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Physiology - NEETMDS- courses
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Physiology

Urine is a waste byproduct formed from excess water and metabolic waste molecules during the process of renal system filtration. The primary function of the renal system is to regulate blood volume and plasma osmolarity, and waste removal via urine is essentially a convenient way that the body performs many functions using one process. Urine formation occurs during three processes:

Filtration

Reabsorption

Secretion

Filtration

During filtration, blood enters the afferent arteriole and flows into the glomerulus where filterable blood components, such as water and nitrogenous waste, will move towards the inside of the glomerulus, and nonfilterable components, such as cells and serum albumins, will exit via the efferent arteriole. These filterable components accumulate in the glomerulus to form the glomerular filtrate.

Normally, about 20% of the total blood pumped by the heart each minute will enter the kidneys to undergo filtration; this is called the filtration fraction. The remaining 80% of the blood flows through the rest of the body to facilitate tissue perfusion and gas exchange.

Reabsorption

 

The next step is reabsorption, during which molecules and ions will be reabsorbed into the circulatory system. The fluid passes through the components of the nephron (the proximal/distal convoluted tubules, loop of Henle, the collecting duct) as water and ions are removed as the fluid osmolarity (ion concentration) changes. In the collecting duct, secretion will occur before the fluid leaves the ureter in the form of urine.

Secretion

During secretion some substances±such as hydrogen ions, creatinine, and drugs—will be removed from the blood through the peritubular capillary network into the collecting duct. The end product of all these processes is urine, which is essentially a collection of substances that has not been reabsorbed during glomerular filtration or tubular reabsorbtion.

Reflexes

A reflex is a direct connection between stimulus and response, which does not require conscious thought. There are voluntary and involuntary reflexes.

The Stretch Reflex:

The stretch reflex in its simplest form involves only 2 neurons, and is therefore sometimes called a 2-neuron reflex. The two neurons are a sensory and a motor neuron. The sensory neuron is stimulated by stretch (extension) of a muscle. Stretch of a muscle normally happens when its antagonist contracts, or artificially when its tendon is stretched, as in the knee jerk reflex. Muscles contain receptors called muscle spindles. These receptors respond to the muscles's stretch. They send stimuli back to the spinal cord through a sensory neuron which connects directly to a motor neuron serving the same muscle. This causes the muscle to contract, reversing the stretch. The stretch reflex is important in helping to coordinate normal movements in which antagonistic muscles are contracted and relaxed in sequence, and in keeping the muscle from overstretching.

Since at the time of the muscle stretch its antagonist was contracting, in order to avoid damage it must be inhibited or tuned off in the reflex. So an additional connection through an interneuron sends an inhibitory pathway to the antagonist of the stretched muscle - this is called reciprocal inhibition.

 

The Deep Tendon Reflex:

Tendon receptors respond to the contraction of a muscle. Their function, like that of stretch reflexes, is the coordination of muscles and body movements. The deep tendon reflex involves sensory neurons, interneurons, and motor neurons. The response reverses the original stimulus therefore causing relaxation of the muscle stimulated. In order to facilitate that the reflex sends excitatory stimuli to the antagonists causing them to contract - reciprocal activation.

 

The stretch and tendon reflexes complement one another. When one muscle is stretching and stimulating the stretch reflex, its antagonist is contracting and stimulating the tendon reflex. The two reflexes cause the same responses thus enhancing one another.

 

The Crossed Extensor Reflex -

The crossed extensor reflex is just a withdrawal reflex on one side with the addition of inhibitory pathways needed to maintain balance and coordination. For example, you step on a nail with your right foot as you are walking along. This will initiate a withdrawal of your right leg. Since your quadriceps muscles, the extensors, were contracting to place your foot forward, they will now be inhibited and the flexors, the hamstrings will now be excited on your right leg. But in order to maintain your balance and not fall down your left leg, which was flexing, will now be extended to plant your left foot (e.g. crossed extensor). So on the left leg the flexor muscles which were contracting will be inhibited, and the extensor muscles will be excited

Structure of a nerve:

A peripheral nerve is arranged much like a muscle in terms of its connective tissue. It has an outer covering which forms a sheath around the nerve, called the epineurium. Often a nerve will run together with an artery and vein and their connective coverings will merge. Nerve fibers, which are axons, organize into bundles known as fascicles with each fascicle surrounded by the perineurium. Between individual nerve fibers is an inner layer of endoneurium.

 

 The myelin sheath in peripheral nerves consists of Schwann cells wrapped in many layers around the axon fibers. Not all fibers in a nerve will be myelinated, but most of the voluntary fibers are. The Schwann cells are portrayed as arranged along the axon like sausages on a string. Gaps between the Schwann cells are called nodes of Ranvier. These nodes permit an impulse to travel faster because it doesn't need to depolarize each area of a membrane, just the nodes. This type of conduction is called saltatory conduction and means that impulses will travel faster in myelinated fibers than in unmyelinated ones.

The myelin sheath does several things:

1) It provides insulation to help prevent short circuiting between fibers.

2) The myelin sheath provides for faster conduction.

3) The myelin sheath provides for the possibility of repair of peripheral nerve fibers. Schwann cells help to maintain the micro-environments of the axons and their tunnel (the neurilemma tunnel) permits re-connection with an effector or receptor  CNS fibers, not having the same type of myelination accumulate scar tissue after damage, which prevents regeneration.

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

Regulation of glomerular filtration :

1. Extrinsic regulation : 

- Neural regulation : sympathetic and parasympathetic nervous system which causes vasoconstriction or vasodilation respectively .
- Humoral regulation : Vasoactive substances may affect the GFR , vasoconstrictive substances like endothelin ,Angiotensin II , Norepinephrine , prostaglandine F2 may constrict the afferent arteriole and thus decrease GFR , while the vasodilative agents like dopamine , NO , ANP , Prostaglandines E2 may dilate the afferent arteriole and thus increase the filtration rate .

2. Intrinsic regulation : 

- Myogenic theory ( as in the intrinsic regulation of cardiac output) .
- Tubuloglomerular feedback: occurs by cells of the juxtaglomerular apparatus that is composed of specific cells of the distal tubules when it passes between afferent and efferent arterioles ( macula densa cells ) , these cells sense changes in flow inside the tubules and inform specific cells in the afferent arteriole (granular cells ) , the later secrete vasoactive substances that affect the diameter of the afferent arteriole.

 Acute Obstructive Disorders
 1.    Heimlich maneuver
 2.    Bypass, tracheostomy w/catheter to suck up secretion

Bile contains:

  • bile acids. These amphiphilic steroids emulsify ingested fat. The hydrophobic portion of the steroid dissolves in the fat while the negatively-charged side chain interacts with water molecules. The mutual repulsion of these negatively-charged droplets keeps them from coalescing. Thus large globules of fat (liquid at body temperature) are emulsified into tiny droplets (about 1 µm in diameter) that can be more easily digested and absorbed.

 

  • bile pigments. These are the products of the breakdown of hemoglobin removed by the liver from old red blood cells. The brownish color of the bile pigments imparts the characteristic brown color of the feces.

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