Anatomy III Exam Flashcards
(182 cards)
1
Q
Where is TSH secreted from?
A
Anterior Pituitary
2
Q
What hormones are released by posterior pituitary?
A
Oxytocin
ADH
3
Q
What hormone is released by paraventricular nucleus?
A
Oxytocin
4
Q
What hormone is released by supraoptic nucleus?
A
Antidiuretic Hormone
5
Q
What are tropic hormones and gives some examples
A
target other endocrine glands
PRL, GH
6
Q
What causes increase in IGF-1 from liver?
A
protein
exercise
fasting
sleep
7
Q
What causes decrease in IGF-1 from liver?
A
insulin
stress (cortisol)
estrogen
8
Q
Age of peak secretion from pineal gland?
A
1-5 year olds
9
Q
What does calcitonin do and where is it secreted from?
A
thyroid
decrease Ca++
10
Q
What does calcitriol do?
A
increase Ca++ by:
Inc GI absorption
Dec renal excretion
Inc bone resorption
11
Q
What is bone resorption
A
osteoclast break down bone to release Ca++ (Inc Blood Ca++)
12
Q
What are the three main layers of adrenal gland? (in to out)
A
Adrenal medulla
Adrenal cortex
connective tissue capsule
13
Q
What are the layers of adrenal cortex (in to out)?
A
Zona reticularis
Zona fasciculata
Zona glomrulosa
14
Q
What does the zona reticularis secrete?
A
DHEA progesterone estrogen testosterone androstenedione
15
Q
What does the zona fasciculata secrete?
A
cortisol
16
Q
What does the zona glomerulosa secrete?
A
aldosterone
17
Q
What does the adrenal medulla secrete?
A
EPI
NE
18
Q
What is the action of adrenal medulla?
A
fight or flight
19
Q
What is the action of zona fasciculata?
A
regulate blood sugar anti-inflammatory immune response modification heart and blood vessel toning stimulate CNS stress rxn normalization
20
Q
What is the action of zona reticularis?
A
antioxidant tissue repair sex hormones balance cortisol anti-aging
21
Q
What is the action of zona glomerulosa?
A
aldosterone: inc Na+, dec K+, conserve water –> increase BP
22
Q
What cell of pancreas secretes insulin?
A
Beta cell
23
Q
where is pancreas located?
A
retroperiotoneal and
inferior and dorsal to stomach
24
Q
what are Islets of Langerhans
A
pancreatic islets
contain alpha and beta cells
25
what is sphincter of Oddi?
where pancreatic duct opens
26
what does delta cells of pancreas secrete?
somatostatin --> inhibit insulin
27
What do Sertoli cells do and where are they?
testis
| progress germ cells to spermatozoa
28
What do Leydig cells do and where are they?
testis
| produce testosterone
29
What are granulosa cells?
ovarian cells that surround eggs to form follicles
30
What do granulosa cells secrete?
estrogen
| progesterone
31
What does somatostastin do and where is it secreted from?
increase glucose
| pancreatic delta cells
32
What do F cells do?
inhibit somatostatin
33
What does aldosterone do?
Na/K pump: Na in, K out --> water conservation --> increase BP
34
What is the alimentary canal?
mouth to anus GI tract
35
What do accessory digestive organs do?
secretions that contribute to food breakdown
36
What are the layers of alimentary canal?
Mucosa
Submucosa
Muscularis Externa
Serosa/Adventitia
37
What are the layers of the Mucosa layer and what do they each do?
lamina propria: nutrient absorption
| muscularis mucosae: movement
38
Where is serosa and adventitia each present?
serosa: below diaphragm, intraperitoneal organs
adventitia: esophagus; retroperitoneal organs
39
What does the submucosa layer do?
vascular, lymphatics, and nerve supplies
40
What does the muscularis externa do?
peristalsis
41
What does the serosa/adventitia do?
reduce friction and lubricate
42
Mesenteric Adenitis
inflammation of lymph nodes
43
Meissner's plexus (Submucosal)
regulates glands (enzymes) and smooth muscle
44
Auberchach's plexus (Myenteric)
controls motility (pushes food down)
45
What are the tongue muscles and what do they each do?
Intrinsic: speech; not attached to bone
Extrinsic: protrude and deviate tongue; attach to bone
Lingual frenulum: tongue to floor of mouth
46
What layer does stomach have that the rest of the alimentary canal doesnt?
innermost oblique layer in muscular externa
47
What does the parietal cell of stomach secrete?
HCl
48
What does the chief cell of stomach secrete?
pepsinogen
49
What cell secretes gastrin in stomach
G cell (neuroendocrine cell)
50
What does the intrinsic factor in stomach do?
required for B12 absorption in intestines
51
What does somatostatin in the stomach do?
inhibit acid secretion
52
What does gastrin do?
regulates stomach secretion and motility
53
What does histamine in the stomach do?
help produce acid
54
What are the phases of gastric secretion?
Cephalic
Gastric
Intestinal
55
What enzyme increases the pH of chyme and what is it secreted by?
Secretin
GIP
CCK
by duodenum
56
upper esophageal sphincter blood supply
inferior thyroid artery
| vein drains from inferior thyroid vein to brachiocephalic v.
57
thoracic esophagus blood supply
thoracic aorta, bronchial arteries
| veins drain from azygous vein to superior vena cava
58
lower esophagus blood supply
left gastric and left splenic arteries
| veins drain from gastric veins to portal system
59
What is esophageal varices caused by?
portal hypertension, cirrhosis. liver disease
60
What arteries supply greater curve of stomach
L/R gastro-omental arteries
61
What arteries supply lesser curve of stomach
L/R gastric a.
62
What arteries supply fundus of stomach
short gastric a.
63
What is caput medusa?
portal hypertension with accumulation of peritoneal fluid
64
What does secretin stimulate?
secretion of sodium bicarbonate from pancreas and bile in liver
65
What supplies upper duodenum?
gastroduodenal artery
66
What supplies most of small intestines?
superior mesenteric artery
67
What layer of small intestines is villi and microvilli in?
mucosa
68
What is Crypts of Lieberkuhn?
immune cells and STEM cells in mucosa layer of small intestine
69
What is the strongest layer of small intestine?
submucosa
70
Where are Brunners Glands and what does it do
```
duodenum submucosa
increase pH (alkaline secretions and inhibit chief and parietal cells)
```
71
What are in the submucosal layer and what does each do?
brunners glands: increase pH
peyers patches: lymph nodules in ILEUM
lacteals: lymph capillary absorbs fats in villi
72
Where is Peyers patches?
Ileum submucosa
73
Does small intestines have serosa or adventitia?
serosa
74
gastroileal reflex
food in stomach --> ileum segmentation (constriction) --> gastrin release --> ileocecal sphincter relax --> chyme to large intestine
75
Peristalsis v. Segmentation
Peristalsis: moves
Segmentation: mix and churn
76
Bile functions
digest/absorb fat
| excrete bili
77
What are epiploic appendages?
fatty sacs on colon
78
What is a haustrum?
balloon pouches of colon
79
teniae coli
3 longitudinal bands
| contracts to produce bulges (haustra)
80
What parts of large intestines have serosa layer?
transverse and sigmoid
81
What supplies large intestines?
superior mesenteric artery: lower duodenum to 2/3 of transverse colon
inferior mesenteric artery: descending, sigmoid, rectum
82
Which hemorrhoids do not hurt?
internal hemorrhoidal plexus
83
What vitamins does large intestine produce?
Vitamin B and K
84
When does defecation occur?
when external sphincter VOLUNTARILY relax
85
What are the quadrants of liver where are they ?
Right: seen on all views
Left
Caudate: posterior to left, by IVC
Quadrate: inferior to left (between falciform lig and gallbladder)
86
What is the round ligament?***
fibrous remains of fetal umbilical vein
87
What gives 75% of hepatic blood supply?
portal vein
88
What does portal vein collect from?***
```
distal esophagus
stomach
small/large intestines
pancreas
spleen
```
89
What is bile canaliculi?
small tubes that collect bile secreted from hepatocytes; merge to form bile ductiles --> merge into common bile duct
90
bilirubin
product of RBC breakdown (heme)
91
"hilum of liver"
porta hepatis
92
what is cystic duct and what does it join with?
duct of gallbladder
merge with common hepatic duct
--> common bile duct
93
what is the Portal Triad and where is it?
Hepatic vein: nutrients
Hepatic artery: O2
Bile duct
@each of 6 corners of lobules
94
Kupffer cells
hepatic stellate macrophages on sinusoid wall
95
"Space of Disse"
where plasma filtered into lymph
| between hepatic cells and epithelial cells
96
Hepatic sinusoid
vascular channels;
| between central vein and hepatic a/v
97
most versatile and multifunctional cell in body
hepatocyte
98
Hepatocyte functions***
```
thousands of enzymes
store glycogen
breakdown RBC
Synthesize plasma proteins
produce non-essential AA
gluconeogenesis
hormones
detox
bile
urea
```
99
what is urea produced from?
ammonia and CO2
100
Cirrhosis
when hepatocyte death > reproduction
101
Kupffer cell functions***
destroy RBC
produce AB/plasma proteins/bile pigments
phagocytosis
activation --> early alcohol induced liver injury
102
Liver functions
```
produce bile salts
eliminate bili
metabolise steroid hormones
drug detox
produce urea
breakdown carbs, fat, protein
recycle and store minerals and vitamins
remove bacteria
coagulation
```
103
How is hemoglobin metabolized?
by spleen
globin: cut up and AA recycled
heme: iron and bili (iron stored in liver; bili in liver)
104
Which is direct and indirect bilirubin?
conjugated bili = direct (measured)
| unconjugated = indirect (calculated; bound to albumin)
105
Which bili is water soluble and which is not?***
```
conjugated = water soluble
unconjugated = insoluble
```
106
What level of total bili indicated diseased state?
4mg/dL or more
107
Dark urine means...
elevation of direct bili (bc soluble)
108
What happens to bilirubin in bowels?
bacteria metabolize conjugated bili to urobilinogen
109
What happens to urobilinogen
1. reabsorbed and secreted in urine (yellow)
| 2. or exit colon and convert to urobilin and stercobilin (brown feces)
110
How is bilirubin conjugated?
glucuronyl transferase in hepatocyte combine bili and glucuronic acid
111
cause of jaundice
excessive RBC destruction
impaired bili uptake
decrease bili conjugation
bile flow obstruction
112
cause of prehepatic jaundice
excessive hemolysis
113
cause of intrahepatic jaundice
impaired conjugation or removal of bili in bile
114
cause of posthepatic jaundice
obstruction of bile between liver and intestine
115
absorptive state of liver***
break down carbs and proteins --> liver regulate levels (storage as glycogen/triglycerides or usage or synthesize protein) --> enter portal vein --> IVC
116
postabsorptive state of liver***
1. plasma glu level <80 --> break glycogen to glu
| 2. after 4+hrs of this and if get to <70, gluconeogenesis (glu from alt sources like adipose, AAs)
117
what happens in transamination?
amine switched from AA to keto acid --> AA forms glutamic acid
118
what happens in oxidative deamination?
amine of glutamic acid (ammonia) combines with CO2 --> urea
119
keto acid modification
keto acids from transamination altered to enter Krebs cycle --> ATP
120
what happens to pts with excessive ammonia?
confused; hepatic encephalopathy
121
What is urea?
CO2 + Ammonia; way for body to remove ammonia
122
HIGH AST
alcohol hepatocyte damage
123
HIGH ALT
viral hepatocyte damage
124
HIGH ALK PHOS
biliary canaliculi/duct obstruction (or bone issues)
125
HIGH GGT
Alcohol abuse
| or obstruction
126
Bile duct obstruction signs
elevated ALK PHOS and GGT
127
Early liver failure
hepatosplenomegaly
128
late liver failure
small liver
129
Portal hypertension manifestations
ascites
hemorrhoids
esophageal > gastric varicose --> GI bleed
spider angiomata
130
hepatocyte destruction manifestations
```
hypocoagulation
jaundice
hepatic encephalopathy (coma and death!)
feminization (testicular failure)
ascites/edema
```
131
Albumin
produced in liver and keeps fluid in blood and prevent leakage
low levels: kidney/liver problem
132
hepatorenal syndrome
cirrhosis can lead to poor renal blood supply --> renal failure --> death
133
3 systems of alcohol metabolism
Alcohol dehydrogenase (ADH) system --> liver cytoplasm
Microsomal ethanol-oxidizing system (MEOS) --> ER
Catalase --> peroxisomes
134
what is the function of transitional epithelium of mucosal layer of bladder?
expands!
135
trigone
opening of ureters and urethra; triangular
136
afferent arteriole and efferent arteriole
afferent: blood enter glomerulus
efferent: exit glomerulus
137
podocyte
wrap around capillaries in bowman's capsule with basement membrane
138
proximal convoluted tubule
REabsorption: ions, AA, glu, H2O (65%) back in blood
| ACTIVE
139
SGLT2 inhibitor
account for 90% of glu reabsorption
140
What does the Loop of Henle do (Asc/Desc)?
Descending: passively absorb water (drive by osmolarity from asc)
Ascending: actively pump out salts (Na, K, Cl)
141
What does the distal convoluted tubule do?
absorb ions, monitor pH
| low pressure --> macula densa cells stimulate JG cells of afferent arteriole to release renin --> increase BP
142
Collecting ducts
Multiple distal convoluted tubules dump into duct
absorb water
breakdown Urea!
143
Where does urea go from collecting ducts?
major part of urine released; some urea held to increase osmolarity of medulla and drive water resorption in Loop of Henle
144
Where does collecting duct connect to?
collecting duct --> renal calyx --> pelvis --> ureter --> bladder --> urethra
145
Diuretics and what are they used for?
increase rate of volume output
| Usage: edema, HTN, intoxication
146
Osmotic diuretic
Mannitol
| not easily reabsorbed and increases osmolarity in urine --> water retention/in
147
Loop diuretic
Lasix
blocks Na/Cl co transporters in Ascending Limb of Loop--> decrease active absorption --> increase water retention in urine
lose K tho
148
Thiazide diuretics
hydrochlorothiazide (HCTZ)
| blocks Na/Cl co transporters in DISTAL tubule
149
aldosterone antagonists
spironolactone (aldactone)
| inhibit aldosterone in collecting tubule; decrease Na resorption and decrease K secretion
150
sodium channel blockers
triamterene
also blocks Na out/K in pump; Na stays in Collecting tubule, drawing water in, K stays in medulla
doesnt affect aldosterone system
151
What is a K sparing diuretic?
aldosterone antagonist, sodium channel blockers
| K stays in medulla
152
What is the leading cause of kidney failure
diabetes
153
Second cause of kidney failure
HTN
154
What are the three categories of acute renal failure?
1. prerenal: decreased blood to kidney
2. intrarenal: abnormality in kidney
3. postrenal: obstruction
155
what is chronic renal failure?
progressive and irreversible loss of nephrons (complications after 70-75% loss)
remaining nephrons enlarge
156
fourchette and what is opposite of it anteriorly?
frenulum of labia minora (posterior)
| prepuce of clitoris (anteriorly)
157
What are Skene's glands (paraurethral glands) and what is it analogous to in the male?
lesser vestibular glands
| male prostate
158
where are Bartholin's glands?
right beneath fascia
| greater vestibular glands/bulbourethral glands
159
What length of pelvic outlet might prevent fetus passage?
< 9.5cm
160
What is the most uncommon bony pelvis type and what can happen with it?
platypelloid
| C section
161
What are the types of bony pelvis?
anthropod: AP>transverse; not good
platypelloid: not good
android: wide transverse
gynecoid: most spacious (more common); best
162
What do Kegel exercises do and what muscle does it target?
strengthen pelvic floor muscle (pubovaginalis)
| help w/incontinence
163
What are the pelvic floor muscles
levator ani: iliococcygeus, pubococcygeus, puborectalis
164
Most likely muscle damage in child birth?
pubococcyeus
165
What is the pouch of Douglas?
rectouterine pouch
166
What cells are in the middle of cervix?
columnar epithelia
| swabbed in pap smears
167
What are the four parts of fallopian tube?
infundibulum
ampulla
isthmus
uterine part
168
what is the introitus?
vaginal vestibule
169
What structure has fimbriae?
infundibulum
170
Where does fertilization occur in the fallopian tube?
ampulla
171
Where is the most common site for ectopic pregnancy?
ampulla
172
What layer does the ovary not have and why?
peritoneum
| to expel oocyte
173
which ligament of uterus looks like bat wings and what does it do?
broad ligament
| encloses uterus, holds nerves and vessels
174
What keeps the ovaries up and in place?
suspensory ligament of ovaries
175
What layer is shedded during menses?
stratum functionalis of endometrium
176
What artery constricts during menses?
spiral artery --> necrosis of stratum functionalis
177
veinous drainage of lateral 2/3 of uterus
pampiniform plexus-->ovarian veins-->IVC(R)/renal vein(L)
178
veinous drainage of medial 2/3 of uterus
uterine plexus--> internal iliac
179
What are the lymph nodes of the pelvis?
```
superficial inguinal nodes: external genitalia, anus
sacral nodes: lower third vagina
internal
common iliac
external:
lumbar nodes: upper uterus, ovaries
```
180
External perineal innervation
ilioinguinal nerve and genitofemoral nerve
pudendal nerve
perineal branch of post femoral cutaneous
coccygeal and last sacral
181
what is most common acute complicatin of lymph node dissection?
pelvic hemorrhage
182
what lymph node should you sample when dealing with ovarian cancer?
aortic and subaortic nodes bc metastasis spreads in cephalad direction
