NEET MDS Lessons
Physiology
A heart rate that is persistently greater than 100bpm is termed tachycardia. A heart rate that is persistantly lower than 60 pulse per min is termed bradycardia. Let's examine some factors that could cause a change in heart rate:
- Increased heart rate can be caused by:
- Increased output of the cardioacceleratory center. In other words, greater activity of sympathetic nerves running to the heart and a greater release of norepinephrine on the heart.
- Decreased output of the cardioinhibitory center. In other words, less vagus nerve activity and a decrease in the release of acetylcholine on the heart.
- Increased release of the hormone epinephrine by the adrenal glands.
- Nicotine.
- Caffeine.
- Hyperthyroidism - i.e., an overactive thyroid gland. This would lead to an increased amount of the hormone thyroxine in the blood.
- Decreased heart rate can be caused by:
- Decreased activity of the cardioacceleratory center.
- Increased activity of the cardioinhibitory center.
- Many others.
Regulation of Blood Pressure by Hormones
The Kidney
One of the functions of the kidney is to monitor blood pressure and take corrective action if it should drop. The kidney does this by secreting the proteolytic enzyme renin.
- Renin acts on angiotensinogen, a plasma peptide, splitting off a fragment containing 10 amino acids called angiotensin I.
- angiotensin I is cleaved by a peptidase secreted by blood vessels called angiotensin converting enzyme (ACE) — producing angiotensin II, which contains 8 amino acids.
- angiotensin II
- constricts the walls of arterioles closing down capillary beds;
- stimulates the proximal tubules in the kidney to reabsorb sodium ions;
- stimulates the adrenal cortex to release aldosterone. Aldosterone causes the kidneys to reclaim still more sodium and thus water.
- increases the strength of the heartbeat;
- stimulates the pituitary to release the antidiuretic hormone (ADH, also known as arginine vasopressin).
All of these actions, which are mediated by its binding to G-protein-coupled receptors on the target cells, lead to an increase in blood pressure.
1. Automatic control (sensory) of respiration is in - brainstem (midbrain)
2. Behavioral/voluntary control is in - the cortex
3. Alveolar ventilation -the amount of atmospheric air that actually reaches the alveolar per breath and that can participate in the exchange of gasses between alveoli and blood
4. Only way to increase gas exchange in alveolar capillaries - perfusion-limited gas exchange
5. Pulmonary ventiliation not effected by - concentration of bicarbonate ions
6. Central chemoreceptors - medulla - CO2, O2 and H+ concentrations
7. Peripheral chemoreceptors - carotid and aortic bodies- PO2, PCO2 and pH
8. Major stimulus for respiratory centers - arterial PCO2
9. Rhythmic breathing depends on
1. continuous (tonic) inspiratory drive from DRG (dorsal respiratory group)
2. intermittent (phasic) expiratory input from cerebrum, thalamus, cranial nerves and ascending spinal cord sensory tracts
10. Primary site for gas exchange - type I epithelial cells for alveoli
Surface Tension
1. Maintains stability of alveolus, preventing collapse
2. Surfactant (Type II pneumocytes) = dipalmityl lecithin
3. Type II pneumocyte appears at 24 weeks of gestation;
1. Surfactant production, 28-32 weeks;
2. Surfactant in amniotic fluid, 35 weeks.
3. Laplace equation for thin walled spheres P = 2T
a. P = alveolar internal pressure r
b. T = tension in the walls r = radius of alveolus
4. During normal tidal respiration
1. Some alveoli do collapse (Tidal pressure can't open)
2. Higher than normal pressure needed (Coughing)
3. Deep breaths & sighs promote re-expansion
4. After surgery/Other conditions, Coughing, deep breathing, sustained maximal respiration
Tubular secretion:
Involves transfer of substances from peritubular capillaries into the tubular lumen. It involves transepithelial transport in a direction opposite to that of tubular absorption.
Renal tubules can selectively add some substances that have not been filtered to the substances that already have been filtered via tubular secretion.
Tubular secretion mostly function to eliminate foreign organic ions, hydrogen ions ( as a contribution to acid base balance ), potassium ions ( as a contribution to maintaining optimal plasma K+ level to assure normal proceeding of neural and muscular functions), and urea.
Here we will focus on K+ secretion and will later discuss H+ secretion in acid base balance, while urea secretion will be discussed in water balance.
K+ is filtered in glomerular capillaries and then reabsorbed in proximal convoluted tubules as well as in thick ascending limb of loop of Henley ( Na-2Cl-K symporter)
K+ secretion takes place in collecting tubules (distal nephron) . There are two types of cells in distal nephron:
- Principal cells that reabsorb sodium and secrete K+ .
- Intercalated cells that reabsorb K+ in exchange with H+.
Mechanism of secretion of K+ in principal cells : Two steps
- K+ enters tubular cells by Na/K ATPase on the basolateral membrane.
- K+ leaves the tubular cells via K+ channels in apical membrane.
Aldosterone is a necessary regulatory factor.
If there is increased level of K+ in plasma,excessive K+ is secreted , some of which is reabsorbed back to the plasma in exchange with H+ via the intercalated cells.
The endocrine system along with the nervous system functions in the regulation of body activities. The nervous system acts through electrical impulses and neurotransmitters to cause muscle contraction and glandular secretion and interpretation of impulses. The endocrine system acts through chemical messengers called hormones that influence growth, development, and metabolic activities
Cell, or Plasma, membrane
- Structure - 2 primary building blocks include
protein (about 60% of the membrane) and lipid, or
fat (about 40% of the membrane).
The primary lipid is called phospholipids, and molecules of phospholipid form a 'phospholipid bilayer' (two layers of phospholipid molecules). This bilayer forms because the two 'ends' of phospholipid molecules have very different characteristics: one end is polar (or hydrophilic) and one (the hydrocarbon tails below) is non-polar (or hydrophobic):
- Functions include:
- supporting and retaining the cytoplasm
- being a selective barrier .
- transport
- communication (via receptors)