The Effect of Cystic Fibrosis on the Process of Digestion and the Processes of Glycolysis - Assignment Example

Question 1 People with cystic fibrosis produce abnormally thick mucous that obstructs ducts. One of the major organs affected is the pancreas. What would be the effect of this disorder on the process of digestion? ---- Cystic fibrosis or as most commonly known as CF is very injurous disease to the digestive system. It is a fact that those people who are having cystic fibrosis are tend to produce abnormally thick mucous. These are very much prone in creating obstructions in the ducts. One of the major organs that get severely affected in this process is the pancreas. The state of thickened secretions may cause liver problems. This may lead to worsen situations in patients. The bile that gets secreted by the liver in order to aid in digestion has got all the chances of getting blocked. This blockage in the bile ducts may lead to liver damage and hampers the whole digestive mechanism in the body. As this gets continued the chances of getting affected by cirrhosis gets higher. In this state of cirrhosis, liver fails to rid the blood of toxins. It simultaneously gets weaker in making important proteins which are responsible for blood clotting. The failure of liver leads to lots of problems in the digestive system. As thick mucus production, under every circumstance results in frequent lung infections, it results in a severe secretion diminution of pancreatic enzymes. As the pancreas develops cysts and becomes scarred; poor digestion and absorption of foods gets distracted. This directly hampers in the growth and there is a compulsory possibility for fatty diarrhea. Sometimes diarrhea may not be apparent, but hinders the child growth. The deficiency in fat-soluble vitamins is also one of the major troubles that the body can face during this process. The consequences are such that the male patient can be infertile due to congenital bilateral absence that is in the vas deferens. The symptoms of CF also appear in childhood. This gets detected by the presence of Meconium ileus in a newborn, another very significant digestive disorder. It starts with intestinal obstruction due to fetal stool (meconium). Williams SG, Westaby D, Tanner MS, Mowat AP (1992, 877-92) finds that the blockage is due to meconium gets abnormally thick in infants with CF. With enemas, the thick stool can be loosening up. There are many more intestinal obstruction causes due to CF. Cystic fibrosis usually affects the digestive system that includes the organs like, stomach, intestines, colon, and other organs. It very directly affects the gastrointestinal tract leading to pancreatic disease. Colombo C, Russo MC, Zazzeron L, Romano G. in 'Liver disease in cystic fibrosis' comes up withthe idea that the risk of developing rectal prolapse is also a common risk that persists in the CF patients. The reason is the large volumes of stool. This is also in response to the combination of it with high abdominal pressure that causes due to severe chronic coughing from lung disease that exists. The solution lies in the situation when there is an improvement in the pancreatic dysfunction. As it treated with oral pancreatic enzyme therapy, it simultaneously leads to lower volume of stools and decreases the affects of rectal prolapse. Gallstones and gallstone complications are the common disorders in the digestive system that patients with CF suffer in most of the instances. These are the most common disorder detections that have been discovered as the affects of CF in the digestive system. Question 2 You are working in the accident and emergency department. A patient has been admitted suffering trauma to the thigh and is haemorrhaging severely. Describe the role of the renin-angiotensin system in try to maintain blood volume and blood pressure. ---- The renin-angiotensin system that is also called RAS or the renin-angiotensin-aldosterone system, that is RAAS is nothing but a pure a hormone system. Its functionality lies in the fact of regulating blood pressure and water or fluid balance in the body. This is the reason that for a patient with trauma to the thigh and is haemorrhaging, due to accidents needs tremendous support of renin-angiotensin system. After such injuries it is obvious that the blood pressure fluctuates. As it gets low, the kidneys secrete rennin for the instant production of angiotensin. It is the role of angiotensin that is vital for the cause of blood vessels to constrict resulting in increased blood pressure. High Blood Pressure: Heart and Blood Vessel Disorders states that angiotensin, under the renin-angiotensin system is also very important to stimulate the secretion of the hormone aldosterone from the patient's adrenal cortex. It is the aldosterone that is responsible for the tubules of the kidneys to retain sodium and water in the body of the patient. As such the accident affected patient can increases the volume of fluid in the body, increasing the blood pressure (2005). Solomon, Scott D; Anavekar, Nagesh (2005), states that with the help of proper drugs the renin-angiotensin-aldosterone system can be kept under control preventing too high blood pressure in the body. They are also effective for the purpose of lowering blood pressure in this system. The practice is for the balanced phenomenal control of high blood pressure or hypertension, heart failure, kidney failure, and harmful effects of diabetes in the patients. These preventive measures are every much of positive use for a patients with trauma to the thigh and severe haemorrhaging. There are many clinical significance of renin-angiotensin system. It is manipulated clinically to treat high blood pressure. This is a common situation that needs to be handles, especially accident affected patients. ACE inhibitors or the inhibitors of angiotensin-converting enzyme like those of Captopril, are applied in order to reduce the formation of the more potent angiotensin II. On the contrary ARBs or angiotensin receptor blockers are used for the purpose of preventing angiotensin II to react and act on as angiotensin receptors. These are the precautionary measures that are very much under speculations and are developed as per the application of preventive measures. This system regulates blood pressure when a. there is a fall in the blood pressure for systolic, to 100 mm Hg or lower. It is a state when the kidneys release the enzyme renin into the bloodstream. b. renin splits angiotensinogen, large protein gets circulated in the bloodstream, as angiotensin I. c. Angiotensin I, split into pieces by angiotensin-converting enzyme, that is ACE as a very active hormone; angiotensin II. d. angiotensin II is responsible for the formation of muscular walls of small arteries increasing blood pressure and triggers the release of the hormone aldosterone from the adrenal glands and antidiuretic hormone from the pituitary gland. e. aldosterone retain salt from kidneys, and excrete potassium, causing water to be retained. It results in the increasing of blood volume and blood pressure in the body of the patient. Eventually the importance of renin-angiotensin system or renin-angiotensin-aldosterone system is to have systematic control over the blood volume and blood pressure in a state of instability. The whole system functions towards the maintenance of the blood pressure under all sever circumstances. Their application is very important when a patient with severe haemorrhaging and extreme thigh trauma comes under medical inspection. Question 3 Describe briefly how the processes of glycolysis and gluconeogenesis contribute to the regulation of blood glucose level. ---- The process of glycolysis and gluconeogenesis literally contribute a lot in the regulation of blood glucose level. These are the primary process that functions towards the maintenance and stabilisation of the blood glucose levels. They function for the conversion of glucose into pyruvate. This is very much in the periphery of concomitant production of smaller amount of adenosine triphosphate that is also known as ATP. The process begins with phosphorylation of glucose by hexokinases, to form glucose 6-phosphate (G6P) (Hunt, A. et al. 2007). It lowers down the glucose concentration, by the means of promoting continuous transport of glucose into the cell through the plasma membrane. The major functionality, as stated by Cohn and Kolinsky Am J Physiol, (1949; 156: 345-348) is of the processes of glycolysis and gluconeogenes is in the capacity to block the glucose from leaking out. The consistent of phosphorolysis or hydrolysis of intracellular starch or glycogen are the sources for the reformation of glucose in the body. It is during fasting, that the process undertaken by gluconeogenesis maintains blood sugar levels. It is done by the means of increasing glucose production in the body. The same situation changes phase after meal. It is here that the hormone insulin turns down gluconeogenesis and ensures that blood sugar levels don’t rise too high. Bakris GL, Fonseca VF, Katholi RE, et al. (2004) states that the application needs to change with those patients who are having resistance for insulin. In such cases the blood sugar levels normally rises if gluconeogenesis is continued. This somewhat leads to the risk of developing type II diabetes in the patient that is relatively dangerous. As gluconeogenesis are the reverse of those elements that are found in glycolysis, all the three regulated exergonic gluconeogenesis reactions gets replaced with favourable reactions. The enzymes, like, hexokinase/glucokinase, phosphofructokinase, and pyruvate kinase of glycolysis are often replaced by glucose-6-phosphatase, fructose-1, 6-bisphosphatase, and PEP carboxykinase respectively in the process of adoption. This is the way through which glycolysis and gluconeogenesis are more inhibit of each other and they stand in order to prevent the formation of a futile cycle in the body. Cytoplasm has got most of the enzymes that are responsible for gluconeogenesis. With the process to transport phosphoenolpyruvate from the mitochondrion into the cytosol, the cytosolic enzyme the processes of glycolysis and gluconeogenesis turn up to be successful in the regulation of blood glucose level in the body. They actively control the action of a key enzyme and stabilise and balance the glucose level. The regulation through signal transduction by cAMP and its phosphorylation are also an art of major functionality of the process. Factors that are responsible in the regulation of the activity of the gluconeogenesis pathway adopt the means of inhibiting the activity or expression of key enzymes. On the contrary, acetyl CoA and citrate are all activated through gluconeogenesis enzymes (pyruvate carboxylase and fructose-1, 6-bisphosphatase, respectively). Question 4 Name the hormones involved in the regulation of the male and female reproductive functions and briefly describe the role of each hormone. (remember to include in your answers the sites of the secretions of those regulatory hormones). ---- The hormones that are involved in the regulation of the male and female reproductive functions are androgens, estrogens and progestagens. However there are specific classification and sub divisional demarcation of each group. The androgens have got the category of androstenediol. This is the steroid metabolite that has acts and function as the main regulator of gonadotropin secretion in human body. The participation of androstenedione or andro is all about being an androgenic steroid that is more subsequently produced by the testes, adrenal cortex, and ovaries. androstenediones are often gets converted metabolically to testosterone and likewise to all other androgens. The androstenedione or andro are also the parent structure of estrone and are having basic initiativein the shifting process. dehydroepiandrosterone (DHEA) is the next category of a steroid for hormonal secretion that gets produced in the adrenal cortex from cholesterol. Natural estrogens are its primary precursor and thus called dehydroisoandrosterone or dehydroandrosterone too. Androgens also include a sub-category that is called dihydrotestosterone (DHT). This is the hormone that stands as a metabolite of testosterone. DHT is found to be much more potent androgen than testosterone. It mainly works towards the binding of stronger capacitance to androgen receptors and thus very appropriately gets produced in the adrenal cortex. Androsterone is the next level of chemical by-product that is created during the breakdown of androgens in the body. It is also very much available and properly derived from progesterone (John Bernard Henry, 2001) . In this process there is every chance that exerts minor masculinising effects, however it always depend over the one-seventh the intensity of testosterone. Equal amounts in the plasma and urine are a part of these hormones and are equally effective in the cases related to both males and females sexual regulations. The very next category is that of estrogens. It has got three major naturally occurring estrogens in women. They are namely estradiol, estriol, and estrone. The production of all these three estrogens results from the participation of androgens through actions of enzymes in the body. Estradiol is a kind of estrogen hormone that gets produced from testosterone and on the other hand estrone from androstenedione. The next category is of estrone. Estrone is basically weaker than estradiol in performing and hormonal functionality. Premarin,is another such sub-category of estrogen that is very much commonly prescribed in the estrogenic drug. It is very likely contains the steroidal estrogens equilin and equilenin. Added to equilin and equilenin it also bears estrone sulphate n it. The last but not the least category is that of progestagens. these progestagens are also spelled progestogens or gestagens. These are those hormones that produce effects similar to those of progesterone, the only natural progestagen. Otherwise the technological inventions have come up with the progestogens that are basically synthetic and are often referred to as progestins under every specification. It has been well realised that all kinds of progestagens have antiestrogenic. These are very much active in counteracting the effects of estrogens on the body. Added to this antigonadotropic are very appropriately distributed for the purpose of inhibiting the production of sex steroids by gonads. These are the specific properties that get well structured in the timing for the hormonal activation. Question 5 Describe the nervous and muscular mechanisms involved in the micturition reflex. Consider both the voluntary and involuntary aspects of micturition. ---- The nervous and muscular mechanisms involved in the micturition reflex are very spontaneous and are related to the functionality of it. They are both voluntarily and involuntarily performed for the requisite purposes. It is the urination, that often gets represented as micturition, voiding, and emiction. From practical stand point it is the process of disposing urine from the urinary bladder that passes through the urethra to the outside of the body. S. Oliver, C. Fowler and A. Mundy et al., (2003, pp. 7–16.), declares that this is the process that gets mechanised through proper combination of neuron and the muscular activation of the organs adjacent to it. In case of all the healthy adults, the process of urination is under voluntary control; whereas in case of infants and individuals with neurological injury, the whole process of urination ccur as an involuntary reflex. In this process the bladder has got dual role. These are very appropriately for the purpose to store urine for much of the time without excess leakage. The very next involvement of the bladder is related to the purpose to void the bladder content completely. It is here that there is the rapid indulgence cited at a time that is under the control of a particular individual. If there is a kind of failure in all these achievements and attempts then the objectives will result in incontinence. It is very much ineffective voiding or retention of urine. As a result there are subsequent causes that rely for the neuron and muscular functionality in this process. There is no doubt that there comes in a considerable reduction in the quality of life. The consequences may also lead to various significant medical problems in the individual. Thus the assessments shows that the main organs involved in urination are basically the bladder and the urethra. There is a strong participation led by the smooth muscle of the bladder, called detrusor. Ronald A. Sacher and Richard A. McPherson clarifies that, it is innervated by sympathetic nervous system fibers. These fibers are from the lumbar spinal cord. Added to these, there are parasympathetic fibers from the sacral spinal cord for the act of participation. The major role is also played by the fibers in the pelvic nerves that are very much present to constitute the main afferent limb of the voiding reflex. In the same way the parasympathetic fibers to the bladder constitute the excitatory efferent limb that are very much in the process to be present internally in these nerves. External urinary sphincter that is innervated by somatic fibers in Onuf's nucleus has got the major participation for the micturition reflex. There are lots of pathological causes that work towards the understanding of all these consequences. There are all the possibilities that determine the neuron and the muscular functionality in the micturition reflex. The major consequences are more or less related to the bladder. The proper understanding of the normal and physiological processes, results in the proper maintenance and application of appropriate controlled status that is very much into the active means of voiding of urine. References Bakris GL, Fonseca VF, Katholi RE, et al. 2004; GEMINI investigators. Metabolic effects of carvedilol vs metoprolol in patients with type 2 diabetes mellitus and hypertension. JAMA., 292: 2227-2236. Bakris, G. L., Fonseca, V., Katholi, R. E., McGill, J. B., Messerli, F., Phillips, R. A., Raskin, P., Wright, J. T. Jr, Waterhouse, B., Lukas, M. A., Anderson, K. M., and Bell, D. S. 2005; Differential effects of {beta}-blockers on albuminuria in patients with type 2 diabetes. Hypertension, 46(6):1309-15 Bakris, G. L., Bell, D. S., Fonseca, V., Katholi, R., McGill, J., Phillips, R., Raskin, P., Wright, J. T. Jr, Iyengar, M., Holeslaw, T., and Anderson, K. M. J, 2005; The rationale and design of the glycemic effects in diabetes mellitus carvedilol-metoprolol comparison in hypertensives (gemini) trial. Diabetes Complications, 19(2):74-9 Cohn and Kolinsky Am J Physiol., 1949; EFFECT OF BLOOD SUGAR LEVELS AND INSULIN LACK ON GLUCONEOGENESIS BY THE KIDNEY, 156: 345-348 Colombo C, Russo MC, Zazzeron L, Romano G. 2006 Jul, Liver disease in cystic fibrosis. J Pediatr Gastroenterol Nutr.; 43 Suppl 1:S49-55. PMID 16819402 Direct projections from the periaqueductal gray. [Neurosci Lett. 1994] - PubMed Result High Blood Pressure: Heart and Blood Vessel Disorders. Merck Manual Home Edition. http://www.merck.com/mmhe/sec03/ch022/ch022a.html [retrieved on 25.09.08] Hunt, A . et al. (2007). "Reduced cerebral glucose metabolism in patients at risk for Alzheimer's disease". Psychiatry Research: Neuroimaging 155 (2): 147–154. John Bernard Henry, M.D. 2001. Clinical diagnosis and Management by Laboratory Methods 20th edition, Saunders, Philadelphia, PA, Reflexes to sacral parasympathetic neurones concer...[J Physiol. 1969] - PubMed Result Ronald A. Sacher and Richard A. McPherson, 2001.Widmann's Clinical Interpretation of Laboratory Tests 11th edition, F.A. Davis Company, Ronen Arai, GI Effects of Cystic Fibrosis, n.d., http://yourtotalhealth.ivillage.com/gi-effects-cystic-fibrosis.html [retrieved on 25.09.08] S. Oliver, C. Fowler and A. Mundy et al., (2003), Measuring the sensations of urge and bladder filling during cystometry in urge incontinence and the effects of neuromodulation, Neurourol Urodyn, 22 pp. 7–16. Solomon, Scott D; Anavekar, Nagesh (2005). "A Brief Overview of Inhibition of the Renin-Angiotensin System: Emphasis on Blockade of the Angiotensin II Type-1 Receptor". Medscape Cardiology 9 (2) .http://www.medscape.com/viewarticle/503909 [retrieved on 25.09.08] Williams SG, Westaby D, Tanner MS, Mowat AP. 1992 Oct, Liver and biliary problems in cystic fibrosis. Br Med Bull.; 48(4):877-92. PMID 1458306 Read More