NEET MDS Lessons
Physiology
Lipids:
- about 40% of the dry mass of a typical cell
- composed largely of carbon & hydrogen
- generally insoluble in water
- involved mainly with long-term energy storage; other functions are as structural components (as in the case of phospholipids that are the major building block in cell membranes) and as "messengers" (hormones) that play roles in communications within and between cells
- Subclasses include:
- Triglycerides - consist of one glycerol molecule + 3 fatty acids (e.g., stearic acid in the diagram below). Fatty acids typically consist of chains of 16 or 18 carbons (plus lots of hydrogens).
- phospholipids - Composed of 2 fatty acids, glycerol, phosphate and polar groups , phosphate group (-PO4) substitutes for one fatty acid & these lipids are an important component of cell membranes
steroids - have 4 rings- cholesterol, some hormones, found in membranes include testosterone, estrogen, & cholesterol
Alveolar Ventilation: is the volume of air of new air , entering the alveoli and adjacent gas exchange areas each minute . It equals to multiplying of respiratory rate by ( tidal volume - dead space).
Va = R rate X (TV- DsV)
= 12 X ( 500-150)
= 4200 ml of air.
Ingestion: Food taken in the mouth is
- ground into finer particles by the teeth,
- moistened and lubricated by saliva (secreted by three pairs of salivary glands)
- small amounts of starch are digested by the amylase present in saliva
- the resulting bolus of food is swallowed into the esophagus and
- carried by peristalsis to the stomach.
Ventilation simply means inhaling and exhaling of air from the atmospheric air into lungs and then exhaling it from the lung into the atmospheric air.
Air pressure gradient has to exist between two atmospheres to enable a gas to move from one atmosphere to an other.
During inspiration: the intrathoracic pressure has to be less than that of atmospheric pressure. This could be achieved by decreasing the intrathoracic pressure as follows:
Depending on Boyle`s law , the pressure of gas is inversely proportional to the volume of its container. So increasing the intrathoracic volume will decrease the intrathoracic pressure which will allow the atmospheric air to be inhaled (inspiration) . As decreasing the intrathoracic volume will increase the intrathoracic pressure and causes exhaling of air ( expiration)
So. Inspiration could be actively achieved by the contraction of inspiratory muscles : diaphragm and intercostal muscles. While relaxation of the mentioned muscles will passively cause expiration.
Contraction of diaphragm will pull the diaphragm down the abdominal cavity ( will move inferiorly) , and then increase the intrathoracic volume ( vertically) . Contraction of external intercostal muscle will pull the ribs upward and forward which will additionally increase the intrathoracic volume ( transversely , the net result will be increasing the intrathoracic volume and decreasing the intrathoracic pressure.
Relaxation of diaphragm will move it superiorly during expiration, the relaxation of external intercostal muscles will pull the ribs downward and backward , and the elastic lungs and chest wall will recoil. The net result is decreasing the intrathoracic volume and increasing intrathoracic pressure.
All of this occurs during quiet breathing. During forceful inspiration an accessory inspiratory muscle will be involved ( scaleni , sternocleidomastoid , and others) to increase negativity in the intrathoracic pressure more and more.
During forceful expiration the accessory expiratory muscles ( internal intercostal muscles and abdominal muscles ) will be involved to decrease the intrathoracic volume more and more and then to increase intrathoracic pressure more and more.
The pressure within the alveoli is called intralveolar pressure . Between the two phases of respiration it is equal to the atmospheric pressure. It is decreased during inspiration ( about 1 cm H2O ) and increased during expiration ( about +1 cm H2O ) . This difference allow entering of 0.5 L of air into the lungs.
Intrapleural pressure is the pressure of thin fluid between the two pleural layers . It is a slight negative pressure. At the beginning of inspiration it is about -5 cm H2O and reachs -7.5 cm H2O at the end or inspiration.
At the beginning of expiration the intrapleural pressure is -7.5 cm H2O and reaches -5 cmH2O at the end of expiration.
The difference between intralveolar pressure and intrapleural pressure is called transpulmonary pressure.
Factors , affecting ventilation :
Resistance : Gradual decreasing of the diameter of respiratory airway increase the resistance to air flow.
Compliance : means the ease , which the lungs expand.It depends on both the elastic forces of the lungs and the elastic forces , caused by the the surface tension of the fluid, lining the alveoli.
Surface tension: Molecules of water have tendency to attract each other on the surface of water adjacent to air. In alveoli the surface tension caused by the fluid in the inner surface of the alveoli may cause collapse of alveoli . The surface tension is decreased by the surfactant .
Surfactant is a mixture of phospholipids , proteins and ion m produced by type II pneumocytes.
Immature newborns may suffer from respiratory distress syndrome , due to lack of surfactant which is produced during the last trimester of pregnancy.
The elastic fibers of the thoracic wall also participate in lung compliance.
Normal Chemical Composition of Urine
Urine is an aqueous solution of greater than 95% water, with a minimum of these remaining constituents, in order of decreasing concentration:
Urea 9.3 g/L.
Chloride 1.87 g/L.
Sodium 1.17 g/L.
Potassium 0.750 g/L.
Creatinine 0.670 g/L .
Other dissolved ions, inorganic and organic compounds (proteins, hormones, metabolites).
Urine is sterile until it reaches the urethra, where epithelial cells lining the urethra are colonized by facultatively anaerobic gram-negative rods and cocci. Urea is essentially a processed form of ammonia that is non-toxic to mammals, unlike ammonia, which can be highly toxic. It is processed from ammonia and carbon dioxide in the liver.
Pain, Temperature, and Crude Touch and Pressure
General somatic nociceptors, thermoreceptors, and mechanoreceptors sensitive to crude touch and pressure from the face conduct signals to the brainstem over GSA fibers of cranial nerves V, VII, IX, and X.
The afferent fibers involved are processes of monopolar neurons with cell bodies in the semilunar, geniculate, petrosal, and nodose ganglia, respectively.
The central processes of these neurons enter the spinal tract of V, where they descend through the brainstem for a short distance before terminating in the spinal nucleus of V.
Second-order neurons then cross over the opposite side of the brainstem at various levels to enter the ventral trigeminothalamic tract, where they ascend to the VPM of the thalamus.
Finally, third-order neurons project to the "face" area of the cerebral cortex in areas 3, 1, and 2 .
Discriminating Touch and Pressure
Signals are conducted from general somatic mechanoreceptors over GSA fibers of the trigeminal nerve into the principal sensory nucleus of V, located in the middle pons.
Second-order neurons then conduct the signals to the opposite side of the brainstem, where they ascend in the medial lemniscus to the VPM of the thalamus.
Thalamic neurons then project to the "face" region of areas 3, I, and 2 of the cerebral cortex.
Kinesthesia and Subconscious Proprioception
Proprioceptive input from the face is primarily conducted over GSA fibers of the trigeminal nerve.
The peripheral endings of these neurons are the general somatic mechanoreceptors sensitive to both conscious (kinesthetic) and subconscious proprioceptive input.
Their central processes extend from the mesencephalic nucleus to the principal sensory nucleus of V in the pons
The subconscious component is conducted to the cerebellum, while the conscious component travels to the cerebral cortex.
Certain second-order neurons from the principal sensory nucleus relay proprioceptive information concerning subconscious evaluation and integration into the ipsilateral cerebellum.
Other second-order neurons project to the opposite side of the pons and ascend to the VPM of the thalamus as the dorsal trigeminothalamic tract.
Thalamic projections terminate in the face area of the cerebral cortex.
The Stomach :
The wall of the stomach is lined with millions of gastric glands, which together secrete 400–800 ml of gastric juice at each meal. Three kinds of cells are found in the gastric glands
- parietal cells
- chief cells
- mucus-secreting cells
Parietal cells : secrete
Hydrochloric acid : Parietal cells contain a H+ ATPase. This transmembrane protein secretes H+ ions (protons) by active transport, using the energy of ATP.
Intrinsic factor: Intrinsic factor is a protein that binds ingested vitamin B12 and enables it to be absorbed by the intestine. A deficiency of intrinsic factor as a result of an autoimmune attack against parietal cells causes pernicious anemia.
Chief Cells : The chief cells synthesize and secrete pepsinogen, the precursor to the proteolytic enzyme pepsin.
Secretion by the gastric glands is stimulated by the hormone gastrin. Gastrin is released by endocrine cells in the stomach in response to the arrival of food.