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Essentials of Medical Physiology
K Sembulingam, Prema Sembulingam
SECTION 1: GENERAL PHYSIOLOGY
1:
Cell
INTRODUCTION
CELL
TISSUES
ORGANS
SYSTEMS
STRUCTURE OF THE CELL
CELL MEMBRANE
COMPOSITION OF CELL MEMBRANE
STRUCTURE OF CELL MEMBRANE
Structural Model of the Cell Membrane
Lipid Layer of the Cell Membrane
1. Phospholipids
Functions of Lipid Layer
Protein Layers of the Cell Membrane
Functions of Proteins in Cell Membrane
Carbohydrates of the Cell Membrane
Functions of Carbohydrates
FUNCTIONS OF CELL MEMBRANE
CYTOPLASM
ORGANELLES IN CYTOPLASM
1. ENDOPLASMIC RETICULUM
Types of Endoplasmic Reticulum
Rough Endoplasmic Reticulum
Functions of Rough Endoplasmic Reticulum
Smooth Endoplasmic Reticulum
Functions of Smooth Endoplasmic Reticulum
2. GOLGI APPARATUS
Functions of Golgi Apparatus
3. LYSOSOMES
Types of Lysosomes
Functions of Lysosomes
4. PEROXISOMES
Functions of Peroxisomes
5. CENTROSOME AND CENTRIOLES
6. SECRETORY VESICLES
7. MITOCHONDRION
Functions of Mitochondrion
8. RIBOSOMES
Types of Ribosomes
Functions of Ribosomes
9. CYTOSKELETON
Microtubules
Intermediate Filaments
Microfilaments
NUCLEUS
STRUCTURE OF NUCLEUS
Nuclear Membrane
Nucleoplasm
Chromatin
Chromosomes
Nucleolus
FUNCTIONS OF NUCLEUS
DEOXYRIBONUCLEIC ACID
STRUCTURE OF DNA
GENE
GENETIC DISORDERS
1. Single Gene Disorders
2. Multifactorial Genetic Disorders
3. Chromosomal Disorders
4. Mitochondrial DNA Disorders
RIBONUCLEIC ACID
STRUCTURE OF RNA
TYPES OF RNA
1. Messenger RNA (mRNA)
2. Transfer RNA (tRNA)
3. Ribosomal RNA (rRNA)
GENE EXPRESSION
TRANSCRIPTION OF GENETIC CODE
TRANSLATION
GROWTH FACTORS
CELL DEATH
NECROSIS
Causes for Necrosis
Necrotic Process
Reaction of Neighboring Tissues after Necrosis
APOPTOSIS
Functional Significance of Apoptosis
Activation of Apoptosis
Apoptotic Process
CELL ADAPTATION
ATROPHY
Causes for Atrophy
Types of Atrophy
HYPERTROPHY
1. Physiological Hypertrophy
2. Pathological Hypertrophy
3. Compensatory Hypertrophy
HYPERPLASIA
1. Physiological Hyperplasia
2. Compensatory Hyperplasia
3. Pathological Hyperplasia
DYSPLASIA
METAPLASIA
1. Physiological Metaplasia
2. Pathological Metaplasia
CELL DEGENERATION
CELL AGING
STEM CELLS
TYPES OF STEM CELLS
1. Embryonic Stem Cells
2. Adult Stem Cells
ADVANTAGES OF STEM CELLS
2:
Cell Junctions
DEFINITION AND CLASSIFICATION
OCCLUDING JUNCTIONS
TIGHT JUNCTION
Structure of Tight Junction
Functions of Tight Junction
Applied Physiology
COMMUNICATING JUNCTIONS
GAP JUNCTION
Structure of Gap Junction
Functions of Gap Junction
Regulation of the Diameter of Channels in Gap Junction
Applied Physiology
CHEMICAL SYNAPSE
ANCHORING JUNCTIONS
ADHERENS JUNCTION
FOCAL ADHESION
DESMOSOME
HEMIDESMOSOME
Applied Physiology
CELL ADHESION MOLECULES
TYPES OF CELL ADHESION MOLECULES
3:
Transport through Cell Membrane
INTRODUCTION
BASIC MECHANISM OF TRANSPORT
PASSIVE TRANSPORT
SIMPLE DIFFUSION THROUGH LIPID LAYER
SIMPLE DIFFUSION THROUGH PROTEIN LAYER
Protein Channels or Ion Channels
Types of Protein Channels or Ion Channels
Regulation of the Channels
Gated Channels
Ion Channel Diseases
FACILITATED OR CARRIER MEDIATED DIFFUSION
FACTORS AFFECTING RATE OF DIFFUSION
1. Permeability of the Cell Membrane
2. Temperature
3. Concentration Gradient or Electrical Gradient of the Substance across the Cell Membrane
4. Solubility of the Substance
5. Thickness of the Cell Membrane
6. Size of the Molecules
7. Size of the Ions
8. Charge of the Ions
SPECIAL TYPES OF PASSIVE TRANSPORT
BULK FLOW
FILTRATION
OSMOSIS
Osmotic Pressure
Reverse Osmotic Pressure
Colloidal Osmotic Pressure and Oncotic Pressure
ACTIVE TRANSPORT
MECHANISM OF ACTIVE TRANSPORT
SUBSTANCES TRANSPORTED BY ACTIVE TRANSPORT
TYPES OF ACTIVE TRANSPORT
PRIMARY ACTIVE TRANSPORT
Primary Active Transport of Sodium and Potassium: Sodium – Potassium Pump
Transport of Calcium Ions
Transport of Hydrogen Ions
SECONDARY ACTIVE TRANSPORT
Symport and Antiport
Sodium Co-transport
Sodium Counter Transport
SPECIAL TYPES OF ACTIVE TRANSPORT
ENDOCYTOSIS
1. Pinocytosis
2. Phagocytosis
3. Receptor Mediated Endocytosis
EXOCYTOSIS
TRANSCYTOSIS
MOLECULAR MOTORS
APPLIED PHYSIOLOGY
4:
Homeostasis
INTRODUCTION
ROLE OF VARIOUS SYSTEMS OF THE BODY IN HOMEOSTASIS
COMPONENTS OF HOMEOSTATIC SYSTEM
MECHANISM OF ACTION OF HOMEOSTATIC SYSTEM
5:
Acid–Base Balance
INTRODUCTION
HYDROGEN ION AND pH
DETERMINATION OF ACID–BASE STATUS
REGULATION OF ACID–BASE BALANCE
REGULATION OF ACID–BASE BALANCE BY ACID–BASE BUFFER SYSTEM
DEFINITION
Types of Buffer Systems
1. Bicarbonate Buffer System
2. Phosphate Buffer System
3. Protein Buffer System
REGULATION OF ACID–BASE BALANCE BY RESPIRATORY MECHANISM
REGULATION OF ACID–BASE BALANCE BY RENAL MECHANISM
APPLIED PHYSIOLOGY – DISTURBANCES OF ACID–BASE STATUS
ACIDOSIS
ALKALOSIS
RESPIRATORY ACIDOSIS
Causes of Excess CO2 in the Body
RESPIRATORY ALKALOSIS
Causes of Decrease in CO2 in the Body
METABOLIC ACIDOSIS
Causes of Metabolic Acidosis
METABOLIC ALKALOSIS
CLINICAL EVALUATION OF DISTURBANCES IN ACID–BASE STATUS – ANION GAP
QUESTIONS IN GENERAL PHYSIOLOGY
LONG QUESTIONS
SHORT QUESTIONS
SECTION 2: BLOOD AND BODY FLUIDS
6:
Body Fluids
INTRODUCTION
SIGNIFICANCE OF BODY FLUIDS
1. IN HOMEOSTASIS
2. IN TRANSPORT MECHANISM
3. IN METABOLIC REACTIONS
4. IN TEXTURE OF TISSUES
5. IN TEMPERATURE REGULATION
COMPARTMENTS OF BODY FLUIDS – DISTRIBUTION OF BODY FLUIDS
COMPOSITION OF BODY FLUIDS
ORGANIC SUBSTANCES
INORGANIC SUBSTANCES
MEASUREMENT OF BODY FLUID VOLUME
INDICATOR DILUTION METHOD
Principle
Formula to Measure the Volume of Fluid by Indicator Dilution Method
Uses of Indicator Dilution Method
Characteristics of Marker Substances
Marker Substances Used to Measure Fluid Compartments
MEASUREMENT OF TOTAL BODY WATER
MEASUREMENT OF EXTRACELLULAR FLUID VOLUME
MEASUREMENT OF PLASMA VOLUME
MEASUREMENT OF INTERSTITIAL FLUID VOLUME
MEASUREMENT OF INTRACELLULAR FLUID VOLUME
CONCENTRATION OF BODY FLUIDS
OSMOLALITY
OSMOLARITY
Mole and Osmole
TONICITY
i. Isotonic Fluid
ii. Hypertonic Fluid
iii. Hypotonic Fluid
MAINTENANCE OF WATER BALANCE
APPLIED PHYSIOLOGY
DEHYDRATION
Definition
Classification
Causes
Signs and Symptoms
Severe dehydration
Very severe dehydration
Aging Effects on Dehydration
Treatment
WATER INTOXICATION OR OVERHYDRATION
Definition
Causes
Signs and Symptoms
Treatment
7:
Blood
INTRODUCTION
PROPERTIES OF BLOOD
COMPOSITION OF BLOOD
BLOOD CELLS
Hematocrit Value
PLASMA
SERUM
FUNCTIONS OF BLOOD
1. NUTRIENT FUNCTION
2. RESPIRATORY FUNCTION
3. EXCRETORY FUNCTION
4. TRANSPORT OF HORMONES AND ENZYMES
5. REGULATION OF WATER BALANCE
6. REGULATION OF ACID–BASE BALANCE
7. REGULATION OF BODY TEMPERATURE
8. STORAGE FUNCTION
9. DEFENSIVE FUNCTION
8:
Plasma Proteins
INTRODUCTION
NORMAL VALUES
ALBUMIN/GLOBULIN RATIO
SEPARATION OF PLASMA PROTEINS
1. PRECIPITATION METHOD
2. SALTING OUT METHOD
3. ELECTROPHORETIC METHOD
4. COHN'S FRACTIONAL PRECIPITATION METHOD
5. ULTRACENTRIFUGATION METHOD
6. GEL FILTRATION CHROMATOGRAPHY
7. IMMUNOELECTROPHORETIC METHOD
PROPERTIES OF PLASMA PROTEINS
1. MOLECULAR WEIGHT
2. ONCOTIC PRESSURE
3. SPECIFIC GRAVITY
4. BUFFER ACTION
ORIGIN OF PLASMA PROTEINS
IN EMBRYO
IN ADULTS
FUNCTIONS OF PLASMA PROTEINS
1. ROLE IN COAGULATION OF BLOOD
2. ROLE IN DEFENSE MECHANISM OF BODY
3. ROLE IN TRANSPORT MECHANISM
4. ROLE IN MAINTENANCE OF OSMOTIC PRESSURE IN BLOOD
Importance of Osmotic Pressure – Starling's Hypothesis
5. ROLE IN REGULATION OF ACID–BASE BALANCE
6. ROLE IN VISCOSITY OF BLOOD
7. ROLE IN ERYTHROCYTE SEDIMENTATION RATE (ESR)
8. ROLE IN SUSPENSION STABILITY OF RED BLOOD CELLS
9. ROLE IN PRODUCTION OF TREPHONE SUBSTANCES
10. ROLE AS RESERVE PROTEINS
PLASMAPHERESIS
DEFINITION
PROCEDURE
CLINICAL SIGNIFICANCE OF PLASMAPHERESIS – THERAPEUTIC PLASMA EXCHANGE
Procedure
Uses of Plasmapheresis
VARIATIONS IN PLASMA PROTEIN LEVEL
9:
Red Blood Cells
INTRODUCTION
NORMAL VALUE
MORPHOLOGY OF RED BLOOD CELLS
NORMAL SHAPE
Advantages of Biconcave Shape of RBCs
NORMAL SIZE
NORMAL STRUCTURE
PROPERTIES OF RED BLOOD CELLS
1. ROULEAUX FORMATION
2. SPECIFIC GRAVITY
3. PACKED CELL VOLUME
4. SUSPENSION STABILITY
LIFESPAN OF RED BLOOD CELLS
FATE OF RED BLOOD CELLS
FUNCTIONS OF RED BLOOD CELLS
VARIATIONS IN NUMBER OF RED BLOOD CELLS
PHYSIOLOGICAL VARIATIONS
A. Increase in RBC count
B. Decrease in RBC count
3. Pregnancy
PATHOLOGICAL VARIATIONS
Pathological Polycythemia
Primary Polycythemia – Polycythemia Vera
Secondary Polycythemia
Anemia
VARIATIONS IN SIZE OF RED BLOOD CELLS
VARIATIONS IN SHAPE OF RED BLOOD CELLS
VARIATIONS IN STRUCTURE OF RED BLOOD CELLS
10:
Erythropoiesis
DEFINITION
SITE OF ERYTHROPOIESIS
IN FETAL LIFE
1. Mesoblastic Stage
2. Hepatic Stage
3. Myeloid Stage
IN NEWBORN BABIES, CHILDREN AND ADULTS
PROCESS OF ERYTHROPOIESIS
STEM CELLS
CHANGES DURING ERYTHROPOIESIS
STAGES OF ERYTHROPOIESIS
1. Proerythroblast (Megaloblast)
2. Early Normoblast
3. Intermediate Normoblast
4. Late Normoblast
5. Reticulocyte
6. Matured Erythrocyte
FACTORS NECESSARY FOR ERYTHROPOIESIS
GENERAL FACTORS
1. Erythropoietin
2. Thyroxine
3. Hemopoietic Growth Factors
MATURATION FACTORS
1. Vitamin B12 (Cyanocobalamin)
2. Intrinsic Factor of Castle
3. Folic Acid
FACTORS NECESSARY FOR HEMOGLOBIN FORMATION
11:
Hemoglobin and Iron Metabolism
INTRODUCTION
NORMAL HEMOGLOBIN CONTENT
FUNCTIONS OF HEMOGLOBIN
TRANSPORT OF RESPIRATORY GASES
i. Transport of Oxygen
ii. Transport of Carbon Dioxide
BUFFER ACTION
STRUCTURE OF HEMOGLOBIN
IRON
PORPHYRIN
GLOBIN
TYPES OF NORMAL HEMOGLOBIN
ABNORMAL HEMOGLOBIN
ABNORMAL HEMOGLOBIN DERIVATIVES
CARBOXYHEMOGLOBIN
Sources of Carbon Monoxide
Signs and Symptoms of Carbon Monoxide Poisoning
METHEMOGLOBIN
Methemoglobinemia
SULFHEMOGLOBIN
Blood Level of Sulfhemoglobin
SYNTHESIS OF HEMOGLOBIN
SYNTHESIS OF HEME
FORMATION OF GLOBIN
CONFIGURATION
SUBSTANCES NECESSARY FOR HEMOGLOBIN SYNTHESIS
DESTRUCTION OF HEMOGLOBIN
IRON METABOLISM
IMPORTANCE OF IRON
NORMAL VALUE AND DISTRIBUTION OF IRON IN THE BODY
DIETARY IRON
Heme Iron
Nonheme Iron
ABSORPTION OF IRON
TRANSPORT OF IRON
STORAGE OF IRON
DAILY LOSS OF IRON
REGULATION OF TOTAL IRON IN THE BODY
12:
Erythrocyte Sedimentation Rate
DEFINITION
DETERMINATION OF ESR
WESTERGREN'S METHOD
Westergren's Tube
WINTROBE'S METHOD
Wintrobe's Tube
NORMAL VALUES OF ESR
VARIATIONS OF ESR
PHYSIOLOGICAL VARIATION
PATHOLOGICAL VARIATION
SIGNIFICANCE OF DETERMINING ESR
FACTORS AFFECTING ESR
13:
Packed Cell Volume and Blood Indices
DEFINITION
METHOD OF DETERMINATION
SIGNIFICANCE OF DETERMINING PCV
NORMAL VALUES OF PCV
VARIATIONS IN PCV
INCREASE IN PCV
DECREASE IN PCV
BLOOD INDICES
IMPORTANCE OF BLOOD INDICES
DIFFERENT BLOOD INDICES
CALCULATION OF BLOOD INDICES
14:
Anemia
INTRODUCTION
CLASSIFICATION OF ANEMIA
MORPHOLOGICAL CLASSIFICATION
1. Normocytic Normochromic Anemia
2. Macrocytic Normochromic Anemia
3. Macrocytic Hypochromic Anemia
4. Microcytic Hypochromic Anemia
ETIOLOGICAL CLASSIFICATION
1. Hemorrhagic Anemia
2. Hemolytic Anemia
3. Nutrition Deficiency Anemia
4. Aplastic Anemia
5. Anemia of Chronic Diseases
SIGNS AND SYMPTOMS OF ANEMIA
1. SKIN
2. CARDIOVASCULAR SYSTEM
3. RESPIRATION
4. DIGESTION
5. METABOLISM
6. KIDNEY
7. REPRODUCTIVE SYSTEM
8. NEUROMUSCULAR SYSTEM
15:
Hemolysis and Fragility of Red Blood Cells
DEFINITION
PROCESS OF HEMOLYSIS
FRAGILITY TEST
CONDITIONS WHEN HEMOLYSIS OCCURS
HEMOLYSINS
CHEMICAL SUBSTANCES
SUBSTANCES OF BACTERIAL ORIGIN OR SUBSTANCES FOUND IN BODY
16:
White Blood Cells
INTRODUCTION
CLASSIFICATION
MORPHOLOGY OF WHITE BLOOD CELLS
NEUTROPHILS
EOSINOPHILS
BASOPHILS
MONOCYTES
LYMPHOCYTES
NORMAL WHITE BLOOD CELL COUNT
VARIATIONS IN WHITE BLOOD CELL COUNT
PHYSIOLOGICAL VARIATIONS
PATHOLOGICAL VARIATIONS
Leukocytosis
Neutrophilia
Eosinophilia
Basophilia
Monocytosis
Lymphocytosis
Leukemia
Leukopenia
Neutropenia
Eosinopenia
Basopenia
Monocytopenia
Lymphocytopenia
LIFESPAN OF WHITE BLOOD CELLS
PROPERTIES OF WHITE BLOOD CELLS
FUNCTIONS OF WHITE BLOOD CELLS
NEUTROPHILS
Substances Present in Granules and Cytoplasm
Mechanism of Action of Neutrophils
Respiratory Burst
Pus and Pus Cells
EOSINOPHILS
Mechanism of Action of Eosinophils
BASOPHILS
Mechanism of Action of Basophils
Mast Cell
MONOCYTES
LYMPHOCYTES
LEUKOPOIESIS
STEM CELLS
FACTORS NECESSARY FOR LEUKOPOIESIS
Colony Stimulating Factors
17:
Immunity
DEFINITION AND TYPES OF IMMUNITY
INNATE IMMUNITY OR NONSPECIFIC IMMUNITY
Mechanisms of Innate Immunity
ACQUIRED IMMUNITY OR SPECIFIC IMMUNITY
Types of Acquired Immunity
DEVELOPMENT AND PROCESSING OF LYMPHOCYTES
T LYMPHOCYTES
Types of T Lymphocytes
Storage of T Lymphocytes
B LYMPHOCYTES
Types of B Lymphocytes
Storage of B Lymphocytes
ANTIGENS
DEFINITION AND TYPES
NONSELF ANTIGENS
Types of Nonself Antigens
CHEMICAL NATURE OF THE ANTIGENS
DEVELOPMENT OF CELL MEDIATED IMMUNITY
INTRODUCTION
ANTIGEN PRESENTING CELLS
Types of Antigen Presenting Cells
Role of Antigen Presenting Cells
MHC and HLA
Presentation of Antigen
Sequence of Events during Activation of Helper T Cells
ROLE OF HELPER T CELLS
Role of TH1 Cells
Role of TH2 Cells
ROLE OF CYTOTOXIC T CELLS
Mechanism of Action of Cytotoxic T Cells
Other Actions of Cytotoxic T Cells
ROLE OF SUPPRESSOR T CELLS
ROLE OF MEMORY T CELLS
SPECIFICITY OF T CELLS
DEVELOPMENT OF HUMORAL IMMUNITY
INTRODUCTION
ROLE OF ANTIGEN PRESENTING CELLS
Presentation of Antigen
Sequence of Events during Activation of B Cells
Transformation B Cells
ROLE OF PLASMA CELLS
ROLE OF MEMORY B CELLS
ROLE OF HELPER T CELLS
ANTIBODIES
Types of Antibodies
Structure of Antibodies
1. Constant Region
2. Variable Region
Mechanism of Actions of Antibodies
1. Direct Actions of Antibodies
2. Actions of Antibodies through Complement System
Specificity of B Lymphocytes
Functions of Different Antibodies
NATURAL KILLER CELL
CYTOKINES
IMMUNIZATION
PASSIVE IMMUNIZATION
Passive Natural Immunization
Passive Artificial Immunization
ACTIVE IMMUNIZATION
Active Natural Immunization
Active Artificial Immunization
Toxoids
IMMUNE DEFICIENCY DISEASES
CONGENITAL IMMUNE DEFICIENCY DISEASES
ACQUIRED IMMUNE DEFICIENCY DISEASES
Acquired Immune Deficiency Syndrome (AIDS)
AUTOIMMUNE DISEASES
HUMAN LEUKOCYTE ANTIGEN SYSTEM AND AUTOIMMUNE DISEASES
COMMON AUTOIMMUNE DISEASES
1. Insulin Dependent Diabetes Mellitus
2. Myasthenia Gravis
3. Hashimoto's Thyroiditis
4. Graves' Disease
5. Rheumatoid Arthritis
ALLERGY AND IMMUNOLOGICAL HYPERSENSITIVITY REACTIONS
ALLERGENS
Common Allergens
IMMUNOLOGICAL HYPERSENSITIVE REACTIONS
Type I or Anaphylactic Reactions
Type II or Cytotoxic Reactions
Type III or Antibody Mediated Reactions
Type IV or Cell Mediated Reactions
Type V or Stimulatory/Blocking Reactions
18:
Platelets
INTRODUCTION
STRUCTURE AND COMPOSITION
CELL MEMBRANE
Glycoproteins
Phospholipids
MICROTUBULES
CYTOPLASM
Proteins
Enzymes
Hormonal Substances
Other Chemical Substances
Platelet Granules
NORMAL COUNT AND VARIATIONS
PHYSIOLOGICAL VARIATIONS
PATHOLOGICAL VARIATIONS
PROPERTIES OF PLATELETS
ADHESIVENESS
AGGREGATION (GROUPING OF PLATELETS)
AGGLUTINATION
FUNCTIONS OF PLATELETS
1. ROLE IN BLOOD CLOTTING
2. ROLE IN CLOT RETRACTION
3. ROLE IN PREVENTION OF BLOOD LOSS (HEMOSTASIS)
4. ROLE IN REPAIR OF RUPTURED BLOOD VESSEL
5. ROLE IN DEFENSE MECHANISM
ACTIVATORS AND INHIBITORS OF PLATELETS
ACTIVATORS OF PLATELETS
INHIBITORS OF PLATELETS
DEVELOPMENT OF PLATELETS
LIFESPAN AND FATE OF PLATELETS
APPLIED PHYSIOLOGY – PLATELET DISORDERS
19:
Hemostasis
DEFINITION
STAGES OF HEMOSTASIS
1. VASOCONSTRICTION
2. FORMATION OF PLATELET PLUG
3. COAGULATION OF BLOOD
20:
Coagulation of Blood
DEFINITION
FACTORS INVOLVED IN BLOOD CLOTTING
SEQUENCE OF CLOTTING MECHANISM
ENZYME CASCADE THEORY
Stages of Blood Clotting
STAGE 1: FORMATION OF PROTHROMBIN ACTIVATOR
Intrinsic Pathway for the Formation of Prothrombin Activator
Sequence of Events in Intrinsic pathway
Extrinsic Pathway for the Formation of Prothrombin Activator
Sequence of Events in Extrinsic Pathway
STAGE 2: CONVERSION OF PROTHROMBIN INTO THROMBIN
Sequence of Events in Stage 2
STAGE 3: CONVERSION OF FIBRINOGEN INTO FIBRIN
Sequence of Events in Stage 3
BLOOD CLOT
DEFINITION AND COMPOSITION OF CLOT
CLOT RETRACTION
FIBRINOLYSIS
Formation of Plasmin
Sequence of Events Involved in the Activation of Plasminogen
Action of Plasmin
Significance of Lysis of Clot
ANTICLOTTING MECHANISM IN THE BODY
ANTICOAGULANTS
1. HEPARIN
Mechanism of Action of Heparin
Uses of Heparin
2. COUMARIN DERIVATIVES
Mechanism of Action
Uses
3. EDTA
Mechanism of Action
Uses
4. OXALATE COMPOUNDS
Mechanism of Action
Uses
5. CITRATES
Mechanism of Action
Uses
6. OTHER SUBSTANCES WHICH PREVENT BLOOD CLOTTING
PHYSICAL METHODS TO PREVENT BLOOD CLOTTING
1. COLD
2. COLLECTING BLOOD IN A CONTAINER WITH SMOOTH SURFACE
PROCOAGULANTS
1. THROMBIN
2. SNAKE VENOM
3. EXTRACTS OF LUNGS AND THYMUS
4. SODIUM OR CALCIUM ALGINATE
5. OXIDIZED CELLULOSE
TESTS FOR CLOTTING
BLEEDING TIME
CLOTTING TIME
PROTHROMBIN TIME
PARTIAL PROTHROMBIN TIME
THROMBIN TIME
APPLIED PHYSIOLOGY
BLEEDING DISORDERS
1. Hemophilia
2. Purpura
3. von Willebrand Disease
THROMBOSIS
Causes of Thrombosis
Complications of Thrombosis
21:
Blood Groups
INTRODUCTION
ABO BLOOD GROUPS
LANDSTEINER'S LAW
BLOOD GROUP SYSTEMS
ABO SYSTEM
DETERMINATION OF THE ABO GROUP
Principle of Blood Typing – Agglutination
Requisites for Blood Typing
Procedure
Results
IMPORTANCE OF ABO GROUPS IN BLOOD TRANSFUSION
MATCHING AND CROSS MATCHING
INHERITANCE OF ABO AGGLUTINOGENS AND AGGLUTININS
TRANSFUSION REACTIONS DUE TO ABO INCOMPATIBILITY
Severity of Transfusion Reactions
Cause for Transfusion Reactions
Signs and Symptoms of Transfusion Reactions
1. Jaundice
2. Cardiac Shock
3. Renal Shutdown
Rh FACTOR
INHERITANCE OF Rh ANTIGEN
TRANSFUSION REACTIONS DUE TO Rh INCOMPATIBILITY
HEMOLYTIC DISEASE OF FETUS AND NEWBORN – ERYTHROBLASTOSIS FETALIS
1. Severe Anemia
2. Hydrops Fetalis
3. Kernicterus
OTHER BLOOD GROUPS
1. LEWIS BLOOD GROUP
2. MNS BLOOD GROUPS
3. OTHER BLOOD GROUPS
IMPORTANCE OF KNOWING BLOOD GROUP
22:
Blood Transfusion
INTRODUCTION
CONDITIONS WHEN BLOOD TRANSFUSION IS NECESSARY
PRECAUTIONS
PRECAUTIONS TO BE TAKEN BEFORE THE TRANSFUSION OF BLOOD
PRECAUTIONS TO BE TAKEN WHILE TRANSFUSING BLOOD
TRANSFUSION REACTIONS
BLOOD SUBSTITUTES
EXCHANGE TRANSFUSION
PROCEDURE
CONDITIONS WHICH NEED EXCHANGE TRANSFUSION
AUTOLOGOUS BLOOD TRANSFUSION
23:
Blood Volume
NORMAL BLOOD VOLUME
VARIATIONS IN BLOOD VOLUME
PHYSIOLOGICALVARIATIONS
1. Age
2. Sex
3. Surface Area of the Body
4. Body Weight
5. Atmospheric Temperature
6. Pregnancy
7. Exercise
8. Posture
9. High Altitude
10. Emotion
PATHOLOGICAL VARIATIONS
MEASUREMENT OF BLOOD VOLUME
DIRECT METHOD
INDIRECT METHOD
Determination of Plasma Volume
Determination of Blood Cell Volume
ii. Determination of blood volume by radioisotope method
REGULATION OF BLOOD VOLUME
APPLIED PHYSIOLOGY
HYPERVOLEMIA
1. Hyperthyroidism
2. Hyperaldosteronism
3. Cirrhosis of the Liver
4. Congestive Cardiac Failure
HYPOVOLEMIA
1. Hemorrhage or Blood Loss
2. Fluid Loss
3. Hemolysis
4. Anemia
5. Hypothyroidism
24:
Reticuloendothelial System and Tissue Macrophage
DEFINITION AND DISTRIBUTION
RETICULOENDOTHELIAL SYSTEM OR MACROPHAGE SYSTEM
MACROPHAGE
CLASSIFICATION OF RETICULOENDO THELIAL CELLS
FIXED RETICULOENDOTHELIAL CELLS – TISSUE MACROPHAGES
1. Connective Tissue
2. Endothelium of Blood Sinusoid
3. Reticulum
4. Central Nervous System
5. Lungs
6. Subcutaneous Tissue
WANDERING RETICULOENDOTHELIAL CELLS AND TISSUE MACROPHAGES
1. Free Histiocytes of Blood
2. Free Histiocytes of Solid Tissue
FUNCTIONS OF RETICULOENDO THELIAL SYSTEM
25:
Spleen
STRUCTURE OF SPLEEN
RED PULP
WHITE PULP
FUNCTIONS OF SPLEEN
1. FORMATION OF BLOOD CELLS
2. DESTRUCTION OF BLOOD CELLS
3. BLOOD RESERVOIR FUNCTION
4. ROLE IN DEFENSE OF BODY
APPLIED PHYSIOLOGY
SPLENOMEGALY AND HYPERSPLENISM
Effects of Splenomegaly
HYPOSPLENISM AND ASPLENIA
26:
Lymphatic System and Lymph
LYMPHATIC SYSTEM
ORGANIZATION OF LYMPHATIC SYSTEM
DRAINAGE OF LYMPHATIC SYSTEM
SITUATION OF LYMPH VESSELS
LYMPH NODES
Structure of Lymph Node
Lymphatic Vessels to Lymph Node
Distribution of Lymph Nodes
FORMATION OF LYMPH
ADDITION OF PROTEINS AND FATS
CONCENTRATION OF LYMPH
RATE OF LYMPH FLOW
Factors Increasing the Flow of Lymph
COMPOSITION OF LYMPH
FUNCTIONS OF LYMPH
FUNCTIONS OF LYMPH NODES
APPLIED PHYSIOLOGY – SWELLING OF LYMPH NODES
27:
Tissue Fluid and Edema
DEFINITION
FUNCTIONS OF TISSUE FLUID
FORMATION OF TISSUE FLUID
FILTRATION
Starling's Hypothesis
REABSORPTION
APPLIED PHYSIOLOGY – EDEMA
DEFINITION
TYPES OF EDEMA
INTRACELLULAR EDEMA
1. Edema due to Malnutrition
2. Edema due to Poor Metabolism
3. Edema due to Inflammation of Tissues
EXTRACELLULAR EDEMA
1. Edema due to Heart Failure
2. Edema due to Renal Diseases – Generalized Edema
3. Edema due to Decreased Amount of Plasma Proteins
4. Edema due to Lymphatic Obstruction – Lymphedema
5. Edema due to Increased Endothelial Permeability
PITTING AND NON-PITTING EDEMA
QUESTIONS IN BLOOD AND BODY FLUIDS
LONG QUESTIONS
SHORT QUESTIONS
SECTION 3: MUSCLE PHYSIOLOGY
28:
Classification of Muscles
DEPENDING UPON STRIATIONS
DEPENDING UPON THE CONTROL
DEPENDING UPON THE SITUATION
29:
Structure of Skeletal Muscle
MUSCLE MASS
MUSCLE FIBER
NUCLEI
MYOFIBRIL
MICROSCOPIC STRUCTURE OF A MYOFIBRIL
Light Band or ‘I’ Band
Dark Band or ‘A’ Band
SARCOMERE
ELECTRON MICROSCOPIC STUDY OF SARCOMERE
Actin Filaments
Myosin Filaments
CONTRACTILE ELEMENTS (PROTEINS) OF MUSCLE
MYOSIN MOLECULE
ACTIN MOLECULE
TROPOMYOSIN
TROPONIN
OTHER PROTEINS OF THE MUSCLE
SARCOTUBULAR SYSTEM
STRUCTURES CONSTITUTING THE SARCOTUBULAR SYSTEM
‘T’ Tubules
‘L’ Tubules or Sarcoplasmic Reticulum
FUNCTIONS OF SARCOTUBULAR SYSTEM
Function of ‘T’ Tubules
Function of ‘L’ Tubules
COMPOSITION OF MUSCLE
30:
Properties of Skeletal Muscle
EXCITABILITY
DEFINITIONS
TYPES OF STIMULUS
QUALITIES OF STIMULUS
Intensity of Stimulus
Duration of Stimulus
EXCITABILITY CURVE OR STRENGTH – DURATION CURVE
Method to Obtain the Curve
Characteristic Features of the Curve
1. Rheobase
2. Utilization Time
3. Chronaxie
CONTRACTILITY
TYPES OF CONTRACTION
Isotonic Contraction
Isometric Contraction
SIMPLE MUSCLE CONTRACTION OR TWITCH OR CURVE
Important Points in Simple Muscle Curve
Periods of Simple Muscle Curve
Causes of Latent Period
CONTRACTION TIME
Red Muscles
Pale Muscles
FACTORS AFFECTING FORCE OF CONTRACTION
A. Effect of Strength of Stimulus
B. Effect of Number of Stimulus
1. Beneficial Effect
2. Superposition
3. Summation
1. Fatigue
2. Tetanus
Pathological Tetanus
Treppe or Staircase Phenomenon
C. Effect of Variations in Temperature
D. Effect of Load
LENGTH – TENSION RELATIONSHIP
Active Tension
Length – Tension Curve
Resting Length
Tension vs Overlap of Myofilaments
REFRACTORY PERIOD
1. Absolute Refractory Period
2. Relative Refractory Period
Refractory Period in Skeletal Muscle
Refractory Period in Cardiac Muscle
MUSCLE TONE
DEFINITION
MAINTENANCE OF MUSCLE TONE
In Skeletal Muscle
In Cardiac Muscle
In Smooth Muscle
APPLIED PHYSIOLOGY – ABNORMALITIES OF MUSCLE TONE
31:
Changes during Muscular Contraction
INTRODUCTION
ELECTRICAL CHANGES DURING MUSCULAR CONTRACTION
RESTING MEMBRANE POTENTIAL
ACTION POTENTIAL
Depolarization
Repolarization
Properties of Action Potential
ACTION POTENTIAL CURVE
Stimulus Artifact
Latent Period
Firing Level and Depolarization
Overshoot
Repolarization
Spike Potential
After Depolarization or Negative after Potential
After Hyperpolarization or Positive after Potential
IONIC BASIS OF ELECTRICAL EVENTS
Resting Membrane Potential
Action Potential
MONOPHASIC, BIPHASIC AND COMPOUND ACTION POTENTIALS
Monophasic Action Potential
Biphasic Action Potential
Recording of Biphasic Action potential
Compound Action Potential
GRADED POTENTIAL
PATCH CLAMP TECHNIQUE
Procedure
Patch Clamp Configurations
PHYSICAL CHANGES DURING MUSCULAR CONTRACTION
HISTOLOGICAL CHANGES DURING MUSCULAR CONTRACTION
ACTOMYOSIN COMPLEX
MOLECULAR BASIS OF MUSCULAR CONTRACTION
1. Excitation Contraction Coupling
2. Role of Troponin and Tropomyosin
3. Sliding Mechanism and Formation of Actomyosin Complex – Sliding Theory
Energy for Muscular Contraction
Relaxation of the Muscle
Molecular Motors
CHEMICAL CHANGES DURING MUSCULAR CONTRACTION
LIBERATION OF ENERGY
Breakdown of ATP
Resynthesis of ATP
Significance of Hydrogen Atoms Released during Carbohydrate Metabolism
Summary of Resynthesis of ATP during Carbohydrate Metabolism
CHANGES IN pH DURING MUSCULAR CONTRACTION
In Resting Condition
During Onset of Contraction
During Later Part of Contraction
At the End of Contraction
THERMAL CHANGES DURING MUSCULAR CONTRACTION
RESTING HEAT
INITIAL HEAT
i. Heat of Activation
ii. Heat of Shortening
iii. Heat of Relaxation
RECOVERY HEAT
32:
Neuromuscular Junction
DEFINITION AND STRUCTURE
DEFINITION
STRUCTURE
Axon Terminal and Motor End Plate
Synaptic Trough or Gutter
Synaptic Cleft
Subneural Clefts
NEUROMUSCULAR TRANSMISSION
1. RELEASE OF ACETYLCHOLINE
2. ACTION OF ACETYLCHOLINE
3. ENDPLATE POTENTIAL
Properties of Endplate Potential
Significance of Endplate Potential
4. MINIATURE ENDPLATE POTENTIAL
5. FATE OF ACETYLCHOLINE
Reuptake Process
NEUROMUSCULAR BLOCKERS
DRUGS STIMULATING NEUROMUSCULAR JUNCTION
MOTOR UNIT
DEFINITION
NUMBER OF MUSCLE FIBERS IN MOTOR UNIT
RECRUITMENT OF MOTOR UNITS
APPLIED PHYSIOLOGY – DISORDERS OF NEUROMUSCULAR DISEASES
1. MYASTHENIA GRAVIS
2. EATON-LAMBERT SYNDROME
33:
Smooth Muscle
DISTRIBUTION SMOOTH MUSCLE
FUNCTIONS OF SMOOTH MUSCLE
IN CARDIOVASCULAR SYSTEM
IN RESPIRATORY SYSTEM
IN DIGESTIVE SYSTEM
IN RENAL SYSTEM
IN REPRODUCTIVE SYSTEM
STRUCTURE OF SMOOTH MUSCLE
TYPES OF SMOOTH MUSCLE FIBERS
SINGLE UNIT OR VISCERAL SMOOTH MUSCLE FIBERS
Distribution of Single Unit Smooth Muscle Fibers
MULTIUNIT SMOOTH MUSCLE FIBERS
Distribution of Multiunit Smooth Muscle Fibers
ELECTRICAL ACTIVITY IN SINGLE UNIT SMOOTH MUSCLE
RESTING MEMBRANE POTENTIAL
CAUSE FOR UNSTABLE RESTING MEMBRANE POTENTIAL – SLOW WAVE POTENTIAL
ACTION POTENTIAL
1. Spike Potential
2. Spike Potential Initiated by Slow Wave Rhythm
3. Action Potential with Plateau
TONIC CONTRACTION OF SMOOTH MUSCLE WITHOUT ACTION POTENTIAL
IONIC BASIS OF ACTION POTENTIAL
ELECTRICAL ACTIVITY IN MULTIUNIT SMOOTH MUSCLE
CONTRACTILE PROCESS IN SMOOTH MUSCLE
MOLECULAR BASIS OF SMOOTH MUSCLE CONTRACTION
Calcium – Calmodulin Complex
Length-Tension Relationship – Plasticity
NEUROMUSCULAR JUNCTION IN SMOOTH MUSCLE
CONTROL OF SMOOTH MUSCLE
NERVOUS FACTORS
HUMORAL FACTORS
Hormones and Neurotransmitters
Other Humoral Factors
34:
Electromyogram and Disorders of Skeletal Muscle
DEFINITION
ELECTROMYOGRAPHIC TECHNIQUE
ELECTROMYOGRAM
DISORDERS OF SKELETAL MUSCLES – MYOPATHY
1. MUSCULAR DYSTROPHY
Duchenne Muscular Dystrophy
Becker's Muscular Dystrophy
2. DISEASES INVOLVING MUSCLE TONE
Hypertonia
Hypotonia
Myotonia
3. FIBRILLATION AND DENERVATION HYPERSENSITIVITY
Fibrillation
Denervation Hypersensitivity
4. MYASTHENIA GRAVIS
Causes
Symptoms
5. LAMBERT-EATON SYNDROME
6. MCARDLE'S DISEASE
7. MITOCHONDRIAL MYOPATHY
8. NEMALINE MYOPATHY
35:
Endurance of Muscle
STRENGTH OF THE MUSCLE
TYPES OF MUSCLE STRENGTH
Contractile Strength
Holding Strength
POWER OF THE MUSCLE
ENDURANCE OF THE MUSCLE
QUESTIONS IN MUSCLE PHYSIOLOGY
LONG QUESTIONS
SHORT QUESTIONS
SECTION 4: DIGESTIVE SYSTEM
36:
Introduction to Digestive System
INTRODUCTION
FUNCTIONAL ANATOMY OF THE DIGESTIVE SYSTEM
WALL OF GASTROINTESTINAL TRACT
1. MUCUS LAYER
Epithelial Lining
Lamina Propria
Muscularis Mucosa
2. SUBMUCUS LAYER
3. MUSCULAR LAYER
4. SEROUS OR FIBROUS LAYER
NERVE SUPPLY TO GASTROINTESTINAL TRACT
INTRINSIC NERVE SUPPLY – ENTERIC NERVOUS SYSTEM
Auerbach's Plexus
Meissner's Nerve Plexus
EXTRINSIC NERVE SUPPLY
Sympathetic Nerve Fibers
Parasympathetic Nerve Fibers
37:
Mouth and Salivary Glands
FUNCTIONAL ANATOMY OF MOUTH
FUNCTIONS OF MOUTH
SALIVARY GLANDS
PAROTID GLANDS
SUBMAXILLARY GLANDS
SUBLINGUAL GLANDS
MINOR SALIVARY GLANDS
CLASSIFICATION OF SALIVARY GLANDS
1. Serous Glands
2. Mucus Glands
3. Mixed Glands
STRUCTURE AND DUCT SYSTEM OF SALIVARY GLANDS
PROPERTIES AND COMPOSITION OF SALIVA
PROPERTIES OF SALIVA
COMPOSITION OF SALIVA
FUNCTIONS OF SALIVA
1. PREPARATION OF FOOD FOR SWALLOWING
2. APPRECIATION OF TASTE
3. DIGESTIVE FUNCTION
Salivary Amylase
Maltase
Lingual Lipase
4. CLEANSING AND PROTECTIVE FUNCTIONS
5. ROLE IN SPEECH
6. EXCRETORY FUNCTION
7. REGULATION OF BODY TEMPERATURE
8. REGULATION OF WATER BALANCE
REGULATION OF SALIVARY SECRETION
NERVE SUPPLY TO SALIVARY GLANDS
PARASYMPATHETIC FIBERS
Parasympathetic Fibers to Submandibular and Sublingual Glands
Parasympathetic Fibers to Parotid Gland
SYMPATHETIC FIBERS
FUNCTION OF NERVE FIBERS SUPPLYING SALIVARY GLANDS
Function of Parasympathetic Fibers
Function of Sympathetic Fibers
REFLEX REGULATION OF SALIVARY SECRETION
1. Unconditioned Reflex
2. Conditioned Reflex
EFFECT OF DRUGS AND CHEMICALS ON SALIVARY SECRETION
APPLIED PHYSIOLOGY
HYPOSALIVATION
HYPERSALIVATION
OTHER DISORDERS
1. Xerostomia
2. Drooling
3. Chorda Tympani Syndrome
4. Paralytic Secretion of Saliva
5. Augmented Secretion of Saliva
6. Mumps
7. Sjögren's Syndrome
38:
Stomach
FUNCTIONAL ANATOMY OF STOMACH
PARTS OF STOMACH
1. Cardiac Region
2. Fundus
3. Body or Corpus
4. Pyloric Region
STRUCTURE OF STOMACH WALL
GLANDS OF STOMACH
CLASSIFICATION OF GLANDS OF THE STOMACH
STRUCTURE OF GASTRIC GLANDS
Fundic Glands
Pyloric Glands
Cardiac Glands
Enteroendocrine Cells
FUNCTIONS OF GASTRIC GLANDS
FUNCTIONS OF STOMACH
1. MECHANICAL FUNCTION
i. Storage Function
ii. Formation of Chyme
2. DIGESTIVE FUNCTION
3. PROTECTIVE FUNCTION
4. HEMOPOIETIC FUNCTION
5. EXCRETORY FUNCTION
PROPERTIES AND COMPOSITION OF GASTRIC JUICE
PROPERTIES OF GASTRIC JUICE
COMPOSITION OF GASTRIC JUICE
FUNCTIONS OF GASTRIC JUICE
1. DIGESTIVE FUNCTION
Pepsin
Gastric Lipase
Actions of Other Enzymes of Gastric Juice
2. HEMOPOIETIC FUNCTION
3. PROTECTIVE FUNCTION – FUNCTION OF MUCUS
4. FUNCTIONS OF HYDROCHLORIC ACID
MECHANISM OF SECRETION OF GASTRIC JUICE
SECRETION OF PEPSINOGEN
SECRETION OF HYDROCHLORIC ACID
Factors Stimulating the Secretion of Hydrochloric Acid
Factors Inhibiting the Secretion of Hydrochloric Acid
REGULATION OF GASTRIC SECRETION
METHODS OF STUDY
1. Pavlov's Pouch
2. Heidenhain's Pouch
3. Bickel's Pouch
4. Farrel and Ivy Pouch
5. Sham Feeding
Procedure
PHASES OF GASTRIC SECRETION
CEPHALIC PHASE
Unconditioned Reflex
Conditioned Reflex
GASTRIC PHASE
1. Nervous Mechanism
2. Hormonal Mechanism – Gastrin
INTESTINAL PHASE
INTERDIGESTIVE PHASE
FACTORS INFLUENCING GASTRIC SECRETION
COLLECTION OF GASTRIC JUICE
GASTRIC ANALYSIS
METHODS OF GASTRIC ANALYSIS
1. Fractional Test Meal (FTM)
2. Nocturnal Gastric Analysis
3. Histamine Test
APPLIED PHYSIOLOGY
1. GASTRITIS
Causes of Acute Gastritis
Causes of Chronic Gastritis
Features
2. GASTRIC ATROPHY
Cause
Features
3. PEPTIC ULCER
Causes
Features
4. ZOLLINGER-ELLISON SYNDROME
Cause
Features
39:
Pancreas
FUNCTIONAL ANATOMY AND NERVE SUPPLY OF PANCREAS
FUNCTIONAL ANATOMY OF EXOCRINE PART OF PANCREAS
NERVE SUPPLY TO PANCREAS
PROPERTIES AND COMPOSITION OFPANCREATIC JUICE
PROPERTIES OF PANCREATIC JUICE
COMPOSITION OF PANCREATIC JUICE
FUNCTIONS OF PANCREATIC JUICE
DIGESTIVE FUNCTIONS OF PANCREATIC JUICE
DIGESTION OF PROTEINS
1. Trypsin
2. Chymotrypsin
3. Carboxypeptidases
4. Nucleases
5. Elastase
6. Collagenase
DIGESTION OF LIPIDS
1. Pancreatic lipase
2. Cholesterol ester hydrolase
3. Phospholipase A
4. Phospholipase B
5. Colipase
6. Bile salt-activated lipase
DIGESTION OF CARBOHYDRATES
NEUTRALIZING ACTION OF PANCREATIC JUICE
MECHANISM OF PANCREATIC SECRETION
SECRETION OF PANCREATIC ENZYMES
SECRETION OF BICARBONATE IONS
REGULATION OF PANCREATIC SECRETION
STAGES OF PANCREATIC SECRETION
1. CEPHALIC PHASE
2. GASTRIC PHASE
3. INTESTINAL PHASE
Hormones Stimulating Pancreatic Secretion
Secretin
Cholecystokinin
Hormones Inhibiting Pancreatic Secretion
COLLECTION OF PANCREATIC JUICE
IN ANIMALS
IN HUMAN
APPLIED PHYSIOLOGY
PANCREATITIS
1. Acute Pancreatitis
2. Chronic Pancreatitis
STEATORRHEA
Causes of Steatorrhea
40:
Liver and Gallbladder
FUNCTIONAL ANATOMY OF LIVER AND BILIARY SYSTEM
LIVER
Hepatic Lobes
Hepatic Lobules
Hepatocytes and Hepatic Plates
Portal Triads
BILIARY SYSTEM
BLOOD SUPPLY TO LIVER
HEPATIC ARTERY
PORTAL VEIN
HEPATIC VEIN
PROPERTIES AND COMPOSITION OF BILE
PROPERTIES OF BILE
COMPOSITION OF BILE
SECRETION OF BILE
STORAGE OF BILE
BILE SALTS
FORMATION OF BILE SALTS
ENTEROHEPATIC CIRCULATION OF BILE SALTS
FUNCTIONS OF BILE SALTS
1. Emulsification of Fats
2. Absorption of Fats
3. Choleretic Action
4. Cholagogue Action
5. Laxative Action
6. Prevention of Gallstone Formation
BILE PIGMENTS
FORMATION AND EXCRETION OF BILE PIGMENTS
FATE OF CONJUGATED BILIRUBIN
NORMAL PLASMA LEVELS OF BILIRUBIN
FUNCTIONS OF BILE
1. DIGESTIVE FUNCTION
2. ABSORPTIVE FUNCTIONS
3. EXCRETORY FUNCTIONS
4. LAXATIVE ACTION
5. ANTISEPTIC ACTION
6. CHOLERETIC ACTION
7. MAINTENANCE OF PH IN GASTROINTESTINAL TRACT
8. PREVENTION OF GALLSTONE FORMATION
9. LUBRICATION FUNCTION
10. CHOLAGOGUE ACTION
FUNCTIONS OF LIVER
1. METABOLIC FUNCTION
2. STORAGE FUNCTION
3. SYNTHETIC FUNCTION
4. SECRETION OF BILE
5. EXCRETORY FUNCTION
6. HEAT PRODUCTION
7. HEMOPOIETIC FUNCTION
8. HEMOLYTIC FUNCTION
9. INACTIVATION OF HORMONES AND DRUGS
10. DEFENSIVE AND DETOXIFICATION FUNCTIONS
GALLBLADDER
FUNCTIONS OF GALLBLADDER
1. Storage of Bile
2. Concentration of Bile
3. Alteration of pH of Bile
4. Secretion of Mucin
5. Maintenance of Pressure in Biliary System
FILLING AND EMPTYING OF GALLBLADDER
1. Neural Factor
2. Hormonal Factor
REGULATION OF BILE SECRETION
APPLIED PHYSIOLOGY
JAUNDICE OR ICTERUS
Types of Jaundice
1. Prehepatic or Hemolytic Jaundice
2. Hepatic or Hepatocellular or Cholestatic Jaundice
3. Posthepatic or Obstructive or Extrahepatic Jaundice
HEPATITIS
Causes and Types
Viral Hepatitis
Causes
Features of Hepatitis
CIRRHOSIS OF LIVER
Causes
Features
GALLSTONES
Definitions
Formation of Gallstones
Causes for Gallstone Formation
Diagnosis of Gallstone
Features
Treatment for Gallstone
41:
Small Intestine
FUNCTIONAL ANATOMY
INTESTINAL VILLI AND GLANDS OF SMALL INTESTINE
INTESTINAL VILLI
CRYPTS OF LIEBERKÜHN OR INTESTINAL GLANDS
BRUNNER'S GLANDS
PROPERTIES AND COMPOSITION OF SUCCUS ENTERICUS
PROPERTIES OF SUCCUS ENTERICUS
COMPOSITION OF SUCCUS ENTERICUS
FUNCTIONS OF SUCCUS ENTERICUS
1. DIGESTIVE FUNCTION
Proteolytic Enzymes
Amylolytic Enzymes
Lipolytic Enzyme
2. PROTECTIVE FUNCTION
3. ACTIVATOR FUNCTION
4. HEMOPOIETIC FUNCTION
5. HYDROLYTIC PROCESS
FUNCTIONS OF SMALL INTESTINE
1. MECHANICAL FUNCTION
2. SECRETORY FUNCTION
3. HORMONAL FUNCTION
4. DIGESTIVE FUNCTION
5. ACTIVATOR FUNCTION
6. HEMOPOIETIC FUNCTION
7. HYDROLYTIC FUNCTION
8. ABSORPTIVE FUNCTIONS
Absorption of Carbohydrates
Absorption of Proteins
Absorption of Fats
Absorption of Water and Minerals
Absorption of Vitamins
REGULATION OF SECRETION OF SUCCUS ENTERICUS
NERVOUS REGULATION
HORMONAL REGULATION
METHODS OF COLLECTION OF SUCCUS ENTERICUS
IN MAN
IN ANIMALS
Thiry Loop
Thiry-Vella Loop
APPLIED PHYSIOLOGY
1. MALABSORPTION
2. MALABSORPTION SYNDROME
3. CROHN'S DISEASE OR ENTERITIS
Causes
Features
4. TROPICAL SPRUE
Cause
Features
5. STEATORRHEA
6. CELIAC DISEASE
Cause
Features
42:
Large Intestine
FUNCTIONAL ANATOMY OF LARGE INTESTINE
STRUCTURE OF WALL OF LARGE INTESTINE
SECRETIONS OF LARGE INTESTINE
COMPOSITION OF LARGE INTESTINAL JUICE
FUNCTIONS OF LARGE INTESTINAL JUICE
Neutralization of Acids
Lubrication Activity
FUNCTIONS OF LARGE INTESTINE
1. ABSORPTIVE FUNCTION
2. FORMATION OF FECES
3. EXCRETORY FUNCTION
4. SECRETORY FUNCTION
5. SYNTHETIC FUNCTION
APPLIED PHYSIOLOGY
DIARRHEA
Causes
Features
CONSTIPATION
Causes
APPENDICITIS
Causes
Features
ULCERATIVE COLITIS
Cause
Features
43:
Movements of Gastrointestinal Tract
MASTICATION
MUSCLES AND THE MOVEMENTS OF MASTICATION
CONTROL OF MASTICATION
DEGLUTITION
ORAL STAGE OR FIRST STAGE
PHARYNGEAL STAGE OR SECOND STAGE
1. Back into Mouth
2. Upward into Nasopharynx
3. Forward into Larynx
4. Entrance of Bolus into Esophagus
ESOPHAGEAL STAGE OR THIRD STAGE
1. Primary Peristaltic Contractions
2. Secondary Peristaltic Contractions
Role of Lower Esophageal Sphincter
DEGLUTITION REFLEX
Stimulus
Afferent Fibers
Center
Efferent Fibers
Response
APPLIED PHYSIOLOGY
1. Dysphagia
2. Esophageal Achalasia
3. Gastroesophageal Reflux Disease (GERD)
MOVEMENTS OF STOMACH
HUNGER CONTRACTIONS
Type I Hunger Contractions
Type II Hunger Contractions
Type III Hunger Contractions
RECEPTIVE RELAXATION
PERISTALSIS OF STOMACH
FILLING AND EMPTYING OF STOMACH
FILLING OF STOMACH
EMPTYING OF STOMACH
Chyme
1. Volume of Gastric Content
2. Consistency of Gastric Content
3. Chemical Composition
4. pH of the Gastric Content
5. Osmolar Concentration of Gastric Content
REGULATION OF GASTRIC EMPTYING
Nervous Factor
Hormonal Factors
APPLIED PHYSIOLOGY – ABNORMAL GASTRIC EMPTYING
1. Gastric Dumping Syndrome
2. Gastroparesis
VOMITING
CAUSES OF VOMITING
MECHANISM OF VOMITING
Nausea
Retching
Act of Vomiting
VOMITING REFLEX
Center for Vomiting during Motion Sickness and Vomiting Induced by Drugs
Center for Psychic Stimuli Induced Vomiting
MOVEMENTS OF SMALL INTESTINE
MIXING MOVEMENTS
Segmentation Contractions
Pendular Movement
PROPULSIVE MOVEMENTS
Peristaltic Movements
Peristaltic Rush
PERISTALSIS IN FASTING – MIGRATING MOTOR COMPLEX
Significance of Peristalsis in Fasting
MOVEMENTS OF VILLI
MOVEMENTS OF LARGE INTESTINE
MIXING MOVEMENTS – SEGMENTATION CONTRACTIONS
PROPULSIVE MOVEMENTS – MASS PERISTALSIS
DEFECATION
DEFECATION REFLEX
Act of Defecation
Gastrocolic Reflex
PATHWAY FOR DEFECATION REFLEX
EVACUATION OF GASES FROM GASTROINTESTINAL TRACT
EVACUATION OF ACCUMULATED GASES
BELCHING
Causes for Accumulation of Gases in Stomach
Act of Belching
FLATULENCE
Quantity of Flatus
Source of Gases in Intestine
Constituents of Flatus
44:
Gastrointestinal Hormones
INTRODUCTION
CELLS SECRETING THE HORMONES
DESCRIPTION OF GASTROINTESTINAL HORMONES
1. GASTRIN
Stimulant for Secretion
Actions
2. SECRETIN
Stimulant for Secretion
Actions
3. CHOLECYSTOKININ
Stimulant for Secretion
Actions
4. GLUCOSE DEPENDENT INSULINOTROPIC HORMONE
Stimulant for Secretion
Actions
5. VASOACTIVE INTESTINAL POLYPEPTIDE
Stimulant for Secretion
Actions
6. GLUCAGON
Stimulant for Secretion
Action
7. GLICENTIN
Stimulant for Secretion
Action
8. GLUCAGON LIKE POLYPEPTIDE-1
Stimulant for Secretion
Actions
9. GLUCAGON LIKE POLYPEPTIDE-2
Stimulant for Secretion
Action
10. SOMATOSTATIN
Stimulant for Secretion
Actions
11. PANCREATIC POLYPEPTIDE
Source of Secretion
Stimulant for Secretion
Actions
12. PEPTIDE YY
Stimulant for Secretion
Actions
13. NEUROPEPTIDE Y
Stimulant for Secretion
Action
14. MOTILIN
Stimulant for Secretion
Actions
15. SUBSTANCE P
Source of Secretion
Stimulant for Secretion
Actions
16. GHRELIN
Stimulant for Secretion
Actions
OTHER GASTROINTESTINAL HORMONES
45:
Digestion, Absorption and Metabolism of Carbohydrates
CARBOHYDRATES IN DIET
1. POLYSACCHARIDES
2. DISACCHARIDES
3. MONOSACCHARIDES
DIGESTION OF CARBOHYDRATES
IN THE MOUTH
IN THE STOMACH
IN THE INTESTINE
Amylolytic Enzyme in Pancreatic Juice
Amylolytic Enzymes in Succus Entericus
FINAL PRODUCTS OF CARBOHYDRATE DIGESTION
ABSORPTION OF CARBOHYDRATES
ABSORPTION OF GLUCOSE
ABSORPTION OF GALACTOSE
ABSORPTION OF FRUCTOSE
METABOLISM OF CARBOHYDRATES
46:
Digestion, Absorption and Metabolism of Proteins
PROTEINS IN DIET
DIGESTION OF PROTEINS
IN THE MOUTH
IN THE STOMACH
IN THE SMALL INTESTINE
Proteolytic Enzymes in Pancreatic Juice
Proteolytic Enzymes in Succus Entericus
FINAL PRODUCTS OF PROTEIN DIGESTION
ABSORPTION OF PROTEINS
METABOLISM OF PROTEINS
47:
Digestion, Absorption and Metabolism of Lipids
LIPIDS IN DIET
SATURATED FATS
UNSATURATED FATS
1. Monounsaturated Fats
2. Polyunsaturated Fats
3. Trans Fats
DIGESTION OF LIPIDS
IN THE MOUTH
IN THE STOMACH
IN THE INTESTINE
Role of Bile Salts
Lipolytic Enzymes in Pancreatic Juice
Lipolytic Enzyme in Succus Entericus
FINAL PRODUCTS OF FAT DIGESTION
ABSORPTION OF LIPIDS
STORAGE OF LIPIDS
TRANSPORT OF LIPIDS IN BLOOD – LIPOPROTEINS
LIPOPROTEINS
Functions of Lipoproteins
Importance of Lipoproteins
METABOLISM OF LIPIDS
LIPID PROFILE
QUESTIONS IN DIGESTIVE SYSTEM
LONG QUESTIONS
SHORT QUESTIONS
SECTION 5: RENAL PHYSIOLOGY AND SKIN
48:
Kidney
INTRODUCTION
FUNCTIONS OF KIDNEY
1. ROLE IN HOMEOSTASIS
i. Excretion of Waste Products
ii. Maintenance of Water Balance
iii. Maintenance of Electrolyte Balance
iv. Maintenance of Acid–Base Balance
2. HEMOPOIETIC FUNCTION
3. ENDOCRINE FUNCTION
4. REGULATION OF BLOOD PRESSURE
5. REGULATION OF BLOOD CALCIUM LEVEL
FUNCTIONAL ANATOMY OF KIDNEY
DIFFERENT LAYERS OF KIDNEY
1. Outer Cortex
2. Inner Medulla
3. Renal Sinus
PARENCHYMA OF KIDNEY
49:
Nephron
INTRODUCTION
RENAL CORPUSCLE
SITUATION OF RENAL CORPUSCLE AND TYPES OF NEPHRON
1. Cortical Nephrons
2. Juxtamedullary Nephrons
STRUCTURE OF RENAL CORPUSCLE
Glomerulus
Bowman's Capsule
Histology
TUBULAR PORTION OF NEPHRON
PROXIMAL CONVOLUTED TUBULE
Histology
LOOP OF HENLE
Descending Limb
Hairpin Bend
Ascending Limb
Length and Extent of Loop of Henle
Histology
DISTAL CONVOLUTED TUBULE
Histology
COLLECTING DUCT
50:
Juxtaglomerular Apparatus
DEFINITION
STRUCTURE OF JUXTAGLOMERULAR APPARATUS
1. MACULA DENSA
2. EXTRAGLOMERULAR MESANGIAL CELLS
Glomerular Mesangial Cells
3. JUXTAGLOMERULAR CELLS
FUNCTIONS OF JUXTAGLOMERULAR APPARATUS
SECRETION OF RENIN
Stimulants for Renin Secretion
Renin–Angiotensin System
Actions of Angiotensins
SECRETION OF OTHER SUBSTANCES
REGULATION OF GLOMERULAR BLOOD FLOW AND GLOMERULAR FILTRATION RATE
51:
Renal Circulation
INTRODUCTION
RENAL BLOOD VESSELS
MEASUREMENT OF RENAL BLOOD FLOW
REGULATION OF RENAL BLOOD FLOW
AUTOREGULATION
Renal Autoregulation
1. Myogenic Response
2. Tubuloglomerular Feedback
SPECIAL FEATURES OF RENAL CIRCULATION
52:
Urine Formation
INTRODUCTION
GLOMERULAR FILTRATION
INTRODUCTION
Filtration Membrane
1. Glomerular Capillary Membrane
2. Basement Membrane
3. Visceral Layer of Bowman's Capsule
Process of Glomerular Filtration
Ultrafiltration
METHOD OF COLLECTION OF GLOMERULAR FILTRATE
GLOMERULAR FILTRATION RATE (GFR)
FILTRATION FRACTION
PRESSURES DETERMINING FILTRATION
1. Glomerular Capillary Pressure
2. Colloidal Osmotic Pressure
3. Hydrostatic Pressure in Bowman's Capsule
Net Filtration Pressure
Starling's Hypothesis and Starling Forces
FILTRATION COEFFICIENT
FACTORS REGULATING (AFFECTING) GFR
1. Renal Blood Flow
2. Tubuloglomerular Feedback
3. Glomerular Capillary Pressure
4. Colloidal Osmotic Pressure
5. Hydrostatic Pressure in Bowman's Capsule
6. Constriction of Afferent Arteriole
7. Constriction of Efferent Arteriole
8. Systemic Arterial Pressure
9. Sympathetic Stimulation
10. Surface Area of Capillary Membrane
11. Permeability of Capillary Membrane
12. Contraction of Glomerular Mesangial Cells
13. Hormonal and Other Factors
TUBULAR REABSORPTION
INTRODUCTION
METHOD OF COLLECTION OF TUBULAR FLUID
1. Micropuncture Technique
2. Stop Flow Method
SELECTIVE REABSORPTION
MECHANISM OF REABSORPTION
1. Active Reabsorption
2. Passive Reabsorption
ROUTES OF REABSORPTION
Transcellular Route
Paracelluar Route
SITE OF REABSORPTION
1. Substances Reabsorbed from Proximal Convoluted Tubule
2. Substances Reabsorbed from Loop of Henle
3. Substances Reabsorbed from Distal Convoluted Tubule
REGULATION OF TUBULAR REABSORPTION
1. Glomerulotubular Balance
2. Hormonal Factors
3. Nervous Factor
THRESHOLD SUBSTANCES
1. High Threshold Substances
2. Low Threshold Substances
3. Nonthreshold Substances
TRANSPORT MAXIMUM – TM VALUE
Threshold Level in Plasma for Substances having Tm Value
REABSORPTION OF IMPORTANT SUBSTANCES
Reabsorption of Sodium
1. Transport from Lumen of Renal Tubules into the Tubular Epithelial Cells
2. Transport from Tubular Cells into the Interstitial Fluid
3. Transport from Interstitial Fluid to the Blood
Reabsorption of Water
Reabsorption of Glucose
Reabsorption of Amino Acids
Reabsorption of Bicarbonates
TUBULAR SECRETION
INTRODUCTION
SUBSTANCES SECRETED IN DIFFERENT SEGMENTS OF RENAL TUBULES
53:
Concentration of Urine
INTRODUCTION
FORMATION OF DILUTE URINE
FORMATION OF CONCENTRATED URINE
MEDULLARY GRADIENT
MEDULLARY HYPEROSMOLARITY
DEVELOPMENT AND MAINTENANCE OF MEDULLARY GRADIENT
COUNTERCURRENT MECHANISM
COUNTERCURRENT FLOW
COUNTERCURRENT MULTIPLIER
Loop of Henle
Role of Loop of Henle in Development of Medullary Gradient
Other Factors Responsible for Hyperosmolarity of Medullary Interstitial Fluid
COUNTERCURRENT EXCHANGER
Vasa Recta
Role of Vasa Recta in the Maintenance of Medullary Gradient
ROLE OF ADH
SUMMARY OF URINE CONCENTRATION
1. BOWMAN'S CAPSULE
2. PROXIMAL CONVOLUTED TUBULE
3. THICK DESCENDING SEGMENT
4. THIN DESCENDING SEGMENT OF HENLE'S LOOP
5. THIN ASCENDING SEGMENT OF HENLE'S LOOP
6. THICK ASCENDING SEGMENT
7. DISTAL CONVOLUTED TUBULE AND COLLECTING DUCT
APPLIED PHYSIOLOGY
54:
Acidification of Urine and Role of Kidney in Acid-Base Balance
INTRODUCTION
SECRETION OF HYDROGEN IONS
SODIUM-HYDROGEN ANTIPORT PUMP
ATP DRIVEN PROTON PUMP
REMOVAL OF HYDROGEN IONS AND ACIDIFICATION OF URINE
BICARBONATE MECHANISM
PHOSPHATE MECHANISM
AMMONIA MECHANISM
APPLIED PHYSIOLOGY
55:
Renal Function Tests
PROPERTIES AND COMPOSITION OF NORMAL URINE
PROPERTIES OF URINE
COMPOSITION OF URINE
RENAL FUNCTION TESTS
EXAMINATION OF URINE – URINANALYSIS
PHYSICAL EXAMINATION
1. Volume
2. Color
3. Appearance
4. Specific Gravity
5. Osmolarity
6. pH and Reaction
MICROSCOPIC EXAMINATION
1. Red Blood Cells
2. White Blood Cells
3. Epithelial Cells
4. Casts
5. Crystals
6. Bacteria
CHEMICAL ANALYSIS
1. Glucose
2. Protein
3. Ketone Bodies
4. Bilirubin
5. Urobilinogen
6. Bile Salts
7. Blood
8. Hemoglobin
9. Nitrite
EXAMINATION OF BLOOD
EXAMINATION OF BLOOD AND URINE
56:
Renal Failure
INTRODUCTION
ACUTE RENAL FAILURE
CAUSES
FEATURES
CHRONIC RENAL FAILURE
CAUSES
FEATURES
1. Uremia
2. Acidosis
3. Edema
4. Blood Loss
5. Anemia
6. Hyperparathyroidism
57:
Micturition
INTRODUCTION
FUNCTIONAL ANATOMY OF URINARY BLADDER
NERVE SUPPLY TO URINARY BLADDER AND SPHINCTERS
SYMPATHETIC NERVE SUPPLY
Function of Sympathetic Nerve
PARASYMPATHETIC NERVE SUPPLY
Function of Parasympathetic Nerve
SOMATIC NERVE SUPPLY
Function of Pudendal Nerve
FILLING OF URINARY BLADDER
PROCESS OF FILLING
CYSTOMETROGRAM
Definition
Method of Recording Cystometrogram
Description of Cystometrogram
Segment I
Segment II
Segment III
MICTURITION REFLEX
APPLIED PHYSIOLOGY
1. ATONIC BLADDER – EFFECT OF DESTRUCTION OF SENSORY NERVE FIBERS
Conditions of Destruction of Sensory Nerve Fibers
2. AUTOMATIC BLADDER
3. THE UNINHIBITED NEUROGENIC BLADDER
4. NOCTURNAL MICTURITION
58:
Dialysis and Artificial Kidney
DIALYSIS
ARTIFICIAL KIDNEY
CONDITIONS WHEN ARTIFICIAL KIDNEY IS REQUIRED
MECHANISM OF FUNCTION OF ARTIFICIAL KIDNEY
FREQUENCY AND DURATION OF DIALYSIS
DIALYSATE
PERITONEAL DIALYSIS
UREMIA
COMPLICATIONS OF DIALYSIS
59:
Diuretics
INTRODUCTION
GENERAL USES OF DIURETICS
ABUSES AND COMPLICATIONS OF DIURETICS
TYPES OF DIURETICS
1. OSMOTIC DIURETICS
2. DIURETICS WHICH INHIBIT ACTIVE REABSORPTION OF ELECTROLYTES
A. Loop Diuretics – Diuretics which Inhibit the Electrolyte Reabsorption in Thick Ascending Limb of Henle's Loop
B. Diuretics which Inhibit Active Transport of Electrolytes In Proximal Part of Distal Convoluted Tubule
C. Diuretics which Inhibit Active Transport of Electrolytes in Distal Part of Distal Convoluted Tubule and Collecting Duct
3. DIURETICS WHICH INHIBIT ACTION OF ALDOSTERONE
4. DIURETICS WHICH INHIBIT THE ACTIVITY OF CARBONIC ANHYDRASE
5. DIURETICS WHICH INCREASE GLOMERULAR FILTRATION RATE
6. DIURETICS WHICH INHIBIT SECRETION OF ADH
7. DIURETICS WHICH INHIBIT ADH RECEPTORS
60:
Structure of Skin
INTRODUCTION
EPIDERMIS
1. STRATUM CORNEUM
2. STRATUM LUCIDUM
3. STRATUM GRANULOSUM
4. STRATUM SPINOSUM
5. STRATUM GERMINATIVUM
DERMIS
1. SUPERFICIAL PAPILLARY LAYER
2. RETICULAR LAYER
APPENDAGES OF SKIN
COLOR OF THE SKIN
1. PIGMENTATION OF THE SKIN
Melanin
2. HEMOGLOBIN IN THE BLOOD
61:
Functions of Skin
FUNCTIONS OF THE SKIN
1. PROTECTIVE FUNCTION
i. Protection from Bacteria and Toxic Substances
ii. Protection from Mechanical Blow
iii. Protection from Ultraviolet Rays
2. SENSORY FUNCTION
3. STORAGE FUNCTION
4. SYNTHETIC FUNCTION
5. REGULATION OF BODY TEMPERATURE
6. REGULATION OF WATER AND ELECTROLYTE BALANCE
7. EXCRETORY FUNCTION
8. ABSORPTIVE FUNCTION
9. SECRETORY FUNCTION
62:
Glands of Skin
SEBACEOUS GLANDS
SWEAT GLANDS
ECCRINE GLANDS
Distribution
Structure
Secretory Activity of Eccrine Glands
Control of Eccrine Glands
APOCRINE GLANDS
Distribution
Structure
Secretory Activity of Apocrine Glands
Control of Apocrine Glands
Pheromones
63:
Body Temperature
INTRODUCTION
HOMEOTHERMIC ANIMALS
POIKILOTHERMIC ANIMALS
BODY TEMPERATURE
NORMAL BODY TEMPERATURE
TEMPERATURE AT DIFFERENT PARTS OF THE BODY
Core Temperature
VARIATIONS OF BODY TEMPERATURE
Physiological Variations
Pathological Variations
HEAT BALANCE
HEAT GAIN OR HEAT PRODUCTION IN THE BODY
1. Metabolic Activities
2. Muscular Activity
3. Role of Hormones
4. Radiation of Heat from the Environment
5. Shivering
HEAT LOSS FROM THE BODY
1. Conduction
2. Radiation
3. Convection
4. Evaporation – Insensible Perspiration
5. Panting
REGULATION OF BODY TEMPERATURE
HEAT LOSS CENTER
HEAT GAIN CENTER
MECHANISM OF TEMPERATURE REGULATION
When Body Temperature Increases
1. Promotion of Heat Loss
2. Prevention of Heat Production
When Body Temperature Decreases
APPLIED PHYSIOLOGY
HYPERTHERMIA – FEVER
Classification of Fever
Hyperpyrexia
Causes of Fever
Signs and Symptoms
HYPOTHERMIA
Classification of Hypothermia
Causes of Hypothermia
Signs and Symptoms
QUESTIONS IN RENAL PHYSIOLOGY AND SKIN
LONG QUESTIONS
SHORT QUESTIONS
SECTION 6: ENDOCRINOLOGY
64:
Introduction to Endocrinology
INTRODUCTION
CELL TO CELL SIGNALING
CHEMICAL MESSENGERS
Classification of Chemical Messengers
1. Endocrine Messengers
2. Paracrine Messengers
3. Autocrine Messengers
4. Neurocrine or Neural Messengers
ENDOCRINE GLANDS
METHODS OF STUDY
STUDY OF ENDOCRINE GLANDS
1. Functional Anatomy
2. Functions
3. Evidences to Support the Functions of the Gland
4. Regulation of Activity of the Gland
5. Applied Physiology
STUDY OF HORMONES
Half-life of the Hormones
STUDY OF ENDOCRINE DISORDERS
1. Causes
2. Signs and Symptoms
3. Syndrome
65:
Hormones
CHEMISTRY OF HORMONES
STEROID HORMONES
PROTEIN HORMONES
TYROSINE DERIVATIVES
HORMONAL ACTION
INTRODUCTION
HORMONE RECEPTORS
Situation of the Hormone Receptors
Regulation of Hormone Receptors
MECHANISM OF HORMONAL ACTION
1. By Altering the Permeability of Cell Membrane
2. By Activating the Intracellular Enzyme
3. By Acting on Genes
66:
Pituitary Gland
INTRODUCTION
ANTERIOR PITUITARY
PARTS
DEVELOPMENT
HISTOLOGY
Chromophobe Cells
Chromophil Cells
REGULATION OF SECRETION
Hypothalamo-Hypophyseal Relationship
Regulation of Anterior Pituitary Secretion
Releasing and Inhibitory Hormones
HORMONES SECRETED BY ANTERIOR PITUITARY
GROWTH HORMONE
Source of Secretion
Chemistry, Blood Level and Daily Output
Transport
Half-life and Metabolism
Actions of Growth Hormone
1. On Metabolism
2. On Bones
Mode of Action of GH on Bones and Metabolism
Somatomedin
Growth Hormone Receptor
Regulation of GH Secretion
Role of Hypothalamus in the Secretion of GH
Feedback Control
Role of Ghrelin in the Secretion of GH
OTHER HORMONES OF ANTERIOR PITUITARY
Thyroid Stimulating Hormone (TSH)
Adrenocorticotropic Hormone (ACTH)
Follicle Stimulating Hormone (FSH)
Luteinizing Hormone (LH)
Prolactin
β Lipotropin
POSTERIOR PITUITARY
PARTS
DEVELOPMENT
HISTOLOGY
Pituicytes
Unmyelinated Nerve Fibers
Other Structures
HORMONES OF POSTERIOR PITUITARY
Experimental Evidence
Neurophysins
ANTIDIURETIC HORMONE
Source of Secretion
Chemistry and Half-life
Actions
Mode of Action on Renal Tubules
Vasopressor Action
Regulation of Secretion
OXYTOCIN
Source of Secretion
Chemistry and Half-life
Actions in Females
Action in Males
Mode of Action of Oxytocin
APPLIED PHYSIOLOGY – DISORDERS OF PITUITARY GLAND
HYPERACTIVITY OF ANTERIOR PITUITARY
1. Gigantism
2. Acromegaly
3. Acromegalic Gigantism
4. Cushing's Disease
HYPOACTIVITY OF ANTERIOR PITUITARY
1. Dwarfism
Causes
2. Acromicria
3. Simmond's Disease
HYPERACTIVITY OF POSTERIOR PITUITARY
Syndrome of Inappropriate Hypersecretion of Antidiuretic Hormone (SIADH)
HYPOACTIVITY OF POSTERIOR PITUITARY
Diabetes Insipidus
HYPOACTIVITY OF ANTERIOR AND POSTERIOR PITUITARY
Dystrophia Adiposogenitalis
67:
Thyroid Gland
INTRODUCTION
HISTOLOGY OF THYROID GLAND
HORMONES OF THYROID GLAND
SYNTHESIS OF THYROID HORMONES
STAGES OF SYNTHESIS OF THYROID HORMONES
1. Thyroglobulin Synthesis
2. Iodide Trapping or Iodide Pump
3. Oxidation of the Iodide
4. Iodination of Tyrosine
5. Coupling Reactions
STORAGE OF THYROID HORMONES
RELEASE OF THYROID HORMONES FROM THE THYROID GLAND
RATE OF SECRETION
TRANSPORT OF THYROID HORMONES IN THE BLOOD
METABOLISM OF THYROID HORMONES
MODE OF ACTION OF THYROID HORMONES
FUNCTIONS OF THYROID HORMONES
1. ON BASAL METABOLIC RATE
2. ON PROTEIN METABOLISM
i. By Increasing the Translation of RNA
ii. By Increasing the Transcription of DNA to RNA
iii. By Increasing the Activity of Mitochondria
iv. By Increasing the Activity of Cellular Enzymes
3. ON CARBOHYDRATE METABOLISM
4. ON FAT METABOLISM
5. ON PLASMA AND LIVER FATS
6. ON VITAMIN METABOLISM
7. ON BODY TEMPERATURE
8. ON GROWTH
9. EFFECT ON BODY WEIGHT
10. EFFECT ON BLOOD
11. ON CARDIOVASCULAR SYSTEM
i. On Heart Rate
ii. On the Force of Contraction of the Heart
iii. On Blood Vessels
iv. On Arterial Blood Pressure
12. EFFECT ON RESPIRATION
13. ON GASTROINTESTINAL TRACT
14. ON CENTRAL NERVOUS SYSTEM
i. On Development of Central Nervous System
ii. On the Normal Function of Central Nervous System
15. ON SKELETAL MUSCLE
16. ON SLEEP
17. ON SEXUAL FUNCTION
18. ON OTHER ENDOCRINE GLANDS
REGULATION OF SECRETION OF THYROID HORMONES
ROLE OF PITUITARY GLAND
Thyroid Stimulating Hormone
Chemistry
Half-life and Plasma Level
Actions of TSH
Mode of Action of TSH
ROLE OF HYPOTHALAMUS
FEEDBACK CONTROL
ROLE OF IODIDE
ROLE OF OTHER FACTORS
APPLIED PHYSIOLOGY – DISORDERS OF THYROID GLAND
1. HYPERTHYROIDISM
Causes for Hyperthyroidism
Signs and Symptoms of Hyperthyroidism
Exophthalmos
2. HYPOTHYROIDISM
Myxedema
Cretinism
3. GOITER
Goiter in Hyperthyroidism – Toxic Goiter
Goiter in Hypothyroidism – Nontoxic Goiter
TREATMENT FOR THYROID DISORDERS
TREATMENT FOR HYPERTHYROIDISM
Surgical Removal
Antithyroid Substances
TREATMENT FOR HYPOTHYROIDISM
THYROID FUNCTION TESTS
68:
Parathyroid Glands and Physiology of Bone
INTRODUCTION
PARATHORMONE
SYNTHESIS OF PARATHORMONE
ACTIONS OF PARATHORMONE
On Blood Calcium Level
On Blood Phosphate Level
1. On Bone
2. On the Kidneys
3. On Gastrointestinal Tract
Role of PTH in the Activation of Vitamin D
Activation of Vitamin D
Role of Calcium Ion in Regulating 1, 25-Dihydroxycholecalciferol
REGULATION OF PARATHORMONE SECRETION
Blood Level of Calcium
Blood Level of Phosphate
APPLIED PHYSIOLOGY – DISORDERS OF PARATHYROID GLANDS
HYPOPARATHYROIDISM – HYPOCALCEMIA
Causes for Hypoparathyroidism
Hypocalcemia and Tetany
Hypocalcemic Tetany
Latent or Subclinical Tetany
HYPERPARATHYROIDISM – HYPERCALCEMIA
Hypercalcemia
PARATHYROID FUNCTION TESTS
CALCITONIN
ACTIONS OF CALCITONIN
1. On Blood Calcium Level
2. On Blood Phosphate Level
REGULATION OF CALCITONIN SECRETION
CALCIUM METABOLISM
IMPORTANCE OF CALCIUM
NORMAL VALUE
TYPES OF CALCIUM
Calcium in Plasma
Calcium in Bones
SOURCE OF CALCIUM
1. Dietary Source
2. From Bones
DAILY REQUIREMENTS OF CALCIUM
ABSORPTION AND EXCRETION OF CALCIUM
Absorption from GI Tract
Excretion
REGULATION OF BLOOD CALCIUM LEVEL
1. Parathormone
2. 1,25-Dihydroxycholecalciferol – Calcitriol
3. Calcitonin
Effects of Other Hormones
PHOSPHATE METABOLISM
IMPORTANCE OF PHOSPHATE
NORMAL VALUE
REGULATION OF PHOSPHATE LEVEL
1. Parathormone
2. Calcitonin
3. 1,25-Dihydroxycholecalciferol – Calcitriol
Effects of Other Hormones
PHYSIOLOGY OF BONE
FUNCTIONS OF BONE
1. Protective Function
2. Mechanical Function
3. Metabolic Function
4. Hemopoietic Function
CLASSIFICATION OF BONE
PARTS OF BONE
COMPOSITION OF BONE
Matrix
Bone Salts
STRUCTURE OF BONE
Compact Bone
Spongy Bone
CELL TYPES OF BONE
1. Osteoblasts
2. Osteocytes
Functions of osteocytes
3. Osteoclasts
BONE GROWTH
Ossification and Calcification
Growth in Length
BONE REMODELING
Bone Resorption – Osteoclastic Activity
Bone Formation – Osteoblastic Activity
Mineralization
Significance of Bone Remodeling
Regulation of Bone Remodeling
REPAIR OF BONE AFTER FRACTURE
APPLIED PHYSIOLOGY – DISEASES OF BONE
1. Osteoporosis
2. Rickets
3. Osteomalacia
69:
Endocrine Functions of Pancreas
ISLETS OF LANGERHANS
INSULIN
SOURCE OF SECRETION
CHEMISTRY
PLASMA LEVEL AND HALF-LIFE
SYNTHESIS
METABOLISM
ACTIONS OF INSULIN
1. On Carbohydrate Metabolism
2. On Protein Metabolism
3. On Fat Metabolism
4. On Growth
Houssay Animal
MODE OF ACTION OF INSULIN
Insulin Receptor
REGULATION OF INSULIN SECRETION
1. Role of Blood Glucose Level
2. Role of Proteins
3. Role of Lipid Derivatives
4. Role of Gastrointestinal Hormones
5. Role of Endocrine Hormones
6. Role of Autonomic Nerves
GLUCAGON
SOURCE OF SECRETION
CHEMISTRY AND HALF-LIFE
SYNTHESIS
METABOLISM
ACTIONS OF GLUCAGON
1. On Carbohydrate Metabolism
2. On Protein Metabolism
3. On Fat Metabolism
4. Other Actions
MODE OF ACTION OF GLUCAGON
REGULATION OF GLUCAGON SECRETION
1. Role of Blood Glucose Level
2. Role of Amino Acid Level in Blood
3. Role of Other Factors
SOMATOSTATIN
SOURCE OF SECRETION
CHEMISTRY AND HALF-LIFE
SYNTHESIS
ACTIONS OF SOMATOSTATIN
MODE OF ACTION OF SOMATOSTATIN
REGULATION OF SECRETION OF SOMATOSTATIN
PANCREATIC POLYPEPTIDE
SOURCE OF SECRETION
CHEMISTRY AND HALF-LIFE
METABOLISM
ACTIONS
MODE OF ACTION OF PANCREATIC POLYPEPTIDE
REGULATION OF SECRETION
REGULATION OF BLOOD SUGAR LEVEL (BLOOD GLUCOSE LEVEL)
NORMAL BLOOD SUGAR LEVEL
Necessity of Regulation of Blood Glucose Level
ROLE OF LIVER IN THE MAINTENANCE OF BLOOD SUGAR LEVEL
ROLE OF INSULIN IN THE MAINTENANCE OF BLOOD SUGAR LEVEL
ROLE OF GLUCAGON IN THE MAINTENANCE OF BLOOD SUGAR LEVEL
ROLE OF OTHER HORMONES IN THE MAINTENANCE OF BLOOD SUGAR LEVEL
APPLIED PHYSIOLOGY
HYPOACTIVITY – DIABETES MELLITUS
Types of Diabetes Mellitus
Type I Diabetes Mellitus
Type II Diabetes Mellitus
Signs and Symptoms of Diabetes Mellitus
Complications of Diabetes Mellitus
Diagnostic Tests for Diabetes Mellitus
Latent Diabetes
Treatment for Diabetes Mellitus
HYPERACTIVITY – HYPERINSULINISM
Cause of Hyperinsulinism
Signs and Symptoms of Hyperinsulinism
70:
Adrenal Cortex
IMPORTANCE OF ADRENAL GLANDS
FUNCTIONAL ANATOMY OF ADRENAL GLANDS
HISTOLOGY OF ADRENAL CORTEX
HORMONES OF ADRENAL CORTEX
SYNTHESIS, TRANSPORT AND FATE OF ADRENOCORTICAL HORMONES
SYNTHESIS
TRANSPORT
Mineralocorticoids
Glucocorticoids
Sex Hormones
FATE OF CORTICOSTEROIDS
MINERALOCORTICOIDS
SOURCE OF SECRETION
CHEMISTRY AND HALF-LIFE
DAILY OUTPUT AND PLASMA LEVEL
FUNCTIONS OF MINERALOCORTICOIDS
Life Saving Hormone
1. On Sodium Ions
2. On Extracellular Fluid Volume
3. On Blood Pressure
4. On Potassium Ions
5. On Hydrogen Ion Concentration
6. On Sweat Glands and Salivary Glands
7. On Intestine
MODE OF ACTION
REGULATION OF SECRETION
GLUCOCORTICOIDS
SOURCE OF SECRETION
CHEMISTRY AND HALF-LIFE
DAILY OUTPUT AND PLASMA LEVEL
FUNCTIONS OF GLUCOCORTICOIDS
Life Protecting Hormone
1. On Carbohydrate Metabolism
2. On Protein Metabolism
3. On Fat Metabolism
4. On Water Metabolism
5. On Mineral Metabolism
6. On Bone
7. On Muscles
8. On Blood Cells
9. On Vascular Response
10. On Central Nervous System
11. Permissive Action of Glucocorticoids
12. On Resistance to Stress
13. Anti-inflammatory Effects
14. Anti-allergic Actions
15. Immunosuppressive Effects
MODE OF ACTION
REGULATION OF SECRETION
Role of Anterior Pituitary – ACTH
Role of Hypothalamus
Feedback Control
ADRENAL SEX HORMONES
EXOGENOUS STEROIDS
SYNTHETIC STEROIDS
APPLIED PHYSIOLOGY
HYPERACTIVITY OF ADRENAL CORTEX
1. CUSHING'S SYNDROME
Causes
Pituitary Origin
Adrenal Origin
Signs and Symptoms
Tests for Cushing's Syndrome
Treatment for Cushing's Syndrome
2. HYPERALDOSTERONISM
Causes
Primary Hyperaldosteronism
Secondary Hyperaldosteronism
Signs and Symptoms
3. ADRENOGENITAL SYNDROME
Causes
Symptoms
HYPOACTIVITY OF ADRENAL CORTEX
1. ADDISON'S DISEASE OR CHRONIC ADRENAL INSUFFICIENCY
Causes for Primary Addison's Disease
Signs and Symptoms
Tests for Addison's Disease
Addisonian Crisis or Adrenal Crisis or Acute Adrenal Insufficiency
2. CONGENITAL ADRENAL HYPERPLASIA
Causes
Symptoms
71:
Adrenal Medulla
INTRODUCTION
HORMONES OF ADRENAL MEDULLA
PLASMA LEVEL OF CATECHOLAMINES
HALF-LIFE OF CATECHOLAMINES
SYNTHESIS OF CATECHOLAMINES
METABOLISM OF CATECHOLAMINES
ACTIONS OF ADRENALINE AND NORADRENALINE
MODE OF ACTION OF ADRENALINE AND NORADRENALINE – ADRENERGIC RECEPTORS
Alpha Adrenergic Receptors
Alpha2 receptors
Beta Adrenergic Receptors
ACTIONS
1. On Metabolism (via Alpha and Beta Receptors)
2. On Blood (via Beta Receptors)
3. On Heart (via Beta Receptors)
4. On Blood Vessels (via Alpha and Beta2 Receptors)
5. On Blood Pressure (via Alpha and Beta Receptors)
6. On Respiration (via Beta2 Receptors)
7. On Skin (via Alpha and Beta2 Receptors)
8. On Skeletal Muscle (via Alpha and Beta2 Receptors)
9. On Smooth Muscle (via Alpha and Beta Receptors)
10. On Central Nervous System (via Beta Receptors)
11. Other Effects of Catecholamines
REGULATION OF SECRETION OF ADRENALINE AND NORADRENALINE
DOPAMINE
APPLIED PHYSIOLOGY – PHEOCHROMOCYTOMA
72:
Endocrine Functions of Other Organs
PINEAL GLAND
SITUATION AND STRUCTURE
FUNCTIONS
Melatonin
THYMUS
SITUATION
FUNCTIONS
1. Processing the T Lymphocytes
2. Endocrine Function of Thymus
KIDNEYS
1. ERYTHROPOIETIN
Source of Secretion
Action of Erythropoietin
2. THROMBOPOIETIN
3. RENIN
Source of Secretion
Actions of Renin
4. 1,25-DIHYDROXYCHOLECALCIFEROL – CALCITRIOL
Formation of 1,25-Dihydroxycholecalciferol
Action of 1,25-Dihydroxycholecalciferol
5. PROSTAGLANDINS
HEART
ATRIAL NATRIURETIC PEPTIDE
Effect of ANP on Sodium Excretion
Effect of ANP on Blood Pressure
BRAIN NATRIURETIC PEPTIDE
Clinical Importance of BNP
C-TYPE NATRIURETIC PEPTIDE
73:
Local Hormones
INTRODUCTION
LOCAL HORMONES SYNTHESIZED IN TISSUES
PROSTAGLANDINS AND ITS RELATED HORMONES
1. Prostaglandins
2. Thromboxanes
3. Prostacyclin
4. Leukotrienes
5. Lipoxins
OTHER LOCAL HORMONES SYNTHESIZED IN TISSUES
1. Acetylcholine
2. Serotonin
3. Histamine
4. Substance P
5. Heparin
6. Leptin
7. Gastrointestinal Hormones
LOCAL HORMONES PRODUCED IN BLOOD
KININS
Formation of Kinins
Actions of Bradykinin
Action of Kallidin
Actions of Kallikreins
QUESTIONS IN ENDOCRINOLOGY
LONG QUESTIONS
SHORT QUESTIONS
SECTION 7: REPRODUCTIVE SYSTEM
74:
Male Reproductive System
INTRODUCTION
MALE REPRODUCTIVE ORGANS
PRIMARY SEX ORGANS
Testis
ACCESSORY SEX ORGANS
Seminal Vesicles
Prostate Gland
Urethra
Penis
External and Internal Genitalia
FUNCTIONAL ANATOMY OF TESTIS
COVERINGS OF TESTIS
1. Tunica vasculosa
2. Tunica Albuginea
3. Tunica Vaginalis
PARENCHYMA OF TESTIS
Seminiferous Tubules
Rete Testis
Vas Efferens
Epididymis
Vas Deferens
Interstitial Cells of Leydig
SEMINIFEROUS TUBULE
Germ Cells
Sertoli Cells
Blood-testis Barrier
FUNCTIONS OF TESTIS
GAMETOGENIC FUNCTIONS OF TESTIS – SPERMATOGENESIS
STAGES OF SPERMATOGENESIS
1. Stage of Proliferation
2. Stage of Growth
3. Stage of Maturation
4. Stage of Transformation
Spermination
ROLE OF SERTOLI CELLS IN SPERMATOGENESIS
ROLE OF HORMONES IN SPERMATOGENESIS
1. Follicular Stimulating Hormone
2. Testosterone
3. Estrogen
4. Luteinizing Hormone
5. Growth Hormone
6. Inhibin
7. Activin
OTHER FACTORS AFFECTING SPERMATOGENESIS
ENDOCRINE FUNCTIONS OF TESTIS
FUNCTIONS OF TESTOSTERONE
Functions of Testosterone in Fetal Life
1. Sex differentiation in fetus
Cryptorchidism
Functions of Testosterone in Adult Life
MODE OF ACTION OF TESTOSTERONE
REGULATION OF TESTOSTERONE SECRETION
In Fetus
In Adults
Feedback Control
MALE ANDROPAUSE OR CLIMACTERIC
APPLIED PHYSIOLOGY
EFFECTS OF EXTIRPATION OF TESTES
1. Effects of Extirpation of Testes before Puberty-Eunuchism
2. Effects of Extirpation of Testes Immediately after Puberty
3. Effect of Extirpation of Testes in Adults
HYPERGONADISM IN MALES
Cause
Symptoms
HYPOGONADISM IN MALES
Causes
Signs and Symptoms
Fröhlich's Syndrome
75:
Seminal Vesicles
STRUCTURE OF SEMINAL VESICLES
PROPERTIES AND COMPOSITION OF SEMINAL FLUID
PROPERTIES
COMPOSITION
FUNCTIONS OF SEMINAL FLUID
1. NUTRITION TO SPERMS
2. CLOTTING OF SEMEN
3. ON FERTILIZATION
76:
Prostate Gland
STRUCTURE OF PROSTATE GLAND
PROPERTIES AND COMPOSITION OF PROSTATIC FLUID
PROPERTIES
COMPOSITION
FUNCTIONS OF PROSTATIC FLUID
1. MAINTENANCE OF SPERM MOTILITY
2. CLOTTING OF SEMEN
3. LYSIS OF COAGULUM
APPLIED PHYSIOLOGY – ENLARGEMENT OF PROSTATE GLAND
77:
Semen
NATURE OF SEMEN
PROPERTIES OF SEMEN
COMPOSITION OF SEMEN
SPERMS
Structure of Spermatozoon
1. Head
2. Neck
3. Body
4. Tail
PRODUCTS FROM SEMINAL VESICLES
PRODUCTS FROM PROSTATE GLAND
SEMEN ANALYSIS
QUALITIES OF SEMEN REQUIRED FOR FERTILITY
APPLIED PHYSIOLOGY
78:
Female Reproductive System
FEMALE REPRODUCTIVE ORGANS
PRIMARY SEX ORGANS
ACCESSORY SEX ORGANS
FUNCTIONAL ANATOMY OF ACCESSORY SEX ORGANS
Uterus
Cervix
Vagina
SEXUAL LIFE IN FEMALES
FIRST PERIOD
SECOND PERIOD
THIRD PERIOD
79:
Ovary
FUNCTIONAL ANATOMY OF OVARY
MEDULLA
CORTEX
OVARIAN HORMONES
ESTROGEN
Chemistry and Source of Secretion
Different Forms
Plasma Level
Synthesis
Transport in Plasma
Metabolism
FUNCTIONS OF ESTROGEN
1. Effect on Ovarian Follicles
2. Effect on Uterus
3. Effect on Fallopian Tubes
4. Effect on Vagina
5. Effect on Secondary Sexual Characters
6. Effect on Breast
7. Effect on Bones
8. Effect on Metabolism
9. Effect on Electrolyte Balance
Mode of Action of Estrogen
Regulation of Estrogen Secretion
PROGESTERONE
Chemistry and Source of Secretion
Synthesis
Plasma Level
Transport in Blood
Metabolism
FUNCTIONS OF PROGESTERONE
1. Effect on Fallopian Tubes
2. Effect on the Uterus
3. Effect on Cervix
4. Effect on the Mammary Glands
5. Effect on Hypothalamus
6. Thermogenic Effect
7. Effect on Respiration
8. Effect on Electrolyte Balance
Mode of Action of Progesterone
Regulation of Secretion of Progesterone
80:
Menstrual Cycle
MENSTRUAL CYCLE
DEFINITION
DURATION OF MENSTRUAL CYCLE
CHANGES DURING MENSTRUAL CYCLE
OVARIAN CHANGES DURING MENSTRUAL CYCLE
FOLLICULAR PHASE
Ovarian Follicles
1. Primordial Follicle
2. Primary Follicle
3. Vesicular Follicle
4. Graafian Follicle
OVULATION
Process of Ovulation
LUTEAL PHASE
Corpus Luteum
Development of Corpus Luteum
Structure of Corpus Luteum
Functions of Corpus Luteum
Fate of Corpus Luteum
UTERINE CHANGES DURING MENSTRUAL CYCLE
MENSTRUAL PHASE
Changes in Endometrium during Menstrual Phase
PROLIFERATIVE PHASE
Changes in Endometrium during Proliferative Phase
SECRETORY PHASE
Changes in Endometrium during Secretory Phase
CHANGES IN CERVIX AND VAGINA DURING MENSTRUAL CYCLE
CHANGES IN CERVIX DURING MENSTRUAL CYCLE
Proliferative Phase
Secretory Phase
VAGINAL CHANGES DURING MENSTRUAL CYCLE
Proliferative Phase
Secretory Phase
REGULATION OF MENSTRUAL CYCLE
HORMONES INVOLVED IN REGULATION
Hypothalamic Hormone
Anterior Pituitary Hormones
Ovarian Hormones
REGULATION OF OVARIAN CHANGES
Follicular Phase
Ovulation
Luteal Phase
REGULATION OF UTERINE CHANGES
Proliferative Phase
Secretory Phase
Menstrual Phase
APPLIED PHYSIOLOGY
MENSTRUAL SYMPTOMS
PREMENSTRUAL SYNDROME (PMS)
ABNORMAL MENSTRUATION
ANOVULATORY CYCLE
81:
Ovulation
INTRODUCTION
PROCESS OF OVULATION
HORMONAL REGULATION OF OVULATION
DETERMINATION OF OVULATION TIME
DETERMINATION OF BASAL BODY TEMPERATURE
DETERMINATION OF HORMONAL EXCRETION IN URINE
DETERMINATION OF HORMONAL LEVEL IN PLASMA
ULTRASOUND SCANNING
CERVICAL MUCUS PATTERN
SIGNIFICANCE OF DETERMINING OVULATION TIME
82:
Menopause
CLIMACTERIC AND MENOPAUSE
CAUSE FOR MENOPAUSE
CHANGES DURING MENOPAUSE – POSTMENOPAUSAL SYNDROME
CAUSE
SYMPTOMS
TREATMENT – HORMONE REPLACEMENT THERAPY (HRT)
83:
Infertility
DEFINITION
INFERTILITY IN MALES
CAUSES FOR INFERTILITY IN MALES
INFERTILITY IN FEMALES
CAUSES FOR INFERTILITY IN FEMALES
84:
Pregnancy and Parturition
INTRODUCTION
FERTILIZATION OF THE OVUM
SEX CHROMOSOMES AND SEX DETERMINATION
SEX CHROMOSOMES
SEX DETERMINATION
IMPLANTATION
DEVELOPMENT OF PLACENTA AND EMBRYO
MATERNAL CHANGES DURING PREGNANCY
STRUCTURAL CHANGES
1. Ovaries
2. Uterus
3. Vagina
4. Cervix
5. Fallopian Tube
6. Mammary Glands
INCREASE IN BODY WEIGHT
METABOLIC CHANGES
1. Basal Metabolic Rate
2. Protein Metabolism
3. Carbohydrate Metabolism
4. Lipid Metabolism
5. Water and Mineral Metabolism
CHANGES IN PHYSIOLOGICAL SYSTEMS
1. Blood
2. Cardiovascular System
Pre-eclampsia
Eclampsia
3. Respiratory System
4. Excretory System
5. Digestive System
6. Endocrine System
7. Nervous System
GESTATION PERIOD
PARTURITION
BRAXTON HICKS CONTRACTIONS
FALSE LABOR CONTRACTIONS
STAGES OF PARTURITION
First Stage
Second Stage
Third Stage
MECHANISM OF LABOR
ROLE OF UTERUS
ROLE OF CERVIX
ROLE OF HORMONES
Maternal Hormones
Fetal Hormones
Placental Hormones
Estrogen
Progesterone
Oxytocin
Relaxin
Prostaglandins
Catecholamines
Cortisol
85:
Placenta
INTRODUCTION
FUNCTIONS OF PLACENTA
NUTRITIVE FUNCTION
EXCRETORY FUNCTION
RESPIRATORY FUNCTION
Exchange of Respiratory Gases between Fetal Blood and Maternal Blood
Bohr's Effect and Double Bohr's Effect
ENDOCRINE FUNCTION
1. Human Chorionic Gonadotropin
2. Estrogen
3. Progesterone
4. Human Chorionic Somatomammotropin (HCS)
Actions of HCS
5. Relaxin
FETOPLACENTAL UNIT
FUNCTIONS OF FETOPLACENTAL UNIT
86:
Pregnancy Tests
INTRODUCTION
BIOLOGICAL TESTS
1. ASCHHEIM-ZONDEK TEST
2. KUPPERMAN TEST
3. FRIEDMAN TEST
4. HOGBEN TEST
5. GALLI-MAININI TEST
Disadvantages of Biological Tests
IMMUNOLOGICAL TESTS
PRINCIPLE
REQUISITES
1. Antiserum from Rabbit
2. Red Blood Cells from Sheep
3. Urine
PROCEDURE
OBSERVATION AND RESULT
ADVANTAGES OF IMMUNOLOGICAL TESTS FOR PREGNANCY
87:
Mammary Glands and Lactation
DEVELOPMENT OF MAMMARY GLANDS
AT BIRTH
AT CHILDHOOD
AT PUBERTY
DURING PREGNANCY
ROLE OF HORMONES IN GROWTH OF MAMMARY GLANDS
1. ESTROGEN
Growth of Ductile System
2. PROGESTERONE
Growth of Glandular Tissue
3. PROLACTIN
4. PLACENTAL HORMONES
5. OTHER HORMONES
LACTATION
MILK SECRETION
1. Initiation of Milk Secretion or Lactogenesis
2. Maintenance of Milk Secretion or Galactopoiesis
MILK EJECTION
Milk Ejection Reflex
EFFECT OF LACTATION ON MENSTRUAL CYCLE
BREAST MILK
COMPOSITION
ADVANTAGES OF BREAST MILK
DISADVANTAGES OF ANIMAL MILK
88:
Fertility Control
INTRODUCTION
RHYTHM METHOD (SAFE PERIOD)
MECHANICAL BARRIERS – PREVENTION OF ENTRY OF SPERM INTO UTERUS
CHEMICAL METHODS
ORAL CONTRACEPTIVES (PILL METHOD)
1. CLASSICAL OR COMBINED PILLS
Mechanism of Action
2. SEQUENTIAL PILLS
3. MINIPILLS OR MICROPILLS
DISADVANTAGES AND ADVERSE EFFECTS OF ORAL CONTRACEPTIVES
LONG TERM CONTRACEPTIVES
INTRAUTERINE CONTRACEPTIVE DEVICE (IUCD) – PREVENTION OF FERTILIZATION AND IMPLANTATION OF OVUM
MECHANISM OF ACTION OF IUCD
DISADVANTAGES OF IUCD
MEDICAL TERMINATION OF PREGNANCY (MTP) – ABORTION
1. DILATATION AND CURETTAGE (D AND C)
2. VACUUM ASPIRATION
3. ADMINISTRATION OF PROSTAGLANDIN
SURGICAL METHOD (STERILIZATION) – PERMANENT METHOD
TUBECTOMY
VASECTOMY
QUESTIONS IN REPRODUCTIVE SYSTEM
LONG QUESTIONS
SHORT QUESTIONS
SECTION 8: CARDIOVASCULAR SYSTEM
89:
Introduction to Cardiovascular System
CARDIOVASCULAR SYSTEM
HEART
RIGHT SIDE OF THE HEART
LEFT SIDE OF THE HEART
LAYERS OF WALL OF THE HEART
PERICARDIUM
i. Outer Parietal Pericardium
ii. Inner Visceral Pericardium
MYOCARDIUM
i. Muscle Fibers which Form the Contractile Unit of the Heart
ii. Muscle Fibers which Form the Pacemaker
iii. Muscle Fibers which Form the Conductive System
ENDOCARDIUM
SEPTA OF THE HEART
VALVES OF THE HEART
Atrioventricular Valves
Semilunar Valves
ACTIONS OF THE HEART
CHRONOTROPIC ACTION
INOTROPIC ACTION
DROMOTROPIC ACTION
BATHMOTROPIC ACTION
Regulation of Actions of the Heart
BLOOD VESSELS
ARTERIAL SYSTEM
VENOUS SYSTEM
COMPLICATIONS IN BLOOD VESSELS
Aorta and Arteries
Arterioles
Capillaries
Veins
DIVISIONS OF CIRCULATION
SYSTEMIC CIRCULATION
PULMONARY CIRCULATION
90:
Properties of Cardiac Muscle
EXCITABILITY
DEFINITION
ELECTRICAL POTENTIALS IN CARDIAC MUSCLE
Resting Membrane Potential
Action Potential
1. Initial Depolarization
2. Initial Repolarization
3. Plateau – Final Depolarization
4. Final Repolarization
IONIC BASIS OF ACTION POTENTIAL
1. Initial Depolarization
2. Initial Repolarization
3. Plateau – Final Depolarization
4. Final Repolarization
Restoration of Resting Membrane Potential
SPREAD OF ACTION POTENTIAL THROUGH CARDIAC MUSCLE
RHYTHMICITY
DEFINITION
PACEMAKER
Experimental Evidences
Spread of Impulses from SA Node
Rhythmicity of Other Parts of the Heart
Pacemaker in Amphibian Heart
Spread of Impulses from Sinus Venosus
Rhythmicity of Different Parts of the Heart in Amphibians
ELECTRICAL POTENTIAL IN SA NODE
Resting Membrane Potential – Pacemaker Potential
Action Potential
Ionic Basis of Electrical Activity in Pacemaker
CONDUCTIVITY
CONDUCTIVE SYSTEM IN HUMAN HEART
VELOCITY OF IMPULSES AT DIFFERENT PARTS OF THE CONDUCTIVE SYSTEM
CONTRACTILITY
ALL OR NONE LAW
Cause for All or None Law
STAIRCASE PHENOMENON
Cause for Staircase Phenomenon
SUMMATION OF SUBLIMINAL STIMULI
REFRACTORY PERIOD
Absolute Refractory Period
Relative Refractory Period
Refractory Period in Skeletal Muscle
Refractory Period in Cardiac Muscle
Significance of Long Refractory Period in Cardiac Muscle
Demonstration of Refractory Period in Heart
91:
Cardiac Cycle
DEFINITION
DIVISIONS OF CARDIAC CYCLE
SUBDIVISIONS AND DURATION OF CARDIAC CYCLE
SYSTOLE
DIASTOLE
DESCRIPTION OF EVENTS OF CARDIAC CYCLE
ATRIAL SYSTOLE
Pressure and Volume Changes
Fourth Heart Sound
Atrial Systole
Atrial Events vs Ventricular Events
ISOMETRIC CONTRACTION PERIOD
First Heart Sound
Significance of Isometric Contraction
EJECTION PERIOD
PROTODIASTOLE
Second Heart Sound
ISOMETRIC RELAXATION PERIOD
Significance of Isometric Relaxation
RAPID FILLING PHASE
Third Heart Sound
SLOW FILLING PHASE
ATRIAL SYSTOLE
INTRA-ATRIAL PRESSURE CHANGES DURING CARDIAC CYCLE
SIGNIFICANCE
METHODS OF STUDY
Pulmonary Capillary Wedge Pressure
MAXIMUM AND MINIMUM PRESSURE IN ATRIA
INTRA-ATRIAL PRESSURE CURVE
‘a’ Wave
‘x’ Wave
‘c’ Wave
‘x1’ Wave
‘v’ Wave
‘y’ Wave
INTRAVENTRICULAR PRESSURE CHANGES DURING CARDIAC CYCLE
SIGNIFICANCE
METHODS OF STUDY OF INTRAVENTRICULAR PRESSURE CHANGES
MAXIMUM AND MINIMUM PRESSURE IN VENTRICLES
INTRAVENTRICULAR PRESSURE CURVE
‘A-B’ Segment
‘B-C’ Segment
‘C-D’ Segment
‘D-E’ Segment
‘E-F’ Segment
‘F-G’ Segment
‘G-A’ Segment
AORTIC PRESSURE CHANGES DURING CARDIAC CYCLE
SIGNIFICANCE
METHOD OF STUDY
MAXIMUM AND MINIMUM PRESSURE IN AORTA
AORTIC PRESSURE CURVE
VENTRICULAR VOLUME CHANGES DURING CARDIAC CYCLE
SIGNIFICANCE
METHODS OF STUDY
1. By using Henderson's Cardiometer
2. By Angiography
VOLUME OF BLOOD IN THE RIGHT AND LEFT VENTRICLES
End Diastolic Volume and End Systolic Volume
Ejection Fraction
VENTRICULAR VOLUME CURVE
‘A-B’ Segment
‘B-C’ Segment
‘C-D’ Segment
‘D-E’ Segment
‘E-F’ Segment
‘F-G’ Segment
‘G-A’ Segment
92:
Heart Sounds
INTRODUCTION
DIFFERENT HEART SOUNDS
IMPORTANCE OF HEART SOUNDS
DESCRIPTION OF HEART SOUNDS
FIRST HEART SOUND
Characteristics
Causes
Applied Physiology
First Heart Sound and ECG
SECOND HEART SOUND
Characteristics
Cause
Applied Physiology
Second Heart Sound and ECG
THIRD HEART SOUND
Characteristics
Cause
Conditions when Third Heart Sound becomes Audible by Stethoscope
Third Heart Sound and ECG
FOURTH HEART SOUND
Characteristics
Cause
Conditions when Fourth Heart Sound becomes Audible
Fourth Heart Sound and ECG
TRIPLE AND QUADRUPLE HEART SOUNDS
TRIPLE HEART SOUND OR GALLOP RHYTHM
Conditions when Triple Heart Sound is Produced
QUADRUPLE HEART SOUND
Conditions when Quadruple Heart Sound is Produced
Summation Gallop
METHODS OF STUDY OF HEART SOUNDS
BY USING STETHOSCOPE
i. Mitral Area (Bicuspid Area)
ii. Tricuspid Area
iii. Pulmonary Area
iv. Aortic Area
BY MICROPHONE
BY PHONOCARDIOGRAM
Appearance of Heart Sounds in Phonocardiogram
First Heart Sound
Second Heart Sound
Third Heart Sound
93:
Cardiac Murmur
INTRODUCTION
CLASSIFICATION OF MURMUR
SYSTOLIC MURMUR
1. Incompetence of Atrioventricular Valves
2. Stenosis of Semilunar Valves
3. Murmur due to Anemia
4. Septal Defect
5. Coarctation of Aorta
DIASTOLIC MURMUR
1. Stenosis of Atrioventricular Valves
2. Incompetence of Semilunar Valves
CONTINUOUS MURMUR
Patent Ductus Arteriosus
94:
Electrocardiogram (ECG)
DEFINITIONS
USES OF ECG
ELECTROCARDIOGRAPHIC (ECG) GRID
DURATION
AMPLITUDE
SPEED OF THE PAPER
ECG LEADS
BIPOLAR LEADS
Lead I
Lead II
Lead III
UNIPOLAR LEADS
1. Unipolar Limb Leads
2. Unipolar Chest Leads
WAVES OF NORMAL ELECTROCARDIOGRAM
‘P’ WAVE
Cause
Duration
Amplitude
Morphology
Clinical Significance
‘QRS’ COMPLEX
Cause
Duration
Amplitude
Morphology
Clinical Significance
‘T’ WAVE
Cause
Duration
Amplitude
Morphology
Clinical Significance
‘U’ WAVE
Clinical Significance
INTERVALS AND SEGMENTS OF ECG
‘P-R’ INTERVAL
Duration
Clinical Significance
‘Q-T’ INTERVAL
Duration
Clinical Significance
‘S-T’ SEGMENT
J Point
Duration of ‘S-T’ Segment
Clinical Significance
‘R-R’ INTERVAL
Significance
Duration
Significance of Measuring ‘R-R’ Interval
1. Heart Rate
2. Heart Rate Variability
Significance of HRV
95:
Vector
INTRODUCTION
INSTANTANEOUS MEAN VECTOR
DEGREE OF INSTANTANEOUS MEAN VECTOR
DEGREE OF INSTANTANEOUS MEAN VECTOR AT DIFFERENT LIMB LEADS
Standard Limb Lead I (Right Arm and Left Arm)
Standard Limb Lead II (Right Arm and Left Leg)
Standard Limb Lead III (Left Arm and Left Leg)
Lead aVR
Lead aVF
Lead aVL
CALCULATED VECTOR OR MEAN QRS VECTOR
CALCULATION OF MEAN QRS VECTOR
VECTORAL ANALYSIS
VECTOR CARDIOGRAM
96:
Arrhythmia
DEFINITION AND CLASSIFICATION OF ARRHYTHMIA
NORMOTOPIC ARRHYTHMIA
SINUS ARRHYTHMIA
ECG Changes
Cause
SINUS TACHYCARDIA
ECG Changes
Conditions when Sinus Tachycardia Occurs
Features
SINUS BRADYCARDIA
ECG Changes
Conditions when Sinus Bradycardia Occurs
Features
ECTOPIC ARRHYTHMIA
HEART BLOCK
Sinoatrial Block – AV Nodal Rhythm
Atrioventricular Block
1. Incomplete Heart Block
2. Complete Heart Block (Third degree heart block)
EXTRASYSTOLE
Extrasystole and Compensatory Pause
1. Atrial Extrasystole
2. Nodal Extrasystole
3. Ventricular Extrasystole
Conditions when Extrasystole Occurs
PAROXYSMAL TACHYCARDIA
1. Atrial Paroxysmal Tachycardia
2. AV Nodal Paroxysmal Tachycardia – Bundle of Kent
3. Ventricular Paroxysmal Tachycardia
ATRIAL FLUTTER
ATRIAL FIBRILLATION
VENTRICULAR FIBRILLATION
ABNORMAL PACEMAKER
ARTIFICIAL PACEMAKER
CURRENT OF INJURY
97:
Effect of Changes in Electrolyte Concentration on Heart
INTRODUCTION
EFFECT OF CHANGES IN SODIUM ION CONCENTRATION
EFFECT OF CHANGES IN POTASSIUM ION CONCENTRATION
EFFECT OF HYPERKALEMIA
EFFECT OF HYPOKALEMIA
EFFECT OF CHANGES IN CALCIUM ION CONCENTRATION
EFFECTS OF HYPERCALCEMIA
Calcium Rigor
EFFECTS OF HYPOCALCEMIA
Experimental Evidences
98:
Cardiac Output
INTRODUCTION
DEFINITIONS AND NORMAL VALUES
1. STROKE VOLUME
2. MINUTE VOLUME
3. CARDIAC INDEX
EJECTION FRACTION
CARDIAC RESERVE
VARIATIONS IN CARDIAC OUTPUT
PHYSIOLOGICAL VARIATIONS
PATHOLOGICAL VARIATIONS
Increase in Cardiac Output
Decrease in Cardiac Output
DISTRIBUTION OF CARDIAC OUTPUT
FACTORS MAINTAINING CARDIAC OUTPUT
1. VENOUS RETURN
i. Respiratory Pump
ii. Muscle Pump
iii. Gravity
iv. Venous Pressure
v. Sympathetic Tone
2. FORCE OF CONTRACTION
Preload
Afterload
3. HEART RATE
4. PERIPHERAL RESISTANCE
MEASUREMENT OF CARDIAC OUTPUT
MEASUREMENT OF CARDIAC OUTPUT BY DIRECT METHODS
1. By Using Cardiometer
2. By Using Flowmeter
Disadvantages of Direct Methods
MEASUREMENT OF CARDIAC OUTPUT BY INDIRECT METHODS
Invasive and Noninvasive Methods
Different Indirect Methods
1. By Fick's Principle
Measurement of Cardiac Output by Using Oxygen Consumption
Measurement of Cardiac Output by Using Carbon Dioxide
2. Indicator (Dye) Dilution Method
3. Thermodilution Technique
4. Esophageal Doppler Transducer Technique
5. Doppler Echocardiography
6. Ballistocardiographic Method
CARDIAC CATHETERIZATION
DEFINITION
CONDITIONS WHEN CARDIAC CATHETERIZATION IS PERFORMED
PROCEDURE
Left Heart Catheterization
Right Heart Catheterization
USES OF CARDIAC CATHETERIZATION
Diagnostic Uses of Cardiac Catheterization
Therapeutic Uses of Cardiac Catheterization – Interventional Cardiology
99:
Heart–Lung Preparation
INTRODUCTION
PROCEDURE
USES OF HEART–LUNG PREPARATION
100:
Cardiac Function Curves
INTRODUCTION
CARDIAC OUTPUT CURVES
NORMAL CARDIAC OUTPUT CURVES
FACTORS AFFECTING CARDIAC OUTPUT CURVES
Shift to Left
Shift to Right
EFFECT OF EXTRACARDIAC PRESSURE ON CARDIAC OUTPUT CURVE
VENOUS RETURN CURVES
ANALYSIS OF CARDIAC FUNCTION CURVES
COUPLING OF CARDIAC AND VASCULAR FUNCTIONS
101:
Regulation of Heart Rate
INTRODUCTION
HEART RATE
NORMAL HEART RATE
TACHYCARDIA
BRADYCARDIA
REGULATION OF HEART RATE
VASOMOTOR CENTER – CARDIAC CENTER
VASOCONSTRICTOR AREA – CARDIOACCELERATOR CENTER
Situation
Function
Control
VASODILATOR AREA – CARDIOINHIBITORY CENTER
Situation
Function
Control
SENSORY AREA
MOTOR (EFFERENT) NERVE FIBERS TO HEART
PARASYMPATHETIC NERVE FIBERS
Origin
Distribution
Function
Vagal Tone
Effect of Stimulation of Vagus Nerve
Mode of Action of Vagus Nerve
SYMPATHETIC NERVE FIBERS
Origin
Course and Distribution
Function
Sympathetic Tone
Effect of Stimulation of Sympathetic Nerves
Mode of Action of Sympathetic Nerves
SENSORY (AFFERENT) NERVE FIBERS FROM HEART
FACTORS AFFECTING VASOMOTOR CENTER – REGULATION OF VAGAL TONE
1. IMPULSES FROM HIGHER CENTERS
Cerebral Cortex
Hypothalamus
2. IMPULSES FROM RESPIRATORY CENTERS
3. IMPULSES FROM BARORECEPTORS – MAREY'S REFLEX
Baroreceptors
Situation
Nerve Supply
Function – Marey's Reflex
4. IMPULSES FROM CHEMORECEPTORS
Chemoreceptors
Situation
Structure
Nerve Supply
Function
Sinoaortic Mechanism and Buffer Nerves
5. IMPULSES FROM RIGHT ATRIUM – BAINBRIDGE REFLEX
6. IMPULSES FROM OTHER AFFERENT NERVES
7. BEZOLD-JARISCH REFLEX
102:
Hemodynamics
INTRODUCTION
MEAN VOLUME OF BLOOD FLOW
DEFINITION AND FORMULA
IMPORTANCE
METHODS OF STUDY
1. By Using Flowmeters
2. By Using Plethysmograph
3. By Venous Occlusion Plethysmography
4. By Fick's Principle
TYPES OF BLOOD FLOW
1. Streamline Flow
2. Turbulent Flow
FACTORS MAINTAINING VOLUME OF BLOOD FLOW
1. Pressure Gradient
2. Resistance to the Blood Flow (Peripheral Resistance)
3. Viscosity of Blood
4. Diameter of Blood Vessels
5. Velocity of Blood Flow
HAGEN-POISEUILLE EQUATION
WINDKESSEL EFFECT
VELOCITY OF BLOOD FLOW
DEFINITION
MEAN VELOCITY OF BLOOD FLOW IN DIFFERENT VESSELS
METHODS OF STUDY
1. By Using Flowmeters
2. By Hemodromography
FACTORS MAINTAINING VELOCITY
1. Cardiac Output
2. Cross sectional Area of Blood Vessels
3. Viscosity of Blood
PHASIC CHANGES IN THE VELOCITY OF BLOOD FLOW
CIRCULATION TIME
DEFINITION
MEASUREMENT OF CIRCULATION TIME
Substances used for Measuring Circulation Time
TYPICAL CIRCULATION TIMES
TOTAL CIRCULATION TIME AND HEARTBEAT
CONDITIONS ALTERING CIRCULATION TIME
Conditions in which Circulation Time is Prolonged (Sluggish Blood Flow)
Conditions in which Circulation Time is Shortened (Rapid Blood Flow)
LOCAL REGULATION OF BLOOD FLOW – AUTOREGULATION
INTRODUCTION
ROLE OF PRESSURES IN AUTOREGULATION
Perfusion Pressure and Effective Perfusion Pressure
THEORIES OF AUTOREGULATION
1. Myogenic Theory
2. Metabolic Theory
AUTOREGULATION IN SOME VITAL ORGANS
103:
Arterial Blood Pressure
DEFINITIONS AND NORMAL VALUES
1. SYSTOLIC BLOOD PRESSURE
2. DIASTOLIC BLOOD PRESSURE
3. PULSE PRESSURE
4. MEAN ARTERIAL BLOOD PRESSURE
VARIATIONS
PHYSIOLOGICAL VARIATIONS
1. Age
2. Sex
3. Body Built
4. Diurnal Variation
5. After Meals
6. During Sleep
7. Emotional Conditions
8. After Exercise
PATHOLOGICAL VARIATIONS
DETERMINANTS OF ARTERIAL BLOOD PRESSURE – FACTORS MAINTAINING ARTERIAL BLOOD PRESSURE
CENTRAL FACTORS
1. Cardiac Output
2. Heart Rate
PERIPHERAL FACTORS
3. Peripheral Resistance
4. Blood Volume
5. Venous Return
6. Elasticity of Blood Vessels
7. Velocity of Blood Flow
8. Diameter of Blood Vessels
9. Viscosity of Blood
REGULATION OF ARTERIAL BLOOD PRESSURE
NERVOUS MECHANISM FOR REGULATION OF BLOOD PRESSURE – SHORT TERM REGULATION
VASOMOTOR SYSTEM
1. VASOMOTOR CENTER
2. VASOCONSTRICTOR FIBERS
Vasomotor Tone
3. VASODILATOR FIBERS
MECHANISM OF ACTION OF VASOMOTOR CENTER IN THE REGULATION OF BLOOD PRESSURE
1. Baroreceptor Mechanism
2. Chemoreceptor Mechanism
Situation
Nerve supply
Function
3. Higher Centers
4. Respiratory Centers
RENAL MECHANISM FOR REGULATION OF BLOOD PRESSURE – LONG TERM REGULATION
BY REGULATION OF EXTRACELLULAR FLUID VOLUME
THROUGH RENIN-ANGIOTENSIN MECHANISM
Actions of Angiotensin II
Actions of Angiotensin III and Angiotensin IV
HORMONAL MECHANISM FOR REGULATION OF BLOOD PRESSURE
HORMONES
1. Adrenaline
2. Noradrenaline
3. Thyroxine
4. Aldosterone
5. Vasopressin
6. Angiotensins
7. Serotonin
8. Vasoactive Intestinal Polypeptide (VIP)
9. Bradykinin
10. Prostaglandins
11. Histamine
12. Acetylcholine
13. Atrial Natriuretic Peptide
14. Brain Natriuretic Peptide
15. C-type Natriuretic Peptide
LOCAL MECHANISM FOR REGULATION OF BLOOD PRESSURE
LOCAL VASOCONSTRICTORS
LOCAL VASODILATORS
Vasodilators of Metabolic Origin
Vasodilators of Endothelial Origin
MEASUREMENT OF ARTERIAL BLOOD PRESSURE
DIRECT METHOD
INDIRECT METHOD
Apparatus
Principle
Procedure
Automatic Blood Pressure Instrument
APPLIED PHYSIOLOGY
HYPERTENSION
Definition
Types of Hypertension
Experimental Hypertension
Manifestations of Hypertension
Treatment of Hypertension
HYPOTENSION
Definition
Types
104:
Venous Pressure
DEFINITION AND NORMAL VALUES
VENOUS PRESSURE IN THE EXTREMITIES OF THE BODY
VENOUS PRESSURE IN CENTRAL AND PERIPHERAL VEINS
VARIATIONS OF VENOUS PRESSURE
MEASUREMENT OF VENOUS PRESSURE
DIRECT METHOD
INDIRECT METHOD
FACTORS REGULATING VENOUS PRESSURE
1. VIS A TERGO OR FORCE FROM BEHIND
2. VIS A FRONTE OR FORCE FROM FRONT
3. VIS A LATRE OR FORCE FROM SIDE
4. VOLUME OF VENOUS BLOOD
5. PERIPHERAL RESISTANCE
6. GRAVITY AND POSTURE
EFFECT OF RESPIRATION ON VENOUS PRESSURE
VALSALVA MANEUVER OR VALSALVA EXPERIMENT
Uses of Valsalva Maneuver
MÜELLER'S MANEUVER OR MÜELLER'S EXPERIMENT
Uses of Müeller's Maneuver
105:
Capillary Pressure
INTRODUCTION
REGIONAL VARIATIONS
MEASUREMENT
REGULATION
CAPILLARY ONCOTIC PRESSURE
106:
Arterial Pulse
INTRODUCTION
TRANSMISSION OF PULSE
VELOCITY OF TRANSMISSION OF PULSE
DELAY IN THE TRANSMISSION OF PULSE
METHODS OF RECORDING ARTERIAL PULSE
1. BY USING MANOMETER
2. BY USING DUDGEON'S SPHYGMOGRAPH
3. BY USING ELECTRONIC PULSE TRANSDUCER
INTERPRETATION OF ARTERIAL PULSE TRACING
PULSE POINTS
EXAMINATION OF RADIAL PULSE
1. RATE
Variations
2. RHYTHM
3. CHARACTER
4. VOLUME
5. CONDITION OF WALL OF THE BLOOD VESSEL
6. DELAYED PULSE
i. Femoral Delay
ii. Radial-radial Delay
APPLIED PHYSIOLOGY – ABNORMAL PULSE
1. PULSUS DEFICIT
2. PULSUS ALTERNANS
3. ANACROTIC PULSE
4. THREADY PULSE OR WEAK PULSE
5. PULSUS PARADOXUS
6. WATER HAMMER PULSE
7. ABNORMAL PULSE IN PATENT DUCTUS ARTERIOSUS
8. ABNORMAL PULSE IN AORTIC REGURGITATION
107:
Venous Pulse
INTRODUCTION
SIGNIFICANCE
EXAMINATION OF VENOUS PULSE
METHODS TO RECORD VENOUS PULSE
RECORDING OF VENOUS PULSE – JUGULAR VENOUS PULSE TRACING
APPLIED PHYSIOLOGY – ABNORMAL VENOUS PULSE
ELEVATED JUGULAR VENOUS PULSE
KUSSMAUL'S SIGN
ABNORMALITIES OF WAVES IN JUGULAR PULSE TRACING
1. Elevation of ‘a’ Wave
2. Cannon ‘a’ Wave
3. Abnormal ‘v’ Wave
4. Abnormal ‘x’ Wave
5. Abnormal ‘y’ Wave
108:
Coronary Circulation
DISTRIBUTION OF CORONARY BLOOD VESSELS
CORONARY ARTERIES
Branches of Coronary Arteries
VENOUS DRAINAGE
PHYSIOLOGICAL SHUNT
CORONARY BLOOD FLOW AND ITS MEASUREMENT
NORMAL CORONARY BLOOD FLOW
MEASUREMENT OF CORONARY BLOOD FLOW
Direct Method
Indirect Method
PHASIC CHANGES IN CORONARY BLOOD FLOW
ROLE OF LEFT VENTRICLE IN PHASIC CHANGES
ROLE OF RIGHT VENTRICLE IN PHASIC CHANGES
FACTORS REGULATING CORONARY BLOOD FLOW
1. NEED FOR OXYGEN
2. METABOLIC FACTORS
Adenosine
Other Substances
Reactive Hyperemia
3. CORONARY PERFUSION PRESSURE
4. NERVOUS FACTORS
APPLIED PHYSIOLOGY – CORONARY ARTERY DISEASE
CORONARY OCCLUSION
MYOCARDIAL ISCHEMIA AND NECROSIS
Myocardial Ischemia
Necrosis
MYOCARDIAL INFARCTION – HEART ATTACK
Myocardial Stunning
Symptoms of Myocardial Infarction
CARDIAC PAIN – ANGINA PECTORIS
Cause for Cardiac Pain
Sensory Pathway
Chronic Angina Pectoris
Treatment for Angina Pectoris
109:
Cerebral Circulation
INTRODUCTION
CEREBRAL VESSELS AND NORMAL CEREBRAL BLOOD FLOW
MEASUREMENT OF CEREBRAL BLOOD FLOW
1. KETTY AND SCHMIDT'S NITROUS OXIDE METHOD
2. BY USING RADIOACTIVE SUBSTANCES
3. BY COMPUTERIZED AXIAL TOMOGRAPHY (CAT)
4. BY POSITRON EMISSION TOMOGRAPHY (PET)
5. BY MAGNETIC RESONANCE IMAGING (MRI)
REGULATION OF CEREBRAL BLOOD FLOW
1. AUTOREGULATION
i. Effective Perfusion Pressure
ii. Cerebral Vascular Resistance
2. CHEMICAL FACTORS
3. NERVOUS FACTORS
APPLIED PHYSIOLOGY – STROKE
110:
Splanchnic Circulation
INTRODUCTION
MESENTERIC CIRCULATION
DISTRIBUTION OF BLOOD FLOW
REGULATION OF MESENTERIC BLOOD FLOW
1. Local Autoregulation
2. Activity of GI Tract
3. Nervous Factor
4. Chemical Factors – Functional Hyperemia
SPLENIC CIRCULATION
IMPORTANCE OF SPLENIC CIRCULATION
STORAGE OF BLOOD
REGULATION OF BLOOD FLOW TO SPLEEN
HEPATIC CIRCULATION
BLOOD VESSELS
NORMAL BLOOD FLOW
REGULATION OF BLOOD FLOW TO LIVER
1. Systemic Blood Pressure
2. Splenic Contraction
3. Movements of Intestine
4. Chemical Factors
5. Nervous Factors
111:
Capillary Circulation
INTRODUCTION
MICROCIRCULATION
FEATURES OF CAPILLARIES
Study of Capillary Circulation
DIMENSIONS OF CAPILLARIES
VELOCITY AND VOLUME OF BLOOD FLOW
STRUCTURE OF CAPILLARIES
ENDOTHELIAL CELLS
PERICYTES
PATTERN OF CAPILLARY SYSTEM
1. PREFERENTIAL CHANNELS
2. TRUE CAPILLARIES
ANATOMICAL AND PHYSIOLOGICAL SHUNTS
Anatomical Shunt
Physiological Shunt
Shunt in Capillaries vs Shunt in Heart
PECULIARITIES OF CAPILLARY BLOOD FLOW
FUNCTIONS OF CAPILLARIES
DIFFUSION
FILTRATION
PINOCYTOSIS
FACTORS CONTROLLING CAPILLARY CIRCULATION
NERVOUS FACTORS
CHEMICAL FACTORS
112:
Circulation through Skeletal Muscle
INTRODUCTION
FACTORS REGULATING BLOOD FLOW TO SKELETAL MUSCLE
MECHANICAL FACTORS
CHEMICAL FACTORS
NERVOUS FACTORS
APPLIED PHYSIOLOGY – VARICOSE VEINS
113:
Cutaneous Circulation
ARCHITECTURE OF CUTANEOUS BLOOD VESSELS
FUNCTIONS OF CUTANEOUS CIRCULATION
NORMAL BLOOD FLOW TO SKIN
REGULATION OF CUTANEOUS BLOOD FLOW
VASCULAR RESPONSES OF SKIN TO MECHANICAL STIMULI
WHITE REACTION
LEWIS TRIPLE RESPONSE
1. Red Reaction
2. Flare
Axon Reflex
3. Wheal
Dermographism
114:
Fetal Circulation and Respiration
INTRODUCTION
BLOOD VESSELS IN FETUS
FETAL LUNGS
CHANGES IN CIRCULATION AND RESPIRATION AFTER BIRTH – NEONATAL CIRCULATION AND RESPIRATION
1. FIRST BREATH OF THE CHILD
2. FLOW OF BLOOD TO LUNGS
3. CLOSURE OF FORAMEN OVALE
4. REVERSAL OF BLOOD FLOW IN DUCTUS ARTERIOSUS
5. CLOSURE OF DUCTUS VENOSUS
6. CLOSURE OF DUCTUS ARTERIOSUS
115:
Hemorrhage
DEFINITION
TYPES AND CAUSES OF HEMORRHAGE
1. ACCIDENTAL HEMORRHAGE
2. CAPILLARY HEMORRHAGE
3. INTERNAL HEMORRHAGE
4. POSTPARTUM HEMORRHAGE
5. HEMORRHAGE DUE TO PREMATURE DETACHMENT OF PLACENTA
EFFECTS OF HEMORRHAGE
IMMEDIATE COMPENSATORY EFFECTS OF HEMORRHAGE
1. On Cardiovascular System
2. On Skin
3. On Tissue Fluid
4. On Kidneys
5. On Renin Secretion
6. On Secretion of Antidiuretic Hormone
7. On Secretion of Catecholamines
8. On Respiration
9. On Nervous System
DELAYED COMPENSATORY EFFECTS OF HEMORRHAGE
1. Restoration of Plasma Volume
2. Restoration of Plasma Proteins
3. Restoration of Red Blood Cell Count and Hemoglobin Content
116:
Circulatory Shock and Heart Failure
DEFINITION
MANIFESTATIONS OF CIRCULATORY SHOCK
STAGES OF CIRCULATORY SHOCK
FIRST STAGE OR COMPENSATED STAGE
SECOND STAGE OR PROGRESSIVE STAGE
THIRD STAGE OR IRREVERSIBLE STAGE
TYPES AND CAUSES OF CIRCULATORY SHOCK
SHOCK DUE TO DECREASED BLOOD VOLUME – HYPOVOLEMIC SHOCK
1. Hemorrhagic Shock
2. Traumatic Shock
3. Surgical Shock
4. Burn Shock
5. Dehydration Shock
SHOCK DUE TO INCREASED VASCULAR CAPACITY – VASOGENIC SHOCK
1. Neurogenic Shock
2. Anaphylactic Shock
3. Septic Shock
SHOCK DUE TO CARDIAC DISEASES – CARDIOGENIC SHOCK
SHOCK DUE TO OBSTRUCTION OF BLOOD FLOW – OBSTRUCTIVE SHOCK
TREATMENT FOR CIRCULATORY SHOCK
1. BLOOD TRANSFUSION
2. PLASMA TRANSFUSION
3. ADMINISTRATION OF PLASMA SUBSTITUTES
4. ADMINISTRATION OF SYMPATHOMIMETIC DRUGS
5. ADMINISTRATION OF GLUCOCORTICOIDS
6. OXYGEN THERAPY
7. BY CHANGING THE POSTURE
HEART FAILURE
INTRODUCTION
Acute Heart Failure
Chronic Heart Failure
Congestive Heart Failure
CAUSES OF HEART FAILURE
SIGNS AND SYMPTOMS OF HEART FAILURE
Signs and Symptoms of Chronic Heart Failure
Signs and Symptoms of Acute Heart Failure
TYPES OF HEART FAILURE
1. Systolic Heart Failure
2. Diastolic Heart Failure
3. Right Sided Heart Failure
4. Left Sided Heart Failure
COMPENSATED VERSUS DECOMPENSATED HEART FAILURE
117:
Cardiovascular Adjustments during Exercise
INTRODUCTION
TYPES OF EXERCISE
DYNAMIC EXERCISE
STATIC EXERCISE
AEROBIC AND ANAEROBIC EXERCISES
AEROBIC EXERCISE
ANAEROBIC EXERCISE
METABOLISM IN AEROBIC AND ANAEROBIC EXERCISES
SEVERITY OF EXERCISE
1. MILD EXERCISE
2. MODERATE EXERCISE
3. SEVERE EXERCISE
EFFECTS OF EXERCISE ON CARDIOVASCULAR SYSTEM
1. ON BLOOD
2. ON BLOOD VOLUME
3. ON HEART RATE
4. ON CARDIAC OUTPUT
5. ON VENOUS RETURN
6. ON BLOOD FLOW TO SKELETAL MUSCLES
7. ON BLOOD PRESSURE
Blood Pressure after Exercise
QUESTIONS IN CARDIOVASCULAR SYSTEM
LONG QUESTIONS
SHORT QUESTIONS
SECTION 9: RESPIRATORY SYSTEM AND ENVIRONMENTAL PHYSIOLOGY
118:
Physiological Anatomy of Respiratory Tract
INTRODUCTION
TYPES OF RESPIRATION
PHASES OF RESPIRATION
FUNCTIONAL ANATOMY OF RESPIRATORY TRACT
RESPIRATORY UNIT
STRUCTURE OF RESPIRATORY UNIT
Alveolar Cells or Pneumocytes
RESPIRATORY MEMBRANE
NONRESPIRATORY FUNCTIONS OF RESPIRATORY TRACT
1. OLFACTION
2. VOCALIZATION
3. PREVENTION OF DUST PARTICLES
4. DEFENSE MECHANISM
i. Lung's Own Defenses
ii. Defense through Leukocytes
iii. Defense through Macrophages
iv. Defense through Mast Cell
v. Defense through Natural Killer Cell
vi. Defense through Dendritic Cells
5. MAINTENANCE OF WATER BALANCE
6. REGULATION OF BODY TEMPERATURE
7. REGULATION OF ACID–BASE BALANCE
8. ANTICOAGULANT FUNCTION
9. SECRETION OF ANGIOTENSIN CONVERTING ENZYME
10. SYNTHESIS OF HORMONAL SUBSTANCES
RESPIRATORY PROTECTIVE REFLEXES
COUGH REFLEX
Causes
Mechanism
Reflex Pathway
SNEEZING REFLEX
Causes
Mechanism
Reflex Pathway
SWALLOWING (DEGLUTITION) REFLEX
119:
Pulmonary Circulation
PULMONARY BLOOD VESSELS
PULMONARY ARTERY
BRONCHIAL ARTERY
Physiological Shunt
CHARACTERISTIC FEATURES OF PULMONARY BLOOD VESSELS
PULMONARY BLOOD FLOW
PULMONARY BLOOD PRESSURE
Pulmonary Arterial Pressure
Pulmonary Capillary Pressure
MEASUREMENT OF PULMONARY BLOOD FLOW
REGULATION OF PULMONARY BLOOD FLOW
1. CARDIAC OUTPUT
2. VASCULAR RESISTANCE
3. NERVOUS FACTORS
4. CHEMICAL FACTORS
5. GRAVITY AND HYDROSTATIC PRESSURE
i. Apical Portion – Zone 1
ii. Midportion – Zone 2
iii. Lower Portion – Zone 3
120:
Mechanics of Respiration
RESPIRATORY MOVEMENTS
INTRODUCTION
MUSCLES OF RESPIRATION
Primary Respiratory Muscles
Accessory Respiratory Muscles
Inspiratory Muscles
Accessory Inspiratory Muscles
Inspiratory Muscles
MOVEMENTS OF THORACIC CAGE
1. Thoracic Lid
2. Upper Costal Series
3. Lower Costal Series
4. Diaphragm
MOVEMENTS OF LUNGS
Collapsing Tendency of Lungs
Factors causing Collapsing Tendency of Lungs
Factors Preventing Collapsing Tendency of Lungs
Surfactant
Chemistry
Formation
RESPIRATORY PRESSURES
INTRAPLEURAL PRESSURE
Definition
Normal Values
Cause for Negativity of Intrapleural Pressure
Measurement
Significance of Intrapleural Pressure
INTRA-ALVEOLAR PRESSURE
Definition
Normal Values
Measurement
Significance of Intra-alveolar Pressure
Transpulmonary Pressure
COMPLIANCE
DEFINITION
Significance of Determining Compliance
NORMAL VALUES
Compliance in Relation to Intra-alveolar Pressure
Compliance in Relation to Intrapleural Pressure
Specific Compliance
TYPES OF COMPLIANCE
1. Static Compliance
2. Dynamic Compliance
Static Compliance vs Dynamic Compliance
MEASUREMENT OF COMPLIANCE
Measurement of Static Compliance
Measurement of Dynamic Compliance
APPLIED PHYSIOLOGY
Increase in Compliance
1. Old Age (physiological)
2. Emphysema (Pathological)
Decrease in Compliance
WORK OF BREATHING
WORK DONE BY RESPIRATORY MUSCLES
UTILIZATION OF ENERGY
1. Airway Resistance
2. Elastic Resistance of Lungs and Thorax
3. Nonelastic Viscous Resistance
121:
Pulmonary Function Tests
INTRODUCTION
LUNG VOLUMES
TIDAL VOLUME (TV)
Normal Value
INSPIRATORY RESERVE VOLUME (IRV)
Normal Value
EXPIRATORY RESERVE VOLUME (ERV)
Normal Value
RESIDUAL VOLUME (RV)
Normal Value
LUNG CAPACITIES
INSPIRATORY CAPACITY (IC)
VITAL CAPACITY (VC)
FUNCTIONAL RESIDUAL CAPACITY (FRC)
TOTAL LUNG CAPACITY (TLC)
MEASUREMENT OF LUNG VOLUMES AND CAPACITIES
SPIROMETER
Respirometer
Spirogram
COMPUTERIZED SPIROMETER
3. PLETHYSMOGRAPHY
MEASUREMENT OF FUNCTIONAL RESIDUAL CAPACITY AND RESIDUAL VOLUME
1. HELIUM DILUTION TECHNIQUE
Procedure to Measure Functional Residual Capacity
Measured Values
Calculation
Procedure to Measure Residual Volume
2. NITROGEN WASHOUT METHOD
Procedure to Measure Functional Residual Capacity
Measured Values
Calculation
Procedure to Measure Residual Volume
3. PLETHYSMOGRAPHY
VITAL CAPACITY
DEFINITION
LUNG VOLUMES INCLUDED IN VITAL CAPACITY
NORMAL VALUE
VARIATIONS OF VITAL CAPACITY
Physiological Variations
Pathological Variations
Measurement
FORCED EXPIRATORY VOLUME (FEV) OR TIMED VITAL CAPACITY
DEFINITION
NORMAL VALUES
SIGNIFICANCE OF DETERMINING FEV
RESPIRATORY MINUTE VOLUME (RMV)
DEFINITION
NORMAL VALUE
VARIATIONS
MAXIMUM BREATHING CAPACITY (MBC) OR MAXIMUM VENTILATION VOLUME (MVV)
DEFINITION
NORMAL VALUE
MEASUREMENT
PEAK EXPIRATORY FLOW RATE (PEFR)
DEFINITION
NORMAL VALUE
MEASUREMENT
SIGNIFICANCE OF DETERMINING PEFR
RESTRICTIVE AND OBSTRUCTIVE RESPIRATORY DISEASES
RESTRICTIVE RESPIRATORY DISEASE
OBSTRUCTIVE RESPIRATORY DISEASE
122:
Ventilation
PULMONARY VENTILATION
DEFINITION
NORMAL VALUE AND CALCULATION
Normal Value
Calculation
Pulmonary Ventilation
ALVEOLAR VENTILATION
DEFINITION
NORMAL VALUE AND CALCULATION
Normal Value
Calculation
DEAD SPACE
DEFINITION
TYPES OF DEAD SPACE
Anatomical Dead Space
Physiological Dead Space
NORMAL VALUE OF DEAD SPACE
MEASUREMENT OF DEAD SPACE – NITROGEN WASHOUT METHOD
VENTILATION – PERFUSION RATIO
DEFINITION
NORMAL VALUE AND CALCULATION
Normal Value
Calculation
SIGNIFICANCE OF VENTILATION – PERFUSION RATIO
WASTED AIR AND WASTED BLOOD
VARIATIONS IN VENTILATION – PERFUSION RATIO
Physiological Variation
Pathological Variation
123:
Inspired Air, Alveolar Air and Expired Air
INSPIRED AIR
DEFINITION
COMPOSITION
ALVEOLAR AIR
DEFINITION
COMPOSITION
RENEWAL
METHOD OF COLLECTION
EXPIRED AIR
DEFINITION
COMPOSITION
METHOD OF COLLECTION
124:
Exchange of Respiratory Gases
EXCHANGE OF RESPIRATORY GASES IN LUNGS
RESPIRATORY MEMBRANE
From Alveolar Portion
In between Alveolar Portion and Capillary Portion
From Capillary Portion
DIFFUSING CAPACITY
Diffusing Capacity for Oxygen and Carbon Dioxide
Factors Affecting Diffusing Capacity
Relation between Diffusing Capacity and Factors Affecting it
DIFFUSION COEFFICIENT AND FICK'S LAW OF DIFFUSION
Diffusion Coefficient
Fick's Law of Diffusion
DIFFUSION OF OXYGEN
Entrance of Oxygen from Atmospheric Air into the Alveoli
Diffusion of Oxygen from Alveoli into the Blood
DIFFUSION OF CARBON DIOXIDE
Diffusion of Carbon Dioxide from Blood into Alveoli
Exit of Carbon Dioxide from the Alveoli into the Atmospheric Air
EXCHANGE OF GASES AT TISSUE LEVEL
DIFFUSION OF OXYGEN FROM BLOOD INTO THE TISSUES
DIFFUSION OF CARBON DIOXIDE FROM TISSUES INTO THE BLOOD
RESPIRATORY EXCHANGE RATIO
DEFINITION
NORMAL VALUES
RESPIRATORY QUOTIENT
DEFINITION
NORMAL VALUE
125:
Transport of Respiratory Gases
TRANSPORT OF OXYGEN
AS SIMPLE SOLUTION
IN COMBINATION WITH HEMOGLOBIN
Oxygen Carrying Capacity of Blood
OXYGEN HEMOGLOBIN DISSOCIATION CURVE
Method to Plot Oxygen Hemoglobin Dissociation Curve
Normal Oxygen Hemoglobin Dissociation Curve
P50
Factors Affecting Oxygen Hemoglobin Dissociation Curve
Bohr's Effect
TRANSPORT OF CARBON DIOXIDE
TRANSPORT OF CARBON DIOXIDE AS DISSOLVED FORM
TRANSPORT OF CARBON DIOXIDE AS CARBONIC ACID
TRANSPORT OF CARBON DIOXIDE AS BICARBONATE
Chloride Shift or Hamburger Phenomenon
Reverse Chloride Shift
TRANSPORT OF CARBON DIOXIDE AS CARBAMINO COMPOUNDS
CARBON DIOXIDE DISSOCIATION CURVE
Normal Carbon Dioxide Dissociation Curve
Haldane Effect
126:
Regulation of Respiration
INTRODUCTION
NERVOUS MECHANISM
RESPIRATORY CENTERS
MEDULLARY CENTERS
1. Dorsal Respiratory Group of Neurons
2. Ventral Respiratory Group of Neurons
PONTINE CENTERS
1. Pneumotaxic Center
4. Apneustic Center
CONNECTIONS OF RESPIRATORY CENTERS
Efferent Pathway
Afferent Pathway
INTEGRATION OF RESPIRATORY CENTERS
Role of Medullary Centers
Role of Pontine Centers
Pre-Bötzinger Complex
FACTORS AFFECTING RESPIRATORY CENTERS
1. Impulses from Higher Centers
2. Impulses from Stretch Receptors of Lungs: Hering-Breuer Reflex
3. Impulses from ‘J’ Receptors of Lungs
4. Impulses from Irritant Receptors of Lungs
5. Impulses from Baroreceptors
6. Impulses from Chemoreceptors
7. Impulses from Proprioceptors
8. Impulses from Thermoreceptors
9. Impulses from Pain Receptors
CHEMICAL MECHANISM
CENTRAL CHEMORECEPTORS
Situation
Mechanism of Action
PERIPHERAL CHEMORECEPTORS
Mechanism of Action
127:
Disturbances of Respiration
INTRODUCTION
APNEA
DEFINITION
APNEA TIME
CONDITIONS WHEN APNEA OCCURS
1. Voluntary Effort
2. Apnea after Hyperventilation
3. Deglutition Apnea
4. Vagal Apnea
5. Adrenaline Apnea
CLINICAL CLASSIFICATION OF APNEA
1. Obstructive Apnea
2. Central Apnea
3. Mixed Apnea
HYPERVENTILATION
DEFINITION
CONDITIONS WHEN HYPERVENTILATION OCCURS
EFFECTS OF HYPERVENTILATION
HYPOVENTILATION
DEFINITION
CONDITIONS WHEN HYPOVENTILATION OCCURS
EFFECTS OF HYPOVENTILATION
HYPOXIA
DEFINITION
CLASSIFICATION AND CAUSES OF HYPOXIA
I. Hypoxic Hypoxia
II. Anemic Hypoxia
III. Stagnant Hypoxia
IV. Histotoxic Hypoxia
EFFECTS OF HYPOXIA
Immediate Effects
Delayed Effects of Hypoxia
TREATMENT FOR HYPOXIA – OXYGEN THERAPY
In Normal Atmospheric Pressure
In High Atmospheric Pressure – Hyperbaric Oxygen
Efficacy of Oxygen Therapy in Different Types of Hypoxia
OXYGEN TOXICITY (POISONING)
DEFINITION AND CAUSE
EFFECTS OF OXYGEN TOXICITY
HYPERCAPNEA
DEFINITION
CONDITIONS WHEN HYPERCAPNEA OCCURS
EFFECTS OF HYPERCAPNEA
1. Effects on Respiration
2. Effects on Blood
3. Effects on Cardiovascular System
4. Effects on Central Nervous System
HYPOCAPNEA
DEFINITION
CONDITIONS WHEN HYPOCAPNEA OCCURS
EFFECTS OF HYPOCAPNEA
1. Effects on Respiration
2. Effects on Blood
3. Effects on Central Nervous System
ASPHYXIA
DEFINITION
CONDITIONS WHEN ASPHYXIA OCCURS
EFFECTS OF ASPHYXIA
1. Stage of Hyperpnea
2. Stage of Convulsions
3. Stage of Collapse
DYSPNEA
DEFINITION
DYSPNEA POINT
CONDITIONS WHEN DYSPNEA OCCURS
1. Respiratory Disorders
2. Cardiac Disorders
3. Metabolic Disorders
DYSPNEIC INDEX
PERIODIC BREATHING
DEFINITION AND TYPES
CHEYNE-STOKES BREATHING
Causes for Waxing and Waning
Conditions when Cheyne-Stokes Breathing Occurs
BIOT'S BREATHING
Features of Biot's Breathing
Causes of Abrupt Apnea and Hyperpnea
Conditions when Biot's Breathing Occurs
CYANOSIS
DEFINITION
DISTRIBUTION OF CYANOSIS
CONDITIONS WHEN CYANOSIS OCCURS
CYANOSIS AND ANEMIA
CARBON MONOXIDE POISONING
INTRODUCTION
SOURCES OF CARBON MONOXIDE
TOXIC EFFECTS OF CARBON MONOXIDE
SYMPTOMS OF CARBON MONOXIDE POISONING
TREATMENT FOR CARBON MONOXIDE POISONING
ATELECTASIS
DEFINITION
CAUSES
EFFECTS
PNEUMOTHORAX
DEFINITION
CAUSES
TYPES AND EFFECTS
1. Open Pneumothorax
2. Closed Pneumothorax
3. Tension Pneumothorax
PNEUMONIA
DEFINITION
CAUSES
TYPES
EFFECTS
Delirium
BRONCHIAL ASTHMA
DEFINITION
CAUSES
FEATURES
PULMONARY EDEMA
DEFINITION
CAUSES
EFFECTS
PLEURAL EFFUSION
DEFINITION
CAUSES
FEATURES
PULMONARY TUBERCULOSIS
DEFINITION
FEATURES
EMPHYSEMA
DEFINITION AND CAUSES
DEVELOPMENT OF EMPHYSEMA
EFFECTS OF EMPHYSEMA
128:
High Altitude and Space Physiology
HIGH ALTITUDE
BAROMETRIC PRESSURE AND PARTIAL PRESSURE OF OXYGEN AT DIFFERENT ALTITUDES
CHANGES IN THE BODY AT HIGH ALTITUDE
EFFECTS OF HYPOXIA
EFFECTS OF EXPANSION OF GASES ON THE BODY
EFFECTS OF REDUCED ATMOSPHERIC TEMPERATURE
EFFECTS OF LIGHT RAYS
MOUNTAIN SICKNESS
DEFINITION
SYMPTOMS
1. Digestive System
2. Cardiovascular System
3. Respiratory System
4. Nervous System
TREATMENT
ACCLIMATIZATION
DEFINITION
CHANGES DURING ACCLIMATIZATION
1. Changes in Blood
2. Changes in Cardiovascular System
3. Respiratory System
4. Changes in Tissues
AVIATION PHYSIOLOGY
ACCELERATIVE FORCE
GRAVITATIONAL FORCE
EFFECTS OF GRAVITATIONAL FORCES ON THE BODY
Effects of Positive G
Effects of Negative G
PREVENTION OF EFFECTS OF G FORCES ON THE BODY
1. By Using Abdominal Belts
2. By Using Anti-G-suit
SPACE PHYSIOLOGY
EFFECTS OF TRAVEL BY SPACECRAFT
1. Effects on Cardiovascular Systems and Kidneys
2. Effects on Blood
3. Effects on Musculoskeletal System
4. Effects on Immune System
5. Space Motion Sickness
129:
Deep Sea Physiology
INTRODUCTION
BAROMETRIC PRESSURE AT DIFFERENT DEPTHS
EFFECT OF HIGH BAROMETRIC PRESSURE – NITROGEN NARCOSIS
SYMPTOMS
PREVENTION
TREATMENT
DECOMPRESSION SICKNESS
DEFINITION
CAUSE
SYMPTOMS
PREVENTION
TREATMENT
SCUBA
130:
Effects of Exposure to Cold and Heat
EFFECTS OF EXPOSURE TO COLD
HEAT PRODUCTION
1. By Increased Metabolic Activities
2. By Shivering
PREVENTION OF HEAT LOSS
EFFECTS OF EXPOSURE TO SEVERE COLD
LOSS OF TEMPERATURE REGULATING CAPACITY
FROSTBITE
EFFECTS OF EXPOSURE TO HEAT
HEAT EXHAUSTION
DEHYDRATION EXHAUSTION
HEAT CRAMPS
HEATSTROKE – SUNSTROKE
Heatstroke
Sunstroke
Persons Susceptible to Heatstroke or Sunstroke
Features
Heatstroke and Humidity
Prevention
Treatment
131:
Artificial Respiration
CONDITIONS WHEN ARTIFICIAL RESPIRATION IS REQUIRED
METHODS OF ARTIFICIAL RESPIRATION
MANUAL METHODS
Mouth to Mouth Method
Holger Nielsen Method or Back Pressure Arm Lift Method
MECHANICAL METHODS
Drinker's Method
Ventilation Method
132:
Effects of Exercise on Respiration
INTRODUCTION
EFFECTS OF EXERCISE ON RESPIRATION
PULMONARY VENTILATION
1. Higher Centers
2. Chemoreceptors
3. Proprioceptors
4. Body Temperature
5. Acidosis
DIFFUSING CAPACITY FOR OXYGEN
CONSUMPTION OF OXYGEN
OXYGEN DEBT
VO2 MAX
RESPIRATORY QUOTIENT
QUESTIONS IN RESPIRATORY SYSTEM AND ENVIRONMENTAL PHYSIOLOGY
LONG QUESTIONS
SHORT QUESTIONS
SECTION 10: NERVOUS SYSTEM
133:
Introduction to Nervous System
DIVISIONS OF NERVOUS SYSTEM
CENTRAL NERVOUS SYSTEM
Parts of Brain
1. Prosencephalon
2. Mesencephalon
3. Rhombencephalon
PERIPHERAL NERVOUS SYSTEM
1. Somatic Nervous System
2. Autonomic Nervous System
134:
Neuron
INTRODUCTION
CLASSIFICATION OF NEURON
DEPENDING UPON THE NUMBER OF POLES
1. Unipolar Neurons
2. Bipolar Neurons
3. Multipolar Neurons
DEPENDING UPON THE FUNCTION
1. Motor Neurons
2. Sensory Neurons
DEPENDING UPON THE LENGTH OF AXON
1. Golgi Type I Neurons
2. Golgi Type II Neurons
STRUCTURE OF NEURON
NERVE CELL BODY
Nucleus
Nissl Bodies
Neurofibrils
Mitochondria
Golgi Apparatus
DENDRITE
AXON
Organization of Nerve
Internal Structure of Axon – Axis Cylinder
Nonmyelinated Nerve Fiber
Myelinated Nerve Fiber
MYELIN SHEATH
Chemistry of Myelin Sheath
Formation of Myelin Sheath – Myelinogenesis
Functions of Myelin Sheath
NEURILEMMA
Functions of Neurilemma
NEUROTROPHINS – NEUROTROPHIC FACTORS
NERVE GROWTH FACTOR
Chemistry
Functions
OTHER NEUROTROPHINS
1. Brain Derived Neurotrophic Growth Factor
2. Ciliary Neurotrophic Factor (CNTF)
3. Glial Cell Line Derived Neurotrophic Factor (GNDF)
4. Fibroblast Growth Factor (FGF)
5. Neurotrophin-3 (NT-3)
135:
Classification of Nerve Fibers
BASIS OF CLASSIFICATION
1. DEPENDING UPON STRUCTURE
i. Myelinated Nerve Fibers
ii. Nonmyelinated Nerve Fibers
2. DEPENDING UPON DISTRIBUTION
i. Somatic Nerve Fibers
ii. Visceral or Autonomic Nerve Fibers
3. DEPENDING UPON ORIGIN
i. Cranial Nerves
ii. Spinal Nerves
4. DEPENDING UPON FUNCTION
i. Sensory Nerve Fibers
ii. Motor Nerve Fibers
5. DEPENDING UPON SECRETION OF NEUROTRANSMITTER
i. Adrenergic Nerve Fibers
ii. Cholinergic Nerve Fibers
6. DEPENDING UPON DIAMETER AND CONDUCTION OF IMPULSE (ERLANGER-GASSER CLASSIFICATION)
136:
Properties of Nerve Fibers
EXCITABILITY
ACTION POTENTIAL OR NERVE IMPULSE
Properties of Action Potential
ELECTROTONIC POTENTIAL OR LOCAL RESPONSE
Properties of Electrotonic Potential
VOLTAGE CLAMPING
Principle of Voltage Clamping
Equipment for Voltage Clamping
Nerve Fibers Used for Voltage Clamping
CONDUCTIVITY
MECHANISM OF CONDUCTION OF ACTION POTENTIAL
CONDUCTION THROUGH MYELINATED NERVE FIBER – SALTATORY CONDUCTION
Mechanism of Saltatory Conduction
REFRACTORY PERIOD
TYPES OF REFRACTORY PERIOD
1. Absolute Refractory Period
2. Relative Refractory Period
SUMMATION
ADAPTATION
INFATIGABILITY
ALL OR NONE LAW
137:
Degeneration and Regeneration of Nerve Fibers
INTRODUCTION
DEGREES OF INJURY
FIRST DEGREE OF INJURY
SECOND DEGREE OF INJURY
THIRD DEGREE OF INJURY
FOURTH DEGREE OF INJURY
FIFTH DEGREE OF INJURY
DEGENERATIVE CHANGES IN THE NEURON
WALLERIAN DEGENERATION OR ORTHOGRADE DEGENERATION
RETROGRADE DEGENERATION
Changes in the Nerve Cell Body
Changes in the Axon Proximal to Cut End
TRANSNEURONAL DEGENERATION
REGENERATION OF NERVE FIBER
CRITERIA FOR REGENERATION
STAGES OF REGENERATION
138:
Nrurogila
DEFINITION
CLASSIFICATION OF NEUROGLIAL CELLS
CENTRAL NEUROGLIAL CELLS
ASTROCYTES
Fibrous Astrocytes
Protoplasmic Astrocytes
Functions of Astrocytes
MICROGLIA
Functions of Microglia
OLIGODENDROCYTES
Function of Oligodendrocytes
PERIPHERAL NEUROGLIAL CELLS
SCHWANN CELLS
Functions of Schwann Cells
SATELLITE CELLS
Functions of Satellite Cells
139:
Receptors
DEFINITION
CLASSIFICATION OF RECEPTORS
EXTEROCEPTORS
1. Cutaneous Receptors
2. Chemoreceptors
3. Telereceptors
INTEROCEPTORS
PROPERTIES OF RECEPTORS
1. SPECIFICITY OF RESPONSE – MÜLLER'S LAW
2. ADAPTATION – SENSORY ADAPTATION
3. RESPONSE TO INCREASE IN THE STRENGTH OF STIMULUS
4. SENSORY TRANSDUCTION
5. RECEPTOR POTENTIAL
Properties of Receptor Potential
Significance of Receptor Potential
Mechanism of Development of Receptor Potential
Generation of Action Potential in the Nerve Fiber
140:
Synapse
DEFINITION
CLASSIFICATION OF SYNAPSE
ANATOMICAL CLASSIFICATION
1. Axoaxonic Synapse
2. Axodendritic Synapse
3. Axosomatic Synapse
FUNCTIONAL CLASSIFICATION
1. Electrical Synapse
2. Chemical Synapse
FUNCTIONAL ANATOMY OF CHEMICAL SYNAPSE
FUNCTIONS OF SYNAPSE
EXCITATORY FUNCTION
Excitatory Postsynaptic Potential
Mechanism of Development of EPSP
Properties of EPSP
Significance of EPSP
INHIBITORY FUNCTION
1. Postsynaptic Inhibition
2. Presynaptic Inhibition
3. Renshaw Cell Inhibition
PROPERTIES OF SYNAPSE
1. ONE WAY CONDUCTION – BELL-MAGENDIE LAW
2. THE SYNAPTIC DELAY
3. FATIGUE
4. SUMMATION
i. Spatial Summation
ii. Temporal Summation
5. ELECTRICAL PROPERTY
CONVERGENCE AND DIVERGENCE
CONVERGENCE
DIVERGENCE
141:
Neurotransmitters
DEFINITION
HISTORY
CRITERIA FOR NEUROTRANSMITTER
CLASSIFICATION OF NEUROTRANSMITTERS
DEPENDING UPON CHEMICAL NATURE
1. Amino Acids
2. Amines
3. Others
DEPENDING UPON FUNCTION
1. Excitatory Neurotransmitters
2. Inhibitory Neurotransmitters
TRANSPORT AND RELEASE OF NEUROTRANSMITTER
INACTIVATION OF NEUROTRANSMITTER
REUPTAKE OF NEUROTRANSMITTER
IMPORTANT NEUROTRANSMITTERS
ACETYLCHOLINE
Synthesis
Fate
Acetylcholine Receptors
NORADRENALINE
DOPAMINE
SEROTONIN
HISTAMINE
GAMMA AMINOBUTYRIC ACID (GABA)
SUBSTANCE P
NITRIC OXIDE
NEUROMODULATORS
NON-OPIOID PEPTIDES
OPIOID PEPTIDES
i. Enkephalins
ii. Dynorphins
iii. Endorphins
COTRANSMISSION AND COTRANSMITTERS
142:
Reflex Activity
DEFINITION AND SIGNIFICANCE OF REFLEXES
REFLEX ARC
CLASSIFICATION OF REFLEXES
I. DEPENDING UPON WHETHER INBORN OR ACQUIRED
1. Unconditioned Reflexes or Inborn Reflexes
2. Conditioned Reflexes or Acquired Reflexes
II. DEPENDING UPON THE SITUATION OF THE CENTER
1. Cerebellar Reflexes
2. Cortical Reflexes
3. Midbrain Reflexes
4. Bulbar or Medullary Reflexes
5. Spinal Reflexes
III. DEPENDING UPON THE PURPOSE – FUNCTIONAL SIGNIFICANCE
1. Protective Reflexes or Flexor Reflexes
2. Antigravity Reflexes or Extensor Reflexes
IV. DEPENDING UPON THE NUMBER OF SYNAPSE
1. Monosynaptic Reflexes
2. Polysynaptic Reflexes
V. DEPENDING UPON CLINICAL BASIS
SUPERFICIAL REFLEXES
1. MUCOUS MEMBRANE REFLEXES
2. CUTANEOUS REFLEXES OR SKIN REFLEXES
DEEP REFLEXES
VISCERAL REFLEXES
1. PUPILLARY REFLEXES
i. Light Reflex
ii. Accommodation Reflex
iii. Ciliospinal Reflex
2. OCULOCARDIAC REFLEX
3. CAROTID SINUS REFLEX
PATHOLOGICAL REFLEXES
1. BABINSKI'S SIGN
2. CLONUS
Ankle Clonus
Patellar Clonus
3. PENDULAR MOVEMENTS
PROPERTIES OF REFLEXES
1. ONE WAY CONDUCTION (BELL-MAGENDIE LAW)
2. REACTION TIME
3. SUMMATION
i. Spatial Summation
ii. Temporal Summation
4. OCCLUSION
5. SUBLIMINAL FRINGE
6. RECRUITMENT
7. AFTER DISCHARGE
8. REBOUND PHENOMENON
9. FATIGUE
RECIPROCAL INHIBITION AND RECIPROCAL INNERVATION
RECIPROCAL INHIBITION
RECIPROCAL INNERVATION
CROSSED EXTENSOR REFLEX
SIGNIFICANCE OF RECIPROCAL INHIBITION
REFLEXES IN MOTOR NEURON LESION
UPPER MOTOR NEURON LESION
LOWER MOTOR NEURON LESION
143:
Spinal Cord
INTRODUCTION
GRAY MATTER OF SPINAL CORD
NUCLEI
Nuclei in Posterior Gray Horn
Nuclei in Lateral Gray Horn
Nuclei in Anterior Gray Horn
LAMINAE
Laminae in Posterior Gray Horn
Lamina in Lateral Gray Horn
Laminae in Anterior Gray Horn
Lamina around Central Canal
WHITE MATTER OF SPINAL CORD
TRACTS IN SPINAL CORD
ASCENDING TRACTS OF SPINAL CORD
1. ANTERIOR SPINOTHALAMIC TRACT
Situation
Origin
Course
Termination
Function
Effect of Lesion
2. LATERAL SPINOTHALAMIC TRACT
Situation
Origin
Course
Termination
Function
Effect of Lesion
3. VENTRAL SPINOCEREBELLAR TRACT
Situation
Origin
Course
Termination
Function
Effect of Lesion
4. DORSAL SPINOCEREBELLAR TRACT
Situation
Origin
Course
Termination
Function
Effect of Lesion
5. SPINOTECTAL TRACT
Situation
Origin
Course
Termination
Function
6. FASCICULUS DORSOLATERALIS
Situation
Origin
Course
Function
7. SPINORETICULAR TRACT
Situation
Origin
Course
Termination
Function
8. SPINO-OLIVARY TRACT
9. SPINOVESTIBULAR TRACT
10. FASCICULUS GRACILIS (TRACT OF GOLL) AND
11. FASCICULUS CUNEATUS (TRACT OF BURDACH)
Situation
Origin
Course
Termination
Functions
Effect of Lesion
12. COMMA TRACT OF SCHULTZE
DESCENDING TRACTS OF SPINAL CORD
PYRAMIDAL TRACTS
Nerve Fibers
Origin
Course
Internal Capsule
In pons
Termination
Function
Effects of Lesion at different levels
EXTRAPYRAMIDAL TRACTS
1. MEDIAL LONGITUDINAL FASCICULUS
Situation
Origin
Course
Extent
Termination
Function
Effects of Lesion
2. ANTERIOR VESTIBULOSPINAL TRACT
Situation
Origin
Extent
Course
Termination
Function
3. LATERAL VESTIBULOSPINAL TRACT
Situation
Origin
Extent
Course
Termination
Functions
Effect of Lesion
4. RETICULOSPINAL TRACT
Situation
Origin
Extent
Termination
Functions
Effect of Lesion
5. TECTOSPINAL TRACT
Situation
Origin
Extent
Course
Termination
Function
6. RUBROSPINAL TRACT
Situation
Origin
Extent
Course
Termination
Function
7. OLIVOSPINAL TRACT
Situation
Origin
Termination
Function
APPLIED PHYSIOLOGY
COMPLETE TRANSECTION OF SPINAL CORD
I. Stage of Spinal Shock
II. Stage of Reflex Activity
III. Stage of Reflex Failure
INCOMPLETE TRANSECTION OF SPINAL CORD
Symptoms of Incomplete Transection
I. Stage of Spinal Shock
II. Stage of Reflex Activity
III. Stage of Reflex Failure
HEMISECTION OF SPINAL CORD – BROWN-SÉQUARD SYNDROME
Symptoms of Hemisection of Spinal Cord
EFFECTS OF HEMISECTION OF SPINAL CORD BELOW THE LEVEL OF LESION
On the Same Side
On the Opposite Side
EFFECTS OF HEMISECTION OF SPINAL CORD AT THE LEVEL OF LESION
On the Same Side
On the Opposite Side
DISEASES OF SPINAL CORD
1. Syringomyelia
2. Tabes Dorsalis
3. Multiple Sclerosis
4. Disk Prolapse
144:
Somatosensory System and Somatomotor System
SOMATOSENSORY SYSTEM
DEFINITION AND TYPES OF SENSATIONS
1. Somatic Sensations
2. Special Sensations
TYPES OF SOMATIC SENSATIONS
A. Epicretic Sensations
B. Protopathic Sensations
C. Deep Sensations
SENSORY PATHWAYS
Somatosensory Pathways
SENSORY FIBERS OF TRIGEMINAL NERVE
Origin
Termination
Central Connections
LEMNISCI
APPLIED PHYSIOLOGY
SOMATOMOTOR SYSTEM
MOTOR ACTIVITIES OF THE BODY
SOMATOMOTOR SYSTEM
SPINAL CORD AND CRANIAL NERVE NUCLEI
Motor Neurons
Final Common Pathway
Functions of Motor Neurons
CEREBRAL CORTEX
CEREBELLUM
BASAL GANGLIA
CLASSIFICATION OF MOTOR PATHWAYS
Pyramidal and Extrapyramidal Pathways
Pyramidal Tracts
Extrapyramidal Tracts
Lateral and Medial Motor Systems
Lateral Motor System
Functions of medial motor system
UPPER MOTOR NEURON AND LOWER MOTOR NEURON
Upper Motor Neuron
Lower Motor Neuron
APPLIED PHYSIOLOGY
Effects of Lesion of Motor Neurons
Paralysis
145:
Physiology of Pain
INTRODUCTION AND DEFINITION
BENEFITS OF PAIN SENSATION
COMPONENTS OF PAIN SENSATION
PATHWAYS OF PAIN SENSATION
PATHWAY OF PAIN SENSATION FROM SKIN AND DEEPER STRUCTURES
Receptors
First Order Neurons
Second Order Neurons
Third Order Neurons
Center for Pain Sensation
PATHWAY OF PAIN SENSATION FROM FACE
PATHWAY OF PAIN SENSATION FROM VISCERA
PATHWAY OF PAIN SENSATION FROM PELVIC REGION
VISCERAL PAIN
CAUSES OF VISCERAL PAIN
REFERRED PAIN
DEFINITION
EXAMPLES OF REFERRED PAIN
MECHANISM OF REFERRED PAIN
Dermatomal Rule
NEUROTRANSMITTERS INVOLVED IN PAIN SENSATION
ANALGESIA SYSTEM
ANALGESIC PATHWAY
Role of Analgesic Pathway in Inhibiting Pain Transmission
Neurotransmitters of Analgesic Pathway
GATE CONTROL THEORY
APPLIED PHYSIOLOGY
146:
Brainstem
INTRODUCTION
MEDULLA OBLONGATA
PONS
MIDBRAIN
TECTUM
1. Superior Colliculus
2. Inferior Colliculus
CEREBRAL PEDUNCLES
1. Basis Pedunculus
2. Substantia Nigra
3. Tegmentum
Red Nucleus
147:
Thalamus
INTRODUCTION
THALAMIC NUCLEI
MIDLINE NUCLEI
INTRALAMINAR NUCLEI
MEDIAL MASS OF NUCLEI
LATERAL MASS OF NUCLEI
POSTERIOR GROUP OF NUCLEI
CONNECTIONS OF THALAMIC NUCLEI
THALAMIC RADIATIONS
1. ANTERIOR (FRONTAL) PEDUNCLE OR RADIATION
2. SUPERIOR (CENTROPARIETAL) PEDUNCLE OR RADIATION
3. POSTERIOR (OCCIPITAL) PEDUNCLE OR RADIATION
4. INFERIOR (TEMPORAL) PEDUNCLE OR RADIATION
FUNCTIONS OF THALAMUS
1. RELAY CENTER
2. CENTER FOR PROCESSING OF SENSORY INFORMATION
Functional Gateway for Cerebral Cortex
3. CENTER FOR DETERMINING QUALITY OF SENSATIONS
i. The Discriminative Nature
ii. The Affective Nature
4. CENTER FOR SEXUAL SENSATIONS
5. ROLE IN AROUSAL AND ALERTNESS REACTIONS
6. CENTER FOR REFLEX ACTIVITY
7. CENTER FOR INTEGRATION OF MOTOR ACTIVITY
APPLIED PHYSIOLOGY
THALAMIC LESION
THALAMIC SYNDROME
1. Loss of Sensations
2. Astereognosis
3. Ataxia
4. Thalamic Phantom Limb
5. Amelognosia
6. Spontaneous Pain and Thalamic Over-reaction
7. Involuntary Movements
8. Thalamic Hand or Athetoid Hand
148:
Internal Capsule
DEFINITION
SITUATION
DIVISIONS
1. ANTERIOR LIMB
2. POSTERIOR LIMB
3. GENU
4. CAUDAL PORTION
APPLIED PHYSIOLOGY – EFFECT OF LESIONS OF INTERNAL CAPSULE
1. EFFECT OF LESION IN ANTERIOR LIMB
2. EFFECT OF LESION IN POSTERIOR LIMB
3. EFFECT OF LESION IN GENU
4. EFFECT OF LESION IN CAUDAL PORTION
149:
Hypothalamus
INTRODUCTION
NUCLEI OF HYPOTHALAMUS
CONNECTIONS OF HYPOTHALAMUS
AFFERENT CONNECTIONS TO HYPOTHALAMUS
EFFERENT CONNECTIONS FROM HYPOTHALAMUS
FUNCTIONS OF HYPOTHALAMUS
1. SECRETION OF POSTERIOR PITUITARY HORMONES
2. CONTROL OF ANTERIOR PITUITARY
3. CONTROL OF ADRENAL CORTEX
4. CONTROL OF ADRENAL MEDULLA
5. REGULATION OF AUTONOMIC NERVOUS SYSTEM
6. REGULATION OF HEART RATE
7. REGULATION OF BLOOD PRESSURE
8. REGULATION OF BODY TEMPERATURE
9. REGULATION OF HUNGER AND FOOD INTAKE
Feeding Center
Satiety Center
Mechanism of Regulation of Food Intake
i. Glucostatic Mechanism
ii. Lipostatic Mechanism
iii. Peptide Mechanism
iv. Hormonal Mechanism
v. Thermostatic Mechanism
10. REGULATION OF WATER BALANCE
i. Thirst Mechanism
ii. ADH Mechanism
11. REGULATION OF SLEEP AND WAKEFULNESS
12. ROLE IN BEHAVIOR AND EMOTIONAL CHANGES
Reward Center
Punishment Center
Role of Reward and Punishment Centers
Rage
Sham Rage
13. REGULATION OF SEXUAL FUNCTION
14. ROLE IN RESPONSE TO SMELL
15. ROLE IN CIRCADIAN RHYTHM
APPLIED PHYSIOLOGY – DISORDERS OF HYPOTHALAMUS
1. DIABETES INSIPIDUS
2. DYSTROPHIA ADIPOSOGENITALIS
3. KALLMANN'S SYNDROME
4. LAURENCE-MOON-BIEDL SYNDROME
5. NARCOLEPSY
6. CATAPLEXY
150:
Cerebellum
PARTS OF CEREBELLUM
VERMIS
Fissures Present Over the Surface of Vermis
CEREBELLAR HEMISPHERES
DIVISIONS OF CEREBELLUM
ANATOMICAL DIVISIONS
1. Anterior Lobe
2. Posterior Lobe
3. Flocculonodular Lobe
PHYLOGENETIC DIVISIONS
1. Paleocerebellum
2. Neocerebellum
PHYSIOLOGICAL OR FUNCTIONAL DIVISIONS
1. Vestibulocerebellum
2. Spinocerebellum
3. Corticocerebellum
FUNCTIONAL ANATOMY OF CEREBELLUM
GRAY MATTER
1. Molecular or Plexiform Layer
2. Purkinje Layer
3. Granular Layer
Afferent Fibers to Cerebellar Cortex
Neuronal Activity in Cerebellar Cortex and Nuclei
CEREBELLAR NUCLEI
1. Fastigial Nucleus
2. Globosus Nucleus
3. Emboliform Nucleus
4. Dentate Nucleus
WHITE MATTER OF CEREBELLUM
i. Inferior Peduncles
ii. Middle Peduncles
iii. Superior Peduncles
VESTIBULOCEREBELLUM (ARCHICEREBELLUM)
COMPONENTS OF VESTIBULOCEREBELLUM
CONNECTIONS OF VESTIBULOCEREBELLUM
Afferent Connections
Efferent Connections
FUNCTIONS OF VESTIBULOCEREBELLUM
Mechanism of Action of Vestibulocerebellum
SPINOCEREBELLUM (PALEOCEREBELLUM)
COMPONENTS OF SPINOCEREBELLUM
CONNECTIONS OF SPINOCEREBELLUM
Afferent Connections
Efferent Connections
FUNCTIONS OF SPINOCEREBELLUM
CORTICOCEREBELLUM (NEOCEREBELLUM)
COMPONENTS OF CORTICOCEREBELLUM
CONNECTIONS OF CORTICOCEREBELLUM
Afferent Connections
Efferent Connections
AFFERENT–EFFERENT CIRCUIT (CEREBRO-CEREBELLO-CEREBRAL CONNECTIONS)
FUNCTIONS OF CORTICOCEREBELLUM
Mechanism of Action of Corticocerebellum
APPLIED PHYSIOLOGY – CEREBELLAR LESIONS
DISTURBANCES IN TONE AND POSTURE
1. Atonia or Hypotonia
2. Attitude
3. Deviation Movement
4. Effect on Deep Reflexes
DISTURBANCES IN EQUILIBRIUM
While Standing
While Moving – Gait
DISTURBANCES IN MOVEMENTS
151:
Basal Ganglia
INTRODUCTION
COMPONENTS OF BASAL GANGLIA
CORPUS STRIATUM
i. Caudate Nucleus
ii. Lenticular Nucleus
SUBSTANTIA NIGRA
SUBTHALAMIC NUCLEUS OF LUYS
CONNECTIONS OF BASAL GANGLIA
FUNCTIONS OF BASAL GANGLIA
1. CONTROL OF MUSCLE TONE
2. CONTROL OF MOTOR ACTIVITY
i. Regulation of Voluntary Movements
ii. Regulation of Conscious Movements
iii. Regulation of Subconscious Movements
3. CONTROL OF REFLEX MUSCULAR ACTIVITY
4. CONTROL OF AUTOMATIC ASSOCIATED MOVEMENTS
5. ROLE IN AROUSAL MECHANISM
ROLE OF NEUROTRANSMITTERS IN THE FUNCTIONS OF BASAL GANGLIA
APPLIED PHYSIOLOGY – DISORDERS OF BASAL GANGLIA
1. PARKINSON'S DISEASE
Causes of Parkinson's Disease
Signs and Symptoms of Parkinson's Disease
Treatment for Parkinson's Disease
2. WILSON'S DISEASE
3. CHOREA
4. ATHETOSIS
5. CHOREOATHETOSIS
6. HUNTINGTON'S CHOREA
7. HEMIBALLISMUS
8. KERNICTERUS
152:
Cerebral Cortex
INTRODUCTION
HISTOLOGY OF CEREBRAL CORTEX
LAYERS OF CEREBRAL CORTEX
1. Molecular or Plexiform Layer
2. External Granular Layer
3. Outer Pyramidal Layer
4. Internal Granular Layer
5. Ganglionic Layer or Internal Pyramidal Layer
6. Fusiform Cell Layer
NEOCORTEX AND ALLOCORTEX
LOBES OF CEREBRAL CORTEX
CEREBRAL DOMINANCE
CEREBRAL DOMINANCE AND HANDEDNESS
BRODMANN AREAS
FRONTAL LOBE OF CEREBRAL CORTEX
PRECENTRAL CORTEX
1. Primary Motor Area
Area 4
Area 4S
2. Premotor Area
Area 6
Area 8
Broca's Area or Areas 44 and 45
3. Supplementary Motor Area
PREFRONTAL CORTEX OR ORBITOFRONTAL CORTEX
Connections
Functions of Prefrontal Cortex
APPLIED PHYSIOLOGY – FRONTAL LOBE SYNDROME
PARIETAL LOBE
SOMESTHETIC AREA I
Areas
Connections
Localization – Homunculus
Functions
Effect of Stimulation
Effects of Lesion
SOMESTHETIC AREA II
SOMESTHETIC ASSOCIATION AREA
Sensorymotor Area
APPLIED PHYSIOLOGY
TEMPORAL LOBE
PRIMARY AUDITORY AREA
Connections
Functions
AUDITOPSYCHIC AREA
AREA FOR EQUILIBRIUM
APPLIED PHYSIOLOGY – TEMPORAL LOBE SYNDROME
OCCIPITAL LOBE
AREAS OF VISUAL CORTEX
Connections
Functions
APPLIED PHYSIOLOGY
METHODS TO STUDY CORTICAL CONNECTIONS AND FUNCTIONS
BY CUTTING OR DESTRUCTION OF NERVE CELL
BY RECORDING ELECTRICAL ACTIVITY – EVOKED POTENTIAL
Evoked Potential
Diagnostic Uses of Evoked Potential
BY PHYSIOLOGICAL NEURONOGRAPHY
BY SCANNING
153:
Limbic System
INTRODUCTION
COMPONENTS OF LIMBIC SYSTEM
ARCHICORTICAL STRUCTURES
PALEOCORTICAL STRUCTURES
JUXTALLOCORTICAL STRUCTURES
SUBCORTICAL STRUCTURES
CONNECTIONS OF LIMBIC SYSTEM
FUNCTIONS OF LIMBIC SYSTEM
1. OLFACTION
2. REGULATION OF ENDOCRINE GLANDS
3. REGULATION OF AUTONOMIC FUNCTIONS
4. REGULATION OF FOOD INTAKE
5. CONTROL OF CIRCADIAN RHYTHM
6. REGULATION OF SEXUAL FUNCTION
7. ROLE IN EMOTIONAL STATE
8. ROLE IN MEMORY
9. ROLE IN MOTIVATION
154:
Reticular Formation
DEFINITION
SITUATION OF RETICULAR FORMATION
ORGANIZATION OF RETICULAR FORMATION
1. RAPHE GROUP
2. PARAMEDIAN GROUP
3. LATERAL GROUP
4. MEDIAL GROUP
5. INTERMEDIATE GROUP
DIVISIONS OF RETICULAR FORMATION
NUCLEI OF MEDULLARY RETICULAR FORMATION
NUCLEI OF PONTINE RETICULAR FORMATION
NUCLEI OF MIDBRAIN RETICULAR FORMATION
CONNECTIONS OF RETICULAR FORMATION
AFFERENT CONNECTIONS
EFFERENT CONNECTIONS
FUNCTIONS OF RETICULAR FORMATION
ASCENDING RETICULAR ACTIVATING SYSTEM (ARAS)
Functions of ARAS
Mechanism of Action of ARAS
DESCENDING RETICULAR SYSTEM
Descending Facilitatory Reticular System
Descending Inhibitory Reticular System
155:
Preparations of Animals for Experimental Studies
INTRODUCTION
DECORTICATE PREPARATION
DECEREBRATE PREPARATION
THALAMIC (MIDBRAIN) PREPARATION
SPINAL PREPARATION
156:
Proprioceptors
PROPRIOCEPTORS
MUSCLE SPINDLE
STRUCTURE OF MUSCLE SPINDLE
Types of Intrafusal Fibers
NERVE SUPPLY TO MUSCLE SPINDLE
Sensory Nerve Supply
Motor Nerve Supply
FUNCTIONS OF MUSCLE SPINDLE
1. Role of Muscle Spindle in Stretch Reflex
2. Role of Muscle Spindle in the Maintenance of Muscle Tone
GOLGI TENDON ORGAN
STRUCTURE OF GOLGI TENDON ORGAN
NERVE SUPPLY TO GOLGI TENDON ORGAN
FUNCTIONS OF GOLGI TENDON ORGAN
1. Role of Golgi Tendon Organ in Forceful Contraction
2. Role of Golgi Tendon Organ in Inverse Stretch Reflex
3. Role of Golgi Tendon Organ in Lengthening Reaction
PACINIAN CORPUSCLE
FREE NERVE ENDING
157:
Posture and Equilibrium
DEFINITION
BASIC PHENOMENA OF POSTURE
MUSCLE TONE
Definition
Significance of Muscle Tone
Development of Muscle Tone
Regulation of Muscle Tone
Abnormalities
STRETCH REFLEX
POSTURAL REFLEXES
CLASSIFICATION OF POSTURAL REFLEXES
STATIC REFLEXES
I. General Static Reflexes or Righting Reflexes
II. Local Static Reflexes or Supporting Reflexes
III. Segmental Static Reflexes
IV. Statotonic or Attitudinal Reflexes
STATOKINETIC REFLEXES
158:
Vestibular Apparatus
INTRODUCTION
LABYRINTH
BONY LABYRINTH
MEMBRANOUS LABYRINTH
FUNCTIONAL ANATOMY OF VESTIBULAR APPARATUS
SEMICIRCULAR CANALS
Ampulla
OTOLITH ORGAN OR VESTIBULE
RECEPTOR ORGAN IN VESTIBULAR APPARATUS
RECEPTOR ORGAN IN SEMICIRCULAR CANAL – CRISTA AMPULLARIS
Hair Cells
Cupula
RECEPTOR ORGAN IN OTOLITH ORGAN – MACULA
Otolith Membrane
Situation of Macula
NERVE SUPPLY TO VESTIBULAR APPARATUS
FIRST ORDER NEURON
Vestibular Nuclei
Fibers to Cerebellum
SECOND ORDER NEURON
1. Vestibulo-ocular Tract
2. Vestibulospinal Tract
3. Vestibuloreticular Tract
4. Vestibulocerebellar Tract
FUNCTIONS OF VESTIBULAR APPARATUS
FUNCTIONS OF SEMICIRCULAR CANALS
Superior Semicircular Canal
Horizontal Semicircular Canal
Posterior Semicircular Canal
Mechanism of Stimulation of Receptor Cells in Semicircular Canal
Electrical Potential in Hair Cells – Mechanotransduction
Adaptation of Receptors in Semicircular Canal during Rotation
Nystagmus
Postrotatory Reactions
Nystagmus in Pathological Conditions
FUNCTION OF OTOLITH ORGAN
Function of Utricle
Function of Saccule
Role of Otolith Organ in Resting Position
EFFECTS OF STIMULATION OF SEMICIRCULAR CANALS
ROTATIONAL MOVEMENT
Barany Chair
Effects of Stimulation of Semicircular Canals by Rotation
Postrotatory Reactions
Reaction during Rotation with Opened Eyes
CALORIC STIMULATION
Effects of Caloric Stimulation
APPLIED PHYSIOLOGY – EFFECT OF LABYRINTHECTOMY
BILATERAL LABYRINTHECTOMY
UNILATERAL LABYRINTHECTOMY
MOTION SICKNESS
DEFINITION
CAUSE
SYMPTOMS
PREVENTION
159:
Electroencephalogram (EEG)
INTRODUCTION
SIGNIFICANCE OF EEG
METHOD OF RECORDING EEG
WAVES OF EEG
ALPHA RHYTHM
Alpha Block
BETA RHYTHM
DELTA RHYTHM
THETA WAVES
EEG DURING SLEEP
160:
Physiology of Sleep
SLEEP REQUIREMENT
PHYSIOLOGICAL CHANGES DURING SLEEP
1. PLASMA VOLUME
2. CARDIOVASCULAR SYSTEM
Heart Rate
Blood Pressure
3. RESPIRATORY SYSTEM
4. GASTROINTESTINAL TRACT
5. EXCRETORY SYSTEM
6. SWEAT SECRETION
7. LACRIMAL SECRETION
8. MUSCLE TONE AND REFLEXES
9. BRAIN
TYPES OF SLEEP
1. RAPID EYE MOVEMENT SLEEP (REM SLEEP)
2. NON-RAPID EYE MOVEMENT SLEEP (NREM OR NON-REM SLEEP)
STAGES OF SLEEP AND EEG PATTERN
RAPID EYE MOVEMENT SLEEP
NON-RAPID EYE MOVEMENT SLEEP
Stage I: Stage of Drowsiness
Stage II: Stage of Light Sleep
Stage III: Stage of Medium Sleep
State IV: Stage of Deep Sleep
MECHANISM OF SLEEP
SLEEP CENTERS
1. Role of Raphe Nucleus
2. Role of Locus Ceruleus of Pons
Inhibition of Ascending Reticular Activating System (ARAS)
APPLIED PHYSIOLOGY – SLEEP DISORDERS
1. INSOMNIA
2. HYPERSOMNIA
3. NARCOLEPSY AND CATAPLEXY
4. SLEEP APNEA SYNDROME
5. NIGHTMARE
6. NIGHT TERROR
7. SOMNAMBULISM
8. NOCTURNAL ENURESIS
9. MOVEMENT DISORDERS DURING SLEEP
161:
Epilepsy
INTRODUCTION
TYPES OF EPILEPSY
GENERALIZED EPILEPSY
GRAND MAL
Tonic Stage
Clonic Stage
Causes of Grand Mal
PETIT MAL
Causes of Petit Mal
PSYCHOMOTOR EPILEPSY
Causes of Psychomotor Epilepsy
LOCALIZED EPILEPSY
162:
Higher Intellectual Functions
HIGHER INTELLECTUAL FUNCTIONS
LEARNING
DEFINITION
TYPES OF LEARNING
1. Non-associative Learning
2. Associative Learning
MEMORY
DEFINITION
TYPES OF MEMORY
1. Explicit Memory
2. Implicit Memory
1. Short Term Memory
2. Long Term Memory
1. Sensory Memory
2. Primary Memory
3. Secondary Memory
ANATOMICAL BASIS OF MEMORY
PHYSIOLOGICAL BASIS OF MEMORY
Facilitation
Habituation
Basis for Short Term Memory
Basis for Long Term Memory
Sites of Encoding
Experimental Studies of Memory – Aplysia
CHEMICAL OR MOLECULAR BASIS OF MEMORY
Memory Engram
Molecular Basis of Facilitation
Molecular Basis of Habituation
CONSOLIDATION OF MEMORY
DRUGS FACILITATING MEMORY
APPLIED PHYSIOLOGY – ABNORMALITIES OF MEMORY
1. Amnesia
2. Dementia
3. Alzheimer's Disease
CONDITIONED REFLEXES
DEFINITION
TYPES OF CONDITIONED REFLEXES
CLASSICAL CONDITIONED REFLEXES
Method of Study – Pavlov's Bell-Dog Experiments
TYPES AND PROPERTIES OF CLASSICAL CONDITIONED REFLEXES
POSITIVE CONDITIONED REFLEXES (EXCITATION OF CONDITIONED REFLEXES)
1. Primary Conditioned Reflex
2. Secondary Conditioned Reflex
3. Tertiary Conditioned Reflex
NEGATIVE CONDITIONED REFLEXES (INHIBITION OF CONDITIONED REFLEXES)
1. External or Indirect Inhibition
2. Internal or Direct Inhibition
INSTRUMENTAL OR OPERANT CONDITIONED REFLEXES
Conditioned Avoidance Reflex
Food Avoidance Conditioning
Conditioned Reward Reflex
PHYSIOLOGICAL BASIS OF CONDITIONED REFLEXES
SPEECH
DEFINITION
MECHANISM OF SPEECH
DEVELOPMENT OF SPEECH
First Stage
Second Stage
NERVOUS CONTROL OF SPEECH
A. Motor Areas
B. Sensory Areas
C. Wernicke's Area
APPLIED PHYSIOLOGY – DISORDERS OF SPEECH
APHASIA
Causes for Aphasia
Types of Aphasia
Head's Classification of Aphasia
DYSARTHRIA OR ANARTHRIA
Causes of Dysarthria
DYSPHONIA
STAMMERING
163:
Cerebrospinal Fluid (CSF)
INTRODUCTION
PROPERTIES AND COMPOSITION OF CSF
FORMATION OF CSF
SITE OF FORMATION
MECHANISM OF FORMATION
SUBSTANCES AFFECTING THE FORMATION OF CSF
CIRCULATION OF CSF
ABSORPTION OF CSF
PRESSURE EXERTED BY CSF
FUNCTIONS OF CSF
COLLECTION OF CSF
LUMBAR PUNCTURE
Posture of Body for Lumbar Puncture
Uses of Lumbar Puncture
BLOOD-BRAIN BARRIER
STRUCTURE OF BLOOD-BRAIN BARRIER
FUNCTIONS OF BLOOD-BRAIN BARRIER
Substances which can Pass through Blood-Brain Barrier
Substances which cannot Pass through Blood-Brain Barrier
BLOOD – CEREBROSPINAL FLUID BARRIER
APPLIED PHYSIOLOGY – HYDROCEPHALUS
164:
Autonomic Nervous System (ANS)
INTRODUCTION
DIVISIONS OF ANS
SYMPATHETIC DIVISION
SYMPATHETIC GANGLIA
I. Paravertebral or Sympathetic Chain Ganglia
II. Prevertebral or Collateral Ganglia
III. Terminal or Peripheral Ganglia
Sympathoadrenergic System
PARASYMPATHETIC DIVISION
CRANIAL NERVES OF PARASYMPATHETIC DIVISION
1. Tectal or Midbrain Level
2. Bulbar Level or Bulbar Outflow
3. Sacral Outflow
FUNCTIONS OF ANS
NEUROTRANSMITTERS OF ANS
SYMPATHETIC FIBERS
PARASYMPATHETIC FIBERS
Catecholamines
Acetylcholine
Receptors of Neurotransmitter
SYMPATHOMIMETIC DRUGS
SYMPATHETIC BLOCKERS
PARASYMPATHOMIMETIC DRUGS
PARASYMPATHETIC BLOCKERS
GANGLIONIC BLOCKERS
QUESTIONS IN NERVOUS SYSTEM
LONG QUESTIONS
SHORT QUESTIONS
SECTION 11: SPECIAL SENSES
165:
Structure of the Eye
SPECIAL SENSES
FUNCTIONAL ANATOMY OF THE EYEBALL
MORPHOLOGY
ORBITAL CAVITY
EYELIDS
CONJUNCTIVA
LACRIMAL GLAND
WALL OF THE EYEBALL
OUTER LAYER OR TUNICA EXTERNA OR TUNICA FIBROSA
1. Sclera
2. Cornea
MIDDLE LAYER OR TUNICA MEDIA OR TUNICA VASCULOSA
1. Choroid
2. Ciliary Body
3. Iris
INNER LAYER OR TUNICA INTERNA OR TUNICA NERVOSA OR RETINA
1. Layer of Pigment Epithelium
2. Layer of Rods and Cones
3. External Limiting Membrane
4. Outer Nuclear Layer
5. Outer Plexiform Layer
6. Inner Nuclear Layer
7. Inner Plexiform Layer
8. Ganglion Cell Layer
9. Layer of Nerve Fibers
10. Internal Limiting Membrane
FUNDUS OCULI
OPTIC DISK – BLIND SPOT
MACULA LUTEA
Fovea Centralis
INTRAOCULAR FLUID
VITREOUS HUMOR
AQUEOUS HUMOR
Properties of Aqueous Humor
Composition of Aqueous Humor
Formation of Aqueous Humor
Drainage of Aqueous Humor
Functions of Aqueous Humor
INTRAOCULAR PRESSURE
LENS
STRUCTURE OF THE LENS
1. The Capsule
2. The Anterior Epithelium
3. The Lens Substance
CHANGES IN THE LENS DURING OLD AGE
OCULAR MUSCLES
MUSCLES OF THE EYEBALL
1. Intrinsic Muscles
2. Extrinsic Muscles
INNERVATION OF OCULAR MUSCLES
Innervation of Intrinsic Muscles
Innervation of Extrinsic Muscles
1. Oculomotor Nerve
2. Trochlear Nerve
3. Abducent Nerve
OCULAR MOVEMENTS
MOVEMENTS IN VERTICAL AXIS
1. Abduction or Lateral Movement or Outward Movement
2. Adduction or Medial Movement or Inward Movement
MOVEMENTS IN TRANSVERSE AXIS
1. Elevation or Upward Movement
2. Depression or Downward Movement
MOVEMENTS IN ANTEROPOSTERIOR AXIS
1. Extorsion
2. Intorsion
SIMULTANEOUS MOVEMENTS OF BOTH EYEBALLS
1. Conjugate Movement
2. Disjugate Movement
3. Persuit Movement
4. Saccadic Movement
APPLIED PHYSIOLOGY
GLAUCOMA
Types of Glaucoma
Causes of Glaucoma
Symptoms of Glaucoma
Treatment for Glaucoma
CATARACT
Causes of Cataract
Symptoms of Cataract
Treatment for Cataract
166:
Visual Process
INTRODUCTION
IMAGE FORMING MECHANISM
NEURAL BASIS OF VISUAL PROCESS
STRUCTURE OF ROD CELL
1. Outer Segment
2. Inner Segment
3. Cell Body
4. Synaptic Terminal
STRUCTURE OF CONE CELL
1. OUTER SEGMENT
2. Inner Segment
3. Cell Body
4. Synaptic Terminal
FUNCTIONS OF RODS AND CONES
Functions of Rods
Functions of Cones
Achromatic Interval
CHEMICAL BASIS OF VISUAL PROCESS
RHODOPSIN
Chemistry of Rhodopsin
Photochemical Changes in Rhodopsin–Wald's Visual Cycle
Resynthesis of Rhodopsin
PHOTOTRANSDUCTION
Significance of Hyperpolarization
PHOTOSENSITIVE PIGMENTS IN CONES
DARK ADAPTATION
Definition
Causes for Dark Adaptation
Dark Adaptation Curve
LIGHT ADAPTATION
Definition
Causes of Light Adaptation
NIGHT BLINDNESS
Definition
Causes of Night Blindness
ELECTRICAL BASIS OF VISUAL PROCESS – ELECTRORETINOGRAM
DEFINITION
METHOD OF RECORDING ERG
WAVES OF ERG
ACUITY OF VISION
DEFINITION
TEST FOR VISUAL ACUITY
Distant Vision
Near Vision
167:
Field of Vision
DEFINITION
BINOCULAR AND MONOCULAR VISION
BINOCULAR VISION
MONOCULAR VISION
DIVISIONS OF VISUAL FIELD
TEMPORAL AND NASAL FIELDS
UPPER AND LOWER FIELDS
CORRESPONDING RETINAL POINTS
DIPLOPIA
Causes of Diplopia
Experimental Diplopia
BLIND SPOT
VISUAL FIELD AND RETINA
MAPPING OF VISUAL FIELD
168:
Visual Pathway
INTRODUCTION
VISUAL RECEPTORS
FIRST ORDER NEURONS
SECOND ORDER NEURONS
THIRD ORDER NEURONS
CONNECTIONS OF VISUAL RECEPTORS TO OPTIC NERVE
PRIVATE PATHWAY
DIFFUSE PATHWAY
COURSE OF VISUAL PATHWAY
1. OPTIC NERVE
2. OPTIC CHIASMA
3. OPTIC TRACT
4. LATERAL GENICULATE BODY
5. OPTIC RADIATION
6. VISUAL CORTEX
Areas of Visual Cortex and their Function
APPLIED PHYSIOLOGY – EFFECTS OF LESION AT DIFFERENT LEVELS OF VISUAL PATHWAY
169:
Pupillary Reflexes
INTRODUCTION
LIGHT REFLEX
DIRECT LIGHT REFLEX
INDIRECT LIGHT REFLEX
PATHWAY FOR LIGHT REFLEX
CILIOSPINAL REFLEX
ACCOMMODATION REFLEX
DEFINITION
MECHANISM OF ACCOMMODATION
Young-Helmholtz Theory
Purkinje-Sanson Images
Other Adjustments in Eyeball during Accommodation
ACCOMMODATION REFLEX
PATHWAY FOR ACCOMMODATION REFLEX
Afferent Pathway
Center
Efferent Pathway
RANGE AND AMPLITUDE OF ACCOMMODATION
Amplitude of Accommodation at Different Ages
APPLIED PHYSIOLOGY
ARGYLL ROBERTSON PUPIL
HORNER'S SYNDROME
PRESBYOPIA
170:
Color Vision
INTRODUCTION
VISIBLE SPECTRUM AND SPECTRAL COLORS
SPECTRAL COLORS
Purkinje Phenomenon
EXTRASPECTRAL COLORS
PRIMARY COLORS
COMPLEMENTARY COLORS
THEORIES OF COLOR VISION
1. THOMAS YOUNG'S TRICHROMATIC THEORY
2. HELMHOLTZ TRICHROMATIC THEORY
3. GRANIT'S MODULATOR AND DOMINATOR THEORY
Dominators
Modulators
4. HARTRIDGE'S POLYCHROMATIC THEORY
First Unit
Second Unit
Third Unit
5. HERING'S THEORY OF OPPOSITE COLORS
First Substance
Second Substance
Third Substance
COLOR SENSITIVE AREAS IN RETINA
CONTRAST EFFECTS
SIMULTANEOUS CONTRAST
SUCCESSIVE CONTRAST
AFTER IMAGE
1. POSITIVE AFTER IMAGE
2. NEGATIVE AFTER IMAGE
APPLIED PHYSIOLOGY – COLOR BLINDNESS
CAUSES FOR ACQUIRED COLOR BLINDNESS
1. Trauma
2. Chronic Diseases
3. Drugs
4. Toxins
5. Alcoholism
6. Aging
CLASSIFICATION OF COLOR BLINDNESS
1. Monochromatism
2. Dichromatism
3. Trichromatism
TESTS FOR COLOR BLINDNESS
171:
Errors of Refraction
AMETROPIA
MYOPIA OR SHORT SIGHTEDNESS
Cause
Correction
HYPERMETROPIA OR LONG SIGHTEDNESS
Cause
Correction
ANISOMETROPIA
ASTIGMATISM
CAUSE OF ASTIGMATISM
TYPES OF ASTIGMATISM
1. Regular Astigmatism
2. Irregular Astigmatism
CORRECTION OF ASTIGMATISM
PRESBYOPIA
CAUSES OF PRESBYOPIA
CORRECTION OF PRESBYOPIA
172:
Structure of Ear
EXTERNAL EAR
AURICLE OR PINNA
EXTERNAL AUDITORY MEATUS
1. The Outer Cartilaginous Part
2. The Inner Bony Part
MIDDLE EAR
AUDITORY OSSICLES
1. Malleus
2. Incus
3. Stapes
AUDITORY MUSCLES
1. Tensor Tympani
2. Stapedius
Tympanic Reflex
EUSTACHIAN TUBE
INTERNAL EAR
COCHLEA
COMPARTMENTS OF COCHLEA
1. Basilar Membrane
2. Vestibular Membrane
ORGAN OF CORTI
Situation and Extent
Structure
1. Border Cells
2. Inner Hair Cells
3. Inner Phalangeal Cells
4, 5. Inner and Outer Pillar Cells – Rods of Corti
6. Outer Phalangeal Cells
7. Outer Hair Cells
8. Cells of Hensen
9. Cells of Claudius
10. Tectorial Membrane and Lamina Reticularis
173:
Auditory Pathway
INTRODUCTION
RECEPTORS
FIRST ORDER NEURONS
SECOND ORDER NEURONS
THIRD ORDER NEURONS
CORTICAL AUDITORY CENTERS
FUNCTIONS OF CORTICAL AUDITORY CENTERS
APPLIED PHYSIOLOGY – EFFECT OF LESION
174:
Mechanism of Hearing
INTRODUCTION
ROLE OF EXTERNAL EAR
ROLE OF MIDDLE EAR
ROLE OF TYMPANIC MEMBRANE
ROLE OF AUDITORY OSSICLES
Impedance Matching
Types of Conduction
ROLE OF EUSTACHIAN TUBE
ROLE OF INNER EAR
TRAVELING WAVE
Resonance Point
EXCITATION OF HAIR CELLS
ELECTRICAL EVENTS DURING PROCESS OF HEARING
SOUND TRANSDUCTION
RECEPTOR POTENTIAL OR COCHLEAR MICROPHONIC POTENTIAL
ROLE OF HAIR CELLS
Role of Inner Hair Cells
Role of Outer Hair Cells
Role of Efferent Nerve Fibers to Hair Cells
ENDOCOCHLEAR POTENTIAL OR ENDOLYMPHATIC POTENTIAL
Cochlear Fluids
Electrical Potential
Significance of Endocochlear Potential
ACTION POTENTIAL IN AUDITORY NERVE FIBER
PROPERTIES OF SOUND
APPRECIATION OF PITCH OF THE SOUND – THEORIES OF HEARING
THEORIES OF FIRST GROUP
1. Telephone Theory of Rutherford
2. Volley Theory
THEORIES OF SECOND GROUP
1. Resonance Theory of Helmholtz
2. Place Theory
3. Traveling Wave Theory
APPRECIATION OF LOUDNESS OF SOUND
LOCALIZATION OF SOUND
175:
Auditory Defects
TYPES AND CAUSES OF AUDITORY DEFECTS
CONDUCTION DEAFNESS
NERVE DEAFNESS
Causes for Nerve Deafness
TESTS FOR HEARING
RINNE'S TEST
WEBER'S TEST
AUDIOMETRY
176:
Sensation of Taste
TASTE BUDS
SITUATION OF TASTE BUDS
1. Filiform Papillae
2. Fungiform Papillae
3. Circumvallate Papillae
STRUCTURE OF TASTE BUD
PATHWAY FOR TASTE
RECEPTORS
FIRST ORDER NEURON
SECOND ORDER NEURON
THIRD ORDER NEURON
TASTE CENTER
PRIMARY TASTE SENSATIONS
DISCRIMINATION OF DIFFERENT TASTE SENSATIONS
TASTE SENSATIONS AND CHEMICAL CONSTITUTIONS
1. SWEET TASTE
2. SALT TASTE
3. SOUR TASTE
4. BITTER TASTE
5. UMAMI
Threshold for Taste Sensations
TASTE TRANSDUCTION
1. SWEET RECEPTOR
2. SALT RECEPTOR
3. SOUR RECEPTOR
4. BITTER RECEPTOR
5. UMAMI RECEPTOR
APPLIED PHYSIOLOGY – ABNORMALITIES OF TASTE SENSATION
1. AGEUSIA
2. HYPOGEUSIA
3. TASTE BLINDNESS
4. DYSGEUSIA
177:
Sensation of Smell
OLFACTORY RECEPTORS
VOMERONASAL ORGAN
Vomeronasal Receptors in Human Beings
OLFACTORY PATHWAY
GENERATOR POTENTIAL IN OLFACTORY RECEPTOR
CLASSIFICATION OF ODOR
THRESHOLD FOR OLFACTORY SENSATION
ADAPTATION
APPLIED PHYSIOLOGY – ABNORMALITIES OF OLFACTORY SENSATION
ANOSMIA
HYPOSMIA
HYPEROSMIA
QUESTIONS IN SPECIAL SENSES
LONG QUESTIONS
SHORT QUESTIONS
INDEX
TOC
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