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62 Cards in this Set

  • Front
  • Back
List the three nerve plexuses found in GI tract.
Myenteric (b/w long and circular muscularis externae)

Meisnner (sub-mucosal)

Mucosal (in the mucosa)
Which hormone causes contraction of the gall bladder?
CCK
Which hormone's release is stimulated by low pH?
Secretin (it blocks release of gastric acid)
Insulin secretion is potentiated by...
GIP
This hormone is called "nature's antacid"
Secretin
This hormone causes parietal cells to secrete HCL
Gastrin
This hormone inhibits gastric emptying (also causes contraction of the gall bladder)
CCK
This hormone is released in response to carbohydrates.
GIP (is causes release of Insulin)
Acid stimulates release of _____ and inhibits release of_______.
Secretin and Gastrin
This hormone is under neuronal control and causes gastric and intestinal motility.
Motilin (note: under neuronal control)
List 4 characteristics of smooth muscle cells in GI track..
(1) Gap junctions
(2) Myosin regulated contraction
(3)Contraction frequency regulated by pacemaker cells Iterstitial cells of cajal
(4)Neurotrasmitter release via varicosities (one can target many cells)
This neurotransmitter is vital for smooth muscle relaxation.
VIP (also, Epi- SNS response)

Causes relxation of LES and Stomach.
Impact of vagotomy on stomach...
Vagotomy takes away VIF and VEF. VIF are responsible for stomach relaxation. Hence, with vagotomy stomach becomes less distensible (it is highly contracted). Remeber, contraction is intrinsic and does not require neural input.
Effect of increases HCL in duodenum...
Overall--- Inhibit stomach emptying.

Inhibit Antral contractions
Stimulate pyloric contractions

(secretin release and vagovagal reflex)
This hormone is responsible for Migratory Motor Complex of Small Intestine.
Motilin
List the two general types of contractions in small intestine.
Segmental (for mixing)

Peristaltic (for propulsion)
What is distinct about BER in small intestine versus large?
In SI, BER decreases distally however, in Large Intestine, BER increases distally.
Two types of contractions in LI are...

What is their frequency?
Segemental and Mass movement.

Segemental contractions ( 12 to 60 secs) stop during mass movement (1 to 3 times/day).

NOTE: During mass movements, haustrations disappear.
Which hormone is responsible for receptive relaxation?
CCK
Mass movement contractions happen in...

Migratory Motility Complex contractions happen in..
LI (1to3 times a day, cause disapperance of haustra)

Stomach (every 90 mins during fasting)
What are the two functions of Vasopressin?
Smooth muscle (arteriolar) constriction (Via V1 receptor - Gq)

Water retention - Increases water and urea permibiality in the collecting duct (via V2 receptro -
How does ADH impact ACTH release?
It increases it (there are V1 receptors on Ant Pit)
Vasopressin....

V1 receptor functions and location
V1 - (1) JG cells - Inhibit Renin release (2) SM contraction (3) Increase ACTH release (4) Decrease glomerular filteration rate

V2 - Collecting tubutles...increase water and urea permibiality. (water retention)
Which receptors are most sensitive to ADH?
V2 (ones on collecting tubules).

Only a little ADH increase, increases water retention.
ADH Stimulatory factors....

ADH Inhibitory factors...
(1) Hypoglycemia (2) Increase osmolarity (3) Decreased BV (4) Difficulty urinating (5) Pain (6) Nicotine and Opiates. (DON't PEE)

PEE causing...Water intoxicity (hypoosmolarity), Ethanoly, Hyperglycemia, ANP agonist (feels like too much blood volume)
Functions of Oxytocin...
SMOOTH MUSCLE CONTRACTION
(1) Increase uterine contractions (2) cause milk ejection (3) Released at orgasm, causes contractions of uterus to help propel sperm
Which hormone is primarily responsible for uterine contractions...
Oxytocin (via positive feedback loop)
List compounds inhibiting iodine uptake..

Compound that inhibits TP
Thiocynates and Percohlates

Thioureas, Methomazole (blocks TP but doesn't impact peripheral conversion)
Thyroid binding protein levels are modified by..
Estrogen - Increase it

Glucocorticoid and Androgen - Decrease it
Where are Thyroid alpha 1 and beta2 receptors
Alpha1 - heart and beta2 - Pit and HT (b2 don't raise o2 consumption)
How does cold and stress impact TSH levels?
Cold - Increase it.

Stress - Decreases it
Explain thyroid feeback regulation (when I deficient)
I deficiency will cause decreased levels to T3, T4. Hence, TSH will go up and thyroid function will incease.

RESULTS in Goiter (thyroid gland enlargement - but the pt can be hyper, hypo or euthryroid.
How does ACTH impact Adrenal cortex?
Increase CHLS availability (Increase LDL-R, Denovo synthesis, SCC).

Increase Steroid synthesis (SCC, Hydroxylases)
How is Cortisol metabolized?
Using 11 beta OHSteriod DHD. This is a reversible rxn.
How is cortisol anti-inflammatory?
(1) Blocks arachdonic synthesis
(2) COX2 inhibitor
(3) Prevents neutrophil binding to LTs
(4) PAF inhibitor
(5) NO inhibitor

Early response - Inhibits edema
Intermediate - Inhibits swelling
Late - Inhibits keloid and scar formation
How is cortisol immunosuppresive?
Inhibits IL1 synthesis by Macrophage (no T cell stimulation - no fever)

Inhibits IL2 synthesis by T cells (no T cell proliferation)
How does Cortisol modify WBC?
Raises Neutrophil levels.

Lowers Lymphocytes, Basophils, Eosinophils, Monocytes.
Explain immuno-feedback loop for cortisol.
IL1 cause Cortisol release but Cortisol inhibits IL-1.

Existing cytokines cause cortisol release and cortisol inhibition keeps them in check.
Metyrapone test
To test if aqequate ACTH is being made.

Inhibits 11beta hydroxylase.

This causes...No cortisol synthesis, Increase 11deoxy-cortisol and ACTH levels.
Aldosterone actions and clinical outcomes
(1) Increase Na reabsoroption (2) Increase K secretion (3) Increase H secretion

Clinically causes...hyptertension, Increase in ECF volume, Hypokalemia and Metabolic alkalosis
Three regulators of Aldosterone synthesis..
(1) Renin/Angiotensin system
(2) K levels
(3) ACTH
What is aldosterone metabolized to...
17-keto steriod
Which hormone controls PNMT?
Cortisol
Which enzyme is used to metabolize catecholamines?
Monoamine Oxidase and Catechol-o-methyl transferase
Where are following receptors found...

a1
a2
b1
b2
a1 - Post-synaptic terminals
a2 - Pre-synaptic terminals
b1 - Heart
b2 - Smooth muscle (liver, GI, bronchiol)

B2 - Dilates
B1 - Increases cardiac contractility
Compare EPI and NE effec on heart.
EPI - Increase HR, Decreases TPR, Increase SBP, Decreases DBP, Cardiac output goes up

NE - Decrease HR, TPR goes up, Cardiac output drops
List some tissues that are not effected by Insulin
Brain, GI tract, Renal medulla and RBC
Insulin levels decreased by...

Insulin levels increased by..
SEFA - Somatostatin, Exercise, Fasting, A adrenergic (epi inhibits insulin

Glc, FFA, K, Glucagon, GIP, GLP, PSNS, Sulfonylurea drugs
What is the primary target organ of Glucagon?
Liver
Glucagon's 2nd messanger is...
cAMP
List some tissues that are not effected by Insulin
Brain, GI tract, Renal medulla and RBC
Osteocytic Osteolysis
Stimulated by PTH

Transfer of bone salts to plasma (by osteocytes)
What do following glands contribute to the semen?

Prostate
Seminal Vescicle
Prostate - Fibrinolysin, Acid Phosphatase, Citrate, Bicarbonates, Clotting Enzymes

Seminal Vesicle - Fructose, PGs, Seminin, Fibrinogen
How does PRL impact testosterone synthesis?
It activates it BUT very high levels inhibit testosterone synthesis.

High levels cause impotence.
What are the four DIRECT effects of LH surge?
(1) Restart Meiosis in oocyte.
(2) Release PGE.
(3) Terminate Estrogen synthesis and upregulate Progesterone Synthesis.
(4) Differentiate follicular cells into luteal cells.
What is required to keep CL?
Before pregnancy - LH
After - hCG

(Estrogen and Progesterone inbibit it)
Roles of progesterone during pregnancy
Main role - prevent uterine contractions (to support pregnancy)

Mammary gland development
Which hormones induce Oxytocin receptors?

LH, FSH receptors during cycle..

Which hormone maintains decidual tissue before placenta?
Estrogen and Relaxin

Estrogen

Progesterone
What is the main DIRECT stimulus for uterine contractions?
PGE2

Release caused by Oxytocin and Estrogen.
What can be injected to control uterine bleeding after pregnancy?
Oxytocin
Why no lactation during pregnanc?
Glands are ready but HIGH Estrogen is blocking HIGH PRL.

Parturition causes drop in Estrogen and now PRL can cause lactation.
List what is inhibited by following gastic hormones.

CCK
Secretin
GIP
CCK - Gastring Empying

Secretin - Gastric Emptying, Mucosal growth, Gastric acid release

GIP - Gastric acid release