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Physio Ch. 16

the absorptive state is when you absorb nutrients from the Gi tract
absorptive state means that the nutrients are available for...and the excess nutreitns are... use by cells...stored in cells for later use (liver muscles adipose)
postabsorptive state happens...and is when the.. between meals...Gi tract is empy
during postabsorptive state, the nutrients... are taken from body stores and made available for cells
absorptive state maintains...via... blood nutrient levels...glucose, tryglycerides and amino acids
glucose can be used... in all cells
the liver is good at taking up glucose and converting it to glycogen
the addipose tissue converts glucose to fats
muscle tissue does what with glucose stores it as glycogen
triglycerides in the absortpive state: the adipose tissue is good at picking up triglycerides
fatty acids get converted to adipose
glycerol goes to the liver
amino acids in the absoprtive state go to liver and muscle tissue (buildmore muscle proteins)
post state maintains...via.. blood glucose levels...glucose sources and glucose sparing
glucose sources include glycogenolysis in the liver and muscles, lipolysis in adipose tissue and gluconeogensis in the liver and kidneys
gluconeogenesis gets glucose from...which are all... pyruvate & lactate, & glycerol & amino acids...non carb sources
glucose sparing is when...are used as.. fatty sources instead of glucose
glucose sparing: fat metabolism is not possible in nervous system so ketones in the blood can be used in nervous system instead
fasting does what decreases synthesis
fasting involves glycogenolysis, lipolysis and gluconeogenesis (primarily in the liver)
prolonged fasting involves kidney gluconeogenesis and ^ lipolysis
^ lipolysis during prolonged fasting > ^ blood ketones ^ nervous system use of ketones
insulin comes from pancreatic islets, B cells
in the absorptive state, that you can... ^ nutrients and prevent hyperglycemmia (^ blood sugar levels)
in the post state you...which means... dec insulin...release nutrients
cell activity in the absorptive state...are stimulated to... liver, cardiac and skeletal muscle and adipose tissue...take up glucose and fats
skeletal muscles synthesize ketones, glycogen and amino acids
adipose tisue synthesizes triglycerides
cell activity in the post state involves liver, cardiac and skeletal muscle and adipose tissue releasing nutrients
insulin w/ receptor interaction signals...which results in... transduction pathway ...insertion of glucose transporters
lack of insulin w/o receptor interaction signals...which results in... signal transduction pathway broken...glucose transporters taken up by cell
regulation of insulin secretion involves plasma glucose levels, plasma amino acid levels, incretins, parasymp and inhibition of b cells
regulating insulin via plasma glucose levels is a...and the normal range is... negative feedback system...60-120 mg/dL whole blood
plasma amino acid regulation of insulin is also a... negative feedback system
incretins include GIP and glucagon-like peptide-1 (GLP-1)
incretins are produced in the...and released in response to... small intestine...eating
incretines do...which means they... feedfoward...release insulin before plasma glucose levels rise
parasympathetic stimulation of b cells: stimulation is due you... eating...release insulin
parasymp stim of b cells is you.. feedfoward system..release insulin before plasma glucose levels rise
inhibition of b cells: stimulation of the...and you increase... sympathetic system...epinephrine from adrenal medulla
inhbition of b cells does what inhibits insulin release
glucagon is made by pancreatic islet A cells
glucagon is primarily active in the...and it prevents... and it has no known effect on... liver..hypoglycemia...adipose cells
glucagon increases glycogenolysis, gluconeogensis and production of ketones
regulation of glucagon secretion happens via plasma glucose levels, sympathetic stimulation and ^ epinephrine from adrenal medulla
plasma glucose levels for regulating glucagon secretion is a negative feedback system
sympathetic system for regulating glucagon secretion involves stimulating a cells
^ epi from the adrenal medulla to regulate glucagon involves the stimulation of a cells
epi and the symp system have...effects..including... indirect...inhibiting B cells and stimulating A cells
epi and symp inhibit B cells > dec insulin release > dec storage
epi and symp stimulate a cells > ^ glucagon release
epi and symp also...including direclty stimulate cells...liver, skeletal msucles and adipocytes cells
liver cells do glycogenolysis and gluconeogensis
skeletal muscles do glycogenolysis
adipocytes do lipyolysis
regulation of epi and symp involves..which is a... plasma glucose levels...neg feedback system
cortisol comes from the...and can either be adrenal cortex...normal levels or stress levels
normal levels of cortisol means cortisol is a...and it allows maintains.. permissive hormone...liver, adipose...function in post state...normal enzyme levels (blood sugar, amino acids and fatty acids)
stress levels of cortisol have...such as... direct effects...reducing cell sensitivity to insulin, ^ gluconeogenesis, protein catabolism and lipolysis and dec muscle/adipose uptake of glucose
growth hormone comes from the...and at normal levels:....excess levels:... anterior pituitary...protein production and effects
excess levels of growth hormone lead to...which means... anti-insulin effects...keeping nutrients in blood
anti-insulin effects of excess levels of growth hormone increase..and decrease... gluconeogenesis, protein catabolism and lipolysis...muscle and adipose uptake of glucose
exercise increases...which then increases... energy demand...liver glycogenolysis, liver gluconeogenesis and adipocyte lipolysis
exercise: reaction is similar you see a decrease in... fasting...plasma glucose
during exercise, the dec in plasma glucose leads to... dec plasma insulin and increase plasma glucagon
dec plasma glucose > increase plasma glucagon increases... symp and epi action as well as cortisol and growth hormone action
neural response to exercise is to increase symp and epi action (not due to dec plasma glucose)
exercise: ^ glucose uptake and utilizationg by muscle cells is the opposite of...and the muscle contraction stimualtes... fasting...insertion of glucose transporters in cell membrane (imp for diabetes mellitus)
diabetes ="..."...and diuresis is... running through...large flow of water w/ low osmolarity
mellitus - "..." and leads to... sweet..osmotic diuresis
osmotic diuresis resulsts in solute loss (glucose) w/ accompanying water loss
osmotic diuresis also results in...which is when... glucosuria: glucose in the urine...>180 mg/dl of whole blood
osmotic diuresis is caused by a lack of insulin or insulin receptors
insipidus - "..." and leads to... non-sweet...water diuresis
water diuresis is solvent loss w/o accompying solute loss
water diuresis involves... vasopressin as the issue
central diabetes insipidus not making vasopressin
nephrogenic diabetes insipidus not responding to vasopressin
type I diabetes mellitus is also called insulin dependent diabetes or juvenile diabetes
type I involves lacking the ability to...because of... produce insluin from the pancreas..autoimmune destruction of B cells
type I has...and ... low plasma insulin levels...high plasma glucose levels
high plasma glucose levels in type I involves the inability to...and continued... absorb glucose (no glucose transporters installation)...liver glycogenolysis and gluconeogenesis and lipolysis
type I diabetes causes people to have osmotic diuresis, diaetic ketoacidosis and other problems
osmotic diuresis is a consequence of...and happens when both types of diabetes...glucose transport maximum (tmax) is surpassed and water follows the solute
osmotic diuresis is when the...which is called... filtered load > tmax > substance present in urine...glucosuria
glucosuria is when plasma [glucose] > 180 mg/dl
diabetic ketoacidosis is increased...>...>... lipolysis > ^ plasma ketones > ^ ketones in urine and H in plasma
other problems with type I are increased...which leads to.. na loss and additional water loss... decreased plasma volume > dec arterial pressure and blood flow
type II diabetes mellitus is also called non-insulin dependent diabetes or adult onset (except now we have childhood obesity)
type II involves decreased receptor sensitivity to insulin
type II usually has...but...which involves... normal plasma insulin levels...high plasma glucose levels...inability to absorb glucose, continued liver glycogenolysis and gluconeogenesis and lipolysis
role of obesity in type II involves...and the new hypothesis is... insulin resistance...adipocyte hormone resistan
resistan resists...and is produced in... insulin...repsonse to excess adipose tissue
resistan does downregulation of glucose transporters in skeletal muscle and adipose tissue
other factors of type II defective B cells
defective B cells happens because of..and it means you don't... no effect of insulin...increase insulin secretion at high plasma glucose levels
treatment for type II diet and weight reduction (can be reversible) and exercise
exercising increases number of glucose transporters in skeletal muscle cells to keep fat tissues active
hypoglycemia is ...usually in the... low plasma glucose concentration ... post state
potential causes of hypoglycemia are excess insulin and poor post state regulation
excess insulin causes hypoglycemia: which involves....excess..and increased... b cell tumor...insulin injection and too strong response...insulin secretion
what treats increased insulin secretion in type II ? sulfonylureas
poor post state regulation happens in...and involves... liver disease..inactive a cells and dec glucagon secretion
liver disease means there is no... return of nutrients to blood stream (since liver is a storage place for nutrients)
poor post state regulation in hypoglycemia involves a dec in cortisol and glycogenolysis/gluconeogenesis
symptoms of hypoglycemia symp system responses and lack of glucose to brain
symp system responses include... nervousness, ^ HR, sweating and anxiety
lack of glucose to the brain causes..and...because of... headache, confusion, dizziness, lack of coordination...convulsions, unconsciousness and're not providing your brain w/ enough utrients to metabolize atp for energy
increased plasma cholesterol: sources of cholesterol dietary cholesterol and cholsterol synthesis
dietary cholesterol comes from animal fats - saturated fats, and transfatty acids
cholesterol is used in the...and also its used for... cell membrane...steroid hormone production
cholesterol synthesis happens in the GI tract and mainly the liver
LDL stands for...and optimal levels of LDL are... low density lipoproteins...< 100 mg/dl
LDL is a...that... cholesterol carrier...delivers cholesterol to cells and keeps it in the circulatory system
LDL: genetic component is...and it decreases... familial hypercholestrolemia...LDL uptake by cells - LDL and cholesterol remain in plasma
HDL stands for...and optimal levels should be... high density lipoproteins...>40 mg/dl
HDL is a...that.. cholesterol carrier...removes cholesterol
HDL delivers cholesterol to... the liver for secretion (bile) to get it out of the circ. system and also to the steriod producing cells
LDL:HDL ratio should be...and associated with... 2:1...lower ratio...lower risk of cardiovascular diseases like atherosclerosis
ratio in men is...and women.. 3.6...3.2
total energy expenditure of the body = heat produced + work + energy stored
heat is produced as a result of...such as... energy conversion...glucose > ATP
energy conversions involve...which are... 1st and 2nd laws of isn't created/destroyed just converted and conversion degrades some energy to heat
work involves...and can either be... force and distance...external work and internal work
external work using... moving objects outside the body or your body itself...skeletal muscles
internal work involves...via 5 things... moving objects within the body...skeletal muscles, smooth muscles in GI, cardiac muscle, protein transporters and metabolism
energy stored is stored chemically
metabolic rate is the energy expenditure per unit time (calories/hr or kcal/24 hr)
MR is measured in calories
kcall = ...=... calorie (C)...1000calories
kcal is the amt of heat required to raise temp of 1L of h2o 1 degree celsius
calorie = ...and is the amt of 1/1000kcal...heat required to raise temp of 1 mL of h2o 1 degree celsius
which is more common kcal or calorie calorie
BMR is the calorie use necessary to remain alive
BMR is measured while you are mentally and physically at rest, in the post state (12 hours of no food) and comfortable temp
factors affecting BMR and MR involves thyroid hormone, epi, food induced thermogenesis and muscle activity
thyroid hormone TH and epi both have...which involves the ability to... calorigenic effect...increase BMR bec cells are metabolically active
food-induced thermogenesis involves a...due to... rapid increase in MR...processing of food by the liver
muscle activity involves...that can dramatically... skeletal muscle...^ MR
if something is...then it will... voluntary...effect MR
energy stored = energy intake - (heat produced + external work)
energy not used heat production or work...stored in adipose tissue usually bec its the most efficient storage and it concentrates the energy
control of food intake involves...such as... negative feedback systems...long term and short torm
long term control of food intake involves...which is a.. leptin..hormone from adipose tissue
leptin does what inhibits hypothalamus neuropeptide Y which decreases food intake
obesity means you have a reduced response to leptin or a mutated leptin
short term control of food intake involves...which involve... brain and hunger...satiation signals, positive and neg reinforcement and ghrelin
satiation signals include...which increases 3 things insulin (tells body we're full)...body temp, GI stretch and chemoreceptor action and CCK
pos and neg reinforcement happens via food smell, taste, texture and stress
ghrelin is a...that stimulates or inhibits?... GI hormone...stimulates hypothalamus neuropeptide Y and increases food intake
being overweight and obese increae health risks...hypertension, atherosclerosis, heart disease, diabetes and sleep apnea
heat disease is fat on and in heart/coronary arteries
BMI is found by wgt (kg)/ heigh^2 (m)
a overweigh and a obese > 25...> 30
it is not known at what BMI...and confounding factors include... health risks start increasing...sedentary lifestyle and dietary habits
patterns of...affect BMI fat deposition (apple is worse than pear)
decreasing BMI can reduce health risks
genetic factors for overweight and obesity include thrifty genee and survival as well as leptin
thrifty genes are good at conversion rate and metabolism
leptin causes overweightness and obesity bec of either...or... genetic mutation (inactive leptin produced)...leptin insensitivity (normal leptin production but reduced response)
weight set points involve altering calorie intake and exercise
altering calorie intake is when the body attemps to maintain weight within a range
if you increase calorie intake then...but if you decrease calorie intake... ^ metabolic expenditure (including BMR)...dec metabolic expenditure (including BMR)
exercise does what increases caloric expenditure in order to alter set point
short term effects of exercise immediate calorie ependiture so theres less for storage
long term effects of exercise lowers weight set point and increases metabolic demand w/ increasedmuscle mass and BMR
humans are...which means we... homeothermic..maintain a constant body temp w/i a homeostatic range
body temp can't exceed...and is usually problematic at... 43 deg cels...41 deg cels
advantage of being homeothermic it allows enzymes to be functional at a predicatble rate
core body temp variation can be seen in...and involves... oral vs rectal...activity level, circadian rhythm and progesterone levels in women
mechanisms of heat loss and gain radiation, conduction, convection and evaporation
radiation involves...and can be either electromagnetic waves coming off of something...gain or loss via the air
conduction happens via...and can be either physical touch...gain or lass
convection involves...and usually... moving air/water (wind chill) loss but can gain
evaporation requires...and you... energy input from the body...convert water from liquid to gaseous phase
evaporation...converted 600 kcal/L of H20
evaporation is heat...and is dependent on... loss only...humidity levels
temp regulating reflexes: goal is to maintain core body temp
sensory component of temp regulating reflexes involves...either.. thermoreceptors...peripherally or centrally
peripheral thermoreceptors are located in the...and provide... skin...feedforward regulation
central thermoreceptors are located in...and provide... internal organs and hypothalamus...neg feedback system
integration component of temp regulating reflexes involve the.. hypothalamus and cerebral cortex
hpothalamus involves the...and symp system...motor system which is involuntary responses to regulate temp
cerebral cortex regulates temperature..via.. voluntarily...motor system
heat production involves...which is actually.. skeletal muscle activity...involuntary
skeletal muuscle activity regulating heat production involves shivering thermogenesis and nonshivering thermogenesis in infants
shivering thermogenesis is controlled through the...and there is no... only heat production
nonshivering thermogenesis in infants-age 2 involves...and activation of... ^ epi and symp stimulation > ^ BMR > ^ heat production...brown adipose in infants
heat loss or gain the..serves to regulate heat exchange radiation, conduction and
the skin serves to regulate heat exchange by modifying peripheral blood flow, surface area, clothing and surroundings
modifying peripheral blood flow involves vasoconstriction when youre cold and vasodilating when youre hot
modifying surface area happens via huddling or extension
modifying clothing involves additional insulation
heat loss via evaporation is either insensible water loss and sweating
insensible water loss is...via.. passive/involuntary loss...respiration and permeable skin covering
sweating is... active water loss: active secretion via sweat glands
sweating involves...and its effeciency is dependent upon... symp stimulation (ACh neurot instead of NE)...relative humidity
temperature acclimatization is when you physiologically adjust to temperature
temp acclimatization involves...such as... changes in mechanics of temperature regluation...starting to sweat sooner and adjust sweat composition
sweat composition means you increase aldosterone secretion which is responsible for sweat secretion
increasing aldosterone secretion means your sweat glands...and you reabsorb more na...increase sweat water content and decrease sweat na content
fevers raise..while... temperature set point...maintaining a higher core temperature
maintaining a higher core temperature during a fever involves...that... endogenous pyrogens...reset thermal set point
endogenous pyrogens are released from...and also released in response to... activated macrophages...stress and trauma
endogenous pyrogen release is inhibited by aspirin
fevers also involve...where you... chills...increase thermal set point > detect body as cold > ^ heat production
chills maintain core temperature at new set point until reset to normal
fevers must involve a way to..via... prevent excessive fever and resetting set point...endogenous cryogens
endogenous cyrogens bring..via... temperature down...vasopressin neurotransmitter
advantages of a fever is to kill pathogens and prevent their reproduction
hyperthermia is when the...and the most common example is... core temperature increases w/o change in set point...exercise
exercising eventually... ^ heat gain > ^ reflexive heat loss...heat gain is equivalent to heat loss
exercise results in core temp elevation
heat exhaustion is the result of...and you can...due to... active heat loss system...collapse...hypotension : dec MAP (bec you lose soo much water)
MAP= co x tpr
heat exhaustion leads to dec plasma volume (CO) due to ^ sweating and dec TPR due to peripheral vasodilation
heat stroke involves a nonfunctioning heat-regulation system
heat stroke involves an...which causes you to... elevated core temperature...collapse, seize and be unconscious
heat stroke may follow heat exhaustion
Created by: handrzej



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