Pathophysiology Test 1 Chapter 10

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define the terms nutritional status and metabolism

nutritional status describes the condition of the body related to the availability and use of nutrients
metabolism is the organized process through which nutrients such as carbohydrates, fats, and proteins are broken down, transformed, or otherwise converted into cellular energy

define the term calorie and state the number of calories derived from the oxidation of 1 g of protein, fat, and carbohydrate

calorie is the amount of heat or energy required to raise the temperature of 1 g of water by 1 degree C
the oxidation of protein provides 4kcal/g; fats 9 kcal/g; carbohydrates 4kcal/g

calories in =

calories used + calories stored

caloric intake is controlled by

appetite
hunger and satiety centers in hypothalamus

calorie use is controlled by

metabolic rate
thyroid hormones
activity level

calories are stored in

adipose tissue
white adipose tissue
brown adipose tissue
90% of body energy stored as triglycerides in the fat cells of the body.

Brown adipose mostly NB and able to produce heat.

discuss the role of the hypothalamus in the control of energy intake

the hypothalamus contains the feeding center for hunger and satiety
it recieves neural input from the GI tract that provides information about stomach filling, chemical signals from nutrients in the blood, and input from the cerebral cortex regarding the smell, sight, and taste of food

adipose tissue

not just a resovior for energy storage
express and secrete bioactive peptides
energy metabolism
neuroendocrine function
immune function
chronic inflammatory response
abnormal cytokine production
increase c reactive protein
type 2 diabetes

list the major causes of malnutrition and starvation

poverty
lack of knowledge
acute and chronic illness
self imposed dietary restriction

upper and lower body obesity

Two types of obesity based on distribution of fat
Upper body: central, abdominal, or visceral

Lower body: peripheral or gluteal-femoral.

Determined by dividing the waist by the hip circumference. Waist to hip ratios greater than 1.0 in men or 0.8 in women

marasmus

too few calories in diet
too little protein in diet
progressive loss of muscle mass and fat stores due to inadequate food intake that is equally deficient in calories and protein
child with marasmus has a wasted appearance with loss of muscle mass stunted growth and loss of subcutaneous fat; a protruding abdomen (from muscular hypotonia)wrinkled skin sparse dry and dull hair and depressed heart rate blood pressure and body temp diarrhea is common

kwashiorkor

adequate calories in diet
too little protein in diet
more severe form of malnutrition
severe loss of the viscera protein compartment with a resultant hypoalbuminemia that gives rise to generalized or dependent edema

state the causes of malnutrition in trauma and illness

in persons with severe injury or illness net protein breakdown is accelerated and protein rebuilding disrupted. protein mass is lost from the liver, GI tract, kidneys, and heart. as protein is lost from the liver, hepatic synthesis of proteins declines and plsma protein levels are decreased
there also is a decrease in immune cells
wound healing is poor, and the body is unable to fight off infection bc of multiple immunologic malfunctions throughout the body

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