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Endocrine pancreas is an important endocrine organ as it secretes insulin blood pressure dizziness buy discount vasotec line, the only antidiabetogenic and antiketogenic hormone in the body blood pressure medication effects on sperm buy vasotec 5mg with amex. Importance of insulin-glucagon ratio: Pancreas secre tes another three hormones: glucagon heart attack 913 cheap 5mg vasotec overnight delivery, somatostatin and pancreatic polypeptide. Insulin is anabolic and promotes storage of nutrients (glucose, fatty acids and amino acids), whereas glucagon is catabolic and promotes mobilization of nutrients from their storage depots into the blood stream. Insulin and glucagon, by their opposing effects, control metabolism of carbohydrate, fat and protein to ensure energy supply during basal and active states. As insulin and glucagon have reciprocal physiological actions, the ratio of insulin to glucagon is more important than their individual concentrations in the regulation of intermediary metabolisms. They acknowledged and shared the prize with Charles H Best and James Bertram Collip, who had also worked with them. Usually, the conditions that stimulate secretion of one inhibit the secretion of other, because when one is essential for the body the other is usually not. Deficiency of insulin produces diabetes mellitus and its excess results in hypoglycemia. On the contrary, deficiency of glucagon produces hypoglycemia and its excess worsens diabetes mellitus. Packets of insulin are present in the form of secretory granules in the cell cytoplasm that measure about 0. Each packet of insulin is present in a vesicle and a clear space or halo exists between the wall of the vesicle and the packet. A developed system of microtubules and microfila ments are present in the cytoplasm that facilitates the exocytosis of vesicles. He made his first major contribution before he finished his medical school, with the discovery of epidermal nonpigmentary dendritic cells that are derived from the bone marrow and play a role in cell-mediated immunity. He described different types of cells in the pancreatic islets, that later became known as the islets of Langerhans. Note, A and B chains contains 21 and 30 amino acids respectively, and they are connected by disulphide bridges. Fate of islet hormones: the hormones secreted from islets are released into the pancreatic vein from where they are transported into the portal vein and from there they enter general circulation: 1. This special arrangement provides liver the first and maximum access to the proper concentrations of islet hormones as they are secreted, and then to other this sues in the body. Thus, liver being the primary site of substrate metabo lism avails maximum advantage of actions of islet hor mones, especially of insulin and glucagon. They receive about 10% of the total pancreatic blood supply though they constitute only about 1% of the pancreatic tissue. There is a portal arrangement of the blood vessels of pancreas, which allows hormones secreted from a cell group to reach the other islet cells. This arrangement is essential for paracrine regulation of hormone secretion from the islet cells. Usually, stimulation of b adrenergic receptor increases insulin secretion and a adrenergic receptor decreases it. Insulin is synthesized as monomers that immediately form the crystalline hexamer unit within two zinc atoms (Application Box 60.
Structure Unlike skeletal muscle fibers that cannot multiply once differentiation is complete around birth hypertension meds purchase vasotec in united states online, the smooth muscles are capable of dividing throughout the life of the individual blood pressure medication side effects cough order discount vasotec online. The small size of cells is an advantage for smooth muscle for precisely controlling visceral functions blood pressure chart bottom number discount vasotec 5mg overnight delivery. With the help of the stroma and the gap junctions, the mechanical as well as electrical activities of the cells are coupled, so that contraction occurs in an integrated and coordinated fashion. Innervations of Smooth Muscles Smooth muscles exhibit a spontaneous, slow wave rhythm. Branches of the autonomic nervous system innervate the smooth muscles, most of which are supplied by sympathetic as well as parasympathetic fibers: 1. In response to a nerve action potential, neurotransmitters are secreted from the numerous varicosities present along the axon, and then diffuse to the adjacent tissues. Since the release of neurotransmitters is not confined to the axon terminals, highly specialized neuromuscular junctions are absent in smooth muscles. Unlike the skeletal muscle, the receptors for neurotransmitters are not gathered at the neuromuscular junctions, they are scattered along the postsynaptic membrane. Small, electron-dense, dark areas called dense bodies are present throughout the cytoplasm, as well as attached to the cell membrane. Those associated with the cell membrane are often called membrane-associated dense bodies or patches, or focal adhesions. Thin Filaments In smooth muscles, thin filaments are composed of actin and tropomyosin molecules but troponin protein complex is absent. Electrical Properties Unlike the skeletal muscle where the stimulus arrives in the form of an all-or-none action potential, in smooth muscles the contraction may or may not be preceded by an action potential. The smooth muscles react to a variety of stimuli, which may be neural (sympathetic or parasympathetic); hormonal (circulating catecholamines, serotonin, histamine, angiotensin, vasopressin, oxytocin, estrogen, and progesterone); chemical (hypoxia, hypercapnia, and H+); cold; and stretch. The transmission of nerve impulse in sympathetic and parasympathetic nerves supplying visceral muscles and properties of visceral muscle were studied in detail by Dale. Scientists contributed Organization of Filaments the relationship between the thick and thin filaments is poor and they are less well organized. In cross sections through the overlap region of the filaments, the geometric pattern as found in striated muscles are not seen. Because of the absence of a highly organized arrangement of contractile apparatus, the length tension relationship in the smooth muscles is very much flexible. During the sliding-filament mechanism, the gap between the actin filaments reduces and the shortening force is transmitted through the dense bodies to the plasma membrane producing contraction of the muscle fiber. Organization of Muscle Fibers the smooth muscle fibers are organized in sheets and the cells are connected to adjacent cells by short strands of connective tissue. In addition, collagen and elastin fibers are embedded in a reticular connective tissue that traverses through the whole organ, connecting and holding the cells together. Most importantly, the cells are linked to each other by gap junctions, by which many cells are activated at a time by single action potential. Otto Loewi "for their discoveries relating to transmission of chemical nerve impulses, especially in sympathetic and parasympathetic nerves". Their pioneering works were in the field of transmission of nerve impulses, especially its chemical basis. Dale had also studied the details of smooth muscle functions Chapter 29: Smooth Muscle and Cardiac Muscle 279 Characteristic Electrical Activities 1. When the stimulus is excitatory, the membrane potential decreases and it increases in response to an inhibitory stimulus.
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Excess gas production results in borborygmi (gurgling sounds in the intestine) and abdominal distention blood pressure normal range 5mg vasotec with visa. Sucrase-Isomaltase Deficiency Deficiency of sucrase and isomaltase in the brush border of enterocytes is an autosomal recessive disease heart attack by one direction purchase vasotec 5 mg mastercard. In this condition pulse pressure 14 cheap vasotec 10mg line, ingestion of glucose or galactose or starch produces diarrhea and flatulence. Oligosaccharidases activity is maximum in duodenum and upper jejunum and minimum toward the terminal part of ileum. Absorption of Carbohydrates the carbohydrate absorption is maximum in duodenum and jejunum, which progressively decreases toward the terminal part of ileum. The easily absorbable forms of carbohydrate are monosaccharides that are glucose, galactose, and fructose. The transport is greatly influenced by the concentration of Na+ in the intestinal lumen. The higher the concentration of Na+, the greater the degree of glucose absorption. The concentration of Na+ is less in the enterocytes, which is created by Na+K+ pump present on the basolateral membrane of the cells that pumps Na+ into the lateral intercellular space from the enterocytes in exchange for K+. Oral Sugar Tolerance Test In carbohydrate malabsorption diseases oral sugar tolerance test is performed to diagnose the disease. An oral dose of sugar (in question) is given to the patient following which the concentration of the sugar in patients, blood and stool is monitored. If the patient is intolerant to the sugar, the ingestion of sugar causes diarrhea and flatulence, the concentration of sugar in stool increases, but characteristically the sugar concentration fails to increase in the blood. Digestion and Absorption of Proteins the quality and quantity of dietary protein depend on the socioeconomic status and food habit of the individual. Chapter 51: Principles of Digestion and Absorption 423 Digestion of Proteins Digestion of protein starts in the stomach. In the duodenum and small intestine, the proteins are digested by proteases secreted in the pancreatic secretion. The enterokinase secreted from mucosal cells of duodenum and jejunum converts trypsinogen into trypsin, which then acts as an enzyme to convert other proteases. These enzymes hydrolyze the peptides produced by pancreatic proteases into oligopeptides and amino acids. However, deficiency of lingual and gastric lipase does not result in malabsorption of fat as pancreatic lipase is actually important for lipid digestion. Principal fat digestion starts in the duodenum by the pancreatic lipase, which hydrolyses 1 and 3 bonds of triglycerides that results in formation of free fatty acid and 2-monoglycerides (2-monoglycerols). Pancreatic lipase acts on lipids that have been emulsified (emulsification by bile acids). There is another lipase secreted from pancreas called as bile salt activated lipase, which also assists in lipid digestion. Absorption Lipids are absorbed by passive diffusion and carrier mediated transport. As soon as lipids enter the cell they are esterified, therefore a gradient is maintained for their entry into the cell.
For its central location in the brain blood pressure chart pdf download order 5 mg vasotec otc, hypo thalamus is closely connected with the limbic system blood pressure explanation buy vasotec 10 mg visa, autonomic nervous system and pituitary gland heart attack restaurant order generic vasotec. Therefore, hypothalamus is the main neural structure for the inte gration of visceral homeostatic mechanisms. Through the regulation of pituitary secretions, hypothalamus plays a master role in the control of many endocrine functions of the body. As the hormones secreted from hypothalamus (especially to posterior pituitary) are synthesized in hypo thalamic neurons, they are called as neurohormones. Scientists contributed Hypothalamus as an Endocrine Gland the hypothalamus plays an important role in the regula tion of endocrine functions. Through its connection with anterior pituitary gland, it controls: - thyroid functions (hypothalamo-pituitary-thyroid axis), - adrenocortical secretions (hypothalamo-pituitaryadrenocortical-axis), and - gonadal functions (hypothalamo-pituitary-gonadal axis). Via its influence on sympathetic output, hypothalamus controls secretions of adrenal medulla (hypothalamosympatho-adrenal-axis). Therefore, hypothalamus is apparently desig nated as the "master of endocrine orchestra". Integration with Neural Structures Anatomically and physiologically, hypothalamus is situ ated at the center of the brain, below the corpus callo sum and thalamus. Therefore, hypothalamus collects and integrates information from various parts of 454 Section 6: Endocrine Physiology. These neural inputs convey the information regarding alertness, application of nociceptive stimuli, sleepwakeful ness, changes in environment, emotion, visual, olfactory and gustatory sensations and so on. After gathering these infor mation, hypothalamus appropriately alters body functions partly through its influences on endocrine secretions and partly through its control on major neural outputs from brain like projections from brainstem cardiorespiratory centers, and autonomic and limbic outputs (Flowchart 54. Hypothalamus, via its endocrine influences also controls thirst, appetite, energy store, body fat composition, immu nity, behavior and visceral functions. Thus, hypothalamus through its extensive neuroendocrine connections, controls major body functions. Hence, diseases affecting hypotha lamic nuclei result in many pathological syndromes. Note, after receiving inputs from all these structures hypothala mus funnels these inputs to brainstem and pituitary for regulation of visceral functions. Hypothalamic Hormones Hypothalamic hormones are secreted from various nuclei of the brain. Hypothalamic hormones can be classified broadly into three categories: anterior pituitary regulating hormones, posterior pituitary hormones and other hormones. Limbic system, especially from amygdala, septum, olfactory bulb, and hippocampus. Anterior Pituitary Regulating Hormones Hypothalamic hormones that regulate anterior pituitary secretions are known as releasing or release inhibiting hormones as they stimulate or inhibit the release of various hormones from this part of the pituitary. The hormones are: Thyrotropin releasing hormone, gonadotropin releas ing hormone, corticotropin releasing hormone, growth hormone releasing and inhibiting hormones, and prolactin Chapter 54: Hypothalamus and Hypothalamopituitary Axis Flowchart 54. It stimulates prolactin synthesis and secretion from lactotrophs of anterior pituitary. Release Inhibiting Hormones Growth Hormone Inhibiting Hormone (Somatostatin) Somatostatin is a peptide having 14 amino acids. Y secretion in hypothalamus increases during feeding and decreases during cessation of feeding (satiety). Many neurotransmitters that stimulate food intake increase neuropeptide Y release and neurochemicals that inhibit feeding decrease neuropeptide Y release from hypothalamus. They are synthesized in supraoptic and paraventricular nuclei of hypothalamus and stored in posterior pituitary (for details, see below and refer the chapter on "posterior pituitary"). Applied Physiology Endocrine hypothalamic dysfunctions lead to abnormali ties of hypothalamoendocrine axes described above.