Test your knowledge of kidney and urinary system anatomy by dragging the structures from the left to correctly

complete each
sentence on the right.

YF

renal corpuscles

Com

renal pelvis
YF

renal cortex Each of the kidneys@ can be divided into two regions: the outer portion
is the renal cortex@ and the inner portion is the renal medulla@.
>

renal medulla
The renal cortex contains all of the renal corpuscles@, while the renal
TTY medulla contains loops of Henle@ from juxtamedullary nephrons and
bladder merging collecting ducts@.

a YF
; Collecting ducts pass through the medulla on their way to the kidney's
kidneys central cavity, the renal pelvis@®, which is then continuous with the
Co
ureters@.

ureters

a YF
Urine flows from the ureters into the bladder® and is then eliminated
from the body via the urethra@.
urethra

loops of Henle

YF

collecting ducts
Label the figure below to demonstrate your knowledge of the structural organization of cortical and juxtamedullary nephrons. Hints
and close-up views are made available by placing the cursor over some drop-boxes.

Peritubular capillaries
Afferent arteriole
Efferent arteriole
. A

Distal convoluted tubule “

Medullary collecting duct =
Afferent arteriole
Proximal convoluted tubule = ~
— Leb
Descending limb

Cortical collecting duct

Renal corpuscle c
°
r
t
e
J x

Cortical collecting duct

Loop of Henle

Glomerulus ] [ Descending limb

Cosficome y tio Thick segment
Corticomedullary junction ] [ limbof ascending @& .
Corticomedullary . .
junction M.

.
Vasa recta
|
Artery Medullary collecting duct .
Macula densa

7 |
. “ Urine

nnee_Janenonet
© McGraw-Hill Education —
Label the figure below to assess your understanding of the structural organization of the juxtaglomerular apparatus. Close-up views
are available by placing the cursor over some drop-boxes.

Symnathetic
oyiilp

Smooth muscle cells

Smooth muscle cells

Macula densa
Match each renal process on the left with the correct number on the right to demonstrate your understanding of the three basic renal
processes.

Glomerular filtration

Artery
Afferent Glomerular Efferent
arteriole capillary arteriole 1.

Glomerular filtration

Tubular secretion 2.
Tubular secretion

Peritubular
capillary
3.
Vein Tubular reabsorption

Urinary
excretion
Tubular reabsorption © McGraw-Hill Education
The figures below illustrate renal handling of three hypothetical substances X, Y, or Z. Some substances within the body are normally
handled by the kidneys just like these hypothetical substances. Match each image with its correct description for renal handling of the
substances listed at right.

Normal renal handling

of foreign chemicals Normal renal handling
like drugs/toxins of water and Na+

Substance Y

© McGraw-Hill Education © McGraw-Hill Education

Normal renal handling

of glucose

© McGraw-Hill Education
Label the following figure with the correct terms to assess your understanding of the renal tubular epithelium.

Tight
junction

Peritubular
Apical capillary
membrane

fh HU
Basolateral
Basolateral
membranes
membranes

Peritubular Tubular
capillary epithelial cell
Tight
junction
Interstitial
fluid
| Apical
membrane

Tubular
lumen

Interstitial
Tubular fluid
epithelial
cell

© McGraw-Hill Education
Which of the following is least likely to be filtered into Bowman's capsule in a normal, healthy person?

Multiple Choice

QO Glucose
O |@

Plasma protein

Sodium

Urea
O

Bicarbonate ion
O
Constriction of the decreases hydrostatic pressure in

Multiple Choice

afferent arterioles; glomerular capillaries

efferent arterioles; proximal convoluted tubules

OO O

renal vein; peritubular capillaries

O

efferent arterioles; glomerular capillaries

efferent arterioles; Bowman's capsule

O
Which of the following describes tubular reabsorption in the kidney?

Multiple Choice

O The movement of substances from the peritubular capillaries into the tubular fluid

The movement of substances from the proximal tubule into the loop of Henle
O
O |@/}

Transepithelial transport from the lumen of the tubule into renal interstitial fluid

Movement of Na’, CI’, and water from glomerular capillaries into Bowman's capsule

Transport of solutes from the renal medullary interstitial fluid into the collecting duct
O
Which of the following substances undergoes renal tubular secretion?

Multiple Choice

O a

O xe

e KC

OC m0
Review structural and functional characteristics associated with gastrointestinal tract organs by matching each characteristic on the left
with its associated organ on the right.

The basic
electrical rhythm Air and food
generates three paths cross in
peristaltic waves this area
per minute
——————_____
[|]
——————___
— Pharynx Esophagus Stomach Small Intestine Large Intestine
Secretions from c >
the liver and
Small amounts
pancreas, two
of vitamin K are
GI accessory
absorbed
organs, empty
into this organ
ee a

Protein The most

digestion in an important site
acidic for protein
environment digestion
——__
————

The principal Most dietary

site of fat water is
digestion absorbed

—___
SS

Rapid peristaltic
The site of most
motility is the
absorption
sole function

—————__
a

Intrinsic factor is
Bacteria are
manufactured
normally found
and secreted
here
into the lumen
——_—__
Review the various gastrointestinal exocrine secretions by correctly matching the secretion on the left with its description on the right.

Bile is produced by the liver, stored in the gallbladder, and enters the duodenum through the
common bile duct. This substance aids in the emulsification of fats.

Lipase is secreted from pancreatic exocrine cells into the pancreatic duct. This enzyme breaks
down fats into free fatty acids and monoglycerides.

Pepsinogen is an inactive enzyme precursor secreted from chief cells into gastric glands in the
stomach.

Mucus is secreted from specialized cells scattered throughout the Gl tract. This substance
provides lubrication within the Gl tract and protects the epithelial cell surface.

Bicarbonate is secreted from duct cells that line the pancreatic duct, and eventually empties into
the duodenum through the sphincter of Oddi. This substance helps to neutralize the pH.

Intrinsic factor is secreted from parietal cells in the stomach, and it is needed to absorb vitamin
B:2 in the small intestine.

HCl is secreted from parietal cells that line gastric glands in the stomach, which leads to a very
acidic environment.

Amylase is found in saliva and is secreted from pancreatic exocrine cells into the pancreatic
duct. This substance aids in the breakdown of polysaccharides into glucose and maltose.

Pepsin is an enzyme that becomes activated in the lumen of the stomach and aids in the
digestion of proteins.
 Label the following figure to review carbohydrate digestion within the small intestine and monosac_ haride e* -urption.

Intestinal
Lumen
epithelia! cell
ee
—_.,
ill | | | | | | |
Interstitial fluid Pancreatic
amylase

Polysaccharides Maltose
$< $$ _
—_——_—
ingested
Monosaccharides
disaccharides

Fructose

SGLT High [Na*}]

———_____
nn

Low [Na*] High [K7]

————_____
©. ee

Brush border
Low [K7]
enzymes
——————
Apical membrane
Basolateral
membrane
$$
$

eae

Glucose and Facilitated diffusion

of
Galactose | monosaccharides |
Hill E
_——
Primary active
lon channel
transport pump
—————____/
Label the following figure to review protein digestion within the small intestine and peptide and amino acid absorption.
——
ntestinal
Lumen epithelia! ce
—__
oe
Pancreatic
nterstitial fluid
peptidases
—————__

=
—————ain

Proteins Small peptides

a

ae

Brush border
Amino acids
peptidases
\

——————

High "
[Na*} Low [Na*]
a

High [H™] High [K7}

$$
a

Primary active
Low [K*} transport pump
a
|

ra

Apica
lon channel
memorane
a

—————————
Secondary
Basolaters!
membrane
active
transporter
es
——————_
© McGraw-Hill Educatio
Amino acid
transporters
Peptidases
————“
Label the figure below for a general overview of fat absorption across intestinal epithelial cells.

Fat droplet
Fat droplet
— >

Bile salts and Bile salts and

phospholipids phospholipids

Emulsion droplets o oe @ .
—— ~ Emulsion droplets
- . | Baan
Bile salts and
sed pancreatic |
Lumen of small intestine eee
a r| Lumen of small intestine
o
Bile salts and pancreatic os?
ipase ee* Micelles

Micelles

Diffusion [ Diffusion

A monoglyceride
A monoglyceride

Amphipathic proteins
Epithelial cell

Epithelial cel Amphipathic proteins — ©)

——$
Chylomicron
a
XN az

Droplets of triglyceride
Lacteal (and other small lipids)
enclosed by membrane.
from the endoplasmic Lacteal
reticulum
© McGraw-Hill Educati Chylomicron
Complete the figure below to review how intestinal phase pathways inhibit gastric emptying. Hints are made available by placing the
cursor over some of the drop-boxes.

* plasma enterogastrones Long neural reflexes

( CNS )
t sympathetic efferents [ | parasympathetic efferents \
q 7

Short neural reflexes via

enteric neurons
+ plasma enterogastrones L Stomach
1 gastric emptying
—)
Short neural refi J

—
oom)
Duodenum
| acidity tFat tT Amino Distension
Hypertonicity l = T |

t secretion of enterogastrones

| ? secretion ofenterogastrones | [ Stimulate neural receptors

Stimulate neural receptors | | | |

© McGraw-Hill Education
| parasympathetic efferents
Examine each of the relationships given in the partial sentences provided below. Drag each label to the proper position indicating the
best conclusion of each sentence. Not all labels are eligible for each dock. The letters A, B, C, and D will guide you as to which labels
should be considered for each dock.

A: HCl is to pepsinogen as:

pepsinogen.
See) oe
‘eveaen B: The brush border is to the small
intestine as:
B: Gastric glands are to
the stomach.

C: Bile is to the liver as:

C: Salivary amylase is to
the parotid glands.
D: Trypsin is to protein as:

D: Lipase is to cholesterol.
Drag each label identifying an enzyme to categorize the term as being associated with protein, carbohydrate, or lipid metabolism.

Salivary amylase

Lingual lipase
Carbohydrate Protein Lipid
Pancreatic amylase

Pepsin

Aminopeptidase

Carboxypeptidase

Trypsin

Chymotrypsin

Pancreatic lipase

Elastase
Diabetes insipidus is a condition in which there is a malfunction involving antidiuretic hormone—ADH (also known as vasopressin).
There are two forms of this disease. In central diabetes insipidus (CDI), the hypothalamus cannot secrete ADH, while in nephrogenic
diabetes insipidus (NDI), the kidneys become insensitive to ADH. At left below are a list of symptoms associated with diabetes
insipidus. Drag each symptom to the correct box at right to indicate whether it is likely to occur: (1) only in a patient with CDI, (2) only in
a patient with NDI, (3) in patients with either condition, or (4) in neither type of patient.

Patients with CDI Patients with Either CDI

ADH levels below normal or NDI

ADH levels above normal

Abnormally large urine

volume

Abnormally high urine

osmolarity

Injecting ADH significantly

increases urine osmolarity

Injecting ADH does not Patients with NDI Patients with Neither CDI
change urine osmolarity / : nor NDI

Glucose in the urine

Large thirst and water

intake
A patient develops a tumor on the left adrenal gland that hypersecretes aldosterone. Click on all of the physiological changes and
symptoms below that are likely to result.
A previously healthy patient developed a plaque build-up that severely reduced blood flow to the right kidney. Click on all of th
expected physiological changes that are likely to result from this blockage.
Complete each sentence below to show your understanding of the major mechanisms by which a decrease in total-body Na’ elicits a
compensatory change in the glomerular filtration rate (GFR).

afferent

chemoreceptors

Diarrhea leads to a/an increase Na* and H20 loss from the body.
constriction
These losses lead to a decrease in plasma volume, and subsequently a
dilation decrease in venous, arterial, and atrial pressures.
lat

+ Reflexes mediated by baroreceptors increase/s the activity of renal

efferent sympathetic nerves.

Increased sympathetic output increases the constriction of afferent renal

volume arterioles, which decreases the net glomerular filtration pressure.

decrease This directly leads to a decrease in glomerular filtration rate (GFR), which
decreases the excretion of Na* and H20.

pressures

increase

baroreceptors

glomerular filtration rate (GFR)

Complete each sentence then drag the steps into the proper sequential order to review how Na” reabsorption is controlled by the
renin-angiotensin system.

Drag the text blocks below into their

aldosterone Zi correct order.
———_
& To begin, a decrease in blood pressure stimulates the renal
angiotensin | juxtaglomerular cells to increase the secretion of renin into the blood.

angiotensin II Renin splits a small polypeptide, angiotensin |, from a large plasma

protein, angiotensinogen, which is produced by the liver.

angiotensin-converting
enzyme (ACE) The inactive angiotensin | undergoes further cleavage to form the
biologically active angiotensin Il.

angiotensinogen
is found in high concentrations on the luminal surface of capillary endothelial
cells.
excretion
Angiotensin I| targets the cardiovascular system, where it mediates
————__ vasoconstriction of arterioles.
liver

——————_—_—_——— It also has receptors located on the adrenal cortex, where it stimulates
the secretion of the hormone aldosterone into the blood plasma.
reabsorption

Aldosterone targets the epithelial cells within the cortical collecting

renin ducts, which causes an increase in the reabsorption of Na*.

—_
Overall, this results in a decrease in the excretion of Na~ and H20,
vasoconstriction allowing for plasma volume to be restored toward normal.
|

blood pressure
At left is a list of processes that influence acid-base balance in the body. Classify each process as likely to result in H* GAIN or LOSS
from the body by dragging it to the correct category at right.

Processes Resulting in H* GAIN

Generation of CO2

Metabolism of proteins and similar

organic molecules

Loss of nongastric Gl fluids in

diarrhea

Formation of excessively alkaline

urine

Metabolism of organic anions

Senieeeeeaenaets Processes Resulting in H* LOSS

Excessively low urine pH

Hyperventilation
Fill in the table below with the appropriate terms to test your knowledge of changes that occur in acid-base disorders.

[ crea
Decrease [ Increase-_ Renal
compensation [rim , abnormality . | [ Reflex ventilatory
compensation

TABLE 14.8 Changes in the Arterial Concentrations of H*,HCO,~, and Carbon Dioxide in Acid-Base Disorders

t } Renal compensation | Primary abnormality

nannies t (oem 3
J

; } Primary abnormality } Reflex ventilatory

compensation
Test your knowledge of hypothalamic osmoreceptors and regulation of renal water excretion by correctly completing each sentence
below.

| anterior pituitary

| collecting duct

| excretion To begin, imagine that excess water has been ingested into the body.
This decreases body fluid osmolarity.

| osmolarity This change is sensed by osmoreceptors located within the

hypothalamus.

These neurons decrease their action potential firing frequency resulting

| posterior pituitary in a decrease in the secretion of vasopressin from the posterior
pituitary.

A decrease in circulating levels of vasopressin decreases the

| reabsorption permeability of the collecting duct epithelial cells to water, which leads
to a decrease in water reabsorption.

Water remains in the tubular lumen, and thus there is an increase in the
vasopressin water excretion.

| volume

| water
Drag each renal function listed on the left into the table at right to demonstrate your knowledge of the major functions of each renal
tubule segment.

TABLE 14.5 Summary of “Division of Labor” in the Renal Tubules

Forms ultrafiltrate of plasma

Glomerulus/Bowman’s capsule
Bulk reabsorption of solutes and water.
secretion of solutes and organic substances
J Proximal tubule

Establishes medullary osmotic gradient; ===

secretion of urea

. Loop of Henle
Fine-tuning of the reabsorption and secretion
of small quantities of remaining solutes

Descending limb
Fine-tuning of water reabsorption; Ascending limb
reabsorption of urea

Distal tubule and cortical

collecting ducts

collecting ducts
Drag each controlling factor from the list on the left into the table at right to demonstrate your knowledge of how the function of
individual renal tubule segments is regulated.

aOR iam ee SU Romi

Starling forces (Pgc, Pbs, etc.)

Glomerulus/Bowman’s capsule
Active transport of solutes with passive
water reabsorption; parathyroid hormone Proximal tubule
inhibits phosphate ion reabsorption

Passive water reabsorption; active

transport of NaCl
Loop of Henle
Aldosterone stimulates Na* reabsorption
and K* secretion: parathyroid hormone
stimulates Ca** reabsorption Descending limb
Ascending limb
Vasopressin increases passive
reabsorption of water
Distal tubule and cortical
collecting ducts

Cortical and medullary

collecting ducts
Drag each label describing a regulatory response to the appropriate stimulatory scenario.

Elevated Potassium Elevated Plasma Volume Increased Osmolarity

~

“Decreased Potassium Decreased Plasma Volume Decreased Osmolarity—

c + ~ c +
Review events, including diabetic ketoacidosis, caused by severe untreated insulin deficiency in type 1 diabetes mellitus by labeling
the sequence of events at right with the correct terms from the left. Hints are made available by placing the cursor over some drop-
boxes.

a + renal filtration of
* Na and water glucose and ketones
excretion =
Osmotic diuresis

* Nav and water

excretion

+ Plasma volume

| arterial blood
pressure

+ Brain blood flow

SZ.
© McGraw-Hill Education Impaired brain function, coma, death
Following the consumption of a meal, blood glucose levels in healthy individuals will

Multiple Choice

O disappear.

O decrease.

O remain stable.

O increase.
Insulin, released after a meal is consumed by a person who does not have diabetes mellitus, will cause blood glucose levels to

Multiple Choice

O decrease far below normal.

convert to protein.

O return to normal.

increase far above normal.

In type 1 diabetes, blood glucose levels remain high after eating a meal because

Multiple Choice

O no insulin is released.

O too much insulin is released.

O protein is converted to glucose.

O the kidneys are not working.

In type 2 diabetes, blood glucose levels remain high after eating a meal because

Multiple Choice

O the kidneys are not working.

no insulin in released.
O JO}O

target cell sensitivity to insulin is less than normal.

too much insulin is released.

target cell sensitivity to insulin is greater than normal.

O
Insulin does all of the following except -

Multiple Choice

O Increase cellular uptake of glucose

Increase cellular uptake of amino acids

O O
O }O}

Increase the activity of glycolytic enzymes and decrease the activity of enzymes reponsible for catabolizing proteins and fats

Increase the rate of ketone synthesis in the liver

Increase the rate of glycogen synthesis in the liver and muscles

All of the following have a glucose counter-regulatory effect except

Multiple Choice

O Growth hormone

Glucose-dependent Insulinotropic Peptide

|}O

Cortisol
OO

The sympathetic nervous system

Glucagon
O
The type of fat that carries the greatest health risk is because it

Multiple Choice

O visceral fat; has the highest rates of leptin secretion

O visceral fat; is lipolyzed more readily and its breakdown products travel directly to the liver via the hepatic portal vein

O subcuteneous fat; has the highest rate of leptin secretion

O subcutaneous fat; creates greater challenges in thermoregulation

Which of the following is FALSE of ApoB lipoproteins?

Multiple Choice

O they are more proatherogenic than apoA lipoproteins

O the ApoB class contains chylomicrons, VLDL, and LDL

O the primary function of ApoB lipoproteins is transfering cholesterol to cells that need it

O the amount of ApoB lipoproteins in the blood is increased by overfeeding (i.e. a positive energy balance)
List in order the steps of atherosclerosis development from first to last.

Rank the options below.

| Leukocytes phagocytose lipoproteins and generate "fatty streaks"

there is damage to endothelial cells, which allows lipoprotein infiltration of the subendothelial tissue and increased chemoattraction of leukocytes

Foam cells secrete chemokines and inflammatory cytokines which amplifies the immune response, causes vascular smooth muscle proliferation and migration, and secretion of extra-cellular
matrix proteins

Cells begin to die and create a necrotic core within the plaque

Weakened plaque ruptures and leads to massive clotting response, occluding the artery

| A stable plaque develops

Type Il Diabetes Mellitus is characterized by due to

Multiple Choice

O complete lack of insulin; autoimmune destruction of pancreatic beta cells

O complete lack of insulin; ectopic fat deposits in the liver and resulting lipotoxicity

O insulin insensitivity; autoimmune destruction of pancreatic beta cells

O insulin insensitivity; downregulation of insulin receptors

An experiment was performed in which a hormone was infused at a constant rate for a brief time, while the blood concentrations of
glucose, insulin, and glucagon were monitored. The resulting data are shown in the graph below. Identify the hormone infused and
distinguish which data trace belongs with each variable by dragging the labels from the left into the boxes at right.

Injected Hormone

Glucagon

[Glucose] (mg/dL), [Insulin] (ug/mL), or [Glucagon] (pg/mL)

Variables

[Glucose]

{Insulin}

[Glucagon]

© McGraw-Hill Education
An experiment was performed in which a hormone was infused at a constant rate for a brief time, while the blood concentrations of
glucose, insulin, and glucagon were monitored. The resulting data are shown in the graph below. Identify the hormone infused and
distinguish which data trace belongs with each variable by dragging the labels from the left into the boxes at right.

Injected Hormone

Insulin

[Glucose] (mg/dL), [Insulin] (g/mL), or [Glucagon] (pg/mL)

Variables

[Glucose]

[Insulin]

[Glucagon]

co
Time (minutes)
© McGraw-Hill Education
Investigate your knowledge of carbohydrate, protein, and lipid metabolism by classifying the target-cell responses at left as an
absorptive state event or a postabsorptive state event.

. _ : Absorptive State Postabsorptive State

Increased glucose Net protein Event Event
uptake and —
utilization in most oe =a a
cells

Net triglyceride
No ketone synthesis in
synthesis in liver adipocytes and
liver

Increased \{ Increased
transport of amino glycogen storage
acids into muscle in muscle tissue
cells and liver

No Glycogenolysis in
gluconeogenesis in muscle tissue and
liver liver

supavsi
p in || muscle
catboism n
tissue

Decreased glucose Increased ketone

uptake and and fatty acid
utilization in most utilization in most
cells cells

Glucose sparing -
for use by nervous ae
tissue
 Insulin and glucagon are important hormones that regulate the events of the absorptive and postabsorptive states. Classify the
statements at left as being related to insulin or glucagon.

Glucagon
2d
Secreted by beta cells of
Promotes absorptive
the pancreatic islets of
Langerhans
state events

Stimulates the insertion of

Secretion is stimulated by
GLUT-4 transporters into
increased plasma
muscle cell and adipocyte
glucose
membranes

Secretion is stimulated by
Secretion is stimulated by cretins, hormones
elevated amino acid released by gastrointestina
concentrations cells during ingestion of
meals

Secretion is stimulated by Secretion is inhibited by

increased increased sympathetic
parasympathetic activity activity

Secreted by alpha cells of

Promotes postabsorptive
the pancreatic islets of
state events
Langerhans

Controls metabolic events

Secretion is stimulated by
that lead to glucose
hypoglycemia
sparing

Increases
Considered a glucose- gluconeogenesis in the
counterregulatory control liver along with cortisol
and growth hormone

Secretion is stimulated by Secretion is stimulated by

circulating plasma increased sympathetic
epinephrine activity
Review how insulin and glucagon regulate the metabolic transitions from feasting to fasting by completing each sentence on the right
with the correct term from the left. Then, click and drag the sentences to arrange them in a logical order, starting with what happens
first after eating a meal.

Drag the text blocks below into their

GLUT-4 transporters a correct order.

absorptive You have just eaten a carbohydrate-rich meal; therefore, you have an increased
plasma glucose concentration, and your body is in the absorptive state.
adipocytes
An increase in plasma glucose stimulates pancreatic islet beta cells to increase the
alpha cells secretion of insulin.

beta cells Insulin stimulates the translocation of GLUT-4 transporters from cytoplasmic vesicles
to the plasma membrane in adipocytes and muscle cells, which increases glucose
uptake.
decrease

Insulin also causes liver cells to decrease glucose output and to store glucose as
glucagon glycogen.

gluconeogenesis
Four hours after you've eaten your meal, your plasma glucose concentration starts to
fall, and your body is now in the postabsorptive state.
glucose

A decrease in plasma glucose stimulates pancreatic islet alpha cells to increase the
glycogen
secretion of glucagon.

Glucagon stimulates the liver to increase glycogenolysis, gluconeogenesis, and the

synthesis of ketones.
ketones

liver Finally, the glucose supplied by the liver is spared for use by the nervous system,
while the rest of the tissues in the body use fatty acids and ketones for energy.

nervous system

postabsorptive
Examine each of the relationships given in the partial sentences provided below. Drag each label to the proper position indicating the
best conclusion of each sentence. Not all labels are eligible for each dock. The letters A, B, C, and D will guide you as to which labels
should be considered for each dock.

A: Glycogen is to the absorptive phase

as:

A: Glucose is to the
postabsorptive phase. .
B: HDLs are to removal from tissue as:

B: LDLs are to tissue

delivery.

C: Proteolysis is to proteins as:

C: Lipolysis is to
triglycerides.
D: Urine is to urea as:

D: Feces are to
cholesterol.
Examine each of the relationships given in the partial sentences provided below. Drag each label to the proper position indicating the
best conclusion of each sentence. Not all labels are eligible for each dock. The letters A, B, C, and D will guide you as to which labels
should be considered for each dock.

A: Insulin is to protein synthesis as:

A: Absence of insulin is to
ketone synthesis.

B: Glucose is to gluconeogenesis as:

B: Glycerol is to lipolysis.

C: Glycogen synthase is to glycogen

as:

C: Hormone sensitive
lipase is to free fatty acids
and glycerol.
Label the diagram below to review the major metabolic pathways of the absorptive state.

All tissues Muscle All tissues (~ se tissue

Protein Glycogen COz +H20 + ue Triglycerides

Fi
af WW C
J Glucose Glycerol 3- Fatty acids
Amino
phosphate _
acids Glucose

Glucose Fatty acids | “"°#¥°="*=5

_J

-
Glucose

© McGraw-Hill Education
Label the diagram below to review the major metabolic pathways of the postabsorptive state. A hint is made available by placing the
cursor over one of the drop-boxes.

All Muscle Adipose tissue

[ Glycogen } [ Protein | Glycogen | Triglycerides

Amino
ids
Lactate and Glycerol Fatty acids

CO, +H;0+
energ

Glucose

tacare —{__ctucose
Urea

ut a-keto acids
& J eo
—— Amino acids \S Energy +60,
[So] eo | cnccngreveus) |
Ketones 4
© McGraw-Hill Education
Evaluate your knowledge of the structures and functions of Sertoli cells by completing each of the following sentences.

Leydig cells The Sertoli cells form part of the wall of the seminiferous tubules.

Sertoli cell barrier

Tight junctions between cells help to form the Sertoli cell barrier, which prevents
chemicals in the plasma from reaching the tubular lumen.
androgen-binding protein
All stages of spermatogenesis take place between the walls of two adjacent Sertoli
estrogen cells.

follicle-stimulating hormone (FSH) Sertoli cells secrete fluid and androgen-binding protein into the tubular lumen.

inhibin In response to follicle-stimulating honnone (FSH) from the anterior pituitary and to local
testosterone produced by Leydig cells, Sertoli cells secrete a variety of chemical
messengers.
male
Paracrine agents secreted by Sertoli cells stimulate sperm proliferation and
seminiferous tubules
differentiation and also influence the function of neighboring Leydig cells.

Sertoli cells also secrete the protein hormone inhibin, which inhibits follicle-
sperm stimulating hormone (FSH) secretion from the anterior pituitary.

spermatogenesis
Sertoli cells phagocytize defective sperm.

testosterone
During embryonic development, Sertoli cells secrete Antimiillerian hormone (AMH),
which causes the female duct system to regress.
Antimiillerian hormone (AMH)

female
Test your knowledge of granulosa cells by correctly completing each of the following sentences.

Leydig cells
Granulosa cells surround and nourish the primary oocyte contained within the dominant
follicle.
androgen

antrum Granulosa cells secrete chemical messengers that influence the oocyte and also the
surrounding theca cells.

aromatase

corpus luteum Granulosa cells secrete fluid into the antrum.

__ Granulosa cells contain receptors for the ovarian hormone estrogen and the anterior
‘ pituitary hormone follicle-stimulating hormone (FSH) during the early and middle follicular
luteinizing hormone (LH) phases.

theca Granulosa cells express an enzyme called aromatase, which converts androgen from theca
cells to estrogen.

primary oocyte

a Granulosa cells secrete the protein hormone inhibin, which inhibits follicle-stimulating
hormone (FSH) secretion from the anterior pituitary.

follicle-stimulating hormone (FSH)

In the late follicular phase, granulosa cells also express luteinizing hormone (LH) receptors
in preparation for ovulation and formation of the corpus luteum.
granulosa cells

Sertoli cells
The granulosa cells in the female are analogous to Sertoli cells in the male.
Label the following figure to review the relationships between ovarian and uterine changes across the menstrual cycle.

Follicle

Ovarian , py : { } 2

[od
Corpus luteum event — wy ; @ o

©
wn
o

oO
m

3
°
6

Progesterone

Menstrual

Proliferative

1 5
Secretory Ute
IU

rine , . !

Follicula Ovarian
meer phase Follicular Follicular

Luteal
Below at right are events that occur at various times during the menstrual cycle. Drag the immediate cause of each event from the left
into the corresponding blank at right.

Corpus luteum deciines in size The fall in estrogen around day 15. Follicle disruption and rupture, corpus
luteum beginning to form.

The fall in progesterone around day 25. Corpus luteum declines in size.
Falling LH levels: and thus loss of
its trophic effect

The degeneration of the corpus luteum. Falling _LH levels: and thus loss of its
( } trophic effect.

Follicle disruption and rupture,

corpus luteum beginning to form The exponential rise in estrogen around day 10. Increased follicle size, local
positive feedback, LH receptors are now expressed on granulosa cells as
well.
fT

Increased follicle size, local The sloughing of the uterine endometrium on days 1-5. Low estrogen and
positive feedback, LH receptors
progesterone levels.
are now expressed on granulosa
cells as well
—

Low estrogen and progesterone

levels
Below at right are events that occur at various times during the menstrual cycle. Drag the immediate cause of each event from the left
into the corresponding blank at right.

Increasing FSH levels

Presence of human The rapid growth of a follicle on days 1-5: Increasing FSH levels
chorionic gonadotropin
(hCG)
The persistence of the corpus luteum during pregnancy: Presence of
human chorionic gonadotropin (hCG)
Rising inhibin levels,
negative feedback The decline in FSH between days 5—10: Rising inhibin levels, negative
feedback

Falling gonadotropin concentrations around day 21: Negative feedback

LH surge and ovulation from estrogen and progesterone

Ovulation: Positive feedback of estrogen on the anterior pituitary and

the LH surge
Positive feedback of
estrogen on the anterior
pituitary and the LH surge Transformation of a follicle into a corpus luteum: LH surge and ovulation

Negative feedback from

estrogen and progesterone
Label the diagram below to assess your knowledge of sex differentiation in females.

XX chromoson A ,
\ XX chromosomes }

Differentiation into
fetal ovaries

Transformation into
uterus, fallopian tubes,
inner vagina

© McGraw-Hill Education
Drag each of the labels to identify whether it refers to male or female differentiation.

Typical male differentiation ( a —

Controlled by SRY gene

Due to expression of AMH

Degeneration of Mullerian ducts

Degeneration of Wolffian ducts

Ductule degeneration due to

absence of testosterone

Duciule system forming into vas \

deferentia

Mullerian ductule fusion

© McGraw-Hill Education
Label the diagram below to summarize hormonal control of male reproductive function.

< Begin>
(i ]
Secretes GnRH

Secretes GnRH

Sertoli cells

(locah
Testosterone Leydig
cells

Stimulate Testosterone
spermatogenesis
ood

Stimulate
spermatogenesis}

nhibin 8

—————

© McGraw-Hill Education
Label the diagram below depicting hormonal control of ovarian function during the early and middle follicular phases.

Secretes
GnRH
tes us
a GnRH
fin hypothalamo-pituitary
portal vessels)
— .

Anterior pituitary
(Primarily FSH) Secretes FSH
and LH

LH

nhibin

Estrogen

© McGraw-Hill Education
Label the diagram below depicting hormonal control of ovarian function during the late follicular phase and ovulation.

Large amounts of Progesterone and

| estrogen estrogen
Label the diagram below depicting hormonal control of ovarian function during the luteal phase.

Hypothalamus
Secretes GnRH

Decreased GnRH

Secretes FSH+LH portal vessels)

J
(Primarily FSH) Secretes FSH+LH

ee
ee
ee
ee es
ee
Decreased FSH +
LH in plasma

ee
ee
a a a
ee a
| Inhibin |
ee | Progesterone and
and |}

—
| Progesterone and

© McGraw-Hill Education