Study Guide for Final Exam

General Notes:
Bring a scantron form, pencils and pen to the exam! It is going to be at 100 of the 200 points on the final will be from the last part of the course. The other 100 points will cover the first and second midterm material, so look over the study guides from those exams. These learning objectives are for the new material only...the previous learning objectives still apply! As usual, you should go over your notes and the referred reading, particularly anything that Dr. Timiras suggested you review. A lot of the new material was based on review of the old material too, which makes your life easier. You will find notes for Professor Timiras' lectures on the website, and use those those as a guide. Please refer to your lecture notes for the guest lectures. The exam will be multiple choice, true-false, short essays, diagrams, and some fill in the blank.

Growth.
Know the causes of shortness of stature as well as gigantism. See also Dr. Helbocks lecture with growth curves as well. You are not to calculate expected height with the formulas, but you should know the influences. Understand the different kinds of growth (relative/allometric, catch-up, compensatory, and functional demand in regulation of growth). Know the figures from Chapter 15 in the syllabus that she referred to in lectures. Know the S-shaped sigmoid growth curve and where the two peaks of accelerated growth take place. When looking at the charts and graphs be aware of the values on the X and Y values, particularly if it is a height or a rate or if the age is prenatal or postnatal to adolescent age. Understand the different proportions of the head and body from the fetal stage to the adult. Know the development of the different organs and their growth patterns.
Immune System
Go over the different cells in the immune system and their functions (T-helper, T-killer, T-suppressor cells; B cells, plasma/memory cells, antibodies; neutrophils, macrophages, natural killer cells, etc). Understand what it means to "fix complement" or "complement-mediated lysis, CML": set of plasma proteins or their precursors that are sequentially activated by contacting the heavy chains of immunoglobulins (Ab) attached to antigens on bacteria. The binding induces a cascade in which the proteins form a hole in the cell membrane and cause lysis. It also attracts phagocytic cells to remove debris. Review the antigen presentation process in the macrophage-T cell interaction and the Tcell-Bcell interaction, as well as what happens in viral infections. Understand the role of the thymus in clonal deletion: immature T cells become mature in thymus must undergo a mixing/exposure to normal cells and self-antigens. If any T cell interacts then it is destroyed and never has the potential to leave the thymus. Understand what is meant by thymic involution (review the graphs for thymus weight). Know the differences between IgG, IgA, IgM, IgD, and IgE. Understand the developmental processes of T cells, neutrophils, complement proteins, and mature B cells. When do each begin to show in the fetus?
Hypothalamic-Pituitary-Gonadal Axis, Puberty, and Adolescence
Review normal development of the different sexes from earlier lectures. Understand the hormonal regulation of the mature reproductive system. What cells are involved and what do they secrete, and how do they feedback on each other? How does this process differ between male and female? Understand the mature "gonadostat" and how it develops. Keep in mind the levels of GnRH, gonadotropins LH and FSH, and sex steroids after birth, during the juvenile period, and how change comes about during puberty. Understand why the onset of puberty is delayed until the hypothalamus matures. How does this maturation take place? How is the secretion of GnRH regulated by the hypothalamus? The level of hormones required for inhibition of GnRH release increases during puberty. The maturation of the limbic system is very important. The pineal gland secretes melatonin, which regulates the diurnal changes that help signal an internal clock. This may contribute to the onset of puberty but is unclear. Understand the concept of precocious puberty. Review the biological and social factors affecting development of sexual behavior. Know the differences in puberty for females and males, including changes in heart rate, age of onset, height of growth peaks, genital and extragenital changes that occur.
Musculoskeletal
Understand the different types of muscles and their characteristics. Know the steps in contraction and the role of Ca++, troponin, tropomyosin, actin, and myosin. What hormones would affect calcium levels (and thus excitability) in the muscle? Know the differences between the Type I slow muscle fiber and the Type II fast fibers. Understand that muscle differentiates from myoblasts that come from mesoderm. Know when the earliest muscle activity is recorded (8 weeks) and when recognizable contractions are observed (16-18 fetal weeks). Know the development muscle (e.g. fetal myosin subunits differ from adult version.) Understand the ability of the muscle fibers for plasticity and regeneration. Review pages 287-293 and related figures.
Stress
Know the handout! Have a general understanding of the relationship between stress and growth. The stress response is essential for the body's ability to cope with threats to health and well-being. Be familiar, however, with the tradeoff that stress exacts in terms of growth. Know the physiologic characteristics of the immediate stress response mediated by the sympathetic nervous system, as mediated by epinephrine and norepinephrine. (HSM: hypothalamic-sympathetic-adrenomedullary axis) Understand the effects of epinephrine on specific tissues: cardiovascular, respiratory, and metabolic . Know that epinephrine is most important in the acute response to stress. Its effects are short-lived, although repeated stresses can cause equally frequent elevations in epinephrine. Know the physiologic characteristics of the more long-lasting stress response mediated by the hypothalamic-pituitary-adrenocortical axis. Decreased glucose utilization all over the body. Reduction in cellular protein in all tissues except the liver. Increased mobilization of fatty acids. The net effect is to slow or inhibit overall growth and development, which requires glucose and protein. Know the consequences of chronic stress listed on the handout from lecture.
Establishment of Mature Homeostasis
Understand the cardiovascular changes that accompany adolescence, as discussed in lecture. Know overall trends and changes in regulation of the following: Heart rate Blood pressure Venous return (a determinant of stroke volume) Cardiac contractility (a determinant of stroke volume) Understand the trend in basal metabolic rate from birth to maturity
Nutrition and Eating Disorders
Understand the characteristics of bulimia and anorexia, as discussed in lecture. Explain the difference between the "feeding center" and the "satiety center". How do leptin, CCK, and adipsin play a role in appetite and obesity? Underand the specific deficiencies and characteristics of the types of malnutrition discussed in lecture, including kwashiorkor and marasmus.