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NEET MDS Synopsis - Lecture Notes

📖 Physiology

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Respiratory System

Physiology

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

 

RESPIRATORY DISORDERS - Asthma
Physiology

Asthma = Reversible Bronchioconstruction 4%-5% of population
    Extrinsic / Atopic = Allergic, inherited (familia), chromosome 11
    IgE, Chemical Mediators of inflammation
    
a.    Intrinsic = Negative for Allergy, Normal IgE, Negative Allergic Tests

    Nucleotide Imbalance cAMP/cGMP: cAMP = Inhibits mediator release, cGMP = Facilitates mediator release
b.    Intolerance to Asprin (Triad Asthma)
c.    Nasal Polyps & Asthma

d.    Treatment cause, Symptoms in Acute Asthma
    1.    Bronchial dilators
    2.    steroids edema from Inflamation
    3.    Bronchiohygene to prevent Secondary Infection, (Remove Excess Mucus)
    4.    Education

The Parathyroid Glands

Physiology

The Parathyroid Glands

The parathyroid glands are 4 tiny structures embedded in the rear surface of the thyroid gland. They secrete parathyroid hormone (PTH) a polypeptide of 84 amino acids. PTH increases the concentration of Ca2+ in the blood in three ways. PTH promotes

  • release of Ca2+ from the huge reservoir in the bones. (99% of the calcium in the body is incorporated in our bones.)
  • reabsorption of Ca2+ from the fluid in the tubules in the kidneys
  • absorption of Ca2+ from the contents of the intestine (this action is mediated by calcitriol, the active form of vitamin D.)

PTH also regulates the level of phosphate in the blood. Secretion of PTH reduces the efficiency with which phosphate is reclaimed in the proximal tubules of the kidney causing a drop in the phosphate concentration of the blood.

Hyperparathyroidism

Elevate the level of PTH causing a rise in the level of blood Ca2+ .Calcium may be withdrawn from the bones that they become brittle and break.

 Patients with this disorder have high levels of Ca2+ in their blood and excrete small amounts of Ca2+ in their urine. This causes hyperparathyroidism.

Hypoparathyroidism

This disorder have low levels of Ca2+ in their blood and excrete large amounts of Ca2+ in their urine.

Red Blood Cells (erythrocytes)
Physiology

Red Blood Cells (erythrocytes)

  • Women average about 4.8 million of these cells per cubic millimeter (mm3; which is the same as a microliter [µl]) of blood.
  • Men average about 5.4 x 106 per µl.
  • These values can vary over quite a range depending on such factors as health and altitude.
  • RBC precursors mature in the bone marrow closely attached to a macrophage.
  • They manufacture hemoglobin until it accounts for some 90% of the dry weight of the cell.
  • The nucleus is squeezed out of the cell and is ingested by the macrophage.

RBC have characteristic biconcave shape

Thus RBCs are terminally differentiated; that is, they can never divide. They live about 120 days and then are ingested by phagocytic cells in the liver and spleen. Most of the iron in their hemoglobin is reclaimed for reuse. The remainder of the heme portion of the molecule is degraded into bile pigments and excreted by the liver. Some 3 million RBCs die and are scavenged by the liver each second.

Red blood cells are responsible for the transport of oxygen and carbon dioxide.