Shock Is Caused by an Inadequate Cardiac Output

Action Potential Pain Flow Chart

The beginning student often erroneously believes that the heart is the sole determinant of cardiac output. In Chapter 14, we learned that the peripheral circulation also plays an important governing role in the circulation. The peripheral circulation controls the filling pressure of the heart as well as its afterload, two major determinants of the stroke volume. This interaction between the heart and the periphery is vividly illustrated by the shock syndrome. In its simplest form, circulatory...

Voltage Dependent Release of Neurotransmitter

One of the most interesting aspects of synaptic transmission is the mechanism by which an action potential in the presynaptic terminal triggers the release of the chemical transmitter substance. One possibility is that transmitter release is due to some aspect of the sequence of permeability changes underlying the action potential in the presynaptic terminal. The action potential is associated with a slight influx of Na+ and a slight efflux of K+. Perhaps in some way either the small influx of...

Development Of Brain Vesicles

The closed lumen of the neural tube is altered in shape as a result of enlargement of the three brain vesicles, particularly the telencephalon. As the cerebral hemispheres of the telencephalon increase in size, two lateral expansions of the lumen form the first and second (lateral) ventricles, connected to each other and to the third ventricle by a thin, Y-shaped midline channel called the foramen of Monro. Continued posterior and inferior expansion of the hemispheres eventually forces the...

Transport In The Thin And Thick Ascending Limb

When the tubular fluid turns the bend at the tip of the loop of Henle, it enters the thin ascending limb of the loop of Henle. At this point, the epithelial transport properties change dramatically. Both the thin and the thick regions of the ascending limb of the loop of Henle are water impermeable because of the absence of aquaporin water channels, and there is no significant transepithelial water flow. On the other hand, these regions avidly reabsorb NaCl and can remove 20-25 of the filtered...

Clinical Note

Lesions and Motor Reflex Abnormalities Specific lesions within the neuronal components of the somatic motor system can cause characteristic abnormalities in motor reflexes. Flaccid paralysis usually denotes the loss of peripheral nerve innervation. Without input from alpha motor neurons of the spinal cord, there is no voluntary movement of the muscle and no resistance to passive movement. No reflexes can be elicited, and atrophy of the muscle will be observed. Unlike components of the central...

Transmission Across Synapses

Transmission across synapses in the ANS is mediated by chemicals known as neurotransmitters. These chemicals are synthesized within the nerves and in most instances are stored in synaptic vesicles in the nerve endings. Upon activation of the nerve, nerve action potentials invade the nerve ending, causing the release of a portion of the stored neurotransmitter. Once released, the neurotransmitter binds to specific receptors located on postsynaptic structures. Only those cells that possess...

Overview Of Sensory Pathways

It is apparent from the descriptions given earlier that specific areas of brain, spinal cord, or peripheral nervous tissue are assigned specific functional roles based on their relative position with the nervous system (Fig. 5). A general rule for neurons might be stated, Where you are is what you are.'' However, the nervous system should not be viewed as a series of isolated modules with specified duties rather, it more correctly resembles A. Cross sections of the nervous system FIGURE 5...

Ovarian Hormones

The principal hormones secreted by the ovary are estrogens (estradiol-17fi and estrone) and progesterone. These hormones are steroids and are derived from cholesterol by the series of reactions depicted in Fig. 6. Their biosynthesis is intricately interwoven with the events of the ovarian cycle. In addition, the ovary produces a large number of biologically active peptides, most of which act within the ovary as paracrine growth factors, but at least two, inhibin and relaxin, are produced in...

Female Reproductive Tract

The adult human ovaries are paired, flattened ellipsoid structures that measure about 5 cm in their longest dimension. They lie within the pelvic area of the abdominal cavity attached to the broad ligaments that extend from either side of the uterus by peritoneal folds called the mesovaria. Both the gamete-producing and hormone-producing functions of the ovary take place in the outer or cortical portion. It is within the ovarian cortex that the precursors of the female gametes, the oocytes, are...

The Olfactory Cortex

Mitral cells and tufted cells send central processes within the lateral olfactory tract to the primary olfactory cortex located on the inferior surface of the temporal lobe. The neurotransmitters utilized in this pathway appear to be excitatory neuropeptides and perhaps amino acids such as glutamate and aspartate. Mitral cells release cholecystokinin tufted cells release corticotropin-releasing hormone. This relatively simple sensory pathway is unusual in that it is the only sensory system...

Excitation Of The Muscle Cell

All muscle cells have resting membrane potentials in the range of 70 to 90 mV. As in nerve, this potential is due to the presence of ionic concentration gradients (with K+ being greater intracellularly and Na+ greater extracellularly) and to the resting membrane being much more permeable to K+ than to Na+. Muscle cells are excitable due to the presence of voltage-dependent ion channels in their cell membranes. However, the type of channels present, the manner in which channels are activated,...

The Olfactory Bulb

Odorant receptors and associated second-messenger systems are primarily localized within the ciliary tufts of olfactory neurons. The tufts extend from the surface of the epithelial plate and are immersed in mucous. The cell body, located in deeper epithelial layers, has a single nonmyelinated axon that must pass through small holes in the cribriform plate before synapsing on the olfactory bulb located just above the level of the eyes (Fig. 3). These are among the smallest (therefore, slowest...

Transport In The Distal Convolution And Collecting Duct

As discussed in Chapter 23 (see Fig. 5 in that chapter), the distal convolution, i.e., the portion of the nephron between the macula densa and the beginning of the cortical collecting duct, consists of the distal convoluted tubule and the connecting tubule. The initial portion of the distal convolution is a very short continuation of the thick ascending limb, which is followed by the abrupt appearance of distal tubule cells (DCT cells), which have highly amplified basolateral membranes, as well...

The Endocrine System

Chapter 2 considered the general issue of chemical communication between cells. This section focuses on the classic endocrine glands and their hormones. A hormone is a chemical substance that is released into the blood in small amounts and that, after delivery by the circulation, elicits a typical physiologic response in other cells. An endocrine gland is a group of cells that produce and secrete a hormone. Endocrine glands are also called ductless glands to distinguish them from exocrine...

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Arachnoid Granulations

Telencephalon cerebral cortex basal ganglia Diencephalon thalamus pineal hypothalamus FIGURE 2 Growth and folding of the rostral portion of the neural tube. Human embryos at the three-vesicle stage at about 28 days (A) and the five-vesicle stage at about 38 days (B). Dorsal views of the unfolded embryos show the expansion of the neural tissue during development. Lateral views of the embryos show the three bends or flexures that occur as the embryo develops. The organization of the adult brain...

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Biosynthesis, secretion, metabolism, 691 Ca2+ regulation, 680, 698f cells of origin, 691 physiologic actions, 691-693 in pig plasma, 694f secretion regulation, 693 Calcitonin gene related peptide characteristics, 691 mRNA splicing, 692f Calcitriol, see 1,25-Dihydroxycholecalciferol Calcitropic hormones hypercalcemic challenge response, 698 hypocalcemic challenge response, 698 Calcium in actin-myosin interactions, 138-139 excitation-contraction coupling, 182-183 parathyroid glands and hormone,...

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E, see Epinephrine EA, see Efferent arteriole Eardrum, see Tympanic membrane Eccentric hypertrophy definition, 945 heart structure, 945f E-C coupling, see Excitation-contraction coupling ECF volume, see Extracellular fluid volume ECG, see Electrocardiogram ECL cells, see Enterochromaffin-like cells Ectopic focus, in premature heart characteristics, 235, 243, 260 definition, 243 in exercise, 937 extracellular fluid volume, 425, 426 in heart failure, 942-943 lung fluid balance, 273 overview,...

Sound Amplification And Attenuation

The elaborate system of fluid-filled membrane ducts within the cochlea serves to amplify sound vibrations and to provide maximum acuity while at the same time protecting receptor cells from potential damage from high-intensity sounds. The tips of the stereocilia are embedded in a gelatinous meshwork called the tectoral membrane, which is connected to the reticular lamina at one end and to a bony protuberance called the modiolus at the other end (see Fig. 5). This arrangement produces a shearing...

The Gamma Loop System

The muscle spindle not only serves as a feedback system to the alpha motor neuron, but has within it a separate feedback system of its own called the gamma loop system. This system operates to maintain tension on the intrafusal muscle fibers. To provide information about static or changing muscle length, the annulospiral ring must be under some minimal amount of tension otherwise, the stretch-sensitive channels remain closed, and no action potentials are generated. A correction for this...

Overview Of The Peripheral Nervous System

The peripheral nervous system arises from specialized cells (neural crest cells) located along the lateral edges of the neural plate (see Fig. 1). These cells bud off and become separated from the neural tube as it forms. Some groups of neural crest cells migrate to form a linear array of dorsal root ganglia located adjacent to the lateral borders of the spinal cord. These cells function as sensory

Morphology

The adrenal glands are bilateral structures situated above the kidneys. They are comprised of an outer region or cortex, which normally makes up more than three-quarters of the adrenal mass, and an inner region or medulla (Fig. 1). The medulla is a modified sympathetic ganglion that, in response to signals reaching it through cholinergic, preganglionic fibers, releases either or both of its two hormones, epinephrine and norepi-nephrine, into adrenal venous blood. The cortex arises from...

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Macrophage colony stimulating factor, 684 definition, 833 eye structure, 808 Macula densa cellular effect of NaCl, 355f characteristics, 337 Macular yellow, 824 Magnesium ion fluid compartment ionic composition, 6 kidney, 445-446 Magnocellular pathways characteristics, 574 function, 815 ganglion cell function, 808 Main sensory nucleus, 802 Male reproduction development, 729f germinal epithelium, 724-726 Leydig cells, 723-724 overview, 720 sexual differentiation, 728-730 testes, 720-722...

Conduction in Myelinated Axons

Clearly, there must be another means available by which axons can increase their propagation velocity without drastic changes in fiber diameter. You will note from the relationship for propagation velocity that by changing the membrane capacitance velocity can be affected directly without involving the square root relationship. It is possible to decrease the membrane capacitance simply by coating the axonal membrane with a thick insulating sheath. This is exactly the strategy used by the...

Calcium Balance

Calcium is the most abundant ion in the body but 99 of it is in the skeleton and does not participate in the regulation of the plasma Ca2+ concentration. Typical adults ingest about 600 to 1500 mg of calcium daily however, the gastrointestinal tract absorbs only 150-200 mg day. This rate of absorption is regulated largely by the most active metabolite of vitamin D3, 1,25-dihydroxycholecalciferol 1,25(OH)2D3 see Chapter 43 , in response to the demands for the maintenance of the normal ECF...

Protein

Dietary protein intake varies greatly among individuals of like background and among groups with different geographic, cultural, and economic foundations. Adult humans require 0.5-0.7 g of protein per kilogram of body weight per day to maintain nitrogen balance. Young children may require 4 g kg per day. In addition to dietary intake, protein is present in gastrointestinal secretions and the cells shed into the lumen of the digestive tract. This protein is handled in the same manner as dietary...

Insulin

Although neither GH nor T4 appears to be an important determinant of fetal growth, insulin may act as a growth-promoting hormone during the fetal period. Infants born of diabetic mothers are often larger than normal, especially when the diabetes is poorly controlled. Because glucose readily crosses the placenta, high concentrations of glucose in maternal blood increase fetal blood glucose and stimulate the fetal pancreas to secrete insulin. In the rare cases of congenital deficiency of insulin...

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Action potentials (continued) Na+, 78f Na+ and K+ concentrations, 85-86 Na+ and K+ conductance, 83f nerve, 72, 73-74, 76-78 nerve, sketch, 78f optic nerve, 72f plateau phase, calcium channel role, 180 propagation, basic principles, 89-90 repolarization, voltage-dependent potassium conductance role, 83-85 sciatic nerve, 792f sequence of steps, 90f skeletal muscle, shock response, 130f sodium hypothesis, 76-78 sound intensity, 845 tetraethylammonium, 85f threshold, 86 Activation gate, 180 Active...

Vectors Can Be Determined From The Limb Leads

As action potentials are conducted through the heart, the resulting dipoles are constantly changing in both magnitude and orientation. Because of the physical orientation of the limb leads, they are sensitive to the orientation of the dipoles generated by the heart. Consider a vertically oriented dipole whose positive pole points down toward the patient's foot. This would cause the pubis to be positively charged with respect to either shoulder. Thus, the pen would be deflected upward in leads...

Regulation Of Blood Flow

As discussed in Chapter 10, the flow of blood through a vascular bed depends on the pressure gradient across it and its resistance to flow. Because arterial and venous pressures are normally maintained within narrow limits, regulation in flow through an organ is achieved by changing the internal diameter of the major resistance vessels, that is, the arterioles. Vascular resistance within many organs is regulated by systems that are intrinsic to the organ, as well as by extrinsic influences,...

Distribution of Blood Flow

The distribution of pulmonary blood flow throughout the pulmonary vascular tree and to different parts of the lung is not uniform. This was first shown in humans with a technique measuring pulmonary blood flow at different heights in the erect human lung using an insoluble radioactive gas. A saline solution containing radioactive xenon was infused in a vein, so the gas would enter the lung in proportion to blood flow (similar to CO2 elimination from the blood). Radioactive counters were placed...

Potassium Transport By The Intestines

K+ is both absorbed and secreted by the intestines. The bulk of the K + that enters the intestinal tract, derived from salivary, gastric, pancreatic, and biliary secretions as well as dietary intake, is reabsorbed in the small intestine. The primary mechanism responsible is probably diffusion through paracellular pathways. Thus, the reabsorption of water, secondary to the active absorption of Na + and other solutes (see below), will tend to concentrate K + in the chyme. But, as noted earlier,...

Fuels

Fuel selection during exercise is determined by both the duration and intensity of exercise. A short sprint such as a 50-meter dash will be fueled entirely by muscle stores of glycogen and phosphocreatine. At the other extreme of a long trek, oxidation of free fatty acids is the most important fuel. Protein is not a major fuel for exercise, comprising less than 2 of the substrate during the first hour of exercise and rising to only 15 after five hours. Fats contribute about two-thirds of the...

Physiological Actions Of Ovarian Steroid Hormones

As described above, intraovarian actions of estradiol and progesterone are intimately connected to ovulation and formation of the corpus luteum. In general, extra-ovarian actions of these hormones ensure that the ovum reaches its potential to develop into a new individual. Ovarian steroids act on the reproductive tract to prepare it for fulfilling its role in fertilization, implantation, and development of the embryo, and they induce changes elsewhere that equip the female physically and...

Airway Defense Mechanisms

The exchange surface area of the lung is the largest interface between the body and the environment. Therefore, the lungs have an important set of mechanisms to defend the body from foreign matter. The first line of defense is the upper airways, including the mouth and nose. A major function of the upper airways is to warm and humidify air entering the respiratory system, which prevents drying and cooling of the delicate epithelial barrier in the lungs. Complex air passages in the nose, called...

Morphology Of The Endocrine Pancreas

The 1 to 2 million islets of the human pancreas range in size from about 50-500 mm in diameter and contain from 50-300 endocrine cells. Collectively the islets comprise only 1-2 of the pancreatic mass. They are highly vascular, with each cell seemingly in direct contact with a capillary. Blood is supplied by the pancreatic artery and drains into the portal vein, which thus delivers the entire output of pancreatic hormones to the liver. The islets are also richly innervated with both sympathetic...

Limitations Of Pulmonary Gas Exchange

Gas exchange limitations in the lungs can reduce PO2 throughout the O2 cascade. Recall that limitations do not decrease resting Vo2, although they may limit maximal O2 consumption during exercise. Hypoxemia is defined as a decrease in blood PO2, and arterial hypoxemia, or decreased PaO2, indicates a limitation of pulmonary gas exchange. Gas exchange limitation does not imply a decrease in resting O2 consumption, because Po2 will adjust throughout the O2 cascade to maintain O2 consumption in a...

Physiology Of The Mineralocorticoids

Although several naturally occurring adrenal cortical hormones, including glucocorticoids, can produce mineralocorticoid effects, aldosterone is by far the most important mineralocorticoid physiologically. In its absence there is a progressive loss of sodium by the kidney, which results secondarily in a loss of extracellular fluid (see Chapter 29). Recall that the kidney adjusts the composition of the extracellular fluid by processes that involve formation of an ultrafiltrate of plasma followed...

Physiologic Effects Of Thyroid Hormones

Growth and Maturation Skeletal System One of the most striking effects of thyroid hormones is on bodily growth (see Chapter 44). Although fetal growth appears to be independent of the thyroid, growth of the neonate and attainment of normal adult stature require optimal amounts of thyroid hormone. Because stature or height is determined by the length of the skeleton, we might anticipate an effect of thyroid hormone on growth of bone. However, there is no evidence that T3 acts directly on...

Control Of Testicular Function

Physiological activity of the testis is governed by two pituitary gonadotropic hormones follicle-stimulating hormone (FSH) and luteinizing hormone (LH) (see Chapter 38). The same gonadotropic hormones are FIGURE 3 The formation of mammalian germ cells. Each primary spermatogonia ultimately gives rise to 64 sperm cells. Cytokinesis is incomplete in all but the earliest spermatogonial divisions, resulting in expanding clones of germ cells that remain joined by intercellular bridges. (From Fawcett...

Descending Motor Tracts In The Spinal Cord

Reflex activity generated from motor programs in the spinal cord represents the foundation of the motor hierarchy. These programs provide the basic plans by which movement can be achieved in a coordinated fashion. In addition, they facilitate the transfer of information about more complex movements and about volitional movement from brain to appropriate groups of lower motor neurons. Motor input to spinal cord levels is received in two major pathways (1) the ventromedial pathway, consisting of...

Key Points

Substantia Nigra Pars Reticulata Mouse

Coordination of cortical motor commands is achieved by motor loop pathways that pass information from the cortex through the basal ganglia and thalamic nuclei and back to the cortex. The direct (excitatory) and indirect (inhibitory) pathways of the basal ganglia loop provide opposite, counterbalanced influences on activity of the motor cortex. The dopaminergic nigrostriatal pathway modulates activity in the direct and indirect pathways, maintaining a critical level of excitatory drive for...

Physiologic And Pathophysiologic Changes In Renal Blood Flow And Glomerular Filtration Rate

Although GFR and RPF are normally relatively constant, they can change from their normal set point when influenced by other signaling systems. Under normal conditions, the GFR is nearly maximal so that most of the normal physiologic changes occur in the direction of decreasing GFR. Presuming there are no changes in plasma protein concentration, this could be accomplished by changes in afferent or efferent arteriolar resistance, or in the ultrafiltration coefficient Kf. The effects of arteriolar...

Control Of Ventilation

The body contains several physiologic control systems to maintain arterial pH (pHa) within normal limits, to meet the oxygen demands of the tissues, to minimize the mechanical work of breathing, and to prevent lung injury by environmental agents. This means that limitations in lung function or gas exchange can be masked by the physiologic control systems acting to maintain homeostasis. Therefore, knowledge of the normal physiology of respiratory control is critical for understanding respiratory...

Impairments In Urinary Concentrating And Diluting Ability

Deficiencies in the ability of the kidney to regulate plasma osmolality by appropriately forming either dilute or concentrated urine may have several causes. There may be a defect in production or regulation of vasopressin release, an inability of the collecting duct to respond to vasopressin, or a failure to form a medullary osmolality gradient. Diabetes insipidus refers to high rates of production of dilute urine either because the posterior pituitary fails to release vasopressin or because...

Some General Characteristics Of Carriermediated Transport

The following features are so widely characteristic of carrier-mediated transport processes that they are generally considered sufficient and often necessary criteria for the implication of carriers in the transport of a given solute 1. Virtually all carriers appear to display a high degree of structural specificity with regard to the substances they will bind and transport. For example, the carriers responsible for the transport of glucose into animal cells are highly stereospecific they will...

Hierarchical Arrangement Of Motor Cortical Areas

Firing of MI upper motor neurons is associated with relatively simple motor commands more complex movements are linked to upper motor neurons in area MII (Fig. 2). Two separate somatotopic maps are present in MII The supplementary motor area (SMA) is located near the superior medial region of the cortex, and the premotor area (PMA) occupies a more lateral position. Pyramidal cells in these areas contribute to corticofugal pathways and are also heavily interconnected to MI. Both areas of MII...

Regulation Of Metabolism During Feeding And Fasting

Immediately after eating, metabolic activity is directed toward the processing and sequestration of energy-rich substrates that are absorbed by the intestines. This phase is dominated by insulin, which is secreted in response to three inputs to the beta cells. The cephalic, or psychological aspect of eating, stimulates insulin secretion through acetylcholine and vasoactive inhibitory peptide (VIP) released from vagal fibers that innervate islet cells. Food in the small intestine stimulates...

Salt And Water Reabsorption In The Proximal Tubule

Mass Flow Balance Proximal Tubule

As shown in the following sections, it is important to think of the transport of each substance along the nephron in terms of its rate of movement rather than by its concentration in the tubular fluid. The same considerations of mass balance that apply to the kidney as a whole also apply to the proximal tubule. In the case of the proximal tubule, the rate of input of substances is determined by the product of the glomerular filtration rate (GFR) and the concentration of the substance in the...

Metabolism Of Thyroid Hormones

Because T4 is bound much more tightly by plasma proteins then T3, a greater fraction of T3 is free to diffuse out of the vascular compartment and into cells where it can produce its biological effects or be degraded. Consequently, it is not surprising that the half-time for disappearance of an administered dose of 125I-labeled T3 is only one-sixth of that for T4, or that the lag time needed to observe effects of T3 is considerably shorter than that needed for T4. However, because of the binding...

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IC, see Inspiratory capacity ICCs, see Interstitial cells of Cajal ICF, see Intracellular fluid compartment Ideal alveolar-arterial pulmonary oxygen difference, 301 Ideal gas law, respiratory system, 263-264 IgA, see Immunoglobulin A IGFBPs, see Insulin-like growth factor- binding proteins IGF-I, see Insulin-like growth factor I IGF receptors, see Insulin-like growth factor receptors IL, see Interleukins Ileocecal sphincter relaxation, 480 Immune system defense mechanisms, 275 response and...

Secretory Processes In The Proximal Straight Tubule

Excretion Pah

The proximal tubule has an important function in secreting many substances that can be regarded as metabolic by-products or potential toxins. Given normal rates of production of some metabolic byproducts, the body requires a renal secretory process to maintain acceptable plasma concentrations. Renal secretory processes serve a more important role in excreting exogenous toxic substances that are ingested in the diet. Secretion of these substances results in an excretion rate that exceeds their...

Central Auditory Pathways

Auditory Pathway Action Potential Nerves

The central pathway of the auditory system contains a large number of relay nuclei within the brain stem (Fig. 6). Central fibers from primary sensory neurons in the spiral ganglia project along with vestibular fibers in cranial nerve VIII and synapse first within the dorsal and ventral cochlear nuclei located near the pontomedullary junction. Ascending fibers from these nuclei project to both the FIGURE 4 Structure and functional relationships of the basilar membrane. The cochlea is shown...

Pancreatic Secretion

Exchange Between And Ions

Pancreatic exocrine secretion consists of an aqueous or bicarbonate component and an enzymatic component. The aqueous component consists primarily of water and sodium bicarbonate and is produced by the cells lining the pancreatic ducts. The aqueous component neutralizes duodenal contents, preventing injury to the duodenal mucosa and bringing the contents within the pH range necessary for optimal enzymatic digestion of nutrients. The enzymatic or protein component is a low-volume secretion from...

Criteria for Active Transport of Ions

In a previous section we distinguished between passive (or downhill) and active (or uphill) transport of uncharged molecules. The sole criterion for this distinction is the relation between the direction of the net movement of the molecule and the direction of the concentration gradient. If an uncharged molecule moves or is transported from a region of higher concentration to one of lower concentration, the transport process is said to be passive (or downhill) because the flow is in the...

Hormonal Interactions During Exercise

During exercise, overall oxygen consumption may increase 10-15 times in a well-trained young athlete. The requirements for fuel are met by mobilization of reserves within muscle cells and from extramuscular fuel depots. Rapid uptake of glucose from blood can potentially deplete, or at least dangerously lower, glucose concentrations and hence jeopardize the brain unless some physiologic controls are operative. We can consider two forms of exercise short-term maximal effort, characterized by...

Chylomicron Exocytosis Mechanism

Chylomicron Formation

Neutral Neutral, aromatic, aliphatic Abnormalities of Protein Assimilation Decreases in the amounts (or absence) of proteolytic enzymes occur in cases of pancreatic insufficiency as might develop in patients with pancreatitis or cystic fibrosis. Such decreases in the amounts of active enzymes may impair protein digestion to the point at which absorption is decreased and nitrogen is lost in the stool. The congenital absence of trypsin alone can also result in protein malabsorption. Trypsin is...

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Activities are discussed in Chapter 35, which is concerned with the digestion and absorption of nutrients. Between meals, pancreatic enzymes are stored in zymogen granules that have migrated to an area near the apical membrane of the acinar cell. A secretory stimulus results in the fusion of the granule membrane with the apical membrane of the cell and the secretion of enzyme contents into the lumen. This process of exocytosis is the only step in the synthesis of the proteins, formation of...

Normal Bowel Rectosphincteric Reflex

FIGURE 12 Mass movement. (A) Colon before entry of barium sulfate. (B) Barium enters proximal ascending colon, showing haustra. (C) As more barium enters, the haustra disappear from a portion of the ascending and transverse colons, and a contraction begins in this area. (D) The contraction has moved a portion of the barium into the caudad transverse colon. (E) Haustra return. exposing them to absorptive surfaces. These contractions last from 12-60 seconds and generate intraluminal pressures...

Gastrointestinal Smooth Muscle

The smooth muscle cells in each part of the gastrointestinal (GI) tract have structural and functional differences. However, certain basic properties are common to all of these cells. Smooth muscle cells make up all of the contractile tissue of the GI tract with the exception of the pharynx, the upper one-third to one-half of the esophagus, and the external anal sphincter, which are striated muscle. Smooth muscle cells are smaller than skeletal muscle cells and are long, narrow, and spindle...

Respiratory Muscles

Ventilatory flow is driven by pressure differences between the alveoli and the atmosphere. In normal individuals at rest, active contraction of skeletal muscle generates this pressure difference during inspiration. In contrast, expiration at rest results from passive elastic recoil of the lungs. The diaphragm is the main muscle of inspiration and, therefore, the most important muscle for resting breathing. The diaphragm is innervated by the phrenic nerve, which originates from the third,...

Bile Secretion And Gall Bladder Function

Bilirubin Formation Pathway

Bile is responsible for the principal digestive functions of the liver. The presence of bile in the small intestine is necessary for the digestion and absorption of lipids. The problem of the insolubility of fats in water is solved by the constituents of bile. The bile salts and other organic components of bile are responsible in part for emulsifying fat so that it can be digested by pancreatic lipase. The bile acids also take part in solubilizing the digestion products into micelles. Micellar...

Immune System Defense Mechanisms

The lung is similar to all other organs by containing lymphocytes (T and B cells) in the interstitium. These defense cells originate from the bone marrow and lymph nodes and respond to foreign invaders with cellular (acquired antibody) mechanisms. Dendritic cells present antigens to the lymphocytes. Considering that up to 1010 antigenic particles may reach the alveoli every day, the challenge for the pulmonary immune system is to process this foreign material and not overamplify an inflammatory...

Diffusion Of Electrolytes

The previous section dealt with the diffusion of uncharged particles, but many of the fundamental properties of the diffusional process described therein also apply to the diffusion of charged particles. In both instances, net flow due to diffusion is the result of random thermal movements, and the diffusion coefficients of the particles are inversely proportional to their molecular or hydrated ionic radii. However, because ions bear a net electrical charge, the diffusion of a salt such as...

Integrated Actions Of Metabolic Hormones

Metabolic fuels absorbed from the intestine are largely converted to storage forms in liver, adipocytes and muscle. It is fair to state that storage is virtually the exclusive province of insulin, which stimulates biochemical reactions that convert simple compounds to more complex storage forms and inhibits fuel mobilization. Hormones that mobilize fuel and defend the glucose concentration of the blood are called counter-regulatory and include glucagon, epinephrine, norepinephrine, cortisol,...

Water Reabsorption Driven By Solute Reabsorption

As described earlier, reabsorption of Na+ with its accompanying anions is driven by the Na+,K+-ATPase. This movement is also accompanied by the reabsorption of other solutes linked to Na+ reabsorption including glucose, amino acids, and other organic solutes. The net effect of the reabsorption of all of these solutes is to deplete the tubular lumen of solutes while adding them to the lateral intercellular spaces and interstitium. Therefore, the fluid in the proximal tubule should become...

Functional Anatomy Of The Kidney

Juxtamedullary Nephrons

A person's kidney is about the size of a clenched fist. When examined in cross section as shown in Fig. 1, the kidney is easily divided into two regions the cortex and the medulla. The blood, lymphatic, and neural supply of the kidney enter through the hilus together with the ureter, which carries the urine from the kidney to the bladder, where it is stored until emptied by micturition (urination). In the human kidney, the medulla terminates in several conical structures called papillae. The...

Salivary Secretion

The functions of saliva fall into three general categories digestion, lubrication, and protection. Saliva is produced in large volumes, relative to the weight of the salivary glands, by an active process. Unlike the process in the other gastrointestinal glands, the secretion of saliva is almost totally under neural control. Both branches of the autonomic nervous system stimulate salivary secretion, although the para-sympathetic system provides a much stronger input. The healthy adult secretes...

Autoregulation

As shown in Fig. 10, RBF and GFR remain relatively constant over a wide range of systemic blood pressures. To prevent changes in blood flow and GFR with changes in systemic blood pressure that occur normally during the day with changes in activity, the resistance to flow must change appropriately. As systemic blood pressure increases, total renal vascular resistance increases so that blood flow and GFR remain constant. Autoregulation, which is exhibited in the circulation of many organs, refers...

Action Potencial Note

Hypokalemia Heart Action Potential

Effect of Diuretics on Potassium Balance Loop diuretics, that is, diuretics that act primarily on the Na+ K+ 2Cl cotransporter in the thick ascending limb of the loop of Henle, increase the delivery of salt and water to the more distal portions of the nephron because they interfere with Na+ and water reabsorption in the loop of Henle (see also Chapter 28). For the reasons given in the text, the increase in Na+ delivery and volume flow to the connecting tubule and collecting duct favor K+...

Movement Of Material Through The Esophagus

Peristalsis Movement

The obvious function of the esophagus is to serve as a conduit for and to propel swallowed material to FIGURE 4 Neural pathways involved in the regulation of pharyngeal and esophageal peristalsis. Vagal sensory input is relayed to the swallowing center in the medulla, where output to muscles is coordinated with respiration. Muscles of the pharynx and the striated esophagus are innervated via the nucleus ambiguus smooth muscles of the esophagus are innervated via the dorsal motor nucleus....

Motor Neurons For Head And Neck Muscles

Reflex Arc Diagram

Muscles of the head and neck are for the most part highly specialized, and each exhibits unique functional properties. Extraocular muscles are innervated by lower motor neurons in cranial nerves III (oculomotor), IV (trochlear), and VI (abducens), which originate from the brain stem. They are among the fastest muscles in the body and are continually active during awake hours as well as during certain segments of the sleep cycle, called rapid eye movement (REM) sleep. As described below, the...

Examples

Potential Health Therapy

A typical adult human ingests of 8-10 g about NaCl each day. There is no metabolic production of this inorganic compound, so for a steady state to be maintained (as is further discussed in Chapter 29) NaCl must be excreted (by the sum of urinary, sweat, and fecal routes) at the same rate of 8-10 g per day. 2. Water is typically ingested at a rate of 1-2 L day with about 150-250 mL day added from metabolism of various substrates such as glucose. Water loss, which occurs via the same routes as...

Coronal View Of Brain Showing Spinal Cord

Brain Coronal Cross Section Spinal Cord

Herpes zoster virus, commonly known as chicken pox, preferentially infects neurons of the peripheral nervous system, particularly dorsal root ganglion cells. Individuals infected with the virus during childhood usually display red, itchy spots on the skin for approximately 1 week and are symptom free thereafter. However, the virus may remain dormant, usually residing in a single dorsal root ganglion, and can become reactivated in some individuals decades later to produce a condition known as...

Regulation Of Thyroid Hormone Secretion

As already indicated, secretion of thyroid hormones depends on stimulation of thyroid follicular cells by TSH, which bears the primary responsibility for integrating thyroid function with bodily needs (Chapter 38). In the absence of TSH, thyroid cells are quiescent and atrophy, and, as we have seen, administration of TSH increases both synthesis and secretion of T4 and T3. Secretion of TSH by the pituitary gland is governed by positive input from the hypothalamic hormone thyrotropin-releasing...

Mqe

Mix Picture Push And Pull Actions

FIGURE 15 Synergistic effects of human growth hormone (hGH) and the synthetic glucocorticoid dexamethasone (Dex) on lipolysis as measured by the increase in glycerol release from rat adipocytes. Both hGH and Dex were effective when added individually, but when added together their effect was greater than the sum of their individual effects. (From Gorin et al., Endocrinology 1990 126 2973.) FIGURE 16 Push-pull mechanism. Epinephrine inhibits insulin secretion while promoting glucagon secretion....

Mechanical Response Of Smooth Muscle In Vivo

Most smooth muscles form, along with other tissues, the walls of hollow organs such as the gastrointestinal tract, the uterus, and the blood vessels. In these organs, smooth muscle contractions serve many purposes such as the movement of lumenal contents, the regulation of lumenal volume, and the alteration of the resistance to flow through the lumen. For some of these functions, contractions must be phasic to allow the lumens to refill between contractions. For others, contractions must be...

Alveolar Ventilation

Ventilation is the first step in the O2 cascade, and the level of alveolar ventilation (Va) is the most important physiologic factor determining arterial Po2 for any given inspired Po2 and level of O2 demand (Vo2) in healthy lungs. As described in Chapter 18, anatomic dead space reduces the fraction of the tidal volume that reaches the alveoli where Va is alveolar ventilation, fR is respiratory frequency, VT is tidal volume, and VD is anatomic dead space. Anatomic dead space can be measured...

Lcg Hormon Function

FABPs, see Fatty acid-binding protein Facial nerve, in taste, 858 Facilitated diffusion characteristics, 533 definition, 38 overview, 59 Facilitatory neurons, Aplysia short-term sensitization, 911 Fahraeus-Lindquist effect, 166 Fallopian tubes, 742 Fasciculus, dorsal spinal column, 801 Fastigial nucleus, spinocerebellum, 890 Fasting blood constituents, 672f IGF-I and GH effects, 712f leptin concentration, 676f metabolic hormones, 671f metabolism regulation, postprandial period, 669-671...

General Properties Of Sensory Receptors

Sensory information from the body reaches the nervous system piecemeal through a series of separate sensory pathways associated with specific sensory modalities. These pathways consist of sensory receptors and their projections to designated receiving areas in the cortex. A unified perception of our physical world emerges from the coordinated response of these primary receiving areas and secondary association areas. Separate pathways for the special senses of vision, hearing, taste, and...

Stanley G Schultz

The word diabetes derives from the Greek, Stapatvo, meaning passing through'' or too swift a passage of the matter that is drunk.'' It is used today to describe the condition of excessive production of urine or polyuria. As discussed earlier (Chapters 28 and 41), there are two forms of diabetes. One is diabetes insipidus, which results from impaired secretion or production of the antidiuretic hormone (ADH) due to injury to the hypothalamus or supraoptic nucleii. Diabetes insipidus can also,...

The Muscle Spindle

The driving force on lower motor neurons comes from three major sources (1) sensory pathways from the spinal cord and brain stem that trigger reflex actions, (2) interneurons within the spinal cord that interconnect synergistic and antagonistic motor neuron pools, and (3) upper motor neurons in the motor cortex and other motor areas in the brain that provide complex motor commands. One of the major sensory inputs to the lower motor neuron is derived from specialized end organs located within...

Ho

FIGURE 6 Biosynthesis of ovarian hormones. Cleavage of the cholesterol side chain by P450scc between carbons 21 and 22 gives rise to 21-carbon progestins. Removal of carbons 20 and 21 by the two-step reaction catalyzed by P450c17 (17a hydroxylase lyase) produces the 19-carbon androgen series. Aromatization of ring A catalyzed by P450cyp19 (aromatase) eliminates carbon 19 and yields 18-carbon estrogens. 3pHSD, 3p hydroxyster-oid dehydrogenase 17pHSD, 17p hydroxysteroid dehydrogenase.

Other Neural Reflexes Involved With Blood Pressure Regulation

Although the baroreceptor reflex is the primary moment-to-moment controller of aortic pressure, other 0 50 100 150 200 250 Mean Arterial Pressure (mm Hg) FIGURE 6 Variations in mean arterial pressure over a 24-hr period in a normal dog before and several weeks after baroreceptor denervation. (Modified from Guyton AC, Hall JE. Textbook of medical physiology, 9th ed. Philadelphia WB Saunders, 1996.) mechanisms exist that come into play under periods of extreme cardiovascular stress. These are...

Avb

GABA, see Gamma aminobutyric acid Gag reflex, 806 Galactose, 534, 534f Gall bladder bile concentration, 526-527 bile expulsion, 527-528 bile secretion, overview, 520-521 filling, 526 Gall stones characteristics, 527 during pregnancy, 966 Gametes, 758-759 Gamma aminobutyric acid inhibitory postsynaptic potentials, 116 olfactory bulb, 852 rhythmic breathing, 318 Gamma loop system, 867, 869-870 Gamma motor neurons, 869f, 870 Ganglion cells cortex blob region, 825f function, 807 receptive field...

Glomerular Filtration

Afferent Efferent Rpf Gfr

The high hydrostatic pressure of the blood in the glomerular capillaries is responsible for a net driving force favoring ultrafiltration from the glomerular capillaries. In the young male adult, the glomerular filtration rate GFR averages about 130 mL min, which amounts to a whopping 187 L day. The high rate of glomerular filtration means that as plasma flows through the kidneys at a rate of 670 mL min, 130 mL min, or 20 , is filtered. This 20 represents what is referred to as the filtration...

The Visual Cortex

Cells within the six ocular dominance layers of the lateral geniculate project to distinct ocular dominance stripes or columns within Brodmann's area 17 also called area VI of the primary visual cortex see Fig. 11 . Pairs of adjacent ocular dominance columns one with ipsilat-eral projections from the lateral geniculate nucleus LGN , and the other with contralateral projections receive information about the same point in visual space. Adjacent pairs are collectively designated as a hyper-column....

Specialized Features Of Rod And Cone Photoreceptors

The two types of retinal photoreceptor cells, rods and cones, are not evenly distributed across the retina Fig. 3 . Cones are concentrated in the foveal region, whereas rods are absent. Several of the cellular characteristics of cones make them particularly suited for high-acuity vision. Because of the tightly packed arrangement of foveal cones, the foveal region is capable of high-resolution finegrained responses. In addition, the outer segment, which contains most of the visual pigment of the...

Physiologic Determinants of Airway Resistance

Several physiologic factors are also important in determining airway resistance, in addition to the physical factors discussed earlier. Tissue resistance requires additional changes in Ppl to generate a given flow rate. The elastic behavior of the chest wall and the network of elastin and collagen in the lungs create a resistance to volume changes during ventilation. This resistance can be measured by getting a true measure of PA with a plethysmograph by independently solving Boyle's law for...

Emotions Related To Autonomic Nervous System Function

Strong emotional feelings are often associated with most autonomic responses. Coordinated parasympa-thetic responses evoke a vegetative state that generates an overall relaxed, pleasurable feeling. They are often linked to eating behavior and can be triggered by food-related sensory stimuli, such as seeing or smelling appetizing food. The opposite is true for coordinated responses from the sympathetic division of the ANS. In this case, sympathetic pathways coordinate protective responses,...

Xvf

FIGURE 8 Three sets of mechanical g and electrical mV tracings from the caudad region of the stomach. A Slow-wave depolarization of insufficient magnitude to cause contraction. B Increased depolarization results in contraction. C Electrical slow wave with multiple spike potentials and extended plateau produces a vigorous and extended contraction. Although digestive events and the resulting neural and hormonal input to the stomach are not necessary for slow waves to occur, they markedly affect...

Gastric Motility

Activity of the smooth muscle of the stomach carries out three principal functions 1 The muscle relaxes to accommodate large volumes ingested during a meal 2 contractions mix ingested material with gastric juice, facilitating digestion, solubilizing some constituents, and reducing the size of the particles and 3 contractions propel material into the duodenum at a rate regulated to provide optimal time for intestinal digestion and absorption. Structure and Innervation of the Stomach Unlike the...

Vitamin Dendocrine System

A derivative of vitamin D3,1,25-dihydroxycholecalcif-erol 1,25 OH 2D3 , is indispensable for maintaining adequate concentrations of calcium in the extracellular fluid and adequate mineralization of bone matrix. Vitamin D deficiency leads to inadequate calcification of bone matrix and severe softening of the skeleton, called osteomalacia, and may result in bone deformities and fractures. Osteomalacia in children is called rickets and may produce permanent deformities of the weight-bearing bones...

Lipids

The daily dietary intake of fat varies from below 25 g, or less than 12 of caloric intake found among rice-eating Asian cultures , to as much as 140-160 g, or 40 of the caloric intake found among some individuals in Western meat-eating cultures . The difference is due primarily to the increased intake, in the latter group, of saturated fatty acids found in red meat and dairy products. The intake of unsaturated fatty acids is approximately the same in both groups. Among those substances...

Lh

FIGURE 11 Ovarian-pituitary interactions at different phases of the menstrual cycle. Solid arrows, stimulation dashed arrows, inhibition. Note that the frequency of the GnRH pulse generator slows in the luteal phase, and that the amplitude may increase at midcycle. the luteinization process. Conversely, the gradual loss of sensitivity of luteal cells to LH accounts for the decrease in progesterone and estrogen secretion during the latter part of the luteal phase. Thus, one of the unique...

Henderson Hasselbalch Equation

The Henderson-Hasselbalch equation describes the relationship between Pco2 pH, and HCO3- in human blood as follows where HCO- is the bicarbonate concentration in millimoles per liter, and 0.03 PCO2 is the total dissolved CO2 concentration, also in millimoles per liter 0.03 mmol L per mm Hg is the solubility of CO2 in water . As described in Chapter 31, the Henderson-Hasselbalch equation is based on the chemical equilibrium between carbonic acid and its dissociation products The dissociation...

Active And Passive Solute Transport

Up until this point, solute reabsorption in the proximal tubule has been discussed in general terms as FIGURE 8 Effect of reduced plasma colloid osmotic pressure and increased interstitial fluid pressure on the permeability properties of the junctional complexes. It has been proposed that an increase in interstitial fluid pressure may be associated with an increased permeability of the junctional complexes between proximal tubule cells that would enable backflux diffusion of Na , Cl-, HCO , and...

Regulation Of Cardiac Output

Any change in cardiac output must be the result of a change in either the vascular or the cardiac function curves. Neural, endocrine, and other regulatory mechanisms constantly change cardiac output to meet the body's metabolic needs by altering those curves. Often, simultaneous changes in several parameters work in concert or in opposition. For example, a decrease in blood volume may have little or no effect on mean circulatory filling pressure if the decreased blood volume is accompanied by...

Gibbsdonnan Equilibrium Ion Pumps And Maintenance Of Cell Volume

Gibbs Donnan Equilibrium

So far we have considered three of the functions that are fulfilled by the operation of Na -K pumps. First, they are responsible for the high K and low Na concentrations characteristic of the intracellular fluid of higher animals. A number of enzymes involved in intermediary metabolism and protein synthesis appear to require relatively high concentrations of K for optimal activity and are inhibited by high concentrations of Na the activities of these enzymes would be markedly impaired if the...

Development And Maintenance Of Medullary Hyperosmolality

Thus far, this chapter has discussed the effects of the hyperosmotic medullary interstitium on the abstraction of water from the thin descending limb and from the medullary collecting duct in the presence of vasopressin. How does this medullary hyperosmolality develop, and how is it maintained in the face of plasma flow through the medulla In any other tissue, one would expect that the constant blood flow, as well as the constant water entry from the thin descending limb of the loop of Henle...

Paracrines

Paracrines are synthesized in and released from endocrine cells in the same fashion as hormones. However, the amounts released do not reach the general circulation in concentrations sufficient to produce effects. Instead, paracrines act on cells in their immediate vicinity, reaching them by simple diffusion or perhaps movement through capillaries before being diluted in the general circulation. One can assess the biologic significance of a hormone by correlating its plasma levels with its...