmoreceptors)
  2. A way to create concentrated urine (countercurrent system and ADH)
  3. A way to create dilute urine (Absence of ADH)
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43
Q

Congestive Heart Failure:
- A failing heart will have ____
- Which leads to a ____ in BP
- Which leads to an increase in plasma _____
And ____ Sodium excretion
- sodium excretion is also ___ by _____ via hormonal pathway
- Which leads to ____ Water reabsorption/retention
- Excess water will _____
- All of this leads to ______

A

Congestive Heart Failure:
- A failing heart will have “Reduce Cardiac Output”
- Which leads to a “Decrease” in BP
- Which leads to an increase in plasma “Renin –> Angiotensin II”
And “Decrease” Sodium excretion
- sodium excretion is also “Decreased” by Aldosterone” via hormonal pathway
- Which leads to “Increased” Water reabsorption/retention
- Excess water will “move into interstitial spaces”
- All of this leads to “edema”

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44
Q

What is the hormonal component of congestive heart failure?

A

Because of a decrease in BP, there will be an increase of renin which lead to more angiotensin II for more aldosterone secretion

All of this leads to decrease water excretion and more water retention

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45
Q

Is sweat hypo osmotic or hyperosmotic?

A

Hypoosmotic: You lose more water than you do salt

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46
Q

Describe the steps when there is an increase in plasma osmolarity

A
  1. Plasma osmolarity increase = it is saltier
  2. Osmoreceptors will shrink
  3. Increase in signal for post. pituitary to secrete ADH
  4. Increase in ADH
  5. Decrease in Water excretion and increase in water retention
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47
Q

Describe the steps when there is a decrease in plasma volume

A
  1. Decrease in plasma volume = decrease in plasma sodium and a decrease pressure
  2. This will decrease GFR
    Increase the renin angiotensin pathway
    And increase Plasma ADH
  3. This all increases sodium and water retention

***NOTE the main mode of action that this takes is the hormonal path of Renin angiotensin for sodium retention

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48
Q

What does excessive sweating do?

A

Decrease plasma volume and increase plasma osmolarity

detected by baroreceptors and osmoreceptors respectively

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49
Q

What is the most abundant intracellular ion?

A

Potassium

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50
Q

Most of the potassium that is filtered is ____

A

Reabsorbed

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51
Q

Some of the potassium can be ____ by the ______

A

secreted by the cortical collecting duct and is regulated according to need

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52
Q

How is potassium secreted ?

A

Sodium potassium pump will take the sodium back in while secreting the potassium into the interstitial fluid and moves through diffusion

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53
Q

How does aldosterone affect potassium in renal physiology?

A

It increases potassium secretion

Makes sense: it increases sodium reabsorption, therefore increases potassium secretion via the sodium potassium pump

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54
Q

What are two things that can affect potassium secretion?

A

Aldosterone and potassium levels

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55
Q

Higher than normal potassium in the ECF

A

Hyperkalemia: Cells can be excited easily

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56
Q

Lower than normal potassium in the ECF

A

Hypokalemia: Cells are less likely to be excited

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57
Q

What all is calcium involved in?

A 
Cell division
Function of many enzymes
Heart electrical activity
Neurotransmitter secretion
Hormone secretion
Oocyte activation
Removal of inhibition of muscle contraction 
Blood clotting 
Formation of bones and teeth
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58
Q

Higher than normal Calcium in the ECF

A

Hypercalcemia
Depresses nervous system and muscle activity
(Less of a gradient to make an action potential)

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59
Q

Lower than normal calcium in the ECF

A

Hypocalcemia
Causes nervous system excitement and tetany
(Takes very little to get something started because who know when calcium will come by again)

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60
Q

Where is calcium found in the body?

A

0.1% in the ECF
1% in the cell’s organelles
98.9% in the bones

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61
Q

Of the ECF calcium, where is calcium found and filterable?

A

50% ionized
9% combined with other ions
41% bound to proteins
Proteins cannot be filtered by the kidneys therefore only 59% of the 0.1% of calcium is filterable

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62
Q

How calcium stored in the bones?

A

As a crystalline salt called hydroxyapatite

Ca10(PO4)6(OH)2

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63
Q

What is the organic matrix of bone?

A

Collagen fibers plus ground substance

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64
Q

Osteoclats will

A

breakdown down and add calcium and phosphate to the ECF

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65
Q

What two things are needed for osteoclasts to be fully activated

A

PTH and vitamin D

Low vitamin D = low reabsorption of calcium into the blood

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66
Q

What dissolves the organic matrix in bone

A

proteolytic enzymes from osteoclasts

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67
Q

What dissolves the inorganic matrix in bone

A

acids released from osteoclasts

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68
Q

What is the role of osteoblasts

A

To take calcium out of the blood and add it to bone

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69
Q

How does PTH affect osteoclasts?

A

PTH binds to osteoblasts which then induces an autocrine signal that will allow it to become an osteoclast

70
Q

Calcitonin

A

Acts mainly on bones to decrease ECF calcium concentrations

of very litter importance

71
Q

How much of filtered calcium reabsorbed?

A

99% of it (80% of it is unregulated)

72
Q

What does PTH do on the DT/CD?

A

Increase Calcium reabsorption

73
Q

How is PTH connected to vitamin D?

A

PTH will cleave and activate an enzyme that will, in turn, activate the enzyme necessary to make vitamin D (1,25 dihydroxyvitamin D) usable

74
Q

Which vitamin D is dietary and which is made within the body?

A

Vitamin D2 is dietary

Vitamin D3 is made from the our skin via UV radiation

75
Q

Where does inactive vitamin D go to be activated?

A

First modification in the liver, then final activation in the kidneys by PTH

76
Q

What is the 1,25 dihydroxyvitamin D’s hormonal abilities?

A

It is carried by the blood to the intestine where it will increase the absorption of calcium and phosphate from our diets

77
Q

T/F Vitamin D increases PTH activity in osteoblast/clasts

A

True: Makes them more useful in calcium reabsorption

78
Q

How much calcium in the diet is actually absorbed?

A

35%

the rest is excreted in the feces

79
Q

T/F all the dietary, reabsorption, and excretion of calcium equals out to 0%

A

True: Therefore, it is set around a set point

80
Q

What two forms do phosphates exist in?

A

HPO4 2- and P2PO4-

81
Q

Where can phosphates be found in our bodies?

A

Bone matrix, Buffer system, ATP, ADP, cAMP, GTP, cGMP, DNA, RNA, and proteins

82
Q

How much of plasma phosphate is filterable?

A

50%

83
Q

Where are phosphates reabsorbed?

A

Proximal tubules

84
Q

What is the role of PTH in the reabsorption of phosphate

A

it decreases it

it increases calcium

85
Q

What is the pathway of digestion?

A 
Mouth
pharynx
esophagus
stomach
small intestine
large intestine anus
86
Q

What is the purpose of accessory organs in the GI tract?

A

To secrete things that will help with digestion

87
Q

What are the accessory organs in the GI tract?

A

Salivary glands, liver, gallbladder, exocrine glands of the pancreas

88
Q

Define Digestion in the GI tract

A

Breaking down of food into smaller particles (macromolecules that can be absorbed)

Mechanically (chewing) and by actions of digestive enzymes, acid, and bile

89
Q

Define secretion in the GI tract

A

Release of enzymes, acid, and bile into the lumen of the GI tract

90
Q

Define Absorption in the GI tract

A

Movement of molecules resulting from digestion from the GI tract across a lay of epithelial cells and into the blood or lymph

91
Q

Define motility in terms of the GI tract

A

Contraction of smooth muscles in the GI tract wall that mix the luminal contents and propel them forward from the mouth to the anus

92
Q

What is the purpose of saliva?

A

Antibacterial
Contains mucus for lubricating food particles before swallowing
Contains amylase that will begin the breakdown of polysaccharides
dissolves molecules so that they can interact with chemoreceptors (gives the sense of taste)

93
Q

What provides a pathway from the oral cavity to the stomach?

A

Pharynx and esophagus

94
Q

T/F digestion is actively occurring in the pharynx and esophagus

A

False

95
Q

What organ stores food?

A

The stomach

96
Q

What produces gastrin?

A

The stomach

97
Q

What dissolves the particulate matter in food, kills bacteria, and activates pepsinogens into pepsin?

A

Hydrochloric acid

98
Q

Where is pepsin first found and its function?

A

The stomach

Begins the digestion of proteins

99
Q

What is the purpose of mucus in the stomach?

A

Lubrication and protection

Protection from acid, pepsin, and mechanical strain

100
Q

Where can intrinsic factor be found and its purpose?

A

The stomach and is used to absorb vitamin B12

101
Q

What can the stomach absorb?

A

Ethanol, aspirin, and a little bit of water

102
Q

What does the stomach regulate?

A

The rate at which things are entering the small intestine

103
Q

What is chyme?

A

Solution of partially digested protein and polysaccharide fragments, fat droplets, salt, water, and other small molecules int the stomach, SI, and LI

104
Q

How is the small intestine divided up?

A

Duodenum, Jejunum, and ileum

105
Q

Where do most digestion and absorption occur?

A

The small intestine via hydrolytic enzymes

106
Q

T/F Enzymes for carbs, fats, and proteins are secreted by accessory organs for the digestion of nutrients

A

False: Enzymes for carbs, fats, and proteins are embedded in the luminal surfaces of cells lining the SI or are secreted into the lumen by the pancreas

107
Q

What does the SI secrete?

A

Water, salts, and mucus

108
Q

What does the gallbladder and liver secrete?

A

bile into the small intestine

109
Q

Where is the main hub for all absorption and digestion?

A

SI: absorbs monosaccharides, fatty acids, amino acids, vitamins, minerals, and water

110
Q

What is the purpose of the motility in the SI?

A

Mixes the contents with various secretions

Brings the contents closer to the epithelial wall for absorption

Slowly propels the chyme to the large intestine

111
Q

What does the pancreas secrete?

A

Pancreatic juices:
Bicarbonate (Buffer against stomach acid)
Enzymes necessary for digesting carbs, proteins, fats, and nucleic acids

112
Q

What does the liver secrete?

A 
Bile salts (not an enzyme, but breaks down fat) 
Bicarbonate (neutralization)
113
Q

What organic waste product along with some trace metals is placed into the feces by the liver?

A

Bilirubin via bile secretion

114
Q

What is the purpose of the gallbladder?

A

To store bile between meals
(bile comes from the liver)

Secretes the bile into the duodenum

115
Q

What is the purpose of the large intestine?

A

Secrete mucus
Concentrates and temporarily stores undigested matter
Mixes and propels its contents
Sends it to the rectum for defection

116
Q

What aspect of the luminal surface increases its surface area?

A

The fact that it is convoluted

117
Q

From the stomach on, the luminal surface secrete what?

A

Exocrine: mucus into the lumen
Endocrine: hormones into the blood

118
Q

Exocrine glands of the lumen secretes:

A 
Water
Acid
Enzymes
mucus
ions 
into the lumen
119
Q

What are the four tunics of the GI wall?

A

Mucosa
Submucosa
Muscularis Externus
Serosa

120
Q

Which tunic is a single layer of epithelial cells that contain blood and lymphatic vessels and nerve fibers and a thin layer of smooth muscles?

A

Mucosa tunic

121
Q

Which tunic is made of connective tissue that contains the submucosal plexus and some blood and lymphatic vessels?

A

Submucosa tunic

122
Q

What tunic is made of two layers of smooth muscles and are separated by neurons? Those neurons combine to be called the___

A

Muscularis externus tunic

Myenteric plexus

123
Q

The myenteric plexus gets its innervation from the ____

A

Autonomic nervous system

124
Q

What are the two types of muscles in the muscularis externus tunic?

A

Circular Muscles: Which narrow the tube

Longitudinal Muscles: Which shorten the tube

125
Q

What organ in the GI system has a three-layered muscularis externus?

A

Stomach

126
Q

What tunic covers the outer surface of the GI tube?

A

Serosa Tunic

127
Q

Where is the serosa not present, but instead has an adventitia?

A

Esophagus

128
Q

What is a mesentery?

A

Sheets of connective tissue that connects the serosa to the abdominal cavity

  • Fused double layer of peritoneal membrane
  • Holds organs in place
  • Allows a route for blood vessels, lymphatics, and nerves
129
Q

Villi can be found in

A

the small intestine

130
Q

Brush border is a part of the

A

Villis that contain microvilli

131
Q

A lacteal is

A

the center of each villus that contains capillaries and a single, blind-ended lymphatic vessel that absorbs fats and allows them to enter the lymphatic system

132
Q

What veins drain the SI, LI, pancreas, and parts of the stomach?

A

Hepatic Portal

133
Q

Where does the hepatic porta vein circulate to?

A

They give rise to secondary capillary network that will supply the liver

134
Q

What does the liver receive and do with it from the hepatic portal?

A

The things that have been digested

It will process it: Metabolize, detoxify, store, etc. (everything but fats)

135
Q

What is the peritoneum?

A
  • A serous membrane similar to the pleural cavity and pericardial membranes
    o Covers the external surface of many digestive organs and also lines the inner surface of the abdominopelvic cavity wall
    o Encloses the peritoneal cavity
     Filled with a thin layer of lubricating serous fluids
136
Q

Carbs are ingested as:

A

Starch
Sucrose
Lactose
Galactose

137
Q

Cellulose is metabolized by

A

bacteria in the cecum

138
Q

Digestion of carbs is done by

A

amylase (from saliva and the pancreas)
*** Mainly happens in the small intestine
Results in a mix of maltose and short chains of glucose molecules

139
Q

What enzymes are embedded in the luminal membranes that break down carbs?

A
  • Lactase: Breaks down lactose
  • Sucrase: Breaks down sucrose
  • Maltase: breaks down maltose
  • Alpha-dextrinase
140
Q

What are the water-soluble monosaccharides?

A

Fructose
Galactose
Glucose

141
Q

Glucose and galactose enter the epithelial cells via

A

SGLT-1 via secondary transport

Coupled with sodium

142
Q

Fructose enters the epithelial cells via

A

GLUT-5

143
Q

T/F Glucose, Galactose, and Fructose exit the epithelial cells into the interstitial fluid via GLUT-2

A

True: Through diffusion

144
Q

T/F essential amino acids are the ones that we make ourselves

A

False: Essential AA’s are the AA’s that we cannot produce

145
Q

What is the waste product of breaking down AA?

A

The nitrogens from AA breakdowns end up in urea

146
Q

Pepsin from the stomach will

A

Break down proteins into fragments

147
Q

Trypsin and Chymotrypsin from the pancreas

A

produces peptide fragments

148
Q

What will break down peptide fragments into free AA?

A

Carboxypeptidase and aminopeptidase which are embedded int he SI mucosal epithelial cell membrane (brush border)

149
Q

Free amino acids are absorbed by

A

sodium co-transport

requires ATP: secondary active transport

150
Q

Chains of 2 or 3 amino acids move into the cells by

A

Secondary active transport with hydrogen

*** They are then hydrolyzed into free AA within the cell

151
Q

T/F All proteins have to be digested in order to be absorbed

A

False: Some proteins can be absorbed whole via endocytosis

i.e. Antibodies from mother’s milk

152
Q

Lipids are ingested as

A

triglycerides

153
Q

What breaks down triglycerides and what are they broken into?

A

Lipases

2 free fatty acids and 1 monoglyceride

154
Q

Emulsification

A

Speeds up digestion of fat by breaking down fat droplets into smaller droplets

155
Q

Emulsification is achieved by

A

Mechanical disruption via churning activity

Emulsifying agents: bile salts, and lecithin (phospholipid)

156
Q

Micelles

A

Bile salts surround the small fat droplets that open and close and speeds up their movement towards the epithelial cells for absorption

157
Q

T/F Fats use secondary transport to be absorbed

A

False: Fats freely diffuse through the plasma membrane

158
Q

What happens to fats inside of the cell?

A

They are reassembled into triglycerides again in the smooth ER and form a fat droplet that will move through the Golgi and the plasma membrane to be placed into the interstitial fluid

159
Q

What are micelle like droplets called in the interstitial fluid?

A

Chylomicrons

160
Q

T/F Chylomicrons move through the basement membrane of capillaries and travel through the blood

A

False: Chylomicrons are prevented from entering the blood capillaries because of the basement membrane. They instead enter the lacteal and enter the lymphatic system to eventually be placed into the venous blood

161
Q

What vitamins are fat-soluble?

A

Vitamins A, D, E, and K

162
Q

What vitamins are water-soluble?

A

Vitamins B and C

163
Q

What vitamin needs help from which protein to be absorbed?

A

Vitamin B12 uses assistance from Intrinsic Factor

164
Q

How is Vitamin B and C absorbed?

A

Diffusion or carrier-mediated transport

165
Q

How are vitamins A, D, E, and K absorbed?

A

Same pathway as fats

166
Q

Where is water mainly absorbed in the GI system?

A

Small amounts in the stomach, but the main absorption is in the small intestine

167
Q

How is water absorbed?

A

Diffusion through the small intestine epithelial membranes following a gradient

168
Q

How is sodium absorbed?

A

Sodium is absorbed by creating a gradient with a sodium-potassium pump, then it moves in either through an ion channel or through co-transport with another molecule

169
Q

What is the exception in terms of trying to absorb as much as possible?

A

Potassium and calcium and Iron

They are both under physiological regulations

170
Q

T/F some ions are secreted and absorbed through the SI and LI

A

True: Ions like bicarbonate are secreted and then absorbed again

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