NEET MDS Lessons
Physiology
The Types of muscle cells. There are three types, red, white, and intermediate.
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White Fibers Fast twitch Large diameter, used for speed and strength. Depends on the phosphagen system and on glycolysis-lactic acid. Stores glycogen for conversion to glucose. Fewer blood vessels. Little or no myoglobin. |
Red Fibers Slow twitch Small diameter, used for endurance. Depends on aerobic metabolism. Utilize fats as well as glucose. Little glycogen storage. Many blood vessels and much myoglobin give this muscle its reddish appearance. |
Intermediate Fibers: sometimes called "fast twitch red", these fibers have faster action but rely more on aerobic metabolism and have more endurance. Most muscles are mixtures of the different types. Muscle fiber types and their relative abundance cannot be varied by training, although there is some evidence that prior to maturation of the muscular system the emphasis on certain activities can influence their development
An anti-diruetic is a substance that decreases urine volume, and ADH is the primary example of it within the body. ADH is a hormone secreted from the posterior pituitary gland in response to increased plasma osmolarity (i.e., increased ion concentration in the blood), which is generally due to an increased concentration of ions relative to the volume of plasma, or decreased plasma volume.
The increased plasma osmolarity is sensed by osmoreceptors in the hypothalamus, which will stimulate the posterior pituitary gland to release ADH. ADH will then act on the nephrons of the kidneys to cause a decrease in plasma osmolarity and an increase in urine osmolarity.
ADH increases the permeability to water of the distal convoluted tubule and collecting duct, which are normally impermeable to water. This effect causes increased water reabsorption and retention and decreases the volume of urine produced relative to its ion content.
After ADH acts on the nephron to decrease plasma osmolarity (and leads to increased blood volume) and increase urine osmolarity, the osmoreceptors in the hypothalamus will inactivate, and ADH secretion will end. Due to this response, ADH secretion is considered to be a form of negative feedback.
There are three types of muscle tissue, all of which share some common properties:
- Excitability or responsiveness - muscle tissue can be stimulated by electrical, physical, or chemical means.
- contractility - the response of muscle tissue to stimulation is contraction, or shortening.
- elasticity or recoil - muscles have elastic elements (later we will call these their series elastic elements) which cause them to recoil to their original size.
- stretchability or extensibility - muscles can also stretch and extend to a longer-than-resting length.
The three types of muscle: skeletal, cardiac, and visceral (smooth) muscle.
Skeletal muscle
It is found attached to the bones for movement.
cells are long multi-nucleated cylinders.
The cells may be many inches long but vary in diameter, averaging between 100 and 150 microns.
All the cells innervated by branches from the same neuron will contract at the same time and are referred to as a motor unit.
Skeletal muscle is voluntary because the neurons which innervate it come from the somatic or voluntary branch of the nervous system.
That means you have willful control over your skeletal muscles.
Skeletal muscles have distinct stripes or striations which identify them and are related to the organization of protein myofilaments inside the cell.
Cardiac muscle
This muscle found in the heart.
It is composed of much shorter cells than skeletal muscle which branch to connect to one another.
These connections are by means of gap junctions called intercalated disks which allow an electrochemical impulse to pass to all the connected cells.
This causes the cells to form a functional network called a syncytium in which the cells work as a unit. Many cardiac muscle cells are myogenic which means that the impulse arises from the muscle, not from the nervous system. This causes the heart muscle and the heart itself to beat with its own natural rhythm.
But the autonomic nervous system controls the rate of the heart and allows it to respond to stress and other demands. As such the heart is said to be involuntary.
Visceral muscle is found in the body's internal organs and blood vessels.
It is usually called smooth muscle because it has no striations and is therefore smooth in appearance. It is found as layers in the mucous membranes of the respiratory and digestive systems.
It is found as distinct bands in the walls of blood vessels and as sphincter muscles.
Single unit smooth muscle is also connected into a syncytium similar to cardiac muscle and is also partly myogenic. As such it causes continual rhythmic contractions in the stomach and intestine. There and in blood vessels smooth muscle also forms multiunit muscle which is stimulated by the autonomic nervous system. So smooth muscle is involuntary as well
Transport of Carbon Dioxide
A. Dissolved in Blood Plasma (7-10%)
B. Bound to Hemoglobin (20-30%)
1. carbaminohemoglobin - Carb Dioxide binds to an amino acid on the polypeptide chains
2. Haldane Effect - the less oxygenated blood is, the more Carb Diox it can carry
a. tissues - as Oxygen is unloaded, affinity for Carb Dioxide increases
b. lungs - as Oxygen is loaded, affinity for Carb Dioxide decreases, allowing it to be released
C. Bicarbonate Ion Form in Plasma (60-70%)
1. Carbon Dioxide combines with water to form Bicarbonate
CO2 + H2O <==> H2CO3 <==> H+ + HCO3-
2. carbonic anhydrase - enzyme in RBCs that catalyzes this reaction in both directions
a. tissues - catalyzes formation of Bicarbonate
b. lungs - catalyzes formation of Carb Dioxide
3. Bohr Effect - formation of Bicarbonate (through Carbonic Acid) leads to LOWER pH (H+ increase), and more unloading of Oxygen to tissues
a. since hemoglobin "buffers" to H+, the actual pH of blood does not change much
4. Chloride Shift - chloride ions move in opposite direction of the entering/leaving Bicarbonate, to prevent osmotic problems with RBCs
D. Carbon Dioxide Effects on Blood pH
1. carbonic acid-bicarbonate buffer system
low pH → HCO3- binds to H+
high pH → H2CO3 releases H+
2. low shallow breaths → HIGH Carb Dioxide → LOW pH (higher H+)
3. rapid deep breaths → LOW Carb Dioxide → HIGH pH (lower H+)
The defecation reflex:
As a result of the mass movements, pressure is exerted on the rectum and on the internal anal sphincter, which is smooth muscle, resulting in its involuntary relaxation. Afferent impulses are sent to the brain indicating the need to defecate. The external sphincter is voluntary muscle and is controlled by the voluntary nervous system. This sphincter is relaxed along with contraction of the rectal and abdominal muscles in the defecation reflex
White Blood Cells (leukocytes)
White blood cells
- are much less numerous than red (the ratio between the two is around 1:700),
- have nuclei,
- participate in protecting the body from infection,
- consist of lymphocytes and monocytes with relatively clear cytoplasm, and three types of granulocytes, whose cytoplasm is filled with granules.
Lymphocytes: There are several kinds of lymphocytes, each with different functions to perform , 25% of wbc The most common types of lymphocytes are
- B lymphocytes ("B cells"). These are responsible for making antibodies.
- T lymphocytes ("T cells"). There are several subsets of these:
- inflammatory T cells that recruit macrophages and neutrophils to the site of infection or other tissue damage
- cytotoxic T lymphocytes (CTLs) that kill virus-infected and, perhaps, tumor cells
- helper T cells that enhance the production of antibodies by B cells
Although bone marrow is the ultimate source of lymphocytes, the lymphocytes that will become T cells migrate from the bone marrow to the thymus where they mature. Both B cells and T cells also take up residence in lymph nodes, the spleen and other tissues where they
- encounter antigens;
- continue to divide by mitosis;
- mature into fully functional cells.
Monocytes : also originate in marrow, spend up to 20 days in the circulation, then travel to the tissues where they become macrophages. Macrophages are the most important phagocyte outside the circulation. Monocytes are about 9% of normal wbc count
Macrophages are large, phagocytic cells that engulf
- foreign material (antigens) that enter the body
- dead and dying cells of the body.
Neutrophils
The most abundant of the WBCs. about 65% of normal white count These cells spend 8 to 10 days in the circulation making their way to sites of infection etc Neutrophils squeeze through the capillary walls and into infected tissue where they kill the invaders (e.g., bacteria) and then engulf the remnants by phagocytosis. They have two types of granules: the most numerous are specific granules which contain bactericidal agents such as lysozyme; the azurophilic granules are lysosomes containing peroxidase and other enzymes
Eosinophils : The number of eosinophils in the blood is normally quite low (0–450/µl). However, their numbers increase sharply in certain diseases, especially infections by parasitic worms. Eosinophils are cytotoxic, releasing the contents of their granules on the invader.
Basophils : rare except during infections where these cells mediate inflammation by secreting histamine and heparan sulfate (related to the anticoagulant heparin). Histamine makes blood vessels permeable and heparin inhibits blood clotting. Basophils are functionally related to mast cells. . The mediators released by basophils also play an important part in some allergic responses such as hay fever and an anaphylactic response to insect stings.
Thrombocytes (platelets):
Thrombocytes are cellular derivatives from megakaryocytes which contain factors responsible for the intrinsic clotting mechanism. They represent fragmented cells which contain residual organelles including rough endoplasmic reticulum and Golgi apparati. They are only 2-microns in diameter, are seen in peripheral blood either singly or, often, in clusters, and have a lifespan of 10 days.
Hypoxia
- Hypoxia is tissue oxygen deficiency
- Brain is the most sensitive tissue to hypoxia: complete lack of oxygen can cause unconsciousness in 15 sec and irreversible damage within 2 min.
- Oxygen delivery and use can be interrupted at several sites
|
Type of |
O2 Uptake |
Hemoglobin |
Circulation |
Tissue O2 Utilization |
|
Hypoxic |
Low |
Normal |
Normal |
Normal |
|
Anemic |
Normal |
Low |
Normal |
Normal |
|
Ischemic |
Normal |
Normal |
Low |
Normal |
|
Histotoxic |
Normal |
Normal |
Normal |
Low |
- Causes:
- Hypoxic: high altitude, pulmonary edema, hypoventilation, emphysema, collapsed lung
- Anemic: iron deficiency, hemoglobin mutations, carbon monoxide poisoning
- Ischemic: shock, heart failure, embolism
- Histotoxic: cyanide poisoning (inhibits mitochondria)
- Carbon monoxide (CO) poisoning:
- CO binds to the same heme Fe atoms that O2 binds to
- CO displaces oxygen from hemoglobin because it has a 200X greater affinity for hemoglobin.
- Treatment for CO poisoning: move victim to fresh air. Breathing pure O2 can give faster removal of CO
- Cyanide poisoning:
- Cyanide inhibits the cytochrome oxidase enzyme of mitochondria
- Two step treatment for cyanide poisoning:
- 1) Give nitrites
- Nitrites convert some hemoglobin to methemoglobin. Methemoglobin pulls cyanide away from mitochondria.
- 2) Give thiosulfate.
- Thiosulfate converts the cyanide to less poisonous thiocyanate.
- 1) Give nitrites