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Metabolism & Nutrition, Part 1: Crash Course A&P #36

I weigh about 80 kilograms. Most of that, let’s say 64 percent, is water
— though you can’t tell by looking. I mean, as organisms go, I like to think that
I look fairly solid. After water, the next largest proportion of
me is protein, about 16% — not just in my muscles, but also in things like the tiny
sodium-potassium pumps in my neurons, and the hemoglobin in my blood, and the enzymes
driving the chemical reactions in every one of my 37 trillion cells. Then another 16% of me is fat, which I’m
totally OK with; Four percent of me is minerals, like the calcium
and phosphorus in my bones, and the iron in my blood; and 1 percent is carbohydrates, most of which
is either being consumed as I talk to you, or is sitting around as glycogen waiting to
be used. But here’s the thing: It’s not like I just ate 80
kilograms of food and then all this happened. Instead, my body, like yours, is constantly
acquiring stuff, extracting some of it to keep, burning some of it for energy, and getting
rid of the rest. But even the stuff that my body does hold
onto doesn’t last forever. Some of the chemicals that I absorb in my food eventually become
a part of me. But enzymes wear out, and membranes break down, and DNA gets oxidized. So, they
get discarded. And then I need more of those chemicals to
reconstruct the material that I’ve lost. As a result, over the course of my lifetime,
my cells will synthesize somewhere between 225 and 450 kilograms of protein … That’s like 3, or 4, or 5 separate me’s
— just made of protein. And all of the protein and fat and
carbohydrates nucleic acids that make up me, of course, come from food. Every organism has to keep taking in and breaking
down food, to keep resupplying itself with the raw materials it needs to survive. And all that activity requires energy, which
we also gain from food. So, how do our bodies actually convert what
we eat into energy and raw materials? The answer is a neverending series of reactions
that are dedicated to doing two vital, and totally contradictory, things: One set of chemical reactions destroys the
reactants that you give them, reducing big, complex substances into molecular rubble. And the other set reassembles that rubble
into new and bigger products that are put together again to make you. So our bodies are constantly reinventing themselves —
in a perpetual state of loss, but also always rebuilding. And even though all of this is happening at the
cellular level, its consequences could hardly be larger. These two sets of reactions are where everything
that we’ve learned so far — about the digestive, endocrine, circulatory, and respiratory systems
— really starts to come together. Together, these processes make up your metabolism. Now the sciencey word metabolism has
come to have a meaning in popular speech, but metabolism isn’t just one thing. People talk about metabolism as meaning, like,
how fast your body burns the fuel in your food, or how high your personal energy level
is. And that’s fine for use by personal trainers
and fitness magazines. But physiologically, metabolism really describes every
single biochemical reaction that goes on in your body. And maybe more importantly, it reconciles
two conflicting chemical processes that are always, simultaneously underway inside of
you. One of those chemical forces is anabolism. Anabolic reactions construct things and consume
energy. These are the processes that take the small
monomer building blocks in your food — like monosaccharides and fatty and amino acids
— and build them into bigger, more complex polymers like carbs, and fats, and proteins
that are used in your cells. Then, when you need new building blocks, or
you need to release some energy, those polymers in your body, or new ones in your food, get
broken up — by catabolic reactions. The processes of catabolism break down bigger
molecules, and in breaking their bonds, release the energy you need to stay warm, and move
around, and provide your cells with fuel … to build the polymers back up again. To be honest, your metabolism is a lot like
Sisyphus. It works really hard. But it is never finished. And the boulder that your inner Sisyphus is
always pushing uphill and watching fall back down? That’s nutrients — the molecules
that your body is forever breaking up, and then rebuilding, only to have them break apart
again. And these nutrients — the materials your
body needs to build, maintain and repair itself — come in six major groups. By volume, the majority of what we consume
— and what makes up our bodies — is water, so that’s maybe the most vital nutrient. Then there are vitamins, compounds that come
in either fat-soluble or water soluble forms. They aren’t used as building blocks or for
energy, but they’re essential in helping the body make use of other nutrients that
do do those things. Vitamin C, for example, helps improve iron
absorption, while vitamin K is crucial to blood clotting, and some B vitamins are important
in the production of ATP from glucose. Minerals, like vitamins, they don’t provide
fuel, but they have all sorts of other functions. Calcium, magnesium, and phosphorus harden
bones and teeth, while iron is, of course, crucial in hemoglobin. Plus, potassium, sodium,
and chlorine help maintain your body’s pH balance and are used in action potentials. So water, vitamins, and minerals are all … necessary. But the three major nutrients that everyone
always talks about — the ones you find on food labels, from oatmeal to Pop-Tarts — are
carbohydrates, lipids, and proteins. Most of the carbohydrates you’ve ever eaten — with the exception of lactose in milk —
originally came from plants. Mono- and disaccharides come from fruits, honey,
sugar beets and sugar cane, while polysaccharide starches come from veggies and grains. The main thing you need to know is that the
monosaccharide glucose is the be-all-end-all molecular fuel that your cells need to make
ATP. ATP being the molecule that your cells use
to drive anabolic reactions, when they need to make new polymers or get anything else
done — whether that’s operating a sodium-potassium pump, or detaching the head of a myosin filament
to contract a muscle. But ATP is too unstable to store, so cells
often store energy in the form of glucose, which they can then catabolize and convert
to ATP when they need it. Now, some of your cells can get their energy
from fats. But many of the most important ones, like your neurons and red blood cells,
feed exclusively on glucose. So most of the carbs that your intestines absorb are converted
to glucose for that reason. But, if it’s not needed right away, that
energy can also get stored as glycogen in your liver and muscles, or converted to glycerol
and fatty acids to make triglyceride fats. And even though there seems to be a marketing
war going on against dietary fats, we most definitely need them. The fats in your adipose tissue store energy,
of course, but they also store fat-soluble vitamins, and cushion your organs. Lipids also form the myelin that insulates
the neurons in your brain and throughout your body, as well as the oil in your skin, and they
provide the vital calorie content found in breast milk. But there are other important lipids, like
cholesterol, which is the precursor to things like testosterone and estrogen… …and, of course, phospholipids, which form
the cell membrane in every single one of the three-dozen-or-so-trillion cells you have. Now, if you’re into eating meat, a lot of
the fat that you ingest might come from that. But guess what: Plants have fat too. Plants use lipids for energy storage just
like we do, except they do it in fruits, and nuts, and seeds. Which, when you think of
it, are kind of like plant breast milk — it’s food for their growing babies. Either way, though, when you eat lipids, your
body breaks down triglycerides into glycerol and fatty acids. Those molecules can then be processed and
used in the making of ATP. Or they might be converted into other kinds of fatty acids,
which your cells can then re-assemble into your very own triglycerides or phospholipids. And your liver happens to be great at converting
one fatty acid into another, but there are some it just can’t synthesize. For example, omega 6 and 3 fatty acids are
called essential fatty acids, because your body can’t make them, so they have to be
ingested. They get turned into all kinds of useful molecules,
like the ones used for synapse formation in the brain, and for signalling inflammation
during the healing process. But — if carbohydrates provide energy, and
fats insulate and store energy, then just about everything else is done with proteins. They form the bulk of your muscle and connective
tissue, but they’re also what the ion channels and pumps are made of in your neurons and
muscle cells, and they make up your enzymes, which are responsible for pretty much every
chemical reaction in your body. In other words, your body runs on protein,
and pretty much is protein. Nutritionally speaking, meats, dairy products,
eggs, legumes, nuts, cereals are particularly high in protein. But because everything we
eat was once alive, and every cell of every living thing contains protein, as long as
you’re eating whole foods, you’re at least partially re-stocking your protein supplies. Now it might seem like you’d have eat muscle
to make muscle, or eat enzymes to make enzymes, but that’s not how it works. Since all of your proteins are made up of
just 20 amino acids, the differences between the thousands of unique proteins are simply
in the sequence of those amino acids. And, of course, you have a specialized molecule
that knows just which amino acids to put together in what order to make a certain protein. It’s called DNA. When you consume some hamburger, for example,
the protein actin in the meat gets catabolized into its component amino acids, which gets
mixed up with all the amino acids from the other proteins in the meat — like the collagen
and elastin and titin and myosin — as well as all the protein from the bun and the tomato
and the mayonnaise. Those amino acids then get reassembled using
anabolic reactions into your very own, but somewhat different, proteins, as defined by
your DNA. Each cell is like a picky little Gordon Ramsay
and it has to have every amino acid needed — every ingredient present — before it will
even think about starting to make a protein. And just like with your lipids, your cells
can improvise, and convert some amino acids to others if they’re missing an ingredient. However, there are nine essential amino acids
that you cannot make from others, and have to eat. Now lots of foods don’t provide every essential
amino acid, but when you combine foods, like beans and rice, or pasta and cheese, you do
get all of the essential amino acids. Which is important because, remember: after water,
you are mostly made of protein. On the order of 16% But what about the one percent of you? The
carbohydrates? How that tiniest fraction of you ends up creating
all of the energy, is what we’ll discover next time. But for now, you’ve learned all about the
vital nutrients — including water, vitamins, minerals, carbs, fats, and proteins — as
well as how anabolic reactions build structures and require energy, while catabolic reactions
tear things apart and release energy. And together, these competing forces form the
wonderfully conflicted process known as metabolism. Thank you to our Headmaster of Learning, Linnea
Boyev, and thanks to all of our Patreon patrons whose monthly contributions help make Crash
Course possible, not only for themselves, but for everyone, everywhere. If you like
Crash Course and want to help us keep making videos like this, you can go to patreon.com/crashcourse This episode was filmed in the Doctor Cheryl
C. Kinney Crash Course Studio, it was written by Kathleen Yale, edited by Blake de Pastino,
and our consultant is Dr. Brandon Jackson. It was directed by Nicholas Jenkins, edited
by Nicole Sweeney; our sound designer is Michael Aranda, and the Graphics team is Thought Cafe.

Randall Smitham



  1. Grand Philosopher Posted on December 24, 2018 at 7:57 pm

    damn i love this guy

  2. John Ungerleider Posted on December 24, 2018 at 11:21 pm

    Crash course medical school

  3. ianthespaceguy Posted on December 28, 2018 at 1:31 pm

    Sounds inefficient….

  4. Llwyd Morgan Posted on December 29, 2018 at 7:59 pm

    be all and end all..eh.. keto❓🤔

  5. Aria V Posted on January 4, 2019 at 8:40 am

    Women have about 20% or more fat

  6. Fatima Hussein Posted on January 10, 2019 at 4:46 am

    Trying to take notes but he talks too fast

  7. Elif YILMAZ Posted on January 12, 2019 at 4:17 pm

    he speaks very fast. That's why I had a headache.

  8. Lorraine Joseph Posted on January 15, 2019 at 2:43 am

    That poor skeleton model has a slipped disc between his lumbar vertebrae.

  9. Bond Anisston Posted on January 15, 2019 at 5:50 am

    Please give me a favor, take a minute on medication, smoke smth and slow down my friend!

  10. C. Holmes Posted on January 16, 2019 at 7:01 am

    i believe you can explain the purpose of life for the laymen..
    next CrashCourse..

  11. Nanda Mulya Posted on January 16, 2019 at 11:45 am

    Im made of non living material, how am i living?

  12. Jesica Rhodes Posted on January 28, 2019 at 3:35 am

    You said carbohydrates are how we make all of our energy, BUT triglycerides can be broken down and used to make ATP???

  13. christy liebillie Posted on January 30, 2019 at 4:17 am

    I don't understand.. am I stupid. I hardly understand English and I'm not a science student

  14. xColindres Posted on February 2, 2019 at 9:07 pm

    Danm this sounds complicated I'm glad my body does this while on cruise control.

  15. kuneho Posted on February 3, 2019 at 7:46 am

    I’m like 50% water, and 50% fat 🤷🏽‍♀️

  16. Joy Imoniaga Posted on February 6, 2019 at 11:59 am

    You are trying to impact knowledge and not telling a fairytale for Christ sake slow down

  17. 1000 Posted on February 6, 2019 at 5:16 pm

    Way too surface level for what I was looking for. I guess this channel is geared towards small children.

  18. emily nelson Posted on February 8, 2019 at 7:09 pm

    love your videos! but trying to take notes and listen is impossible when you talk so fast.

  19. drsupremo88 Posted on February 9, 2019 at 12:30 pm

    Muscle hankkkkkk

  20. Adam Kučera Posted on February 9, 2019 at 2:14 pm

    5:30 more like, almost every cell can run on fats, but then there are few who require glucose

  21. Clint Ching Posted on February 22, 2019 at 1:55 am

    "…glucose is the be-all-end-all molecular fuel that your cells need to make ATP."
    Ketone bodies: Am I a joke to you?

  22. Precious Hope Posted on March 2, 2019 at 10:55 pm

    this helped so much, god bless you nice guy!

  23. Vegan Linked Posted on March 5, 2019 at 12:48 pm

    Man this is just great, this is such a great video! You nailed this one man and really I'm going to have to study it a few times and look forward to it! I've been learning everything in catabolic scattered pieces and this video is the anabolic equivalent of what I needed!!!

  24. John Galdino Posted on March 9, 2019 at 5:17 am

    When myosin "crawls" (what's the good term for it?) on actin, could it be categorized as a single type of reaction, as it requires the breakdown of ATP, but also the temporary binding of ATP to the myosin "heads" and of calcium ions to troponin molecules?

  25. I'm Mad Posted on March 14, 2019 at 11:57 pm

    Great lecture hank

  26. PigPig Memes Posted on March 15, 2019 at 5:07 pm

    Thanks! This helped me with my 3 page assignment 🙂

  27. Frank Back Posted on March 15, 2019 at 9:38 pm

    Our team is [seeking|looking for} highly motivated [individuals|entrepreneurs] to help us kick off the launch of our new DNA Nutrition company. When you join our team, you will receive $8,000 worth of Eric Worre training included at no cost. If you are interested in learning more, please post "info" for more details.

  28. oskar tang Posted on March 17, 2019 at 1:56 pm

    I watched it at 0.75x speed😀

  29. Hani Fahim Posted on March 20, 2019 at 5:25 am

    Why you speak so quickly ??

  30. Mahmoud Hammash Posted on March 21, 2019 at 12:24 pm

    0.75 is the original speed 😀

  31. Gilgamesh Posted on March 27, 2019 at 11:56 pm

    lol, who's here for extra credit xd

  32. Gautam Kunal Posted on April 1, 2019 at 5:29 am

    data data data beep beep beep.. take a breath man slow down.. or make video on how fast you can throw information and how fast a normal mind can digest it….

  33. Gamer Bouss Posted on April 3, 2019 at 11:01 am

    For some reason the DNA keeps on moving on hanks table

  34. Ricardo Abreu Posted on April 3, 2019 at 5:20 pm

    Slow down, caralho!

  35. Daniel Hain Posted on April 7, 2019 at 3:02 pm

    Guys smoke a joint and play it on slow! I love crash course so much! stoners rule the world!

  36. Supreme Posted on April 11, 2019 at 3:47 am

    What’s the 9th essential amino acid? There’s only 8 last time I checked.

  37. neeraj singh Posted on April 16, 2019 at 8:43 pm

    It means fat is good source of energy compare to carbohydrates .. carbs @ 4kcal protine @ 4kcal n fats @9 kcal..it means fat is really good

  38. Ashley Noelle Posted on April 16, 2019 at 8:58 pm

    This dude has got to be either a vegan himself or married to one.

  39. The Rojava Revolution 2019 Posted on April 23, 2019 at 11:19 pm

    I’m finally understanding crash course. The trick is to keep your mind open. Don’t get caught up in the WHY just understand what’s placed in front of you. Then, in the future, things will slowly come together over time.

  40. Kenley Ambroise Posted on April 28, 2019 at 4:25 pm

    ty! IB tests are next week and I've only discovered a viable way to study last week 🤣

  41. vc_ visions Posted on April 29, 2019 at 1:57 pm

    But dr.sebi said glucose is the number 1 enemy in disease. To avoid glucose as much as possible. But that doesn’t make since if we need it to produce atp. How did Dr. Sebi go 2 months eating nothing but a plant? Makes no sense to me

  42. Abdulrahman Radwan Posted on April 30, 2019 at 8:19 am

    Thanx so much doctor

  43. audrey opalmier Posted on April 30, 2019 at 9:31 pm

    Whoever is finding it too fast, go on the 3 dots and adjust the speed 😉

  44. ZIED BEN NACER Posted on May 2, 2019 at 9:03 pm

    i watch it in 0.75x speed

  45. Christopher Har V Posted on May 4, 2019 at 11:38 pm

    The clipping together of his sentences so that there’s never a millisecond of silence between his points is incredibly fatiguing on the ear and the mind.

  46. Abigail Andrade Posted on May 7, 2019 at 3:48 am

    I just have to say thank you. And for all the people out there who complains about how fast he speeks. Dudes you can adjuste the velocity or watch another video. Search for solutions and don let hate on the comments section.

  47. Foodie boi Posted on May 7, 2019 at 11:26 am


  48. Shreyas K Posted on May 10, 2019 at 5:01 am

    sorry if this is nitpicking, but 64+16+16+4+1=101 0:25

  49. Vick Posted on May 17, 2019 at 4:45 pm

    Had to watch video at x.75 speed 😢

  50. Andre Johnson Posted on May 18, 2019 at 12:36 pm

    * puts peanuts in the nut category when he also mentions the legume category * 7:39

    Love your videos.

  51. TheaDragonSpirit Posted on May 21, 2019 at 10:06 pm

    6:00 – It's not a marketing war. It's simply if you eat fruits and veggies you will get enough fat. Possibly chuck in some nuts and seeds now and again. It's not a war against fat, it's a war against eating foods high in fat, because these foods cause more harm then good.

  52. Ken Bell Posted on May 23, 2019 at 1:40 am

    You do NOT need glucose to produce ATP Hank. Ketones are more efficient.
    Please research the topic more thoroughly and update your beliefs.

  53. Brenda Contreras Posted on May 24, 2019 at 2:19 pm

    I had to pause video like 10 times not because I'm slow but there are so much to learn and analize too much info at the time lol

  54. Vanessa Gomez Posted on May 30, 2019 at 4:26 pm

    love this. thank you so much, i love crash course

  55. Nikka Lai Posted on June 5, 2019 at 12:24 pm

    Two minutes in – let me throw in an intro

  56. Caitlin Lynch Posted on June 6, 2019 at 12:43 pm

    Has anyone noticed the %s at the beginning add up to 101%? I literally did the maths twice, and then with a calculator because I thought I'd gone mad…

  57. Peter Foster Posted on June 8, 2019 at 8:46 pm

    Very efficiently explained.

  58. Vigneswara Prabhu Posted on June 13, 2019 at 3:37 pm

    Wow, That was Impressive. He pretty much glossed over Most of Lehninger in 10 Min.

  59. Starry Starr Posted on June 14, 2019 at 6:27 pm

    How are we only 1% carbs when carbs energize the entire body…. I dont buy it

  60. Vanessa Gomez Posted on June 17, 2019 at 5:18 pm

    go vegan ahhah

  61. Harvey Bennett Posted on June 19, 2019 at 9:26 am

    Hi HANK…. hee hee hee, I love your glassessssss giggles you make me feel special. My parents never look at me and tell me to look in the corner for 5 hours a day. Please come and visit me in Yorkshire! love you!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! I want to give thos glassessssssss a good licking. 😛 Whats that on your desk :).

  62. anthony white Posted on June 19, 2019 at 11:42 pm

    Thank you for the videos!

  63. The Daily Digestion Posted on June 28, 2019 at 3:53 am

    Great video!! Thank you!!👍❤️🙏🏻🐇

  64. Yosef Yura Attakov Posted on June 29, 2019 at 7:52 pm

    hank i wanted to tell you somthing..
    you are 101% a human 0:02–0:35
    had to calculate it 5 times to see it

  65. Jason's Family and friends Videos Posted on July 7, 2019 at 5:09 am

    I love these vids but at around 5mins, 'glucose is the be all that your body needs to drive atp' no, ketones (catabolism of adipose tissue or body fat) also create atp and on far greater amounts and efficiency with less water and oxygen. No essential carbohydrates. The small amount of glucose needed by the body in some cells can be made by the liver from protein (glyconeogenesis).

  66. Getty Tandi Posted on July 10, 2019 at 10:14 am

    I hardly follow.

    He's a fast speaker

  67. Katherine Bonkowski Posted on July 16, 2019 at 5:56 am

    You are what you eat, so eat good foods.

  68. Im black And gay Posted on July 18, 2019 at 10:17 am

    So what's metabolism

  69. Kelly Kirkpatrick Posted on July 18, 2019 at 5:00 pm

    Slow down

  70. Anna Baker Posted on July 18, 2019 at 8:39 pm

    well like the video but to fast with speaking on the topic a little slower next time thank you

  71. Brenda Flores Posted on July 20, 2019 at 1:32 pm

    Great explanation! Thank you.

  72. Richard Greathead Posted on July 25, 2019 at 12:17 pm

    Great info! Thanks for sharing!

  73. Lil Woozy Posted on July 27, 2019 at 1:45 am


  74. Sayali Mane Posted on July 27, 2019 at 12:55 pm

    You look like Carl Sagan

  75. Sky Doll Posted on August 1, 2019 at 9:16 am

    Why did you just describe yourself as a good product ? 🤮

  76. Skull-Session Productions Posted on August 2, 2019 at 11:17 pm

    This guy reminds me of John Mulaney 😂😂😂

  77. Ann A Posted on August 6, 2019 at 5:50 pm

    I love your graphics.

  78. kunal chugh Posted on August 8, 2019 at 7:24 pm

    Talking to yourself ?

  79. Pritam Sarkate Posted on August 17, 2019 at 10:23 am

    Talk little slow please

  80. Leen Shammout Posted on August 17, 2019 at 11:29 am

    One of the best channels ever , very helpful ❤️

  81. Safa Safa Posted on August 19, 2019 at 3:54 am

    What is a low energy person? energy comes from food only. If you don't eat 3 times a day, you suffer on long term; immune system weaker , bones weaker etc. donkeys in security have their own science

  82. Gacha Girl Posted on August 19, 2019 at 3:24 pm

    It seems like he talks at normal speed at 0.75 speed

  83. Josiah Kratz Posted on August 22, 2019 at 2:44 am

    Listen here crash course before you convince the world to stop eating meat…..acknowledge the only source of complete protein comes from animals!

  84. Anita Burke Posted on August 25, 2019 at 10:49 pm

    I almost took metabolism in college, but I took karate instead

  85. Aeric Posted on August 26, 2019 at 5:59 am

    Yeah but what should I eat?

  86. Khandeece Posted on August 29, 2019 at 6:12 am

    How are they able to know this

  87. Richard Hunting Posted on September 1, 2019 at 12:25 am

    Loved the Gordon Ramsey reference!

  88. DiabloMinero Posted on September 3, 2019 at 8:15 pm

    Vitamin K2, in addition to its expected role in blood clotting, helps the body transfer calcium out of arteries and into bones, thus protecting against both heart disease and osteoporosis.
    Oh, and neurons don't run exclusively on glucose. They can derive up to 75% of their energy from ketone bodies if you're on a low-carbohydrate diet.
    And plant protein sometimes has lousy bioavailability. The fact that grains have tons of amino acids in them doesn't mean you can actually get at them.

  89. Caitlyn Robinson Posted on September 4, 2019 at 10:52 am

    Please make a Crash Course pathophysiology!

  90. Kooshi Koo Posted on September 7, 2019 at 1:33 pm

    Your brain can use ketones bodies (produced from fats in the liver) as well as glucose.

  91. WizardlyTim Posted on September 7, 2019 at 9:23 pm

    An instructor from an A&P class I took years ago pointed out that pretty much every "popular" food combo we can think of contains all the essential amino acids. Cultures that first discovered these combinations had the habit of not being dead during tough times when dietary options were reduced down to simple of dishes of beans and rice, peas and carrots, etc. And now a-days, those combinations are basically ingrained into the culture of what we eat together.

  92. AriannaAyers Posted on September 9, 2019 at 1:13 pm

    I did not find this video useful. The narrator spoke too quickly, and the graphics weren't as polished as I'd hoped. Back to Medscape I suppose.

  93. 젠츄리챙bp Posted on September 10, 2019 at 11:50 am

    Korean please..

  94. Angeline Gonyea Posted on September 12, 2019 at 5:52 pm

    love playing it on 0.75 playback

  95. Justin Murray Posted on September 13, 2019 at 7:09 pm

    Suddenly hungry…

  96. Yasar for Forever Posted on September 16, 2019 at 3:17 pm

    i have best solution for your every health problem

  97. Victorio Petarnella Posted on September 17, 2019 at 3:12 pm

    aee qm e br manda salve 🇧🇷🇧🇷🇧🇷

  98. Giovanni Leal Posted on September 17, 2019 at 3:13 pm

    quem eh br manda salve