kleinridders

• frontal lobe

• parietal lobe

• occipetal lobe

• temporal lobe

Neurons

• generation and transmission of electrical nerval activity

Glia

• Astrocytes (nourishment of neurons)

• Oligodendrocytes (insulation, rapid transmission)

• Microglia (macrophages)

• ependymal cells (line the wall of ventricular system)

endothelia cells

• brain has a vascular system

• neurons of the hypothalamus

• LH: lateral hypothalamus

• ARC: arcuate nucleus (senses peripheral signals)

• PVH: paraventricular hypothalamus

• located at the ARC region of the Hypothalamus

POMC

• proopiomelanocorti neurons

• anorexigenic (reduce food intake)

AGRP

• agouti-related peptide neurons

• orexigenic (increase food intake)

Leptin and Insulin inhibit AGRP and stimulate POMC

• regulate hunger and satiety

• AGRP inhibits second order neuron (NPV and AGRP)

• POMC stimulates second order neurons (alpha MSH)

hormones

• Ghrelin (induces food intake)

• Insulin and Amylin (reduce food itake)

• Leptin (reduces food intake) produced by adipocytes

Nutrients

• Carbohydrates, Proteins and fat reduce food intake at different levels

• physiology and psychology modulate food intake

• hedonic: motivation/reward (neuronal)

• homeostasis: hunger <-> satiety (hormones from the GIT, nutrients)

• adiposity -> Leptin and insulin reduce food intake

Ateries

• transport of blood (high pressure)

• strong vascular wall

Veins

• transport of blood (low pressure)

• thin vascular wall, venous valves, blood reservoir

Capillaries

• single cell layers with pores

• exchange of fluids, nutrients, electrolytes ,gases, etc.

• 3 types of capillarys

  • continous (limited permeability) -> brain

  • fenestrated (contains pores) -> kidney

  • sinosoid (discontinous membrane) -> liver

= quantity of blood that passes a given point in the system in a given time

(adults ca. 5 000 mL/min)

• cardiac output = heart rate * stroke volume

determinant of blood flow

• velocity, blood pressure, resistance

affected by

• body metabolism, exercising, age, size

• blood pressure differs in different parts (Aorta high, veins low)

• acessory route for fluid flow from inerstitial space to blood

• special lymph channels in all tissues

• lymphatic vessels empty in thoracic duct and right lymphatic duct

• ducts empty into the subclavian veins

• 2 antigens (express on the surface)

  -> typ A, typ B, typ AB and 0

corpuscular components

• Erythrocytes, leukocytes (Monocytes, Granulocytes)

non corpuscula components

• plasma/serum (water, elektrolytes, proteins)

• hemostasis after vessel trauma

• severred vessel -> formation of platelet plug -> coagulation -> growth fibrous tissue

• blood coagulation pathway -> cascade of enzyme ctalysed reactions

1. formation of prothrombin

2. conversion prothrombin -> thrombin

3. fribrinogen -> fibrin

extrinsic pathway

• tissue thromboplastins released

• tissue factor -> factor VII -> VIIa -> factor X -> Xa + Ca2+

intrinsic pathway

• exposure of blood to collagen activates XII -> XIIa

• XIIa (serin protease) -> factor XI -> XIa -> factor IX -> IXa + Ca2+

• Xa + V + phospholipase + Ca2+ form prothrombin activator

• Vitamin K is required for the synthesis of prothrombin

• Thrombin stimulates its own formation

primary

• causes unkown

• risk factor: genetic, hormonal, salt

secondary

• classification (renal, endocrine)

• causes: pregnancy, drugs, licoric

normocytic

• acute blood loss, chronic infection, bone marrow insufficency

macrocatic

• pernicous anemia, folic acid deficency

• MCV high, MCH high, MCHC high

microcytic

• iron deficency, thalassemia, protein defficency, chronic lead exposure

• MCV low, MCH low, MCHC low

MCH = mean corpuscular hemoglobin

MCV = mean corpuscular volume

MCHC = mean corpuscular hemoglobin concentration

kidney:

glomerulus

loop of henle

• regulation of water excretion

• urine concentration

• thick decending limb (PST = proximal straight tubule)

• thing segement (DTS + ATS = decending and ascending thin segment)

• thick ascending limb (TAL)

  • water impermeable

  • reabsorption Na+, K+, Cl-

• 2 epithelial layers (visceral and parietal)

• Glomerulus, Podocytes, mesangial cells

• filtration barrier

  (capillary membrane, basement membrane, epithel)

• juxtaglomerula apparatus (distal tubule + afferente ateriole)

• regulate blood pressure + filtration rate

A controlling Acid base balance

W controlling Water balance

E mainaitning electrolyte balance

T removing toxins from waste products

B controlling blood pressure

E producing the hormone erythropoietin

D activating vitamin D

• high transport capacity

• sodium linked transport processes

• reabsorption of HCO3-

• pssive absorption of water and Cl-

• reabsorption of proteins and amino acids

  
  

• regulation of water excretion

• reabsorption of Na+, Cl-, K+

• fine tuning of urine composition

• Na+ reabsorption

• Ca2+ reabsorption

• K+ secretion

• hormones Renin, Erythropoietin, Kinins, Eicosanoids

• Quantification of renal function via the glomerula filtration rate (GFR)

• Marker of GFR

  • freely filtered in glomerulum

  • no absorption or secretion in tubulr system

  • exogenous Inulin

  • endogenous creatine

• equation for estimation of GFR

  • creatine clearance = (creatine concentration urine / creatine concentration serum) * urinary volume

protein secretion

• Proteinurea = excreation more than 150 mg/d

• glomerula -> high molecular weight

• tubular -> low molecular weight

acute renal failure

• prerenal acute renal failure

  • reduction in blood flow to kidney

• intrarenal acute renal failure

  • intrinsic deffect (drugs)

• postrenal acute renal failure

  • external obstruction (stones)

• retention of water and NaCl, K+, H+

• accumulation of waste products

• anurea

chronic renal failure

• diabetis, hypertension, infection

• anemia, disturbed bone mineralisation, protein deficiency

• Hypothalamus -> Thyroid-releasing hormone, Corticotropin-releasing hormone

• anterior pituary -> Thyroid-stimulation hormone, adrenocorticotropin hormone

• posterior pituary -> antidiuretic hormone, oxytocin

• Thyroid -> Thyroxine, Trijodthyronin

• adrenal cortex -> Cortisol, Aldosterone

• adrenal medulla -> Norepinephrine, epinephrine

• kidney -> renin

• heart -> aterial natriuretic peptide

• stomach -> gastrin, Ghrelin

• Pancreas -> Insulin, Glucagon

• Parathyroid -> Parathyroid hormone

• Testes/ovaries -> Testosterone/estrogen

• small intestine -> secretin

• adipocytes -> leptin

• iodine is required for throxine formation

• iodide trapping in thyroid follicels (stimulated by TSH)

• oxidation of iodide to iodine

• combination with tyrosine residues

  -> Thyroxine (T4) and Trijodthyroxine (T3)

• pinocytosis of thyroglobulin into thyroid cell

• fusion with lysosome -> release of T3 and T4

• transport in circulation bound to plasma proteins

• uptake by cellular receptors

effects

• induction of gene transcription

• increase cellular metabolic activity

• stimulation of carbohydrate and lipid metabolism

• increase vitamin requirement

• reduction of body weight

• increase blood flow

• increase GIT mobility

• effect on ZNS and muscle function

• excitability, nervousness

• heat intolerance, weight loss,…

• T4 high, TSH low

• hashimoto, endemic

• fatigue, slugishness, heart reate down

• T4 low, TSH high

• adrenocortical hormones = steroid derived from cholesterol

• mineralcorticoids: Aldosteron, Deoxycorticosterone

• Glucocorticoids: Cortisol, Corticosterone

mineralcorticoids

• effect on renal tubular function (reabsorption of Na+ increased, secreation of K+ increased)

• increase of aterial pressure

• Aldosterone:

  • cAMP in epithelia cells increase

  • stimulation of phosphatidylinositol

glucocorticoids

• effect on carbohydrate metabolism (stimulation of gluconeogenesis, adrenal diabetis)

• effect on protein metabolism (mobilize amino acids)

• effect on lipid metabolism (mobilize fatty acids)

• stimulation of food intake

• Cortisol

  • stress induced secretion

  • can inhibit inflamation (stabilization membranes)

Mouth

• upper lip

• palate

• Uvula

• palatine tonsile

• tounge

• lower lip

Glands

• paratoide gland

• sublingual gland

• submaxillary gland

• esophagus

• fundus

• cardia

• body

• pylorus

• duodenum

main structure elements

• serosa longitudinale muscle

• circular muscle

• submucosa

• mucosa

enteric nervous sytem

• meissners nerve plexus

• myenteric nerve

-> movement and secretion

• mastication = grinding

  -> enzyme activity increase, passage through GIT increase, intracellular nutrients availability increase

• swallowing (oral -> pharyngeal - esophagial)

• saliva secreation

  • promotes mastication

  • dissolves particles

  • contains amylase and lipase

• peristalsis

  • propulsive and mixing movement

  • intermitten constrictive contraction

  • optimized for every part of GIT

• divided into 4 sections

• reservoir, grinding and mixing, regulation of chyme

• pH is acidic

• gastric juice

  • mucus, HCL, Pepsinogen, cathepsinogen, lipase, intrinsic factors

Gastrin

• protein, nerval

• G cells in stomache, duodenum and jejunum

• gastric acid secretion

Cholecystokinin

• protein, fat, acid

• I cells in Duodenum, Jejunum and ileum

• pancreatic enzyme secretion

• gallblader contraction

secretin

• acid, fat

• S cells in duodenum, Jejunum, Ileum

• pepsin secretion

gastric inhibitory peptide

• protein, fat, carbohydrates

• K cells in duodenum, jejunum

• insulin release

Motilin

• fat, acid, nerval

• M cells in stomach, duodenum, jejunum

• gastric and intestinal motility

  
  

• ghrelin -> endocrine cells GIT induce food intake

• gastric signal -> stomache stretch reduce food intake

• CCK -> duodenum, jejunum reduce food intake

• glucagon like peptide -> ileum and colon reduce food intake

• PYY -> ileum reduce food intake

Achalsia

• lower esophagal sphincter fails to open

• backup of food

GERD

• gastroesophagal reflux disease

• stomache acid frequently flows black

peptic ulcer

• open sores on the inside lining

• causes: food poisining, bacteria,…

chrons disease

• inflammatory bowl disease

• cause unkown

upper tract

• nasal cavity, pharynx, larynx

• warm up, humidify, filter

lower tract

• trachea, primary bronchi, lung, ribs, wertebra, sternum, diaphragma, intercostal musculues

inspration

• increase in chest diameter, contraction of diaphragma

expiraton

• reduction in chest diameter, ralaxation of diaphragma, elastic recoil of lung

• tidal volume

  • volume inspired/expired with normal breath

• inspratory reserve volume (IRV)

• expiratory reserve volume (ERV)

• residual volume (RV)

  • volume of air that always remains in the lung

• dead space volume (0,15l)

systemic circulation

• part of blood that carrys oxygen away from heart and back

pulmonary circulation

• part of blood from the heart to lung and back to the heart

• site of exchange at aveoli

• hemoglobin (tetramer) and myoglobin (monomer in muscle)

• cooperative binding of oxygen has an allosterice effect

  -> affinity of oxygen increase after binding first oxygen

• CO2 + H20 <-> H+ + HCO3-

• oxygen binding inversly to CO2 concentration

• transport faciliated by hemoglobin

• transport dependent on hemoglobin content, oxygen partial pressure and pH

• storage of oxygen via myoglobin

• damage of alveoli

• rupture leding to large air space

• decreased surface for gas exchange

• chronic obstructive pulmonary disease (COPD)

• abnormal collection of air in the pleural space

• induced by damage to chest wall

• fluid accumulation in the tissue and air space of lung

• impaired gas exchange and respiratory failure

• caused by left ventricle failure or injury to lung tissue or its blood vessels

• due to CVD

• restricted blood flow -> decreased oxygen level