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Practical Physiology: A New Approach
Sameer Mohommed Khan
PART 1: HEMATOLOGY
CHAPTER 1:
Introduction to Hematology
DEFINITION
COMPOSITION OF BLOOD
Cellular Component
Liquid Component
FUNCTIONS OF BLOOD
HEMATOLOGICAL TESTS
QUESTIONS
CHAPTER 2:
Compound Microscope
HISTORY
Anton Van Leeuwenhoek (Fig. 2.1)
Birth of the Microscope
Robert Hooke
Charles A Spencer
DEFINITION
TYPES OF MICROSCOPE
Light Microscopes
Simple Microscope
Compound Microscopes
Dissection or Stereo Microscope
Electron Microscopes
Transmission Microscope
Scanning Electron Microscope
Reflection Electron Microscope
PHYSICAL BASIS OF THE MICROSCOPY
Resolution or Resolving Power
Working Distance
Numerical Aperture
Racking the Microscope
Principle of Microscopy
PARTS OF THE COMPOUND MICROSCOPE (FIG. 2.2)
Structural Framework
Illumination System
Magnification
PRECAUTIONS WHILE USING THE MICROSCOPE
PROCEDURE OF USING THE MICROSCOPE
Focusing under Low Power
Focusing under High Power
Focusing under Oil Immersion
QUESTIONS
CHAPTER 3:
Collection of Blood Sample
INTRODUCTION
SOURCES OF BLOOD SAMPLE
ANTICOAGULANTS
COLLECTION OF THE CAPILLARY BLOOD (SKIN PRICK METHOD)
PRECAUTIONS
PROCEDURE
OBSERVATION
QUESTIONS
CHAPTER 4:
Hemocytometry
INTRODUCTION
PRINCIPLE
CONSTITUENTS OF HEMOCYTOMETER
Diluting Pipettes
The Counting Chamber
Improved Neubauer's Counting Chamber
The WBC square (Fig. 4.4)
The RBC square (Fig. 4.4)
A. Pricking the finger
B. Charging of the Neubauer's chamber
IMPORTANT POINTS FOR EXAMINATION
QUESTIONS
CHAPTER 5:
Estimation of Hemoglobin
INTRODUCTION
Normal Values
Adults
FUNCTIONS OF HEMOGLOBIN
TYPES OF HEMOGLOBIN
Normal Hemoglobin
Adult Hemoglobin
Abnormal Hemoglobin
Unstable Hemoglobin
DIFFERENT METHODS OF ESTIMATING HEMOGLOBIN
Sahli's Acid Hematin Method
Principle
Requirements
Procedure
Precautions
Advantages of Sahli's Method
Disadvantages of Sahli's Method
Hemoglobin Estimation by Cyanmethemoglobin Method
Introduction
Equipments
Principle
Method
Calculation
Comments
Normal Range
Drabkin's Solution: Composition
Clinical Significance
Conditions that Decrease Hemoglobin Concentration
Conditions that Increase Hemoglobin Concentration
QUESTIONS
CHAPTER 6:
Total Erythrocyte Count
INTRODUCTION
Features of the Normal RBC
Normal Values
METHODS OF ESTIMATION OF TOTAL RBC COUNT
Requirements
Procedure
Counting
Rules of Counting
Calculation of Dilution Factor
Calculation
Clinical Significance
Variations
Conditions that Decrease the RBC Count
Conditions which increase the RBC Count
QUESTIONS
CHAPTER 7:
Total Leukocyte Count
INTRODUCTION
Normal Values
PRINCIPLE
REQUIREMENTS
PROCEDURE
OBSERVATION
COUNTING
CALCULATION
VARIATIONS
Conditions that Increase the WBC Count
Conditions that Decrease the WBC Count
IMPORTANT TERMINOLOGIES
IMPORTANCE OF WBC COUNT
QUESTIONS
CHAPTER 8:
Differential Leukocyte Count
INTRODUCTION
Normal Counts
PREPARATION AND EXAMINATION OF BLOOD SMEAR FOR DLC
Making a Smear
Principle
Requirements
Procedure (Fig. 8.2)
Precautions
Features of Ideal Blood Film (Fig. 8.3)
Fixation and Staining of the Blood Smear
Requirements
Examination of the Stained Blood Film
Counting and Calculation
Clinical Significance
Variations
QUESTIONS
CHAPTER 9:
Determination of Hematocrit/ Packed Cell Volume
DEFINITION
METHODS OF DETERMINING HEMATOCRIT
Wintrobe's Method
Principle
Requirements
Procedure
Precautions
Observation
Result
Clinical Significance
Variations
True Hematocrit
Venous Blood Hematocrit
QUESTIONS
CHAPTER 10:
Red Blood Cell Indices
INTRODUCTION
CALCULATION OF RED CELL INDICES
Mean Corpuscular Volume
Definition
Calculation of MCV
Importance of MCV
Causes of Microcytosis
Causes of Macrocytosis
Mean Corpuscular Hemoglobin
Definition
Calculation
Importance
Mean Corpuscular Hemoglobin Concentration
Definition
Calculation
Importance
Color Index
Definition
Calculation
Importance
QUESTIONS
CHAPTER 11:
Erythrocyte Sedimentation Rate
DEFINITION
METHODS OF ESTIMATION
Principle
Requirements
Procedure
Advantages
Disadvantages
Factors Affecting ESR
Clinical Significance
Physiological Variations in ESR
Pathological Increase in ESR
Pathological Decrease in ESR
QUESTIONS
CHAPTER 12:
Determination of Blood Groups
INTRODUCTION
Different Blood Group Systems
PRINCIPLE
REQUIREMENTS
PROCEDURE
OBSERVATIONS AND RESULTS
Result (Fig. 12.2)
PRECAUTIONS
IMPORTANCE OF BLOOD GROUPING
QUESTIONS
CHAPTER 13:
Estimation of Bleeding Time and Clotting Time
BLEEDING TIME
Introduction
Definition
Normal bleeding time
Method
Materials Used
Procedure
Observation
Advantages
Clinical Importance
CLOTTING TIME
Definition
Method
Principle
Requirements
Procedure
Normal Value
Importance
Variations
QUESTIONS
CHAPTER 14:
Estimation of Platelet Count
INTRODUCTION
METHODS OF COUNTING
Platelet Count by Hemocytometry
Rees–Ecker Method for Manual Platelet Count
The Brecher–Cronkite method
Clinical Significance
Functions
Variations
QUESTIONS
CHAPTER 15:
Absolute Eosinophil Count
INTRODUCTION
METHODS
Direct Method
Principle
Requirements
Procedure
Calculation
Thorn Test
Clinical Significance
Variations
Functions
QUESTIONS
CHAPTER 16:
Reticulocyte Count
INTRODUCTION
METHODS OF COUNTING
1. Manual Method
Principle
Requirements
Procedure
Observation and Results
Calculation
Understanding Test Results
Precautions
Importance
2. Alternative Testing Methods
Before the Test
The Test
Infants and Young Children
QUESTIONS
CHAPTER 17:
Determination of Osmotic Fragility
INTRODUCTION
AIM
PRINCIPLE
SPECIMEN
PROCEDURE
OBSERVATION
REPORT
NORMAL VALUE
VARIATIONS
QUESTIONS
PART 2: CLINICAL EXAMINATION
CHAPTER 18:
Introduction to Human and Clinical Physiology
CHAPTER 19:
History Taking and General Physical Examination
HISTORY TAKING
General Information
Special Information
PHYSICAL EXAMINATION
A. General Physical Examination
General Appearance
B. Systematic Physical Examination
Inspection
Palpation (Palp = Gentle Touching)
Percussion (Percur = Beat Through)
Auscultation (Auscul = Listening)
QUESTIONS
CHAPTER 20:
Respiratory System
CLINICAL EXAMINATION OF RESPIRATORY SYSTEM
INTRODUCTION (FIG. 20.1)
General Physical Examination
Vital Signs
Respiratory System Examination Proper
QUESTIONS
INTRODUCTION
INDICATIONS OF PULMONARY FUNCTION TESTS
A. Lung Volumes
B. Lung Capacities
Simple Spirometer
Procedure
Timed Vital Capacity (FEV₁)
QUESTIONS
Questions for OSPE or Spotters
DEFINITION
AIM
PRINCIPLE
APPARATUS
PRECAUTIONS
PROCEDURE
Normal Respiratory Movements
Recording the Effect of Various Parameters that Affect Breathing
OBSERVATION
1. Normal Breathing
2. Breath-holding Time
3. Voluntary Hyperventilation
SIGNIFICANCE
QUESTIONS
CHAPTER 21:
Cardiovascular System
INTRODUCTION
DEFINITION
PARAMETERS OF THE PULSE
PRECAUTIONS
PROCEDURE
REPORTING OF THE PULSE
VARIATIONS
SIGNIFICANCE OF DETERMINING PULSE
QUESTIONS
INTRODUCTION
DEFINITION
TYPES OF BLOOD PRESSURE
METHODS OF MEASUREMENT
Requirements
Principle
Methodology
1. Palpatory Method
2. Auscultatory Method
3. Oscillatory Method
Clinical Significance
Variations in Blood Pressure
Physiological Variations
Hypertension
Hypotension
QUESTIONS
INTRODUCTION
VITAL SIGNS
CARDIOVASCULAR EXAMINATION
Inspection
Palpation
Percussion
Auscultation
Heart Sounds
Murmurs
QUESTIONS
INTRODUCTION
PRINCIPLE
REQUIREMENTS
PROCEDURE
PRECAUTIONS
NORMAL INTERVALS
SYSTEMATIC INTERPRETATION OF THE ECG
Heart Rate
Rhythm
Mean QRS Axis (Cardiac Vector)
Rough Estimation
Abnormal ECG
A. Abnormalities of the heart rate:
B. Abnormal Axis Deviation
C. Abnormalities in Waves and Segments
SIGNIFICANCE OF RECORDING ECG
QUESTIONS
CHAPTER 22:
Central Nervous System
INTRODUCTION
COMPONENTS OF THE SENSORY SYSTEM
SENSORY PATHWAYS
METHOD OF EXAMINATION
Principle
Requirements
Procedure
Tactile Sensibility
Position Sense
Vibration Sense
Pain
Temperature
Role of Higher Centers: Somatosensory Cortex
Primary Sensory Area or First Somatic Area (S1)
Secondary Sensory Area or Second Somatic Area (S2)
Physiological Significance of Sensory Examination
IMPORTANT POINTS FOR EXAMINATION
QUESTIONS
INTRODUCTION
COMPONENTS OF MOTOR SYSTEM
Tracts
Motor Areas of the Brain
Requirements
Nutrition or Bulk of the Muscle
Tone of the Muscle
Strength of the Muscle
Coordination of Movement
Gait
Involuntary Movements
QUESTIONS
INTRODUCTION
CLASSIFICATION OF THE REFLEX
Tendon or Deep Reflexes
Precautions
Requirements (Fig. 22.5)
Procedure
Jendrassik's Maneuver
Superficial Reflexes
Plantar Reflex (L5, S1)
Abdominal Reflex (T7 – T12)
Clinical Importance
QUESTIONS
INTRODUCTION
CLASSIFICATION
Olfactory Nerve
Testing for the Sensation of Smell
Optic
Visual Acuity
Field of Vision
Color Vision
Applied Physiology
Occulomotor, Trochlear and Abducent (The Third, Fourth and Sixth Nerve)
Procedure
Pupillary Light Reaction
Accommodation Reflex
Trigeminal Nerve
Procedure
Facial Nerve
Vestibulocochlear Nerve (Auditory Nerve)
Test for Vestibular Part
Test for Cochlear Part
Glossopharyngeal Nerve
Vagus
Accessory Nerve
Hypoglossal
Procedure
Important Points for Examination
QUESTIONS
CHAPTER 23:
Gastrointestinal System
INTRODUCTION
Anatomical landmarks
METHOD OF EXAMINATION
History
General Physical Examination
Examination of Oral Cavity
Examination of Abdomen
Bowel Sounds
Procedure
Arterial Sounds
IMPORTANT POINTS FOR EXAMINATION
QUESTIONS
PART 3: GENERAL TIPS FOR EXAMINATION PREPARATION
CHAPTER 24:
Essentials for Examination Preparation
GENERAL TIPS FOR PRACTICAL EXAMINATIONS
INTRODUCTION
Basic Requirements
Content
Presentation
Summary
INDEX
TOC
Index
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