physiology unit 3

1. Know some of the functions of hormones and their release sites.

a. Function
i. Rate of enzymatic reactions
ii. Transport of ions or molecules across membranes
iii. Gene expression/protein synthesis
b. Release Sites?

2. Know the three different classifications of hormones.

a. Peptide/Protein hormones
i. Insulin
ii. ACTH
iii. TRH
iv. Prehormone and Prohormone
b. Steroids
i. Cholesterol
ii. Estrogen
iii. Testosterone
iv. Aldosterone
c. Amine hormones
i. Melatonin
ii. Catecholamine
iii. Thyroid Hormones

3. Be able to describe the characteristics of Peptide hormones.

a. Extracellular receptors
b. Fast effect
c. Activate second messenger systems

4. Describe the components of peptide hormones. Be able to describe the development and processing of a peptide hormone.

a. Preprohormone goes through blood
b. Turns into prohormone
c. Prohormone goes from ER to Golgi
d. Prohormone gets chopped into peptide to be activated

5. Be able to provide specific examples of peptide hormone processing. Include in your description ACTH, TRH, and Insulin.

a. Preprohormone TRH turns into 6 TRH but lots of filler
b. Prohormone ACTH turns into multiple different hormones
c. Prohormone ProInsulin folds into itself with disulfide bridges

6. Be able to describe the characteristics of Steroid hormones.

a. Lipophilic and made from cholesterol
b. Goes into cytoplasm or nucleus
c. Slow response, need help to dissolve
d. Genomic changes with intracellular receptors
e. Non-genomic if bound to membrane receptors

7. Explain the process of how steroid hormones act on intracellular receptors.

a. Unbind from carriers and stroll in
b. Receptor-hormone complex binds to DNA to activate or repress gene

8. Be able to describe the characteristics of Amine hormones.

a. Tryptophan or Tyrosine Derived
b. Hybrid of peptide and steroid

9. Be able to distinguish between the three different hormones when given just the name of a hormone.

a. Peptide
i. Process of elimination
b. Steroid
i. Something one

1. Testosterone

2. Progesterone
   c. Amine
   i. Melatonin
   ii. T3, T4
   iii. -Amine
   iv. Epinephrine
   v. Norepinephrine

1. Define what trophic hormones are and provide an example.

a. Cause secretion of other hormones
i. -tropin, like gonadotropin
ii. Neagative feedback usually turns off response

11. Describe the Parathyroid hormone pathway.

a. Lower calcium triggers more pth
b. More pth triggers an increase in calcium
c. And so on

12. Identify the three major groups of neurohormones.

a. Posterior pituitary hormones from hypothalamus
b. Tropic hormones from hypothalamus act on anterior pituitary
c. Catecholamines come from medulla

13. Know the characteristics of the anterior and posterior pituitary gland. Know each of the hormones released from each part.

a. Anterior makes and releases six (endocrine tissue)
i. Prolactin
ii. Growth Hormone (GH)
iii. Follicle-Stimulated Hormone (FSH)
iv. Luteinizing Hormone (LH)
v. Adrenocorticotropic Hormone (ACTH)
vi. Thyroid Stimulating Hormone (TSH)
b. Posterior just releases stuff made in hypothalamus (nervous tissue)
i. Oxytocin
ii. Vasopressin

14. Describe the hypothalamic-hypophyseal portal system and its advantages.

a. Hypothalamus sends trophic hormones (Releasing Hormones (RH)) to anterior pituitary
b. Pros
i. Direct delivery with no dilution
ii. Only need small amounts of hypothalamic trophic hormones

15. Distinguish between a short-loop feedback system and a long-loop feedback system.

a. Short-loop feedback
i. Pituitary hormones affect secretion of hypothalamus hormone
b. Long-loop feedback
i. Hormones after pituitary affect secretion of hypothalamus or pituitary hormone

16. Explain the concepts of synergism, permissiveness, and antagonism. Provide examples of each.

a. Synergism
i. A and B do more than their individual effects do combined
b. Permissiveness
i. A and B only work well when together
c. Antagonism
i. B diminishes effect of A

17. Recognize the possible reasons for abnormalities in the endocrine system.

a. Tissues don’t respond to hormone
b. Receptors can be scuffed
c. Signal transduction can be scuffed

18. Know the difference between primary and secondary pathologies of the endocrine system and be able to identify them.

a. Primary
i. Last integrating center
b. Secondary
i. Trophic integrating center (pituitary or hypothalamus usually)

1. Distinguish between a monosynaptic reflex and a polysynaptic reflex.

a. Monosynaptic
i. One synapse between afferent and efferent neurons
b. Polysynaptic
i. Two or more synapses
c. Autonomic
i. One synapse in CNS and another in autonomic ganglion

2. Describe the components of a muscle spindle. Include in your answer alpha motor neuron, gamma motor neuron, intrafusal muscle fiber, and extrafusal muscle fiber.

a. Muscle Spindle
i. Alpha motor neuron innervate extrafusal (normal muscle fibers)
ii. Gamma motor neuron innervate intrafusal (muscle spindles)

3. Describe how signals are regulated in the muscle spindles and how stretch can trigger a reflex.

a. Always firing
b. Muscle spindles fire more when it stretches
c. Muscle contracts to prevent damage from over-stretching

4. Describe alpha gamma coactivation and explain why it is important.

a. Maintains spindle function after contraction
b. Intrafusal and extrafusal both have to contract to see how far it goes

5. Describe where Golgi tendon organs are located, their role, and how they function.

a. Links muscle to tendon
b. When stretched it relaxes the muscle
c. Inhibits motor neuron to relax muscle

6. Explain the Patellar Tendon (Knee Jerk) Reflex.

a. Tendon is tapped to stretch muscle spindle
b. Fires action potential (monosynaptic) and excites quad to contract

7. Explain the Crossed Extensor Reflex.

a. Pain activates receptor
b. To spinal cord and diverges
c. One goes for pain, other goes for reflex
d. Pull foot and adjust body weight so no falling happens

8. Be able to distinguish between the three different types of movement (reflex, voluntary, and rhythmic).

a. Reflex
i. Least complex, spinal cord or brain
ii. Fast
b. Voluntary
i. Most complex, brain or cerebellum
ii. Learned movements with practice
c. Rhythmic
i. Intermediate complexity, spinal cord and brain
ii. Walking or running

9. Know the general pathway of how muscles are integrated.

a. Muscle Reflex
i. Stimulus goes to receptor and then spinal cord then muscle
ii. Sensory stuff goes to spinal cord then up to cortex to process

1. Know the general pathway of how voluntary movement is coordinated.

a. Voluntary Movement
i. Stimulus
ii. Plan (gotta think)
iii. Timing by brain
iv. Execution by skeletal muscles
v. Execution by extrapyramidal stuff on posture, balance etc.
vi. Always feedback

11. Describe what the corticospinal tract. Include in your answer pyramids and medulla oblongata.

a. Brain fires signal down spinal cord to trigger neurons
i. Through Medulla Oblongata
ii. Most nerves cross at pyramids

12. Explain what Parkinson’s disease is and what causes it.

a. Progressive neurological disease
b. Shaking, loss of function
c. Basal ganglia neurons go bad and don’t release dopamine

1. Be familiar with the general characteristics of the heart, blood vessels, and blood.

a. Heart
i. Septum divides left and right halves
ii. Has two pumps
b. Blood Vessels
i. Veins, arteries, and capillaries
ii. (Veins venir, Arteries away)
iii. Pulmonary and systemic circulation
c. Blood
i. Cells and plasma

2. Understand how pressure changes in difference blood vessels.

a. Decreases from heart to arteries to capillaries and then to veins

3. Define hydrostatic pressure. Know how it relates to height.

a. Pressure on walls of container
b. Higher water exerts higher pressure

4. Know how pressure is generated in the cardiovascular system.

a. Contracting muscles
b. Driving pressure is created by ventricles
c. Dilation lowers pressure
d. Constriction increases pressure
e. Volume is applicable as well

5. Know how flow can be affected by distance. Know the relationship between flow and pressure.

a. Higher flow is correlated to higher pressure
b. Pressure falls with distance because friction

6. Describe how resistance affects flow.

a. Inverse relationship

7. Describe the three parameters that determine resistance for a fluid flowing through a tube.

a. Tube Length
b. Tube Radius
c. Fluid Viscosity

8. Understand all the variables in Poiseuille’s Law. Know the simplified equation for resistance.

a. R=8L(viscosity n)/pir^4
b. Really just 1/r^4
c. Length is anatomy
d. Blood pretty much has a set viscosity

9. Know the relationship between flow of blood, the pressure gradient, and the resistance to flow.

a. Flow is basically P/R

1. Compare and contrast flow rate and velocity of flow.

a. Flow rate is how much goes through (L/min)
b. Velocity if flow is how fast it moves (m/s) or flow rate/area (q/a)

11. Know some of the general characteristics of the heart.

a. Base is at the top
b. Apex is at the bottom
c. Ventral side of cavity between lungs
d. Myocardium is cardiac muscle
e. Surrounded by pericardium membrane sac
f. Ventricles are bulk of the heart

12. Know the direction of blood flow through the heart.

a. Right Side of Heart (Right to the Lungs)
i. Vena Cava
ii. Right atrium
iii. Tricuspid Valve
iv. Right Ventricle
v. Pulmonary Valve
vi. Pulmonary Artery (away to lungs)
b. Left
i. Pulmonary Veins (has oxygen now)
ii. Left atrium
iii. Mitral Valve
iv. Left Ventricle
v. Aortic Valve
vi. Aorta
vii. Systemic arteries

13. Know each of the valves of the heart. Know where they are and their additional names.

a. Atrioventricular valves
i. Between atria and ventricles
ii. Tricuspid on right side
iii. Bicuspid or mitral on left side
b. Semilunar valves
i. Between ventricles and arteries
ii. Aortic and pulmonary valves

14. Distinguish between contractile cells and autorhythmic cells.

a. Contractile
i. Striated fibers with sarcomeres
ii. Like skeletal muscle
b. Autorhythmic or pacemaker
i. Smaller and fewer
ii. Signal contraction
iii. Activate themselves

15. Review some of the differences between cardiac
    muscle and skeletal muscle.

a. Smaller and nucleated
b. Join through gap junctions
c. SR is smaller
d. Mitochondria are huge

16. Know the steps of Excitation-Contraction coupling in Cardiac Muscle.

a. Action Potential opens L-type receptor
b. Ca enters cell
c. Ca from SR joins to bind to troponin
d. Reverse happens

17. Know each of the steps involved in the action potential of a Cardiac Contractile Cell.

a. Na channels open
b. Na channels close at the peak
c. Ca channels open and fast K channels close
d. Ca channels close and Slow K channels open
e. Rest

18. Compare the cardiac muscle’s refractory period to its twitch.

a. Almost as long as the entire twitch

19. Know each of the steps involved in the action potential of a Cardiac Autorhythmic Cell.

a. Funny Channel activated when repolarization happens
i. Parasympathetic decreases conductance to decrease heartrate
ii. Sympathetic increases conductance to increase heartrate
b. Calcium triggers depolarization
c. K channels open at peak to come back down

2. Know each of the steps involved in the conducting system of the heart.

a. Depolarization
b. Goes from SA to AV node via intermodal pathways
c. Gets more depolarized
d. Shoots down into apex of the heart
e. Goes back from apex

21. Compare and contrast the AV node and the SA node.

a. Atrioventricular node
i. Routes signals to contract from apex to base
ii. Slower conduction
b. Sinoatrial node
i. Sets heartbet
ii. AV node and Purkinje fibers can be pacemakers sometimes

22. Know each part of an ECG (P, Q, R, S, T) and how it correlates to the heart.

a. P- atrial depolarization, small lump
b. QRS- ventricular depolarization
c. T- ventricular repolarization, also small lump

23. Know how the events of the electrical conducting system of the heart relates to an ECG.

a. Atria contract after P
b. Ventricles contract after S

24. Describe the major events in the heart cycle. Include in your answer late diastole, atrial systole, isovolumic ventricular contraction, ventricular ejection, and isovolumic ventricular relaxation.

a. Late diastole
i. Relaxed and ventricles fill
b. Atrial systole
i. Atrial contraction puts a bit of blood into ventricles
c. Isovolumic ventricular contraction
i. Ventricles push back to close valves
d. Ventricular ejection
i. Pressure builds and opens valves
e. Isovolumic Ventricular relaxation
i. Pressure falls and valves close again

25. Know about each of the heart sounds and where they occur during the heart cycle.

a. First
i. Vibrations after AV valves close (Lub)
ii. Ventricles are filled
b. Second
i. Vibrations by closing of semilunar valve
ii. Blood is shot out of ventricles

26. Be able to read and describe the events of a PV diagram of a heart.

a. Left ventricular volume
i. Low volume and low pressure

1. Ventricule is filling
2. Passive filling/atrial contraction
3. Mitral valve is open
   ii. High volume and low pressure
4. Ventricle is filled
5. Nothing is open
6. Isovolumic contraction
   a. No change in volume
   b. Increase pressure
   iii. High Volume and high pressure
7. Semilunar valve is open
8. Ventricular ejection
   iv. High pressure and low volume
9. Nothing is open
10. Isovolumic relaxation
    a. No change in volume
    b. Decrease in pressure

27. Be able to interpret a Wiggers diagram and collect information about it like the heart rate and the end diastolic volume.

a. First slope is bicuspid valve closing as pressure builds
b. Meets aorta line and the blood goes into aorta
c. After decreasing, semilunar valves will shut and make a sound
d. From left to right, bicuspid valve is closed the whole time

28. Be able to calculate Cardiac output and stroke volume.

a.       Stroke Volume

                                                               i.      EDV-ESV (Ending volume-Starting Volume)

                                                             ii.      Amount of blood pumped by one ventricle during contraction

                                                           iii.      Around 70 mL

b.       Cardiac Output

                                                               i.      Stroke Volume*Heart Rate

                                                             ii.      Heart rate is P wave to P wave

                                                           iii.      Amount of blood pumped by one ventricle in time

29. Know how parasympathetic and sympathetic innervation affect the electrical activity of heart cells.

a. Parasympathetic
i. Decreases heart rate
ii. Hyperpolarizes cell
b. Sympathetic
i. Increases heart rate

3. Understand what affects venous return.

a. Skeletal muscle pump
b. Respiratory pump
c. Sympathetic innervation of veins

31. Define the Frank-Starling Law.

a. Stroke Volume increases as EDV increases

32. Define an inotropic agent and give an example.

a. Affects contractility
i. Epinephrine, norepinephrine are positive
ii. Increases Stroke Volume as a result

33. Conductance Order

a. Sinus Node (SA Node)
b. Internodal Pathways
c. AV Node
d. Left and Right Bundle Branches
e. Purkinje Fibers

1. Be able to describe the anatomy of the adrenal gland. Know which type of hormones are released from the adrenal cortex and the adrenal medulla.

a. Cortex secretes steroids (endocrine)
b. Capsule is the outside
i. CRH in the hypothalamus
ii. ACTH in anterior pituitary
iii. Cortisol in adrenal cortex
c. Then Medulla- catecholamines (nervous tissue)

2. Know each of the layers of the adrenal cortex and which hormones are released from each layer.

a. Layers
i. Glomerulosa- Aldosterone
ii. Fasciculata- Cortisol (glucocorticoid)
iii. Reticularius- Sex hormones

3. Know the functions of cortisol.

a. Mediation of stress
b. Protective against hypoglycemia through permissiveness
c. Metabolism
i. Gluconeogenesis (reverse glycolysis)
ii. Breakdown of skeletal muscle proteins
iii. Lipolysis
iv. Negative calcium balance
v. Brain function
d. Immunosuppressant
i. Supression of Immune Sytsem
ii. Inhibits inflammation
iii. Prevent rejection of organs
iv. allergies

4. Define hypercortisolism (Cushing’s disease) and hypocortisolism (Addison’s disease).

a. Hyper/Cushings
i. Adrenal Tumor secretes cortisol
ii. Pituitary tumor secretes acth
b. Hypercortisolism/Addisons
i. Hyposecretion of all adrenal steroid hormones

5. Explain the three common causes of Cushing’s syndrome.

a. Adrenal tumor secretes cortisol
b. Pituitary tumor secretes acth
c. Doctor just gives too much (iatrogenic)

6. Describe how ACTH is related to melanocortin.

a. Melanocortins are MSH and ACTH
b. ACTH can bind to those receptors
c. Comes from same preprohormone

7. Recognize some of the characteristics of Addison’s disease and Cushing’s syndrome.

a. Addisons
i. Weight loss
ii. Darkening of skin
b. Cushings
i. Buffalo hump
ii. Moon face

8. Know the characteristics of Thyroid hormone.

a. Long-term effects
b. Not essential
c. Needed for growth/development
d. Bind to plasma proteins (TBG)
e. Deiodinases remove iodine from T4 to make T3
f. Metabolism is the main thing

9. Know the anatomy of the thyroid gland.

a. Thyroid follicles and capillaries
b. By larynx

1

. Be able to describe how thyroid hormone is produced. Know the function of de-iodinase.

11. Recognize pathologies associated with the thyroid gland. Include in your study Graves’ disease, hyperthyroidism, hypothyroidism, exophthalmos, myxedema, and ascites.

a. Hyperthyroidism/Grave’s
i. TSI in grave’s stimulate thyroid
ii. Tumors can also make TSH

1. Increases oxygen consumption and heat
2. Increase protein catabolism and get weaker
3. Easily excitable
4. Influence heart
   iii. Exophthalmos
5. Eyes pop out more
   b. Hypothyroidism
   i. No negative feedback increases TSH
   ii. Or just lack of iodine in diet to make goiters
6. Slow metabolism and oxygen
7. Decrease protein synthesis
8. Slower
9. Slower heart rate
   iii. Myxedema
10. Bags under the eyes
    iv. Ascites
11. Round stomachs
12. Can’t drain lymph
13. Filtration higher than absorption

12. Recognize some of the characteristics of growth hormone.

a. Sleep?
b. Binds to a protein in blood
c. Insulin-like growth factors
d. More proteins
e. More glucose/fatty acids

13. Describe the general characteristics of growth hormone. Include in your answer dwarfism, gigantism, and acromegaly.

a. Dwarfism is lack of GH
b. Gigantism is too much GH
c. Acromegaly is too much GH as adult

14. Understand how tissues and bone grow and how calcium and hydroxyapatite play a role in that development.

a. Tissues grow with hormones
b. Bones need calcium to grow
i. Hydroxyapatite Is most common calcium phosphate

15. Explain the role of osteoblasts and osteoclasts.

a. Osteoblasts
i. Build up bone
b. Osteoclasts
i. Break down bone

16. Explain some of the roles of calcium.

a. Signals
b. Cement to hold cells together
c. Coagulation cascade
d. Affect excitability of neurons

17. Know the different ways that the body can return calcium to the ECF or how it can remove calcium from the ECF.

a. Passive filtration, gradients, active transport

18. Describe the role of parathyroid hormone, calcitriol, and calcitonin.

a. PTH
i. Makes calcitriol
ii. Brings Ca to ECF

1. From bone
2. From kidney
3. Absorbs more from blood
   b. Calcitriol
   i. Helps PTH do what it can
   c. Calcitonin
   i. Barely does anything
   ii. Antagonistic with kidney/bone
   iii. Mostly in animals

19. Understand the importance of calcium and phosphate in homeostasis. Recognize some of the symptoms of osteoporosis.

a. Bone reabsorption has to be more than bone deposition
i. Bones break down faster than being built

1. Describe what precapillary sphincters, metarterioles, and pericytes are.

a. Pericyte
i. Decrease capillary permeability
b. Metaterioles
i. Bypass channels
ii. Blood flows here when capillaries are cut off
c. Sphincters
i. Can close off capillaries when stressed

2. Distinguish between the presence of endothelium, elastic tissue, smooth muscle, and fibrous tissue within the different blood vessels.

a. Arteries are the biggest the largest
b. Veins have got everything
c. Arteriole is just smooth muscle
d. Venule is just fibrous tissue
e. Capillaries are straight endothelium

3. Describe what angiogenesis is, why it is important, and how you can inhibit and promote it.

a. Antiogenesis is making new blood vessels
i. Controlled by cytokines

1. VEGF and FGF promote

2. Statins inhibit

3. Explain how blood is pushed through the body.
   a. High to low pressure

5. Know the steps of ventricular contraction and
   ventricular relaxation?

a. Contraction
i. Ventcile contracts
ii. Semilunar valve opens
iii. Aorta and Arteries expand and story pressure
b. Relaxation
i. Isovolumic ventricular relaxation
ii. Semilunar valve shuts
iii. Arteries go back to original size and pressure continues

6. Know how to calculate Pulse pressure and mean arterial pressure.

a. Pulse Pressure
i. Systolic P-Diastolic P
b. MAP
i. Diastolic P + 1/3(Pulse Pressure)

7. Know how arteriolar resistance is regulated.

a. Local control (muscles and what not)
b. Sympathetic reflexes
c. Hormones

8. Know how arteries dilate and contract based on the presence norepinephrine or epinephrine.

a. Alpha receptors do both dilation and constriction
b. Tonic control
c. Contracts more when epinephrine is present, no antagonistic control

9. Distinguish between active hyperemia and reactive hyperemia.

a. Active
i. Matches blood flow to metabolism
b. Reactive
i. Happens after blood flow has decreased due to occlusion

1. Explain the baroreceptor reflex. Include in your answer: CVCC, SA node, and autonomic innervation.

a. Response to an increase in MAP
i. Baroreceptors fire
ii. CVCC picks up on it
iii. SA Node is told to decrease heart rate
iv. Is autonomic innervation?

11. Describe the basic characteristics of capillaries. Be able to distinguish between continuous, fenestrated, and sinusoid capillaries.

a. Continuous- normal
b. Fenestrated- large pores
c. Sinusoid- bit ol capillaries

12. Compare and contrast the velocity of blood flow to the total area covered by the different blood vessels

a. Gonna be the same with same area
b. Some will just be faster if one tightens up
c. Higher total area means slower flow (capillaries slow, everything else fast)

13. Describe the different transport mechanisms of capillaries

a. Transcytosis and channels
b. Diffusion
c. Paracellular pathway too

14. Define the following words: Bulk flow, absorption, and filtration

a. Bulk flow- mass movement due to pressure
b. Absorption- into capillaries (osmotic pressure)
i. veins
c. Filtration- out of capillaries (hydrostatic pressure)
i. arteries

15. Explain why the Lymphatic system is important and how that relates to the circulatory system.

a. Return fluids/proteins to blood
b. Pick up fat and put it in the blood
c. Filter for pathogens

16. Describe how Atherosclerotic plaques are formed.

a. LDL accumulation
b. Macrophages build up to be foam cells
c. Scar tissue builds and gets thick
d. Can burst

17. Know the difference between HDL and LDL

a. HDL-C is healthy
b. LDL-C is not

18. Know the various risk factors for heart disease including the controllable and noncontrollable factors

a. Can’t Control
i. Sex
ii. Age
iii. Family history
b. Control
i. Smoking
ii. Obesity
iii. Sitting
iv. hypertension

19. Explain the causes of Diabetes Mellitus, Pulmonary Edema, Congestive Heart Failure, Essential hypertension, Edema, hypertension

a. Essential Hypertension
i. Hereditary
b. Pulmonary Edema
i. Mismatched CO
ii. Leads to congestive heart failure
c. Diabetes Mellitus
i. Metabolic disorder