UC Berkeley-MCB 32 Chs 15-20
UC Berkeley-MCB 32 Chs 15-20
Popular in Course
verified elite notetaker
Popular in Department
This 27 page Reader was uploaded by Michelle M. on Saturday February 8, 2014. The Reader belongs to a course at a university taught by a professor in Fall. Since its upload, it has received 440 views.
Reviews for UC Berkeley-MCB 32 Chs 15-20
Report this Material
What is Karma?
Karma is the currency of StudySoup.
You can buy or earn more Karma at anytime and redeem it for class notes, study guides, flashcards, and more!
Date Created: 02/08/14
Chapter 15 The Immune System 0 Defense Mechanisms o InnateNonspecific mmunity internal external defenses I PAMPsused to identify self from nonself cells receptors for these patterns on cell surfaces tolllike receptors 0 cells w to ike receptors dendritic cells macrophages release cytokines recruit other cells I Complement System compement proteins of innate immune system promote phagocytosis lysis inflammation 0 Phagocytosis neutrophils mononuclear phagocyte system monocytes and macrophages organ specific phagocytes liver spleen lymph nodesfixed phagocytes o Macrophages detect pathogen secrete proinflammatory cytokinesrecruit neutrophils and monocytes via chemotaxis attracted to chemokine chemicalsphagocytes in blood join those in tissue via EXTRAVASATION I Feverthermostat set by hypothalamus increases due to release of ENDOGENOUS PYROGEN I INTERFERONSproteins that interfere with ability of virus to infect cells alpha beta gamma o AdaptiveSpecific Immunity I ANTIGENSmolecules that stimulate ANTIBODY production 0 HAPTENSsmall mo bind to proteins to become antigenic determinant sites stimulate antibody production o Lymphocytes and Lymphoid organs primarythymus amp bone marrow secondaryymph nodes spleen tonsils I T LYMPHOCYTESseed thymus cell mediated immunity attack cells directly continuously replaced by thymus I B LYMPHOCYTESprocessed in bone marrow fight bacterial infection secretes antibodies into blood and lymphhumoral immunity I Secondary lymphoid organscollect pathogens allow lymphocytes to come attack them o Local Inflammation Innate system activated via tolllike receptorsmacrophages and mast cells secrete cytokinesattracts neutrophils and monocytes T lymphocytesB lymphocytes produce antibodieseukocytes come via chemotaxismicroorganisms killed via phagocytosis by neutrophilsneutrophis apoptosis I MAST CELLSin tissues contain HEPARIN anticoagulant release HISTAMINE broncholiar constriction vasodilation 0 Functions of B Lymphocytes o Antibodies contained by gamma gobuin plasma protein gAabundant in external secretions gGmain form in circulation gMsecreted during primary response gDantigen receptor on lymphocytes IgEaergic symptons I 2 heavy H chains 2 light L chains Fab region VhV variable amino acids Fc region rest I B lymphocytes have antibodies on membrane that serve as receptors I Diversity due to antigen independent genetic recombination antigendependent lymphocyte division somatic hypermutation win B cells class switch recombination o Complement system OPSONZATONabiity for antibodies to stimulate phagocytosis I COMPLEMENTproteins C1C9 1 recognition 2 4activation 59attack via COMPLEMENT FIXATION 0 Classic pathway of activationgG and IgM bind to antigens alternativeinitiated by bacterial polysaccharides 0 C59 form membrane attack complex 0 Liberated complement fragments chemotaxis opsonization stimulation of histamine release Functions ofT LymphocytesKiller Helper and Regulatory o Killer Helper Regulatory I Killercytotoxicdestroy body cells w foreign molecules cellmediation destruction must come in contact secrete PREFORINS create a pore in the cell osmotic destruction and GRANZYM ES cause destruction of ce s DNA I Heper enhance immune response by secreting LYMPHOKINES 3 subtypes 1 produce interleukin2 and gamma interferon 2 produces interleukin4510 17 intereukin17 I Regulatoryinhibit Killer TB lymphocyte activity defend against autoimmune diseasesallergic rxns I Lymphokinescytokines of lymphocytes autocrine regulators Interleukins 1activates T cells 2 activates killerreg T cells 4 required for proliferationclone development of B cells o Receptorscannot bind to free antigens I Antigenpresenting ces macrophages dendritic cesB cells Langerhans from bone marrow make up skin39s epidermis present antigens to T cells I Histocompatibility antigenscombo of antigens on tissue cells proteins coded by major histocompatibility complex MHC on chromosome 6 produce 2 molecules class 1 and 2 0 Helper T cells require class 2 molecules attached to antigen presenting cell Killer T cells require class 1 attached to target cell o Macrophage partially digests foreign particleantigens from particle moved onto macrophages surfacepresents antigen cass 2 MHC to Helper T cells activates it o Destruction ofT Lymphocytes I T cell surface receptorFAS after attacks T cell produces FAS ligand triggers apoptosis Active and Passive Immunity o Active Immunity I Clonal selection theoryB cells inherit ability to form antibodies produces one kind only inherited specificity exposure to antigencones are produced plasma or memory cells 0 Germinal centerwin secondary lymphoid organs I Secondary responseactive immunity quicker than sluggish primary response I Vaccinationsinduce primary response w nonlethal injections may use attenuated viruses no not cause disease killed viruses recombinant viral proteins 0 ADJUVANTSboost immune response o Body produces antibodies against NONSELF ANTIGENS tolerates SELF ANTGENS antibodies made against sef antigensAUTOANTBODIES killer T cells that attack sef antigensAUTOREACTVE T CELLS I Mechanisms of Immunological Toerance CLONAL DELETION lymphocytes that recognize self antigens are destroyed CLONAL ANERGY lymphocytes that recognize sef antigens are inactivated CENTRAL TOLERANCE mechanisms in thymus and bone marrow PERIPHERIAL TOLERANCE outside o Passive Immunityimmune protection that is produced by the transfer of antibodies to a recipient from a human or animal donor I IMMUNOLOGICAL COMPETENCEability to mount a specific immune response I MONOCLONAL ANTIBODIESproduced by an isolated pure clone of cells Tumor Immunoogy Benignsowgrowing limitedMaignant fastgrowing metastasis considered cancer tumor antigens activate immune response I Immunological surveillancerole of the immune system in fighting cancer tumor cells show up frequently but are destroyed before they become malignant tumor cells secrete immunosuppressive molecules o Natural Killer Cellslymphocytes part of the innate immune system I Array of receptors distinguish normal from malignant celltocell contact o Cancer risk increases with age and stress 0 Diseases caused by the Immune System o Autoimmunity Autoimmune diseasesfailure of immune system to recognize and tolerate sef antigens I Rheumatoid arthritis diabetes mellitus multiple sclerosis Graves disease glomerulonephritis thyroiditis pernicious anemia psoriasis systemic lupus erythermatosus I 6reasons for failed sef toerance Antigen that does not normally circulate becomes exposed self antigen otherwise tolerated is altered by combining with foreign hapten antibodies may be produced that are directed against other antibodies antibodies produced against foreign antigens may cross react with sef antigens sef antigens may be presented to the helper T lymphocytes together with class2 MHC molecules inadequate activity of regulator T lymphocytes o Immune Complex Diseases antigenantibody combinations that are free not attached to cells activates complement proteins and promotes inflammation continuously formed wout phagocytosisproonged inflammationorgan damage I Rheumatoid arthritis systemic lupus erythematosus SLE o AllergyHypersensitivity I Immediate Hypersensitivitydue to abnormal B lymphocyte responses to allergens cause runny nose red eyes hives 0 gEreease of histamine from basophils and mast cells vasodiation capillary permeability edema 0 Immediate hypersensitivity tested by injecting antigens under skin fare andwheal reaction I Delayed Hypersensitivitysymptoms take hours to develop ce mediated T cell response 0 Contact dermatitis caused by poison ivy Chapter 16 Respiratory Physiology 0 The Respiratory System RESPRATONVENTLATON GAS EXCHANGE OXYGEN UTILIZATION o Structure of the Respiratory System Gas exchange occurs across ALVEOLI air sacs Typel95 to 97 surface area of lungs very thin main gas exchange Type2 secrete pulmonary surfactant and reabsorb Naquot and H20 0 Alveolar wall is strong alveoli are polyhedral and clustered together at ends of respiratory bronchioles thin air tubes Air passages of system divided into RESPIRATORY where gas exchange occurs including bronchioles and terminal alveolar sacs and CONDUCTION anatomical structures through which air passes before reaching resp zone mouth nose pharynx larynx trachea primary bronchiup to terminal bronchioles ZONES 0 Conducting structures maintain constant internal body temp by warming inspired air filter air via mucus Airpharynxgottis in middle of larynxtrachearightleft pulmonary bronchitermina bronchiolesrespiratory bronchiolesaveoar sacs TRACHEOTOMYsurgically opening the trachea TRACHEOSTOMYinsertion of a tube into the trachea to permit breathing and to keep the passageway open o Thoracic Cavity DIAPHRAGM sheet of striated muscle divides front of body into lower ABDOMINOPELVIC CAVITY liver pancreas GI tract spleen genitourinary tract and upper THORACIC CAVITY heart lungs blood vessels trachea esophagus thymus 0 Central regionMEDASTNUM enveloped by two wet epithelial membranes PLEURAL MEMBRANES o Top PARIETAL pleura lines inside of thoracic wall inner VISCERAL PLEURA covers surface of lungs 0 Physical Aspects of Ventilation o Intrapulmonary and Intrapleural Pressures INTRAPLEURAL SPACE btwn parietal and visceral contains thin layer of fluid lubricant for lungs to slide against chest during breathing Air enters lungs bc atmospheric pressure is greater than INTRAPULMONARYINTRAALVEOLAR PRESSURE INTRAPLEURAL PRESSURElungs pull in one direction thoracic wall in the othersubatmospheric pressure in intrapleural space btwn the two structures TRANSPULMONARY PRESSUREdifference btwn intrapulmonary and intrapleural pressure 0 Pressure win lungs intrapulmonary always gt pressure outside lungs intrapleural BOYLE S LAW pressure of a given quantity of gas is inversely proportional to its volume 0 Lung vol increases when inhalingintrapumonary pressure decreases air goes in 0 Lung vol decreases when exhalingintrapumonary pressure increases air leaves o Physical Properties of the Lungs COMPLIANCEchange in lung volumechange in transpulmonary pressure ie stretchability ELASTICITYable to return to initial size after being distended high elastin protein content SURFACE TENSIONfluid absorption is driven by active Natransport secretion driven by active Clquot transport alveolar surface has tension bc water molecules pull tightly togetherincreases air pressure within alveolus 0 LAW OF LAPLACE pressure in alveolus is directly proportional to surface tension and inversely proportional to radius of the alveolus o Surfactant and Respiratory Distress Syndrome SURFACTANTsubstance in alveolar fluid reduces surface tension consists of phospholipids intersperses btwn water molecules prevents alveoli from collapsing during respiration RESPIRATORY DISTRESS SYNDROME RDSlack of surfactant in premature babiesaveoi collapse ACUTE RESPIRATORY DISTRESS SYNDROME ARDSppl with septic shock fall in bp due to vasodilation bc of infection endure inflammationaveoar and capillary permeabilityaccumuation of proteinrich fluid in lungs 0 Mechanics of Breathing o Inspiration lnhaling and Expiration Exhaling EXTERNAL and INTERNAL INTERCOSTAL MUSCLES btwn portions of the rib cage PARASTERNAL intercostals btwn costal cartilages Inspiration Contraction of diaphragmincrease thoracic volume contraction of parasternal and external intercostals contraction of SCALENE PECTORALIS MINOR and STERNOCLEIDOMASTOID musclesintrapumonary pressure decreasesair flow into lungs Expiration thorax and lungs recoil after stretch decrease in lung volumeintrapumonary pressure increasesair flows out o Pulmonary Function Tests TIDAL VOLUME amount of air expired in each breath VITAL CAPACTY maximum amount of air that can be forcefully exhaled after maximum inhalation 0 Vital capacitytida volume INSPIRATORY RESERVE VOLUME maximum amount of gas that can be inspired after a normal tidal expiration EXPIRATORY RESERVE VOLUME maximum volume of gas that can be expired during forced breathing in addition to tidal volume RESIDUAL VOLUME voume of air you cannot expire EXPIRATORY RESERVE VOLUME additional air left in the lungs after an unforced expiration o Together make FUNCTIONAL RESIDUAL CAPACITY TOTAL MINUTE VOLUME mutipying the tidal volume by number of breaths per minute 6Lmin ANATOMICAL DEAD SPACEarea conducting system where fresh air is mixed with internal air of low oxygen conc and high carbon dioxide conc volume of air here is always constant RESTRICTIVE DISORDERSvital capacity is reduced to below normal OBSTRUCTIVE DISORDERSvital capacity is normal rate of expiration is compromised by something 0 Tested by FEV forced expiratory volume test o Pulmonary Disorders DYSPNEAshortness of breath ASTHMA obstruction of air flow through bronchioles that occurs during quotattacks caused by inflammation mucus secretion bronchoconstriction causes dyspnea wheezing 0 Allergic asthmachronic inflammatory disorder of the airways IgE antibodies produced 0 Often treated with glucocorticoids Singulair EMPHYSEMAdestruction of alveolar tissue reduces surface area for gas exchange collapse of bronchioles caused by cigarette smoke CHRONIC OBSTRUCTIVE PULMONARY DISEASE COPD chronic inflammation w narrowing of the airways and destruction of alveolar walls 0 Smokingmajor preventable cause of cancer I PULMONARY FIBROSISresult of lung damage lung structure is disrupted by accumulation of fibrous proteins 0 Gas Exchange in the Lungs I 760mmgpressure of quotone atmosphere atmospheric pressure at sea level I DALTON S LAW tota pressure of a gas mixture is equal to the sum of pressures that each gas mixture would exert independently 0 PARTIAL PRESSUREpressure that a particular gas in a mixture exerts independently I Pdry atmospherePN2PO2PCO2760mmg N2593 O2159 CO28 0 Calculation of P02 I When altitude increases total atmospheric pressure and partial pressure of gases decrease I Inhaled air in respiratory zone has 100 humidity water vapor pressure here is 47mmHg I PwetatmospherePN2PO2PCO2PH20 Po2decreased to 150mm Hg 0 Partial Pressures of Gases in Blood I When iquidgas amount of gas dissolved in fluid reaches max value 0 HENRY S LAW max value depends on solubility of gas into the fluid constant temperature of the fluid more dissolves in cold water but blood temp is constant partial pressure of the gas directly influences value I OXYGEN ELECTRODE produces an electric current in proportion to the concentration of dissolved oxygen that has been developed 0 Significance of Blood P02 and P002 measurements I P02 provides a good index of lung function but not total oxygen content of whole blood 0 Normal P02 of systemic arterial blood is 5mmHg less than P02 of alveolar air hemoglobin is saturated with oxygen 0 Breathing pure oxygen from a tank increases the amount of oxygen dissolved in plasma increase the rate of oxygen diffusion to the tissues but will NOT affect total oxygen content of blood because hemoglobin is already saturated 0 Pulmonary Circulation and VentilationPerfusion Ratios I Cardiac output of each ventricle 55L pulmonary circulation blood fowsystemic blood flow I Pulmonary circuationowresistance ow pressure arterioles dilate when alveolar P02 is raised constrict when it is lowered 0 Everything is the opposite to that of the systemic circulation pathway 0 Constriction of pulmonary arterioles where alveolar P02 is low and dilation when it s high helps match ventilation to PERFUSION blood flow 0 Disorders Caused by High Partial Pressures of Gases I OXYGEN TOXICITYoccurs when P02 rises above 25 atmospheresenzyme oxidation nervous system damage I NITROGEN NARCOSISdue to large amounts o f dissolved nitrogen under high pressure conditions dizziness and drowsiness I DECOMPRESSION SICKNESSsurfacing from high pressure conditions too rapidlyquick decompressionformation of nitrogen gas bubbles in tissue fluidsblood Hemoglobin and Oxygen Transport 0 O O O Hemoglobincan bind w four molecules of oxygen Four globin polypeptide chains four heme pigments two alphatwo beta protein chains 0 OXYHEMOGLOBN reduced form of iron oxygen 0 DEOXYHEMOGLOBINhemoglobin after oxygen is released to the tissues 0 METHEMOGLOBN oxidized hemoglobin iron in oxidized statecannot bond w oxygen 0 CARBOXYHEMOGLOBINreduced heme bonds w carbon monoxide stronger than oxygen bond CO displaces oxygen in hemoglobin PERCENT OXYHEMOGLOBIN SATURATON oxyhemoglobintotal hemoglobin usuay97 ANEMA hemogobin concentration is lowow oxygen in blood POLYCHYTHEMIAhemoglobin conc rises above normal ERYTHROPOIETINhormone controls hemoglobin production produced by kidneys LOADING REACTON deoxyhemogobinoxygenoxyhemogobin in lungs UNLOADING REACTIONOxyhemoglobindeoxyhemogobin Oxygen in systemic capillaries 0 High P02 drives rxn to the right low to the left Oxyhemoglobin Dissociation Curve iustration of percent oxyhemoglobin at different values of P02 Arteries P02 at 100mmHg 97 saturation Veins P02 at 40mmHg 75 saturation Dissociation curve is S shaped oxyhemoglobin percent saturation stays pretty constant at normal elevations during exercise venous P02 decreases arterial percent saturation stays the same changes in percentage oxyhemoglobin in veins indicates unloading into tissues Effect of pH and Temperature on Oxygen Transport BOHR EFFECT affinity of hemoglobin for oxygen decreases when pH is lowered and increases when pH is raised reduced affinitymore unloading of oxygen into tissues 0 Dissociation curve shifts right for more acidic pH and vice versa right shiftmore unloading left shiftmore oxygen in lungs 0 Dissociation curve moves right as temperature increases Effect of 23 DPG on Oxygen Transport Red blood cells obtain energy anaerobically no mitochondria side reaction of glycolytic pathway23diphosphoglyceric acid production inhibited by oxyhemoglobin ANEMIAred blood cells produce more 23 DPG ADULT HEMOGLOBINtwo alphatwo beta protein chains maternal hemoglobin A can bind to 23 DPG FETAL HEMOGLOBN 2 alpha2 gamma protein chains fetal hemoglobin F cannot bind to 23 DPG higher affinity for oxygen Inherited Defects in Hemoglobin Structure and Function Sicklecell anemia recessive person produces hemoglobin 5 point mutation in beta chain red blood cells thus have sickle shapereduced flexibility reduces blood flow damage plasma membrane and promotes hemolysis Thaassemia people of Mediterranean descent can get any of a family of hemoglobin diseases 0 Alpha thalassemiadecreases synthesis of alpha chains of hemoglobin 0 Beta thaassemia synthesis of beta chains is impaired Muscle Myoglobin MYOGLOBINred pigment in striated muscle cells has one heme higher affinity for oxygen oxygen is only released when P02 is very low oxygen transfer from blood to mitochondria oxygen storage 0 Carbon Dioxide Transport I CO2 carried by blood as dissolved form as carbaminohemoglobin as bicarbonate ion most I CARBONIC ANHYRDRASE catalyzes rxn where CO2 binds w water to form carbonic acid rxn favored in blood cells rather than plasma o Chloride Shift I Much carbonic acid produced to pass through systemic capillaries which causes HZCO3 H HCO339 more bicarbonate diffuses outward than hydrogen ion inside of red blood cells have net positive charge ions trapped win them attracts chloride which moves in as bicarbonate moves outCHLORDE SHIFT I Deoxyhemoglobin bonds H more strongly than does oxyhemoglobin CO2 increases oxygen unloading oxygen unloading improves carbon dioxide transport o Reverse Chloride Shift I Deoxyhemoglobin converted to oxyhemoglobin in pulmonary capillaries hydrogen ions are released win red blood cells which attracts bicarbonate and leads to H HCO3 9H2CO3 I Under lower Pcoz concentrations carbonic anhydrase catalyzes carbonic acid to carbon dioxide and water I REVERSE CHLORIDE SHIFTin pulmonary capillaries converts carbonic acid to water and carbon dioxide 0 AcidBase Balance of the Blood o Principles of AcidBase Balance I Blood plasma pH 735745 carbonic acid can be converted to a gas VOLATILE major buffer in plasma is bicarbonate ion I ACIDOSISfall in blood pH below 735 ALKALOSISrise in blood pH above 745 I RESPIRATORY COMPONENT of balance represented by plasma carbon dioxide concentration METABOLIC COMPONENT represented by free bicarbonate concentration RESPIRATORY ACDOSS inadequate ventilationrise in plasma concentration of carbon dioxide and thus carbonic acid RESPIRATORY ALKALOSS excessive ventilationowering of plasma concentration of carbon dioxide METABOLIC ACIDOSISexcessive production of nonvolatile acids or loss of bicarbonate fall in blood pH METABOLIC ALKALOSIStoo much bicarbonate or inadequate nonvolatile acids I HENDERSONHASSELBALCH EQUATION pH61og HCO339OO3Pco2 o Ventilation and AcidBase Balance I HYPOVENTILATIONhigh arterial Pcoz excessive carbonic acid production I HYPERVENTILATIONrate of ventiationgtcarbon dioxide production Pcoz decreases 0 Effect of Exercise and High Altitude on Respiratory Function o Ventilation During Exercise I P02 Pm and pH remain constant during exercise by increased breathing rate explained by neurogenic and humoral mechanisms Neurogenicsensory nerve activity from exercising limbs may stimulate respiratory muscles OR input from cerebral cortex may stimulate the brain stem centers to modify ventilation Humora chemica factors in blood may stimulate ventilation during exercise Both are involved in the HYPERPNEA increased total minute volume of exercise 0 Continued heavy exercise canLACTATE TH RESHOLD maximum rate of oxygen consumption that can be attained before blood lactic acid levels rise as a result of anaerobic metabolism due to aerobic limitations of muscles o Acclimatization to High Altitude Percent oxyhemoglobin saturation goes down as altitude increases rate at which oxygen can be delivered to the cells decreases HYPOXIC VENTILATORY RESPONSEincreased breathing due to decreased arterial P02 produces respiratory alkalosis NO produced in lungs increased levels in hypoxic people vasodilator 0 NOS SNO may be transferred from the blood to the rhythmicity center where it may stimulate breathing 22 of blood oxygen unloaded to tissues at rest increases at high altitudes affinity for oxygen is reduced Kidneys secrete erythropoietin in response to decreased tissue oxygen concentration which increases production of hemoglobin and red blood cells POLYCYTHEMIAhigh red blood cell count increases viscosity of bloodpumonary hypertensionedema and ventricular hypertrophy Ideal hemoglobin concentration 18gdl of blood if above that may CHRONIC MOUNTAIN SICKNESS Ch 18 The Digestive System Introduction to the Digestive System o Functions Motility of food through tract ingestion mastication deglutition peristalsis Secretion exocrineenzymes HCI endocrine hormones Digestion Absorption storage and elimination immune barrier simple columnar epithelium that lines intestine Composed of GASTROINTESTIONAL TRACT and ACCESSORY DIGESTIVE ORGANS Layers of Gastrointestinal tract I MUCOSA absorptive and major secretory layers lines lumen of GI tract simple columnar epitheiumamina propria surrounded by muscularis mucosae I SUBMUCOSAconnective tissue serves mucosa contains blood vessels glands nerves SUBMUCOSAL PLEXUS I MUSCULARISsegmented contractions and peristaltic movement through GI smooth muscle MYENTRIC PLEXUS btwn inner circular and outer longitudinal layers major nerve supply for GI I SEROSAouter wall of GI tract bindingprotective layer o Regulation of Gastrointestinal tract I Innervated by sympatheticparasympathetic nerves vagus nerve for upper organs postganglionic sympathetic fibers innervate GI tract and suppress peristalsis and secretory activity I Contains intrinsic sensory neuronshelp w local regulation of digestive tract I Digestive system regulated extrinsically by autonomic nervous system intrinsically by enteric nervous system and paracrine regulators 0 Mouth to Stomach I MasticationDegutition swallowinginvolves 25 pairs of muscles pharynx and esophagus controlled by SWALLOWING CENTER o Esophagusconnects pharynx to stomach muscular tube lined w nonkeratinized stratified squamous epithelium peristalsis moves food down esophagus LOWER ESOPHOGEAL SPHNCTERtermina portion narrowed helps prevent regurgitation o Stomachcontinuous with esophagus empties into intestine stores food initiates digestion kill bacteria move food into intestine as CHYME I Upper cardiac region upper fundus lower body lower pyloric region antrumpyoric sphincter I GASTRIC PTS openings of folds in gastric mucosa into stomach lumen GATRIC GLANDScells that line the folds combine to form this 0 Gastric gland cells mucous neck cells secrete mucus parietal cells secrete HCI chief cells secrete pepsinogen ECL cells secrete histamine and serotonin G cells secrete gastrin D cells secrete somatostatin 0 secrete intrinsic factor absorbs Vitamin B12 stomach secretes GHRELIN 0 Exocrine secretions of gastric cells waterGASTRC JUICE o Pepsin and Hydrochloric Acid Secretion I Parietal cells secrete H into gastric lumen via HK ATPase pumps H into lumen K out take in CI coupled to bicarbonate movement out I HCI secretion stimulated by gastrin histamine neurotransmitters makes gastricjuice very acidic pHlt2 acidity serves following functions 0 Denaturation of ingested proteins partial digestion of pepsinogen enzymes releases pepsin enzyme for digestion activates pepsin 0 Defense against stomach lining damage by acid and pepsin ADHERENT LAYER OF MUCUS on epithelial surface neutralizes acid that hits lining slows diffusion of pepsin into epithelial cells I Proteins partially digested by pepsin carbs and fats not at all digestion occurs in intestine I Peptic ulcerserosion of stomach mucus excessive gastric acid secretion bc of gastrin due to Helicobacter pylori bacteria in GI tract treated with proton pump inhibitor Prilosec I Prostaglandins from gastric mucosa stimulate mucus and bicarbonate production inhibited by non steroidal anti inflammatory drugs I ACUTE GASTRTS gastric barriers to sef digestion break downacid leaks into submucosainflammationhistamine releasemore inflammation 0 Small ntestine between pyloric sphincter and ileocecal valve of large intestine 3m long I First part DUODENUM then JEJUNUM then ILEUM products of digestion absorbed across epithelial lining o Villi and Microvilli I VILLIfold of mucosa projects into intestinal lumen covered with columnar epithelial cells w GOBLET CELLS LAMINA PROPRIA contains lymphocytes blood capillaries central lacteal I INTESTINAL CRYPTSnarrow pouches of intestinal villi that open through pores to intestinal lumen 0 Intestinal lumen renewed every 45 days I MICROVILLIfoldings at the apical surface of each epithelial membrane produce a BRUSH BORDER on edges of columnar epithelial cells o Intestinal enzymes I BRUSH BORDER ENYZMES microvilli enzymes on plasma membrane of microvilli 0 ENTEROKINASErequired for activation of trypsin enzyme o Intestinal contractions and Motility I Weak peristalsis SEGMENTATIONmajor contractile activity constriction of lumen I Smooth muscle contraction paced by SLOW WAVES pacemaker cesNTERSTTAL CELLS OF CAJAL 0 Large IntestineColon I Chyme from ileumcecumascending colontransverse colondescending colonsigmoid colonrectumana canalanus outer surface of colon bulges outward to form HAUSTRA pouches o Intestinal Microbiotamicrofloramicroorganisms in body 10 times more than human cells I COMMENSAL BACTERIA produce Vitamins B and K ferment indigestible molecules and secrete mucus prevented from causing inflammation via innate and adaptive immune system I Inflammatory bowel diseasechronic intestinal inflammation o Fluid and Electrolyte Absorption in the Intestine I Small intestine receives 7 9L fluidabsorbs most passes 152L to large intestine200m passed asfeces I Passive absorption of water aldosterone stimulates watersalt reabsorption in the intestine I Secretion of water out via osmosis o Defecation I Waste passes to rectumincrease in rectal pressurereaxation of internal anal sphincter urge to defecate 0 Defecation reflexrectal pressure rises to a high point external anal sphincter relaxes and feces are admitted through 0 Liver Gallbladder and Pancreas o Liverlargest internal organ HEPATOCYTES liver cells form HEPATIC PLATES 12 cells thick plates separated by SINUSOIDS large capillary spaces lined by endothelial cells w processes and fenestrae Regeneration Products of digestion absorbed in capillarieshepatic portal veincapiaryhepatic veiniver 0 PORTAL SYSTEM capillaryveincapiaryvein Hepatic plates arranged into LIVER LOBULES central vein branches of portal vein and HEPATIC ARTERY 0 Bile secreted into BILE CANALICULI drained by bile ducts drain into hepatic ducts Liver clears blood of compounds by removing them from the blood and excreting them into the intestine with the bile eliminated w feces 0 Exception ENTEROHEPATIC CIRCULATIONcompounds released to bile absorbed through small intestine carried back to liver again secreted into bile ducts Function Bile Production and Secretion250 to 1500m of bile per day 0 BILE PIGMENTBILIRUBINproduced in spleen liver bone marrow FREEnot water soube carried to blood attached to albumin CONJUGATEDwatersoluble secreted into bile coverts bacteria into UROBILINOGEN half is absorbed by intestine enters hepatic portal vein some is secreted into bile and returned to intestine via enterohepatic circulation rest enters general circulation part in plasma is not attached to albumin filtered by kidneys into urine 0 BILE ACID derivatives of cholesterol conjugate w glycine or taurine to form BILE SALTS huddle together in aqueous solution to form MICELLES Function Detoxication of the Blood via excretion in the bile phagocytosis by Kupffer cells in sinusoids chemical alteration 0 Ammonia converted into urea by liver enzymes porphyrins converted into BILIRUBIN purines into URIC ACID 0 Steroid hormones are conjugated become anionic hydrophilic transported to the bile canaliculi via MULITSPECIFIC ORGANIC ANION TRANSPORT carriers Function Secretion of Glucose triglycerides and Ketone Bodies gycogenesis lipogenesis glycogenolysis gluconeogenesis ketogenesis Function Production of plasma proteins o Gallbladdersaclike organ inferior surface of liver storesconcentrates bile ejects it through the cystic duct into the common bile ductduodenum o Pancreasexocrine and endocrine functions EndocrinePANCREATIC ISLETS secrete insulin and glucagon into blood Exocrinesecretes pancreatic juice through the pancreatic duct into duodenum from ACINI Pancreatic juice bicarbonate20 different digestive enzymes amylase trypsin lipase 0 Most enzymes begin as inactive zymogens 0 Neural and Endocrine Regulation of the Digestive System Duodenum secretes SECRETIN hormone stomach secretes GASTRIN and CCK small intestine secretes GIP o Regulation of Gastric FunctionExtrinsic Control has 3 phases Cephalic phase Control by the brain via the vagus nerves conditioned stimuli can evoke gastric secretion vagus nerve activatedchief cells secrete pepsinogen parietal cells secrete HCI via ECL secretion of histamine I Gastric phase Arrival of food in stomach secretion stimulated in response to distention of stomach and chemical nature of chyme partial digestion of proteinschief cells secrete gastrinstimuates pepsinogenindirect HCI secretion 0 Positive feedback more pepsinogenHCI reeasemore proteins digested 0 Negative feedback HCI release regulated by gastrin decreases in amount as pH decreases inhibited by somatostatin I Intestinal phase inhibition of gastric activity when chyme enters the small intestine increase in osmolality when chyme arrives in duodenum stretch in duodenumvagus nerve activatedinhibition of gastric motility and secretion presence of fatduodenum secretes ENTEROGASTRONE ex GIP gastricgucosedependent inhibitinginsulinotropic peptide somatostatin CCK GLP1 all reduce gastric activity to small intestine can digestabsorb the food 0 GLP1 and GIP insulin secretion from pancreatic islets o Regulation of Intestinal Function I Enteric Nervous Systemouter myentericAuerbach s plexus along length of GI tract inner submucosalMeissner s plexus in small and large intestine regulates peristalsis 0 100 million neurons interneurons and sensory and automatic motor neurons o Sensory travel up vagus nerve intestineCNS EXTRINSIC AFFERENTS INTRINSIC AFFERENTS synapse w interneurons of ENS I Enterochronaffinlike cells ECL of intestine secrete SEROTONIN 5 hydroxytrptamineintrinsic afferentsactivate motor neurons in submocosal plexus and secrete MOTILINcontraction in duodenum and stomach antrum I GUANYLINparacrine regulator produced by ileum and colon stimulates via cGMP intestinal epithelial cells to secrete Cl and water inhibits absorption of Na UROGUANYLINproduced by intestine stimulates kidneys to excrete salt in the urine I Intestinal reflexes GASTROILEAL refex increased gastric activityincreased motility of ileum and increased movements of chyme through the ileocecal sphincter ILEOGASTRIC refex distension of ileum causes a decrease in gastric motility NTESTNO NTESTNAL refexes overdistention of one intestinal segment causes relaxation throughout the rest of the intestine o Regulation of Pancreatic Juice and Bile Secretion I Ach release from vagus nerve and CCK from duodenumsecretion of pancreatic enzymes from acinar cells 0 CCK in response to proteinfat content of chyme secretin in response to fall in duodenal pH below 45 I Liver secretes bile continuously increased by a meal stimulated by bile acids that return to liver from intestine via hepatic portal vein enterohepatic circulation secretin CCK stimulates bile duct to secrete bicarbonate o Trophic Effects of Gastrointestinal Hormones I Gastrin secreted by pyloric mucosa of stomach may exert trophic effects on the gastric mucosa I CCK may exert trophic effects on the acinar cells of the pancreas 0 Digestion and Absorption of Carbohydrates Lipids and Proteins o Digestion and Absorption of Carbohydrates I SALIVARY AMYLASE breaks down polysaccharides most digestion occurs in duodenum via PANCREATIC AMYLASE cleaves starch to produce maltose and maltriose oligosaccharides hydrolyzed into monosaccharides by brush border enzymes on microvilli of small intestine passes through epithelial cells into interstitial fluid to diffuse into blood capillaries o Digestion and Absorption of Proteins I Stomach pepsin breaks down proteins into shorter chain most digestion occurs in duodenum and jejunum TRYPSIN CHYMOTRYPSIN ELASTASE cleave peptide bonds CARBOXYPEPTIDEASE removes amino acids from the carboxyl end of polypeptides AMINOPEPTIDEASE removes amino acids from amino end 0 Digested into amino acids absorbed via cotransport of Na into epithelial cells secreted into blood capillaries o Digestion and Absorption of Lipids I EMULSIFICATIONbile salt micelles secreted into duodenum break up fat into triglyceride droplets 0 PANCREATIC LIPASE digests the droplets liberates free fatty acids and monoglycerides 0 PHOSPHOLYPASE A digests phospholipids into fatty acids and lysolecithin 0 Digested products are polar enter bile salt micelles I Digestion products leave micelles enter intestinal epithelial cells resynthesize triglycerides and phospholipids 0 Form CHYLOMICRONS with protein secreted into lymphatic capillaries of intestinal villi pass through lymphatic system into venous blood I Cholesteroltriglycerides apolipoproteins secreted into blood as VLDLs very owdensity lipoproteins converted to LDLs lowdensity lipoproteins which transport cholesterol to various organs returned from organs to the liver attached to HDLs highdensity lipoproteins Chapter 19 Reguation of Metabolism 0 Nutritional Requirements KILOCALORIE kca1000 calories 1 caorieenergy required to raise temp of 1cm3 H20 1 degree o Metabolic Rate total rate of body metabolism and Caloric Requirements Measured by body heatO2 consumption influenced by activity HYPOTHERMIAlow body temp induced during surgery of brainheart BMR basal metabolic rate baseine rate of individual at comfortable temp 12 hours after food determined by sex age body surface area genetics physical activity 0 Positive energy balance calories ingtcaories out 0 Negative energy balance calories outgtcaories in o Anabolic Requirements ANABOLISMsynthesis reactions occur constantly CATABOLISMhydrolysis of polymers catabolism of stored material increases during exercise monomers used as restored material or energy must be replaced by food TU RNOVER RATE rate at which a molecule is broken down and resynthesized ESSENTIAL AMINO ACIDSmust be obtained through food lysine tryptophan phenylalanine threonine valine methionine leucine isoleucine histidine ESSENTIAL FATTY ACIDSlinoleic acid omega 6 linolenic acid omega3 0 OMEGA3 fatty acidsfirst double bond on 3quot carbon from the methyl end o Vitamins and Minerals Vitamins coenzymes in metabolic reactions must be obtained through food 0 FATSOLUBLE vitamins ADEK o Vitamin E antioxidant block inflammation o Vitamin K produces prothrombin and clotting factors o Vitamin A retino retinal retinoic acid regulates embryonic development epithelial membrane structurefunction immune system regulation o Vitamin Dproduced by skin regulates calcium balance required for calcification of bones I Vitamin D derivative used to treat PSORIASIS inflammation of skin 0 WATER SOLUBLE vitamins thiamine B1 riboflavin B2 niacin B3 pyridoxine B6 pantothenic acid biotin folic acid B12 C o Coenzymes for carblipidprotein metabolism antioxidants inactivate free radicals damage tissue by removing an electron Mineralscofactors for enzymes TRACE ELEMENTS iron zinc manganese fluorine copper molybdenum chromium selenium o Free Radicals and Antioxidants FREE RADCAL moecue with an unpaired electron highly reactive reactive oxygen species if contain oxygen or reactive nitrogen species produced by phagocytes to destroy bacteria 0 Excessive productionOXDATVE STRESS cell death aging cancer inflammatory diseases heart disease stroke hypertension arthritis multiple sclerosis Alzheimer39s 0 Enzymes help to prevent excessive accumulation GLUTATHIONEtripeptide inactivates free radicals ANTIOXIDANTglutathionine vitamins C E take electron from free radicals 0 Regulation of Energy Metabolism ENERGY RESERVES provide molecules to be oxidized for energy I CIRCULATING ENERGY SUBSTRATESmolecules carried by blood to cells for use in respiration glucose fatty acids amino acids o Regulatory Functions of Adipose Tissue I WHITE ADIPOSE tissuemain site of energy storage in body triglycerides stored in ADIPOCYTES 0 Adipocytes increase in number over life differentiate due to circulating fatty acids differentiation requires PPARy nuclear receptor proteinwhen bound to ligand stimulates adipogenesis in subcutaneous tissue of adults I ADIPOKENESregulatory molecules from adipocytes regulate hunger metabolism insulin sensitivity 0 TUMOR NECROSIS FACTOR ALPHAsecreted by macrophages converted from monocytes reduces ability of skeletal muscle to remove glucose from the blood in response to insulin 0 LEPTIN acts on hypothalamus to regulate hunger and food intake RESISTIN RETINOL BINDING PROTEIN 4 increased during obesity 0 ADIPONECTINdecreases during obesity antidiabetic effects I Alcohol canFATTY LIVER I Starving people have reduced adipose tissue and leptin secretiondecine in T lymphocyte responseess immune system strength I Leptin may regulate reproductive system onset of puberty menstrual cycle I Obesityrisk factor for cardiovascular disease diabetes high amount of visceral fathigh waist tohip ratio due to increase in adipocyte size 0 Measured by BMwh2 o Regulation of Hunger and Metabolic Rate I ARCUATE NUCLEUScenter in the hypothalamus project to other brain areas as influenced by neurotransmitters from brain regions and hormones from the blood 0 One part produces MELANOCORTIN neurotransmitters decrease hunger 0 One part produces NEUROPEPTIDE Y and AGOUT RELATED protein increase hunger I Polypeptides target arucate nuclei to signal hungersatiety 0 GHRELINhunger signal from stomach results from stimulation in nucleus to secrete neuropeptide Yagoutirelated protein short term 0 CCK from intestine suppresses hunger short term 0 PYY from small intestine regulates hunger on an intermediatetime basis 0 LEPTINfrom adipose tissue satiety factor secretion increases as stored fat increases stimulates MSHMeanocortin release ong term 0 INSULINfrom B ces of pancreatic islets suppresses hunger neuropeptide Y long term o Caloric Expenditures3 components I Basal Metabolic Rate energy expended by relaxed person majority of total calorie expenditure I Adaptive Thermogenesisheat energy expended due to change in temp and digestionabsorption of food 10 of total calorie expenditure I Physical Activity raises metabolic rate I Nonshivering Thermogenesisheat production wout shivering major function of BROWN ADIPOSE tissue which have many small fat droplets abundant in infants neck of adults 0 Due to presence of UCP1 H channels for ion to move into mitochondria o More brown fat in women lean people I THERMIC EFFECT OF FOOD diet is a regulator of adaptive thermogenesis regulated by brain via activation of sympathoadrenal system 0 During starvation leptin secretion declines which makes thyroxine secretion decline o Metabolic rate decreases o Hormonal Regulation of Metabolism ABSORPTIVE STATEhigh levels of energy carrier absorption in intestine POSTABSORPTIVEFASTING STATElow levels of energy carrier absorption in intestine Hormones regulate rate at which energy substrates are withdrawndeposited out from and into energy reserves 0 Energy Regulation by the Pancreatic Islets hormonesecreting cells win pancreatic exocrine tissue Pancreatic Islet cells BETA secrete insulin ALPHA secrete glucagon DELTA somatostatin o Regulation of Insulin and Glucagon Secretion Regulated by plasma conc of glucoseamino acids insulin promotes attachment of GLUT4 carriers onto plasma membrane storage of glycogen and fat Fasting plasma glucose conc65 105mgd rises to 140150 during meal absorption 0 Depolarizes beta cellsopens Ca2 channelsCa2 stimulates exocytosis of insulin vesicles ORAL GLUCOSE TOLERANCE TEST measure of ability of beta cells to release insulin insulin to lower blood glucose person drinks glucose soltn checked regularly for plasma glucose conc 0 Normal glucose conc reduced to normal in 2 hours Parasympathetic nerves stimuate GI function beta cell release Sympathetic stimuates glucagon Intestine anticipates glucose uptake via GLP1 and GIP stimulate insulin secretion o Insulin and Glucagon Absorptive State when blood glucose levels are rising Insulin promotes anabolism promotes uptake of glucose and incorporation into energyreserve molecules promotes cellular uptake of amino acids targetskeeta muscles and liver 0 Gycogeness efficient energy reserve molecule mostly fat Insulin acts on hypothalamus to inhibit vagus nerve from stimulating liver to release glucose o Insulin and Glucagon Postabsorptive Stage low blood glucose levels Liver secretes glucose via GLYCOGENOLYSIS frees glucose from 100g glycogen GLUCONEOGENESIS amino acid release from muscle glucagon and cortisol stimulate enzyme production in liver amino acidgucose Skeletal muscles heart liver kidneys use free fatty acids as energy source LIPOLYSIS KETOGENESIS reduce activity of glycolitic enzymes that break down glycogen 0 Diabetes Mellitus and Hypoglycemia DIABETES MELLITUS chronic high blood glucose hyperglycemia due to insufficient insulin secretion or inability of secreted insulin to stimulate cellular uptake of glucose from blood o Type 1 Diabetes Meitus autoimmune disease beta cells secrete littleno insulin destroyed Associated w genes on chromosome 6 Major Histocompatibility Complex Killer T cells destroy beta cells via apoptosis causes hyperglycemiagucose in the urine glucose cannot enter adipose fatty acid releaseketone bodies formed ketosisexcessive water secretion in urine ketoacidosis High glucagon secretion helps raise plasma glucose even more helps convert fatty acids into ketone bodies Requires insulin injections cancomas and death o Type 2 Diabetes Mellitus 95 secreted glucose unable to stimulate cellular uptake of glucose Obese people must secrete large amounts of insulin to keep plasma glucose levels normal INSULIN RESISTANCEtissue sensitivity to insulin is low inherited trait but increased by obesity 0 Insulin not able to stimulate muscles to take in glucose nor to prevent liver from secreting 0 IMPAIRED GLUCOSE TOLERANCEhigh glucose plasma high oral test results Weight lossdecrease in adipocyte sizedecreases insulin resistanceess chance of diabetes 0 Exercisesmaer adipocytesmore tissue sensitivity CanMETABOLIC SYNDROME o Hypoglycemialow blood glucose levels REACTIVE HYPOGLYCEMIAhypoglycemia due to oversecretion of insulin causes tremor hunger weakness mental confusion blurred vision 0 Metabolic Regulation by Adrenal Hormones Thyroxine and Growth Hormone o Adrenal Hormones Medulla secretes catecholamines epinephrine norepinephrine 0 Stimulate glycogenolysis lipolysis glucose release from liver 0 B3adrenergic receptorsstimulated by norepinephrine in brown fat high rate of energy expenditure Cortex secretes corticosteroids mineralcorticoids glucocorticoids 0 In response to ACTH stress response ie during exercise cortisol promotes lipolysis gluconeogenesis muscle protein breakdown o Thyroxine TetraiodothyronineT4secreted by thyroids in response to TSH from pituitary Prehormone converted to T3 for activation regulates cell respiration rate contributes to growthdevelopment 0 Stimulates resp by inhibiting ATP production increases aerobic respincreases metabolic heat production Sets BMR normal level of thyroxine needed for proper development of CNS in kidscatabolism and anabolism in everyone o Growth Hormone Somatotropinsecreted by anterior pituitary stimulates growth inhibited by SOMATOSTATIN stimulated by GHRH GFs insulinlike growth factorspolypeptides similar to proinsulin mediate GH action SOMATOMEDINS mediate somatotropin 1 and 2 1autocrine regulatorhormone 2insuinlike Increased during fasting and after high protein meals anabolic and catabolic protein synthesis raises blood glucose levels Stimulates skeletal growth in growth plates of cartilage in kids bones epiphyseal discs turn from cartilage to bone growth stops when bone is formed Excessive secretion of GHGGANTSM excessive secretion of GH after plates are turned to boneACROMEGALY no height increase jaw increasebone deformities Inadequate secretion of GHDWARFISM 0 Regulation of Calcium and Phosphate Balance o Bone Deposition and Resorption Skeleton stores calcium and phosphate as HYDROXYAPATITE crystals Ca2PO43quot from blood by action of OSTEOBLASTS 0 BONE DEPOSITIONosteoblasts secrete collagen protein matrix hardened by hydroxyapatite 0 BONE RESORPTIONhydroxyapatite dissolved by OSTEOCLASTS Ca2PO43quot returned to blood osteoclasts bind to matrix quotruffled membrane dissoves Ca2PO43quot and digests matrix proteins Osteoblasts have a ligand that binds to RANK receptors whichosteocast formation also have osteoprotegerin that inhibits RANK binding Plasma concentrations of Ca2PO43quot kept constant calcium important for many functions blood clotting hormonalneurotransmitter function muscle contraction membrane permeability o Hormonal Regulation of Bone I PTH parathyroid hormone secreted when plasma conc of Ca2 decreases otherwise HYPOCALCEMIA occurs 0 Stimulates osteoclasts to resorb bone Ca2PO4339added to blood 0 Stimulates kidneys to resorb Ca2 decreases resorption of phosphate 0 Stimulates kidneys to produce enzyme needed to convert passive form of vitamin D into its active form Ca2PO43quot absorption from fooddrink I CALCITONINlowers blood calcium concentrations I ESTROGENinvolved in epiphyseal discbone conversion from female ovaries discs from circulating TESTOSTERONE in males 0 Estrogen promotes bone mineralization and prevents osteoporosis stimulates bone depod on I Osteoperosishyperthyroidism may be due to low TSH 0 Leptinreduces hunger increases metabolic rate stimulates osteoblasts o 125 Dihydroxyvitamin D3 I Vitamin D3 produced in skin bc of ultraviolet sunlight food sources provide 1020 of vitamin D I PREHORMONEtwo carbons added to two different spots on vitamin D chain I Helps raise plasma calcium and phosphate by stimulating intestinal absorption of them resorption of bones promotes osteoclast formation renal resportion of calcium and phosphate o Negative Feedback Control of Calcium and Phosphate Balance I PTH secretion controlled by plasma calcium concentrations stimulated by low levels stimulates final level in formation of active vitamin D3 0 PTH inhibits phosphate reabsorption in kidneys so more is excreted and not added to blood I Calcitonin secretion controlled by high plasma calcium levels lowers it by inhibiting osteoclast activity stimulating urinary excretion of Ca2PO43quot by inhibiting their reabsorption Chapter 20Reproduction 0 Sexual Reproduction GAMETES sperm and ova formed win GONADS testes and ovaries via meiosis FERTILIZATIONfusion of sperm and ovaZYGOTE o Sex Determination Zygote contains 23 homologous pairs of chromosomes 1 22AUTOSOMAL each pair w 2 ALLELES forms of each gene 2339 39SEX femaleXX mae XY 0 X inked genes only on longer X chrom Y chrom DNA has testis specific genes win PALINDROMES 0 ALL OVA HAVE AN X Chromosome 2 X chrom In woman39s cells is inactivated BARR BODY GENOMIC IMPRINTINGepigenetic doesn39t alter DNA sequence change in a gametezygote Gonads form in zygoteTESTES or OVARIES form testes formed by TESTS DETERMNNG FACTOR TDF 0 Gene for TDF called SRY on Y chrom 0 SEMINIFEROUS TU BULES of testes appear early in dev contain GERMINAL eventual sperm and NONGERMINAL SERTOLI SUSTENTACULAR cells then LEYDIG secrete testosterone cells appear 0 OVARIAN FOLLICLES appear later in dev for females KLNEFELTER S SYNDROME person has 47 chrom extra X TU RNER S SYNDROME person has 45 chrom o Development of Accessory Sex Organs and External Genitilia Male accessory come from WOLFFIANMESONEPHRIC ducts female from MULERIANPARAMESONEPHRIC ducts 0 Female organsUTERUS UTERINE FALLOPIAN TUBES 0 Male organsEPDDYMS DUCTUSVAS DEFERENS SEMINAL VESICLES EJACULATORY DUCT EXTERNAL GENTLA maesPENS PROSTATE SCROTUM femaeCLORTS from same tubule that forms penis LABIA MAJORA from swelling that forms scrotum 0 Testosterone converts into DHT needed for organ development Gonadic sex determined by X or Y sperm fertilizing egg which determines type of gonad which determines accessory sex organs o Disorders of Embryonic Sexual Development Hermaphrodismboth ovaries and testicles present Pseudohermaphroditesincomplete accessory organs 0 Congenital adrenal hyperplasiafemales recessive excessive androgen secretionmuerian duct organs fallopian tubes masculinized external genitilia 0 Testicular feminization syndromemales w testes no receptors for testosteronefemae genitilia form male sex organs don t 0 5areductase deficiencynormally functioning testes normal testosterone receipts lack ability to produce this enzyme DHT not producedmore female external genitilia 0 Endocrine Regulation of Reproduction o Interactions Between the Hypothalamus Pituitary Gland and Gonads Anterior Pituitary secretes FSH and LH gonadotropic hormones stimulate spermatogenesisoogenesisstimulate gonadal hormone secretion maintain gonad structure 0 Hormone release stimulated by LHRH GnRHgonadotropinreleasing hormone Negative feedback of steroid hormonesFSH and LH secretion regulated by sex steroids estrogen testosterone GnRH secretion inhibited from hypothalamus inhibition of pituitary s response to GnRH 0 Also secretion of NHBN inhibits anterior pituitary s FSH release 0 PULSATILE SECRETION of GnRH from hypothalamus BENIGN PROSTATE HYPERPLASIAabnormal growth of prostate treated by decreased testosterone via GnRH derivatives that decrease LH secretion decrease testosterone 0 Similar treatment used for ENDOMETRIOSISshed tissue implants in ovariespelvisetc o Onset of Puberty Triggered by increased LH secretion more GnRH from hypothalamusgonads secrete more sex steroids testosteroneestradiol17Bsecondary sex characteristics girs MENARCHE menstruation 0 AMENORRHEAcessation of menstrual cycle related to activitybody fat of woman o Pineal Glandsecretes MELATONIN Stimulated more at night by postganglionic sympathetic neurons o Human Sexual Response4 phases EXCITATION PHASE arousa increased muscle tone vasocongestion sex organs fill with blood PLATEAU PHASE orgasmic platform forms ORGASM PHASE contraction of vaginapenis RESOLUTION PHASEbody returns to original state men enter REFRACTORY period unable to ejaculate 0 Male Reproductive System Testesseminiferous tubules spermatogenesis Sertoli ces FSH interstitial tissue Leydig cells for testosterone LH o Control of Gonadotropin Secretion LH stimulates testosterone secretion in Leydig cells testosterone inhibits pituitary LH secretion Inhibin inhibits FSH secretion negative feedbackconstant levels of androgen secretion from testes Testosterone effects on the brain mediated by derivatives made win the brain testosteroneDHT estradiol17B Testosterone levels decline slowly w age o Endocrine Functions of the Testes Testosterone maintain puberty body changes anabolic growth of accessory organs Estrogen estradiol plays part in spermatogenesis negative feedback for testosterone sealing of epiphyseal cartilage plates o Spermatogenesis Germ cells that migrate to tests in embryoSPERMATOGONAmeiosis4 haploid cells sperm cells duplicate by mitosis 1 of 2 PRIMARY SPERMATOCYTE undergoes meiosisSECONDARY SPERMATOCYES 2hapoid SPERMATIDS 4separate into SPERMATOZOA Sertoli cells constitute BLOODTESTIS BARRIER around circumference of each tubule blood must pass through Sertoli cells before entering germinal cells Sertoli produces FAS LIGAND prevents autoimmune destruction of sperm Sertoli cells secrete ANDROGENBINDING PROTEIN ABP Formation of primary spermatocytes during embryonic dev spermatogenesis stops until puberty testosterone a paracrine regulator for spermatogenesis maybe estrogen too o Male Accessory Sex Organs Sperm drained into EPDDYMSDUCTUS VAS DEFERENS carry sperm out of scrotum into pelvic cavity SEMINAL VESICLES add secretions ductus becomes EJACULATORY DUCT that enters PROSTATE and merges with URETH RA there forms semen o Erection Emission and Ejaculation ERECTIONblood flow to erectile tissues corpora cavernosa and corpus spongiosum increase in penis size due to parasympathetic nerve induced vasodilation of arteries into penis NO EMSSON movement of semen into urethra stimulated by sympathetic nerve induced peristalsis EJACULATIONexpulsion of semen out of penis stimulated by sympathetic nerve induced peristalsis o Male Fertility I OLIGOSPERMIAlow sperm concentration in ejaculate decreased fertility sperm count below 50 millejacuationmae infertility I VASECTOMYeach ductus is tied interferes with sperm transport 0 Female Reproductive System I Ovaries suspended partially covered by UTERINEFALLOPIAN TUBES lumen of each tube continuous with UTERUS womb uterus narrows to form CERVIX which opens to VAGINA CLITORISanterior part of labia minora erectile tissue 0 3 uterus layers of uterus PERIMETRIUM outer connective tissue MYOMETRIUM middle smooth muscle ENDOMETRIUM inner epithelial 0 Vagina and urethra covered by folds LABIA MINORA and LABIA MAJORA o Ovarian Cycle I Germ cells migrate to ovariesoogonia some die via apoptosisremaining ones undergo meiosis PRIMARY OOCYTES contained win PRIMARY FOLLICLES which divide to produce layers of GRANULOSA CELLS primary oocytes grow and develop vesices SECONDARY FOLLICLESMATUREGRAAFIAN FOLLICLE primary oocyte completes 1 meitotic division1 secondary oocyte gets all the cytoplasm contained win graafian follicle btwn that and corona radiate surrounding oocyte is ZONA PELLUCDA ge ike layer of proteins and polysaccharides I only 400 oocytes will ovulate in a lifetime I Granulosa cells of follicles secrete estradiol as follicles grow via stimulation by FSH o Ovulation I One follicle develops into a graafian follicle becomes large and forms a bulge on the surface of the ovary follicle ruptures and extrudes its oocyte into uterine tube fertilized or degenerates 0 When fertilized by sperm undergoes second meiotic divisionzygote 0 Empty follicle becomes CORPUS LUTEUMsecretes estradiol and progesterone o PituitaryOvarian Axis I Hormonal interactions btwn anterior pituitary and ovaries pituitary secretes FSH and LH as controlled by GnRH hypothalamus 0 Menstrual Cycle28 days o Phases of Menstrual Cycle Cyclic Changes in the Ovaries I Follicular phaseday 1 to day 13 low steroid hormone secretion some primary folliclessecondary one reaches maturity and becomes graafian ESTRADIOL is secreted in high conc until day 12 0 Growthsecretion dependent on FSH secretion 0 Rise of estradiol secretionmore GnRH secretionLH secretion positive feedback effect o LH SURGElate follicular phase acts to trigger ovulation accompanied by smaller FSH surge I Ovulationgraafian follicle grows large into a blister rapid increase in estradiol secretionLH surgegraafian follicle ruptures day 14 secondary oocyte is released from ovary into uterine tube I Luteal Phase corpus luteum forms secretes estradiol and PROGESTERONE 1 week after ovulation 0 Progesterone and estradiol exert negative feedback effect on FSH and LH 0 Follicle development slowed so as to prevent multiple ovulations 0 EstrogenProgesterone levels fall during late luteal phase due to decrease in corpus luteum function o Cyclic Changes in the Endometrium uterus3 phases I PROLIFERATIVE phaseovary is in follicular phase stratum functionale of endometrium growsspiral arteries develop SECRETORY phasewhen ovary is in luteal phase uterine glands develop due to progesterone endometrium becomes thickspongy well prepared for acceptingnourishing an embryo MENSTRUAL phaseresult of fall in ovarian hormone secretion during late Iuteal cell death of stratum functionale of endometrium spiral arteries responsible for menstrual bleeding o Abnormal Menstruations AMENORRHEAabsence of menstruation DYSMENORRHEApainful menstruation MENORRHAGA prolonged menstrual flow METRORRHAGIAuterine bleeding not associated w menstruation occurs o Effects of Pheromones Stress and Body Fat Release of GnRH in control of reproductive system controlled by feedback effects of hormonesbrain centers 0 Pheromonesmenstrua cycles of roommates synchronize 0 GnRH secretion influenced by stress and emotions can AMENORRHEA quotfunctiona when cessation is due to inadequate GnRH release athleticism o Contraceptive Methods Contraceptive pill ORAL increases blood levels of ovarian steroids for duration of monthly cycleovuation never occursmenstruation occurs during 4 week of placebo pills when estrogenprogesterone levels fall 0 Includes synthetic estrogen and progesterone 0 Now lower doses used in meds that aren t taken orallydon t pass through liver first Rhythm methodsex more than six days before ovulationminima chance of pregnancy 12 days before ovulationpregnancy likely 0 METHOD woman checks oral basal body temp to determine when ovulation occurred during LH surge body temp declines then rises sharply one day later due to progesterone secretion o Menopausecessation of ovarian activity and menstruation age 50 Ovaries depleted of follicles stop secreting estradiol and inhibin FSH and LH secretion elevated Estrogen is in form of ESTRONE from adipose tissue Symptoms vasomotor disturbances quothot flashes atrophy of urethravaginal wall and glands increased risk of atherosclerosis and osteoporosis 0 Fertilization Pregnancy and Parturition CAPACITATIONability of 10 ejaculated sperm to fertilize an ovum must be in tract for 7 hours o Fertilizationin uterine tubes ACROSOMElarge enzymefilled vesicle above sperm nucleus interacts w ZONA PELLUCIDA surrounding oocyte during ACROSOMAL REACTION acrosomal membrane fuses w sperm membrane enzymes release via exocytosis Fertilizationer of oocyte releases Ca2 Ca2quot wave across egg cellstructurametabolic changessecondary oocyte stimulated to continue w meiosismature ovum and 2 polar bodies 0 ZYGOTE forms 12 hours after fertilization centrosome of zygote 23 chromosomes received from sperm o In Vitro Fertilizationgonadotropins injected promote development of many ovarian follicle transvaginal ultrasound guides follicular fluid w secondary oocytes NTRASYTOPLASMC SPERM INJECTION into cytoplasm of isolated secondary oocyteembryos grown in vitro 3 returned to uterus o Cleavage and Blastocyst Formation CLEAVAGE zygote division by mitosis 3036 hours after fertilization 2 39 cleavage at 40 hours 339 39 cleavage at 5060 hoursMORULA 8 cells enters uterus4 day more cleavages becomes BLASTOCYST inner cell mass as fetus outer chorion as placenta made of trophoblasts6 day attached to uterine wa MPLANTATONNIDATION I Fertilized egg early cleavage cesTOTPOTENT able to create entire organism I THERAPUTIC CLONINGproduces stem cells for treatment of diseases inner cell mass of blastocytes isolated and cultured called EMBRYONIC STEM CELLS are PLURIPOTENT can form all body tissues but not trophoblasts needed for reproductive cloning I ADULT STEM CELLS in protected locations where renewal of specialized cells is required are MULTIPOTENT can give rise to many differentiated cell types characteristic of their organ don t jump across GERM LAYER lines 0 Germ ayersectoderm mesoderm endoderm I INDUCED PLURIPOTENT STEM CELLS reprogrammed human fibroblasts used to generate cell lines with different genetic diseases to study disease mechanisms test effects of drugs on diseases test effectiveness and toxicity of drugs on cells from people with genetic differences produce stem cells that can be used to treat many diseases I REGENERATIVE MEDCNCE deveopment of future medical treatments using stem cells Implantation of the Blastocyst and Formation of the Placenta I Blastocyst and trophoblast cells of chorion secrete CHORIONIC GONADOTROPIN hCG to prevent menstruation progesterone and estradiol secretion continued I Days 712 Blastocyst inner cell mass forms ECTODERM nervous system skin ENDODERM gut chorion becomes CYTOTROPHOBLAST and outer SYNCYTIOTROPHOBLAST 0 Snycytiotrophoblast forms bloodfilled cavities in maternal tissue forms villi in the venous blood creating CHORION FRONDOSUM I During implantation endometrium cells of uterus change cell growth glycogen accumulation maternal tissue in contact with chorion frondosum called DECIDUA BASALIS two structures together form PLACENTA I Chorion bulges into uterine cavity beneath it is amnion embryo umbilical cord in fuid fied AMNIOTIC SAC 0 AMNIOCENTESISobtaining amniotic fluid and examining the cells win it during 6quot week of pregnancy to detect genetic abnormalities Exchange of Molecules Across the Placenta I Umbilical arteries deliver fetal blood to vessels within villi of chorion frondosum of placenta circulates and returns to fetus via umbilical vein maternal blood never mixes with fetal blood I Pacentasite of gasmolecule exchange btwn mother and fetus has high metabolic rate produces enzymes Endocrine Functions of the Placenta Pituitary ike and Sex Steroids I Placenta secretes hCG LH ike effects thyroid stimulation and CHORIONIC SOMATOMAMMOTROPIN hCS similar to GH and prolactin I hCG maintains corpus luteum for 55 weeks of pregnancy hCS GH from mother promote lipolysis and increased plasma fatty acid concenctration increased blood glucose concentrations polyuria excretion of much urine in mother I Placenta secretes estrogen and progesterone but cannot produce them on its own forms FETAL PLACENTAL UNIT with fetus to utilize fetus steroid producing tissue secretes ESTRIOL Labor and Parturition I Labor sequence of uterine contractions needed to expel fetus 0 Contractions stimulated by OXYTOCIN and PROSTAGLANDIN 0 Placenta produces CORTICOTROPINRELEASING HORMONE CRH determines when PARTURITION childbirth will occur CRH stimulates ACTH secretion stimulates cortisol secretion from adrenal cortexes of fetus and motherpositive feedback for more CRH stimulates maturation of fetal lungs Fetal adrenal cortex no medulla secretes cortisol outer and DHEAS inner both stimulated by ACTH 0 DHEAS converted into estrogens in placenta promotes sensitivity of mother to oxytocin and prostaglandins Parturition in some animals aided by RELAXIN causes relaxation of cervix required during first trimester in humans not later GENETIC SCREENINGdrop of blood from baby39s foot used to detect genetic disorders UMBILICAL CORD BLOOD BANKINGumbilical cord contains high conc of hematopoietic stem cells Lactation Each mammary gland has 1520 lobes each lobe is divided into lobules which contain alveoli that secrete milk into secondary tubules which converge to form mammary ducts which converge to form a lactiferous duct that drains at nipple milk accumulates at ampulla beneath nipple PROLACTINsecreted by anterior pituitary stimulates mammary glands to produce milk protein controlled by prolactininhibiting hormone PIH or dopamine 0 High estrogenow prolactin pregnancy and vice versa afterbirth Neuroendocrine reflexact of nursing helps maintain high levels of prolactin secretion MLK EJECTON REFLEXMILK LETDOWNstimulus of sucklingsecretion of oxytocin from posterior pituitary Fetus receives IgG antibodies from mother via placenta passive immunity gA antibodies from milk additional immunity Breast feeding can inhibit ovulation natural contraceptive Ch15 Immune System FAS Ligandsurface molecule produced by T lymphocytes bind to FAS surface receptor of sameother T cells to promote apoptosis after infection is cleared helps maintain immunologically privileged sites protect foreign mol BLymphocytesSpecific Immunity produced by bone marrow cells secrete antibodies receptors for antigens into bloodlymph divide into memory and plasma cells in germinal centers of secondary lymphoid organ spleen tonsil lymph node 0 Complement SystemCl activated by IgGIgM antibodies C4 into C4a and bC3 into C3a and bC5 into C5a and bC5C9 form membrane attack complex TLymphocytesSpecific immunity produced by thymus in neck attack infected cells KILLER secrete perforin mol and granzymes into victim celldestruction and require Class1 MHC mol on target cell to be activated HELPER enhance BKiller T cell activity interleukin2 lymphokine and require Class2 MHC mol on antigen presenting cell to be activated REGULATORY inhibit TB cell activity CD25CD4 proteins interleukin10 Mast Cellsin tissues contain heparin release HISTAMINE which stimulates bronchioconstriction and vasodilation capillary permeability promote in ammation NeutrophilsNonspeci c Immune System phagocytic cells in bloodall tissues attracted by chemotaxis to site of in ammation squeeze through vessels into connective tissue EXTRAVASATION ChemotaxisMovement usually of phagocytes towards chemical attractants chemokines Beta interferontype of Interferon mol that produce nonspeci c short acting resistance to viral infection inhibit replication of viruses alpha beta gamma made by almost all cells treats multiple sclerosis Antibodieschemicals responsible for immunity albuminalpha1amp2globulin B globulin Gamma globulin proteins IgG IgA IgM IgD IgE subclass proteins two heavy chains two light H inside L outside stalk is Fe top where binding happens is Fab 0 IgG main circulation secondary response IgA external secretion IgE allergies IgM antigen receptor lymphocyte IgD antigen receptor lymphocyte Haptens small organic mol bind to proteins and become an antigenic determinant site Lasix Example of a loop diuretic inhibit active salt transport out of ascending limb furosemide Graves disease autoimmune disease thyroid produces class 2 MHC mol immune system produces autoantibodies Chapter 16Respiratory Physiology Boyle s Law pressure of a given quantity of gas is inversely proportional to its volume increase in lung volumedecrease in intrapulmonary pressureair comes in Law of Laplace surface tension of alveoli collapses them and increases the air pressure within them this pressure is directly proportional to the surface tension and inversely proportional to the radius of the alveoli Dalton s Law total pressure of gas mixture is equal to the sum of partial pressure of each gas win it pptotal pressurefraction of that gas in the mixture 1 atmosphere760mmHg based on Mercury Hen y s Law max amount of gas dissolved into uid depends on solubility of gas in the uid constant temperature of the uid constant if blood and partial pressure of the gas Increase in blood Pm does not increzgumount of oxygen in red blood cells but increzmtmt of oxygen dissolved in plasma increases rage of oxygen diffusion into tissues Rhythmicity center region of medulla that controls automatic breathing contains 4 I neurons nad 2 E neurons in uenced by the pons APNEUSTIC CENTERpromotes inspiration via I neuron stim PNEOUMOTAXIC CENTER inhibits inspiration HYPOVENTILATION9rise in Phypercg19lower pH HYPERVENTILATION9hypocapnia9rise in pH Bohr Effect affinity of hemoglobin for oxygen decreases as pH decreases increases as pH increases Deoxyhemoglobin Hemoglobin after oxygen has been deposited to tissues higher af nity for H Pulmongry Fibro Result of lung damage accumulation of brous connective tissue proteins Reverse Chloride Shift in pulmonary capillaries carbonic acidcarbon dioxide and water vs opposite chloride shift in systemic capillaries carbonic acidhydrogen ions and bicarbonate hydrogen attracts chloride into cell CAPD Chronic obstructive pulmonary disease chronic in ammation w narrowing airways and destruction of alveolar walls Venous Pg 40mmHg 100mmHg in arteries 105mmHg in alveoli Interngl Respir tion gas exchange btwn blood and other tissues oxygen utilization by tissues vs external air and blood Chapter 19Metabolism Lipogenesis formation of fat stimulated by insulin during absorptive state Lipolysis breakdown of fat into free fatty acids stimulated by glucagon during postabsorptive state Type 1Type 2 Digbetes mellitug 1 insufficient insulin secretion by beta cells autoimmune causes hyperglycemia ketoacidosis high glucagon secretion 2 inability of insulin to sufficiently stimulate cellular uptake of glucose from the blood insulin resistance in tissues elevated glucagon common in obese people Glucagon hormone from alpha cells of pancreatic islets secretion increases during postabsorptive state promotes glycogenloysis gluconeogenesis lipolysis ketogenesis Calcitonin lowers blood calcium levels opposes PTH which raises blood calcium secreted by thyroid C cells Thyroxine secreted by thyroid follicles regulates cell respiration contributes to growth and development sets BMR OsteoblastsOsteoclasts Osteoblasts promote Bone Deposition forms hardended hydroxyapatite crystals control production of Osteoclasts Osteoclasts promote Bone Resorption return of bone calcium and phosphate into blood Leptin secreted by adipose tissue long term hunger regulation maintains stable level of fat storage adipokine Arcuate Nucleus in hypothalamus stimulated by neurotransmitters involved in hunger regulation contains melanocortin stimulates hunger and neuropeptide Yagouti related protein stimulate hunger Hyperphagia overeating caused by lesions in ventromedial area of hypothalamus lesions in lateralhypophagia Chapter 17 Kidneys Glomerulgr Filtration Rag volume of filtrate produced by both kidneys per minute 180L per day total blood every 40 minutes RENAL AUTOREGULATION maintains constant despite changes in arterial pressures decreases w symp stim Excretion rate filtration rate secretion rate reabsorption rate MACULA DENSA site of negative tubuloglomerular feedback Countercurrent multiplier svstem positive feedback system in descendingascending limbs of nephrons builds until maximum concentration of interstitial uid is reacheddriving force for ultra ltrate in nephrons to pass through 0 Vasa Recta maintains COUNTERCURRENT EXCHANGEkeeps NaCl in interstitial pores remove water Renal Plasma Clearance vol of plasma from which a substance is completely removed in one minute Juxtaglomerular apparatus where afferent arteriole comes in contact w the last thick part of ascending loop secretion of renninformation of angiotensin Iangiotensin IIstimulates adrenal cortex to secrete aldosteroneNaK retention Loop of Henle descending and ascending limbs watersalt transport from lumen filtrate to interstitial uid Tubulgr Ultrafiltrz filtrate in capsule passed capillary fenestraeglomerular basement memslit diaphragm Diureses use diuretics decreases blood vol loop no water or salt carbonic acid no water w bicarbo osmotic K sparing Nephron in the kidneys glomerular capsule proximal tube Loop of Henle descendingascending Distal tubeCollecting Duct proximalwater Salt urea descending water ascending salt thick urea distal salt cd waterurea Aldosterone regulates renal sodium reabsorptionpotassium secretion renin angiotension aldosterone Reabsorption Retum of filtered molecules from tubules to the blood 80 of ltrate is reabsorbed most Na is reabsorbed Renal Pyramids in medulla of kidneys project into a minor calyxmaj or calyx renal pelvis ureters path of urine Renal Plasma Threshold min plasma conc of a substance thatexcretion of it into urine glucose180 200mg100mL Renal insufficiency kidney function is reduced hypertension uremia acidosis high potassium ADH binds to collecting duct epithelials and stimulates cAMP fusion of aquaporins to surface promotes water retention increases with increased osmolality and decreased blood volume PAH Para aminohippuric acid when injected secreted into ltrate by peritubular capillaries clearancetotal renal blood ow Chapter 18 Digestive System Oral Cavity Pharynx Esophagus Stomach Small Intestine Large IntestineLiver Gallbladder Pancreas aundice Yellow staining of tissues produced by high conc of freeconjugated bilirubin treated in newboms w blue light Gastrin gastric gland hormone from G cell stimulates ECl cells parietal cells HCl secretion inhibited when pH is too low secreted by liver bilirubin heme derivative conjugated can be secreted bile acids cholesterolbile salts micelles Pepsinogen secreted by chief cells activated by lowered pH hydrolyzes peptide bonds lenses of stomach function CEPHALIC activated vagus nerve chief cells secrete pepsinogen parietal cells secrete HCl through stimulation of ECL cells to secrete histamine GASTRIC vagus nerve stimulated by entrance of food and thus amino acidsproteins in the lumengastrin secretionchief cells secrete pepsinogen ECL cells secrete histamine parietal cells secrete HCl INTESTINAL Inhibition of IP somatostatin CCK GLP 1 HDL High density lipoprotein takes up phospholoipidscholesterol from blood velles unloads liver opposes LDLs Gastroenteritis in ammation of stomach and intestines GASTRITIS in ammation in stomach due to histamine release Small Intestine Duodenum Jejunum Ileum Cholecystitis in ammation of the gallbladder Chapter 20Reproductive SystemEXTRA Turner s Syndrome genotype X0 45 chromosomes phenotypically female Leydig cells cells of interstitial tissues of testes secrete testosterone stimulated by LH Spermatids end product of divided secondary speratocytes haploid cytoplasms are interconnectedsplit into spermatozoa G chorionic gonadotropin secreted by chorion outer part of blastocyst maintains corpus luteum during pregnancy cGMP phosphodiesterz breaks down cGMP gonadotropin FSH and LH regulated by GnRH in hypothalamus and inhibin ialpha reductase converts testosterone into DHT which maintains penisurethrascrotumprostate de ciency more female Amenorrhea cessation of menstruation functional due to inadequate GnRH Dysmennorhea painful Menorrhagia excessive Corpus lutiem empty follicle after ovulation secretes estradiol and progesterone FAS ligand produced by Sertoli cells to kill T lymphocytes and protect immune attack on sperm Colostrom secretion from mammary glands that newborn feeds on for rst 23 days before true lactation begins Hyperphagia overeating caused by lesions in ventromedial area of hypothalamus lesions in lateralhypophagia Sertoli cells cells of seminiferous tubules stimulated by FSH inhibited by inhibin form blood testis barrierproduce FAS ligand spermiogenesis formation of spermatozoa from spermatids
Are you sure you want to buy this material for
You're already Subscribed!
Looks like you've already subscribed to StudySoup, you won't need to purchase another subscription to get this material. To access this material simply click 'View Full Document'