Lecture Exam 2 Flashcards

(132 cards)

1
Q

What are the main functions of the respiratory system?

A

Gas exchange

Vocalization

Olfaction

Acid-base balance

ACE conversion / BP

Pressure Gradient establishment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Name the structures/pathway in order from the mouth/nose to the lungs

A

nose, pharynx, larynx, trachea, bronchi, bronchioles, alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does the conducting division of the respiratory system consist of?

(Structure and function)

A

Those passages that serve only for airflow, essentially from the nostrils through the major bronchioles

  • Upper respiratory tract
    • Structure:
      • Mouth, pharynx, epiglottis
    • Function:
      • Airflow
      • Warm, cleanse, and humidify air
      • Olfaction
  • Lower respiratory tract
    • Structure:
      • Glottis, larynx, trachea, bronchi
    • Function:
      • Airflow and cleansing
      • “Mucous elevator”
      • Vocalization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the respiratory division structures consist of and what are their functions?

A
  • Bronchioles
    • smooth muscle
  • Alveoli
    • Site of gas exchange
    • Cellular specialization
      • Squamous (Type 1) Cells = ~95% of cell
        • Diffusion
      • Great (Type 2) cells = ~5% of cell
        • Repair and surfactant production
        • Wandering macrophages
    • Respiratory membrane
      • Squamous (Type 1) cell
      • Basement membrane
      • Capillary endothelial cell
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Explain the details of the respiratory membrane

Include:

  1. Squamous alveolar cell
  2. Shared basement membrane
  3. Capillary endothelial cell
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the inspiratory and expiratory muscles?

A

Inspiratory muscles:

  • Diaphragm
  • External intercostals

Expiratory muscles:

  • Internal intercostals
  • Abdominal muscles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Name and describe the neural control centers for the respiratory control and what they impact

A

Control of skeletal muscles

  • Medulla
    • Ventral Respiratory Group (VRG)
      • Active in bursts during quiet breathing
      • Control activity of phrenic and intercostal nerve
      • primary generator of respiratory rhythm
  • Dorsal Respiratory Group (DRG)
    • Receives sensory input
    • Modifies activity of the VRG
    • Breathing is adapted to varying conditions
  • PONS
    • Pontine respiratory group (PRG)
      • Modifies activity of VRG and DRG
      • Receives input from high brain centers
        • eg. hypothalamus, limbic system, and cerebral cortex
        • Adapts to sleeping, exercise, vocalization and emotional response changes
  • Neural Output
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Explain the types of stimuli and sensors (Who controls the control centers?)

A
  • Central Chemoreceptors
    • Medulla oblongata - brainstem neurons
      • respond to changes in pH of cerebrospinal fluid
    • “Stimulating” stimuli:
      • Increase CO2 (hypercapnia) or decrease pH of CSF
  • Peripheral Chemoreceptors
    • Carotid and aortic bodies
      • respond to O2 and CO2 content of the blood and pH
    • Stimulating stimuli:
      • Decrease PO2, Increase CO2, or Decrease pH in blood
  • Stretch Receptors
    • Found in smooth muscle of the bronchi and bronchioles and in the visceral pleura
      • Respond to inflation of lungs and signal the DrG by way of vagus nerves
    • Hering-Breuer reflexes (excessive inflation triggers this reflex)
      • Inflation reflex
      • Deflation reflex
      • Prevent damage due to overexpansion or collapse
  • Irritant Receptors
    • Detection of irritating chemicals / gases
      • Trachea receptors trigger coughing
      • Nose and pharynx receptors trigger sneezing
  • Voluntary Control
    • Required for vocalization and swimming
    • Neural bypass of respiratory centers under control of cerebral cortex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the fluid flow directly proportional to?

A

F = delta P / R

Where:

F = flow

Delta P = change in pressure

R = resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the pressure that drives respiration, explain

A

atmospheric (barometric) pressure

the weight of the air above us

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Explain Boyle’s law

A

at constant temperature, the pressure of a given quantity of gas is inversely proportional to its volume

P1V1 = P2V2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Explain how the pressure difference in the lungs and chest cavity are impacted during the respiration cycle

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Explain the breathing mechanistic gas physics, ie. ideal gas law

A

PV = nRT

(Boyle’s law)

P = pressure

V = volume

n = # of gas molecules

R = gas constant

T = temperature

Pressure and volume are inversely proportional

Air moves from high to low pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Explain the respiratory pressure changes during the respiration cycle

A
  • Atmospheric Pressure
    • Air pushing down
    • 760 mm Hg (at sea level)
    • Since it doesn’t change, set to zero
  • Intrapulmonary Pressure
    • Internal pressure in the lungs (in alveoli)
    • Changes due to lung volume
      • Normally -1 to +1 (relative to Patm)
        • -1 = greater volume in lung
        • +1 = lower volume in lung
  • Respiratory Cycle
    • Inspiration
      • Increase in lung volume = decreased intrapulmonary pressure
      • Air flows in
  • Intrapleural pressure
    • Pressure in pleural space
    • A ‘sucking’ force!
    • Based on elastic pull inwards vs. adhesion outwards
    • Varies during respiratory cycle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the factors that enhance pressure in the lungs?

A

Volume changes, most substantial effect

Adhesion of lung to pleural wall

Elasticity of the lungs and chest wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Explain the factors enhancing resistance in the lungs

A
  • Airway diameter
    • Bronchoconstriction
      • Histamine, PSNS
        • for people with allergic response, this is how it is treated
    • Bronchodialation
      • Epinephrine, SNS
      • beta 2 agonists
        • in puffers for people with asthma
  • Pulmonary compliance
    • Surfactant decreases surface tension
      • very easy to fill up under normal circumstances, but as you get older the elasticity decreases
    • Prevents collapse
      • amphiphilic molecules that disrupts and prevents collapse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Explain alveolar ventilation, like breaths per minute for a normal adult and for a child

A

Adult normal = 12 / min

Children = 18 - 20 / min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Explain how to calculate the respiratory minute volume (VE)

A

Respiratory minute volume (VE) = F x Vt

where: F = breaths per minute, Vt = title volume

Normally 12 breaths/min x 500 ml/breath = 6 L/min

Variable by delta F or delta Vt

Up to 200 L/min

If your VE = 6.0 L/min, how many breaths per minute are you taking?

  • cannot answer because you do not have the title volume (Vt)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Explain the alveolar ventilation (VA) and how to calculate it

A

Volume of ‘fresh’ air getting to alveoli

  • Automic dead space (VD)
    • Air ‘left’ in conducting zone
      • Only one way in and out, so the air mixes and that wish why you must subtract out the dead space when calculating the alveolarventilation
    • ~150 ml per breath
  • VA = f ( Vt - Vd)
    • VA = alveolar ventilation
    • Vt = title volume
    • VD = Automic dead space
  • ex: VA = 12 bpm x (500 ml - 150 ml) = 4.2 L/min
    • only about 2/3 of the air we breath is fresh
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the anatomical dead space implications?

  1. If VE stays constant (6.0 L/min), but F goes down, what happens to VA
  2. how many breaths before VA = 0 L/min when VE = 6.0 L/min
A
  1. If F goes up and VE is held constant, VA would also go up
  2. Any amount of breaths over 40, is just replacing dead space air, that is why people pass out when you have panic attacks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Explain the spirometry trend and components

A
  • Tidal Volume
    • Volume of air during normal (quiet) breathing cycle (eupnea)
    • ~500 ml
  • Inspiratory Reserve Volume
    • Volume that can be inspired (over tidal) with maximum effort
    • Hyperpnea
      • 1500 - 500 ml
  • Expiratory Reserve Volume
    • Volume that can be expelled (after tidal) with maximum effort
      • 500 - 1000 ml
  • Residual Volume
    • Volume of air that remains in the lung, even after maximum exhalation
      • Not normally measurable
      • 900 - 1200 ml
      • Due to surfactant, intrapleural pressure
  • Minimal volume (after collapse)
    • 30 - 120 ml
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Explain how each of the following are determined and if you can measure them

  1. Total Lung Capacity
  2. Inspiratory Capacity (IC)
  3. Vital Capacity (VC)
  4. Functional Residual Capacity
A

VT = Tital Volume

IRV = Inspiratory Reserve Volume

ERV = Expiratory Reserve Volume

Vres = Residual Volume

  1. Total Lung Capacity = VT + IRV + ERV + Vres
    • No, cannot measure Vres
  2. Inspiratory Capacity (IC) = VT + IRV
    • Yes, can measure
  3. Vital Capacity (VC) = VT + IRV + ERV
    • Yes, can measure
  4. Functional Residual Capacity = ERV + Vres
    • No, cannot measure Vres
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Explain an overview of gas exchange?

A
  1. Gas diffuses down its own concentration gradient
    • usually talk in partial pressure gradient
  2. The structure of the respiratory memebrane is well adapted for the exchange of O2 and CO2
  3. Hemoglobin carries both O2 and CO2
    • Must have an affinity to oxygen but also needs to be able to dump it off
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Explain the physics behind gas movement

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Explain what makes up air and the details of partial pressure and dalton's law
* **_What is air?_** * **Mixture:** N2, O2, H2O, CO2, other * **Partial Pressure** = % air X air pressure * **Dalton's Law:** PN2 + PO2 + PCO2 + PH2O = 760 mm Hg * PO2 = 760 mm Hg (21%) = 160 mm Hg * PCO2 ​= 760 mm Hg (0.04%) = 0.3mm Hg
26
Explain Henry's Law
Amount of gas in a solution: is directly proportional to its partial pressure * **Henry's Law** * And depends upon the solubility of the gas * CO2 is more soluble in water than O2
27
Explain alveolar gas exchange
Respiratory Efficiency * Large partial pressure gradient * Short distance * High permeability * Large surface area * Greater blood flow around higher alveolar O2 levels and vice versa
28
Explain the oxygen hemoglobin saturation curve and the overall transport of Oxygen
Transport: O2 * Hemoglobin: * Hb + O2 -\>\<- HbO2 * Hemoglobin saturation * % of heme units bound to O2 Transport based on the partial pressures in the blood and tissue as to where it is dropped
29
Explain the partial pressure differences in the circulatory system and how it impacts the respiratory system
30
Explain Alveolar capillary diffusion with CO2 and O2
31
Explain the Hemoglobin saturation curve impact with a change in pH
* Decreased acidity causes more O2 release * (decreased affinity * Bohr effect * eg due to metabolism
32
Explain the hemoglobin saturation curve impact with a change in temperature
* Increased temperature causes more O2 release (decreased affinity) * again, due to metabolism
33
Explain CO2 transport type
* ***_Bicarbonate Ions / carbonic acid_*** * ~90% of CO2 transported * CO2 + H2O -\>\<- H2CO3 -\>\<- H+ + HCO3- * Catalyzed by carbonic anhydrase * converts the chemical reaction (no ATP) * Exchanged for Cl- (chloride shift) = simporter * ***_Bound to Hemoglobin_*** * ~5% of CO2, about 20% of the exchanged CO2 * CO2 + Hb -\>\<- HbCO2 * Carbonimohemoglobin - attraction to CO2 * ***_Dissolved Gas_*** * ~5% of CO2, because CO2 is water soluble
34
Explain the systemic gas exchange process
* **Unloading of oxygen** * Diffusion (100 -\> 40 mm Hg) * **Loading of carbon dioxide** * Diffusion (46 -\> 40 mm Hg) Facilitating this shift is where bicarbonate ions are exchanged for Cl- ions We load our tissue with tissues to allow for it to metabolize and produce energy for the cells
35
Explain a summary of respiratory control
36
Explain a summary of neural control of breathing
37
Explain Hemoglobin Saturation and curve
Arterial blood: * PO2 = 100 mm Hg * 98.5% saturated (hemoglobin not perfect) Venous blood: * PO2 = 40 mm Hg * 75% saturated Curve due to change in shape with O2 binding
38
Explain the positive feedback
Implications: * Good saturation throughout normal body conditions * Self-regulating system: * As blood PO2 falls, more O2 is released * Say, due to increased metabolism * Oxygen stored even in venous blood
39
Explain RBC Metabolism
* 2, 3 BPG * Produced by RBCs * High altitude, anemia * Decreases O2 affinity * Curve shift?
40
Explain Fetal Hemoglobin shift
* Higher affinity for O2 Overall * Steep slope means more sensitive O2 release
41
What are the overall functions of the digestive system?
Ingestion Digestion (mechanical and chemical) Absorption Compaction Defecation
42
What are the main conditions that affect hemoglobin saturation?
1. PO2 of blood 2. Blood pH 3. Temperature 4. RBC metabolism
43
What is oxyhemoglobin (HbO2)?
if one or more molecules of O2 are bound to hemoglobin, the compound is called oxyhemoglobin Whereas hemoglobin with no oxygen bound = deoxyhemoglobin
44
A blood pH \> 7.45 is called _____ and can be caused by a CO2 deficiency called \_\_\_\_\_
alkalosis, hypocapnia * alkalosis = pH \> 7 * Hypocapnia = most common cause of alkalosis, Pco2 \< 37 mm Hg
45
What is the most common cause of acidosis?
Hypercapnia Pco2 \> 43 mm Hg
46
What is the thing that catalyzes the equation to make bicarbonate?
carbonic anhydrase
47
Name each of the accessory organs of the digestive tract and describe the function
48
Describe how the overall digestive system processes are accomplished
* Secretions * By accessory glands * Motility * Skeletal muscles * Smooth muscles * Multi unit * Visceral (single unit) * Peristalsis = one direction * Segmentation = bidirectional mixing
49
Describe the smooth muscles of the digestive system
50
Describe the overall digestive system histology
* Four layers: * Mucosa * Muscous membrane * Lamina propria * Submucosa * Muscularis externa * Serosa
51
Describe the cellular level digestive system histology
Four layers: * Mucosa * Muscous membrane * Lamina propria * Submucosa * Muscularis externa * Serosa
52
what is the esophagus, stomach and intestine nervous system network called and what does it do?
enteric nervous system regulates digestive tract motility, secretion and blood flow
53
Explain the types of control of the digestive system
* **_Neural (long)_** * **Sympathetic/parasympathetic division** * carry sensory signals from the digestive tract to the brainstem and motor commands back to the digestive tract (vagus nerves) * **_Neural (short)_** * **Enteric nervous system** * stretching or chemical stimulation of the digestive tract acts through the myenteric plexus to stimulate contraction * **_Hormones_** * **_​_****gastrin and secretin** * **_Local mechanisms, reflexes_** * **_​_****​secretions = histamine and prostaglandins** * **​stimulate movement**
54
Name the functions of the tongue
**Manipulation** **Sensation** **Production of lingual lipase** (is a skeletal muscle)
55
What are the glands that make up your mouth region?
Parotid, sublingual, submandibular
56
What is the composition of saliva?
water, buffers, antibodies, amylase, mucin, urea
57
Explain salivary control
* Medulla oblongata (MO) salivary center (salivatory nuclei) * Parasympathetic stimulation: lots of watery saliva * Sympathetic inhibition: little, viscous saliva * Response to stimuli * Smell, taste or thought of food
58
Describe the pharynx
* Shared passageway (esophagus and trachea) * Oropharynx * Laryngopharynx
59
Explain the basics of the esophagus
muscular tube Superior and inferior esophageal sphincters
60
Explain the phases of swallowing
* ***_Voluntary oral phase_*** * During chewing, tongue collects food and presses against palate and collects in oropharynx * ***_Involuntary pharyngeal phase_*** * vocal folds and nasal cavity close to prevent food from going in the wrong place * ***_Esophageal phase_*** * wave of involuntary peristalsis
61
What are the structures that make up the Lower GI Tract?
Stomach Accessory Glands Small intestine Digestive Hormonal Regulation
62
Explain the cell in the stomach that specializes in cell replacement?
Stem cells
63
Explain the cell in the stomach that specializes in cell protection?
Mucous cell
64
Explain the cell in the stomach that specializes in the secretion of HCl, intrinsic factor, ghrelin?
Parietal cells
65
Explain the cell in the stomach that specializes in the secretion of pepsinogen?
chief cells
66
Explain the cell in the stomach that specializes in the secretion of chemical messengers?
Enteroendocrine cells
67
Explain a summary of the cellular specialization in the stomach
Stem cells: Replacement Mucous cells: protection Parietal cells: HCl, intrinsic factor, ghrelin Chief cells: pepsinogen Enteroendocrine cells: chemical messengers
68
Explain the volume and types of gastric secretion
produce 2 to 3 L of gastric juice per day * ***_HCl_*** * Mechanism: * CO2 + H2O -\> H2CO3 -\> HCO3- + H+ * H+ / K+ pump * Chloride shift * Alkaline tide * Functions: * Antibacerial action * Protein denaturation * Cell wall breakdown * Pepsin activation * ***_Enzymes_*** * Pepsinogen to pepsin (protein digestion) * Gastric lipase (Fats) * ***_Intrinsic factor_*** (Vitamin B12 absorption) * ***_Chemical messengers_***
69
explain the gastric function in the stomach
* Distention stimulates churning * Gastric emptying through pyloric sphincter * (~3 ml per squirt) * Time in stomach varies * Digestion: proteins and fats * Absorption: not much
70
Explain the cellular anatomy of the stomach
71
What are the three stages that make up the gastric activity?
1. Cephalic phase 2. Gastric phase 3. Intestinal phase
72
Explain the cephalic phase of gastric functional regulation
* Cephalic Phase: (PREP PHASE) * Stimulus: Sight, smell, taste of food * Hypothalamus -\> vagus nerve -\> enteric NS * Response: Gastric juice secretion, gastrin release
73
Explain the gastric phase of gastric functional regulation
* Gastric: WORK * Stimuli: Distention, pH increase, Undigested proteins * Response: Increased gastric juice secretion, gastrin release, increased churning
74
Explain the intestinal phase of gastric functional regulation
* Intestinal Phase: (CONTROL) * Stimuli: Chyme in SI, pH decrease, Undigested nutrients * Response: Hormone release, suppress gastric activity
75
Explain the summary of hormones in the lower GI track
76
Explain the liver overall anatomical structures, histology, and physiology
* **_Anatomical overview:_** * Four lobes * Hepatic portal vein * Hepatic artery * **_Liver histology:_** * Lobules * Blood and bile vessels * Kupffer cells (in sinusoids) * Macrophages (remove bacteria and debris from blood) * **_Liver Physiology_** * Liver digestive function: bile production (fat emulsifier)
77
What is the function of the gallbladder?
storage of bile, release under control of CCK
78
Explain the general anatomy of the pancreas
Pancreatic ducts Ampulla of Vader (hepatopancreatic) Sphicter of Oddi
79
Explain the histology of the pancreas
* Endocrine * Islets of Langerhans * Insulin and glucagon - sugar level balance * Exocrin * Acini cells: secrete pancreatic juice * Neutralization
80
Explain the pancreatic physiological exocrine secretions
* ***_Exocrine secretions_*** (Secretions that cut up carbohydrates, lipids and protein) * **Enzymes (CCK controlled)** * All nutrient classes * PSN (ACh from parasympathetic system), CCK regulate secretions * **Bicarbonate (Secretion controlled)** **Regulation of secretion:** * **ACh** * **​stimulates pancreatic acini to secrete their enzymes during cephalic phase** * **CCK** * **​response to fat in small intestine, stimulates pancreatic acini to secrete enzymes.** * **Gallbladder release** * **Secretin** * **​response to acidity of chyme = neutralize**
81
Explain the primary digestion and absorption of the small intestines, sections and surface area adaptations
Primary site of digestion and absorption * Accepts secretions of the liver and pancreas * Three sections: * Duodenum, jejunum, ileum * Ileocecal valve * Surface area adaptations * Plicae (circular folds) * Villi * Microvilli
82
Explain the histology of the small intestines
* Extensive capillary beds (absorbs everything but fat) * Lacteal * Duodenal (Brunner's) glands * Glands in the submucosa, mucus and alkaline secretions * Mucus production * Intestinal glands (crypts of Leiberkuhn) * Brush boarder enzme production
83
Explain the intestinal motility
* Weak peristaltic waves: * Local (myenteric) control * Gastroenteric reflex: * Whole intestine motility * Gastroileal reflex: * Relaxation of ileocecal valve
84
Explain the gastrin digestive hormonal regulation feedback loop
* Stimulus * Food sensation (senses and distention) * Sensors/CC: * G cells in gastric pits * direct and interic stimulation (vagus nerve) * Effectors: * Gastric secretory cells * gastric smooth muscle * pyloric sphincter * Response: * Increased gastric activity and motility
85
Explain the CCK digestive hormonal regulation feedback loop
* Stimulus * Lipid chyme in intestine (high fats) * Sensors/CC: * SI enteroendocrin cells * Response: * Gastric glands inhibited * stimulates release in pancrease and gallbladder * decreased hunger (CNS)
86
Explain the Secretin digestive hormonal regulation feedback loop
* Stimulus: * Acid chyme in intestine * Sensor: * SI enteroendocrine cells * Response: * Pancreatic buffers and bile production/secretion * Gastric glands inhibited * Gastric motility inhibited (pyloric sphincter)
87
Explain the GIP (Glucose-dependent insulinotropic peptide) digestive hormonal regulation feedback loop
* Stimulus: * Glucose hyperosmolarity * Sensor: * SI enteroendocrine cells * Effectors/response: * Islets of Langerhans - insulin secretion
88
Explain the VIP (Vasoactive intestinal peptide) digestive hormonal regulation feedback loop
* Stimulus: * Distention of pylorus * Sensors/CC: * SI enteroendocrine cells * Effectors/Response: * Intestinal glands - increased secretion * Vasodilation of intestinal vessels * Gastric glands inhibited
89
Explain hydrolysis
water comes in, splits a molecule and results with a combining of one molecule with an OH and another with an H
90
Explain carbohydrate digestion enzymes and products
* Major enzymes: * Salivary and pancreatic amylase (SUGARS) * Products: * Maltose (disaccaride) * Limit dextrins (due to branching) * Further digestion * Intestinal brush boarder enzymes Sucrase: Sucrose -\> fructose + glucose Maltase: Maltose -\> 2 glucose Lactase: Lactose -\> galactose + glucose
91
Explain carbohydrate absorption
* Lumen -\> blood * Glucose and galactose: * Na+ cotransport across apical membrane (SGLT transporters) * Facilitated diffusion across basolateral * Solvent drag (because glucose is highly soluble) * Fructose * Facilitated diffusion
92
Explain the types of protein digestion
* ***_Endopeptidases_*** * Breaks interior amino acid bonds * ***_Expeptidases_*** * Cleaves at ends (pac-man style) * ***_Zymogens_*** * Produced in an inactive form
93
Explain protein digestion in the stomach
* Pepsin (endopeptidase) * Produced as pepsinogen * Secreted by chief cells * Activated by acidity of stomach
94
Explain protein digestion in the small intestine
* Pancreatic proteases * Trypsin (endo) * Chymotrypsin (endo) * Carboxypeptidase (exo) * Brush boarder proteases * Aminopeptidase (exo) * Dipeptidase (endo) * Enterokinase (activator) * turns on trypsin
95
Explain protein absorption
* **Apical membrane** * Amino acids * Na+ cotransport * **Dipeptides, tripeptides** * Active cotransport * Broken down further inside cell * infants can bring more into cell * **Basolateral membrane** * Facilitated diffusion * Lots of carrier proteins to allow things into the cell
96
Explain lipid digestion and lipid packaging
* Issues: * Hydrophobic * Tendency to aggregate * Bile (emulsification) * Lipases: * Lingual * Pancreatic * works on surface area, takes long time * Lipase activity * Triglycerides -\> monoglyceride + 2 fatty acids * Micelle * Absorbable lipid / bile salt complex * Lipid packaging * Chylomicrons * Triglyceride /cholesterol assemblies
97
Explain lipid absorption
* Diffusion * Reassembly * Golgi chylomicron packaging * exocytosis * lacteal entry
98
Name and describe other nondigested things in the small intestine
* ***_Vitamins_*** * Fat soluble (A, D, E, K) absorbed with fats * Water soluble via diffusion * B12 -\> intinsic factor * Greatly enhances the absorption of Vitamin B12 * ***_Minerals_*** * Channel - mediated diffusion * Na+, K+, Cl-, HCO3- * Active transport * Na+, Ca2+, Mg2+, Fe2+ * Cotransport * Na+ * ***_Water absorption_*** * Two liters consumed, but 7 liters enter GI tract * Secretions: salivary, gastric, etc. * Passive: * Driven by osmotic gradient * "water follows salt"
99
What are the functions of the large intestine
water absorption Vitamin absorption Production and elimination of feces
100
Explain the histology of the large intestine
* Lack of villi * No enzyme production * Numerous goblet cells (mucus producing)
101
Explain the physiology and reflex of the large intestine
* Absorption * Water ~1 L daily * Bacteria produced vitamins: * K, biotin, B5 * Movement * Haustral churning * Mass movements * Defication relex
102
Explain the long term and short term appetite regulation
* ***_Short-term regulation_*** * **Ghrelin** * Secreted by parietal cells when empty * Stimulates feeding centers of hypothalamus * **Peptide YY and CCK** * Secreted by enteroendocrine cells when chyme enters small intestine * Inhibit feeding centers of hypothalamus * ***_Long-term Regulation_*** * **Leptin** * Secreted by adipose tissue when fat stores are 'high' * Stimulates satiety center (set point) * **Insulin** * Inhibits feeding center (high blood glucose)
103
Explain calories
* Usable energy sources when oxidized * Fats: 9 kcal/g * Carbs and proteins: 4 kcal/g
104
What are the macronutrients
1. Carbohydrates 2. Fiber 3. Lipids 4. Protein
105
Explain the macronutrient carbohydrate and the dietary sources Stored, energy source, regulation, dietary source
* ***_Carbohydrates:_*** * 440 g ***stored:*** 434 g muscles, 100 g liver, 15-20 plasma * Neurons and RBC ***exclusive energy source*** * ***Regulated*** by insulin and glucagon * ***Dietary sources:*** * Starches * sugars
106
Explain the fiber macronutrient
cellulose RDA 30 g/daily
107
Explain an overview of the Lipid macronutrient
* 15 - 25% of body weight * 80 - 90 % energy requirement * RDA \< 30% calories from fat
108
What are the types of lipid transport?
* ***_Lipoproteins_*** * Protein + lipid transport * ***_Chylomicrons_*** * small particle like micelle * ***_VLDL_*** * very low density lipoprotein * ***_IDL_*** * ***_LDL_*** * ***_HDL_***
109
Explain the exogenous lipid pathway
Dietary source * Digestive tract * -\> lymphatic system * -\> circulatory system * -\> tisues via lipoprotien lipase action * Bypasses hepatic portal system * Chylomicron fate * Lipoprotein lipase * Break down chylomicrons for fatty acid absorption
110
Explain the endogenous lipid pathway
Liver source Liver -\> VLDL -\> IDL -\> Tissue * Chylomicron enters liver * VLDLs formed -\> circulation * Muscles and fat cells absorb triglycerides * teturn to liver as IDL
111
Explain cholesterol transport of lipids
* Low-density lipoprotien (LDL) formed * Triglycerides removed * Cholesterol added * Released into circulation * LDLs are cholesterol "deliveries" * LDLs absorbed by tissues and broken down * Excess cholesterol is released * Absorbed by HDLs Problem: if ICF cholesterol levels are high, LDLs NOT absorbed * Statins decrease cholesterol production in liver
112
Explain protein macronutrient
RDA 0.37 x body weight (lb) in grams Essential and inessential proteins
113
Name and describe the micronutrients
* ***_Minerals_*** * Function: * Bones * Molecular structure * Electrolytes (Na+, K+, Ca2+, Cl-) * ***_Vitamins_*** * 13 essential organic compounds * Metabolic constituents or precursors * Fat soluble * A, D, E, K * Water soluble * B-complex (8), C
114
Explain the difference between catabolism and anabolism
* Catabolism: * Exergonic * Energy yielding * Anabolism: * Endergonic * Energy requiring
115
Explain cellular energetic (redox cycles), name and describe details of each cycle
* ***_Citric acid cycle:_*** * NADH and FADH2 * **Acetyl CoA -\> 3 NADH + 1 FADH2 + 2 CO2 + 1 ATP** * ***_Oxidative phosphorylation:_*** (electron transport chain) * ATP Production * **NADH / FADH2 oxidized -\> H2O produced** * Energy lost to create the H+ gradient to allow for H+ to diffuse down **ATP synthase and make ATP**
116
Name and state anabolic or catabolic to the types of carbohydrate metabolsm
1. Glycolysis (catabolic) 2. Gluconeogenesis (anabolic) 3. Glycogenlysis (catabolic) 4. Glycogenesis (anabolic)
117
Explain Glycolysis carbohydrate metabolism
* Anaerobic in cytosol * Glucose -\> 2 pyruvate + 2 NADH + 2 ATP * (if O2 present) Pyruvate -\> acetyl CoA + CO2 * (If not) Pyruvate -\> lactate
118
Explain gluconeogenesis carbohydrate metabolism
* Anabolic * Glucose synthesis (ATP Required!) * Precursors: * Pyruvate * Ketogenic amino acid * Glycerol * Lactate (cori cycle)
119
Explain glycogenolysis carbohydrate metabolism
* catabolic * Glycogen -\> glucose * Glucagon and epinephrine stimulated (fight or flight response) * Occurs in skeletal muscle and liver
120
Explain glycogenesis carbohydrate metabolism
* anabolic * Glucose -\> glycogen (stimulated by insulin) * Medium term energy storage
121
Explain lipid metabolsms catabolic process
***_LIPOLYSIS_*** * Triglycerides -\> fatty acids * Beta - oxidation * Fatty acids -\> acetyl CoA (51 ATP per 6C) * Excess -\> acetone
122
Explain lipid metabolsms anabolic process
***_Lipogenesis_*** * Acetyl CoA -\> fatty acids (glycolysis) -\> glycerol -\> triglycerides * Because of the accumulation of ATP, does not go into mitochondria and the fat builds
123
Explain the types of protein catabolism metabolism
* ***_Transamination:_*** * **Amino acid + keto acid -\> new amino acid + new keto acid** * then enters citric acid cycle * ***_Deamination:_*** * **Amino acid -\> keto acid + ammonium ion** * **Urea cycle** * If do not have any glucose or fats
124
Explain protein anabolism metabolism
Amination or transamination of keto acids (stick an amino group onto it, requires NRG)
125
Explain the nutrient metabolism summary
126
Explain the overall metabolism summary
127
Explain the absorptive state (after a meal) Major process, primary fuel, controlling hormones
* Anabolism favored: Storing energy * Building and storing (anabolic activities) * Primary fuel: glucose * Controlling hormone: insulin, enterohomones * GRP and CCK also impact because food is being stored
128
Explain the absortive state (after a meal) pathway
129
Explain the postabsorptive state (between meals/starvation) Major process, primary fuel, controlling hormones
* Catabolism: releasing energy * Fuel source: mostly fatty acids * Controlling hormones: Glucagon, epinephrine, growth hormone, glucocorticoids
130
Explain the post absorptive state pathway
131
Explain the metabolic rate
* Basal metabolic rate (BMR) * Just enough energy to maintain vital function * Caloric intake (Mifflin estimate) * P=[10 x m (kg) + 6.25 x h (cm) - 5.0 x age + s] kcal/day * s = +5 males, -161 females * Does not take into account exercise, lean body mass
132
Explain thermoregulation
* Heat transfer * Convection * Radiation * Evaporation * Conduction * Control: * Hypothalamus