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Essentials of Physiology for Dental Students
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
Lipid Layer of Cell Membrane
Protein Layers of the Cell Membrane
Carbohydrates of the Cell Membrane
FUNCTIONS OF CELL MEMBRANE
CYTOPLASM
ORGANELLES IN CYTOPLASM
ORGANELLES WITH LIMITING MEMBRANE
1. ENDOPLASMIC RETICULUM
Types of Endoplasmic Reticulum
Rough Endoplasmic Reticulum
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
ORGANELLES WITHOUT LIMITING MEMBRANE
1. RIBOSOMES
Functions of Ribosomes
2. CYTOSKELETON
Microtubules
Intermediate Filaments
Microfilaments
NUCLEUS
STRUCTURE OF NUCLEUS
Nuclear Membrane
Nucleoplasm
Nucleoli
FUNCTIONS OF NUCLEUS
CELL DEATH
APOPTOSIS
Functional Significance of Apoptosis
NECROSIS
Causes for Necrosis
2:
Cell Junctions
DEFINITION AND CLASSIFICATION
OCCLUDING JUNCTION
TIGHT JUNCTION
Functions of Tight Junctions
COMMUNICATING JUNCTIONS
GAP JUNCTION OR NEXUS
Structure of Gap Junction
Functions of Gap Junction
CHEMICAL SYNAPSE
ANCHORING JUNCTIONS
ADHERENS JUNCTIONS
FOCAL ADHESIONS
DESMOSOME
HEMIDESMOSOME
3:
Transport through Cell Membrane
INTRODUCTION
BASIC MECHANISM OF TRANSPORT
PASSIVE TRANSPORT
SIMPLE DIFFUSION
Simple Diffusion through Lipid Layer
Simple Diffusion through Protein Layer
Protein Channels
FACILITATED OR CARRIER MEDIATED DIFFUSION
FACTORS AFFECTING RATE OF DIFFUSION
SPECIAL TYPES OF PASSIVE TRANSPORT
Bulk Flow
Filtration
Osmosis
Osmotic Pressure
Colloidal Osmotic Pressure and Oncotic Pressure
ACTIVE TRANSPORT
MECHANISM OF ACTIVE TRANSPORT
CARRIER PROTEINS
Uniport
Symport and antiport
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
Sodium Co-transport
Sodium Counter Transport
SPECIAL CATEGORIES OF ACTIVE TRANSPORT
ENDOCYTOSIS
1. Pinocytosis
2. Phagocytosis
3. Receptor Mediated Endocytosis
Mechanism of receptor mediated endocytosis
EXOCYTOSIS
TRANSCYTOSIS
4:
Homeostasis
INTRODUCTION
COMPONENTS OF HOMEOSTATIC SYSTEM
HOMEOSTASIS AND VARIOUS SYSTEMS OF THE BODY
MECHANISM OF ACTION OF HOMEOSTATIC SYSTEM
Negative Feedback Mechanism
Positive Feedback Mechanism
LONG QUESTIONS
SHORT QUESTIONS
SECTION 2: BLOOD AND BODY FLUIDS
5:
Body Fluids
INTRODUCTION
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 Body Fluid Volume by Indicator Dilution Method
Characteristics of Marker Substances
MEASUREMENT OF TOTAL BODY WATER
MEASUREMENT OF ECF VOLUME
Example for Measurement of ECF Volume
MEASUREMENT OF PLASMA VOLUME
Measurement of Plasma Volume by Indicator or Dye Dilution Technique
Calculation
MEASUREMENT OF BLOOD VOLUME
MEASUREMENT OF INTRACELLULAR FLUID VOLUME
MEASUREMENT OF INTERSTITIAL FLUID VOLUME
MAINTENANCE OF WATER BALANCE
APPLIED PHYSIOLOGY
DEHYDRATION
Definition
Classification
Causes
Signs and Symptoms
OVERHYDRATION OR WATER INTOXICATION
Definition
Causes
Signs and Symptoms
6:
Blood and Plasma Proteins
BLOOD
PROPERTIES OF BLOOD
COMPOSITION OF BLOOD
Blood Cells
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
PLASMA PROTEINS
NORMAL VALUES
Albumin/globulin Ratio
VARIATIONS IN PLASMA PROTEIN LEVEL
Hyperproteinemia
Hypoproteinemia
ORIGIN OF PLASMA PROTEINS
PROPERTIES OF PLASMA PROTEINS
Molecular Weight
Specific Gravity
Buffer Action
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
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
7:
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 Polycythemia
B. Decrease in RBC count
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
HEMOLYSIS AND FRAGILITY OF RBC
DEFINITION
Hemolysis
Fragility
PROCESS OF HEMOLYSIS
CONDITIONS WHEN HEMOLYSIS OCCURS
HEMOLYSINS
CHEMICAL SUBSTANCES
SUBSTANCES OF BACTERIAL ORIGIN OR SUBSTANCES FOUND IN BODY
8:
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
4. Vitamins
MATURATION FACTORS
1. Vitamin B12 (Cyanocobalamin)
2. Intrinsic Factor of Castle
3. Folic Acid
FACTORS NECESSARY FOR HEMOGLOBIN FORMATION
9:
Hemoglobin
INTRODUCTION
NORMAL HEMOGLOBIN CONTENT
FUNCTIONS OF HEMOGLOBIN
TRANSPORT OF RESPIRATORY GASES
BUFFER ACTION
STRUCTURE OF HEMOGLOBIN
TYPES OF NORMAL HEMOGLOBIN
ABNORMAL HEMOGLOBIN
ABNORMAL HEMOGLOBIN DERIVATIVES
CARBOXYHEMOGLOBIN
Signs and Symptoms of Carbon Monoxide Poisoning
METHEMOGLOBIN
SULFHEMOGLOBIN
SYNTHESIS OF HEMOGLOBIN
SYNTHESIS OF HEME
FORMATION OF GLOBIN
CONFIGURATION
SUBSTANCES NECESSARY FOR HEMOGLOBIN SYNTHESIS
DESTRUCTION OF HEMOGLOBIN
10:
Erythrocyte Sedimentation Rate and Packed Cell Volume
ERYTHROCYTE SEDIMENTATION RATE
DEFINITION
DETERMINATION OF ESR
Westergren's Method
Wintrobe's Method
NORMAL VALUES OF ESR
By Westergren's Method
By Wintrobe's Method
SIGNIFICANCE OF DETERMINING ESR
VARIATIONS OF ESR
Physiological Variation
Pathological Variation
FACTORS AFFECTING ESR
PACKED CELL VOLUME
DEFINITION
METHOD OF DETERMINATION
SIGNIFICANCE OF DETERMINING PCV
NORMAL VALUES OF PCV
VARIATIONS IN PCV
11:
Anemia
INTRODUCTION
CLASSIFICATION OF ANEMIA
MORPHOLOGICAL CLASSIFICATION
ETIOLOGICAL CLASSIFICATION
1. Hemorrhagic Anemia
2. Hemolytic Anemia
Hereditary Disorders
3. Nutrition Deficiency Anemia
4. Aplastic Anemia
5. Anemia due to Chronic Diseases
SIGNS AND SYMPTOMS OF ANEMIA
SKIN AND MUCOUS MEMBRANE
HAIR AND NAILS
CARDIOVASCULAR SYSTEM
RESPIRATION
DIGESTION
METABOLISM
KIDNEY
REPRODUCTIVE SYSTEM
NEUROMUSCULAR SYSTEM
12:
White Blood Cells
INTRODUCTION
CLASSIFICATION
MORPHOLOGY OF WHITE BLOOD CELLS
NEUTROPHILS
EOSINOPHILS
BASOPHILS
MONOCYTES
LYMPHOCYTES
NORMAL LEUKOCYTE COUNT
VARIATIONS IN LEUKOCYTE COUNT
PHYSIOLOGICAL VARIATIONS
PATHOLOGICAL VARIATIONS
Leukocytosis
Leukopenia
Leukemia
LIFESPAN OF WHITE BLOOD CELLS
PROPERTIES OF WBCs
FUNCTIONS OF WBCs
NEUTROPHILS
Mechanism of Action of Neutrophils
Pus and Pus Cells
EOSINOPHILS
Mechanism of Action of Eosinophils
BASOPHILS
Mechanism of Action of Basophils
Mast Cell
Functions
MONOCYTES
LYMPHOCYTES
LEUKOPOIESIS
STEM CELLS
FACTORS NECESSARY FOR LEUKOPOIESIS
Colony Stimulating Factors
13:
Immunity
DEFINITION AND TYPES OF IMMUNITY
INNATE IMMUNITY OR NONSPECIFIC 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
DEVELOPMENT OF CELL MEDIATED IMMUNITY
INTRODUCTION
ANTIGEN PRESENTING CELLS
Role of Antigen Presenting Cells
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 of B Cells
ROLE OF PLASMA CELLS
ROLE OF MEMORY B CELLS
ROLE OF HELPER T CELLS
ANTIBODIES
Types of Antibodies
Structure of Antibodies
Mechanism of Actions of Antibodies
1. Direct Actions of Antibodies
2. Actions of Antibodies through Complement System
Functions of Different Antibodies
Specificity of B Lymphocytes
NATURAL KILLER CELL
CYTOKINES
IMMUNE DEFICIENCY DISEASES
CONGENITAL IMMUNE DEFICIENCY DISEASES
ACQUIRED IMMUNE DEFICIENCY DISEASES
Acquired Immune Deficiency Syndrome (AIDS)
AUTOIMMUNE DISEASES
14:
Platelets
INTRODUCTION
SIZE OF PLATELETS
SHAPE OF PLATELETS
STRUCTURE AND COMPOSITION
CELL MEMBRANE
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
DEVELOPMENT OF PLATELETS
LIFESPAN AND FATE OF PLATELETS
APPLIED PHYSIOLOGY – PLATELET DISORDERS
THROMBOCYTOPENIA
THROMBOCYTOSIS
THROMBOCYTHEMIA
GLANZMANN THROMBASTHENIA
15:
Hemostasis and Coagulation of Blood
HEMOSTASIS
DEFINITION
STAGES OF HEMOSTASIS
1. Vasoconstriction
2. Formation of Platelet Plug
3. Coagulation of Blood
DEFINITION OF BLOOD COAGULATION
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
Extrinsic Pathway for the Formation of Prothrombin Activator
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
CLOT RETRACTION
FIBRINOLYSIS
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
TESTS FOR CLOTTING
1. BLEEDING TIME
2. CLOTTING TIME
3. PROTHROMBIN TIME
APPLIED PHYSIOLOGY
BLEEDING DISORDERS
1. Hemophilia
2. Purpura
3. von Willebrand Disease
THROMBOSIS
Causes of Thrombosis
Complications of Thrombosis
16:
Blood Groups and Blood Transfusion
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
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
IMPORTANCE OF KNOWING BLOOD GROUP
BLOOD TRANSFUSION
INTRODUCTION
Precautions to be taken Before the Transfusion of Blood
Precautions to be taken while Transfusing Blood
BLOOD SUBSTITUTES
EXCHANGE TRANSFUSION
AUTOLOGOUS BLOOD TRANSFUSION
17:
Reticuloendothelial System and Tissue Macrophage
DEFINITION AND DISTRIBUTION
RETICULOENDOTHELIAL SYSTEM OR MACROPHAGE SYSTEM
MACROPHAGE
CLASSIFICATION OF RETICULOENDOTHELIAL CELLS
FIXED RETICULOENDOTHELIAL CELLS – TISSUE MACROPHAGES
WANDERING RETICULOENDOTHELIAL CELLS
FUNCTIONS OF RETICULOENDOTHELIAL SYSTEM
SPLEEN
FUNCTIONS OF SPLEEN
1. Formation of Blood Cells
2. Destruction of Blood Cells
3. Blood Reservoir Function
4. Role in Defense of Body
18:
Lymphatic System and Lymph
LYMPHATIC SYSTEM
LYMPH NODES
FUNCTIONS OF LYMPH NODES
LYMPH
FORMATION
RATE OF LYMPH FLOW
COMPOSITION OF LYMPH
FUNCTIONS OF LYMPH
19:
Tissue Fluid and Edema
DEFINITION
FUNCTIONS OF TISSUE FLUID
FORMATION OF TISSUE FLUID
FILTRATION
REABSORPTION
APPLIED PHYSIOLOGY – EDEMA
DEFINITION
TYPES OF EDEMA
Intracellular Edema
Extracellular Edema
Pitting and Non-pitting Edema
LONG QUESTIONS
SHORT QUESTIONS
SECTION 3: MUSCLE PHYSIOLOGY
20:
Classification of Muscles
DEPENDING UPON STRIATIONS
DEPENDING UPON CONTROL
DEPENDING UPON SITUATION
21:
Structure of Skeletal Muscle
MUSCLE MASS
MUSCLE FIBER
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
SARCOTUBULAR SYSTEM
COMPOSITION OF MUSCLE
22:
Properties of Skeletal Muscle
EXCITABILITY
DEFINITION
STIMULUS
Types of Stimulus
Intensity of Stimulus
CONTRACTILITY
TYPES OF CONTRACTION
Isotonic Contraction
Isometric Contraction
RED MUSCLE AND PALE MUSCLE
Red Muscles
Pale Muscles
FACTORS AFFECTING FORCE OF CONTRACTION
A. EFFECT OF STRENGTH OF STIMULUS
B. EFFECT OF NUMBER OF STIMULUS
1. Fatigue
2. Tetanus
C. Effect of Variations in Temperature
D. Effect of Load
REFRACTORY PERIOD
1. Absolute Refractory Period
2. Relative Refractory Period
MUSCLE TONE
DEFINITION
MAINTENANCE OF MUSCLE TONE
In Skeletal Muscle
In Cardiac Muscle
In Smooth Muscle
APPLIED PHYSIOLOGY — ABNORMALITIES OF MUSCLE TONE
23:
Electrical and Molecular Changes during Muscular Contraction
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
1. Sodium-potassium pump
2. Selective permeability of cell membrane
Channels for major anions (negatively charged substances) like proteins
Channels for ions
Action Potential
GRADED POTENTIAL
MOLECULAR 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
24:
Neuromuscular Junction
DEFINITION AND STRUCTURE
DEFINITION
STRUCTURE
Axon Terminal and Motor Endplate
Synaptic Trough or Gutter
Synaptic Cleft
Subneural Clefts
NEUROMUSCULAR TRANSMISSION
1. RELEASE OF ACETYLCHOLINE
2. ACTION OF ACETYLCHOLINE
3. ENDPLATE POTENTIAL
4. MINIATURE ENDPLATE POTENTIAL
5. FATE OF ACETYLCHOLINE
Reuptake Process
NEUROMUSCULAR BLOCKERS
MOTOR UNIT
DEFINITION
NUMBER OF MUSCLE FIBERS IN MOTOR UNIT
APPLIED PHYSIOLOGY – DISORDERS OF NEUROMUSCULAR JUNCTION
1. MYASTHENIA GRAVIS
2. EATON-LAMBERT SYNDROME
25:
Smooth Muscle
DISTRIBUTION OF SMOOTH MUSCLE
STRUCTURE OF SMOOTH MUSCLE
TYPES OF SMOOTH MUSCLE FIBERS
SINGLE UNIT OR VISCERAL SMOOTH MUSCLE FIBERS
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
CONTROL OF SMOOTH MUSCLE
NERVOUS FACTORS
HUMORAL FACTORS
LONG QUESTIONS
SHORT QUESTIONS
SECTION 4: DIGESTIVE SYSTEM
26:
Introduction to Digestive System
INTRODUCTION
FUNCTIONAL ANATOMY OF THE DIGESTIVE SYSTEM
WALL OF GASTROINTESTINAL TRACT
1. MUCUS LAYER
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
27:
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
FUNCTIONS OF SALIVA
1. PREPARATION OF FOOD FOR SWALLOWING
2. APPRECIATION OF TASTE
3. DIGESTIVE FUNCTION
Salivary Amylase
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
Function of Parasympathetic Fibers
SYMPATHETIC 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. Mumps
5. Sjögren's Syndrome
28:
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 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
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
SECRETION OF GASTRIC JUICE
SECRETION OF PEPSINOGEN
SECRETION OF HYDROCHLORIC ACID
REGULATION OF GASTRIC SECRETION
METHODS OF STUDY
1. Pavlov's Pouch
2. Farrel and Ivy Pouch
3. Sham Feeding
PHASES OF GASTRIC SECRETION
CEPHALIC PHASE
Unconditioned Reflex
Conditioned Reflex
GASTRIC PHASE
1. Nervous Mechanism
2. Hormonal Mechanism – Gastrin
INTESTINAL PHASE
INTERDIGESTIVE PHASE
APPLIED PHYSIOLOGY
1. GASTRITIS
Causes of Gastritis
Features
2. GASTRIC ATROPHY
Cause
Features
3. PEPTIC ULCER
Causes
Features
29:
Pancreas
FUNCTIONAL ANATOMY and nerve supply of pancreas
FUNCTIONAL ANATOMY OF EXOCRINE PART OF PANCREAS
NERVE SUPPLY TO PANCREAS
PROPERTIES AND 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
REGULATION OF PANCREATIC SECRETION
1. CEPHALIC PHASE
Unconditioned Reflex
Conditioned Reflex
2. GASTRIC PHASE
3. INTESTINAL PHASE
Hormones Stimulating Pancreatic Secretion
Secretin
Cholecystokinin
Hormones Inhibiting Pancreatic Secretion
APPLIED PHYSIOLOGY
PANCREATITIS
Causes of Pancreatitis
Features of Pancreatitis
STEATORRHEA
Causes of Steatorrhea
30:
Liver and Gallbladder
FUNCTIONAL ANATOMY OF LIVER AND BILIARY SYSTEM
LIVER
Portal Triads
BILIARY SYSTEM
BLOOD SUPPLY TO LIVER
HEPATIC ARTERY
PORTAL VEIN
HEPATIC VEIN
PROPERTIES AND COMPOSITION OF BILE
FORMATION 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 FUNCTIONS
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
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
Causes
HEPATITIS
CIRRHOSIS OF LIVER
GALLSTONES
Definitions
Formation of Gallstones
Causes for Gallstone Formation
Features
31:
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
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
REGULATION OF SECRETION OF SUCCUS ENTERICUS
NERVOUS REGULATION
HORMONAL REGULATION
APPLIED PHYSIOLOGY – MALABSORPTION
32:
Large Intestine
FUNCTIONAL ANATOMY 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
Features
33:
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
Role of Lower Esophageal Sphincter
DEGLUTITION REFLEX
Stimulus
Afferent Fibers
Center
Efferent Fibers
Response
MOVEMENTS OF STOMACH
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
VOMITING
CAUSES OF VOMITING
MECHANISM OF VOMITING
Nausea
Retching
Act of Vomiting
VOMITING REFLEX
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
LONG QUESTIONS
SHORT QUESTIONS
SECTION 5: RENAL PHYSIOLOGY AND SKIN
34:
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
35:
Nephron and Juxtaglomerular Apparatus
INTRODUCTION
RENAL CORPUSCLE
SITUATION OF RENAL CORPUSCLE AND TYPES OF NEPHRON
1. Cortical Nephrons
2. Juxtamedullary Nephrons
STRUCTURE OF RENAL CORPUSCLE
1. Glomerulus
2. Bowman's Capsule
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
JUXTAGLOMERULAR APPARATUS
DEFINITION
STRUCTURE OF JUXTAGLOMERULAR APPARATUS
1. Macula Densa
2. Extraglomerular Mesangial Cells
3. Juxtaglomerular Cells
FUNCTIONS OF JUXTAGLOMERULAR APPARATUS
1. Secretion of Renin
2. Secretion of Other Substances
3. Regulation of Glomerular Blood Flow and Glomerular Filtration Rate
36:
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
37:
Urine Formation
INTRODUCTION
GLOMERULAR FILTRATION
INTRODUCTION
Filtration Membrane
Process of Glomerular Filtration
Ultrafiltration
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
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
SELECTIVE REABSORPTION
MECHANISM OF REABSORPTION
1. Active Reabsorption
2. Passive Reabsorption
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
TRANSPORT MAXIMUM – TM VALUE
RENAL THRESHOLD
REABSORPTION OF IMPORTANT SUBSTANCES
Reabsorption of Sodium
Reabsorption of Water
Reabsorption of Glucose
Reabsorption of Bicarbonates
TUBULAR SECRETION
INTRODUCTION
SUBSTANCES SECRETED IN DIFFERENT SEGMENTS OF RENAL TUBULES
SUMMARY OF URINE FORMATION
38:
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 Hyper-osmolarity 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
39:
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
40:
Renal Function Tests
PROPERTIES AND COMPOSITION OF NORMAL URINE
PROPERTIES OF URINE
COMPOSITION OF URINE
RENAL FUNCTION TESTS
EXAMINATION OF URINE URINANALYSIS
EXAMINATION OF BLOOD
EXAMINATION OF BLOOD AND URINE
41:
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
Law of Laplace
Segment III
MICTURITION REFLEX
APPLIED PHYSIOLOGY
1. ATONIC BLADDER – EFFECT OF DESTRUCTION OF SENSORY NERVE FIBERS
2. AUTOMATIC BLADDER
3. THE UNINHIBITED NEUROGENIC BLADDER
4. NOCTURNAL MICTURITION
42:
Skin
STRUCTURE OF SKIN
INTRODUCTION
EPIDERMIS
DERMIS
APPENDAGES OF SKIN
COLOR OF THE SKIN
1. Pigmentation of the Skin
2. Hemoglobin in Blood
GLANDS OF SKIN
SEBACEOUS GLANDS
Composition of Sebum
Functions of Sebum
Activation of Sebaceous Glands at Puberty
Acne
SWEAT GLANDS
Eccrine Glands
Apocrine Glands
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
43:
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
When Body Temperature Decreases
LONG QUESTIONS
SHORT QUESTIONS
SECTION 6: ENDOCRINOLOGY
44:
Introduction to Endocrinology
INTRODUCTION
ENDOCRINE GLANDS
HORMONES
CLASSIFICATION OF HORMONES
HORMONAL ACTION
HORMONE RECEPTORS
Situation of the 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
45:
Pituitary Gland
INTRODUCTION
ANTERIOR PITUITARY
PARTS
HISTOLOGY
HORMONES SECRETED BY ANTERIOR PITUITARY
REGULATION OF SECRETION OF ANTERIOR PITUITARY HORMONES
Releasing and Inhibitory Hormones Secreted by Hypothalamus
GROWTH HORMONE
Actions of Growth Hormone
1. On Metabolism
2. On Bones
Mode of Action of GH on Bones and Metabolism
Somatomedin
Regulation of GH Secretion
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
HISTOLOGY
HORMONES OF POSTERIOR PITUITARY
ANTIDIURETIC HORMONE
Actions
Vasopressor Action
Regulation of Secretion
OXYTOCIN
Actions in Females
Action in Males
Mode of Action of Oxytocin
APPLIED PHYSIOLOGYDISORDERS OF PITUITARY GLAND
HYPERACTIVITY OF ANTERIOR PITUITARY
1. Gigantism
2. Acromegaly
3. Acromegalic Gigantism
4. Cushing's Disease
HYPOACTIVITY OF ANTERIOR PITUITARY
1. Dwarfism
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
46:
Thyroid Gland
INTRODUCTION
HISTOLOGY OF THYROID GLAND
HORMONES OF THYROID GLAND
SYNTHESIS OF THYROID HORMONES
STORAGE OF THYROID HORMONES
RELEASE OF THYROID HORMONES FROM THE THYROID GLAND
TRANSPORT OF THYROID HORMONES IN THE BLOOD
FUNCTIONS OF THYROID HORMONES
1. ON BASAL METABOLIC RATE
2. ON PROTEIN METABOLISM
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
ii. On Blood Vessels
iii. 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
MODE OF ACTION OF THYROID HORMONES
REGULATION OF SECRETION OF THYROID HORMONES
ROLE OF PITUITARY GLAND
Thyroid Stimulating Hormone
Actions of TSH
Mode of Action of TSH
ROLE OF HYPOTHALAMUS
FEEDBACK CONTROL
ROLE OF IODIDE
APPLIED PHYSIOLOGY—DISORDERS OF THYROID GLAND
1. HYPERTHYROIDISM
Causes for Hyperthyroidism
II. THYROID ADENOMA
Signs and Symptoms of Hyperthyroidism
Exophthalmos
2. HYPOTHYROIDISM
Myxedema
Cretinism
3. GOITER
Goiter in Hyperthyroidism — Toxic Goiter
Goiter in Hypothyroidism — Nontoxic Goiter
THYROID FUNCTION TESTS
47:
Parathyroid Glands and Physiology of Bone
INTRODUCTION
PARATHORMONE
ACTIONS OF PARATHORMONE
On Blood Calcium Level
On Blood Phosphate Level
Mode of Action of PTH
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 Tetany
HYPERPARATHYROIDISM—HYPERCALCEMIA
Causes of Hyperparathyroidism
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
CELL TYPES OF BONE
1. Osteoblasts
2. Osteocytes
3. Osteoclasts
BONE REMODELING
Significance of Bone Remodeling
APPLIED PHYSIOLOGY — DISEASES OF BONE
1. Osteoporosis
2. Rickets
3. Osteomalacia
48:
Endocrine Functions of Pancreas
ISLETS OF LANGERHANS
INSULIN
ACTIONS
1. On Carbohydrate Metabolism
2. On Protein Metabolism
3. On Fat Metabolism
4. On Growth
MODE OF ACTION
REGULATION OF 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
ACTIONS
1. On Carbohydrate Metabolism
2. On Protein Metabolism
3. On Fat Metabolism
4. Other Actions
MODE OF ACTION
REGULATION OF SECRETION
1. Role of Blood Glucose Level
2. Role of Amino Acid Level in Blood
3. Role of Other Factors
SOMATOSTATIN
ACTIONS
MODE OF ACTION
REGULATION OF SECRETION
PANCREATIC POLYPEPTIDE
ACTIONS
MODE OF ACTION
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
HYPERACTIVITY — HYPERINSULINISM
Cause of Hyperinsulinism
Signs and Symptoms of Hyperinsulinism
49:
Adrenal Cortex
FUNCTIONAL ANATOMY OF ADRENAL GLANDS
HORMONES OF ADRENAL CORTEX
MINERALOCORTICOIDS
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
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
APPLIED PHYSIOLOGY
HYPERACTIVITY OF ADRENAL CORTEX
1. Cushing's Syndrome
2. Hyperaldosteronism
3. Adrenogenital Syndrome
HYPOACTIVITY OF ADRENAL CORTEX
1. Addison's Disease or Chronic Adrenal Insufficiency
2. Congenital Adrenal Hyperplasia
50:
Adrenal Medulla
INTRODUCTION
HORMONES OF ADRENAL MEDULLA
PLASMA LEVEL OF CATECHOLAMINES
SYNTHESIS OF CATECHOLAMINES
METABOLISM OF CATECHOLAMINES
ACTIONS OF ADRENALINE AND NORADRENALINE
MODE OF ACTION OF ADRENALINE AND NORADRENALINE – 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
51:
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
2. THROMBOPOIETIN
3. RENIN
Actions of Renin
4. 1,25-DIHYDROXYCHOLECAL-CIFEROL – 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
C-TYPE NATRIURETIC PEPTIDE
52:
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
LONG QUESTIONS
SHORT QUESTIONS
SECTION 7: REPRODUCTIVE SYSTEM
53:
Male Reproductive System
INTRODUCTION TO MALE REPRODUCTIVE SYSTEM
PRIMARY SEX ORGANS IN MALES – TESTES
COVERINGS OF TESTIS
FUNCTIONAL ANATOMY OF TESTIS
ACCESSORY SEX ORGANS IN MALES
SEMINAL VESICLES
Properties and Composition of Seminal Fluid
Functions of Seminal Fluid
PROSTATE GLAND
Properties and Composition of Prostatic Fluid
Functions of Prostatic Fluid
URETHRA
PENIS
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
ROLE OF SERTOLI CELLS IN SPERMATOGENESIS
ROLE OF HORMONES IN SPERMATOGENESIS
1. FSH
2. LH
3. GH
4. Testosterone
5. Estrogen
6. Inhibin
7. Activin
OTHER FACTORS AFFECTING SPERMATOGENESIS
ENDOCRINE FUNCTIONS OF TESTIS
FUNCTIONS OF TESTOSTERONE
Functions of Testosterone in Fetal Life
Cryptorchidism
Functions of Testosterone in Adult Life
MODE OF ACTION OF TESTOSTERONE
REGULATION OF TESTOSTERONE SECRETION
In Fetus
In Adults
Feedback Control
SEMEN
PROPERTIES OF SEMEN
COMPOSITION OF SEMEN
SPERM
MALE 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
Before puberty
After puberty
In adults
Dystrophia adiposogenitalis
54:
Female Reproductive System
FEMALE REPRODUCTIVE ORGANS
PRIMARY SEX ORGANS – OVARIES
Medulla
Cortex
Functions of Ovary
ACCESSORY SEX ORGANS
Uterus
Cervix
Vagina
OVARIAN HORMONES
ESTROGEN
Functions of Estrogen
Mode of Action of Estrogen
Regulation of Estrogen Secretion
PROGESTERONE
Functions of Progesterone
Mode of Action of Progesterone
Regulation of Secretion of Progesterone
CLIMACTERIC AND MENOPAUSE
CHANGES DURING MENOPAUSE – POSTMENOPAUSAL SYNDROME
55:
Menstrual Cycle
INTRODUCTION
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
OVULATION
Process of Ovulation
Determination of Ovulation Time
Significance of Determining Ovulation Time
LUTEAL PHASE
Corpus Luteum
Development 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 DURING MENSTRUAL CYCLE
CHANGES IN VAGINA DURING MENSTRUAL CYCLE
REGULATION OF MENSTRUAL CYCLE
HORMONES INVOLVED IN REGULATION
Hypothalamic Hormone
Anterior Pituitary Hormones
Ovarian Hormones
APPLIED PHYSIOLOGY – ABNORMAL MENSTRUATION
56:
Pregnancy, Mammary Glands and Lactation
INTRODUCTION
FERTILIZATION OF THE OVUM
SEX CHROMOSOMES AND SEX DETERMINATION
SEX CHROMOSOMES
SEX DETERMINATION
IMPLANTATION AND DEVELOPMENT OF EMBRYO
PLACENTA
FUNCTIONS OF PLACENTA
1. Nutritive Function
2. Excretory Function
3. Respiratory Function
4. Endocrine Function
1. Human Chorionic Gonadotropin
2. Estrogen
3. Progesterone
4. Human Chorionic Somatomammotropin
5. Relaxin
Fetoplacental Unit
GESTATION PERIOD
PARTURITION
STAGES OF PARTURITION
First Stage
Second Stage
Third Stage
PREGNANCY TESTS
IMMUNOLOGICAL TESTS
Principle
Requisites
Procedure
Observation and Result
DEVELOPMENT OF MAMMARY GLANDS
AT BIRTH
AT CHILDHOOD
AT PUBERTY
DURING PREGNANCY
ROLE OF HORMONES IN GROWTH OF MAMMARY GLANDS
LACTATION
MILK SECRETION
1. Initiation of Milk Secretion or Lactogenesis
2. Maintenance of Milk Secretion or Galactopoiesis
MILK EJECTION
Milk Ejection Reflex
57:
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
LONG QUESTIONS
SHORT QUESTIONS
SECTION 8: CARDIOVASCULAR SYSTEM
58:
Introduction to Cardiovascular System
CARDIOVASCULAR SYSTEM
HEART
RIGHT SIDE OF THE HEART
LEFT SIDE OF THE HEART
SEPTA OF THE HEART
LAYERS OF WALL OF THE HEART
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
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
DIVISIONS OF CIRCULATION
SYSTEMIC CIRCULATION
PULMONARY CIRCULATION
59:
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
SPREAD OF ACTION POTENTIAL THROUGH CARDIAC MUSCLE
RHYTHMICITY
DEFINITION
PACEMAKER
SA Node
Spread of Impulses from SA Node
Rhythmicity of Other Parts of the Heart
ELECTRICAL POTENTIAL IN SA NODE
Resting Membrane Potential — Pacemaker Potential
Action Potential
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 Cardiac Muscle
Significance of Long Refractory Period in Cardiac Muscle
60:
Cardiac Cycle
DEFINITION
EVENTS OF CARDIAC CYCLE
SUBDIVISIONS AND DURATION OF events of CARDIAC CYCLE
ATRIAL EVENTS
VENTRICULAR EVENTS
Ventricular Systole
Ventricular Diastole
DESCRIPTION OF ATRIAL EVENTS
ATRIAL SYSTOLE
ATRIAL DIASTOLE
Atrial Events vs Ventricular Events
DESCRIPTION OF VENTRICULAR EVENTS
VENTRICULAR SYSTOLE
1. Isometric Contraction
2. Ejection Period
VENTRICULAR DIASTOLE
1. Protodiastole
2. Isometric Relaxation
3. Rapid Filling
61:
Heart Sounds
INTRODUCTION
IMPORTANCE OF HEART SOUNDS
DESCRIPTION OF DIFFERENT HEART SOUNDS
FIRST HEART SOUND
Causes
Characteristics
First Heart Sound and ECG
SECOND HEART SOUND
Cause
Characteristics
Second Heart Sound and ECG
THIRD HEART SOUND
Cause
Characteristics
Conditions when Third Heart Sound becomes Audible by Stethoscope
Third Heart Sound and ECG
FOURTH HEART SOUND
Cause
Characteristics
Conditions when Fourth Heart Sound becomes Audible
Fourth Heart Sound and ECG
METHODS OF STUDY OF HEART SOUNDS
BY USING STETHOSCOPE — AUSCULTATION AREAS
i. Mitral Area (Bicuspid Area)
ii. Tricuspid Area
iii. Pulmonary Area
iv. Aortic Area
BY MICROPHONE
BY PHONOCARDIOGRAM
CARDIAC MURMUR
CLASSIFICATION OF MURMUR
62:
Electrocardiogram
DEFINITIONS
USES OF ECG
ELECTROCARDIOGRAPHIC GRID
DURATION
AMPLITUDE
SPEED OF THE PAPER
ECG LEADS
BIPOLAR LIMB 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
‘QRS’ Complex
Cause
Duration
Amplitude
‘T’ WAVE
Cause
Duration
Amplitude
‘U’ WAVE
INTERVALS AND SEGMENTS OF ECG
‘P-R’ INTERVAL
Duration
‘Q-T’ INTERVAL
Duration
‘S-T’ SEGMENT
J Point
Duration of ‘S-T’ Segment
‘R-R’ INTERVAL
Duration
63:
Cardiac Output
INTRODUCTION
DEFINITIONS AND NORMAL VALUES
1. STROKE VOLUME
2. MINUTE VOLUME
3. CARDIAC INDEX
VARIATIONS IN CARDIAC OUTPUT
PHYSIOLOGICAL VARIATIONS
PATHOLOGICAL VARIATIONS
Conditions when Cardiac Output Increases
Conditions when Cardiac Output Decreases
DISTRIBUTION OF CARDIAC OUTPUT
FACTORS MAINTAINING CARDIAC OUTPUT
1. VENOUS RETURN
i. Respiratory Pump
ii. Muscle Pump
2. FORCE OF CONTRACTION
Preload
Afterload
3. HEART RATE
4. PERIPHERAL RESISTANCE
MEASUREMENT OF CARDIAC OUTPUT
64:
Heart Rate
HEART RATE
NORMAL HEART RATE
TACHYCARDIA
BRADYCARDIA
REGULATION OF HEART RATE
VASOMOTOR CENTER – CARDIAC CENTER
VASOCONSTRICTOR AREA – CARDIOACCELERATOR CENTER
Situation
Function
VASODILATOR AREA – CARDIOINHIBITORY CENTER
Situation
Function
SENSORY AREA
MOTOR (EFFERENT. NERVE FIBERS TO HEART
PARASYMPATHETIC NERVE FIBERS
Origin
Distribution
Function
Vagal Tone
SYMPATHETIC NERVE FIBERS
Origin
Course and Distribution
Function
Sympathetic Tone
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
Nerve Supply
Function
Sinoaortic Mechanism and Buffer Nerves
5. IMPULSES FROM RIGHT ATRIUM – BAINBRIDGE REFLEX
6. IMPULSES FROM OTHER AFFERENT NERVES
65:
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
1. Peripheral Resistance
2. Blood Volume
3. Venous Return
4. Elasticity of Blood Vessels
5. Velocity of Blood Flow
6. Diameter of Blood Vessels
7. 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
3. Vasodilator Fibers
MECHANISM OF ACTION OF VASOMOTOR CENTER IN THE REGULATION OF BLOOD PRESSURE
1. Baroreceptor Mechanism
2. Chemoreceptor Mechanism
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
LOCAL MECHANISM FOR REGULATION OF BLOOD PRESSURE
LOCAL VASOCONSTRICTORS
LOCAL VASODILATORS
APPLIED PHYSIOLOGY
HYPERTENSION
Definition
Types of Hypertension
HYPOTENSION
Definition
Types
66:
Venous Pressure and Capillary Pressure
VENOUS PRESSURE
DEFINITION AND NORMAL VALUES
Venous Pressure in the Extremities of the Body
Venous Pressure in Central and Peripheral Veins
EFFECT OF RESPIRATION ON VENOUS PRESSURE
Valsalva Maneuver or Valsalva Experiment
Müeller's Maneuver or Müeller's Experiment
CAPILLARY PRESSURE
DEFINITION AND NORMAL VALUES
REGIONAL VARIATIONS
67:
Arterial Pulse and Venous Pulse
ARTERIAL PULSE
INTRODUCTION
Velocity of Transmission of Pulse
ARTERIAL PULSE TRACING
1. Anacrotic Limb
2. Catacrotic Limb
3. Catacrotic Notch
4. Pre and Postcatacrotic Waves
PULSE POINTS
EXAMINATION OF RADIAL PULSE
1. Rate
2. Rhythm
3. Character
4. Volume
5. Condition of Wall of the Blood Vessel
6. Delayed Pulse
VENOUS PULSE
INTRODUCTION
EXAMINATION OF VENOUS PULSE
JUGULAR VENOUS PULSE TRACING
‘a’ Wave
‘x’ Wave
‘c’ Wave
‘x1’ Wave
‘v’ Wave
‘y’ Wave
68:
Regional Circulation
CORONARY CIRCULATION
DISTRIBUTION OF CORONARY BLOOD VESSELS
Coronary Arteries
Venous Drainage
Physiological Shunt
NORMAL CORONARY BLOOD FLOW
PHASIC CHANGES CORONARY BLOOD FLOW
APPLIED PHYSIOLOGY – CORONARY ARTERY DISEASE
CEREBRAL CIRCULATION
IMPORTANCE
CEREBRAL BLOOD VESSELS
NORMAL CEREBRAL BLOOD FLOW
APPLIED PHYSIOLOGY – STROKE
Definition
Causes
Symptoms
SPLANCHNIC CIRCULATION
INTRODUCTION
MESENTERIC CIRCULATION
Distribution of Blood Flow
SPLENIC CIRCULATION
Importance of Splenic Circulation
Storage of Blood
HEPATIC CIRCULATION
Hepatic Blood Vessels
Normal Blood Flow
CAPILLARY CIRCULATION
MICROCIRCULATION
FEATURES OF CAPILLARIES
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
SKELETAL MUSCLE CIRCULATION
BLOOD FLOW TO SKELETAL MUSCLES
MUSCULAR CONTRACTION AND BLOOD FLOW
CUTANEOUS CIRCULATION
ARCHITECTURE OF CUTANEOUS BLOOD VESSELS
FUNCTIONS OF CUTANEOUS CIRCULATION
BLOOD FLOW TO SKIN
69:
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
70:
Hemorrhage, Circulatory Shock and Heart Failure
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
Acute Hemorrhage
Chronic Hemorrhage
Compensatory Effects
CIRCULATORY SHOCK
DEFINITION
MANIFESTATIONS OF SHOCK
HEART FAILURE
DEFINITION
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
71:
Cardiovascular Adjustments during Exercise
INTRODUCTION
TYPES OF EXERCISE
DYNAMIC EXERCISE
STATIC EXERCISE
AEROBIC AND ANAEROBIC EXERCISES
AEROBIC EXERCISE
ANAEROBIC EXERCISE
SEVERITY OF EXERCISE
1. MILD EXERCISE
2. MODERATE EXERCISE
3. SEVERE EXERCISE
EFFECTS OF EXERCISE ON CARDIOVASCULAR SYSTEM
1. ON BLOOD
2. ON BODY FLUIDS
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
LONG QUESTIONS
SHORT QUESTIONS
SECTION 9: RESPIRATORY SYSTEM AND ENVIRONMENTAL PHYSIOLOGY
72:
Respiratory Tract and Pulmonary Circulation
INTRODUCTION
TYPES OF RESPIRATION
PHASES OF RESPIRATION
FUNCTIONAL ANATOMY OF RESPIRATORY TRACT
RESPIRATORY UNIT
STRUCTURE OF RESPIRATORY UNIT
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
Mechanism
SNEEZING REFLEX
Mechanism
SWALLOWING (DEGLUTITION) REFLEX
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
73:
Mechanics of Respiration
RESPIRATORY MOVEMENTS
INTRODUCTION
MUSCLES OF RESPIRATION
Inspiratory Muscles
Expiratory 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
Surfactant
RESPIRATORY PRESSURES
INTRAPLEURAL PRESSURE
Definition
Normal Values
Cause for Negativity of Intrapleural Pressure
Significance of Intrapleural Pressure
INTRA-ALVEOLAR PRESSURE
Definition
Normal Values
Significance of Intra-alveolar Pressure
Transpulmonary Pressure
COMPLIANCE
DEFINITION
NORMAL VALUES
Compliance in Relation to Intra-alveolar Pressure
Compliance in Relation to Intrapleural Pressure
Variation in Compliance
WORK OF BREATHING
WORK DONE BY RESPIRATORY MUSCLES
1. Airway Resistance
2. Elastic Resistance of Lungs and Thorax
3. Nonelastic Viscous Resistance
74:
Pulmonary Function Tests
INTRODUCTION
LUNG VOLUMES
1. TIDAL VOLUME (TV)
2. INSPIRATORY RESERVE VOLUME (IRV)
3. EXPIRATORY RESERVE VOLUME (ERV)
4. RESIDUAL VOLUME (RV)
LUNG CAPACITIES
1. INSPIRATORY CAPACITY (IC)
2. VITAL CAPACITY (VC)
3. FUNCTIONAL RESIDUAL CAPACITY (FRC)
4. TOTAL LUNG CAPACITY (TLC)
VITAL CAPACITY
DEFINITION AND NORMAL VALUE
VARIATIONS OF VITAL CAPACITY
Pathological Variations
FORCED EXPIRATORY VOLUME (FEV) OR TIMED VITAL CAPACITY
DEFINITION
NORMAL VALUES
SIGNIFICANCE OF DETERMINING FEV
RESPIRATORY MINUTE VOLUME (RMV)
MAXIMUM BREATHING CAPACITY (MBC) OR MAXIMUM VENTILATION VOLUME (MVV)
PEAK EXPIRATORY FLOW RATE (PEFR)
SIGNIFICANCE OF DETERMINING PEFR
RESTRICTIVE AND OBSTRUCTIVE RESPIRATORY DISEASES
RESTRICTIVE RESPIRATORY DISEASE
OBSTRUCTIVE RESPIRATORY DISEASE
75:
Ventilation
PULMONARY VENTILATION
DEFINITION
NORMAL VALUE AND CALCULATION
ALVEOLAR VENTILATION
DEFINITION
NORMAL VALUE AND CALCULATION
DEAD SPACE
DEFINITION
TYPES OF DEAD SPACE
Anatomical Dead Space
Physiological Dead Space
NORMAL VALUE AND MEASUREMENT OF DEAD SPACE
VENTILATION–PERFUSION RATIO
DEFINITION
NORMAL VALUE AND CALCULATION
Normal Value
Calculation
SIGNIFICANCE OF VENTILATION– PERFUSION RATIO
VARIATIONS IN VENTILATION– PERFUSION RATIO
Physiological Variation
Pathological Variation
INSPIRED AIR
ALVEOLAR AIR
RENEWAL
EXPIRED AIR
76:
Exchange and Transport 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
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
Diffusion of Carbon Dioxide from the Alveoli into the Atmospheric Air
EXCHANGE OF RESPIRATORY GASES AT TISSUE LEVEL
DIFFUSION OF OXYGEN FROM BLOOD INTO THE TISSUES
DIFFUSION OF CARBON DIOXIDE FROM TISSUES INTO THE BLOOD
TRANSPORT OF OXYGEN
TRANSPORT OF OXYGEN AS SIMPLE SOLUTION
IN COMBINATION WITH HEMOGLOBIN
Oxygen Carrying Capacity of Blood
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
77:
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
2. Apneustic Center
CONNECTIONS OF RESPIRATORY CENTERS
Efferent Pathway
Afferent Pathway
INTEGRATION OF RESPIRATORY CENTERS
Role of Medullary Centers
Role of Pontine Centers
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
Mechanism of Action
PERIPHERAL CHEMORECEPTORS
Mechanism of Action
78:
Disturbances of Respiration
APNEA
HYPERVENTILATION
HYPOVENTILATION
HYPOXIA
CLASSIFICATION AND CAUSES OF HYPOXIA
I. Hypoxic Hypoxia
II. Anemic Hypoxia
III. Stagnant Hypoxia
IV. Histotoxic Hypoxia
EFFECTS OF HYPOXIA
1. Effects on Blood
2. Effects on Cardiovascular System
3. Effects on Respiration
4. Effects on Digestive System
5. Effects on Kidney
6. Effects on Central Nervous System
TREATMENT FOR HYPOXIA — OXYGEN THERAPY
Efficacy of Oxygen Therapy in Different Types of Hypoxia
OXYGEN TOXICITY (POISONING)
EFFECTS OF OXYGEN TOXICITY
HYPERCAPNEA
EFFECTS OF HYPERCAPNEA
HYPOCAPNEA
EFFECTS OF HYPOCAPNEA
ASPHYXIA
EFFECTS OF ASPHYXIA
1. Stage of Hyperpnea
2. Stage of Convulsions
3. Stage of Collapse
DYSPNEA
PERIODIC BREATHING
CHEYNE-STOKES BREATHING
Hyperpneic Period Waxing and Waning of Breathing
Apneic Period
Conditions when Cheyne-Stokes Breathing Occurs
BIOT'S BREATHING
Causes of Abrupt Apnea and Hyperpnea
Conditions when Biot's Breathing Occurs
CYANOSIS
CONDITIONS WHEN CYANOSIS OCCURS
CARBON MONOXIDE POISONING
EFFECTS OF CARBON MONOXIDE
SYMPTOMS OF CARBON MONOXIDE POISONING
79:
High Altitude and Deep Sea Physiology
HIGH ALTITUDE
BAROMETRIC PRESSURE AND PARTIAL PRESSURE OF OXYGEN AT DIFFERENT ALTITUDES
CHANGES IN THE BODY AT HIGH ALTITUDE
MOUNTAIN SICKNESS
Definition
Symptoms
Treatment
ACCLIMATIZATION
Definition
Changes during Acclimatization
DEEP SEA PHYSIOLOGY
BAROMETRIC PRESSURE AT DIFFERENT DEPTHS
EFFECT OF HIGH BAROMETRIC PRESSURE NITROGEN NARCOSIS
Symptoms
Mechanism
DECOMPRESSION SICKNESS
Definition
Cause
Symptoms
Prevention
Treatment
80:
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
Heatstroke
Features
Treatment
81:
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
82:
Effects of Exercise on Respiration
INTRODUCTION
EFFECTS OF EXERCISE ON RESPIRATION
EFFECT ON PULMONARY VENTILATION
EFFECT ON DIFFUSING CAPACITY FOR OXYGEN
EFFECT ON CONSUMPTION OF OXYGEN
OXYGEN DEBT
VO2 MAX
LONG QUESTIONS
SHORT QUESTIONS
SECTION 10: NERVOUS SYSTEM
83:
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
84:
Neuron and Neuroglia
NEURON
CLASSIFICATION OF NEURON
Depending upon Number of Poles
Depending upon Function
Depending upon Length of Axon
STRUCTURE OF NEURON
Nerve Cell Body
Dendrite
Axon
Myelin Sheath
Neurilemma
NEUROTROPHINS NEUROTROPHIC FACTORS
Nerve Growth Factor
CLASSIFICATION OF NERVE FIBERS
1. Depending upon Structure
2. Depending upon Distribution
3. Depending upon Origin
4. Depending upon Function
5. Depending upon Secretion of Neurotransmitter
6. Depending upon Diameter and Conduction of Impulses
PROPERTIES OF NERVE FIBERS
Excitability
Conductivity
Refractory Period
Summation
Adaptation
Infatigability
All or None Law
DEGENERATION OF NERVE FIBERS
Degenerative Changes in the Neuron
Wallerian or Orthograde Degeneration
Retrograde Degeneration
Transneuronal Degeneration
REGENERATION OF NERVE FIBER
Criteria for Regeneration
Stages of Regeneration
NEUROGLIA
DEFINITION
CLASSIFICATION OF NEUROGLIAL CELLS
Central Neuroglial Cells
Peripheral Neuroglial Cells
85:
Receptors
DEFINITION
CLASSIFICATION OF RECEPTORS
EXTEROCEPTORS
1. Cutaneous Receptors
2. Chemoreceptors
3. Telereceptors
INTEROCEPTORS
1. Visceroceptors
2. Proprioceptors
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
86:
Synapse and Neurotransmitters
DEFINITION
CLASSIFICATION OF SYNAPSE
ANATOMICAL CLASSIFICATION
FUNCTIONAL CLASSIFICATION
1. Electrical Synapse
2. Chemical Synapse
FUNCTIONAL ANATOMY OF CHEMICAL SYNAPSE
FUNCTIONS OF SYNAPSE
EXCITATORY SYNAPSE
Excitatory Postsynaptic Potential
Properties of EPSP
INHIBITORY SYNAPSE
1. Postsynaptic Inhibition
2. Presynaptic Inhibition
3. Renshaw Cell Inhibition
PROPERTIES OF SYNAPSE
1. ONE WAY CONDUCTION - BELL-MAGENDIE LAW
2. THE SYNAPTIC DELAY
Significance of determining synaptic delay
3. FATIGUE
4. SUMMATION
5. ELECTRICAL PROPERTY
NEUROTRANSMITTERS
DEFINITION
CLASSIFICATION OF NEUROTRANSMITTERS
87:
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
1. Superficial Reflexes
2. Deep Reflexes
3. Visceral Reflexes
4. Pathological Reflexes
PROPERTIES OF REFLEXES
1. ONE WAY CONDUCTION (BELL-MAGENDIE LAW)
2. REACTION TIME
3. SUMMATION
i. Spatial Summation
ii. Temporal Summation
4. RECRUITMENT
5. AFTER DISCHARGE
6. REBOUND PHENOMENON
7. FATIGUE
REFLEXES IN MOTOR NEURON LESION
UPPER MOTOR NEURON LESION
LOWER MOTOR NEURON LESION
88:
Spinal Cord
INTRODUCTION
INTERNAL STRUCTURE OF SPINAL CORD
GRAY MATTER OF SPINAL CORD
WHITE MATTER OF SPINAL CORD
TRACTS IN SPINAL CORD
ASCENDING TRACTS OF SPINAL CORD
1. ANTERIOR SPINOTHALAMIC TRACT
Origin
Course
Termination
Function
2. LATERAL SPINOTHALAMIC TRACT
Origin
Course
Termination
Function
3. VENTRAL SPINOCEREBELLAR TRACT
Origin
Course
Termination
Function
4. DORSAL SPINOCEREBELLAR TRACT
Origin
Course
Termination
Function
5. SPINOTECTAL TRACT
Origin
Course
Termination
Function
6. FASCICULUS DORSOLATERALIS
Origin
Course
Function
7. SPINORETICULAR TRACT
Origin
Course
Termination
Function
8. SPINO-OLIVARY TRACT
9. SPINOVESTIBULAR TRACT
10. FASCICULUS GRACILIS (TRACT OF GOLL) AND FASCICULUS CUNEATUS (TRACT OF BURDACH)
Origin
Course
Termination
Functions
Effect of Lesion
DESCENDING TRACTS OF SPINAL CORD
PYRAMIDAL TRACTS
Origin
Course
Termination
Function
EXTRAPYRAMIDAL TRACTS
1. MEDIAL LONGITUDINAL FASCICULUS
Origin
Course
Termination
Function
2. ANTERIOR VESTIBULOSPINAL TRACT
Origin
Course
Termination
Function
3. LATERAL VESTIBULOSPINAL TRACT
Origin
Course
Termination
Functions
4. RETICULOSPINAL TRACT
Origin
Termination
Functions
5. TECTOSPINAL TRACT
Origin
Course
Termination
Function
6. RUBROSPINAL TRACT
Origin
Course
Termination
Function
7. OLIVOSPINAL TRACT
Origin
Termination
Function
89:
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
APPLIED PHYSIOLOGY
SOMATOMOTOR SYSTEM
MOTOR ACTIVITIES OF THE BODY
TYPES OF MOVEMENTS
CLASSIFICATION OF MOTOR PATHWAYS
Pyramidal Tracts
Extrapyramidal Tracts
UPPER MOTOR NEURON AND LOWER MOTOR NEURON
Upper Motor Neuron
Lower Motor Neuron
APPLIED PHYSIOLOGY
Effects of Lesion of Motor Neurons
Paralysis
90:
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
ANALGESIA SYSTEM
GATE CONTROL THEORY
Significance of Gate Control
APPLIED PHYSIOLOGY
91:
Thalamus
INTRODUCTION
THALAMIC NUCLEI
1. MIDLINE NUCLEI
2. INTRALAMINAR NUCLEI
3. MEDIAL MASS OF NUCLEI
4. LATERAL MASS OF NUCLEI
5. POSTERIOR GROUP OF NUCLEI
FUNCTIONS OF THALAMUS
1. RELAY CENTER FOR SENSATIONS
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 SYNDROME
1. Loss of Sensations
2. Astereognosis
3. Ataxia
4. Thalamic Phantom Limb
5. Amelognosia
6. Pain Sensation
7. Involuntary Movements
8. Thalamic Hand or Athetoid Hand
92:
Hypothalamus
INTRODUCTION
NUCLEI OF 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. LAURENCE-MOON-BIEDL SYNDROME
5. NARCOLEPSY
6. CATAPLEXY
93:
Cerebellum
PARTS OF CEREBELLUM
VERMIS
CEREBELLAR HEMISPHERES
DIVISIONS OF CEREBELLUM
VESTIBULOCEREBELLUM (ARCHICEREBELLUM)
COMPONENTS OF VESTIBULOCEREBELLUM
FUNCTIONS OF VESTIBULOCEREBELLUM
Mechanism of Action of Vestibulocerebellum
SPINOCEREBELLUM (PALEOCEREBELLUM)
COMPONENTS OF SPINOCEREBELLUM
FUNCTIONS OF SPINOCEREBELLUM
CORTICOCEREBELLUM (NEOCEREBELLUM)
COMPONENTS OF CORTICOCEREBELLUM
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
94:
Basal Ganglia
INTRODUCTION
COMPONENTS OF BASAL GANGLIA
CORPUS STRIATUM
SUBSTANTIA NIGRA
SUBTHALAMIC NUCLEUS OF LUYS
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
APPLIED PHYSIOLOGY – DISORDERS OF BASAL GANGLIA
1. PARKINSON'S DISEASE
Causes of Parkinson's Disease
Signs and Symptoms of Parkinson's Disease
2. WILSON'S DISEASE
3. CHOREA
4. ATHETOSIS
5. CHOREOATHETOSIS
6. HUNTINGTON'S DISEASE
7. HEMIBALLISMUS
8. KERNICTERUS
95:
Cerebral Cortex and Limbic System
INTRODUCTION
NEOCORTEX AND ALLOCORTEX
LOBES OF CEREBRAL CORTEX
CEREBRAL DOMINANCE
BRODMANN AREAS
FRONTAL LOBE OF CEREBRAL CORTEX
PRECENTRAL CORTEX
1. Primary Motor Area
2. Premotor Area
3. Supplementary Motor Area
PREFRONTAL CORTEX OR ORBITOFRONTAL CORTEX
Functions of Prefrontal Cortex
APPLIED PHYSIOLOGY – FRONTAL LOBE SYNDROME
PARIETAL LOBE
SOMESTHETIC AREA I
Areas
Localization – Homunculus
Functions
SOMESTHETIC AREA II
SOMESTHETIC ASSOCIATION AREA
Sensorymotor Area
APPLIED PHYSIOLOGY
TEMPORAL LOBE
PRIMARY AUDITORY AREA
Functions
AUDITOPSYCHIC AREA
AREA FOR EQUILIBRIUM
APPLIED PHYSIOLOGY – TEMPORAL LOBE SYNDROME
OCCIPITAL LOBE – VISUAL CORTEX
AREAS OF OCCIPITAL LOBE
Functions
APPLIED PHYSIOLOGY
LIMBIC SYSTEM OR LIMBIC LOBE
COMPONENTS
FUNCTIONS
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 Functions
7. Role in Emotional State
8. Role in Memory
9. Role in Motivation
96:
Reticular Formation
DEFINITION
SITUATION OF RETICULAR FORMATION
DIVISIONS OF RETICULAR FORMATION
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
97:
Posture and Equilibrium
DEFINITION
PROPRIOCEPTORS
MUSCLE SPINDLE
Structure of Muscle Spindle
Types of Intrafusal Fibers
Nerve Supply to Muscle Spindle
Functions of Muscle Spindle
GOLGI TENDON ORGAN
Nerve Supply to Golgi Tendon Organ
Functions of Golgi Tendon Organ
PACINIAN CORPUSCLE
FREE NERVE ENDING
BASIC PHENOMENA OF POSTURE
MUSCLE TONE
Definition
Significance of Muscle Tone
Development of Muscle Tone
Regulation of Muscle Tone
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
98:
Vestibular Apparatus
INTRODUCTION
LABYRINTH
FUNCTIONAL ANATOMY OF VESTIBULAR APPARATUS
SEMICIRCULAR CANALS
Ampulla
OTOLITH ORGAN
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
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
Nystagmus
FUNCTION OF OTOLITH ORGAN
Function of Utricle
Function of Saccule
APPLIED PHYSIOLOGY
LABYRINTHECTOMY
MOTION SICKNESS
Cause
Symptoms
99:
Electroencephalogram and Epilepsy
ELECTROENCEPHALOGRAM
DEFINITION
METHOD OF RECORDING EEG
WAVES OF EEG
Alpha Waves
Beta Waves
Delta Waves
Theta Waves
EEG DURING SLEEP
EPILEPSY
DEFINITION
TYPES OF EPILEPSY
Generalized Epilepsy
Localized Epilepsy
100:
Physiology of Sleep
DEFINITION
SLEEP REQUIREMENT
PHYSIOLOGICAL CHANGES DURING SLEEP
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
101:
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
PHYSIOLOGICAL BASIS OF MEMORY
Facilitation
Habituation
Basis for Short Term Memory
Basis for Long Term Memory
Sites of Encoding
Consolidation of Memory
APPLIED PHYSIOLOGY – ABNORMALITIES OF MEMORY
CONDITIONED REFLEXES
DEFINITION
TYPES OF CONDITIONED REFLEXES
Classical Conditioned Reflexes
Instrumental or Operant Conditioned Reflexes
SPEECH
DEFINITION
MECHANISM OF SPEECH
NERVOUS CONTROL OF SPEECH
A. Motor Areas
B. Sensory Areas
C. Wernicke's Area
APPLIED PHYSIOLOGY – DISORDERS OF SPEECH
1. Aphasia
2. Dysarthria or Anarthria
3. Dysphonia
4. Stammering
102:
Cerebrospinal Fluid
INTRODUCTION
PROPERTIES AND COMPOSITION OF CSF
FORMATION OF CSF
CIRCULATION OF CSF
ABSORPTION OF CSF
PRESSURE EXERTED BY CSF
FUNCTIONS OF CSF
COLLECTION OF CSF
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
103:
Autonomic Nervous System
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
FUNCTIONS OF ANS
NEUROTRANSMITTERS OF ANS
SYMPATHETIC FIBERS
PARASYMPATHETIC FIBERS
LONG QUESTIONS
SHORT QUESTIONS
SECTION 11: SPECIAL SENSES
104:
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
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 OR FUNDUS
OPTIC DISK – BLIND SPOT
MACULA LUTEA
Fovea Centralis
INTRAOCULAR FLUIDS
VITREOUS HUMOR
AQUEOUS HUMOR
INTRAOCULAR PRESSURE
LENS
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
OCULAR MOVEMENTS
APPLIED PHYSIOLOGY
GLAUCOMA
CATARACT
105:
Visual Process and Field of Vision
VISUAL PROCESS
INTRODUCTION
IMAGE FORMING MECHANISM
NEURAL BASIS OF VISUAL PROCESS
Functions of Rods
Functions of Cones
CHEMICAL BASIS OF VISUAL PROCESS
Rhodopsin
Photochemical Changes in Rhodopsin
Phototransduction
Significance of Hyperpolarization
Photosensitive Pigment in Cone Cells
Dark Adaptation
Light Adaptation
Night Blindness
ACUITY OF VISION
Definition
Test for Acuity of Vision
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
BLIND SPOT
VISUAL FIELD AND RETINA
MAPPING OF VISUAL FIELD
106:
Visual Pathway
INTRODUCTION
VISUAL RECEPTORS
FIRST ORDER NEURONS
SECOND ORDER NEURONS
THIRD ORDER NEURONS
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
EFFECT OF LESION AT DIFFERENT LEVELS OF VISUAL PATHWAY
107:
Pupillary Reflexes
INTRODUCTION
LIGHT REFLEX
DIRECT LIGHT REFLEX
INDIRECT LIGHT REFLEX
PATHWAY FOR LIGHT REFLEX
Afferent Pathway
Center
Efferent Pathway
CILIOSPINAL REFLEX
ACCOMMODATION
DEFINITION
MECHANISM OF ACCOMMODATION
Young-Helmholtz Theory
ACCOMMODATION REFLEX
PATHWAY FOR ACCOMMODATION REFLEX
Afferent Pathway
Center
Efferent Pathway
APPLIED PHYSIOLOGY – PRESBYOPIA
108:
Color Vision
INTRODUCTION
VISIBLE SPECTRUM AND SPECTRAL COLORS
SPECTRAL COLORS
EXTRASPECTRAL COLORS
PRIMARY COLORS
COMPLEMENTARY COLORS
CONES AND COLOR VISION –YOUNG-HELMHOLTZ TRICHROMATIC THEORY
APPLIED PHYSIOLOGY – COLOR BLINDNESS
CLASSIFICATION OF COLOR BLINDNESS
1. Monochromatism
2. Dichromatism
3. Trichromatism
TESTS FOR COLOR BLINDNESS
109:
Errors of Refraction
EMETROPOIA AND AMETROPIA
MYOPIA OR SHORT SIGHTEDNESS
Cause
Correction
HYPERMETROPIA OR LONG SIGHTEDNESS
ANISOMETROPIA
ASTIGMATISM
CAUSE OF ASTIGMATISM
TYPES OF ASTIGMATISM
1. Regular Astigmatism
2. Irregular Astigmatism
CORRECTION OF ASTIGMATISM
PRESBYOPIA
CAUSES OF PRESBYOPIA
CORRECTION OF PRESBYOPIA
110:
Structure of Ear and Auditory Pathway
EXTERNAL EAR
MIDDLE EAR
AUDITORY OSSICLES
1. Malleus
2. Incus
3. Stapes
AUDITORY MUSCLES
1. Tensor Tympani
2. Stapedius
EUSTACHIAN TUBE
INTERNAL EAR
COCHLEA
COMPARTMENTS OF COCHLEA
ORGAN OF CORTI
Structure
Hair Cells of Organ of Corti
AUDITORY PATHWAY
INTRODUCTION
RECEPTORS
FIRST ORDER NEURONS
SECOND ORDER NEURONS
THIRD ORDER NEURONS
CORTICAL AUDITORY CENTERS
APPLIED PHYSIOLOGY – EFFECT OF LESION
111:
Mechanism of Hearing and Auditory Defects
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
EXCITATION OF HAIR CELLS
ELECTRICAL EVENTS DURING THE PROCESS OF HEARING
SOUND TRANSDUCTION
RECEPTOR POTENTIAL OR COCHLEAR MICROPHONIC POTENTIAL
PROPERTIES OF SOUND
APPRECIATION OF PITCH OF THE SOUND – THEORIES OF HEARING
APPRECIATION OF LOUDNESS OF SOUND
LOCALIZATION OF SOUND
AUDITORY DEFECTS
1. CONDUCTION DEAFNESS
Causes of Conduction Deafness
2. NERVE DEAFNESS
Causes of Nerve Deafness
112:
Sensation of Taste
TASTE BUDS
SITUATION OF TASTE BUD
1. Filiform Papillae
2. Fungiform Papillae
3. Circumvallate Papillae
STRUCTURE OF TASTE BUD
PATHWAY FOR TASTE
PRIMARY TASTE SENSATIONS
TASTE SENSATIONS AND CHEMICAL CONSTITUTIONS
1. SWEET TASTE
2. SALT TASTE
3. SOUR TASTE
4. BITTER TASTE
5. UMAMI
TASTE TRANSDUCTION
APPLIED PHYSIOLOGY – ABNORMALITIES OF TASTE SENSATION
113:
Sensation of Smell
OLFACTORY RECEPTORS
OLFACTORY PATHWAY
GENERATOR POTENTIAL IN OLFACTORY RECEPTOR
CLASSIFICATION OF ODOR
THRESHOLD FOR OLFACTORY SENSATION
APPLIED PHYSIOLOGY –ABNORMALITIES OF OLFACTORY SENSATION
LONG QUESTIONS
SHORT QUESTIONS
INDEX
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