Download Chapter 23,24,25

Chapter 23, 24, 25
NAME__________________
Day and time _________________
Anatomy: upper respiratory system
1.
Explain how the respiratory and cardiovascular systems work together to accomplish
gaseous exchange among the atmosphere, blood, and cells.
2.
Identify parts of the respiratory system in this activity.
ADA.
BB.
L.
Alveolar ducts and alveoli
Bronchi and bronchioles
Larynx
MN.
P.
T.
Mouth and nose
Pharynx
Trachea
a. Arrange respiratory structures listed in the box in correct sequence from first to last in the
pathway of inhalation.
______
______
______
______
______
______
b. Write asterisks (*) next to structures forming the upper respiratory system.
c. Most of the structures listed in the box above are parts of the (conducting? respiratory?) portions
of the respiratory system.
3. List the functions of the below:
a. Mucous membrane-lined spaces and passageways: ________________________________
b. Nostrils: _____________________________________
c. Anterior portion of nasal cavity: __________________________________________________
4. Name the structures of the nose that are designed to carry out each of the following functions.
a. Warm, moisten, and filter air
b. Sense smell
c. Assist in speech
5. a.
Alveoli that inflate easily have (high? low?) compliance.
The presence of a coating called ______________________ lining the inside of alveoli prevents
alveolar walls from sticking together during ventilation and so (increases? decreases?)
compliance.
b.
Surfactant is made by type (I? II? III?) alveolar cells of the lungs, which produce this chemical
especially during the final weeks before birth. A premature infant may lack adequate
production of surfactant; this condition is known as _______________________.
c.
Collapse of all or part of a lung is known as _______________________ (Suck collapse may result
from lack of surfactant or from other factors. Name several of
these factors.
6.
Complete the arrows to indicate whether resistance to air flow increases ( ) or decreases ( )
in each case.
a.
Inhalation, causing dilation of bronchi and bronchioles.
b.
Increase in sympathetic nerve impulses to relax smooth muscle of airways.
c.
COPD such as bronchial asthma or emphysema, with obstruction or collapse or airways.
8.
Contrast these types of breathing patterns.
Tachypnea/dyspnea
9.
Each minute the average adult takes ______breaths (respirations). Check your own
respiratory rate and write it here: _______ breaths per minute.
10.
Of the total amount of air that enters the lungs with each breath, about (99%? 70%? 30%?
5%?) actually enters the alveoli. The remaining amount of air is much like the last portion of a
crowd trying to rush into a store: it does not succeed in entering the alveoli during an inhalation
but just reaches airways and then is quickly ushered out during the next exhalation. Such air is
known as anatomic ______________________ and constitutes about __________ mL of a
typical breath.
11.
12.
Maureen, who weighs 150 pounds, is breathing at the rate of 15 breaths/minute. Her
tidal volume is 480mL/breath. Her minute ventilation is ______________mL. Her
alveolar ventilation rate is likely to be about ________mL/mm.
Match the lung volumes and capacities with the descriptions given. You may find it
helpful to refer to Figure 23.16 in the text.
ERV.
FEV1.0
FRC.
IRV.
Expiratory reserve volume
Forced expiratory volume in one second
Functional residual capacity
Inspiratory reserve volume
RV.
TLC.
VC,
VT.
Residual Volume
Total lung capacity
Vital capacity
Tidal volume
a.
The amount of air taken in with each inhalation during normal breathing is called
__________________________.
b.
At the end of a normal exhalation the volume of air left in the lungs is called _______________.
Emphysemics who have lost elastic recoil of their lungs cnnot exhale adequately, so this volume
will be abnormally large.
c.
Forced exhalation can remove some of the ar in the FRC. The maximum volume of air
that can be expired beyond normal exhalation is called ___________________________
This volume will be small in emphysema patients.
d.
Even after themost strenuous expiratory effort, some air still remains in the lungs; this
amount, which cannot be removed voluntarily, is called ______________________.
e.
The volume of air that represents a person’s maximum breathing ability is called
____________________. This is the sum of ERV, VT and IRV.
f.
Adding RV to VC gives ___________________.
g.
The excess air a person can take in after a normal inhalation is called _____________________.
h.
The amount of the vital capacity that can be forced out in 1 second is called ________________.
13.
Refer to Figure 23.17 in the text, and complete the table below about normal respiratory values.
Notice that each “capacity” consists of the sum of two or more “volumes.” Show how to
calculate those capacities in column 3. Some answers are provided for you.
Volume or
capacity
Full name of
volume or
capacity
Calculation
of capacities
In females
(mL)
In females
(L)
In males
(mL)
In males
(L)
a.
b. ERV
c.
Vital capacity
Inspiration
reserve
Volume
d. IC
e. VC
f.
g. FRC
h.
14.
Omit
Omit
Omit
500
1900
VT + IRV
2400
1200
2.4
0.5
1.2
3600
4.8
Residual volume
Omit
1.1
1800
VC + RV
4.2
6.0
Check your understanding of gas laws by matching the correct law with the condition that it
explains
B.
Boyle’s Law
D.
Dalton’s Law
_____a. If a patient breathes air highly concenTrated in oxygen (as in a hyperbark
Chamber), a higher percentage of
Oxygen will dissolve in the blood and
Tissue. This is the principle underlying
The use of a hyperbark chamber.
_____b. The total atmospheric pressure (760mm
Hg) is due mostly to pressure caused by
Nitrogen, partly to PO2 and slightly to
PCO2.
H. Henry’s Law
______c. Under high PN2 more nitrogen
dissolves in blood. The bends
occurs when pressure decreases
and nitrogen forms bubbles in
tissue as it comes out of solution.
______d. As the size of the thorax increases,
the pressure within it decreases.
15.
a.
Dalton’s law.
The atmosphere contains enough gaseous molecules to exert pressure upon a column of mercury
to make it rise about ______mm. the atmosphere is said to have a pressure of 760mm Hg.
b.
Air is about _____% nitrogen and _____% oxygen.
c.
Dalton’s law explains that of the total 760mm of atmospheric pressure, a certain amount is due to
each type of gas. Determine the portion of the total pressure due to nitrogen molecules:
79% x 760mmHg = ________ mm Hg
This is the partial pressure of nitrogen, or ________________.
d.
Calculate the partial pressure of oxygen.
16.
Complete this clinical correlation activity.
a.
Although most of the atmospheric air inspired is (CO2? N2? O2?) , (most? little?) of this gas
normally dissolves in blood plasma because of the low ______________________ of this gas in
plasma. But in compressed air (most? little?) N2 gas dissolves in plasma. Deep sea divers can
avoid having excessive release of bubbles of this gas in their tissues (the condition known as
_____________________ sickness) by ascending from the depths (rapidly? slowly?)
b.
Hyperbaric oxygenation causes (more? less?) O2 to dissolve in Mr. Costa’s blood since he is
exposed to (0.3-0.4? 3-4?) atmosphere(s) of pressure. Explain why this procedure kills anaerobic
bacteria.
17. Answer these questions about external and internal respiration.
a.
A primary factor in the diffusion of gas across a membrane is the difference in concentration of
the gas (reflected by __________________ pressures) on the two sides of the membrane. (Refer to
text Figure for help.)
Atmospheric air
Alveolar air (Note that this value is lower than that for atmospheric pO2 because
Some alveolar O2 enters pulmonary blood and because of the presence of water vapor.)
b.
Calculate the Po2 difference (gradient) between alveolar air and blood entering lungs and write
that number on the figure.
________mm Hg - __________mm Hg= _________mm Hg
c.
Three other factors that increase exchange of gases between alveoli and blood are:
(large? small?) surface area of lungs; (thick? thin?) respiratory membrane; and (increased?
decreased?) blood flow (perfusion) through lungs (as in exercise).
d.
By the time blood leaves the lungs to return to heat and systemic arteries, its Po2 is normally
(greater than? about the same as? less than?) Po2 of alveoli.
18.
With increasing altitude the air is “thinner,” that is, gas molecules are farter apart. So
atmospheric pressure is lower. Atop a 25,000-foot mountain, this pressure is only 282 mm Hg.
Oxygen still accounts for 21% of the pressure. What is PO2 at that level?
19.
A clinical correlation. Match the clinical cases listed below with the factors (in box) that
can decrease diffusion across the respiratory (alveolar-capillary or a-c) membrane. On each line
that follows, write a rationale for this decrease. The first one is done for you.
DD. Diffusion distance
PP.
Partial pressure of gases
SA. Surface area for gas exchange
SMW.
Solubility and molecular weight
of gases
PP
a. Morphine has been prescribed for Ms. Iudica to alleviate her pain. Rationale:
Morphine slows the respiratory rate, so decreases alveolar pO2. .
_____ b. Mr. Schmidt has interstitial viral pneumonia, with excessive accumulation of fluid in
interstitial spaces. Rationale: ________________________________________________
_____ c. Mrs. Mc. Laughlin was diagnosed with emphysema nine years ago.
Rationale: __________________________________________________.
_____ d. Dr. Wu has a left-sided congestive hear failure (CHF) with pulmonary edema. Arterial blood
gas (ABG) analysis indicates her PO2 is 54 mm Hg and
PCO2 is 43 mm Hg. Rationale: __________________________________.
Physiology of respiration transport of oxygen and carbon dioxide in blood (pages873-879)
19.
Answer these questions about oxygen transport. Refer to Figure in your text.
a.
One hundred mL of blood contains about ________mL of oxygen. Of this, about 19.7mL is
carried as ___________________. Only a small amount of oxygen is carried in the dissolved
state because oxygen has a (high? low?) solubility in blood or water.
b.
Oxygen is attached to the ___________________ atoms in hemoglobin. The chemical formula for
oxyhemoglobin is _____________________. When hemoglobin carries all of the oxygen it can
hold, it is said to be fully ______________________. High PO2 in alveoli will tend to (increase?
decrease?) oxygen saturation of hemoglobin.
c.
Refer to Figure 23.20 in your text. Note that arterial blood, with a PO2 of about 100-105mm Hg,
has its hemoglobin _______% saturated with oxygen. (This may be expressed as SO2 =
________%.)
d.
List four factors that will enhance the dissociation of oxygen from hemoglobin so that oxygen
can enter tissues. (Hint: Think of conditions within active muscle tissue.)
e
At a higher body temperature, for example in high fever (more? less?) oxygen will be attached
to hemoglobin, while (more? less?) oxygen will enter tissues to fuel metabolism. This is known
as a “shift to the (left? right?)” of the oxygen-hemoglobin dissociation curve.
f.
By the time blood enters veins to return to the heart, its oxygen saturation of hemoglobin (SO2)
is about _______%. Note on Figure 23.20 of your text that although po2 drops from 100 in
arterial blood to 40 in venous blood, oxygen saturation drops (more? less?) dramatically, that is,
from 98% to 75%. Of what significance is this?
g.
Fetal hemoglobin (Hb-F) carries 30% (more? less?) oxygen than adult hemoglobin (Hb-A). State the
significance of this fact.
h.
Carbon monoxide has about _______times the affinity that oxygen has for hemoglobin. State the
significance of this fact.
20.
Complete this Checkpoint about transport of carbon dioxide.
a.
Write the percentage of CO2 normally carried in each of these forms: ________% is present in
bicarbonate ion (HCO3); ________% is bound to the globin portion of hemoglobin; _________%
is dissolved in plasma.
b.
Carbon dioxide (CO2) produced by cells of your body diffuses into red blood cells (RBCs) and
combines with water to form ________________________.
c.
Carbonic acid tends to dissociate into two products. One is H+ which binds to
_____________________. The other product is ______________________ (bicarbonate),
which is carried in (RBCs? Plasma?) in exchange for a (K+? Cl-?) ion that shifts into the RBC.
d.
Now write the entire sequence of reactions described in (b) and (c). Be sure to include the
enzyme that catalyzes the first reaction. Notice that the reactions show that increase in CO2 in
the body (such as when respiratory function is inadequate) will tend to cause a buildup of acid
(H+) in the body.
CO2 + _________ (enzyme) ________
H+ + ___________________
Binds
To Hb
e.
Shifts to plasma
in exchange for CI_
The lower the amount of Hb-O2 (oxyhemoglobin) in red blood cells, the (higher? lower?) the
amount of CO2 that hemoglobin can carry. This principle, known as the (Bohr? Haldane?)
effect, means that hypoxic tissues (such as during exercise) can get rid of their CO2 faster.
21.
Note that as the red blood cells reach lung capillaries, the same reactions you just studied occur, but in
reverse. Study Figure 23.24b in the text carefully. Then list the major steps that occur in the lungs so
that CO2 can be exhaled.
22.
Complete the table about respiratory control areas. Indicate whether the area is located in the medulla
(M) or pons (P).
Name
M/P
Function
a.
M
Controls rhythm; consists of inspiratory and
Expiratory areas
b. Pneumotaxic
c.
23.
Prolongs inhalation and inhibits exhalation
Answer these questions about respiratory control.
a.
The main chemical change that stimulates respiration is increase in blood level of
_______________, which is directly related to (decrease in pO2? increase in pCO2? ) of blood.
b.
Cells most sensitive to changes in blood CO2 are located in the (medula? pons? aorta and carotid
arteries?). these are known as (central? peripheral?) chemoreceptors.
c.
An increase in arterial blood Pco2 is called ________________________. Write an arterial Pco2
value that is hypercapnic. ______mm Hg (Even slight? Only severe?) hypercapnia will stimulate
the respiratory system, leading to (hyper? hypo?)-ventilation.
d.
State two locations of chemoreceptors sensitive to changes in PO2.
_____________________ ______________________ . These are known as (central?
peripheral?) chemoreceptors. (Even slight? Only large?) decreases in PO2 level of blood will
stimulate these chemoreptors and lead to hyperventilation. Give an example of a PO2 low
enough to evoke such a response. __________ mm Hg. This condition is (hypoxia?
hypercapnia?)
e.
Increase in body temperature (as in fever), as well as stretching of the anal sphincter, will cause
_______________ -crease in the respiratory rate.
f.
Take a deep breath. Imagine the _____________________ receptors in your airways being
stimulated. These will cause (excitation? inhibition?) of the inspiratory and apneustic areas,
resulting in exhalation. This reflex, known as the _____________reflex, prevents overinflation
of the lungs.
g.
the term ___________ means a brief cessation of breathing.
24.
Indicate whether the following factors will cause apnea (A), an increase in respiratory rate (In)
or decrease (De) in respiratory rate.
_____ a.
Fever
_____ e.
Sudden drop in blood pressure
_____ b.
Prolonged somatic pain
_____ f.
Activation of the limbic system during
emotional anxiety
_____ c.
Sudden, severe pain
_____ d.
Sudden plunge into cold water
_____ g.
Proprioceptive sensations that accompany
exercise
25.
Identify physiological adjustments made during exercise in this Checkpoint.
a.
During exercise, blood flow to the lungs (known as pulmonary ___________)
will (increase? decrease?). The rate of diffusion of oxygen from alveolar air into pulmonary blood
increase _______________ -fold. This rate is known as oxygen _____________ __ ________ .
b.
At the onset of moderate exercise, ventilation abruptly increases primarily in (rate? depth?,
providing more oxygen to activate muscles. This change in ventilation is due primarily to (neural?
chemical or physical?) signals that alert the medulla.
c. The gradual increase in ventilation that follows is due to a slight increase in (pO2? PcO2), and a slight
_________ -crease in temperature that accompany exercise.
26.
Write an essay in which you describe effects of smoking on respiratory efficiency. Include these
terms in your essay: terminal bronchioles, hemoglobin, mucus, cilia and elastic fibers.
27. When the embryo is at about 4 weeks of development, the respiratory system begins to
develop from an outgrowth of the foregut. This outgrowth is known as the respiratory
_____________. Write E next to tissues derived form endoderm, and M next to tissues
derived from mesoderm.
___ a. Cartilage and smooth muscle of trachea
and bronchi
____ b. The fourth and sixth pharyngeal pouches
___ c. Epithelial lining of larynx, trachea
bronchi, and alveoli
____ e. Visceral and parietal pleurae
what form cartilage and smooth muscle
of the larynx
28. Describe COPD in this Checkpoint.
a. COPD stands for C________________ O _________________ P ________________
D__________________. In most cases, COPD is? Is not?) preventable. Name the two principal
types of COPD: _________________ and _________________
b. In emphysema, alveolar walls are broken down so that lungs contain (more? fewer?) alveoli that are
(larger? smaller?) in size. As a result of alveolar destruction, the surface area of the respiratory
membrane __________ -creases, and the amount of gas diffusion ______ -creases also.
c.
Elastic recoil of lungs during exhalation is (increased? reduced?) in emphysemics by destruction of
elastic fibers in alveolar walls. As a result, alveoli remain inflated. Consequently, (more? less?) air is
trapped in lungs, leading to the class “ ___________chested” appearance of an emphysema patient.
TLC, FRC, and arterial PCO2 are ___-creased in persons with emphysema.
d. Asthma (sometimes classified as COPD) involves an acute phase that is characterized by (bronchospasm
and excessive mucus? Inflammation with edema and possible necrosis of cells lining airways?). The late
(chronic) phase involved ___________________.
List several triggers for asthma attacks.
29. Lung Cancer is the number (1? 3? 10?) cause of cancer death in the United States.
At the time of diagnosis, distant metastases are present in about __________% of patients.
Lung cancer is _____ to ______times more common in smokers than in nonsmokers. Secondhand
smoke (is? Is not?) known to lead to lung cancer deaths. The most common form of lung cancer, known
as ____________ carcinoma, occurs in the (alveoli? airways?), leading to blockage of airways, and
inability to get air. (The American Lung Association’s motto is, “If you can’t breathe, nothing else
_____________________>”)
30. Explain how the abdominal thrust (Heimlich maneuver) helps to remove food that might otherwise cause
death by choking.
Digestive System
C H A P T E R
24
1. List the six basic activities of the digestive system.
2.
_____________
_____________
_____________
_____________
_____________
_____________
_____________ digestion occurs by action of enzymes (such as those in saliva)
And intestinal secretion, whereas _____________ digestion involves action of the
teeth and muscles of the stomach and intestinal wall.
3. Now match the names of the layers of the GI wall with the correct description.
Muc. Mucosa
Ser. Serosa
Mus. Muscularis
Sub. Submucosa
____a. Also known as the peritoneum, it
mesentery and omentum
____c. Connective tissue containing glands,
nerves, blood and lymph vessels
____b. Consists of epithelium, lamina propria, ____d. Consists of an inner circular layer
and muscularis mucosae
and an outer longitudinal layer
4. Describe the tissues listed below by completing this table, Identify the layer in which each
tissue is located, type of tissue in each case, and functions of these tissues.
Layer of GI Wall
a. Enteroendocrine
tissue
b. MALT tissue
c. Submucosal plexus
(of Messner)
d. Myenteric plexus
Type of Tissue
Function(s)
Secretes hormones
Lymphatic
Submucosa and
mucosa
ANS nerve tissue
5. Circle correct answers and fill blanks about nervous control of the gastrointestinal (GI) tract.
a. The myenteric plexus innervates parts of the GI walls that regulate (motility?
secretions?), whereas the submucosal plexus alters_____________. Neurons of both of these
plexuses are parts of the (autonomic? enteric? central?) nervous system.
b. Two types of receptors in the GI wall can activate these plexuses. Name them:
_____________-receptors and _____________ receptors. Which of these receptors will be
activated by overdistention of the intestinal wall?_____________.
c. Enteric neurons can also be regulated by the autonomic nervous system (ANS). The
(parasympathetic? sympathetic) division activates the intestine to contract and secrete.
Most parasympathetic neurons to the GI tract travel in the _____________ nerve.
d. (Parasympathetic? Sympathetic?) nerve inhibit GI motility and secretion. List three
emotions that can activate sympathetic nerves:_____________
_____________, _____________.
6. Match the names of theses peritoneal extensions with the correct descriptions.
F. Falciform
G Greater omentum
L. Lesser omentum
___a. Attaches liver to anterior abdominal wall
___b. Blinds intestine to posterior abdominal
wall;provides route for blood and lymph
M. Mesentery
Meso. Mesocolon
d. ___Fatty apron”; covers and helps prevent
e.___ Suspends stomach and duodenum
from liver
___c. Blinds part of large intestine to posterior
abdominal wall
.
Mouth, pharynx, and esophagus (902-911) .
7. Complete this exercise about salivary glands.
a. Which glands are largest? (Parotid? Sublingual? Submandibular?)
Which are inflamed by the vital infection known as mumps? _____________
b. Which secrete the thickest secretion due to presence of much mucus?
_____________
c. About 1 to 11/2(tablespoons? cups? liters?) of saliva are secreted daily.
d. State three or more functions of saliva.
e. The pH of the mouth is appropriate for action of salivary amylase. This is about pH
(2? 6.5? 9?).
f. List five or more chemicals that are in saliva
g. List four or more factors that can stimulate increase in saliva production.
h. (Sympathetic? Parasympathetic?) nerves cause dryness of the mouth, whereas stimuli
tion of saliva production occurs by (sympathetic? parasympathetic?) nerves, specifically
in cranial nerves _____________ and _____________.
i. Mumps is an inflammation of the (parotid? Sublingual? Submandibular?) glands. A
vaccine (is? Is not?) available for this viral disease. Which other oragan (s) also become (s)
inflames in about 30% of men who develop mumps after puberty? _____________.
8. Arrange the following in correct sequence:
____ ____ ____ a. From most superficial to deepest:.
A. Root
B. Neck
C. Crown
____ ____ ____ b. From most superficial to deepest within a tooth:
A. Enamel
B. Dentin
C. Pulp cavity
____ ____ ____c. From hardest to softest:
A. Enamel
B. Dentin
C. Pulp cavity
9. List two functions of the periodontal ligament.
10. Dentitions. a. How many teeth (total) are in a complete set of deciduous (baby) teeth?
____ How many are in a complete set of permanent teeth?____
b. Which teeth are most likely to become impacted? _____________
11. Check your understanding of digestion by completing this Checkpoint.
a. (Deglutition? Mastication?) is term that means chewing. Food is formed into a soft mass
known as a (bolus? chyme?).
b.
Enzymes are used for (chemical? mechanical?) digestion of food. The main enzyme in
saliva is salivary (amylase? lipase?). This enzyme converts _____________ into smaller
carbohydrates. Most starch (is? Is not?) broken down by the time food leaves the mouth.
What inactivates amylase after about an hour in the stomach?
c. Where is lingual lipase made? (Salivary glands? Tongue? Tonsils?) This enzyme starts
the breakdown of _____________.
12. Complete this checkpoint on the pharynx and the esophagus.
a.
Food and air in the mouth pass directly into the (pharynx? esophagus?). Which part of
the pharynx is immediately posterior to the nose and normally has air (but not food)
pass through it? (Laryngo? Naso? Oro?)-pharynx
b.
The esophagus lies (anterior? Posterior?) to the trachea The esophagus is commonly
called the (food? Wind?) pipe. It is about _______cm (_______in.) long
c. The muscularis of the superior one-third of the esophagus consists of (smooth? Striated?) muscle,
whereas the inferior one-third consists of (smooth? Striated?) muscle similar to that found in the
stomach.
d. After passing through the diaphragm, the esophagus ends inferiorly in the (stomach? duodenum?).
If the stomach protrudes upward the diaphragm, the condition is known as a
_____________.
13. Discuss the process of swallowing in this exercise.
a.
The technical term for swallowing is _____________.
b.
Arrange in correct sequence (from first to last) the stages of deglutition listed in the box.
____ ____ ____
E. Esophageal
P. Pharyngeal
V. Voluntary
c. Now match each stage of swallowing with the correct description.
_____ 1. Soft palate and epiglottis close off respiratory
_____ 2. Tongue pushes food back into oropharynx.
______3. Peristaltic contractions push bolus from pharynx to stomach.
14a. Arrange these regions of the stomach according to pathway of food from first to last.
Body
Fundus
Cardia
__________ ___
_____________
__________ ___
_____________
Pylorus
b. Match the terms in the box with the correct description.
GC.
Greater curvature
LC.
Lesser curvature
_____ 1. More lateral and inferior in location
_____2. Attached to lesser omentum
_____3. Attached to greater omentum
c.
In which condition does the pyloric sphincter fail to relax normally? (Pyloric
stenosis? Pylorospasm?) Write on signor symptom of this condition.
15. Complete this table about gastric secretions.
Name of Cell
Type of Secretion
a.Cheif
b. Mucous
Function of Secretion
c.
HCL
d.
Gastrin
Which chemical listed in the above table is secreted excessively in Zollinger-Ellison
Syndrome?_____________
16. How does the structure of the stomach wall differ from that in other parts of the GI tract?
a. Mucosa
b. Muscularis
17. Contrast these two terms related to actions of the stomach: mixing/gastric empty
18. For the first hour after eating, food remains in the _____________ of the stomach and is not
mixed with gastric juice. During this period, the enzyme (lingual lipase? Pepsin? Salivary
amylase?) is most active.
b. A clinical correlation. Both acetylcholine, released by vagal nerves, and gastrin (stimulate?
Inhibit?) HCI production. Their effect is (greater? less?) in the presence of
histamine,which is made by _____________ cells in the stomach wall. Describe the effect of H2
blockers such as a cimetidine (Tagamet) on the stomach.
c. Pepsin is most active at very (acid? Alkaline?) pH.
d. State two factors that enable that stomach to digest protein without digesting its own cells
(which are composed largely of protein)
e. If mucus fails to protect the gastric lining, the condition known as _____________ may result.
f._____________. In adults it is quite (effective? ineffective?). Why?
19. Food stays in the stomach for about ______________ hours. Which food type
leaves the stomach most quickly? _____________ Which types stays in
stomach longest?_____________ Forcible expulsion of stomach contents
through the mouth is known as vomiting or _____________. This process is
controlled by the vomiting center located in the _____________. Prolonged vomiting (can be? Is
never?) serious. Explain why.
20. Complete these statements about pancreas.
a. The pancreas lies posterior to the _____________.
b. The Pancreas is shaped roughly like a fish, with its head in a curve of the
_____________ and its tail nudging up next to the _____________.
c. The pancreas contains two kind of glands. Ninety-nine percent of its cells produce
(endocrine? exocrine?) secretions. One type of these secretions is an (acid? alkaline?)
fluid to neutralize the chime entering the small intestine from the stomach.
d. one enzyme in the pancreatic secretions is trypsin: it digests (fats? carbohydrates?
Proteins?). Trypsin is formed initially in the inactive form (trypsinogen) and is
active by (HCI? NaHCO3? enterokinase). Trypsin itself serves as an activator in the
formation
of the protease named_____________ and the peptidase named _____________.
Most of the amylase and lioase produced in the body are secreted by the pancreas.
Describe the functions of these two enzymes.
f. All exocrine secretions of the pancreas empty into ducts. These empty into the
_____________.
g. A clinical correlation. In most persons the pancreatic duct also receives bile flowing
through the _____________ State some possible complication that
may occur if a gallstone blocks the pancreatic duct.
The endocrine portions of the pancreas are known as the _____________
_____________. List hormones they secrete._____________,
_____________, _____________, _____________.
21. Pancreatic cancer usually (is? Is not?) fatal. It is a (common? rare?) cause of death.
22a. The liver weighs about ____ kg (____pounds). It lies in the _____________
quadrant of the abdomen. Of its two main lobes, the _____________ is the largest.
b.
The _____________ ligament separates the right and left lobes. In the edge of this
ligament is the ligamentum teres ( round ligament of the liver), which is the
obliterated _____________vein.
Blood enters the liver via vessels names _____________ and _____________.
c.
In liver lobules blood mixes in channels called _____________ before leaving the
liver via vessels named _____________.
23a.
Bile secreted from the liver is composed largely of the pigment named
_____________ which is a breakdown product of _____________ cells.
Excessive amount of this pigment give skin a yellowish color, a condition
known as _____________.
Two functions of bile are _____________ of fats and _____________ of fats
(and fat –soluble vitamins). One of the breakdown products of billirubin,
namely
_____________ gives feces the normal brown color.
b.
Name several plasma proteins synthesized by the liver.
c.
Identify two or more types of chemicals that are detoxified (metabolized) by the liver.
d.
List three types of cells phagocytosed by the liver.
e.
The liver can convert excess glucose to _______________and________________
and also reverse those processes. (More on this in Chapter 25.)
f.
The liver stores the four fat-soluble vitamins named_______,________,________
and ______. It also stores a vitamin necessary for erythropoiesis, namely
vitamin _________. The liver also cooperates with kidneys and skin to activate
vitamin ________.
g.
Note that the liver (does? Does not?) secrete digestive enzymes.
24.
Check your understanding of accessory structures of the digestive system by naming
the organ that best fits each description below. Select answers in the box.
G.
Gallbladder
L. Liver
P. Pancreas
______a. Has both exocrine and endocrine functions _____f. Contains phagocytic cells
known as stellate
______b. Its primary functions are to store and
reticuloendothclial (Kupffer’s)
concentrate bile
cells
______c. Ejects bile into the cystic duct
____g. Site of carbohydrate, fat and
protein metabolism
______d. Likely to be biopsied if cirrhosis or hepatitis is suspected
____ h. Removed in a cholecystectomy.
______e. Bilirubin absorbed from worn-out red
blood cells, is secreted into bile here
25. Small intestine (pages 921-931)
Describe the structure of the intestine in this Checkpoint.
a.The average diameter of the small intestine is:
A. 2.5 cm (I inch)
B. 5.0 cm (2 inches)
b. Its average length in a living person is about:
A. 3 m (10 feet)
B. 6 m (20 feet)
c. Name its three main parts (in sequence from first to last):
_____________________
_____________________
_____________________
d. Which part of the small intestine is shortest in length? ____________________
e. Which part connects to the cecum of the large intestine? __________________
26. Match the correct term related to the intestine to the description that fits.
ALF. Aggregated lymphatic follicles
(Peyer’s patches)
BB.
Brush border
CF. Circular folds
DG. Duodenal (Brunner’s glands)
GC. Goblet cells
L.
Lacteal
MALT. Mucosa-associated lymphoid
tissue
MV.
Microvilli
PC.
Paneth cells
V.
Villi
_______ a. Fingerlike projections up to 1 mm high ________f. Lymphatic nodules within the
that give the intestinal lining a velvety
mucous membrane of the small
appearance and increase absorptive
intestine
surface
________g. Fuzzy line marking the tips of
_______b. Microscopic fingerlike projections (200
microvilli; site of intestinal
2
Million per mm ) of plasma membrane
digestive enzymes
_______c. Mucosal ridges (about 10 mm high) that ________h. Lymphatic capillary found
increase intestinal surface area and cause
within each villus
chyme to move in a spiral pattern
________i. Cells at the base of villi that
_______d. Clusters of lymphatic follicles located
that control level of microbes
primarily in the wall of the ileum
________j. Secrete mucus
_______e. Submucosal glands that secret protecttive alkaline fluids
27. Name eight brush border enzymes.
These enzymes function primarily (in the intestinal lumen? at the brush border?).
Decscribe the action of one of these enzymes, a-dextrinase. (Hint: see page 926.)
28.
Contrast types of movements in the small intestine by writing MMC for migrating
mobility complex and S for segmentation next to related descriptions.
________ a. Peristalsis; “pushes” chyme along
________b. Mixing (not pushing) movements as chyme sloshes back and forth
________c.
Movements that occur about 8 to 12 times a minute
________d. Duration of a typical movement is 1.5-2 hours
________e. Movements that are strongest in parts of the small intestine with large volumes
29. Write the main steps in the digestion of each of the three major food types.
a. Carbohydrates
Polysaccharides
_______________________
monosaccharides
such as glucose, fructose, or galactose
b. Proteins
Proteins
c. Lipids
Neutral fats
_______________________
emulsified fats
__________________________
________________________________
30. A clinical correlation. Persons with lactose intolerance lack the enzyme
________________, which is necessary for digestion of lactose found in foods
such as, ____________________. Write a rationale for the usual symptoms of this condition.
Name the relatively simple test that can help to diagnose lactose intolerance.
______________________________________
31. For extra review of roles of GI organs in digestion, identify which chemicals in the
list in the box are made by each of the following organs. Write one answer on each
line provided.
ALB.
Albumin
LIP.
Lipase
AMY.
B.
CHOL.
DA.
ELAS.
ENT.
FP.
HCL.
IF.
Amylase
Bile
Cholesterol
Dipeptidases, aminopeptidases
Elastase
Enterokinase
Fibrinogen and prothrombin
Hydrochloride acid
Intrinsic factor
MUC. Mucus
MLSD. Maltase, lactase, sucrase,
a-dextrinase
NP.
Nucleosidases,phosphatases
P.
Pepsinogen
RD.
Ribonuclease,deoxyribonuclease
SB.
Sodium bicarbonate
TCP. Trypsinogen, chymotrypsinogen,
procarboxypeptidase
a. Salivary glands and tongue: _______ _______ ________
b. Pharynx and esophagus: _______
c. Stomach : _______ ________ ________ _______ __________
d. Pancreas: ________ ________ ________ _________ _________ _________
e. Small intestine: ________ _________ _________ ________ _________
f.
Liver: ________ __________ ____________ _______
g. Large intestine: _______
Secretions involved with digestion, select names of secretions above and write next to related
descriptions below.
________a. Activates pepsinogen
________h . Digest DNA and RNA
________b. The active form of this enzyme starts ________i.
________c. Precursors to protein-digesting enzymes
________d. Helps to neutralize acidic contents
from the stomach
________e. Plasma proteins (two answers)
________f.
Starch-digesting enzymes secreted
by salivary glands and pancreas
________g. Intestinal enzymes that complete
Brush border enzymes that
carry out digestion on the
Surface of villi (three answers)
________j. Complete digestion of proteins
into amino acids
________k. Activates the inactive precursor
To form trypsin.
________l. Most effective of this type of
fat-digesting enzyme is produced by
the pancreas
________m. Emulsifies fats before they can
carbohydrate breakdown, resulting
in simple sugars
be digested effectively; also help
with absorption of fats. (See E10d
below.)
32. Describe the absorption of end products of digestion on this exercise. (Hint: refer to
text Figure 24.20.)
a. Almost all absorption takes place in the (large? Small?) intestine. Absorption is a twostep process. Products of digestion must first be absorbed into (blood or lymph capillaries? epithelial cells lining the intestine?) and then be transported into (blood or lymph capillaries? epithelial cells lining the intestine?).
b. Glucose and some amino acids move across the brush border into epithelial cells
lining the intestine by (primary? secondary?) active transport coupled with active
transport ______. Fructose enters epithelial cells by (diffusion? Facilitated
diffusion?). All simple sugars then cross the basolateral surface of epithelium to enter
capillaries by the process of ________________________.
c. Simple sugars, amino acids, and short-chain fatty acids are absorbed into (blood?
lymph?) capillaries located in __________________in the intestinal wall. These
vessels lead to the _________________vein and then to the ____________________
for storage or metablolism.
d. Long-chain fatty acids and monoglycerides first combine with __________________
salts to form (micelles?chylomicrons?) This enables fatty acids and monoglycerides to
enter epithelial cells in the intestinal lining and soon enter lacteals leading to the
(portal vein? thoracic duct?). Most bile salts are ultimately (eliminated in feces? recycled to
the liver?). This cycle is known as __________________circulation.
e. Aggregates of fats coated with ______________________are known as chylomicrons.
After traveling through lymph and blood, chylomicrons reach hepatocytes in the
______________________ or are stored in __________________where triglycerides are
reformed.
f.
About _______liters (or ______quarts) of fluids are ingested or secreted into the
GI tract each day. OF this fluid, about _______liters come from ingested food and
about ________liters derive from GI secretions. All but about 1 liter of the 9 liters is
reabsorbed by (facilitated diffusion?osmosis? ) into blood capillaries in the walls of the
(small? large?) intestine. Several hundred milliliters of fluid are also reabsorbed each
day into the (small? large?) intestine.
g. Normally about ________ mL of fluid exits each day in feces. When inadequate water
reabsorption occurs, as in (constipation? diarrhea?), then ________________such
as NA+ and Cl- are also lost.
33. The Big Picture: Looking Ahead. Refer to Table 25.6 on page 984 in the text, and
answer these questions.
a. Which vitamins are absorbed with the help of bile? (Water-soluble? Fat-soluble?) Circle
the fat-soluble vitamins: A B12 C D E K
b. Inadequate bile production or obstruction of bile pathways may lead to signs or
symptoms related to deficiencies of fat-soluble vitamins. List several.
34. Explain the following about alcohol absorption.
a. Why it is a good idea to eat some fatty foods with alcohol.
b. Whether women or men are more likely to develop higher blood alcohol level after
consumption of the same amount of alcohol. Explain.
35. The large intestine is so named based on its (diameter? Length) compared to that of
the small intestine. The total length of the large intestine is about ___m(___ft.)
More than 90% of its length consists of the part known as the ______________.
36. Arrange the parts of the large intestine listed in the box in correct sequence in the
pathway of wastes
AnC.
AsC.
C..
DC.
Anal canal
Ascending colon
Cecum
Descending colon
R.
SC.
SF.
TC.
Rectum
Sigmoid colon
Splenic flexure
Transverse colon
________
_________
________
________
__________
________
________
________
_________
37. Contrast different portions of the GI tract by identifying structures of functions associated with each. Use these answers.
LI.
Large intestine
SI. Small intestine
______a. Has thickened bands of longitudinal
______b. Pouches known as haustra give this
structure a puckered appearance
______c. Its fat-filled peritoneal attachments are
known as epiploic appendages
______d. Bacteria here decompose bilirubin to
stercobilin, which gives feces its
brown color
______e. Has rugae
Sto. Stomach
_______ f. Has villi and microvilli
_______g. (Vermiform) appendix is
attached to the cecum here
_______h. Diverticuli are outpouchings
where the muscalaris here
has weakened
_______i. Polyps that grow here can be
observed by colonoscopy.
_______j. Ileocecal valve is located
here (two answers)
38. Contrast terms in each pair:
a. Gastroileal reflex/gastrocoloc reflex
b. Haustral churning/mass peristalsis
c. Diarrhea/constipation
39. Complete this activity describing chemicals associated with digestive wastes (feces).
a. Flatus (gas) in the colon due to the gases _________________________>
_________________________________: these are products of bacterial
fermentation of (carbohydrates? proteins? fats?).
b. Odors due to the chemicals ______________________and _____________:these
are products of bacterial breakdown of (carbohydrates? proteins and amino acids? fats?).
c. Brown color due to the chemical _________________, a product of bacterial
decomposition of ______________________.
d. Hidden (or ________________) blood can be detected in feces; its presence can be
used in diagnosing ____________________.
40. Feces are formed by the time chyme has remained in the large intestine for about
________ hours. List the chemical components of feces.
41. Describe the process of defecation. Include these terms: stretch receptors,
parasympathetic nerves, rectal muscles, sphincters, diaphragm, and abdominal muscles.
42. Physiology of digestion: phases and regulation (pages 937-939)
Answer these questions about events in the process of digestion.
a. Name the three overlapping phases of digestive activities: _______________________
___________________________ and _________________. In which of these phases
do salivary secretions begin as you smell or taste food? _________________________
Which cranial nerves stimulate your salivary glands? ______________________ and
____________________________. (Hint: see Checkpoint B9 earlier in this chapter.)
b. Passage of food into the stomach triggers the __________________________phase of
Digestion. Two types of receptors are involved, namely, _______________________
Receptors and ___________________________-receptors. Stretch receptors respond to
________________________. In the stomach, chemoreceptors are activated by
______-crease of gastric pH as proteins entering the stomach buffer some of the HCl
there.
c. The two main activities during the gastric phase of digestion are peristalsis that is
stimulated by (sympathetic? parasympathetic?)nerves, specifically, thos in cranial nerve
_______, and release of the hormone ___________________that stimulates gastric
secretions.
d. Gastrin is released from G cells in the (esophagus?stomach? small intestine?). Two factors
that trigger release of gastrin are distension of the stomach and release of the
parasympathetic neurotransmitter (acetylcholine? norepinephrine?)from vagus nerves.
List two other factors that trigger release of gastrin.
e. Gastrin travels through the blood to all parts of the body and finally exerts into action
upon two types of target cells within the stomach wall. Name them:
_____________________. And ______________. How do action of gastrins
here facilitate digestion?
f.
In addition, gastrin (stimulates? inhibits?)contraction of the lower esophageal sphincter.
State an effect of this action.
g. Gastrin causes (contraction?relaxation?) of the sphincter. How does this action
affect digestion?
h. What event triggers the third and final phase of digestion? ________________________>
This phase is known as the ________________________ phase of digestion. Circle
correct answers that summarize this phase:
(h1) Gastric motility is (stimulated? Inhibited?) as (symphathetic?) parasympathetic?) nerves
predominate.
(h2) The pyloric sphincter (contracts? Relazes?). Movements of chyme from stomach to
Duodenum is (facilitated? Inhibited?).
(h3) Release of hormones from the intestinal wall (promote? inhibit?) further digestion
Of chyme. (See Checkpoints G2 and G3.)
G2.
Answer these questions about hormonal control of digestion. Fill in blanks with the
name of the hormone in the box that fits each description below.
CCK. Cholecystokinin
G. Gastrin
S. Secretin
______a. Release of this hormone is stimulated
by entrance of acidic chyme into the
duodenum.
______b. Stimulates production of pancreatic _____f. This hormone causes a person to “feel
fluid containing high levels of
full.”
Bicarbonate
______c. Release of this hormone is stimulated _____g. Release of this hormone is inhibited by
by entreance into the duodenum of
the hormone somatostatin.
of chyme rich in partially digested
proteins and fats.
______d. Stimulates pancreas to produce
secretions concentrated with lipase
proteases, and amylase
_____h. Incresases gastric activity (secretion,
motility)
______e. Causes contraction of gallbladder and ______i. Inhibits gastric secretions.
relaxation of the sphincter of the
hepatopancreatic ampulla so that bile ______j. Promote growth and maintenance of
enters duodenum
pancreas; also enhance effects of each
other (two answers)
CHAPTER 25
1. Complete the exercise about the reaction shown below.
(1)
Glucose
Glycogen
(2)
a. You learned earlier that excess glucose may be stored as glycogen. In other words,
glycogen of large branching chains of_____________________________. Name the
process of glycogen formation by labeling (1) in the chemical reaction.
b.. Between meals, when glucose is needed, glycogen can be broken down again to
release glucose. Label (2) above with the name of this process. [Note that a number
of steps are actually involved in both processes (1) and (2).]
a. Which of these two reactions is anabolic? _________________________
d. Where is most (75%) of glycogen in the body stored? ________________________
e. Identify a hormone that stimulates reaction (1). Write its name on the upper arrow
in the reaction above. AS more glucose is stored in the form of glycogen, the blood
level of glucose __________-creases. Now write below the lower arrow the names of two
hormones that stimulate glycogenolysis.
f.
In order for glycogenolysis to occur, a __________________group must be added to
glucose as it breaks away from glycogen. The enzyme catalyzing this reaction is
known as ____________________. Does the reverse reaction [shown in (2)] require
phosphorylation also? (Yes? No?)
2. Define gluconeogenesis and briefly discuss how it is related to other metabolic
reactions.
Name three hormones that stimulate gluconeogenesis.
3. Circle the processes at left and the hormones at right that lead to increased blood glucose
level (hyperglycemia).
Processes
Glycogenesis
Hormones
Insulin
Glycogenolysis
Glycolysis
Gluconeogenesis
Glucagon
Epinephrine
Cortisol
Thyroid hormone
Growth hormone
4 Most lipids are (polar? Nonpolar?), and therefore are hydro-(phylic? Phobic?). Check
your understanding of mechanism that make lipids water-soluble in blood by completing
this Checkpoint. Match answers from the box with related descriptions below.
A.
B.
HDLs.
Apoproteins
LDLs.
Low-density lipoproteins
Chylomicrons
VLDLs. Very low-density lipoproteins
High-density lipoproteins
______a. Designated by letters A,B,C,D, and E,
these proteins surround an inner core
of lipids within lipoproteins. These
chemicals can serve as “docking”
molecules that bind to receptors on
body cells.
cholesterol(which has low density). These
carry 75% of total blood cholesterol, and
are called the “bad” cholesterol
because excessive numbers of these
from atherosclerotic plaques in arteries.
______b.Named so because these molecules are ____d. Made largely (50%) of triglycerides,
composed mainly (close to 50%) of
their numbers increase with a high-fat
protein which has high density; prediet, leading ultimately to high blood
vent accumulation of cholesterol in
levels of LDLs.
Blood, so called the “good” cholesterol.
______c. Named so because these molecules are ____e. Formed almost exclusively (85%) of
composed of small amounts (25%) of
triglycerides derived from dietary fats,
protein but large amounts (50%0 of
they travel through lymphatic pathways
in the GI tract, and then into blood to
reach adipose or muscle tissue.