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THE ENTERIC NERVOUS SYSTEM COMPONENT LOCATED BETWEEN THE CIRCULAR AND LONGITUDINAL MUSCLE LAYERS OF THE LARGE INTESTINE
MYENTERIC PLEXUS
THE AREA OF THE LARGE INTESTINE THAT ABSORBS THE MAJORITY OF WATER IS WHAT?
THE ILEUM
THE PROCESS BY WHICH FECAL CONTENTS ENTERS THE RECTUM IS KNOWN AS WHAT?
MASS MOVEMENT
WHAT IS THE AVERAGE VOLUME OF URINE ELIMINATED EACH DAY?
1500 ML
WHICH SPHINCTER IS MADE OF SKELETAL MUSCLE AND IS UNDER VOLUNTARY CONTROL?
EXTERNAL
WHAT DOES A URINE SPECIFIC GRAVITY OF 1:030 INDICATE?
CONCENTRATED URINE
WHICH OF THE FOLLOWING DIAGNOSTIC CRITERIA IS CONSISTENT WITH THE DIAGNOSIS OF ENCOPRESIS?
AGE OF 5 YEARS
WHAT DOES A GFR OF 95 ML/MIN INDICATE?
NORMAL RENAL FUNCTION
WHICH OF THE FOLLOWING INCREASES THE RISK FOR RENAL CALCULI?
DEHYDRATION
WHY DO AGE SPOTS FORM AS INDIVIDUALS AGE?
MELANOCYTES IN THE TRANSITIONAL LAYER OF SKIN, BETWEEN THE EPIDERMIS AND DERMIS, PRODUCE THE BROWN BLACK PIGMENT MELANIN.  PROLIFERATION OF MELANOCYTES WITH AGING PROMOTES THE FORMATION OF CONCENTRATED CLUSTERS THAT APPEAR ON THE SKIN SURFACE, ESPEIALLY AFTER PROLONGED EXPOSURE TO SUNGLIGHT.
HOW CAN THE ELDERLY PROTECT THEMSELVES FROM INFECTION?
PNEUMONIA AND INFLUENZA ARE AMONG THE TOP 10 CAUSES OF DEATH IN OLDER ADULTS. IMMUNIZATION AGAINST PNEUMONIA AND FLU CAN REDUCE BOTH MORBIDY AND MORTALITY AMONG THE ELDERLY
WHAT TYPES OF PHYSICAL ACTIVITIES ARE CONSIDERED WEIGHT BEARING? WHICH ARE NOT?
WEIGHT BEARING EXERCISES ARE ACTIVITIES THAT ARE USUALLY DONE WHILE STANDING.  THESE EXERCISES WORK AGAINST GRAVITY, STRENGHTENING BONES AND MUSCLES.   EXAMPLES OF WEIGHT BEARING EXERCISES INCLUDE WALKING, JOGGING, HIKING, MOWING THE LOWN, SKIING, SKATING, KARATE, BOWLING, TENNIS, SOCCER, BASEBALL, BASKETBALL, FOOTBALL, HOCKEY, DANCING STEP AEROBICS AND STAIRCLIMBING. WEIGHT TRAININ GWITH MACHINES AND FREE WEIGHTS ARE ALSO BONE BUILDING WEIGHT BEARING ACTIVITIES, AKA RESISTANCE EXERCISES. ACTIVITIES LIKE SWIMMING ARE NOT CONSIDERED WEIGHT BEARING SINCE WATER REDUCES THE EFFECTS OF GRAVITY
WHY WOULD METASTATIC DISEASE INCREASE CALCIUM LEVELS IN THE BLOOD?
CANCER OFTEN INCLUDES BONE AS A SITE FOR METASTASIS.  THE LYTIC EFFECTS OF THE CANCER CAUSES BONE RESORPTION AND DEMINERALIZATION.  INCREASING LEVELS OF CALCIUM ENTER THE BLOOD, INCREASING THE RISK FOR HYPERCALCEMIA.  HYPERCALCEMIA CAN LEAD TO ORGAN FAILURE, COMA, AND DEATH.
WHAT INFLUENCE DOES GEOGRAPHIC LOCATION HAVE ON VITAMIN D PRODUCTION?
SUN EXPOSURE IS PERHAPS THE MOST IMPORTANT SOURCE OF VITAMIN D BECAUSE EXPOSURE TO SUNLIGHT PROVIDES MOST HUMANS WITH THEIR VITAMIN D REQUIREMENT.  UV RAYS FROM THE SUN TRIGGER VITAMIN D SYNTHESIS IN SKIN.  SEASON, GEOGRAPHIC LATITUDE, TIME OF THE DAY, CLOUD COVER, SMOT AND SUNSCREEN AFFECT UV RAY EXPOSURE AND VITAMIN D SYNTHESIS
WHY ARE INDIVIDUALS ON ANTIPSYCHOTIC MEDICATIONS AT RISK FOR THE DEVELOPMENT OF PARKINSONIAN-LIKE SYMPTOMS?
THE MECHANISM OF ACTION OF ANTIPSYCHOTIC MEDICATIONS IS BLOCKADE OF D2 DOPAMINE RECEPTORS.  WHEN THE D2 RECEPTORS OF THE NIGROSTRIATAL PATHWAY (PART OF THE EXTRAPYRAMIDAL SYSTEM) ARE BLOCKED, IT PRODUCES MOVEMENT DISORDERS MUCH LIKE THOSE IN PARKINSON DISEASE, INCLUDING HYPERKINETIC MOVEMENT/TARDIVE DYSKINESIA.  ANTIPSYCHOTIC DRUGS CAN INDUCE EXTRAPYRAMIDAL SIDE EFFECTS OF DOPAMINE DEFICIENCY, INCLUDING MUSCLE STIFFNESS, MILD TREMORS, AND INCREASED SALIVATION
GENETIC INFLUENCES AS THE MAJOR DETERMINANTS OF AGING ARE THE FOCUS OF WHICH OF THE FOLLOWING THEORIES?
DEVELOPMENTAL THEORY
TYPICAL CHANGES IN TOTAL BODY WATER IN THE ELDERLY INCLUDE WHAT?
DECREASED TOTAL BODY WATER DUE TO DECREASE IN MUSCLE MASS
IMMUNE SENESCENCE IS CHARACTERIZED BY WHAT?
ENHANCED AUTOIMMUNE RESPONSE
AGE RELATED CHANGES AFFECTING NEUROLOGIC FUNCTION INCLUDE WHAT?
DECREASED NUMBER OF NEURONS
AN IMBALANCE IN BONE REMODELING CHARACTERISTIC OF OSTEOPOROSIS IS CAUSED BY WHAT?
INCREASED BONE RESORPTION DUE TO INCREASED ACTIVITY OF OSTEOCLASTS
AGE RELATED CHANGES CONTRIBUTING TO IMPAIRED HEALING INCLUDE WHAT?
ATROPHIED CAPILLARY SUPPORT TO DERMIS
OSTEOPOROSIS IS THE RESULT OF AN IMBALANCE FAVORING INCREASED?
OSTECLASTIC ACTIVITY
WHAT IS PARKINSON DISEASE CHARACTERIZED BY?
LEWY BODIES
WHICH ONE OF THE FOLLOWING NEUROTRANSMITTERS IS DEFICIENT IN PARKINSON DISEASE?
DOPAMINE
MEMORY LOSS IN ALZHEIMER DISEASE RESULTS FROM IMPAIRED NEURAL CONDUCTION IN THE ??
HIPPOCAMPUS
  What are the major differences and similarities between the actions of the hypothalamus on the anterior versus the posterior pituitary gland? Why would this difference matter? What is an effective way to remember this difference?
  Major differences are that hormones travel on axons versus the portal vascular system and hormones are made directly in hypothalamus and released directly (unchanged) from the posterior pituitary whereas anterior pituitary can have many steps before getting to the target gland. The difference is important in the pathway, number of steps, target organs, and different hormones needed to induce a response. Effective ways to remember this will vary.  
  How do you usually respond to stress? Think about the last time you were in a haunted house or were really scared. How did your body respond? How does this correlate to the neuroendocrine response described in this section?
  Answers will vary. Should indicate catecholamines induce a neurologic response to receptive organs. For example, blood flow is shunted to vital organs such as the heart, brain, and lungs. As a result, heart rate increases, blood pressure increases, respiratory rate increases, and the person becomes much more alert. The skeletal muscles also become activated to allow a rapid escape. Blood is shunted away from the skin and stomach. So, the person will look pale or ashen and digestion is decreased.
  What effect do you think that drinking alcohol has on ADH levels?
  Alcohol decreases ADH levels causing the inability to retain fluids in the body. Diuresis and dehydration then occurs.  
  What would happen if you had a diet that did not include iodized salt?
  The follicles utilize iodide from dietary intake of iodized salt, combine this with tyrosine, an amino acid, and secrete this combination into the colloid portion of the follicle to form the thyroid hormones. Without iodized salt, you would be unable to produce the thyroid hormones.  
  Would loss of the adrenal cortex or the adrenal medulla be more problematic?
  Adrenal cortex. The adrenal medulla actions are also accomplished by the sympathetic nervous system, so the absence of the adrenal medulla is not life threatening.
  You are on a 1-week hiking trip and one of your friends forgets her glucocorticoid medication that she takes for severe asthma. Should she go back and get the medication or is she OK without it for that week?
  Yes. She absolutely needs to go back if she has been taking this medication for over 1 week. After a prolonged period of time, exogenous glucocorticoids result in adrenal atrophy and decreased cortisol production. This medication is tapered (gradually withdrawn) to allow stimulation of the adrenal cortex to increase endogenous production of cortisol. If she suddenly stops taking the medication she will possibly not have adequate cortisol and perhaps other adrenal hormones to survive.
  Map out how the negative feedback loop is impacted by an ACTH-dependent hypercortisolism versus a non–ACTH-dependent hypercortisolism
  The mechanism of excess cortisol can vary. If this is ACTH-dependent, hypercortisolism will not decrease ACTH production (the ectopic or excess production is independent of cortisol levels). If this is not ACTH-dependent, then ACTH levels should decrease in response to high cortisol levels but the cortisol will remain elevated.
  How would a deficiency of cortisol present in terms of clinical manifestations?
  Hypoglycemia, anorexia, nausea, vomiting, fatigue, weakness, weight loss, and poor stress response.
  Based on the sensations involved, what other nerves do you think are involved in the somatosensory system?
  The sensations of touch, temperature, pain, and body position are processed in the brain. These sensations promote responses, often in the form of reflexes, designed to provide a motor action to prevent/reduce injury. These responses involve the activation of motor neurons.  
  Have you ever banged your head and began rubbing it in response to pain? How might this action decrease the pain sensation?
  The rubbing action may decrease pain by stimulating the “closing of the gate,” inhibiting transmission of ascending pain impulses.
  Why is it necessary to control the amount of light entering the eye?
  The amount of light necessary for sight is regulated by pupil constriction to prevent damage and loss of acuity from too much light entering the eye and coming in contact with the retina. Dilation of the pupil in conditions of low light or darkness allows maximal light entry for sight, not otherwise possible.  
  Why does a vitamin A deficiency cause the development of night blindness?
  Inadequate levels of retinene are unavailable to combine with opsin to form rhodopsin, minimizing the ability of rods to transmit impulses resulting in decreased night vision.  
  What is the most likely explanation for the runny nose that occurs during crying?
  Channels involved in the secretion/release of tears promote movement of fluid from the lacrimal sac into the nasolacrimal ducts, which are excreted through the nose.
  What are the ways that we can voluntarily manipulate pressure changes in the ear?
  We are aware of the eustachian tube at work when we feel air pressure changing in our ears as we yawn, chew, or swallow.
  What are the risks to ear structures when the ears are irrigated?
  There is the chance of pain due to force of irrigation, temperature of irrigation solution, or mechanical injury to ear structures. Rupture of the tympanic membrane is also a risk.  
  What strategies can a person use to avoid barotrauma caused by air travel during an upper respiratory infection?
  Autoinflation measures (yawning, swallowing, and chewing gum), decongestants (intranasal or systemic), myringotomy for severe, recurrent problems may be helpful in the avoidance of barotrauma.  
  Why are anti-inflammatory medications preferred over narcotic analgesics in the treatment of fibromyalgia?
  nflammatory processes and release of inflammatory mediators may be responsible for the pain associated with fibromyalgia. Anti-inflammatory medications may be helpful in blocking the production of the byproducts of the cyclooxygenase pathway, decreasing pain. Narcotic analgesics may complicate the treatment of associated psychiatric disorders and could contribute to the development of addiction and/or tolerance due to the chronic nature of the condition.
  What is the most likely mechanism for the prevention of migraines with antiseizure medications?
  Antiseizure medications work by inhibiting neurotransmitter conduction, usually related to actions of the neurotransmitter GABA, potentially slowing impulses perceived as pain.  
  Why do people with macular degeneration have difficulty with night vision and color differentiation?
  Degeneration of the macular portion of the retina includes loss of photoreceptors, rods, and cones responsible for night vision and color differentiation.  
  What are the implications for older Americans who develop glaucoma? What lifestyle changes can they expect to experience?
  Progressive loss of vision reduces an individual’s ability to care for themselves. Activities of daily living may require assistance, increasing dependence. Loss of visual acuity may result in the inability to drive, promoting dependence. Inability to read or see the television may reduce quality of life.
  What other tissue types can be affected by decreased trophic signals of ovarian hormones? What other tissue types can be similarly affected?
  Any cell dependent on trophic signals will undergo atrophy if the frequency or intensity of the signal is decreased. These cells may include thyroid, uterine, ovarian, adrenal, and pituitary. Lack of demand can also stimulate the development of atrophy. Tissues at risk for atrophy due to decrease in demand include muscle, renal and bone.  
  How are defense mechanisms and the body protections affected in the person who is a mouth breather?
  The mouth may be used for ventilation when the nose is obstructed or in cases of an increased oxygen demand, such as vigorous exercise. The filtration properties and humidification are not as efficient; inspired air is more likely to contain foreign particles and excessive dryness than that inspired through the nose.
  How does your breathing change when you exercise? Why do you think this happens?
  Breathing rate and depth increase during exercise. In the process of exercise, cell metabolism increases dramatically. This produces excess acids that must be removed from the body to prevent acidosis. One mechanism for the removal of these acids is to discharge CO2 (an acidic gas) from the body through the lungs.
  What happens to your oxygen-attracting ability if you eat a diet low in iron?
  Iron is the magnet that has a high affinity for oxygen and pulls the oxygen onto the hemoglobin molecule. Theoretically, the body in iron-deficiency has a reduced oxygen affinity on the hemoglobin molecule. Since hemoglobin is the most efficient carrier of oxygen, lower oxygen on hemoglobin could mean lower oxygen to cells and tissues throughout the body.  
  What happens to oxygen and carbon dioxide transport if there is a lack of RBCs, as in severe hemorrhaging?
  RBCs are major carriers of both oxygen and carbon dioxide. Reduction in overall RBC concentration will result in a reduced carrying capacity of both gases. Although small concentrations of both gases are found dissolved in the plasma, effective transport to all tissues of the body is reduced without RBCs.
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