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Physiology

Red blood cell cycle:

RBCs enter the blood at a rate of about 2 million cells per second. The stimulus for erythropoiesis is the hormone erythropoietin, secreted mostly by the kidney. RBCs require Vitamin B12, folic acid, and iron. The lifespan of RBC averages 120 days. Aged and damaged red cells are disposed of in the spleen and liver by macrophages. The globin is digested and the amino acids released into the blood for protein manufacture; the heme is toxic and cannot be reused, so it is made into bilirubin and removed from the blood by the liver to be excreted in the bile. The red bile pigment bilirubin oxidizes into the green pigment biliverdin and together they give bile and feces their characteristic color. Iron is picked up by a globulin protein (apotransferrin) to be transported as transferrin and then stored, mostly in the liver, as hemosiderin or ferritin. Ferritin is short term iron storage in constant equilibrium with plasma iron carried by transferrin. Hemosiderin is long term iron storage, forming dense granules visible in liver and other cells which are difficult for the body to mobilize.

Some iron is lost from the blood due to hemorrhage, menstruation, etc. and must be replaced from the diet. On average men need to replace about 1 mg of iron per day, women need 2 mg. Apotransferrin (transferrin without the iron) is present in GI lining cells and is also released in the bile. It picks up iron from the GI tract and stimulates receptors on the lining cells which absorb it by pinocytosis. Once through the mucosal cell iron is carried in blood as transferrin to the liver and marrow. Iron leaves the transferrin molecule to bind to ferritin in these tissues. Most excess iron will not be absorbed due to saturation of ferritin, reduction of apotransferrin, and an inhibitory process in the lining tissue.

 

Erythropoietin Mechanism:

Myeloid (blood producing) tissue is found in the red bone marrow located in the spongy bone. As a person ages much of this marrow becomes fatty and ceases production. But it retains stem cells and can be called on to regenerate and produce blood cells later in an emergency. RBCs enter the blood at a rate of about 2 million cells per second. The stimulus for erythropoiesis is the hormone erythropoietin, secreted mostly by the kidney. This hormone triggers more of the pleuripotential stem cells (hemocytoblasts) to follow the pathway to red blood cells and to divide more rapidly.

 

It takes from 3 to 5 days for development of a reticulocyte from a hemocytoblast. Reticulocytes, immature rbc, move into the circulation and develop over a 1 to 2 day period into mature erythrocytes. About 1 to 2 % of rbc in the circulation are reticulocytes, and the exact percentage is a measure of the rate of erythropoiesis.

PHYSIOLOGY OF THE BRAIN

  • The Cerebrum (Telencephalon) Lobes of the cerebral cortex

     

    1. Frontal Lobe
      1. Precentral gyrus, Primary Motor Cortex, point to point motor neurons, pyramidal cells: control motor neurons of the brain and spinal cord. See Motor homunculus
      2. Secondary Motor Cortex repetitive patterns
      3. Broca's Motor Speech area
      4. Anterior - abstract thought, planning, decision making, Personality
    2. Parietal Lobe
      1. Post central gyrus, Sensory cortex, See Sensory homunculus, size proportional to sensory receptor density.
      2. Sensory Association area, memory of sensations
    3. Occipital Lobe
      1. Visual cortex, sight (conscious perception of vision)
      2. Visual Association area, correlates visual images with previous images, (memory of vision, )
    4. Temporal Lobe
      1. Auditory Cortex, sound
      2. Auditory Association area, memory of sounds
    5. Common Integratory Center - angular gyrus, Parietal, Temporal & Occipital lobes
      1. One side becomes dominent, integrats sensory (somesthetic, auditory, visual) information
    6. The Basal nuclei (ganglia)
      1. Grey matter (cell bodies) within the White matter of cerebrum, control voluntary movements
    7. Cauadate nucles - chorea (rapi, uncontrolled movements), Parkinsons: (dopamine neurons of substantia nigra to caudate nucles) jerky movements, spasticity, tremor, blank facial expression
    8. The limbic system - ring around the brain stem, emotions(w/hypothalamus), processing of olfactory information

 

  • The Diencephalon

     

    1. The Thalamus - Sensory relay center to cortex (primitive brain!)
    2. The Hypothalamus
      1. core temperature control"thermostat", shivering and nonshivering thermogenesis
      2. hunger & satiety centers, wakefulness, sleep, sexual arousal,
      3. emotions (w/limbic-anger, fear, pain, pleasure), osmoregulation, (ADH secretion),
      4. Secretion of ADH, Oxytocin, Releasing Hormones for Anterior pitutary
      5. Linkage of nervous and endocrine systems

 

  • The Mesencephalon or Midbrain -

     

    1. red nucleus, motor coordination (cerebellum/Motor cortex),
    2. substantia nigra
  • The Metencephalon
    1. The Cerebellum -
      1. Performs automatic adjustments in complex motor activities
      2. Input from Proprioceptors (joint, tendon, muscles), position of body in Space
        1. Motor cortex, intended movements (changes in position of body in Space)
      3. Damping (breaking motor function), Balance, predicting, inhibitory function of Purkinji cells (GABA), speed, force, direction of movement
    2. The Pons - Respiratory control centers (apneustic, pneumotaxic)
      1. Nuclei of cranial nerves V, VI, VII, VIII

 

  • Myelencephalon

     

    1. The Medulla
      1. Visceral motor centers (vasomotor, cardioinhibtory, respiratory)
      2. Reticular Formation RAS system, alert cortex to incoming signals, maintenance of consciousness, arousal from sleep
      3. All Afferent & Efferent fibers pass through, crossing over of motor tracts
    2. Corpus Callosum: Permits communication between cerebralhemispheres
  • Generalized Brain Avtivity
    1. Brain Activity and the Electroencephalogram(EEG)
      1. alpha waves: resting adults whose eyes are closed
      2. beta waves: adults concentrating on a specific task;
      3. theta waves: adults under stress;
      4. delta waves: during deep sleep and in clinical disorders
    2. Brain Seizures
      1. Grand Mal: generalized seizures, involvs gross motor activity, affects the individual for a matter or hours
      2. Petit mal: brief incidents, affect consciousness but may have no obvious motor abnormalities
    3. Chemical Effects on the Brain
      1. Sedatives: reduce CNS activity
      2. Analgesics: relieve pain by affecting pain pathways or peripheral sensations
      3. Psychotropics: alter mood and emotional states
      4. Anticonvulsants: control seizures
      5. Stimulants: facilitate CNS activity
    4. Memory and learning
      1. Short-term, or primary, memories last a short time, immediately accessible (phone number)
      2. Secondary memories fade with time (your address at age 5)
      3. Tertiary memories last a lifetime (your name)
      4. Memories are stored within specific regions of the cerebral cortex.
      5. Learning, a more complex process involving the integration of memories and their use to direct or modify behaviors
      6. Neural basis for memory and learning has yet to be determined.
  • Fibers in CNS
    1. Association fibers: link portions of the cerebrum;
    2. Commissural fibers: link the two hemispheres;
    3. Projection fibers: link the cerebrum to the brain stem

Plasma:  is the straw-colored liquid in which the blood cells are suspended.

Composition of blood plasma

Component

Percent

Water

~92

Proteins

6–8

Salts

0.8

Lipids

0.6

Glucose (blood sugar)

0.1

Plasma transports materials needed by cells and materials that must be removed from cells:

  • various ions (Na+, Ca2+, HCO3, etc.
  • glucose and traces of other sugars
  • amino acids
  • other organic acids
  • cholesterol and other lipids
  • hormones
  • urea and other wastes

Most of these materials are in transit from a place where they are added to the blood

  • exchange organs like the intestine
  • depots of materials like the liver

to places where they will be removed from the blood.

  • every cell
  • exchange organs like the kidney, and skin.

Carbon Dioxide Transport

Carbon dioxide (CO2) combines with water forming carbonic acid, which dissociates into a hydrogen ion (H+) and a bicarbonate ions:

CO2 + H2O ↔ H2CO3 ↔ H+ + HCO3

95% of the CO2 generated in the tissues is carried in the red blood cells:

  • It probably enters (and leaves) the cell by diffusing through transmembrane channels in the plasma membrane. (One of the proteins that forms the channel is the D antigen that is the most important factor in the Rh system of blood groups.)
  • Once inside, about one-half of the CO2 is directly bound to hemoglobin (at a site different from the one that binds oxygen).
  • The rest is converted — following the equation above — by the enzyme carbonic anhydrase into
    • bicarbonate ions that diffuse back out into the plasma and
    • hydrogen ions (H+) that bind to the protein portion of the hemoglobin (thus having no effect on pH).

Only about 5% of the CO2 generated in the tissues dissolves directly in the plasma. (A good thing, too: if all the CO2 we make were carried this way, the pH of the blood would drop from its normal 7.4 to an instantly-fatal 4.5!)

When the red cells reach the lungs, these reactions are reversed and CO2 is released to the air of the alveoli.

Neurons :

Types of neurons based on structure:

a multipolar neuron because it has many poles or processes, the dendrites and the axon. Multipolar neurons are found as motor neurons and interneurons. There are also bipolar neurons with two processes, a dendrite and an axon, and unipolar neurons, which have only one process, classified as an axon.. Unipolar neurons are found as most of the body's sensory neurons. Their dendrites are the exposed branches connected to receptors, the axon carries the action potential in to the central nervous system.

 

Types of neurons based on function:

  • motor neurons - these carry a message to a muscle, gland, or other effector. They are said to be efferent, i.e. they carry the message away from the central nervous system.
  • sensory neurons - these carry a message in to the CNS. They are afferent, i.e. going toward the brain or spinal cord.
  • interneuron (ie. association neuron, connecting neuron) - these neurons connect one neuron with another. For example in many reflexes interneurons connect the sensory neurons with the motor neurons.

Damage to Spinal Nerves and Spinal Cord

Damage

Possible cause of damage

Symptoms associated with innervated area

Peripheral nerve

Mechanical injury

Loss of muscle tone. Loss of reflexes. Flaccid paralysis. Denervation atrophy. Loss of sensation

Posterior root

Tabes dorsalis

Paresthesia. Intermittent sharp pains. Decreased sensitivity to pain. Loss of reflexes. Loss of sensation. Positive Romberg sign. High stepping and slapping of feet.

Anterior Horn

Poliomyelitis

Loss of muscle tone.  Loss of reflexes. Flaccid paralysis.  Denervation atrophy

Lamina X (gray matter)

Syringomyelia

Bilateral loss of pain and temperature sense only at afflicted cord level. Sensory dissociation. No sensory impairment below afflicted level

Anterior horn and lateral corticospinal tract

Amyotrophic lateral sclerosis

Muscle weakness.  Muscle atrophy. Fasciculations of hand and arm muscles. Spastic paralysis

Posterior and lateral funiculi

Subacute combined degeneration

Loss of position sense. Loss of vibratory sense. Positive Romberg sign. Muscle weakness. Spasticity. Hyperactive tendon reflexes. Positive Babinski sign.

Hemisection of the spinal cord

Mechanical injury

Brown-Sequard syndrome

Below cord level on injured side

Flaccid paralysis. Hyperactive tendon reflexes. Loss of position sense. Loss of vibratory sense. Tactile impairment

Below cord level on opposite side beginning one or two segments below injury

Loss of pain and temperature

1) Storage - the stomach allows a meal to be consumed and the materials released incrementally into the duodenum for digestion. It may take up to four hours for food from a complete meal to clear the stomach. 
2) Chemical digestion - pepsin begins the process of protein digestion cleaving large polypeptides into shorter chains . 
3) Mechanical digestion - the churning action of the muscularis causes liquefaction and mixing of the contents to produce acid chyme. 
4) Some absorption - water, electrolytes, monosaccharides, and fat soluble molecules including alcohol are all absorbed in the stomach to some degree.

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