I.

Introduction to Calcium Homeostasis A. Hypocalcemia- low blood calcium conc. 1. Muscle spasms, heart dysfunction B. Hypercalcemia 1. Conc. of blood higher than normal 2. Diffuse precipitation of calcium phosphate in tissues, leading to organ dysfunction

II.

Major pools of calcium A. Intracellular 1. Mitochondria/ endoplasmic reticulum 2. Release from cellular stores/ influx from ECF 3. Intracellular signaling, enzyme activation, muscle contractions B. Calcium in blood/ ECF 1. Half of calcium in blood is bound to proteins 2. Conc. of phosphorus is equal to that of calcium C. Bone Calcium 1. Majority of body calcium is in bone 2. 99 percent tied up in mineral phase, 1% can rapidly exchange w/ extracellular calcium 3. Most of phosphate is in mineral phase of bone

III.

Functions of Skeleton A. Structural support for heart, lungs, marrow B. Protection of the brain, uterus C. Attachment sites for muscles allowing movement of limbs D. Mineral reservoir for calcium/ phosphorus E. Defense against acidosis F. Trap dangerous materials G. Bone Architecture 1. Spongy- trabecular, gives strength to the ends 2. Cortical- solid bone on the outside forms the shaft of long bone H. Mineral reservoir 1. Bone stores 99% of the body’s calcium, 85% of phosphorus

IV.

Bone Cells

Reabostion of bone mineral releases calcium and phosphate into blood. Glomerular filtrate is reabsorbed from tubular system VI. Maximize reabsoprtion of Ca in kidney ( little calcium loss in pee) B. Parathyroid hormone 1. Come from precursor cells that can be osteoblasts or fat cells 5. Secrete acid/ enzymes which degrade the bone B. Stimulates production of vit. Reduces calcium levels . of calcium 2. Osteoblasts 1. Calcitonin 1. Hormonal Control Systems A. parathyroid hormone 6. Important in calcium homeostasis 2. which was secreted by osteoblasts 4. Precursors have RANK receptors activated by RANK ligand. Moves calcium and phosphate in bone 4. estrogen. Fluxes of Calcium and Phosphate A. PHEX. Increases blood conc. Receptors for vit. Gap junctions 4. D. Osteoclasts 1. Small intestine 1. Bone 1. Dietary calcium is absorbed B. Form bone 2. Cuboidal/columnar in shape 3. suppressing this effect allows calcium to be doposited C. Precursors circulate in the blood/bone marrow 3. Di in kidney 3. Can eliminate phosphate in kidney 5. Reservoir of calcium 2.A. Kidney 1. Dissolve or reabsorb bone 2.helps regulate phosphate excreted by the kidney V.

S by a type of calcium resstance (hypocalcciuric hypercalcemia) 3. Secreted in response to hypercalcemia 3. Parathyroid cells/ C cells in thyroid gland involved with control of parathyroid hormone and calcitonin D. Parathyroid Gland/ Hormone A. 4. Vitamin D 1. Calcium sensor is a component of the system responsible for calcium homeostasis B. Stops bone reabsorption C. Activating mutations 1. Stop adenylate cyclase. The Calcium sensing Receptor A.2. Enhances excretion of calcium into urine 4. Most important endoc . Activation of phospholipase C which can make second messengers DAG/IP3 3. Facilitate absorption of calcium from small intestine VII. Abnormal set point in sensitivity of the parathyroid gland to blood calium conc. Mutations 1. Elevated sensitivity to calcium 2. Made through activity of parathyroid hormone 2. oc cAMP C. Different mutations in the calcium sensor gene have been id 2. G protein receptor family 2. Calcium sensing receptor 1. Hypercalciruic hpyocalcemia which is the opposite of what is seen with inactivating mutations VIII. which suppresses conc.

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