NEET MDS Lessons
Physiology
Levels of Organization:
CHEMICAL LEVEL - includes all chemical substances necessary for life (see, for example, a small portion - a heme group - of a hemoglobin molecule); together form the next higher level
CELLULAR LEVEL - cells are the basic structural and functional units of the human body & there are many different types of cells (e.g., muscle, nerve, blood)
TISSUE LEVEL - a tissue is a group of cells that perform a specific function and the basic types of tissues in the human body include epithelial, muscle, nervous, and connective tissues
ORGAN LEVEL - an organ consists of 2 or more tissues that perform a particular function (e.g., heart, liver, stomach)
SYSTEM LEVEL - an association of organs that have a common function; the major systems in the human body include digestive, nervous, endocrine, circulatory, respiratory, urinary, and reproductive.
There are two types of cells that make up all living things on earth: prokaryotic and eukaryotic. Prokaryotic cells, like bacteria, have no 'nucleus', while eukaryotic cells, like those of the human body, do.
Lung volumes and capacities:
I. Lung`s volumes
1. Tidal volume (TV) : is the volume of air m which is inspired and expired during one quiet breathing . It equals to 500 ml.
2. Inspiratory reserve volume (IRV) : The volume of air that could be inspired over and beyond the tidal volume. It equals to 3000 ml of air.
3. Expiratory reserve volume (ERV) : A volume of air that could be forcefully expired after the end of quiet tidal volume. It is about 1100 ml of air.
4. Residual volume (RV) : the extra volume of air that may remain in the lung after the forceful expiration . It is about 1200 ml of air.
5. Minute volume : the volume of air that is inspired or expired within one minute. It is equal to multiplying of respiratory rate by tidal volume = 12X500= 6000 ml.
It is in female lesser than that in male.
II. Lung`s capacities :
1. Inspiratory capacity: TV + IRV
2. Vital capacity : TV+IRV+ERV
3. Total lung capacity : TV+IRV+ERV+RV
Neural Substrates of Breathing
A. Medulla Respiratory Centers
Inspiratory Center (Dorsal Resp Group - rhythmic breathing) → phrenic nerve→ intercostal nerves→ diaphragm + external intercostals
Expiratory Center (Ventral Resp Group - forced expiration) → phrenic nerve → intercostal nerves → internal intercostals + abdominals (expiration)
1. eupnea - normal resting breath rate (12/minute)
2. drug overdose - causes suppression of Inspiratory Center
B. Pons Respiratory Centers
1. pneumotaxic center - slightly inhibits medulla, causes shorter, shallower, quicker breaths
2. apneustic center - stimulates the medulla, causes longer, deeper, slower breaths
C. Control of Breathing Rate & Depth
1. breathing rate - stimulation/inhibition of medulla
2. breathing depth - activation of inspiration muscles
3. Hering-Breuer Reflex - stretch of visceral pleura that lungs have expanded (vagal nerve)
D. Hypothalamic Control - emotion + pain to the medulla
E. Cortex Controls (Voluntary Breathing) - can override medulla as during singing and talking
SPECIAL VISCERAL AFFERENT (SVA) PATHWAYS
Taste
Special visceral afferent (SVA) fibers of cranial nerves VII, IX, and X conduct signals into the solitary tract of the brainstem, ultimately terminating in the nucleus of the solitary tract on the ipsilateral side.
Second-order neurons cross over and ascend through the brainstem in the medial lemniscus to the VPM of the thalamus.
Thalamic projections to area 43 (the primary taste area) of the postcentral gyrus complete the relay.
SVA VII fibers conduct from the chemoreceptors of taste buds on the anterior twothirds of the tongue, while SVA IX fibers conduct taste information from buds on the posterior one-third of the tongue.
SVA X fibers conduct taste signals from those taste cells located throughout the fauces.
Smell
The smell-sensitive cells (olfactory cells) of the olfactory epithelium project their central processes through the cribiform plate of the ethmoid bone, where they synapse with mitral cells. The central processes of the mitral cells pass from the olfactory bulb through the olfactory tract, which divides into a medial and lateral portion The lateral olfactory tract terminates in the prepyriform cortex and parts of the amygdala of the temporal lobe.
These areas represent the primary olfactory cortex. Fibers then project from here to area 28, the secondary olfactory area, for sensory evaluation. The medial olfactory tract projects to the anterior perforated substance, the septum pellucidum, the subcallosal area, and even the contralateral olfactory tract.
Both the medial and lateral olfactory tracts contribute to the visceral reflex pathways, causing the viscerosomatic and viscerovisceral responses.
Water: comprises 60 - 90% of most living organisms (and cells) important because it serves as an excellent solvent & enters into many metabolic reactions
- Intracellular (inside cells) = ~ 34 liters
- Interstitial (outside cells) = ~ 13 liters
- Blood plasma = ~3 liters
40% of blood is red blood cells (RBCs)
plasma is similar to interstitial fluid, but contains plasma proteins
serum = plasma with clotting proteins removed
intracellular fluid is very different from interstitial fluid (high K concentration instead of high Na concentration, for example)
- Capillary walls (1 cell thick) separate blood from interstitial fluid
- Cell membranes separate intracellular and interstitial fluids
- Loss of about 30% of body water is fatal
Ions = atoms or molecules with unequal numbers of electrons and protons:
- found in both intra- & extracellular fluid
- examples of important ions include sodium, potassium, calcium, and chloride
Ions (Charged Atoms or Molecules) Can Conduct Electricity
- Giving up electron leaves a + charge (cation)
- Taking on electron produces a - charge (anion)
- Ions conduct electricity
- Without ions there can be no nerves or excitability
- Na+ and K+ cations
- Ca2+ and Mg2+ cations control metabolism and trigger muscle contraction and secretion of hormones and transmitters
Na+ & K+ are the Major Cations in Biological Fluids
- High K+ in cells, high Na+ outside
- Ion gradients maintained by Na pump (1/3 of basal metabolism)
- Think of Na+ gradient as a Na+ battery- stored electrical energy
- K+ gradient forms a K+ battery
- Energy stored in Na+ and K+ batteries can be tapped when ions flow
- Na+ and K+ produce action potential of excitable cells
Control of processes in the stomach:
The stomach, like the rest of the GI tract, receives input from the autonomic nervous system. Positive stimuli come from the parasympathetic division through the vagus nerve. This stimulates normal secretion and motility of the stomach. Control occurs in several phases:
Cephalic phase stimulates secretion in anticipation of eating to prepare the stomach for reception of food. The secretions from cephalic stimulation are watery and contain little enzyme or acid.
Gastric phase of control begins with a direct response to the contact of food in the stomach and is due to stimulation of pressoreceptors in the stomach lining which result in ACh and histamine release triggered by the vagus nerve. The secretion and motility which result begin to churn and liquefy the chyme and build up pressure in the stomach. Chyme surges forward as a result of muscle contraction but is blocked from entering the duodenum by the pyloric sphincter. A phenomenon call retropulsion occurs in which the chyme surges backward only to be pushed forward once again into the pylorus. The presence of this acid chyme in the pylorus causes the release of a hormone called gastrin into the bloodstream. Gastrin has a positive feedback effect on the motility and acid secretion of the stomach. This causes more churning, more pressure, and eventually some chyme enters the duodenum.
Intestinal phase of stomach control occurs. At first this involves more gastrin secretion from duodenal cells which acts as a "go" signal to enhance the stomach action already occurring. But as more acid chyme enters the duodenum the decreasing pH inhibits gastrin secretion and causes the release of negative or "stop" signals from the duodenum.
These take the form of chemicals called enterogastrones which include GIP (gastric inhibitory peptide). GIP inhibits stomach secretion and motility and allows time for the digestive process to proceed in the duodenum before it receives more chyme. The enterogastric reflex also reduces motility and forcefully closes the pyloric sphincter. Eventually as the chyme is removed, the pH increases and gastrin and the "go" signal resumes and the process occurs all over again. This series of "go" and "stop" signals continues until stomach emptying is complete.
Glomerular filtration
Kidneys receive about 20% of cardiac output , this is called Renal Blood Flow (RBF) which is approximatley 1.1 L of blood. Plasma in this flow is about 625 ml . It is called Renal Plasma Flow (RPF) .
About 20 % of Plasma entering the glomerular capillaries is filtered into the Bowman`s capsule .
Glomerular filtration rate is about 125 ml/min ( which means 7.5 L/hr and thus 180 L/day) This means that the kidney filters about 180 liters of plasma every day.
The urine flow is about 1ml/min ( about 1.5 liter /day) This means that kidney reabsorbs about 178.5 liters every day .
Filtration occurs through the filtration unit , which includes :
1- endothelial cells of glomerular capillaries , which are fenestrated . Fenestrae are quite small so they prevent filtration of blood cells and most of plasma proteins .
2- Glomerular basement membrane : contains proteoglycan that is negatively charged and repels the negatively charged plasma proteins that may pass the fenestrae due to their small molecular weight like albumin . so the membrane plays an important role in impairing filtration of albumin .
3- Epithelial cells of Bowman`s capsule that have podocytes , which interdigitate to form slits .
Many forces drive the glomerular filtration , which are :
1- Hydrostatic pressure of the capillary blood , which favours filtration . It is about 55 mmHg .
2- Oncotic pressure of the plasma proteins in the glomerular capillary ( opposes filtration ) . It is about 30 mm Hg .
3- Hydrostatic pressure of the Bowman`s capsule , which also opposes filtration. It is about 15 mmHg .
The net pressure is as follows :
Hydrostatic pressure of glomerular capillaries - ( Oncotic pressure of glomerular capillaries + Hydrostatic pressure of the Bowman capsule):
55-(35+10)
=55-45
=10 mmHg .
Te glomerular filtration rate does not depend only on the net pressure , but also on an other value , known as filtration coefficient ( Kf) . The later depends on the surface area of the glomerular capillaries and the hydraulic conductivity of the glomerular capillaries.