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A Textbook of Practical Physiology
CL Ghai
SECTION ONE:
Hematology
1-1 The Compound Microscope
1. PARTS OF THE MICROSCOPE
A. The Support System.
B. The Focusing System
C. The Optical (Magnifying) System
D. The Illumination System
2. PHYSICAL BASIS OF MICROSCOPY
A. Visual Acuity
B. Resolving Power (Resolution)
C. Magnification
D. Numerical Aperture (NA)
E. Image Formation in the Compound Microscope
F. Working Distance
G. Calculation of Total Magnification
3. PROTOCOL (PROCEDURES) FOR THE USE OF MICROSCOPE
Principle
Procedures
A. Focusing Under Low Power (100 x)
B. Focusing Under High Power (450 x)
C. Focusing Under Oil-immersion (1000 x)
“Racking the Microscope”
4. COMMON DIFFICULTIES ENCOUNTERED BY STUDENTS
5. PRECAUTIONS AND ROUTINE CARE
6. OTHER TYPES OF MICROSCOPES
QUESTIONS
1-2 The Study of Common Objects
PREPARATION OF SLIDES
1-3 Collection of Blood Samples
1. ASEPSIS
A. Sterilization of Equipment
B. Cleaning/Sterilization of Skin
C. Prevention of Contamination
2. THE BLOOD SAMPLE
A. Sources and Amount of Blood Sample
B. Containers for Blood Sample
C. Differences Between Venous and Capillary Blood
3. COMMONLY USED ANTICOAGULANTS
A. In vitro Anticoagulants
B. In Vivo Anticoagulants and Their Clinical Use
4. COLLECTION OF VENOUS BLOOD
APPARATUS AND MATERIALS
PROCEDURES
PRECAUTIONS
5. COLLECTION OF CAPILLARY BLOOD (SKIN-PRICK METHOD)
Selection of Site for Skin Prick
APPARATUS
PROCEDURES
Ear-lobe Prick
Pricking the Heel
PRECAUTIONS
QUESTIONS
1-4 Hemocytometry (Cell Counting) The Diluting Pipettes
HEMOCYTOMETRY
Principle
Units for Reporting
Significance of Counting the Cells in a Chamber
Automatic Electronic Cell Counters
Sources of Error in Cell Counting
Steps in Hemocytometry
Hemocytometer
STUDY OF THE DILUTING PIPETTES
Parts of a Diluting Pipette
Principle Underlying the Use of Diluting Pipettes
Differences Between the Two Pipettes
Filling the Pipette
Calculation of Dilution Obtained (Dilution Factor)
PRECAUTIONS
QUESTIONS
1-5 Hemocytometry (Cell Counting) The Counting Chamber
PROCEDURES
PRECAUTIONS
QUESTIONS
1-6 Examination of Fresh Blood: A. Drop Preparation B. Preparing a Peripheral Blood Film
A. DROP PRESENTATION
APPARATUS AND MATERIALS
PROCEDURES
OBSERVATIONS
B. PREPARATION OF A BLOOD FILM (BLOOD SMEAR)
PROCEDURES
OBSERVATIONS
Features of an Ideal Blood Film
PRECAUTIONS
Cleaning the Slides
QUESTIONS
1-7 Estimation of Hemoglobin
PRINCIPLE
APPARATUS AND MATERIALS
PROCEDURES
Sources and Degree of Error
OBSERVATIONS AND RESULTS
Normal Values
OTHER METHODS OF ESTIMATING HEMOGLOBIN
PRECAUTIONS
QUESTIONS
1-8 The Red Cell Count
PRINCIPLE
APPARATUS AND MATERIALS
PROCEDURES
Rules for Counting
OBSERVATIONS AND RESULTS
Degree and Sources of Error
Normal Red Cell Count
PRECAUTIONS
QUESTIONS
1-9 Determination of Hematocrit (HcT) (Packed Cell Volume; PCV)
APPARATUS AND MATERIALS
PROCEDURES
OBSERVATIONS AND RESULTS
PRECAUTIONS
QUESTIONS
1-10 Normal Blood Standards (Absolute Corpuscular Values and Indices)
APPARATUS AND MATERIALS
PROCEDURES
I. Mean Corpuscular Volume (MCV)
II. Mean Corpuscular Hemoglobin (MCH)
III. Mean Corpuscular Hemoglobin Concentration (MCHC)
IV. Mean Corpuscular Diameter (MCD)
V. Color Index (CI)
QUESTIONS
1-11 The Total Leucocyte Count (TLC) White Cell Count (WCC)
PRINCIPLE
APPARATUS AND MATERIALS
PROCEDURES
OBSERVATIONS AND RESULTS
Sources and Degrees of Error
PRECAUTIONS
QUESTIONS
Physiological Leucocytosis
Pathological Leucocytosis
Physiological Leucopenia
Pathological Leucopenia
1-12 Staining a Peripheral Blood Film The Differential Leucocyte Count (DLC)
PRINCIPLE
Special Importance of a Blood Smear
APPARATUS AND MATERIALS
Steps in Differential Leucocyte Counting
PROCEDURES
A. Preparing the Blood Films
B. Fixing and Staining of Blood Films
OBSERVATIONS AND RESULTS
C. Assessment of Stained Blood Smears
Feature of a Well-stained Blood Smear
D. Identification of Leucocytes Under Oil-immersion
E. Differentiation Between Various Leucocytes
F. Differential Counting of Leucocytes
PRECAUTIONS
QUESTIONS
1-13 The Cooke-Arneth Count (Arneth Count)
APPARATUS AND MATERIALS
Procedures
PRECAUTIONS
QUESTIONS
1-14 Absolute Eosinophil Count
PRINCIPLE
APPARATUS AND MATERIALS
PROCEDURES
OBSERVATIONS AND RESULTS
PRECAUTIONS
QUESTIONS
1-15 Study of Morphology of Red Blood Cells
PROCEDURES
1-16 The Reticulocyte Count
PRINCIPLE
APPARATUS AND MATERIALS
Theory of Reticulocyte Staining
PROCEDURES
OBSERVATIONS AND RESULTS
Calculations
PRECAUTIONS
QUESTIONS
1-17 Erythrocyte Sedimentation Rate (ESR)
PRINCIPLE
APPARATUS AND MATERIALS
PROCEDURES
APPARATUS AND MATERIALS
PROCEDURES
OBSERVATIONS AND RESULTS
PRECAUTIONS
QUESTIONS
1-18 Blood Grouping (Syn: Blood Typing)
PRINCIPLE
APPARATUS AND MATERIALS
PROCEDURES
OBSERVATIONS AND RESULTS
PRECAUTIONS
QUESTIONS
1-19 Tests for Hemostasis (Bleeding time; coagulation time; Platelet count; and other tests)
PHYSIOLOGICAL BASIS OF BLEEDING DISORDERS
DEFECTS OF PLATELETS AND VESSEL WALLS
DEFECTS OF CLOTTING
TESTS FOR HEMOSTASIS
BLEEDING TIME (BT) AND CLOTTING TIME (CT)
PROCEDURES
PRECAUTIONS
PROCEDURE
A. DIRECT METHODS
PROCEDURES
[B] INDIRECT METHOD
[C] AUTOMATED METHOD
[I] Capillary Blood Clotting Time (Wright's Capillary Glass Tube Method)
[II] Drop Method
[III] Venous Blood Clotting Time (Lee and White Test-tube Method)
QUESTIONS
Basic Theory of Coagulation
1-20 Osmotic Fragility of Red Blood Cells (Syn: Osmotic Resistance of Red Blood Corpuscles)
PRINCIPLE
APPARATUS AND MATERIALS
PROCEDURES
OBSERVATIONS AND RESULTS
Normal Range of Fragility
Modified Experiment
PRECAUTIONS
QUESTIONS
1-21 Specific Gravity of Blood and Plasma (Copper Sulphate Falling Drop Method of Philips and van Slyke)
PRINCIPLE
APPARATUS AND MATERIALS
PROCEDURES
OBSERVATION AND RESULTS
QUESTIONS
1-22 Determination of Viscosity of Blood
PROCEDURES
Viscosity of Blood
Significance of Viscosity of Blood
SECTION TWO:
Human Experiments
2-1 Stethography Recording of Normal and Modified Movements of Respiration
APPARATUS AND MATERIALS
PROCEDURES, OBSERVATIONS AND RESULTS
PRECAUTIONS
QUESTIONS
2-2 Determination of Breath Holding Time (BHT)
PROCEDURES
OBSERVATIONS AND RESULTS
QUESTIONS
2-3 Spirometry (Determination of Vital Capacity, Peak Expiratory Flow Rate, and Lung Volumes and Capacities
DEFINITIONS AND TERMINOLOGY
LUNG VOLUMES AND CAPACITIES
STATIC AND DYNAMIC LUNG VOLUMES AND CAPACITIES
A. SPIROMETRY (VITALOMETRY) EFFECT OF POSTURE ON VITAL CAPACITY
PROCEDURES
OBSERVATIONS AND RESULTS
B. RECORDING SPIROMETER
PROCEDURES
C. TIMED VITAL CAPACITY (FEV1)
Clinical Significance of Timed Vital Capacity
PEAK EXPIRATORY FLOW RATE (PEFR)
PROCEDURE
QUESTIONS
2-4 Pulmonary Function Tests
PULMONARY FUNCTION TESTS
Purpose of Lung Function Tests
Classification of Pulmonary Function Tests
QUESTIONS
2-5 Cardiopulmonary Resuscitation (CPR) (Cardiopulmonary-Cerebral Resuscitation (CPCR)
AIM OF CPR
THE ABC OF CPR
CAUSES OF CARDIOPULMONARY ARREST
SIGNS AND SYMPTOMS OF CARDIOPULMONARY ARREST
WHAT TO DO IMMEDIATELY
What Not To Do
GENERAL PLAN FOR CARDIOPULMONARY RESUSCITATION
ARTIFICIAL RESPIRATION (PULMONARY RESUSCITATION)
A. Manual Methods
B. Mouth-to-Mouth Respiration (Rescue breath; Exhaled-air ventilation)
PROCEDURES
C. Mechanical Respirators
EXTERNAL CARDIAC MASSAGE (CARDIAC RESUSCITATION)
PROCEDURES
In Infants
Internal or Open Cardiac Massage
CPR for Oneself
Reasons for Failure of CPR
Ventricular Fibrillation (VF)
INHALATION OF FOREIGN BODYHEIMLICH MANEUVER (ABDOMINAL THRUST)
PROCEDURES
Emergency Procedure in Children
QUESTIONS
2-6 Recording of Systemic Arterial Blood Pressure
INTRODUCTION
Measurement of Blood Pressure
PRINCIPLE
APPARATUSES
Stethoscope (Steth = chest, scope = to inspect)
Sphygmomanometer(Commonly called the “BP apparatus”)
PROCEDURES
A. Palpatory Method (Riva Rocci 1896)
B. Oscillometric Method
PROCEDURE
C. Auscultatory Method (Korotkoff, 1905)
COMMENTS, OBSERVATIONS AND RESULTS
PRECAUTIONS
QUESTIONS
2-7 Effect of Posture, Gravity and Muscular Exercise on Blood Pressure and Heart Rate
PROCEDURAL PRECAUTIONS
EFFECT OF CHANGE IN POSTURE
PROCEDURES
EFFECT OF GRAVITY
PROCEDURES
EFFECTS OF MUSCULAREXERCISE
PROCEDURES
OBSERVATIONS AND RESULTS
QUESTIONS
2-8 Cardiac Efficiency Tests (Exercise Tolerance Tests)
QUESTIONS
2-9 Demonstration of Carotid Sinus Reflex
PROCEDURES
QUESTIONS
2-10 Demonstration of Venous Blood Flow
PROCEDURES
QUESTIONS
2-11 Recording of Venous Pressure
PROCEDURES
Experiment I
Experiment II
Experiment III
QUESTIONS
2-12 Demonstration of Triple Response
2-13 Electrocardiography (ECG)
INSTRUMENTATION
I. The ECG, Machine
II. Electrodes
III. ECG Paper
IV. Pen Recording System
V. Electrocardiographic Leads
PROTOCOL
2-14 Experiments on Student Physiograph
2-15 Perimetry (Charting the Field of Vision)
PERIMETER
Student Perimeter
Factors Affecting Visual Field
PROCEDURES
PRECAUTIONS
QUESTIONS
2-16 Mechanical Stimulation of the Eye
2-17 Physiological Blind Spot
I.Mariotte's Experiment
II.Plotting the Blind Spot
2-18 Near Point and Near Response
PROCEDURE
II.Near Response
III.Range of Accommodation
QUESTIONS
2-19 Sanson Images
PROCEDURES
2-20 Demonstration of Stereoscopic Vision
PROCEDURES
2-21 Dominance of the Eye
PROCEDURES
2-22 Subjective Visual Sensations
2-23 Tuning-Fork Tests of Hearing
INTRODUCTORY
I. Nature and Characteristics of Sound Waves
II. Mechanism of Hearing
III. Auditory Pathway
IV. Tests of Hearing
TUNING-FORK TESTS
Air (Ossicular) Conduction (AC)
Bone Conduction (BC)
Principles of Tuning-Fork Tests
PROCEDURES
I.Rinne's Test
II.Weber's Test
III. Schwabach's Test
QUESTIONS
2-24 Localization of Sound
2-25 Masking of Sounds
2-26 Sensation of Taste
PROCEDURES
2-27 Sensation of Smell
2-28 Laboratory Exercise on Sensations of Touch, Pain, Temperature
TOUCH, PRESSURE, VIBRATION
PROCEDURES
PAIN
TEMPERATURE
2-29 Electroencephalography (EEG)
FEATURES OF EEG WAVES
Cause of EEG Waves
INSTRUMENTATION
PROTOCOL
Interpretation of EEG
Clinical Applications of EEG
2-30 Electro-neuro Diagnostic Tests Nerve Conduction Studies Motor Nerve Conduction in Median Nerve
PRECAUTIONS
NERVE CONDUCTION STUDIES
Clinical Significance
Nerves and Nerve Fibers
MOTOR NERVE CONDUCTION
Principle
PROCEDURE
2-31 Electro-neuro Diagnostic Tests Sensory Nerve Conduction in Ulnar Nerve
PROCEDURES
OBSERVATIONS AND RESULTS
QUESTIONS
2-32 Electro-neuro Diagnostic Tests Electromyography (EMG)
INTRODUCTION
MOTOR UNIT POTENTIAL (MUP)
METHODOLOGY
Principle
Instrumentation
Procedure for Surface EMG
Procedure for Needle EMG
OBSERVATIONS AND RESULTS
QUESTIONS
2-33 Electro-neuro Diagnostic Tests Evoked Potentials Brainstem Auditory, Visual, Somatosensory, and Motor Evoked Potentials
BRAINSTEM AUDITORY EVOKED POTENTIALS (BAEPS)
Equipment
PROCEDURES
Equipment
PROCEDURES
Observations and Results
MOTOR EVOKED POTENTIALS (MEPS)
2-34 Electro-neuro Diagnostic Tests The Hoffmann's Reflex (H-Reflex)
INTRODUCTION
Equipment
PROCEDURE
2-35 Study of Human Fatigue Mosso's Ergography
EQUIPMENT
PROCEDURES
Factors that Affect Onset of Fatigue
QUESTIONS
2-36 Autonomic Nervous System (ANS) Tests (Autonomic Function Tests; AFTs)
INTRODUCTION
AUTONOMIC FUNCTION TESTS
Equipment Required
Procedure
Rationale
Procedure
Rationale
Results
Results
Rationale
Procedure
Rationale
Procedure
Procedure
Observations
Clinical Significance
Procedure
C. OTHER TESTS
1. TEST FOR PUPILLARY FUNCTION
Denervation Hypersensitivity
2. TEST FOR LACRIMATION (Schirmer's test)
2-37 Semen Analysis
PROCEDURES
QUESTIONS
2-38 Pregnancy Diagnostic Tests
I. BIOLOGICAL DIAGNOSTIC TESTS
II. IMMUNOLOGICAL TESTS
Principle
Procedures
III. ULTRASONOGRAPHY
QUESTIONS
2-39 Birth Control Methods
QUESTIONS
SECTION THREE:
Clinical Examination
3-1 Outline for History Taking and General Physical Examination
I. HISTORY TAKING
A. General Interrogation
B. Special Interrogation
II. PHYSICAL EXAMINATION
A. General Physical Examination
B. SYSTEMIC PHYSICAL EXAMINATION (Common Non-invasive Procedures)
Inspection
COMMONLY USED TERMS
3-2 Clinical Examination of the Respiratory System
INSPECTION
PALPATION
PERCUSSION
Protocol
AUSCULTATION
3-3 Clinical Examination of the Cardiovascular System
IMPORTANT SIGNS AND SYMPTOMS OF CARDIOVASCULAR DISEASE
QUESTIONS
PALPATION OF THE RADIAL ARTERY
Jugular Venous Pressure
Procedure
EXAMINATION OF THE HEART
Inspection
PALPATION
PERCUSSION
AUSCULTATION
3-4 Clinical Examination of the Gastrointestinal Tract (GIT) and Abdomen
IMPORTANT SIGNS AND SYMPTOMS OF GIT DISEASE
INSPECTION
PALPATION
PERCUSSION
AUSCULTATION
3-5 Clinical Examination of the Nervous System
COMPONENTS OF THE MOTOR SYSTEM
Planning and Execution of Movements
Testing The Motor Functions
Testing the Muscles of the Trunk
A. SUPERFICIAL REFLEXES
B. DEEP REFLEXES
Stimulus
C. VISCERAL REFLEXES
MOTOR NEURON LESIONS
Presence of Involuntary Movements
Gait
PHYSIOLOGICAL AND ANATOMICAL CONSIDERATIONS
Components of Sensory System
“Labeled Line Principle”
Pathways for General Sensations
Functions
Terminology
Clinical Testing of General Sensations
Touch (Tactile) Sensation
Proprioception
Vibration
Pain
Temperature
Stereognosis
SECTION FOUR:
Experimental Physiology (Amphibian and Mammalian Experiments)
4-1 Study of Apparatus
APPARATUSES
ELECTRICAL CONNECTIONS
Arranging The Apparatus
Trouble Shooting
Ringer's Solution
4-2 Dissection of Gastrocnemius Muscle-Sciatic Nerve Preparation
4-3 Simple Muscle Twitch (Effect of a Single Stimulus)
PRINCIPLE
APPARATUS
PROCEDURES
OBSERVATIONS AND RESULTS
QUESTIONS
4-4 Effect of Changing the Strength of Stimulus
PROCEDURES
Precautions
QUESTIONS
4-5 Effect of Temperature on Muscle Contraction
EXPERIMENTAL PROCEDURES
QUESTIONS
4-6 Velocity of Nerve Impulse
EXPERIMENTAL PROCEDURES
Calculation of Velocity
QUESTIONS
4-7 Effect of Two Successive Stimuli
EXPERIMENTAL PROCEDURES
QUESTIONS
4-8 Genesis of Tetanus (Effect of Many Successive Stimuli)
EXPERIMENTAL PROCEDURES
QUESTIONS
4-9 Phenomenon of Fatigue and its Site (Effect of Continued Stimulation)
PROCEDURES
QUESTIONS
4-10 Effect of Load and Length on Muscle Contraction (Free-and After-Loading)
PROCEDURES
OBSERVATIONS AND RESULTS
QUESTIONS
4-11 Exposure of Frog's Heart and Normal Cardiogram
OBSERVATIONS
NORMAL CARDIOGRAM
Procedures
QUESTIONS
4-12 Effect of Temperature on Frog's Heart
PROCEDURES
Effect of Temperature on the Heart
4-13 Effect of Stimulation of Vagosympathetic Trunk and Crescent; Vagal Escape; Effect of Nicotine and Atropine
PROCEDURES
QUESTIONS
4-14 Effect of Stimulation of Vagosympathetic Trunk and Crescent; Vagal Escape; Effect of Nicotine and Atropine
EXPERIMENTAL PROCEDURES
QUESTIONS
4-15 Properties of Cardiac Muscle (Stannius Ligatures)
PROCEDURES
Refractoriness in the Beating Heart:Extrasystole and Compensatory Pause
Stannius Ligatures
QUESTIONS
4-16 Perfusion of Isolated Heart of Frog
PROCEDURES
4-17 Study of Reflexes in Spinal and Decerebrate Frogs
SPINAL FROG
DECEREBRATE FROG
QUESTIONS
4-18 Experiments on Anesthetized Dog
INSTRUMENTATION
EXPERIMENTAL PROTOCOL
The Blood Pressure Tracing
EXPERIMENTS
SECTION FIVE:
Charts
5-1 Arterial Pulse Tracing (Figure 5-1)
5-2 Jugular Venous Pulse Tracing (Figure 5-2)
5-3 Electrocardiogram (ECG) (Figure 5-3)
5-4 Cardiac Cycle (Figure 5-4)
OTHER QUESTIONS
5-5 Oxygen Dissociation Curve (Figure 5-5)
5-6 Lung Volumes and Capacities (Figure 5-6)
5-7 Strength-duration Curve (Figure 5-7)
5-8 Action Potential in a Large Myelinated Nerve Fiber (Figure 5-8)
5-9 Action Potentials in Cardiac Muscle Fibers (Figure 5-9)
5-10 Dye Dilution Curve (Figure 5-10)
5-11 Snellen's Chart (Figure 5-11)
5-12 Jaeger's Chart
5-13 Ishihara Charts
COLOR VISION
5-14 Oral Glucose Tolerance Test (OGTT) (Figure 5-13)
SECTION SIX:
Calculations
Appendix
INDEX
TOC
Index
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