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Practical Physiology: A New Approach
First Edition: 2016
Printed atDedicated to PREFACE
Hello students, I would like to begin by mentioning a few words about my book which is about the understanding of practical physiology in a better way.
Based on my teaching experience and on what I have observed in the undergraduate students starting from my postgraduate days, I realized that many a times it so happens that we do not concentrate on our practical physiology thinking that it is easier and is of no relevance compared to theory. We even fail to understand the importance of a particular practical both physiologically and clinically. I also feel that, to understand the practical better, it is very important that you have a certain theory background. It is only then our understanding of practical physiology will be better. Over a period of time, I realized that certain difficult topics can be made easy just by integrating your theory knowledge with your practical. For example, if you want to test a particular cranial nerve, you should remember the muscles supplied by that particular nerve. This not only helps you to understand better but also makes your preparation more complete for your examinations, especially your practical viva. I personally believe that if you prepare well and systematically before the examinations, then facing the examinations becomes much easier. Since the pathological diagnosis is immensely based on the normal physiological values, it is important to be aware of the various things dealt with in the practical.
This book is mainly targeted for the first-year medical students who of course have been a great source of motivation and the driving force for me to write this book. The primary reason for me choosing to write this book is to help the students understand the subject and at the same time, help them score better in their examinations.
While attempting to write this book, I have gone through both anatomy and physiology and tried to integrate and include what is relevant to the first-year students, also keeping in mind the clinical applicability of that particular topic.
To tell you something about reading this book, I have tried to cover all the systems. The book is divided into various sections like hematology and clinical physiology. Apart from these, I have also included various charts and diagrams that would contribute for complete preparation in terms of objective-structured practical examination (OSPE). I have stressed more on the hematology, human experiments and clinical examinations part in this book so as to make your understanding more clear in this regard. As amphibian experiments are comparatively reduced and restricted to only demonstration, chances of that being asked in the examination is rare.
The unique feature of the book is that I have tried to incorporate the seminar presentation techniques as well as tips for OSPE as these, form a part and parcel of the moderate educational system.
I would like you to go through the related theory topic before you begin studying the practical aspects.
However, I have mainly focussed on the exam-oriented topics so that you can use the book also as a last-minute revision.
I hope that this book not only helps you to integrate the subject better but also helps you to prepare well for your examinations. Wishing you all the very best of luck in your future career.
Any suggestions are always welcomed.
First of all, I thank the Almighty for giving me the courage and constantly guiding me in a right way and enabling me to achieve this dream.
I am indebted to all my teachers for inspiration, support and encouragement in my process of writing this book and making me what I am today.
I submit my heartiest gratitude to all my respected teachers for devoting their valuable time in going through my book and giving their valuable suggestions.
I express my deepest gratitude to Dr Shoukat Kazi for his sincere guidance and help for completing this book.
I would also like to thank Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President) and Mr Tarun Duneja (Director–Publishing) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, who have been kind and generous towards me and also for their tremendous support and faith in me and my work.
My joy knows no bounds in expressing my cordial gratitude to my dearest wife Dr Anisa Sameer Khan for her belief in me, continuous support and motivation all the way through which lead me to finally make my dream come true.
I also express my gratitude to my family who have been a strong pillar of support in all my years and also showed trust in me that I could achieve this much.INTRODUCTION
Physiology is the science of the functioning of living systems. It is a subcategory of biology. In physiology, the scientific method is applied to determine how organisms, organ systems, organs, cells and biomolecules carry out the chemical or physical function that they have in a living system. The word physiology is derived from Greek “physis” meaning nature and “logia” meaning study of. Physiology aims to understand the functional aspect of the organism that is how our cells, muscles and organs work together and how they interact to maintain the normal body functioning. Physiology is sometimes referred to as the “science of life” where it looks at the living mechanisms from the molecular basis of cell function to the whole integrated behavior of the entire body.
Physiologists say that physiology is a fundamental science for understanding about “life”, how to go about treating diseases and coping with the stresses our bodies are exposed to in different environments. Pathophysiology seeks to understand the abnormalities that occur in human and animal diseases. Physiologists work closely with other scientists and healthcare professionals in seeking out new methods for treating those diseases (translational research).
History of Physiology
Human physiology dates back to at least 420 BC to the time of Hippocrates, the father of medicine. The critical thinking of Aristotle and his emphasis on the relationship between structure and function marked the beginning of physiology in Ancient Greece, while Claudius Galenus (c. 126–199 AD), known as Galen, was the first to use experiments to probe the function of the body. Galen was the founder of experimental physiology. The ancient Indian books of Ayurveda, the Sushruta Samhita and Charaka Samhita also had descriptions on human anatomy and physiology. The medical world moved on from Galvanism only with the appearance of Andreas Vesalius and William Harvey.
During the middle ages, the ancient Greek and Indian medical traditions were further developed by Muslim physicians, most notably Avicenna (980–1037) who introduced experimentation and quantification into the study of physiology in “The Canon of Medicine”. Many of the ancient physiological doctrines were eventually discredited by Ibn al-Nafis (1213– 1288), who was the first physician to correctly describe the anatomy of the heart, the coronary circulation, the structure of the lungs and the pulmonary circulation, for which he is considered the father of circulatory physiology. He was also the first to describe the relationship between the lungs and the aeration of the blood, the cause of pulsation and an early concept of capillary circulation.
Following from the middle ages, the Renaissance brought an increase of physiological research in the western world that triggered the modern study of anatomy and physiology. Andreas Vesalius was an author of one of the most influential books on human anatomy. “De humani corporis fabrica”. Vesalius is often referred to as the founder of modern human anatomy. Anatomist William Harvey described the circulatory system in the 17th century, demonstrating the fruitful combination of close observations and careful experiments to learn about the functions of the body, which was fundamental to the development of experimental physiology. Herman Boerhaave is sometimes referred to as a father of physiology due to his exemplary teaching in Leiden and textbook Institutiones Medicae (1708).
In the 18th century, important works in this field were by Pierre Cabanis, a French doctor and physiologist.
In the 19th century, physiological knowledge began to accumulate at a rapid rate, most notably in 1838 with the Cell Theory of Mattias Schleiden and Theodor Schwann, which radically stated that organisms are made up of units called cells. Claude Bernard's (1813–1878) further discoveries ultimately led to his concept of milieu interieur (internal environment), which would later be taken up and championed as “homeostasis” by American physiologist Walter Cannon (1871–1945).
In the 20th century, biologist also became interested in how organisms other than human being function, eventually spawning the field of comparative physiology and ecophysiology. Major figures in these field include Knot Schmidt–Nielsen and George Bartholomew.