Final Study Guide

Neurophysiology
1. How can an action potential trigger?
a. What is the threshold value and what changes cause the membrane
potential to reach it? The threshold is -55mV. The threshold is
reach by ligand sodium channels.
2. What is a graded potential?
a. What makes an excitatory graded potential?
i. EPSPs serve to bring the membrane potential closer to threshold
for generating an action potential.
b. What makes an inhibitory graded potential?
i. IPSPs make cells membrane potential more negative, making it
harder to generate an action potential.
3. How do inhibitory neurotransmitters work, aka what ion channel opens and
how does it affect the neuron?
a. GABA is the major inhibitory neurotransmitter in the brain. Although it
is not one of the 20 amino acids used to build proteins, it is classified
with the amino acid neurotransmitters because it is a modified form of
glutamate. GABA neurons in the brain are small interneurons that
dampen activity within neural circuits. The ionotropic receptor
increases Cl- flux into the cell, resulting in hyperpolarization of the
postsynaptic membrane.
b. Glycine is the major neurotransmitter released from inhibitory
interneurons in the spinal cord and brainstem. It binds to ionotropic
receptors allowing Cl- to enter. Normal function of glycinergic neurons
is essential for maintaining a balance of excitatory and inhibitory
activity in spinal cord integrating centers that regulate skeletal muscle
contraction.
4. Which neurotransmitters are most common in the CNS?
a. Biogenic Amines-are neurotransmitters are made from amino acid.
b. Serotonin
c. Glutamate
d. GABA
e. Glycine
5. What cells forms the blood brain barrier? Where are the cells located?
a. The cells that forms the blood barrier is the astrocytes and they are
located in the CNS.
Muscle Physiology
1. The role of T-tubules -The purpose of t-tubules is to allow depolarization to
quickly penetrate to the interior of the cell. The t-tubules help to bring the

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3.
4.
5.
6.
7.

extracellular environment to all parts of the muscle cell more quickly which
better coordinates muscle contraction.
b. What types of muscle have them? - Its located in the plasma
membrane of skeletal muscle and cardiac muscle cell.
Where are the major calcium sources for the muscle types we have studied
stored?
How does summation lead to tetanus (maximal contraction force)?
What is the structure of the sarcomere?
a. Z- lines, A band, H Zone, etc.
Motor units, what cells go to form them
What order are they recruited?
Isotonic vs. Isometric contraction
Length of sarcomere vs force generated

Cardiac Physiology
1. SA node, what nerves innervate it?
2. Cardiac Cycle
a. Where and how does blood flow
b. Where is systemic flow and pulmonary flow
c. Oxygenated vs. deoxygenated blood
3. Bariosensors
a. How does the AP frequency change with an increase or a decrease of MAP
4. Cardiac Output
a. What is it?
b. How is it calculated?
Pulmonary Physiology
1. Sensation of blood gasses, O2, CO2, H+
a. Where are they sensed?
b. Are they directly sensed and if not how are they sensed?
c. How are the respiratory rate effected by changes in these blood gasses?
2. Anatomy of lung
a. Muscles that cause contraction
b. Role of interplural space
c. Elasticity of the lung and how that effects expiration
3. Pressures that cause air movement
4. Vital Capacity, Minute Ventilation, Alveoli ventilation, reserve volume

Endocrine Physiology

1. Trophic Hormones
a. What are they? (Are hormones that have other endocrine glands as
their target. Most tropic hormones are produced and secreted by
the anterior pituitary)
b. Long vs short loop feedback
i. Short Feedback loop- generally refers to a pituitary
hormone providing negative feedback to the hypothalamus,
inhibiting secretion of the releasing hormone. For example,
growth hormone releasing hormone (GHRH) from the
hypothalamus is inhibited by growth hormone (GH) that has
been released from the pituitary.
ii. Long loop feedback- refers to the hormone that was
released from the peripheral endocrine glands inhibiting
pituitary and/or hypothalamic secretion of releasing
hormones. For example, insulin-like growth factor 1 (IGF-1) is
stimulated to be released by GH. IGF-1, in turn, inhibits GHRH
and GH secretion by long loop feedback.
c. What influences their release?
2. Adrenal gland
a. Hormones produced and the layers that produce them?
i. Mineralocorticoids(Aldosterone)
1. Secreted from zona glomerulosa
2. Regulates renal sodium and potassium secretion
ii. Glucocorticoids (cortisol mediates 95% of glucocorticoid
activity)
1. Secreted from zona fasciculata and reticularis
2. Regulates bodys response to stress
iii. Sex hormones (androgens)
1. Secreted from zona fasciculata and reticularis
2. Regulate reproductive function
iv. Medulla
1. Secretes epinephrine (80%), norepinephrine (20%) and
dopamine (<1%), under neuronal control
b. Epinephrine, how is it released?
Hypothalamus -> sympathetic nervous system -> adrenal
medulla -> epinephrine
3. Pituitary gland
a. Anterior vs. Posterior
i. Posterior
1. ADH-Blood vessel constriction and water reabsorption
by the kidney
2. Oxytocin- Uterine contractions and milk release
ii. Anterior
1. Growth hormone (GH)
2. Prolactin (PRL)
3. Follicle Stimulating Hormone (FSH)

4. Luteinizing Hormone (LH)

5. Adrenocorticotropic Hormone (ACTH)
6. Thyroid Stimulating Hormone (TSH)
b. What hormones are produced?

4. Thyroid Gland
a. Role of iodine

b. Effects that cause goiters

i. What would happen to plasma levels of T3 and T4 if iodine is
deficient in the diet? (Decrease hypothyroidism)
ii. Then, what would happen to the levels of plasma TSH?
(increase)

iii. However, without iodine, T3 and T4 will remain low. What will
happen to the size of the thyroid? (Increase hypertrophy)
c. Trophic hormone control, what hormone feeds back to which level?

5. Parathyroid Hormone
a. What is it? -are four tiny glands, located in the neck, that control
the body's calcium levels.
b. What does it control- increase the calcium levels in the blood
c. Ca2+ control

Renal Physiology
1. What does filtration, secretion and absorption mean?
i. Filtration- the movement of fluid from blood into the lumen of
the nephron
ii. Secretion-is the removal of selected molecules from the blood and
adds them to the filtrate in the tubule lumen
iii. Absorption- the process of moving substances in the filtrate
from the lumen of the tubule back into the blood flowing through
peritubular capillaries
2. Vasa Recta, its role and placement in relation to the nephron, the counter
current multiplier

i. Vasa Recta- is the long peritubular capillaries that dip into the
medulla.
The U-shape minimizes solute loss from interstitium. Yet, allows
the bulk flow (Starling forces) of fluid and solutes into the blood.
Under steady-state, vasa recta carry away only as much solute
and water as is absorbed from the medullary tubules (usually,
more blood exits the vasa recta than enters).
ii. Countercurrent Multiplier
1. Loop of Henle is filled with fluid at a concentration the
same as that leaving the proximal tubule, 300 mOsm/L.
Active pump of the thick ascending limb lowers the
tubular concentration and raises the interstitial
concentration.
2. The ions entering the medullary interstitium from the
ascending limb creates an osmotic gradient and water
thus leaves the descending limb
3. An osmotic equilibrium is established with the tubular
descending limb and the medullary interstitial fluid
(continued active pumping in the thick ascending limb).
4. Additional fluid from the proximal tubule moves
hyperosmotic fluid in the descending limb to the
ascending limb.
5. Continuous active pumping in the ascending limb adds
additional ions the interstitial fluid and more water moves
out of the descending limb.
6. The descending limb once again reaches an osmotic
equilibrium with the interstitial fluid, which now has a
higher concentration.
7. The process continues until 1400 mOsm/L in the
interstitial fluid is achieved.

3. The function of the regions in the nephron

(a) Bowman's capsule- performs the first step in the filtration of blood to
form urine.
(b) Proximal convoluted tubule (PCT)- The filtrate in the Bowman's
space I just mentioned enters the first duct in the renal tubule. This
duct is called the proximal convoluted tubule, which is a section of the
renal tubule located in the kidney's cortex that is responsible for the
reabsorption of the majority of ultra-filtrate.
(c) Loop of Henle- The principal function of the loop of Henle appears
to be the recovery of water and sodium chloride from the urine.

(d) Distal convoluted tubule (DCT)- is responsible for the

reabsorption of the majority of ultra-filtrate.
4. The anatomy of the nephron There are two part of a kidney nephron:
1) the renal corpuscle and 2) the renal tubule
5. Filtrate formation, aka how does the process of urine formation start? What
forces drive filtration? Hydrostatic

6.

Control of GFR, what kinds of

control exist and what needs to happen to increase or decrease GFR

7. Role of Hormones in maintaining MAP

GI Physiology
1. Absorptive state vs. post-absorptive state, when does each happen, what
sources of energy are used by the body, keep in mind the CNS always uses
glucose, what hormones are released during absorptive vs. post-absorptive
state
The absorptive state is the time during and right after eating a meal. The
absorptive state lasts for four hours, during and after each meal. During this state
glucose is the most important energy fuel. Amino acids and fats are used to form
degraded protein, and small amounts are used to provide ATP. Metabolites are
transformed to fat if they are not used for anabolism. Glucose is formed by the
conversion of fructose and galactose, which are stored in the liver from the entrance
of monosaccharides. Glucose is released into the blood, or converted to glycogen
and fat. Some glucose enters the liver and is used for energy, and any that is not
used will be stored in skeletal muscle as glycogen or in adipose cells as fat. Liver,
skeletal muscle, and adipose cells use triglycerides as their primary energy source.
Amino acid are also used by the liver to synthesize plasma proteins. Essentially all
of the events that occur in the absorptive state are directed by insulin.
The post absorptive state is the period when the GI tract is empty and energy
comes from the breakdown of our bodys reserves. The importance of the post
absorptive state is to maintain blood glucose levels. The brain fuels itself using
glucose as its energy source. We can get glucose from stored glycogen, tissue
proteins, and some from fats. The first available store of glucose is in the livers
stores of glycogen. These stores can maintain blood sugar levels for around four
hours. When the liver stores begin to get small, glycogenolysis begins to take place
in skeletal muscles. The glucose in the skeletal muscles is converted to pyruvic acid,
which enters the blood and is converted back to glucose by the liver and again
reenters the blood. In adipose tissue glycerol is produced and the liver converts it to
glucose. The post absorptive stat is controlled by the intervention of the
sympathetic nervous system and the hormones. Glucagon is a hormone that acts
against insulin by promoting a rise in blood glucose. Targeting the liver and adipose
tissue by accelerating glycogenolysis by the hepatocytes and mobilizes fat stores in
adipose tissues. When insulin is secreted again at the next meal, glucagons release
is inhibited.

2. Where does digestion begin for carbohydrates, fats, and proteins?

Also which enzymes are needed for that digestion and where are
they found in the GI track
Carbohydrates- digestion of carbohydrates begins in the mouth. The enzyme
thats breaks down starch is amylase.
Protein- digestion of protein begins in the stomach. The enzymes that are

responsible for the breakdown of protein are pepsin, secreted by the

stomach, and trypsin and chymotrypsin, secreted by the pancreas
Fat- Digestion of certain fats begins in the mouth, where lingual lipase
breaks down short chain lipids into diglycerides. The presence of fat in the
small intestine produces hormones that stimulate the release of pancreatic
lipase from the pancreas, and bile from the liver, enabling the breakdown of
fats into fatty acids.
3. What roles do the accessory GI organs, liver and pancreas, have in digestion?
Liver

Secretion of bile important in the digestion and absorption of fats, and

contains waste products
Metabolic processing of nutrients
Removal of aged red blood cells
Elimination of waste products
Synthesis of plasma proteins
Secretion and modification of hormones
Detoxification of xenobiotics

Pancreas

The exocrine pancreas is very important for digestion and

absorption.
It secretes pancreatic juice into the duodenum.
Pancreatic juice contains:
o
o
o
o

pancreatic -amylase
several proteases
lipases
nucleases

4. How are the smaller molecules created after chemical and physical digestion
absorbed?

Absorption of Carbohydrates

The active transport of glucose occurs on the brush border membrane

through SGLTs.
As a result, a high concentration of glucose builds up on the inside of the
epithelial cells.
Then, facilitated diffusion through GLUTs will carry the glucose through the
basolateral membrane.
Galactose is absorbed by the same mechanism.
Fructose is transported across the brush border membrane by facilitated
diffusion and may be converted to glucose inside the epithelium.

Absorption of Amino Acids and Proteins

Amino acids and di- and tri-peptides are actively transported across the brush
border using the electrochemical gradient of sodium or hydrogen.
Passive transport across basolateral membrane
At least 4 active transporters for amino acids.
Distinct transporters for di- and tri-peptides.
Once inside, peptides are generally converted to amino acids.
However, a small amount of peptides do cross the epithelial cells using a
combination of endocytosis and exocytosis. This is more common in infants
(e.g. the absorption of antibodies from mothers milk).
Absorption of Fats

The bile micelles carry the monoglycerides and free fatty acids to the
membrane of the villi.
The monoglycerides and free fatty acids then diffuse into the membrane,
where they are soluble. The bile acids then go back to the chyme where they
can help absorb more lipids.
In the epithelial cells, the monoglycerides and fatty acids are taken up by the
ER.
In the ER, they are converted to triglycerides and packaged into lipoproteins
called chylomicrons for release to the interstitial fluid through the basal
membrane.
Chylomicrons are too big to enter capillaries, but they can enter the
lymphatic system, which ultimately takes them the blood stream.

5. Organs of the GI tract

Duodenum- receives the chyme from the stomach. In the duodenum, the
chyme is mixed with pancreatic juice and bile from the liver via the gall
bladder.
Jejunum -receives the chyme from the duodenum and continues to absorb
nutrients.
Ilium -Generally, absorption is complete before the chyme reaches the ileum,
the last section of the small intestine.

General Physiology
1. The flow equation
2. The effects of parasympathetic and sympathetic nervous system, broad
effects on each organ system
3. Response to hemorrhage, systemic effects again broad effects in the whole
body