07-physiology, 45 notes to pg

8/18/2019 07-Physiology, 45 Notes to Pg

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45 NOTES TO PG

—Dr. Ankit Yadavendra, M.B.B.S., Dr.V.M.G.M.C., Solapur

7 PHYSIOLOGY

viscosity measure-Osborn viscometer

pulse-Dudgeon sphygmograph

Surf Tension-STalagmometer

orexin-wakefulness, appetite, Alz ds

ACh secret eye-Amacrine cell

ANS

↑M1-stom( HCl)

↓ ↓M2-AV>SA node( conduct vel, ventricle rate)

↑ ↑M3-sm m(EDRF-vasodil), bronchospasm, GIT( motility), freq micturition, salivary,lacrimal, sweat gld, constrictor pupillae, ciliary m

CELL

cell memb

fluid mosaic/Singer Nicolson model

lipid wt:prot wt=1:1

SA-carb:lipid:prot=3%:42%:55%

↑ ↑lipid bilayer-self sealing, hydrophobic-MI-phospholipid, FA- fluidity

cholesterol-fluidity buffer

→↓ t emp>Tm fluidity

→↑ t emp dipole movem

prot

extracell-Ig

transmemb(integral)-glycophorin, IgG superfamily

periph(on inner layer)-spectrin, ankyrin


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intracell-Hb

filament

micro-weakest, endo,exocytosis-actin

intermed-join microtubule& microfilament- laminin, keratin, vimentin, desmin, GFAP,

peripherin, neurofilament microTubule-sTrongest, mitotic spindle, separation of genetic material-tubulin

molecular prot

ATPase

→ kinesin-axoplasm trpt +ve end microtubule

dynein

→ cytosolic-move vesicle –end of microtubule

axonemal-power ciliary& flagellar prot

myosin-m contract

GTPase dynamin-endocytosis

jnal region b/n 2cell

desmoSome/macula adherenS-tensile Strength in Skin, gum, cx

gap jn/connexon(hemich=6connexin)-bidirect free passage of material b/n

2electrically coupled cell, 3μ, no synapt delay-heart

tight jn prot/zonula occludens

occludens

claudins

Jn Adhesion Molecule(JAM)

BBB,stom wall,UB wall

focal adhesion molecule-generate intracellular signal when subject to stress

gap jn prot

connexins(6subunit)

cell adhesion molec(CAM)

Cadherin(Ca depend cell adhesion molecule)

integrin-leucocyte adhes to endoth cell

selectin-leucocyte rolling

IgG superfamily-ICAM,PECAM

tpt prot

pore(aquaporin,perforin)-always open

ch-intermittent open

voltag gated-Na ch in n memb(blocked by tetrodoxin, saxidoxin)

ligAnd gated-ionotropic recept, GABA-A(Cl), nAChR-fast


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metaBotropic recept-cNG gated, GABA-B, mAChR, cGMP gated(rods)

time gated-slow Ca ch(Purkinje fibre)

mech gated-touch recept(skin)

carrier

facilitated diffusion

sec active tpt-GLUT,SGLT pump

P-ATPase, E1-E2 ATPase, Na-K ATPase, SERCA

V-ATPase H+ trpt

F-ATPase

study of ch

patch clamp technique

best –ve feedback mech-temp regulat> osmoregulat

urea tpt

UTA1,2,3,4-kidn

UTAB-RBC

→ →prot synth in ribosome on RER initial folding of polypeptide chain in RER cis end

→ →of Golgi app storage, conc, process, packaging, sorting in Golgi app trans end

→ → →Golgi app secret vesicle in cytosol cell memb exocytosis

exocytosis/cell vomiting/reverse pinocytosis/emeiocytosis

constitutive-continuous(mucus secretion, IgA secretion)

Ca ATP

docking prot

syntaxin(key snare prot)

synaptobrevin

μ snare prot

SNAP-25

endocytosis

constitutive-continuous, no sp signal req(vit uptake)

Ca

ATP clathrin(LDL uptake, ion uptake in GI cell)

caveolin(endoth cell for absorption of nutrition,FA)

dynamin/pinchase

ligand-recept complex in pinocytosis dissociate in endosome d/t acidic pH of vesicle

vesicular tpt(cytopempsis)


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permeability across cell memb

H2O> indole> glycerol= urea> Try> glu> Cl> K> Na

total body H2O(60%)

ICF(40%)

ECF(20%) interstitial fluid(15%)

plasma(5%)

spaces-pleural,pericardium(1.5%)

compartment-indicator

TBW-D2O>tritium oxide, antipyrine, aminopyrine

ECF-inulin(most accurate), sucrose, mannitol, Na thioSO4, Na22, I125 iothalmate

plaSma vol-EvanS blue(T1824), sr albumin label with I125

bld cell vol-Cr51 label RBC

interstitial fl vol=ECF–pl vol ICF=TBW–ECF

bioimpedance spectroscopy

RBF-PAH

GFR-most accurate(inulin), MC(creatinine)

Na-K pump

fn-cell vol regulat>RMP

heterodimer

α(larger)

ECF side-K bind site, ouabain(digitalis) binding site

ICF side-Na binding site, ATP binding site, phosphorylat site(Asp376)↑T3,T4- no.

↑aldosterone- no.,activity

↑insulin- activity

↓ANF,dopamine- activity

hypokalemia

hyperpolarisation

hyperkalemia

↓depolarization, excitat heart stop in diastole

hypercalcemia

Ca-memb stabilising

heart stop in systole


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hypocalcemia

↑excitability

Cl ch(anim,bact)-dimer

epith Na ch-trimer

K ch,aquaporin-tetramerCl ch(human),lig gate ACh ch-pentamer

RBC memb at rest most permeable-Cl

RBC RMP(–10mV) d/t-Na K pump

neuron RMP(–70mV) d/t-K

neuron RMP close to-K

neuron RMP equal to-Cl

organ max hydrostatic press-kidn(46mmHg)

organ with max Kf(ultrafiltration constant)-Kidnmax permeable capillary-liver

CVS

cardiac m(striated,involunt)

↑intercalated disc-Zline- cell adhesion, provide electromech tethering

gap jn-fnal syncytium

sarcotubular system-Zline

voltage sensor-dihydropyridine

Ca source-ECF(maj)+ sarcopl reticulum

↓unphosphorylated phospholamban- SERCA

1T tubule/sarcomere along Z line elasticity-titin

myosin heavy light chain

α,β-fetal heart

α-adult atrium

β-adult ventr

internodal path(AMP-BWT)

Ant-Bachman

Mid-Wenkebach

Post-Thorelbundle of His-gives lt br, continues as rt br

gate cell merge with-Purkinje fibre

ventr AP

RMP=–90mV

0-depolarisat-Na influx


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1-early repolarisat-K efflux

2-plateau-Ca influx

3-late repolarisat-K efflux

4-hyperpolarisat-delayed closure K ch

SAnode AP RMP=–60mV

↓0-depolarisat- K efflux, opening funny ch(Na>K), Ca influx(Ca ch-main)

3-repolarisat-K efflux

4-prepotential phase-delay closure K ch

↑ → ↑ → → ↓ → ↑sympath- Gprot cAMP phosphorylat prot depolar time HR

↓ →↑ →↓ → ↓parasympath-( cAMP depolar time), (open KACh ch in ph4 slope of ph4) HR

→ ↓ → ↓CNX slope of prepotent(pacemaker potential) HR

→Purkinje fibre-prepotent AP

Depolarisat heart(DAN)

→ → → →1st-SA AV atria ventr(1st-lt upper part intervent septum rt), Apex,

eNdocardium

→last-base epicardium

repolarisat

→ventr(1st-base,epicard last-apex,endocard)

part-conduction speed(m/s)

SA node=0.05

AV node=0.05 bundle His=1

Purkinje fibre=4

part-impulse(gen/s)

SA node=80-100

AV node=40-60

Purkinje fibre=15-40

↑+cHRonotropic- HR

↑+Dromotropic- conDuction↑+inoTRopic- conTRactility

↑+bathmotropic- excitability

→adenosine affer arteriole constrict(A1), coronary vasodilatat

vasomotor centre


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nucleus tractus solitarius

cauDalVLM(meD)-Depressor

rostralVLM(lat)-pressor

↓ ↑ stimul-cortex, limbic syst, pain, chemorecept, pO2, pCO2, MAP


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↓TSH-postoperative, a/c illness

↓Wolf Chaikoff effect- organic bind of I2

thyroxin binding prot

freeT3=0.2%, freeT4=0.02%

thy bindin globulin(maj thy h bind prot)

thyroxin binding albumin thyrox bindin prealbumin(transthyretin)

paracrine regulat

factor release by 1cell act on adjac cell

↓pancreat somatostain- insulin secret

autocrine regulat

factor release by a cell act on same

IGF1-chondrocyt,breast epit,gonad cell

↓ANP- HR,BP

sec messenger for GnRH-phospholipaseC

hormesis

dose response phenom

↑ ↓low dose- , high dose-

J/invert U shape

effect of chemotactic peptide on neutrophil adhesion

proopiomelanocortin(285AA)

ACTH,MSH βlipoprot h

γlipoprot h

βendorphin

CLIP(CorticotropLike Intermlobe Peptide)

P metab

↓NaPiIIa-absorpt in PCT- by PTH

NaPiIIb-absorpt in duod,SI

NaPiIIc-absorpt in PCT

GH-early division spermatogenesis

↑-exercise, fasting, stress

↓-REM sleep

↑ →age

↓h-aldosterone, calcitonin, GH, prolactin, renin, E


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↑h-PTH, FSH, LH, NE

—h-cortisol, epinephrine, insulin, T3,T4, testosterone, GLP1)

PTH(84AA polypeptide)

↓ →↑sr Ca++ sr PTH

action↑ -Ca resorp fr bone, Ca reabsorp fr DCT

→ → → → → →liver angiotensinogen(α2globulin) (JGcell renin) angiotensin I (ACE)

→ → → →angiotensin II (aminopeptidase) angiotensin III (angiotensinase) active

fragm

→ → ↑ → ↑aldosterone cytoplasm recept transcription of mRNA in ren tubule synth of

Aldosterone Induced Prot(ATP)/NaK ATPase& βsubunit of amiloride sensitive Na ch

mineralocorticoid recept-DCT, cortical CD, sal gld, colon, brain(hippocamp), myocard, periph vasc

resist, brown adipose ts, sweat gld

↑ ↑- hyperkalemia> angiotensin II> ACTH> hyponatremia

vassopressin recept(GPCR)

V1/1A-Ca,IP3-glycogenolysis(liver), vasoconstrict, PLT aggregat, intest contraction

↑ ↑V2-cAMP- H2O reabs fr CD, release factorVIII& vWF

↑V3/1B-Ca,IP3- ACTH

erythropoietin

synth-peritubular capillary(juxtatubular interstitial cell) in renal cortex(85%)+perivenular hepatocyte liver(15%)

insulin secret

↑ ↑- glucagon, pl glu

↓ ↑- sympath stim, somatostatin, salicylate

GIT

taste

↑bitter-GPCR, intracell Ca(IP3DAG)

salty-amiloride sensit Na ch↑ →sour- intracell H+ close K ch

↑ →sweet-GPCR, cAMP close K ch

umami-Glu recept(MSG, diNaGMP, diNaI MP)

electrical activity of sm m

RMP=–50-–60mV


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basic electric rhyth-d/t oscillat in activity of Na-K pump(variable freq)=5-15mV

max freq-duod(12/min), min freq-caecum(2/min)

enteric NS

intrinsic

MYenteric/Auerbach plex-Motility SubmucoS/MeiSSner plex-Secret, bld Supply

extrinsic

parasymp

sympath

→Migrating MOTor compLex(MOTiLin)-fasting, ring of contract-body of stom dist

ileum, fn-clearing action, occur>2h after last meal, cycle=5cm/min×90min

massive active contraction-colon during defecation

max postprand motility-sigmoid colon> descend colon> transv colon

pacemaker cell of GIT-interstitial cell of Cajal-midportion of stom

pacemaker potential SI-duod Revers peristalsis-Rectum

segmentation/mixing contraction

promote progressive mixing of food particle

duod


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gastrin

↑HCl,delay gastric emptying

CCK

↑ ↑CCK- prod of prot digest

↑ ↓GB contract, pancr enz secret, secretin action, satiety, NTsecretin

↑HCO3 in bile& pancr juice GIP(Glu dep Insulinotropic Peptide)

↑insulin

ghrelin

↑ghrelin-sleep deprive, anorexia

↑ ↑ ↑orexigenic, fat deposition, choice of food, memory, GH

salivary secretion

HCO3, amylase, lingolipase(Ebner gld on tongue dome), lysozyme, kallikriene, K(max

amount) phase-cephalic(MI), oral, gastric

gastric secretion

→ →pepsin, G-lipase, HCl(MI)(bactericidal, pepsinogen pepsin, Fe+++ Fe++)

phase-cephalic,gastric,intest

intest secretion

Paneth/ZYMOgEn-lysOZYME

N-Neurotensin

L-gLucagon

→disaccharidase, di&tripeptidase, enterokinase(trypsinogen trypsin)

colon secretion

K(max conc)

bile salt

amphipathic nature

→emulsificat fat in SI detergent action

bile uptake by hepatocyte-Na dep

absorption stom-weak acid, weak base, salicylate,alcohol

duod-Fe++(max), Ca, Na, Cl, vit, FA, AA, SO4, sugar

jejunum-carb, prot, fat(long chain), alcoh(max), FA(max), Na(max),

H2O(max-5500ml), Ca(max), vitB9(max), Ab

dist ileum-90%bile salt(max), vitB12(max)

colon-5%bile salt, electrolyte, H2O(1000ml), short chain FA(by colonic bact)


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Fe(prox duod)

→ → → →food(ferric Fe+++) absorb(ferrous Fe++) tpt(Fe+++) store(Fe++)


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↑-ACh,neostigmine,SCh,morphine

↓-NO,VIP,atropine

GI peristalsis

↑-ACh,subsP

↓-VIP,NO,ATP

KIDNEY

↑ ↓Angiotens II act on Eff arteriole, (low conc)- GFR, (high conc)- GFR

↓Epinephrine-act on Aff arteriole, GFR

(A attack E, E attack A)

renal handling of diff subst

not filt-prot

freely filt, not reabs, not secret-inulin

freely filt, compl reabs-glu, AA, HCO3(MI buffer, 24mEq/l) freely filt, partl reabs-electrol, urea(52%), H2O(99.5%)

freely filt, compl secret-PAH(low conc)

freely filt, partl secr-PAH(high con), creat

glomerulotubul balance, max H+ secret by-PCT

acidification urine-CD

1st part kidn affect in hypoxia-medulla

GFR max-3rd decade

pacemaker ureter-minor calyces

DCT secrete-NH3

collecting duct

P(Principal) cell-Na reabsorpt, ADH stimulat H2O reabsorpt

I(Intercalated) cell-H+ secret, HCO3– tpt

Ca

99% reabsorb=65%PCT+ 25-30%thick ascend limb Henle loop+ 4-9%DCT,CD

free H2O clearance

urine is hyPOtonic with plasm-POsitive

urin hypertonic with pl-–ve isotonic=0

aquaporin

1-basolat&apical memb PCT, thin desc limb loop Henle

2-lumin memb CD

3-basolat memb CD


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4-basolat memb CD,brain

5-sal,lacrim,resp

9-WBC,liver,lung,spleen

JG apparatus(cortic nephr)

JG cell-tunica med of affer arteriole, secrete renin macula denSa/modif tubular epith cell, beginning of DCT, Sensor for Na&Cl

Lacis/extraglom mesangial cell-take up immune complex in GNephritis

countercurrent mech

muLtipLier-Loop HenLe(create interstit hyperosmolarity-max=1200mosmol/l), driven

by conc of Na

exChange-vasa reCta(maintain medullary hyperosmol)

glu abs in kidn

prox PCT-SGLT2,GLUT2 distal PCT-SGLT1,GLUT1

GLUT1-constitutively express

GLUT2-glu exit

GLUT3-neuron

GLUT4-insulin dep,m,adipose ts

GLUT5-fru

SGLT1-GIT(1Na:2glu)

SGLT2-kidn(1Na:1glu)

SGLT3-kidn(1Na:1glu)

NS

BBB d/t-tight jn b/n endoth cell> astrocyte

CNS-1oligodendrocyte:20axon

PNS-1Schwann cell-b/n 2node Ranvier

AP in spinal motor neuron arise in-init seg(high Na ch per unit area)> axon hillock

AP in sens neuron arise in-init node of Ranvier(max Na ch per unit area)

AP

cathode ray oscilloscope-patch clamp techn RMP=–70mV

firing level=–55mV

depolar-Na influx

overshoot=+30mV(close to equilibrium potential Na)

↓ ↑repolar- Na permeability, delay K permeab(K efflux)

↓afterdepolar-slight K effux rate


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hyperpolar=–71-–72mV

cell with K efflux depolar-haircell cochlea

cell with Ca efflux depol-heart(SA node)

Na-2gate(M-activat, H-deactivat), 3possible state

K-1gate(M)

demyelinat upto 3node Ranvier-stop AP propagation in n

refractory period

→ ⅓absolute-depolarisat repolarisat

⅓ →relative- repolarisat start of afterdepolarisation

fastest velocity

n-low Ra(resist), high Rm(memb resist), low Cap

node Ranvier-low Rm, high cap

→rheobase-min strength current response→utilisation time-time taken by rheobase response

→chronaxie=time 2×rheobase response

lesser chronaxie-more excitable ts

n


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IV(C)-slow pain, touch, press

myelinated-conduct vel=6×diam

unmyelinated-CV=√diam

fastest conduct-propriocept

suscept to(PHir Laya ABC BABa)

Press-A>B>C

Hypox-B>A>C

Local anaes-C>B>A

order of block-aut> sens[temp(cold> hot)> pain> touch> press> propriocept)> motor]

order of recovery-motor> sens> autonomic

reflex

asynaptic

axon reflex → blunt inj(Lewis triple response) red rxn (hist)+ FLare(axon reFLex)+ wheal(hist+

bradykinin)

monosynaptic

DTR

↑ stimul- m LEngth

recept-m spindLE

affer-IA,II

centre-spinal cord

effer-Aα

response-m contract, maintain m tone

no. of synapse=1 bisynaptic

inverse sTrEtch reflex

↑ stimul- m TENsion

recept-Golgi TENd org(1GTO/13-15m fibre)

affer-Iβ

centre-spinal cord

effer-Aα

response-m relaxat

no. of synapse=2

m spindle

intrafusal m fibre(Aγ)

nuclear bag(1-3)

dyNamic-aNNular spiral ending(IA)

Static-flower Spray ending(IA,II)

nuclear chain(4-5)


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static(IA,II)

extrafusal fibre(Aα-contraction)

axonotmesis-motor march

degeneration& regeneration of n Wallerian degeneration(CAM)-change in distal stump+ prox stump upto 1node of R

24-48h-Chromatolysis(n cell body swell, Nissle granule disapp)

upto3d-distal stump carries AP

3-6d-Axonal degenerat distal stump

6-10d-Myelin degenerat

10d-oil droplet in empty tube

15d-repair start-sprouting fr prox tube, Schwann cell proliferat

80d-repair completed(80% diam)

axoplasmic tpt Ca

ATP

microtubule(α&βtubulin)

molecular motor-kinesin, dyenin, myo V

fast(kinesin)

→ Antegrade(400mm/d) Assembl(+) end

→ retrograde(200mm/d) disassembl(–) end-rabies virus(3mm/h), TT, nGF

slow(dyenin-antegrade)

0.5-10mm/d

microfilament

neurofilament-maintain diam of axon

receptor-sensation

Rapidly adapting(RMP)

Meissner corpuscle-fine touch, low freq vibration(80Hz)

PaciniaN corpuscle-vibratioN

Slowly adapting(SMR)

Merkel disc-crude touch, pressure, texture, fine touch

Ruffini end organ-crude touch, sustain pressure, jt position

other free n ending-touch, pain, pressure

hair end organ-movem of object on body

Krause end bulb-cold

thermal receptor

Aδ&C-cold, C-warmth


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10°C—24°C(max activat)—40°C

overlap-30-40°C

response to cold

→ ↑ →environm temp


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I-ACh

II-amine-hist, epinephrine, D, NE, 5HT

III-AA-Glu, GABA, Gly

IV-small molecule-NO, adenosine

transmission in sympath ganglia fast EPSP-ACh(ms)

slow EPSP-AChM1(s)

slow IPSP-AChM2(s)

late slow EPSP-GnRH(min)

sweat gld secret-sweat+VIP

NM ds

presynaptic-tetanospasmin, botulinum toxin, Lambert Eaton synd

postsynaptic-myasth gravis, strychnine

decortication

damage to corticoretic tract-mod rigidity

decerebration

damage to corticoretic& basal ganglia tract-severe rigidity

sk m(striate,voluntary)

contractile prot

AcTin(polymer of f-actin, 2strand in double helix, ATPase activit)

myosin II

regulating prot tropomyosin(1molecule cover 1active site on actin)

troponin(I-actIn, T-Tropomyosin, C-Ca)

struct prot

actinin(bind actin to Z-line)

titin(largest prot, 3million Dalton, attach Z-line to M-line, elasticity to m)

desmin(attach Z-line to plasma memb)

sarcolemmal prot

→ laminin(EC matrix, attach αdystroglycan)

→ αdystroglycan(connect laminin βdystroglycan)

Bet dystroglycan(within memB)→ syntropin(attach βdystroglycan on inner side memb)

→ dystrophin-(connect syntropin actin) Duchenne(absent)-Becker(less) m dystrophy

sarcoglycan(outer side cell memb)-limb girdle dystrophy

perlecan(EC matrix, endoth cell)

sarcospan(within memb)


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2T tubule/sarcomere(at jn of I&A band)

DHPR(T tubule), RYR(L tubule)

1thick filam surround by-6thin filam

1thin filam surround by-3thick filam

thin:thick=2:1

1thick filam=500myosin molecule 1thin filam=7actin+3troponin+1tropomyosin

Sarcomere-Struct unit m

motor unit-fnal unit m

sarcotubular syst-AI jn

voltage sensor-voltage gated Ca ch

Ca source-sarcopl reticulum

H(Hexagon) zone-only myosin

pseudoH zone-reversal of polarity of myosin head(no myosin head)

A(Anisotropic,dArk) band-myosin+over lapping actin I(Isotropic,lIght) band-actIn

Z line-b/n 2sarcomere, centre of I band

M(Myomesin) line-centre of A band

sarcomere=½I+A+½I

during contract

↓ I-

↓ H-

A-no change

Z lines-come closer

M line-more prominent

CM(Contraction M) band-at 1.5μ CZ(Contract Z) band-at 1.25μ

walk along theory-1ATP-1cycle

Huxley sliding filament/Rachet/walk along theory

→ → →cross bridge power stroke ATP hydrolysis recocking

type1 m(SOR1)

Small,Slow

Oxidative metab

Red longer twitch

more mitoch

more Mb

slow sustain contract

delay fatiguability

standing-ATP store=7-8s


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type2a m

mod oxidat metab

mod glycolysis

walking

type2b m

fast fatiguable running

energy supply

100m-85% glycolysis

2mile-20% glycolysis

marathon-5% glycolysis

at optimum lth sarcomere-max overlap b/n actin&myosin, max no.actin-myosin

cross bridge, max tension

slow twitch motor unit

recruit 1st,100-500m fibre, innervat by αmotor neuronfast motor unit

1000-2000m fibre, αmotor neuron

sm m(unstriate, involuntary)

prot-actin, myosin, tropomyosin(relation prot), calmodulin(Ca binding prot), no

troponin

sinGle unit(Gap jn+)-GIT

multiunit(gap jn–)-iris, ciliary body

contract of sm m

→ → ↑ →Ca influx Ca calmodulin complex myosin light chain kinase phosphorylation

→ ↑ →myosin head myosin ATPase actin-myosin cross bridge format(latch mech)relaxat

phosphatase/dephosphorylase enzyme

thin:thick=15:1

no Z line,dense bodies

ascend tract

post column(fine touch, vibrat, conscious propriocept, 2pt discriminat, localisat,

stereognosis, ability to judge ° of press)

fasciculus Cuneatus(tract of BurdaCh)-UL

fasciculus Gracilis(tract of Gall)-LL→ 1st order-DRG(recept i/l medulla)

→ 2nd order-i/l medulla c/l thalamus(VPL)

→ 3rd order-c/l thalamus c/l postcentral gyrus(BA-3,2,1)

sensory homunculus(grotesque figure of Penfield& Rasmussen)-max-lip,

min-genitalia

ant spinothalamic tract(crude touch, itch, tickle, sexual, detection of press)


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lat spinothalamic(pain, temp)

→ 1st order-DRG(recep i/l dorsal horn)

→ 2nd order-i/l dors horn c/l thal(VPL)

→ 3rd order-c/l thalam c/l cortex

spinocerebellar(unconscious proprioception)

dorsal(uncross) ventral(cross)

internal arcuate fibre medulla-internal arcuate fibre

Fast pain

sharp/prick/stab, epicritic, good, Aδ fibre, mech/therm stimulus, NT-Glu, lat

spinothalamic tract(lamina Five substantia gelatinosa)

slow pain

dull/diffuse/aching/burning, protopathic, bad, autonomic sympath, C fibre, ischem,

NT-substance P, tract goes to reticular formation(sleep wake cycle), periaqueduct

grey, periventr hypothal(ANS) terminate in thalamus(lamina II of substantiagelatinosa of Rolando)

endogen pain inh

endogenous opioid(enkephalin, endorphin)-at site of stimulus, dorsal horn, rostral

site

gate control theory of Melzac& Wall-large diam Aβ inh C fibre

descend pain inh pathw-periaqueduct grey, raphe magnus(5HT), enkephalin

thalamus

sens relay nuclei

non-specific midline

intralaminar

→ ant thal nuclei-Papez circuit-emotion, learning, short long term memory

conversion

specific

VPL-somatic sensation

VPM-taste

LGB-visual sens

MGB-audit sens

ventroant, ventrolat-proc msg fr basal ganglia& cerebellum

Papez circuit

→ →med temp lobe/hippocampus mammillary body of hypothalamus

→ → →(mammilothalamic tr) ant thalam nucl basal forebrain (amygdala/limbic

syst-window ),(neocortex-stored)


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descending tract

med,axial m,tone&posture

ant corticospinal

tectospinal

vestibulospinal

reticulospinal ponS(Stim)

medulla(inh)

lat,dist m,fine skill movem

lat corticospinal(pyramidal)

rubrospinal/alternat pathw

hypothalamus(TRβ2 recept)

response to cOld-pOst

response to heAt-Ant

osmoreceptor-ant hunger-lat

↑thirst( 10mosmol/l)-lat(preoptic nucl)

rage-lat

satiety-ventromed(cocaine amphet regulated transcript)

reward-med forebrain bundle, nucleus accumbens(drug addict-D3), ventromed

self stimul-med forebrain bundle

agGREssive resp-periaqueductal GREy

Punishment-Periaqueductal grey

Circadian rhythm-supraChiasmatic

sleep-preoptic

sexual-Antmost(mAl)& postmost(fem) portion

brain area involving self stimulation

ventral tegmentum

med forebrain bundle

nucleus accumbens(D3)

frontal cortex

cerebellum(3part, 4nuclei, 5cell)

→lat med-DEGF

neo/cerebrocerebellum-Dentate nucleus(largest), motor planning palaeo/spinocerebellum-Emboliform(dist m)& Globosus nucl

archae/vestibulocerebellum-Fastigius nucl(oldest), floculonodular lobe-postural

balance

cell(GBSPG)

Granular(E)

basket(I)


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stellate(I)

purkinje(I)

golgi(I)

afferent fibre

→ → inf oLIvary nucl (cLImbing fibre) +Purkinje cell

→ → → → other affer input (Mossy fibre) +granular cell (parallel fibre) Purkinje cell greatest populat of neuron-cerebellum

silent area of brain-cerebellum(does not show evoke potential)

fnal unit-Purkinje cell, deep nuclei

vermis-maintain stand& walking posture

feed forward inh-basket, Purkinje cell

connection/tract of cerebellum(RO DEV MainCabSeThaVaha IC SauDinRaha)

afferent(cerebell peduncl)

inf-Reticulocerebellar, Olivocerebellar, Dorsal spinocerebellar, Ext arcuate fibr,

Vestibulocerebellar Middl-Cerebropontocerebellar

Sup-Tectocerebellar, Ventr spinocerebellar

Efferent(cerebell peduncle)

Inf-Cerebellovestibular

Sup-Dentatorubrothalamocortical, Reticulospinal

Brodman area-fn

3,1,2(somat sensor, postcentral gyrus)-gen conscious, touch, pain, temp

4(prim motor)-initiat of movem

6,8(premotor)-fineness movem, volunt eye movem

7(visuosensory, postcalcarine sulcus, occipit lobe)-visual sensepercept-homonymous hemianopia+ macular sparing

9,10,11,12(prefrontal)-intelligence, memory, ego, self respect, social behav,

personality

18,19(visuopsychic, parastriate, occipit lobe)-correlation of visual impulse with past

memory

22(Wernicke-sup temp gyrus)-audit agnosia/word deaf

41,42(prim auditary-lt temp lobe)-process semantic in speech& vision

44,45(Brocca-inf frontal gyrus)

brain fibre-connection association-different cortic area in same hemisphere

commissural-correspond area in 2cerebral hemisphere

projection-cerebral cortex with lower level

basal ganglia(CPPG)

1)Caudate nucleus


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2)Putamen

3)Globus pallidus/pallidum

internum

externum

4)substantia nigra

pars compacta pars reticulata

5)subthalamic nucl/body of Luy(excitat, glutamate)

striatum=1+2

lentiform nucleus=2+3

amygdala nucleus-med temp lobe

nucleus tractus solitarius(medulla)

NT-Glu, ACh, GABA, opioid

GVA → tonsil, pharynx, post tongue, carotid body& sinus CNIX

→ pharynx, larynx, trach, esoph, thorac&abd viscera CNX

SVA

⅔ → ant tongue CNVII

⅓ → post tongue CNIX

→ postmost tongue, epiglottis CNX

integrat centre-postural reflex

spinal cord-m tone,+ve supporting rxn, crossed extensor reflex

medulla-tonic labyrinthine reflex, tonic neck reflex

midbrain-righting reflex cerebral cortex-hopping& placing rxn, long loop stretch reflex

Little Albert study-conditional stimulus to produce conditional reflex

↑nGF- ANS neuron growth

BBB

substance cross-H2O, CO2, O2, lipid soluble subst, free steroid h, glu(GLUT1)

cant cross-prot, polypeptide, prot bound steroid h, H+, HCO3

after spinal shock wears off

1st reflex-bulbocavernous( flexor withdrawal> stretch reflex

CSF absorpt

↑->112mmH2O

↓-


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no-


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sO2—pO2

95-97

90-60

75-40

+ve cooperativity(DOTR)

→ DeoxyHb OxyHb→ Tense Relax

Hill coeff

n=1-no cooperativity

n>1-+ve cooperat

noxyHb

↓Hb affinity for CO- by HisE7

diffusion capacity of O2

↑-exercise, pulm hge, asthma, CHF

↓ ↑-ILD, sarcoid, berylium poisoni, secret of PDGF by alveolar epith

hypoxia

→pulm arteriole-activat K ch vasoconstrict

syst arteriole-vasodilat

zone

standing

II-Pa>Palv>Pv(waterfall zone)

III-Pa>Pv>Palv

recumbent-zoneIII

matching of ventilat perfusion lung-lat decubitus, awake, close chest

resp centr

medulla pacemaker-preBottzinger complex-generate resp rhythm

DRG(nucl tract solitarius)-I-quiet resp

sect at lower medulla-apnoea

↑ VRG(nucl ambiguous&retroambiguous )-I&E- requirem

sect at upp medull-norm resp+ irregular rhythm+ gasping

pons


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↓ Pneumotaxic(nucl Parabrachialis, upper pons)- depth of insp

↑ midsectio(bel pnemotax)- depth,slow

↑ apneustic(lower pons)- depth of insp

↓ CNX- depth of insp

strong vagal stim-apnoea

↑ b/l vagotomy- depth,slow midsection+b/l vagotomy-apneusis

resp chemorecept

periph

↓ ↑ pO2(MI,satO2


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Rx-treatment SCC-squamous cell carcinoma, sr-serum, Sx-surgery, sz-seizure tm-tumour, ts-tissue UL-upper limb, u/l-unilateral vag-vagina, VC-vocal cord, vel-velocity, vert-vertebra, vit-vitamin, vol-volume w-week, wt-weight

Xr-X ray y-year #-fracture °-degree

-(N.B.-THESE NOTES ARE ONLY FOR THE PURPOSE OF GUIDANCE AND HELP

TO PG ASPIRANTS, NOT FOR COMMERCIAL OR OTHER PURPOSE. REFERENCE

HAS BEEN TAKEN FROM VARIOUS STANDARD TEXTBOOKS. FOR ANY

FEEDBACK/QUERY PLEASE CONTACT- [email protected] or

[email protected] )

07-physiology, 45 notes to pg

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