tailieunhanh - Applied Surgical Physiology Vivas - part 5

Điều này cho thấy rằng dưới một tải lọc của glucose của khoảng 400 mgmin 1, tất cả các đường lọc được hấp thụ bởi ống lượn gần (thông qua một quá trình hoạt động). Trên này tải lọc, đường bắt đầu xuất hiện trong nước tiểu từ khả năng của các tế bào hình ống để hút lại đường vượt qua. | APPLIED SURGICAL PHYSIOLOGY VIVAS G 13. Below is a graph of glucose transport in the nephron versus plasma glucose concentration. What does it show GLOMERULAR FILTRATION AND RENAL CLEARANCE Plasma glucose concentration mg dl Adapted from NMS Physiology 4th edition Bullock Boyle Wang 2001 Lippincott Williams Wilkins This shows that below a filtered load of glucose of about 400mgmin 1 all of the glucose filtered is absorbed by the proximal tubule through an active process . Above this filtration load glucose starts to appear in the urine since the ability of the tubular cells to reabsorb glucose is overcome. This maximum absorptive rate is called the tubular transport maximum Tm . The splay on the graph is due to the variations in the glucose handling of individual nephrons. 64 APPLIED SURGICAL PHYSIOLOGY VIVAS IMMOBILIZATION 1. Which systems of the body show physiologic changes following prolonged immobilization The musculoskeletal system Cardiovascular system Autonomic nervous system The extra-cellular fluid compartment There are also changes in overall body composition of fat and protein 2. What are these changes in the overall body composition that you have mentioned Reduction in the lean body mass this is seen as an increase in the excretion of nitrogen after the 5th day of bed rest. The level of protein catabolism falls after several weeks but is still higher than normal Increase of adipose tissue deposition as a replacement for loss of muscle mass Increased potassium excretion since this is the major intracellular cation and especially rich in muscle loss of potassium is an indicator of loss of total body lean tissue mass 3. How long after continued bed rest are cardiovascular changes seen About three weeks. 4. What are these changes Increase in heart rate after three weeks the rate increases about half a beat per minute per day of immobilization Reduction of stroke volume this is associated with a measure of cardiac atrophy CO and arterial pressure are .

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