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Phase 1 Cram > SUGER > Flashcards

SUGER Flashcards

1
Q

What 3 things does growth hormone stimulate

A

Protein synthesis
Lipolysis
Glucose metabolism

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2
Q

Name the 3 controlling steps of RAAS initiation

A

macula densa in the distal convoluted tubule detect LESS NaCl in the tubule
• Sympathetic stimulation
• Little or no arteriolar stretch (i.e. low blood volume due to the lack of Na+ and thus H2O)

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3
Q

What releases renin

A

Renin is secreted by juxtaglomerular cells located in the afferent arterioles

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4
Q

What cleaves angiotensinogen to angiotensin I

A

Renin

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5
Q

Where is angiotensinogen produced

A

Liver

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6
Q

Describe the conversion of angiotensin I to angiotensin II

A

Angiotensin I is biologically inactive

Cleaved to angiotensin II (active agent) by angiotensin-converting enzyme (ACE)

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7
Q

Where is ACE produced

A

Lungs

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8
Q

How does angiotensin II cause the secretion of aldosterone

A

Stimulates the cells of the zona glomerulosa in the adrenal cortex of the supradrenal/adrenal glands to secrete the steroid hormone called ALDOSTERONE

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9
Q

What is the effect of angiotensin II on bp

A

Is a vasoconstrictor, which results in vasoconstriction especially at the efferent arteriole, this in turn results in the increase in pressure resulting in an increased GFR

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10
Q

How does aldosterone cause increase blood volume

A

Aldosterone acts on principal cells of the collecting duct which results in increased Na+ and H2O reabsorption

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11
Q

What effect does angiotensin II have on the hypothalamus

A

Stimulates thirst and ADH release resulting in water retention

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12
Q

Why is creatinine used as a marker substance

A

Freely filtered
Not metabolised
Not secreted or reabsorbed

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13
Q

Where is atrial natriuretic peptide synthesised and secreted from

A

Cardiac atrial cells

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14
Q

Effects of ANP

A

Acts as a renal vasodilator > afferent arteriole dilator > increased GFR
Inhibits Na+ reabsorption
Inhibits aldosterone

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15
Q

What is parathyroid hormone released in response to

A

Low plasma [Ca2+]

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16
Q

Effect of PTH on the distal tubule when [Ca] is low

A

PTH binds with receptors and causes an increase in Ca2+ uptake from the tubule
Stimulates the formation of Vit D

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17
Q

What are the 2 cell types found in the CT

Give their functions

A

Principal cells - respond to aldosterone and ADH, reabsorption of Na and water
Intercalated cells - secrete acid or HCO3

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18
Q

Functions of skin

A
  • Barrier to infection
  • Thermoregulation
  • Protection against trauma
  • Protection against UV
  • Vitamin D synthesis
  • Regulation of H2O loss
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19
Q

What are the 3 basic layers of the skin

A

Epidermis
Dermis
Subcutaneous tissue

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20
Q

What are the layers of the epidermis

A 
Stratum corneum 
S lucidum
S granulosum 
S spinosum
S basale

Come Let’s Get Sun Burnt

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21
Q

How does the skin prevent transepidermal water loss

A

Tight junctions between cells in stratum granulosum, epidermal lipids and keratin in stratum corneum

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22
Q

Which layer of the skin is vitamin D stored

A

Subcutaneous layer

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23
Q

What is the pH of healthy skin

A

5.5

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24
Q

Describe the healthy skin barrier

A

1) filaggrin produces natural moisturising factor (NMF) - this helps maintain skins hydration and an acidic environment on the outer surface of the stratum corneum
2) Balance the introduction of new cells in the basal layer.
3) lipid lamellas keep water inside the cell. Irritant and allergens tend to bounce off surface of skin

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25
Q

What is the affect of an increased pH on the skin

A

Degradatory proteases are no longer inhibited so they breakdown the corneodesmosomes
Increase pH also impairs the formation of lipid lamellae - allows skin cells to move apart which reduces water retention

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26
Q

What are sebaceous glands responsible for

A

Producing a lipid rich sebum which protects the hair

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27
Q

When does acne occur

A

When hair follicles become blocked with sebum, bacteria and skin cells

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28
Q

What type epithelium is found in skin

A

Keratinising stratified squamous epithelium

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29
Q

What is the arterial supply to the adrenals

A
  • Superior adrenal artery from inferior phrenic
  • Middle adrenal artery from abdominal aorta
  • Inferior adrenal artery from renal artery
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30
Q

What is the difference in venous drainage between the right and left adrenals

A

Right adrenal vein drains directly into IVF

left adrenal vein drain first into the left renal vein then into the IVF

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31
Q

What innervates the adrenals

A

Splanchnic nerve

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32
Q

What are the 3 parts of the adrenal cortex (outer to inner)

State what each produce

A

Zona glomerulosa - produces mineralocorticoids (aldosterone)

Zona fasciculata - glucocorticoids (cortisol)

Zona reticularis -Sex steroids (androgens) and cortisol

GFR, Make Good Sex

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33
Q

Which hormones are secreted from the adrenal medulla

A

Adrenaline

Noradrenaline

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34
Q

What is the precursor to all corticosteroids

A

Cholesterol

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35
Q

What % of cortisol in circulation is free

A

5%

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36
Q

Functions of cortisol

A 
Inhibit growth and reproduction 
Reduction of inflammation 
Reduction of bone formation 
Gluconeogenesis and carb metabolism 
Proteolysis and lipolysis
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37
Q

What is the effect of adrenaline and noradrenaline when released in response to stress

A 
Increase HR and BP
dilates pupil 
Inhibits insulin release 
Increases glucagon release
Increase in sweating
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38
Q

What are the receptors for adrenaline and noradrenaline

A

Adrenaline - high affinity beta receptors

Nor - high affinity alpha

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39
Q

What affect does cortisol have on insulin

A

Antagonistic affect as it stops it from acting in cells as cortisol wants to maintain high blood glucose for stressful situations

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40
Q

What spinal levels does the thyroid gland sit between

A

Anterior neck between C5 - T1

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41
Q

What divides the thyroid into its left and right lobe

A

The isthmus

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42
Q

What 2 muscles does the thyroid lie between

A

Sternohyoid and sternothyroid muscle

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43
Q

What can be found on the posterior surface of the thyroid

A

4 parathyroid glands

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44
Q

What is the blood supply to the thyroid

A

Superior thyroid arteries

  • 1st branch of external carotid artery
  • Supplies anterior and superior portions

Inferior thyroid arteries

  • branch of subclavian artery
  • Supplies posterior and inferior aspect
45
Q

What innervates the thyroid and parathyroid gland

A

Sympathetic trunk

46
Q

Name the thyroid hormones T3 and T4

A

T3 - triiodothyronine

T4 - thyroxine

47
Q

Describe the process of thyroid hormone secretion ( hypothalamic-pituitary-thyroid axis)

A
  • Thyrotropin releasing hormone (TRH ) released by hypothalamus in response to neural inputs
  • TSH then released by anterior pituitary gland
  • This acts on thyroid gland to secrete T3 and 4
  • T4 is converted to T3 and acts on its target cells
  • TSH and TRH are inhibited through negative feedback
48
Q

What are the metabolic actions of T3

A
  • stimulates carb absorption in small intestine and increases fatty acid release from adipocytes
  • maintain high BMR
  • increases body temp
49
Q

How is T3 important in brain maturation

A
  • formation of axon terminals
  • formation of synapses
  • growth of dendrites and dendritic extensions
  • formation of myelin
50
Q

What is the physiological difference between T3 and 4

A

T4 is most abundant but T3 is the biologically active form of T4

51
Q

Where do the parathyroid glands drain into

A

Thyroid plexus

52
Q

Function of parathyroid glands

A

Regulate calcium and phosphate levels

Secretes parathyroid hormone in response to low Ca or high phosphate

53
Q

Effects of PTH

A

• Increases calcium reabsorption in renal distal tubule
• Increases intestinal calcium absorption (via activation
of vitamin D) – duodenum and jejunum
• Increases calcium release from bone (stimulated
osteoclasts activity)
• Decreases phosphate reabsorption
• Binds to G protein coupled receptors

54
Q

Describe the difference in shape between right and left adrenal glands

A

Right is pyramidal

Left is crescent shaped

55
Q

The kidneys are encased in layers of fat and fascia

Give them deep to superficial

A

Renal capsule – tough fibrous capsule.
Perinephric fat – collection of extraperitoneal fat.
Renal fascia (also known as Gerota’s fascia or perirenal fascia) – encloses the kidneys and the suprarenal glands.
Paranephric fat – mainly located on the posterolateral aspect of the kidney.

56
Q

What is the difference between positive and negative feedback

A

Negative - as a hormone increase in [ ], it INHIBITS the release of another
In positive feedback it PROMOTES the release of another

57
Q

Name the 6 hormones produced by the anterior pituitary

hint: FLAGTOP

A 
FSH – Follicle Stimulating Hormone
LH – Luteinizing Hormone
ACTH – Adrenocorticotropic hormone
GH – Growth Hormone
TSH – Thyroid Stimulating Hormone
O - ignore 
Prolactin
58
Q

Name the 2 hormones produced by the posterior pituitary gland

A

ADH/ Vasopressin

oxytocin

59
Q

What are hypophysiotropic hormones

A

Hypothalamic hormones that control secretion of anterior pituitary
hormones

60
Q

What is the name of the hypophysiotropic hormone that stimulates the release of LH and FSH

A

Gonadotropin-releasing hormone (GnRH)

61
Q

What effect does (LH) and (FSH) have on males

A

LH - stimulates production of testosterone by leydig cells

FSH - Stimulates spermatogenesis by stimulating sertoli cells to produce androgen binding protein

62
Q

What effect does luteinising hormone (LH) and follicle stimulating hormone (FSH) have on females

A

LH -> Stimulates ovulation + ovarian follicle maturation + corpus luteum formation.
FSH -> regulates development + growth of ovarian follicle + affects 1st half of menstrual cycle

63
Q

Name the hypophysiotropic hormone that stimulates the release of ACTH

A

Corticotropin-releasing-hormone

64
Q

Describe the HPA axis

Adrenal

A

Corticotropin releasing hormone stimulates Adrenocorticotropic hormone which causes an increase in cortisol production in the zona fasciculata of adrenal cortex

65
Q

Name the hypophysiotropic hormone that stimulates the release of growth hormone

A

Growth hormone releasing hormone (GHRH)

66
Q

What processes are GH involved in

A 
Skeletal growth and bone density 
Muscle strength 
Protein synthesis 
Glycogenolysis 
Lipolysis
67
Q

What hormone inhibits GH

A

somatostatin

68
Q

Where is GH produced

A

Somatotrophs

69
Q

What causes the release of prolactin

A

Suckling

Thyroid releasing hormone

70
Q

What inhibits the release of prolactin

A

dopamine

71
Q

Functions of prolactin

A

Initiate breast milk production

Maintain milk production once established

72
Q

How are the anterior and posterior pituitary different

A
  • Anterior has no neural connection to hypothalamus while posterior does
  • posterior pituitary STORES and releases hormones, anterior SYNTHESISES and releases hormones
73
Q

Where is oxytocin synthesised

A

paraventricular nucleus of hypothalamus

74
Q

Function of oxytocin

A
  • Contraction of smooth muscle in the breast to promote milk ejection during lactation
  • acts on the uterus to cause uterine contractions during labour-> promoting onset of labour
  • Exerts positive feedback on itself
75
Q

Where is anti diuretic hormone produced

A

Supraoptic nucleus of hypothalamus

76
Q

Give 5 things that ADH is released in response to

A
  • Increased osmotic pressure in blood
  • Decreased blood volume
  • Trauma/stress
  • Increased PCO2
  • Decreased PO2
77
Q

Describe the negative feedback of ADH

A
  • Osmoreceptors in the hypothalamus detect change
  • ADH binds to V2 receptors on the collecting ducts -> increased expression of aquaporin 2 in cortical collecting duct
  • This allows the passage of water from the CD into the blood to reduce the plasma osmolality -> ↑water reabsorption and blood volume
  • vasoconstriction of SM cells around blood vessels increases bp
78
Q

How does the anterior pituitary receive its blood supply

A

through portal venous circulation called hypothalamo-hypophyseal portal vessels

79
Q

What are the 3 main cell types in islets of langerhans

State what each release

A
  • Delta cells - somatostatin (inhibitors)
  • Alpha cells - glucagon
  • Beta cells - insulin
80
Q

How is the active form of insulin produced

A

A and B chains connected by C peptide - proinsulin

Insulin is produced when C peptide is cleaved

81
Q

Function of insulin

A
  • Reduces glucose output by liver
  • Increase storage of glucose, FA + aa
  • Stops breakdown of fat + muscle
82
Q

Describe the feedback loop when blood glucose rises

A

Insulin is released and glucagon release is inhibited

There is increased glycogenesis in the liver and muscles

Gluconeogenesis is inhibited

83
Q

Describe the feedback loop when glucose levels fall

A

Glucagon is released and insulin release is inhibited

Glycogenolysis occurs to release glucose from the liver and muscles into the blood

Gluconeogenesis occurs

84
Q

Glucose moves into beta cells via which channel

A

GLUT2 channel

85
Q

What causes depolarisation of the beta cells membrane

A

Metabolism of glucose occurs which makes ATP
ATP causes the closure of ATP-sensitive potassium channels
This causes the membrane to depolarise

86
Q

How is insulin released from beta cells after membrane depolarisation

A

Depolarisation causes voltage-gated Ca channels to open inducing an influx of Ca2+
Ca2+ binds to vesicles containing insulin
These vesicles fuse with the cell membrane and release insulin

87
Q

How does insulin cause a decrease in blood glucose level after leaving beta cells

A

Insulin binds to insulin receptors on muscle + fat cells

Triggers intracellular signalling cascade -> mobilisation of intracellular GLUT4 vesicles to cell membrane

GLUT4 vesicle integrates into cell membrane -> ↑number of membrane glucose transporters -> ↑rate of glucose facilitated diffusion (uptake) into cell -> ↓blood glucose level

88
Q

What secretes melatonin

A

pineal gland

89
Q

What do C cells secrete

A

calcitonin

90
Q

What 3 cells does the parathyroid contain

A

chief cells
oxyphils
adipocytes

91
Q

Histologically, what can be used to determine whether the specimen is thyroid or parathyroid

A

Thyroid may contain calcium oxalate crystals but parathyroid wont

92
Q

Where are islets of langerhans most abundant in the pancreas

A

pancreatic tail

93
Q

What is the most prominent layer of the adrenal cortex

A

Zona fasciculata

94
Q

Where is spermicide produced

A

Seminiferous tubule

95
Q

Anatomy of the testes : SREEVE UP

A 
Seminiferous tubules 
Rete testes 
Efferent ducts
Epididymis 
Vas deferens 
Ejaculatory duct
Urethra 
Penile urethra
96
Q

What is syngamy

A

Fusion of the male and female pronuclei

97
Q

What does a pregnant womens ‘water breaking’ describe

A

Amniotic sac ruptures, amniotic fluid flows through the vagina

98
Q

Parasympathetic innervation to detrusor

A

Pelvic splanchnic nerve

S2-4

99
Q

Sympathetic innervation of detrusor

A

Hypogastric nerve

T12-L2

100
Q

Describe branching of the renal artery

A

Renal artery -> segmental arteries -> interlobar arteries -> arcuate arteries -> interlobular arteries -> afferent arterioles -> glomerular capillaries -> efferent arteriole -> peritubular capillaries

101
Q

What innervates the external urethral sphincter

A

Pudendal nerve

S2-4

102
Q

Where are C cells located

A

Thyroid gland

103
Q

Which layer of the epidermis is acellular

A

Stratum corneum

104
Q

Primary event in the switch from storage to voiding

A

Relaxation of urethral sphincter

105
Q

What effect does aldosterone have on transporter protein in DCT

A

Increase in Na - K exchange transporters

106
Q

What are incretins

A

Secreted by endothelial cells in GI tract.

Functions to increase the effect of insulin in response to glucose

107
Q

Give 2 examples of incretins

A

Glucagon like peptide

Glucagon dependent insulinotropic peptide

108
Q

Epithelium lining the vas deferens

A

Pseudostratified columnar

109
Q

What secretes relaxin

A

Placenta and ovaries

Phase 1 Cram (12 decks)

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